Identification of the Living and the Dead PDF

14 Identification of the living and the dead ▪▪ Introduction ▪▪ Age estimation in the living ▪▪ Methods of identification ▪▪ Bibliography and information sources ▪▪ Ident...

14 Identification of the living and the dead ▪▪ Introduction ▪▪ Age estimation in the living ▪▪ Methods of identification ▪▪ Bibliography and information sources ▪▪ Identity of decomposed or skeletalised remains ▪▪ Further general resources ▪▪ Mass disasters Introduction individuals have no records with them, and the estima- tion is required to determine, for example, if they have Loss of identity and proof of identity is a common prob- achieved the age of criminal responsibility in the rel- lem in the medicolegal setting. Such loss of identity evant jurisdiction or if are they classed by age as chil- might be deliberate, for example, if someone wishes to dren, in which case different legal principles may apply conceal their own identity or that of another for criminal to their situation. Estimation of age is simpler in children or other personal reasons, or it might be unintentional, and young people where developmental milestones may for example, due to natural disaster (e.g., tsunami, wild- be relevant and is more difficult and far less precise in fire, volcanic eruption) or terrorist or accidental events mature adults. However, recent advances in DNA analy- (e.g., 9/11). Individuals (themselves or relatives) or legal sis and in particular the recognition that the epigenetic and national authorities may require that identity to be signature of DNA methylation changes during an indi- established. This may apply to living or deceased indi- vidual’s lifespan means that DNA methylation age-cor- viduals. related changes have the potential to act as a (relatively) Formal, correct identification of a body is a key ques- accurate means of age estimation. tion to be answered when a body is found in any medi- There are additional means of identification such as colegal investigation of death. In England & Wales, it fingerprint or DNA databases, but these will only be of represents the first question to be answered at the relevance where the databases are well established and Coroner’s inquest. Often visual identification by an where the individual has been convicted of, or is being appropriate person may not be possible due to factors investigated for criminal offences. For these reasons, the such as facial trauma, decomposition, loss of body parts person or body with no previous criminal record may or deliberate mutilation and other techniques must be prove to be more difficult to identify than those with such employed to confirm identity. a record with, or exposure to, a justice system. The pro- All governments require systems to be in place for liferation of genealogical databases has however created the rapid implementation of mass disaster responses an additional potential source of DNA profiles that can in situations of multiple deaths so that casualties and be accessed by police and other bodies, and is likely to deceased can be identified expeditiously. This is for result in complex human and civil rights concerns over legal process, reassurance and support for relatives of the coming years. the injured and deceased. Assessment of the deceased to establish identity is a specialised task for a multiprofessional team which Methods of identification may include forensic pathologists, forensic odontolo- gists, forensic anthropologists, forensic physicians and Identification criteria radiologists. Their work will be often set in challenging Identification criteria used are referred to as primary or and difficult conditions, in the midst of humanitarian secondary. Primary identification criteria are 1) finger- work and investigations for possible criminal cases. All prints, 2) DNA, and 3) dental. those working in the forensic setting should be aware of It must be recognised that in recent years the speci- the general principles to establish identity in the living ficity of some aspects of fingerprint and dental assess- and deceased. ments have been brought into question. Secondary This same group of practitioners may be called criteria include features such as unique medical char- upon (individually or together) to assist in establishing acteristics, deformity, marks and scars, radiological a person’s age. The two main settings where this may evidence, personal effects and distinctive clothing. be relevant is in criminal cases and asylum applica- Examples of other features that may also provide tions. Reasons to know age are manifold, and frequently some assistance in identification include clothing,  Methods of identification 199 photographs and location. Additional techniques such elements of forensic science) that the use of DNA should as gait analysis or facial profiling from CCTV can be use- be considered as another piece of the jigsaw in the over- ful when other features cannot be used, although their all puzzle of solving crime and identifying unknown accuracy is less consistent. individuals. Comparison of DNA profiles with assumed or known family members or against known databases can ensure DNA profiling a person’s identity is established. If these comparisons The specificity of individual DNA profiles means that cannot be done, other tests must be used. from a statistical point of view it can be considered spe- As forensic DNA analysis continues to progress, cific to any given