Unusual and Fatal Case of an Undiagnosed Intravascular Large B-cell Lymphoma: The Oncologist’s Great Imitator†

Intravascular lymphoma (IVL) is a rare subtype of extranodal lymphomas that is characterized by the selective growth of neoplastic cells within the lumen of small vessels. Authors document the case of an unexpected death caused by an undiagnosed intravascular large B-cell lymphoma with multi-organ involvement, which had initially manifested as an infection and then as an unclarified central nervous system pathology. Histological examination showed a diffuse intravascular large B-cell brain lymphoma with prominent cerebral involvement. The relevance of the case report reveals the importance of an autopsy of an extremely rare and threatening pathology that in most cases is diagnosed only postmortem. As a result, the role of the forensic pathologist becomes particularly important. When specifically performing an in-depth autopsy evaluation with a specific histologic analysis, it is possible to identify the intravascular lymphoma and declare a more accurate cause of death.     

Ethyl Glucuronide Concentration in Hair of Detainees: A Preliminary Study

Through the measurement of ethyl glucuronide in hair (hETG), it is possible to assess chronic alcohol abuse over time. In this paper, we present a study on hETG in Italian prison inmates. Analyses were performed by LC-MS according to a previously published method. Results were evaluated using the cut-offs established by the Society of Hair Testing. Positives samples (ETG > 30 pg/mg) accounted for 6% of all subjects, with concentrations ranging from 42 pg/mg up to 270 pg/mg, abstinent subjects (ETG < 7 pg/mg) accounted for 88%, and moderate alcohol consumption (7 < ETG < 30 pg/mg) for 6% of the subjects. No females displayed ETG values above 30 pg/mg. Among positive samples, only two subjects did not declare heavy alcohol consumption and were found strongly positive at 210 and 270 pg/mg. To the best of our knowledge, this represents the first study on ETG hair concentration on prison inmates.     

MI Implementation in Juvenile Justice: A Case Report

Motivational interviewing (MI) is a communication style focused on enhancing clients’ own motivation towards change. In the justice system MI has evidence to support that it enhances communication and change behaviors in youth. As most MI training is designed for healthcare settings training and implementation of MI must be adapted to fit the juvenile justice model. This includes both rehabilitation and restorative justice. Here we describe the details that allowed one county small county in Pennsylvania to roll out MI training and initial skills review in less than 6 months. The case reviews the details of planning, trainings, and timing of activities. We then discuss what elements of those details fit into a greater implementation plan that may be applied elsewhere. Four key elements were instrumental to implementation: 1) appreciation of JPO time constraints, 2) cost containment 3) using blending to enhance JPO flexibility with MI use, and 4) policies that normalize use of MI. This outline may assist other courts in their own implementation efforts.     

Pitfalls of Computed Tomography 3D Reconstruction Models in Cranial Nonmetric Analysis*

Many studies in the literature have highlighted the utility of virtual 3D databanks as a substitute for real skeletal collections and the important application of radiological records in personal identification. However, none have investigated the accuracy of virtual material compared to skeletal remains in nonmetric variant analysis using 3D models. The present study investigates the accuracy of 20 computed tomography (CT) 3D reconstruction models compared to the real crania, focusing on the quality of the reproduction of the real crania and the possibility to detect 29 dental/cranial morphological variations in 3D images. An interobserver analysis was performed to evaluate trait identification, number, position, and shape. Results demonstrate a false bone loss in 3D models in some cranial regions, specifically the maxillary and occipital bones in 85% and 20% of the samples. Additional analyses revealed several difficulties in the detection of cranial nonmetric traits in 3D models, resulting in incorrect identification in circa 70% of the traits. In particular, pitfalls included the detection of erroneous position, error in presence/absence rates, in number, and in shape. The lowest percentages of correct evaluations were found in traits localized in the lateral side of the cranium and for the infraorbital suture, mastoid foramen, and crenulation. The present study highlights important pitfalls in CT scan when compared with the real crania for nonmetric analysis. This may have crucial consequences in cases where 3D databanks are used as a source of reference population data for nonmetric traits and pathologies and during bone-CT comparisons for identification purposes.     

