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Abstract This study challenges historical paradigms using a large-scale integrated bioarchaeological approach, focusing on the female experience over the last 2,000 years in Milan, Italy. Specifically, 492 skeletons from the osteological collection of Milan were used to elucidate female survivorship and mortality by integrating bioarchaeological and paleopathological data, paleoepidemiological analyses, and historical contextualization. Findings revealed changes in female longevity, with a notable increase from Roman to contemporary eras, albeit plateauing in the Middle Ages/modern period. Significant sex-specific differences in mortality risk and survivorship were observed: females had higher mortality risk and lower survivorship in the Roman (first-fifth century AD) and Modern (16th-18th century AD) eras, but this trend reversed in the contemporary period (19th-20th century AD). Cultural and social factors negatively impacted female mortality in Roman and modern Milan, while others buffered it during the Middle Ages (sixth-15th century AD). This study underscored the importance of bioarchaeological inquiries in reconstructing the past, providing answers that may challenge historical assumptions and shedding light on how the interplay of cultural, social, and biological factors shaped the female experience across millennia.

Abstract In forensic commingled contexts, when the disarticulation occurs uniquely at the atlantoaxial joint, the correct match of atlas and axis may lead to the desirable assembly of the entire body. Notwithstanding the importance of this joint in such scenarios, no study has so far explored three-dimensional (3D) methodologies to match these two adjoining bones. In the present study, we investigated the potential of re-associating atlas and axis through 3D–3D superimposition by testing their articular surfaces congruency in terms of point-to-point distance (Root Mean Square, RMS). We analysed vertebrae either from the same individual (match) and from different individuals (mismatch). The RMS distance values were assessed for both groups (matches and mismatches) and a threshold value was determined to discriminate matches with a sensitivity of 100%. The atlas and the corresponding axis from 41 documented skeletons (18 males and 23 females), in addition to unpaired elements (the atlas or the axis) from 5 individuals, were superimposed, resulting in 41 matches and 1851 mismatches (joining and non-joining elements). No sex-related significant differences were found in matches and mismatches (p = 0.270 and p = 0.210, respectively), allowing to pool together the two sexes in each group. RMS values ranged between 0.41 to 0.77 mm for matches and between 0.37 and 2.18 mm for mismatches. Significant differences were found comparing the two groups (p

Abstract Forensic anthropologists dealing with personal identification (PI) of human remains have recently stressed the need to explore the potential of “secondary identifiers” for identifying victims who died in particular events for whom images often represent the main antemortem data available. Being the face the part most exposed in images, characteristics as pigmented skin lesions (PSLs), can be crucial if combined with other input. Since no data is available on frequencies and distribution of facial PSLs in the general population, this study aims at systematically collecting such data to verify their potential in PI and to open a debate on the aid that “secondary identifiers”, regardless of their specific nature, can give to the identification of the deceased in specific forensic contexts. A retrospective analysis on three-dimensional facial models of 1039 Italian subjects (from 4 to 84 years old) was conducted to examine the incidence of PSLs discriminated according to size and position in well-defined facial areas. From the collected data we developed a probabilistic approach providing the likelihood ratio (LR) for two settings: (1) the relative frequencies of nevi in the various facial areas, providing the deriving compound probability of owning a certain facial PSLs pattern; and (2) codes describing the facial nevi pattern of each individual of our population, thus testing their uniqueness and so their potential in PI. The calculated LRs mostly proved high identifying strength, particularly when provided by the compound probability-based approach. Data on incidence and position of facial nevi, their generated codes, and the probabilistic approach here presented, all constitute a starting point for advancing secondary identifiers. Nonetheless, although this preliminary study proved facial PSLs as valuable and potentially useful for identification, their significance and validity should be interpreted with caution as we are still at the first theoretical step clearly based on ideal conditions, and thus further investigations are due on the limitations of their use in practical identifying settings. Therefore, being this systematic study only a preliminary one in its nature, it is recommended not to use this kind of approach until further studies will test its validity in several practical conditions.