individual. identifying, extracting and amplifying smaller and The molecule of DNA has two strands of sugar and smaller amounts of genetic material, so the risks of phosphate molecules that are linked by combinations contamination from other sources increase. Crime of four bases, adenine, thymine, cytosine and gua- and mass disaster scenes have great potential for cross nine, forming a double helix structure. Only about 10 contamination and standard operating procedures to per cent of the molecule is used for genetic coding (the avoid contamination must always be in place to mini- active genes), the remainder being ‘silent’. In these mise this risk. Appropriate protective clothing must be silent zones, there are between 200 and 14,000 repeats worn to prevent the investigators obscuring any rel- of identical sequences of the four bases. Sir Alec Jeffreys evant DNA by their own material being inadvertently found that adjacent sequences were constant for a shed from exposed skin, or by sneezing, or perhaps given individual and that they were transmitted, like even by touching. In many jurisdictions, it is now a blood groups, from the DNA of each parent. The statis- requirement for all those involved in the identification, tical analysis of DNA identification is extremely com- collection and analysis of samples to provide exclusion plex and it is important that any calculations are based DNA samples in the same way as exclusion fingerprints upon the DNA characteristics of a relevant population were once provided. and not upon the characteristics of a ‘standard’ popu- lation somewhere else in the world. Forensic genetics Examination of dental structures developed from protein-based techniques and brought Forensic odontology is one of the most important with it the term ‘DNA fingerprinting’, this being based specialties available to establish or confirm identity on restriction fragment length polymorphisms (RFLPs) of unknown bodies whether in isolation, after terror- of high-­molecular-weight DNA. Development of ana- ist events, in mass graves or after natural disasters. lytical techniques resulted such as the amplification The success of such identification is very dependent of much smaller short tandem repeat (STR) sequences on access to ante mortem records from general den- using the polymerase chain reaction (PCR) which soon tal practitioners. Pre-existing (ante mortem) dental replaced RFLP analysis and became standard in genetic records and charts and radiographic images can be identification. STR multiplexes are now available which compared with examination of the dentition of the simultaneously amplify up to 30 STR loci from as little as deceased (Figure 14.1). If these are not immediately 15 cells or fewer. The huge volume of information asso- available an odontologist will construct dental charts ciated with the great range of observed STR genotypes of bodies whose identity remains unknown or uncon- allows for genetic individualisation (with the exception firmed despite a police investigation, so that, should of identical twins). dental information become available at a later date, Unlike before, there is now no need to match blood the two sets of records may be then be compared. The with blood, and semen with semen, as all the DNA in essence of the identification by dentition is compari- one individual’s body must of necessity be identical. son. This implies that the dental chart has to be com- Buccal swabbing permits simple sampling of a sus- pared with, and found to match, a chart whose origins pect. A suspect in any crime leaving cells or biological are known (Figure 14.2). Unfortunately, studies suggest fluids at a scene leaves proof of their presence at the that the recording of accurate dental charts by general scene. The continued ability to analyse smaller and dental practitioners is sometimes inadequate. smaller amounts of DNA and to recover and analyse The forensic odontologist is of prime importance in historical samples means that many old crimes can mass disasters where trauma is likely to make visual be investigated (or reinvestigated) and there is now a identification impossible. The great advantage of den- considerable number of individuals being found guilty tal identification is that the teeth are the hardest and of a crime decades later as a result of DNA advances. most resistant tissues in the body and can survive total Additionally, and some might argue more impor- decomposition and even severe fire, short of actual cre- tantly, there is a considerable body of those who were mation and thus DNA samples (e.g., from teeth pulp) incorrectly convicted, being exonerated, as a result of which can be collected by the forensic odontologist can these newer techniques. It is important (as with most be stored for future analysis (Figure 14.3). 200 Identification of the living and the dead Figure 14.1 Identification from the teeth: post mortem X-rays (outlined in red) are compared with ante m­ ortem radi- ography which, in this case shows a good match. (From Saukko P, Knight B. Knight’s Forensic Pathology. 