Long- and short-term risk factors in the prediction of inpatient suicide: review of the literature

The prediction of suicide remains a major challenge for health care professionals in inpatient settings. A clearer identification of factors specific to inpatient suicide is required to improve both practice and research within this area. This paper provides an overview of the inpatient suicide literature to date focusing on two particularly salient themes: Long term and short term prediction of suicide. Since the concept of short-term suicide risk dominates clinical practice, issues in relation to dynamic risk factors are emphasized.     

Community Influence on Adolescent Obesity: Race/Ethnic Differences

Using a sample of 20,000 adolescents (Add Health data), this study examined the influences of community poverty and race/ethnicity on adolescent obesity. Multilevel analyses revealed strong evidence for the unique influences of community poverty and race/ethnicity on adolescent obesity net of family characteristics. The prevalence of obesity is significantly higher in poor communities than in affluent communities; and it is higher among African Americans, Hispanics and Native Americans than among Whites. The interaction between race/ethnicity and community poverty indicates that race/ethnicity moderates the influence of community poverty on the prevalence of obesity. Although the prevalence of obesity is higher among minorities than among Whites, the influence of community poverty is stronger for Whites than for minorities, suggesting that unlike Whites, most minority groups may not accrue benefits of structural community advantages. The state of being overweight as the outcome variable provided essentially the same findings. The practical implications are discussed.     

Validation of the InnoXtract™ DNA extraction method for bone,teeth, and rootless hair

Forensic casework samples often include human hairs, teeth, and bones. Hairs with roots are routinely processed for DNA analysis, while rootless hairs are either not tested or processed using mitochondrial DNA. Bones and teeth are submitted for human remains identifications for missing persons and mass disaster cases. DNA extraction from these low templates and degraded samples is challenging. The new InnoXtract DNA extraction method utilizes magnetic beads that are optimized to bind small DNA fragments, as small as 100 base pairs, to purify high-yield DNA from compromised samples. This validation study evaluates InnoXtract's ability to obtain amplifiable DNA from samples such as rootless hairs and skeletal remains. Studies performed include sensitivity, stability, repeatability, reproducibility, non-probative samples, and comparison to standard organic extractions. Sensitivity studies demonstrate average yield recoveries ranging from 53% to 100% and 73% to 85% for the InnoXtract hair and bone methods, respectively. Studies demonstrate consistent results across a range of sample types, such as insulted and un-insulted bone and teeth, as well as hair shafts from donors of various ages, gender, race, and hair characteristics. The InnoXtract bone method outperformed organic extraction. The method was successfully automated on a MagMAX™ Express-96, with recoveries over 70% relative to the manual version. InnoXtract has the potential as an automated high-throughput, high-yield bone extraction method with 6 h of total extraction time for up to 96 samples. The validation study results demonstrate that the InnoXtract kits produce high-yield and high-quality DNA from compromised bone, teeth, and hair shaft samples.     

Review of analytical methods for screening and quantification of fentanyl analogs and novel synthetic opioids in biological specimens

Fentanyl, fentanyl analogs, and other novel synthetic opioids (NSO), including nitazene analogs, prevail in forensic toxicology casework. Analytical methods for identifying these drugs in biological specimens need to be robust, sensitive, and specific. Isomers, new analogs, and slight differences in structural modifications necessitate the use of high-resolution mass spectrometry (HRMS), especially as a non-targeted screening method designed to detect newly emerging drugs. Traditional forensic toxicology workflows, such as immunoassay and gas chromatography mass spectrometry (GC–MS), are generally not sensitive enough for detection of NSOs due to observed low (sub-μg/L) concentrations. For this review, the authors tabulated, reviewed, and summarized analytical methods from 2010–2022 for screening and quantification of fentanyl analogs and other NSOs in biological specimens using a variety of different instruments and sample preparation approaches. Limits of detection or quantification for 105 methods were included and compared to published standards and guidelines for suggested scope and sensitivity in forensic toxicology casework. Methods were summarized by instrument for screening and quantitative methods for fentanyl analogs and for nitazenes and other NSO. Toxicological testing for fentanyl analogs and NSOs is increasingly and most commonly being conducted using a variety of liquid chromatography mass spectrometry (LC–MS)-based techniques. Most of the recent analytical methods reviewed exhibited limits of detection well below 1 μg/L to detect low concentrations of increasingly potent drugs. In addition, it was observed that most newly developed methods are now using smaller sample volumes which is achievable due to the sensitivity increase gained by new technology and new instrumentation.     

Exploiting the post-attendee URL feature in Zoom webinar to distribute malware

The post-attendee Uniform Resource Locator (URL) feature within the video conferencing application known as Zoom is often overlooked by digital forensic experts as a potential risk for malware transmission. However, with the ability to redirect webinar participants to any URL set by the host for the webinar, the post-attendee URL can be abused by bad actors to expose webinar participants to malicious websites or, in the worst-case scenario, force participants to download a file through the use of a direct download link URL. This study aims to showcase how this exploit can be replicated by creating an experimental environment involving four Windows 10 desktops running Zoom version 5.7.5 and creating a webinar with four user accounts acting as webinar participants and setting the post-attendee URL value to the URL of a website that contained a keylogger. In another trial, the same experimental environment was utilized, with the only difference being the post-attendee URL that was set to redirect webinar participants to a download link for a .jpg file. In both instances, every user account that joined the webinar via clicking on the invitation link that was emailed to each user account after registering for the webinar was redirected to the post-attendee URL regardless of their user account role. These results not only prove that the post-attendee URL can be exploited, but also provide insight as to how this type of attack can be prevented.