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La vergogna può essere definita come la paura anticipatoria di essere esposti al giudizio negativo degli altri o proprio. Da un punto di vista evoluzionista la vergogna ha un fondamentale valore adattivo per l'individuo in quanto garantisce l'appartenenza e la permanenza all'interno del proprio gruppo sociale di riferimento, in quanto inibisce e limita i comportamenti che risulterebbero socialmente poco accettabili ed è connessa alla paura di perdere il rango sociale o di essere esclusi dal gruppo di conspecifici. La vergogna si esprime attraverso la manifestazione di segnali di resa che inibiscono l'aggressività del dominante e solitamente favoriscono l'evitamento di situazioni potenzialmente umilianti riducendo fortemente l'esplorazione (Gilbert, 1997; Kim et al., 2011).L'approccio terapeutico dei disturbi connessi alla vergogna è focalizzato principalmente sul miglioramento delle capacità di regolazione della stessa, mediante l'esplorazione e l'utilizzo di sistemi motivazionali poco presenti nel repertorio interpersonale del paziente. Il riconoscimento delle proprie rigidità motivazionali permette al paziente di comprendere i principali meccanismi alla base delle sue difficoltà e di esplorare concretamente all'interno del contesto terapeutico anche l'utilità di altri sistemi motivazionali prosociali. Nel percorso terapeutico di tali disturbi, il processo di costruzione dell'alleanza terapeutica rappresenta un passaggio centrale perché incentrato concretamente sull'utilizzo del registro cooperativo che costituisce e mantiene una solida alleanza terapeutica che rappresenta un importante fattore terapeutico di per sé e un significativo predittore di buon esito. La Teoria Evoluzionistica delle Motivazioni (TEM & Liotti, 1994/2005; Liotti, Fassone & Monticelli, 2017) sostiene che il sistema cooperativo è un elemento costituente dell'alleanza terapeutica e l'unico sistema motivazionale connesso in modo significativo al miglioramento delle funzioni metacognitive (Liotti & Gilbert 2011; Monticelli et al., 2018; Monticelli et al., 2020; Monticelli & Liotti, 2021).

The analysis of postmortem protein degradation has become of large interest for the estimation of the postmortem interval (PMI). Although several techniques have been published in recent years, protein degradation-based techniques still largely did not exceed basic research stages. Reasons include impractical and complex sampling procedures, as well as highly variable protocols in the literature, making it difficult to compare results. Following a three-step procedure, this study aimed to establish an easily replicable standardized procedure for sampling and processing, and further investigated the reliability and limitations for routine application. Initially, sampling and processing were optimized using a rat animal model. In a second step, the possible influences of sample handling and storage on postmortem protein degradation dynamics were assessed on a specifically developed human extracorporeal degradation model. Finally, the practical application was simulated by the collection of tissue in three European forensic institutes and an international transfer to our forensic laboratory, where the samples were processed and analyzed according to the established protocol.

A 9-year-old boy collapsed shortly after complaining of shortness of breath. Despite immediate resuscitation measures, the boy died. A few weeks earlier, he had received antibiotic treatment for respiratory infection. However, the post-mortem examination revealed an advanced tumor mass of the mediastinum with infiltration of vital structures, which was identified as a small blue round neoplasm with aspects of an extramedullary Ewing-like sarcoma by supplementary histological and immunohistochemical examinations.This dramatic clinical course of events shows that the possible presence of serious diseases should always be considered behind harmless symptoms, even in children.

Il caso di M., condotto integrando più approcci terapeutici, offre lo spunto per una rilettura clinica che si avvale di una teoria unitaria di riferimento. Nella prospettiva cognitivista multi-motivazionale si può considerare la vergogna come principale elemento patoplastico da cui originano sia le condotte autoconsolatorie di M., sia l'aggressività distruttiva che esita nel revenge porn.

When decomposition of a recovered body is fairly advanced, identification based on common morphologic features is often impossible. In these cases, short tandem repeat (STR) marker genotyping has established itself as a convenient and reliable alternative. However, at very progressed stages of decomposition, postmortem tissue putrefaction processes can decrease DNA yields considerably. Hence, not all types of tissue are equally suitable for successful STR marker-based postmortem identification. Bone or dental material is often analysed in corpses with advanced decompositional changes. However, processing of these materials is very elaborate and time and resource consuming. We have therefore focused on the suitableness of various types of soft tissue swabs, where DNA extraction is easier and faster. By sampling 28 bodies at various stages of decomposition, we evaluated the suitability of different tissues for genotyping at varying degrees of physical decay. This was achieved by a systematic classification of the sampled bodies by morphological scoring and subsequent analysis of multiple tissue swabs of the aortic wall, urinary bladder wall, brain, liver, oral mucosa and skeletal muscle. In summary, we found variable degrees of suitability of different types of soft tissue swabs for DNA-based identification. Swabs of the aortic wall, the urinary bladder wall and brain tissue yielded the best results — in descending order — even at advanced levels of decay. Supplementary Information The online version contains supplementary material available at 10.1007/s00414-021-02601-3.