INTRODUZIONE: L'abuso sugli anziani rappresenta una problematica critica; finora nessun articolo ha discusso le scale ed i metodi di valutazione esistenti alla luce dei fattori di base (es: famiglia, contesto sociale) e della presentazione clinica delle persone anziane potenzialmente abusate. Obiettivo: fornire una panoramica dei fattori di rischio e protettivi, dei segni, dei sintomi e dei criteri di valutazione che gli infermieri possono seguire per valutare situazioni potenzialmente correlate all'abuso sugli anziani. MATERIALI E METODI: Revisione narrativa su Pubmed, CINAHL e Cochrane Library. RISULTATI: Sono stati rinvenuti 19 strumenti di valutazione disponibili in letteratura, cosa che ha permesso di concentrarsi su quelli dedicati all'assistenza infermieristica. Questo aspetto è fondamentale a causa della natura multiforme dell'abuso sugli anziani, in cui sono coinvolti aspetti infermieristici, medici, legali, sociali ed etici. DISCUSSIONE: Molti degli strumenti recuperati sono stati concepiti per medici o operatori sanitari non infermieri, ed alcuni richiedevano molto tempo (ad esempio, interviste di 2 ore) o l'utilizzo in combinazione con altri strumenti. Gli strumenti EASI e HS-EAST sono gli unici strumenti validati che gli infermieri possono utilizzare. Tuttavia, l'EASI è solo parzialmente validato, in quanto non è stata riportata un'analisi di coerenza interna, il che potrebbe limitare la riproducibilità della valutazione. L'HS-EAST è stato testato solo sulle donne. CONCLUSIONI: La valutazione della persona anziana con segni e sintomi di potenziale violenza rimane un argomento importante nei contesti infermieristici. È necessario condurre studi di validazione per ottenere strumenti affidabili che permettano di identificare con successo le potenziali vittime

Abstract Background Non-natural mortality in children and adolescents is a global public health problem that varies widely from country to country. Data on child and adolescent maltreatment are not readily available, and mortality due to violent causes is also underestimated. Methods Injury-related mortality rates (overall and by specific causes) from 2000 to 2018 in selected European countries were analysed to observe mortality patterns in children and adolescents using data from the Eurostat database. Age-standardized mortality rates per 100,000 person-years were calculated for each country. Joinpoint regression analysis with a significance level of 0.05 and 95% confidence intervals was performed for mortality trends. Results Children and adolescent mortality from non-natural causes decreased significantly in Europe from 10.48 around 2005 to 5.91 around 2015. The Eastern countries (Romania, Bulgaria, Poland, Slovakia, Czech Republic) had higher rates; while Spain, Denmark, Italy, and the United Kingdom had the lowest. Rates for European Country declined by 5.10% per year over the entire period. Larger downward trends were observed in Ireland, Spain and Portugal; smaller downward trends were observed for Eastern countries (Bulgaria, Czech Republic, Poland, Slovakia) and Finland. Among specific causes of death, the largest decreases were observed for accidental causes (-5.9%) and traffic accidents (-6.8%). Conclusions Mortality among children and adolescents due to non-natural causes has decreased significantly over the past two decades. Accidental events and transport accidents recorded the greatest decline in mortality rates, although there are still some European countries where the number of deaths among children and adolescents from non-natural causes is high. Social, cultural, and health-related reasons may explain the observed differences between countries.

Forensic microbiology is a relatively new discipline, born in part thanks to the development of advanced methodologies for the detection, identification and characterization of microorganisms, and also in relation to the growing impact of infectious diseases of iatrogenic origin. Indeed, the increased application of medical practices, such as transplants, which require immunosuppressive treatments, and the growing demand for prosthetic installations, associated with an increasing threat of antimicrobial resistance, have led to a rise in the number of infections of iatrogenic origin, which entails important medico-legal issues. On the other hand, the possibility of detecting minimal amounts of microorganisms, even in the form of residual traces (e.g., their nucleic acids), and of obtaining gene and genomic sequences at contained costs, has made it possible to ask new questions of whether cases of death or illness might have a microbiological origin, with the possibility of also tracing the origin of the microorganisms involved and reconstructing the chain of contagion. In addition to the more obvious applications, such as those mentioned above related to the origin of iatrogenic infections, or to possible cases of infections not properly diagnosed and treated, a less obvious application of forensic microbiology concerns its use in cases of violence or violent death, where the characterization of the microorganisms can contribute to the reconstruction of the case. Finally, paleomicrobiology, e.g., the reconstruction and characterization of microorganisms in historical or even archaeological remnants, can be considered as a sister discipline of forensic microbiology. In this article, we will review these different aspects and applications of forensic microbiology.

Abstract Mass spectrometry (MS)-based proteomics has recently attracted the attention from forensic pathologists. This work is the first report of the development of a shotgun bottom-up proteomic approach based on rapid protein extraction and nano-liquid chromatography/high-resolution mass spectrometry applied to full-thickness human skin for the differential analysis of normal and ecchymotic tissues to identify new biomarkers for bruise characterization and dating. We identified around 2000 proteins from each pooled extract. The method showed excellent precision on independent replicates, with Pearson correlation coefficients always higher than 95%. Glycophorin A, a known biomarker of vital wounds from immunochemical studies, was identified only in ecchymotic tissues, as confirmed by Western blotting analysis. This finding suggests that this protein can be used as a MS-detectable biomarker of wound vitality. By focusing on skin samples from individuals with known wound dating, besides Glycophorin A, other proteins differentially expressed in ecchymotic samples and dependant on wound age were identified, although further analysis on larger datasets are needed to validate these findings. This study paves the way for an in-depth investigation of the potential of MS-based techniques for wound examination in forensic pathology, overcoming the limitations of immunochemical assays.

