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Bicycles are employed as means of transportation across various age groups, from young students to the elderly, for work, education, health, and leisure trips. Despite not achieving high speeds, bicyclists remain vulnerable to severe and even fatal injuries when they are involved in traffic accidents. Although the rising awareness of ecological issues and traffic law enforcement mean that cyclists are increasingly susceptible to road traffic crashes and injuries. Injuries resulting from a traffic accident involving cyclists can show distinct and specific characteristics depending on the manner of occurrence. The aim of this study is to provide a systematic review of the literature on injuries sustained in cyclists involved in road accidents describing and analysing elements useful for forensic assessment. The literature search was performed using PubMed, Scopus, and Web of Science from January 1970 to March 2023. Eligible studies have investigated issues of interest to forensic medicine about traffic accidents involving bicycles. A total of 128 studies satisfied the inclusion criteria and were categorized and analyzed according to the anatomical regions of the body affected (head, neck, thoraco-abdominal, and limb injuries), and the assessment of lesions in reconstruction of the bicycle accident was examined and discussed. This review highlights that injuries resulting from a traffic accident involving cyclists can show distinct and specific characteristics depending on the manner of occurrence and the energy levels involved in the crash. The assessment of injuries offers valuable insights that integrated with circumstantial and engineering data perform the reconstruction of accident dynamics. • Bicycle riders are susceptible to high and low-energy impacts, each associated with distinct fatal injury patterns. • The unique injury patterns found in bike riders can relate to helmet usage or not and to bike structural components. • Features of the injuries help in reconstructing the accident dynamics, combined with circumstantial and engineering data. [ABSTRACT FROM AUTHOR]

Hanging is one of the most common suicide methods worldwide. Neck injuries that occur upon such neck compression – fractures of the thyrohyoid complex and cervical spine, occupy forensic pathologists for a long time. However, research failed to identify particular patterns of these injuries corresponding to the force distribution a ligature applies to the neck: the issue of reconstructing the knot in a noose position persists. So far, machine learning (ML) models were not utilized to classify knot positions and reconstruct this event. We conducted a single-institutional, retrospective study on 1235 autopsy cases of suicidal hanging, developed several ML models, and assessed their classification performance in a stepwise manner to discriminate between: 1. typical ('posterior) and atypical ('anterior' and 'lateral') hangings, 2. anterior and lateral hangings, and 3. left and right lateral hangings. The variable coding was based on the presence/absence of fractures of greater hyoid bone horns (GHH), superior thyroid cartilage horns (STH), and cervical spine. Subject age was considered. The models' parameters were optimized by the Genetic Algorithm. The accuracy of ML models in the first step was very modest (c. 60%) but increased subsequently: Multilayer Perceptron – Artificial Neural Network and k-Nearest Neighbors performed excellently discriminating between left and right lateral hangings (accuracy 91.8% and 90.6%, respectively). The latter is of great importance for clarifying probable hanging fracture biomechanics. Alongside the conventional inferential statistical analysis we performed, our results further indicate the association of the knot position with ipsilateral GHH and contralateral STH fractures in lateral hangings. Moreover, odds for unilateral GHH fracture, simultaneous GHH and STH fractures, and cervical spine fracture were significantly higher in atypical ('anterior' and 'lateral') hangings, compared to typical ('posterior') hangings. [Display omitted] • Thyrohyoid and cervical spine fractures are characteristic of hangings. • The pattern of these fractures may indicate the knot in the noose position. • So far, conventional statistical analysis has not revealed these patterns. • So far, machine learning has not been utilized to reconstruct the knot position. • Machine learning models excellently discriminated left from right knot position. [ABSTRACT FROM AUTHOR]

The recognition of abuse and/or neglect still represents a challenge for both clinicians and forensic pathologists. Whereas abusive behaviors have been largely described among pediatric and elderly populations, adults' abuse and neglect is less frequently encountered, and therefore investigated. We report a case of a middle-aged woman without any known organic or psychiatric disorders who died of a multiple organ failure (MOF) due to extreme cachexia and bed-resting syndrome. The integration of all clinical, autopsy and histopathological data highlighted a picture of severe malnutrition, restraint, and widespread traumatic injuries related to abuse and neglect. We believe that the case here presented could be useful for both clinicians and forensic pathologists as it underlines once again the importance of collecting and integrating all medical evidence (both in the ante- and post-mortem settings) for reconstructing the most probable pathophysiology of disorders and injuries, comparing that reconstruction with the allegations of the caregivers, and thus identifying any potential abuse and/or neglect behaviors. • Abuse and neglect may occur even in middle-aged people without disabilities and psychiatric disease. • Special attention is needed to clinical findings incosistent with medical history or in contrast to anamnestic data. • Severe malnutrition, restraint and multiple traumatic lesions are possible forms of presentation of abuse and neglect. • Forensic pathologist expertise is crucial to define the means of production of injuries and reveal discrepancies with allegations. [ABSTRACT FROM AUTHOR]

Objective assessment of cardiac hypertrophy in forensic pathology practice is of great significance for forensic pathologists, for whom reference values for normal heart weights are needed. Developed regions such as Europe, the United States, and Japan recalculate the weight of human organs at regular intervals, but in China, there has been no systematic calculation of the weights of human organs since 2006. To statistically analyse the heart weight of Chinese adults postmortem and obtain a reference range. 4170 adult autopsy reports were collected from 12 forensic departments in 10 provinces in China. The causes of death were classified by sex, and heart weight and the heart weight/body height ratio reference values were further calculated according to different body mass index and body heights. Finally, the cutoff value of cardiac hypertrophy in Chinese adults was calculated. In the group of non-cardiovascular disease causes of death, the cardiac weight of the electric death group was higher, while the heart weight of the prolonged bed-rest group was significantly reduced. After the electric death and prolonged bed-rest groups were excluded, heart weight, the heart weight/body height ratio, and cutoff values for cardiac hypertrophy were further classified and analysed according to body mass index. The mean reference values for heart weight in men and women with normal weight status were 325.82 ± 41.60 g and 286.39 ± 44.84 g, and the heart weight/body height ratios were 1.95 ± 0.23 in men and 1.82 ± 0.27, respectively. The cutoff values for cardiac hypertrophy were 387.35 g for men and 346.80 g for women. The heart weight reference values of both sexes in this study were significantly higher than those in 2006, which is considered related to the development of China's economy and the improvement of people's living standards. This study also suggests the need for a new round of statistical surveys and updated data on the weight of other organs. • This study proposes updated references values for normal heart weight in China. • Gender, age, and BMI should be taken into account to measure heart hypertrophied. • Normal heart weight does not exclude cardiac pathology as the cause of death. • Heart weight does not necessarily increase in cases of sudden unexplained death. [ABSTRACT FROM AUTHOR]

Forensic pathologists are frequently confronted with questions about whether an injury is likely to have been inflicted by an assault or be self-inflicted. However, little is known of the epidemiological variables that might be applicable to differentiate between homicides and suicides in deaths caused by single stab injuries to the trunk. Using the Swedish forensic autopsy register, we identified 94 homicides and 45 suicides between 2010 and 2021 in which death followed a single stab injury to the trunk. We extracted characteristics from the cases and performed statistical analyses using the Mann-Whitney U test, Chi-square test and logistic regression model. Victims of homicides were younger than suicide victims (median age 33 years vs. 52 years, p < 0.05), and males were in the majority in both groups (93% vs. 82%). In numerous homicide victims, stab wounds were placed in the back and in axillar regions, unlike in suicides victims in which the stabs were all placed on the medial part of the anterior trunk. Vertical entrance wounds in the skin combined with a medially running injury channel (n = 13) showed a positive predictive value of 100% (95% CI 75.3–100) for homicide, although the sensitivity was low. Homicides were conclusively associated with an outdoor death scene (OR 19.0, 95% CI 7.6–47.1), injury to thoracic bone/cartilage (OR 3.8, 95% CI 1.6–9.0), influence of alcohol (OR 7.1, 95% Cl 2.9–17.7) and illicit drugs (OR 4.3, 95% CI 1.5–11.9). The observed forensic characteristics of stab injuries could be used as a tool when assessing the manner of death in single stabs. Further research on variables associated with manner of death are needed and we suggest also including characteristics of surviving victims in such analyses. • Homicide victims were predominately young males and often found outdoors. • All suicidal stabs were located on the medial part of the anterior trunk. • Homicidal stabs were scattered on all sides of the trunk. • Alcohol and illicit narcotics were more often proved in homicides. [ABSTRACT FROM AUTHOR]