Punches without the use of instruments/objects are a common type of body violence and as such a frequent subject of medicolegal analyses. The assessment of the injuries occurred as well as of the potential of the assault to produce severe body harm is based on objective traces (especially the documented injuries of both parties involved) as well as the—often divergent—descriptions of the event. Quantitative data regarding the punching characteristics that could be used for the assessment are rare and originate mostly in sports science. The aim of this study was to provide physical data enabling/facilitating the assessment of various punching techniques. A total of 50 volunteers took part in our study (29 males and 21 females) and performed severe punches with the fist, with the small finger edge of the hand (karate chop), and with the open hand with both the dominant and the non-dominant hands in randomized order. The strikes were performed on a boxing pad attached to a KISTLER force plate (sampling frequency 10,000 Hz) mounted on a vertical wall. The punching velocity was defined as the hand velocity over the last 10 cm prior to the contact to the pad and ascertained by using a high-speed camera (2000 Hz). Apart from the strike velocity, the maximum force, the impulse (the integral of the force-time curve), the impact duration, and the effective mass of the punch (the ratio between the impulse and the strike velocity) were measured/calculated. The results show a various degree of dependence of the physical parameters of the strikes on the punching technique, gender, hand used, body weight, and other factors. On the other hand, a high degree of variability was observed that is likely attributable to individual punching capabilities. In a follow-up study, we plan to compare the “ordinary” persons with highly trained (boxers etc.) individuals. Even though the results must be interpreted with great caution and a direct transfer of the quantitative parameters to real-world situations is in general terms not possible, the study offers valuable insights and a solid basis for a qualified forensic medical/biomechanical assessment.

ZusammenfassungEin junger Maschinist verlor während der Bedienung eines Mastseilgeräts mit Kran und Prozessor – zum Rücken, Entasten und Einschneiden von Bäumen – plötzlich das Bewusstsein und verstarb trotz Reanimationsmaßnahmen noch an der Arbeitsstätte. Bei der ärztlichen Leichenschau fiel ein ca. 1,5 × 1 cm großer Hautdefekt rechts an der Brustkorbvorderseite auf, welcher nicht genauer zugeordnet werden konnte. Die Umstände des Unfalls konnten durch die Obduktion und Untersuchungen am Unfallort geklärt werden. Die Sägekette des Prozessors war gerissen und ein Teil davon gelangte in die Sicherheitskabine des Mastseilgeräts, da die Sicherheitstür mit 12 mm Polycarbonatverglasung nicht geschlossen war. Dieser Kettenteil traf den Maschinisten in die Brust, was letztlich tödliche Verletzungen verursachte.

In recent years, protein decomposition has become of increasing interest for the use in forensic estimation of the postmortem interval (PMI). Especially skeletal muscle tissue has proven to be a prime target tissue, among other reasons, due to its large abundance in the human body. In this regard, it is important to know whether there are any intra- and intermuscular differences in the behavior of protein degradation. Thus, samples from different locations within several skeletal muscles as well as from cardiac and smooth muscle tissue samples were collected from three autopsy cases with varying degree of decomposition. Samples were analyzed by SDS-PAGE and Western blotting and compared for protein degradation patterns. Intramuscular variations turned out to be minimal and without major influence for the use of the method. Observed intermuscular differences provide possibilities for future improvement of the precision and temporal application range. The results of this study show the strengths and current limitations of protein degradation-based PMI estimation and provide a deeper understanding of intraindividual postmortem protein degradation processes.

Estimating the postmortem interval (PMI) is one of the major tasks and a continuous challenge in forensic pathology. It is often an exclusion process of available methods, which ultimately can lead to an unsatisfactory outcome due to poor reliability. This problem is most acute in the late PMI, when decomposition proceeds and some methods (such as rigor, livor, and algor mortis) are no longer applicable. Several methods, such as forensic entomology, skeletal muscle protein degradation, and the study of body decomposition by application of a morphological scoring, are expected to provide further information; however, all have certain limitations and weaknesses. Availability of a tool-box of methods allows a case-specific selection of the most appropriate one(s), or eventually provides improvements in the overall accuracy and precision of the PMI estimation by merging and combining methods. To investigate practical (field) application, eventual interferences, and/or synergetic effects, as well as the robustness of these methods towards specific influencing factors, a field study was conducted, using eight pig cadavers of different body weights and physical coverage, left to decompose under natural conditions for 16 days. Morphological changes during decomposition were assessed using the total body score (TBS), muscle samples were collected to analyze protein degradation, and insect colonization was evaluated. The results reveal strengths and current limitations of all tested methods, as well as promising synergistic effects, and thus, provide a baseline for targeted future research.

Folgt man der gangigen Meinung, so fuhren „Ohrfeigen“ haufig nur zu sog. Bagatellverletzungen. Jedoch ist man als Sachverstandiger vor Gericht immer wieder mit der Diskrepanz zwischen „lediglich“ einer Ohrfeige und einem angeblich daraus resultierenden schweren Verletzungsmuster konfrontiert. Dies kann bei fehlender Kenntnis der moglichen Verletzungsfolgen von Schlagen mit der flachen Hand (Ohrfeigen, „Watschen“) durchaus zu einer falschen Beurteilung durch Sachverstandige fuhren. Es erfolgte eine retrospektive Auswertung von mundlichen Gutachten vor Gericht bzw. der schriftlichen Dokumentation derselben im Hinblick auf die (juristische) Wertung von Schlagen mit der flachen Hand und den im Rahmen der Verhandlung beschriebenen Verletzungsfolgen aus den Jahren 2014–2018. Es zeigte sich in insgesamt 129 Verhandlungen, dass in den meisten Fallen als Folge von Schlagen mit der flachen Hand lediglich „Bagatellverletzungen“ entstanden. Am haufigsten wurden Rotungen und/oder Schmerzen sowie kleinere blutende Verletzungen beschrieben. In Einzelfallen kann es jedoch auch zu massiven Verletzungen wie etwa Frakturen und Verletzungen des Trommelfells kommen. Auch wenn die Gewalteinwirkungen auf den ersten Blick oftmals nur wenig intensiv erschienen, so kann es je nach Intensitat und Technik auch zu massiven Verletzungen kommen, wobei anzumerken ist, dass die Beschreibungen der Gewalteinwirkungen und der Verletzungen in foro bzw. die schriftliche Dokumentation fur eine rechtsmedizinische Beurteilung und Auswertung oftmals erheblich verbesserungswurdig erscheint.

