Homicide and concealment of the corpse. Autopsy case series and review of the literature.

INTRODUCTION: The concealment of the body following a homicide undermines different moments of the forensic and medico-legal investigations. The aim of the present study is to provide an overview of the literature and the forensic casuistry of the Institute of Legal Medicine of Padova for analyzing and discussing diverse methodological approaches for the forensic pathologist dealing with covered-up homicides. MATERIAL AND METHODS: A literature review, updated until September 2019, was performed, and a literature pool of forensic cases was built. In-house cases were included by conducting a retrospective analysis of the forensic caseworks of Padova of the last 20 years. Data regarding epidemiology, methodology of assessment, methods of concealment, and answers to medico-legal issues were extracted for both data sets. RESULTS AND DISCUSSION: Seventy-eight papers were included in the literature review (78.2% being case reports or case series, 17% retrospective studies, and 6% experimental studies or reviews). Literature and in-house data sets consisted of 145 and 13 cases, respectively. Death scene investigation, radiology, toxicology, and additional analyses were performed in 20-54% of literature and 62-77% of in-house cases. Cover-up by multiple methods prevailed. Death was caused by head trauma in about 40% of cases (both data sets), strangulation in 21% of literature, and 7% of in-house cases, and was undetermined in 17% of literature and 7% of in-house cases. CONCLUSIONS: The methodology of ascertainment should be case-specific and based on a multidisciplinary and multimodal evaluation of all data, including those gained through novel radiological and/or analytical techniques.

Sex selection in late Iberian infant burials: Integrating evidence from morphological and genetic data.

OBJECTIVE: The aim of this study was to analyze the infant burials found inside Iberian homes in relation to a possible case of sex selection. METHODS: The study included the remains of 11 infant individuals buried under the 10 houses excavated in the late Iberian village of Camp de les Lloses (Tona, Barcelona, Spain). Sex was determined using genetic analysis. RESULTS: Our results showed that almost all the burials were females. However, the age interval of death was wide enough to weaken the premise of infanticide, and the burials probably represent cases of natural death. DISCUSSION: Infanticide in its different forms has long been argued as an explanation for the infant remains found throughout various burial sites. Many authors thought that infanticide, mainly femicide, was the main method of population control in ancient times. However, there is no anthropological evidence (age distribution and sex analyzed genetically) to support the intentional killing of females in this or in other cases. We hypothesized that there was a positive selection for females to be buried inside the houses, probably related to their benefactor roles.

Bodily circulation and the measure of a life: Forensic identification and valuation after the Titanic disaster.

This article analyzes the process of body recovery that took place after the sinking of the Titanic in 1912. Focusing on how identification was intertwined with valuation, I show how notions of economic class informed decisions about which human bodies were fit for preservation as human bodies. The RMS Titanic steamship was a microcosm of social circulation in the early 20th-century Atlantic, and life on board was systematically stratified according to economic class. During the recovery that following the sinking, 114 bodies, or one-third of the total recovered, were buried at sea, most of them crewmembers or immigrant passengers who had held third-class tickets. Sea burial exposed the bodies to rapid and inaccessible decomposition, thereby selectively excluding those bodies from the archival and forensic record even as those victims' names and personal artefacts were recorded for posterity. The recovery process thus demonstrates that the material existence of those passengers' remains was not a given, but instead emerged in varied ways through identification and recovery practices. Such practices drew on notions of economic value and identifiability to shape bodily materials, which were selectively preserved, transformed, and/or put out of reach. As such, I argue that identification and valuation are thoroughly enmeshed with what I call instantiation, or determinations of how and whether something exists.

Body Disposal: Spatial and Temporal Characteristics in Korean Homicide.