To investigate the epidemiological characteristics, clinic-pathological findings and recent use of substances of abuse and prescribed drugs in sexual activity-related sudden death (SArSD). Multicenter population-based study on forensic autopsies conducted in 27 provinces of Spain over 12 years (2010–2021). Out of 18046 autopsied natural deaths, 64 cases (0.35 %) of SArSD were investigated (87 % males). Women were younger than males (50.5 ± 13.4 years vs 37.2 ± 14.2; p = 0.017). Sudden cardiac deaths (SCD) accounted for 87 % of cases. Ischemic heart disease was the predominant pathology (58 %), mainly affecting men ≥ 36 years of age. Cerebral haemorrhage (8 %) and asthma (5 %) were the leading non-cardiac causes. In young adults, SADS (36 %) and asthma (27 %) were the main causes The disease responsible of SCD was diagnosed in life in 7 subjects. In 64 % there were cardiovascular risk factors, mainly obesity. Toxicological analysis detected illicit drugs (23 %), mainly cocaine, medications for erectile dysfunction (9 %), and ethanol ≥ 0.5 g/L (8 %). Deaths occurred usually in the context of heterosexual intercourse and during or immediately after sexual activity. The most common location was at home (63 %). In 12 men the sexual partner was a sex worker. SArSD has a low incidence in the general population affecting middle-aged males during intercourse with a heterosexual partner. It is of cardiovascular origin, mainly due to ischemic heart disease that frequently remained silent during life. There is a frequent association with obesity, use of cocaine (and, to a lesser extent, medications for erectile dysfunction) and performing unconventional sexual practices. Forensic investigation is useful for developing prevention strategies. [Display omitted] • Multicenter design, covering a population of 20 million inhabitants over 12 years. • Low incidence affecting mainly middle-aged males during heterosexual intercourse. • Cardiac origin, mainly due to ischemic heart disease that remained silent in life. • Frequent association with use of cocaine and medications for erectile dysfunction. • Relative high of frequency of obesity and performing unusual sexual practices. [ABSTRACT FROM AUTHOR]

Dog bites pose a significant global public health issue and are the most common type of injury caused by animals. While most dog bites result in minor harm, they can also lead to severe or even fatal consequences. In cases involving serious injury or death, forensic pathologists investigate various aspects, including the crime scene, the injuries sustained by the victim, and the characteristics of the dog suspected to have caused the bite. The aim of this study is to provide a systematic review of the literature on the medical-legal implications of dog bites in forensic practice, in order to recognize the dog bite victim features, the injuries and their consequences related to, and to identify the offending dogs. The literature search was performed using PubMed, Scopus and Web of Science from January 1980 to March 2023. Eligible studies have investigated issues of interest to forensic medicine about dog bites to humans. A total of 116 studies met the inclusion criteria and were included in the review and they were organized and discussed by issue of interest (biting dog features, dog bite victim features, anatomical distribution of dog bites, injuries related to dog bites, cause of death, bite features, dog identification and post-mortem dog depredation). The findings of this systematic review highlight the importance of bite mark analysis in reconstructing the events leading to the attack and identifying the dog responsible. In medical forensic evaluations of dog bite cases, a multidisciplinary approach is crucial. This approach involves thorough analysis of the crime scene, identification of risk factors, examination of dog characteristics, and assessment of the victim's injuries. By combining expertise from both human and veterinary forensic fields, a comprehensive understanding can be achieved in dog bite cases. • Bite mark analysis plays a crucial role in reconstructing the events preceding an attack. • Forensic odontology and genetic analyses are essential tools for identifying the dogs responsible for the attack. • A human and veterinary forensics multidisciplinary approach is necessary to evaluate dog bites effectively. [ABSTRACT FROM AUTHOR]

Forensic pathology and forensic anthropology are inherently related fields. The observations made during the autopsy and the conclusions from the anthropological analysis highlight the complementarities between the two approaches. In this review, gunshot wounds, sharp force injuries, chop wounds, blunt trauma, burned bodies, mechanical asphyxia and dismemberment will be analyzed from both perspectives. The result of this systematic review is that the conclusions stemming from the presence or absence of bone injuries must be very cautious because the observation of severe bone lesions does not always mean that this trauma was the cause of death; conversely, traumatic death, and even homicide, can be associated with a complete absence of bone lesions. [ABSTRACT FROM AUTHOR]

Blunt force trauma is the most common injury found during autopsies. Among the cases involving blunt force injuries, fractures to the skull are the most frequent, and these are often fatal to the victim. Understanding the circumstances surrounding the creation of such injuries is essential for investigating trauma-related deaths. This paper explores the characteristics of cranial trauma produced following one to three consecutive blows with a series of blunt objects. Fourteen Synbone® spheres filled with porcine gelatine and coated with rubber skin were used to simulate the human skull in a series of experiments. Trials recreated two scenarios, individuals standing and individuals with their head resting against a hard surface. Six blunt objects were used to represent possible weapons. Each sphere was struck twice to generate fracture patterns, which were then analysed. In most simulations of a blow to the head resting against a hard surface, the first fracture follows a linear pattern regardless of the direction of force and/or the surface of the weapon; while the second blow results in a depressed fracture. In the case of a free moving head, weapons with large contact surfaces result in depressed fractures, while weapons with small contact surfaces may not cause a fracture at all. Our results are consistent with Moritz who stated that, if the head is free to move, the fractures will be linear or incompletely depressed. Inversely, if the head rests against a solid surface, a blow will result in a depressed fracture. More experiments are needed to verify these preliminary observations. [ABSTRACT FROM AUTHOR]

Asphyxia-related deaths have always been a challenging task in the speciality of forensic pathology. Apart from helpful macroscopical signs (e.g., strangulation mark, cyanosis, petechial haemorrhage, and lung oedema), recent literature indicates that prolonged asphyxia is sufficient to induce an increase in mast cells (MC). Inflammatory cells migrate from the bone marrow to the lungs, aiding in the diagnosis of fatal asphyxial deaths. HIF1-α, a key regulator protein, is released from lung tissue capillaries during catastrophic hypoxia circumstances, as previously demonstrated in immunohistochemistry (IHC) research. The present study analyzed lung samples from 164 medico-legal autopsy cases, including 57 asphyxia/hypoxia deaths and 107 controls (non-asphyxial deaths). Peribronchial, perivascular and perialveolar MCs were detected using CD117 antibody, and the average of MCs in each of these locations was noted in each case. The results indicated a statistically significant increase in peribronchial and perialveolar mast cells (MC) in fatal asphyxial deaths, including those caused by hanging, drowning, or postural asphyxia. Peri-bronchial MC in lung sections of asphyxial deaths were in the range of 0.2–5.4 and in non-asphyxial samples were in the range of 0.0–2.2. Peri-alveolar MCs in lung sections of asphyxial deaths were in the range of 0.0–0.6 and in non-asphyxial samples were in the range of 0.0–0.2. Our data suggest that mast cells (MC) play an important role in fatal hypoxia-related mortality and CD 117 may be a reliable marker for detection of mast cells in asphyxial deaths. It could be very beneficial to forensic pathologists tasked with differentiating fatal asphyxia fatalities from other causes of death. • Prolonged and acute asphyxia can induce an increase in mast cells in the lungs. • The present study analyzed lung samples from 164 medico-legal autopsy cases, including 57 asphyxia/hypoxia deaths and 107 controls (non-asphyxia deaths). • The mast cells were identified using CD-117 as a immunohistochemical marker. • Peri-bronchial and Peri-alveolar mast cells were significantly increased in deaths related to asphyxia. • Our data suggest that mast cells play an important role in fatal hypoxia-related mortality. [ABSTRACT FROM AUTHOR]