Bei (fraglichen) Gewaltdelikten wird haufig zwischen Faustschlagen und Schlagen mit der flachen Hand differenziert; daruber hinaus werden nicht selten Begriffe wie Ohrfeige (Watsche, Backpfeife o. A.) verwendet, die jedoch keine klare und allgemein akzeptierte Bedeutung haben. Auserdem liegen keine belastbaren naturwissenschaftlichen Daten zur Intensitat bzw. zum Verletzungspotenzial derartiger Handlungen vor. Die vorliegende Studie hatte zum Ziel, die fur eine traumatomechanische Analyse wesentlichen Aspekte des Phanomens Ohrfeige zu untersuchen bzw. darzustellen. Es erfolgten eine Befragung insgesamt 30 Freiwilliger zu ihrem individuellen Verstandnis des Begriffs „Ohrfeige“, insbesondere in Bezug auf den Begriff „Schlag mit der flachen Hand“, einerseits und eine Messung schlagrelevanter Parameter (Schlagkraft im Zeitverlauf, Schlaggeschwindigkeit) im biomechanischen Labor andererseits. Aus den Messergebnissen wurden die wesentlichen Schlagparameter (Kraftstos, effektive Masse) errechnet und Unterschiede zwischen diversen Gruppen statistisch bewertet. Es zeigten sich deutliche Unterschiede im Verstandnis des Begriffs „Ohrfeige“ und entsprechend in den biomechanischen Charakteristika der Schlage, die eine ganze Bandbreite von sehr leichten Kontakten bis zu intensiven Stosen umfassten. Ferner zeigten sich zu erwartende Differenzen in der Schlagintensitat zwischen Frauen und Mannern und zwischen der dominanten und nichtdominanten Hand. Bei der Bewertung von Schlagen erwies sich die Beschreibung mittels Begriffen wie „Ohrfeige“ als wertlos; vielmehr mussen in jedem Einzelfall die konkreten Merkmale der Schlagbewegung eruiert werden. Betrachtet man die messtechnisch ermittelten Stosparameter im Kontext bekannter biomechanischer Belastbarkeit im Kopfbereich, kommen nicht nur banale Verletzungen, sondern evtl. auch mittelschwere Verletzungen als direkte Schlagfolgen durchaus in Betracht.

This study aimed to determine whether hydromorphone and codeine can be detected in oral fluid specimens following administration of Substitol™, a slow-release formulation of morphine. This is of interest for those monitoring treatment compliance using drug testing. Oral fluid specimens collected for compliance assessment in routine clinical practice or as part of a clinical trial were subjected to quantitative analysis of hydromorphone, morphine, codeine, and 6-acetylmorphine using highly sensitive mass spectrometric methods. Oral fluid was collected using a Greiner Bio-One saliva collection system. Patients undergoing substitution treatment with Substitol™, methadone, or buprenorphine were included, together with patients undergoing pain treatment with hydromorphone. Hydromorphone was detected in 642 of the 663 (97%) samples from substitol-treated patients. Concentrations were not higher in methadone- and buprenorphine-treated patients who relapsed into heroin use, or in patients on hydromorphone therapy. Codeine was detected in 29% of the samples. These concentrations were lower than those in patients who had relapsed to heroin use. Clinical administration of morphine can lead to detectable concentrations of both hydromorphone and codeine in oral fluids. This should be taken into consideration when using drug testing in oral fluid samples for compliance assessment in this patient group.

Attachment theory is useful, but per se it may not be sufficient to understand the complexity of human relationships. For this reason, we believe that there is the need to refer to a broader (evolutionary theory of motivation; Liotti, Psychoanal Inquiry 37(5):319–331, 2017) that considers normal functioning as the result of the harmonious activation of various motivational systems, each aimed at achieving an objective of high evolutionary value (adaptive for the individual, the social group, and the species). In this approach, pathology results from the disharmonious and dysfunctional activation of one or more motivational systems. This leads to a theory of care aimed at modulating the maladaptive activation of motivational systems by recognizing each patient’s dysfunctional interpersonal schemas and restoring his ability to function in more flexible ways. Motivational monitoring allows us to recognize impasses/ruptures within the therapeutic alliance and effectively use interventions to restore it. It may enhance patients’ emotional regulation and the interpersonal attunement between patient and therapist, reducing the risk of dropouts and leading to better therapeutic outcomes.

This contribution clarifies some fundamental principles of the clinical use of the case formulation and the therapeutic relationship from an evolutionary theory of motivation (ETM) viewpoint. From an ETM perspective, the case formulation is conceived as a dynamic, concrete, and intensely emotional and relational element. It is formulated and shared with the patient at the beginning of the therapy—as happens in other cognitive behavioral treatments—but it is subject to continuous verification, especially during relational events. The elements of the procedure are the recognition of therapeutic alliance crises; the identification of who, between patient and therapist, is in charge of the ongoing rupture; the assessment of various types of rupture; and the formulation of the clinical intervention.

