Disaster victim identification operations with fragmented, burnt, or commingled remains: experience-based recommendations

Lateral angle: A landmark-based method for the sex estimation in human cremated remains and application to an Austrian prehistoric sample

OBJECTIVES

Estimating the sex of cremated human remains is difficult. The petrous bone frequently survives the cremation due to its density. Wahl observed the lateral angle to be sexually dimorphic in the 1980s. Previous studies showed various cut-off points to separate females from males, which are hardly replicable and difficult to apply. We want to test the Wahl method and compare it to a new landmark-based version.

MATERIALS AND METHODS

In this study, we measured the lateral angle of 35 cremated petrous bones from late bronze age Austria using micro-CT scans. Technical errors of measurement were calculated for two different methods to intersect the internal acoustic meatus virtually in the midline (manual or landmark-based intersection). Furthermore, sex was estimated based on morphological features and metric measurements. This information was used in logistic regression modeling to define a cut-off point in our sample.

RESULTS

The technical errors of measurement suggested that a landmark-based method was more precise in comparison to a manual intersection which was much more intuitive. Inter- and intra-observer errors were low which improved reliability. The logistic regression model produced good results in our sample (p = 0.02, R2 = 0.38, accuracy = 0.8). The mean lateral angle was similar to studies which focused on prehistoric cremated petrous bones.

DISCUSSION

The proposed landmark-based method was precise, quick, and could be easily applied, even by unexperienced researchers. The size of the lateral angle seemed to be population-specific but also dependent on the method applied. We recommend to use the proposed landmark-based method which is more precise.

Sex Differentiation of Trabecular Bone Structure Based on Textural Analysis of Pelvic Radiographs

Objectives: The purpose of this paper is to assess the determination of male and female sex from trabecular bone structures in the pelvic region. The study involved analyzing digital radiographs for 343 patients and identifying fourteen areas of interest based on their medical significance, with seven regions on each side of the body for symmetry. Methods: Textural parameters for each region were obtained using various methods, and a thorough investigation of data normalization was conducted. Feature selection approaches were then evaluated to determine a small set of the most representative features, which were input into several classification machine learning models. Results: The findings revealed a sex-dependent correlation in the bone structure observed in X-ray images, with the degree of dependency varying based on the anatomical location. Notably, the femoral neck and ischium regions exhibited distinctive characteristics between sexes. Conclusions: This insight is crucial for medical professionals seeking to estimate sex dependencies from such image data. For these four specific areas, the balanced accuracy exceeded 70%. The results demonstrated symmetry, confirming the genuine dependencies in the trabecular bone structures.

Identification method for dental alloy type using a cosine similarity program: A preliminary investigation

Although dental evidence is frequently used for the identification of unidentified persons, information about the many types of alloys used in prosthetics is not utilized. If the type of alloy can be identified from a small amount of material, the scope of the search could be narrowed. In this experiment, a method was investigated for identifying the alloy type using 3 kinds of cutting points (a white point and 2 types of silicone points). Wavelength-dispersive X-ray spectroscopy (WDS) was used for elemental analysis. The elements were translated into multidimensional vectors, and the cosine similarity was calculated to compare vectors of the WDS results and vectors of the official data of alloys. According to the results, cosine similarity showed a concordance of more than 0.8. The developed program is expected to be useful as a method for identifying alloy types using only a small amount of grinding dust.

Operational Health Pavilions in Mass Disasters: Lessons Learned from the 2023 Earthquake in Turkey and Syria

The massive earthquake that hit Turkey and Syria in February 2023 killed tens of thousands of people, and most of the deceased have not yet been identified. Many victims were pulled from the rubble hours or days later, injured and in need of assistance, treatment, and food, and many have not yet been connected with their families. Armed forces, volunteers, technicians, and health workers must cooperate in synergy in these situations to ensure effective interventions and to improve resilience. Based on the lessons learned from the response efforts to this recent natural catastrophe, this brief report proposes, for the first time, an organisational model structured around five functional pavilions that can be safely set up at the edge of a disaster area. Each pavilion should run its own activities to make a vital contribution to the overall coordinated emergency response. Looking to the future, it is extremely important to apply a technical approach that leads to maximum operational synergy at a disaster site and during the first phase of a sudden-onset emergency.

