An interlaboratory study to evaluate the utility of gas chromatography-mass spectrometry and gas chromatography-infrared spectroscopy spectral libraries in the forensic analysis of fentanyl-related substances

Synthetic opioids such as fentanyl account for over 71,000 of the approximately 107,000 overdose deaths reported in the United States in 2021. Fentanyl remains the fourth most identified drug by state and local forensic laboratories, and the second most identified drug by federal laboratories. The unambiguous identification of fentanyl-related substances (FRS) is challenging due to the absence or low abundance of a molecular ion in a typical gas chromatography-mass spectrometry (GC-MS) analysis and due to a low number of fragment ions that are similar among the many potential isomers of FRS. This study describes the utility of a previously reported gas chromatography-infrared (GC-IR) library for the identification of FRS within a blind, interlaboratory study (ILS) involving seven forensic laboratories. Twenty FRS reference materials, including those with isomer pairs in the library, were selected based on either their presence in the NIST library and/or some similarity of the mass spectra information produced. The ILS participants were requested to use the Florida International University (FIU) GC-MS and GC-IR libraries supplied by FIU to search for matches to their unknown spectra generated from in-house GC-MS and GC-IR analysis. The laboratories reported improvement in the positive identification of unknown FRS from ~75% using GC-MS alone to 100% correct identification using GC-IR analysis. One laboratory participant used solid phase IR analysis, which produced spectra incompatible with the vapor phase GC-IR library to generate a good comparison spectrum. However, this improved when searched against a solid phase IR library.     

Fatal pulmonary haemorrhage from a perforated and possibly iatrogenic thoracic aortic aneurysm

A 56-year-old man, with Noonan's syndrome, underwent surgical correction of an aortic co-arctation almost two decades before his sudden and unexpected demise. The immediate cause of death was massive pulmonary haemorrhage, which was preceded by recurrent mild haemoptysis that was attributed to pneumonia, clinically. Autopsy revealed the presence of a saccular thoracic aortic aneurysm, arising from the apparently weakened anastomosis left by the previous operation. The aneurysm had eroded into the apical segment of the left lung, where it perforated with consequent severe, acute pulmonary haemorrhage. It was observed that the anastomotic line traversed the aneurysmal wall, with the resultant formation of a true aneurysm, rather than merely a pseudo-aneurysm. It is postulated that this finding of an iatrogenic true aneurysm represents a rare, delayed complication of aortic surgery.     

‘Joe everyday,people off the street’: a qualitative study on mediators’ roles and skills in victim–offender mediation

This qualitative study examined multiple perspectives of participants who experienced a Victim–Offender Mediation (VOM) program in a Midwestern city in the United States. Of particular interest are the roles and skills of mediators. Data consisted of 34 face‐to‐face interviews with 37 participants including adult crime victims, juvenile offenders and their parents, mediators and representatives from referring agencies. Insider perspectives regarding the roles and skills of the mediators in restorative processes were revealed through personal stories. Although the majority of the participants reported that the roles and skills of mediators were consistent with restorative justice principles, this exploratory study also revealed that some roles and skills exhibited by mediators were inconsistent with restorative justice values, which shows the variance of ‘real world’ restorative justice. Recommendations are made to promote mediators’ roles and skills that are compatible with restorative justice principles.     

A chance for a breakthrough in Russo-Japanese relations: will the logic of great power relations prevail?

Under Mori Yoshiro the Japanese government energetically pursued Russia's new leader, Vladimir Putin. Progress was achieved, as Putin recognized the 1956 treaty in which Moscow pledged to return two islands. From the summer of 2000, however, a backlash could be detected. The architects of the initiative not only failed to make their case to Japanese politicians, but also became the object of two years of attacks, leading to Suzuki Muneo's ouster from the LDP and arrest and to Togo Kazuhiko being fired as ambasador to The Netherlands. Under Koizumi Junichiro Japan lost interest, while the media feasted on the image of foreign policy being hijacked. Lost in the media frenzy and setback to relations was the case for why Tokyo and Moscow need each other as great power partners in the face of rising Chinese power and overwhelming US power. Since both parties sided with the US war against terror, the logic of cooperation has become clearer. A general outline for an interim agreement is well understood on both sides, but a breakthrough is unlikely soon.     

