Identification of victims from two mass-graves in Serbia: A critical evaluation of classical markers of identity

Humanitarian forensic medicine: a systematic review

Various concerns relating to international humanitarian law and human rights were risen by natural catastrophes (tsunamis, floods, fires), the Covid-19 pandemic, the epidemic breakouts of Ebola, as well as the significant migrant wave observed in the Mediterranean region. Forensic Medicine has direct interactions with both domestic and international law, and thus is frequently asked to provide solutions for these issues. The term "Humanitarian Forensic Action" (HFA), which refers to the application of forensic science to serve humanitarian endeavors, was created. The management of crises including armed conflicts, natural disasters, and humanitarian crises is therefore related to HFA. HFA is a specialized field of forensic sciences that is used to handle the identification of the deceased and human remains, as well as to contribute to the management of the dead, the management of mass disasters, and the investigation of abuse and torture. The psychosocial effects that these tragic events have on the victims, their loved ones, and society at large represent another HFA-related field. Firstly this systematic review aims to present all available international literature that discusses HFA as a unique forensic discipline. Secondly, through this review, it is hoped that HFA awareness will be risen among forensic practitioners, thus allowing improved adoption in general and future development as a branch of forensic sciences. As far as we are aware, there isn't another systematic study that presents the entirety of HFA's branches at once.

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.

Monitoring of simulated clandestine graves of dismembered victims using UAVs, electrical tomography, and GPR over one year to aid investigations of human rights violations in Colombia, South America

In most Latin American countries, there are significant numbers of missing people and forced disappearances, over 120,000 in Colombia alone. Successful detection of shallow buried human remains by forensic search teams is difficult in varying terrain and climates. Previous research has created controlled simulated clandestine graves of murder victims to optimize search techniques and methodologies. This paper reports on a study on controlled test site results over four simulated dismembered victims' clandestine graves as this is sadly a common scenario encountered in Latin America. Multispectral images were collected once post-burial, electrical resistivity surveys were collected 4 times, and ground penetrating radar (GPR) surveys were collected three times up to the end of the 371 day survey monitoring period. After data processing, results showed that the multispectral data set could detect the simulated clandestine and control graves, with electrical resistivity imaging relative high resistances over some of the simulated graves but not over the empty control graves. GPR results showed good imaging on the Day 8 surveys, medium imaging on the Day 294 surveys, and medium to good imaging on the Day 371 surveys. Study implications suggest that, while clandestine graves of dismembered homicide victims would likely result in smaller-sized graves when compared to graves containing intact bodies, these graves can still potentially be detected using remote sensing and geophysical methods.

Progress in forensic bone DNA analysis: Lessons learned from ancient DNA

Research on ancient and forensic DNA is related in many ways, and the two fields must deal with similar obstacles. Therefore, communication between these two communities has the potential to improve results in both research fields. Here, we present the insights gained in the ancient DNA community with regard to analyzing DNA from aged skeletal material and the potential use of the developed protocols in forensic work. We discuss the various steps, from choosing samples for DNA extraction to deciding between classical PCR amplification and massively parallel sequencing approaches. Based on the progress made in ancient DNA analyses combined with the requirements of forensic work, we suggest that there is substantial potential for incorporating ancient DNA approaches into forensic protocols, a process that has already begun to a considerable extent. However, taking full advantage of the experiences gained from ancient DNA work will require comparative studies by the forensic DNA community to tailor the methods developed for ancient samples to the specific needs of forensic studies and case work. If successful, in our view, the benefits for both communities would be considerable.

A First World War example of forensic archaeology

Between 1919 and 1921, the First World War battlefields of France and Belgium were searched by the British Army for the single graves and small cemeteries containing the bodies of British and Commonwealth soldiers. This process was called "concentration". When found, these graves were exhumed, the bodies within were examined to try and establish or confirm identification, and were subsequently reburied in newly built. Imperial War Grave Commission cemeteries. This task was carried out by military staff working for the Directorate of Graves Registration and Enquiries. They had no forensic or medical experience and yet in less than three years they moved hundreds of thousands of graves, on a scale never seen before or since. Written records were issued for the soldiers working on exhumation in 1919 giving detailed instructions on how to search for buried or unburied individuals, the method to follow for excavating these graves and directions for the examination of bodies. These instructions are very similar to those used in modern forensic archaeology when excavating single or mass graves, or when dealing with multiple bodies following mass disasters. They show an awareness of the effects of human burials on the surrounding environment and address search and excavation problems that are still experienced. The example given here in France and Belgium is one of the earliest examples of Forensic Archaeology for humanitarian purposes, and the instructions issued are probably the earliest written instructions for a Forensic Archaeological excavation.