Understanding the challenges of disaster victim identification: perspectives of Australian forensic practitioners

Disaster victim identification (DVI) is an important process in the aftermath of disasters to provide answers for the families and communities of victims. Australian forensic practitioners contribute to such processes internationally under difficult post-disaster circumstances. The aim of the study was to better understand the challenges experienced by forensic practitioners in international DVI operations. Participants (N = 20) included DNA analysts, fingerprint examiners, forensic odontologists, forensic pathologists, and mortuary technicians who had experience in DVI operations. Participants were interviewed about their experiences and perceptions of the challenges of DVI. The findings provide valuable insights into the types of DVI operations in which Australian forensic practitioners have been involved internationally. Thematic analysis of interview data resulted in five main themes: the post-disaster work environment; DVI management and processes; political and financial influences; teamwork in intercultural and interdisciplinary contexts; and confronting the emotional realities of DVI work. The analysis highlights the interrelated challenges associated with DVI operations in international contexts. Practitioners also provided suggestions for improvement, which generally aligned with the themes and reflected an ethos of learning and continuous improvement in DVI. Further research on education and training and capacity-development initiatives is warranted.

Re-examining so-called 'secondary identifiers' in Disaster Victim Identification (DVI): Why and how are they used?

Disaster victim identification (DVI) refers to the identification of multiple deceased persons following an event that has a catastrophic effect on human lives and living conditions. Identification methods in DVI are typically described as either being primary, which include nuclear genetic markers (DNA), dental radiograph comparisons, and fingerprint comparisons, or secondary, which are all other identifiers and are ordinarily considered insufficient as a sole means of identification. The aim of this paper is to review the concept and definition of so-called 'secondary identifiers" and draw on personal experiences to provide practical recommendations for improved consideration and use. Initially, the concept of secondary identifiers is defined and examples of publications where such identifiers have been used in human rights violation cases and humanitarian emergencies are reviewed. While typically not investigated under a strict DVI framework, the review highlights the idea that non-primary identifiers have proven useful on their own for identifying individuals killed as a result of political, religious, and/or ethnic violence. The use of non-primary identifiers in DVI operations in the published literature is then reviewed. Because there is a plethora of different ways in which secondary identifiers are referenced it was not possible to identify useful search terms. Consequently, a broad literature search (rather than a systematic review) was undertaken. The reviews highlight the potential value of so-called secondary identifiers but more importantly show the need to scrutinise the implied inferior value of non-primary methods which is suggested by the terms "primary" and "secondary". The investigative and evaluative phases of the identification process are examined, and the concept of "uniqueness" is critiqued. The authors suggest that non-primary identifiers may play an important role in providing leads to formulating an identification hypothesis and, using the Bayesian approach of evidence interpretation, may assist in establishing the value of the evidence in guiding the identification effort. A summary of contributions non-primary identifiers may make to DVI efforts is provided. In conclusion, the authors argue that all lines of evidence should be considered because the value of an identifier will depend on the context and the victim population. A series of recommendations are provided for consideration for the use of non-primary identifiers in DVI scenarios.

Identification of victims of the collapse of a mine tailing dam in Brumadinho

The collapse of the B1 Dam of VALE SA mining company in Brumadinho, Minas Gerais, Brazil was the largest humanitarian disaster and occupational accident in the country's history, and it posed challenges regarding the management and identification of multiple victims. We evaluated the impact of the iron ore tailings on the victims' bodies. We examined the scientific identification of the victims and the dynamics of the disaster over the 1st year after it occurred. We also determined the socio-demographic profiles of the victims. In this retrospective, cross-sectional study, we investigated the expert reports of the victims' biological remains from 25 January 2019 to 25 January 2020. We analysed the socio-demographic data, identification methods, identification status, identification time, and necroscopic information. During the study period, 259 of 270 victims were identified, and 603 biological materials were analysed; among them, 86.2% were body parts and 13.8% were whole bodies. Of the total cases registered that year, 476 (78.9%) were submitted during the first 10 weeks after the disaster. Friction ridge analysis accounted for 67.9% of primary identifications and DNA analysis did so for 91.6% of re-identification cases. Body dismemberment was 3.4 times greater among mine workers than among community victims. Adult males accounted for the greatest number of victims (P < 0.001). Polytraumatic injury was the prevalent single cause of death. Necropsy examination revealed the occurrence of asphyxia in 7% of cases. The higher number of fatalities and greater dismemberment among employees than with community residents underlines the occupational dangers in the mining industry and clarifies the dynamics of the disaster. In the initial weeks after the dam collapsed, friction ridge analysis was the most appropriate method for identification. Subsequently, DNA analysis became the most-used technique for identification and re-identification owing to the great volume of body parts and decomposed biological tissue. Autopsy allowed diagnosis of the causes of death to be clarified according to the Brazilian criminal legal system.