Abstract In this paper, we present the results of toxicological analyses of preserved brain tissue and bone samples from the remains of the seventeenth century patients of the Ospedale Maggiore, the main hospital in Milan and one of the most innovative hospitals in Europe from the Renaissance period. Beneath it, the crypt functioned as the burial place for the deceased of the hospital. In this multidisciplinary study of the remains, toxicological analyses in particular were performed with HPLC–MS/MS on different biological samples from nine individuals. Anthropological, paleopathological, histological, radiological examinations and radiocarbon dating were also carried out. As a result, archeotoxicological analyses revealed the presence of codeine, morphine, noscapine and papaverine, derived from Papaver somniferum, a plant present in the hospital pharmacopeia used as a narcotic, analgesic, astringent, coagulant, and antitussive agent. Such analyses have shed light on the pharmacological therapies administered to the patients near the time of death and have implemented our knowledge of medical treatment and drug administration in the 1600’s.

Abstract Stature is a biological trait directly determined by the interaction of genetic and environmental components. As such, it is often evaluated as an indicator for the reconstruction of skeletal biological profiles, past health, and social dynamics of human populations. Based on the analysis of 549 skeletons from the CAL (Collezione Antropologica LABANOF), a study of the diachronic trend of male and female adult stature in Milan (Italy) is being proposed here, covering a time span of about 2000 years, ranging from the Roman era to present-days. The skeletons, from necropolises dedicated to the less wealthy classes of Milanese society, were assigned to one of following five historical periods: Roman Era (first–fifth centuries AD), Early Middle Ages (sixth–tenth centuries AD), Late Middle Ages (eleventh–fifteenth centuries AD), Modern Era (sixteenth–eighteenth centuries AD) and Contemporary Era (nineteenth–twentieth centuries AD), and their stature was estimated according to the regression formulae of Trotter (1970). The collected data were then subjected to statistical analyses with ANOVA using R software. Although stature values showed an ample standard deviation in all periods, statistical analyses showed that stature did not significantly vary across historical periods in Milan for both sexes. This is one of the rare studies showing no diachronic changes in the trend of stature in Europe.

Background: In forensic pathology, asphyxia presents a problem as frequently as it is thorny and challenging. Some knowledge in forensic pathology is still considered to be traditionally acquired and is not critically assessed with modern statistical or technical tools. In this study, we seek to examine the injuries that are considered to be typical of cases of hanging (neck lesions, haemorrhages, and pleural and epicardial petechiae). Methods: We evaluated whether there was, indeed, a statistically significant association between these injuries and deaths from hanging as compared to non-hanging deaths. We collected 399 cases (32 deaths by hanging and 367 cases of non-hangings), built contingency tables and performed chi-square tests for each variable (lesion) examined; we also analysed this association in various subgroups of the sample (according to sex, age and weight ranges). Results: Our results did not deviate from the expected outcome based on traditional knowledge, although they do provide a more detailed demonstration and clarification of traditional knowledge regarding this topic. Conclusions: These findings provide valuable insights for future discussion, examination and deepening of knowledge that is traditionally accepted but often undersupported in the literature.

Soil is a dynamic matrix which can rapidly respond to disturbance events, such as the death and the deposition of an organism. Moreover, soil can be considered an archive of data due to its ability to record the traces of disturbance events. Accordingly, the biogeochemical analysis of the geopedological evidence could turn into a valuable tool for the study of decomposition processes. Hence, the aim of the present research is to detect the evidence of material exchange, linked to decomposition, between the bone tissue from two skeletal remains of the Sepolcreto (i.e., burial ground) in the crypt of the Ca’ Granda (Milan, Italy), and the pedosedimentary matrix from the stratigraphic unit US3 in which they were immersed. Both biological and geopedological specimens were analysed using a Scanning Electron Microscope equipped with facility for energy-dispersive spectroscopy (SEM-EDS) which pointed out the presence of a mutual exchange of material between the two substrates, underlying the intensity of the interaction between organisms (even if dead) and the environment in which they are located. The results were also able to lead to the detection of an inedited kind of material, mainly composed of organic matter resulted from the decomposition of human remains and preserved bone and soft tissues, which could be considered for introducing a new type of Anthrosol.