4th ed. Boca Raton: CRC Press, 2016 [Fig. 26.8].) Teeth are in fact very well protected by the hard and soft tissues of the oral cavity. It is not uncommon for a body to show signs of incineration, while the molar teeth have only slight damage, if any, from fire. As the temperature of the environment and, hence, the body in question, rises the tongue will swell protecting the surfaces of the teeth facing the inside of the mouth. The ramus of the mandible will also offer some protection to the outer surfaces of the molar teeth, as will the soft tissue of the cheek. The anterior teeth (upper and lower incisors and Figure 14.2 Example of completed dental chart. canines) are the most susceptible to fire damage. Again, as the temperature of the environment rises, soft tissues will start losing moisture, and the lips being only soft tissue will therefore shrink away, leaving the front teeth unprotected. In cases where the fire has been fierce or prolonged these teeth will be calcined, in other words, turned into ash. These teeth will maintain their shape for as long as they remain undisturbed but the slightest force will cause them to crumble and disintegrate. While the posterior teeth anatomy and restorations often provide most of the information for identifying a deceased indi- vidual, in a time when people may have less dental treat- Figure 14.3 Despite soft tissue destruction, dentition ment due to better dental care, the shape and position of is retained after fire. anterior teeth could be vital for facial comparison with a smiling photograph of the presumed deceased. The forensic odontologist attending the scene would Where no previous records are available, exami- stabilise the incinerated teeth using transparent cold nation of the mouth and the teeth can still give some cure acrylic (Figure 14.4a and b). This material is found general information on age, sex, diet and ethnic origin, in most surgeries and comes in a liquid monomer and and some dentures may have the name or initials of the powder which will solidify within minutes of being individual printed on them. mixed together. Thus, powder and liquid can be mixed, at the scene, to a runny consistency and then dripped Dental identification of a burnt body gently over the incinerated teeth and allowed to seep The discovery of a body involved in a fire is one of two through and set. This only takes a few minutes. The teeth types of scenarios; the first being when it is useful for can then be examined properly at the mortuary once the the forensic odontologist to attend the scene before the body has been moved. It is still worth covering the head body is moved, the other being when fetal or newborn with a plastic bag tied at the neck to ensure any frag- remains are suspected to be present. ments that fall off during transit are not lost.  Methods of identification 201 (a) (b) Figure 14.4 Preserving fire-damaged teeth at the scene. A forensic odontologist applies cold cure acrylic liquid to teeth (a), which sets and helps protect the teeth during transportation to the mortuary (b). Fingerprints can only be established by matching the parameters that can be measured or seen on an individual with the same The recovery of the fingerprints from decomposing and parameters that were known to apply to, or to be present damaged bodies requires the use of specialised tech- on, a named individual. Identification is established by niques which are the province of the fingerprint experts. matching a range of general observations made about Prints may often be obtained from desquamated skin the body to a range of general information known to be or from the underlying epidermis after shedding of the true about that particular individual. The finding of a stratum corneum following prolonged submersion. unique medical feature (e.g., a previous uncommon sur- Their accuracy has been called into question recently gical procedure), or a combination of specific features, but they retain their usefulness in many cases where that is known to be possessed by that individual alone identification is required, such as air disasters, in partic- will add considerable weight to the conclusions. ular with intact trauma victims with few burn injuries. In both the living and dead, the height, weight, Body Mass Index (BMI) and general physique must Morphological characteristics be recorded and compared. Hair colour and length, Identity cannot be established by the simple measure- including bleaching or dyeing, the presence of a beard ment of a set of parameters of an individual or a body. It or moustache and the amount and distribution of other 202 Identification of the living and the dead body hair, including genitalia and other sites that are commonly shaved, all need to be established. Skin pig- Box 14.1 The ‘Sydney Shark Case’ (1935) mentation should also be recorded as far as possible. All A shark in a Sydney, Australia aquarium vomited clothing, jewellery and other ornaments on the person a human arm, severed at the shoulder, with rope must be recorded and photographed as they may pro- around the wrist. It was well preserved despite hav- vide useful information about the sex, race and even ing been in the shark’s digestive tract for the week in occupation and social status of the body, even if they which it had been in the aquarium. The arm bore a are not sufficient for identification. Surgical scars, old tattoo of two boxers in fighting poses on it, enabling injuries, congenital deformities, striae from childbirth police to identify a man who had gone missing some or rapid weight changes, cultural or tribal scars or nine days before the shark’s capture. Examination of markings, circumcision, female genital mutilation, pig- the arm revealed that it had been cut off the body mented lesions, papillomata and other skin marks or rather than being bitten off by a shark. A man was abnormalities