A comparison of the international protocols for the forensic assessment of conflict-related sexual violence victims.

International protocols for forensic investigations are often created by committee and in isolation. When field tested, the results of such tests are rarely reported to the wider forensic community. This study presents a comparative study of one such protocol, the International Protocol on the Documentation and Investigation of Sexual Violence in Conflict: Best Practice in the Documentation of Sexual Violence as a Crime or Violation of International Law. The protocol was used in a pilot study involving 20 victims of conflict-related sexual assault in the Democratic Republic of the Congo (DRC). The results of the pilot study were compared with an existing database of 341 victims of sexual assault (also from the same region of the DRC) who were examined using another protocol developed and utilized by Medicins Sans Frontier (MSF). The results clearly indicate the international protocol was far superior in all aspects, including comprehensive data capture and ease-of-use. Although the MSF protocol is intended for humanitarian purposes, all medical records are subject to potential downstream forensic applications. Given constraints in funding and resources in conflict zones, the wide-spread adoption of the full international protocol would ensure that every victim receives a complete, forensically valid examination suitable for the future pursuit of justice.

Tangential cranial ballistic impact: An illustration of the limitations of post-mortem CT scan?

Post-mortem imaging has become more frequently used in forensic procedures, notably in a ballistic context. Despite many advances in this field, the interpretation of computed tomography (CT) can be a very complex matter. Our case illustrates the difficulties of interpretation after quasi-tangential cranial ballistic impact and keyhole wounds. These wounds are difficult to visualize on CT and are among the factors complicating the precise determination of ballistics. These sources of error remind us that CT findings must be interpreted in close comparison with autopsy findings.

The fate of human remains in a maritime context and feasibility for forensic humanitarian action to assist in their recovery and identification.

The number of annual maritime fatalities reported in the Mediterranean has more than doubled in the last two years, a phenomenon closely linked to the increase of migrants attempting to reach Europe via the Mediterranean. The majority of victims reportedly never gets recovered, which in part relates to the fact that the mechanisms and interaction of factors affecting marine taphonomy are still largely not understood. These factors include intrinsic factors such as whether the individual was alive or dead at the time of submergence, the individual's stature and clothing, as well as extrinsic factors such including ambient temperature, currents, water depth, salinity and oxygen levels. This paper provides a compilation of the current literature on factors influencing marine taphonomy, recovery and identification procedures for submerged remains, and discusses the implications for the retrieval and identification of maritime mass fatalities as part of the humanitarian response, specifically humanitarian forensic action, to the consequences of the current migration phenomenon.

Death from Hypothermia during a Training Course under "Extreme Conditions": Related to Two Cases.

Death from hypothermia following exhaustion or from various complicated pathologies is no longer a frequent cause of death among combat troops. During a training course under "extreme conditions" in the French Alps, two young African officers died. Confronted with these two clinically confirmed cases of hypothermia, the unknown anatomopathological and biological specificities associated with death from hypothermia were highlighted. In these typical and clinically confirmed cases of death from subacute exhaustion hypothermia, none of the signs revealed by the autopsy were specific. Although some recent publications have addressed the utility of postmortem biochemical markers when establishing a diagnosis, with no anamnesis, with no knowledge or analysis of the circumstances of death, and without an in situ examination of the body, it appears difficult, if not impossible, to confirm that death was caused by hypothermia.

Buprenorphine-related deaths: unusual forensic situations.

The success of high-dose buprenorphine (HDB) as substitution therapy for major opioid dependence is related to its partial agonist effect on opioid receptors, which in theory makes it very safe to use. However, numerous deaths directly attributable to buprenorphine have been described in the literature. These deaths are generally related to misuse of HDB with intravenous administration and/or concomitant use of benzodiazepines, and they usually occur in patients on HDB substitution therapy for opioid dependence. We present three deaths attributed to HDB which arose from uncommon mechanisms and led to unusual forensic situations. The first death was that of a patient admitted to hospital after simultaneous prescription of HDB, clonazepam, oxazepam, and cyamemazine. The second death followed forcible administration of a very low dose of HDB to a patient with post-hepatitis C cirrhosis and heart failure. The third death was subsequent to an HDB overdose, probably with suicidal intent, in a young woman who had not been prescribed the drug as opiate substitute. Such deaths raise the question of the mechanisms involved and draw attention to the resulting unusual forensic situations.