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MicroRNAs (miRNAs) are important post-transcriptional regulators in several diseases, including cancer, immunologic and cardiovascular diseases. A growing list of miRNAs are dysregulated in cardiac arrhythmias, contractility diseases, myocardial infarction (MI), sudden cardiac death (SCD), chronic heart failure and hypertrophy. However, the exact regulatory pathways, through which miRNAs exert their effects are often unclear. In this study, we measured the expression patterns of miR-21, miR-939 and miR-30e in postmortem human MI. The aim of the study was to examine the influence of these miRNAs on cardiac inducible nitric oxide synthase (iNOS) mRNA levels. We measured iNOS mRNA and miRNA expression patterns by means of qPCR. Further we used correlation analyses to determine causality between miRNA expression and cardiac iNOS levels. iNOS mRNA, miR-21, miR-939 and miR-30e were significantly upregulated in infarcted and non-infarcted regions of postmortem human MI hearts in comparison to healthy controls. While miR-21 and miR-939 showed their strongest expression in infarcted regions, miR-30e peaked in the non-infarcted myocardium. Further, we found a significant correlation between miR-939 and iNOS expression levels in controls and infarcted regions. The results indicate, that miR-939 is a regulator of cardiac iNOS expression. However, a massive iNOS activation might exceed the capability of miR-939 to keep its expression in balance. miR-21 and miR-30e do not seem to influence cardiac iNOS levels in MI. Further studies are needed to evaluate downstream targets of these miRNAs and their signaling pathways to clarify their role in human MI., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Over the past years, next-generation sequencing (NGS) technologies revolutionized the possibilities in a broad range of application areas. Also in the field of forensic genetics, NGS continuously gained in importance and attentiveness. A significant number of sudden cardiac deaths (SCD) in the young is due to heritable arrhythmia syndromes emphasizing the need of examining the genetic basis in these cases also with regard to the identification of relatives and/or patients being at risk. As a result, high-throughput methods became of increasing value in molecular autopsy investigations enabling the analysis of a broad spectrum of genes. Most standard protocols are optimized for high-quality samples and frequently not directly applicable to challenging forensic sample material. In the present study, we intended to examine a comprehensive gene panel associated with SCD and inherited arrhythmogenic disorders. We compared three different hybridization-based library preparation technologies in order to implement a suitable NGS workflow for heterogeneous, forensic as well as diagnostic sample material. The results obtained indicated, that the Illumina technologies Nextera DNA Flex and TruSeq were compatible with samples exhibiting varying levels of degradation. In comparison, the TruSight method also resulted in good sequencing data, but seemed to be more dependent on DNA integrity. The preparation protocols evaluated in our study are not restricted to molecular autopsy investigations and might be helpful for and transferrable to further forensic research applications., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Introduction: Repatriated corpses may have been autopsied abroad. The aim of the study was to compare the findings from second medico-legal autopsies with those from primary autopsies abroad to spotlight possible implications for the management of repatriated corpses., Material and Methods: All autopsies from a 20-year period at the Institute of Legal Medicine in Frankfurt am Main on repatriated corpses of German citizens were reviewed. The results were compared with the information from the body passports, the protocols of the autopsies in the country of death, and the police files., Results: In total, 151 corpses repatriated from 56 different countries were autopsied. The interval between death and autopsy in Germany was 2-603 days (median: 11 days). 91 of the repatriated corpses (59.5%) had previously been autopsied abroad. Three body cavities had been opened in 78.0% (71/91) of the original autopsies; among them, there were 11 cases (15.5%) with dissection of all organs, as opposed to 7 cases (9.9%) with all organs intact and in situ. Of the previously autopsied corpses, 62.6% were accompanied by a body passport that noted the cause of death. In nearly 75% of these cases, the stated cause of death was compatible with that established at second autopsy. In 5 cases (10.2%), the cause of death established in the second autopsy disagreed with that on the body passport. The most prominent disparity was a cranial gunshot wound rather than the stated fatal fall., Discussion: This analysis of individual cases spotlights the problematics of an uncritical approval of the body passport. In light of the different procedural autopsy standards around the world, the validity of an autopsy abroad is discussed in the context of the second autopsy results., Conclusion: A second external postmortem examination by qualified medical practitioners should be obligatory in all cases of repatriated corpses, with notification of the criminal police in all cases of non-natural or undetermined death. A timely second autopsy is recommended even in cases with previous autopsy abroad., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

