Elisa Castoldi

The difficult task of assessing perimortem and postmortem fractures on the skeleton: a blind text on 210 fractures of known origin.

The distinction between perimortem and postmortem fractures is an important challenge for forensic anthropology. Such a crucial task is presently based on macro‐morphological criteria widely accepted in the scientific community. However, several limits affect these parameters which have not yet been investigated thoroughly. This study aims at highlighting the pitfalls and errors in evaluating perimortem or postmortem fractures. Two trained forensic anthropologists were asked to classify 210 fractures of known origin in four skeletons (three victims of blunt force trauma and one natural death) as perimortem, postmortem, or dubious, twice in 6 months in order to assess intraobserver error also. Results show large errors, ranging from 14.8 to 37% for perimortem fractures and from 5.5 to 14.8% for postmortem ones; more than 80% of errors concerned trabecular bone. This supports the need for more objective and reliable criteria for a correct assessment of peri‐ and postmortem bone fractures.

An osteological revisitation of autopsies: comparing anthropological findings on exhumed skeletons to their respective autopsy reports in seven cases.

Forensic anthropologists and pathologists are more and more requested to answer questions on bone trauma. However limitations still exist concerning the proper interpretation of bone fractures and bone lesions in general. Access to known skeletal populations which derive from cadavers (victims of violent deaths) who underwent autopsy and whose autopsy reports are available are obvious sources of information on what happens to bone trauma when subjected to taphonomic variables, such as burial, decomposition, postmortem chemical and mechanical insults; such skeletal collections are still however quite rare. This study presents the results of the comparative analysis between the autopsy findings on seven cadavers (six of which victims of blunt, sharp or gunshot wounds) and those of the anthropological assessment performed 20 years later on the exhumed dry bones (part of the Milano skeletal collection). The investigation allowed us to verify how perimortem sharp, blunt and gunshot lesions appear after a long inhumation period, whether they are still recognizable, and how many lesions are no longer detectable or were not detectable at all compared to the autopsy report. It also underlines the importance of creating skeletal collections with known information on cause of death and trauma.

The Difficult Task of Diagnosing Prostate Cancer Metastases on Dry Bone

The interpretation of pathology on skeletal remains is mandatory for implementing the biological profile and for disease recognition. Prostate cancer is one of the most common tumors, with a high preference for the skeleton as a primary site of metastasis. Its diagnosis on bone is however still ambiguous, due to its “osteoblastic” and resorptive manifestation. This study investigates distribution and appearance of prostate cancer metastases on dry bone on six known cases (selected from the Milano Cemetery Skeletal Collection) and one healthy individual. A macroscopic inspection was performed highlighting the abnormalities observed, describing location, shape, dimension, and aspect. A great amount of proliferative and mixed lesions was noticed, but also cases of pure lytic lesions were displayed. The multiple appearances of the manifestations observed display the difficulty in correctly identifying such a pathology, but also the potential and advantages provided by investigating a study sample with known antemortem history.

A modern documented Italian identified skeletal collection of 2127 skeletons: the CAL Milano Cemetery Skeletal Collection

The CAL Milano Cemetery Skeletal Collection is a modern and continuously growing identified osteological collection of 2127 skeletons under study in the Laboratorio di Antropologia e Odontologia Forense (LABANOF) in the Department of Biomedical Sciences for Health of the University of Milan (Italy), and part of the Collezione Antropologica LABANOF (CAL). The collection presents individuals of both sexes and of all age groups with a high representation of the elderly and an interesting sample of infants. Each individual is associated with a documentation that includes sex, age-at-death, dates of birth and death, and a death certificate that specifies the exact cause of death and the chain of events that led to it (related pathological conditions or traumatic events). It was also possible to recover for several individuals the autopsy reports and antemortem photographs. This documented osteological collection is of crucial interest in physical and forensic anthropology: it provides unique teaching opportunities and more importantly considerable research possibilities to test and develop sex and age estimation methods, investigate key subjects of forensic relevance and discuss pathological markers, among others. The aim of this paper is to introduce the CAL Milano Cemetery Skeletal Collection as a new identified skeletal collection and present its research and teaching potential.

The taphonomy of blood components in decomposing bone and its relevance to physical anthropology.

OBJECTIVES The variation and persistence of blood components, in particular red blood cells (RBCs), within bone tissue during the decomposition process, especially at the early stages and in different taphonomic conditions, has never been thoroughly investigated, regardless of the fact that knowing how blood survives or degrades within bone could be of help in solving many anthropological issues, such as trauma analysis and interpretation. MATERIALS AND METHODS This research investigated the influence of time and taphonomy on the persistence and detectability of blood components in parietal bone fragments (of different post mortem periods and taphonomic conditions) through histological (Hematoxilin and Eosin, HE) and immunohistochemical (Glycophorin A, GYPA) analyses. RESULTS The immunohistochemical investigation for GYPA showed the presence of RBCs under the form of erythrocyte debris or residues otherwise morphologically unidentifiable using only HE staining. Hence, while well-defined RBCs can be observed only in the first week of decomposition, afterward these structures can be detectable with certainty only by immunohistochemical analysis, which reveals discrete quantities of RBC residues also in dry bone (post mortem interval, or PMI, of 15 years), but not in archaeological samples, in which the greater PMI and the different taphonomic conditions together could be the answer behind such difference. DISCUSSION This study highlights the usefulness and potential of immunohistochemical detection of GYPA in RBC investigation and gives a realistic idea of the persistence and detectability of erythrocytes in different osteological taphonomic conditions, in contrast to results reported by some authors in literature. Another important result concerns the detection of RBC residues in dry bone, which opens the way to the possible use of RBCs in trauma interpretation.

