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Liquid chromatography–triple quadrupole mass spectrometry (LC–MS-MS) assays are frequently utilized for screening and confirmatory purposes in the forensic toxicology laboratory. While these techniques are excellent for the targeted identification and quantitation of a wide variety of drug classes, validation and determining fit-for-purpose is a significant requirement for each method. In the USA, the American National Standards Institute and Academy Standards Board first edition of Standard 036 currently serves as a primary resource in forensic toxicology method validation and mandates that laboratories evaluate critical performance characteristics to help ensure the production of forensically defensible results. Due to the variability of specimen quality frequently encountered in the discipline of postmortem toxicology, the State of Maryland Office of the Chief Medical Examiner Forensic Toxicology Laboratory routinely analyzes solid tissue specimens as part of the medicolegal death investigation process and evaluates liver as a representative solid tissue matrix during method validation. Authentic postmortem specimens (e.g. liver, kidney, skeletal muscle, and spleen) were used to investigate the effects of analyzing solid tissue homogenate versus solid tissue supernatant on bias, precision, and ionization suppression/enhancement of Δ9-THC and Δ9-THCCOOH. Bias was <20% for Δ9-THC and Δ9-THCCOOH in liver homogenate and supernatant with a single exception of the low QC concentration for Δ9-THC in liver homogenate (–29%). Within-run and between-run CV was <20% for Δ9-THC and Δ9-THCCOOH in liver homogenate and supernatant. Δ9-THC and Δ9-THC-d3 exhibited significant ion suppression in both liver homogenate and supernatant, while Δ9-THCCOOH and Δ9-THCCOOH-d3 showed both ion suppression and enhancement in these matrices. Noticeable quantitative differences were observed in authentic postmortem solid tissue homogenate and supernatant specimens despite evaluating identical tissue samplings. A brief discussion of the results is presented using a validated LC–MS-MS method for the confirmation and quantitation of Δ9-THC and Δ9-THCCOOH in postmortem casework. [ABSTRACT FROM AUTHOR]

Background: Informing policy and practice with up-to-date evidence on the social determinants of health is an ongoing challenge. One limitation of traditional approaches is the time-lag between identification of a policy or practice need and availability of results. The Right Here Right Now (RHRN) study piloted a near-real-time data-collection process to investigate whether this gap could be bridged. Methods: A website was developed to facilitate the issue of questions, data capture and presentation of findings. Respondents were recruited using two distinct methods--a clustered random probability sample, and a quota sample from street stalls. Weekly four-part questions were issued by email, Short Messaging Service (SMS or text) or post. Quantitative data were descriptively summarised, qualitative data thematically analysed, and a summary report circulated two weeks after each question was issued. The pilot spanned 26 weeks. Results: It proved possible to recruit and retain a panel of respondents providing quantitative and qualitative data on a range of issues. The samples were subject to similar recruitment and response biases as more traditional data-collection approaches. Participants valued the potential to influence change, and stakeholders were enthusiastic about the findings generated, despite reservations about the lack of sample representativeness. Stakeholders acknowledged that decision-making processes are not flexible enough to respond to weekly evidence. Conclusion: RHRN produced a process for collecting near-real-time data for policy-relevant topics, although obtaining and maintaining representative samples was problematic. Adaptations were identified to inform a more sustainable model of near-real-time data collection and dissemination in the future.

Few studies have been done on the incidences of train-related pedestrian fatalities throughout the United States, with no previous studies reported in the State of Maryland. A retrospective study was conducted at the statewide medical examiner's office in Maryland to evaluate the characteristics of train-related pedestrian fatalities from 2014 to 2018. The aim of the study was to analyze circumstances of deaths through the medicolegal death investigation and postmortem examination findings, including toxicological study, to help identify epidemiological characteristics of pedestrian-train-related fatalities. A total of 48 pedestrian-train deaths were identified. Of the 48 cases identified, 21 deaths (43.75%) were determined to be accident, 20 deaths (41.67%) were suicide, and 7 deaths (14.58%) whose manner of death could not be determined. Of the 21 accidental victims, 17 were male and 4 were female (M:F ratio = 4.3:1), 11 (52.38%) were white, 6 (28.57%) African American, and 4 Hispanic (19.05%), with age ranging from 16 to 58 years (mean age = 35). Of the 20 suicide victims, 17 were males and 3 females (M:F ratio = 5.7:1), 16 (80%) were white, 2 (10%) African American, and 2 (10%) Hispanic, with age ranging from 22 to 60 years (mean age = 40). The majority of accidents occurred during weekday evening rush hours between 4:00 pm and 7:00 pm, while the suicides showed no specific time frames. No specific peak for seasons of year was found in suicides or accidents. Postmortem toxicological studies showed that 52.38% (11/21 cases) of accidental victims were positive for alcohol and 30% (6/20 cases) of suicide victims were positive for alcohol. Manner of death could not be determined in 7 cases because of unclear circumstances of death. Thorough death scene investigation and complete postmortem examination, including comprehensive toxicological testing, is very important in all train-related pedestrian fatalities. Determining the manner of death can directly affect the outcome of civil ligation and dispersal of insurance benefits. The characteristic profiles of train-related pedestrian fatalities can also assist effective preventive measures on railway suicides and accidents. [ABSTRACT FROM AUTHOR]

The article focuses on the juvenile justice system in the U.S. and explore the state of immigration law as it interacts with juvenile adjudications and the ways in which such adjudications can implicate immigration consequences. It mentions that treatment of expunged records and rehabilitative statutes generally in the immigration context and expungement of records pursuant to juvenile rehabilitative statutes.