Multidisciplinary Forensic Approach in "Complex" Bodies: Systematic Review and Procedural Proposal

The recovery of severely altered cadavers (i.e., extensively decomposed, mummified, charred or dismembered) can be a challenge for forensic pathologists due to the difficulties in identification, PMI estimation and manner and cause of death determination. In such cases, integrating routine approaches (autopsy, histology, toxicology) to more specific forensic branches can be fundamental to improving the investigative process. In this paper a systematic review using PubMed, Scopus and Web of Science databases has been performed. The aim was to evaluate the forensic approaches implemented in the management of severely altered bodies due to decomposition, mummification, skeletonization, charring or dismemberment (to which we refer to as "complex"), and the role of each approach in the solution of a case. Then, the literature revision results were used to propose a schematic flowchart summarizing the post mortem activities that can be performed in forensic practice, adaptable in relation to each case.

Palatal Rugae Patterns in Fars, Turkmen, and Sistani Ethnicities in the Eastern Part of the Caspian Littoral of Iran

In forensic medicine, it is important to identify whole or fragmented bodies. This aim can be particularly challenging in mass disasters. Palatal rugae patterns can be used as a surrogate parameter in forensic medicine. This stems from the difficulty in falsifying these patterns, their resistance to trauma, to decomposition for several days postmortem, and to combustion under high-temperatures, as well as being distinguishable among different races. The present study aimed to analyze the differences in the palatal rugae patterns among three Iranian ethnicities (Fars, Turkmen, and Sistani). This retrospective study involved the use of archived materials. The study casts were selected from the database of patients who visited a private orthodontics clinic. A total of 309 dental casts (103 Fars, 103 Turkmen, and 103 Sistani) were assessed, which belonged to 181 females and 128 males aged between 12 and 30 years (mean: 16.86 ± 3.18 years). The difference in the mean number of palatal rugae in women between the three ethnicities was statistically significant. Also, the differences in the total number of straight rugae were significant between the three ethnic groups. The most common rugae shapes in the three ethnic groups were the straight and wavy shapes. The length of the palatal rugae in the primary and secondary rugae among the study subjects younger than 18-years-old was significantly different between the three ethnic groups. Thus, the present research highlighted the differences in palatal rugae patterns among three Iranian ethnicities. Therefore, palatal rugae can be used in forensic medicine as a complementary approach to human identification.

Osteoimmunology: The effect of autoimmunity on fracture healing and skeletal analysis

Understanding factors that affect bone response to trauma is integral to forensic skeletal analysis. It is essential in forensic anthropology to identify if impaired fracture healing impacts assessment of post-traumatic time intervals and whether a correction factor is required. This paper presents a synthetic review of the intersection of the literature on the immune system, bone biology, and osteoimmunological research to present a novel model of interactions that may affect fracture healing under autoimmune conditions. Results suggest that autoimmunity likely impacts fracture healing, the pathogenesis however, is under researched, but likely multifactorial. With autoimmune diseases being relatively common, significant clinical history should be incorporated when assessing skeletal remains. Future research includes the true natural healing rate of bone; effect of autoimmunity on this rate; variation of healing with different autoimmune diseases; and if necessary, development of a correction factor on the natural healing rate to account for impairment in autoimmunity.

Recent advances in forensic biology and forensic DNA typing: INTERPOL review 2019-2022

This review paper covers the forensic-relevant literature in biological sciences from 2019 to 2022 as a part of the 20th INTERPOL International Forensic Science Managers Symposium. Topics reviewed include rapid DNA testing, using law enforcement DNA databases plus investigative genetic genealogy DNA databases along with privacy/ethical issues, forensic biology and body fluid identification, DNA extraction and typing methods, mixture interpretation involving probabilistic genotyping software (PGS), DNA transfer and activity-level evaluations, next-generation sequencing (NGS), DNA phenotyping, lineage markers (Y-chromosome, mitochondrial DNA, X-chromosome), new markers and approaches (microhaplotypes, proteomics, and microbial DNA), kinship analysis and human identification with disaster victim identification (DVI), and non-human DNA testing including wildlife forensics. Available books and review articles are summarized as well as 70 guidance documents to assist in quality control that were published in the past three years by various groups within the United States and around the world.