We present the results of the first study on the decomposition of hanging carcasses in a forest habitat of Poland. The decomposition of 12 hanging pigs and 12 ground pigs, which were used as control, in spring, summer, and autumn was examined during a two-year study. Mosaic decomposition was observed with bloating, active decay, and advanced decay irrespective of the carrion treatment (hanging vs ground). Bloating was less visible or did not occur at all in hanging pigs. After undergoing advanced decay, carcasses became mummified and remained in the hanging position. Complete skeletonization was observed only within the head in one case in summer. Irrespective of the carrion treatment, the active decay was driven by the same blow fly species with a similar seasonal pattern of larval dominance. The season was found to affect the decomposition of the hanging carcasses as revealed by a distinct delay in the onset of bloating in autumn and the late onset of active decay in spring. The duration of active decay was the shortest in summer and the longest in autumn. The effect of carrion treatment on the rate of decomposition was statistically insignificant. Nevertheless, some differences in the duration of decomposition between hanging and ground pigs were observed. The most distinct difference was that earlier decomposition proceeded faster in hanging pigs in spring and a delayed decomposition was observed in autumn. In summer, decomposition was similar in all the carcasses. The presented results are largely in contrast to the findings of previous studies on decomposition of hanging pig carrion. [ABSTRACT FROM AUTHOR]

The relationship between the point of blunt impact and the location of cranial fracture initiation continues to be poorly understood. The current study used high-speed video to capture cranial fracture initiation and propagation in impact experiments on twelve unembalmed, intact human cadaver heads. Video footage provided direct evidence that blunt cranial impacts can produce linear fractures initiating peripheral to the impact site. Four tests produced only remote peripheral linear fractures with no damage at the known point of impact, demonstrating that the pattern of linear fractures does not necessarily indicate impact site. The range of variation observed in these experiments suggests that cranial fracture formation is more complex than it is typically described in the current literature. Differences in biomechanical and fracture results obtained with three different shaped implements provided evidence that impact surface is one important factor influencing the outcomes of blunt cranial impacts. [ABSTRACT FROM AUTHOR]

Diagnosis of sepsis-related death by autopsy is often a complex process. Presepsin (PSEP) is typically used as a marker for diagnosing sepsis after death; however, its efficacy remains unclear. In the present study, we compared the levels of PSEP, C-reactive protein (CRP), and procalcitonin (PCT) in the postmortem serum of femoral blood to determine their efficacies as biomarkers for the postmortem differentiation of sepsis. Patients (n = 93; 48 males, 45 females with a mean age: 62.8 ± 19.2 years) who were admitted to and died in hospitals were screened for sepsis based on the sequential organ failure assessment score, and those with clinically confirmed sepsis were assessed in this study. All patients underwent autopsy within 48 h (n = 44 patients) or 48-96 h (n = 49 patients) of death. The cadavers were divided into two groups using the Sepsis-3 criteria: control group (n = 74) comprising patients without clinically diagnosed sepsis, and the group of patients who were clinically diagnosed with sepsis (n = 19). The area under the curve values (AUCs) for CRP, PCT, and PSEP levels in the sepsis group were 0.83, 0.817, and 0.977, respectively, with optimal cutoff levels of 7 mg/dL (sensitivity: 78.9%, specificity: 77.0%) for CRP, 0.07 ng/mL (sensitivity: 84.2%, specificity: 68.9%) for PCT, and 1250 pg/mL (sensitivity: 100.0%, specificity: 91.9%) for PSEP. No significant differences were noted for PSEP levels for gender, age, elapsed time after death, and the presence or absence of postmortem trauma. The present study demonstrated that compared to CRP and PCT, PSEP is a superior biomarker for the postmortem differentiation of sepsis and that a concentration >1250 pg/mL is highly likely to indicate sepsis within 96 h of death. This is the first report confirming the superiority of PSEP for diagnosing sepsis after death. [ABSTRACT FROM AUTHOR]

Post-mortem study of the brain is extremely relevant to medico-legal autopsies. However, it can be difficult to handle due to its fragility. This article presents a study on the development of an arterial solidifying technique that can be applied to analyze arterial circulation, consequently easing the handling and later diagnosis of diseases in this anatomical site. Vinylpolysiloxane silicone is introduced into the internal carotid arteries until it completely fills the arterial tree, creating a detailed model of the arterial's internal anatomy. This technique is fast, easy to apply and requires no previous tissue fixation. In addition, it allows for further toxicological and pathological tests. In conclusion, this technique represents a simple, sensitive and efficient method to employ in conventional autopsies, which can help in the diagnosis of death. [ABSTRACT FROM AUTHOR]

The term overkill usually indicates the infliction of massive injuries by far exceeding the extent necessary to kill the victim. Only few articles or textbooks report this term that is mostly associated with sex-motivated homicides where injuries, generally stabbing, are directed to significant sexual parts of the body. The aim of this study is to shed light on the phenomenon of overkill by reviewing some cases personally analyzed by the authors from both a forensic pathology rather than forensic psychiatry views. The reported results coupled with the literature revision confirmed the importance of a complete analysis of all criminological elements for better defining overkill cases. [ABSTRACT FROM AUTHOR]

Human bone histological analysis is a useful tool to assess post mortem diagenesis and to predict successful nuclear DNA typing of forensic material. This study is part of a series of studies developed by the authors intended to improve the understanding of post mortem diagenesis and to develop applications for DNA analysis of skeletal species from tropical soils, in order to optimize genetic and anthropological protocols. The aim of this study was to analyze the impact of burial period on the integrity of exhumed compact bone microstructure from tropical climate. In fragments of exhumed human femora from 39 individuals from the same cemetery (exhumed group) and 5 fresh femora from routine autopsies (control group), sections stained by hematoxylin-eosin were analyzed in order to measure bone microstructural integrity. We found that bone integrity index in exhumed group was negatively influenced by the period of burial (r = -0.37, p < 0.05) and highly significantly decreased (p < 0.0001) in comparison to control group. The period of burial and nitric acid decalcification time was positively correlated (r = 0.51; p < 0.01), leading to imply a bone petrification process during inhumation. Exhumed group showed higher level of matrix bone loss (p < 0.001), as expected, and 87% of cases analyzed were "tunneled" as described by Hackett. Bone integrity index and bone matrix tend to decrease in bones buried in tropical soil between 8-14 years of inhumation. This period is short if we consider cases in which there are preserved bones interred for longer periods in other environments. These data must be considered in cases where genetic identification of exhumed skeletons from tropical environment is required. The diagenesis in these bones and the variations of results found are discussed, clarifying some challenges for forensic laboratories, especially in DNA analysis. [ABSTRACT FROM AUTHOR]

Acute pulmonary emphysema (APE) is describedin cases of drowning and can be considered as a sign of vitality. In our experience, however, APE is not very evident in cases of saltwater drowning. The present study aims at investigating whether APE is present in both fresh and saltwater drowning by means of digital morphometric analysis of lung tissue. We investigated and compared a group of saltwater drowning and a group of freshwater drowning, while cases of acute external bleeding were investigated as negative control group. Tissue samples from each pulmonary lobe were collected during autopsy and examined by optical microscope. The area of alveolar spaces was calculated by means of image analysis software, recording the mean alveolar area (MAA) for each group. MAA was 24,852 μm2 in the saltwater drowning group, 34,133 μm2 in the freshwater drowning group and 21,871 μm2 in the negative control group. The MAA in freshwater drowning was significantly higher than in saltwater drowning and controls. No statistical differences were observed between saltwater drowning and controls. The results of this study suggest that APE is not a typical sign of death by saltwater drowning. [ABSTRACT FROM AUTHOR]

We report the preliminary observations of the peptide content of decomposition fluid produced under controlled laboratory conditions and in the absence of a soil matrix. Four domestic pig (Sus scrofa domesticus) cadavers were used to model human decomposition over a four-week trial period; physical characteristics were recorded and the peptide components of decomposition fluid was analysed using high performance liquid chromatography-time of flight mass spectrometry. Preliminary data analysis indicated that a range of peptides were consistently detected across the course of the trial period and 27 of these were common to all four cadavers; 22 originating from haemoglobin. The peptides associated with haemoglobin subunit alpha and beta displayed a breakdown pattern that remained consistent for all cadavers for the duration of the trial. Though identification of peptides during decomposition has potential for estimating the time since death, quantification of selected peptides is likely to be essential to identify time-dependent trends. [ABSTRACT FROM AUTHOR]

