Comparison of the causes of death and wounding patterns in urban firearm-related violence and civilian public mass shooting events.

BACKGROUND: There are no reports comparing wounding pattern in urban and public mass shooting events (CPMS). Because CPMS receive greater media coverage, there is a connation that the nature of wounding is more grave than daily urban gun violence. We hypothesize that the mechanism of death following urban gunshot wounds (GSWs) is the same as has been reported following CPMS. METHODS: Autopsy reports of all firearm-related deaths in Washington, DC were reviewed from January 1, 2016, to December 31, 2017. Demographic data, firearm type, number and anatomic location of GSWs, and organ(s) injured were abstracted. The organ injury resulting in death was noted. The results were compared with a previously published study of 19 CPMS events involving 213 victims. RESULTS: One hundred eighty-six urban autopsy reports were reviewed. There were 171 (92%) homicides and 13 (7%) suicides. Handguns were implicated in 180 (97%) events. One hundred eight (59%) gunshots were to the chest/upper back, 85 (46%) to the head, 77 (42%) to an extremity, and 71 (38%) to the abdomen/lower back. The leading mechanisms of death in both urban firearm violence and CPMS were injury to the brain, lung parenchyma, and heart. Fatal brain injury was more common in CPMS events as compared with urban events involving a handgun. CONCLUSION: There is little difference in wounding pattern between urban and CPMS firearm events. Based on the organs injured, rapid point of wounding care and transport to a trauma center remain the best options for mitigating death following all GSW events. LEVEL OF EVIDENCE: Epidemiological, level IV.

Wounding Patterns Based on Firearm Type in Civilian Public Mass Shootings in the United States.

BACKGROUND: There are no studies correlating wounding pattern or probability of death based on firearm type used in civilian public mass shooting (CPMS) events. Previous studies on non-CPMS events found that handguns are more lethal than rifles. We hypothesized that CPMS events associated with a handgun are also more lethal than those associated with a rifle. STUDY DESIGN: A retrospective study of autopsy reports from CPMS events was performed; CPMS was defined using the FBI and the Congressional Research Service definition. Site(s) of injury, site(s) of fatal injury, and presence of potentially preventable death (PPD) were determined independently by each author and cross-referenced to firearm type used. RESULTS: Autopsy reports of 232 victims from 23 events were reviewed. Seventy-three victims (31%) were shot by handguns, 105 (45%) by rifles, 22 (9%) by shotguns, and 32 (14%) by multiple firearms. Events using a handgun were associated with a higher percentage killed, and events using a rifle were associated with more people shot, although neither difference reached statistical significance. Victims shot by handguns had the highest percentage of having more than 1 fatal wound (26%); those shot by rifle had the lowest percentage (2%) (p = 0.003). Thirty-eight victims (16%) were judged to have had a PPD. The probability of having a PPD was lowest for events involving a handgun (4%) and highest for events involving a rifle (23%) (p = 0.002). Wounding with a handgun was significantly associated with brain (p = 0.007) and cardiac injury (p = 0.03). CONCLUSIONS: Civilian public mass shooting events with a handgun are more lethal than those associated with use of a rifle.

Identifying Pigment Mixtures in Art Using SERS: A Treatment Flowchart Approach.

A novel treatment flowchart approach for surface-enhanced Raman scattering (SERS) is used to identify both blue and yellow organic pigments in a single microscopic sample from a series of reference oil paints as well as an actual 18th century oil painting. In particular, several treatment strategies using acids and solvents are integrated into a specific flowchart designed to enable the minimally invasive identification of unknown blue (i.e., indigo, Prussian blue) and yellow organic (i.e., Reseda lake, Stil de Grain, gamboge) pigments in one sample. We demonstrate the first successful identification of a yellow lake pigment in a historic painting using SERS as well as the utility of our treatment flowchart approach for identifying pigments of varying resonance conditions, surface affinities, and treatment requirements in a single microscopic sample from a historic oil painting.