Enhancing accurate data collection in mass fatality kinship identifications: Lessons learned from Hurricane Katrina

A mass fatality DNA identification effort is a complex process in which direct matching and kinship analysis is used for identifying human remains. Kinship DNA identification is an important tool in the identification process in which victim's DNA profiles are compared to the profiles of “known” biologically related reference samples. Experience from the 9/11 World Trade Center DNA identification efforts showed that forms used to record biological relationships are important and that inaccurately documented information may hamper the kinship analysis and DNA identification process. In the identification efforts following Hurricane Katrina, a Family and/or Donor Reference Collection (FDRC) form was used as a means to document the reported relationship between the reference DNA donor and the purported missing individual. This FDRC form was developed based upon lessons learned from 9/11 and the Tsunami identification efforts. This paper analyses the effectiveness of the FDRC form used in the Hurricane Katrina kinship DNA identification efforts and proposes an improved sample collection form for kinship and other donor reference samples. The data presented can be used to enhance the accuracy of the data collection process through an improved sample collection form, streamlining the DNA kinship identification process and decreasing the burden on valuable resources.     

Forensic aspects of mass disasters: strategic considerations for DNA-based human identification

Many mass disasters result in loss of lives. Law enforcement and/or public safety and health officials often have the responsibility for identifying the human remains found at the scene, so they can be returned to their families. The recovered human remains range from being relatively intact to highly degraded. DNA-based identity testing is a powerful tool for victim identification in that the data are not restricted to any particular one to one body landmark comparison and DNA profile comparisons can be used to associate separated remains or body parts. Even though DNA typing is straightforward, a disaster is a chaotic environment that can complicate effective identification of the remains. With some planning, or at least identification of the salient features to consider, stress can be reduced for those involved in the identification process. General guidelines are provided for developing an action plan for identification of human remains from a mass disaster by DNA analysis. These include: (1) sample collection, preservation, shipping and storage; (2) tracking and chain of custody issues; (3) laboratory facilities; (4) quality assurance and quality control practices; (5) parsing out work; (6) extraction and typing; (7) interpretation of results; (8) automation; (9) software for tracking and managing data; (10) the use of an advisory panel; (11) education and communication; and (12) privacy issues. In addition, key technologies that may facilitate the identification process are discussed, such as resin based DNA extraction, real-time PCR for quantitation of DNA, use of mini-STRs, SNP detection procedures, and software. Many of the features necessary for DNA typing of human remains from a mass disaster are the same as those for missing persons' cases. Therefore, developing a missing persons DNA identification program would also provide the basis for a mass disaster human remains DNA identification program.     

Disclosing incidental findings in brain research: The rights of minors in decision‐making

MRI is used routinely in research with children to generate new knowledge about brain development. The detection of unexpected brain abnormalities (incidental findings; IFs) in these studies presents unique challenges. While key issues surrounding incidence and significance, duty of care, and burden of disclosure have been addressed substantially for adults, less empirical data and normative analyses exist for minors who participate in minimal risk research. To identify ethical concerns and fill existing gaps, we conducted a comprehensive review of papers that focused explicitly on the discovery of IFs in minors. The discourse in the 21 papers retrieved for this analysis amply covered practical issues such as informed consent and screening, difficulties in ascertaining clinical significance, the economic costs and burden of responsibility on researchers, and risks (physical or psychological). However, we found little discussion about the involvement of minors in decisions about disclosure of IFs in the brain, especially for IFs of low clinical significance. In response, we propose a framework for managing IFs that integrates practical considerations with explicit appreciation of rights along the continuum of maturity. This capacity‐adjusted framework emphasizes the importance of involving competent minors and respecting their right to make decisions about disclosure. J. Magn. Reson. Imaging 2013;38:1009–1013. © 2013 Wiley Periodicals, Inc.     

Recommendations for large-scale exhumations of Potter's Fields: Cases in the US

Increased commitment to humanitarian identification and advances in DNA technology contribute to growing interest in large scale identification operations for unidentified, interred remains. However, scant literature discusses the practical challenges in conducting cemetery exhumations en masse for the purposes of DNA sampling and reinterment. This paper draws on a case study of cemetery exhumations conducted in the US as part of a multi-agency, multi-year endeavor, Operation UNITED. Challenges and strategies for managing logistics and manpower, locating human remains in active cemeteries, and overcoming containment and preservation issues of adult and juvenile remains are presented. This paper evidences the potential for investigation into cemetery exhumation strategies to assist in effective humanitarian identification.     