must all be recorded. Appropriate pho- arrested and subsequently acquitted. tography of such features should always be done so that others (e.g., a relative, friend or doctor) may be able to confirm an identity from these features. In a living person or recently deceased intact body, identification by relatives if visual identification is not the facial appearance may be of great significance from possible. ethnic and racial aspects and from individual appear- ances. High-quality frontal and profile photographs should be taken for comparison. Identity of decomposed or skeletalised remains Tattoos and body piercings When apparent human skeletal remains are discovered, Tattoos and piercings that have been individualised a number of questions need to be asked. The answers to (e.g., by site, design, or specific personal information) these questions may require the expertise of patholo- may provide unique features for identification. The gists, anthropologists, odontologists, radiologists, anat- main use of tattoos and piercings in forensic medicine is omists and scientists. Box 14.2 shows the questions and in the identification of the bodies of unknown persons. answers that may arise. Once again, the simple presence of a tattoo does not gen- Where pre mortem clinical radiological images are erally confirm identification and ideally there has to be available comparison of these with the post mortem a comparison with, for example, images of that person films may give a definite identity. where the tattoos are visible. Good quality ante mortem images can be very helpful when compared with images of the deceased, and can be used if a visual identifica- Mass disasters tion is not possible or so that they can be circulated Mass disasters require systematic collection of foren- when the identity is not known. sic evidential samples; a chain of custody ensuring Worldwide there is a vast range of tattoos. Some continuity and integrity of the sample trail; and once designs have specific meaning or significance within analysed, the application of appropriate evidential and certain subgroups of society. Others may, for example, interpretative standards. At the time of the disaster it indicate previous or current military service, or street may initially be unclear whether an event has happened gang membership. Others are personalised to that indi- by accident, natural disaster or following a crime. Ante vidual. However, nowadays designs originating from mortem data from potential decedents, including den- throughout the world are purely used as body decora- tal, fingerprint and DNA samples should be sought at the tion, and they provide little assistance in assessing the earliest opportunity for later comparison. Comparator region or nationality or cultural group of origin of the fingerprints can be obtained from personal items, in individual. Names and dates of birth within tattoos the home, workplace or crime databases. DNA samples may be useful. Decomposing bodies should be exam- can be obtained from items such as toothbrushes, hair- ined carefully for tattoos, which may be rendered more brushes and razors. Possible family members may be visible when the superficial desquamated stratum cor- asked to provide samples for DNA analysis. General neum is removed. Prior to current techniques of identi- dental practitioners should be approached to provide fication the discovery of a tattoo on a body part provided dental charts, radiographs and dental impressions a means of identification (Box 14.1). where available. Matching of the ante mortem data with Body piercing is widespread, and the site and type the post mortem samples may be done using specialised of piercing should be noted and piercings can be used software systems when available so that identities can as part of visual identification or can be recovered for be confirmed.  Mass disasters 203 Box 14.2 Issues arising following the discovery of apparently human remains Are the remains actually bones? What was the age of the person at death? Sometimes objects such as stones, plastic models or This will require a multiprofessional approach utilising even pieces of wood are mistaken by the public or the skills of the forensic pathologist, anthropologist, police for bones: the anatomical shape, character and odontologist and radiologist, each contributing to the texture may not always be obvious to someone who is overall picture. medically trained, but in most cases will be. What was the height (stature) of the person? Are the remains human? The head to heel measurement of even the newly This is a more difficult question to answer. Differentiating deceased is rarely the same as the person’s standing human from animal bones is not always easy. A foren- height in life, owing to a combination of factors, including sic pathologist or forensic physician should be able to muscle relaxation and shrinkage of intervertebral discs. identify almost all of the human skeleton, although If a whole skeleton is present, an approximate height phalanges, carpal and tarsal bones can be extremely can be obtained by direct measurement but, because of difficult to positively identify as human because some a range of factors (e.g., changes in joint spaces, articu- animals have extremity bones with features similar lar cartilage) this can only be an approximation. If only to the human hand and wrist. Identifying the source some bones are available, calculations can be made of fragmented or