From flesh to bones: Multi-omics approaches in forensic science.

Recent advancements in omics techniques have revolutionised the study of biological systems, enabling the generation of high-throughput biomolecular data. These innovations have found diverse applications, ranging from personalised medicine to forensic sciences. While the investigation of multiple aspects of cells, tissues or entire organisms through the integration of various omics approaches (such as genomics, epigenomics, metagenomics, transcriptomics, proteomics and metabolomics) has already been established in fields like biomedicine and cancer biology, its full potential in forensic sciences remains only partially explored. In this review, we have presented a comprehensive overview of state-of-the-art analytical platforms employed in omics research, with specific emphasis on their application in the forensic field for the identification of the cadaver and the cause of death. Moreover, we have conducted a critical analysis of the computational integration of omics approaches, and highlighted the latest advancements in employing multi-omics techniques for forensic investigations.

Testing the accuracy of the DRNNAGE software for age estimation in a modern Greek sample.

Estimation of age-at-death from human skeletal remains is fundamental in forensic anthropology as part of the construction of the biological profile of the individual under study. At the same time, skeletal age-at-death estimation in adults is problematic due to the disparity between chronological and biological age, the important inter-individual variability at the rate of skeletal aging, and inherent biases in the available methodologies (e.g., age mimicry). A recent paper proposed a method for skeletal age-at-death estimation based on multiple anatomical traits and machine learning. A software was also created, DRNNAGE, for the easy implementation of this method. The authors of that study supported that their methods have very high repeatability and reproducibility, and the mean absolute error of the age estimation was ~6 years across the entire adult age span, which is particularly high and promising. This paper tests the proposed methodology on a modern documented Greek sample of 219 adult individuals from the Athens Collection, with age-at-death from 19 to 99 years old. The sample was split into males and females as well as into individuals under and over 50 years old. We also divided the sample in 10-year intervals. First, intra- and inter-observer error was estimated in order to assess repeatability and reproducibility of the variables employed for age-at-death estimation. Then, the validity (correct classification performance) of DRNNAGE for each anatomical region individually, as well as all combined, was evaluated on each demographic separately and on the pooled sample. According to the results, some of the variables showed very low repeatability and reproducibility, thus their use should be cautious. The DRNNAGE software showed overall highly accurate age-at-death estimates for individuals older than 50 years, but poor on younger adults, with only exception the cranial sutures, which performed surprisingly well for all age groups. Overall, these results support the importance of cross-validation and the use of population-specific methods in forensic anthropology.

Consequences of heterogeneity in aging: parental age at death predicts midlife all-cause mortality and hospitalization in a Swedish national birth cohort.

BACKGROUND: The processes that underlie aging may advance at different rates in different individuals and an advanced biological age, relative to the chronological age, is associated with increased risk of disease and death. Here we set out to quantify the extent to which heterogeneous aging shapes health outcomes in midlife by following a Swedish birth-cohort and using parental age at death as a proxy for biological age in the offspring. METHODS: We followed a nationwide Swedish birth cohort (N = 89,688) between the ages of 39 and 66 years with respect to hospitalizations and death. Cox regressions were used to quantify the association, in the offspring, between parental age at death and all-cause mortality, as well as hospitalization for conditions belonging to the 10 most common ICD-10 chapters. RESULTS: Longer parental lifespan was consistently associated with reduced risks of hospitalization and all-cause mortality. Differences in risk were mostly evident from before the age of 50 and persisted throughout the follow-up. Each additional decade of parental survival decreased the risk of offspring all-cause mortality by 22% and risks of hospitalizations by 9 to 20% across the 10 diseases categories considered. The number of deaths and hospitalizations attributable to having parents not living until old age were 1500 (22%) and 11,000 (11%) respectively. CONCLUSIONS: Our findings highlight that increased parental lifespan is consistently associated with health benefits in the offspring across multiple outcomes and suggests that heterogeneous aging processes have clinical implications already in midlife.

Age at death during the Covid-19 lockdown in French metropolitan regions: a non parametric quantile regression approach.

