Occultism and playing with the dead: When rituals go wrong.

There have been at least two deaths in Albania linked to ritualistic/satanic practices, which have provoked considerable public concern. Until the 1990s, Albania was strictly atheist. However, since then some religious sects have been establishing themselves. In fact, satanic killings and ritualistic deaths are rare in Albania. We describe two such cases that occurred in 2020 along with consideration of the psychological profiles of perpetrators and victims.The first case involved two deaths: a mother and daughter whose bodies were found near each other, with another daughter in attendance who was diagnosed as clearly psychotic, and legally did not face any charge thereafter. This daughter was witnessing the decomposition of her sister's mummified corpse. She said she was waiting for the "Messiah" to resurrect her. Apparently, while performing ritualistic ceremonies, the daughter and her mother refused food until the mother died from starvation. It was at that point that police broke into the house and discovered the situation.The second case involved a young woman who was found dead, apparently following a trivial infection. Her body (abdomen and dorsum) had written symbols on it, suggesting Satanism and the occult.A detailed analysis of the death scenes and crime scenes provide valuable data for further proceedings, but psychological evaluation of the perpetrators may prove more difficult, and more so where the victims have died.

Assessing bone maturity: Compositional and mechanical properties of rib cortical bone at different ages.

Understanding what maturity entails for bone, when it arrives, and its pre- and post-maturity traits and properties are very important for understanding its evolution and physiology. There is a clear but fine distinction between the chronological age of bone (the age of its donor) and the tissue age of the bone packets it comprises at the microscopic level. Whole bone fragility changes with age due to mass and architecture effects, but so do the properties of bone at the tissue level. Tissue age and tissue-level properties are therefore increasingly attracting a great deal of attention recently. The present study investigated compositional and material changes in the hydroxyapatite crystals, the collagenous phase, changes in bone matrix composition and its nanoindentation properties and their decline with chronological age in later life. The aim was to track the age threshold at which cortical bone arrives at maturity and what happens following that threshold. To do so FTIR, DSC/TGA, XRD, nanoindentation and microindentation were used to investigate rib cortical bone material across a cohort of 86 individuals from one ethnic group with age spanning between 17 and 82 years. Results of this cross-sectional study showed a clear increase in mineral content relative to the organic and water contents across all ages. Furthermore, an increase in crystal size and consequent decrease in strain (coherence length) was detected associated with secondary mineralisation and an increase in carbonate substitution. Overall, we observe a number of modifications which contribute to a typical functional behaviour of bone showing an increase in both indentation modulus and hardness until the age of about 35 after which both of these properties decline gradually and concomitantly to other physicochemical changes and seemingly until the end of one's life.

Age related changes of rib cortical bone matrix and the application to forensic age-at-death estimation.

Forensic anthropology includes, amongst other applications, the positive identification of unknown human skeletal remains. The first step in this process is an assessment of the biological profile, that is: sex, age, stature and ancestry. In forensic contexts, age estimation is one of the main challenges in the process of identification. Recently established admissibility criteria are driving researchers towards standardisation of methodological procedures. Despite these changes, experience still plays a central role in anthropological examinations. In order to avoid this issue, age estimation procedures (i) must be presented to the scientific community and published in peer reviewed journals, (ii) accurately explained in terms of procedure and (iii) present clear information about the accuracy of the estimation and possible error rates. In order to fulfil all these requirements, a number of methods based on physiological processes which result in biochemical changes in various tissue structures at the molecular level, such as modifications in DNA-methylation and telomere shortening, racemization of proteins and stable isotopes analysis, have been developed. The current work proposes a new systematic approach in age estimation based on tracing physicochemical and mechanical degeneration of the rib cortical bone matrix. This study used autopsy material from 113 rib specimens. A set of 33 parameters were measured by standard bio-mechanical (nanoindentation and microindentation), physical (TGA/DSC, XRD and FTIR) and histomorphometry (porosity-ImageJ) methods. Stepwise regressions were used to create equations that would produce the best 'estimates of age at death' vs real age of the cadavers. Five equations were produced; in the best of cases an equation counting 7 parameters had an R2 = 0.863 and mean absolute error of 4.64 years. The present method meets all the admissibility criteria previously described. Furthermore, the method is experience-independent and as such can be performed without previous expert knowledge of forensic anthropology and human anatomy.