burned/cremated bones generally from established tables, of which there are many. Height requires the skill of a forensic anthropologist or com- can be estimated from a range of long bones including parative anatomist. the humerus, ulnar and femur. Other bones such as the sternum have also been used in this setting. Do the remains represent one or more bodies (is there What is the ancestry of the deceased? co-mingling of body parts)? This is a very complex area of much controversy and sits Clearly, if there are two intact skulls or two intact left firmly within the realm of anthropologists whose main femurs then specific expertise is not required. If there focus lies within the field of craniometrics. is no obvious duplication, it is important to examine each bone carefully to assess whether the sizes and Can a personal identity be discovered? appearances match. Excluding the possibility of co- The previous criteria can assign bones broadly to vari- mingling of skeletal remains is the realm of the forensic ous groups of age and sex but putting a name to the anthropologist. individual depends, as does all identification, upon hav- ing reliable, corroborative ante mortem data. There are What is the biological sex? occasions when foreign bodies such as bullets or other There is a vast anthropological literature on these metallic fragments may be found embedded in the skel- matters with norms established for a range of popu- eton; these may either relate to the cause of death or lations. The skull and the pelvis offer the best informa- may simply be an incidental finding. Sometimes these tion on sexing; although the femur and sternum can can assist in identification. Surgical or other implant provide assistance. There are, however, many studies procedures (e.g., pacemakers, arthroplasty implants, which explore these and other structures including implantable defibrillators) have a unique reference the maxillary sinus volume, and the nature of teeth number which may identify the maker; these and other and the size of the patella. It is important to attempt unique medical data are often useful in establishing to determine the sex of each of these structures and identity, and can frequently be seen after radiological not to rely on the assessment of just one. Examination imaging and tracked, following referral to the implant by a forensic anthropologist or anatomist is vital. manufacturer, to the named patient. An emergency or major incident may result in fatali- process involves bringing together ante mortem and ties. Disaster victim identification (DVI) is the interna- post mortem information to make a positive identi- tionally accepted term for the processes and procedures fication by scientific means in a dignified manner, for recovering and identifying deceased people and taking into account the needs of the investigation pro- human remains in multiple fatality incidents. The cess, the needs of the bereaved and the needs of the 204 Identification of the living and the dead community. Within the UK, the National Disaster Victim purposes. This also requires that the practitioner has a Identification Unit coordinates the national capability realistic understanding of the variation expressed by of the police service to respond to mass fatality inci- the human form and the extrinsic and intrinsic factors dents in the UK. The team works with police services, that may affect any age estimation process. government departments, local authorities and other Four main means of age estimation are available, agencies to do this. The Coroner in England & Wales (or and the more of these that are used the more likely Procurator Fiscal in Scotland), is responsible for chair- it is that the result of the examination will correlate ing the Identification Commission, where the identity of well with the chronological age of the individual. the deceased is confirmed. It is the Coroner’s responsi- Underestimation of age is unlikely to raise any issue in bility to establish the deceased’s identity and how, when relation to an infringement of human rights (as younger and where the death occurred. They have the power to: persons tend to be treated more advantageously in the take lawful possession and control of deceased persons legal process) but an over-estimation of age can have or human remains from when the death is reported adverse effects. It is essential that the final estimation until all enquiries are complete; authorise removing the is robust and conveys a realistic range within which deceased from their place of death to a mortuary; and the chronological age is most likely to occur. As yet, authorise a post mortem examination. Body recovery the use of DNA for age estimation is not a feature of the teams will identify the deceased wherever they may be legal process. Any element of doubt must result in an found. They will then be photographed before they are increased range of possibilities. It is not possible in any moved to assist any criminal investigation and to assist circumstance to ascertain with certainty whether an the Coroner in establishing cause of death. At the mor- individual is 20 or 21 years of age. An assessment of 20 tuary, any personal items will be retrieved. These will be years ranges from a specific calendar date (birthday) to used as indicators of the potential identity of the person. a date that is 364 days beyond that date and only one Investigators will then go with a family liaison officer to day short of the