Distinguishing thermally altered bones from debris using imaging and fluorescence spectrometry

Bushfires and mass disasters from which result fatal fire victims are two types of events in which Forensic Anthropology acts aiding in the recovery of human remains and the identification of the victims. This is a challenging job since bones that have undergone fire-caused alterations can be unrecognizable. Therefore, collecting evidence at the scene is very important and should be thorough. To evaluate the potential of the application of optical techniques for the recovery and analysis of burnt skeletal material in forensic contexts, this exploratory study focused on analysing reflectance and luminescence properties of bone to differentiate between skeletal remains and debris. The sample includes burnt human bones, as well as non-human bones and debris (like metal, fabric, and others). The reflectance experiments revealed to be quite ineffective, not showing a response pattern that allowed for discrimination between skeletal remains and debris. Three techniques were used to detect luminescence, which included imaging (with a camera), fluorescence spectrometry, and laser-induced fluorescence spectroscopy (excitation: 440 nm). Luminescence results were more promising, registering a positive response for several samples, with a general consistency of results between the different methodologies. Nevertheless, burning conditions and individual characteristics (e.g., pathologies) can introduce limitations to the techniques.

The burning maze: The potential value of the human bony labyrinth in estimating sex of calcined remains

Estimating sex from burnt human remains is a challenging task in bioanthropology, mainly due to their high level of alteration and fragmentation. Protected within the petrous part of the temporal bone, the bony labyrinth may be particularly valuable for assessing the sex of burnt remains. This prospective study aims at testing predictive models, already found reliable on unburnt bony labyrinths, to burnt specimens. Six discriminant functions were applied on six bony labyrinths of donated adult cadavers of known sex, before and after outdoor burning experiments. Comparisons between unburnt and burnt measurements were executed using Mann-Whitney U tests while shape and size differences induced by fire exposure were examined through a geometric morphometrics (GM) analysis. Predicted sex on unburnt bony labyrinths was consistent with known sex in five cases while a systematic misclassification for males was highlighted on burnt specimens. Higher values of shrinkage were found in males for two measurements included in the equations. GM analysis revealed significant differences in centroid size among males after calcination. Visualization of mean consensus of both female and male bony labyrinths evidenced a reduction in cochlear size and variations in the width and length of semicircular canals of burnt specimens. This exploratory study seems to confirm that designing sex estimation standards specifically for burnt bony labyrinth may be advisable. Understanding how the burning process could impact its morphology is highly recommended through further experiments on larger samples and in controlled environments.

A disaster victim identification workshop focused on forensic odontology using embalmed human remains

A high number of victims of mass casualty incidences are identified through their teeth. While forensic odontologists need to have a complex skillset during a disaster victim identification (DVI) response, hands-on training opportunities are rare. In countries with very limited forensic casework, such as New Zealand, many forensic odontologists find it difficult to achieve the number of annual forensic dental identifications required to maintain their credentialling. This report details the development of a hands-on forensic odontology-focused DVI workshop using human Crosado-embalmed remains. Anonymous participant evaluations, including five-point Likert and open-ended items, were performed in both years the workshop was held. A total of 10 and 17 participants, predominantly dentists, attended the workshop in 2020 and 2021, respectively. Participant feedback was extremely positive. Likert items were statistically similar between participants in both years. Open-ended items revealed positive feedback regarding the use of cadaveric remains, the gained hands-on experience, or the teamwork aspect. Participants who attended the workshop in both years commented on the positive aspect of repetition to cement their skills. As areas of improvement, participants named (for example) time management and the number of portable X-ray devices, leading to changes that were implemented in 2021. Moreover, the participants expressed interest to further their skills on decomposed, burnt, and fragmented human remains, which for ethical reasons has yet to be implemented. The DVI workshop described here, using embalmed human remains, provides an opportunity to add dental identifications toward annual credentialling requirements for forensic odontologists. Participants rated the course to be excellent overall and highly relevant for their role. For future workshops, there is an interest to include further aspects of the DVI response such as fingerprinting or police work as well as remains, which are altered due to natural or physical reasons.