BACKGROUND: Lockdowns have been implemented to limit the number of hospitalisations and deaths during the first wave of 2019 coronavirus disease. These measures may have affected differently death characteristics, such age and sex. France was one of the hardest hit countries in Europe with a decreasing east-west gradient in excess mortality. This study aimed at describing the evolution of age at death quantiles during the lockdown in spring 2020 (17 March-11 May 2020) in the French metropolitan regions focusing on 3 representatives of the epidemic variations in the country: Bretagne, Ile-de-France (IDF) and Bourgogne-Franche-Comté (BFC). METHODS: Data were extracted from the French public mortality database from 1 January 2011 to 31 August 2020. The age distribution of mortality observed during the lockdown period (based on each decile, plus quantiles 1, 5, 95 and 99) was compared with the expected one using Bayesian non-parametric quantile regression. RESULTS: During the lockdown, 5457, 5917 and 22 346 deaths were reported in Bretagne, BFC and IDF, respectively. An excess mortality from + 3% in Bretagne to + 102% in IDF was observed during lockdown compared to the 3 previous years. Lockdown led to an important increase in the first quantiles of age at death, irrespective of the region, while the increase was more gradual for older age groups. It corresponded to fewer young people, mainly males, dying during the lockdown, with an increase in the age at death in the first quantile of about 7 years across regions. In females, a less significant shift in the first quantiles and a greater heterogeneity between regions were shown. A greater shift was observed in eastern region and IDF, which may also represent excess mortality among the elderly. CONCLUSIONS: This study focused on the innovative outcome of the age distribution at death. It shows the first quantiles of age at death increased differentially according to sex during the lockdown period, overall shift seems to depend on prior epidemic intensity before lockdown and complements studies on excess mortality during lockdowns.

Subnational estimates of life expectancy at birth in India: evidence from NFHS and SRS data.

BACKGROUND: Mortality estimates at the subnational level are of urgent need in India for the formulation of policies and programmes at the district level. This is the first-ever study which used survey data for the estimation of life expectancy at birth ([Formula: see text]) for the 640 districts from NFHS-4 (2015-16) and 707 districts from NFHS-5 (2019-21) for the total, male and female population in India. METHODS: This study calculated annual age-specific mortality rates from NFHS-4 and NFHS-5 for India and all 36 states for the total, male and female population. This paper constructed the abridged life tables and estimated life expectancy at birth [Formula: see text] and further estimated the model parameters for all 36 states. This study linked state-specific parameters to the respective districts for the estimation of life expectancy at birth [Formula: see text]for 640 districts from NFHS-4 and 707 districts from NFHS-5 for the total, male and female population in India. RESULTS: Findings at the state level showed that there were similarities between the estimated and calculated [Formula: see text] in most of the states. The results of this article observed that the highest [Formula: see text] varies in the ranges of 70 to 90 years among the districts of the southern region. [Formula: see text] falls below 70 years among most of the central and eastern region districts. In the northern region districts [Formula: see text] lies in the range of 70 years to 75 years. The estimates of life expectancy at birth [Formula: see text] shows the noticeable variations at the state and district levels for the person, male, and female populations from the NFHS (2015-16) and NFHS (2019-21). In the absence of age-specific mortality data at the district level in India, this study used the indirect estimation method of relating state-specific model parameters with the IMR of their respective districts and estimated [Formula: see text] across the 640 districts from NFHS-4 (2015-16) and 707 districts from NFHS-5 (2019-21). The findings of this study have similarities with the state-level estimations of [Formula: see text] from both data sources of SRS and NFHS and found the highest [Formula: see text] in the southern region and the lowest [Formula: see text] in the eastern and central region districts. CONCLUSIONS: In the lack of [Formula: see text] estimates at the district level in India, this study could be beneficial in providing timely life expectancy estimates from the survey data. The findings clearly shows variations in the district level [Formula: see text]. The districts from the southern region show the highest [Formula: see text] and districts from the central and eastern region has lower [Formula: see text]. Females have higher [Formula: see text] as compared to the male population in most of the districts in India.

A modal age at death approach to forecasting adult mortality.

Recent studies have shown that there are some advantages to forecasting mortality with indicators other than age-specific death rates. The mean, median, and modal ages at death can be directly estimated from the age-at-death distribution, as can information on lifespan variation. The modal age at death has been increasing linearly since the second half of the twentieth century, providing a strong basis from which to extrapolate past trends. The aim of this paper is to develop a forecasting model that is based on the regularity of the modal age at death and that can also account for changes in lifespan variation. We forecast mortality at ages 40 and above in 10 West European countries. The model we introduce increases forecast accuracy compared with other forecasting models and provides consistent trends in life expectancy and lifespan variation at age 40 over time.

[The gender aspects of changes in mortality during COVID-19 pandemic as exemplified by Moscow].

