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Die Beurteilung von Verletzungen durch Schusswaffen gehört zu den typischen Aufgaben der Rechtsmedizin. In den vorangegangenen Kapiteln wurde deutlich dargelegt, dass auf Grund einer Vielzahl zu berücksichtigender physikalischer Parameter und Effekte die rechtsmedizinische Beurteilung derartiger Verletzungen recht komplex ist. Insbesondere spielt die Kurzzeitigkeit der Vorgänge (eine Schussverletzung findet innerhalb einiger weniger Millisekunden statt) eine ganz entscheidende Rolle.

In the situation of a shortage of ventilation beds, ethically justifiable, transparent and comprehensible decisions must be made. This concept proposes that all patients are first intubated depending on necessity and then assessed by a triage team afterwards. In this situation newly admitted COVID patients compete with newly admitted Non-COVID patients as well as patients already treated in intensive care units for a ventilator. The combination of short-term and long-term prognoses should enable the interprofessional triage team to make comprehensible decisions. The aim of the prioritization concept is to save as many human lives as possible and to relieve the treatment team of the difficult decision on prioritization.

A man was found injured with a cut on the left side of his neck and unconscious on the floor of his garage. He reported being attacked from behind, robbed and injured with a sharp instrument. During the analysis of the blood trace pattern doubts arose if the story of the man was true and a self-inflicted injury could be considered. If the course of events is reconstructed on the basis of blood traces, the incident did not take place at one place. In a niche a carpet knife was found hidden in an oil canister. After extensive investigations a suspect was exonerated and the injured person was sentenced for feigning the commission of a crime.

Introduction: The curricular implementation of events (or programs) for science-related training in human medicine has been on the agenda of the medical faculties since the publication of the Federal-State Working Group . The Medical Faculty of the University of Cologne developed and established a systematic, longitudinal science curriculum together with the start of the model curriculum in human medicine in 2003. Here, we investigate the questions of whether the described (para-) curricular elements are accepted by students and lecturers and how they are evaluated, especially by students. In addition, we investigate whether selected parameters can be used to demonstrate changes in the students' scientific activities.Project description: The program "Research and Medical Studies" (RaMS) consists of several components: these elements of the mandatory curricular (Scientific Projects, SP) and optional components (Research in Medical Studies (RiMS), Research Track (RT), Research Fair Cologne (RFC)) are described here. Results were recorded at various levels: Likert Scale evaluation of the event's elements were collected as satisfaction parameters from the students Process data on participation in the voluntary events were collected and evaluated as absolute and relational figures (WS 12/13-SS 17). Data on the outcome of the RaMS program were collected: Type of scientific projects in the academic years 2011/12-2014/15), number and type of available projects offered at the RFC (in the years 2011-18) and number of student research funding applications in a comparison of the periods 2010-13 vs. 2014-17). Results: The students' acceptance of mandatory and paracurricular courses of the RaMS program is pleasingly high, which is not surprising, at least in the case of the voluntary courses. The participation of students in RiMS, RT and RFC is satisfactory for voluntary courses. In the case of the RT, with certified participation of approximately 47% of all registrations (corres, Einleitung: Die curriculare Implementierung von Veranstaltungen (bzw. Programmen) zur wissenschaftsbezogenen Ausbildung in der Humanmedizin steht spätestens seit der Publikation der Bund-Länder-Arbeitsgruppe auf der Agenda der Medizinischen Fakultäten. Die Medizinische Fakultät der Universität zu Köln hat mit Beginn des Modellstudiengangs Humanmedizin 2003 ein systematisches, longitudinales Wissenschaftscurriculum entwickelt und etabliert. Hier untersuchen wir die Fragen, ob die beschrieben (para-) curricularen Elemente von den Studierenden und Lehrenden angenommen und wie diese insbesondere von den Studierenden bewertet werden. Zudem wird untersucht, ob sich anhand ausgewählter Parameter eine Änderung der wissenschaftlichen Aktivitäten der Studierenden beschreiben lässt.Projektbeschreibung: Das Programm "Forschung und Medizinstudium" (FuM) besteht aus mehreren Komponenten: Diese Elemente der pflichtcurricularen (Wissenschaftliche Projekte, WP) und additiven Anteile (Forschung im Medizinstudium (FiM), Research Track (RT), Forschungsbörse Medizin Köln (FBK)) werden beschrieben. Ergebnissicherungen wurden auf verschiedenen Ebenen durchgeführt: Likert-skalierte studentische Veranstaltungskritiken zu den Elementen wurden als Zufriedenheitsparameter erhoben. Prozessdaten zur Teilnahme an den freiwilligen Veranstaltungen wurden erhoben und als absolute sowie als relationale Zahlen ausgewertet (WS 12/13-SS 17). Daten zum Outcome des Programms FuM wurden erhoben: Art der Wissenschaftlichen Projekte den Studienjahren 2011/12-2014 /15), Anzahl und Art der vermittelten Projekte auf der FBK (in den Jahren 2011-18) und Anzahl studentischer Forschungsförderungsanträge im Vergleich der Zeiträume 2010-13 vs. 2014-17). Ergebnisse: Die Akzeptanz der Studierenden von pflicht- sowie paracurricularen Veranstaltungen des Programms FuM ist erfreulich hoch, was zumindest bei den freiwilligen Veranstaltungen nicht verwundert. Die Teilnahme der Studierenden an FiM, RT und FBK ist für freiwil