Abstract Fracture dating is an issue at the forefront of forensic sciences. While dating fracture is crucial to understanding and verifying the chronology of events in cases of abuse and violent death, its application is the subject of considerable discussion in the scientific community, filled with limitations and difficulties. Current methods for fracture dating are mainly based on a qualitative assessment through macroscopy, microscopy, and imaging and subject to variations depending on the experience of the observer. In this paper, we investigated the potential of quantifiable micro-CT analysis for fracture dating. Five histomorphometric parameters commonly used for the study of the 3D bone trabecular microarchitecture with micro-CT were calculated based on nine fractures of known post-traumatic ages, including the degree of anisotropy, connectivity density, bone volume fraction, trabecular thickness, and trabecular separation. As a result, trends in the evolution of the microarchitecture of the bone relative to age of the callus could be identified, in particular concerning anisotropy, trabecular separation and connectivity density, consistent with the healing bone process. The findings obtained in this pilot study encourage further research in quantifiable parameters of the bone microarchitecture as they could represent useful features for the construction of objective models for fracture dating.

In the global migration crisis, one of the challenges in the effort to identify deceased migrants is establishing their region of origin, which facilitates the search for ante mortem data to be compared with the post mortem information. This pilot study explores the potential of using stable isotope analysis to distinguish between individuals coming from West Africa and the Horn of Africa. Six individuals (four of known origin and two of unknown origin) were sampled. δ13CVPDB(keratin), δ15NVPDB(keratin) and δ18OVSMOW(keratin) of hair were analysed using Elemental Analyzers coupled with Isotope Ratio Mass Spectrometry (IRMS). δ18OVSMOW(carbonate) and δ13CVPDB(carbonate) of bone were analysed using GasBench II with IRMS, while 87Sr/86Sr composition was determined in bone and dental enamel using laser ablation multi-collector inductively coupled plasma mass spectrometry. The stable isotope compositions of the individual from the Horn of Africa differed from the other individuals. The differences found between 87Sr/86Sr of enamel and bone and between δ18O and δ13C in bone and hair reflect changes in sources of food and water in accordance with regionally typical migration journeys. The analysis of multiple stable isotopes delivered promising results, allowing us to narrow down the region of origin of deceased migrants and corroborate the information about the migration journey.

In Italy, in only 2018, 3310 people died in road traffic accidents, more than in any other European country. Since the revelation of this occurrence, the authors carried out an analysis aimed at investigating if there was a difference in the injury patterns among different road users. A retrospective post-mortem study on road traffic fatalities was performed, which had been autopsied at the Institute of Forensic Medicine of Milan. First, the authors analyzed the epidemiological data of all the 1022 road traffic accidents subjected to an autopsy from 2007 to 2019. Secondly, further analysis of individual autopsy reports was carried out. For this purpose, 180 autopsies belonging to 5 different categories were analyzed: car, pedestrian, motorbike, bicycle, and truck. Seventy-six percent of road traffic fatalities were male, 54% were between 10 and 49 years of age, and 62% of the patients died before arriving at a hospital. “Multiple injuries” was the main cause of death. Traumatic brain injuries were particularly high in pedestrians and cyclists. In car, motorbike, and truck fatalities, thoracic and abdominal injuries were the most frequent. Therefore, pedestrians and cyclists had a higher prevalence for traumatic head injuries, while car, motorcycle, and truck occupants, on the other hand, had a higher prevalence for thoracic and abdominal injuries.

Paranasal sinuses represent one of the most individualizing structures of the human body and some of them have been already analyzed for possible applications to personal identification, such as the frontal and sphenoid sinuses. This study explores the application of 3D–3D superimposition to maxillary sinuses in personal identification. One hundred head CT-scans of adult subjects (equally divided among males and females) were extracted from a hospital database. Maxillary sinuses were segmented twice from each subject through ITK-SNAP software and the correspondent 3D models were automatically superimposed to obtain 100 matches (when they belonged to the same person) and 100 mismatches (when they were extracted from different individuals), both from the right and left side. Average RMS (root mean square) point-to-point distance was then calculated for all the superimpositions; differences according to sex, side, and group (matches and mismatches) were assessed through three-way ANOVA test (p < 0.017). On average, RMS values were lower in matches (0.26 ± 0.19 mm in males, 0.24 ± 0.18 mm in females) than in mismatches (2.44 ± 0.87 mm in males, 2.20 ± 0.73 mm in females) with a significant difference (p < 0.001). No significant differences were found according to sex or side (p > 0.017). The study verified the potential of maxillary sinuses as reliable anatomical structures for personal identification in the forensic context.

In this study, we analyzed blood samples obtained from 169 cadavers subjected to an autopsy from 1 October 2019 to 27 March 2020. The presence of anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies was searched by lateral flow immunochromatographic assay (LFIA) and ELISA tests and the SARS-CoV-2 RNA was tested in blood and available lung tissues by real-time PCR (RT-PCR) and droplet digital PCR (ddPCR). Five cases resulted in positives at the serological screening for anti-SARS-CoV-2. Three results were weakly positive for IgM while only one showed strong reactivity for IgG antibodies. The fifth subject (who died in December 2019) resulted positive for the ELISA test. The detection of SARS-CoV-2 RNA resulted in positive only in the blood and lung tissues of such cases. These data suggest that cadaveric blood may be a suitable substrate for the assessment of SARS-CoV-2 infection; moreover, they extend the observations of sporadic cases of SARS-CoV-2 infection in North Italy prior to the first confirmed cases.

