SOME FORENSIC ASPECTS OF BALLISTIC IMAGING

Analysis of ballistics evidence (spent cartridge casings and bullets) has been a staple of forensic criminal investigation for almost a century. Computer-assisted databases of images of ballistics evidence have been used since the mid-1980s to help search for potential matches between pieces of evidence. In this article, we draw on the 2008 National Research Council Report Ballistic Imaging to assess the state of ballistic imaging technology. In particular, we discuss the feasibility of creating a national reference ballistic imaging database (RBID) from test-fires of all newly manufactured or imported firearms. A national RBID might aid in using crime scene ballistic evidence to generate investigative leads to a crime gun’s point of sale. We conclude that a national RBID is not feasible at this time, primarily because existing imaging methodologies have insufficient discriminatory power. We also examine the emerging technology of micro- stamping for forensic identification purposes: etching a known identifier on firearm or ammunition parts so that they can be directly read and recovered from crime scene evidence. Microstamping could provide a stronger basis for identification based on ballistic evidence than the status quo, but substantial further research is needed to thoroughly assess its practical viability

Patients as researchers - innovative experiences in UK National Health Service research

Consumer involvement is an established priority in UK health and social care service development and research. To date, little has been published describing the process of consumer involvement and assessing ‘consumers’ contributions to research. This paper provides a practical account of the effective incorporation of consumers into a research team, and outlines the extent to which they can enhance the research cycle; from project development and conduct, through data analysis and interpretation, to dissemination. Salient points are illustrated using the example of their collaboration in a research project. Of particular note were consumers’ contributions to the development of an ethically enhanced, more robust project design, and enriched data interpretation, which may not have resulted had consumers not been an integral part of the research team

The effect of an emollient containing urea, ceramide NP, and lactate on skin barrier structure and function in older people with dry skin

Xerosis affects up to 75% of older people and develops as a result of a skin barrier defect. Emollients are widely used to treat xerosis; however, there is limited understanding of the differences between them and their effects on the skin barrier in older people. This study aimed to compare the effect of a commercially available emollient containing 5% urea, ceramide NP and lactate (test emollient) to an alternative emollient without these additives (control emollient) on the properties of the skin barrier in older people. Two cohorts of 21 volunteers aged 60+ years with dry skin were recruited. The first applied the test emollient to one forearm and no treatment to the other for 28-days. The second compared the test emollient to the control emollient observing the same parameters. Effects on the skin barrier were determined by measuring skin barrier function, hydration, skin surface pH and by analyzing FTIR spectra before and after treatment. A third cohort of 6 young adults was recruited to investigate the effect of a single treatment with the test emollient on the molecular structure of the skin barrier at greater depths by employing the tape-stripping technique. The test emollient hydrated the skin to a significantly greater extent and for a longer period of time compared to the control emollient, an effect associated with a significant elevation of carboxylate groups (a marker of NMF content) within the stratum corneum. Furthermore, the test emollient imparted additional benefits to the structure and function of the skin barrier not exhibited by the control emollient. In conclusion the test emollient addressed the pathological features of xerotic aged skin, supporting its use as first-line therapy for xerotic skin conditions in this population

W-Curve Alignments for HIV-1 Genomic Comparisons

The W-curve was originally developed as a graphical visualization technique for viewing DNA and RNA sequences. Its ability to render features of DNA also makes it suitable for computational studies. Its main advantage in this area is utilizing a single-pass algorithm for comparing the sequences. Avoiding recursion during sequence alignments offers advantages for speed and in-process resources. The graphical technique also allows for multiple models of comparison to be used depending on the nucleotide patterns embedded in similar whole genomic sequences. The W-curve approach allows us to compare large numbers of samples quickly.We are currently tuning the algorithm to accommodate quirks specific to HIV-1 genomic sequences so that it can be used to aid in diagnostic and vaccine efforts. Tracking the molecular evolution of the virus has been greatly hampered by gap associated problems predominantly embedded within the envelope gene of the virus. Gaps and hypermutation of the virus slow conventional string based alignments of the whole genome. This paper describes the W-curve algorithm itself, and how we have adapted it for comparison of similar HIV-1 genomes. A treebuilding method is developed with the W-curve that utilizes a novel Cylindrical Coordinate distance method and gap analysis method. HIV-1 C2-V5 env sequence regions from a Mother/Infant cohort study are used in the comparison.The output distance matrix and neighbor results produced by the W-curve are functionally equivalent to those from Clustal for C2-V5 sequences in the mother/infant pairs infected with CRF01_AE.Significant potential exists for utilizing this method in place of conventional string based alignment of HIV-1 genomes, such as Clustal X. With W-curve heuristic alignment, it may be possible to obtain clinically useful results in a short time-short enough to affect clinical choices for acute treatment. A description of the W-curve generation process, including a comparison technique of aligning extremes of the curves to effectively phase-shift them past the HIV-1 gap problem, is presented. Besides yielding similar neighbor-joining phenogram topologies, most Mother and Infant C2-V5 sequences in the cohort pairs geometrically map closest to each other, indicating that W-curve heuristics overcame any gap problem

Hemodynamic Effects of Entry and Exit Tear Size in Aortic Dissection Evaluated with In Vitro Magnetic Resonance Imaging and Fluid-Structure Interaction Simulation

