Postmortem Computed Tomography in Firearm Homicides: A Retrospective Case Series,

Postmortem computed tomography (PMCT) is integrated into the evaluation of decedents in several American medical examiner offices and medicolegal death investigative centers in many other countries. We retrospectively investigated the value of PMCT in a series of firearm homicide cases from a statewide centralized medical examiner’s office that occurred during 2016. Autopsies were performed or supervised by board-certified forensic pathologists who reviewed the PMCT scans prior to autopsy. PMCT scans were re-evaluated by a forensic radiologist blinded to the autopsy findings and scored by body region (head–neck, thoracoabdominal, and extremities). Injury discrepancies were scored using a modified Goldman classification and analyzed with McNemar’s test. We included 60 males and 20 females (median age 31 years, range 3–73). Based on PMCT, 56 (79.1%) cases had injuries relevant to the cause of death in a single body region (24 head–neck region, 32 thoracoabdominal region). Out of these 56 cases, 9 had a missed major diagnosis by PMCT outside that region, including 6 extremity injuries visible during standard external examination. Yet all had evident lethal firearm injury. We showed that PMCT identifies major firearm injuries in homicide victims and excludes injuries related to the cause of death in other regions when a single body region is injured. Although PMCT has a known limited sensitivity for soft tissue and vascular pathology, it can be combined with external examination to potentially reduce or focus dissections in some of these cases depending on the circumstances and medicolegal needs.     

The Stability of 4-Chloromethcathinone in Blood and Vitreous Humor

We present results of our study on the stability of 4-chloromethcathinone (4-CMC) in authentic postmortem peripheral blood and vitreous humor samples. The stability of 4-CMC was determined in postmortem blood samples (for a period of 90 days) and vitreous humor (30 days) at three different temperatures: −15°C, +4°C, and + 23°C. The analyses were carried out using ultra-high-performance liquid chromatography coupled with triple-quadrupole tandem mass spectrometry (UHPLC-QqQ-MS/MS). In both materials, the lowest 4-CMC stability was demonstrated at room temperature. The blood samples stored in a freezer (−15°C) showed stability for the entire study period (90 days), while in the case of the vitreous humor sample stored at the same temperature the concentration of the substance decreased by 53% after 30 days. The study carried out in authentic postmortem blood and vitreous humor samples confirms the previous reports of 4-CMC instability in biological material. Authors suggest that the biological material should be stored frozen until analyses are carried out as soon as possible after collection of the material.     

Chemical Imaging of Human Fingermark by X-ray Photoelectron Spectroscopy (XPS)

X-ray photoelectron spectroscopy (XPS) is a widely used technique to characterize the surface chemistry of materials. It plays a crucial role in accessing qualitative and quantitative information and in detecting the presence of chemical functional groups on the surface of any material. The forensic methods available to detect and identify elements and organic/inorganic compounds are often destructive, so evidence cannot be re-analyzed. However, XPS allows rapid analysis of samples without damaging them. Recently, an increasing number of forensic researchers have begun to study certain chemical information on fingermarks. In this study, the authors aimed to present the applicability and power of XPS imaging in fingermark analysis which can also provide specific information about the fingermark chemical composition. Herein, monochromated X-ray (Al Kα) spot size was fixed at 50 μm. XPS mapping resulted in the acquisition of spectra at each pixel, in an array of 41 × 30 pixels with a step size of 50 μm. Then, a simple discussion has been made about how the scanned surface spectrum and basic snapshot spectra are used to identify different components at a fingertip of a scanned surface area (~3 mm²). Hence, a fingermark pattern contaminated with caffeine, TiO₂, and Pb/PbO deposited on the silicon wafer can be chemically mapped and visualized by XPS using principal component analysis (PCA). Thus, the present study showed the possible applicability of XPS for the identification of illicit drugs of abuse, gunshot residue, and skin care products on latent fingermark by mimicking a crime scene evidence.     