DNA Commission of the International Society for Forensic Genetics (ISFG): Recommendations regarding the role of forensic genetics for disaster victim identification (DVI)

The ISFG membership consists of scientists and medical professionals specialized in using genetic testing for kinship analysis and the individualization of biological material. This expertise makes the forensic geneticist a resource of advice to international and national organizations dealing with human identifications and causes many DNA laboratories to get involved in DVI tasks. The present recommendations are meant to educate more forensic geneticists about their potential involvement in mass fatality preparedness and possible DVI efforts, as well as to provide practical guidance for each of the laboratories’ individual tasks. The idea to work on DNA-specific recommendations was born after a round table discussion dealing with the 2004 Tsunami disaster in south east Asia during the 21st congress of the International Society for Forensic Genetics on the Azores, Portugal, in September 2005. The ensuing discussion between scientists and pathologists that had been involved in the International Center in Khao Lak, Thailand, revealed the need for the scientific community to be better prepared to answer the local authorities’ questions by formulating generally acceptable scientific standards for the most efficient use of DNA-based victim identification methods. These recommendations, as well as the many cited references, are intended to provide guidance on establishing preparedness for the forensic genetics laboratory, on collecting and storing ante-mortem and post-mortem samples suitable for DNA analysis, on DNA extraction and genetic typing strategies, on data management, and on issues related to the biostatistical interpretation and reporting of results.     

Digging up the recent Spanish memory: genetic identification of human remains from mass graves of the Spanish Civil War and posterior dictatorship

The Spanish Civil War (1936–1939) and posterior dictatorship (until 1970s) stands as one of the major conflicts in the recent history of Spain. It led to nearly two hundred thousand men and women executed or murdered extra-judicially or after dubious legal procedures. Nowadays, most of them remain unidentified or even buried in irretraceable mass graves across Spain. Here, we present the genetic identification of human remains found in 26 mass graves located in Northern Spain. A total of 252 post-mortem remains were analyzed and compared to 186 relatives, allowing the identification of 87 victims. Overall, a significant success of DNA profiling was reached, since informative profiles (≥12 STRs and/or mitochondrial DNA profile) were obtained in 85.71% of the remains. This high performance in DNA profiling from challenging samples demonstrated the efficacy of DNA extraction and amplification methods used herein, given that only around 14.29% of the samples did not provide an informative genetic profile for the analysis performed, probably due to the presence of degraded and/or limited DNA in these remains. However, this study shows a partial identification success rate, which is clearly a consequence of the lack of both appropriate family members for genetic comparisons and accurate information about the victims’ location. Hence, further perseverance in the exhumation of other intact graves as well as in the search of more alleged relatives is crucial in order to facilitate and increase the number of genetic identifications.     

Study of criteria influencing the success rate of DNA swabs in operational conditions: A contribution to an evidence-based approach to crime scene investigation and triage

DNA is nowadays swabbed routinely to investigate serious and volume crimes, but research remains scarce when it comes to determining the criteria that may impact the success rate of DNA swabs taken on different surfaces and situations. To investigate these criteria in fully operational conditions, DNA analysis results of 4772 swabs taken by the forensic unit of a police department in Western Switzerland over a 2.5-year period (2012–2014) in volume crime cases were considered.A representative and random sample of 1236 swab analyses was extensively examined and codified, describing several criteria such as whether the swabbing was performed at the scene or in the lab, the zone of the scene where it was performed, the kind of object or surface that was swabbed, whether the target specimen was a touch surface or a biological fluid, and whether the swab targeted a single surface or combined different surfaces. The impact of each criterion and of their combination was assessed in regard to the success rate of DNA analysis, measured through the quality of the resulting profile, and whether the profile resulted in a hit in the national database or not.Results show that some situations—such as swabs taken on door and window handles for instance—have a higher success rate than average swabs. Conversely, other situations lead to a marked decrease in the success rate, which should discourage further analyses of such swabs. Results also confirm that targeting a DNA swab on a single surface is preferable to swabbing different surfaces with the intent to aggregate cells deposited by the offender.Such results assist in predicting the chance that the analysis of a swab taken in a given situation will lead to a positive result. The study could therefore inform an evidence-based approach to decision-making at the crime scene (what to swab or not) and at the triage step (what to analyse or not), contributing thus to save resource and increase the efficiency of forensic science efforts.     