This study explores the body disposal patterns in a sample of 54 Korean homicides that occurred between 2006 and 2012. Based on information collected by the police during their investigation, factors that could influence body disposal patterns were examined, such as homicide classification, intention, whether an accomplice was present, and offender mental disorder. Bivariate analyses showed that the majority of the victims who were disposed of were acquaintances of the offenders. Moreover, several offenders were more likely to dispose of the dead body "within hours" of killing the victim. Dead bodies were usually recovered in agricultural areas, forest/wooded areas, as well as residential areas. It was also noteworthy that, in 47 cases, the offender had knowledge of the geographic area where the body was dumped. In cases of "expressive" homicide, victims were more likely to be disposed of somewhere far away (e.g., over 40 km) from the crime scene, whereas "instrumental" homicide victims appeared to be disposed of somewhere closer (e.g., within 30 km) to the crime scene. Results are discussed in light of their practical implications for homicide investigations.

Demographic differences between funerary caves and megalithic graves of northern Spanish Late Neolithic/Early Chalcolithic.

OBJECTIVES: The study focuses on the estimation of demographic parameters of Late Neolithic/Early Chalcolithic (mid 4th-early 3rd millenniums cal. BC) burial sites from the La Rioja region (Ebro valley, northern Spain) to identify demographic characteristics. MATERIALS AND METHODS: The human remains come from three caves (Las Yurdinas II, Peña Larga, and La Peña de Marañón) and three megalithic graves (Alto de la Huesera, San Martín, and Peña Guerra II). The total skeletal sample consists of a minimum of 261 individuals, 149 being buried in caves and 112 in megalithic graves. Data based on age and sex estimation are analyzed using abridged life tables, mortality rates, and sex ratios. RESULTS: A systematic bias against children under 5 years of age is detected both in caves (5 q0 = 187.92%) and megalithic graves (5 q0 = 71.43%) but also against some juveniles and adults compared with population models, though a statistically significant greater lack of infants is worth noting in the megaliths (t-test, P = 0.012). Moreover, a significant divergence in sex ratios (χ(2) , P = 0.002) is also identified between site types, clearly prioritizing women in caves (sex ratio = 0.45) and men in megalithic graves (sex ratio = 1.33). CONCLUSIONS: This evidence is interpreted as the result of different selective burial patterns. The mortuary variability could lie behind intragroup differential status relationships, though the hypothesis of two populations performing distinct funerary practices in a small region cannot be rejected at the present state of the research. Am J Phys Anthropol 160:284-297, 2016. © 2016 Wiley Periodicals, Inc.

Characterizing Ebola Transmission Patterns Based on Internet News Reports.

BACKGROUND: Detailed information on patient exposure, contact patterns, and discharge status is rarely available in real time from traditional surveillance systems in the context of an emerging infectious disease outbreak. Here, we validate the systematic collection of Internet news reports to characterize epidemiological patterns of Ebola virus disease (EVD) infections during the West African 2014-2015 outbreak. METHODS: Based on 58 news reports, we analyzed 79 EVD clusters (286 cases) ranging in size from 1 to 33 cases between January 2014 and February 2015 in Guinea, Sierra Leone, and Liberia. RESULTS: The majority of reported exposures stemmed from contact with family members (57.3%) followed by hospitals (18.2%) and funerals (12.7%). Our data indicate that funeral exposure was significantly more frequent in Sierra Leone (27.3%) followed by Guinea (18.2%) and Liberia (1.8%; χ(2) test; P < .0001). Funeral exposure was the dominant route of transmission until April 2014 (60%) and was replaced with hospital exposure in June 2014-July 2014 (70%), both of which declined after interventions were put in place. The mean reproduction number of the outbreak was 2.3 (95% confidence interval [CI], 1.8, 2.7). The case fatality rate was estimated at 74.4% (95% CI, 68.3, 79.8). CONCLUSIONS: Overall, our findings based on news reports are in close agreement with those derived from traditional epidemiological surveillance data and with those reported for prior outbreaks. Our findings support the use of real-time information from trustworthy news reports to provide timely estimates of key epidemiological parameters that may be hard to ascertain otherwise.

Yet another inquiry into the trustworthiness of eighteenth-century Bills of Mortality: the Newcastle and Gateshead Bills, 1736-1840.

