The outcome of the forensic triage preceding disaster victim identification in the downing of Malaysia Airlines flight 17.

Malaysia Airlines flight 17 crashed on 17 July 2014 while flying over an area of armed conflict in eastern Ukraine. The first forensic trace evidence was collected after the human remains were transferred to a safe location in the Netherlands for identification and repatriation. Disaster victim identification processes were therefore undertaken in concert with the forensic investigation. Prior to these processes, X-ray and computed tomography scanners were used to reveal foreign objects in the human remains, and a large number of these fragments were recovered after the forensic triage. A distinct group of metal fragments was identified as being potential remnants of high-energy foreign objects. Forensic analysis revealed that they were explosively deformed unalloyed steel fragments, some of which had shapes consistent with pre-formed metal fragments found in a 9N314M warhead used in Buk SA-11 missiles. Furthermore, thin film deposits of cockpit glass and aluminium were identified on the most heavily deformed side of some of the explosively deformed metal fragments, suggesting they came from outside the airplane. These findings supported early suspicions that Malaysia Airlines flight 17 was struck by a Buk SA-11 missile. KeypointsA multidisciplinary approach for combined identification and forensic investigation of human remains after a mass fatality incident.The combined use of complementary X-ray techniques for detection and provisional characterization of foreign objects in human remains.The use of sensitive and highly discriminative state of the art techniques for analysing foreign objects recovered from human remains.

Renal secondary hyperparathyroidism should be considered a differential diagnosis in forensic cases where animal abuse is suspected.

This case description reports an adult dog with multiple rib fractures that was initially suspected to be the victim of non-accidental trauma, but eventually was diagnosed with severe chronic interstitial nephritis and renal secondary hyperparathyroidism leading to fibrous osteodystrophy and multiple pathological fractures. The importance of the specific expertise of a dedicated expert panel on animal abuse is discussed. This case illustrates the significance of the identification of normal, pathological, and breed-related variations within an animal in addition to forensic expertise, emphasizing that the presence of multidisciplinary teams in an expert panel on animal abuse is crucial.

Minimizing aerosol bone dust during autopsies.

When sawing bone for medical or medico-legal procedures, fine, airborne dust is produced (aerosols) that can pose a health hazard when inhaled. The aim of this study was to determine the influence of saw blade frequency and contact load, bone condition, test environment, and saw blade type, on the production of aerosol particles. A custom test setup was designed, manufactured and used in 8 bone sawing experiments, using a particle counter to determine the production of aerosol particles while varying the 5 chosen parameters. The number of counted particles was highest with higher saw blade frequencies, lower saw blade contact loads, in dry completely skeletonized bone compared to fresh bone, and using an electrical oscillating saw compared to hand-sawing. Under all conditions, the high amount of aerosol counted posed potential health risks. The ventilation system that we tested was adequate in removing the produced particles, but these high-tech systems are not always available in developing countries or emergency situations. The production of aerosols can be reduced by optimizing the sawing parameters. However, even the lowest number of aerosol particles counted during the current study was high enough to cause potential health risks to practitioners. Safety precautions should be taken, such as external ventilation, proper breathing gear, and adequate protocols, to truly minimize the risk in all bone sawing scenarios.

Aerosol production during autopsies: The risk of sawing in bone.

When sawing during autopsies on human remains, fine dust is produced, which consists of particles of sizes that may fall within the human respirable range, and can act as vectors for pathogens. The goal of this study was to explore the potential effects of saw blade frequency and saw blade contact load on the number and size of airborne bone particles produced. The methodology involved the use of an oscillating saw with variable saw blade frequencies and different saw blade contact loads on dry human femora. Released airborne particles were counted per diameter by a particle counter inside a closed and controlled environment. Results corroborated with the hypotheses: higher frequencies or lower contact loads resulted in higher numbers of aerosol particles produced. However, it was found that even in the best-case scenario tested on dry bone, the number of aerosol particles produced was still high enough to provide a potential health risk to the forensic practitioners. Protective breathing gear such as respirators and biosafety protocols are recommended to be put into practice to protect forensic practitioners from acquiring pathologies, or from other biological hazards when performing autopsies.

Circumferential urinary sphincter surface electromyography: A novel diagnostic method for intrinsic sphincter deficiency.