Fractures of the sternum are rare compared to other bone fractures. Especially in children, sternal fractures are rarely diagnosed and represent only a small percentage of the total number of sternal fractures. In the case of a 10-year-old boy, he presented to the pediatrician with constant breathing-related pain in the chest region and similar complaints had already existed 1 week ago. The sonographic examination revealed a suspected fracture of the sternum, which was confirmed by a subsequent X-ray examination. After discussing the findings the mother stated that the pain first occurred after the 12-year-old cousin had hit the sternum of her son with his knee. The question of the plausibility of the claimed injury mechanism was raised. Against the background of the described case, an overview of epidemiological data, underlying injury mechanisms and anatomical peculiarities of isolated sternal fractures in childhood is given, with reference to the current literature. It could be shown that isolated sternal fractures can occur during age-typical playing activities. In the overall view, the plausibility of the stated injury mechanism could therefore be confirmed in the presented case.

Physical match examinations usually pursue the goal of proving the former unity of fragments. Each fracture structure is individually formed and thus distinguishable. An irregular sequence of changes in direction of the fracture creates the fracture structure, which is influenced by a multitude of non-reproducible factors. The examination of fracture surfaces is carried out with forensic comparative light microscopes and using reverse lighting. Alternatively, 3D surface scanners and comparison software are increasingly used in forensic science. This article presents three cases in which fragments that remained in the body of the victim after attacks by sharp and blunt forces were compared with the weapons of the perpetrators. In addition, recommendations are given for the photographic documentation and recovery of fragments in a way that does not damage the fracture surfaces. In two of the presented case studies, the victim was attacked with knives and fragments of the knife blades remained in the body of the victim. In the third case, the perpetrators used a wooden baseball bat of which a fragment remained in a head wound of the victim. In all three cases the fragments could be assigned to the weapons based on the fracture structures.

Vitamin A is essential for human health, but current intake levels in many developing countries such as India are too low due to malnutrition. According to the World Health Organization, an estimated 250 million preschool children are vitamin A deficient globally. This number excludes pregnant women and nursing mothers, who are particularly vulnerable. Efforts to improve access to vitamin A are key because supplementation can reduce mortality rates in young children in developing countries by around 23%. Three key genes, BCMO1, BCO2, and SCARB1, have been shown to be associated with the amount of β-carotene (BC) in milk. Whole-genome sequencing reads from the coordinates of these 3 genes in 202 non-Indian cattle (141 Bos taurus, 61 Bos indicus) and 35 non-Indian buffalo (Bubalus bubalis) animals from several breeds were collected from data repositories. The number of SNP detected in the coding regions of these 3 genes ranged from 16 to 26 in the 3 species, with 5 overlapping SNP between B. taurus and B. indicus. All these SNP together with 2 SNP in the upstream part of the gene but already present in dbSNP (https://www.ncbi.nlm.nih.gov/projects/SNP/) were used to build a custom Sequenom array. Blood for DNA and milk samples for BC were obtained from 2,291 Indian cows of 5 different breeds (Gir, Holstein cross, Jersey Cross, Tharparkar, and Sahiwal) and 2,242 Indian buffaloes (Jafarabadi, Murrah, Pandharpuri, and Surti breeds). The DNA was extracted and genotyped with the Sequenom array. For each individual breed and the combined breeds, SNP with an association that had a P-value

A55-year-old man was found lifeless next to his car on an autobahn. On the left side of the neck there were huge gaping laceration type wounds. During the autopsy the injuries were found to partially have fine abrasions at the border and irregular margins of the wounds. The cause of death was named as injury-related polytrauma with inhalation of blood. During the further investigations atruck was seized, which showed sharp-edged damage to the metal on the right front of the vehicle. The injuries on the corpse were consistent with the ragged damaged edges on the truck so that this could be interpreted as aform of unusual and accident-related contact of the man with the truck.

Diabetes mellitus is one of the most common chronic diseases in childhood and adolescence, whereby a clear increase in the prevalence of type 2 diabetes mellitus can be observed in this age group. This disease can lead not only to long-term damage but also to sometimes fatal complications, especially in puberty. This article presents two autopsy cases with such fatal complications. In one case the underlying disease was type 1 diabetes mellitus and in the second case type 2 diabetes mellitus. Following the autopsy in both cases post-mortem biochemical and toxicological investigations could be carried out and by the use of the Traub formula the cause of death could be established as a diabetic coma (hyperosmolar and ketoacidotic) due to insufficient administration of insulin.

