Metal and metalloid multi-elementary ICP-MS validation in whole blood, plasma, urine and hair. Reference values

Four multi-elementary metal and metalloid quantification methods using inductively coupled plasma mass spectrometry (ICP-MS) were developed and validated in human whole blood, plasma, urine and hair by means of a single preparation procedure for each sample. The ICP-MS measurements were performed using a Thermo Elemental X7CCT series and PlasmaLab software without a dynamic reaction cell. With this procedure 27-32 elements can be simultaneously quantified in biological matrices: Li, Be, B, Al, V, Cr, Mn, Co, Ni, Cu, Zn, Ga, Ge, As, Se, Rb, Sr, Mo, Pd, Ag, Cd, Sn, Sb, Te, Ba, W, Pt, Hg, Tl, Pb, Bi, U. Whole blood, plasma and urine samples (0.4 ml each) were diluted with purified water, acid, triton X100 and butanol. Rhodium was used as internal standard. The urine sample results were corrected for enzymatic creatinine determination. Twenty-five milligrams hair samples were acid mineralized after a decontamination procedure and diluted as previously described for biological fluids. To be validated, each element had to show linearity with a correlation coefficient higher than 0.99. The intra-assay and inter-assay inaccuracy, measured as the variation coefficient, were below 5 and 10% respectively. Global performance was assessed by a quality control program. Our laboratory is a registered participant of the Institut National de Santé Publique du Québec (Sainte-Foy, Canada) inter-laboratory comparison program for whole blood, urine, and beard hair of non-occupationally exposed individuals spiked with selected elements. In our study multi-element metal and metalloid analysis was assessed for 27 elements in whole blood, 27 elements in plasma, 30 elements in urine and 32 elements in hair, from 0 to 25, or 250 to 1000 ng/ml, depending on the element. Quantification limits ranged from 0.002 ng/ml (U) to 8.1 ng/ml (Al) for whole blood, from 0.002 ng/ml (U) to 7.7 ng/ml (Al) for plasma, from 0.001 ng/ml (U) to 2.2 ng/ml (Se) for urine, and from 0.2 pg/mg (Tl) to 0.5 ng/mg (B) for hair. Normal values were determined in whole blood (n=100), plasma (n=100), urine (n=100), and hair (n=45) of healthy volunteers, leading to approximately 10,000 analyses. All results are presented and discussed. Clinical toxicology and forensic toxicology applications are also reported. ICP-MS has made significant advances in the field of clinical biology, particularly in toxicological analysis. This is due to the use of extremely effective equipment that permits better clinical and forensic toxicological analysis of metal and metalloid status of each individual patient.     

The fingernails of Mary Sullivan: developing reliable methods for selectively isolating endogenous and exogenous DNA from evidence

The fingernails of Mary Sullivan, the last victim of the Boston Strangler, were examined to determine if any genetic information about the murderer could be obtained. The nails were extremely friable necessitating the development of new techniques for isolating and purifying DNA. DNA yields from nails were optimized by using a NaOH-based preparation technique, which was simple, efficient, and minimized handling. Methods for selectively and thoroughly removing exogenous material on nails were also developed through use of a species-specific PCR assay, wherein mitochondrial DNA from the nail could easily be differentiated from DNA of contaminating cells.     

Homicide attempt with a Japanese samurai sword

The use of Japanese swords for homicidal attempts is rare. A Japanese samurai sword is a sharp and cutting object. When faced with the use of this weapon, one must distinguish between stabs and incised wounds. Incised wounds can rarely lead to death, but because of the size of the weapon, stabs usually cause much more serious injuries. Stabs also imply a penetrating movement, whereas incised wounds can be the consequence of protective circular blows. Therefore, it is important to distinguish clinically between these two kinds of wounds. We report a case where the perpetrator argued he had given a circular blow, unfortunately hitting the victim. The pieces of evidence are discussed.     

Influenza A/H1N1 (2009) Infection as a Cause of Unexpected Out‐of‐Hospital Death in the Young*

Abstract: In March 2009, a new strain of influenza A/H1N1 virus was identified in Mexico, responsible for a pandemic. Worldwide, more than 13,500 patients died, most often from acute respiratory distress syndrome. Because sudden death cases were rare, involving mostly young apparently healthy persons, influenza A/H1N1 (2009)‐related deaths may be misdiagnosed, which can raise medico‐legal issues. Case history: we report on an unexpected out‐of‐hospital death involving a young male with no past medical history and no vaccination. Fever was his only symptom. Laboratory tests: histology showed patchy necrotic foci with mononuclear inflammation in the lungs. The heart was histologically normal, but virological analyses using molecular biology on frozen myocardial samples showed high virus load. In conclusion, this case report shows that influenza A/H1N1 (2009) virus can be a cause of sudden cardiac death in the young and demonstrates the importance of quantitative virological analyses for the diagnosis of myocarditis.     

