Carbon‐Based Fingerprint Powder as a One‐Step Development and Matrix Application for High‐Resolution Mass Spectrometry Imaging of Latent Fingerprints

Carbon‐based materials are often used as matrices for matrix‐assisted laser desorption/ionization mass spectrometry (MALDI‐MS) and its imaging (MALDI‐MSI). However, researchers have refrained from using carbon‐based fingerprint powder (CFP) as a matrix due to high background and contamination. In this work, the compatibility of CFP is reevaluated with MALDI‐MSI using a high‐resolution mass spectrometer (HRMS) and compared to traditional organic matrices. Relevant fingerprint compounds were easily distinguished from carbon cluster peaks when using HRMS. For fair comparison, half of a fingerprint was dusted with CFP while the other half was dusted with traditional organic matrices. All compounds studied had comparable, or higher, signal‐to‐noise (S/N) ratios when CFP was used as the matrix. Additionally, chemical image qualities closely followed the trend of S/N ratios. CFP proved to be an effective one‐step development and matrix application technique for MALDI‐MSI of latent fingerprints, when carbon cluster peaks are well separated by a HRMS.     

Implementation and Optimization of the Sodium‐Rhodizonate Method for Chemographic Shooting Distance Estimation

In shooting incident investigations where it is important to estimate the shooting distance, the sodium‐rhodizonate coloring method has been used for the visualization of GSR patterns extensively. This publication describes the optimization of this method by the use of a heated press for the transfer of GSR traces on garments, as well as variation of a number of other important process parameters. Our final aim for this project was to prepare a formal validation of the coloring method as prerequisite for its inclusion into the scope of ISO17025‐certified methods in the GSR Laboratory. A number of important factors and process parameters were identified, such as buffer composition and pH, type of textile used as a substrate and resolution of the documentation of the results. Results were tested using a synthetic proficiency test. Our optimized method has been found to be a very effective technique for visualization of macroscopic GSR traces.     

Near‐fatal Intoxication with the “New” Synthetic Opioid U‐47700: The First Reported Case in the Czech Republic

Recreational use of the potent synthetic opioid 3,4‐ dichloro‐N‐(2‐(dimethylamino)cyclohexyl)‐N‐methylbenzamide (U‐47700) is rising, accompanied by increasingly frequent cases of serious intoxication. This article reports a case of near‐fatal U‐47700 intoxication. A man was found unconscious (with drug powder residues). After 40 h in hospital (including 12 h of supported ventilation), he recovered and was discharged. Liquid chromatography/high‐resolution mass spectrometry (LC/HRMS) or gas chromatography/mass spectrometry (GC/MS) were used to detect and quantify substances in powders, serum and urine. Powders contained U‐47700 and two synthetic cannabinoids. Serum and urine were positive for U‐47700 (351.0 ng/mL), citalopram (<LOQ), tetrahydrocannabinol (THC: 3.3 ng/mL), midazolam (<LOQ) and a novel benzodiazepine, clonazolam (6.8 ng/mL) and their metabolites but negative for synthetic cannabinoids. If potent synthetic opioids become cheaper and more easily obtainable than their classical counterparts (e.g., heroin), they will inevitably replace them and users may be exposed to elevated risks of addiction and overdose.     

Bilateral Asymmetry of Nutrient Foramen Position in Forearm Bones: Implications for its Use in Sorting Commingled Remains

Commingling is frequently encountered in cases examined by the Committee on Missing Persons in Cyprus, and pair‐matching is routinely used as a preliminary segregation method. Here we examine the degree of bilateral asymmetry in nutrient foramen position of the radius and ulna to determine whether nutrient foramen position may be useful in visual and/or ostetometric pair‐matching. Differences in nutrient foramen position between left‐right pairs from the same individual were compared with differences in nutrient foramen position between different individuals. Bilateral asymmetry in nutrient foramen position was found to be high, indicating that it is not a reliable trait for pair‐matching. Bilateral asymmetry and between‐person variation were found to differ between the two bones examined, suggesting that nutrient foramen position in other long bones should also be tested.     