The article presents a study which measures levetiracetam, topiramate, and hydroxycarbazepine in postmortem cases. The study uses acid or neutral drug screening process to quantify the drugs. Results show that the liver and kidney concentrations of the three drugs are on similar order of magnitude as the blood concentrations, however only the levetiracetam concentration in a single case showed a kidney or liver concentration greater than five times the blood concentration.

The article presents a study on the distribution of phencyclidine (PCP) into vitreous humor. It mentions that heart blood, subclavian blood and vitreous humor specimens from 26 PCP-positive postmortem cases were analyzed to evaluate the distribution of PCP in vitreous humor. It mentions that the specimens were analyzed by solid-phase extraction followed by gas chromatography-mass spectrometry. It declares that the results reveals that all positive blood specimens were associated with positive vitreous humor specimen, and on average, the blood PCP concentrations were greater than the vitreous humor PCP concentrations. It concludes that there were considerable variability between cases, which shows that the detection of PCP in postmortem cases' interpretative value is limited.

The article provides information on the case of a 47-year-old man whose death was caused by an abuse on sevoflurane. The presence of sevoflurane was confirmed using a headspace gas chromatography-mass spectrometry. The concentration of the heart blood sevoflurane was 16 mg/L, and the concentration of the peripheral blood sevoflurane was 8.0 mg/L. When the heart blood was examined, no other drugs or other volatile substances were confirmed. Moreover, cardiac arrhythmia due to sevoflurane toxicity was the cause of his death as ruled out by the examiner.

The article focuses on the distribution of ether in two postmortem cases. Headspace gas chromatography-mass spectrometry in the selective ion monitoring mode was used to determine ether concentrations in the two cases. In the first case, the medical examiner ruled that the cause of death was asphyxia due to hanging. In case 2, the cause of death was asphyxia and the manner of death was suicide.

Liquid chromatography-triple quadrupole mass spectrometry (LC-MS-MS) assays are frequently utilized for screening and confirmatory purposes in the forensic toxicology laboratory. While these techniques are excellent for the targeted identification and quantitation of a wide variety of drug classes, validation and determining fit-for-purpose is a significant requirement for each method. In the USA, the American National Standards Institute and Academy Standards Board first edition of Standard 036 currently serves as a primary resource in forensic toxicology method validation and mandates that laboratories evaluate critical performance characteristics to help ensure the production of forensically defensible results. Due to the variability of specimen quality frequently encountered in the discipline of postmortem toxicology, the State of Maryland Office of the Chief Medical Examiner Forensic Toxicology Laboratory routinely analyzes solid tissue specimens as part of the medicolegal death investigation process and evaluates liver as a representative solid tissue matrix during method validation. Authentic postmortem specimens (e.g. liver, kidney, skeletal muscle, and spleen) were used to investigate the effects of analyzing solid tissue homogenate versus solid tissue supernatant on bias, precision, and ionization suppression/enhancement of Δ9-THC and Δ9-THCCOOH. Bias was <20% for Δ9-THC and Δ9-THCCOOH in liver homogenate and supernatant with a single exception of the low QC concentration for Δ9-THC in liver homogenate (-29%). Within-run and between-run CV was <20% for Δ9-THC and Δ9-THCCOOH in liver homogenate and supernatant. Δ9-THC and Δ9-THC-d3 exhibited significant ion suppression in both liver homogenate and supernatant, while Δ9-THCCOOH and Δ9-THCCOOH-d3 showed both ion suppression and enhancement in these matrices. Noticeable quantitative differences were observed in authentic postmortem solid tissue homogenate and supernatant specimens despite evaluating identical tissue samplings. A brief discussion of the results is presented using a validated LC-MS-MS method for the confirmation and quantitation of Δ9-THC and Δ9-THCCOOH in postmortem casework., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Cathinone derivatives (bath salts) have emerged as the latest drugs of abuse. 3,4-methylenedioxypyrovalerone (MDPV) is the primary active ingredient in bath salts used in this country. This article presents the second reported cause of death by MDPV intoxication alone. In April 2011, a delusional man was emergently brought to a hospital, where he self-reported bath salt usage. He became agitated, developed ventricular tachycardia, hyperthermia, and died. Comprehensive alcohol and drug testing was performed. Using the alkaline drug screen, heart blood contained 0.7 mg/L MDPV and peripheral blood contained 1.0 mg/L MDPV. His bizarre behavior with life-threatening hyperthermia was consistent with an MDPV-induced excited delirium state. MDPV is not yet found by routine immunoassay toxicology screens. Testing for MDPV should be considered in cases with a history of polysubstance abuse with stimulant type drugs, report of acute onset of psychogenic symptoms, excited delirium syndrome, or presentation in a hyperthermic state., (© 2013 American Academy of Forensic Sciences.)