The EU as a global rule of law promoter: the consistency and effectiveness challenges

This paper aims to examine the consistency and effectiveness of the EU as a global promoter of values by focusing on the rule of law, one of the key values on which the EU is based and which is also supposed to guide EU’s external action. The paper first offers the diagnosis that the EU has failed to properly address a number of key issues: (i) what the EU seeks to promote under the heading ‘rule of law’, (ii) how it measures and monitors a country’s adherence to this principle and (iii) the disconnect between its external and internal policies and instruments. To address these issues, four key recommendations are made: (i) the adoption of a guidance note, (ii) the development of a transversal measurement and monitoring instrument, (iii) the adoption of a rule of law checklist and (iv) the revision of the role of EU Fundamental Rights Agency, with the view of transforming it into a ‘Copenhagen Commission’ with new powers and a broader geographical remit.     

Young and armed: a cross-sectional study on weapon carrying among adolescents

The purpose of this study was to identify empirically, for the first time in France, the prevalence of adolescent weapon carrying with particular focus on the contribution of a broad range of social bonding, strain, social learning, and sociodemographic predictors. A multivariate logistic regression model was conducted using a backward elimination procedure to identify the significant predictors of weapon carrying controlling for age, gender, and SES in a sample of 12,706 French youth aged 11–19 years. Results revealed that the odds of weapon carrying increased among adolescents who suffered from past victimization, who had a negative relationship with their mother, and who repeated a grade at school. Moreover, holding pro-delinquent beliefs and having delinquent peers also increased the odds of weapon carrying. Our findings highlight the importance of the interpersonal and social context when examining the determinants of weapon carrying and showed a unique contribution of components of social bonding, strain, and social learning in weapon carrying among adolescents.     

Unpredictable Behavior Under the Influence of “Magic Mushrooms”: A Case Report and Review of the Literature

Fatalities implicating psychedelic mushrooms are not a common clinical situation in everyday forensic medicine. Despite classification as an illegal drug in many countries, psilocybin mushrooms have the reputation of being safe. We report the case of a young man who jumped from a second story balcony under the influence of psilocybin mushrooms. The psilocin assay was performed by gas chromatography coupled to an electron‐impact ionization time‐of‐flight detector (GC‐EI‐TOF) after solid‐phase extraction. Total psilocin was quantified in peripheral and cardiac blood as 60 and 67 ng/mL, respectively, and in urine (2230 ng/mL), bile (3102 ng/mL), and vitreous humor (57 ng/mL). This case report and review of literature highlights the danger of psilocybin mushrooms. Isolated use of psilocybin mushrooms by a regular consumer without psychiatric history, even under “safe” circumstances, can lead to a fatal outcome.     

Postmortem Measurement of Human Chorionic Gonadotropin in Vitreous Humor and Bile

Abstract: Postmortem human chorionic gonadotrophin (HCG) blood assay can confirm postmortem diagnosis of pregnancy or document situations in which HCG levels are elevated. In some cases, however, blood sampling is not possible at autopsy. In this study, HCG was quantified by enzyme‐linked fluorescent assay (ELFA) in the bile (n = 5), vitreous humor (n = 4), and postmortem blood (n = 4) of five pregnant women. There were no false negatives in the pregnant subjects (n = 5) or false positives in controls (n = 34), enabling this test to be recommended for routine use in forensic contexts in which the detection of elevated HCG levels could be of interest.     

Serving the creditors after insolvency filings: from value creation to value distribution

This paper provides original empirical evidence on the financial outcome of insolvency filings in Europe. We adopt a cross-country analysis of the determinants of recovery rates isolating three types of creditors (junior, senior, and new money claims). We investigate the structure of recoveries on a unique hand-collected sample of bankrupt firms in France, Germany, and the UK. We initially question value maximization, and study to which extent the legal provisions prevailing after insolvency filing can influence creditors’ overall recoveries. Three procedures differ significantly from our benchmark (UK liquidations). French continuation and UK receivership exert a positive influence onto total repayments, while such influence becomes negative under French liquidation. We relate this finding to the ability of the two former procedures to improve coordination among the creditors, monitoring of the debtor, and/or incentives to file early. We then analyze value distribution by examining competition between the categories of creditors. We show that the insolvency systems do not converge. Junior and senior creditors are better served under the German and the French continuation procedures than in any other bankruptcy path. At the opposite, the UK liquidation procedures fail to satisfactorily serve the junior/senior creditors. Still, nearly all the insolvency procedures support fresh financing by protecting quite well new money claims. Overall, we do not confirm any superiority of one family of insolvency system over another, but rather stress the importance of an appropriate design of the procedures, especially regarding the incentives they create before and after insolvency filing.