The mortality is a major component of damage caused by COVID-19. The comparative analysis of changes in mortality was carried out on the basis of the ROSSTAT data over 2012-2020 to determine differences in losses of male and female population caused by pandemic in Moscow. It is demonstrated that at close trends in mortality of males and females before pandemic, in 2020 their mortality changed differently. At equal increase of male and female mortality, main contribution into excess mortality (excluding contribution of COVID-19) was made approximately equally by diseases of nervous system and circulatory system in males and diseases of nervous system in females. The male mortality from COVID-19 is 1.9 times higher than female mortality. As a result of younger average age of death the amount of economic losses in terms of years of potential life lost (PYLL) due to premature death of males because of COVID-19 exceeds economic losses due to premature death of females up to 2 times. Although the average age of death of females from all causes decreased by smaller amount, their values of PYLL increased more, mainly due to higher rate of female mortality from disease of nervous system and from mortality related to drug addiction. In Moscow, the highest increase of PYLL is conditioned by dearth related to drug addiction and alcohol consumption. In the structure of this indicator in males they are ranked fourth and fifth. In females, alcohol-related deaths are ranked as sixth and drug-related deaths as eighth. The pandemic, contributing into increase in economic losses, didn't change their leading causes: diseases of circulatory system, external causes and neoplasms in males; neoplasms, diseases of circulatory system and external causes in females. The value of PYLL due to death from COVID-19 takes sixth place in males and fourth place in females.

Negative correlation between organ heteroplasmy, particularly hepatic heteroplasmy, and age at death revealed by post-mortem studies of m.3243A > G cases.

Mitochondrial DNA m.3243A > G mutation causes mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) and its associated multi-organ disorders, including diabetes. To clarify associations between m.3243A > G organ heteroplasmy and clinical phenotypes, including the age at death, we combined genetic and pathological examinations from seven unreported and 36 literature cases of autopsied subjects. Clinical characteristics of subjects were as follows: male, 13; female, 28; unknown, 2; the age at death, 36.9 ± 20.2 [4-82] years; BMI, 16.0 ± 2.9 [13.0-22.3]; diabetes, N = 21 (49%), diabetes onset age 38.6 ± 14.2 years; deafness, N = 27 (63%); stroke-like episodes (StLEp), N = 25 (58%); congestive heart failure (CHF), N = 15 (35%); CHF onset age, 51.3 ± 14.5 years. Causes of death (N = 32) were as follows: cardiac, N = 13 (41%); infection, N = 8 (25%); StLEp, N = 4 (13%); gastrointestinal, N = 4 (13%); renal, N = 2 (6%); hepatic, N = 1 (2%). High and low heteroplasmies were confirmed in non-regenerative and regenerative organs, respectively. Heteroplasmy of the liver, spleen, leukocytes, and kidney for all subjects was significantly associated with the age at death. Furthermore, the age at death was related to juvenile-onset (any m.3243A > G-related symptoms appeared before 20) and stroke-like episodes. Multiple linear regression analysis with the age at death as an objective variable showed the significant contribution of liver heteroplasty and juvenile-onset to the age at death. m.3243A > G organ heteroplasmy levels, particularly hepatic heteroplasmy, are significantly associated with the age at death in deceased cases.

Inter-population differences in acetabular senescence: relevance in age-at-death estimation.

Since investigation of the timing of the skeletal traits among the acetabula of different populations is lacking, this study aims to evaluate the relevance of geographical origin in the acetabulum aging process and in the usability of the SanMillán-Rissech aging method. The acetabula of 826 European North Americans derived from the Bass Collection (USA) have been analyzed and compared with 611 Portuguese acetabula from the Luis Lopes Collection (Portugal) applying the most updated acetabular age estimation technique (2017). After evaluating and comparing the acetabular aging rates between both populations by Mann-Whitney U tests, the inaccuracy values (bias and absolute error) were analyzed and compared using population-specific reference samples and using references differing in geographical origin by Wilcoxon tests. In general terms, the North Americans age faster than the Portuguese, especially the females, reaching the consecutive acetabular stages at younger ages. Regarding the SanMillán-Rissech method accuracy, using population-specific reference samples produces, as a general rule, better outcomes. In addition, an exhaustive meta-analysis of inaccuracy values has demonstrated that this method provides better estimation values than pubic symphysis and auricular surfaces regardless of the geographic coherence of the reference sample. These inter-population skeletal differences are derived from different factors than age, highlighting the impact of both biological and social background on age estimation. A thorough analysis of the skeletal age-based timing becomes essential to understanding, deciphering and being able to minimize bias and potential inaccuracy or even counteract them when applying the age estimation methods to different populations.