Background Sexual violence is a present problem in our society; however, many assaults are not reported by those affected. In order to make it possible for forensic evidence to be obtained from the persons concerned despite the fact that the incidents were only reported at a later date, different organizational structures have been set up in North Rhine-Westphalia and other federal states. Objective The cases registered at the Institute of Forensic Medicine were examined from a statistical point of view and related to the general experience gained over this period. Material and methods Retrospectively, all cases with anonymous evidence collection (ASS) at the Institute of Forensic Medicine of the Medical Faculty of the University of Cologne were analyzed for the period from 5 June 2011 to 31 December 2018. The case collective was scientifically analyzed. Results The registered cases (total so far 275) showed an accumulation in the urban area of Cologne compared to the surrounding towns and showed a peak in the age groups of 14-20 years old as well as 21-30 years old. So far, only samples from female persons have been received. On average 5.9 evidential items were registered per case, including swabs, clothing, blood and urine samples. In 28 cases, a complaint was subsequently filed. Formalities (e.g. labelling and sealing) were the main problems in the course of evidence collection. In principle, good acceptance and improvement in the documentation of cases of anonymous forensic evidence after sexual offences was shown over the entire period.

A 75-year-old woman refused medical treatment of a squamous cell carcinoma of the facial skin for personal reasons, which led to a pronounced finding with exposure of brain structures. Cutaneous squamous cell carcinomas (PEK) account for almost 20% of all non-melanocytic skin tumors and are the second most frequent skin tumor after basal cell carcinoma. The incidence increases with age. Etiologically, actinic precancerous skin lesions caused by ultraviolet (UV) radiation as well as long-term damage caused by chemical noxae and also chronic inflammatory and degenerative skin changes play a role. The cause of death in the present case was a tumor toxic cardiovascular failure with pronounced tumor cachexia. It was impressive that even with destruction of the skull and brain parenchyma, death occurred in such an advanced stage of the disease and not earlier in time. The relatives could not be reproached for failing to provide help as an adult person in a state of clear thinking is allowed to refuse treatment.

Background. Although corpse disposal itself is not a rare phenomenon, the wrapping of a corpse is less common, and its facets can be very varied. Objective. The cases available enabled different constellations to be determined and analyzed with respect to the method, motivation and type of wrapping. Material and methods. A retrospective analysis of forensic post-mortem examinations from 2009-2016 at the Institute of Forensic Medicine at the Cologne Medical School was conducted. Cases and results of the postmortem examinations were scientifically reviewed. The evaluation included only cases of corpses that had been fully or partly wrapped. Results. These cases represent a broad range of constellations including seven cases of completed homicide, three cases of completed suicide, one case of an autoerotic fatality and one case of natural death. In cases of homicide the corpse is generally wrapped for transportation and concealment but the placement and wrapping of the corpse vary. Just as varied and imaginative are the wrappings of corpses resulting from suicide, autoerotic accidents and more harmless cases.

An almost 3aEuroyear-old girl was brought to the pediatric surgery department by her mother at night. The patient presented with the chief complaint of a massive, deformed helmet-shaped, fluctuating and pressure-sensitive swelling of the head. The history of the present injury allegedly began with nocturnal awakening to find the aforementioned physical findings and no visible scalp injury. The neurological examination was clinically uneventful. Anemia was present but did not require a blood transfusion. A coagulation disorder could be excluded by laboratory analysis. Other previous medical and surgical interventions were non-contributory. Cross-sectional magnetic resonance imaging (MRI) and ultrasound imaging of the skull revealed a marked subgaleal hematoma, without intracranial pathologies. Paravertebral hematomas and crescent-shaped superficial lesions were noted on the girl's back, which could be explained by violently embracing the thorax. A non-accidental trauma as a result of a tangential, shearing force against the head was suspected. Subsequently, a broad subgaleal hematoma extending over the sutures was noted and was macromorphologically easily distinguishable from a locally limited cephalohematoma. Violent tearing of the scalp hair was suspected to be the most likely cause.

This report discusses the case of presumed unusual abuse of an 11-year-old boy with a central African background. The boy presented with deep cuts on the back of both hands which contained traces of chili powder. This unusual injury, which was ostensibly meted out by his mother, was discovered by family friends and finally reported by the children's hospital emergency unit doctors to the child protection services. During the legal proceedings, the mother denied any responsibility for the crime even though she had initially admitted her actions. The court convicted her of the abuse of a ward in concomitance with aggravated battery. She was sentenced to a term of 1 year and 1 month on probation.

In the case of the death of a76-year-old woman, the situation found at the scene including adistinctive bloodstain pattern and multiple sharp force trauma pointed to the question, whether the injuries were self-inflicted. Due to the results of the bloodstain pattern analysis, autopsy and toxicological analyses in combination with the police investigations, death by a third party could be excluded. Death was due to hemorrhagic shock caused by external bleeding through massive self-inflicted injuries. A special feature of the findings was the intensity of the cuts to the wrist leading to subtotal amputation of the hand.