Traumatic bilateral vertebral artery dissection

Traumatic vertebral artery dissection is not often seen by forensic pathologists, and cases investigated are scarce in the forensic literature. We present the case of a 40-year-old woman cyclist who was struck by a car while wearing a helmet, and was neurologically near normal immediately thereafter at Emergency. She presented 48 h later with acute right hemiparesis, decreasing level of consciousness, and unsteadiness. CT revealed massive cerebellar infarction. CT angiography was normal. The patient died in coma 7 days after injury and autopsy revealed bilateral edematous cerebellar infarction and bilateral vertebral artery dissection. Rotational neck injury and mural tear in the wall of the Atlantic parts of both vertebral arteries is suggested as the possible mechanism of the arterial injury. Head and neck injuries are reported as a precipitating cause of vertebral artery injury. The possible influence of trauma may be further underestimated if longer intervals between vessel dissection and ischemia occur. The current case illustrates that "talk-and-die" syndrome may be due to occult vertebral artery dissection, possibly bilateral. In forensic cases of delayed death after mild trauma to the head and neck, the vertebral arteries should be examined for the cause of death.     

Use of thermal drone in detection and assessment of larval mass temperature in decomposed rabbit carcasses

Manual ground searches and cadaver dogs are traditional methods for locating remains, but they can be time- and resource-intensive, resulting in the decomposition of bodies and delay in victim identification. Therefore, thermal imaging has been proposed as a potentially useful tool for detecting remains based on their temperature. This study investigated the potential of a novel search technique of thermal drones to detect surface remains through the detection of maggot mass temperatures. Two trials were carried out at Selangor, Malaysia, each utilizing 12 healthy male Oryctolagus cuniculus European white rabbits and DJI Matrice 300 RTK drone China, equipped with a thermal camera; Zenmuse H20T to record the thermal imaging footage of the carcasses at various heights (15, 30, 60–100 m) for 14 days for each trial. Our results demonstrated that the larval masses and corresponding heat emissions were at their largest during the active decay stage; therefore, all the carcasses were observable in thermal images on day 5 and remained until day 7. Statistical analyses showed that (1) no statistically significant differences in thermal images between clothed and unclothed subjects (p > 0.05); (2) 15 m above ground level was proven to be the optimal height, as it showed the greatest contrast between the carcass heat signature and the background (p < 0.005). Our data suggested the potential window of detection of thermal signatures was detectable up to 7 days post-deposition. This could be an important guideline for the search and recovery teams for operational implementation in this tropical region.     

Experimental results on data analysis algorithms for extracting and interpreting edge feature data for duct tape and textile physical fit examinations

A physical fit is an important observation that can result from the forensic analysis of trace evidence as it conveys a high degree of association between two items. However, physical fit examinations can be time-consuming, and potential bias from analysts may affect judgment. To overcome these shortcomings, a data analysis algorithm using mutual information and a decision tree has been developed to support practitioners in interpreting the evidence. We created these tools using data obtained from physical fit examinations of duct tape and textiles analyzed in previous studies, along with the reasoning behind the analysts' decisions. The relative feature importance is described by material type, enhancing the knowledge base in this field. Compared with the human analysis, the algorithms provided accuracies above 90%, with an improved rate of true positives for most duct tape subsets. Conversely, false positives were observed in high-quality scissor cut (HQ-HT-S) duct tape and textiles. As such, it is advised to use these algorithms in tandem with human analysis. Furthermore, the study evaluated the accuracy of physical fits when only partial sample lengths are available. The results of this investigation indicated that acceptable accuracies for correctly identifying true fits and non-fits occurred when at least 35% of a sample length was present. However, lower accuracies were observed for samples prone to stretching or distortion. Therefore, the models described here can provide a valuable supplementary tool but should not be the sole means of evaluating samples.     

Do bone elasticity and postmortem interval affect forensic fractographic analyses?

