Putrefaction in the pandemic: a comparative study of the frequency of advanced decomposition change in coronial autopsies since the start of the COVID-19 pandemic - December 2024

The persistent problem of drowning - A difficult diagnosis with inconclusive tests - September 2024

Although the diagnosis of drowning may appear straightforward the reality is that it is sometimes one of the most difficult in forensic pathology. To begin with, there is no universal agreement on what constitutes drowning with some definitions using the term in the absence of a lethal outcome. Next are the significant problems that arise in finding immersed bodies and in assessing the death scene. Prolonged post mortem intervals are associated with artefactual modifications of the body from putrefaction and post mortem animal predation. Both of these may create and disguise injuries. The absence of pathognomonic pathological features at autopsy and the presence of potentially life threatening underlying organic illnesses complicate determination of both the cause and manner of death. There may even be no autopsy findings to indicate that immersion had occurred. Finally, the unreliability of laboratory tests with significant overlap with control cases where death had no association with immersion presents further problems. Thus lethal drowning remains a complex event that requires the use of a wide variety of information sources, not just data gleaned from the dissection table.

Direct link to the article

A Reevaluation of the Death of Vincent van Gogh Suicide or Murder? The Need for a Definitive Autopsy - August 2024

9th Annual Seminar - Drug Facilitated Crime - August 2024

*Event of interest*

Date: Friday, 13th September 2024

Time: Registration starts at 8:45am, with the programme beginning promptly at 9:30am.

Venue: Barber-Surgeons’ Hall, 1A Monkwell Square, Moorgate, London EC2Y 5BL

Seminar Highlights:

Anca Frinculescu – Pharmaceutical Analyst, TICTAC Communications Ltd

Dr Lewis Couchman – Faculty and Research Director, ASI

Dr Justin Varney – Director of Public Health, Birmingham City Council

Dawn Dines – CEO and Founder, Stamp Out Spiking

Russell Webster – Independent Researcher on Drugs & Crime

This year's theme, ‘Drug Facilitated Crime,’ will provide invaluable insights and foster critical discussions. Attendance is free, but spaces are limited, so we encourage you to secure your place as soon as possible.

To book your seat, visit: https://docs.google.com/forms/d/e/1FAIpQLSfFYotAH3bVX2Qf1p2TNOp_qAocOSmAajKX4UuhzgtzFinAdg/viewform or email: info@forensic-access-group.co.uk to register.

Please feel free to forward this invitation to your colleagues who might be interested in attending.

Postmortem Burns to Conceal Homicidal Deaths: an Eight-Year Study. - July 2024

Burned corpses are of medicolegal importance as circumstances may suggest means that are used for committing or concealing homicidal death or death occurring due to accidental causes. Postmortem burns, which may include homicidal burns (torch murder) or burns used to conceal the crime, are committed with the motive of identity destruction, transposing the cause and manner of death and destruction of evidence. The present study aimed to analyse the cases of postmortem burns in the context of the cause of death, manner of death and circumstances pertaining to death. This is a retrospective study performed in the Government Medical College δ Hospital, Aurangabad (MH), India, between 1 January 2009 - 31 December 2016. Cases involving burn injuries were examined in detail by autopsy reports, toxicological analyses, crime scene investigation and police records submitted at the Institute's office. A careful examination of vitality signs of burns, soot deposition in the lower respiratory tract and the presence of other fatal injuries was performed for each case. Cases exposed to fire before death were all excluded. Similarly, bodies being charred to such an extent to prevent distinguishing the vitality of burns were also excluded. Postmortem burns were recorded in 13 cases (0.46%) of deceased bodies to cover homicides. Females were reported to be more commonly involved and more in a household environment. Head injury was the most common cause of death, followed by death due to asphyxia due to any means. The findings of the present study reinforce the fact that burning cannot always effectively destroy the evidence, hindering the perpetrator from covering up the crime. Apart from the evidence at autopsy, a transdisciplinary approach must be initiated with detailed crime scene investigation, toxicology, ascertaining the cause of death with analyses of fatal injuries and contributory data for identification of the deceased.

Direct link to the article.

Working Smarter on Cold Cases: Identifying Factors Associated with Successful Cold Case Investigations - June 2024

Cold case squads have garnered much attention; however, they have yet to undergo significant empirical scrutiny. In the present study, the authors interviewed investigators and reviewed 189 solved and unsolved cold cases in Washington, D.C., to determine whether there are factors that can predict cold case solvability. In the interviews, new information from witnesses or information from new witnesses was cited as the most prevalent reason for case clearance. The case reviews determined that there were factors in each of the following domains that predicted whether cases would be solved during cold case investigations: Crime Context, Initial Investigation Results, Basis for Opening Cold Case, and Cold Case Investigator Actions. The results suggest that it is possible to prioritize cold case work based on the likelihood of investigations leading to clearances.

Direct link to the article.

The final destination: Incorporating ‘Death by GPS’ into forensic and legal sciences - June 2024

This article seeks to give visibility to a growing program: Motorists who set out for travel following directions from their GPS device and never return. These occurrences have gained the moniker ‘Death by GPS’. From giving incorrect directions, to taking motorists to isolated areas, to directing motorists into unsafe neighborhoods, GPS technology has led several people into catastrophic scenarios. This article is split into two sections. In the first section, the varying causes of Death by GPS are examined, alongside notable cases. In the second section, as Death by GPS is understudied in forensic science and legal spaces, the author explores the societal and scientific benefits of filling this gap. Relying on relevant collision figures, cultural trends, death science, legal studies, and ethics literature, this article produces groundwork on the growing issue of Death by GPS and identifies areas for future exploration.

Direct link to the article.

Finding the here in where: Keatley's Winthropping in missing persons and no-body homicide cases. - June 2024

No-body homicide cases are typically difficult to investigate, owing to the lack of forensics and leads. Researchers in the fields of forensics, criminology, and psychology have attempted to provide assistance to these investigations through their respective disciplines. The focus of the current case study review is on a combined approach to assisting in no-body homicides and cold cases. The proposed approach will outline a geographical profiling technique that has previously been used in no-body homicide investigations, Winthropping. Alongside this, forensic linguistic analyses will be outlined to show how a combination may provide fresh leads and investigative avenues for further exploration. A series of 4 real-world cases in which bodies were moved, dumped, and hidden by a suspect, who subsequently revealed knowledge of the clandestine grave are given. The aim is that readers from related fields and disciplines might synergistically collaborate to develop the area and further help in these cases.

Direct link to the article.

Interpretable algorithmic forensics - March 2024

One of the most troubling trends in criminal investigations is the growing use of “black box” technology, in which law enforcement rely on artificial intelligence (AI) models or algorithms that are either too complex for people to understand or they simply conceal how it functions. In criminal cases, black box systems have proliferated in forensic areas such as DNA mixture interpretation, facial recognition, and recidivism risk assessments. The champions and critics of AI argue, mistakenly, that we face a catch 22: While black box AI is not understandable by people, they assume that it produces more accurate forensic evidence. In this Article, we question this assertion, which has so powerfully affected judges, policymakers, and academics. We describe a mature body of computer science research showing how “glass box” AI—designed to be interpretable—can be more accurate than black box alternatives. Indeed, black box AI performs predictably worse in settings like the criminal system. Debunking the black box performance myth has implications for forensic evidence, constitutional criminal procedure rights, and legislative policy. Absent some compelling—or even credible—government interest in keeping AI as a black box, and given the constitutional rights and public safety interests at stake, we argue that a substantial burden rests on the government to justify black box AI in criminal cases. We conclude by calling for judicial rulings and legislation to safeguard a right to interpretable forensic AI.

Direct link to the article

Clinical and historical aspects of the Elephant Man: Exploring the facts and the myths - March 2024

Joseph Merrick, the Elephant Man, presented to the Royal London Hospital in 1884 with an obscure condition that puzzled his contemporaries, and fascinates clinicians to this day. Throughout the 1900s, a number of theories were advanced to explain the numerous growths that covered his body: neurofibromatosis, Proteus syndrome, and a combination of childhood injury, fibrous dysplasia, and pyarthrosis. The debate continued throughout the 20th century without resolution. Today, new consensus on the genetic and clinical diagnosis of neurofibromatosis and Proteus syndrome has allowed advancements in the Elephant Man's diagnosis. Using recent clinical diagnostic criteria it is now possible to conclude that Joseph Merrick was in all likelihood suffering from Proteus syndrome. Nevertheless, details of his genotype remain unknown. Obtaining intact DNA from the Elephant Man's skeleton is challenging, yet it is possible that sequencing Merrick's genome could provide genetic confirmation of his clinical diagnosis, and shed light on the process of tumourigenesis.

Direct link to the article.

Acute and Chronic Effects of Cocaine on Cardiovascular Health - February 2024

Cardiac complications resulting from cocaine use have been extensively studied because of the complicated pathophysiological mechanisms. This study aims to review the underlying cellular and molecular mechanisms of acute and chronic effects of cocaine on the cardiovascular system with a specific focus on human studies. Studies have consistently reported the acute effects of cocaine on the heart (e.g., electrocardiographic abnormalities, acute hypertension, arrhythmia, and acute myocardial infarction) through multifactorial mechanisms. However, variable results have been reported for the chronic effects of cocaine. Some studies found no association of cocaine use with coronary artery disease (CAD), while others reported its association with subclinical coronary atherosclerosis. These inconsistent findings might be due to the heterogeneity of study subjects with regard to cardiac risk. After cocaine use, populations at high risk for CAD experienced coronary atherosclerosis whereas those at low risk did not experience CAD, suggesting that the chronic effects of cocaine were more likely to be prominent among individuals with higher CAD risk. Studies also suggested that risky behaviors and cardiovascular risks may affect the association between cocaine use and mortality. Our study findings highlight the need for education regarding the deleterious effects of cocaine, and access to interventions for cocaine abusers.

Direct link to the article.

Accuracy and reliability of forensic handwriting comparisons - February 2024

Forensic handwriting examination involves the comparison of writing samples by forensic document examiners (FDEs) to determine whether or not they were written by the same person. Here we report the results of a large-scale study conducted to assess the accuracy and reliability of handwriting comparison conclusions. Eighty-six practicing FDEs each conducted up to 100 handwriting comparisons, resulting in 7,196 conclusions on 180 distinct comparison sets, using a five-level conclusion scale. Erroneous "written by" conclusions (false positives) were reached in 3.1% of the nonmated comparisons, while 1.1% of the mated comparisons yielded erroneous "not written by" conclusions (false negatives). False positive rates were markedly higher for nonmated samples written by twins (8.7%) compared to nontwins (2.5%). Notable associations between training and performance were observed: FDEs with less than 2 y of formal training generally had higher error rates, but they also had higher true positive and true negative rates because they tended to provide more definitive conclusions; FDEs with at least 2 y of formal training were less likely to make definitive conclusions, but those definitive conclusions they made were more likely to be correct (higher positive predictive and negative predictive values). We did not observe any association between writing style (cursive vs. printing) and rates of errors or incorrect conclusions. This report also provides details on the repeatability and reproducibility of conclusions, and reports how conclusions are affected by the quantity of writing and the similarity of content.

Direct link to the article.

Femicide and forensic pathology: Proposal for a shared medico-legal methodology - February 2024

Human scent signature on cartridge case survives gun being fired: A preliminary study on a potential of scent residues as an identification tool - January 2024

This paper focuses on a chemical analysis of human scent samples that were obtained from cartridge cases after being fired and their comparison with scent samples collected under laboratory conditions. Scent samples were analyzed by comprehensive two-dimensional gas chromatography coupled with the time-of-flight mass spectrometer. The results obtained from the chemical analyzes confirmed the desired stability of the human scent evidence and outlined the possible application for forensic purposes. The qualitative results of the study converge with the findings of previous studies on the composition of human scent and the chemical composition of human fingerprints. Furthermore, statistical analyzes were performed employing similarity algorithms such as Pearson’s and Spearman’s correlations, or Kendall’s tau. The resulting comparison of the scent samples secured on fired cartridge cases compared with those samples collected under laboratory conditions yielded ten out of ten correct identifications of the scent inflictor.

Direct link to the article.

Where can offenders be found when they are not committing crimes? A cross-sectional survey of British police officers on non-crime locations - January 2024

To date, the bulk of research on place and crime has concentrated on crime scene locations and home addresses of both victims and perpetrators. Beyond these locations, less is known about where offenders can be found during regular, non-criminal activity. These ‘non-crime locations’ provide information about offenders' lifestyles, their relationships with co-offenders, their preferred spots, and the places beyond the spatiotemporal boundaries of the crime where they may plan, manage, or deal with the aftermath of their behaviour. Yet there is a lack of systematic evidence, with the available research relying on local ethnographic designs, small samples or both, as access to such data was limited. This study utilises a novel approach by relying on the professional experience of intelligence police officers assigned to deal with serious and organised crime in the West Midlands County of the United Kingdom to determine the whereabouts of three types of non-crime locations: (a) hangout spots, (b) recruitment spots and (c) contraband hideout spots. Results suggest that offenders frequently visit gyms, specific restaurants, or private residences (not unlike locations where normative people hang out), and new members can be recruited anywhere. Drugs and firearms are strategically hidden near vulnerable persons. According to police officers, offenders are unconcerned by surveillance in these spots and choose venues not usually owned by criminal groups. Theoretical, methodological, and practical implications are discussed.

Article can be viewed here.

The evidential value of dental calculus in the identification process - January 2024

DNA analysis-based identification is by far the gold standard in forensic genetics and it should be performed in every case involving human remains or unidentified bodies. Bones and teeth are the preferred source of human DNA for genetic analysis. However, there are cases where the nature of the proceedings and historical significance prevent the disruption of skeletal structure. The remains may also be heavily degraded. In such situations, forensic geneticists seek alternative sources of human DNA. Teeth calculus has proven to be a viable source of DNA for identification purposes. The aim of this study was to assess the concentration of human DNA in teeth calculus and evaluate the usefulness of teeth calculus as a DNA source in the identification process. Teeth calculus was collected from skeletons exhumed between 2021 and 2022 by the PBGOT (Polish Genetic Database of Victims of Totalitarianism) team from the former Stalag IID prisoner-of-war camp in Stargard. Genetic analyses included the determination of autosomal and Y-STR markers. The total concentration of human DNA was also evaluated in samples from teeth calculus and teeth taken from the same individuals. The pilot study included 22 skeletons with a sufficient amount of calculus for isolation (specified in the protocol). Samples were taken from the largest areas of calculus deposited on lingual surfaces of mandibular incisors. The prepared samples underwent DNA extraction. Our study demonstrated that teeth calculus is a source of human DNA for remains from the World War II period. The obtained DNA concentration allowed for the determination of STR markers. It was shown that teeth calculus contains human DNA in an amount suitable for preliminary identification analyses.

Direct link to the article.

Accidental Injury or “Shaken Elderly Syndrome”? Insights from a Case Report - January 2024

Subdural haemorrhage (SDH) as result of a traumatic brain injury (TBI) is a common cause of death in cases of fatal physical abuse. Since intracranial bleeding is a common finding in elderly due to age-related intracranial changes or increasing prevalence of anticoagulant medication, differential diagnosis between inflicted and non-inflicted head injury is challenging. A case of an elderly woman’s death caused by TBI is reported. Autopsy showed multiple polychromatic bruises and a frontoparietal hematoma with bilateral subacute SDH. History excluded paraphysiological or pathological non-traumatic conditions that could justify SDH, while iatrogenic factors only played a contributory role. Since polychromatic bruises distributed on the face, the upper extremities and the chest were consistent with forceful grasping/gripping or repeated blows and SDH can form in absence of impact or by mild/minor blows, SDH was considered the result of repeated physical abuses. Differential diagnosis between traumatic and non-traumatic SDH is still challenging for forensic pathologists. As largely accepted in the pediatric population and occasionally described also in adults, however, violent shaking should be also considered as a possible mechanism of SDH—especially in elderly who do not have any sign of impact to the head.

Direct link to the article.

Wrongful convictions and claims of false or misleading forensic evidence - October 2023

The results are reported of a study to examine case factors associated with 732 wrongful convictions classified by the National Registry of Exonerations as being associated with “False or Misleading Forensic Evidence.” A forensic error typology has been developed to provide a structure for the categorization and coding of factors relating to misstatements in forensic science reports; errors of individualization or classification; testimony errors; issues relating to trials and officers of the court; and evidence handling and reporting issues. This study, which included the analysis of 1391 forensic examinations, demonstrates that most errors related to forensic evidence are not identification or classification errors by forensic scientists. When such errors are made, they are frequently associated with incompetent or fraudulent examiners, disciplines with an inadequate scientific foundation, or organizational deficiencies in training, management, governance, or resources. More often, forensic reports or testimony miscommunicate results, do not conform to established standards, or fail to provide appropriate limiting information. Just as importantly, actors within the broader criminal justice system—but not under the purview of any forensic science organization—may contribute to errors that may be related to the forensic evidence. System issues include reliance on presumptive tests without confirmation by a forensic laboratory, use of independent experts outside the administrative control of public laboratories, inadequate defense, and suppression or misrepresentation of forensic evidence by investigators or prosecutors. In approximately half of wrongful convictions analyzed, improved technology, testimony standards, or practice standards may have prevented a wrongful conviction at the time of trial.

Direct link to the article.

Telling us less than what they know: Expert inconclusive reports conceal exculpatory evidence in forensic cartridge-case comparisons. - October 2023

Cartridge-case comparison experts are tasked with determining whether a reference sample associated with the suspect originated from the same source as the evidence sample found at the crime scene. Same-source reports have strong inculpatory value and different-source reports have strong exculpatory value. Surprisingly, inconclusive reports have strong exculpatory value as they occur much more frequently for actualnon-matches than for actual matches. We used a Signal Detection Model to test our hypothesis that some experts report inconclusive when they detect a non-match. Consistent with this hypothesis, we found that even when examiners were able to perfectly discriminate matches from non-matches, they rendered inconclusive reports on 32% of non-match trials. Experts are biased to avoid rendering different-source reports, which conceals exculpatory information that innocent persons desperately need to establish their innocence. We argue that this biased examiner might result fromanadversarial allegiance bias combined with a flawed response scale.Keywords: forensic science; signal detection theory; bias; feature-comparison methods; cartridge-case comparisons.

Direct link to the article.

Bitten or struck by dog: A rising number of fatalities in Europe, 1995-2016. - October 2023

We analyzed fatal dog attacks in Europe 1995-2016 using official death cause data from Eurostat. The data comprised the number of fatalities assigned The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) code W54 "bitten or struck by dog", which includes deaths due to direct attacks but which excludes many complications following dog bites, such as rabies. In 2016, dogs killed 45 Europeans, which translates to an incidence of 0.009 per 100,000 inhabitants. This is comparable to estimates from the USA (0.011), and Canada (0.007), but higher than Australia (0.004). The number of European fatalities due to dog attacks increased significantly at a rate of several percent per year. This increase could not be explained by increases in the human or the dog populations. By taking all fatalities reported 1995-2016 into account, we investigated the effects of age, gender and geography. First, children, including infants, were common victims, but also middle-aged and the elderly, while people between ages 10 and 39 were rarely killed by dogs. Second, boys and men were overrepresented, but only in certain age groups and in certain parts of Europe. Third, there were large national and regional differences, both in the effects of gender and in incidences, which ranged from 0 to 0.045 per 100,000 inhabitants. This study of dog-related fatalities at a European level is the first of its kind and forms a basis for more detailed, national studies.

Direct link to the article.

Is it possible to estimate sex from signatures and handwriting? A review of literature, observations, and future perspectives. - October 2023

Estimation of sex holds great significance in the field of Forensic Science since it helps establish the identity of an individual during a crime scene investigation. Sex differences in human behaviour are the result of natural selection. Sexually dimorphic stimuli of cognitive and behavioural activities may influence the phenotypic expression of our motor skills. Human traits such as signatures and handwriting are phenotypic manifestation of these skills. These phenotypic biological and behavioural traits have inherent sexual dimorphism and may help to identify sex in different circumstances. For instance, to establish the sex of an individual or deceased, forensic samples of the human body such as voice samples, features of fingerprints and footprints, the skeleton, or its remains are helpful. Similarly, the sex of an individual may also be identified from their corresponding handwriting and signature. Handwriting experts can extract peculiar features from handwriting and signatures which could help establish whether the signatures belong to a male or a female. A female writer may have attractive, rounded, upright, tidy, skilled, well-formed strokes, artistic design, better penmanship, and greater length of the signature compared to the signature of a male. Here, we review the studies related to the identification of sex from signatures and handwriting and present inferences about vital features and methods of sex identification through handwriting. These mainly suggest that the accuracy of sex prediction from signature and handwriting ranges from 45 to 80%. We also present writing examples to show sex-based differences in the signature and handwriting of males and females. The female's handwriting is more decorative, arranged, aligned, neat, and clean as compared to that of the male. Based on the writing samples and the review of literature, we suggest that forensic handwriting experts may eliminate suspects based on the sex of the writer, which can simplify the identification process of disputed or questionable signatures and handwriting.

Direct link to the article.

“Considerable Grief”: Dead Bodies, Mortuary Science, and Repatriation after the Great War - September 2023

In September 1919, Mary McKenney was forced to relive the horrors of her husband Arthur’s death. Sergeant Arthur McKenney was wounded in France and returned to the United States.¹ Despite his minor injury, he later died at a US Army hospital in Colonia, New Jersey from shock following an operation. After the autopsy, his body was turned over to an undertaker and then shipped home. The military inspector who cleared the body for travel missed the undertaker’s unsuccessful attempt to close the autopsy incisions. Arthur McKenney arrived in Boston, but the box was poorly nailed and emitted a horrible odor. The body appeared in an “advanced stage of putrefaction…the underclothing was stained and the coat wet from purging,” and fluid “trickled from the mouth and nose.”² The incident precipitated a wave of correspondence between Arthur’s family and military personnel. It serves as a symbol of the politically charged intersection of deceased service members’ bodies, the state, and the family in modern war.