Lipstick traces may be encountered in forensic investigations as traces left on clothing, drinkware, tissue papers or other surfaces. However, their probative value is limited by the discriminatory power and destructiveness of existing analysis schemes. This work employed analytical spectroscopy with chemometrics to provide objective and non-destructive characterisation of lipsticks for forensic purposes. 22 red-shaded and 18 nude-shaded lipsticks were analysed using visible absorbance and diffuse reflectance spectroscopy, as well as attenuated total reflectance Fourier transform infrared spectroscopy. Principal component analysis readily distinguished most samples based on their spectral profiles, with subsequent models yielding discrimination accuracies exceeding 94% for each spectroscopic mode. This could provide a greater level of confidence when conducting 'questioned versus known' comparisons of similar lipsticks. Further testing using external validation sets produced identification accuracies of 73-100 %, which may allow investigative leads to be more readily obtained from recovered lipstick traces. [ABSTRACT FROM AUTHOR]

In many countries, hanging is the most common suicide method. When a person is found hanged however, one always has to consider that the alleged suicide scene possibly covers up a homicide. In such cases, hanging may have been the actual method of killing or the victim may have been harmed by a different method and was subsequently hanged. Apart from the inspection of the scene, the autopsy findings are of great importance to differentiate between suicide and homicide. Up to now, a considerable number of cases have been observed in which suicide by hanging was wrongly assumed at first. In the case presented, there were some facts raising doubts about a suicidal act already at scene. Nevertheless the forensic pathologists erroneously assumed that the findings on the corpse were consistent with suicide. The later elucidation of the case as a homicide by manual strangulation with subsequent suspension of the victim was essentially based on a new assessment of the autopsy findings in a second opinion. [ABSTRACT FROM AUTHOR]

Hypoxanthine (Hx) is produced during terminal stages of purine catabolism in humans. The concentrations of Hx and l-lactic acid in vitreous humor highly correlate with post-mortem interval (PMI). In this study, we measured the concentrations of Hx and l-lactic acid in uncontrolled authentic vitreous humor from cadavers, and investigated the correlation between these molecules and PMI. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used for the quantitative analysis of Hx and l-lactic acid in vitreous humor. These concentrations were also corrected by four seasons such as spring, summer, autumn, and winter and temperatures on the day of death such as -10 to 5 °C, 6-15 °C, 16-25 °C, and 26-32 °C that may affect the biomarker concentrations. Vitreous humors were collected from cadavers with known time of death at the National Forensic Service (NFS), Republic of Korea. The correlation between the concentrations of Hx and l-lactic acid in vitreous humors and PMI was evaluated using 79 corpses (53 males and 26 females), with sampling time ranging from 13 to 103 h after death. The average daily ambient temperature at the time of death of each sample was investigated to calibrate the correlation with PMI. Following correction of the concentrations of Hx and l-lactic acid with temperature, the correlation of Hx and l-lactic acid with PMI increased from 0.53 to 0.59 for Hx and 0.38 to 0.42 for l-lactic acid. The highest correlation of Hx and l-lactic acid concentrations with PMI was observed in the winter season, with an R2 value of 0.80 and 0.71 for Hx and l-lactic acid, respectively. The correlation of Hx and l-lactic acid with PMI was corrected by ambient temperature for each season, resulting in an increase in the R2 value to 0.88 for Hx and 0.72 for l-lactic acid. The best correlation was observed when the temperature was corrected after dividing by season. [ABSTRACT FROM AUTHOR]

The spleen is only uncommonly investigated in the forensic setting. Thorough examinations are performed in some specific situations such as splenic trauma (including iatrogenic trauma from cardiopulmonary resuscitation attempts), anaphylaxis, drowning, and sepsis-related deaths. The aim of this review is to present the available literature focusing on a few selected splenic diseases as well as forensic investigations performed on the spleen in order to summarize the most frequent situations in which this routinely unexplored organ may merit more extensive examination. [ABSTRACT FROM AUTHOR]

Diatom analysis is very effective for positive diagnosis of water inhalation in drowning. However, conventional strong acid diatom testing is laborious and potentially dangerous. We propose a simple, fast, and safe protocol using inexpensive reagents such as papain, SDS, and 5 N HCl for extracting diatoms from lung, kidney, and liver tissues. First, we determined optimal conditions for papain digestion using porcine tissues. Papain digestion was clearly superior to Proteinase K digestion. Next, for assessing the assay effectiveness in practical cases, the papain digestion protocol was applied to 80 tissue samples from 20 suspected drowning victims. Left and right lung tissues (1 g each) were digested in 15-mL conical centrifuge tubes. Kidney and liver tissues (10 g each) were extracted in 175-mL conical centrifuge bottles. Papain dissolved all organs sufficiently and permitted clear visualization of diatoms, although papain's solubilization activity was still inferior to strong acid digestion. The proposed enzymatic method requires only a low-speed centrifuge and water bath. Diatoms typically can be extracted from tissue samples within 3-5 h. The cost of protease is reduced some 6-fold by using papain in place of Proteinase K. Thus, the proposed method can be useful as a less-laborious, less-hazardous, and less-costly minimal test when the conventional strong acid digestion method is not performed due to personnel, equipment, budgetary limitation, or environmental and safety considerations. [ABSTRACT FROM AUTHOR]

Introduction: Among the several techniques proposed for the estimation of the Post Mortem Interval (PMI), the analysis of odorous amines has been applied in the past, with conflicting results. The aims of this study are: (i) to develop and validate a GC-MS method for the determination of putrescine (PUT) and cadaverine (CAD) in the human brain (validation study) and (ii) to study the relation of PUT and CAD concentration in the human brain and the PMI (decomposition study).Materials and Methods: Validation study. Analysis has been performed through GC-MS after a liquid-liquid extraction and a single step-derivatization for the identification and quantification of odorous amines in brain cortex samples. The standard protocol used in forensic toxicology, slightly modified for endogenous compounds according to recent guidelines, was used for validation. Decomposition study. Three uninjured human brains were sampled during the autopsy of three fatal traumatic cases. Along a 120-hour period of decomposition under experimental conditions, each brain was sampled along predetermined time intervals.Results: Validation study. Both PUT and CAD validation parameters were within the acceptable values defined by the Scientific Working Group for Forensic Toxicology (SWGTOX), with better selectivity, linearity, accuracy and precision values for PUT. Decomposition study. A significant relationship between PUT and CAD levels and PMI has been demonstrated through statistical analysis with a correlation coefficient of 0.98 for PUT and 0.93 for CAD (p < 0.0001).Conclusion: Although further experimental studies on a wider number of samples are necessary, the results of this study suggest a possible role of polyamine levels in brain cortex for the estimation of PMI. [ABSTRACT FROM AUTHOR]

Providing evidence of asphyxia death is a challenging issue in forensic pathology. Besides helpful macroscopical signs (e.g. strangulation mark, lung edema), recent data from literature indicate that the time of protracted asphyxia suffices to trigger an increase of giant cells and a migration of inflammatory cells from the bone marrow to the lung, thus offering a help in diagnosis of asphyxia death. In search of new valid asphyxia markers, the present study examined this hypothesis and investigated the leading role of pre-existing lung tissue cells and their functional state in reaction patterns to asphyxia. In specimens of suffocated human lungs following a short (n = 13) and a long asphyxia terminal episode (n = 15), and controls (sudden cardiovascular (n = 11) and traumatic deaths (n = 7)), the count of alveolar phagocytes, megakaryocytes, giant and mast cells, using H&E and toluidine blue staining, was performed. To show macrophage activation, immunohistochemical stainings for CD68, late (25F9) and early (MRP-8/-14) stage inflammatory markers were used. Measuring concentration of tryptase in femoral blood acted as a parameter for mast cell degranulation and consequently their activation. Results showed the lack of specificity of macroscopical parameters despite an association of suffocation with heavy lung edema. No significant differences in the numbers of inflammatory cells in the lungs of different case groups were detected. The doubling of MRP-8- and a five-fold elevation of MRP-14-positive cells compared to cardiovascular controls, proved an early activation state of pre-exiting monocytes in protracted asphyxia. These activated monocytes induced the degranulation of mast cells, resulting in slightly elevated tryptase levels in suffocation compared to cardiovascular controls. In summary, the duration of asphyxia (max. 20 min in cases investigated) only suffices to cause changes on molecular level, being not detectable in any specific macroscopical or histological form in the lung. Despite a potential utility of this molecular insight in individual cases, these results point to the classic doctrine of the evaluation of a rounded overall picture, accentuating on the proof of the ligature tool and the marks of suffocation process. [ABSTRACT FROM AUTHOR]