In sex determination from crania, a "vertical" forehead is considered a female feature, while a "sloping" forehead is considered a male feature. Precise description of frontal inclination with a quantitative measure like an angle is considerably more difficult as it requires accurate identification of clearly defined craniometric points. In the literature, the morphognostic terms "frontal bone inclination," or "frontal profile," are defined in numerous ways. The aim of this study was to determine which of these frontal inclination definitions is best suited for sex estimation. In a study in the context of the digital forensic osteology project, 10 of the frontal angle definitions described in the literature were assessed for their usefulness in sex determination on 211 virtual crania, reconstructed from postmortem CT-data. Custom-developed software was used for the automated measurement of frontal bone inclination angles from lateral-profile, volume-rendered 3D cranial images in which 10 anthropometric landmarks had been manually marked. Discriminant function analysis was performed to determine if satisfactory accuracy rates for the classification of sex could be achieved with defined variables. Four of the ten examined definitions were found to be highly significant for sex determination; three of these, also provided satisfactory intra- and inter-observer reliability. The frontal angle according to Schwalbe provided the best accuracy rate of 75.4% and a critical discriminatory value (separation value) of 88.6°: angles greater than this, suggest female sex; angles smaller than this, suggest male sex. Further, the open-source, custom-developed software introduced here proved compatible with commonly used image-processing and statistical programs and allowed quick, automated, valid measurement of numerous cranial angles. Other craniometric angles can, thus, also be quickly and easily determined with this software., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Hammer blows cause serious, often fatal injuries, especially when massive blunt violence is targeted at the head region. The evaluation of the injury potential depends not only on the body region hit, but also on the characteristics of the hammer as a weapon and on the physical characteristics of the attacker. This study aimed at elucidating the dependency between the physical constitution of a perpetrator and the intensity of hammer blows, thus to verify or refute this seemingly obvious interrelation sometimes expressed in the saying that a "strong hand strikes harder". For this purpose, 113 volunteers of different ages and sexes took part in different experimental settings. While, as expected, clear differences between male and female were detectable in the striking power of single and multiple strokes, there were no age or sex differences with regard to the maximum number of strokes per time unit. Strength differences in slamming with a hammer between men and women exceeded expectations in this study. Using the fracture forces as described by Sharkey et al. in an exemplary manner, one can expect a fracture of the skull in 9 out of 10 cases with a 300 g hammer by men for intensively executed single strokes, whereas this was only the case for approx. 2/10 women in this study. The maximum circumference of the upper arm and the width of the shoulder girdle correlate significantly with the achievable impact forces of individual hammer blows in both sexes. A simple measurement of the hand force with a manometer using the regression formula y [kN] = 0.144 × manual grip force -1.08 can be used as a rough estimation parameter for the theoretically achievable impact force. If one strikes repeatedly with the same hammer for 1 min, the magnitude of a single strike decreases continuously from 4.5 kN to 2.6 kN on average. If a 1500 g hammer is used instead of a 300 g hammer, one does not get the fivefold impact force you might expect at first sight, but only on the order of twice the impact force, about 14 kN on average. The results prove the importance of physical experiments, whose results can help to better interpret the magnitude and effects of hammer blows as a form of potentially life-threatening violence., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Trisomy 21 is the most common human chromosomal abnormality. Its manifestation includes intellectual impairment and more or less typical anatomical malformations and functional deficiencies that can cause sudden or unexpected deaths. Typical medicolegal questions at autopsy are related to medical malpractice, improper care, neglect, or abuse, and, depending on the cause of death, whether the death might have been avoidable. The aim of this study was to examine whether the causes of death in individuals with trisomy 21 were linked to the known health risks for this condition and to consider how these deaths might have been prevented., Material and Methods: A retrospective study was performed at the Institutes for Legal Medicine in Giessen and Frankfurt am Main, Hesse, Germany. All records for forensic autopsy cases within a 20-year period from 1998 to 2017 were reviewed for the diagnosis trisomy 21", respectively, "Down's syndrome"., Results: Twenty-three cases complied with the inclusion criteria trisomy 21 and autopsy. The age of the deceased ranged from 23 days to 61 years. Infectious diseases, mainly respiratory, were the leading cause of death, followed by accidental deaths., Conclusion: The medicolegal relevance of the known health risks in Down's syndrome could be illustrated by the autopsy findings and the results of the additional examinations. The known high susceptibility to infections, with an increased risk of a rapid course and lethal outcome, in individuals with Down's syndrome could be confirmed in our study. A sound knowledge of the risks and abnormalities associated with trisomy 21 are helpful in medicolegal assessments, particularly, in relation to medical malpractice charges., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Cases of sudden cardiac death (SCD) in young and apparently healthy individuals represent a devastating event in affected families. Hereditary arrhythmia syndromes, which include primary electrical heart disorders as well as cardiomyopathies, are known to contribute to a significant number of these sudden death cases. We performed postmortem genetic analyses in young sudden death cases (aged <45years) by means of a defined gene panel using massive parallel sequencing (MPS). The data were evaluated bioinformatically and detected sequence variants were assessed using common databases and applying in silico prediction tools. In this study, we identified variants with likely pathogenic effect in 6 of 9 sudden unexpected death (SUD) cases. Due to the detection of numerous unknown and unclassified variants, interpretation of the results proved to be challenging. However, by means of an appropriate evaluation of the findings, MPS represents an important tool to support the forensic investigation and implies great progress for relatives of young SCD victims facilitating adequate risk stratification and genetic counseling., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The earliest mention of a stowaway in the wheel well of an airplane dates back to 1947: A 30-year-old man chose this mode of travel for a trip from Lisbon to Brazil and survived (Véronneau et al., 1996). In a retrospective study, we evaluated cases with lethal outcome of stowaways in airplane wheel wells by focusing on forensic autopsy results, in particular, in regard to hypothermia, hypoxia, and injuries. In addition, the flight routes, flight altitudes, and flight durations were analyzed. Using the forensik ® program, a search of all the autopsies performed between 1994-2017 at the Institute of Legal Medicine in Frankfurt am Main, Germany, was conducted, using the key words "airplane," "flights," and "wheel well." All of the thus retrieved autopsy reports, medicolegal expert reports, and police investigation reports were then evaluated. Five cases were included in our study. The decedents were all men, aged between 14 and 26 years. Four of the decedents had been discovered at the Frankfurt Main airport within airplane wheel wells; the fifth man had been discovered in a woods underlying one of the flight approach paths to the airport. Two stowaways had died of hypoxic asphyxiation, possibly in conjunction with hypothermia as a contributing factor. One stowaway died of the polytrauma he sustained when he was crushed by retracting landing gear. For a further stowaway, the cause of death could not be macroscopically determined at autopsy. In one case, only an external postmortem examination had been performed, without autopsy. Analysis of the flight routes, altitudes, and durations showed that the flights had been international flights, the flight altitudes had varied between 7000m (∼23,000ft) und 11,000m (∼36,000ft), and the flight duration had been between 4 and 9.5h. At high altitudes, the ambient conditions in wheel wells, which are not pressurized, are rarely survived by stowaways, with hypoxic asphyxiation likely posing greater peril than hypothermia. Further dangers are that of being crushed by retracting landing gear after takeoff, or of falling out of a wheel well, from a great height, when the landing gear is deployed. When it appears conceivable that a stowaway may have fallen from an aircraft wheel well during landing or takeoff, an autopsy and discovery scene investigation are essential to reconstructing the course of events., (Copyright © 2018 Elsevier B.V. All rights reserved.)