Read more here on Nursing Clio blog: https://nursingclio.org/2019/04/18/considerable-grief-dead-bodies-mortuary-science-and-repatriation-after-the-great-war/

Serial Killings and Attempted Serial Killings in Hospitals, Nursing Homes, and Nursing Care. - September 2023

Reanalysis of Iceman's Genome Due to Contaminated DNA Reveals Anatolian Ancestry - August 2023

The Tyrolean Iceman is known as one of the oldest human glacier mummies, directly dated to 3350–3120 calibrated BCE. A previously published low-coverage genome provided novel insights into European prehistory, despite high present-day DNA contamination. Here, we generate a high-coverage genome with low contamination (15.3×) to gain further insights into the genetic history and phenotype of this individual. Contrary to previous studies, we found no detectable Steppe-related ancestry in the Iceman. Instead, he retained the highest Anatolian-farmer-related ancestry among contemporaneous European populations, indicating a rather isolated Alpine population with limited gene flow from hunter-gatherer-ancestry-related populations. Phenotypic analysis revealed that the Iceman likely had darker skin than present-day Europeans and carried risk alleles associated with male-pattern baldness, type 2 diabetes, and obesity-related metabolic syndrome. These results corroborate phenotypic observations of the preserved mummified body, such as high pigmentation of his skin and the absence of hair on his head.

Direct link to the article.

Injuries Due to Law Enforcement Use of Force in the United States, 2006-2015: Trends in Severity and by Race - August 2023

The Ichabodies – death dummies™ - August 2023

Angie McLachlan MA; BA (Hons); MBIE; Dip MoD, (a recent DipMoD graduate, AFMS), is a death care tutor and thanatologist with over three decades of experience within and around the funeral sector. With a deep commitment to providing ethical training, Angie utilizes dummy bodies (The Ichabodies – death dummies™), to depict the sometimes-visceral nature of death, to help students gain knowledge about what might be involved while caring for the dead.

By designing, building and using these dummies (ranging in age from pre-term to adult), Angie offers a unique way to explore and understand some of the intricacies of care of the body after death. While engaging in practical work, students are encouraged to ask questions and to develop ideas for their own role in end-of-life care, in whatever aspect this may be. This immersive approach helps students to challenge societal taboos and often, their own pre-conceived ideas, while forming strategies for taking their learning forward into their workplace.

The use of dummies, as opposed to learning with real dead people, gives an ethical freedom to explore simulated scenarios and situations. Students can discuss different body-care plans from Traditional, Green, Eco and Home Funeral standpoint, gaining understanding of what might be involved when assisting families who seek help to look after someone with complex needs – such as decomposition, odours and leakage.

Dummies can help to promote open and honest conversations about death and dying, further, it is also possible to provide a tangible representation of the physical and emotional aspects of working with people after death. This kind of work may evoke affecting and physical responses for those entering the sector, responses that are usefully explored prior to being confronted with a real client or situation. As an independent researcher, Angie has written about ‘Coping Strategies’ and their importance for workers within the end-of-life sector[1] (https://www.equinoxpub.com/home/religion-death-senses/ Pub. due: 1-10-2024), and is able to link the academic and practical work in their training sessions.

Based in Dorset, Angie has been invited to teach all over Britain. In addition to providing practical body-care courses, they have spoken to a variety of audiences ranging from G.P. Training Days, University Conferences, to educational sessions for the funeral sector and volunteer groups attached to Hospices and bereavement organisations. Additionally, Ichabod Smith and Angie have been included at ‘Death-Day’ events in Bournemouth, Southampton, and Glasgow.

Angie is available for bookings sessions and may be based:

• At a Funeral Directors’ premises and be mortuary related – 1 or 2 days
• In a hall or classroom and ‘home-based’ for Death Doulas and Soul Midwives – 1 day
• Talks for volunteers or groups with a dummy present in the room – The presentation and content vary according to the course venue and the needs of those attending.
   

Current adult dummies:

Vichi Smith (illustrated) – Demonstrating: Fungating sarcoma of right breast, secondaries in mandible; tracheostomy tube; PEG feeding tube; Foley catheter and urinary bag; drug lines; plus, decomposition signs in the trunk and appropriate ‘body fluids’ exudate and odours.

Ich-aah Smith – Demonstrating: Oral Closure techniques; Necrotic diabetic foot, oedematous leg care; plus, appropriate ‘body fluids’ leakage and odours related to necrosis, oedema and decomposition.

Ichabod Smith – Demonstrating: Hypostasis, skin-slip, Pacemaker; Stoma care; Foley catheter and urinary bag; base of spine pressure sore; drug lines; stomach-purge; plus, appropriate ‘body fluids’ and odours.

Further information:

https://www.redplaitinterpretation.com/ichabod.html

www.redplaitinterpretation.com

https://journal.equinoxpub.com/FIR/article/view/13063

LinkedIN:

https://www.linkedin.com/in/angie-mclachlan-67b7b3211/

Debunking Three Rape Myths - August 2023

Acceptability of post-mortem imaging among Muslim and non-Muslim communities - August 2023

Examination of misconceptions surrounding fatal fire victims - July 2023

Fire deaths are not unusual in forensic investigative practice but due to the destructive nature of fire they are often very difficult to investigate. With the need to identify the deceased and the events surrounding the manner and cause of death, knowledge of thermally induced alteration to the human body is important. Within the fire investigation community, a number of misconceptions have been present for years regarding the protrusion of the tongue as an indicator of life during the fire, and fractured skulls the result of brains boiling and skulls exploding. This work presents qualitative analysis on the experimental burning of 42 unembalmed human donated cadavers with the San Luis Obispo Strike Team (SLOFIST) on their annual Forensic Fire Death Investigation Course (FFDIC), in years 2017 to 2019. Prior to burning the position of the tongue within the dental arch was confirmed and sharp, blunt, surgical and gunshot trauma to the cranium documented. Temperature was recorded from ignition through to suppression with thermocouples present both within the scene and the body. Post burn analysis on the position of the tongue, observation of cranial fracture and presence of brain tissue were recorded and analysed in conjunction with thermocouple data, fire scene dynamics and body demographics. The results provide a more comprehensive understanding of the thermal environmental factors involved in producing the phenomena that facilitate these misconceptions, identifying that a more thorough understanding of individual fire scenes and their development is essential when interpreting alteration and injury to the body of the fatal fire victim.

Direct link to the article.

Lethal event in diving with self-contained underwater breathing apparatus: A forensic study - July 2023

Increased lung weight in fatal intoxications is not unique to opioid drugs - July 2023

Fatal intoxications with opioids are known to be associated with an increased lung weight, as well as with brain and pulmonary edema and urinary retention. However, there is evidence to suggest that fatal intoxications with non-opioid substances are also associated with increased lung weight; however, the latter aspect has not been comprehensively analyzed. To determine to what extent opioid and non-opioid substances are associated with increased lung and brain weight, we studied these organs in cases where the cause of death was attributed to intoxication with a single agent. Using data from cases autopsied at the National Board of Forensic Medicine (NBFM) in Sweden from 2009 through 2019 where the cause of death was attributed to a single substance, we created models of combined lung weight and brain weight. The models used age and sex as predictors as well as nested varying effects for the specific intoxicant and category of intoxicant. Suicidal hanging with negative toxicology cases served as controls. The population majority was male among both intoxications (68%) and controls (83%). The most common single substance group was opioids. All tested substances were associated with heavier lungs than controls, with the largest effect in the opioid group. Our findings show that several substances are associated with increased lung weight and that among intoxication deaths there is no difference in expected brain weight between substances. Hence, heavy lungs, without a reasonable explanation, should prompt a broad toxicological screening.

Direct link to the article.

Firearm injury - a preventable public health issue - June 2023

Firearm-related injury is a leading cause of death disproportionately affecting adolescents and young adults across the world, especially in the Americas. Little progress has been made over the past four decades, as inaction and the adoption of ineffective or unevidenced interventions have become commonplace. The COVID-19 pandemic reconfigured health systems towards prevention and harm reduction, sharpened public attention to the burden of preventable deaths, and inspired a fresh ambition of eliminating avertable deaths. In this Viewpoint, we argue that preventing firearm injury should garner bolder action in post-pandemic public health and we present a case for reducing the global burden of firearm injury supported by evidence and international examples. Crucially, we aim to guide policy making in directions that end the cycle of grief, anger, activism, deflection, and inaction and create more peaceful and fairer societies.

Link to the article.

Application of 3D imaging and selfies in forensic dental identification - June 2023

With increased access to smartphones, the selfie has gained immense popularity in the past decade. Selfie images could be a significant source of ante-mortem (AM) image data in cases where dental records are unavailable or considered insufficient. The application of 3D imaging and selfies has not been explored to its full potential in human dental identification. The present study aimed to evaluate the feasibility of using selfies as AM data and comparing with 3D post-mortem (PM) scans as an alternative to multiple 2D PM photographs in forensic dental identification. The study sample consisted of 18 selfies (12 matching and 6 non-matching) and 15 3D dental scans obtained from the study participants. The study sample was assessed by 6 experienced forensic odontologists (Raters) in two phases; Phase I-Visual comparison of 2D selfies to 3D scans and Phase II-2D selfies superimposed upon 3D scans. Each rater looked at 15 cases, and a total of 1620 comparisons were made by 6 raters (72 for the 12 matching cases and 1548 were for non-matching) and the opinions for each of the comparisons were analyzed. The results of the study show that use of the 3D superimposition method increased the certainty of the conclusions reached by the raters for the cases with correct matches. Furthermore, 94.2% of the 1548 non-matching comparisons were correctly excluded, compared with 77% for the 2D visual comparison method. The study demonstrated the applicability of this 3D method as a valuable tool in assisting the forensic odontologist with dental identification using selfies.

Link to the article.

Malaysia to decriminalise suicide - June 2023

Malaysia is seeking to decriminalise suicide attempts. The announcement comes after Malaysia's parliament voted to remove the mandatory death penalty, cut down the number of offences punishable by death, and abolish natural-life prison sentences.The current law stipulates that anyone attempting suicide can be imprisoned for up to one year, fined, or both. The government will retain "aiding and abetting" suicide as a criminal offense.

How long can a dead body remain infectious? - June 2023

The SARS-CoV-2 pandemic involved several changes and difficulties in the work of forensic pathologists. Postmortem nasopharyngeal swabs for the diagnosis of the SARS-CoV-2 infection are recommended before an autopsy examination by the Centers for Disease Control and Prevention.

Autopsy examinations must not be performed for SARS-CoV-2 infection cases when airborne infection isolation rooms or other suitable spaces are unavailable. However, it has not yet been reported whether the presence of SARS-CoV-2 at a low viral load may be enough to infect and disseminate the contagion.

Here, we report the case of a 67-year-old man found dead at home on November 9, 2020, and transferred immediately after to the Genova District Mortuary. As the first postmortem molecular nasopharyngeal swab resulted positive, a weekly sampling was carried until February 4, 2021. All the molecular tests were positive for SARS-CoV-2, including the last swab performed 87 days after the arrival of the corpse at the morgue. Virus isolation conducted on VERO E6 cells revealed no cytopathic effect indicating no viral replication as early as 18 days after the corpse's arrival at the morgue and until January 2021.

Our findings suggest that the presence of the genome of SARS-CoV-2 at low viral load should not be considered a sign of an active infection but a trace of a remaining viral genome from a previous infection. Then, if the virus shows no replication activity, its molecular detection should not constitute a threat to public health. Further studies are required to establish the infection's potential and its correlation with viral load.

Key Words: nasopharyngeal swabs, SARS-CoV-2 culture, COVID-19, forensic pathology, autopsy

(Am J Forensic Med Pathol 2022;43: 215–219)

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The Sexome ? A proof of concept study into microbial transfer between heterosexual couples after sexual intercourse - May 2023

The detection and recovery of male DNA post-assault is important in sexual assault investigations, particularly where an offender is unknown to the victim. The collection of DNA evidence often occurs when the female victim undergoes a forensic medical assessment. Analysis regularly results in mixed autosomal DNA profiles with both victim and perpetrator DNA, often making it difficult to interpret a male profile suitable for DNA database searching. While short tandem repeat (STR) profiling of the male Y-chromosome is often used to overcome this challenge, successful identification of an individual can be hindered by the paternal inheritance pattern of Y-STRs and small Y-STR databases. Human microbiome research has suggested that a person’s microbial diversity is unique. Therefore microbiome analysis using Massively Parallel Sequencing (MPS) could serve as a useful adjunct method of perpetrator identification. This study aimed to identify bacteria taxa that were unique to each participant and compare the bacterial communities found on their genitals both pre- and post-coitus. Samples were collected from six male-female sexual partner pairs. Volunteers were asked to self-collect low vaginal (females) and penis shaft and glans (males) samples before and after intercourse. Samples were extracted using the PureLink™ Microbiome DNA Purification Kit. Extracted DNA underwent library preparation using primers targeting the V3-V4 hypervariable regions of the bacterial 16S rRNA gene (∼450 bp). Libraries were sequenced on the Illumina MiSeq® platform. From the sequence data derived, statistical analysis was performed to investigate if bacteria sequences could be used to infer contact between each male-female pairing. Unique bacterial signatures were detected in low frequencies (<1%) in male and female participants pre-coitus. The data indicated a significant disruption to microbial diversity post-coitus in all samples. A transfer of the female microbiome during intercourse was most significant. As expected, one couple who did not use a barrier contraceptive yielded the most microbial transfer and disruption to diversity demonstrating a proof-of-concept in the utility of microbiome interrogation for sexual assault cases. Further genomic analysis is needed to confirm species and subspecies classification of bacteria that may produce a unique microbial profile that could then be used to identify a specific individual. Link to full article: https://www.sciencedirect.com/science/article/abs/pii/S0379073823001615#preview-section-abstract

The first drug-related death associated with xylazine use in the UK and Europe - May 2023

On November 8th 2022, the United States Food and Drug Administration (FDA) issued a statement alerting healthcare professionals to the increasing prevalence of xylazine in illicit drug overdoses in the country. Xylazine is a veterinary medicine with sedative, analgesic and muscle relaxant properties that is used as a heroin/fentanyl adulterant on the illicit drug market in North America. Here we report the first drug-related death associated with xylazine in the United Kingdom. The National Programme on Substance Abuse Deaths (NPSAD) receives reports on drug-related deaths from coroners in England, Wales and Northern Ireland on a voluntary basis. the NPSAD was searched for cases with xylazine detections in cases received by December 31, 2022. One drug-related death associated with xylazine use was reported to NPSAD by December 31, 2022. The deceased was a 43-year-old male who was founds dead at home with drug paraphernalia located at the property in May 2022. The post-mortem examination identified recent puncture wounds to the groin. Coronial documentation reports that the deceased had a history of illicit drug use. A number of drugs were detected by post-mortem toxicology and xylazine was implicated in death alongside heroin, fentanyl and cocaine. To the best of our knowledge, this is the first death associated with xylazine use reported in the UK, and even Europe, and indicates the entry of xylazine into the UK drug supply. This report highlights the importance of monitoring changes in illicit drug markets and the emergence of new drugs.

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Differentiating individuals through the chemical composition of their fingermarks - May 2023

Fingermark patterns are one of the oldest means of biometric identification. During this last decade, the molecules that constitute the fingermark residue have gained interest among the forensic research community to gain additional intelligence regarding its donor profile including its gender, age, lifestyle or even its pathological state. In this work, the molecular composition of fingermarks have been studied to monitor the variability between donors and to explore its capacity to differentiate individuals using supervised multi-class classification models. Over one year, fingermarks from thirteen donors have been analysed by Matrix-Assisted Laser Desportion/Ionisation Mass Spectrometry Imaging (n = 716) and mined by different machine learning approaches. We demonstrate the potential of the fingermark chemical composition to help differentiating individuals with an accuracy between 80% and 96% depending on the period of sample collection for each donor and size of the pool of donors. It would be premature at this stage to transpose the results of this research to real cases, however the conclusions of this study can provide a better understanding of the variations of the chemical composition of the fingermark residue in between individuals over long periods and help clarifying the notion of donorship.

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Re-examining so-called 'second identifiers' in Disaster Victim Identification (DVI): Why and how are they used? - May 2023

Disaster victim identification (DVI) refers to the identification of multiple deceased persons following an event that has a catastrophic effect on human lives and living conditions. Identification methods in DVI are typically described as either being primary, which include nuclear genetic markers (DNA), dental radiograph comparisons, and fingerprints comparisons, or secondary, which are all other identifiers and are ordinarily considered insufficient as a sole means of identification. The aim of this paper is to review the concept and definition of so-called "secondary identifiers" and draw on personal experiences to provide practical recommendations for improved consideration and use. Initially, the concept of secondary identifiers is defined and examples of publications where such identifiers have been used in human rights violation cases and humanitarian emergencies are reviewed. While typically not investigated under a strict DVI framework, the review highlights the idea that non-primary identifiers have proven useful on their own for identifying individuals killed as a result of political, religious, and/or ethnic violence. The use of non-primary identifiers in DVI operations in the published literature is then reviewed. Because there is a plethora of different ways in which secondary identifiers are referenced it was not possible to identify useful search terms. Consequently, a broad literature search (rather than a systematic review) was undertaken. The reviews highlight the potential value of so-called secondary identifiers but more importantly show the need to scrutinise the implied inferior value of non-primary methods which is suggested by the terms "primary" and "secondary". The investigative and evaluative phases of the identification process are examined, and evaluative phases of the identification process are examined, and the concept of "uniqueness" is critiqued. The authors suggest that non-primary identifiers may play an important role in providing leads to formulating an identification hypothesis and, using the Bayesian approach of evidence interpretation, may assist in establishing the value of the evidence in guiding the identification effort. A summary of contributions non-priamry identifiers may make to DVI efforts is provided. In conclusion, the authors argue that all lines of evidence should be considered because the value of an identifier will depend on the context and the victim population. A series of recommendations are provided for consideration for the use of non-primary identifiers in DVI scenarios.

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Swipe right: The emergence of dating-app facilitated sexual assault. A descriptive retrospective audit of forensic examination caseload in an Australian metropolitan service - May 2023

The use of dating 'apps' to facilitate real-world social encounters between strangers is culturally mainstream. Sexual assaults facilitated following dating-app meetings have been reported in the media, and anecdotally noted at increasing frequency by clinical forensic physicians. Limited empirical data suggests there has been a marked increase in real life sexual offences facilitated in this manner. There is little additional information known about the circumstances of these alleged incidents. This retrospective audit of a small forensic examination caseload from an Australian metropolitan clinical forensic medicine service identified that 14% (11 of 76) of alleged sexual assaults where complainants underwent a forensic examination were facilitated following a dating-app meeting. Further analysis of these cases identified that all complainants were female, most under 30 years of age. All alleged a single male perpetrator and in over half of the cases the complainant was impaired. In all cases where it was asked (n = 9), the alleged incident occurred at the first face-to-face meeting. More than half of the incidents occurred at the alleged perpetrator's private residence. Anogenital injuries were observed at the time of forensic examination in 60% of cases, and 70% had visible body injuries. There was no reported condom use. Only one complainant had no observable injury. This small case series quantified a high proportion of forensic sexual assault examination caseload as being facilitated by dating-app meetings, and identified some common features that may be characteristic of alleged sexual assaults occurring in this manner. The authors propose a larger prospective period of data collection at the time of forensic medical examination, to characterize the features of sexual assaults allegedly occurring following app-based meetings.

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Comparing the diagnostic accuracy of post-mortem CT with invasive autopsy in fire-related deaths: A systematic review - April 2023

The value of post-mortem computed tomography (PMCT) in trauma victims is well established. In this review the diagnostic accuracy and value of PMCT will be investigated specifically for fire-related deaths, which has yet to be fully investigated. PRISMA guidelines informed this systematic review. A total of ten databasees were searched in December 2020. All articles exploring the use of PMCT and autopsy to investigate fire related deaths in adults were deemed eligible for inclusion, and were reviewed by two independent researchers. The QUADAS-2 tool was used to assess the quality of these papers. Seven studies were selected, containing a total of 110 burns victims. PMCT was superior in identifying fractures, and is particularly accurate with regards to fractures and injuries of the skull, facial bones, neck and extremities. However, PMCT fared poorly in identifying signs of vitality during a fire compared to autopsy. Toxicological examinations to assess carbon monoxide levels were often still required to make a conclusive diagnosis of fire as the cause of death. Despite the heterogeneity of the methodologies reviewed, it is clear that PMCT is an extremely powerful visualisation tool with great potential for documentation and examination in forensic cases. The limitations of PMCT mean that it can not fully replace autopsy in these cases, but if autopsy is not available PMCT, in combination with a toxicology and histology examination, can identify the cause of death to a high degree of certainty.

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Wrongful convictions and claims of false or misleading forensic evidence - April 2023

The results are reported of a study to examine case factors associated with 732 wrongful convictions classified by the National Registry of Exonerations as being associated with "False or Misleading Forensic Evidence". A forensic error typology has been developed to provide a structure for the categorization and coding of factors relating to misstatements in forensic science reports; errors of individualization or classification; testimony errors; issues relating to trials and officers of the court; and evidence handling and reporting issues. This study, which included the analysis of 1391 forensic examinations. demonstrates that most errors related to forensic evidence are not identification or classification errors by forensic scientists. When such errors are made, they are frequently associated with incompetent or fraudulent examiners, disciplines with an inadequate scientific foundation, or organizational deficiencies in training, management, governance, or resources. More often, forensic reports or testimony miscommunicate results, do not conform to established standards, or fail to provide appropriate limiting information. Just as importantly, actors within the broader criminal justice system - but not under the purview of any forensic science organization - may contribute to errors that may be related to the forensic evidence. System issues include reliance on presumptive tests without confirmation by a forensic laboratory, use of independent experts outside the administrative control of public laboratories, inadequate defense, and suppression or misrepresentation of forensic evidence by investigators or prosecutors. In approximately half of wrongful convictions analyzed, improved technology, testimony standards, or practice standards may have prevented a wrongful conviction at the time of trial.