This note is a preliminary analysis of the Newcastle and Gateshead Bills of Mortality, a hitherto unused source for understanding some of the most significant aspects of vital registration and burial practices in the North East's capital, c. 1736-1840. The Bills are annual totals of the number of burials and baptisms which took place in all of the ancient Anglican parishes in Newcastle and Gateshead. One of the most lucid aspects of the Bills is that they recorded the number of burials which took place in the 'infamous' un-consecrated burial ground of Ballast Hills located on the outskirts of the east-end of the town. Attention here is given to the initial accuracy of the Bills by focusing upon All Saints parish in Newcastle which accounted for approximately 50 per cent of the town's total population over the entire period. Here the data revealed in the Bills are compared directly with the burials which were registered by the parish clerk in All Saints. The major finding of this preliminary study is the huge discrepancy between the number of reported burials and the number of baptisms which took place in All Saints over time. The Bills also provide a fully documented account of the impact of Ballast Hills and the apparent "export in corpses" which was clearly taking place on a large scale. By the 1770s-1790s, this one burial ground alone, was consuming roughly 60-70 per cent of the town's dead population. The reasons behind this phenomenon are discussed by looking specifically at the possible impact of religious dissent, burial costs and burial space in the town. The note concludes that while this preliminary analysis is revealing, more work needs to be done which would involve a fuller analysis of all of the parishes recorded in the Bills as well as looking more closely at the registration of baptisms, stillbirths and the heavy "traffic in corpses" which was clearly a major defect of vital registration in Georgian Newcastle.

Are we all equal at death?: death competence in municipal cemetery management.

Managers of local government cemeteries should balance social and cultural expectations with fiscal responsibility and when they do so they demonstrate death competence in cemetery management. This study reviews the cultural and social equity aspects of the consumption of cemetery services and develops tools to take into account social equity and cultural concerns for public sector cemetery managers. Cemetery demand and pricing models are developed and applied to the case of Austin, Texas. These models enhance the estimation of demand by taking into account cultural factors and contextualize pricing in terms of social equity concerns.

Exploring the relationship between dental wear and status in late medieval subadults from England.

Dental wear patterns were recorded on 458 deciduous molar teeth, of 142 subadults from late medieval (AD 1086-1539) England, to explore the relationship between dental wear and burial status of children. A new ordinal method for scoring dental wear stages on the deciduous molar teeth was devised. It was postulated that if a discernible relationship between dental wear stage and burial location could be seen then this could reflect a difference in diet between those receiving higher or lower status burial. The dental wear stages recorded were statistically similar for the dentitions of subadults from different cemeteries, as well as from different burial locations, indicating a comparable diet for the children studied.

Validity of verbal autopsy method to determine causes of death among adults in the urban setting of Ethiopia.

BACKGROUND: Verbal autopsy has been widely used to estimate causes of death in settings with inadequate vital registries, but little is known about its validity. This analysis was part of Addis Ababa Mortality Surveillance Program to examine the validity of verbal autopsy for determining causes of death compared with hospital medical records among adults in the urban setting of Ethiopia. METHODS: This validation study consisted of comparison of verbal autopsy final diagnosis with hospital diagnosis taken as a "gold standard". In public and private hospitals of Addis Ababa, 20,152 adult deaths (15 years and above) were recorded between 2007 and 2010. With the same period, a verbal autopsy was conducted for 4,776 adult deaths of which, 1,356 were deceased in any of Addis Ababa hospitals. Then, verbal autopsy and hospital data sets were merged using the variables; full name of the deceased, sex, address, age, place and date of death. We calculated sensitivity, specificity and positive predictive values with 95% confidence interval. RESULTS: After merging, a total of 335 adult deaths were captured. For communicable diseases, the values of sensitivity, specificity and positive predictive values of verbal autopsy diagnosis were 79%, 78% and 68% respectively. For non-communicable diseases, sensitivity of the verbal autopsy diagnoses was 69%, specificity 78% and positive predictive value 79%. Regarding injury, sensitivity of the verbal autopsy diagnoses was 70%, specificity 98% and positive predictive value 83%. Higher sensitivity was achieved for HIV/AIDS and tuberculosis, but lower specificity with relatively more false positives. CONCLUSION: These findings may indicate the potential of verbal autopsy to provide cost-effective information to guide policy on communicable and non communicable diseases double burden among adults in Ethiopia. Thus, a well structured verbal autopsy method, followed by qualified physician reviews could be capable of providing reasonable cause specific mortality estimates in Ethiopia. However, the limited generalizability of this study due to the fact that matched verbal autopsy deaths were all in-hospital deaths in an urban center, thus results may not be generalizable to rural home deaths. Such application and refinement of existing verbal autopsy methods holds out the possibility of obtaining replicable, sustainable and internationally comparable mortality statistics of known quality. Similar validation studies need to be undertaken considering the limitation of medical records as "gold standard" since records may not be confirmed using laboratory investigations or medical technologies. The validation studies need to address child and maternal causes of death and possibly all underlying causes of death.