Composite Machine Learning Algorithm for Material Sourcing,

This study developed a composite machine learning algorithm for attribution of materials of forensic interest (like ammonium nitrate) to original sources. k-nearest neighbor and random forest models were used for source elimination and classification, respectively, in a two-step, composite algorithm based on particle color, size/shape, and trace element concentration features. Novel approaches for simulation to supplement within-source reference features based on empirically measured multi-lot analyses, an improved hold-one-lot-out method for cross-validation, an assessment of the likelihood of the presence of a reference sample, fusion of the source probabilities from the respective classification models, and the calculation of metrics for assessing ensemble sourcing performance are described. Excellent sourcing predictions were obtained; the sourcing algorithm identified the correct source as the top choice 89% of the time, and the correct source was identified to be an average of 2.7 times more likely than the most likely incorrect source.     

Examination of Hacking and Blunt Force Skeletal Trauma

Hacking trauma is prevalent in forensic cases involving genocide and dismemberment, but research into the identification of this type of trauma is lacking. The present study examines characteristics of hacking and blunt force skeletal trauma in order to determine if there is a point at which blunt force trauma becomes distinguishable from hacking trauma. Ten implements with a range of blade angles (i.e., the striking surface of the implement) were used in conjunction with a controlled-force hacking device to impact 100 limb bones of white-tailed deer (Odocoileus virginianus). Observations of the trauma included the occurrence and degree of fragmentation, the entrance widths of the impacts, and composite scores of six hacking characteristics, especially the distinctive V-shaped kerf. ANOVA tests and regression analyses were used to assess the relationships between these characteristics and the blade angles. A significant relationship (p-value = 0.011) was found between the composite hacking scores and the blade angles, indicating that blunt force and hacking trauma can be distinguished. The entrance widths of the impacts exhibited a significant relationship with the blade angles (p-value = 0.037). There was also a significant relationship between the visibility of a V-shaped kerf in the bones (p-value = 0.003), with visibility decreasing around the 60° blade angle. These data should assist in establishing guidelines to differentiate hacking and blunt force skeletal trauma in cases where the implement is on a spectrum between sharp and blunt.     

New Approaches to Age Estimation Using Palatal Suture Fusion

Palatal suture fusion has seen little testing and/or application due in part to an inadequately described relationship to formal age ranges. This study presents a modified scoring method that examines fusion on samples of modern documented adult males and compares two Bayesian approaches to age estimation. In the first analysis, American and Portuguese collections were used to derive univariate and multivariate transition analysis (TA) parameters, which combined with an informative prior, estimated age in a sample of modern Americans and Portuguese. For the second analysis, a Bayesian multiple linear regression (BMLR) used indicator statuses as the independent variables with age as the dependent variable. Highest posterior density regions (HPDRs) and highest posterior density intervals (HDI) were calculated for a holdout sample. Final age estimates for the methods were tested for accuracy using cumulative binomial tests at 75% and 90% coverages. The HPDRs from multivariate TA captured age better for younger individuals, but consistently underaged. The cumulative binomial tests on the BMLR results indicated the prediction intervals performed as expected, and we show they are narrower (more precise) and/or more accurate than the corresponding HPDR. The modified method presented here formally links palatal suture obliteration to age using two different approaches, one of which (BMLR) is new to the aging literature. The BMLR provided results free from bias and more reasonable age ranges while maintaining accuracy. We present a look-up table and a free, simple R file for users to download and run their own estimates with BMLR.     

新冠肺炎疫情期间公安法医应当加强尸体甄别和个体防护

因鉴定体制特点,公安法医除参与尸体有关的现场勘查工作外,还需进行尸体检验工作。在此过程中,可能面对很多风险,受伤和中毒等事件时有发生。然而,国内公安法医对新冠肺炎等传染病流行期间死亡的尸体如何甄别进行尸体检验鉴定,对现场勘查及尸体检验工作的防护只有少量规定,且内容不够详尽。本文对法医在现场勘查中遇到的尸体及尸体检验中实验室建设、职业现状、风险评估及防范措施等进行了论述。最后,建议出台相关的制度规定等具体约束规范措施,以保障公安法医现场勘查及尸体检验工作的顺利进行,以解除基层鉴定机构和鉴定人的后顾之忧。     