The estimation of the postmortem interval (PMI) is of critical importance in forensic routine. The most frequently applied methods, however, are all restricted to specific time periods or must be excluded under certain circumstances. In the last years it has been shown that the analysis of muscle protein degradation has the potential to contribute to according delimitations in practice. In particular, upon biochemical analysis, the specific time points of degradation events provide reasonable markers for PMI delimitation. Nevertheless, considerable research is yet required to increase the understanding of protein decomposition and how it is affected by individual and environmental influencing factors. This is best investigated under standardized conditions, however, a considerate selection of proxies, regarding costs, effort, and expected outcome is required. Here, we use pigs to compare muscle protein decomposition in whole bodies and dismembered body parts (amputated hind limbs). Not only do experiments on body parts reduce the costs and allow easier handling in basic research, but also they aid to investigate the practical application of PMI estimation in dismembered body parts, or other extensive injuries, which are not unusual scenarios in crime investigation. Specifically, we investigated whether there are differences in the degradation rates of selected muscle proteins, sampled from dismembered legs and from hind limbs attached to whole pig bodies. Our results show distinct time-dependent degradation patterns of muscle proteins in a predictable manner regardless of sample origin. We are able to demonstrate that amputated hind limbs are suitable proxies for the analysis of muscle protein degradation, especially to investigate certain influencing factors and establish according standardized models. Supplementary Information The online version contains supplementary material available at 10.1007/s00414-021-02571-6.

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

A most precise determination of the postmortem interval (PMI) is a crucial aspect in forensic casework. Although there are diverse approaches available to date, the high heterogeneity of cases together with the respective postmortal changes often limit the validity and sufficiency of many methods. Recently, a novel approach for time since death estimation by the analysis of postmortal changes of muscle proteins was proposed. It is however necessary to improve the reliability and accuracy, especially by analysis of possible influencing factors on protein degradation. This is ideally investigated on standardized animal models that, however, require legitimization by a comparison of human and animal tissue, and in this specific case of protein degradation profiles. Only if protein degradation events occur in comparable fashion within different species, respective findings can sufficiently be transferred from the animal model to application in humans. Therefor samples from two frequently used animal models (mouse and pig), as well as forensic cases with representative protein profiles of highly differing PMIs were analyzed. Despite physical and physiological differences between species, western blot analysis revealed similar patterns in most of the investigated proteins. Even most degradation events occurred in comparable fashion. In some other aspects, however, human and animal profiles depicted distinct differences. The results of this experimental series clearly indicate the huge importance of comparative studies, whenever animal models are considered. Although animal models could be shown to reflect the basic principles of protein degradation processes in humans, we also gained insight in the difficulties and limitations of the applicability of the developed methodology in different mammalian species regarding protein specificity and methodic functionality.

This article is a portrait of Giovanni Liotti, eminent psychiatrist and scholar of attachment theory who recently passed away. In this paper, we recall some fundamental steps in his professional and personal life: Liotti's encounter and friendship with Bowlby; Liotti's construction of a bridge between cognitive therapy (of which he was a pioneer) and attachment theory; the interest in attachment disorganization as a precursor of dissociative symptoms and syndromes in adolescence and adulthood; his appreciation for Janet's ideas (which Liotti helped bring back to the attention of clinicians and researchers) and his contribution in highlighting the role of

This article is a portrait of Giovanni Liotti, eminent psychiatrist and scholar of attachment theory who recently passed away. In this paper, we recall some fundamental steps in his professional and personal life: Liotti's encounter and friendship with Bowlby; Liotti's construction of a bridge between cognitive therapy (of which he was a pioneer) and attachment theory; the interest in attachment disorganization as a precursor of dissociative symptoms and syndromes in adolescence and adulthood; his appreciation for Janet's ideas (which Liotti helped bring back to the attention of clinicians and researchers) and his contribution in highlighting the role of real traumatic experiences in the development of psychopathology; Liotti's attempt to go beyond attachment theory and formulate for the clinical context an evolutionary theory of motivation, which analyzes different interpersonal motivational systems beyond attachment and caregiving, an emphasizes in particular the importance of cooperation in psychotherapy.

Vitreous humor (VH) is a specimen of great value in forensic investigations and is being used for evaluating possible post-mortem formation of ethanol. Ethyl glucuronide (EtG) is an ethanol metabolite that has found interest for the same purpose. Both compounds can be measured in VH and because of differences in rate of distribution and elimination they may offer complementary information.VH, femoral blood (FB) and urine were collected from 117 autopsy cases for forensic investigation. Ethanol was measured with headspace gas chromatography, while EtG was measured with liquid chromatography - tandem mass spectrometry.Ethanol was detected in all matrices in 39 cases, while EtG was present in 62 cases. The VH-FB and the VH-urine ethanol concentrations in the 39 cases were statistically correlated (p0.00001). In one case with an ethanol concentration of 0.11 g/L in FB, no ethanol was detected in VH and urine, and no EtG in any specimen, indicating a possible post-mortem formation. EtG was present in VH in more cases than in FB and urine. The correlation between the EtG concentrations in VH and FB was statistically significant (p0.0003) as was the case also for VH and urine (p0.001). The combined information on ethanol and EtG concentrations in the three matrices can be used to interpret alcohol drinking habit before death. This study confirms the value of using VH as a specimen in forensic investigations regarding recent exposure to ethanol. EtG can be used not only for investigating post-mortem ethanol formation but also for estimating recent alcohol drinking.