The first rib as a method of adult age-at-death estimation in a modern South African sample.

An age-at-death estimation method using the first rib may be particularly advantageous as this rib is relatively easy to identify, not easily damaged postmortem, and associated with less mechanical stresses compared to other age indicators. Previously, mixed results have been achieved using the first rib to estimate age-at-death. This study aimed to develop and test an age-at-death estimation method using the first rib. An identified modern black South African sample of 260 skeletons were used to collect age-related data from the first rib. Multiple linear regression analysis equations were created from this data for male, female, and combined samples. When tested on a hold-out sample, equations generated mean inaccuracies of 7-13 years for point estimates. The 95% confidence intervals contained the true age in 11-33% of individuals depending on the equation used, but wider intervals generated using 95% prediction intervals contained true ages for 100% of individuals. Point estimate inaccuracies are comparable to other age-at-death estimation methods and may be useful if single indicator estimation is unavoidable in the case of missing or damaged bones. However, combined methods that use indicators from many areas of the skeleton are preferable and may reduce interval widths.

Cardiovascular risk factors predict age at death in 60-year follow-up of the Seven Countries Study.

OBJECTIVES: To study age at death (AD) and its determinants in cohorts of middle-aged men followed-up until extinction. MATERIAL AND METHODS: A total of 9063 middle-aged men enrolled in 10 cohorts of 6 countries (USA, Finland, the Netherlands, Italy, Greece and Japan) within the Seven Countries Study were examined and then followed up for 60 years until extinction. AD was computed and a small number of risk factors were tested through multiple linear regression as possibly related to attained AD. RESULTS: AD ranged across cohorts from 71.8 years in East Finland and 80.5 years in Crete with levels roughly lower in the USA and Northern Europe and higher elsewhere. Across cohorts, the correlation coefficients of systolic blood pressure (R = -0.58) and of CVD prevalence (R = -0.65) versus average AD were the only significant ones. At the individual level in the pool of all cohorts, a multiple linear regression model showed that age, vigorous physical activity, never and ex-smokers were favorably related to AD, while the reverse was true for systolic blood pressure, heart rate, serum cholesterol, CVD prevalence and silent ECG abnormalities. BMI had a parabolic relationship with AD. The predicting power of single risk factors, expressed in years gained or lost, was relatively small, but arbitrary combinations of several of them produced large differences in AD. CONCLUSIONS: A small number of CVD risk factors were strongly associated with AD in a life-long follow-up.

Focus on age at death in field epidemiology.

Age at death (AD) is an old metric recently re-evaluated for the study of longevity and mainly used in demography. Developed experience using AD in field epidemiology is summarized with cohorts followed-up for variable periods of time, frequently until extinction or close to extinction, a must to correctly adopt this metric. For practical purposes, a small number of examples is reported condensing previously published results to highlight various aspects of the problem. AD became the alternative of overall death rates when comparing cohorts reaching extinction or near extinction. AD was useful to characterize different causes of death in order to describe their natural history and possible etiology. With the use of multiple linear regression, a large number of possible determinants of AD were identified and some combinations of them resulted in large estimated differences in AD of 10 years or more across individuals. AD is a powerful tool to study population samples followed-up until extinction or near extinction. It allows to compare the life-long experience of different populations, to compare the role of different causes of death and to study the determinants of AD that are conditioning longevity.

Estimating age at death by Hausdorff distance analyses of the fourth lumbar vertebral bodies using 3D postmortem CT images.

The existing methods for determining adult age from human skeletons are mostly qualitative. However, a shift in quantifying age-related skeletal morphology on a quantitative scale is emerging. This study describes an intuitive variable extraction technique and quantifies skeletal morphology in continuous data to understand their aging pattern. A total of 200 postmortem CT images from the deceased aged 25-99 years (130 males, 70 females) who underwent forensic death investigations were used in the study. The 3D volume of the fourth lumbar vertebral body was segmented, smoothed, and post-processed using the open-source software ITK-SNAP and MeshLab, respectively. To measure the extent of 3D shape deformity due to aging, the Hausdorff distance (HD) analysis was performed. In our context, the maximum Hausdorff distance (maxHD) was chosen as a metric, which was subsequently studied for its correlation with age at death. A strong statistically significant positive correlation (P < 0.001) between maxHD and age at death was observed in both sexes (Spearman's rho = 0.742, male; Spearman's rho = 0.729, female). In simple linear regression analyses, the regression equations obtained yielded the standard error of estimates of 12.5 years and 13.1 years for males and females, respectively. Our study demonstrated that age-related vertebral morphology could be described using the HD method. Moreover, it encourages further studies with larger sample sizes and on other population backgrounds to validate the methodology.