In forensic death investigations, estimating the postmortem interval (PMI) is critical. An accurate PMI estimate increases the speed and accuracy of identifying the remains by narrowing the time frame in which the death occurred, thus reducing the pool of possible decedents. Cape Town, South Africa has a high level of unnatural death, and due to a burdened death investigation system, many remain unidentified. There has been a tendency to broadly apply quantitative models of decomposition across biogeographically unique circumstances. A prime example is the widespread application of the total body score (TBS)/accumulated degree day (ADD) model developed by Megyesi et al. (2005), later refined by Moffatt et al. (2016). However, the appropriateness of applying a single model to a wide range of locations with unique geography and climates remains in question. The aim of the study was to evaluate and compare the accuracy of Megyesi and Moffatt models for estimating PMI in Cape Town, South Africa. Using pig carcasses, Finaughty established baseline data on the rates and patterns of terrestrial decomposition in summer and winter in two different locations in a forensically significant area of Cape Town. Among the baseline data, Finaughty derived TBS values using the Megyesi criteria. The present study used these values to estimate the ADD per the Megyesi and Moffatt models, which would correspond to an estimated PMI. These estimated values were compared to actual ADD values. Estimates of ADD were inaccurate for both models in winter, and only partially in summer. The Moffatt model was more accurate in earlier decomposition stages, with the Megyesi model more accurate in later decomposition stages. These results indicate the Cape Town environments may contain factors that the two models do not consider, producing inaccurate PMI estimations at various TBS' values. ADD does not depict the entire taphonomic story; the decomposition process appears to be too complex for universal modelling based on a single or narrow suite of variables. Seasonality was an important factor in determining the accuracy of the models, primarily resulting in underestimations of the true PMI values. These findings show the impracticality of applying models developed for- or in one region to any other and support the need to establish regionally-specific equations for estimating PMI in a forensic context. Alternatively, more complex models employing "big data" from a more comprehensive suite of variables which influence the rate and pattern of decay could be developed. [ABSTRACT FROM AUTHOR]

Background: This paper describes the performance of four Randox drug arrays, designed for whole blood, for the near-body analysis of drugs in a range of post-mortem body specimens.Methods: Liver, psoas muscle, femoral blood, vitreous humor and urine from 261 post-mortem cases were screened in the mortuary and results were obtained within the time taken to complete a post-mortem. Specimens were screened for the presence of amfetamine, barbiturates, benzodiazepines, benzoylecgonine, buprenorphine, cannabinoids, dextropropoxyphene, fentanyl, ketamine, lysergide, methadone, metamfetamine, methaqualone, 3,4-methylenedioxymetamfetamine, opioids, paracetamol, phencyclidine, salicylate, salicylic acid, zaleplon, zopiclone and zolpidem using the DOA I, DOA I+, DOA II and Custom arrays.Results: Liver and muscle specimens were obtained from each of the 261 post-mortem cases; femoral blood, vitreous humor and urine were available in 98%, 92% and 72% of the cases, respectively. As such, the equivalent of 12,978 individual drug-specific, or drug-group, immunoassay tests were undertaken. Overall >98% of the 12,978 screening tests undertaken agreed with laboratory confirmatory tests performed on femoral blood.Conclusions: There is growing interest in the development of non-invasive procedures for determining the cause of death using MRI and CT scanning however these procedures are, in most cases, unable to determine whether death may have been associated with drug use. The Randox arrays can provide qualitative and semi-quantitative results in a mortuary environment enabling pathologists to decide whether to remove specimens from the body and submit them for laboratory analysis. Analysis can be undertaken on a range of autopsy specimens which is particularly useful when conventional specimens such as blood are unavailable. [ABSTRACT FROM AUTHOR]

Heat-shock proteins (HSPs) are expressed during cellular stress, especially thermal stress, to support protein homeostasis. Extensive investigations have revealed that HSP27 is rapidly and intensively expressed in the pulmonary and renal tissues of most cases of death due to fire, contrary to cases without premortem thermal influences, which are negative for HSP expression. As such, HSP27 can be used as a marker of vitality in the investigation of fire-related deaths. Without positive HSP27 expression or only slight expression, one can conclude that the deceased was not alive at the time of heat stress. This is presented in two case reports of men who were shot and later burned. HSP espression could not be found in these cases. In the very early supravital period, particularly the latency and supravital periods, metabolic processes can continue after irreversible cardiac arrest. Extensive cellular stress can lead to an immunohistochemically detectable expression of HSP in this portmortem period. This is shown in the case report of a 49-year-old man who immediately died and burned following the massive detonation of an air mine. Immunohistochemical studies of recovered renal tissues have revealed HSP27 expression in the vessel walls as well as renal tubules, as presented in a third case report. This HSP expression can be considered as a phenomenon of supravitality. Heat stress induces massive cellular stress and the expression of HSP under global ischemic conditions. When vitality is to be determined in cases of suspected fire deaths, the possibility of supravital expression has to be considered. [ABSTRACT FROM AUTHOR]

A postmortem root band (PMRB) is defined as "an opaque ellipsoidal band composed of a collection of parallel elongated air/gas spaces and is approximately 0.5mm above the root bulb and about 2mm below the skin surface" [1]. It is generally accepted that it can appear in the root of hairs attached to remains during decomposition [1]. This study aimed to investigate the underlying cause and mechanism of PMRB formation. This was done (i) by observing the overall frequency and the intrinsic variability in anagen hairs containing a PMRB collected across five regions of a human decedent's scalp at three time points, and (ii) by determining if PMRB-like features can be induced via immersion in in-vitro controlled environments of anagen hairs plucked from the scalp of a human decedent (ex-situ postmortem hairs) not containing a PMRB. The results of the first objective illustrated that as time since death increased, the frequency of hairs containing a PMRB across the scalp sampling regions increased and the intrinsic variability decreased. The results of the second objective demonstrated that both an aqueous environment and microbial activity are essential for the formation of PMRB-like features. This study was the first to statistically analyze the intrinsic variability of PMRB formation, as well as the first to induce PMRB-like features in roots of ex-situ postmortem hairs. [ABSTRACT FROM AUTHOR]

The high rates of abandoned neonatal remains admitted to Salt River Mortuary (SRM), Cape Town, and the dearth of literature published in South Africa prompted a retrospective assessment of these cases to describe the profile and assess the scope of the post-mortem investigation of abandoned neonates, as well as determine the prosecution rate of abandoned live births. Demographic details, scene information and post-mortem findings were obtained from medico-legal case files concerning non-viable fetuses, stillbirths and concealment of birth cases admitted to SRM between 1 January 2012 and 31 December 2016 (n=249). Despite the majority of the cases being natural deaths, the cause of death frequently remained 'undetermined' in these cases, often due to the presence of decomposition. Histological analyses were only performed in a small fraction of undetermined cases. Furthermore, the hypothesis that the prosecution rate of abandoned live births is extremely low was supported by this study, with only one case prosecuted in the 5-year period. For the remainder of the cases, the court status was given as either 'under investigation' (47.8%) or 'case closed' (47.8%). In the majority of the instances, the case was closed due to the unknown identity of the biological mother; however, DNA analyses were not performed in all of these cases. Overall, the data highlighted the need for the development and implementation of standard protocols, and recommendations were made for conducting the medico-legal investigation of abandoned neonates in a South African setting. [ABSTRACT FROM AUTHOR]

