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• A total of 369,210 bacterial isolates were obtained from in-patients in the J-SIPHE database. • The bacterial species before/after the early COVID-19 phase in Japan were compared. • The ratio of number of bacteria isolated by droplet infection decreased. • Droplet transmission decreased/remained constant after the COVID-19 initial phase. • February-May 2020 showed increased behavioral change for COVID-19 prevention. During the coronavirus disease 2019 (COVID-19) pandemic, a change in the trend of infections was observed. However, there are few reports comprehensively assessing the impact of the early phase of COVID-19 on the trend of bacteria isolated. We extracted the number of positive cultures of hospitalized patients for approximately 200 institutions using the Japanese national database. The outcome was the ratio of 10 species isolated in comparison to the total isolates for each month. Interrupted time-series analyses were conducted between 13 (from Jan-2019 to Jan-2020) and 8 (from May-2020 to Dec-2020) monthly data points. A total of 369,210 isolates were involved. Differences in the level change for Streptococcus pneumoniae, Haemophilus influenzae , and Streptococcus pyogene s decreased significantly by 0.272 (95% confidence interval [CI]:0.192-0.352), 0.244 (95%CI:0.174-0.314), and 0.324 (95%CI:0.06-0.589), respectively. Bacteria transmitted by contact infection, such as Staphylococcus aureus , did not decrease. Differences in slope change were not significant in all species. The ratios of isolated bacteria transmitted by droplet infection decreased immediately after the early phase of COVID-19 and maintained the same level. The awareness and behavioral changes toward increased COVID-19 prevention might have a substantial impact on the prevention of bacterial infections, especially droplet infections. [ABSTRACT FROM AUTHOR]

The number of unidentified corpses has been increasing in recent years. There is a need for an objective and readily applicable method to estimate age, which is important information for identification. In previous reports, we reported that the protein folding ratio (R PF) of skin, as measured by Raman spectroscopy using cross sections of skin samples, is highly correlated with age. In this study, we investigated the possibility of estimating age by measuring Raman spectra from the skin surface of cadavers using a portable device. The resultant intercept, slope, and root mean square error were 97.9, – 63.7 (p < 0.0001), and 11.68, respectively. We evaluated this regression formula by using 10-fold cross-validation, resulting in a coefficient of determination of 0.51. The portable Raman spectrometer may be of assistance in estimating age at death of corpses at the scene of discovery. • Estimating cadaveric age using skin surface Raman spectra was attempted. • The resultant intercept, slope, and RSME were 97.9, – 63.7 (p < 0.0001), and 11.68, respectively. • The regression formula was assessed with 10-fold cross-validation, yielding an R2 of 0.51. • A portable Raman spectrometer could help estimate the age of corpses found at the scene. [ABSTRACT FROM AUTHOR]

Purpose: Japanese society has reached an unprecedented level of aging, with elderly people accounting for 25.1% of the population in October 2013. These changes have created concerns regarding deaths among the elderly. In this study, we compared recent forensic autopsy cases with cases from about 20 years ago, with the goal of understanding the context of death among the elderly within Japanese society today. Methods We investigated the forensic autopsy records of 297 people aged 65 years or above. In order to examine the effect of residential circumstances, we classified these cases into two groups: people who lived alone (group A) and those who lived with their family (group B). Forty-five of these autopsy cases were conducted about 20 years ago (1989 to 1993) and 252 cases were recent (2009 to 2013). The cases were limited to people who had been found dead or in a critical situation at home. We investigated the first finder, the period of time elapsed between death and discovery, and the cause of death. Results The incidence of the first finder being a family member was more than 20% greater in group B compared with group A. The proportions of cases for which it took more than three days for someone to find the body or an abnormal situation were about 14% and 7% in groups A and B, respectively, 20 years ago, and about 48% and 19% among the recent cases. These proportions were significantly higher among the recent cases. Among recent cases, a post-mortem elapsed time of more than 3 days occurred more often in group A than group B (p = 0.0002). None of the older cases had an unknown cause of death in either group. However, among the recent cases from both groups, 20–30% of cases resulted in unknown causes of death. The incidences of unknown causes of death were significantly higher among the recent cases in both groups (p = 0.015) and in group B alone (p = 0.037). The incidences of murder cases were significantly lower in group B among the recent cases (p = 0.0022). Discussion Elderly people who live alone are not easily found or aided when in critical situations, and they may only be discovered after death. Prolongation of the postmortem interval (PMI) results in the deterioration of the corpse making determination of cause of death problematic. The results of this study suggest that there are three factors that isolate elderly people and increase the difficulty in determining their cause of death: reduced communication with family members, reduced communication with neighbors or the community, and the increasing prevalence of the nuclear family. In group B, the prolonged discovery time and the increased incidence of unknown causes of death suggest reduced communication with family members, even though the incidence of being found by a family member was higher than in group A. The murder rate was significantly lower in group B, which may suggest that cases of domestic murder were overlooked. Support for a safe life and peaceful ending for the elderly requires a system based on three factors: remote monitoring to ensure safety, the establishment of elderly groups providing mutual support, and increased visits from welfare workers. Understanding the circumstances of the elderly who die alone is beneficial to countries facing an aging society with weakened family or community structures, and who hope for better support for the elderly. [ABSTRACT FROM AUTHOR]