When a morphologically separated skull and mandible are found in the same case context, the possibility of a match arises. Two criteria with which to determine a match are the rough articulation between the mandibular condyles and cranial base itself and, most importantly, the fit of the teeth. However, when there has been intravital or postmortem tooth loss, this important criterion is not available. To date, only Reichs (1989) has investigated further compatibility criteria to solve the question of putative commingling in a case where a mandible seemed to originate from a female, while all other bones originated from a male individual. In a different reported case (Preißler et al. 2017), a mandible seemed too big for a skull; DNA analysis, however, confirmed that both originated from the same female individual. To investigate the metric relationship between mandible and skull we measured the postmortem CT data records of 223 corpses (virtual skulls) in OsiriX © MD for the following linear parameters: bicondylar breadth (KDB), biradicular breadth (AUB), and bizygomatic breadth (ZYB). The indices KDB/ZYB and KDB/AUB were developed and used to define ranges for matches and mismatches. Furthermore, the intra-observer reliability for the method was assessed. An intraclass correlation coefficient of >0.99 for every parameter showed that the used measurements are highly reliable. The 2.5-97.5 percentile for the KDB/AUB index lay between 0.91 and 1.05, while the range for the KDB/ZYB index was between 0.87 and 1.00. Within these ranges, it is possible to roughly assess whether or not a mandible and skull might be compatible, even if this can only be verified by forensic DNA analysis. If an index value lies outside these ranges, it can be assumed that skull and mandible do not match. Future studies should include more samples from a broader population spectrum so that these metric relationships can be used for different populations., (Copyright © 2018. Published by Elsevier B.V.)

