Detection of concealed knowledge via the ERP-based technique Brain Fingerprinting: Real-life and real-crime incidents.

Brain Fingerprinting (BFP) is an electroencephalogram-based system used to detect knowledge, or absence of knowledge of a real-life incident (e.g., a crime) in a person's memory. With the help of BFP, a potential crime suspect can be classified as possessing crime-related information (Information-Present), not possessing crime-related information (Information-Absent), or Indeterminate (BFP unable to classify a subject). In the lab setting, we compare the ground-truth of a subject (i.e., real-life involvement in an incident) against their classification based on BFP testing. We report two studies: replication of BFP with university students (Study 1) and replication of BFP with parolees (Study 2). In Study 1, we tested 31 subjects (24 females, seven males, mean age = 21.3) on either their own or another subject's real-life incident. BFP correctly classified nine Information-Present and 18 Information-Absent subjects, but with one false positive and three exclusions. In Study 2, we tested 17 male parolees (mean age = 47.5) on their own or another parolee's crime incident. BFP correctly classified two Information-Present and six Information-Absent subjects. However, there was also one false positive classification and three Indeterminates. Additionally, we identified three subjects who could not complete the BFP testing and two exclusions. We posit that BFP is not yet at a stage to be considered a robust and accurate crime-detection tool as claimed in former articles. Nevertheless, after addressing the limitations, BFP has considerable potential as an information detection tool in forensic investigations, especially for detecting idiosyncratic crime-relevant knowledge in a perpetrator, in addition to helping to confirm the accuracy of a suspect's claim of innocence.

Stimulating and Enhancing Partnerships Between Transplant Professionals and Law Enforcement: Recommendations.

To help combat trafficking in human beings for organ removal (THBOR), transplant professionals need to do more than carry out careful, multidisciplinary screening of potential living donors; they also need to communicate and collaborate with law enforcement professionals. This will involve transplant professionals educating investigators and prosecutors about transplant practices and in turn learning about THBOR and how it is prosecuted. Cases of illegal organ transplantation need to be detected at different levels. First, the victims of the crime itself need to be identified, especially when they present themselves for screening. Physicians have a collective responsibility to prevent exploitation of people, including THBOR victims. The second level involves the more difficult matter of making reports that involve transplant tourists who have returned home after receipt of an organ and need follow-up care. Besides counseling patients prospectively about the legal as well as medical risks in receiving a vended organ in a foreign transplant center, physicians treating such patients could have an obligation to report what has happened, if the government has established a mechanism that either allows reporting THBOR that does not include the identity of the patient or that treats patients as victims provided they cooperate in investigation and prosecution of the persons responsible for obtaining or implanting the organs. The third level of cooperation involves transplant professionals who participate in THBOR. Professional societies need to undertake programs to make physicians and nurses aware that their responsibility to protect their professions' reputation includes identifying members of their professions who depart from professional ethics. Doing so allows the local professional societies and state boards to discipline such violators. All 3 of these functions would be facilitated by the creation by an international body such as World Health Organization of a registry of patients who travel internationally to receive a legitimate organ transplant.

Inefficiencies and vulnerabilities of telephone-based communication between U. S. poison control centers and emergency departments.

CONTEXT: Poison control centers (PCCs) and emergency departments (EDs) rely upon telephone communication to collaborate. PCCs and EDs each create electronic records for the same patient during the course of collaboration, but those electronic records are not shared. OBJECTIVE: The purpose of this study was to describe the current, telephone based process of PCC-ED communication as the basis for potential process improvement. MATERIALS AND METHODS: This study was conducted at one PCC and two tertiary care EDs. We developed workflow diagrams to depict clinician descriptions of the current process, descriptions obtained through interviews of key informants. We also analyzed transcripts of phone calls between emergency departments and the poison control center, corresponding to a random sample of 120 PCC cases occurring January 1-December 31, 2011. RESULTS: Collaboration between the ED and PCC takes place during multiple telephone calls, and the process is unsupported by shared documentation. The process occurs in three phases: notification, collaborative care, and ongoing consultation. In the ED, multiple care providers may communicate with the PCC, but only one ED care provider communicates with the poison control center specialist at a time. Handoffs occur for both ED and PCC. Collaborative care planning is common and most cases involve some type of request for information, whether vital signs, laboratory results, or verification that a treatment was administered. We found evidence of inefficiencies and safety vulnerabilities, including the inability of PCC specialists to reach ED care providers, telephone calls routed through multiple ED staff members in an attempt to reach the appropriate care provider, and exchange of clinical information with non-clinical staff. In 55% of cases, the patient was discharged prior to any synchronous telephone communication between the ED care provider and a PCC specialist. Ambiguous communication of information was observed in 22% of cases. In 12% of cases, a PCC specialist was unable to obtain requested information from the ED. DISCUSSION AND CONCLUSION: Inefficiencies and vulnerabilities occur in telephone-based PCC-ED communication. Prudence begs consideration of alternative processes and models of ED-PCC communication and information sharing, including a process that supports collaboration with health information exchange.