Effects of Cremation on Fetal Bones

The charring process is a weak point of anthropological analysis as it changes bone morphology and reduces information obtainable, specially in fetuses. This experiment aims at verifying the conservation of fetal bones after cremation. A total of 3138 fetuses of unknown sex and age were used, deriving from legal and therapeutic abortions from different hospitals of Milan. Cremations took place in modern crematoria. Nine cremation events were analyzed, each ranging from 57 to 915 simultaneously cremated fetuses. During the cremations, 4356 skeletal remains were recovered, 3756 of which (86.2%) were morphologically distinguishable. All types of fetal skeletal elements were found, with the exception of some cranial bones. Only 3.4% of individuals could be detected after the cremation process, because of the prevalence of abortions under 12 lunar weeks. All fire alterations were observed and the results were statistically analyzed. This pilot study confirmed the possibility of preservation of fetal skeletal elements after cremation.

Comparison of Different Swabs for Sampling Inorganic Gunshot Residue from Gunshot Wounds: Applicability and Reliability for the Determination of Firing Distance

This study concentrates on samples of bare pork skin, with and without bristles, and dried bovine ribs shot with a semi‐automatic pistol to find the best methodology and sampling surface in the search for inorganic gunshot residues (IGSR). Four quadrants of known surface areas were sampled at different distances from the bullets hole with different swabs: tapes in graphite, Leukosilk® white tape, 3M® transparent tape, and a cotton swab to assess the technique able to collect the highest amounts of IGSR with the lowest contribution of the blank. The cotton swab wet in 10% HNO3 gave the best results. The highest amounts of IGSR, measured by ICP‐OES and MS, were detected on a surface of 3‐cm radius from the bullets edge. The amount of metals collected decreased with the firing distance between 20 and 60 cm. The procedure was efficient for sampling different tissues like skin and bones.

Diabetic bone lesions: a study on 38 known modern skeletons and the implications for forensic scenarios

Diabetes mellitus is a condition with severe and life-threatening complications and epidemic proportions worldwide. The study of diabetes on bones can provide crucial information to the forensic practice, the archeological field and medical research. In this paper, the authors report and discuss the lesions observed on the skeletons of 38 individuals (plus 11 negative control samples) of the CAL Milano Cemetery Skeletal Collection with known diabetes. As a result, different types of lesions were highlighted in the feet: periosteal new bone formation, lysis of tuft, lytic lesions, evidence of trauma, osteomyelitis, and osteochondritis dissecans. In 50% of the skeletons of the study sample, lesions were located on bones of the first ray of the foot. Vascular calcifications were also collected and considered. None of these lesions is pathognomonic of diabetes and each implies a broad differential diagnosis that can be confronted with the upper and axial lesions. However, they are coherent with the disease development and complications. This study is the first to document skeletons with known diabetes from an identified collection and discuss their diagnostic potential.

Commentary: Long-term results of organ procurement from burn victims. Burns. 2017 Sep;43(6):1163–1167. doi: 10.1016/j.burns.2017.05.012. Epub 2017 Jun 9. PubMed PMID: 28602588. Schmauss D, Bigdeli AK, Hellmich S, Barreiros AP, Kremer T, Germann G, Kneser U, Megerle KO

The CAL Milano Cemetery Skeletal Collection is a modern and continuously growing identified osteological collection of 2127 skeletons under study in the Laboratorio di Antropologia e Odontologia Forense (LABANOF) in the Department of Biomedical Sciences for Health of the University of Milan (Italy), and part of the Collezione Antropologica LABANOF (CAL). The collection presents individuals of both sexes and of all age groups with a high representation of elderly and an interesting sample of infants. Each individual is associated with a documentation that includes sex, age-at-death, dates of birth and death, and a death certificate that specifies the exact cause of death and the chain of events that led to it (related pathological conditions or traumatic events). It was also possible to recover for several individuals the autopsy reports and antemortem photographs.

Bone microscopy: guiding knowledge from history to forensic medicine

Calcified tissues are well known microscopically, but the diagnostic potential of bone micro-anatomy is still underestimated. The shape and size of osteons or of lamellar bone are unique and fundamental for determining the species of origin of human remains, and for understanding age, disease, and trauma; thus micro-anatomy is crucial to many disciplines, from archaeology to forensic medicine. This presentation aims at illustrating and reviewing all such applications. The first question arising when studying skeletal remains is: “is it human?”. Macroscopic analysis alone can sometimes be insufficient in understanding if they belong to a human or to another animal; in such cases, the microscopic characteristics can be the only instrument capable of providing a reply, by evaluating the presence of osteons, their pattern and distribution, as well as the their metrical parameters [1]. Secondly, bone tissue formation as well as the constant bone remodeling process result in a strong correlation between the age of an individual and both the tissue pattern and the number of osteons per unit area in a bone cross-section, parameters on which most of the histological age-estimating methods are based. These methods are particularly important in distinguishing subadults from adults, and, among the latter, in estimating age where other methods result unsatisfactory [2]. Bone histology can also be diagnostic in the research for pathological diseases and traumatic events, especially with concern to the moment in which a trauma occurred [2]. Finally, the type and degree of microscopic damage can give some insight into the environmental surroundings in which the bone was, and a taphonomic profile useful for the verification of taphonomic events and clues on the post mortem interval of the sample [3]. All these contributions demonstrate that even just a small piece of bone, in fact a microscopic part of it, is fundamental and can sometimes be the only instrument for the correct interpretation of the story that human remains can tell.