Applicability of pulp/tooth ratio method for age estimation

The purpose of this study was to evaluate the reliability of the tooth/pulp ratio method in the process of age estimation at the moment of death in a forensic context and compare it with standard anthropological methods. After the exhumation of mass graves located in sites in Batajnica, Serbia, in 2002 and 2003, skeletal material was thoroughly analyzed by a group of anthropologists and pathologists. As a part of the investigation, orthopantomography (OPG) was performed for each individual. During 2018 these OPGs were reexamined for scientific purposes. Age-at-death was assessed by means of the pulp/tooth ratio method applied to all available lower premolars. Estimated age following standard anthropological methods and chronological age (obtained after DNA identification of victims) was taken from the records. Age estimation using the pulp/tooth ratio and standard methods was compared with chronological age. The pulp/tooth ratio method was accurate in 81.25% of all cases and the standard method was accurate in 56.25% of all cases. The pulp/tooth ratio method of age estimation was found to be applicable and accurate. However, age estimation should be based on all available methods.

Forensic anthropology in the global investigation of humanitarian and human rights abuse: Perspective from the published record

Forensic anthropologists have played key roles in the historical development of forensic science applications to global humanitarian and human rights issues. These anthropological initiatives can be traced back to the Smithsonian seminar organized by T. D. Stewart in 1968 and published in 1970. Key developments include the 1984 delegation sent by the American Association for the Advancement of Science to Argentina and the formation of the Argentine Forensic Anthropology Team. Subsequent highlights include major anthropological involvement in support of investigations by international criminal tribunals, formation of forensic anthropology teams in different countries and activities of the International Commission of Missing Persons and the forensic unit of the International Committee of the Red Cross. Recent developments feature the formation of the Humanitarian and Human Rights Resource Center of the American Academy of Forensic Sciences and its support of worthwhile projects in many countries. The published record provides historical perspective on these developments.

Nutrient canals and porosity of the bony palate: A basis for the biological plausibility of the anterior middle superior alveolar nerve block

BACKGROUND

The authors investigated morphologic parameters of the palatal cortex that affect the diffusion of local anesthetic solution in the region of the anterior middle superior alveolar (AMSA) nerve block injection site.

METHODS

The authors used computed tomographic (CT) and micro-CT imaging to assess 20 human skulls from an anatomic collection. Analysis of the CT images included frequency, distribution, and width of the nutrient canals in the bony palate, according to to the person's sex and age. Micro-CT analysis involved measuring the thickness and porosity of palatal cortical bone in the area of the AMSA injection site in relation to the thickness and porosity of the opposite buccal cortical bone.

RESULTS

There was a statistically significant difference (P = .042) in the location of the nutrient canals between male specimens (> 50% in the border region) and female specimens (> 50% in the palatal process). Furthermore, the female skulls had significantly wider nutrient canal foramina (P = .042) than did the male skulls. Despite greater thickness, the palatal cortex in the area of the AMSA injection site had slightly greater porosity than did the buccal cortex. A significantly greater number of microcanals penetrated the whole cortical thickness in palatal than in buccal cortical bone (P = .001).

CONCLUSIONS

The distribution and width of nutrient canals differed between male and female skulls. At the microscopic level, structural characteristics of the palatal cortex provide a good anatomic basis for the potential of a satisfactory AMSA injection success rate.

PRACTICAL IMPLICATIONS

The AMSA technique success rate might be increased if the clinician adjusts the injection site to the distribution of nutrient canals, depending on the sex of the patient.

An automatic method for skeletal patterns classification using craniomaxillary variables on a Colombian population

BACKGROUND

The mandibular bone is an important part of the forensic facial reconstruction and it has the possibility of getting lost in skeletonized remains; for this reason, it is necessary to facilitate the identification process simulating the mandibular position only through craniomaxillary measures, for this task, different modeling techniques have been performed, but they only contemplate a straight facial profile that belong to skeletal pattern Class I, but the 24.5% corresponding to the Colombian skeletal patterns Class II and III are not taking into account, besides, craniofacial measures do not follow a parametric trend or a normal distribution.

