Automated DNA extraction using the QIAsymphony platform: Estimation of DNA recovery from simulated forensic stains

The aim of this study was to evaluate the forensic protocol recently developed by Qiagen for the QIAsymphony automated DNA extraction platform. Samples containing low amounts of DNA were specifically considered, since they represent the majority of samples processed in our laboratory. The analysis of simulated blood and saliva traces showed that the highest DNA yields were obtained with the maximal elution volume available for the forensic protocol, that is 200 ml. Resulting DNA extracts were too diluted for successful DNA profiling and required a concentration. This additional step is time consuming and potentially increases inversion and contamination risks. The 200 ml DNA extracts were concentrated to 25 ml, and the DNA recovery estimated with real-time PCR as well as with the percentage of SGM Plus alleles detected. Results using our manual protocol, based on the QIAamp DNA mini kit, and the automated protocol were comparable. Further tests will be conducted to determine more precisely DNA recovery, contamination risk and PCR inhibitors removal, once a definitive procedure, allowing the concentration of DNA extracts from low yield samples, will be available for the QIAsymphony.

New perspectives in the use of ink evidence in forensic science: Part III: Operational applications and evaluation

The research reported in this series of article aimed at (1) automating the search of questioned ink specimens in ink reference collections and (2) at evaluating the strength of ink evidence in a transparent and balanced manner. These aims require that ink samples are analysed in an accurate and reproducible way and that they are compared in an objective and automated way. This latter requirement is due to the large number of comparisons that are necessary in both scenarios. A research programme was designed to (a) develop a standard methodology for analysing ink samples in a reproducible way, (b) comparing automatically and objectively ink samples and (c) evaluate the proposed methodology in forensic contexts. This report focuses on the last of the three stages of the research programme. The calibration and acquisition process and the mathematical comparison algorithms were described in previous papers [C. Neumann, P. Margot, New perspectives in the use of ink evidence in forensic science-Part I: Development of a quality assurance process for forensic ink analysis by HPTLC, Forensic Sci. Int. 185 (2009) 29-37; C. Neumann, P. Margot, New perspectives in the use of ink evidence in forensic science- Part II: Development and testing of mathematical algorithms for the automatic comparison of ink samples analysed by HPTLC, Forensic Sci. Int. 185 (2009) 38-50]. In this paper, the benefits and challenges of the proposed concepts are tested in two forensic contexts: (1) ink identification and (2) ink evidential value assessment. The results show that different algorithms are better suited for different tasks. This research shows that it is possible to build digital ink libraries using the most commonly used ink analytical technique, i.e. high-performance thin layer chromatography, despite its reputation of lacking reproducibility. More importantly, it is possible to assign evidential value to ink evidence in a transparent way using a probabilistic model. It is therefore possible to move away from the traditional subjective approach, which is entirely based on experts' opinion, and which is usually not very informative. While there is room for the improvement, this report demonstrates the significant gains obtained over the traditional subjective approach for the search of ink specimens in ink databases, and the interpretation of their evidential value.

Invasive candidiasis: comparison of management choices by infectious disease and critical care specialists.

OBJECTIVE: To compare the management of invasive candidiasis between infectious disease and critical care specialists. DESIGN AND SETTING: Clinical case scenarios of invasive candidiasis were presented during interactive sessions at national specialty meetings. Participants responded to questions using an anonymous electronic voting system. PATIENTS AND PARTICIPANTS: Sixty-five infectious disease and 51 critical care physicians in Switzerland. RESULTS: Critical care specialists were more likely to ask advice from a colleague with expertise in the field of fungal infections to treat Candida glabrata (19.5% vs. 3.5%) and C. krusei (36.4% vs. 3.3%) candidemia. Most participants reported that they would change or remove a central venous catheter in the presence of candidemia, but 77.1% of critical care specialists would start concomitant antifungal treatment, compared to only 50% of infectious disease specialists. Similarly, more critical care specialists would start antifungal prophylaxis when Candida spp. are isolated from the peritoneal fluid at time of surgery for peritonitis resulting from bowel perforation (22.2% vs. 7.2%). The two groups equally considered Candida spp. as pathogens in tertiary peritonitis, but critical care specialists would more frequently use amphotericin B than fluconazole, caspofungin, or voriconazole. In mechanically ventilated patients the isolation of 10(4) Candida spp. from a bronchoalveolar lavage was considered a colonizing organism by 94.9% of infectious disease, compared to 46.8% of critical care specialists, with a marked difference in the use of antifungal agents (5.1% vs. 51%). CONCLUSIONS: These data highlight differences between management approaches for candidiasis in two groups of specialists, particularly in the reported use of antifungals.