Forensic fractographic features of bone reliably establish crack propagation in perimortem injuries. We investigated if similar fracture surface features characterize postmortem fractures. Experimentally induced peri- and postmortem fractures were used to assess if fractographic features vary as bone elasticity decreases during the postmortem interval (PMI). Thirty-seven unembalmed, defleshed human femoral shafts from males and females aged 33–81 years were fractured at varying PMIs with a drop test frame using a three-point bending setup and recorded with a high-speed camera. Vital statistics, cause of death, PMI length, temperature, humidity, collagen percentage, water loss, fracture energy, and fractography scores were recorded for each sample. Results showed that fractographic features associated with perimortem fractures were expressed in PMIs up to 40,600 accumulated degree hours (ADH), or 60 warm weather days. Hackle was the most consistently expressed feature, occurring in all fractures regardless of ADH. The most variable characteristics were wake features (78.4%) and arrest ridges (70.3%). Collagen percentage did not correlate strongly with ADH (r = −0.04, p = 0.81); however, there was a strong significant correlation between ADH and water loss (r = 0.74, p < 0.001). Multinomial logistic regression showed no association between fractographic feature expression and ADH or collagen percentage. In conclusion, forensic fractographic features reliably determine initiation and directionality of crack propagation in experimentally induced PMIs up to 40,600 ADH, demonstrating the utility of this method into the recent postmortem interval. This expression of reliable fractographic features throughout the early PMI intimates these characteristics may not be useful standalone features for discerning peri- versus postmortem fractures.     

Discrimination of phenethylamine regioisomers and structural analogues by Raman spectroscopy

In this study, the Raman spectra of 21 phenethylamines were obtained using far‐red excitation (785 nm). The distinguishing ability of Raman for phenethylamines, especially for phenethylamine regioisomers and structural analogues, was investigated. Here, the evaluation of a cross section of Raman spectra demonstrated that all types of phenethylamines were distinguishable, even for certain structural analogues with high spectrum similarity. Raman exhibited high distinguishing ability for phenethylamine regioisomers that differ in the substitution position of halogen, methoxy, alkyl, or other substituted groups; as well as for structural analogues containing different groups, such as furanyl, 2,3‐dihydrofuranyl, halogen, and alkyl substituted at the same position. The Raman spectra for homologues with differences in only a methyl group were found to be highly similar; however, their spectra demonstrated small but detectable differences. Four analogue mixtures and 59 seized samples were also analyzed to study the practical use of the Raman method in forensic field. 95% of the seized samples were correctly identified, which significantly validated the ability of Raman method in identifying the correct isomers. Accordingly, this study provides a non‐destructive, high‐throughput and minimal sample preparation technique for the discrimination of phenethylamines.     

Beyond COVID-19: Five commentaries on expert knowledge,executive action,and accountability in governance and public administration

Several Canadian and international scholars offer commentaries on the implications of the COVID-19 pandemic for governments and public service institutions, and fruitful directions for public administration research and practice. This first suite of commentaries focuses on the executive branch, variously considering: the challenge for governments to balance demands for accountability and learning while rethinking policy mixes as social solidarity and expert knowledge increasingly get challenged; how the policy-advisory systems of Australia, Canada, New Zealand, and United Kingdom were structured and performed in response to the COVID-19 crisis; whether there are better ways to suspend the accountability repertoires of Parliamentary systems than the multiparty agreement struck by the minority Liberal government with several opposition parties; comparing the Canadian government’s response to the COVID-19 pandemic and the Global Financial Crisis and how each has brought the challenge of inequality to the fore; and whether the COVID-19 pandemic has accelerated or disrupted digital government initiatives, reinforced traditional public administration values or more open government.     

The use of serum protein analysis in the diagnosis of fatal envenomation via Crotalus horridus (timber rattlesnake)

Deaths occurring due to rattlesnake envenomization are extremely rare and must be thoroughly investigated in the same manner as any other type of death. Our research presents the case of an adult white male who suffered a fatal timber rattlesnake (Crotalus horridus) envenomation in northwest Florida in 2018. Blood samples were taken from the decedent's heart and vasculature of the chest and sent for serum proteomic analysis. Serum proteomic analysis was utilized in order to identify proteins from timber rattlesnake (C. horridus) found within the victim's blood. The confirmation of the presence of timber rattlesnake venom within the victim's blood allows the forensic pathologist to determine the cause of death most accurately and likewise, assists with the manner of death determination. Blood samples were separated into two groups: one with the abundant endogenous proteins depleted to facilitate detection of lower abundant proteins and one undepleted. In the depleted sample, a total of 712 proteins were identified, with 47 of the proteins (6.6%) occurring originating from timber rattlesnake (C. horridus). Likewise, a total of 742 proteins were identified in the undepleted sample, with 52 of the proteins (7.0%) occurring in timber rattlesnake (C. horridus). No timber rattlesnake (C. horridus) proteins were found in control human serum.     