In temperature based death time estimation the construction of a death time interval using the conventional Nomogram method (NM) is not permissible for bodies in which rectal temperature (T r ) has reached or closely approximated equilibrium with ambient temperature (T a ). We provide a logic approach to compute a minimum time since death with high probability. We also provide a simple graphical solution to be used at the crime scene for preliminary estimation. Special attention is advised in regards to cases with T a >23°C as well as borderline cases. Proof by induction, application to test cases and one example of use are presented., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The corpse of a 71-year-old woman was found on the floor of her smoke-filled room. The source of the fire was the mattress of a double bed on which newspapers had apparently been set aflame. The woman's history in conjunction with the finding situation suggested an act of suicide. No signs of soot inhalation or soot swallowing were found at autopsy. Other vital signs were absent. Severe cardiac disease was the most notable pre-existing medical condition. Although the concentration of COHb in heart blood was low (3%), the concentration of cyanide was found to be 4.3mg/l in heart blood and 1.9mg/l in lung tissue. Cyanide was not found in the stomach contents. The BAC (blood alcohol concentration) was zero. Several prescribed drugs could also be demonstrated. The cause of death was deemed to be cyanide poisoning, possibly in conjunction with the pre-existing cardiac disease. The reported case illustrates that a lethal amount of cyanide can be inhaled during a fire even if there is no inhalation or swallowing of soot and no significant increase in the COHb level. In such cases, the demonstration of cyanide assumes significance as a vital sign indicating that the victim was alive when the fire started., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Introduction: The lifestyle product 'Eezup!' appeared on the German market and promised to normalize energy metabolism. Among vitamins (B 1 , B 2 , B 6 , C, E and zinc), rice protein and fructose the addition of alcohol dehydrogenase and catalase enzymes is a novel approach. The product was advertised as capable of boosting the rate of alcohol elimination., Methods: Seventeen subjects (11 men, 6 women, 19-58 years old), participated in a two-way crossover drinking study. Unfiltered wheat beer (4.4g% alcohol content) was drank within one hour to reach blood alcohol concentrations of 1‰ (1g/kg whole blood). On one day "Eezup!" was taken according to the manufacturer's instructions before and after drinking which was substituted for a placebo on the second test day. Blood samples were taken during 9h and ethanol and congener alcohols were determined. A comparison of C max , t max , area under the curve (AUC) for ethanol and congener alcohols, and the hourly elimination rate of ethanol (β 60 ) was performed to investigate an effect of Eezup!., Results: Ethanol concentrations (Cmax) were in the range of 0,63-1,00‰ (median 0,85‰) and 0.62-1.22‰ (median 0.84‰) in the placebo and "Eezup!" condition, respectively, and not statistically different. Also t max (1-2.5h) and AUCs did not differ. The ethanol elimination rates were 0.16‰/h (0.14-0.19‰/h) and 0.17‰/h (0.14-0.22 ‰/h) in the placebo and "Eezup!" condition without significant difference. The pharmacokinetic parameters of the congener alcohols (1-propanol, isobutanol, 3-methyl-1-butanol, 2-methyl-1-butanol) as well as of methanol did also not differ., Conclusions: The results of the present study failed to show any effect of the sobering product "Eezup!" on the amount of ethanol and congener alcohols absorbed (C max , t max, AUC) and on the ethanol elimination rate (β 60 )., (Copyright © 2017 Elsevier B.V. All rights reserved.)

A routine question encountered in medicolegal practice is whether the death of a patient in proximity to a surgical procedure is due to medical malpractice. The case of a 62-year-old man who died two weeks after undergoing a VATS sleeve resection of the upper right lung lobe in conjunction with radical lymphadenectomy, a routine surgical procedure, is reported. To address the issue of medical malpractice, a forensic autopsy was ordered by the investigative authority. During the autopsy, the lungs were removed as a whole and fixed in formalin and were later dissected in cooperation with a thoracic surgeon. In the course of this dissection, a bronchovascular fistula, which had led to the occlusion of the bronchial system with clotted blood, was discovered. Bronchovascular fistulas are a rare complication of bronchial sleeve resections. Because this surgical complication is essentially always fatal, it is highly pertinent to medicolegal practice. The presented case report also lists other important complications associated with bronchial anastomosis and elucidates a pragmatic approach to obtaining an expert clinical assessment of possible medical malpractice after operations through the example of a dissection performed in cooperation with a thoracic surgeon., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Approximately during the 30th week of pregnancy, a woman gave birth to a still-born child in a hospital. After first citing an extraneous cause for the premature still-birth, the woman later admitted to having self-induced the abortion by injecting the antiseptic Rivanol ® (active agent: ethacridine lactate) through her abdominal wall into the amniotic cavity. The investigating authorities ordered an autopsy of the fetus along with additional toxicological investigations. To the naked eye, no obvious cause of death was apparent. The main autopsy findings were four skin defects (puncture/stabbing wounds) on the ball of the fetus's left thumb, with slight bleeding around the punctures and into the underlying fatty tissue, and a yellowish discoloration of the fetus's body surface, especially of the umbilical cord and fingernails. On basis of the results, the child would have been viable. Femoral vein blood and urine from the fetus were analyzed for ethacridine, as were an amniotic fluid sample and maternal blood and urine samples, which had been collected as evidence. The concentration of ethacridine in the amniotic fluid was 16mg/l. In the postmortem fetal blood and urine samples, the concentrations were 0.36mg/l and 0.34mg/l, respectively, while concentrations of 0.091mg/l and 0.42mg/l, respectively, were found in the serum and urine samples from the mother. In many countries, foremost in China, ethacridine lactate, to which both mother and child are exposed, is widely used as safe abortion method. Although the ethacridine concentrations found in blood and urine samples of the mother in our case are consistent with published values, we believe to be the first to report postmortem ethacridine concentrations in a fetus. While exposure to ethacridine is not toxicologically relevant for the mother, it is fatal for the fetus because it causes the placental decidua capsularis to separate from the decidua parietalis or decidua placentalis, respectively. Prostaglandins that are then produced induce labor. In medicolegal contexts, the proof for an abortion through the administration of ethacridine lactate lies in the typical yellow discoloration of the fetus in conjunction with the toxicological demonstration of the substance in fetal body fluids, and if possible also in maternal body fluids., (Copyright © 2016. Published by Elsevier Ireland Ltd.)