Bone histomorphometry of the clavicle in a forensic sample from Albania.

Forensic assessment of skeletal material includes age estimation of unknown individuals. When dealing with extremely fragmented human remains that lack macro-features used in age estimation, histological assessment of the skeletal elements can be employed. Historically, microscopic methods for age assessment used by forensic anthropologists have been available since 1965. Several skeletal elements have been used for this purpose. Among them, the clavicle has garnered very little attention. The purpose of this study is to explore the validity of clavicular histomorphometry as an age marker in a modern Balkan sample. This study examined a modern clavicular autopsy sample from Albania. The sample consisted of 33 individuals of known age and cause of death. Data were collected for micro-anatomical features including osteon population density (OPD) and cortical area. Intra- and inter-observer errors were assessed through technical error of measurement (TEM) and R coefficient. A validation study was performed in order to test the accuracy of existing histological formulae. Regression analysis was run to developed age prediction models with the best models tested through cross-validation and the comparison between OPD for the Albanian sample and a European-American sample examined. Intra- and inter-observer error TEM results demonstrated values falling within the limits of acceptance. The existing histological methods did not perform accurately on the sample under study. Regression equations for Albanians produced age estimations deviating 8 and 11 years from known age. Cross-validation on the most accurate regression formula which includes OPD as a single variable demonstrated similar mean errors. Statistically significant differences were observed between the Albanian and the European-American population when the two samples were compared. The research presented is the fifth article published and the fifth population explored on clavicular microstructure. The potential of histology to estimate age on the Albanian population is shown here; however, population effect, diet and health status might be considered. Further inclusion of individuals will corroborate our preliminary findings.

Age-Related Trends in the Trabecular Micro-Architecture of the Medial Clavicle: Is It of Use in Forensic Science?

The mechanical and structural properties of bone are known to change significantly with age. Within forensic and archaeological investigations, the medial end of the clavicle is typically used for estimating the age-at-death of an unknown individual. Although, this region of the skeleton is of interest to forensic and clinical domains, alterations beyond the macro-scale have not been fully explored. For this study, non-destructive micro-computed tomography (µ-CT) was employed to characterize structural alterations to the cancellous bone of the medial clavicle. Fresh human cadaveric specimens (12-59 years) obtained at autopsy were utilized for this study, and were scanned with a voxel size of ~83 µm. Morphometric properties were quantified and indicated that the bone volume, connectivity density, mineral density, and number of trabeculae decreased with age, while the spacing between the trabeculae increased with age. In contrast to other sub-regions of the skeleton, trabecular thickness, and degree of anisotropy did not correlate with age. Collectively, this could suggest that the network is becoming increasingly perforated with age rather than exhibiting trabecular thinning. These results are used in the context of deriving a potential protocol for forensic investigations by using this particular and largely unexplored region of the skeleton, and provide inspiration for future experiments concerning micro-architectural and small scale changes in other regions of the human skeleton.

The Use of Psychoactive Substances and Illegal Drugs in the Albanian Society.

BACKGROUND: To create a representative picture of the prevalence and the total number of drug users in Albania from 2012 to 2016, and compare those numbers to previous years with other available data. METHODS: The required data for the conductance of this study was collected from three different fronts, namely The Institute of Forensic Medicine (IFM), Clinical Toxicology and Addictions Service, University Hospital "Mother Theresa" Tirana (CTS) and Methadone Maintenance Treatment Centers. The study targets all individuals who have consumed at least once abusive drugs and psychotropic substances during the period 2012-2016 in the Republic of Albania. A total of 7050 reported cases over the given period were reviewed. RESULTS: Overall, Cannabis Sativa was the highest consumed drug, present in 62.58% of the cases. Other substances with a noticeable prevalence of use were heroin (15.02%) and cocaine (5.1%). It was found out that there were 36 drug-related deaths from 2012 to 2016. During this period of time, only 9 individuals resulted positive for Sexually Transmitted Infections (STI), of which, one positive for Hepatitis C and the remaining 8 positives for HIV. About 25% of drug users in Albania belong to the young subgroup of the population (13-32 years old). CONCLUSION: Overall, taking into consideration all three databases, the number of drug users has significantly increased. There are more officially reported drug users today compared to 2012, however, different trends are observed during different periods. Youngsters are more eager and tempted to use and experiment more with safer and less harmful drugs like cannabis, meanwhile, as age increases, there is a tendency to shift towards more potent and dangerous drugs. Prevention and reducing the prevalence of use of psychoactive drugs is one of the main goals of public health.