Fatal Ischemic Enteritis with Hemorrhage—A Late Complication of Treated Wilms Tumor

A 35‐year‐old man with a history of childhood Wilms tumor successfully treated with radiotherapy, chemotherapy, and surgery, collapsed and died unexpectedly in hospital following admission for abdominal pain. At autopsy, there was ischemic necrosis of the small intestine with altered blood within the stomach and small intestine. Within the upper abdominal aorta, there was patchy confluent calcific atherosclerosis with extension into the proximal superior mesenteric artery which was occluded by thrombus. Death was attributed to ischemic enteritis of the small intestine caused by mesenteric artery thrombosis complicated by gastrointestinal hemorrhage with aspiration. Localization of atherosclerosis to the radiation field with no significant atherosclerosis elsewhere and the young age of the decedent were supportive of radiation‐induced atherogenesis. Geographically, localized atherosclerosis at autopsy in a tumor survivor should raise the possibility of a treatment‐related side effect that may directly contribute to death many years after the original therapeutic intervention.     

Lead Theft—A Study of the “Uniqueness” of Lead from Church Roofs

In the United Kingdom, theft of lead is common, particularly from churches and other public buildings with lead roofs. To assess the potential to distinguish lead from different sources, 41 samples of lead from 24 church roofs in Northamptonshire, U.K, have been analyzed for relative abundance of trace elements and isotopes of lead using X‐ray fluorescence (XRF) and inductively coupled plasma mass spectrometry, respectively. XRF revealed the overall presence of 12 trace elements with the four most abundant, calcium, phosphorus, silicon, and sulfur, showing a large weight percentage standard error of the mean of all samples suggesting variation in the weight percentage of these elements between different church roofs. Multiple samples from the same roofs, but different lead sheets, showed much lower weight percentage standard errors of the mean suggesting similar trace element concentrations. Lead isotope ratios were similar for all samples. Factors likely to affect the occurrence of these trace elements are discussed.     

Occult Adrenocortical Carcinoma and Unexpected Early Childhood Death

A four‐year‐old previously well boy collapsed unexpectedly and was taken immediately to hospital, where he developed seizures and cardiogenic shock with lethal, rapidly progressing multi‐organ failure. At autopsy, the height was >90th percentile and there were indications of early virilization. Internally, a friable tumor of the left adrenal gland was identified that had invaded the left renal vein and inferior vena cava. Histology revealed typical features of an adrenocortical carcinoma with aggregated trabeculae of cells containing abundant eosinophilic cytoplasm and large pleomorphic nuclei. There was strong positive cytoplasmic staining for inhibin; mitochondria were shown on electron microscopy to contain prominent electron‐dense granules. Death was due to massive pulmonary tumor embolism. Although adrenocortical carcinomas are very rare and are more commonly found in adults, the current case demonstrates that they may also occur in childhood and be responsible for unexpected death by the very unusual mechanism of tumor embolism.     

Use of a pig model to demonstrate vulnerability of major neck vessels to inflicted trauma from common household items

Commonly available items including a ball point pen, a plastic knife, a broken wine bottle, and a broken wine glass were used to inflict stab and incised wounds to the necks of 3 previously euthanized Large White pigs. With relative ease, these items could be inserted into the necks of the pigs next to the jugular veins and carotid arteries. Despite precautions against the carrying of metal objects such as knives and nail files on board domestic and international flights, objects are still available within aircraft cabins that could be used to inflict serious and potentially life-threatening injuries. If airport and aircraft security measures are to be consistently applied, then consideration should be given to removing items such as glass bottles and glass drinking vessels. However, given the results of a relatively uncomplicated modification of a plastic knife, it may not be possible to remove all dangerous objects from aircraft. Security systems may therefore need to focus on measures such as increased surveillance of passenger behavior, rather than on attempting to eliminate every object that may serve as a potential weapon.