Body-kun/body-chan style model figures for artists in forensic visualization applications

Posture and body position are often in the focus of forensic medicine. Visualization for the purposes of documentation, teaching, scientific presentation or expert opinion in court is often desired. Plenty of possible tools to support visualization are available. However, there is a significant gap between quick drawings and more complex techniques. Body-chan (female) and body-kun (male) artist’s model figurines (genericized trademark) may provide a useful means to fill this gap. These models, about 12–15 cm in height, are multi-articulated humanoids of realistic proportions, intended to serve as models for manga (japanese comic) drawing. Plenty of different models are available in different quality which usually are equipped with interchangeable hand and feet attachments, a frame for ‘levitating’ positions as well as assorted objects to scale. These inexpensive models may be positioned quickly and intuitively. Photodocumentation from various angles can be performed using a mobile phone camera. Images may be further improved applying digital image manipulation software. Taken together, the process is quick and intuitive and the level of achievable complexity is sufficient for many forensic applications

Application of the "bubbling" procedure to dead body portraits in forensic identification

Purpose A procedure is needed for bodies with disfiguring injuries to the face and the use of their portrait for visual identification. Method We present the application of a simple image processing procedure, otherwise known as ”bubbling,” which is based on the concept of ”perceptual filling-in,” to images for visual identification in the forensic context. The method is straight forward and can be performed using readily available software and hardware.. Results The method is demonstrated and examples are shown. The visual recognition of known persons using “bubbled” images was successfully tested. Conclusion The “bubbling” procedure for visual identification enhancement is quick and straightforward and may be attempted before escalating to more involved identification methods and procedures

Relative blood loss in forensic medicine-do we need a change in doctrine?

In forensic medicine, blood loss is encountered frequently, either as a cause of death or as a contributing factor. Here, risk to life and lethality assessment is based on the concept of relative blood loss (absolute loss out of total volume). In emergency medicine, the Advanced Trauma Life Support (ATLS) classification also refers to relative blood loss. We tested the validity of relative blood loss benchmarks with reference to lethality. Depending on the quality of the total blood volume (TBV) estimation formula, relative blood loss rates should be reflected in the case cohort as significantly higher absolute blood loss in heavier individuals since all TBV estimation formulas positively correlate body weight with TBV. Method: 80 autopsy cases with sudden, quantifiable, exclusively internal blood loss were retrospectively analyzed and a total of 8 different formulas for TBV estimation were applied. Results: No statistical correlation between body weight and absolute blood loss was found for any of the tested TBV estimation algorithms. All cases showed a wide spread of both absolute and relative blood loss. Discussion: The principle of relative blood loss is of very limited use in casework. It opens the forensic expert opinion to unnecessary criticism and possible negative legal implications. Conclusion: We challenge the use of relative blood loss benchmarks in textbooks and practical casework and advocate for its elimination from the ATLS’s grading system. If necessary, we recommend the use of BMI-adjusted algorithms for TBV estimation

"Scalping" in the context of criminal dismemberment and mutilation-a case report and review of the literature

We report on a case of criminal dismemberment and attempted scalping of a homicide victim with a “Mohawk” haircut. Case fndings are presented. A review of the literature was performed for scalping in its historical and cultural context and particularly in criminal dismemberment and mutilation: Historically, scalping was prevalent in many ancient cultures around the world, where scalps were taken as trophies or “proof of kill”, much like shrunken heads, trophy skulls, and other artefacts. Scalping was particularly widespread in Northern America in the context of tribal warfare, both before and after colonization. The iconic “Mohawk” haircut is closely linked with scalping, as it was meant to taunt the enemy. In the modern forensic context, scalping constitutes a form of criminal mutilation. However, cases of criminal dismemberment and mutilation are rare in forensic casework. Our literature review revealed a low number of scalping in criminal dismemberment and mutilation cases. The documentation was overall poor. Positioning scalping within the classifcation of criminal mutilation and dismemberment was difcult. In literature, even though case numbers were small, the majority of “textbook scalping” cases were German. The presented case, to our best knowledge, is the frst modern-day photo-documented case of (attempted) scalping, even more so of a person wearing a “Mohawk”