Species identification plays an important role in forensic entomology and is mandatory for an accurate calculation of the minimum post-mortem interval. Many important Diptera and Coleoptera taxa of the cadaver community can already be identified by common barcoding approaches, i.e., by sequencing a 658bp region in the mitochondrial cytochrome c oxidase subunit I (coI) gene. Nevertheless, there is still a lack of reference barcodes for species, in particular, that can be found on cadavers at later decomposition stages. Flies of the family Piophilidae illustrate this gap of knowledge perfectly. Due to the fact that a reliable morphological identification key for the immature stages of this flies is still missing and the immature stages of many piophilids cannot be assigned to a certain species, there is need for additional tools to identify forensically relevant taxa. We collected adult piophilid specimens at 10 locations in five European countries: Spain (n=3 locations), Germany (n=3), Portugal (n=2), Poland (n=1) and Switzerland (n=1). Apart from the coI barcoding region, we additionally analyzed a 398bp long region of the nuclear elongation factor 1 alpha (ef1a) and subsequently established the molecular identifier for nine piophilid species. In addition, we present the molecular phylogeny of the examined taxa., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Developmental data of necrophagous blow fly species can be used to estimate a minimum postmortem interval (PMImin) in death investigations by estimating the age of larvae sampled from the cadaver. The most important parameter used in this age estimation is the increase in larval length during growth. Larval length can be compared to species-specific reference data to get an age estimate for the larval specimen. The exploration of this type of data and the use of an appropriate statistical method are the major challenges in evaluating forensic entomological data sets. In Europe, Calliphora vicina is one of the most dominant species with forensic entomological relevance. Despite its frequency and importance, there are currently no published developmental studies for German populations of this blow fly that can be referenced for larval age estimations. This is regrettable because the geographical origin of different populations may lead to phenotypic plasticity in the same species and population-specific growth patterns that differ from published data sets. To address this shortcoming, the objective of the present research was to generate growth data for C. vicina which can be used for age estimation in German casework. We present, for the first time, local developmental data for the larval stages of German C. vicina, reared at three constant temperatures (15, 20 and 25°C) and compare the results with published studies on C. vicina development from elsewhere. To analyse the development we chose a quantile mixed effects model because of its robustness and insensitivity towards outliers. Quantile regression was developed as an extension of the linear model to estimate rates of change in all parts of the distribution of a response variable and to discover more useful predictive relationships between variables. By applying a linear quantile mixed effect model, we estimated the 0.1 and 0.9 quantile functions of the larval age for each temperature. Graphically, these quantile functions act like reference bands and therefore, plots for larval stages 1-3 can be used to estimate the age of a larva. Nevertheless, the post-feeding stage still remains difficult to describe with linear models and need to be further investigated. A comparison of the results from this present study with the currently applied methods for age estimation of C. vicina still demonstrates the importance of collecting growth rates for local blow fly populations and of standardising experimental designs and statistical analyses., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Introduction: Aging human remains is a critical issue in anthropology and forensic medicine, and the search for accurate, new age-estimation methods is ongoing. In our study, we, therefore, explored a new approach to investigate a possible correlation between age-at-death (aad) and geometric irregularities in the bone structure of human skull caps. We applied the concept of fractal geometry and fractal dimension D analysis to describe heterogeneity within the bone structure., Methods: A high-resolution flat-panel computed tomography scanner (eXplore Locus Ultra) was used to obtain 229,500 images from 221 male and 120 female (total 341) European human skulls. Automated image analysis software was developed to evaluate the fractal dimension D, using the mass radius method. The frontal and the occipital portions of the skull caps of adult females and males were investigated separately. The age dependence of the fractal dimension D was studied by correlation analysis, and the prediction accuracy of age-at-death (aad) estimates for individual observations was calculated., Results: D values for human skull caps scatter strongly as a function of age. We found sex-dependent correlation coefficients (CC) between D and age for adults (females CC=-0.67; males CC=-0.05). Prediction errors for aad estimates for individual observations were in the range of ±18 years at a 75% confidence interval., Conclusions: The detailed quantitative description of age-dependent irregularities in the bone microarchitecture of skull vaults through fractal dimension analysis does not, as we had hoped, enable a new aging method. Severe scattering of the data leads to an estimation error that is too great for this method to be of practical relevance in aad estimates. Thus, we disclosed an interesting sex difference., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