In the field of Forensic Medicine the number of unidentified cadavers has increased due to natural disasters and international terrorism. The age estimation is very important for identification of the victims. The degree of sagittal closure is one of such age estimation methods. However it is not widely accepted as a reliable method for age estimation. In this study, we have examined whether measuring impedance value (z-values) of the sagittal suture of the skull is related to the age in men and women and discussed the possibility to use bone impedance for age estimation. Bone impedance values increased with aging and decreased after the age of 64.5. Then we compared age estimation through the conventional visual method and the proposed bone impedance measurement technique. It is suggested that the bone impedance measuring technique may be of value to forensic science as a method of age estimation. [ABSTRACT FROM AUTHOR]

Abstract: Computed tomography (CT) in forensic medicine is commonly used in determination of cause of death. Here, we show that the information provided by CT may also be of value for estimation of time after death. The relationship between abdominal aorta narrowing just below the diaphragm and time after death was examined in 140 cases. Aorta narrowing was defined using a flatness ratio, which was calculated by dividing the shorter axis of the aorta by the longer axis. Time after death was classified into 6 time periods. The flatness ratio gradually and significantly decreased with increased postmortem time, showing increased aorta narrowing with increased time after death. A further examination of aorta narrowing in 15 autopsy cases in which CT images were taken at two postmortem times gave similar findings. The results of the study suggest that aorta narrowing in postmortem CT imaging may be used to estimate time after death. [Copyright &y& Elsevier]

Abstract: Background: Computed Tomography (CT) is now utilized as an effective tool for postmortem diagnoses. However, reports on the temporal evolution in imaging findings of these postmortem CT is limited. Case presentation: One night, a 66 year old male following drinking at a bar on his way home slept in the road. He was ran over by a taxi at 01:28 and immediately transferred to a nearby hospital. During his transfer to the hospital, he lost consciousness and fell into a state of cardiopulmonary arrest, and died despite resuscitation attempts. CT images were taken at 02:30. Following this, CT images were re-taken 54 h after death, just prior to a medicolegal autopsy. Result & discussion: Small amount of intra-abdominal hemorrhage was found during the initial CT examination. However, the extent of intra-abdominal bleeding observed during the second CT examination performed 54 h later had substantially increased. During the autopsy, the amount of intra-abdominal hemorrhage was 1700 mL. Injury to the mesentery, liver and pancreas was also observed. Additional major injuries discovered during the autopsy were, skin abrasions and lacerations of the scalp, subarachnoid hemorrhage, fractures of the ribs, right humerus, and pelvic bones. The deceased postmortem blood alcohol level was 2.4 mg/mL. The cause of death was determined as exanguination due to systemic injury. The mechanism of the postmortem increase in the intra-abdominal hemorrhage remained unknown. However, the amount of bleeding found during autopsies may not be the same as that at the time of death. As a result, the criteria for the diagnosis of the cause of death in autopsies should be carefully reconsidered. In addition, accompanying CT imaging at the time of death and possible postmortem changes should be carefully considered in postmortem CT imaging, so that there will not be incorrect assignment of the causes of death. [Copyright &y& Elsevier]