OBJECTIVE

The aim of this study was to employ an automatic non-parametric method as the Support Vector Machines to classify skeletal patterns through craniomaxillary variables, in order to simulate the natural mandibular position on a contemporary Colombian sample.

MATERIALS AND METHODS

Lateral cephalograms (229) of Colombian young adults of both sexes were collected. Landmark coordinates protocols were used to create craniomaxillary variables. A Support Vector Machine with a linear kernel classifier model was trained on a subset of the available data and evaluated over the remaining samples. The weights of the model were used to select the 10 best variables for classification accuracy.

RESULTS

An accuracy of 74.51% was obtained, defined by Pr-A-N, N-Pr-A, A-N-Pr, A-Te-Pr, A-Pr-Rhi, Rhi-A-Pr, Pr-A-Te, Te-Pr-A, Zm-A-Pr and PNS-A-Pr angles. The Class Precision and the Class Recall showed a correct distinction of the Class II from the Class III and vice versa.

CONCLUSIONS

Support Vector Machines created an important model of classification of skeletal patterns using craniomaxillary variables that are not commonly used in the literature and could be applicable to the 24.5% of the contemporary Colombian sample.

Disaster Management and General Dental Practitioners in India: An Overlooked Resource

OBJECTIVE

To assess General Dental Practitioners' (GDPs) in India willingness to participate in disaster management and their previous training pertaining to disaster management, and to assess GDP objective knowledge, attitude, and behavior regarding disaster management.

MATERIALS AND METHODS

This study was a cross-sectional survey conducted on all GDPs of Jodhpur, Rajasthan, India. Willingness to participate, perceived knowledge, perceived effectiveness, objective knowledge, attitude, and behavior regarding disaster management were assessed through questionnaire method. Information also was collected regarding age, gender, religion, and residence.

RESULTS

A total of 142 out of 180 GDPs participated in the study, representing a response rate of 79%. A majority (85%) of respondents were willing to participate in disaster management. Mean score for knowledge was 12.21%, for attitude was 33.56%, for behavior was 14.50%, and for perceived effectiveness was 9.08%. Significant correlations were observed between qualification and perceived effectiveness (P=.003), and between attitude and years of practice (P=.04). Willingness to participate in disaster management and age showed significant association (P=.000).

CONCLUSIONS

High willingness and attitude to participate in disaster management was observed among respondents. Low knowledge and behavior scores were observed among GDPs.

Osteometric sorting of skeletal elements from a sample of modern Colombians: a pilot study

The Colombian armed conflict has been catalogued not only as the longest civil war in the western hemisphere, but also as having one of the highest indexes of missing persons. Among the several challenges faced by forensic practitioners in Colombia, the commingling of human remains has been recognised as one of the most difficult to approach. The method of osteometric sorting described by Byrd and Adams and Byrd (2008) has proven relevant as a powerful tool to aid in the reassociation process of skeletal structures. The aim of this research was to evaluate the three osteometric sorting models developed by Byrd (2008) (paired elements, articulating bone portions and other bone portions) in a sample of modern Colombian individuals. A set of 39 linear measurements was recorded from a sample of 100 individuals (47 females and 53 males aged between 20 and 74 and 18 and 77 years, respectively), which was used to create a reference sample database. A different subset of eight individuals (five females aged between 23 and 48 years, and three males aged between 27 and 43 years) was employed to randomly create six small-scale commingled assemblages for the purposes of testing the osteometric sorting models. Results demonstrate that this method has significant potential for use in the Colombian forensic context.

Identification process of skeletal remains from mass graves: Our experience and proposal guidelines

Aim of this paper is to present our experience and proposal guidelines for reducing the number of samples for DNA analysis of skeletal remains from mass graves, whether for scientific purpose or for the identification of mass graves victims. Therefore, the analysis of 94 bone fragments included the following measurements: femur length and the femoral head diameter, the diameter of the upper, wider portion and lower wider portion of the bone fragment, densitometry of the fragments and measurement of mass and volume of fragments. Bone density was determined on the basis of measured values of mass and volume. The results of fragment matching by physical analyses were compared with the pairing results obtained by previously conducted DNA analysis. Deviation in measured values of matching bone fragments that made a pair was calculated for all successfully matched fragments. By the results of DNA analysis 36 femoral pairs were successfully formed. Measured values were added to the DNA analysis. Out of 36 pairs, positively ascertained by the DNA analysis, 29 pairs were formed after adding the results of physical measurements and removing the data where femur samples were damaged. Total correspondence in measurements of the femoral length was noted in 25.9% pairs, while the correspondence within the 5% error was 100%. Density of the tested femurs was significantly different for the same person (DNA match), both for the left and the right femoral fragment. It would be optimal to choose only the whole-length left or right femur and thus reduce the number of samples by 50%. With regard to the results of our research and the observations deriving from them, as well as to the guidelines we used in the study, we suggested these guidelines be used both for scientific researches and to identify mass graves victims.