Burial surveillance detected significant reduction in HIV--related deaths in Addis Ababa, Ethiopia.

OBJECTIVE: To determine the level of HIV-related mortality reduction after the introduction of large-scale antiretroviral therapy (ART) using a burial surveillance system coupled with verbal autopsy (VA) in Addis Ababa, Ethiopia. METHODS: Prospective burial surveillance was established in 2001 at cemeteries in Addis Ababa. VA interviews were periodically conducted on a random sample of adult burials registered between 2001 and 2009. Independent physicians reviewed the completed VA questionnaires and assigned underlying causes of death. The period before 2005 was defined as pre-ART and that since 2005 as the ART era. HIV-specific mortality fractions were calculated by age, sex and year of burial to examine the mortality trends before and during the ART era. RESULTS: Of the 4239 VA physician diagnoses, 1087 (25.6%) were ascribed to HIV-related deaths. HIV-related deaths in 2009 were 33% fewer than in 2001. The proportion of HIV-related deaths was reduced from 44.0% in the pre-ART period to 20.0% in the ART era. Mortality in women (36.7%) declined more than in men (30%). A marked reduction in HIV-specific mortality was observed in the age group 30-39 years (from 69.1% pre-ART to 46.8% during ART era) compared to 20-29 (from 60.5% pre-ART to 41.0% during ART) and 40-49 year olds (49.7%) pre-ART to 34.4% during ART provision). CONCLUSION: Burial surveillance combined with VA demonstrated a significant reduction in HIV-related deaths during the provision of free ART. Replication of burial surveillance is recommended in similar settings, where a vital registration system is non-existent, to track large-scale population-level interventions.

Status and health in Roman Dorset: the effect of status on risk of mortality in post-conquest populations.

The Roman conquest of Britain was previously shown to have negatively impacted health, particularly for children, older adults, and men. We build upon this previous research by investigating the effect that status had on risks of mortality within the Roman Britain populations of Dorset. This study incorporates a sample of 291 individuals excavated from several cemeteries in the county of Dorset dating between the first to early fifth centuries AD. To assess the effect of status on risks of mortality, burial type was used as a proxy for status and modeled as a covariate affecting the Siler and Gompertz-Makeham models of mortality. The results of these analyses indicate that high-status individuals, particularly children, had a lower mortality risk compared to lower-status groups; and for those buried in urban cemeteries, higher-status individuals of all age-groups had a lower mortality risk. As with our previous study (Redfern and DeWitte: Am J Phys Anthropol 144 (2011) 269-285), we found that male mortality risk was higher than females, which we consider to reflect underlying sex-differences in immunity and disease response.

Abandonment of newborn infants: a Danish forensic medical survey 1997-2008.