Cardiac Ventricular Laceration Due to Child Abuse: Abusive Ventricular Laceration

Traumatic cardiac ventricular ruptures in children are rare. Only a single case of left ventricular rupture due to child abuse has been reported. We report a child who sustained a fatal left ventricular apical rupture. It appeared to have resulted from hydrostatic forces resulting from abusive blunt thoracic injury. That he was being abused was previously missed when he was presented to the emergency department with facial pyoderma. It was not noted that he also had lip and oral mucosal injury, sites not affected by staph toxins. As a result, his underlying, abusive and secondarily infected, facial flow type scald burn was not appreciated. Within a week thereafter his fatal injury occurred, accompanied by extensive and obvious associated abusive injuries. Postmortem high‐detail whole body computed tomography scanning aided the autopsy. Although rare, ventricular rupture from abusive blunt thoracic injury can occur.     

Bone Area Histomorphometry

Quantifying the amount of cortical bone loss is one variable used in histological methods of adult age estimation. Measurements of cortical area tend to be subjective and additional information regarding bone loss is not captured considering cancellous bone is disregarded. We describe whether measuring bone area (cancellous + cortical area) rather than cortical area may improve histological age estimation for the sixth rib. Mid‐shaft rib cross‐sections (n = 114) with a skewed sex distribution were analyzed. Ages range from 16 to 87 years. Variables included: total cross‐sectional area, cortical area, bone area, relative bone area, relative cortical area, and endosteal area. Males have larger mean total cross‐sectional area, bone area, and cortical area than females. Females display a larger mean endosteal area and greater mean relative measure values. Relative bone area significantly correlates with age. The relative bone area variable will provide researchers with a less subjective and more accurate measure than cortical area.     

Complex Congenital Heart Malformation Including Transposition of the Great Vessels,Presenting as Sudden Unexplained Infant Death

Transposition of the great vessels (TGV) is a common congenital heart defect that is difficult to diagnose before birth. Antenatal diagnosis is associated with increased survival. Unusual features such as anomalous pulmonary artery origin may delay cyanosis, decreasing clinical suspicion. A three‐week old female infant who had never been cyanotic presented for forensic autopsy due to onset of unresponsiveness at home. History included risk factors for TGV and signs of heart enlargement that were not recognized during life. Cardiac pathology consultation identified D‐type TGV with additional rare anomalies. TGV may present as sudden unexplained infant death (SUID) for forensic autopsy if variant features prevent development of cyanosis. Cardiac pathology consultation is helpful in clarifying these features.     

A Fatal Case of Poisoning with Fentanyl Transdermal Patches in Japan

Fentanyl transdermal patches have been used to treat cancer‐ and noncancer‐related chronic pain. However, its inappropriate or illegal application may cause fatal poisoning. We herein present the case of a Japanese woman in her 40s who was found dead with seven 25‐μg/h fentanyl transdermal patches on her body. We established a detailed toxicological analysis procedure to quantify fentanyl, and its metabolite norfentanyl, and other drugs (acetaminophen, allylisopropylacetylurea, celecoxib, estazolam, promethazine, and sertraline) in human whole blood by ultra‐high‐performance liquid chromatography–tandem mass spectrometry. The measured fentanyl and norfentanyl concentrations in the femoral and cardiac blood were 0.051 and 0.072 μg/mL and 0.033 and 0.076 μg/mL, respectively. The decedent's fentanyl concentrations were consistent with previously reported postmortem blood levels for fatal cases of poisoning by fentanyl transdermal patches. Based on the decedent's case history, autopsy findings, and toxicological analyses, the cause of death was identified as intoxication with transdermal fentanyl.     

Medical–Legal Partnerships: How Legal Services can Dramatically Improve Health Outcomes,and the Missed Opportunity to Help Women Seeking Abortions

There are significant health disparities in the United States, with low‐income and minority Americans experiencing higher rates of chronic disease and autoimmune disorders. Research has firmly established that social factors ‐ such as malnutrition, limited access to healthcare, and safe housing ‐ play a critical role in these health disparities. Medical‐Legal Partnerships are a relatively new approach to improving the health of people living in poverty by addressing the root causes of these health‐harming social factors. This article discusses the benefits of Medical‐Legal Partnerships and argues for continued expansion of the model, particularly in pediatricians’ offices, because parents are more likely to seek medical care for their children than themselves. This article further discusses how legal constraints prevent federal funding for Medical‐Legal Partnerships in abortion clinics; this creates a missed opportunity to work with women who are seeking abortions, many of whom face considerable social and economic challenges that could be addressed through legal assistance. This article digs into the legal restrictions that create this missed opportunity and proposes potential solutions to better serve the vulnerable population of abortion‐seeking women.