Disaster management among dental graduates in a private dental institution in India: a pilot study

OBJECTIVE

To obtain insights into disaster management among dental graduates in a dental institute in India.

METHODS

A total of 103 of 104 house surgeons in Shri Dharmasthala Manjunatheswar College of Dental Sciences and Hospital, Dharwad, participated in the main study (response rate = 99.04%). Their knowledge, attitude, and behavior regarding disaster management were assessed by use of a survey questionnaire. Information was also collected regarding age, gender, religion, and residence.

RESULTS

Mean knowledge, attitude, and behavior scores toward disaster management were 45.46%, 79.53%, and 37.70%, respectively. A significant relationship was observed between knowledge and attitude scores (r = 0.248, P = .012). No significant differences were found in knowledge, attitude, and behavior by gender, religion, and residence. Religion was a significant predictor of knowledge scores (χ2 = 10.108, P = .006).

CONCLUSIONS

Respondents had favorable attitudes toward disaster management, but their knowledge and behavior required considerable improvement. Knowledge of the respondents was significantly associated with their attitude. This pilot study highlights the need for curriculum changes in dental education in India and further nationwide study.

Dental age assessment validity of radiographic methods on Serbian children population

In order to establish reliable age estimation method based on dental development, various correlations between chronological age and real growth were tested. Demirjian's scheme was mostly used, but lately the Willems' method has been found to be more reliable. The aim of this study was to evaluate the accuracy of Demirjian's and Willems' methods for dental age estimation in Serbian children population. The study sample encompassed panoramic radiographs of 686 children (322 boys and 364 girls) with age range from 4 to 15 years. The dental age was assed using Demirjian's and Willems' maturity scores. Statistical analysis was performed to test the accuracy of investigated methods by comparing the mean chronological and mean estimated age in total sample, as well as in each group comprising individuals within one-year-age-interval. Both methods showed discrepancy between obtained and chronological age. The Demirjian's method overestimated age with a mean accuracy of 0.45 in boys and 0.42 in girls, while Willems' method showed lower discrepancy (0.12 and 0.16 in boys and girls, respectively). Overall, both methods were unsatisfactory in some age groups, however, Willems' method provided more accurate age estimation in majority of categories. In summary, our results suggest that Willem's method was more accurate for estimating dental age in contemporary Serbian children population.

Rapid disaster victim identification in mass fatality incidents: decision-support tool to facilitate human remains identification

OBJECTIVES

A quantitative decision-support tool (DST), using a combination of selected human physical attributes as identification elements, was developed to facilitate body identification in mass fatality incidents, particularly in settings with limited availability of technological resources and forensic expertise.

METHODS

To construct the DST, the external biological attributes of interest were first selected. A process was then developed to guide collection of the selected categories of attributes and record them into objective antemortem (AM) and postmortem (PM) records. Finally, a framework for assessing the similarity between confronting PM-AM attribute records was established. The DST evaluates the similarities between each set of like attributes in the AM and PM records being compared. It then computes an overall similarity score for each evaluated AM record that was compared to a selected PM record. The AM record with the highest score represents the highest probable match, with the PM file selected for the comparison.

RESULTS

Multiple simulations across a range of mass fatality situations demonstrated the effectiveness of the DST in the experimental setting.

CONCLUSIONS

The developed DST may provide authorities with a method for expediting body identification without completely eliminating any missing person file from consideration. Under specific circumstances, this method may reduce the need for technologically sophisticated forensic identification techniques (eg, dental records, fingerprints, and DNA). At a minimum, it should facilitate the efficiency of the current technological matching process.

Willingness to participate in disaster management among Indian dental graduates

INTRODUCTION

India has been the focal point of various disasters, and has suffered considerable losses due to the same. Manpower shortage can impede disaster management; hence, including dental professionals in disaster management in India can be crucial.