Being sudden cardiac death (SCD) and acute myocardial infarction (AMI) frequent occurrences in forensic medicine, extensive research has been published about the use of cardiac troponin T (cTnT) as a potential specific postmortem biochemical marker. However, cTnT has produced uncertain results, leading to the lack of a standardized application in routine postmortem examinations. The present systematic review focuses on the determination of whether cTnT may be considered as a suitable marker for the postmortem diagnosis of AMI and SCD, analysing the literature according to the following criteria: only human experiments, published from 1st January 2001 to 12th April 2018, available in English, on the following databases: (1). Medline/PubMed/MeSH search words: (("heart"[MeSH Terms] OR "cardiac"[All Fields]) AND ("troponin"[MeSH Terms] OR "troponins"[All Fields]) AND forensic[All Fields] AND "postmortem"[All Fields]); (2). Embase, Lilacs and Cochrane Library. 16 full-text articles were included. cTnT has been demonstrated to be elevated in a variety of pathological conditions, not strictly related to cardiac causes, but rather to the severity and extent of myocardial damage from various causes. cTnT levels have been consistently found higher in pericardial fluid than in the peripheral blood. Reviewed studies showed that the most suitable biological sample for cTnT evaluation seems to be pericardial fluid, since it may be less affected by haemolysis of blood. cTnT seems to be quite stable up to a PMI (postmortem interval) smaller than 48h; after this time, a mild time-dependent increase has been demonstrated. CPR seems to have no influence on cTnT values. The postmortem cut-offs differ from clinical ones, and at present no consensus has been reached concerning the postmortem ranges. Further research needs to be carried out in order to establish a common accepted cut-off value for forensic use. [ABSTRACT FROM AUTHOR]

The impact of nanopathology in medicine necessarily involves also the anatomo-pathological diagnostics, because of the current large spread of nanoparticles in the environment and the wide spectrum of correlated human diseases. The main entrance gates of nanoparticles into the body are respiratory inhalation, gastro-intestinal absorption and injection of polluted drugs. In all these cases, their penetration in the lymphatic or blood streams are possible, with subsequent systemic translocation. Different diseases can be generated by nanoparticles exposure, from a direct contact irritation to the onset of granulomatous diseases. Interestingly, they can also act as endocrine disruptors on the autocrine and paracrine systems. At cellular level, nanoparticles can damage the DNA content leading to a subsequent tumorigenesis. In the forensic setting, they can be searched in case of known exposure to inorganic particulate matter or in case of diseases of unknown origin, from granulomatous reactions to foreign inclusions in neoplastic tissues. The combined physical-histopathological studies allow to relate possible environmental/industrial pollution with the pathology and offer a novel tool for forensic investigations, but, overall, they represent new technical evidences for lawyers to present in a court. [ABSTRACT FROM AUTHOR]

Introduction: In a previous work, we wanted to evaluate if the histochemical determination of lead in Gunshot Residues (GSR) on firearm wounds could be misled due to possible environmental contamination produced by heavy metals and, in particular, by lead. The Sodium Rhodizonate test and its confirmation test with 5% HCl Sodium Rhodizonate resulted to be negative and therefore we wanted to verify if these techniques were sensible enough in order to evaluate this element. We have assessed, on these same samples, a more sensitive technique, as inductive coupled plasma mass spectrometry (ICP-MS) is. This technique is able to detect elements in solution at concentrations as low as 10-15gL-1.Materials and Methods: Skin samples taken from two groups of victims, whose cause of death was not related to gunshot wounds were analyzed using ICP-MS: group A included 25 corpses found in open spaces after a long time; group B included 16 corpses exhumed after a period of 11 years. As a positive control group we used skin samples from two subjects that had died due to firearm wounds: as a negative control group we used three different types of plain paraffin slides without included biological material.Results: At the analysis by ICP-MS, the evaluation of the samples belonging to groups A, B and for the negative control groups resulted to be negative for traces of lead (Pb), barium (Ba) and antimony (Sb). On the other hand, high concentrations of GSR could be found in the positive control group were victims died for firearm wounds.Conclusions: On these basis, we can state that environmental Pb does not contaminate cadavers exposed to open air nor those buried in soil, as confirmed using to ICP-MS technique. Sodium Rhodizonate and 5% HCl Sodium Rhodizonate confirmation test have therefore a high sensitivity, highlighting GSRs, for the diagnosis of death caused by firearm wounds. [ABSTRACT FROM AUTHOR]

Forensic anthropologists have traditionally relied on their knowledge and experience of the decomposition stages to make an assessment of the time since death. However, recently new and empirical methods have been developed in various regions worldwide that propose to estimate the post-mortem interval (PMI) based on the observed decomposition changes alongside important taphonomic variables. Yet despite these methods being predominantly geographic specific, a number of methods have suggested they are effective universally and it is these 'universal' methods that have been inadequately test in Australia. The current study evaluated the accuracy of two of these methods in an Australian context, specifically the Greater Western Sydney region. The protocol developed by Megyesi et al. (2005) [1] was investigated because it is commonly cited in the literature and the PMI formula created by Vass (2011) [2] was also investigated because of its 'universal' claim. Between December 2014 and March 2016, two experimental trials were undertaken during the Australian summer seasons. Sixteen adult pig carcasses were left to decompose undisturbed on a soil surface common throughout the Western Sydney region and the Megyesi et al. (2005) [1] and Vass (2011) [2] methods were applied to the remains during this period. The results showed the Megyesi et al. (2005) [1] method overestimated the known PMI of remains, whereas the Vass (2011) [2] formula underestimated the time since death of the remains in these trials. The inaccuracy may be attributed to the constants which make up the variables in these formulas and they may not reflect the values of these variables in the Western Sydney region. [ABSTRACT FROM AUTHOR]

The spleen is infrequently investigated in forensic pathology routine. Thorough examinations are performed in very specific situations such as splenic trauma (including iatrogenic trauma from cardiopulmonary resuscitation attempts), anaphylaxis-related deaths, drowning and sepsis. The purpose of this review article is to provide a general overview of available literature focusing on a few selected splenic diseases as well as available forensic investigation techniques performed on the spleen in order to summarize the most frequent situations of forensic interest in which this routinely unexplored organ may merit more extensive examination. [ABSTRACT FROM AUTHOR]

Forensic thanatology comprises the investigation of every phenomenon related to death performed through cadaveric exams. The pink tooth phenomenon (PTP) emerges as a thanatological finding registered during medical or dental autopsy. The PTP consists of a reddish or pink coloration caused in the teeth by the penetration of pulpal hemoglobin in the dentinal tubules. Initially, the PTP was associated with specific violent deaths, such as drowning, hanging and poisoning. However, scientific reports have pointed towards the occurrence of PTP as an expression of cadaveric decomposition regardless of the cause of death. The present study aims to report eight dental autopsies of victims of violent death that presented the PTP. The autopsies were conducted by forensic pathologists and dentists between 2013 and 2018. Seven victims were males and one was female. The age ranged above 6years old. Cranio-encephalic trauma, firearm shooting and asphyxia figured as the causes of death. All the victims were in advanced decomposition. The PTP was detected in deciduous and permanent, anterior and posterior and maxillary and mandibular teeth. Forensic experts, especially dentists, must be aware of the PTP for more detailed registration of postmortem findings and more accurate cadaveric exams. [ABSTRACT FROM AUTHOR]

Complex suicides are rare and consist in the use of more than one method to induce death, representing a challenging investigation for forensic pathologists. According to the several combinations reported in literature, they have been classified into "typical" (where two common suicide methods are associated) and "atypical" (where more than two methods, or infrequent combinations of suicide methods are involved). In the case discussed here, an elderly man suffering of depression was found dead inside the tool shed of his house with a knife embedded in the abdomen and two plastic bags fastened around the neck using a twine. Three other superficial stab wounds were clustered close to the penetrating lesion. Internal examination revealed haemorrhagic infiltration at the mesentery and haemoperitoneum. No evident signs of asphyxia were highlighted and the cause of death was attributed to haemorrhagic shock. This association of suicide methods has turned out to be unusual. A review of the literature concerning complex suicides, abdominal self-stabbing and plastic bag suffocation has been managed. Crime scene and details of the used tools, medical and psychiatric history of the victim and features of the internal and external lesions have been examined and compared to previous studies. Toxicological analyses were not performed. [ABSTRACT FROM AUTHOR]