assessment of an age of 21 years. The recover items that could assist the identification, such as means of assessment that should be used now to esti- personal items from the deceased’s home that may yield mate age in the living are: fingerprints or DNA, or their dental records from their dentist. Once identification evidence has been collected Social and psychological evaluation: This this will be presented to the Identification Commission requires evaluation by a highly trained clinician which will decide if it meets the standards required to or social work practitioner. confirm identity. Further evidence may need to be col- External estimation of age: This evaluation must lected. If identity reaches the standard of proof required be undertaken by a qualified clinician (a forensic then the evidence will then inform an inquest into the physician, or a paediatrician for the child and geri- death. atrician for the elderly; examination by more than one practitioner may be appropriate). Age estimation in the living Skeletal estimation of age: This investigation can- not be undertaken visually and therefore relies For the deceased, investigation of identity and age is on technology to assist the process (exposure to generally undertaken by order of, and with the con- much of the relevant technology has risk from ion- sent of, legal authorities, for example, the Coroner in ising radiation and can only be undertaken with England & Wales. informed consent). In the living, other constraints apply. The essential Dental estimation of age. element of any age estimation procedure is to ensure that it complies with, and fulfils, all local and/or Certain aspects of each of these means of assessment national legal and ethical requirements. All practitio- are well recognised. External estimation of age should ners, clinical or forensic, must take full responsibility use Tanner staging to assess child maturity (Figure for their actions in relation to the human rights of the 14.5). Skeletal estimation will assess hand/wrist radio- subject undergoing investigation. It is essential that the graphs in the first instance, which are compared against practitioner, clinical or forensic, undertaking the esti- standards previously published. A visual intraoral mation is experienced in the interpretation and presen- inspection will inform the practitioner as to the stage tation of data emanating from the investigation. They of emergence and loss of the dentition and is particu- must have a current and extensive understanding of the larly useful for age evaluation in the pre-pubertal years. limitations of their investigation both in relation to the Pubertal and post-pubertal individuals will, however, physical technology available to them and to the nature require a radiographic investigation subject to their of the database to which they will refer, for comparison local regulatory guidelines and statute.  Bibliography and information sources 205 Stage G = genitals (boys) B = breasts (girls) P = pubic hair (girls) 1 Pre-adolescent Pre-adolescent No hair 2 Scrotum pink and Breast bud Few fine texture change, slight hairs enlargement of the penis 3 Longer penis Larger, but no Darkens, larger testes nipple contour coarsens, separation starts to curl 4 Penis increases Areola and pailla Adult type, in breadth, dark from secondary smaller scrotum mound. area Menarche usually commeneces at this stage 5 Adult size Mature (pailla Adult type projects, areola follows breast contour) Figure 14.5 Tanner staging for the assessment of child maturity. Bibliography and information Champod C. Fingerprint identification: advances since the 2009 National Research Council report. Philos Trans R Soc Lond B Biol sources Sci 2015;370(1674). pii: 20140259. A v. London Borough of Croydon and Secretary of State for the Chiba F, Makino Y, Torimitsu S, et al. Stature estimation based on Home Department; WK v. Secretary of State for the Home femoral measurements in the modern Japanese population: Department and Kent County Council EWHC 939 (Admin), a cadaveric study using multidetector computed tomogra- UK: High Court (England and Wales). http://www.unhcr.org/ phy. Int J Legal Med 2018;132(5):1485–1491. refworld/docid/4a251daf2.html (Accessed 1 May 2019). Chryrostomou P, Thompson TJU. Anthropology: ancestry assess- A (R on The Application Of, By His Litigation Friend, Valbona ment. In: Payne-James JJ, Byard RW (eds). Encyclopedia of Mejzninin) v London Borough Of Croydon EWHC Forensic and Legal Medicine, 2nd ed. Oxford: Elsevier; 2016, 2921 (Admin). http://www.familylawweek.co.uk/site.aspx? 162–168. i=ed28430 (Accessed 1 May 2019). Clement JG. Odontology: overview. In: Payne-James JJ, Byard Algee-Hewitt BFB. Geographic substructure in craniometric esti- RW (eds). Encyclopedia of Forensic and Legal Medicine, 2nd ed. mates of admixture for contemporary American populations. Oxford: Elsevier; 2016, 615–623. Am J Phys Anthropol 2017;164(2):260–280. Crawley H. When Is a Child Not a Child? Asylum, Age Disputes and Auyeung TW, Lee JS, Kwok T, et al. Estimation of stature by mea- the Process of Age Assessment. London: London Immigration suring fibula and ulna bone length in 2443 older adults. J Nutr Law Practitioners’ Association (ILPA); 2007. Health Aging 2009;13(10):931–936. Dalitz GD. Age determination of adult human remains by teeth Barsley RE, Bernstein ML, Brumit PC, et al. Epidermis and enamel: examination. J Forensic Sci Soc 1962;3:11–21. insights into gnawing criticisms