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Evidence of D-shaped wounds in the intrasomatic bullet path: two case reports - March 2023

The final appearance of gunshot wounds is influenced by both the projectile's behavior from the muzzle to the terminal target and by the intrinsic characteristics of the anatomical compartments where the lesion(s) occur. The D-shaped morphology is an uncommon yet well-known finding in the forensic literature and has been described when the surface of impact with the skin is represented by the bullet's lateral projection. Two cases where D-shaped gunshot wounds were observed are hereby presented: in both cases, interaction with multiple intermediate targets (case 1) and a human intermediate target (case 2) had been documented and confirmed by the forensic examination. Despite the different dynamics of production, this peculiar morphology was described throughout most of the intrasomatic bullet path in both victims. The discovery of D-shaped gunshot wounds can guide the forensic pathologist in the ballistic reconstruction of the event by supporting the hypothesis of an interaction with an intermediate target that has led to deviation from the initial trajectory and destabilization of the bullet associated with the loss of kinetic energy.

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Inside the Medical Examiner's Office, where opioids fuel surge in deaths - March 2023

This news article by the New York Times is about the rising number of deaths at the Office of the Chief Medical Examiner in New York City. In post-pandemic times, deaths continue to rise due to drug overdoses, and this article highlights the opioid pandemic as seen in the OCME.

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Understanding the burden of unidentified bodies: A systematic review - March 2023

While human identification is a crucial aspect of medico-legal investigations, many individuals remain unidentified each year across the world. The burden of unidentified bodies is often referred to when motivating for improved methods of identification, and anatomical teaching, yet the actual burden is somewhat unclear. A systematic literature review was undertaken to identify articles that empirically investigate the number of unidentified bodies experienced. Despite the large number of articles returned, an alarmingly low number (24 articles) provided specific and empirical details on the number of unidentified bodies, demographics and trends thereof. It is possible that this lack of data is due to the variable definition of 'unidentified' bodies and the use of alternative terminology such as 'homelessness' or 'unclaimed' bodies. Nevertheless, the 24 articles provided data for 15 forensic facilities across ten countries of both developed and developing statuses. On average, developing countries experienced more than double (9.56%) the number of unidentified bodies when compared to developed nations (4.40%). While facilities were mandated under different legislations and infrastructures available varied greatly, the most common issue faced is the lack of standardised procedures for forensic human identification. Further to this, the need for investigative databases was highlighted. Through addressing the standardisation of identification procedures and terminology, alongside the appropriate utilisation of existing infrastructure and database creation, the number of unidentified bodies could be significantly reduced globally.

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Examination of methadone involved overdoses during the COVID-19 pandemic - March 2023

The US opioid overdose epidemic continues to escalate. The restrictions on methadone availability including take-home dosing were loosened during the COVID-19 pandemic although there have been concerns about the high street value of diverted methadone. This report examined how fatal overdoses involving mathadone have changed over the past two decades including during the pandemic. The CDC's Wide-ranging Online Data for Epidemiologic Research (WONDER) was used to find the unintentional methadone related overdose death rate from 1999 to 2020. Unintentional methadone deaths were defined using the ICD X40-44 codes with only data fo methadone (T40.3). Data from the DEA's Automation of Reports and Consolidated Orders System (ARCOS) on methadone overall use, opioid treatment programs use, and pain management use was gathered for all states for 2020 and corrected for population. There have been dynamic changes over the past two decades in methadone overdoses. Overdoses increased from 1999 (0.9/million) to 2007 (15.9) and declined until 2019 (6.5). Overdoses in 2020 (9.6) were 48.1% higher than in 2019 (t(50) = 3.05, p<.005). The state level correlations between overall methadone use (r(49) = +0.75, p<.001), and opioid treatment program use (r(49) = +0.77, p<.001) with overdoses were positive, strong, and statistically significant. However, methadone use for pain treatment was not associated with methadone overdoses (r(49) = -0.08). Overdoses involving methadone significantly increased by 48.1% in 2020 relative to 2019. Policy changes that were implemented following the COVID-19 pandemic involving methadone take-homes may warrant further study before they are made permanent.

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The Doppelgänger phenomenon and death: A peculiar case of homicide by a subject with first-episode psychosis - February 2023

The Doppelgänger phenomenon refers to the experience of a direct encounter with one's self, characterised by: (i) the perception of a figure with one's own identical physical features; or (ii) the apprehension that the perceived figure shares the same personality and identity. The Doppelgänger does not only look like the same person, it is his/her double. The perceptual element is usually a hallucination, although occasionally a false perception of an actual figure may be involved. This phenomenon has been described in individuals suffering from overwhelming fear, severe anxiety or intoxication, epilepsy, as well as in the sleep-wakefulness transition. It has also been reported in major psychoses. The fear of imminent death often precedes the Doppelgänger experience. This report presents the case of a 30-year-old man, Mr. Y, who was stabbed to death by Mr. X, his "double". The aggressor and his victim, although not related, were truly doubles; remarkably, they shared the same name and surname, age, professional activity and place of work. Moreover, they attended the same sports center but barely knew each other. The forensic psychiatric evaluations in Mr. X, subsequent to the crime committed, were suggestive of a psychotic condition. This case is unique in the scientific literature. In the most serious psychotic forms, the issue of the "double" calls into question not only the dissociative processes involved in the etiopathogenesis of the disorder, but also bio-psycho-social elements, as well as personal data in this case, which made the victim and the aggressor "identical". In the context of psychopathological functioning, the delusional mood (Wahnstimmung) that precedes the development of delirium is a sort of gateway to an impending psychotic illness, involving delusional awareness or mood (atmosphere). In psychosis, splitting is the main issue and this influence is seen as an evil, foreign, apocalyptic and unknown side no longer recognised as belonging to the self even in a psysical sense. In such a situation, it is felt that the only way to survive is by suppressing one's double as a defense against disorganisation of the self.

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"Blood, Bucks and Bias": Reliability and biasability of crime scene investigators' selection and prioritization of blood traces - February 2023

When crime scene investigators (CSIs) encounter crime scene with large volumes of blood, some selection and prioritization is often needed, and this will impact on what blood is and is not available for forensic analysis. What factors influence CSIs decision making process is largely unknown. This study examines the effects of awareness of limited resources and irrelevant contextual information indicating either a homicide or a suicide on CSIs collection of blood traces. To this end, two scenario-based experiments with CSIs and novices were conducted. Overall, the results suggest that even when CSIs decisions are made under identical conditions, their trace selection varies both when it comes to numbers and locations. Furthermore, awareness of limited resources made CSIs collect fewer traces and their selections also varied following the contextual case information, showing similarities and differences with novices. Since blood traces can be used to establish both activity and identity, the findings can have important implications for the subsequent investigation as well as trial.

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Criminal justice responses to domestic violence and abuse in England: An analysis of case attrition and inequalities using police data - February 2023

Responding to domestic violence and abuse (DVA) poses significant challenges for the criminal justice system, with recent studies highlighting a number of significant gaps and failings in the nature of the police response in particular. This paper reports on findings from a component of the multi-stage ESRC funded project 'Justice, Inequality and Gender-Based Violence' (ESRC grant ES/M010090/1) that relates to 400 reported incidents of DVA involving intimate partners recorded by two police force areas in England in 2014. Drawing on this large data set concerning a wide range of incidents, this paper employs quantitative methods to analyse the trajectories of reports made to the police, and the factors that may influence their progress through, or attrition from the criminal justice system. In doing so, this paper finds that certain 'inequality' factors such as victim gender, vulnerability (including mental health) and incident type are found to impact the progression of cases through the criminal justice system. This work seeks to build on our understanding of what happens to incidents of DVA that are brought to the attention of the police by victims and survivors, and reflects upon how the outcomes of such incidents impact the broader devate concerning the pursuit of a formal, or criminal 'justice' in cases of DVA.

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Characteristics of skin injuries caused by power drill - January 2023

Skin injuries caused by power drills have been rarely reported. A case is described of a 51-year-old woman who was found dead on a motorway after committing suicide by jumping from a bridge. The body showed a total of nine circular/oval penetrating injuries of the chest and abdomen with very regular, smooth margins, and particular features due to the presence of "skin islands" inside the lesion and "short radial linear abrasions" around the margins. These injuries were caused by a power drill, which was later found in the woman's apartment. For comparison, experimental tests were carried out with the same drill and different bits of pig skin, whose appearance resembled those found on the body. Especially skin islands were also reproduced in the experimental tests. The presented case shows the possibility of this rare method of suicide (or suicide attempt) and the typical characteristics of such peculiar skin lesions that pose problems of differential diagnosis with other injuries such as gunshot injuries.

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From crime scene to court room: A review of the current bioanalytical evidence workflows used in rape and sexual assault investigations in the United Kingdom - January 2023

Sexual assault casework requires the collaboration of multiple agency staff to formalise an investigative pipeline running from crime scene to court. While the same could be said of many other forensic investigations, few require the additional support of health care staff and the combined forensic involvement of body-fluid examiners, DNA experts and analytical chemists. The sheer amount of collaborative effort between agencies is laid out through a detailed examination of the investigative workflow from crime scene to courtroom with each step in the pipelines detailed and discussed. Beginning with a review of sexual assault legislation in the United Kingdom this article details how sexual assault investigations are initiated by police and supported by sexual assault referral centre (SARC) staff who are often the first responders providing primary healthcare and patient support to victims while simultaneously collecting and assessing forensic evidence. Detailing the myriad of evidential material that can be documented and collected at the SARC, the review identifies and categorises key forensic tests to first detect and identify body-fluids recovered from evidence through to the secondary analysis of DNA to help identify the suspect. This review also focusses on the collection and analysis of biological material used to support the allegation that the sexual activity was non-consensual and provides a breakdown of common marks and trauma as well as a review of common analytical methods used to infer Drug Facilitated Sexual Assault (DFSA). The culmination of the investigative pipeline is discussed by reviewing the Rape and Serious Sexual Assault (RASSO) workflow used by the Crown Prosecution Service before providing our thoughts on the future of forensic analysis and possible changes to the described workflows.

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A TikTok™ "Benadryl Challenge" death - A case report and review of the literature - January 2023

TikTok™, a social media platform popular with teenagers and young adults, hosts a variety of short-form user videos with durations from 15 s to 10min. Among these videos are potentially dangerous "challenges", such as the "Skull Breaker" challenge and the "Benadryl" challenge. Benadryl (diphenhydramine) is an over-the-counter medication with potential for misuse in both suicidal and recreational purposes. We report the case of a q4-year-old girl who reportedly ingested an unknown amount of diphenhydramine while taking part in a TikTok™ social media challenge. Autopsy revealed marked bilateral pulmonary congestion and edema, as well as a bright pink granular material within the esophagus, stomach, duodenum, and proximal jejunum. A postmortem femoral blood sample result identified a lethal blood concentration of duphenhydramine (49,658 ng/mL). Physicians and other healthcare providers need to be aware of social media trends that may pose public health threats. Teenagers are a particularly susceptible group and need to be informed of the risks associated with these "challenges". For the forensics field, a knowledge of and process for accessing social media platforms can be critical for investigating deaths. Given the extremely elevated concentration of diphenhydramine in this case, a knowledge of circumstances of death, the scene, and social media trends can assist the forensic pathologist in determining the correct manner of death - accident versus suicide.

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Firearm as a blunt weapon - Three cases of pistol whipping and a review of the literature - January 2023

Firearm weapons are not just limited to firing projectiles but can also be employed in beating a person. When used for imparting blows, they produce characteristic soft tissue injuries in the form of abrasions, bruises, hematomas, and lacerations with or without associated fractures. The hits are preferably given over the head. The hands may show typical defense wounds if the victim is conscious and anticipatory. The contours and dimensions of injuries may correspond to different parts of the gun, thereby allowing a possible weapon match. Three autopsy cases of gunshot homicides and herein reported whereby, in addition to the gunshot injuries, patterned blunt injuries over the head of all the decedents were noted with/without underlying impressed fracture(s) of skull. The injuries represented blows sustained from different parts of the pistol(s) employed in killing. The morphological patterns and weapon-centric specificity of wounds as well as the diagnostic cautions required during their interpretation at autopsy are discussed.

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Springtime Peaks and Christmas Troughs: A National Longitudinal Population-Based Study into Suicide Incidence Time Trends in the Netherlands - December 2022

Time trends are one of the most studied phenomena in suicide research; however, evidence for time trends in the Dutch population remains understudied. Insight into time trends can contribute to the development of effective suicide prevention strategies. Time trends in national daily and monthly data of 33,224 suicide events that occurred in the Netherlands from 1995 to 2015 were examined, as well as the influence of age, gender, and province, in a longitudinal population-based design with Poisson regression analyses and Bayesian change point analyses. Suicide incidence among Dutch residents increased from 2007 until 2015 by 38%. Suicide rates peak in spring, up to 8% higher than in summer (p < 0.001). Suicide incidence was 42% lower at Christmas, compared to the December-average (IIR - 0.580, p< 0.001). After Christmas, a substantial increase occurred on January 1, which remained high during the first weeks of the new year. Suicide occurred more than twice as often in men than in women. For both genders, the results indicated a spring time peak in suicide incidence and a trough at Christmas. Suicide rates were highest in the elderly (age group, 80+), and no evidence was found of a differential effect by season in the age groups with regard to suicide incidence. No interaction effect was found with regard to province of residence for both season and Christmas, indicating that no evidence was found that these time trends had differential effect in the Dutch provinces in terms of suicide incidence. Evidence was found for time trends in suicide incidence in the Netherlands. It is recommended to plan (mental) health care services to be available especially at high-risk moments, at spring time, and in the beginning of January. Further research is needed to explore the protective effect of Christmas in suicide incidence.

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Characteristics of fatal insulin overdoses - December 2022

This study was undertaken to review fatal cases of insulin overdose in South Australia (SA) over a 20-year period to assess rates and characteristics of insulin-related deaths among insulin-dependent diabetics and non-diabetics for all manners of death. Records from the National Coronial Information System (NCIS) and Forensic Science SA (FSSA) were searched for all cases of fatal insulin overdose in South Australia (SA) between 2000 and 2019. Collected variables included age, sex, cause of death, scene findings, manner of death, decedent medical and personal histories, biochemistry, toxicology, histopathology, and autopsy findings. Statistical analyses were performed using R (version 4.1.2). Forty cases of insulin overdose were identified in SA between 2000 and 2019. Twenty-nine cases (72.5%) were suicides, with the remaining cases classified as accidental or undetermined intent. Thirteen of the 22 insulin-dependent diabetics (59%) had a history of depression, 10 of whom had previously demonstrated suicidal ideation. The current study has shown that suicides using insulin among insulin-dependent diabetics are equally as prevalent, if not more so than fatal accidental insulin overdoses. This can largely be attributed to insulin-dependent diabetic access to a potentially lethal substance. Suicide prevention strategies should focus on insulin-dependent diabetics with a history of depression, particularly for those with access to rapid-acting insulin.

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Comparison of findings identified at traditional invasive autopsy and postmortem computed tomography in suicidal hangings - December 2022

Cases of suicidal hanging are a common death referred for medico-legal autopsy throughout the world. Although some advocate using postmortem computed tomography (PMCT) without traditional invasive autopsy (TIA) to investigate such deaths, others reject this approach. There is currently limited evidence to guide practice. In this context, the TIA reports and PMCT images of 50 cases of suspected suicidal hanging during an 11-month period were reviewed. The reviewers were blinded to the findings of the other modality. A Cohen's Kappa coefficient (K) was calculated to assess agreement between TIA and PMCT across a range of pertinent findings. This analysis demonstrated perfect agreement for identification of a ligature (K = 1.00) and a strong level of agreement for identification of a ligature suspension point (K = 0.832) but only a minimal level of agreement for overall ligature mark (K = 0.223). PMCT demonstrated a weak level of agreement for fractures of hyoid bone (K = 0.555) and thyroid cartilage (K = 0.538). Three probable fractures not identified at TIA were identified on PMCT. TIA was shown to be superior in the identification of intramuscular and laryngeal fracture-related haemorrhage/bruising whereas PMCT was superior to TIA in identifying body gas deposition. There was overall good correlation between the natural disease and trauma identified elsewhere in the body during the TIA and PMCT. The study demonstrates that PMCT can assist the investigation of suspected suicidal hangings. However, the accuracy of many findings is limited, and if it is used as an alternative to the TIA, potentially pertinent findings, such as fractures of the laryngeal cartilages, could be missed.

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The outcome of the forensic triage preceding disaster victim identification in the downing of Malaysia Airlines flight 17 - December 2022

Malaysia Airlines flight 17 crashed on 17 July 2014 while flying over an area of armed conflict in eastern Ukraine. The first forensic trace evidence was collected after the human remains were transferred to a safe location in the Netherlands for identification and repatriation. Disaster victim identification processes were therefore undertaken in concert with the forensic investigation. Prior to these processes, X-ray and computed tomography scanners were used to reveal foreign objects in the human remains, and a large number of these fragments were recovered after the forensic triage. A distinct group of metal fragments was identified as being potential remants of high-energy foreign objects. Forensic analysis revealed that they were explosively deformed unalloyed steel fragments, some of which had shapes consistent with pre-formed metal fragments found in a 9N314M warhead used in Buk SA-11 missiles. Furthermore, thin film deposits of cockpit glass and aluminium were identified on the most heavily deformed side of some of the explosively deformed metal fragments, suggesting they came from outside the airplane. These findings supported early suspicions that Malaysia Airlines flight 17 was struck by a Buk SA-11 missile.

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The shifting narrative of uncertainty: A case for the coherent and consistent consideration of uncertainty in forensic science - November 2022

This review of academic, policy and case law materials identifies current challenges in reaching a coherent understanding of uncertainty in forensic science in terms of articulating a definition, and the types and characteristics of uncertainty. It is identified that there is a shifting narrative characterized by a move from avoiding uncertainty, towards an increasing awareness of its complexity and acceptance of its unavoidable and ineliminable nature at every stage of the forensic science process. Despite this shift, there is still significant progress to be made in order to reach the requisite level of clarity in how uncertainty is understood and conceptualized for the purposes of developing more holistic and effective frameworks for its evaluation and reporting. This review sets out a basis for developing a coherent and consistent understanding of uncertainty in forensic science across institutions and stakeholders.

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Kathleen Folbigg case - November 2022

This publication is about Kathleen Folbigg, who has spent 19 years in prison after being convicted of manslaughter and murder of her four children. A rare genetic mutation that affects heart function has been found in two of her children, and is the subject of a new inquiry which started last week.

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Increasing use of sodium nitrate in suicides - an emerging trend - November 2022

Sodium nitrite (NaNO2) is a compound with broad practical applications in food preservation, automotive maintenance, and animal control. Sodium nitrate is also potentially fatal when ingested, as it interferes with the ability of red blood cells to transport oxygen. While incidents of accidental consumption have been reported in the literature, case reports of sodium nitrate being used as a pharmacological suicide agent are becoming more frequent. Therefore, a study was undertaken to evaluate trends in sodium nitrate deaths in South Australia between 2000 and 2019. All cases of fatal sodium nitrite ingestion were identified in the Toxicology database and autopsy reports at Forensic Science SA (FSSA). Ten cases of fatal sodium nitrite ingestion were identified, with the rate of cases increasing significantly over the study period (p > .001). Of the ten deaths attributed to sodium nitrite toxicity, eight were male, and two were female. The age range of decedents was 22-74 years (mean 51.9, SD 21.1), 22-74 years for males (mean 58.4, SD 18.2) and 23-29 years for females (mean 26.0, SD 4.2). Males (80%) and those with a history of depression and/or suicidal ideation (70%) were over-represented within the study population. While autopsy findings were generally consistent with the literature, scene findings emphasized the accessibility of sodium nitrite to the general public. This study highlights both a significant increasing trend in the use of sodium nitrite in suicides and important analytical limitations in the evaluation of suspected cases.

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Suicide versus homicide firearm injury patterns on trauma systems in a study of the National Trauma Data Bank - November 2022

Firearm related mortaility in the USA surpassed all other developed countries. This study hypothesizes that injury patterns, weapon type, and mortality differ between suicide groups as opposed to homicide. The American College of Surgeons National Trauma Database was queried from January 2017 to December 2019. All firearm related injuries were included, and weapon type was abstracted. Differences between homicide and suicide groups by sex, age, race, and injury severity were compared using a Mann-Whitney test for numerical data and Fisher's exact test for categorical data. The association between weapon type and mortality relative to suicide as opposed to homicide was assessed in Fisher's exact tests. Significance was defined as p < 0.05. There were 100,031 homicide and 11,714 suicide subjects that met inclusion criteria. Homicides were mostly assault victims (97.6%), male (88%), African-American (62%), had less severe injury (mean (ISS) 12.07) and a median age of 20 years old (IQR: 14, 30, p < 0.01). Suicides were mostly male (83%), white (79%), had more severe injury (mean ISS 20.73), and a median age of 36 years old (IQR: 19, 54, p < 0.01). Suicide group had higher odds of head/neck (OR = 13.6) or face (OR = 5.7) injuries, with lower odds of injury to chest (OR = 0.55), abdominal or pelvic contents (OR = 0.25), extremities or pelvic girdle (OR = 0.15), or superficial soft tissue (OR = 0.32). Mortality rate was higher for suicide group (44.8%; 95% confidence interval (CI) 43.9%, 45.7%) compared to the homicide group (11.5%; 95% CI 11.3%, 11.7%). Suicide had higher mortality, more severe injuries, and more head/neck/facial injuries than homicide. Majority of suicides were with handguns.