Use of deep learning in forensic sex estimation of virtual pelvic models from the Han population

Accurate sex estimation is crucial to determine the identity of human skeletal remains effectively. Here, we developed convolutional neural network (CNN) models for sex estimation on virtual hemi-pelvic regions, including the ventral pubis (VP), dorsal pubis (DP), greater sciatic notch (GSN), pelvic inlet (PI), ischium, and acetabulum from the Han population and compared these models with two experienced forensic anthropologists using morphological methods. A Computed Tomography (CT) dataset of 862 individuals was divided into the subgroups of training, validation, and testing, respectively. The CT-based virtual hemi-pelvises from the training and validation groups were used to calibrate sex estimation models; and then a testing dataset was used to evaluate the performance of the trained models and two human experts on the sex estimation of specific pelvic regions in terms of overall accuracy, sensitivity, specificity, F1 score, and receiver operating characteristic (ROC) curve. Except for the ischium and acetabulum, the CNN models trained with the VP, DP, GSN, and PI images achieved excellent results with all the prediction metrics over 0.9. All accuracies were superior to those of the two forensic anthropologists in the independent testing. Notably, the heatmap results confirmed that the trained CNN models were focused on traditional sexual anatomic traits for sex classification. This study demonstrates the potential of AI techniques based on the radiological dataset in sex estimation of virtual pelvic models. The excellent sex estimation performance obtained by the CNN models indicates that this method is valuable to proceed with in prospective forensic trials.

The use of orthopedic surgical devices for forensic identification: A systematic review

BACKGROUND AND AIM

Identification of human bodies is a necessary step in forensic practice. DNA analysis, fingerprints, and dental charting are considered conventional identification methods. However, these methods are not always applicable. Orthopedic surgical implantable devices provide valuable identity information when conventional methods of identification are not applicable or in challenging circumstances. This paper aims to review the usage of orthopedic implantable devices for forensic human identification.

METHODS

A search for relevant articles using the PubMed database in January 2021 identified 8 articles that met the inclusion criteria.  Results: These articles highlighted the importance of the use of orthopedic implantable devices as an additional method for positive identification, especially in disaster situations. It is a method that needs antemortem and postmortem radiographs, comprehensive information of the orthopedic implantable device like company and serial number, logo, name, medical records of previous surgical intervention, and for the family member's history to match with the identification details.

CONCLUSIONS

Efforts should be made to include all information pertaining to orthopedic implantable devices in the medical records. Educating and training forensic experts on the use of such devices in the identification process is essential, as this technique is practical, low-cost, and time-saving.

Accurate and semi-automated reassociation of intermixed human skeletal remains recovered from bioarchaeological and forensic contexts

Commingled remains describes the situation of intermixed skeletal elements, an extremely common occurrence in contemporary forensic cases, archaeological mass graves, as well as fossil hominin assemblages. Given that reliable identification is typically impossible for commingled contexts, a plethora of previous studies has focused on the development of refined methods for reassociating the bones of each individual skeleton. Here, a novel virtual approach for quantifying the degree of three-dimensional shape compatibility between two adjoining bone articular surfaces is put forth. Additionally, the integrability of this method with traditional osteometric techniques is evaluated. We focus on the paradigm of the hip joint, whose articulating bone elements (the femur and the innominate bone) are crucial for reconstructing the biological profile of unidentified human remains. The results demonstrate that this new semi-automated methodology is highly accurate both for large commingled assemblages (such as those resulting from mass disasters or burials) as well as smaller-scale contexts (such as those resulting from secondary burials).

Strengthening the role of forensic anthropology in personal identification: Position statement by the Board of the Forensic Anthropology Society of Europe (FASE)

In this position statement, the Board members of the Forensic Anthropology Society of Europe (FASE) argue that forensic anthropology methods can be used as means of personal identification, particularly in situations with limited availability of traditional identification methods (i.e. dactyloscopy, odontology, and molecular genetic analysis). This statement has been issued taking into account the international migration crises related to thousands of deaths worldwide, in which the utility of these traditional means of identification has been sporadic to non-existent. The statement is however not limited to deaths related to the migration crises, as similar problems may occur in fatalities en masse such as in natural disasters and armed conflicts, and on a smaller scale in cases of homeless or otherwise socioeconomically disadvantaged persons. The number of reports on personal identification based on sound anthropological methodology is increasing in the scientific literature. However, more research is needed to develop evidence-based standard operating procedures and statistical frameworks. It remains essential to raise awareness among forensic practitioners, law enforcement, and judiciary professionals on the utility of forensic anthropology in cases where it can provide sufficient information for identification.