The Accuracy and Repeatability of Reconstructing Single Bullet Impacts Using the 2D Ellipse Method

When a bullet punctures a surface, it leaves behind a bullet impact, which can be analyzed in order to determine the origin and trajectory path from which a bullet was discharged using many different scientific methods to reconstruct a shooting scene. The purpose of the research was to test the accuracy and repeatability of reconstructing the impact angle of single bullet impacts using the ellipse method. The research was conducted by firing various calibers of ammunition into drywall panels positioned at varying angles of incidence from 88° until ricochet occurred. This was done in order to determine which caliber type and angle of incidence are most accurate and precise for reconstructing a shooting scene. The study examined four caliber types fired into drywall panels, with 5 repeated shots for each of the 11 angles of incidence (n = 220). Furthermore, 31 participants partook in the study to estimate a bullet impact angle of incidence utilizing the ellipse method. The results show that the best performance (accuracy and repeatability) is seen with the measurements of the 0.45 caliber ammunition. When angle of incidences is low (<64°), the performance (accuracy and repeatability) was seen to be better in all caliber ammunitions. Overall, the data provided for single bullet impacts deposited in drywall show that the ellipse method is useful in providing measurements for most crime scene reconstruction purposes and has also demonstrated that results vary depending on the type of ammunition, firearm, and angle of incidence being examined.     

Postmortem Computed Tomography and Magnetic Resonance Imaging of Gunshot Wounds to the Neck

Postmortem magnetic resonance imaging (MRI) is rarely used for the radiologic assessment of gunshot injuries, although it has clear advantages over postmortem computed tomography (CT) with regard to the imaging of soft tissue injuries. Another benefit in using MRI is that lodged projectiles composed of nonferromagnetic material such as lead present only marginal metal artifacts compared with severe artifacts on CT. This case report presents CT and MRI findings in a case with two gunshot wounds to the neck: a perforating wound and a nonperforating wound with a lead bullet lodged in the cervical spine. The decedent underwent CT and MRI before the scheduled autopsy. A ring of radiopaque material under the dermis in the fatty tissue was identified at both entrance wounds on CT, which was indicative of contact shots. The perforating gunshot was clearly indicated on CT by bullet fragments along the wound channel through the perforated 6th cervical vertebra and the fractured cricoid cartilage at the exit wound. The second trajectory, however, was only assumed based on the presence of gunshot residues at the entrance wound and the position of the lodged bullet. The radiologic assessment was severely impeded by the metal artifacts on CT. Barely noticeable metal artifacts on MRI allowed for clear visualization of the soft tissue injuries and the ruptured medulla oblongata. Only MRI clarified the soft tissue injuries of the brainstem noninvasively, which could provide specific and graphic information on the rapidity of death and the incapacitation of the victim.     

Overlooking Feigning Behavior May Result in Potential Harmful Treatment Interventions: Two Case Reports of Undetected Malingering

Clinicians tend to overestimate their ability to recognize feigning behavior in psychiatric patients, especially if it concerns patients who have been admitted for observation. Feigning can be either externally motivated (e.g., for financial compensation, known as malingering) or internally motivated (e.g., to assume the “sick role,” known as factitious disorder). Persistent presentation of severe symptoms is usually associated with the factitious disorder. We present two patients with strong external incentives who consistently and convincingly feigned severe psychiatric symptoms during a protracted period of inpatient observation in a specialized center; both were engaged in a procedure for medical asylum. The first case presented with the clinical picture of a psychotic depression with severe motor symptoms, and the second case showed symptoms of a chronic post-traumatic stress disorder with secondary psychotic symptoms. Both cases were thoroughly investigated but feigning was overlooked, and unnecessary and harmful treatment interventions were given. To prevent iatrogenic damage, we recommend a critical attitude that takes malingering as an option into account in settings where patients are often involved in high stake legal procedures. A clinical sign that might indicate feigning is therapy-resistant symptoms. To rule out feigning a comprehensive, multimethod approach is required, but an active stance toward collateral information is essential. Specialized psychological tests may be useful for preliminary screening, but for their use in culturally diverse populations as in refugee mental health more research is needed.