Laryngohyoid fractures in hanging victims are one of the most studied and paradoxically contradictory topics in forensic pathology. According to literary sources, the incidence of laryngohyoid fractures in hanging varies significantly, from 0% to 100%. To verify the diagnostic significance of these injuries in hanging, we prospectively and consecutively analyzed the occurrence of laryngohyoid fractures in a group of 178 suicidal hanging victims (M/F=150/28, aged 14-94years, mean age=50, complete suspension=111 cases, partial suspension=67 cases) in relation to selected variables (age, sex, weight, the completeness of body suspension, and ligature knot location). Altogether, we identified the following types of laryngohyoid fractures in 129 of 178 cases (72.5%): isolated fracture(s) to the thyroid cartilage in 60 cases (33.7%), combined thyrohyoid fractures in 41 cases (23.0%), isolated fracture(s) to the hyoid bone in 28 cases (15.7%), and no fractures to the cricoid cartilage or the cervical vertebrae. The highest frequency of laryngohyoid fractures was found in lateral hangings (right lateral: 26/34, 76.5%; left lateral: 31/37, 83.8%), whereas the lowest rate was found in anterior hangings (4/11, 36.4%). In lateral hangings, fractures more often occurred contralaterally to the suspension point. Statistical analysis revealed significant associations of the occurrence of laryngohyoid fractures with the age of the victim (p=0.028), with the position of the ligature knot on the neck (p=0.019) and with the age-corrected weight of the victim (p=0.026). In addition, we performed a systematic updated review and critical appraisal of relevant literary sources to report the incidence, fracture patterns, and contributing variables of laryngohyoid injuries in hanging. Both the results of our study and the provided literary synthesis show that if evaluated properly, laryngohyoid fractures in hanging may diagnostically offer far more than just evidence that injury to the neck occurred and may also present research opportunities regarding several issues that should be further analyzed and explained. [ABSTRACT FROM AUTHOR]

Vertebrate scavenging can significantly accelerate the rate of decomposition, which can hinder estimating the post-mortem interval (PMI). Patterns of decomposition and scavenging are highly specific to different environments in a forensic context, with no known data for South Africa. A better understanding of local decomposition patterns, taking scavenging into account, could increase the accuracy of PMI estimation and improve identification of human remains. Using a porcine model in the forensically significant thicketed Cape Flats Dune Strandveld habitat, the effect of vertebrate scavenging on the decomposition process was examined. This part of Cape Town suffers from poor socioeconomic conditions and a high murder rate, which is due in part to the dense population. Human decomposition was simulated using three small (∼20kg) domestic pig (Sus scrofa domesticus) carcasses, with ethical clearance. One pig served as a control and was caged to prevent vertebrate but not invertebrate access; the other two served as experimental treatments. They were deployed in Delft, Cape Town, and observed by motion-activated, time-lapse remote photography to record scavenger species and activity. A rapid increase in the decomposition rate was observed due to Cape grey mongoose (Galerella pulverulenta) scavenging, with early skeletonisation reached by both experimental pigs by day 14, compared to the control remaining in advanced decomposition after 93 days. Mongoose is the primary scavenger in this habitat, and showed notable patterns of feeding behaviour, exclusively within daylight hours. Scavenging activity was only influenced by rainfall later in the cycle. This research provides knowledge on locally relevant decomposition patterns and highlights the necessity for PMI estimation methods to consider vertebrate scavengers. This may improve human skeletal identification in forensic cases. There is scope for expansion of this study, with an investigation of seasonal effects, the interaction between invertebrate and vertebrate activity, as well as, the effect of clothing on scavenger access. [ABSTRACT FROM AUTHOR]

In this experiment, 170 experimental false starts on human (120 lesions) and pig bones (50 lesions) were analyzed under stereomicroscope. The goal was to evaluate the potential of three "secondary" features (patterns of striae on the kerf floor, blade drift and bone islands) to diagnose saw class and saw set. We also assessed the performance of each of these features in ambiguous cases observed in a previous study, based on three main characters (minimum width of the kerf, shape of the kerf walls, and shape of the kerf profile). Among these three "secondary" features, striae on the kerf floor proved to be useful: the undulating or undulating/straight pattern of the striae on the kerf floor indicates an alternating set whereas thin and straight striae indicates a wavy set. Blade drift and bone islands may be indicative of large teeth size. These secondary features, in combination with the three main characters previously studied, may help identify the class of the saw. [ABSTRACT FROM AUTHOR]

The aims of this investigation were to determine the characteristics and prevalence of anatomical variants of the larynx apparatus and to evaluate the impact of these variants on the accurate diagnosis of laryngeal fractures. A population-based study was carried out, analyzing a series of 207 consecutive autopsied cases in the Institute of Legal Medicine of Galicia (Northwestern Spain). The prevalence of triticeal cartilage was 52.7% and that of agenesis of thyroid horns 10%. Calcification of the stylo-hyoid ligament accounted for 1.4%. We identified three new anatomical variants: the terminal segmentation of the thyroid horns (11.6%), ectopic superior thyroid horns (8%) and lateral thyrohyoid ossification (5.3%). These three names, based on anatomical criteria, are the author's proposal to solve the lack of uniformity in the designation of these variants. Agenesis of thyroid horns were related to the presence of ectopic superior thyroid horns in 93% of cases, either uni or bilateral. The combination of variants was present in 6.8% of the cases, being the terminal segmentation of the thyroid horns in association with triticeal cartilage the most frequent (3.8%). The probability of misdiagnosis due to the presence of anatomical variations in deaths by pressure on the neck was high in this population (71.5%). The prevalence of triticeal cartilage in more than half of the sample, determined an important rate of potential errors (46.4%), followed by the mistaken diagnoses induced by terminal segmentation of thyroid horns (7.3%) and by ectopic superior thyroid horns (6.3%). The likelihood of a misdiagnosed laryngeal fracture was greater if the thyroid cartilage was affected, with a higher proportion of false positives comparing to the hyoid bone (p<0.001). The higher frequency of thyroid fractures in neck pressure together with the prevalence and location of triticeal cartilage on the lower third of the lateral thyrohyoid ligament are the main reasons for these results. Further studies should be done with larger samples to expand epidemiological data and consolidate these results and their influence on the diagnosis of mechanical asphyxias. [ABSTRACT FROM AUTHOR]

The effect of vertebrate scavenging can drastically alter the rate of decomposition and cause skeletal scatter, which hinders human forensic recovery and identification. Patterns of scavenging, disarticulation and scatter in a forensic context are specific to different environments with no known data for South Africa. A better understanding of these patterns can increase the chances of full body recovery and improve identification of human remains. In this preliminary study, the effect of wild vertebrate scavenging on skeletal scatter was examined using a porcine model in the forensically significant thicketed Cape Flats Dune Strandveld habitat. This area is a densely populated part of Cape Town, which suffers from poor socioeconomic conditions and a high murder rate. Ethics was granted for the use of three small (∼20kg) domestic pig (Sus scrofa domesticus) carcasses as proxies for human decomposition. They were deployed in Delft, Cape Town, and observed by motion-activated cameras to record wild scavenger activity. One pig served as a control and was caged to prevent vertebrate but not invertebrate access; the other two served as experimental treatments. Scatter was recorded every second day by marking the location of skeletal elements and measuring the distance and angle from the centre of each deposition site. No scattering was observed in the control, but notable scattering patterns were observed in the experimental pigs due to Cape grey mongoose (Galerella pulverulenta) scavenging, the only vertebrate scavenger species observed. No clear pattern of scatter distance over time was followed. Scatter began in the skeletonisation phase (day 25-30), resulting in a maximum distance of 12.67m and scatter/search area of 504.32m2. Mongoose-induced skeletal scatter followed a distinct pattern of movement into dense undergrowth, a previously unobserved behaviour and a key finding of this study. These results provide baseline data for sub-adult human scatter, or scatter of smaller components of an adult human skeleton, as demonstrated in the forensic case example provided. Knowledge is provided on locally relevant decomposition patterns and informs search methods for improved human skeletal recovery in forensic cases. There is scope for expansion of this study, with an investigation of seasonal effects, the interaction between invertebrate and vertebrate activity, as well as, the effect of clothing on scavenger access. [ABSTRACT FROM AUTHOR]

