A forensic investigation on the persistence of organic gunshot residues

Gunshot residues (GSR) are a potential form of forensic traces in firearm-related events. In most forensic laboratories, GSR analyses focus on the detection and characterisation of the inorganic components (IGSR), which are mainly particles containing mixtures of lead, barium and antimony originating from the primer. The increasing prevalence of heavy metal-free ammunition challenges the current protocols used for IGSR analysis. To provide complementary information to IGSR particles, the current study concentrated on the organic components (OGSR) arising from the combustion of the propellant. The study focused on four compounds well-known as being part of OGSR: ethylcentralite (EC), methylcentralite (MC), diphenylamine (DPA), N-nitrosodiphenylamine (N-nDPA). This study assessed the retention of these OGSR traces on a shooter’s hands. The overall project aim was to provide appropriate information regarding OGSR persistence, which can be suitable to be integrated into the interpretation framework of OGSR as recommended by the recent ENFSI Guideline for Evaluative Reporting in Forensic Science. The persistence was studied through several intervals ranging from immediately after discharge to four hours and two ammunition calibres were chosen: .40 S&W calibre, used by the NSW Police Force; and .357 Magnum, which is frequently encountered in Australian casework. This study successfully detected the compounds of interest up to four hours after discharge. The trends displayed a large decrease in the amount detected during the first hour. A large variability was also observed due to numerous factors involved in the production, deposition and collection of OGSR

Early Allograft Dysfunction Increases Hospital Associated Costs After Liver Transplantation—A Propensity Score–Matched Analysis

Concepts to ameliorate the continued mismatch between demand for liver allografts and supply include the acceptance of allografts that meet extended donor criteria (ECD). ECD grafts are generally associated with an increased rate of complications such as early allograft dysfunction (EAD). The costs of liver transplantation for the health care system with respect to specific risk factors remain unclear and are subject to change. We analyzed 317 liver transplant recipients from 2013 to 2018 for outcome after liver transplantation and hospital costs in a German transplant center. In our study period, 1-year survival after transplantation was 80.1% (95% confidence interval: 75.8%-84.6%) and median hospital stay was 33 days (interquartile rage: 24), with mean hospital costs of euro115,924 (SD euro113,347). There was a positive correlation between costs and laboratory Model for End-Stage Liver Disease score (r(s) = 0.48, P < 0.001), and the development of EAD increased hospital costs by euro26,229. ECD grafts were not associated with a higher risk of EAD in our cohort. When adjusting for recipient-associated risk factors such as laboratory Model for End-Stage Liver Disease score, recipient age, and split liver transplantation with propensity score matching, only EAD and cold ischemia increased total costs. Conclusion: Our data show that EAD leads to significantly higher hospital costs for liver transplantation, which are primarily attributed to recipient health status. Strategies to reduce the incidence of EAD are needed to control costs in liver transplantation

Chronic Urinary Outflow Obstruction Resulting from Prostatic Neurofibromatosis

Neurofibromatosis type 1 is a disorder characterized by tumors of autonomic peripheral nerve sheaths. Visceral involvement is infrequent, with genitourinary involvement being rarer. Presented here is a case of a 52-year-old male who presented with an acute renal injury secondary to renal tract obstruction. Transurethral resection of the enlarged prostate demonstrated neurofibromatosis with no signs of malignant transformation

Absence of zoonotic Bartonella species in questing ticks: First detection of Bartonella clarridgeiae and Rickettsia felis in cat fleas in the Netherlands

<p>Abstract</p> <p>Background</p> <p>Awareness for flea- and tick-borne infections has grown in recent years and the range of microorganisms associated with these ectoparasites is rising. <it>Bartonella henselae</it>, the causative agent of Cat Scratch Disease, and other <it>Bartonella </it>species have been reported in fleas and ticks. The role of <it>Ixodes ricinus </it>ticks in the natural cycle of <it>Bartonella </it>spp. and the transmission of these bacteria to humans is unclear. <it>Rickettsia </it>spp. have also been reported from as well ticks as also from fleas. However, to date no flea-borne <it>Rickettsia </it>spp. were reported from the Netherlands. Here, the presence of <it>Bartonellaceae </it>and <it>Rickettsiae </it>in ectoparasites was investigated using molecular detection and identification on part of the gltA- and 16S rRNA-genes.</p> <p>Results</p> <p>The zoonotic <it>Bartonella clarridgeiae </it>and <it>Rickettsia felis </it>were detected for the first time in Dutch cat fleas. <it>B. henselae </it>was found in cat fleas and <it>B. schoenbuchensis </it>in ticks and keds feeding on deer. Two <it>Bartonella </it>species, previously identified in rodents, were found in wild mice and their fleas. However, none of these microorganisms were found in 1719 questing <it>Ixodes ricinus </it>ticks. Notably, the gltA gene amplified from DNA lysates of approximately 10% of the questing nymph and adult ticks was similar to that of an uncultured <it>Bartonella-</it>related species found in other hard tick species. The gltA gene of this <it>Bartonella-</it>related species was also detected in questing larvae for which a 16S rRNA gene PCR also tested positive for "<it>Candidatus </it>Midichloria mitochondrii"<it/>. The gltA-gene of the <it>Bartonella-</it>related species found in <it>I. ricinus </it>may therefore be from this endosymbiont.</p> <p>Conclusions</p> <p>We conclude that the risk of acquiring Cat Scratch Disease or a related bartonellosis from questing ticks in the Netherlands is negligible. On the other hand fleas and deer keds are probable vectors for associated <it>Bartonella </it>species between animals and might also transmit <it>Bartonella </it>spp. to humans.</p