So far, studies investigating the comparability of breath alcohol concentration (BrAC) with blood alcohol concentration (BAC) have focused on the accuracy of BrAC testing instruments. The presented study, conducted with cases from the district of the Middle Hessian Police Headquarters, is to the best of our knowledge the first to compare both methods under real-life conditions in normal policing situations. For a 1-year period, alcohol-impaired drunk-driving suspects, who were by criminal procedure required to give a blood sample, were offered a voluntary, additional BrAC test with a "Dräger Alcotest 7110 Evidential". The BrAC test was to be administered as soon as possible after the suspect had been apprehended, without, however, delaying the collection of the blood sample. Ninety-two cases could be included in our study. In 30 cases, a blood sample was not taken; in 11 cases, a BrAC test could not be performed. In the remaining 51 cases, we found the following pairings of BrAC and BAC results: BrAC≥0.55 mg/l and BAC≥1.1‰ (n=39); 0.25 mg/l≤BrAC<0.55 mg/l and 0.5‰≤BAC<1.1‰ (n=5); BrAC≥0.55 mg/l and BAC<1.1‰ (n=4); BrAC<0.55 mg/l and BAC≥1.1‰ (n=3). The mean value for the conversion factor, Q, was 2.12‰l/mg. In accord with numerous other studies, our study results would suggest a value of 2.1‰ l/mg to German legislature as a new statutory value for Q. In borderline cases, of which there were already 7 in our study with 51 cases, suspects could benefit both from a BrAC test or a BAC test, with the benefit lastly depending more on early testing time than on the test method used. Our results support the call for the earliest possible measurement of alcohol concentration values after a drunk driving offense was committed. In some situations, this can probably only be accomplished with BrAC testing. A supplementary blood sample and BAC testing could compensate for the known weaknesses of BrAC testing. Thus, the complementary use of both methods might be a viable option., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Introduction: The objective of this article was to explore age-at-death estimates in forensic medicine, which were methodically based on age-dependent, radiologically defined bone-density (HC) decay and which were investigated with a standard clinical computed tomography (CT) system. Such density decay was formerly discovered with a high-resolution flat-panel CT in the skulls of adult females. The development of a standard CT methodology for age estimations--with thousands of installations--would have the advantage of being applicable everywhere, whereas only few flat-panel prototype CT systems are in use worldwide., Methods: A Multi-Slice CT scanner (MSCT) was used to obtain 22,773 images from 173 European human skulls (89 male, 84 female), taken from a population of patients from the Department of Neuroradiology at the University Hospital Giessen and Marburg during 2010 and 2011. An automated image analysis was carried out to evaluate HC of all images. The age dependence of HC was studied by correlation analysis. The prediction accuracy of age-at-death estimates was calculated. Computer simulations were carried out to explore the influence of noise on the accuracy of age predictions., Results: Human skull HC values strongly scatter as a function of age for both sexes. Adult male skull bone-density remains constant during lifetime. Adult female HC decays during lifetime, as indicated by a correlation coefficient (CC) of -0.53. Prediction errors for age-at-death estimates for both of the used scanners are in the range of ±18 years at a 75% confidence interval (CI). Computer simulations indicate that this is the best that can be expected for such noisy data., Conclusions: Our results indicate that HC-decay is indeed present in adult females and that it can be demonstrated both by standard and by high-resolution CT methods, applied to different subject groups of an identical population. The weak correlation between HC and age found by both CT methods only enables a method to estimate age-at-death with limited practical relevance since the errors of the estimates are large. Computer simulations clearly indicate that data with less noise and CCs in the order of -0.97 or less would be necessary to enable age-at-death estimates with an accuracy of ±5 years at a 75% CI., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

A skull without lower jaw was found and brought in for identification. It was suspected to be that of a man reported missing five years ago. An undated antemortal dental chart and two dental films of the 1st and 2nd dental quadrants, both taken about 4 years before the man went missing, were available for comparison. The method of choice in solving the identity question was comparative dental radiography. Despite numerous attempts, it was not possible to obtain radiographs of the upper jaw that duplicated the X-ray beam angulation of the antemortem dental films. The skull was thus scanned with a multislice computed tomography (MSCT) scanner, and virtual radiographs with the desired angulation were generated from the data with the maximum intensity projection (MIP) technique. The resulting virtual radiographs could, however, not be used for superimposition with the antemortem radiographs because of their poor resolution and the occurrence of artifacts caused by metallic dental fillings. The upper jaw was therefore scanned again, this time with a high resolution eLU-CT (eXplore Locus Ultra flat panel CT). The resulting eLU-CT datasets were visualized with the MIP technique and yielded virtual radiographs that could be compared with the antemortem radiographs. Positive identification could be assumed with near certainty after dental features could be matched in the superimposition of antemortem and postmortem radiographs. In the presented case, eLU-CT was used for the first time for a comparative dental radiographic identification., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

With the goal of obtaining additional practically applicable methods for estimating the PMI of skeletal remains, 39 samples of human and 5 samples of domestic animal long bones with known PMI (PMI=1 to approximately 2000 years) were tested with two established methods (UV-fluorescence of a freshly sawn cross-section and the luminol test) and two screening tests (Hexagon-OBTI® test and Combur® test) that were being tried out in this context for the first time. The hypothesis underlying this experiment was the supposition that the PMI-related chemiluminescence of the luminol reaction for bone is based on the presence of persisting hemin from hemoglobin molecules in bone. Our results showed that lack of luminescence and reduced UV-fluorescence were more meaningful results for estimating PMI and excluding forensic relevance than a positive luminol reaction or strong UV-fluorescence, as both of the latter findings revealed the limitations of these methods in this particular context. Particularly for cases showing a positive luminol reaction, the use of additional absolute dating methods may be indicated. Against our expectations, both the Combur® test strips and the Hexagon-OBTI® test, which were both devised to demonstrate blood, delivered negative results for all samples. They are thus not suitable for estimating the PMI of skeletal remains. Future research will be necessary to elucidate whether the negative results obtained for these tests may be due to the poor solubility of potentially present hemoglobin or hemoglobin breakdown products in the Tris buffer used in this experiment., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