of human bitemark evidence. Dumache R, Ciocan V, Muresan C, Enache A. Molecular DNA Am J Forensic Med Pathol 2018;39(2):​87–97. analysis in forensic identification. Clin Lab 2016;62​(1–2): Benson J, Williams J. Age determination in refugee children. Aust 245–248. Fam Physician 2008;37:821–824. Dvorak J, George J, Junge A, Hodler J. Age determination by Black SM. Bone pathology and antemortem trauma. In: Payne- magnetic resonance imaging of the wrist in adolescent male James JJ, Byard RW (eds). Encyclopedia of Forensic and Legal football players. Br J Sports Med 2007;41:45–52. Medicine, 2nd ed. Oxford: Elsevier; 2016, 129–137. Eipel M, Mayer F, Arent T, et al. Epigenetic age predictions based Bowers CM, Pretty IA. Expert disagreement in bitemark case- on buccal swabs are more precise in combination with cell work. J Forensic Sci 2009;54(4):915–918. type-specific DNA methylation signatures. Aging (Albany NY) Briggs CA. Anthropology: sex determination. In: Payne-James JJ, 2016;8(5):1034–1048. Byard RW (eds). Encyclopedia of Forensic and Legal Medicine, Euling SY, Herman-Giddens ME, et al. Examination of US puberty 2nd ed. Oxford: Elsevier; 2016. timing data from 1940 to 1994 for secular trends: panel find- ings. Pediatrics 2009;121(Suppl 3):​S172–S191. 206 Identification of the living and the dead Flecker H. Roentgenographic observations of the times of Prajapati G, Sarode SC, Sarode GS, et al. Role of forensic odontol- appearance of epiphyses and their fusion with the diaphyses. ogy in the identification of victims of major mass disasters J Anat 1933;67:118–164. across the world: a systematic review. PLOS ONE 2018;13(6):​ Freire-Aradas A, Phillips C, Lareu MV. Forensic individual age e0199791. estimation with DNA: from initial approaches to methylation Parson W. Age Estimation with DNA: from forensic DNA finger- tests. Forensic Sci Rev 2017;29(2):121–144. printing to forensic (epi)genomics: a mini-review. Gerontology Gilsanz V, Ratib O. Hand Bone Age: A Digital Atlas of Skeletal Maturity. 2018;64(4):326–332. Berlin: Springer; 2005. Pyle SI, Waterhouse AM, Greulich WW. A Radiographic Standard of Gleiser I, Hunt EE Jr. The permanent mandibular first molar; Reference for the Growing Hand and Wrist. Cleveland: The Press its calcification, eruption and decay. Am J Phys Anthropol of Case Western Reserve University; 1971. 1955;13:253–284. Rani SU, Rao GV, Kumar DR, et al. Age and gender assessment Greulich WW, Pyle SI. Radiographic Atlas of Skeletal Development of through three-dimensional morphometric analysis of maxil- the Hand and Wrist. Stanford: Stanford University Press; 1959. lary sinus using magnetic resonance imaging. J Forensic Dent Hackman L, Black SM. Age estimation in the living. In: Payne- Sci 2017;9(1):46. James JJ, Byard R. (eds). Encyclopedia of Forensic and Legal Ritz S, Schütz HW, Peper C. Postmortem estimation of age at Medicine, Volume 1. 2nd ed. Oxford: Elsevier; 2016, 34–40. death based on aspartic acid racemization in dentin: its appli- Hampikian G, Peri G, Lo SS, et al. Case report: coincidental inclu- cability for root dentin. Int J Leg Med 1993;​105:289–293. sion in a 17-locus Y-STR mixture, wrongful conviction and Rivers E. Children: Stages of growth and development. In: Payne- exoneration. Forensic Sci Int Genet 2017;31:1–4. James JJ, Byard RW (eds). Encyclopedia of Forensic and Legal Hampikian G, West E, Akselrod O. The genetics of innocence: Medicine, 2nd ed. Oxford: Elsevier; 2016, 539–557. analysis of 194 U.S. DNA exonerations. Annu Rev Genomics Roberts G, Lucas V, McDonald F. Age estimation in the living: Hum Genet 2011;12:97–120. dental age estimation – theory and practice. In: Payne-James Jeffreys AJ. The man behind the DNA fingerprints: an interview JJ, Byard R (eds). Encyclopedia of Forensic and Legal Medicine, with Professor Sir Alec Jeffreys. Investig Genet 2013;4(1):21. Volume 1, 2nd ed. Oxford: Elsevier; 2016, 41–69. Jeffreys AJ, Wilson V, Thein SL. Hypervariable minisatellite regions Royal College of Paediatrics and Child Health. The Health Of in human DNA. Nature 1985;314:67–73. Refugee Children: Guidelines For Paediatricians. London: Royal Kaplowitz PB, Oberfield SE. Reexamination of the age limit for College of Paediatrics and Child Health; 1999. defining when puberty is precocious in girls in the United Saks MJ, Albright T, Bohan TL, et al. Forensic bitemark identifi- States: implications for evaluation and treatment. Drug and cation: weak foundations, exaggerated claims. J Law Biosci Therapeutics and Executive Committees of the Lawson Wilkins 2016;3(3):538–575. Pediatric Endocrine Society. Pediatrics 1999;104:936–941. Saraf A, Kanchan T, Krishan K, et al. Estimation of stature from Kranioti EF, García-Donas JG, Can IO, Ekizoglu O. Ancestry esti- sternum: exploring the quadratic models. J Forensic Leg Med mation of three Mediterranean populations based on cranial 2018;58:9–13. metrics. Forensic Sci Int 2018;286:265, e1–265.e8. Saunders E. The Teeth, a Test of Age, Considered with Reference to Kvaal SI, Kolltveit KM, Thompsen IO, Solheim T. Age determination the Factory Children, Addressed to the Members of Both Houses of adults from radiographs. Forensic Sci Int 1995;​74:175–185. of Parliament. London: Renshaw; 1837, 1–2. Liu S, Mi Z, Langenburg GM, Wu J. Accuracy and reliability of Schaefer M, Black SM, Scheuer L. Juvenile Osteology: A Laboratory feature selection by Chinese fingerprint examiners. Forensic and Field Manual. London: Elsevier; 2009. Sci Res 2017;2(4):203–209. Scheuer JL, Black SM. The Juvenile Skeleton. London: Academic Liversidge HM, Molleson TI. Developing permanent tooth length Press; 2004. as an estimate of age. J Forensic Sci 1999;44:917–920. Schmeling A. Age estimation in the living: imaging and age Liverpool City Council (R, on the application of) v. London Borough estimation. In: Payne-James JJ, Byard R (eds). Encyclopedia of Hillingdon EWHC 1702 (Admin). https://www. of Forensic and Legal Medicine, Volume 1, 2nd ed. Oxford: casemine.com/judgement/uk/5a8ff72a60d03e7f57ea900e Elsevier; 2016, 70–78. (Accessed 1 May 2019). Schmeling A, Olze A, Reisinger W, Geserick G. Age estimation Marshall WA. Growth and sexual maturation in ­normal puberty. of living people undergoing criminal proceedings. Lancet Clin Endocrinol Metab 1975;4:3–25. 