Concealment of pregnancy and newborn infant abandonment are closely associated with neonaticide, the killing of an infant within the first 24 h of life or less than 28-30 days depending on the jurisdiction. Abandonment of newborn infants occurs throughout the world and often the outcome for the infant is death. Together with neonaticide it is felt to be one of the least preventable crimes. In this retrospective study we present all forensically known Danish cases of abandoned newborn infant corpses, covering the period from 1997 to 2008. Eleven newborn infant corpses were found; we registered characteristics of the newborn infants and the circumstances of the cases based on autopsy reports. One further newborn infant was included, dating back to 1992, as it was found to be connected with one of the later cases. The mean age of the women who abandoned their newborn infants was 22 years, and five of the autopsied newborn infants were probably alive when abandoned. In two cases the newborn infants were half siblings and abandoned by the same mother. The time span from abandonment to when the newborn infant was found ranged from hours to 7 years. Two-thirds of the newborn infants were girls (66.6%). The most common means of disposal was in a plastic bag (~60%); only one newborn infant was wearing clothes when found. Causes of death were usually given as asphyxia, brain injury or simply undetermined. Two-thirds of the newborn infants showed signs of violence. None of the newborn infants had congenital malformations.

Gleaning signals about the past from cemetery data.

Cemetery headstones provide an easily accessible source of demographic data in human populations. In common with other sources of demographic data, such as skeletal samples, cemetery data may not be representative of the populations from which they were derived. In some circumstances they can be reasonably representative, however, and in such cases they may provide signals about demographic changes in the population that contributed to the cemetery. We present here analyses of burials occurring between 1900 and 1990 at the Columbia Cemetery in Columbia, Missouri. Our analyses, in combination with archival materials relating to infrastructure improvements in Columbia and data on infectious disease mortality in the state of Missouri, show that patterns of death observed in the cemetery data provide evidence for the timing of changes in the health of Columbia's residents. At the time that major improvements in sanitation and hygiene were implemented, burials of individuals dying under age 45 decreased significantly while burials of individuals older than 45 remained relatively high. Furthermore, data on infectious disease mortality indicate significant declines in deaths from water- and milk-borne infections, but no change in mortality from respiratory illnesses. These data also indicate that observed changes occurred about a decade later in Columbia than in large cities and more densely populated states elsewhere in the United States. Thus, this study illustrates the value of cemetery data in helping to fill gaps about how and when different events known to affect patterns of birth and death may have played out across time and space.

Yet another inquiry into the trustworthiness of eighteenth-century London's Bills of Mortality.

This is an enquiry into how eighteenth-century London's Bills of Mortality were compiled. It concludes that while they remain tolerably accurate in aggregate, particularly when considered over a number of years, they are liable to be very misleading if particular localities or parishes are considered. They are a record of registered burials-not deaths-of most of those who had been baptised as Anglicans, so they omit some burial grounds within London, and some dissenters. Crucially, they are most misleading guides to those who had died in one parish but whose family chose to have them buried in another. Several London parishes deliberately undercut their neighbours by charging lower burial fees to attract custom; others opened extra-parochial burial grounds. St Martin-in-the-Fields offers an example of the latter from 1806, but the scale of the new burial ground was not large and it was mainly confined to those who had died in the workhouse. Much more significant was the neighbouring parish of St Anne Soho, which at its peak period in the 1760s to the 1790s was alone handling the equivalent of between 2 and 5 per cent of all Anglican burials within the total area of London's Bills of Mortality. This was only one, though perhaps a particularly egregious, London parish, while the export of corpses to one's erstwhile 'home' parish demonstrates why the Bills cannot be trusted in their detailed geography, as well as providing a warning to all English population historians confronted with a sudden fall or rise in their burial totals.

Monitoring cause-specific adult mortality in developing countries: a comparison of data sources for Addis Ababa and its implications for policy and research.

Hospital statistics of causes of death for developing countries may be biased when the utilization of hospital services is low or selective. Using Addis Ababa, Ethiopia as an example, we argue that hospital data can be useful for demonstrating general cause-specific mortality patterns. In addition, a comparison of hospital statistics with data from a surveillance of burials allows for the identification of weaknesses in health services provision. We find a low level of hospital services utilization during terminal illness. Despite similarities in the cause of death structure in the different data sources, hospital statistics under-estimate the prevalence of infectious diseases. In addition, we identify an important gender bias in the utilization of health services in the direction of males being significantly more likely to die in medical facilities than females.