This study investigated whether digital, high-resolution CT-images of the internal human sagittal suture structure include information that enables a novel method of age at death (aad) determination. To accomplish this, coronal, flat-panel-based volumetric computed tomography (eXplore Locus Ultra scanner) images were automatically analyzed by a software implementation of an algorithm that determines user independent whether a suture is open or closed. 29,205 images of the local vicinity of the sagittal suture of 164 males and 85 females of European descent were investigated separately for both sexes. We used conditional probabilities and a chi(2)-test to investigate whether there is a correlation between aad and suture obliteration or not. The computer-aided analysis enables us to handle huge volumes of data that could not otherwise be analyzed within a reasonable time frame. The implemented algorithm ensured a strongly reproducible, reliable, accurate, and fast differentiation between closed and open sutures. The evaluation of various statistical parameters suggests that there is no reason to assume a correlation between age and suture closure--with equal findings for both sexes. Therefore, we conclude that determination of aad based on the evaluation of sagittal suture obliteration is not possible. This agrees well - thus unsatisfactorily - with the recent literature., ((c) 2010 Elsevier Ireland Ltd. All rights reserved.)

Foreign body granulomas in the lungs following acute singular or long time intravenous drug abuse are frequent findings during microscopic investigation of the lungs. Most cases present single granulomas. Cases with multiple foreign body granulomas, already palpable during autopsy and leading to pulmonary granulomatosis with multiple granulomas are less frequent. We report the case of a 32-year old man, dying suddenly and unexpectedly after a well-known history of drug abuse for more than a decade. The granulomas are caused by foreign particle embolization immediately after intravenous injection of not only the drug itself but also of adulterants, e.g. cotton fibers, potato starch or microcrystalline cellulose. At the end, a reduction in the size of the pulmonary bed had occurred followed by pulmonary hypertension. For the first time, lung dust in such a case was characterised by energy dispersive X-ray (EDX)., (Copyright 2010 Elsevier Ireland Ltd. All rights reserved.)

Because of the increasing lack of recent bone collections, ethical issues concerning maceration procedures, and progress in radiological imaging techniques, computed tomography (CT) scans offer an alternative to traditional anthropological bone collection. The present study examined volume-rendered cranial CT (CCT) scans from 50 crania to morphologically evaluate sex characteristics. CCT scans were performed and scored by two teams (Teams A and B) of two examiners each (2x50=100 examinations) to evaluate the occurrence and/or absence of morphological traits. Altogether, 60 of 100 crania (31 Team A+29 Team B) crania were determined to be male, and 40 (19 Team A+21 Team B) were determined to be female when using the scoring system adapted from Knussmann. These results imply a sex determination accuracy rate of 96%. Only in one case was recalculation of weighting factors necessary to determine one additional correct classification. As a single parameter, arcus superciliaris evaluation permitted the most accurate sex determination (female, 84.2%; male, 85.5%). No significant difference in accuracy rates was observed between the two sexes (p<0.65, chi(2)=0.39, Fisher's exact test). Interobserver bias rates for both teams were very low (kappa=0.83). The present study shows that volume-rendered CCT images are suitable for the collection of data concerning morphologic sex determination of skulls. Thus, this method may be helpful in both actual forensic casework and the systematic reevaluation and improvement of classical anthropological methods and their adaptation to changing populations., (2010 Elsevier Ireland Ltd. All rights reserved.)

Unlabelled: Amongst numerous other morphological, chemical, physical, and histological dating methods, the assessment of the chemiluminescence of weathered organic traces on bone finds by means of the luminol reaction is common practice. Opinion differs on the diagnostic value of this procedure for differentiating between historical and recent skeletonized human remains., Design: Chemiluminescence (CL) was tested in randomized, blind experiments on pulverized bone samples with known postmortem intervals from four different periods (1st-3rd century, 1878-1902, 1965-1972, 1995-2003). In addition to determining the sensitivity and specificity of the CL-analysis, likelihood ratios and predictive values were calculated. The degree of interobserver and intraobserver agreement was determined using Kappa statistics., Results: Based on our sample, we found false positive results in approximately 7.5% of all examined historical cases and false negative results in approximately 15% of the recent samples. Altogether, a correct classification of 88.75% (overall classification) was found (sensitivity=0.85, specificity=0.925; likelihood ratio=11.3; odds ratio=69.8). Taking a-priori probabilities into consideration (prevalence for recent=26%), a positive predictive value (PPV) of only 79.9% could be calculated, while the negative predictive value (NPV) lay at 94.6%. The results from subsequent Kappa statistics further illustrated that the quality of the results was, on the whole, observer independent (kappa=0.93; 95% CI=0.84-1.0). Intraobserver bias calculation yielded a value of kappa=0.975 (95% CI=0.92-1.0)., Conclusion: The analysis of CL on dry bones in determining the postmortem interval is not valid as an only method. In other respects, the luminol test is reproducible, repeatable and cost-effective and could help in assessing the postmortem interval (PMI). The results of this study document the potential danger of forensically relevant cases being erroneously sorted out if further examinations do not take place. We would like to emphasize that still only a combination of different methods including the analysis of environmental conditions and the interpretation of the anthropological profile can allow an acceptable estimate of the PMI from skeletonized remains, even if the methodological spectrum is being expanded by different absolute dating methods using radionuclide techniques.