Psychothérapie et psychiatrie forensique [Psychotherapy and forensic psychiatry].

Psychotherapists in the forensic field are in an uncomfortable position. The reluctance of patients to be subjected to such obligatory treatments and to face their own violence contributes to this difficult position. The mission of public safety assigned to these treatments, their assessment through risk of recidivism rather than therapeutic effectiveness as well as misconception by lawyers and authorities of what psychotherapy really is reinforce the difficulty of such a practice. However, a clarification of the nature of each type of interventions allows the establishment of viable psychotherapeutic framework adapted to penal constraints. The developments of approaches specifically tailored to prison settings as well as to sexual offenders are illustrations of this point.

Forensic science and the paradigm of quality

Due to various contexts and processes, forensic science communities may have different approaches, largely influenced by their criminal justice systems. However, forensic science practices share some common characteristics. One is the assurance of a high (scientific) quality within processes and practices. For most crime laboratory directors and forensic science associations, this issue is conditioned by the triangle of quality, which represents the current paradigm of quality assurance in the field. It consists of the implementation of standardization, certification, accreditation, and an evaluation process. It constitutes a clear and sound way to exchange data between laboratories and enables databasing due to standardized methods ensuring reliable and valid results; but it is also a means of defining minimum requirements for practitioners' skills for specific forensic science activities. The control of each of these aspects offers non-forensic science partners the assurance that the entire process has been mastered and is trustworthy. Most of the standards focus on the analysis stage and do not consider pre- and post-laboratory stages, namely, the work achieved at the investigation scene and the evaluation and interpretation of the results, intended for intelligence beneficiaries or for court. Such localized consideration prevents forensic practitioners from identifying where the problems really lie with regard to criminal justice systems. According to a performance-management approach, scientific quality should not be restricted to standardized procedures and controls in forensic science practice. Ensuring high quality also strongly depends on the way a forensic science culture is assimilated (into specific education training and workplaces) and in the way practitioners understand forensic science as a whole.

Postmortem dynamic CT-angiography : P30

Purpose: Forensic imaging and especially forensic radiology is a new trend in forensic medicine. More and more forensic institutes set up their own CT-scanner in order to perform postmortem cross-sectional imaging. Due to this trend, a new subspecialty was born: the forensic radiology. To image the vascular system after death, a postmortem CT- angiography can be performed. Methods and materials: In the Institute of Forensic Medicine in Lausanne, a science group has been created with specialists of different medical fields that has set up a new technique of forensic CT-angiography. The method consists in the creation of a postmortem circulation by the use of a modified heart lung machine. As circulating liquid Angiofil, an oily contrast agent, is injected. Results: With the aid of this technique, the whole vascular system of a deceased person can be imaged in detail without autopsy. The circulating contrast allows demonstrating the vascular system when it is under pressure, similarly to living patients. First experiences showed, that vascular pathologies such as cardiac tamponade and aortic dissection can be well demonstrated. Since the oily Angiofil strictly remains in the intravascular space, no artifacts had been observed during the CT-examination and the later performed autopsy. Conclusion: Post-mortem dynamic CT angiography is of great advantage in forensic pathology, because the detailed mapping of the entire vascular system is almost impossible with conventional autopsy tools.

Extraction and concentration of vapors from fire debris for forensic purposes: evaluation of the use of Radiello Passive Air Sampler

The Radiello Passive Air Sampler is one of the latest innovations developed for the sampling of pollutants in the air by passive headspace. It has been reported that its properties allow an enhanced sensitivity, reproducibility and adsorption capacity. It therefore appears to be of interest in the extraction of potential residues of ignitable liquids present in fire debris when arson is suspected. A theoretical approach and several laboratory tests have made it possible to precisely characterize in a forensic perspective the potential of the device in extracting and concentrating the vapors of ignitable liquids found in fire debris. Despite some advantages, the Radiello device appears to be less efficient than traditional axial symmetry samplers.

Le syndrome métabolique: des spécialistes au médecin de premier recours [Metabolic syndrome: from specialists to the first aid physician]

Numerous algorithms originating from evidence-based medicine already exist; in spite of this, metabolic syndrome management remains problematical and needs to be improved. Specialists, working interactively and referring to clinical scenarios, pooled their specific areas of expertise in a transverse perspective of the metabolic syndrome management by the primary care physician. This concerted multidisciplinary approach has clearly revealed that a bio-psycho-social approach is absolutely essential in the management of this type of patients.