2001;358:89–90. Marshall WA, Tanner JM. Variations in pattern of pubertal changes Schmeling A, Grundmann C, Fuhrmann A, et al. Criteria for age in girls. Arch Dis Child 1969; 44:291–303. estimation in living individuals. Int J Leg Med 2008;122:457– Marshall WA, Tanner JM. Variations in the pattern of pubertal 460. changes in boys. Arch Dis Child 1970;45:13–23. Schmidt S, Mühler M, Schmeling A, et al. Magnetic reso- Menéndez Garmendia A, Sánchez-Mejorada G, Gómez-Valdés nance imaging of the clavicular ossification. Int J Leg Med JA. Stature estimation formulae for Mexican contemporary 2007;121:321–324. population: a sample based study of long bones. J Forensic Shrestha R, Acharya J, Shakya A, Acharya J. Searching for kin Leg Med 2018;54:87–90. amidst tragedy-disaster victim identification operations for Murphy RE, Garvin HM. Morphometric Outline analysis of US Bangla Flight 211. J Forensic Sci. 2019;64(3):824–827. ancestry and sex differences in cranial shape. J Forensic Sci Simpson EK. Anthropology: morphological age estimation. In: 2018;63(4):1001–1009. Payne-James JJ, Byard RW (eds). Encyclopedia of Forensic and Page M, Taylor J, Blenkin M. Reality bites: a ten-year retrospec- Legal Medicine, 2nd ed. Oxford: Elsevier; 2016, 189–195. tive analysis of bitemark casework in Australia. Forensic Sci Int Smith S. ‘The Sydney Shark case’. In: Smith S. Mostly Murder. 2012;216(1–3):82–87. London: Panther books; 1984.  Further general resources 207 Solheim T. A new method for dental age estimation in adults. van der Linden FPGM, Duterloo HS. The Development of the Forensic Sci Int 1993;59:137–147. Human Dentition: An Atlas. Hagerstown: Harper and Row; Tabasum Q, Sehrawat JS, Talwar MK, Pathak RK. Odontometric sex 1976. estimation from clinically extracted molar teeth in a North von Wurmb-Schwark N, Preusse-Prange A, Heinrich A, et al. A Indian population sample. J Forensic Dent Sci 2017;9(3):176. new multiplex-PCR comprising autosomal and y-specific Tanner JM. Foetus into Man: Physical Growth from Conception to STRs and mitochondrial DNA to analyze highly degraded Maturity. London: Open Books; 1978. material. Forensic Sci Int Genet 2009;3(2):96–103. Tanner JM, Whitehouse RH. Clinical longitudinal standards for Wadhwani S, Shetty P, Sreelatha SV. Maintenance of antemortem height, weight, height velocity, weight velocity and stages dental records in private dental clinics: knowledge, attitude, of puberty. Arch Dis Child 1976;51:170–179. and practice among the practitioners of Mangalore and sur- Tanner JM, Whitehouse RH, Healy MJR. A New System for rounding areas. J Forensic Dent Sci 2017;9(2):78–82. Estimating Skeletal Maturity from the Hand and Wrist, with Wheeler MD. Physical changes of puberty. Endocrinol Metab Clin Standards Derived from a Study of 2,600 Healthy British Children. North Am 1991;20:1–14. Paris: Centre International de l’Enfance; 1962. Wittwer-Backofen U, Gampe J, Vaupel JW. Tooth cementum Tanner JM, Whitehouse RH, Marshall WA, et al. Assessment of annulation for age estimation: results from a large known Skeletal Maturity and Prediction of Adult Height (TW2 Method), age validation study. Am J Phys Anthropol 2004;123:119–129. 2nd ed. London: Academic Press; 1975. Tanner JM, Healy MJR, Goldstein H, Cameron N. Assessment of Skeletal Maturity and Prediction of Adult Height (TW3 Method). Further general resources London: W.B. Saunders; 2001. Black S, Aggrawal A, Payne-James JJ. Age Estimation in the Living. Thompson TJU. Anthropology: cremated bones. In: Payne-James London: Wiley; 2010. JJ, Byard RW (eds). Encyclopedia of Forensic and Legal Medicine, Bowers CM. Forensic Dental Evidence: An Investigator’s Handbook, 2nd ed. Oxford: Elsevier; 2016, 177–182. 2nd ed. Amsterdam: Academic Press; 2011. Todd TW. Atlas of Skeletal Maturation. St Louis: C.V. Mosby; 1937. College of Policing. Civil emergencies: disaster victim identi- Torimits S, Makino Y. Anthropology: Stature estimation from the fication. https://www.app.college.police.uk/app-content/ skeleton. In: Payne-James JJ, Byard RW (eds). Encyclopedia of civil-emergencies/disaster-victim-identification/dvi-roles- Forensic and Legal Medicine, 2nd ed. Oxford: Elsevier; 2016, and-responsibilities/ (Accessed 1 May 2019). 221–226. Royal College of Paediatrics & Child Health. Refugee and unac- Ubelaker DH. Human Skeletal Remains: Excavation, Analysis and companied asylum seeking children and young people. Interpretation. Washington, DC: Smithsonian Institute Press; https://www.rcpch.ac.uk/topic/refugee (Accessed 01 May 1978. 2019). Ulery BT, Hicklin RA, Roberts MA, Buscaglia J. Interexaminer varia- tion of minutia markup on latent fingerprints. Forensic Sci Int 2016;264:89–99.