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Accuracy of forensic pathologists in incorporating post-mortem CT in forensic death investigations - October 2022

Post-mortem computed tomography (PMCT) is now performed routinely in some medical examiner's officers, and the images are typically interpreted by forensic pathologists. In this study, the question of whether pathologists appropriately identify significant PMCT findings and incorporate them into the death investigation report and the cause and manner of death (COD and MOD) statements was addressed. 200 cases where PMCT was performed were reviewed retrospectively. The cases were divided into four categories: (1) full autopsy without radiology consultation (n = 77), (2) external exam without radiology consultation (n = 79), (3) full autopsy with radiology consultation (n = 26), (4) external exam with radiology consultation (n = 18). A radiologist (not the consult radiologist) read the PMCT images, and a pathologist (not the case pathologist) reviewed the case pathologist's post-mortem examination report in tandem to determine any PMCT findings omitted from the report. Omitted findings were classified into error types according to a modified Goldman classification including Major 1: Unrecognized fatal injury or pathology that would change COD and/or MOD, and Major 2: Unrecognised fatal injury or pathology that would not change COD and/or MOD. A total of 13 Major errors were identified (6.5%), and none definitively changed the MOD. All four Major-1 errors which could change the COD were found in Category 2. Of 9 Major-2 errors, 2 occurred in Category 1, 6 occurred in Category 2, and 1 occurred in Category 4. In conclusion, forensic pathologists who routinely utilize computed tomography (CT) interpret CT images well enough to reliably certify the COD and MOD.

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Triangulating Amsterdam's illicit stimulant use trends by wastewater analysis and recreational drug use monitoring - October 2022

Drug consumption estimates are of relevance because of public health effects as well as associated criminal activities. Wastewater analysis of drug residues enables the estimation of drug consumption and drug markets. Short-term and long-term trends of cocaine, MDMA (ecstasy), amphetamine (speed) and methamphetamine (crystal meth), were studied for the city of Amsterdam. MDMA (+41%) and cocaine (+26%) showed signigicantly higher weekend vs. week consumption, while no differences were observed for the other drugs. The consumption of MDMA, cocaine, amphetamine and methamphetamine significantly increased between 2011 and 2019. Weekly trends emerging from wastewater analyses were supposed by qualitative and quantitative data from a recreational drug use monitoring scheme. However, information collected in panel interviews within nightlife networks and surveys among visitors of pubs, clubs and festivals only partially reflected the long-term increase in consumption as registered from wastewater analysis. Furthermore, methamphetamine use was not well presented in survey data, panel studies and test service samples, but could be monitored through wastewater analysis. This illustrates that wastewater analysis can function as an early warning if use and user groups are small or difficult to reach through other forms of research. All in all, this study illustrates that wastewater-based epidemiology is complementary to research among user groups, and vice versa. These different types of information enable to connect observed trends in total drug consumption to behaviour of users and the social context in which the use takes place as well as validate qualitative signals about (increased) consumption of psychoactive substances. Such a multi-angular approach to map the illicit drug situation on local or regional scale can provide valuable information for public health.

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Gunshot residues found at the exit wound: a case report - October 2022

Gunshot residues (GSRs) play an important role in forensic investigations of gun-related violence. The presence of GSRs has been described to help identify the bullet entry area, as it was supposed not to be found at exit wounds. This report details the suicidal headshot of an 84-year-old male where unburned tube-like, cuboid and flake-formed powder particles have been found not only at the inside of the muzzle but also circular around the exit wound. With very short-barrelled weapons, it must be expected that part of the propellant charge leaves the barrel unburned behind the bullet. In contrast to that, the barrel length of the used weapon should lead to a complete burn-up of powder particles. The surprisingly large number of unburned powder particles present at the exit would of the injury gave reason for further investigation to understand the underlying ballistic aspects and outlines the importance of having a close look at incidence scene photos during an ivestigation.

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From detection to sentencing: A homicide case flow analysis of the Dutch criminal justice system - October 2022

Homicide engenders broad moral concerns in society, and its aftermath can be understood as a barometer for criminal justice policy. Of all homicides committed, however, only some lead to arrest, to prosecution and ultimately to conviction in court. So far, no study has assessed the entire flow of homicide cases through the criminal justice system based on a nationwide sample. This study seeks to fill this empirical void by describing the entire flow of homicide cases and assessing the size of outflow at each stage of the criminal justice funnel in the Netherlands for a 20-year period. Our analysis highlights two main findings: First, the vast majority of suspects first identified by the police are ultimately sentenced for a homicide. Second, even in a country with low homicide rates and high rule of law indices, selection takes place at all stages of the criminal justice funnel. Whilst outflow mostly centres around exceptional clearance and legal factors, future work should assess the extent to which extra-legal characteristics play a role in crimes that are being investigated as potential homicides.

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Deaths associated with community donation bins: A ten-year retrospective review describing five cases in British Columbia and Ontario - September 2022

Community donation bins have become more common in the urban setting over the past several years. Many non-profit organizations use these sturdy metal enclosures for unobserved collection of various donated items such as clothing, books, and household items. Although the donated items are often of low individual value. donation bins may become a target of individuals in low socioeconomic situations seeking desired items for personal use or resale, or for personal shelter within the bin. To identify donation bin-associated deaths, we reviewed cases taken under the jurisdiction of the coroner for investigation in the provinces of British Columbia and Ontario, Canada, over the years 2009 to 2019. We present the circumstances and post-mortem findings of five deaths that occurred in British Columbia and Ontario (Canada) between 2009 and 2019, wherein the decedents were each believed to have been reaching into donation bins and became caught within the door mechanism and died as a consequence of compression asphyxia involving the chest and/or neck. Donation bins have the potential for harm when individuals attempt to access the bin contents through the entry portal. We advocate for greater attention and changes in the placement location and/or design of these potentially dangerous devices. 

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Honour suicide and forced suicide in the UK - September 2022

This article aims to explore the phenomenon of suicide in relation to honour based violence (HBV). Although HBV is explored in depth in relation to honour killing, forced marriage and female genital mutilation, its link and manifestation in the form of suicide has not been discussed in existing literature. This article examins how suicide can manifest itself in honour based patriarchal communities as either honour suicide or forced suicide. Although both forms of suicide are carried out as a result of HBV, there is a crucial difference between them and this needs to be identified and distinguished to hold perpetrators accountable before the law. Honour suicide and forced suicide both occur in honour based patriarchal communities and such practices spread around the world via immigration; hence the UK is not immune from this. Due to the complexity of the incidents and vulnerability of the victims, honour suicide and forced suicide are likely to be unreported and unrecognised by the legal system. Therefore, the discussion in this article will look at the national law in England and Wales related to suicide and critically examine whether it can address instances of honour suicide and forced suicide if they occur under its jurisdiction. Accordingly, it will suggest law reforms to address effectively the issue of suicide committed as a result of HBV and abuse.

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Effects of chemical warfare agent decontaminants on trace survival: Impact on fingermarks deposited on glass - September 2022

Following a chemical incident involving chemical warfare agents or more broadly, chemical weapons, there are two possible approaches in dealing with the traditional forensic analysis of contaminated exhibits. The first is to analyze the contaminated items under safe conditions (i.e. in laboratories dedicated to the handling of such substances), while the second relies on item decontamination prior to processing them in traditional forensic laboratories. One of the main limitations of the latter is the possible degradation or destruction of traces caused by the decontamination process. Hence, it is crucial to have as much information as possible on the impact of different decontamination agents and procedures on traces. This research presents experimental results on the recovery of fingermarks on glass after the application of decontaminants typically used in case of chemical incidents. The impact of 11 decontaminants on fingermarks deposited on glass and on the subsequent enhancement with cyanoacrylate and Small Particle Reagent (SPR) was evaluated (by visual examination) by four evaluators. The results of the study demonstrated that the persistence of fingermarks on glass is highly dependent on the type of decontaminant used. Decontamination agents based on the principle of nucleophilic substitution to neutralize toxic chemicals allowed good subsequent development of fingermarks with SPR. Powdered decontaminants did not show any indication of alteration of fingermarks, whereas decontamination with oxidants leads to variable results.

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Frontline response: Exploring the impact of COVID-19 on stalking behaviours - September 2022

COVID-19 pandemic lockdown changed the way in which we engage with others and our ability to enjoy free movement away from the confinement of our own homes. Whilst this dramatic change affected everyone, it constituted something much more threatening for victims of stalking, repeatedly targeted by those with an obsessive and fixated behaviour. Whilst we know more about the impact of lockdown on stalking behaviour, very little is known about how the police and frontline workers are responding to this challenge. This research aims to increase an understanding of stalking in this context. Firstly, it presents a quantitative examination of recorded data on stalking offences provided by all 43 police forces across England and Wales. In addition, it explores the experiences of those working on the frontline who respond to reports of stalking made by victims. A total of 15 in-depth interviews were conducted with twelve police officers from three forces in England, as well as three advocates of victims from two national stalking services. Analyses show that stalking behaviour has increased and evolved to use accessible channels alongside the COVID restrictions. In conclusion, considerable pressure has been placed on frontline workers to adapt and respond not only to increased incidents but also the changes in the nature of stalking behaviour.

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Domestic violence against men - prevalence and risk factors - August 2022

According to the World Health Organisation (WHO), intimate partner violence is among the major risks to women's health around the world. Men, too, can be victims of domestic violence; like female victims, they tend to present initially with their injuries to a family physician or an emergency room. Domestic violence against men is thus a relevant issue for physicians of all specialties. This review is based on publications by a comprehensive, selective search in the PubMed database and with the Google Scholar search service, as well as on a retrospective analysis of data on the injured persons, the aggressors, and the nature of the violence that was experienced and the injuries that were sustained. The studies identified by the search yielded prevalence rates of 3.4% to 20.3% for domestic physical violence against men. Most of the affected men had been violent toward their partners themselves. 10.6 - 40% of them reported having been abused or maltreated as children. Alcohol abuse, jealousy, mental illness, physical impairment, and short relationship duration are all associated with a higher risk of being a victim of domestic violence. The reported consequences of violence include mostly minor physical injuries, impaired physical health, mental health problems such as anxiety or a disruptive disorder, and increased consumption of alcohol and/or illegal drugs. The prevalence of violence against men and the risk factors for it have been little studied to date. It would be desirable for preventive measures to be further developed and for special help to be made available to the affected men.

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Firearm suicides in Sweden - August 2022

In a setting with restrictive firearm laws, prevention of firearm deaths is challenging. Around 100 firearm suicides occur annually in Sweden, representing the most common manner of death from firearm use. In order to explore a possible correlation between firearm suicides and firearm availability, legality of firearm possession, and demographic and geographical factors, all forearm suicides in Sweden among adults during the years 2016-2017 were studied. Data were collected from the National Board of Forensic Medicine and the Swedish Police. In total, 221 firearm suicides were found. Most victims were male (99%) and half (49%) were ≥65 years old. Firearm suicide rates were positively correlated with firearm ownership rates in Swedish countries. Legal firearms (80%) and long-barreled firearms (76%) predominated in the overall material, but illegal firearms were common among young suicide victims (18-29 years) and in urban areas. Prevention work needs to emphasize strategies to reach firearm owners at risk of suicide. Local health and healthcare-related factors, as well as geographic and demographic factors, should be considered in tailoring such strategies.

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Alternative stories and the decision to prosecute: an applied approach against confirmation bias in criminal prosecution - August 2022

In many legal systems, preliminary proceedings and the prosecutor's charging decision predict the outcome of the trial, as reflected in high conviction rates. This charging decision is mostly based on the final police report, which is primarily aimed to substantiate the given suspicion and may lead to a preponderance of incriminating evidence. This study investigated if a written statement by the defense (an alternative story) can balance out this information disparity and can alter the charging decision. Building on classical debiasing methods, the Story Model and narrative persuasion, this study hypothesized that an alternative story reduces the likelihood of being charged, because the police report becomes less unique. Participants of three experiments (criminal-law students, N = 684) received either only the police report, or the police report plus an alternative story (vs. a statement merely claiming innocence) and were asked to make charging decisions. The presence of prior conviction evidence (PCE) was varied. Results show that 1) an alternative story reduces (and PCE increases) the likelihood of being charged, 2) a statement merely claiming innocence is less but still effective, and 3) PCE effects were small and inconsistent. Underlying mechanisms, implications for criminal procedural law, and applicability to adversarial systems are discussed.

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Non-fatal strangulation and COVID-19 common symptoms and signs: considerations for medical and forensic assessment - July 2022

Emerging evidence suggests that an onset or escalation of interpersonal violence has been occurring during the COVID-19 pandemic, particularly among persons in intmate or familial relationships. Strangulation (or neck compression) is a common form of interpersonal violence and can result in serious adverse health outcomes, including death. The identification and attribution of injuries from non-fatal strangulation are complex, as there may be an absence of external signs of injury and their appearance may be delayed by many days. There is a heavy reliance on clinician identification of 'red flag' symptoms and signs, the presence of which necessitates urgent further assessment. Additional challenges arise when acute non-fatal strangulation symptoms and signs are shared with other clinical conditions. In such cases, differentiating between the conditions based on the symptoms and signs alone is problematic. This study presents the diagnostic challenges faced when conducting forensic assessments of COVID-19 positive and suspected COVID-19 (S/COVID) patients following allegations of non-fatal strangulation in the setting of physical and sexual assaults. The implications of shared symptoms and signs, for forensic clinicians, primary healthcare, and emergency practitioners, as well as other frontline service providers, are discussed.

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Recovery of touch DNA from RDX-C4 evidences - July 2022

RDX (Royal Demolition Explosive) is the organic compound with the formula (O2NNCH2)3. It is a white solid material without smell or taste, widely used as an explosive. It is more energetic explosive than TNT, and it was used widely in World War II. The estimated number of RDX-C4 cases in Bahrain ranged between the years 2015–2018 (May) with a total quantity of 370.72 KG in a total number of 38 cases. The effect of explosive RDX-C4 is very massive and can cause many causalities and fatalities among civilians and policemen. These cases consisted of adhesive film with tapes wrapped around RDX-C4 substance (Demolition Charge M112), black batteries, pipes, black bag contained RDX-C4, and in magnetic improvised explosive device (IED). Touch DNA recovery utilized different collection methods, such as nylon swabbing, tape lifting, and direct cutting of certain parts of the samples that were positive of RDX-C4 through DXR Raman Spectrometer. Samples were extracted and purified with magnetic beads chemistry and quantified. Low copy DNA extracts were subjected to a concentration step. DNA extracts were amplified and processed for detection to obtain reliable results using GlobalFiler Amplification PCR kit and run through ABI 3500xL Genetic Analyzer for fragment length determination. This study discovered that RDX-C4 cannot bind to the DNA nor to the solutions used in DNA typing. Thus, it does not cause DNA inhibition or degradation. From this point of view, obtaining acceptable and fit results using advanced techniques was successful. This study will be very useful and informative to assist the forensic community in terrorism case applications worldwide as terrorists do not respect geographical boundaries nor ethnicities of the victims, and the use of DNA profiling technology is the most suitable way to identify the terrorists and keep an end to their violence.

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Forensic intelligence-led prevention of drug-facilitated sexual assaults - July 2022

This study explores the potentially broader contribution of forensic science to preventive public health through the proactive view promoted by forensic intelligence. For that purpose, a new working framework is applied as a strategic tool that channelizes forensic intelligence in a more understandable and didactic way for decision-makers, guiding preventive crime processes. Concretely, the implementation of this operational framework focuses on preventing drug-facilitated sexual assaults in the nightlife context. Through a two-stage research scheme, the working framework is used as a study tool for understanding this violent phenomenon and as a strategic thinking and action platform for overcoming it. Forensic intelligence-guided actions significantly enhanced institutional and direct support facing this specific form of sexual violence. Awareness messages targeting potential assailants, witnesses, and victims reached more that half a thousand students from the university and pre-university education through a preventive intervention within the educational system. Moreover, the inter-professional dialogue between forensic science and other health, security, and education disciplines shows the broader proactive role of forensic science beyond the traditional retroactive view limited to courtrooms and intelligence-led policing. This study demonstrates as forensic intelligence becomes applicable for civilians, who need to participate as decision-makers in intelligence-led preventive processes, anticipating the need for intervention by police and judicial authorities. 

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Psychopathic femicide: The influence of psychopathy on intimate partner homicide - July 2022

High scores in psychopathy were associated with acts of violence, and the prevalence of this condition is greater among the prison population than among the general population. In terms of its relation to femicide, two studies, one carried out in Sweden and another in Spain with a prison population, found that psychopathy is an uncommon condition among perpetrators of femicide. This study analyzes 97 cases of femicide in the whole of Spain, in which it was possible to evaluate the degree of psychopathy of the perpetrators using the Psychopathy Checklist-Revised (PCL-R). The scores are analyzed not only directly, but also in terms of Factors and Facets. The results show an average in the total score of the PCL-R of 14.4, with only 13 subjects (13.4%) presenting scores of 25 or more, and just 3 (3.1%) of these presenting scores of 30 or higher. It was found that, in general, high scores in psychopathy are associated with shorter relationships and less time between the first complaint, the breakup, and the femicide. What is more, characteristics of the victims, such as addiction to toxic substances or economic dependency, also demonstrated a relationship to the scores of the perpetrators of femicide in the PCL-R. Lastly, it was found that the scores in the different dimensions of psychopathy are associated with different types of violence, whereby there was a noteworthy difference between the most explicit violence and control exercised over the partner.

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Forensic alcohol calculations in transgender individuals undergoing gender-affirming hormonal treatment - July 2022

There are an increasing number of individuals undergoing gender-affirming hormonal treatment (GAHT) to treat gender dysphoria. Current forensic alcohol calculations require knowledge of the sex of the individual, but this may disadvantage trans people as research has demonstrated that there are physiological changes in individuals who are undergoing GAHT. Using previously published studies on total body water (TBW) in cis individuals, and the known changes in lean body mass and hematocrit in trans individuals, it is possible to estimate TBW in trans individuals and compare them to those cis equation estimations. When using these revised rubics, it was determined that for trans women the use of the cis male anthropometric TBW equation only gives a small underestimation of TBW (0.9%) compared to the underestimation of TBW using the cis female TBW equation (-17.7%). For trans men, the use of the cis female TBW equation gives the largest disadvantage, underestimating TBW by -10.8% compared to the cis male TBW equation, that overestimates TBW by 6.6%. For this reason. it is recommended that if the sex at birth of an individual is not known or disclosed, any forensic alcohol calculations in forensic alcohol reports are made assuming that the gender declared by the individual is their sex at birth. Further research to develop validated anthropometric TBW equations are urgently needed as to not disadvantage trans people when forensic alcohol calculations are carried out.

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Cognitive and human factors in legal layperson decision making: Sources of bias in juror decision making - June 2022

Juries in adversarial courts are tasked with several responsibilities. They are asked to: 1) assess the credibility and reliability of the evidence presented; 2) deliberate; 3) and then reach a decision. Jurors are expected to evaluate said evidence in a rational/impartial manner, thus allowing the defendant their right to a fair trial. However, psychological research has shown that jurors are not rational and can reach inaccurate decisions by being biased by certain factors. The aim of the current review was to explore the potential sources from which biases are introduced into the jury. Three main sources of bias were focussed upon: 1) pre-trial bias; 2) cognitive bias; 3) bias from external legal actors (expert witnesses). Legal scholar commonly cite deliberations as a method of attenuating individual juror bias, this claim is evaluated in the review. The review concludes that bias is a multifaceted phenomenon introduced from many different elements, and that several sources of bias may interact with one another during a jury trial to cause the effects of bias to snowball. Four recommendations are made: 1) juror selection should be utilised to create heterogenous juries that challenge problematic biases from individual jurors; 2) increase the quality of expert testimony through training; 3) procedures such as Linear Sequential Unmasking should be adopted by expert witnesses to filter out some sources of bias; 4) legal professionals and jurors should be educated about the effects that biases may have on decision making; 5) more research into bias in jurors is needed.

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Forensic biomarkers of lethal traumatic brain injury - June 2022

Traumatic brain injury (TBI) is a major cause of death and its accurate diagnosis is an important concern of daily forensic practice. However, it can be challenging to diagnose TBI in cases where macroscopic signs of the traumatic head impact are lacking and little is known about the circumstances of death. In recent years, several post-mortem studies investigated the possible use of biomarkers for providing objective evidence for TBIs as the cause of death or to estimate the survival time and time since death of the deceased. This work systematically reviewed the available scientific literature on TBI-related biomarkers to be used for forensic purposes. Post-mortem TBI-related biomarkers are an emerging and promising resource to provide objective evidence for cause of death determinations as well as survival time and potentially even time since death estimations. This literature review of forensically used TBI-biomarkers revealed that current markers have low specificity for TBIs and only provide limited information with regards to survival time estimations and time since death estimations. Overall, TBI fatality-related biomarkers are largely unexplored in compartments that are easily accessible during autopsies such as urine and vitreous humour. Future research on forensic biomarkers requires a strict distinction of TBI fatalities from control groups, sufficient sample sizes, combinations of currently established biomarkers, and novel approaches such as metabolomics and mi-RNAs.

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The use of fly artifacts in a crime scene: Is there any application for forensic toxicology? - May 2022

Fly artifacts (FA) are bloodstains resulting from insect activity at a crime scene, usually by feeding on human blood. Whether these artifactual stains might be useful for forensic toxicological investigations in cases of absence of conventional and unconventional matrices, for example, in cases concealment of the body or of extensive putrefaction, has not yet been investigated. The purpose of this study is to understand if FA trace evidence permits toxicological analysis when traditional matrices are not available. To this aim, FA experimentally produced by Calliphora vomitoria feeding on human blood of a cocaine and heroin user were collected from absorptive and non-absorptive material. FA material was analyzed by a new simple and fast LC-MS/MS methods. Results were evaluated in terms of presence of the drug and relative amount of the detected molecules. From a qualitative point of view, the analysis of FA revealed all the substances originally detected in post-mortem blood in both cases. The ratios of cocaine/benzoylecgonine, codeine/morphine, and 6-monoacetylmorphine/morphine recovered in FA from cotton-textile materials and from non-absorptive surfaces were consistent with data resulted from original post-mortem blood. The preliminary study herein reported demonstrated that FA are extremely informative in case of cocaine and heroin users and merit further research in order to be applied in real caseworks.