Dental hygiene students' matching accuracy when comparing antemortem dental radiographs and oral photographs to simulated postmortem WinID3® odontograms

Matching dental antemortem (AM) and postmortem (PM) data for human identification is especially challenging when the workforce is limited. Dental hygienists have served mass fatality incidents (MFIs) due to dental-related expertise. However, forensics within dental hygiene education and research on transferable skills is limited. This qualitative balance design study assessed senior dental hygiene students' match accuracy of simulated cases varying in dental identifiers based on AM full mouth series (FMS) radiographs and oral photographs to PM WinID3^® odontograms to demonstrate possible disaster victim identification (DVI) transferable skills gained during formal education. A convenience sample of senior dental hygiene students (n = 31) was presented information on WinID3^® interpretation, then presented with 5 mismatched cases and asked to visually interpret each to make 10 total matches; five based on AM FMS with simulated PM WinID3^® odontograms and five based on AM photographs with PM WinID3^® odontograms. Match accuracy scores ranged from 41.9% to 58.1% for cases with 1–10 identifiers, and 77.4% to 93.5% for cases with 11–40 identifiers. Accuracy when matching AM radiographs to PM odontograms versus AM photographs to PM odontograms was compared and revealed no statistical differences in match accuracy depending on image type (p = 0.388 to 1.000). Results of this pilot study suggests transferable match accuracy skills resulted from the participants' dental hygiene formal education. These baseline skills with additional specialized training support the rationale for dental hygienists serving on DVI teams. More research is needed in education and practice when preparing dental hygienists for forensic-based service.     

Medical examiner response to the drug overdose epidemic in King County Washington: “Real-time” surveillance,data science,and applied forensic epidemiology

As the overdose epidemic overwhelmed medicolegal death investigation offices and toxicology laboratories, the King County Medical Examiner's Office responded with “real-time” fatal overdose surveillance to expedite death certification and information dissemination through assembling a team including a dedicated medicolegal death investigator, an information coordinator, and student interns. In-house testing of blood, urine, and drug evidence from scenes was performed using equipment and supplies purchased for surveillance. Collaboration with state laboratories allowed validation. Applied forensic epidemiology accelerated data dissemination. From 2010 to 2022, the epidemic claimed 5815 lives in King County; the last 4 years accounted for 47% of those deaths. After initiating the surveillance project, in-house testing was performed on blood from 2836 decedents, urine from 2807, and 4238 drug evidence items from 1775 death scenes. Time to complete death certificates decreased from weeks to months to hours to days. Overdose-specific information was distributed weekly to a network of law enforcement and public health agencies. As the surveillance project tracked the epidemic, fentanyl and methamphetamine became dominant and were associated with other indicators of social deterioration. In 2022, fentanyl was involved in 68% of 1021 overdose deaths. Homeless deaths increased sixfold; in 2022, 67% of 311 homeless deaths were due to overdose; fentanyl was involved in 49% and methamphetamine in 44%. Homicides increased 250%; in 2021, methamphetamine was positive in 35% of 149 homicides. The results are relevant to the value of rapid surveillance, its impact on standard operations, selection of cases requiring autopsy, and collaboration with other agencies in overdose prevention.     

The impact of fentanyl on DUIDs and traffic fatalities: Blood and oral fluid data

Fentanyl has emerged as the most prolific drug in the ongoing opioid epidemic and has greatly impacted traffic safety in recent years. This study aimed to evaluate fentanyl prevalence and concentrations in blood and oral fluid in driving under the influence of drugs (DUID) cases in three different regions (i.e., Alabama, Orange County, CA, and Houston, TX) from 2017 to 2022. Furthermore, traffic fatalities were evaluated for Alabama and Orange County, CA. Fentanyl positivity in DUID and traffic fatalities increased for most years in this study. In Alabama, the prevalence of fentanyl DUID cases increased 4-fold in 2022 compared to 2017. Orange County's increase from 2017 to 2022 was 14-fold. In Houston, the increase was approximately 2-fold from 2019 to 2022. The greatest increase for all laboratories coincided with the start of the COVID-19 pandemic. In 2022, the median fentanyl DUID blood concentrations were 4.7, 11, and 4.7 ng/mL in Alabama, Orange County, and Houston, respectively. Most fentanyl cases were polydrug cases (≥90%). Methamphetamine, THC, and alprazolam were the most frequently detected drugs in combination with fentanyl. Alabama has collected oral fluid and blood in DUID cases since 2018. The detection of fentanyl in oral fluid was comparable to blood. However, 59% and 8.7% of fentanyl-positive cases had concentrations of >20 ng/mL in oral fluid and blood, respectively. Therefore, oral fluid as an alternative or supplemental specimen to blood is an attractive approach for fentanyl in DUID cases. This study contributes to understanding recent fentanyl trends and their impact on traffic safety.