Forensic, legal, and clinical aspects of deaths associated with implanted cardiac devices

As the population ages, the prevalence of heart failure and individuals wearing an implanted cardiac device is increasing. The combination of different underlying pathophysiologies and (the combination of) implanted cardiac devices can become a challenge with regard to the determination of cause and manner of death in such individuals. Additionally, heart disease is frequently associated with mental disease, ranging from anxiety and depression to suicidality and suicide (attempts). At the same time, the correct diagnosis of cause and manner of death is the basis for quality assurance, further therapeutic advances, legal safety, and suicide prevention. By that, an interdisciplinary field between legal medicine, clinicians, and law enforcement opens up. In this field, the different participants can simultaneously benefit from and need each other. For example, legal medicine experts need investigatory results and clinical expertise for the interpretation of readout data of implanted cardiac devices in order to correctly determine the cause of death. A correctly determined cause of death can assist law enforcement and help clinicians to further improve various therapeutic approaches based on correct mortality data collection. In addition, it is the basis for identification of suicides of device carriers, allowing psychological and psychiatric experts to better understand the burden of mental disease in this particular cohort. Against this interdisciplinary background, this manuscript summarizes information about psychiatric comorbidities and suicidality while being on a device. Thereby, basic information on complications and malfunctions of implanted cardiac devices, device-associated deaths with particular emphasis on device manipulation is displayed as basic information needed for correct determination of the cause of death. Also, legal and ethical issues in this field are outlined. The final result is a proposal of an interdisciplinary assessment workflow for a conjoint approach to improve the diagnosis of deaths associated with implanted cardiac devices. It will allow for a differentiation between an individual who died with or due to the device

Forensic, legal, and clinical aspects of deaths associated with implanted cardiac devices

As the population ages, the prevalence of heart failure and individuals wearing an implanted cardiac device is increasing. The combination of different underlying pathophysiologies and (the combination of) implanted cardiac devices can become a challenge with regard to the determination of cause and manner of death in such individuals. Additionally, heart disease is frequently associated with mental disease, ranging from anxiety and depression to suicidality and suicide (attempts). At the same time, the correct diagnosis of cause and manner of death is the basis for quality assurance, further therapeutic advances, legal safety, and suicide prevention. By that, an interdisciplinary field between legal medicine, clinicians, and law enforcement opens up. In this field, the different participants can simultaneously benefit from and need each other. For example, legal medicine experts need investigatory results and clinical expertise for the interpretation of readout data of implanted cardiac devices in order to correctly determine the cause of death. A correctly determined cause of death can assist law enforcement and help clinicians to further improve various therapeutic approaches based on correct mortality data collection. In addition, it is the basis for identification of suicides of device carriers, allowing psychological and psychiatric experts to better understand the burden of mental disease in this particular cohort. Against this interdisciplinary background, this manuscript summarizes information about psychiatric comorbidities and suicidality while being on a device. Thereby, basic information on complications and malfunctions of implanted cardiac devices, device-associated deaths with particular emphasis on device manipulation is displayed as basic information needed for correct determination of the cause of death. Also, legal and ethical issues in this field are outlined. The final result is a proposal of an interdisciplinary assessment workflow for a conjoint approach to improve the diagnosis of deaths associated with implanted cardiac devices. It will allow for a differentiation between an individual who died with or due to the device

Control of endothelial quiescence by FOXO-regulated metabolites.