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Males as victims of intimate partner violence - results from a clinical-forensic examination centre - May 2022

Only a few studies have reported on males as victims of intimate partner violence (IPV) so far. The aim of this study is to analyse the frequency and case characteristics of physical violence against male IPV victims examined in a clinical-forensic medical examination centre for victims of violence in Germany over an 11-year period, contributing to a better understanding of IPV in men. Male victims represented 6.2% of IPV cases (n = 167) with a median age of 40 years. Cases were reported to the police in 78.4% before medicolegal examination. In 60.5% of the cases, the perpetrator was the current partner, and 82% occurred in a domestic environment with a predominance of female offenders. In more than half of the cases (57.5%), the victims consulted the examination centre without prior healthcare utilisation. About one-third of the victims reported previous IPV (31.7%). The findings point to the relevance of men as victims of IPV, case group–specific risk factors, injury-dependent behaviour related to healthcare utilisation, the need to establish or strengthen specialised support services for affected men and underscore the importance of clinical-forensic services in documenting and assessing violence-related injuries.

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Unlocking the potential of forensic traces: analytical approaches to generate investigative leads - May 2022

Forensic investigation involves gathering the information necessary to understand the criminal events as well as linking objects or individuals to an item, location or other individual(s) for investigative purposes. For years techniques such as presumptive chemical tests, DNA profiling or fingermark analysis have been of great value to this process. However, these techniques have their limitations, whether it is a lack of confidence in the results obtained due to cross-reactivity, subjectivity and low sensitivity; or because they are dependent on holding reference samples in a pre-existing database. There is currently a need to devise new ways to gather as much information as possible from a single trace, particularly from biological traces commonly encountered in forensic casework. This review outlines the most recent advancements in the forensic analysis of biological fluids, fingermarks and hair. Special emphasis is placed on analytical methods that can expand the information obtained from the trace beyond what is achieved in the usual practices. Special attention is paid to those methods that accurately determine the nature of the sample, as well as how long it has been at the crime scene, along with individualising information regarding the donor source of the trace.

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Drug-related celebrity deaths: A cross-sectional study - April 2022

Celebrities are at risk for premature mortality as well as drug-related death. Despite being a vulnerable patient group, celebrities influence people’s health behaviours through biological, psychological and social processes. Therefore, celebrity endorsement of the topic could be one way to challenge the current “opioid endemic”. The aim of this study was to better understand the factors surrounding drug-related celebrity deaths by investigating the incidence as well as substances used between 1970 and 2015 using a cross-sectional study design. Compared to the 20th century, the total number of celebrities who died from a drug-related death in the 21st century increased, possibly due to an increased involvement of prescription opioids. Negative effects on individual health decisions of celebrity’s followers could be the result.

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Multitechnique approach for discrimination and identification of lipsticks for forensic purposes - April 2022

Cosmetics are becoming more and more popular; consequently, the chance for finding them as microtraces at a crimes scene increases. They are easily transferable and can provide a link between a suspect and a victim. For this reason, identifying and comparative analysis of red lipstick – the most popular and used – is required. The aim of this study was to apply a multitechnique methodology for the comparative forensic analysis of the red lipsticks traces of a very similar hue. The possibilities and advantages of attenuated total reflection infrared spectroscopy (ATR-FTIR), confocal Raman microscopy (CRM), capillary electrophoresis (MEKC) and gas chromatography-mass spectrometry (GC-MS) were combined for this purpose, and this methodology has the potential to be applied in the comparative analysis of red lipsticks for forensic purposes.

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Violence against women and DFSA: a review of the main drugs - March 2022

Sexual violence is a universal phenomenon without restriction to sex, age, ethnicity or social class that causes devastating effects in the physical and mental health spheres, in the short-term and long-term, such as pregnancy, sexually transmitted infections (STI) and greater susceptibility to psychiatric symptoms, especially depression. Some cases of sexual assault and rape are based on the use of so-called drug-facilitated sexual assault (DFSA), which cause victims’ loss of consciousness and inability to defend, making them vulnerable to violence. This article aimed to review the literature on gender violence and the drugs used to facilitate sexual assault, addressing their mechanism of action and pharmacokinetics, as well as drug detection times in human body and types of forensic identification. It is understood that the knowledge of these drugs and their pharmacological and diagnostic mechanisms should be widely disseminated, especially about sensitivity tests and the time the drug remains in the body, which would validate the promotion of evidence to prove abuse, and, thus, being able to give a promising outcome to cases of aggression, which is extremely beneficial for women.

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Extracorporeal membrane oxygenation (ECMO) in the forensic setting: a series of 19 forensic cases - March 2022

Extracorporeal membeane oxygenation (ECMO) employs vascular cannulation and a gas exchange circuit to provide support to patients with severely compromised cardiopulmonary function. ECMO is often the last intervention taken before death and thus presents a unique challenge to medical examiners. This study describes the characteristics of decedents on ECMO at the time of death, including clinical indications, types of circuit configurations, causes and manners of death, gross findings at autopsy, and therapeutic complications.

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The importance of forensic evidence on criminal guilt - February 2022

Recent studies have found that the general public perceives forensic evidence to be relatively inaccurate and to involve high levels of human judgement. This study examines how important the general public finds forensic evidence by comparing decisions on guilt and punishment in criminal cases that involve forensic versus eyewitness testimony evidence and examining whether a CSI effect exists. The results indicate that forensic evidence was associated with more guilty verdicts and higher confidence in a guilty verdict. Forensic evidence did not change the expected sentence length and did not generally affect the ideal sentence length. However, for rape, respondents believed that the defendant should receive a longer sentence when forensic evidence was presented but forensic evidence did not alter likely sentence that respondents expected the defendant to receive. The results of this study did not support a CSI effect. Overall, this study suggests that forensic evidence – particularly DNA – has a stronger influence during the verdict stage than the sentencing stage.

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Neck-MRI experience for investigation of survived strangulation victims - February 2022

For the medicolegal evaluation of victims of survived strangulation, a neck-magnetic resonance imaging (MRI) can be performed for assessing lesions in the inner soft tissues. Such MRI examinations have been performed for a test period of 4 years with the aim of evaluating the use of this tool by forensic pathologists and identifying medicolegal indicators for the performance of neck-MRI in surviving victims of strangulation. Medicolegal reports were from all victims examined during the test period were retrospectively reviewed, and objective lesions (e.g. petechiae, bruising and abrasions) and reported clinical symptoms (e.g. vision disorder, dysphasia) were extracted from the reports. These findings were compared to those reported from the neck-MRI. When MRI was performed, relevant findings were detected in 45% of the cases. This leads to the suspicion that many more findings could have been detected in the other victims, if an MRI had been performed in those cases. These results lead to the conclusion that an MRI examination of victims of suspected strangulation is useful, and strict indications for its application should be established.

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Impact of the Covid-19 lockdown on sexual assault cases in Eastern Denmark - a retrospective forensic study - February 2022

This article aimed to explore if the shutdown of Danish nightlife during the Covid-19 pandemic caused a decrease in the number of clinical forensic examinations of victims of sexual assault in Eastern Denmark. Secondarily, to investigate if there was a change in criminological characteristics, e.g. scene and time of crime, relation to the perpetrator and the proportion of possible drug-facilitated sexual assaults. Pre- and post-lockdown victim profiles were similar regarding assailant relation, location of crime and time of assault. Voluntary intake of alcohol prior to the assault was registered with 46.3% in 2019 and 62% in 2020. The ratio of possible drug-facilitated sexual assault (DFSA) was approximately 50% each year. The lockdown did not seem to change the overall number of examinations or the demographic and criminological characteristics of the sexual assault victims. No decrease in cases of possible DFSA was found despite the lockdown of nightlife venues. 

Link to full article

Suitability of cerebral matter for the forensic identification of highly decomposed bodies - February 2022

When bodies are highly decomposed and identification based on morphologic features is no longer possible, short tandem repeat (STR) genotyping has been proved as a convenient and reliable alternative. However, at very advanced decomposition stages postmortal tissue putrefaction processes can affect microsatellite instability and therefore not all types of post mortem tissues are still equally suitable for STR genotyping and subsequent forensic identification. In this study different cases were evaluated in which a successful forensic identification was only possible with DNA material extracted from specific tissues. By doing the aim was to compare differential suitability of soft tissues for DNA analysis of highly decomposed bodies. This was achieved by a systematic classification of decomposed bodies and the analysis of multiple organs to evaluate the qualification of soft tissue for DNA profiling in respect to the degree of decomposition. Differences in the suitability of various soft tissues for DNA-based identification were detected, and cerebral matter turned out to be one of the most useful targets in highly decomposed bodies.

Link to full article 

Pharmacogenetics and forensic toxicology: A new step towards a multidisciplinary approach - January 2022

Pharmacogenetics analyses the individual behaviour of DNA genes after the administration of a drug. Pharmacogenetic research has been implemented in recent years thanks to the improvement in genome sequencing techniques and molecular genetics. In addition to medical purposes, pharmacogenetics can constitute an important tool for clarifying the interpretation of toxicological data in post-mortem examinations, sometimes crucial for determining the cause and modality of death. This study highlights the importance of forensic pharmacogenetics, a field of toxicology still not fully understood, which is of great help in cases of sudden death, deaths from overdose, deaths after the administration of a drug, and also in cases of complaint of medical malpractice.

Link to full article

Automatic face regonition for forensic identification of persons deceased in humanitarian emergencies - January 2022

The forensic identification process of deceased people mainly consists of the analysis of the DNA, dental records, and physical appearance. In humanitarian emergencies, the antemortem documentation needed for forensic analyses may be limited. In this context, face recognition plays a relevant role since antemortem pictures of missing persons are commonly made available by their families. Therefore, automatic recognition systems could be of paramount importance for reducing the search time in databases of face images and for providing a second opinion to the scientists. However, there are only few preliminary studies on automatic face recognition methods for forensic applications, and none of the works in the literature consider problems related to humanitarian emergencies. This paper is the first study on automatic face recognition for humanitarian emergencies in which a recognition methodology is proposed and the accuracy of different biometric methods based on deep learning strategies analysed. The obtained results suggest that automatic recognition methods based on deep learning strategies could be effectively adopted as support tools for forensic identification.

Link to full article

A socialite, a gardener, a message in blood: The murder that still grips France - January 2022

In 1991 Ghislaine Marchal, a wealthy socialite, was found dead in the basement of her villa on the Côte d’Azur. The only door was locked from the outside but also barricaded from within. A message, scrawled in the victim’s own blood, seemed to accuse her gardener. The brutal killing and the subsequent conviction of her Moroccan gardener, Omar Raddad, became one of France’s most enduring murder mysteries, capturing the popular imagination. Now, three decades later, new DNA technology may lead to a second trial that supporters hope will exonerate Mr. Raddad, who has always maintained his innocence, and reopen a case that, though seemingly settled legally, has long unsettled France.

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The "Christmas Holiday Effect" in the Southern Hemisphere - December 2021

A "Christmas Holiday Effect" showing elevated cardiovascular mortality over the Christmas holidays was demonstrated previously in a study from the United States. To separate the effect of seasonality from any holiday effect, a matching analysis was conducted for New Zealand, where the Christmas holiday period falls within the summer season. It was found that cardiac mortality is elevated during the Christmas holiday period relative to surrounding time periods. These findings are consistent with a previously reported study conducted in the United States, suggesting that cardiac mortality does not take a “summer break”.

Full link to article

Bulletproof fingerprint technology takes images in the round - December 2021

Experts at the University of Nottingham have developed a unique method for retrieving high resolution images of fingermarks from curved objects like bullet casings that offers greater detail and accuracy than traditional forensic methods. Scientists from the University of Nottingham's School of Physics and School of Pharmacy developed a rotation stage to allow researchers and forensic practitioners to perform highly sensitive, non-destructive Time-of-Flight Secondary Ion Mass Spectroscopy (ToF-SIMS) measurements and develop high resolution fingerprint images on surfaces that conventional fingerprint imaging fails to pick up at all. The rotation stage that they have developed opens up new possibilities for the retrieval of high-resolution fingerprints from the whole surface area of challenging shapes and materials like metal bullet casings.

Link to full article

A new forensic tool to date human blood pools - December 2021

The study of human blood dynamics in the context of forensic science is becoming a widespread research topic, although the physics behind wetting and drying of blood is not completely understood. Based on the morphological changes of drying blood pools, the following work presents a patentable method to quantitatively date these blood pools for forensic purposes. As for drying drops of blood, cracking patterns are observed but they are more disordered. Similar disordered crack patterns are observed in the case of gels, their evaporation process is, therefore, presented since this topic has been thoroughly investigated. This study aims to find reliable patterns that could give information concerning the evolution of a blood pool over time to lead to practical application of this knowledge. An empirical model is established between final dried blood patterns and the generating mechanism, yielding application in bloodstain pattern analysis for forensic investigations.

Link to full article

Environment influencing serotonin syndrome induced by ecstacy abuse - December 2021

Ecstasy is a recreational drug containing 3,4-methylenedioxymethamphetamine (MDMA). In the U.S., there are several millions of lifetime users, and millions each year added to the list as new users. Only several thousand every year show signs of severe toxicity and require emergency intervention. The illness is known as serotonin (5-HT) syndrome, which can be mild, moderate or severe. The relationship between mild, moderate and severe syndromes appears to be interchangeable, but the severe syndrome is life-threatening. The serotonergic mechanisms of how the mild or moderate syndrome becomes severe and life-threatening have attracted considerable attention in the last few years as an effort to explore new treatments potentially to manage illness and prevent death of patients. High levels of extracellular 5-HT in the brain produced by large doses of MDMA are not always necessary to cause a severe serotonin syndrome. Additional mechanisms may be more important. Recent research has demonstrated that environmental conditions (i.e., non-drug factors) are more critical in determining the severity of MDMA-induced serotonin syndrome than the drug dose. The purpose of the current article was to review available evidence regarding the effect of non-drug factors on serotonergic extrasynaptic receptor responsivity and the severity of MDMA-induced serotonin syndrome.

Link to full article

The forensic spleen: Morphological, radiological, and toxicological investigations - November 2021

The spleen is uncommonly investigated in the forensic setting. Thorough examinations are performed in some specific situations such as splenic trauma, 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.

Link to full article

Defining patterns and behaviours of forward spatter gunshot misting - November 2021

There is a lack of research on forward spatter, blood travelling in the direction of a bullet, as most studies focus on back spatter, blood travelling in the opposite direction of a bullet. The purpose of this research was to study forward-spatter misting patterns by shooting a firearm through a chamber of blood encased in ballistic gel to determine if there is a relationship between bloodstain pattern size as a function of distance and orientation. A bullet was fired through ballistic gel containing a blood chamber, depositing bloodstains onto a large sheet of butcher paper as the target surface. In total, there were 34 trials. The distances observed were 10, 20, 40, and 80 cm, the angles tested were 30°, 60°, and 90°. The orientation between the ballistic gel and paper target varied. A criterion was established to observe the overall area and symmetry of the bloodstain patterns. Statistical analyses indicated a negative linear relation relationship between the bloodstain pattern size and the paper’s angle and distance (R2 = 0.78) and the vertical symmetry of the bloodstain (R2 = 0.87). The orientation between the ballistic gel and paper target can impact the bloodstain pattern’s symmetry and size.

Link to full article

The bastard verdict and its influence on jurors - November 2021

The Scottish legal system is a unique jurisdiction, as jurors are able to give not proven verdicts in addition to the well-known Anglo-American verdicts (guilty and not guilty). The not proven verdict has never been legally defined, meaning that currently legal practitioners can only estimate why a not proven verdict has been given. The main aim of this study was to investigate if jurors violate the regularity principle, which is commonly incorporated in many rational choice models, by testing if the introduction of the not proven verdict has an impact on the outcomes given by jurors. In addition, the study aimed to test if the introduction of the not proven verdict has an impact upon how the not guilty verdict is perceived by jurors. It was found that jurors in a three-verdict system were less likely to give a not guilty verdict in comparison to jurors in a two-verdict system, showing that jurors violate the regularity principle and that the not proven verdict may change how the not guilty verdict is perceived. The findings of this research have implications in relation to juror communication, article 6 of the European Convention of Human Rights and juror rationality.

Link to full article

Voice biometrical match of mother and daughter for forensic purposes - November 2021

The similarity in voices among blood relations has been always a fascinating subject in forensic phonetics. This study is an attempt to report a novel approach to the speaker recognition and comparison of the voice of mother and her daughter by the use of voice biometric software. An attempt has been made to enlighten the role of voice as evidence in forensic investigation. Having noted a lack of oral corpora of mother and daughter voices, we have collected a database which consists of the 40 samples in a combination 20 each of mother & daughter respectively. Voice transcripts of mother and daughter were analyzed & compared using speech analysis software to examine the similarities & variations in sound spectrograms. The results showed that the mother and daughter voice samples have 88%-92% similarity. It is suggested that the system features are to a great extent genetically conditioned and that they are hence useful and robust for comparing speech samples of known and unknown origin, as found in legal cases.

Link to full article

Comprehensive coverage of human last meal components revealed by forensic DNA metabarcoding approach - October 2021

Stomach content analyses are a valuable tool in human forensic science to interpret perimortem events. While the identification of food components of plant and animal origin has traditionally been conducted by macro- and microscopical approaches in case of incomplete digestion, molecular methods provide the potential to increase sensitivity and taxonomic resolution. In particular, DNA metabarcoding (PCR-amplification and next generation sequencing of complex DNA mixtures) has seen a rapid growth in the field of wildlife ecology to assess species’ diets from faecal and gastric samples. This pilot study applied for the first time a DNA metabarcoding approach to assess both plant and vertebrate components of 48 human stomach content samples taken during medicolegal autopsies. A final dataset with 34 vertebrate and 124 vegetal unique sequences was obtained, that were clustered to 9 and 33 operational taxonomic units (OTUs), respectively. The results suggest that this approach can provide crucial information about circumstances preceding death, and open promising perspectives for biomedical dietary surveys based on digested food items found in the gastrointestinal tract.

Link to full article

Individualised and non-contact post-mortem interval determination of human bodies using visible and thermal 3D imaging - October 2021

Determining the time since death, i.e., post-mortem interval (PMI), often plays a key role in forensic investigations. The current standard PMI-estimation method empirically correlates rectal temperatures and PMIs, frequently necessitating subjective correction factors. To overcome this, a thermodynamic finite-difference (TFD) algorithm was previously developed, providing a rigorous method to simulate post-mortem temperatures of bodies assuming a straight posture. However, in forensic practice, bodies are often found in non-straight postures, potentially limiting applicability of this algorithm in these cases. An individualised approach has been developed, enabling PMI reconstruction for bodies in arbitrary postures by combining photogrammetry and TFD modelling. Utilising thermal photogrammetry, this approach also represents the first non-contact method for PMI reconstruction. The performed lab and crime scene validations reveal PMI reconstruction accuracies of 0.26 h ± 1.38 h for true PMIs between 2 h and 35 h and total procedural durations of ~15 min.

Link to full article

International Forensic Week 2021 - October 2021

The International Forensic Week 2021 is running from 25 to 29 October and entails a series of lectures devilered by World Renowned Experts. This event is organised by the Malaysian Society of Forensic Medicine and Science in collaboration with the Ministry of Health Malaysia and the Department of Forensic Medicine at the Hospital Pulal Pinang. Speakers presenting include Professor Vanezis, Professor Beh, Professor Milroy, and others. For registration please fill in this form.

This event is free to attend for any present or past student of the Academy.

'Unprecedented' rise in drug overdoses in England linked with synthetic opioid - October 2021

In a National Patient Safety alert issued on 18 August 2021, Public Health England (PHE) said that there have been an “unprecedented number of overdoses” and testing has showed that three cases involved heroin adulterated with the synthetic opioid isotonitazene. “Isotonitazene’s potency and toxicity are uncertain but perhaps similar to, or more than fentanyl, which is about 100x morphine,” said PHE. At least 46 poisonings and 16 deaths have been reported and have been linked to isotonitazene.

Read the news article here.

Reconstruction and physical fit analysis of fragmented skeletal remains using 3D printing and imaging - October 2021

Physical fit analysis (PFA) entails physically fitting fragmented evidence together to determine shared origin. PFA can be challenging to conduct with bone fragments particularly when fragile, sharp, or embedded in other materials. Three-dimensional (3D) imaging and printing techniques can circumvent these challenges. Two different 3D imaging techniques were compared and by generating virtual 3D models and prints of burned human bone fragments, the suitability of these techniques was tested. It was found that 3D imaging and printing allowed for effective PFA without excessively handling the original fragments.

Link to full article

News from Faculty of the History and Philosophy of Medicine and Pharmacy - October 2021

Acute renal failure from envenoming syndrome after massive bee attack - October 2021

Envenoming syndrome is a systemic toxic reaction to the inoculation of large volume of insect venom, typically after a swarm attack from bees. Africanized honey bees are notorious for their aggressive nature, and human deaths resulting from Africanized honey bee attacks are consistently reported. Whereas anaphylaxis is the most common lethal mechanism of injury, delayed deaths can also occur as a consequence of severe venom toxicity with resultant end organ damage. Acute renal failure complicating massive envenomation is a rare but potentially fatal outcome after Africanized honey bee attack and may be heralded by laboratory evidence of rhabdomyolysis.

Link to full article

Professor Vanezis - September 2021

Many congratulations to our Director, Professor Vanezis OBE, who has been appointed as Honorary President of the Balkan Academy of Forensic Sciences!

The molecular autopsy in forensic pathology - September 2021

Molecular autopsy is changing the practice of forensic pathology. Under some circumstances, one must contemplate the involvement of genetic factors to help explain why someone has died unexpectedly. Deaths that the forensic pathologist will be asked to investigation could involve natural disease that has a significant genetic underpinning. Elucidation of genetic mutations may not only further an understanding of the pathophysiology at hand, but also speak to underlying susceptibilities in an individual who dies that may not have been recognized. In addition, one may occasionally identify pathological findings that are confused for trauma that may actually be better explained by an underlying disease process. Using molecular medicine as a tool to explore such possibilities can improve the quality of death investigations and provide a new lens to probe challenging and contentious forensic cases that have proved resistant to traditional methods.