Prevalence of Steatosis Hepatis in the Eurotransplant Region: Impact on Graft Acceptance Rates

Due to the shortage of liver allografts and the rising prevalence of fatty liver disease in the general population, steatotic liver grafts are considered for transplantation.This condition is an important risk factor for the outcome after transplantation.We here analyze the characteristics of the donor pool offered to the Charité –Universitätsmedizin Berlin from 2010 to 2016 with respect to liver allograft nonacceptance and steatosis hepatis. Of the 2653 organs offered to our center, 19.9% (n=527) were accepted for transplantation, 58.8% (n=1561) were allocated to other centers, and 21.3% (n = 565) were eventually discarded from transplantation. In parallel to an increase of the incidence of steatosis hepatis in the donor pool from 20% in 2010 to 30% in 2016, the acceptance rates for steatotic organs increased in our center from 22.3% to 51.5% in 2016 (p 0.001) having less than 30% macrovesicular steatosis hepatis. However, by 2016, the number of canceled transplantations due to higher grades of steatosis hepatis had significantly increased from 14.7% (n = 15) to 63.6% (42; p < 0.001).The rising prevalence of steatosis hepatis in the donor pool has led to higher acceptance rates of steatotic allografts. Nonetheless, steatosis hepatis remains a predominant phenomenon in discarded organs necessitating future concepts such as organ reconditioning to increase graft utilization

High negative predictive value of 68Ga PSMA PET-CT for local lymph node metastases in high risk primary prostate cancer with histopathological correlation

Background: Current guidelines highlight the importance of accurate staging in the management and prognostication of high risk primary prostate cancer. Conventional radiologic imaging techniques are insufficient to reliably detect lymph node metastases in prostate cancer. Despite promising results, there is limited published data on the diagnostic accuracy of PSMA PET-CT to assess local nodal metastases prior to radical prostatectomy. This study aims to assess the diagnostic efficacy of 68Ga PSMA PET-CT in local lymph node staging of high risk primary prostate cancer when compared to histopathological findings following radical prostatectomy with pelvic lymph node dissection. Methods: We retrospectively analysed consecutive patients with high risk primary prostate cancer referred by urologists for primary staging PSMA PET-CT using a 68Ga-labeled PSMA ligand, Glu-NH-CO-NHLys-(Ahx)-[HBEDDCC], from October 2015 to October 2017. The scans of patients who underwent radical prostatectomy with pelvic lymph node dissection were interpreted by the consensus reading of two experienced nuclear medicine physicians blinded to clinical and histopathological data. The contemporaneous records of the referring urologists were retrospectively reviewed for noteworthy unexpected PET findings that altered their personal preference for surgical management. Results: Seventy-one patients were recruited and analysed. PSMA PET-CT showed findings compatible with local disease in 47 patients (66.2%), lymph node metastases in 10 patients (14.1%) and distant metastases in 14 patients (19.7%). Twenty-eight patients (twenty-seven of whom had local disease only) underwent surgery yielding 214 lymph nodes, all of which were negative on histopathological analysis. On a node-based analysis, 213 of 214 lymph nodes were accurately identified as negative for disease with a negative predictive value of 100%. 11 patients had unexpected PET findings contemporaneously documented by urologists to alter their preference for surgical management. Conclusions: PSMA PET-CT appears to have a high negative predictive value for local lymph node metastases in high risk primary prostate cancer when compared to histopathological findings following radical prostatectomy with pelvic lymph node dissection

Forward pi^0 Production and Associated Transverse Energy Flow in Deep-Inelastic Scattering at HERA

Deep-inelastic positron-proton interactions at low values of Bjorken-x down to x \approx 4.10^-5 which give rise to high transverse momentum pi^0 mesons are studied with the H1 experiment at HERA. The inclusive cross section for pi^0 mesons produced at small angles with respect to the proton remnant (the forward region) is presented as a function of the transverse momentum and energy of the pi^0 and of the four-momentum transfer Q^2 and Bjorken-x. Measurements are also presented of the transverse energy flow in events containing a forward pi^0 meson. Hadronic final state calculations based on QCD models implementing different parton evolution schemes are confronted with the data.Comment: 27 pages, 8 figures and 3 table

Measurement of Leading Proton and Neutron Production in Deep Inelastic Scattering at HERA

Deep--inelastic scattering events with a leading baryon have been detected by the H1 experiment at HERA using a forward proton spectrometer and a forward neutron calorimeter. Semi--inclusive cross sections have been measured in the kinematic region 2 <= Q^2 <= 50 GeV^2, 6.10^-5 <= x <= 6.10^-3 and baryon p_T <= MeV, for events with a final state proton with energy 580 <= E' <= 740 GeV, or a neutron with energy E' >= 160 GeV. The measurements are used to test production models and factorization hypotheses. A Regge model of leading baryon production which consists of pion, pomeron and secondary reggeon exchanges gives an acceptable description of both semi-inclusive cross sections in the region 0.7 <= E'/E_p <= 0.9, where E_p is the proton beam energy. The leading neutron data are used to estimate for the first time the structure function of the pion at small Bjorken--x.Comment: 30 pages, 9 figures, 2 tables, submitted to Eur. Phys.