Funder: - Cancer Center Support Grant 5P30CA045508Funder: - Medical Research Council (MRC_MC_UU_12022/6)Funder: - Max Planck Society - European Research Council (ERC) Consolidator Grant EMERGE (773047) - European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie action (814316) - Deutsche Forschungsgemeinschaft (SFB 834) - Cardio-Pulmonary Institute (EXC 2026, Project ID: 390649896) - DZHK (German Center for Cardiovascular Research) - Foundation Leducq Transatlantic Network - Stiftung Charité - European Molecular BiologyOrganization (EMBO) Young Investigator ProgrammeEndothelial cells (ECs) adapt their metabolism to enable the growth of new blood vessels, but little is known how ECs regulate metabolism to adopt a quiescent state. Here, we show that the metabolite S-2-hydroxyglutarate (S-2HG) plays a crucial role in the regulation of endothelial quiescence. We find that S-2HG is produced in ECs after activation of the transcription factor forkhead box O1 (FOXO1), where it limits cell cycle progression, metabolic activity and vascular expansion. FOXO1 stimulates S-2HG production by inhibiting the mitochondrial enzyme 2-oxoglutarate dehydrogenase. This inhibition relies on branched-chain amino acid catabolites such as 3-methyl-2-oxovalerate, which increase in ECs with activated FOXO1. Treatment of ECs with 3-methyl-2-oxovalerate elicits S-2HG production and suppresses proliferation, causing vascular rarefaction in mice. Our findings identify a metabolic programme that promotes the acquisition of a quiescent endothelial state and highlight the role of metabolites as signalling molecules in the endothelium

Consensus guidelines for the use and interpretation of angiogenesis assays

The formation of new blood vessels, or angiogenesis, is a complex process that plays important roles in growth and development, tissue and organ regeneration, as well as numerous pathological conditions. Angiogenesis undergoes multiple discrete steps that can be individually evaluated and quantified by a large number of bioassays. These independent assessments hold advantages but also have limitations. This article describes in vivo, ex vivo, and in vitro bioassays that are available for the evaluation of angiogenesis and highlights critical aspects that are relevant for their execution and proper interpretation. As such, this collaborative work is the first edition of consensus guidelines on angiogenesis bioassays to serve for current and future reference