DNA typing from skeletal remains following an explosion in a military fort--first experience in Ecuador (South-America)

We present individual body identification efforts, to identify skeletal remains and relatives of missing persons of an explosion took place inside one of the munitions recesses of the Armoured Brigade of the Galapagos Armoured Cavalry, in the city of Riobamba, Ecuador, on Wednesday, November 20, 2002. Nineteen samples of bone remains and two tissue samples (a blood stain on a piece of fabric) from the zero zone were analysed. DNA extraction was made by Isoamilic Phenol-Chloroform-Alcohol, and proteinase K. We increased PCR cycles to identify DNA from bones to 35 cycles in some cases. An ABI 310 sequencer was used. Determination of the fragment size and the allelic designation of the different loci was carried out by comparison with the allelic ladders of the PowerPlex 16 kit and Gene Scan Analysis Software programme. Five possible family groups were established and were compared with the profiles found. Classical Bayesian methods were used to calculate the Likelihood Ratio and it was possible to identify five different genetic profiles in our country. This paper is important because is a novel experience for our forensic services, because this was the first time DNA had been used as an identification method in disasters, and it was validated by Ecuadorian justice like a very effective method.     

Identification of severely incinerated human remains: the need for a cooperative approach between forensic specialities. A case report

Positive identification of incinerated human remains can be a perplexing problem, especially when there is no genetic material remaining for DNA analysis. This paper illustrates the importance of a multi-disciplinary approach to the identification of such remains, and explores the processes involved in the various effects of heat upon human bone and teeth, and the implications this has for positive identification. A case study is presented to illustrate the various problems encountered and the importance of discovering comprehensive ante-mortem records of the deceased. It is submitted that forensic odontologists and anthropologists be included in the body recovery process, both to maximise the recovery of evidence, and to ensure that all possible avenues for positive identification are explored, so as to avoid the need to rely upon the less robust method of circumstantial identification.     

A Quick Reference Guide for Incidental Findings on Lung Cancer Screening CT Examinations

PurposeThe US Preventive Services Task Force has recommended lung cancer screening (LCS) with low-dose CT (LDCT) in high-risk individuals since 2013. Because LDCT encompasses the lower neck, chest, and upper abdomen, many incidental findings (IFs) are detected. The authors created a quick reference guide to describe common IFs in LCS to assist LCS program navigators and ordering providers in managing the care continuum in LCS.MethodsThe ACR IF white papers were reviewed for findings on LDCT that were age appropriate for LCS. A draft guide was created on the basis of recommendations in the IF white papers, the medical literature, and input from subspecialty content experts. The draft was piloted with LCS program navigators recruited through contacts by the ACR LCS Steering Committee. The navigators completed a survey on overall usefulness, clarity, adequacy of content, and user experience with the guide.ResultsSeven anatomic regions including 15 discrete organs with 45 management recommendations were identified as relevant to the age of individuals eligible for LCS. The draft was piloted by 49 LCS program navigators from 32 facilities. The guide was rated as useful and clear by 95% of users. No unexpected or adverse experiences were reported in using the guide. On the basis of feedback, relevant sections were reviewed and edited.ConclusionsThe ACR Lung Cancer Screening CT Incidental Findings Quick Reference Guide outlines the common IFs in LCS and can serve as an easy-to-use resource for ordering providers and LCS program navigators to help guide management.     

Disaster victim identification

In the event of any mass fatality incident, despite the cause, disaster victim identification must be undertaken; the humanitarian and legal responsibility for this falls on the forensic community. Mass fatality incidents can be natural (e.g., tsunamis, earthquakes, hurricanes), accidental (e.g., building collapse, ship sinking) or can occur as a result of a terrorist attack. Terrorism alone has been responsible for thousands of deaths in recent years and can be encountered in many forms (e.g., suicide bombings, airplane hijackings). In mass fatality situations, the experitise of many specialities are called on to assist in the identification efforts and to allow for the speedy return of recovered human remains to the relatives of the deceased. Today, DNA plays a vital but never solitary role in disaster victim identification.     