Age estimation in juveniles is a critical procedure in judicial cases for verification of imputability or for civil reasons when adopting children. Several methods based both on skeletal and dental growth have been performed and applied on different populations; nevertheless, few articles have compared different methods in order to test their reliability in different conditions and age ranges, and this is a clear obstacle in the creation of common guidelines for age estimation in the living. A comparison of five dental methods (Anderson, Ubelaker, Schour and Massler, Gustafson and Koch, Demirjian) and one skeletal method (Greulich a Pyle atlas) was performed on a population of 94 children aged between 0 and 8 years. Results showed that, whereas under 2 years all the methods have the same inaccuracy, over 2 years the diagram methods, such as Schour and Massler and Ubelaker’s revised one, have a lower error range than the most frequently used Greulich and Pyle atlas and Demirjian method. Schour and Massler, Gustafson and Koch, and Ubelaker methods showed, respectively, a mean error amounting to 0.40, 0.53, and 0.56 years versus the 0.74 and 0.88 years given by Demirjian and the Greulich and Pyle atlas. An in-depth analysis of the potential of several methods is necessary in order to reach a higher adherence of age estimation with the complexity of growth dynamics.

Structural violence is an indirect form of violence that can lead to physiological consequences. Interestingly, these physiological disruptions may affect the skeletons and can therefore provide relevant information on violence and way of life in the analysis of skeletal remains. The aim of the present study was to test the hypothesis that migrants who died in the Mediterranean Sea would present physiological cranial stress markers such as cribra orbitalia (CO), porotic hyperostosis (PH), and linear enamel hypoplasia (LEH) more frequently and more severely than Italians of the 20th century. With this intent, a total of 164 crania were examined: 139 from deceased migrants recovered from a shipwreck in the Mediterranean Sea in 2015, aged between 16 and 35 years old, and 25 of the same age from the CAL Milano Cemetery Skeletal Collection. Both presence and severity of CO, PH, and LEH were evaluated. The data obtained were analyzed using Wilcoxon signed-rank and independence Chi-squared tests to compare the results between the two samples and to test whether there was an association between the sample of migrants and the occurrence of lesions. As a result, CO and PH appeared more frequently and more severely in the migrant sample. In addition, migrants were significantly associated with CO, PH, and LEH (p-values < 0.05). Although this does not imply in any way that CO, PH, and LEH are specific to migration, they should be regarded as indicators of structural violence.

The permanence of a buried body in soil always induces the formation of a decomposition island that can serve as a significant recording location to understand how the persistence of a clandestine grave affects soil. This study aims to analyze the elemental exchange from buried bodies to soil, with a focus on phosphorus content, and to determine the effects of environmental factors on its persistency. The experiment was carried out using eleven swine carcasses buried in an open site (northern Italy). The analyses were performed using the Olsen P method, which allowed for a recognition of the trend of the amount of phosphorus over time, due to the decomposition of phospholipids, followed by the transfer of the element from bone to soil. Additionally, microanalyses performed using a scanning electron microscope (SEM-EDS) on two different soil sample specimens (i.e., “dust” and “plug”) allowed for the identification of numerous phosphatic features (i.e., coatings, infillings, impregnations, and organo-mineral associations), which are the result of the interaction between soil and body fluids and can thus be used as indicators of the former presence of decomposing body (even in its absence). The ultramicroscopic analysis also shows increasing and decreasing amounts of P2O5 over time in the soil, which could be related to environmental conditions (i.e., soil moisture), due to the leaching of phosphorus induced by the percolation of natural rainwater. The study underlines the potential use of these methods to evaluate the possibility of a cadaver–soil linkage and of assessing the burial in the soil for a variable period. Moreover, the study may aid in analyzing the dynamics of phosphorus migration from buried bodies to soil during and after the decomposition process.