Development of a Novel Finger-Trigger Interface for Trigger Pull Measurement

Trigger pull is the force that needs to be exerted on the trigger to discharge a firearm. The measurement of trigger pull can assist in the evaluation of the safety, function, and manufacturing characteristics associated with a firearm during the forensic firearm examination process. Nonetheless, the accuracy and uncertainty of trigger pull measurements may be affected by the measuring device, test procedure, and environmental conditions. In this work, an innovative finger-trigger interface device was developed to facilitate accurate trigger pull measurements. The idea was to reduce the variation related to the position of the measurement device on the trigger in existing measuring methods and devices. Three force sensors based on different technologies were initially evaluated. While two of the three sensors failed to produce data, the miniature capacitive plate sensor exhibited high precision and a linear response over the range of typical trigger pulls. To examine the effects of the finger-trigger interface on trigger pull measurement, different sensor housing prototypes were designed in silico and 3D printed for the construction of three finger-trigger interface devices. The performance of each finger-trigger interface device was evaluated by measuring the trigger pulls of several selected firearms and comparing the data to a previously published study. Our preliminary results demonstrated the novel finger-trigger interface device offered a new way to measure trigger pull in situ with acceptable accuracy and precision.     

Organizational and Human Factors Affecting Forensic Decision-Making: Workplace Stress and Feedback

Although forensic examiners operate in a stressful environment, there is a lack of understanding about workplace stress and feedback. These organizational and human factors can potentially impact forensic science judgments. In this study, 150 practicing forensic examiners from one laboratory were surveyed about their experiences of workplace stress, and the explicit and implicit feedback they receive. Forensic examiners reported that their high stress levels originated more from workplace-related factors (management and/or supervision, backlogs, and the pressure to do many cases) than from personal related factors (family, medical, and/or financial). The findings showed that a few (8%) of the forensic examiners sometimes felt strong implicit feedback about what conclusions were expected from them and that some (14%) also strongly felt that they were more appreciated when they helped to solve a case (e.g., by reaching a “match” as opposed to an “inconclusive” conclusion). Differences were found when comparing workplace stress and feedback levels across three core forensic science fields (forensic biology, chemistry, and latent prints) and across career stages (early, mid, and late). Gaining insights into the stress factors within a workplace and explicit and implicit feedback has implications for developing policies to improve the well-being, motivation, and performance of forensic examiners.     

Civilian Forensic Technician and Sworn Police Officer Job-Related Stress

Forensic Technicians provide crime scene investigation services and are exposed to stressful violent crimes, motor vehicle accidents, biological or chemical hazards, and other appalling imagery. Forensic Technicians would likely experience physical and psychological stress after exposure to trauma, and security vulnerabilities similar to Sworn Police Officers. The perceived availability of mental health resources, job-related physical, psychological stress, and traumatic experiences of both Forensic Technicians and Sworn Police Officers from California law enforcement agencies were investigated using a self-reported survey. Responses were evaluated for any significant differences in the perceived stress, job-related physical stress, and resulting psychological impact affecting the participants. The survey contained a mix of True/False, Circle/Check the Appropriate Box, or Likert Scale (1–5) responses. The results were evaluated statistically and discussed. Results indicated Sworn Police Officers and Forensic Technicians have different on-duty stress levels, but similar off-duty stress levels. Nearly two-thirds of 54 job-related stressors were not significantly different between the two occupations. However, Forensic Technicians reported more adverse effects in 17 physical and psychological job-related activities compared with Sworn Police Officers. Forensic Technicians reported lower awareness levels and availability of agency mental health support services than were reported by Sworn Police Officers. This study reports for the first time an unexpected outcome that perceived and job-related psychological stress is greater for Forensic Technicians than Sworn Police Officers. Possible reasons for this disparity will be discussed as well as stress management tools that should be implemented to reduce health risk factors for both career professionals as well as increase public safety.