Insights into the Differential Preservation of Bone Proteomes in Inhumed and Entombed Cadavers from Italian Forensic Caseworks.

Bone is a hard biological tissue and a precious reservoir of information in forensic investigations as it retains key biomolecules commonly used for identification purposes. Bone proteins have recently attracted significant interest for their potential in estimating post-mortem interval (PMI) and age at death (AAD). However, the preservation of such proteins is highly dependent on intrinsic and extrinsic factors that can hinder the potential application of molecular techniques to forensic sciences. The present study aims at investigating the effects that two commonly used types of burial practices (entombment and inhumation) have on bone protein survival. The sample consists of 14 exhumed individuals from cemeteries in Southern Italy with different AADs (29-85 years) and PMIs (1-37 years). LC-MS/MS analyses show that 16 proteins are better preserved under the entombed conditions and 4 proteins are better preserved under the inhumed conditions, whereas no clear differences are detected for post-translational protein modifications. Furthermore, several potential "stable" protein markers (i.e., proteins not affected by the burial environment) are identified for PMI and AAD estimation. Overall, these results show that the two burial environments play a role in the differential preservation of noncollagenous proteins, confirming the potential of LC-MS/MS-based proteomics in forensic sciences.

Racial-ethnic inequities in age at death among adults with/without intellectual and developmental disability in the United States.

To identify potential differences in racial-ethnic inequities in mortality between adults with/without intellectual and developmental disability, we compared patterns in age at death by race-ethnic status among adults who did/did not have intellectual and developmental disability reported on their death certificate in the United States. Data were from the 2005-2017 U.S. Multiple Cause-of-Death Mortality files. Average age at death by racial-ethnic status was compared between adults, age 18 and older, with/without different types of intellectual and developmental disability reported on their death certificate (N = 32,760,741). A multiple descent pattern was observed among adults without intellectual or developmental disability, with age at death highest among Whites, followed by Asians, Hispanics and Blacks, then American Indians. In contrast, a bifurcated pattern was observed among adults with intellectual disability, with age at death highest among Whites, but lower and similar among all racial-ethnic minority groups. The severity of racial-ethnic inequities in age at death was most pronounced among adults with cerebral palsy. Policy makers and public health experts should be aware that racial-ethnic inequities are different for adults with intellectual and developmental disability - all minorities with intellectual and developmental disability are at greater risk of premature death than their White counterparts.

Performance of three mathematical models for estimating age-at-death from multiple indicators of the adult skeleton.

The mathematical method which will achieve the most accurate and precise age-at-death estimate from the adult skeleton is often debated. Some research promotes Bayesian analysis, which is widely considered better suited to the data construct of adult age-at-death distributions. Other research indicates that methods with less mathematical complexity produce equally accurate and precise age-at-death estimates. One of the advantages of Bayesian analysis is the ability to systematically combine multiple indicators, which is reported to improve the age-at-death estimate. Few comparisons exist between Bayesian analysis and less complex mathematical models when considering multiple skeletal indicators. This study aims to evaluate the performance of a Bayesian approach compared to a phase-based averaging method and linear regression analysis using multiple skeletal indicators. The three combination methods were constructed from age-at-death data collected from 330 adult skeletons contained in the Raymond A Dart and Pretoria Bone Collections in South Africa. These methods were tested and compared using a hold-out sample of 30 skeletons. As is frequently reported in literature, a balance between accuracy and precision was difficult to obtain from the three selected methods. However, the averaging and regression analysis methods outperformed the Bayesian approach in both accuracy and precision. Nevertheless, each method may be suited to its own unique situation-averaging to inform first impressions, multiple linear regression to achieve statistically defensible accuracies and precisions and Bayesian analysis to allow for cases where category adjustments or missing indicators are necessary.

When does the spheno-occipital synchondrosis close?