Background In order to evaluate the ability of traffic participants to drive, standardized and objective measurement methods are needed. In recent analyses it was shown that pupil function is a significant indicator of being under the influence of substances acting on the central nervous system.

Estimation of the postmortem interval in advanced postmortem stages is a challenging task. Although there are several approaches available for addressing postmortem changes of a (human) body or its environment (ecologically and/or biochemically), most are restricted to specific timeframes and/or individual and environmental conditions. It is well known, for instance, that buried bodies decompose in a remarkably different manner than on the ground surface. However, data on how established methods for PMI estimation perform under these conditions are scarce. It is important to understand whether and how postmortem changes are affected under burial conditions, if corrective factors could be conceived, or if methods have to be excluded for respective cases. We present the first multi-methodological assessment of human postmortem decomposition carried out on buried body donors in Europe, at the Amsterdam Research Initiative for Sub-surface Taphonomy and Anthropology (ARISTA) in the Netherlands. We used a multidisciplinary approach to investigate postmortem changes of morphology, skeletal muscle protein decomposition, presence of insects and other necrophilous animals as well as microbial communities (i.e., microbiomes) from August to November 2018 associated with two complete body exhumations and eight partial exhumations. Our results clearly display the current possibilities and limitations of methods for PMI estimation in buried remains and provide a baseline for future research and application.

Driving under the influence of alcohol (DUIA) and drugs (DUID) is considered an elevated risk for traffic safety. When assessing a driver's fitness to drive, standardized and objective measurement methods are still required, in order to clarify the question whether an individual is under the influence of substances acting on the central nervous system (CNS). We exposed healthy test subjects (n=41) as well as persons who were under the influence of cannabis after repeated inhalation to multiple light stimuli using infrared technology and measured the pupillary light reflex (PLR). Toxicological tests of blood samples taken from every subject followed. The aims of this study were to assess the differences in pupillography response between cannabis consumers after a washout period and no cannabis consumers as well as the dose related effects on pupillography parameters of cannabis in cannabis consumers. All four pupillary parameters changed according to a weakened pupil function after acute administration of cannabis in all test subjects. Furthermore, it could be observed that habitual cannabis consumers showed an altered pupillary function just before the first dose was taken, suggesting that the long-term effects and addiction also have to be taken into account, when effects of the CNS are discussed. The results of the present study show that almost all pupil parameters could be reliable indicators for the detection of subjects under the acute effect of cannabis.

Erratum zu: Rechtsmedizin 2019 https://doi.org/10.1007/s00194-019-00362-3 Leider wurden durch ein technisches Versehen die Teilabbildungen in Abb. 2 nicht korrekt veroffentlicht. Wir bitten Sie die korrigierte Abbildung zu beachten und den Fehler zu …

Estimating the time since death is a very important aspect in forensic sciences which is pursued by a variety of methods. The most precise method to determine the postmortem interval (PMI) is the temperature method which is based on the decrease of the body core temperature from 37 °C. However, this method is only useful in the early postmortem phase (~0-36 h). The aim of the present work is to develop an accurate method for PMI determination beyond this present limit. For this purpose, we used sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), Western blotting, and casein zymography to analyze the time course of degradation of selected proteins and calpain activity in porcine biceps femoris muscle until 240 h postmortem (hpm). Our results demonstrate that titin, nebulin, desmin, cardiac troponin T, and SERCA1 degraded in a regular and predictable fashion in all samples investigated. Similarly, both the native calpain 1 and calpain 2 bands disintegrate into two bands subsequently. This degradation behavior identifies muscular proteins and enzymes as promising substrates for future molecular-based PMI determination technologies.

Il presente articolo riporta i risultati di tre studi incentrati sull’ipotesi che la sincope neuromediata tragga origine da un processo psicopatologico dissociativo "somatoforme". Il primo studio, condotto su un campione di 61 pazienti, indaga le possibili relazioni tra una storia evolutiva di tipo traumatico, la presenza di sintomi dissociativi e lo sviluppo della sincope vasovagale. Nel secondo studio, e stata condotta una valutazione psichiatrica di 31 pazienti affetti da sindrome vasovagale, con particolare attenzione alla sintomatologia, sia di entita clinica che subclinica, riferita ad aspetti dissociativi o alla difficolta di identificazione delle proprie emozioni (alessitimia). Infine, nel terzo studio si e rilevato l’assetto motivazionale di 30 pazienti affetti da sincope vasovagale con il metodo AIMIT; l’ipotesi di ricerca e che in tali pazienti una focalizzazione sui propri problemi (sintomi somatici) costituisca una strategia compensatoria a fronte di una tendenza sottostante ad un crollo dissociativo. I risultati confermano in via preliminare le ipotesi avanzate.