Human hair is among the most common kind of evidence secured at crime scenes. Although DNA analysis through STR-typing is possible in principle, it is not very promising for telogenic hair or single hairs. For the mixed traces frequently found in practice, composed of different hair from an unknown number of individuals, mtDNA sequencing of each individual hair seems to be the only possible, even if technically elaborate, solution. If it were possible to pool all hair belonging to an individual prior to DNA analysis, then this effort could not only be reduced, but the number of hair for an STR-approach could also be increased. Although it is possible to examine hair microscopically, this method must be considered unsuitable for pooling, since the results depend strongly on examiner experience, and the hair cannot always be correctly attributed to an individual. The goal of this study was to develop an objective non-DNA-contaminative pooling method for hair. To this end, the efficacy of spectral imaging as a method of obtaining information--beyond that obtained from a purely microscopic and morphological approach--for the identification of individuals was investigated. Three hairs each from 25 test persons (female: 18; male: 7) were examined with a SpectraCube-System and a light microscope. Six spectra were calculated for each hair, and the hairs from each individual were not only compared to each other, but also to those of the other individuals. From a forensic vantage, the examination showed, in particular, that individuals, whose hair could not be distinguished on the basis of morphology, could also not be accurately distinguished with the SpectraCube. The intra-individual differences were, in part, greater than the inter-individual differences. Altogether, the study shows that a person's hair color, as perceived, is composed of many naturally different, individual colors.

In an age of global combat against terrorism, the recognition and identification of people on document images is of increasing significance. Experiments and calculations have shown that the camera-to-subject distance - not the focal length of the lens - can have a significant effect on facial proportions. Modern passport pictures should be able to function as a reference image for automatic and manual picture comparisons. This requires a defined subject distance. It is completely unclear which subject distance, in the taking of passport photographs, is ideal for the recognition of the actual person. We show here that the camera-to-subject distance that is perceived as ideal is dependent on the face being photographed, even if the distance of 2m was most frequently preferred. So far the problem of the ideal camera-to-subject distance for faces has only been approached through technical calculations. We have, for the first time, answered this question experimentally with a double-blind experiment. Even if there is apparently no ideal camera-to-subject distance valid for every face, 2m can be proposed as ideal for the taking of passport pictures. The first step would actually be the determination of a camera-to-subject distance for the taking of passport pictures within the standards. From an anthropological point of view it would be interesting to find out which facial features allow the preference of a shorter camera-to-subject distance and which allow the preference of a longer camera-to-subject distance.

When two human corpses are found in temporal and locational context the assumption of a non-natural cause of death is close at hand. Suicide, extended suicide, homicide or accident (particularly with carbon monoxide) come to mind. When, however, a natural cause of death emerges for both after autopsy and further examinations, this provokes the question whether this incidence is coincidental. In our two presented cases, a married couple each was found dead together. In both cases, the wife needed nursing and was being cared for by a husband who died of cardiac disease shortly before the wife died. In one case, the wife died of acute uncompensated chronic congestive heart failure. In the other case, the cause of death of the wife was hypovolemic shock due to acute gastrointestinal bleeding from recurrent gastric mucosal erosion. It is to be discussed for both cases whether, given the pre-existing illness, the acute stress of the situation in view to the husbands' death may at least have favored the occurrence of death and may, thus, have led to the criminologically conspicuous situation of finding.

The present study was carried out to check whether classic osteometric parameters can be determined from the 3D reconstructions of MSCT (multislice computed tomography) scans acquired in the context of the Virtopsy project. To this end, four isolated and macerated skulls were examined by six examiners. First the skulls were conventionally (manually) measured using 32 internationally accepted linear measurements. Then the skulls were scanned by the use of MSCT with slice thicknesses of 1.25 mm and 0.63 mm, and the 33 measurements were virtually determined on the digital 3D reconstructions of the skulls. The results of the traditional and the digital measurements were compared for each examiner to figure out variations. Furthermore, several parameters were measured on the cranium and postcranium during an autopsy and compared to the values that had been measured on a 3D reconstruction from a previously acquired postmortem MSCT scan. The results indicate that equivalent osteometric values can be obtained from digital 3D reconstructions from MSCT scans using a slice thickness of 1.25 mm, and from conventional manual examinations. The measurements taken from a corpse during an autopsy could also be validated with the methods used for the digital 3D reconstructions in the context of the Virtopsy project. Future aims are the assessment and biostatistical evaluation in respect to sex, age and stature of all data sets stored in the Virtopsy project so far, as well as of future data sets. Furthermore, a definition of new parameters, only measurable with the aid of MSCT data would be conceivable.