Establishing Forensic Anthropology Units in Indian Medical Colleges: From Theory to Praxis

Skeletal Analysis

The big puzzle: A critical review of virtual re-association methods for fragmented human remains in a DVI context'

As part of the new competency-based curriculum, it has now become mandatory for all medical colleges in India to set up simulation centres for training undergraduate medical students. This article describes the establishment of a simulation centre at St. John’s Medical College in India. The important considerations that enabled the success of this process included having a clear vision and mission, identifying and deploying resources effectively, having a transparent, well-defined leadership and administrative structure, conducting timely faculty development programs and the deliberate incorporation of simulation training into the curriculum. The major challenges encountered included the difficulty in involving all faculty due to considerations of time and the development of a viable self-sustaining financial model. Incorporating digital solutions to meet the challenges of tracking student learning as part of the CBC, decentralization of simulation training at the departmental level and establishing the second phase of the centre for speciality and super-specialty training are potential areas that need to be addressed in the future. It is hoped that these experiences will provide some insight to other medical colleges in India and countries with similar contexts as they establish their simulation centres.

Medical research in Indian medical colleges is essential for advancing healthcare and fostering innovation but faces significant challenges such as inadequate infrastructure, limited funding, and insufficient researcher support. Establishing dedicated Research Cells (RCs) offers a viable solution by providing structured support, streamlining administrative processes, and fostering a culture of research excellence. RCs play a pivotal role in managing grants, facilitating ethics approvals, and offering capacity-building programs to enhance research skills and output. Recommendations for effective RC implementation include securing adequate funding, integrating RCs into institutional frameworks, and aligning their objectives with institutional goals. Promoting indigenous indexing agencies and supporting Indian medical journals are critical for improving the visibility and global impact of Indian research. Additionally, incentivizing quality research and ensuring adherence to ethical guidelines are vital for sustaining a robust research ecosystem. This article underscores the transformative potential of Research Cells in addressing systemic issues and enhancing the research environment in Indian medical colleges.

Dr Lundy is a physical anthropologist at the U.S. Army Central Identification Laboratory, Hawaii, and faculty affiliate at the department of anatomy and reproductive biology, University of Hawaii. When skeletal remains are discovered, immediate questions arise. Are they human? If so, how many persons are represented? Was the person male or female? To what ethnic group did he or she belong? How old was the person at the time of death? How tall was the person in life? What is the period of time since death, and what, if any, is the osteological evidence for the cause of death? Forensic pathologists, coroners and police officers are usually not properly trained to perform such examinations. The forensic physical anthropologist is the individual best trained to answer the above questions and in turn, provide investigators with a physical description of the person which can then be compared with missing person reports. A tentative match can then be pursued with detailed dental and medical records in hopes of establishing positive identity. In addition to training in physical anthropology and anatomy, the forensic physical anthropologist must be skilled in the interpretation of the morphology and variation of the human skeleton. Such skills are usually gained by studying large skeletal collections where one gets the 'feel' for the often subtle skeletal variations based upon sex, ethnic group and age. Most forensic anthropologists in the United States are employed in universities and museums and do their forensic work on a consulting basis. A few are employed full-time in government positions. The specialty is small with fewer than 80 members in the Physical Anthropology Section of the American Academy of Forensic Sciences, and less than 40 have undergone voluntary certification in forensic anthropology by the American Board of Forensic Anthropology. What follows is a brief discussion of how the forensic anthropologist attempts to answer the questions posed by the discovery of skeletal remains.

Archaeological theories and methods are developed to reconstruct past human behavior from fragmentary material remains. The interrelated discipline of physical anthropology addresses questions related to skeletal remains while acknowledging taphonomic parameters. The benefit of integrating these disciplines in forensic investigations has gained increasing acknowledgement over the last decades, but the use of forensic archaeology and anthropology (FAA) remains limited in Sweden. The aim of this study is to analyze the field of FAA in Sweden in relation to outdoor and fire crime scenes where human remains are encountered. Based on qualitative interviews, the state and potential developments of FAA within the Swedish police and the National Board of Forensic Medicine are discussed.The results show that for ensic investigations and analysis of human fragmentary remains are not standardized in Sweden. A great responsibility is placed on the individual crime scene investigator who elects how to investigate these sites and who to contract for the analysis of osteological remains. This can endanger evidence collection and interpretation. This study shows that investigations of buried or fragmentary human remains in Sweden could be aided by a development of FAA. Key steps to further development of FAA within Swedish police involve 1) quantifying cases that could benefit from FAA, 2) establish FAA as an independent subject, 3) develop a national infrastructure, 4) offer professional education in the subject(s), and 4) develop best practice to advance evidence collection and legal security in investigations involving fragmentary human remains.An ongoing ISO accreditation of outdoor crime scene investigations within the Swedish police will hopefully benefit FAA development and collaborations with external partners.