In order to evaluate driving abilities of each traffic participant, standardized and objective measurement methods are still needed. The applicability and value of infrared pupillography as an objective measurement method to indicate possible influence of central nervous acting substances has been demonstrated in former publications. To tie in with first results of the study, the aim was to extend the statistical analysis to further parameters of the pupillary light reflex (PLR) in order to demonstrate their relevance and to substantiate the value of infrared pupillography for possible implementation in the framework of routine police traffic checks. We exposed the iris of healthy test subjects (n = 41), as well as of persons who were under the influence of drugs and/or medication (n = 105), to different light stimuli using infrared technology. After measuring and splitting the PLR into single parameters a statistical analysis was performed. The pupillary light reflex was significantly alterated when the examined person was under the influence of central nervous acting substances. In concordance with former reported results, the majority of the parameters approved the high value of the PLR as a reliable indicator of previous consumption of drugs and/or central nervous acting medication. The most appropriate parameters of the pupillary light reflex for identification of drivers under the influence of central nervous acting substances are indicated in the study. Infrared pupillography represents an objective method of measuring the pupil function to indicate a possible influence by central nervous acting substances. As we were able to prove the applicability of the device used in the present study during routine police traffic controls, we suggest that infrared pupillography should become a regular method in scheduled traffic controls in the future, preferably in cooperation with forensic medical centers.

An accurate estimation of the postmortem interval (PMI) is a central aspect in forensic routine. Recently, a novel approach based on the analysis of postmortem muscle protein degradation has been proposed. However, a number of questions remain to be answered until sensible application of this method to a broad variety of forensic cases is possible. To evaluate whether altered in vivo protein metabolism interferes with postmortem degradation patterns, we conducted a comparative study. We developed a standardized animal degradation model in rats, and collected additional muscle samples from animals recovering from muscle injury and from rats with developed disuse muscle atrophy after induced spinal cord injury. All samples were analyzed by SDS-PAGE and Western blot, labeling well-characterized muscle proteins. Tropomyosin was found to be stable throughout the investigated PMI and no alterations were detected in regenerating and atrophic muscles. In contrast, significant predictable postmortem changes occurred in desmin and vinculin protein band patterns. While no significant deviations from native patterns were detected in at-death samples of disuse muscle atrophy, interestingly, samples of rats recovering from muscle injury revealed additional desmin and vinculin degradation bands that did not occur in this form in any of the examined postmortem samples regardless of PMI. It remains to be investigated whether in vivo-altered metabolism influences postmortem degradation kinetics or if such muscle samples undergo postmortem degradation in a regular fashion.

Assessing Interpersonal Motivations in Transcripts (AIMIT) is a validated coding system to assess the activation of interpersonal motivational systems (IMS) in the transcripts of psychotherapy sessions. The Transition Index (TI) is an AIMIT measure that reflects the levels of organisation, synchronisation and harmony amongst two or more IMS when they are rapidly shifting or simultaneously in the clinical dialogue. It is supposed to be a measure of integration and coherence of the patient’s state of mind within the psychotherapeutic sessions. It has also been hypothesized that low TI could be a marker for disorganization of attachment of the patient leading to difficulties in the therapeutic relationships and ruptures in the therapeutic alliance. In order to assess this hypothesis we tested its capability to discriminate between Adult Attachment Interview (AAI) organized and disorganized individuals.Two groups of 15 transcriptions of AAI matched for age and sex, one classified as free-autonomous and one as disorganized, were analysed by the AIMIT method.Compared to organized individuals, disorganized patients at AAI reported lower TI scores (3.7±0.63 vs 3.0±0.53; F=2.98, p=0.005). Furthermore, TI showed a good discriminant capability (Wilks’ Lambda=0.77, p=0.004).This result seems to confirm the usefulness and reliability of AIMIT analysis in evaluating the interpersonal difficulties which often characterize the therapeutic relationship with disorganized attachment patients.

Erratum to: Rechtsmedizin 2016 · 26:485–488 https://doi.org/10.1007/s00194-016-0121-2 After publication of the article, the authors noticed that the neural network was incorrect. A new model was set up and extensively tested. The correct model uses two cut-off values instead of only one 1 cut-off. …

The diester-diterpene alkaloid aconitine was quantified by liquid chromatography-tandem mass spectrometry in post-mortem specimens of three cases where suicidal ingestion of Aconitum napellus L. (´monkshood´) was supposed. In an attempt at rationalization, sample preparation and chromatographic conditions of plasma/serum drug analysis routine were utilized. Linearity was established from 0.5 to 20 µg L(-1) using newborn calf serum (NCS) as a surrogate calibration matrix for all sample types and mesaconitine as an internal standard. Validation (selectivity, sensitivity, precision, accuracy, recovery of the extraction procedure, matrix effect, processed sample stability) confirmed the applicability of the analytical method to various post-mortem matrices. Internal standard selection was based on multi-matrix process efficiency data. In human post-mortem peripheral blood a lower limit of quantification of 0.51 µg L(-1) and a limit of detection of 0.13 µg L(-1) were accomplished (0.1 ml sample aliquots). Aconitine was degraded to a large extent in different sample types when being stored at +20 °C for 30 days, while at -20 °C and for some matrices also at +4 °C no appreciable degradation occurred. Aconitine concentrations in real samples were 10.3-17.9 µg L(-1) (peripheral blood, n = 3), 14.9-87.9 µg L(-1) (heart blood, n = 3), 317-481 µg L(-1) (urine, n = 2), 609-4040 µg L(-1) (stomach content, n = 3), 139-240 µg L(-1) (bile, n = 2), 8.4 µg L(-1) (vitreous humor, n = 1), 54.7 µg L(-1) (pericardial fluid, n = 1), 492 µg kg(-1) (liver, n = 1), 15.2-19.7 mg L(-1) (unknown liquids secured onsite, n = 3). Together with concomitant circumstances the analytical data provided compelling evidence for acute Aconitum poisoning as being the cause of death. Copyright © 2013 John Wiley & Sons, Ltd. Language: en