AIMS: The diagnosis of intrinsic sphincter deficiency (ISD) in patients with stress urinary incontinence (SUI) is not well established. We explored the possibility of applying a new tool: minimally invasive circumferential sphincter surface electromyography (CSS-EMG) to assess the muscular integrity of the urethral sphincter in patients with SUI/ISD. METHODS: CSS-EMG of the urethral sphincter and urodynamic studies were performed in 44 women with SUI. A urethral pressure profile (UPP) was measured in four directions. Maximal urethral closure pressure (MUCP) <40 cm/H2 O or the presence of SUI without urethral hypermobility was used to define ISD. RESULTS: Twenty-one patients had urodynamic SUI, 23 had no SUI and 12 patients had ISD. The mean average rectified value (ARV) of the motor unit action potential (MUAP), an indicator of the strength of urethral rhabdosphincter, was estimated. ARV measured in the 12 o'clock quadrant during maximal contraction was the only CSS-EMG parameter that had significant predictive value for ISD. With an increase in the 12 o'clock ARV value, the likelihood of ISD decreases (Odds Ratio 0.36 95% confidence interval 0.67-0.92). In the ROC curve with ARV measured in the 12 o'clock quadrant during maximal contraction, the explained area was 0.794 (P = 0.02); implying that ARV measured at the 12 o'clock quadrant during maximal contraction was able to predict ISD significantly. CONCLUSIONS: Myogenic changes of the urethral sphincter that contribute to ISD can be assessed with CSS-EMG. This new concept for assessing the functionality of the female urethral sphincter may assist with better understanding of the pathophysiology, the diagnosis and the treatment of SUI.

Microscopic residues of bone from dissolving human remains in acids.

Dissolving bodies is a current method of disposing of human remains and has been practiced throughout the years. During the last decade in the Netherlands, two cases have emerged in which human remains were treated with acid. In the first case, the remains of a cremated body were treated with hydrofluoric acid. In the second case, two complete bodies were dissolved in a mixture of hydrochloric and sulfuric acid. In both cases, a great variety of evidence was collected at the scene of crime, part of which was embedded in resin, polished, and investigated using SEM/EDX. Apart from macroscopic findings like residual bone and artificial teeth, in both cases, distinct microscopic residues of bone were found as follows: (partly) digested bone, thin-walled structures, and recrystallized calcium phosphate. Although some may believe it is possible to dissolve a body in acid completely, at least some of these microscopic residues will always be found.

Statistical analysis of kerf mark measurements in bone.

Saw marks on bone have been routinely reported in dismemberment cases. When saw blade teeth contact bone and the bone is not completely sawed into two parts, bone fragments are removed forming a channel or kerf. Therefore, kerf width can approximate the thickness of the saw blade. The purpose of this study is to evaluate 100 saw kerf widths in bone produced by ten saw types to determine if a saw can be eliminated based on the kerf width. Five measurements were taken from each of the 100 saw kerfs to establish an average thickness for each kerf mark. Ten cuts were made on 10 sections of bovine bone, five with human-powered saws and five with mechanical-powered saws. The cuts were examined with a stereoscopic microscope utilizing digital camera measuring software. Two statistical cumulative logistic regression models were used to analyze the saw kerf data collected. In order to estimate the prediction error, repeated stratified cross-validation was applied in analyzing the kerf mark data. Based on the two statistical models used, 70-90% of the saws could be eliminated based on kerf width.

Femur, rib, and tooth sample collection for DNA analysis in disaster victim identification (DVI) : a method to minimize contamination risk.

Although much literature is available on DNA extraction from tissue samples to obtain the best possible genotyping results, to the best of our knowledge no written recommendations exist on how to excise or extract bone and tooth samples from a victim to facilitate this. Because the possibility of cross-contamination is high, especially when excising numerous samples under disaster conditions, it is important to minimize this risk and to keep samples in optimum condition. In this paper a standard operating procedure is proposed for collection of femur, rib, and tooth samples to aid victim identification both after mass disasters and in (single) forensic investigations.

Urinary incontinence: sphincter functioning from a urological perspective.

Stress urinary incontinence (SUI) is a debilitating disorder caused by malfunctioning of the urethral sphincter. Anatomical and histological properties of the sphincter, its innervation and supporting structures are explained in relation to the closing mechanism of the bladder outlet. Urethral sphincter function is discussed from the passive concept of urethral pressure transmission to the 'hammock theory' and the role of the pubococcygeus muscles. SUI is caused by a combination of intrinsic sphincter deficiency and urethral hypermobility. The difficult interpretation of the parameters in urodynamic investigation to assess intrinsic sphincter deficiency (ISD) and/or urethral hypermobility is discussed. Electromyography (EMG) is valuable in the assessment of the overall urethral sphincter in relation to maneuvers (kinesiological EMG) and at the level of the muscle fiber (needle EMG). The diagnostic potential of circumferential surface EMG in the urethral sphincter is reviewed in relation to the EMG features of ISD.