Disaster victim identification of military aircrew, 1945-2002

BACKGROUND: Aviation accident fatalities are characterized by substantial tissue disruption and fragmentation, limiting the usefulness of traditional identification methods. This study examines the success of disaster victim identification (DVI) in military aviation accident fatalities in the Australian Defense Force (ADF). METHODS: Accident reports and autopsy records of aircrew fatalities during the period 1945-2002 were examined to identify difficulties experienced during the DVI process or injuries that would prevent identification of remains using non-DNA methods. RESULTS: The ADF had 301 aircraft fatalities sustained in 144 accidents during the period 1945-2002. The autopsy reports for 117 fatalities were reviewed (covering 73.7% of aircrew fatalities from 1960-2002). Of the 117 victims, 38 (32.4%) sustained injuries which were severe enough to prevent identification by traditional (non-DNA) comparative scientific DVI techniques of fingerprint and dental analysis. CONCLUSIONS: Many of the ADF fatalities who could not be positively identified in the past could be identified today through the use of DNA techniques. Successful DNA identification, however, depends on having a reference DNA profile. This paper recommends the establishment of a DNA repository to store reference blood samples to facilitate the identification of ADF aircrew remains without causing additional distress to family members.     

Characterization of a modified amplification approach for improved STR recovery from severely degraded skeletal elements

Degraded skeletal remains generally contain limited quantities of genetic material and thus DNA-based identification efforts often target the mitochondrial DNA (mtDNA) control region due to the relative abundance of intact mtDNA as compared to nuclear DNA. In many missing person cases, however, the discriminatory power of mtDNA is inadequate to permit identification when associated anthropological, odontological, or contextual evidence is also limited, and/or the event involves a large number of individuals. In situations such as these, more aggressive amplification protocols which can permit recovery of STR data are badly needed as they may represent the last hope for conclusive identification. We have previously demonstrated the potential of a modified Promega PowerPlex 16 amplification strategy for the recovery of autosomal STR data from severely degraded skeletal elements. Here, we further characterize the results obtained under these modified parameters on a variety of sample types including pristine control DNA and representative case work specimens. Not only is the amplification approach evaluated here sensitive to extremely low authentic DNA input quantities (6 pg), but when the method was applied to thirty-one challenging casework specimens, nine or more alleles were reproducibly recovered from 69% of the samples tested. Moreover, when we independently considered bone samples extracted with a protocol that includes complete demineralization of the bone matrix, the percentage of samples yielding nine or more reproducible alleles increased to 95% with the modified amplification parameters. Overall, direct comparisons between the modified amplification protocol and the standard amplification protocol demonstrated that allele recovery was significantly greater using the aggressive parameters, with only a minimal associated increase in artifactual data.     

The identification of war victims by reverse paternity is associated with significant risks of false inclusion

Since February 2001 the process of DNA identification of war victims in Croatia relies on the database of over 3,000 9-locus (D3S1358, vWA, FGA, TH01, TPOX, CSF1PO, D5S818, D13S317 and D7S820) STR genotypes of relatives of missing persons. Instead of a targeted approach to DNA typing, the genotype of each skeletal remains analysed is compared to all genotypes in the database to identify potential parents and children. Although this approach has significantly increased the pace of identification by DNA typing, non-targeted matching in a database containing several thousand genotypes considerably decreases the significance of inclusion, especially when identification is based on reverse paternity analysis. To support this statistical prediction we present 3 cases of 10 STR loci matches and 1 case of 11 STR loci matches between a child, child's mother and skeletal remains that did not originate from a father of that child.     

Usefulness of blood vessels as a DNA source for PCR-based genotyping based on two cases of corpse dismemberment

The success of PCR-based genotyping of decomposed remains depends on the quality of extracted DNA. Hard tissues and muscles are preferred because of their DNA stability. However, in dismembered corpses the choice of a suitable DNA source is more limited. In short tandem repeat (STR) analysis in two cases of dismembered corpses, we found an advantage of using blood vessels over muscles. To confirm that blood vessels are better for STR typing compared to muscle, we collected nine sets of blood vessels and the adjacent muscle from six other decomposed remains and compared the STR profiles between the blood vessel and muscle samples. Better results for STR typing were obtained in blood vessels. Based on these results, we recommend use of blood vessels as material for PCR-based genotyping in identification of dismembered human remains with heavy postmortem changes.     

Dentine and cementum as sources of nuclear DNA for use in human identification

Teeth are increasingly utilized as a source of nuclear DNA to aid identification of human remains. DNA extraction and the results of genetic analysis from these tissues are extremely variable and to some extent unpredictable. This study examines the availability of nuclear DNA in different areas of the dental hard tissues and explores the extent and nature of the variation within and between individuals. Results of this study indicate that nuclear DNA is available in widely variable quantities in dentine and cementum. This variation exists within teeth and between teeth, even between comparable teeth from the same individual. The quantity of DNA available in dentine is affected by age and dental disease, whereas that in cementum is not. Forensically useful genetic profiles were obtained from as little as 20 mg of tooth powder, thus avoiding the necessity for complete destruction of the tooth. A better understanding of why there is more DNA in one tooth tissue or region compared with another, and of the effects of disease and age, will aid in the selection of which tooth and tissue to sample and will increase the validity of the use of teeth as a source of nuclear DNA for human identification.     