New perspectives in the use of ink evidence in forensic science : part III : operational applications and evaluation

The research reported in this series of article aimed at (1) automating the search of questioned ink specimens in ink reference collections and (2) at evaluating the strength of ink evidence in a transparent and balanced manner. These aims require that ink samples are analysed in an accurate and reproducible way and that they are compared in an objective and automated way. This latter requirement is due to the large number of comparisons that are necessary in both scenarios. A research programme was designed to (a) develop a standard methodology for analysing ink samples in a reproducible way, (b) comparing automatically and objectively ink samples and (c) evaluate the proposed methodology in forensic contexts. This report focuses on the last of the three stages of the research programme. The calibration and acquisition process and the mathematical comparison algorithms were described in previous papers [C. Neumann, P. Margot, New perspectives in the use of ink evidence in forensic science-Part I: Development of a quality assurance process for forensic ink analysis by HPTLC, Forensic Sci. Int. 185 (2009) 29-37; C. Neumann, P. Margot, New perspectives in the use of ink evidence in forensic science-Part II: Development and testing of mathematical algorithms for the automatic comparison of ink samples analysed by HPTLC, Forensic Sci. Int. 185 (2009) 38-50]. In this paper, the benefits and challenges of the proposed concepts are tested in two forensic contexts: (1) ink identification and (2) ink evidential value assessment. The results show that different algorithms are better suited for different tasks. This research shows that it is possible to build digital ink libraries using the most commonly used ink analytical technique, i.e. high-performance thin layer chromatography, despite its reputation of lacking reproducibility. More importantly, it is possible to assign evidential value to ink evidence in a transparent way using a probabilistic model. It is therefore possible to move away from the traditional subjective approach, which is entirely based on experts' opinion, and which is usually not very informative. While there is room for the improvement, this report demonstrates the significant gains obtained over the traditional subjective approach for the search of ink specimens in ink databases, and the interpretation of their evidential value.

Supporting interdisciplinary case studies: development and implementation of a joint learning environment for students in forensic science and criminal law

Scientific reporting and communication is a challenging topic for which traditional study programs do not offer structured learning activities on a regular basis. This paper reports on the development and implementation of a web application and associated learning activities that intend to raise the awareness of reporting and communication issues among students in forensic science and law. The project covers interdisciplinary case studies based on a library of written reports about forensic examinations. Special features of the web framework, in particular a report annotation tool, support the design of various individual and group learning activities that focus on the development of knowledge and competence in dealing with reporting and communication challenges in the students' future areas of professional activity.

Limites des procédés d'investigation de la fonction érectile dans le cadre d'expertises médicolégales [Limits of the processes of investigation of the erectile function in forensic expertises].

Résumé La responsabilité d'un expert chargé d'apprécier la capacité érectile d'un prévenu est importante, car la peine infligée par le tribunal peut dépendre de ses conclusions. Sa tâche est en plus ardue car les procédés d'investigations de la fonction érectile ont tous des limites. Malgré toutes ces limites qui sont décrites dans cet article, l'expert peut aider à la recherche de la vérité comme les auteurs le démontrent. Summary The responsability of the expert in charge to appreciate the erectile capacity of an accused is considerable, as the sentence inflicted by the Tribunal could depend directly on his conclusions. His duty is harder as all the investigation procedures of the erectile functions have limits. Despite these limits, described in this article, the expert can help to discover the truth, as demonstrated by the authors.

The emergence of forensic nursing and advanced nursing practice in Switzerland: an innovative case study consultation.

BACKGROUND AND METHODS: The objectives of this article were to systematically describe and examine the novel roles and responsibilities assumed by nurses in a forensic consultation for victims of violence at a University Hospital in French-speaking Switzerland. Utilizing a case study methodology, information was collected from two main sources: (a) discussion groups with nurses and forensic pathologists and (b) a review of procedures and protocols. Following a critical content analysis, the roles and responsibilities of the forensic nurses were described and compared with the seven core competencies of advanced nursing practice as outlined by Hamric, Spross, and Hanson (2009). RESULTS: Advanced nursing practice competencies noted in the analysis included "direct clinical practice," "coaching and guidance," and "collaboration." The role of the nurse in terms of "consultation," "leadership," "ethics," and "research" was less evident in the analysis. DISCUSSION AND CONCLUSION: New forms of nursing are indeed practiced in the forensic clinical setting, and our findings suggest that nursing practice in this domain is following the footprints of an advanced nursing practice model. Further reflections are required to determine whether the role of the forensic nurse in Switzerland should be developed as a clinical nurse specialist or that of a nurse practitioner.