HYPOTHESIS/PROBLEM

To assess willingness to participate in disaster management among Indian dental graduates; to assess the objective knowledge, attitude, behavior and perceived knowledge regarding disaster management among Indian dental graduates.

METHODS

All the interns in Manipal College of Dental Sciences, Mangalore, Karnataka were included in the present study. Their willingness to participate in disaster management and their objective knowledge, attitude, behavior and perceived knowledge related to disaster management were assessed using a questionnaire.

RESULTS

A total of 86 study subjects participated. A majority (98.8%) of respondents were willing to participate in disaster management. Mean objective knowledge, attitude, behavior and perceived knowledge scores were 48.65%, 80.26%, 29.85% and 60.80% respectively. Males reported higher perceived knowledge than females (P = .008), and respondents residing in hostels reported higher perceived knowledge than those not residing in hostels (P = .02). Gender showed significant correlations with attitude (r = 4.076, P = .044) and behavior (r = 3.722, P = .054), and residence with behavior of respondents (r = 5.690, P = .017).

CONCLUSIONS

A high degree of willingness to provide assistance during disasters was observed among undergraduate dental students. High attitude coupled with low knowledge and behavior scores regarding disaster management was also observed. Gender was associated with attitude and behavior, and residence with behavior of respondents regarding disaster management. Including disaster management in dental curricula and involvement of dental professionals in disaster management might be crucial for disaster management in India.

Discovering the 60 years old secret: identification of the World War II mass grave victims from the island of Daksa near Dubrovnik, Croatia

Aim

To describe the organization, field work, forensic anthropological examination, and DNA analysis conducted to identify the victims from a World War II mass grave found on the Dalmatian island of Daksa near Dubrovnik (Croatia) in 2009.

Methods

Excavation of the site was performed according to standard archeological procedures. Basic anthropological examination was made to determine the minimum number of victims, sex, age at death, and height. The bones with pathological and traumatic changes were identified. DNA was extracted from powdered bones and relatives’ blood samples. Y-chromosome and autosomal short tandem repeats (STR) were used to establish the relationship of the remains with the putative family members.

Results

The remains were found to belong to at least 53 distinctive victims. All were male, mostly with gunshot wounds to the head. DNA analysis and cross-matching of the samples with relatives resulted in 14 positive identifications using the Y-chromosomal STRs and 4 positive identifications using the autosomal STRs.

Conclusions

This study showed that even in cases of more than 50-year-old, highly degraded human remains from mass graves, Y-chromosomal and autosomal STRs analysis can contribute to identification of the victims.

In the absence of dental records, do we need forensic odontologists at mass grave sites?

With the exception of exhumations of mass graves in Latin America, forensic dentists and odontologists are rarely involved in the examination of mortal remains recovered from mass graves. The cited reason is often that "there are no dental records-so what is the point"? In this presentation we review the published accounts of examination of remains arising from the conflict in the former Yugoslavia between 1991 and 1999 in which dental examinations are reported. There are roughly 30,000 missing persons of which more than 15,000 mortal remains have been identified, mostly based on DNA. There are 9 sources which describe postmortem dental examinations of 3919 sets of remains; of these, 23% were purported to have been identified specifically from dental information. Of the 8100 listed missing persons from the Srebrenica mass killings in 1995, we located 600 dental records. A sample of 263 charts was examined for information about first molar treatment as we are concerned that dental charting of individuals who lose their first molars may be incorrectly done if allowance is not made for mesial drift of the remaining molars. We found that of all the first molar extractions that are ever going to occur according to these dental charts, 63% have taken place by age 18. The majority of extracted first molars have a functional age of 17 years. We observe that an adult's remains from Srebrenica usually have only second and third molars, which have often drifted forward to occupy the position of the first molar creating the appearance of third molar agenesis. We conclude: that, since dental identifications of victims in mass graves and mass disasters is the exception rather than the rule, even in the absence of DNA-based identifications, international forensic odontologists have an ethical obligation to become more involved in examination of mass grave victims, that there must be more determined searches for antemortem dental records; that local dentists should be approached to participate in the examination of remains and lastly that dental examination and charting by anthropologists and pathologists may be grossly inaccurate. Furthermore, even in the absence of dental records, there is significant information about the individual to be obtained by an oral biologist since many families have useful memories about the oral status of their loved ones who went missing.