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The relevance of the detection of cocaine in fingerprints - September 2021

The finding that drugs and metabolites can be detected from fingerprints is of potential relevance to forensic science and as well as toxicology and clinical testing. However, discriminating between dermal contact and ingestion of drugs has never been verified experimentally. A commonly held belief is that the detection of metabolites of drugs of abuse in fingerprints can be used to confirm a drug has been ingested. This study shows that cocaine and its primary metabolite, benzoylecgonine, can be detected in fingerprints of non-drug users after contact with cocaine.

Link to full article

Knife Angel - September 2021

The decomposition process of whales and their value in deep-sea human deaths - September 2021

Experimental knowledge of human body decomposition in the deep ocean is very limited, partly due to the logistical challenges of deep-sea research. The literature on ecological responses to the arrival of naturally sunk and implanted whale carcasses on the seafloor represents a potential source of information relevant to questions of human body survival and  recovery in the deep ocean. Whale falls trigger the formation of complex, localized, and dense biological communities that have become a point of interest for marine biologists for the past 2-3 decades. Researchers have documented whale falls by whale type, size, geographic location, water depth and water chemistry, and there have been some comparative analyses of decomposition rates and faunal presence on carcasses. The stages of whale carcass decomposition most relevant to human forensics are those characterised by mobile scavengers that strip the soft tissues from carcasses, and to a lesser degree, other biota that degrade skeletal material. Statistical models used the number of faunal taxa attracted to the whale carcasses as a measure of the ecological response and the potential rate of decomposition, and identified significant influences of carcass age and dissolved oxygen concentration on the ecological response. Applying a forensic lens to whale-fall studies provides a window into an otherwise unseen world from the standpoint of human forensic taphonomy.

Link to full article

Recent spike in deaths could be linked to Fentanyl - August 2021

The Value of CCTV Surveillance Cameras as an Investigative Tool: An Empirical Analysis - August 2021

The Coroner Service - Justice Committee - House of Commons - July 2021

The subject of this Inquiry is the Coroner Service of England and Wales. The Ministry of Justice is responsible for Coroner Service policy and local authorities for funding 85 local coroner services. Coroners are judicial officers. Senior Coroners in each area are responsible with the relevant local authorities for the local coroner service and are aided by part-time Assistant Coroners. Larger areas may also have one or more full-time Area Coroners. All coroners are appointed by the local authority (with the consent of the Chief Coroner and the Lord Chancellor). Historically, coroners’ officers (who investigate deaths on behalf of coroners) have been seconded from local police forces. Other administrative support including accommodation is provided by the local authority.

Full article

The use of sodium nitrite for deliberate self-harm, and the online suicide market: Should we care? - June 2021

Sarah Markham: We have to learn from homicides committed by mental health patients - June 2021

The reduction of data collection of homicides committed by mental health patients is short-sighted and detrimental to the safety of patients and wider society, says Sarah Markham. Sarah Markham is an academic mathematician and patient representative currently pursuing a second PhD in theoretical computer science. She is a member of the BMJ Patient Advisory Panel. 

Link to full article

Forensic Investigation of a Shawl Linked to the “Jack the Ripper” Murders - June 2021

The COVID-19 pandemic and its impact on substance use: Implications for prevention and treatment - May 2021

The COVID-19 pandemic has brought major challenges to healthcare systems and public health policies globally, as it requires novel treatment and prevention strategies to adapt for the impact of the pandemic. Individuals with substance user disorders (SUD) are at risk population for contamination due to multiple factors—attributable to their clinical, psychological and psychosocial conditions. Moreover, social and economic changes caused by the pandemic, along with the traditional difficulties regarding treatment access and adherence—will certainly worsen during this period, therefore aggravate their condition. In addition, this population are potential vectors of transmission. In that sense, specific strategies for prevention and treatment must be discussed. health care professionals dealing with SUD must be aware of the risks and challenges they will meet during and after the COVID-19 outbreak. Addiction care must be reinforced, instead of postponed, in order to avoid complications of both SUD and COVID-19 and to prevent the transmission of coronavirus.

Crime and coronavirus: social distancing, lockdown, and the mobility elasticity of crime - February 2021

Governments around the world restricted movement of people, using social distancing and lockdowns, to help stem the global coronavirus (COVID-19) pandemic. We examine crime effects for one UK police force area in comparison to 5-year averages. There is variation in the onset of change by crime type, some declining from the WHO ‘global pandemic’ announcement of 11 March, others later. By 1 week after the 23 March lockdown, all recorded crime had declined 41%, with variation: shoplifting (− 62%), theft (− 52%), domestic abuse (− 45%), theft from vehicle (− 43%), assault (− 36%), burglary dwelling (− 25%) and burglary non-dwelling (− 25%). We use Google Covid-19 Community Mobility Reports to calculate the mobility elasticity of crime for four crime types, finding shoplifting and other theft inelastic but responsive to reduced retail sector mobility (MEC = 0.84, 0.71 respectively), burglary dwelling elastic to increases in residential area mobility (− 1), with assault inelastic but responsive to reduced workplace mobility (0.56). We theorise that crime rate changes were primarily caused by those in mobility, suggesting a mobility theory of crime change in the pandemic. We identify implications for crime theory, policy and future research.

Link to full article

How close has the Covid-19 pandemic pushed us to the edge of our mental health limits? - January 2021

Trends in suicide during the covid-19 pandemic

An editorial from the BMJ, discussing the increasing trends in suicide during the Covid-19 pandemic. The article discusses the currently available data and suggests preventative measures.

Link to full article

Forensic Identification from a Single Strand of Hair is Now Possible - January 2021

This paper describes a method for obtaining information that can contribute to individual identification from a single hair colored with a hair dye product using a combination of surface-enhanced Raman scattering (SERS) and X-ray fluorescence (XRF) analyses. SERS and XRF spectra of single hog hairs colored with several commercially available hair dye products were measured. SERS spectral patterns tended to be different depending on the hair dye products used for hair coloring. However, SERS spectral patterns of single hog hairs colored with different hair dye products that would produce similar types of dyes were similar. By performing XRF analysis, characteristic metallic elements originating from some hair dye products were detected. Therefore, XRF can contribute to identifying the difference among colored hairs that cannot be identified only by SERS. SERS and XRF analyses of a single shed hair can contribute to individual identification used in forensic science.

Link to full article

An overview of the latest protocols for diagnosis and biosafety in Covid-19 postmortem cases by the American Journal of Forensic Medicine and pathology. - October 2020

COVID-19

Postmortem Diagnostic and Biosafety Considerations

Abstract

As a result of the 2019 novel human coronavirus (COVID-19) global spread, medical examiner/coroner offices will inevitably encounter increased numbers of COVID-19–infected decedents at autopsy. While in some cases a history of fever and/or respiratory distress (eg, cough or shortness of breath) may suggest the diagnosis, epidemiologic studies indicate that the majority of individuals infected with COVID-19 develop mild to no symptoms. Those dying with—but not of—COVID-19 may still be infectious, however. While multiple guidelines have been issued regarding autopsy protocol in cases of suspected COVID-19 deaths, there is some variability in the recommendations. Additionally, limited recommendations to date have been issued regarding scene investigative protocol, and there is a paucity of publications characterizing COVID-19 postmortem gross and histologic findings. A case of sudden unexpected death due to COVID-19 is presented as a means of illustrating common autopsy findings, as well as diagnostic and biosafety considerations. We also review and summarize the current COVID-19 literature in an effort to provide practical evidence-based biosafety guidance for medical examiner-coroner offices encountering COVID-19 at autopsy.

Link to full article

The early postmortem interval (PMI) can be an important clue to investigators. Recent research suggests new noninvasive techniques that can determine the time of death accurately to the hour. - October 2020

Reconstructing the time since death using noninvasive thermometry and numerical analysis

Abstract

The early postmortem interval (PMI), i.e., the time shortly after death, can aid in the temporal reconstruction of a suspected crime and therefore provides crucial information in forensic investigations. Currently, this information is often derived from an empirical model (Henssge’s nomogram) describing posthumous body cooling under standard conditions. However, nonstandard conditions necessitate the use of subjective correction factors or preclude the use of Henssge’s nomogram altogether. To address this, we developed a powerful method for early PMI reconstruction using skin thermometry in conjunction with a comprehensive thermodynamic finite-difference model, which we validated using deceased human bodies. PMIs reconstructed using this approach, on average, deviated no more than ±38 minutes from their corresponding true PMIs (which ranged from 5 to 50 hours), significantly improving on the ±3 to ±7 hours uncertainty of the gold standard. Together, these aspects render this approach a widely applicable, i.e., forensically relevant, method for thermometric early PMI reconstruction.

Link to full article

Researchers at the University of Crete use modern techniques to determine the cause of a 33,000 year old scull. - October 2020

State of the art forensic techniques reveal evidence of interpersonal violence ca. 30,000 years ago

Abstract

The Cioclovina (Romania) calvaria, dated to ca. 33 cal ka BP and thought to be associated with the Aurignacian lithic industry, is one of the few relatively well preserved representatives of the earliest modern Europeans. Two large fractures on this specimen have been described as taphonomic modifications. Here we used gross and virtual forensic criteria and experimental simulations on synthetic bone models, to investigate their nature. Both forensic trauma pattern analysis and experimental models exclude a postmortem origin for the Cioclovina fractures. Rather, they indicate two incidents of blunt force trauma, the second clearly inflicted with a club-like object. The magnitude and extent of the lesions and the lack of signs of healing indicate a fatal injury. The Upper Paleolithic period is noted for intensified technological innovation, increased symbolic behavior, and cultural complexity. We show that the behavioural repertoire of the earliest modern Europeans also comprised violent inter-personal interactions and murder.

Link to full article

Forensic Middle East & Africa Event accredited by Academy of Forensic Medical Sciences for 23 CPD Credits - October 2020

We are delighted to announce that the Virtual Forensic Middle East & Africa Virtual Conference has been accredited by the Academy for 23 CPD points. Registration for this event is free and there is only a simple registration required for attendance via the link below. We wish the Organisers our very best wishes for an effective, successful and productive Conference.

Full details and a press release can be found below.

THREE DAY VIRTUAL FORENSICS CONFERENCE KICKS OFF ON MONDAY

Forensic experts will gather and share their lessons learned during what has been some of the most challenging times seen in the forensics community.

Forensics Middle East & Africa will be held virtually on 12-14 October, as the 4^th instalment of Clarion Defence & Security’s forensics conference series held in the MENA region. After previous successful editions in Abu Dhabi and Bahrain, the virtual event will bring together delegates from all specialities of forensic science looking to exchange knowledge and better practices for the sector. The conference is jointly organised with the Arab Union of Forensic Toxicology and Sciences, which has spearheaded the organising committee in an effort to produce an agenda with compelling scientific content.

The event will open with a day of collaborative sessions including four expert-led workshops covering DVI Interpol guidelines training, an International Committee of the Red Cross mass fatality response planning session, COVID-19 digital tracking demo and a forensics education online training platform solution. On the conference days, forensic science leaders from all over the world will deliver a total of 50 oral presentations in addition to two afternoon poster sessions containing rapid fire presentations on emerging research. On the final day, the conference will conclude with a 15 member, Arabic panel discussion covering challenges and opportunities in the region with representatives from Morocco to Iraq under the moderation of AUFT’s President – Dr. Dina Shokry.

Amongst the keynotes confirmed to present at the event are: Dr. Angel Carracedo, President of the International Academy of Legal Medicine; Professor Claude Roux, President of the International Association of Forensic Sciences; Dr. Duarte Nuno Vieira, Chairman of the Scientific Advisory Board of the Prosecutor of the International Criminal Court and Oran Finegan, Head of Forensics for the International Committee of the Red Cross. In addition to the highlighted keynotes and presenters, the conference is supported by commercial sponsors who will be sharing their latest research & development findings in sponsored conference sessions as well virtual sponsor booths.

The three day, free-to-attend event will offer a much-needed space where a community of forensic practitioners - many of who are frontliners in the current pandemic - a space to learn, train, discuss and network without needing to leave their home or office. This year has been one of the most challenging times seen in the forensics community and this will provide forensic experts a place to share their lessons learned and procure new equipment solutions.

Registration is simple and free via the website: www.forensics-mea.com.

Distinguishing between Contact and Administration of Heroin from a Single Fingerprint using High Resolution Mass Spectrometry - September 2020

Fingerprints are heavily used in forensic investigations and more recently have proven to be a mode of distinguishing between individuals who use drugs or handle them. In this publication of the Journal of Analytical Toxicology by Costa et. al, fingerprints are used to distinguish between users and nonusers of heroin using analytical chemistry methods including LC/MS.

Abstract:

Fingerprints have been proposed as a promising new matrix for drug testing. In previous work it has been shown that a fingerprint can be used to distinguish between drug users and nonusers. Herein, we look at the possibility of using a fingerprint to distinguish between dermal contact and administration of heroin. Fingerprint samples were collected from (i) 10 patients attending a drug rehabilitation clinic, (ii) 50 nondrug users and (iii) participants who touched 2 mg street heroin, before and after various hand cleaning procedures. Oral fluid was also taken from the patients. All samples were analyzed using a liquid chromatography—high resolution mass spectrometry method validated in previous work for heroin and 6-AM. The HRMS data were analyzed retrospectively for morphine, codeine, 6-acetylcodeine and noscapine. Heroin and 6-AM were detected in all fingerprint samples produced from contact with heroin, even after hand washing. In contrast, morphine, acetylcodeine and noscapine were successfully removed after hand washing. In patient samples, the detection of morphine, noscapine and acetylcodeine (alongside heroin and 6-AM) gave a closer agreement to patient testimony on whether they had recently used heroin than the detection of heroin and 6-AM alone. This research highlights the importance of washing hands prior to donating a fingerprint sample to distinguish recent contact with heroin from heroin use.                                                                                                       

Link to full article: https://academic.oup.com/jat/article/44/3/218/5611271

Aquatic Decomposition of Mammalian Corpses: A Forensic Proteomic Approach - September 2020

The postmortem submerged interval (PMSI) is yet another parameter that is very challenging to estimate with a sufficient level of accuracy, during a forensic investigation. Mizukami et. al, 2020 published an insightful article in the Journal of Proteome Research, a study that looks at mouse carcasses submerged in different types of water and how those affect changes in a number of proteins in bones over set periods of time.

Abstract

Methods currently available to estimate the postmortem submerged interval (PMSI) of cadavers in water suffer from poor accuracy, being mostly based on morphological examination of the remains. Proteins present within bones have recently attracted more attention from researchers interested in the estimation of the postmortem interval (PMI) in terrestrial environments. Despite the great potential of proteomic methods for PMI estimation, their application to aquatic environments has not yet been explored. In this study, we examined whether four different types of aquatic environment affected the proteome of mice bones with increasing PMSIs. Results showed that increasing PMSIs can influence the protein abundances more than the different types of water. In particular, the abundance of the muscle protein fructose-bisphosphate aldolase A constantly decreased with increasing PMSIs. Additionally, the protein peptidyl-prolyl cis–trans isomerase showed a significant decrease between controls and aquatic environments. Furthermore, the coagulation factor VII was deamidated only in submerged samples and not in terrestrial controls. Finally, fetuin-A was significantly more deamidated in pond water compared to the other aquatic environments. Overall, this study identified novel potential biomarker candidates that would be useful for the estimation of the PMSI and for the characterization of the type of water involved in criminal investigations.

Full article can be found here:

https://pubs.acs.org/doi/10.1021/acs.jproteome.0c00060

Essential Forensic Medicine - January 2020

Essential Forensic Medicine

Book written by Professor Peter Vanezis

Synopsis:

Provides an invaluable distillation of key topics in forensic medicine for undergraduate, masters, and postgraduate students Essential Forensic Medicine covers the broad area of the forensic medical sciences, delivering core knowledge in the biomedical sciences, and the law and ethics surrounding them. Concise, accessible chapters cover a wide range of topics from basic forensic identification and examination techniques to forensic toxicology and psychiatry. Written by internationally-recognized experts in the field, this authoritative guide offers complete chapter coverage of the legal system, courts, and witnesses; investigation of the deceased and their lawful disposal; and the duties of a registered medical practitioner and the General Medical Council. It instructs readers on the general principles of scene examination and the medico-legal autopsy including how to interpret the many kinds of injuries one can suffer--including those from blunt impact and sharp force, firearms and explosives, asphyxia and drowning. Further chapters cover sexual offences, child abuse, and using DNA in human identification, mental health, alcohol and drug abuse. A fresh, accessible, up to date textbook on forensic medicine Written by a well-known experts with decades of experience in the field Includes numerous figures and tables, and detailed lists of key information Features numerous case studies to reinforce key concepts and ideas explored within the book Helps students to prepare for examinations and enables practitioners to broaden their understanding of the discipline Part of the "Essential Forensic Science" series, Essential Forensic Medicine is a highly useful guide for advanced undergraduate students, master's students, and new practitioners to the field.

The book is now available for preorder on Amazon and other sites: https://www.amazon.co.uk/Essential-Forensic-Medicine/dp/047074863X 

DMJ Examination - March 2019

We would like to congratulate Dr Jiun Yih Lee and Dr Muhamad Yazid Bin Yahya who have both just passed the DMJ(Path) examination. They have both studied very hard during their attachment with us for the past two years.

BAC Accreditation - March 2019

We are very happy to announce that our reaccreditation application has just been approved by the British Accreditation Council.

Further details: https://www.the-bac.org/directory/13526/academy-of-forensic-medical-sciences/

Deaths in Police Custody, England and Wales - November 2017

Following several deaths in custody, the then Home Secretary Theresa May on July 23, 2015 called for all deaths in custody and serious incident in police custody. The organization Inquest has recorded more than 5,600 deaths in prison and police custody in England and Wales, between 1990 and 2016¹. The report by Dame Elish Angiolini QC² contains 110 recommendations for overhauling the way in which the police and health authorities deal with vulnerable people, and how the police complaints watchdog investigates such incidents when they occur. Many are still questioning what will be the outcome from these recommendations will be and how will the Home Office act on this?³.

Image courtesy of (https://www.theatlas.com/charts)

Many believed that Racial stereotyping may be a “significant contributory factor” in deaths that occur in custody across England and Wales. However, they feel the authority has not done much to address this situation

Mental health was a significant issue that was highlighted within the report.

Dame Elish Angiolini QC, in her report highlighted that a serious issue was an unduly high number of deaths of black men in restraint-related deaths, often in antagonistic circumstances. This she believes helps increase the negative perception of many within the Black, Asian and Minority Ethnic (BAME) communities of the police service within England and Wales³.

The report further went on to state “Where there is evidence of racist or discriminatory treatment or other criminality or misconduct, police officers must be held to account through the legal system.”

The recommendations also targeted the Independent Police Complaints Commission (IPCC), stating ex police officers should not be appointed at lead investigators within the IPCC so that integrity and full independence is maintained of those it investigates. A spokesperson from the IPCC was quick to respond stating: “We welcome this independent review, which examines not only these investigations but the wider issues that lie behind them.”

They did not address the issues of having ex-police officers as lead investigators. However, they went on to said: “We are extremely mindful that any subsequent investigation by the IPCC impacts on these groups further, and must be carried out in a way that is not only independent, thorough and effective but also conscious of the impact on all those affected ⁵.”

The statistics showed that in the UK, every prosecution over a death in police custody in the past 15 years ended with acquittal, to many this signify a system that is failing the families and public⁴.

The current Home Secretary Amber Rudd said: “This simply isn’t right, and is why the Government is taking steps to ensure that families bereaved in this way in future get the support and answers they need”. She further stated: “The Government is committed to tackling this issue and that when tragically deaths in police custody do occur, we are clear that they must be investigated thoroughly, and action taken to support families better in future ⁴”.

Since the report has been published, the relatives of those who died in custody called on the government to quickly implement its findings.

Bibliography

1. Dodd, Jamie Grierson and Vikram. The Gaurdian. [Online] 30 October 2017. [Cited: Friday October 2017.] https://www.theguardian.com/uk-news/2017/.

2. Independent report: Deaths and serious incidents in police custody https://www.gov.uk/government/publications/deaths-and-serious-incidents-in-police-custody

3. Hattenstone, Eric Allison and Simon. The Guardian . [Online] 2 November 2017. [Cited: 3 November 2017.] https://www.theguardian.com/.

4. Bulman, May. The Independent News. [Online] 30 October 2017. [Cited: 1 November 2017.] https://www.independent.co.uk/news/uk/home-news/racial-stereotyping-significant.

5. Mohdin, Aamna. In the UK, every prosecution over a death in police custody in the past 15 years ended with acquittal. [Online] 3 November 2017. [Cited: 3 November 2017.] https://qz.com/1117185/ipcc-report-in-the-uk-every-prosecution-over-a-death-in-police-custody-in-the-past-15-years-ended-with-acquittal/.

Recent trends in knife crime in England and Wales - April 2016

In 2015 the Government attempted to address the issues relating to knife crime incidents within England and Wales. With the current surge in knife crime within and around the capital, it has left many in London living in fear of leaving their houses. This high increase of knife related crime continues to rise and remains an important topic on the political agenda and social arena.

According to the Metropolitan Police, there is a significant increase for the first time in eight years in knife crime in London. At the end of March 2015, the Metropolitan Police recorded 9,680 offences (37%) involving knives and other sharp instruments. These figures also showed that there has been a 5% increase in knife injury to under 25 year olds, which earlier in the year this stood as a 22% increase.

As society changes, there seems to be a major rise within violence at home, schools and on the streets; some of which are gang affiliated. Whilst there are other weapons such as guns, swords, baseball bats etc, the knife seem to the preferable choice of weapon for many.

According to the Office for National Statistics (1), offences involving knives or sharp instruments also rose by 2% over the same period (to 26,374). A knife or sharp instrument was found to be involved in 10,270 (39%) robberies and 13,488 (51%) as part of offences of assault with injury or assault with intent to cause serious harm. These figures also reflect the fact that within England and Wales, there was a nine per cent (9%) rise in the number of people caught carrying a knife and a ten percent (10%) increase in knifepoint rapes and sexual assaults (2). Homicides involving a knife or sharp instrument made up around 1% of the total number of knife or sharp instrument offences.

crime being reported to the police. This would significantly affect the overall percentage, as before March 2011, there were a lot of inconsistencies in how knife (including sharp instruments) crime were recorded between the different police force. For example, the West Midlands police force would record broken bottles and glass offences before 2011, which is now excluded from the national data. However, such offences are still recorded within Surrey under knife and sharp instrument returns. John Flatley, head of crime statistics at the ONS believes that the rise in knife crime was real and unlikely to be due to changes in recording practices (3).