Ambiguous loss is a condition of uncertainty experienced following the disappearance of a person or following the psychological absence of a loved one. It generally has psychological and psychosocial repercussions, in addition to economic and administrative consequences. In the current Mediterranean migration crisis, this condition affects families and persons who have remained in the country of origin or are waiting for the arrival of the person in the host country. In the literature few studies have analysed the psychological state of these persons and who they are, especially those who managed to reach the European coasts, and in particular no one has highlighted the desire to know which accompanies the families of the missing. The present study begins to fill this gap by analysing data collected from the families and friends of the missing who disappeared during the crossing of the Mediterranean; it aims to begin to discuss a little known issue, well visible to forensic scientists and psychiatrists and very likely relevant for clinical purposes. To this end, 340 ante mortem forms containing the information collected during interviews of the living to identify the victims were analysed, focusing especially on the data useful to trace a profile of relatives who seek their missing loved ones. Since, for these relatives, the information needed to investigate the emotional and behavioural trends of ambiguous loss was lacking, a different sample of ten patients from the Ethnopsychiatry Department of the Grande Ospedale Metropolitano Niguarda (Milan, Italy) who had recently lost a loved one was also included in the study. The results suggested that the living do not forget those who left and continue to seek their loved ones, even six years after the last contact, some investing economically in their travels. The number of persons looking for the missing supported this, underlining the great number of potential victims of ambiguous loss caused by the migration disasters and lack of identification of the dead. From a psychological point of view, comparisons were identified with post-war victims, highlighting that similar clinical consequences occur regardless of different cultural contexts and modalities of loss. Differences were also identified, especially concerning the tensions that the journey could have caused to the identity of the patients and the loneliness experienced where these persons live, making the cause of the malaise ascribable to the emotional and psychological repercussions of ambiguous loss. In such a situation the identification of a body may represent the way to find one's own roots, to facilitate the end of ambiguity, and to mark the point where they can start rebuilding a life. In conclusion, migrants should not only be included in the group of victims of ambiguous loss, but they should be ensured an integrated health path that takes into account their psychological and social conditions, remembering that the recovery and identification of a body or of an emotional bond may ameliorate mental health concerns.

Virtual anthropology (VA) has recently produced an additional tool for the analysis of commingled remains and is based on the distance analysis between three-dimensional (3D) models of bones. To date, the pair-matching of the innominate bone through a 3D approach remains partially unexplored. Here, 44 abdominal CT scans (22 males and 22 females) were selected from a hospital database, and the pubic bones were segmented through ITK-SNAP software. The models were hollowed with Viewbox4 to minimize the amount of trabecular bone. The left pubic bones were mirrored and superimposed on the right ones, according to the smallest point-to-point difference between the two surfaces through VAM software. RMS distances between models were calculated through VAM, producing RMS values for 20 matches and 420 mismatches for each sex group. Differences in RMS distance values between matches and mismatches were investigated through Mann–Whitney tests (p < 0.05); the repeatability of the procedure was assessed through absolute and relative technical error measurement (TEM and rTEM). RMS distance values of matches and mismatches were significantly different (p < 0.01) in both groups. The method yielded optimal results with high sensitivity (100.0%) and specificity (99.8% in males, 98.8% in females) rates according to the chosen threshold. This project contributes to the research field of VA with a valuable adjunct that may bolster and strengthen the results of the current visual and osteometric methods through a multidisciplinary approach.

During the COVID-19 pandemic, not only crowded refugee camps and immigration detention centers, but also receptions were places in which outbreaks occurred. To date there has been no report of the application of a COVID-19 surveillance system in reception centers for unaccompanied foreign minors only, who most of all deserve the utmost attention. Aware of this critical issue, we implemented a pilot COVID-19 surveillance program at the Zendrini center in Milan. It was started in September 2021 and was carried out for 4 months. Nasopharyngeal antigenic swabs were adopted. One day a week, two forensic physicians performed the first antigenic swab to minors who had just entered the center, or a monitoring swab after 15 days to those who were still hosted at the center. Operators were also swabbed for surveillance. A total of 80 subjects were enrolled and divided into 68 (72.5%) unaccompanied foreign minors and 22 (27.5%) operators. A total of 178 antigenic nasopharyngeal swabs were performed and tested negative. Regarding the monitoring activities, it was found that the minimum number of swabs per subject was 1 and the maximum number was 7, with an average value of 2.2 per individual. Having been able to confirm the absence of SARS-CoV-2 within the community represented a way to protect individual and collective health that could not have been pursued otherwise. Only inclusive approaches can allow communities and societies to respond more effectively to this crisis, and reduce the risk of future ones, intended as both upcoming COVID-19 waves and new infectious diseases.

Although not without subjectivity, the cranial trait scoring method is an easy visual method routinely used by forensic anthropologists in sex estimation. The revision presented by Walker in 2008 has introduced predictive models with good accuracies in the original populations. However, such models may lead to unsatisfactory performances when applied to populations that are different from the original. Therefore, this study aimed to test the sex predictive equations reported by Walker on a contemporary Italian population (177 individuals) in order to evaluate the reliability of the method and to identify potential sexual dimorphic differences between American and Italian individuals. In order to provide new reference data to be used by forensic experts dealing with human remains of modern/contemporary individuals from this geographical area, we designed logistic regression models specific to our population, whose accuracy was evaluated on a validation sample from the same population. In particular, we fitted logistic regression models for all possible combinations of the five cranial morphological traits (i.e., nuchal crest, mastoid process, orbital margin, glabella, and mental eminence). This approach provided a comprehensive set of population-specific equations that can be used in forensic contexts where crania might be retrieved with severe taphonomic damages, thus limiting the application of the method only to a few morphological features. The results proved once again that the effects of secular changes and biogeographic ancestry on sexual dimorphism of cranial morphological traits are remarkable, as highlighted by the low accuracy (from 56% to 78%) of the six Walker’s equations when applied to our female sample. Among our fitted models, the one including the glabella and mastoid process was the most accurate since these features are more sexually dimorphic in our population. Finally, our models proved to have high predictive performances in both training and validation samples, with accuracy percentages up to 91.7% for Italian females, which represents a significant success in minimizing the potential misclassifications in real forensic scenarios.