In forensic work, the spheno-occipital synchondrosis helps identify the deceased as a child or young adult. In the past, it was generally held that the synchondrosis closed between the late teens and 25 years, but recent studies have suggested closure in adolescence. There are also suggestions that the age at closure recorded might be influenced by ancestry and the technique used to study the joint. This comprehensive review of the literature of the past 60 years concludes that the age of closure of the spheno-occipital synchondrosis is very variable, from childhood to the mid-twenties, with no obvious association with the geographical location of the study population. We note that some studies on bony specimens indicated later closure than others using clinical images and draw attention to a possible misinterpretation of the so-called "fusion scar" which might explain this incongruity. Despite an increasing acceptance that the synchondrosis usually closes in adolescence, we are concerned that insufficient heed is being paid to reports of closure in childhood and in the early to mid-twenties. We conclude that, for forensic purposes, it is unwise to declare that the synchondrosis closes in adolescence. It would be safer to state that a closed synchondrosis indicates a person 6 years or over and that an open synchondrosis may be seen up to the mid-twenties. Clearly, for younger individuals, the dentition and, for all individuals in this age range, documentation of unfused postcranial epiphyses would be important in attempting to narrow this very broad estimation of age.

[The lifespans of scholars referred to different disciplines according to data from diverse sources: Inferences and challenges.]

Human lifespan is known to correlate positively with education level. In the present paper, it is explored whether there are significant differences in lifespan among those whose education may be reasonably rated as the highest possible, i.e. among scholars referred to different scientific disciplines. The publications where the lifespans of scholars were estimated against the general population are reviewed, and the estimates are compared with those derived from the Database of Persons Included in Encyclopedias (DBPE), which has been being developed by the authors since 2008 based on Wikipedia records. With all caveats associated with the peculiarities of the procedures of including biographic data in Wikipedia, the estimates derived from the latest version of DBPE correspond to earlier estimates and confirm the conclusions based on other data sources: scholars' mean age at death (MAD) and life expectancy (LE) steadily increased since the Medieval period up to the modern time, were higher than those of the general population, and where the highest among the scientific elite. An unexpected finding was that MAD and LE of economists were usually the highest, whereas those of the mathematicians were lowest compared with specialists in other research fields. The difference between the two extreme cases ranges from ca. 3 to 5 years in different historical periods. Further examination of the difference between the extremes may reveal what factors behind it may be at work generally, even though they manifest themselves less overtly in other cases.

Sex and age determination of human mandible using anthropological parameters and TCI and Kvaal methods: study of a Serbian medieval sample.

PURPOSE: The aim of the study was to test the efficacy, reliability, and applicability of the Kvaal and Tooth Coronal Index (TCI) age determination techniques, and then to compare them with each other, as well as with the conventional anthropological age and sex determination techniques. METHODS: The analyzed material originates from the medieval necropolis of the Vinca-Belo brdo site. During the research, 60 periapical (PA) and 30 orthopantomographic (OPT) images were analyzed. On each analyzed tooth, age assessment was performed using both TCI and Kvaal techniques. The obtained values of dental estimated age were compared with age estimated by anthropological analysis, and the deviations between the estimated and chronological age were analyzed in relation to the assessment technique, type of dental radiograph, tooth group, sex, and age. RESULTS: The mean error between TCI and the osteological method was 8.44 (SD = 7.56, Min = 0.169, Max = 36.4) and between Kvaal and the osteological method was 7.71 (SD = 5.57, Min = 0.133, Max = 26.7). The average value of age recorded by TCI method was 32.5 years and by Kvaal method was 34.7 years. There was no statistically significant difference based on the two radiographic methods, gender, individual teeth, or tooth group pairs. There was a statistically significant positive correlation between age and the error present. CONCLUSION: Gender determination based only on the mandible has a high correlation with the anthropological gender determination. The Kvaal method and the TCI method have proven their efficiency, reliability, and applicability. Significant correlation has been observed between dental and anthropological age and sex determination methods.

[Suicides in Germany: results from the official cause of death statistics]. / Suizide in Deutschland: Ergebnisse der amtlichen Todesursachenstatistik.

The cause of death statistics is an elementary basis for determining important indicators such as death rates, years of life lost, and avoidable deaths as well as their changes over time. The results are used in epidemiological and medical research and provide important recommendations for prevention programs and for health policy in general.This article first gives an overview of the history, legal basis, and methodology of the cause of death statistics in Germany. This is followed by the presentation of the data on suicides in Germany with a focus on the year 2019. These data are mapped based on the characteristics of age, gender, region, and method of suicide. Comparisons with older data available since 1980 are made. The outlook gives an overview of the further development of the cause of death statistics, the reasons for current weaknesses in the data collection process, and possible solutions.