A structural vulnerability approach to older adult suicides: Trends and potential impacts of the COVID-19 pandemic in Clark County, NV (2017-2021).

The ongoing SARS-CoV-2 (COVID-19) pandemic has affected all aspects of life in the United States and around the world. This is particularly true for marginalized and vulnerable groups who face disproportionate levels of violence and premature death within their communities. While general impacts of the pandemic have been well-studied overall, little has been done to examine the correlation between COVID-19 and the risk of suicide among older adults. Older adults are particularly at risk because they face challenges including ageism, inadequate support systems, unreliable transportation, and frequent social isolation. Medicolegal casework offers a unique vantage of these issues, as it aims to identify manner of death which may be influenced by underlying structural vulnerabilities. The current research draws upon data collected from the Clark County Office of the Coroner/Medical Examiner. A sample of 871 older adults (aged 50+), whose manner of death was deemed a suicide between the years 2017-2021, were included in this analysis. Statistical analyses investigated differences between adults aged 50-64, 65-84, and 85+ years. Results suggest statistically significant changes in mechanism of death between pre-pandemic and pandemic periods, indicating a shift in risk factors related to social isolation and the home environment. Understanding such changes in trends directly affects the interpretation of skeletal data in forensic anthropology and thus, should be taken into consideration when developing structural vulnerability profiles. Furthermore, the inclusion of a structural vulnerability approach in forensic case reports has the potential to provide additional context for deaths by suicide and may help develop policies and procedures for mitigating future risk.

Technical Note: Individuals identified by radiographic comparison: A sample of demographics and the region of body used for identification in Clark County, Nevada, USA (2017-2020).

Radiographs regularly aid in identifications by comparing antemortem and postmortem images. The forensic community has widely accepted this method because radiographic images are low in cost, easily transferable, and generally believed to be uncomplicated to assess. However, there is a dearth of diverse, modern radiographic datasets as well as a deficiency in assessing population frequencies of nonmetric traits via radiographs. Further, radiographic comparisons, although typically required as a core competency of practicing forensic anthropologists, do not have standard training and education requirements. To understand the diversity and representation within an opportunistic dataset, we provide a case study of the demographics of decedents identified via radiographic comparison at the Clark County Office of the Coroner/Medical Examiner (CCOCME) in Las Vegas, NV, USA from 2017 to 2020. Additionally, we examined each region of the body used to make radiographic identifications. The sample was majority Caucasian and male, with a mean and median age at death of 64.9 years and 67.0 years, respectively. Our results indicated that this sample was not representative of the greater Clark County population. The most common body region used for comparisons was the chest, followed by the head and neck, pelvis, dentition, and the extremities. Thus, large generalizations made from these types of datasets must be implemented with caution due to the relative lack of diversity and representation. As well, current discussions regarding training and education of forensic anthropologists as they relate to radiographic comparisons are explored.

Misgendering a transgender woman using FORDISC 3.1: A case study.

•FORDISC was unable to classify a transgender woman despite her extensive gender-affirming medical care, including Facial Feminization Surgeries.•This case study demonstrates that there is a need for forensic anthropologists to educate themselves on cases that may involve transgender people.•The use of a biocultural approach will allow forensic anthropologists to better identify marginalized individuals, including transgender women.

Dehydration-Induced alterations to sharp force trauma on Sus domesticus radii.

Dehydration is a taphonomic process that affects nearly all skeletal remains, yet there is a dearth of evidence on this process within the forensic taphonomy literature. When considering the forensic implications of skeletal dehydration, a particular area of concern is sharp force trauma due to its global prominence in forensic cases. In an attempt to address these literature gaps and quantify the effects that dehydration has on skeletal elements, a controlled experiment subjected Sus domesticus (i.e., domestic pig) radii samples (n = 36) to laboratory-induced dehydration after they were inflicted with knife trauma. All samples were photographed pre- and post-dehydration; bone section and kerf mark length, width, and area were then measured from these photographs using ImageJ. Statistical analysis of pre- and post-dehydration samples showed that all measurements experienced significant (p ≤ 0.001) shrinkage, with bone sample area shrinking an average of 8.8 % and kerf mark area an average of 29.7 %. Alterations in length, width and area between the kerf marks and bone samples showed a weak, moderate, and strong correlation, respectively. These findings suggest that anthropological analysis may be affected by dehydration-induced shrinkage, highlighting the necessity of continued research into the effects of dehydration on skeletal trauma.

Novel ophthalmic findings and deep phenotyping in Williams-Beuren syndrome.

BACKGROUND/AIMS: To characterise the ocular manifestations of Williams-Beuren syndrome (WBS) and compare these to patients with isolated elastin mediated supravalvular aortic stenosis (SVAS). METHODS: Fifty-seven patients with a diagnosis of WBS and five with SVAS underwent comprehensive ophthalmic evaluation at the National Institutes of Health from 2017 to 2020, including best-corrected visual acuity, slit-lamp biomicroscopy, optical biometry, dilated fundus examination, optical coherence tomography and colour fundus imaging. RESULTS: Mean age of the 57 WBS patients was 20.3 years (range 3-60 years). Best-corrected visual acuity ranged from 20/20 to 20/400 with mean spherical equivalent near plano OU. Twenty-four eyes (21.8%) had an axial length (AL) less than 20.5 mm and 38 eyes (34.5%) had an AL measuring 20.5-22.0 mm. Stellate iris and retinal arteriolar tortuosity were noted in 30 (52.6%) and 51 (89.5%) WBS patients, respectively. Novel retinal findings in WBS included small hypopigmented retinal deposits (OD 29/57, OS 27/57) and broad foveal pit contour (OD 44/55, OS 42/51). Of the five patients with SVAS, none had stellate iris or broad foveal pit contour while 2/5 had retinal arteriolar tortuosity. CONCLUSION: WBS is a complex multisystem genetic disorder with diverse ophthalmic findings that differ from those seen in isolated elastin mediated SVAS. These results suggest other genes within the WBS critical region, aside from ELN, may be involved in observed ocular phenotypes and perhaps broader ocular development. Furthermore, retinal arteriolar tortuosity may provide future insight into systemic vascular findings in WBS.