Traits of vulnerability in repetitive sexual assaults of mentally disabled people.

The issue of sexual abuse, assault, rape and unwanted pregnancies among mentally disabled women is largely under-reported for many reasons. Several myths prevail including that mentally disabled women offer little interest to sexual predators, together with a negative public attitude and this contributes to the problem. We report the case of a single centre in Albania, where repetitive sexual assaults were perpetrated against three mentally disabled women. Three unwanted pregnancies followed. The issue gained public attention after three criminal abortions were performed secretly with the aim of covering up the story. Charges were raised against the director of the centre and an employee from the nursing staff. Proceedings are still ongoing. We discuss some details from the forensic investigation and consider several systemic weaknesses that have exposed this vulnerable target group to the risk of being severely and repetitively abused. We believe greater staff awareness, and a better medical and legal framework, are indispensable to deter further offences especially where facilities are under-resourced as here.

Rib biomechanical properties exhibit diagnostic potential for accurate ageing in forensic investigations.

Age estimation remains one of the most challenging tasks in forensic practice when establishing a biological profile of unknown skeletonised remains. Morphological methods based on developmental markers of bones can provide accurate age estimates at a young age, but become highly unreliable for ages over 35 when all developmental markers disappear. This study explores the changes in the biomechanical properties of bone tissue and matrix, which continue to change with age even after skeletal maturity, and their potential value for age estimation. As a proof of concept we investigated the relationship of 28 variables at the macroscopic and microscopic level in rib autopsy samples from 24 individuals. Stepwise regression analysis produced a number of equations one of which with seven variables showed an R2 = 0.949; a mean residual error of 2.13 yrs ±0.4 (SD) and a maximum residual error value of 2.88 yrs. For forensic purposes, by using only bench top machines in tests which can be carried out within 36 hrs, a set of just 3 variables produced an equation with an R2 = 0.902 a mean residual error of 3.38 yrs ±2.6 (SD) and a maximum observed residual error 9.26yrs. This method outstrips all existing age-at-death methods based on ribs, thus providing a novel lab based accurate tool in the forensic investigation of human remains. The present application is optimised for fresh (uncompromised by taphonomic conditions) remains, but the potential of the principle and method is vast once the trends of the biomechanical variables are established for other environmental conditions and circumstances.

An unusual lethal gunshot wound to the head.

Atypical gunshot wounds present a challenge for the forensic expert, and sometimes differentiating these from a blunt trauma can be difficult. A careful crime scene investigation can be helpful in finding additional evidence and clarifying the nature of the injuries. We describe a case of an unusual craniocerebral injury that was initially interpreted as a blow from a wooden object. The appearance of the wound lacked the classical characteristics of entrance and exit bullet wounds, but the investigation showed it was due to the ricocheting of a destabilized bullet. Potentially lethal, craniocerebral gunshot injuries are a common occurrence in developing countries even in non-conflict areas, with very bad outcomes even when treated aggressively in specialized neurosurgical facilities. The authors briefly discuss similar cases and opinions in the relevant literature, emphasizing the importance of a rational approach during the reconstruction of the crime scene.

Pattern of lethal trauma among swimmers colliding with a personal watercraft.

Personal watercrafts (otherwise known as Jet Skis or wave runners) possess powerful propelling engines that enable them to reach high velocities. In overcrowded sea shores, especially due to a diversity of human errors (inexperience, underage operator, alcohol-related errors and lack of training), these vessels might cause severe damage to the operator himself, to swimmers in the whereabouts but to the environment as well. We present three fatal victims that were struck and overrun by personal watercrafts used for recreational purposes. One of them had a deep skull trauma resulting from being hit by the hull of the vessel. The other two cases had an impressive and particular pattern of tissue trauma, with deep parallel cutting wounds due to the contact with the propeller helix. All cases were treated as accidental drowning, because even when rescue operations were immediate, the loss of conscience following the severe blunt trauma inside the water left few chances, if any, to survival.