Understanding the complex interplay between morphologic and hemodynamic features in aortic dissection is critical for risk stratification and for the development of individualized therapy. This work evaluates the effects of entry and exit tear size on the hemodynamics in type B aortic dissection by comparing fluid-structure interaction (FSI) simulations with in vitro 4D-flow magnetic resonance imaging (MRI). A baseline patient-specific 3D-printed model and two variants with modified tear size (smaller entry tear, smaller exit tear) were embedded into a flow- and pressure-controlled setup to perform MRI as well as 12-point catheter-based pressure measurements. The same models defined the wall and fluid domains for FSI simulations, for which boundary conditions were matched with measured data. Results showed exceptionally well matched complex flow patterns between 4D-flow MRI and FSI simulations. Compared to the baseline model, false lumen flow volume decreased with either a smaller entry tear (-17.8 and -18.5 %, for FSI simulation and 4D-flow MRI, respectively) or smaller exit tear (-16.0 and -17.3 %). True to false lumen pressure difference (initially 11.0 and 7.9 mmHg, for FSI simulation and catheter-based pressure measurements, respectively) increased with a smaller entry tear (28.9 and 14.6 mmHg), and became negative with a smaller exit tear (-20.6 and -13.2 mmHg). This work establishes quantitative and qualitative effects of entry or exit tear size on hemodynamics in aortic dissection, with particularly notable impact observed on FL pressurization. FSI simulations demonstrate acceptable qualitative and quantitative agreement with flow imaging, supporting its deployment in clinical studies.Comment: Judith Zimmermann and Kathrin B\"aumler contributed equall

Physiotherapist prediction of extubation outcome in the adult intensive care unit

Objective Most patients requiring intubation and mechanical ventilation are extubated successfully at the first attempt; however, a minority experience extubation failure, which is associated with increased risk of ventilator‐associated pneumonia, prolonged intensive care unit (ICU) length of stay and mortality. Physiotherapists have expertise to assess cough strength, work of breathing, respiratory muscle strength, and respiratory secretion load, which are important factors in the outcome of extubation. Accurate prediction of extubation outcome could help to inform management plans pre‐extubation and postextubation. The primary objective of this service evaluation was to report the accuracy of physiotherapists' prediction of extubation outcome in the adult ICU. Methods A single‐centre case note review was undertaken. All subjects who received a physiotherapy assessment of extubation suitability prior to extubation between January and March 2016 in the adult ICU of a large teaching hospital in the United Kingdom were included. Assessment, by both specialist and nonspecialist physiotherapists—which included risk stratification of extubation failure as “high,” “moderate,” or “low”—was undertaken prior to extubation. Logistic regression analysis was performed to determine which pre‐extubation factors were predictive of extubation outcome. Results During the evaluation period, 68 subjects were extubated following a physiotherapy assessment. Physiotherapy risk stratification as “high risk” (OR 4; 95% confidence interval, CI, [1.312]; p=0.009) and “inappropriate” neurological status (OR 3.3; 95% CI [1.0410]; p=0.037) were the only pre‐extubation factors significantly associated with extubation failure. Assessment by specialist physiotherapists demonstrated greater sensitivity (100% vs. 22%) but lower specificity (68% vs. 95%) to detect extubation failure compared with the assessment performed by nonspecialist physiotherapists. Conclusion Patients classified as “high risk” of extubation failure by a physiotherapist are significantly more likely to fail extubation. Specialist physiotherapists should be involved in the decision to extubate patients in the adult ICU

Theorizing healthy settings: a critical discussion with reference to Healthy Universities

The settings approach appreciates that health determinants operate in settings of everyday life. Whilst subject to conceptual development, we argue that the approach lacks a clear and coherent theoretical framework to steer policy, practice and research. Aims: To identify what theories and conceptual models have been used in relation to the implementation and evaluation of Healthy Universities. Methods: A scoping literature review was undertaken between 2010-2013, identifying 26 papers that met inclusion criteria. Findings: Seven theoretical perspectives or conceptual frameworks were identified: the Ottawa Charter; a socio-ecological approach (which implicitly drew on sociological theories concerning structure and agency); salutogenesis; systems thinking; whole system change; organisational development; and a framework proposed by Dooris. These were used to address interrelated questions on the nature of a setting, how health is created in a setting, why the settings approach is a useful means of promoting health, and how health promotion can be introduced into and embedded within a setting. Conclusion: Although distinctive, the example of Healthy Universities drew on common theoretical perspectives that have infused the settings discourse more generally. This engagement with theory was at times well-developed and at other times a passing reference. The paper concludes by pointing to other theories that offer value to healthy settings practice and research and by arguing that theorisation has a key role to play in understanding the complexity of settings and guiding the planning, implementation and evaluation of programmes

Identification of host odour attractants for tsetse flies. Final report 1986-1990

Tsetse flies, Glossina spp., are blood-feeding insects and vectors of trypanosomes, microorganisms which cause sleeping sickness in man and a similar disease, "nagana" in domestic animals. The economic importance of trypanosomiasis is the constraint it imposes on orderly rural development in Africa, leading to under-exploitation of infested land and over-exploitation and degradation of trypanosomiasis-free areas. Traps and targets which attract tsetse flies and kill them could provide environmentally-acceptable, appropriate technology for monitoring and control of tsetse in Africa. Unbaited devices providing only visual attraction have proved effective in monitoring and control of riverine species of tsetse, but not the savannah species found in the fly belt of Malawi, Mozambique, Zambia and Zimbabwe covered by the EDF Regional Tsetse and Trypanosomiasis Control Project (RTTCP). Previously, collaborative was begun between glossinologists of the Zimbabwe Department of Veterinary Services (DVS) and UK Tsetse Research Laboratory (TRL) and chemists at NRI. This brought together the experience of the DVS in the field, the experience of TRL in laboratory bioassay work, and the experience of NRI in using gas chromatography linked to electroantennography (GC-EAG) and chemical techniques to detect and identify insect behaviour-modifying chemicals. Tsetse attractants produced by host animals were identified and synthesised, and dispensing systems for these compounds devised. Traps and targets impregnated with insecticide, baited with these lures were shown to provide effective control of the savannah tsetse species, G. pallidipes and G. m. morsitans