In a response to this rise, commander Dean Haydon, head of Scotland Yard’s homicide and major crime command, and commander Duncan Ball, head of combating gang crime, said four key factors were behind the rise (4) : “the dark web being used to purchase weapons, such as the zombie knife which has a foot-long blade, a cultural change among young people that is encouraging them to use knives, even for trivial disputes or minor theft,reductions in the use of stop and search and improved recording of knife crime statistics.”

In an interview with the Evening Standard newspaper (5), the Metropolitan Police Commissioner Sir Bernard Hogan-Howe, also admitted that limiting stop and search had gone too far and had contributed to the rise in knife offending. He further stated that “the policy would be reversed and more searches carried out.” Some gang members and young people told the police that the reduction of stop and search was no longer a deterrent to them, so carrying of knives and other weapons was much easier. This was after the now home secretary, RT Hon Theresa May called on the different forces to reconsider how they were using stop and search. She further stated (6) “nobody wins when it’s used poorly – particularly if used unfairly against young black men.”

Some officials fail to believe that there is a direct link between stop and search and knife offences as it has never been proven. According to Mark Castle from Victim Support, dealing with the devastating effect of knife crimes on the victims, particularly young people and their families first hand, more work needs to be done to educate people about the dangers of carrying knives (6).

This rise in knife crime can be attributed to a number of factors. Society is changing and there appears to be an increase in violence generally, whether in the home or on the streets. The ‘Stop Knife Crime’ campaign launched by the Met Police, highlighted that amongst some groups of young people there is an attitude that life is cheap and an increasing number seem prepared to carry a knife whether it is for protection or for use in crime (7).

According to the latest Metropolitan Police Service statistics, released on April 15th 2016, there were 46 more knife crime offences, 77 more knife injuries and three more gun crimes from April to March 2015/16 compared with April to March 2014/15.

The families of knife crime victims also work endlessly in promoting peace within their local communities and raising awareness around the tragic experience whether it is loss of a life or survivors of an assault. The call for tougher penalties for those perpetrators, led to new legislations that means that those convicted of carrying a knife for the second time will face a mandatory custodial sentence. In spite of major cut to the police budget, in July 2015, the Met Police launched Operation Sceptre that was designed to coincide with new legislation aimed at reducing knife crime across the whole of London. According to the Metropolitan Police, Operation Sceptre seeks to target not only those who carry and use knives, but also the supply, access and importation of weapons (7).

The Home Secretary Theresa May has recently announced a new agreement of principles between the major retailers and the government with the aim to tackle the knife crime epidemic. According to the agreement, Tesco, Lidl UK, Amazon UK, Wilko, Argos, Morrisons, Asda, Poundland, Sainsbury’s, John Lewis, and Waitrose have committed to continuous staff training, “safely displaying and securely packaging knives, raising public awareness of age restrictions, and robust age verification checks for knife sales whether in-store, or if ordered online, at point of collection or delivery.”(8)

Knives in one high street store kept locked in a thickened glass cabinet.

Detail of warning sign in the window:

This voluntary principle will include a commitment for law enforcement to conduct follow-up test purchases of knives in 6 months and to provide feedback to retailers to take action to tackle breaches of the law. The government will work with the British Retail Consortium to extend this agreement to other retailers. Many acknowledge this as a significant step to reduce the easy access of acquiring a knife.

Home Secretary Theresa May follows up on the agreement by stating…. “Knife crime has a devastating impact on victims, families and communities, and I am determined to do all I can to prevent it.Retailers have a vital role to play in this fight and I welcome today’s commitment.Knives have no place on our streets.

In response to this escalating knife problem, MP and now the Mayor of London, Mr Sadiq Khan, expressed his concern regarding curbing the epidemic. Before being elected to the office of Mayor of London, he said, “I have a real plan to tackle knife crime – based on my experience working with the victims of crime and the police as a lawyer and MP (9).“He further states his plan would include, tougher and more effective sentences for those caught with knives, stop shops selling knives to kids, properly map London’s gangs and make our prevention programmes more effective.

With the latest knife stabbing victim dying, just yards away from Sadiq Khan’s house in Tooting South London, he expressed his sympathy ….” Obviously, as a dad that’s very worrying, but my thoughts are with the mum and family of the victim.” (10) Mr Khan called for tougher action to tackle people carrying knives in London and acknowledged that “knife crime is a growing tragedy in London – we must do more to stop it.” (11)

People leaving floral tributes to Mr Elwin, who was training to become an electrician at Merton College (Courtesy, The Mirror Newspaper, 19th April 2016).

Mr Sadiq’ and current MP Mr Goldsmith (Conservative mayoral candidate) also shared similar views calling for tougher checks to prevent the sale of ‘zombie knives’ online to under 18s. (9) The Government are working on new legislation to ban the so-called ‘zombie-killer’ knives.

Cuts to the Met Police force budget of over four million pounds, meant that there are limited resources available, including the police presence in high crime areas.

Fighting knife crime has to be a collective process, not only a problem for the police or the government. The impact of new policies, legislation and lengthy prison sentences will have slower longer term. However, we have to work with the community to reduce knife crime and knife violence – it will not happen overnight.

Police officers at the scene where a man was stabbed in Tooting (Courtesy Nigel Howard, The Evening Standard, 19th April 2016)

REFERENCES

Flatley, J. Chapter3: Offences involving the use of weapons.

https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/compendium/focusonviolentcrimeandsexualoffences/yearendingmarch2015/ chapter3offencesinvolvingtheuseofweapons#offences-involving-knives-or-sharp-instruments-prevalence-and-trends.

[Online]11 February 2016.[Cited: 18 February 2016.] https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice.

Martin,Bentham M. Evening Standard.

http://www.standard.co.uk/news.[Online]15 October 2015.[Cited: 18 Jnanuary 2016.] http://www.standard.co.uk/news/crime/knife-crime.

T, Alan. The Guardian. The Guardian. [Online] 16 July 2015. [Cited: 19 April 2016.] http://www.theguardian.com/uk-news/2015/jul/16/knife-in-england-and-wales-up-for-first-time-in-four-years.

D, Vikram. Metropolitan police say knife crime up 18% in London. [Online] 20 September 2015. [Cited: 22 February 2016.] http://www.theguardian.com/uk-news/2015/sep/20/metropolitan-police-say-knife-up-18-in-london.

Martin, Justin D. Evening Standard. Evening Standard. [Online] 15 October 2015. [Cited: 17 April 2015.] http://www.standard.co.uk/news/crime/knife-crime-in-britain.

London, BBC News. BBC. BBC. [Online] 16 July 2015. [Cited: 3 4 2016.] http://www.bbc.co.uk/news/uk-33547806.

Police, Metroploitan.Knives take lives. Find out how to help us StopKnifeCrime .[Website] London : s.n., 2016.

Office, Home. International Crime and Policing Conference 2016 and Knife, gun and gang crime. Home Office. [Online] 23 March 2016. [Cited: 18 March 2016.] https://www.gov.uk/government/news/government-and-major-retailers-unite-to-tackle-knife-crime.

P, Laura. Evening Standard. Evening Standard. [Online] Saturday January 2016. [Cited: 18 April 2016.] http://www.standard.co.uk/news/crime/the-15-teenage-victims-of-knife-crime-in-2015-a3143901.html.

John, Matt, Pippa and Justin D. Evening Standard News. Evening Standard. [Online] 19 April 2016. [Cited: 19 April 2016.] http://www.standard.co.uk/news/crime/tooting-stabbing.

E, Sophie. The Mirror News. The Mirror. [Online] 19 April 2016. [Cited: 20 April 2016.] http://www.mirror.co.uk/news/uk-news/tooting-murder-first-picture-trainee-7787629.

Screening to prevent sudden cardiac deaths: more than three years on from the collapse of Fabrice Muamba - April 2015

The collapse of premiership footballer Fabrice Muamba on a cold March night in 2012 during a FA cup quarter final between Bolton Wanderers and Tottenham Hotspurs was watched by millions. Despite ultimately spelling the end of a successful career as a professional footballer, thanks to the quick responses of the team doctors, the assistance of consultant cardiologist Dr Andrew Deaner (a Tottenham fan who ran on to the pitch to help), as well as the quick response of the ambulance service and emergency medicine crews, Fabrice Muamba was successfully resuscitated and made a slow but almost full recovery. Although the cause of his cardiac arrest was never revealed, it is thought that he may suffer from hypertrophic cardiomyopathy (HCM) which, coupled with the extreme physical exertions of premiership football, led to his cardiac arrest.

Other high profile cases in football include the deaths of Marc-Vivien Foé whilst representing Cameroon in the 2003 FIFA Confederation Cup during a game against Columbia, Antonia Puerta who collapsed and died whilst playing for Sevilla in a Spanish league game against Getafe in 2007 and Motherwell’s Phil O’Donnell who collapsed during a Scottish league game against Dundee United in 2009 and died later in hospital. Such cases receive a significant amount of media attention due to the nature of the death of a seemingly fit and well known individual in such a public forum, but thankfully such events are rare. A 2003 study by Corrado et al suggests an increased risk of sudden cardiac death of almost three times for athletes compared to their non-athletic counterparts[i] whilst more recent data suggests the opposite i.e. that athletes have a lower incidence of sudden cardiac death.[ii],[iii]

Overall there are around 60,000 cases of sudden cardiac death a year in the UK.[iv] However this figure includes all deaths, not just those of young athletes. A large and comprehensive 27-year registry of US athletes recorded 1866 sudden deaths in athletes between 1980 and 2006, 1049 of which were deemed to be cardiac in origin.[v] In this registry the most common cause of death was HCM (36%), followed by anomalous coronary arteries (17%). Other less common causes included myocarditis, arrhythmogenic right ventricular cardiomyopathy (ARVC), ion chanellopathies (such as Long QT syndrome) and premature coronary artery disease. Around 80% of the deaths occurred during or just after exercise, be it during a sporting event or practice session. Overall the incidence of sudden death was estimated at around 0.6 per 100,000 per year in this study. A recent comprehensive review by Sharma et al quotes a range of between 0.4-0.8 deaths per 100,000 per year in athletes when analysing only the studies with robust methodologies.[vi] Other studies of young individuals put the figure higher. An incidence of 1.8 deaths per 100,000 per year in the young (age < 35) was reported by the UK Office of National Statistics[vii] and in Italy, the figure was calculated at 2.1 deaths per 100,000 per year.1

Despite the relatively low incidence of sudden cardiac deaths, there is a strong body of opinion that believes more effort should be made to identify athletes with predisposing cardiac conditions prior to engagement in high level activities such as football. Following on from the case of Fabrice Muamba, strong voices from within football, the media and the medical profession at the time of his collapse were heard bemoaning the fact that such an event could have been prevented if more stringent screening measures were in place to identify cardiac diseases that increase the risk of sudden cardiac death.

Taking a broader perspective of competitive sport as a whole, there is considerable heterogeneity between different sports, the competitive level of the sport and the country in which the sport is taking place as to the nature, if any, of the screening programme on offer. Many point to the Italian system of screening for all competitive sport as a model to aspire to. Physician led ECG screening programmes in association with detailed medical histories and examinations have seen an absolute reduction in sudden cardiac death of 89% in competitive athletes since the programme was initiated over 30 years ago.3,[viii] Indeed the Italian system has influenced European Society of Cardiology (ESC) and International Olympic Committee (IOC) guidelines for competitive athletes which recommends an ECG as a minimum for anyone taking part in competitive sport.[ix],[x] In football, FIFA and UEFA drew up guidelines in 2008 that stipulate that every footballer involved in first team activity must have at least an ECG and one echocardiogram in their medical notes.

Prior to Muamba’s cardiac arrest, the English Premier League followed the ESC and IOC guidelines but in the wake of the events of 2012 and the backlash by media, the public and prominent voices within football, more recent guidelines have been introduced by the premier league requiring all players to have bi-annual screening with at the very least and ECG and an echocardiogram if deemed necessary by a consulting physician. Such screening programmes are costly however and there is considerable debate as to the best way to implement them. Wheeler et al analysed the economics of screening programmes and determined that screening with an ECG in combination with a history and medical examination was both reasonable and cost and effective at reducing mortality.[xi]

However screening in isolation is not fool proof. Indeed evidence suggests that the use of ECG and echocardiographic screening, as is standard practice now in the Premiership, can only pick up around 70% of conditions that may lead to sudden cardiac death.[xii],[xiii]Further difficulties can arise in this group when trying to distinguish the natural hypertrophied athlete’s heart to pathological conditions such as HCM.[xiv],[xv] Other such diagnostic grey areas can arise, and these pose problems for medical staff as to how to advise players and clubs, as well as posing problems with regard to future applications for life insurance and mortgages. Some conditions pose a slightly increased risk of sudden cardiac death and such screening tools may lead to exclusion of individuals from sports whose career risk of sudden cardiac death is only minimally increased.

A separate issue highlighted by the collapse of Fabrice Muamba is the availability automatic external defibrillators (AEDs) at football matches as well a proper training for staff to use the devices. At the 2014 FIFA congress, it was revealed that in the last 5 years, 84 reported cases of sudden cardiac arrest had occurred in football matches and training grounds. In 80% of these arrest no AED was available in the stadium and less than a quarter of those individuals were revived. The medical experts that presented this data called for an AED and appropriate medical staff to be available in every football stadium, a message echoed by Professor Jiri Dvorak, FIFA’s Chief Medical Officer who stated that ‘It is required at FIFA competitions to have appropriate medical staff around the pitch and a defibrillator in the stadium’.[xvi] Indeed in England a joint venture between the FA and the British Heart Foundation has led to £1.2 million being made available to provide over 900 AEDs to clubs in tiers 1 – 6 of the National League System and clubs in the Women’s Super League as well as providing training for two representatives from the club in their use.[xvii]

Whilst awareness of sudden cardiac death in football and in young athletes in general grows, the multitude and variety of conditions that can lead to sudden cardiac death, and the difficulty in diagnosis as well as risk stratification means that there will never be a perfect system that will completely eliminate such events as occurred in March 2012. However as both screening tools and our understanding of the disease processes develop, coupled with wider access to AEDs and trained medical staff, one hopes that the incidence of sudden cardiac death in football diminishes.

You may also like to visit Cardiac Risk in the Young (CRY) at: https://www.c-r-y.org.uk/about-us/

Bibliography:

[i] Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sport activity enhance the risk of sudden death in adolescents and young athletes? J Am Coll Cardiol 2003;42:1959–63

[ii] Van Camp SP, Bloor CM, Mueller FO, Cantu RC, Olsen HG. Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc. 1995;27:641– 647.

[iii] Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA. 2006;296(13):1593–601

[iv] National Institute for Health and Clinical Excellence (NICE). Implantable cardioverter defibrillators for arrhythmias. Review of technology appraisal 11. https ://www.nice.org.uk/nicemedia/pdf/TA095guidance.pdf

[v] Maron BJ. Hypertrophic cardiomyopathy and other causes of sudden cardiac death in young competitive athletes, with considerations for preparticipation screening and criteria for disqualification. Cardiol Clin.2007;25(3):399–414

[vi] Harmon KG, Drezner JA, Wilson M, Sharma S.Br J Sports Med. Incidence of sudden cardiac death in athletes: a state-of-the-art review. 2014 Aug;48(15):1185-92.

[vii] https://www.ons.gov.uk/ons/index.html

[viii] Italian Ministry of Health, editor. Gazzetta Ufficiale della Repubblica Italiana: Serie generale 1982:63. 1982. Norme per la tutela sanitaria dell’attività sportiva agonistica (Rules concerning the medical protection of athletic activity) pp. 1715–19

[ix] Corrado D, Pelliccia A, Bjornstad HH, Vanhees L, Biffi A, Borjesson M, et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J. 2005;26(5):516–24. [PubMed]

[x]InternationalOlympic Committee Medical Commission . Sudden cardiovascular death in sport: Lausanne Recommendations: Preparticipation cardiovascular screening. Vol. 2008. Lausanne; Switzerland: 2004

[xi] Wheeler MT, Heidenreich PA, Froelicher VF, Hlatky MA, Ashley EA. Cost effectiveness of pre-participation screening for prevention of sudden cardiac death in young athletes. Ann Intern Med. Mar 2, 2010; 152(5): 276–286.

[xii] de Noronha SV, Sharma S, Papadakis M, Desai S, Whyte G, Sheppard MN. Aetiology of sudden cardiac death in athletes in the United Kingdom: a pathological study. Heart 2009;95:1409-1414

[xiii] de Noronha SV, Behr ER, Papadakis M, Ohta-Ogo K, Banya W, Wells J, Cox S, Cox A, Sharma S, Sheppard MN. The importance of specialist cardiac histopathological examination in the investigation of young sudden cardiac deaths. Europace (2014) 16 (6): 899-907

[xiv] Pellicia A, Maron B J, Spataro A. et al The upper limit of physiological hypertrophy in highly trained elite athletes. N Engl J Med 1991. 324295–301.301

[xv] Maron B J, Pellicia A, Spirito P. Cardiac disease in young trained athletes. Insights into methods for distinguishing athletes heart from structural heart disease, with particular emphasis on hypertrophic cardiomyopathy. Circulation 1995. 911596–1601.1601

[xvi] https://www.fifa.com/aboutfifa/organisation/bodies/congress/news/newsid=1637723/index.html

[xvii] www.bhf.org.uk/football

Downward Trend in Crime - January 2015

It has recently been reported that there has been a reduction in violent crime (1) this could be a result of major changes in society, such as better and improved policing along with the increasing price of alcohol over the years. According to a study by Professor Jonathan Shepherd of Cardiff University, data examined from the NHS has shown a drastic reduction of around 12% in violent crime within England and Wales over the last five years (1). Professor Shepherd further stated that “violence is falling in many Western countries and we do not know all the reasons why”. Could this be the result of major changes in society, such as better and improved policing, along with sharp increases in the cost of alcohol over recent years?

However, many believe that the published figure is not a true representation of the actual number of crimes committed as a result of many criminal offences not being recorded. Surveys that were undertaken by the Crime Survey for England and Wales (CSEW) across the country (face- to –face) showed a significant difference from the number of crimes apparently reported by the police. Both the police and CSEW use different definitions for violent crime therefore this creates a large discrepancy in numbers. Crime such as robbery might be described as “an offence in which violence or the threat of violence is used during a theft”. This will not be classified as violence against a person within the police report but will be interpreted by the CSEW as a violent crime.

A recent release by the Office of National Statistics showed that between 1995 and

2001/02 there was a significant drop in violent crime from 4.2 million to 2.7 million. Since then, this decreasing trend has continued by 13% between the 2007/08 and 2012/13 survey (2), which is very similar to the figures published by the NHS. The Home Office report of 2009/10 compared data from the British Crime Survey (BCS) and police recorded crime showed a consistent fall in overall crime when compared to 2008/09, both by 9% and 8% respectively (3). They then went on to conclude that the recent period of economic recession did not have any effect on the increase in crime between the periods as expected.

These violent crimes are broken down into four major categories: (i) assault without injury (ii) assault with minor injury, (iii) wounding and (iv) robbery; it wasn’t startling to discover that those who are single and aged between 16-24 are twice as likely to be the victims of violent crime. As mentioned earlier, some particular violent crimes such as homicide and sexual assault are not fully covered within the BCS, although these are covered by the police (3).

The reduction within the size of the police force throughout the country also led many to believe there would be a drastic increase in violent crime, in particular property crime during the recession. Surprisingly, that was not the outcome and could be a result of improved policing according to Prof Shepherd. According to the BCS, their report has been regarded as controversial by many; some critics are saying the public does not believe that the crime statistics are right, even though, the BCS report from local areas confirmed that a larger proportion of people (51%) believed that crime had fallen and they’re living in a lower than average crime area (2). This they believed to be a more realistic view of crime within their local area. The UK Statistics Authority was not happy with the negative commentary by these critics and went on to release a statement quoting that they had “not seen any evidence of political interference in the production of the aggregate National Statistics on crime and we are satisfied that the Home Office statisticians responsible for this work are fully committed to maintaining that integrity”.

Max Chambers, Head of Crime and Justice Policy Exchange was also quick to point out and comment that the implementation of “Sensible policies balancing enforcement and prevention can have, and are having, an impact,” on crime reduction within society. The use of neighbourhood policing teams which are more visible within the local areas, particular in high risk crime communities, has shown to be more effective in preventing crime and help in speeding up the rehabilitation process of offenders more successfully.

The steady increase in alcohol prices which is one of the major factors fuelling violent crime within society, means there would be less people getting drunk. According to the study by Prof Shepherd, alcohol “has become less affordable” combined with a fall in the income of those between 18-30 years old. Many pubs and clubs also went out of business throughout the recession, thus forcing many drinkers to stay at home and drink, therefore reducing the risk of them getting into fights with other intoxicated revellers.

According to ‘The Guardian’ newspaper, there was a combined drop of violent crime, which has seen a 5% fall within the police recorded figures. Over the 2011/12 period, the amount of murders reported by the police dropped by 10%, gun crime 17% and an 11% drop in knife crime (4). No one entity can take the credit for this downward trend in crime, however Mark Bangs from the Office for National Statistics deputy head of crime, said…“after levels have crime peaked in the mid-90s, there were then substantial falls through to the 2004-05 survey, after which crime continued to fall at a slower rate, resulting in levels of crime being flat since 2009-10.”. With the crime figures being this low, this created an opportunity for then Crime Prevention Minister Jeremy Browne to announce that this was “the lowest level since the crime survey began in 1981 and in spite of working with a reduced budget many have achieved a significant reduction in crime”(4) .