Evaluation of two population-based input functions for quantitative neurological FDG PET studies

The conventional measurement of the regional cerebral metabolic rate of glucose (rCMRGlc) with fluorodeoxyglucose (FDG) and positron emission tomography (PET) requires arterial or arterialised-venous (a–v) blood sampling at frequent intervals to obtain the plasma input function (IF). We evaluated the accuracy of rCMRGlc measurements using population-based IFs that were calibrated with two a–v blood samples. Population-based IFs were derived from: (1) the average of a–v IFs from 26 patients (Standard IF) and (2) a published model of FDG plasma concentration (Feng IF). Values for rCMRGlc calculated from the population-based IFs were compared with values obtained with IFs derived from frequent a–v blood sampling in 20 non-diabetic and six diabetic patients. Values for rCMRGlc calculated with the different IFs were highly correlated for both patient groups (r0.992) and root mean square residuals about the regression line were less than 0.24 mg/min/100 g. The Feng IF tended to underestimate high rCMRGlc. Both population-based IFs simplify the measurement of rCMRGlc with minimal loss in accuracy and require only two a–v blood samples for calibration. The reduced blood sampling requirements markedly reduce radiation exposure to the blood sampler.     

The application of CamScan 2 in forensic dentistry

Forensic dentistry plays a major role in body identification. The dental examination is very accurate and also, nowadays, in the time of a comprehensive fingerprint and DNA assessment, objectively supported. The identification, which is based on the dental documentation, leads up to 43-89% of a successful process. The purpose of the study is to describe the techniques employed by forensic odontology to identify human remains and also to provide details of some of the novel developments within this area. Comparative methods of dental identification of the unknown subject with pre-mortem clinical records, X-ray images, implant presence, superimposition and DNA analysis confirm the identity of the individual. It was shown that dental identification of a person is based on unique individual characteristics of the dentition and dental restorations, relative resistance of the mineralised dental tissues and dental restorations to changes resulting from decomposition and harsh environmental extremes such as conditions of temperature and violent physical forces.     

Reliable genetic identification of burnt human remains

The identification of severely burnt human remains by genetic fingerprinting is a common task in forensic routine work. In cases of extreme fire impact, only hard tissues (bones, teeth) may be left for DNA analysis. DNA extracted from burnt bone fragments may be highly degraded, making an amplification of genetic markers difficult or even impossible. Furthermore, heavily burnt bones are very prone to contamination with external DNA.We investigated whether authentic DNA profiles can be generated from human bones showing different stages of fire induced destruction (well preserved, semi-burnt, black burnt, blue–grey burnt, blue–grey–white burnt). DNA was extracted from 71 bone fragments derived from 13 individuals. Obtained genetic patterns (STRs and mtDNA sequences) were compared to the genetic pattern of the respective bodies.Our results show that the identification via DNA analysis is reliably and reproducibly possible from well preserved and semi-burnt bones. In black burnt bones the DNA was highly degraded and in some cases no nuclear DNA was left, leaving mitochondrial DNA analysis as an option. Blue–grey burnt bones lead only sporadically to authentic profiles. The investigation of blue–grey–white burnt bones barely led to reliable results.     

DNA analyses of the remains of the Prince Branciforte Barresi family

The five skeletons found buried in the church of Militello di Catania, Sicily, were tentatively identified by morphological analysis and historical reports as the remains of Prince Branciforte Barresi, two of his children, his brother and another juvenile member of the family (sixteenth and seventeenth centuries). In order to attempt to clarify the degree of relationships of the five skeletons, sex testing and mitochondrial DNA (mtDNA) sequence analysis of the hypervariable segments I and II (HV1 and HV2) of control region were performed. Moreover, the 9 bp-deletion marker of region V (COII/tRNA ^lys) was examined. Molecular genetic analyses were consistent with historical expectations, although they did not directly demonstrate that these are in fact the remains of the Prince and his relatives, due to the impossibility of obtaining DNA from living maternal relatives of the Prince. Received: 6 April 1999 / Accepted: 27 September 1999