Die medizinische Beurteilung der Wirkung des elektrischen Stroms auf den menschlichen Korper beschrankt sich nicht nur auf Stromunfalle in hauslicher Umgebung, sondern beinhaltet sowohl die korrekte Anwendung medizinischer Gerate in der Notfall- und psychiatrischen Medizin als auch die Auswirkungen elektrischer Applikation im polizeilichen Einsatz. In Abhangigkeit von der Stromquelle und dem Strom durch den Korper sind todliche Zwischenfalle oftmals das Resultat komplexer Pathomechanismen, die aufgrund einer Vielzahl unspezifischer morphologischer Befunde nicht immer vollstandig geklart werden konnen. Die systematische Analyse primar sichtbarer morphologischer Befunde, einhergehend mit einer Kombination von intensiver Tatortbesichtigung, histologischen Zusatzuntersuchungen und technischem Sachverstandigengutachten ist fur die Rekonstruktion von Geschehensablaufen essenziell und dient als wesentliche Voraussetzung bei der Differenzierung zwischen Unfall, Totungsdelikt und Suizid.

Distanzelektroimpulswaffen wie der TASER® fuhren durch Ubertragung hoher Spannung bei geringer Stromstarke zu einer willentlich nichtbeeinflussbaren, allgemeinen Muskelkontraktion mit konsekutiver Immobilisierung des Getroffenen. Die getroffene Person sturzt zu Boden und ist fur die Dauer der TASER-Wirkung handlungsunfahig. Die Wiederholungsraten von 15–20 elektrischen Impulsen/s rufen eine klonische Muskelkontraktion hervor, ohne dabei einen glatten Tetanus zu initiieren. Trotz etlicher wissenschaftlicher Publikationen, die die Gefahrlichkeit dieser Gerate bei fachgerechter Anwendung als niedrig einstufen, wird immer wieder von Todesfallen berichtet, die in relevanter zeitlicher Nahe zu einem Beschuss mit TASER®-Geraten stehen und deren Todesursache nicht abschliesend geklart werden konnte. Der vorliegende Beitrag setzt sich mit der Funktion und Wirkungsweise von Distanzelektroimpulswaffen auseinander und erortert anhand aktueller wissenschaftlicher Untersuchungen mogliche, potenziell todliche pathophysiologische Konsequenzen fur den menschlichen Korper wahrend und nach einer TASER-Applikation. Anhand der Darstellung eines Todesfalls nach einem TASER-Einsatz in Vancouver 2007 werden Grenzen und Moglichkeiten der forensischen Beweisfuhrung bei konkurrierenden Todesursachen diskutiert.

Die haufigste Ursache fur den plotzlichen Herztod ist die Koronararteriensklerose. Weitere Ursachen schliesen zahlreiche kardiale und extrakardiale pathologische Veranderungen ein. Primare Herztumoren konnen ebenfalls, in Abhangigkeit von ihrer Lokalisation und Auspragung, zu Lebzeiten eine Vielfalt an Symptomen bis hin zum Herztod mit sich bringen. Sowohl die klinische als auch die postmortale Diagnose primarer kardialer Tumoren konnen mitunter schwierig sein und bedurfen zahlreicher, teils spezifischer Untersuchungsmethoden. Die Mehrheit der primaren kardialen Neoplasien ist gutartig. Der Anteil der malignen Tumoren wird auf ca. 25–30% geschatzt. Einschlieslich der histologischen Subtypen betragt die Hamangiomrate bei gutartigen primaren Herzneoplasien zwischen 0,8 und 5%. Die Autoren stellen ihres Erachtens nach den ersten Fall eines arteriovenosen, intramuskular gelegenen Angioms vor, bei insgesamt weitgehend unauffalligen makroskopischen Verhaltnissen.

To evaluate an individual's ability to drive safely, objective measurement methods are required. The primary aim of this study was to assess the applicability and value of infrared pupillography as an objective measurement method to indicate possible influence of central nervous system-acting substances. We exposed healthy test subjects ( n = 41), as well as persons who were under the influence of drugs and/or medication ( n = 105), to different light stimuli and tested the pupillary light reflex using infrared technology. The synoptic examination of numerous parameters, and the possibility of examination under various conditions, made it possible to achieve highly significant differentiation between persons who were under the influence of drugs and/or medication and control persons. Infrared pupillography represents an objective method of measuring pupil function, providing a reliable indicator of previous consumption of drugs and/or medication. In order to increase legal certainty it would thus appear desirable to make infrared pupillography a routine part of police checks in the near future.

The diagnosis of sex using the skull is based mainly on morphological findings. The differential expression of these characteristics is described almost identically in the relevant literature. The descriptions date back to the 18th century and stem from observations of inhomogenous investigations, partly with very small samples. Therefore, it is necessary to re-assess the significance of each characteristic. The objective of the present study is to determine the significance that can be attributed to different morphological characteristics and metric data of the os zygomaticum used in sex diagnostics from a current point of view. A collection of 138 recent human skulls was investigated. Both examination of the morphological characteristics as well as metric analysis of the cheekbone in the test group revealed that both methods were suitable for differentiating sex, but due to their variability they cannot be regarded as sufficiently reliable.