Could the reduction of lead from car fuel cause a reduction of crime? According to the chief biological criminologist, lead which is highly toxic can cause aggressive or dysfunctional behaviour, resulting in poor decision making and aggressive behaviour within individuals(5). A range of biological studies was carried out on criminals by Dr Bernard Gesch, a physiologist at Oxford University, which included their type of diet combined with various other environmental factors. He further states that “lead is a very potent neurotoxin…..” which causes alteration in the brain. The first real statistical data to support this theory was collected by a housing consultant and economist Rick Nevin, when he calculated the rise and fall of the presence of lead in petrol and compared his results to the history of crime. His results were quite startling. As the amount of lead increased, this showed a corresponding rise in violent crime two decades later. Dr Gesch’s studies support this data and he clearly believed that “the lead could account for as much as 90% of the changing crime rate during the 20th century”.(5)

The total exclusion of lead from petrol or the replacement of all petrol cars with electrical or hydrogen powered vehicles would result in a steady drop in violent crime might only be ambitious thinking at the moment, as the theory is not accepted by everyone. Professor of Criminology, Roger Matthews of the University of Kent clearly rejects this theory. He states, “biological criminologists completely misses the point and he doesn’t see a link”. He believes criminals offend because of the different things that push them into crime and not in the nature of their brain tissue (5).

The events of August 6, 2011, called the “BlackBerry riots”, resulted in the Prime Minister David Cameron promise to rid the streets of the UK of all gangs; guilty culprits would be fast-tracked through the courts and sentenced quickly. This can be interpreted as a fear-driving procedure that would help to drive potential perpetrators of violent crime to reconsider their actions before committing a crime.

Even though there are calls for an increase in the number of police officers, since the last report by the Home Office where it showed the number of police officers had fallen below 130,000. Prime Minister David Cameron welcomed the results as “good news”. He further applauded them citing that “we have asked them to do more with less resources ….and they have performed magnificently”.

The number of full-time equivalent police officers in England and Wales was 129,584 in March 2013 – a 4,516 drop from the previous year.

The continual reduction of violent crime within the UK will always be a priority for the government and local authority with the help of the communities to achieve this goal. In a recent report from the Home Office, Home Secretary Theresa May, praised the value of the numerous amount of Special Constables and police volunteers who worked within the communities combatting crimes and re-emphasised the 10% reduction of crime under the present government due to the hard work by both the police and local residents, which would help to continue the downward trend (6).

Bibliography

Shepherd J. BBC NEWS UK. BBC. [Online] 1 August 2014. http://www.bbc.co.uk/news/uk-27119689.

Flatley J. Crime, Regional and Data Access Division. Office of National Statistics. [Online] 13 February 2014. [Cited: 4 August 2014.] www.ons.gov.uk.

Flately J, et al. UK Statistics Authority. Home Office Research, Development and Statistics .[Online] July 2010. [Cited: 20 July 2014.] www.homeoffice.gov.uk/rds.

Travis A.Surpise 8% fall in crime. London : The Guardian, (day and month) 2013 .

Casciani D.Did removing lead from petrol spark a decline in crime? London : BBC News Magazine (day, month) , 2014.

The Rt Hon Theresa May, Secretary of State. GOV.UK. [Online] 25 June 2013. [Cited: 10 August 2014.] www.gov.uk/government.

Is Cycling safe in London? - February 2014

A spate of deaths at the end of 2013 sparked a huge uproar against the cycle lanes (mostly the

superhighways) and the risk of cycling in the city. This led to a widespread analysis by the public, media and politicians in to what can be done to prevent such occurrences in the future.

Until November, 2013 had been a ‘normal’ year for cyclists in London, with the appointment of Andrew Gilligan as London’s first Cycling Commissioner in January highlighting the increasing influence cycling is having on transport in London. This resulted in the release of ‘The Mayor’s Vision for Cycling in London’, an article which included an outline for a ‘Crossrail for bikes’, providing a fully segregated route across London from east to west. (1)

Whilst all was looking on the up for cyclists and their safety on London’s roads, the shocking events of November led to drastic statements and criticism of the system. Six cyclists were killed in less than a fortnight, taking the cycle related deaths to 14 for the 2013. The six deaths occurred in Mile End, Whitechapel, Bow, Holborn, Croydon and Camberwell. Three of these fall directly on or on roads adjoining cycle superhighway two, one of four active cycle superhighways in the city. Eight more are scheduled to be introduced by 2015. Cycle superhighway two covers a large stretch or road in East London, including: Whitechapel High Street, Whitechapel Road, Mile End Road, Bow Road, and the recently added section on Stratford High Street. (2)

Various investigations and research papers on the topic highlighted some common factors which are present in cycle fatalities. One of the most frequent incidences was that of a Heavy Goods Vehicle (HGV) turning left at a junction, with cyclists coming from the inside cycle lane with the intention of continuing straight on. A paper in the Emergency Medicine Journal highlighted that the most common accidents took place during the peak commuting time of 08:00 – 09:00 and within 20 m of a junction, generally on roads with a 30mph speed limit. (3)

A further study conducted at the Royal London Hospital found that over a six year period, the number of cyclist admissions gradually increased (assumed to be due to the increase in cyclists in London), with 82% being due to injury following a collision with a motor vehicle. Collision with HGV’s displayed characteristic patterns although traumatic brain injury was seen to be more commonly associated with collisions with cars. The majority of cyclists admitted after collisions with cars survived, with a small percentage needing longer term medical care. The individuals involved in collisions with HGV’s generally showed sever torso injuries, along with sever haemorrhaging. It was shown that the main cause of death was not necessarily due to the head injury, with the analysis of the non-survivor cases pointing to the surgical control of haemorrhaging being the vital factor. Another frequent method of death found with HGV collisions was exsanguination. The study at the Royal London Hospital showed that over 90% of all admitted for cycle accidents survived after treatment, but it was unable to link survival to the quality of life in the long term. (3)

In response to the deaths the cycling charity CTC stated that they were ‘sickened by the continuing failure to protect cyclists’ with British Cycling demanding and ‘urgent investigation’. The Mayor of London, Boris Johnson, stated:

“There’s no question of blame or finger-pointing. That doesn’t work in these circumstances. But unless people obey the laws of the road and people actively take account of the signals that we put in, there’s no amount of traffic engineering that we invest in that is going to save people’s lives.” He also stated that the riders had “…taken decisions that really did put their lives in danger.” (4)

He also followed these comments up in another interview, stating that cyclists were endangering their lives when not following road traffic laws, making it “very difficult for the traffic engineers to second-guess [their actions]“.

These comments were greatly condemned by both the public and the media, with politicians also criticising the Mayor for deflecting blame and insulting the victims of fatal collisions. Although the Mayor was quick to blame the cyclists for the deaths, it is important to note that statistic from TfL showed that cyclists breaking the law was only identified as a factor in only 6% of cases where there was a fatality or serious injury. (5)

The events of November 2013 also resulted in Operation Safeway, in which around 650 police officers were deployed at 60 junctions in central London during the morning and evening rush hours in order to ‘enforce’ and ‘educate’ the public on the laws and dangers of the road. This was also seen by riders as an attempt to blame riders irrespective of the circumstances as they operation was shown to mainly target cyclists with regard to helmets and high visibility clothing. An article in The Independent showed that studies had found helmets to reduce head, minor and severe brain injuries for cyclists of all ages by up to 58%. Although this shows they are visibly useful, other studies have shown that it is not head injuries that need to be prevented as they are very rarely fatal. When compared with the Netherlands (often cited as one of the safest countries for cyclists), it can be seen that helmets are not the most important factor. There is no mandatory law for cyclists to wear helmets. In fact, it is not uncommon to see moped/scooter riders without helmets. The Dutch have achieved their high standards of safety by providing well directed cycle lanes with their own dedicated rules using lights and signals. They also emphasise the awareness of cyclists to drivers and stress that cyclists must be given way when necessary. (6)

It seems that the most obvious was to improve the safety of cyclists on the road would be to separate them from the motor vehicles. Deputy Prime Minister Nick Clegg has called for the cycle superhighways to “physically separate the cyclists from roads”, which would in turn greatly reduce the number of cyclists hit by a HGV turning left at a junction for example. There have been calls for HGVs to be banned from the city during rush hours but Mr Johnson has refused to allow this, stating that it risks damaging London companies and creating a “serious influx as soon as the ban is over”. He also mentioned the fact that a ban would result in the HGVs having to operate during the night, leading to disruption in residential areas. This was backed up by the fact that only two of the 14 deaths last year could have been affected by the ban (the other 12 happened outside the rush hour, or did not involve lorries.) He did however, state that he is considering a ban on cyclists wearing headphones; a statement that drew criticism once again from cyclists due to the fact that the Metropolitan Police traffic division were unable to identify any serious cycling incidents in which headphone use could be identified as a contributing factor. According to a BBC poll taken in December 2013, the events had resulted in one fifth of regular cycle commuters giving up cycling to work (7), with 68% stating that they felt London’s roads were unsafe to cycle on. It is apparent that there is much to be done to improve safety, but the onus must be shifted from the cyclists to the drivers of both cars and HGVs to adhere to the rules and regulations laid out in order to allow the cyclists to ride safely. (8)

Bibliography

Mayor’s Vision for Cycling in London. Greater London Authority, London Assembly; 2013.

Walker P. The Guardian. [Online].; 2013 [cited 2014 February 7. Available from: http://www.theguardian.com/uk-news/2013/nov/18/sixth-london-cyclist-killed-camberwell-lorry.

Manson J, Cooper S, West A, Foster E, Cole E, Tai NRM. Major trauma and urban cyclists: physiological status and injury profile. Emergency Medicine Journal. 2012 February.

Jones S, Weaver M, Walker P, Wintour P. [The Guardian].; 2013 [cited 2014 February 7. Available from: http://www.theguardian.com/uk-news/2013/nov/14/fifth-london-bike-death-bus-superhighway.

Jones S, Walker P, Wintour P. [The Guardian].; 2013 [cited 2014 February 14. Available from: http://www.theguardian.com/uk-news/2013/nov/14/boris-johnson-london-cycling-deaths.

[BBC News London].; 2013 [cited 2014 February 7. Available from: http://www.bbc.co.uk/news/uk-england-london-25080427.

[BBC News London].; 2013 [cited 2014 February 7. Available from: http://www.bbc.co.uk/news/uk-england-london-25176031.

Brooke M. [London24 Online].; 2013 [cited 2014 February 7. Available from: http://www.london24.com/news/transport/get_rid_of_the_blue_paint_on_london_s_cycle_superhighways_if_the_lane_isn_t_segregated_1_3077254.

Coroner’s court overhaul begins in England and Wales - July 2013

BBC News UK

Most inquests in England and Wales will be completed within six months under a new code of standards for coroners which has come into effect.

The legal framework launched by the Ministry of Justice follows complaints that bereaved families in some areas have had to wait years for a hearing.

The service will be overseen by the first chief coroner Judge Peter Thornton QC.

All 96 coroners will also be subject to mandatory training requirements.

Coroners courts investigate the medical cause of death if it is not known, appears to be unnatural or resulting from violence, or if it happened in custody.

Inquests aim to establish who has died, and how, when and where the death occurred. They are not trials, and so do not determine civil or criminal liability.

The overhaul to the system follows a consultation and aims to make the inquest process more efficient.

The MoJ says it will end “past inconsistencies which led to criticisms of a postcode lottery with bereaved people in some areas facing long waits”.

‘Right support’

Under the rules, coroners will have to complete inquests within six months of being informed of a death “or as soon as is reasonably practicable after that date”.

Inquests can be delayed by factors, such as waiting for criminal proceedings to be completed.

Any inquests that last more than a year must be reported to the newly-appointed chief coroner.

Each year more than 30,000 inquests are held in England and Wales and individual coroners have up to now been responsible for holding hearings “as soon as practicable”. Judge Thornton QC told the BBC that standards had been “a little uneven” and the new national rules would create a more “efficient, effective and modern” service for bereaved families. As chief coroner he said he would be able to “lead the service nationally and try to bring some consistency”, adding he would investigate any case where an inquest had not been carried out within 12 months of a death being reported to a coroner.

Commenting on the measures, justice minister Helen Grant said: “I want to see all coroners delivering the same efficient service across the board, and we have put these changes in law so people can be assured inquests are being conducted quickly, with adequate care and the right support available for those who lose loved ones.”

Releasing bodies

The new rules also mean coroners will have to release the body to the bereaved family as soon as they can, or inform them if it is going to take longer than 28 days.

The government’s consultation on changes noted that some faith groups – notably Muslims and Jewish people – had voiced concerns about releasing bodies for funerals.

Coroners will also have to notify the bereaved within a week of setting the date for the inquest and provide greater access to documents and evidence, such as post-mortem reports, before the inquest takes place.

The laws will also allow coroners to permit less invasive post-mortem examinations – another concern raised by faith groups.

he office of coroner dates back to 1184 and coroners are independent judicial office-holders, appointed and funded by the relevant local authority.

However, once appointed, the coroner is answerable only to the High Court for his or her judicial and administrative decisions.

Analysis:

Clive Coleman Legal correspondent, BBC News

Today’s overhaul of the coroners system is a huge step forward in addressing long-standing criticisms of delay and inconsistency among some of the 96 coroners in England and Wales.

However, concerns remain. Coroners are funded by local authorities and it will be challenging to maintain the new standards in an age of cuts to local services.

Also, campaigners worry that there is still no appeal to the Chief Coroner available over the decision of a coroner.

The only appeal lies to the High Court by way of judicial review, which can be both time-consuming and costly for bereaved families. The Chief Coroner, who is responsible for overseeing the reformed coroner system, has today issued a press notice which is available here:

Further information at: http://www.judiciary.gov.uk/media/media-releases/2013/ChiefCoronerImplementationOfRelevantPartsOfCoronersAndJusticeAct2009.

The statutory instruments that enable the reforms are available here: http://www.legislation.gov.uk/uksi/2013?title=coroner.

Forensic Scientists have recovered fingerprints from food - April 2013

Forensic Scientists at Abertray University in Dundee have managed to unlock the key to recovering fingerprints from food which, Foods had previously proved to be difficult surfaces for obtaining fingerprints from and therefore evidence gathering in foods was overlooked. The new research has now been published in the forensic science journal: ‘Science and Justice’1, the results can now be replicated by others. will lead to a future breakthrough in gathering evidence for police investigations.

The Scientists modified an existing technique in order to obtain fingerprints from fruits and vegetables, something which has never been achieved in the UK before.

Dennis Gentles, a former crime scene examiner and forensic scientist, who has worked at Abertray University over the last 10 years stated:

Foods such as fruits and vegetables used to be in that category, because their surfaces vary so much – not just in their colour and texture, but in their porosity as well. These factors made recovering fingerprints problematic because some techniques, for example, work on porous surfaces while others only work on non-porous surfaces.

He also went to say that: “It may not seem like much, but a piece of fruit might just be the only surface that has been handled in a crime scene, so developing a trusted and tested technique to recover fingerprints from such surfaces is something to be valued by crime scene examiners.

The method of recovering fingerprints was initially designed to take prints from the sticky side of an adhesive tape. Mr Gentles finally stated:

We tried altering the formulation a bit, making it more dilute than that suggested by the Home Office, and found that it out-performed all the other methods we tested.

Although there’s still a considerable amount of research to do before we can recommend techniques for all types of foods, we’ve shown for the first time that it really is possible to recover fingerprints from them – something that was previously thought to be unachievable.

This means the police will now be able to gather even more evidence to present in court, adding more weight to their investigations.

Source: The Independent Newspaper, 26/04/2013

D. Gentles et al: A preliminary investigation into the acquisition of fingerprints on food: Science and Justice, Volume 53, Issue 1, March 2013, Pages 67–72

Mummifying Alan – Egypt’s last secret - October 2011

Featuring expert forensic pathologist, Professor Peter Vanezis, OBE

Mummifying Alan, the award winning documentary, which aired on Channel 4, involved a team of expert specialists attempting to mummify a specially- donated body of a man named Alan. In this documentary, we saw the successful process of mummification being carried out and this gave us a true insight into the ancient Egyptian mummification techniques.

The director of The AFMS and expert forensic pathologist, Professor Vanezis, was closely involved in the mummification process and was responsible for carrying out the autopsy on the deceased and in the extraction of the organs. As stated on the Channel 4 website:

Following ancient Egyptian procedure, he first made a small incision approximately 4 inches long on the left side of the abdomen. He then removed most of the organs through this small opening, cutting them away and removing them one by one.

The exception was the heart, which was left intact because the Egyptians believed it was the seat of intelligence and needed in the last judgement before the soul could enter the next life.

The intestines, stomach, liver and lungs were also regarded as an essential requirement for the body in the afterlife. So, after their removal, each was preserved seperately inside a ‘canopic jar’, protected by its own god whose head was represented on the jar lid.

Although the brain was often removed through the nose using a metal implement, x-ray evidence reveals that many of the best Egyptian mummies had their brains left in place. Therefore, Alan’s brain was left intact.”

Professor Vanezis gave a very detailed explanation of ‘Human Decomposition’, in relation to the work he carried out and this was posted on the main Channel 4 website:

By Professor Vanezis, OBE

From the moment we die our bodies start to break down. This process of decomposition involves a cascade of chemical processes involving enzymes and bacteria, which steadily digest the body.

No two humans decay in exactly the same way, as a number of factors affect both the rate and sequence of decomposition, including temperature, humidity and alkalinity. But, overall, the process follows the same key stages. Understanding these extraordinary and complex molecular events goes to the very heart of forensic science.

Autolysis and Putrefaction

Decomposition begins just minutes after death. Early changes to the body include a drop in core temperature, stiffening of the limbs known as Rigor Mortis and a pooling of the blood under the pressure of gravity known as Post Mortem Lividity.

The onset of death also triggers a process called Autolysis, or self-digestion, whereby our own enzymes literally turn against us, digesting our cells from the inside out, and causing them to rupture and release fluids. This liquefying process rapidly spreads across the whole body, with the first visible signs appearing as blisters and loosening of the skin, known as ‘skin slippage’. As the cells rupture and fluids steadily build up, the body becomes a moist environment, and ideal breeding ground for bacteria and other micro-organisms.

This next stage in the decay process is called Putrefaction. As these micro-organisms break down the soft tissue, they produce a steady build up of gases including ammonia, methane, and carbon dioxide. As these gases accumulate the body becomes increasingly bloated, particularly around the bacteria-rich area of the intestines.

Chemical processes also turn the skin a distinct greenish colour, as sulphur-containing hemoglobin settles in the blood, and bacteria enter the veins creating a visible, dark marbling effect of the skin surface.

Insects

Insects play a major role in decomposition. First on the scene are blowflies, which can detect a dead body within minutes of death – from many miles away. They lay eggs within the first hour, and the blowfly larvae will feed on the tissues and liquids, and in turn a succession of other flies and beetles will appear, collectively breaking down different parts of the soft tissue.

Active Decay and Skeletonisation

In the active decay phase, bacteria and insects continue to break down the body proteins and fats giving the body a deflated and wet appearance, as well as a strong odour.

The final stage of decomposition is skeletonisation, when the flesh has been completely broken down and only dry bone remains. Depending on the environmental conditions, the body may never get to this stage – but instead can become naturally mummified.

Mummification

Mummification occurs most commonly in dry conditions which slow down or arrest the process of putrefaction. Typical features of a mummy include dry, leathery skin that has been completed desiccated. In Ancient Egypt, the desert conditions naturally preserved bodies in this way – before embalmers started to develop the ‘artificial’ practice using natron salt to dry out the tissues.

But, deserts are not the only place where natural mummies have been found.

Dry, cold environments have also created extraordinary mummies, the most famous being Otzi the Iceman and the ‘bog bodies’ of Northern Europe, which have been preserved predominantly through a lack of oxygen and acidic environments that tan the tissues.

Although many ancient cultures preserved their dead in various ways, the Egyptians remain the best known and arguably the most successful mummy makers of all.

Their need to preserve the dead was part of a highly complex belief system which maintained that at death an individual’s soul was reborn into another stage of existence. Here it would be judged by the gods who would weigh the individual’s heart to find out if they had led a good life. If the heart was heavy with sin it was condemned and destroyed, when a second, final death occurred. Yet if their heart was pure, their soul was allowed to pass through into the Afterlife and live forever in a perfect environment, based on the Egyptian landscape. Here the soul could travel around at will, although it still needed to return to its original body which formed its permanent home.

This explains why the Egyptians went to such great lengths to preserve the body after death. This was particularly important in the case of their rulers, the pharaohs, each of whom contained within them a divine soul regarded as the essence of Egypt itself. With this soul maintained and nurtured by special temple rituals during life, it was essential that at death every pharaohs body was perfectly preserved to house this soul, the accumulated powers of which could be accessed in magical rituals to maintain Egypt’s well being.

Yet the most perfect levels of preservation were only achieved after centuries of experimentation and a considerable amount of trial and error.

Although the earliest bodies were buried in hollows in the desert, where the hot sand dried the skin and allowed corrosive bodily fluids to drain away, there is evidence that by c.4500 BC some were also wrapped in linen and coated in various oils and resins. These early bodies were often buried facing east toward the rising sun, with their arms and legs drawn up to the body in the ‘foetal’ position suggesting an early belief in rebirth.

As society developed, the wealthier classes wanted more elaborate burial to reflect their status so began to be buried in purpose-built stone tombs. Yet no longer in direct contact with the hot dry sand, their bodies soon decomposed, leading to the need to remove the internal organs by c.2600 BC. With the previously flexed body now laid out flat to give access to the abdominal area, there is also evidence that the Egyptians had begun to use naturally occurring natron salt as a preservative, in some cases mixing it in water to use as a solution, but most often in its dry form, piled over the body to draw out the body fluids and preserve the skin.

In this way the Egyptians produced mummies for centuries until the dawn of the 18th dynasty c.1500 BC when a new regime brought in dramatic political and religious changes. These changes were even reflected in the way this new dynasty’s royal dead were mummified, the life-like results they achieved now resurrected in the mummification of Alan Billis.