Pervasiveness of inorganic gunshot residue (IGSR) in handguns after cleaning and conditioning procedures.

Memory effect in firearms that is, the possibility for a weapon to release inorganic particles whose elemental composition depends on its entire shooting history, is responsible for most of the interpretation difficulties encountered in forensic gunshot residue analysis. The presence of residues chemically inconsistent with the last discharged round, the creation of particles having unusual elemental profiles, and the dependence of residue population composition on the collection point are all manifestations of memory effect. The experimental results reported in this paper highlight the ineffectiveness of a wide number of gun cleaning procedures in reducing memory effect. Moreover, the common alternative of discharging batches of rounds having a "new" primer mixture does not fully eliminate the possibility to recover "old" residues at least from the shooter's hands. Two brand new pistols and ammunition having lead-based, leadless and heavy metal free primers were used. Specimens, collected both from the shooters' hands and from cotton targets set nearby the gun muzzle, were analyzed by SEM-EDS and by ICP-OES. After discharging 10's of new ammunitions, the number of old residues ejected from the gun muzzle indeed showed an asymptotic decrease to zero. In spite of this, the number of old residues recovered from the shooter's hands did not follow any predictable trend. These different behaviors suggest that all internal components of a gun, and not just the barrel, play a role in memory effect.

On the questioned presence of fluorine in inorganic gunshot residue. Case work experience and experimental evidences.

According to the active ASTM E1588-20 Standard Practice for Gunshot Residue (GSR) Analysis, particles from lead-based primers classified as "characteristic of GSR" will have the chemical composition lead/antimony/barium. Further elements allowed to be incorporated into GSR are explicitly listed in the ASTM guideline. Fluorine is not considered a possible additional element as no common sources of F in shooting related activities have ever been documented. Moreover, presence of fluorine was demonstrated in GSR-similar particles produced by airbag deployments and the possibility to use F as a chemical marker to exclude any discharging of a firearm was consequently suggested. In authors' case work experience, fluorine containing particles were found on stubs collected from victims' clothes, discharged firearms and shooters' hands. Adopting a "case by case" approach, a firearm-related fluorine origin was then sought. Fluorine-based protective lubricants, used both for guns and ammunition components, were experimentally confirmed as a possible source of F in GSR.

Molybdenum in Gunshot Residue: Experimental Evidences and Detection Challenges in the Presence of Lead and Sulfur.

Inorganic gunshot residue (GSR) analysis is carried out by scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDS) in many forensic laboratories. Characteristic GSR often consists of lead­barium­antimony, commonly associated with sulfur. The strength of forensic GSR evidence increases when unusual elements are found in residues collected both from the suspect and from the discharged firearm. The presence of molybdenum in GSR, due to the use of MoS2 lubricants in firearms, is experimentally demonstrated here for the first time. The most intense molybdenum X-ray emissions are MoL peaks at 2.3 keV which overlap with PbM and SK families due to the poor resolution of EDS detectors. When Pb, S, and Mo are allegedly present in the same particle, the reliability of automatic EDS routines is at risk. Missing identifications or false detections and exclusions may then occur. Molybdenum should be considered as detected only if MoK emissions meet the peak-to-background ratio minimum requirements. A strategy to spot Mo-containing residues is described, based on the automated search of MoS2, using a new "Sulfur only" class added to the classification scheme, followed by careful manual review of all GSR particles at an acceleration voltage of 30 kV. Our proposal improves commonly adopted forensic procedures currently followed in casework.

Current concepts of perioperative monitoring in high-risk surgical patients: a review.

A substantial number of patients are at high-risk of intra- or post-operative complications or both. Most perioperative deaths are represented by patients who present insufficient physiological reserve to meet the demands of major surgery. Recognition and management of critical high-risk surgical patients require dedicated and effective teams, capable of preventing, recognize, start treatment with adequate support in time to refer patients to the satisfactory ICU level provision. The main task for health-care planners and managers is to identify and reduce this severe risk and to encourage patient's safety practices. Inadequate tissue perfusion and decreased cellular oxygenation due to hypovolemia, heart dysfunction, reduced cardiovascular reserve, and concomitant diseases are the most common causes of perioperative complications. Hemodynamic, respiratory and careful sequential monitoring have become essential aspects of the clinical practice both for surgeons and intensivists. New monitoring techniques have changed significantly over the past few years and are now able to rapidly identify shock states earlier, define the etiology, and monitor the response to different therapies. Many of these techniques are now minimally invasive or non-invasive. Advanced hemodynamic and respiratory monitoring combines invasive, non-invasive monitoring skills. Non-invasive ultrasound has emerged during the last years as an essential operative and perioperative evaluation tool, and its use is now rapidly growing. Perioperative management guided by appropriate sequential clinical evaluation combined with respiratory and hemodynamic monitoring is an established tool to help clinicians to identify those patients at higher risk in the attempt to reduce the complications rate and potentially improve patient outcomes. This review aims to provide an update of currently available standard concepts and evolving technologies of the various respiratory and hemodynamic monitoring systems for the high-risk surgical patients, highlighting their potential usefulness when integrated with careful clinical evaluation.