The rising popularity of Alpine skiing in recent years has led to an increase of skiing accidents, some with fatal outcome. In this paper, all fatal skiing accidents from the autopsy material of the Institute of Forensic Medicine of the Paris Lodron University Salzburg were evaluated and compared with statistical data of the Alpine Police. In the wintertime of 2005/2006 until 2013/2014, 22 deadly skiing accidents were autopsied. The age of the male and female victims ranged between 12 and 71 years. The main cause of death was craniocerebral and chest trauma. A relevant blood alcohol concentration was detected in only one case. Together with trauma-biomechanical and technical experts, forensic medicine serves as a necessary clarification interface between the investigating authorities and the judiciary. Determining the cause and manner of death as well as reconstructing the accident is the main task of the forensic pathologist. The present study shows that in the county of Salzburg, only a small percentage of fatal skiing accidents is evaluated from a forensic and trauma-biomechanical point of view. Thus the possibilities of an interdisciplinary accident analysis are not always fully utilized.

To assess the effects of cannabis on the ability required to ride a bicycle, repetitive practical cycling tests and medical examinations were carried out before and after inhalative consumption of cannabis. A maximum of three joints with body weight-adapted THC content (300 μg THC per kg body weight) could be consumed by each test subject. Fourteen regular cannabis-consuming test subjects were studied (12 males, 2 females). In summary, only a few driving faults were observed even under the influence of very high THC concentrations. A defined THC concentration that leads to an inability to ride a bicycle cannot be presented. The test subjects showed only slight distinctive features that can be documented using a medical test routinely run for persons under suspicion of driving under the influence of alcohol or drugs.

In order to evaluate driving abilities of each traffic participant, standardised and objective measurement methods are needed. The applicability and value of infrared pupillography as an objective measurement method to indicate possible influence of central nervous acting substances has been demonstrated in former publications. Healthy test subjects (n = 41), as well as persons who were under the influence of drugs and/or medication (n = 105), were exposed to different light stimuli using infrared technology in order to demonstrate the relevance of specific parameters of the pupillary light reflex (PLR) in the field of traffic medicine. Based on former reported results, the statistical examination was extended to further parameters of the PLR, which again confirmed the high value of infrared pupillography as a reliable indicator of previous consumption of drugs and/or medication.

We report a rare case of homicide by hanging. The postmortem examination resulted in a verdict of death by suicidal hanging and the Public Prosecutor's Office released the body for burial. After intervention by the relatives police investigations were resumed. Based on evidence impossible to reconcile with the results of the postmortem examination and requiring further clarification, an autopsy was ordered. The results of the postmortem could not be brought in line with a suicidal hanging and were further substantiated by DNA analysis. The scenario put forward by the defense claiming a secondary transfer of trace evidence onto the ligature and the victim's clothes was excluded because of the distribution pattern and the trace evidence ratio. The defendant was sentenced to 20 years of prison for homicide. The verdict was confirmed by the Supreme Court and commuted to 18 years.

A case of fatal pulmonary embolism with acrylic cement occuring during a percutaneous vertebroplasty on account of a fracture of L1 is described. Autopsy confirmed the presence of large amounts of surgical cement in the paravertebral venous system and in the pulmonary arteries. This rare complication occurred because perivertebral venous cement migration was not recognized during vertebroplasty. To our knowledge, this is the first case of fatal pulmonary embolism caused by surgical cement following a percutaneous vertebroplasty.

A badly decomposed body required identification by means of DNA analysis. A brother and sister of the deceased were available as reference subjects. Although investigation of Y-chromosomal markers established an exclusion condition, autosomal markers suggested a positive identification. In order to increase the reliability of the tests, X-chromosomal markers were also investigated. This analysis showed the body to have an XXY genotype (Klinefelter's syndrome). A number of hypotheses were assessed using biostatistical methods, ultimately resulting in a definite identification. The special aspect of Klinefelter's syndrome proved highly useful for biostatistical analysis.

The development and provision of non-lethal weapons (NLW) allow military and law enforcement personnel to exploit gradual engagement in countering potentially hazardous threats. Chemical, kinetic and electrical weapons systems are used to curb violence in civilian crowds. With inappropriate usage, these technologies can cause potentially fatal injuries that are not only of clinical, but also of legal relevance. In this context, the practicing physician is faced with treatment as well as assessment issues of new forms of injuries. In order to assure medical care and to be able to draw competent expert's conclusions, a detailed knowledge of the medical effects of these NLW is necessary. The review at hand presents today's most popular NLW and gives an overview of their possible injury potential and required treatments.

The case of a female in the latter half of her teens found dead in her father's apartment is reported. A glass containing liquid and plant remnants was found at the death scene. There were no indications of any intervention or the application of force by a third party. Autopsy showed unremarkable findings. Toxicological investigations revealed lethal doses of aconitine, a highly poisonous alkaloid and the major active compound of Aconitum napellus, in all specimens. Plant remnants were identified as A. napellus leaves by a botanist and toxicological examination of the liquid in the glass on site showed extremely high concentrations of aconitine. Additionally, laboratory results revealed that the young female was suffering from thyrotoxicosis factitia, an uncommon form of hyperthyroidism caused by misuse or overdosing of thyroid hormones in order to loose weight. A rare but serious and often fatal complication of hyperthyroidism is thyroid storm. Eventually the condition of thyroid storm due to thyrotoxicosis factitia could have contributed to the woman's death from aconitine poisoning.

Transcatheter aortic valve implantation via transarterial or transapical access is an alternative therapy to treat high-risk patients with severe symptomatic aortic stenosis. Despite growing experience, procedural complications may still occur. We herein report an 86-year-old female patient with fatal left ventricular rupture after transapical transcatheter aortic valve implantation with an Edwards Sapien prosthesis due to severe cardiac amyloidosis.