Post-mortem measurements were made of the body temperature of dogs. The aim of the study was to evaluate and verify a reliable mathematical model that can be used to establish the time elapsed since the death of a dog during the initial post-mortem period at room temperature, using the eye (vitreous body), internal organs (heart, liver, kidney and lung), and rectum as sites for temperature measurement. The measurements were performed at six points in the body using an electronic thermometer in conjunction with a temperature probe. The method of temperature measurement is simple and does not cause perceptible macroscopic changes or disfigure the carcass. Multiple regression analysis was shown to be suitable for estimating the time elapsed from death to the discovery of the body for a period up to 12h post-mortem. The proposed multiple regression equation using body weight and the temperature at a specific site reduces manipulation of the carcass to a minimum and thus reduces error in establishing the time of death. The multiple regression model makes it possible to precisely estimate the time elapsed since the death of the animal. [ABSTRACT FROM AUTHOR]

Congo Red staining is usually used in diagnosing amyloidosis, a pathology characterized by the storage of abnormal proteins in several human organs. When assessed on samples fixated in formalin and embended in paraffin, this staining can undergo several artefacts, causing diagnostic and interpretative difficulties due to its weak stainability and a consequent reduced visibility of the amyloid. These complications, in time, requested several variations of this staining technique, especially in clinical practice, while in the forensic field no protocols has ever been adapted to cadaveric samples, a material that is already characteristically burdened by a peculiar stainability. In our work, studying a sudden death caused by cardiac amyloidosis and diagnosed only with post-mortem exams, we present a modified Congo Red staining used with the purpose to demonstrate amyloid in cadaveric material after the unsuccessfully use of all standard protocols. [ABSTRACT FROM AUTHOR]

When sawing during autopsies on human remains, fine dust is produced, which consists of particles of sizes that may fall within the human respirable range, and can act as vectors for pathogens. The goal of this study was to explore the potential effects of saw blade frequency and saw blade contact load on the number and size of airborne bone particles produced. The methodology involved the use of an oscillating saw with variable saw blade frequencies and different saw blade contact loads on dry human femora. Released airborne particles were counted per diameter by a particle counter inside a closed and controlled environment. Results corroborated with the hypotheses: higher frequencies or lower contact loads resulted in higher numbers of aerosol particles produced. However, it was found that even in the best-case scenario tested on dry bone, the number of aerosol particles produced was still high enough to provide a potential health risk to the forensic practitioners. Protective breathing gear such as respirators and biosafety protocols are recommended to be put into practice to protect forensic practitioners from acquiring pathologies, or from other biological hazards when performing autopsies. [ABSTRACT FROM AUTHOR]

Matrixmetalloproteinases (MMP) 2 and 9 as well as tissue inhibitor of metalloproteinases (TIMP) 1 were tested as markers of myocardial early ischemia/infarctions. Experiments with an animal model, the isolated Langendorff heart, and analysis of human tissue samples drawn during autopsies were performed. Results of the experiments with the Langendorff model implied that the detectable amount of the markers might increase early after the onset of ischemia, in less than one hour, under ideal conditions. The results of the examined human cases showed that MMP-2 is constantly detectable in human myocardial tissue with an increased amount in case of an infarction with longer survival times. MMP-9 and TIMP-1 were negative in control cases, distinct positive staining results were obtained mainly in cases of infarctions with longer survival times and only rarely in those with a short survival time. According to these results MMPs and TIMPs do not qualify as first choice markers of myocardial infarctions. As an interesting side finding in the Langendorff experiments, positive staining results for all three markers were seen in myocardial areas that were mechanically traumatized by ECG-electrodes or ligation of blood vessels. These findings make the markers interesting for forensic wound age estimation. [ABSTRACT FROM AUTHOR]

Tool marks on bones induced by knife blades can be analysed morphometrically in order to enable an allocation of the suspected "inflicting weapon" to the particular morphology of the bone lesions. Until now, geometric morphometrics has not been used to analyse the morphology of knife lesions on fleshed bones in detail. By using twelve experimental knives and a drop weight tower, stab/cut injuries were inflicted on untreated pig ribs. The morphology of the experimentally produced lesions was subsequently recorded with three imaging techniques (μCT, macro photography and SEM) and analysed with different morphometric software (Amira, tps and Morpheus). Based on the measured distances between the walls of the kerf marks, which corresponded to the thickness of the blade, one could conclude to the respective blade thickness with a deviation of max. ±0.35mm and match the injuries to the knives. With subsequent reanalysis after maceration, an average shrinkage factor up to 8.6% was observed. Among the three imaging techniques used in this study, μCT was the most accurate and efficient technique, particularly because it represented the only non-destructive modality to document injuries without maceration, even though μCT is more expensive and time-consuming as well as less accessible than a macro SLR-camera or a SEM. For optimal characterizations of the blades' and kerfs' shapes the software tps proofed to be the best choice. Accordingly, geometric morphometrics could serve as a tool in forensic investigations concerning kerf marks. [ABSTRACT FROM AUTHOR]

Objective: Nowadays, post-mortem computed tomography (PMCT) has become an integral part of Forensic practice. The purpose of the study was to determine PMCT impact on diagnosis of the cause of death within the context of the external examination of the body, when autopsy has, at first, not been requested.Material and Methods: We reviewed the records of 145 cases for which unenhanced PMCT was performed in addition to the external examination of the body from January 2014 to July 2015 at the Institute of Forensic medicine in Strasbourg (France). We confronted final reports from forensic pathologist to the corresponding PMCT reports. Data were collected in a contingency table and the impact of PMCT on the final conclusions of the forensic pathologist was evaluated via a Chi2 test.Results: PMCT results significantly impact the final conclusions of forensic pathologist (p<0,001). In some cases, PMCT permits etiological diagnosis by revealing a cause of death hidden from external examination (mainly natural death) or by supporting the clinical findings of the forensic pathologist. In other cases (traumatic death), PMCT enables fast and exhaustive lesion assessment. Lastly, there are situations where PMCT may be ineffective (intoxication, hanging or some natural deaths).Conclusion: Performing PMCT within the context of the external examination of the body when autopsy has, at first, not been requested could bring significant benefits in diagnosing the cause of death. The impact of PMCT varies depending on the circumstances of death. [ABSTRACT FROM AUTHOR]

Attribution of death to myocarditis continues to be a controversial issue in forensic pathology, despite the existence of established histopathological criteria as well as complementary investigations. The aim of the study was two-fold: (a) to retrospectively analyse the data obtained from a series of clinical and forensic autopsies in order to assess the number of cases with death attributed to myocarditis, and (b) to reevaluate these cases in order to assess how properly the histopathological diagnosis of myocarditis conformed to established criteria and therefore how accurately these were used on the basis of all postmortem investigation findings to conclude the cause of death. 2474 clinical and forensic autopsies were taken into consideration. Myocarditis was recorded as the official, underlying cause of death in 48 cases. Of those, 8 cases were considered to accurately conform to the histopathological Dallas criteria for the presence of myocarditis and could therefore be classified as cases of fatal myocarditis. In 19 out of 48 cases, description of focal myocarditis was considered to accurately fulfill the histopathological Dallas criteria for the presence of myocarditis. However, data provided by histological analysis and virology testing result reevaluation allowed alternative causes of death to be speculated. In another 21 out of 48 cases, description of focal myocardial inflammation was considered to inaccurately meet the histopathological Dallas criteria for the presence of myocarditis. The findings of our own study appear to be in agreement with previous observations in similar study groups and highlight that since myocarditis may occur in association with many diseases, a great deal of evidence is required before settling on categorical conclusions. [ABSTRACT FROM AUTHOR]

When a child consultation center evaluates abused children, evidence of the abuse must be documented. Children who have suffered physical abuse often have bruises, which cannot be confirmed by visualization when the bruise has healed. In forensics, a method to confirm an old bruise by ultraviolet radiation is possible. However, long-term ultraviolet exposure can be harmful. In this study, we observed 15 bruises on healthy volunteer children using four kinds of light sources, including ultraviolet radiation, over time. The violet light source enabled observation of a bruise for a longer time than ultraviolet radiation. Although other studies have shown that violet light is superior for enhancing bruises, this is the first report to evaluate data concerning the ability to identify bruises over time in living children. These results might help to identify evidence of past violence suffered by children. [ABSTRACT FROM AUTHOR]