BackgroundOver the past years medical centres specifically addressed in gender-based violence have developed protocols for the collections of evidence useful in the courtroom, including accurate documentation of physical and psychological states of the victim and collection of samples. Previous studies showed an association between documented physical trauma and conviction but unfortunately, few studies in the recent literature analysed the factors that influence the legal outcome and final judgement. The present study focused on the elements that appeared of significance in the legal outcome, including medico-legal evaluation, source of the crime report and circumstance of the assault.MethodsIt was conducted a retrospective analysis of all the judgments issued by the Public Prosecutor's Office at a Court of a Metropolitan Italian city regarding sexual and domestic violence, from January 1st 2011 to 31st December 31st 2015. Examination regarded the demographic information of the victim and of the defendant, information on the crime, the circumstances of the aggression and medical information retrieved. Sentences were subsequently divided into two categories based on the legal outcome (conviction vs acquittal) and the different characteristics of the two sub-populations were compared to verify if there were variables significantly associated to the judge's final judgment.ResultsOver the 5 years taken into consideration, there have been 1342 verdicts regarding crimes of sexual violence (374 cases) and regarding abuses against family members or cohabitants (875): other 93 cases regarded both sexual violence and abuse. 66.3% ended in conviction of the offender and 33.7% in acquittal of the accused. Cases of conviction were more frequent when they involved: use of a weapon by the assailant, as well as if the assailant had a criminal record and had a history of drug abuse or other addictions; duration of proceeding less 22 months and a civil party involved; presence of clinical documentation together with other deposition in addition to victim's deposition; also frequent episodes of violence and application of precautionary measures were associated to conviction.ConclusionsMany factors seem able to influence the judge's judgment, although clearly each case must be singularly evaluated. The mere presence of medical documentation, without the support of other sources of evidence, such as the victim's statement or further declarations, however, is almost always not definitive for the verdict. Despite so, in cases where there are multiple sources of evidence, clinical documentation can provide useful elements and can give clues on the consistency between the history told and injuries observed.

Thallium intoxications are a rare occurrence in forensic sciences. This paper reports a case of chronic thallium poisoning in a couple hospitalized in Milan, Italy, in which toxicological analyses were performed by the Institute of Legal Medicine of Milan on the request of the Judicial Authority. Preliminary analyses confirmed the presence of thallium in the blood and urine samples of the couple. After positive results were obtained from the biological samples, the Judicial Authority learned that the son of the couple used thallium powder illegally in his field and that the father helped his son in that field almost every day. Therefore, the Judicial Authority suspected that the man had accidentally contaminated the house environment, thus intoxicating his wife. Consequently, they requested the seizing of multiple items from their residency to verify this hypothesis. Each object was sampled internally (content or internal surface) and externally (surface of the container) and the concentrations of thallium were evaluated using ICP-MS analyses. Positive results of items indicate a thallium contamination caused by an external vector. Indeed, they suggest that none of the elements analyzed was the contaminant responsible for the intoxication but the examination of the soles of the man’s shoes argued in favor of an external contamination (the son’s field), suggesting that he was the accidental mean of transportation of the heavy metal into the house. This paper presents a rare case of chronic thallium intoxication in a domestic setting where contamination occurred from an illegal usage of thallium in a field.

Forensic anthropologists rely on a number of parameters when analyzing human skeletal remains to assist in the identification of the deceased, predominantly age-at-death, sex, stature, ancestry or population affinity, and any unique identifying features. During the examination of human remains, it is important to be aware that the skeletal features considered when applying anthropological methods may be influenced and modified by a number of factors, and particular to this article, prescription drugs (including medical and non-medical use) and other commonly used drugs. In view of this, this paper aims to review the medical, clinical and pharmacological literature to enable an assessment of those drug groups that as side effects have the potential to have an adverse effect on the skeleton, and explore whether or not they can influence the estimation of age-at-death, sex and other indicators of the biological profile. Moreover, it may be that the observation of certain alterations or inconsistencies in the skeleton may relate to the use of drugs or medication, and this in turn may help narrow down the list of missing persons to which a set of human remains could belong. The information gathered from the clinical and medical literature has been extracted with a forensic anthropological perspective and provides an awareness on how several drugs, such as opioids, cocaine, corticosteroids, non-steroidal anti-inflammatory drugs, alcohol, tobacco and others have notable effects on bone. Through different mechanisms, drugs can alter bone mineral density, causing osteopenia, osteoporosis, increase the risk of fractures, osteonecrosis, and oral changes. Not much has been written on the influence of drugs on the skeleton from the forensic anthropological practitioner perspective; and this review, in spite of its limitations and the requirement of further research, aims to investigate the current knowledge of the possible effects of both prescription and recreational drugs on bones, contributing to providing a better awareness in forensic anthropological practice and assisting in the identification process of the deceased.