Forensic significance of bruises on the upper arm

Einleitung: Oberarmeinblutungen bei Leichen wecken regelmäßig den Verdacht auf eine „Griffspur“ als mögliche Folge eines Niederhalten, Packens oder Ähnlichen im Rahmen eines Gewaltverbrechens, kommen indes auch im nicht-forensischen Kontext vor. Methodik: Es wurden 422 Fälle des allgemeinen Sektionsgutes und 115 Tötungsdelikte hinsichtlich Häufigkeiten, Morphologie und Einflussfaktoren untersucht. Ergebnisse: Oberarmeinblutungen waren im allgemeinen Sektionsgut häufig (25,8 Prozent), besonders häufig bei bekannten Pflegemaßnahmen wie Umlagerungen, Stützen, Aufrichten, Blutdruckmessung und Schmerzreizprüfung, welche zu 31,0 % im allgemeinen Sektionsgut vorkamen und mit steigendem Lebensalter zunahmen., Oberarmeinblutungen fanden sich jedoch auch bei „atraumatischen“ Subgruppen (Intoxikationen, suizidales Erhängen). Lokalisation und Morphologie ließen nur eingeschränkte Rückschlüsse hinsichtlich der Entstehung von Oberarmeinblutungen zu. Für Fälle von Pflegemaßnahmen war häufiger ein Mischbild aus offenkundig frischen und offenkundig älteren Oberarmeinblutungen sowie eine weitere Verteilung über die Oberfläche vorhanden, möglicherweise aufgrund wiederholter, über einen längeren Zeitraum durchgeführter variierenden Griffe an den Oberarm. Eine allgemein beobachtete Bevorzugung des mittleren Oberarmdrittels war für Pflegemaßnahmen akzentuiert. Klassische „lehrbuchmäßige“ Griffspuren mit Einzelblutung an der Oberarminnenseite (Daumen) und mehreren Blutungen außen waren die Ausnahme. Im untersuchten Kollektiv fanden sich nur 14 Kinder, von welchen nur eines Oberarmeinblutungen aufwies (Tötungsdelikt). Bei den Tötungsdelikten lag der Anteil von Oberarmeinblutungen mit 53,0 % deutlich höher als bei allgemeinen Sektionsfällen, auch waren sie häufiger beidseitig zu finden. Überlebte das Opfer den Angriff für mehrere Stunden, so lag der Anteil der Befunde höher, am Ehesten in Folge von Maßnahmen bei Transport, Einlieferung, Bildgebung und Schmerzreizprüfung. Ein weiterhin erhöhter Anteil von Oberarmeinblutungen zeigte sich bei Raubdelikten, wo eine Eskalation von Bedrohung zu Körperverletzung zu Tötungshandlung angenommen werden konnte. Auch zeigten sich vermehrt Oberarmeinblutungen bei Tötungen durch stumpfe Gewalt sowie bei primär gegen den Kopf gerichteter Gewalteinwirkung. Eingeschränkte histologische Untersuchungen können zur Abgrenzung einer Oberarmeinblutung gegenüber Artefakten oder dermatologischen Krankheitsbildern sinnvoll sein. Die Abgrenzung nur kurz überlebter Oberarmeinblutung gegen agonal oder auch postmortal entstandene war im verwendeten Setting nicht möglich. Schlussfolgerung: Die klinische Rechtsmedizin mit frühzeitiger Hinzuziehung ist wesentlich zur Unterscheidung tatrelevanter Griffspuren gegenüber solchen infolge von Pflegemaßnahmen. Zusatzuntersuchungen bei Kindern wären von Interesse, möglicherweise kommt Oberarmeinblutungen hier in höherem Maße ein Hinweischarakter auf Fremdverschulden zu. Das vorliegende Datenmaterial begründet nicht die Annahme, dass sich Oberarmeinblutungen in den Komplex der Abwehrverletzungen einreihen, obwohl in einzelnen Fällen ein solcher Mechanismus durchaus denkbar erscheint („Bodenkampf“).Introduction: Bruises on the upper arm in dead bodies are suspicious of being „grip marks“ as an indicator of violent crime. They are however found in non- forensic cases as well. Methods: 422 general forensic autopsy cases and 115 confirmed homicide cases were examined in regarding incidence, morphologic features and influential factors. Results: In general forensic autopsy cases findings were frequent (25,8 %), pronounced in cases of physical care cases with shifting, shoring, supporting or erecting a patient from bed, pain stimulation and blood pressure measurement which 31 % had undergone. Physical care rate increased with age. A low-trauma subgroup (lethal intoxication, suicidal hanging) showed findings as well. Site and morphologic features allowed for only limited conclusions regarding the origin of findings. Cases of physical care often showed a mix of obviously fresh as well as aged bruises, with a more extended surface distribution. This might be due to prolonged, repeated trauma by various procedures, nursing or medical. A commonly observed preference for the middle third of the upper arm was accentuated in cases of physical care. Typical “grip marks” with a single bruise on the inner aspect (thumb) and multiple bruises on the lateral aspect (fingers) remained an exception. The general autopsy group contained only 14 children, with only 1 positive case (homicide). For homicide cases bruises on the upper arms were significantly more frequent (53%) than in the general autopsy group, bruises were also found more frequently bilaterally. In initially survived assault the incidence was even higher, possibly due to medical treatment such as lifting and shifting for transportation, radiography and pain stimulation. In robbery cases bruises were also more frequent, with presumable escalation from threat to assault to killing. An elevated ratio of findings was found in lethal blunt force injury and force primarily directed against the head. Limited histological examinations can help to distinguish bruises from lividity or dermatological disorders, they failed to distinguish shortly survived bruises from post-mortem or “while dying” bruises. Conclusion: Therefore timely consultation of the forensic pathologist in survived assault is advised. The data at hand does not support bruises on the upper arm as defensive wounds, even though sometimes it should be considered (e.g. “infight”). Findings may potentially constitute an indicator for assault, however additional examinations are needed