Insect-related evidence must be considered of probative value just as bloodstains, fingerprints, fibers, or any other materials. Such evidence if properly collected and analyzed can also provide useful details in the reopening of old unsolved murders, also called “cold cases”. This paper presents the case of two murders that occurred in two different European countries and remained unsolved for years. The remains of a girl found in Italy 17 years after her disappearance helped to solve a murder that occurred in Britain 8 years prior. The cases were unexpectedly linked together because of the similarities in the ritualistic placing of strands of hair and connections with the suspect. The trace evidence relating to insects and hairs played a relevant role in the conviction of the perpetrator. In Italy, the defense raised the doubt that the strands of hair found nearby the skeletal remains could be the result of insect feeding activity and not the result of a cut by sharp objects. Therefore, it was fundamental to distinguish between sharp force lesions and insect feeding activity on hair. This unusual application of insect-related evidence clearly emphasizes the importance of an appropriate professional collection and analysis of any physical evidence that could be of robust probative value.

Establishing the post mortem interval (PMI) is a key component of every medicolegal death investigation. Several methods based on different approaches have been suggested to perform this estimation. Among them, two methods based their evaluation on the effect of the temperature and time on the considered parameters: total body score (TBS)/accumulated degree-days (ADDs) and insect development. In this work, the two methods were compared using the results of minPMI and PMI estimates of 30 forensic cases occurring in northern Italy. Species in the family Calliphoridae (Lucilia sericata, Calliphora vomitoria and Chrysomya albiceps) were considered in the analyses. The results highlighted the limits of the TBS/ADD method and the importance of the entomological approach, keeping in mind that the minPMI is evaluated. Due to the fact that the majority of the cases occurred in indoor conditions, further research must also be conducted on the different taxa to verify the possibility of increasing the accuracy of the minPIM estimation based on the entomological approach.

The presence of Crocidura sp. on Astipalaia Island was shown, for the first time, in the nineties of the twentieth century. After the re-examination of the already available specimens and the analysis of the more recent material, it emerged that this insular shrew population refers to Crocidura suaveolens group. The presence of this taxon is also reported for the neighboring island of Amorgos. The presence of Crocidura suaveolens group in the Mediterranean islands is a result of Pleistocene survivors as well as human introductions, a both morphometric and genetics investigation on these specimens is deserving of further insights.

The history and cultural heritage of a city can be evaluated not only through the study of the works of art, artifacts or buildings, but also through the examination of the remains of persons who walked the city in the past millennia. Therefore several thousands of skeletal remains found in Lombardia, especially in Milano, act as cultural assets, though in an the ethical scenario of full respect of human remains. In this way the skeletons tell a history concerning the conditions of health, the richness, culture and even violence, which may confirm, integrate or deny the historical sources when available. Preliminary studies performed on skeletons from different areas of Lombardia have already demonstrated the potential of skeletal material in highlighting for example the evolution of infectious diseases from the Roman age to the Middle Ages, the multiethnicity of Milan at the time of St Ambrose, the heavy labor of children which seems to be present among the Longobards who inhabited the geographic areas of Bergamo as well as Manzoni’s plague affecting the remains found under the Spanish walls. How were they different from us for what concerns life expectancy, diseases, interpersonal violence and lifestyle? In this the skeleton comes through as a true cultural asset.

The paper explores the determinants of internal migration in Albania, adopting the Harris-Todaro approach to migration: an internal migration function is estimated using district wage and unemployment rate differentials. The aggregate level wages and unemployment, included in the migration equation, are retrieved from a first stage wage and unemployment equations, estimated controlling for personal characteristics. Moreover, in order to test the predictions of the human capital model of migration, the difference between migrants and non-migrants is emphasized in the estimation. The data source is the "Living Standard Measurement Survey for Albania" (2002), undertaken by the national Institute of Statistics and the World Bank jointly. The results reveal that both wage and unemployment differentials are important determinants of the propensity to migrate in Albania. This conclusion is further emphasized by noting that migrants gain substantially in terms of higher returns to individual characteristics after emigration.