Sex determination from skeletal remains presents significant challenges, particularly when bones are damaged or incomplete. In such cases, histomorphological analysis of fragmented bone pieces becomes essential. The medial clavicle is recognized as a valuable anatomical marker in forensic and anthropological research due to its pronounced sex-related morphological variations. This study aimed to develop a deep learning-based method for sex determination using histological images of the medial clavicle in Thai population, and to evaluate its performance with both validation and blind test sets utilizing the GoogLeNet convolutional neural network architecture. A total of 100 pairs of clavicles were included, with 70 cases (35 males,35 females) assigned to the training group and 30 (15 males,15 females) to the test group. Histological images underwent pre-processing and were standardized in size before being input into the training model. Validation accuracy was assessed using MATLAB, while descriptive statistics for the test set were calculated with SPSS software. GoogLeNet demonstrated superior performance, achieving a validation accuracy of 96.43% and a blind test accuracy of 90%. These results highlight the potential of a deep learning approach using 2D histological images of the medial clavicle as a straightforward and effective tool for sex determination in forensic anthropology, offering a high degree of accuracy. This method paves the way for rapid, objective, and accessible sex identification, even from fragmented human remains, and demonstrates promise for broader applications in the forensic and anthropological sciences.

Forensic anthropological analysis is a valuable component of medicolegal death investigations. Like many other forensic sciences, forensic anthropology has become increasingly sophisticated in recent years, requiring qualified practitioners to complete intensive and long-term postgraduate study. In addition, forensic anthropology has experienced a recent increase in interest (facilitated in part by increased media attention), with the result that many are now much more aware of the nature and value of forensic anthropological services. While the number of qualified and certified forensic anthropologists is increasing, a misconception by a few in the medicolegal community that the numbers of forensic anthropologists cannot properly meet the consultation needs of medical examiner and coroner offices appears to exist, and moreover that anthropological services are often cost-prohibitive. Here we present an overview of the current state of forensic anthropology, including the typically available services, education and training requirements, as well as some information and suggestions for ways in which forensic pathologists and coroners can seek forensic anthropological consultation. Forensic pathology and forensic anthropology are both highly specialized fields with extensive education and training requirements, and a collaborative approach results in the most reliable and scientifically accurate forensic results. This collaboration is eminently achievable. Forensic anthropology is the science of applying anthropological method and theory to matters of medicolegal concern. Many are familiar with the traditional uses of forensic anthropology including estimation of the biological profile (age, sex, ancestry, stature) from unknown skeletal remains and the assessment of skeletal trauma. The science of forensic anthropology, however, has experienced a significant increase in sophistication and breadth in recent years. Depending on the training and interests of the individual anthropologist, as well as the resources of the institution by which they are employed, anthropological examinations may include search and recovery of human remains, the determination of skeletal versus non-skeletal origin, the determination of human versus non-human origin, the assessment of forensic significance of human remains, estimation of various biological parameters (including sex, age, ancestry, stature, as well as skeletal anomalies, pathologies and other conditions), trauma analysis, and personal identification (typically by radiographic comparison). Disclaimer: The views expressed are those of the authors and do not necessarily reflect the official policy or position of the FBI, Department of Defense, or the U.S. Government.

One of the most important tasks in forensic anthropology is the construction of the biological profile, classically defined as a set of four basic biological descriptors: biological sex, age-at-death, ancestry, and stature. Yet, our empirical and technological abilities in reconstructing the life experiences and health from skeletal remains far exceed these four parameters and forensic anthropology could benefit from further descriptors in the search for an identity. In this paper, we propose the inclusion of two other investigations to forensic anthropology practice to implement the already known biological profile: the interpretation of bone disease and lesions, and forensic toxicology on unconventional biological matrices. These analyses can provide information regarding health, habits, and disease burden, and by implementing them in our practice of forensic anthropology, they have the potential to improve the biological profile. We also propose a new term that can include not only the classical biological profile but also further descriptors, namely, the “biocultural profile”.

1 Department of Anthropology, University of Tennessee, Knoxville, Tennessee, USA. *Correspondence to: Dawnie Wolfe Steadman, Department of Anthropology, University of Tennessee, 1621 Cumberland Avenue, Strong Hall Room #502A, Knoxville, TN 37996 USA. E-mail: osteo@utk.edu KEY WORDS: forensic anthropology, quantitative methods, medicolegal casework, human identification, skeletal analysis. Human Biology, Winter 2018, v. 90, no. 1. doi: 10.13110/humanbiology.90.1.05. Copyright © 2018 Wayne State University Press, Detroit, Michigan 48201 invited commentary Who Needs Data? I’ve Got Experience! Dawnie Wolfe Steadman1 * In 2009, the National Academy of Sciences released a blistering report on the current state of forensic science oversight and practice in the United States. The report skewered the current scientifijic integrity and standards of a number of forensic subdisciplines, including fijingerprints , blood spatter, bite marks, and ballistics, and offfered specifijic recommendations to improve forensicscience.Anthropologywasnotspecifijically mentioned in the report, but the same criticisms leveled at the other disciplines, including poor training in quantitative methods, little attention to standards, and the abject lack of errors associated with methods, were obviously relevant to forensic anthropology. To the credit of the discipline, anthropologists have produced scores of articles that focus on quantitative analyses (e.g., Algee-Hewitt 2016, 2017; Hefner et al. 2014; Kooi and Fairgrieve 2013; Megyesi et al. 2005; Slice and Algee-Hewitt 2015; Stoyanova et al. 2015, 2017), validation studies (e.g., Jooste et al. 2016; Kenyhercz et al. 2017a, 2017b; Kim 2016; Milner and Boldsen 2012; Savall et al. 2016; Suckling et al. 2016), and cognitive bias in our methods (Nakhaeizadeh et al. 2014a, 2014b, 2018). The rise of “computational anthropology ,”theuseof advancedcomputingtoproduce models, simulations, and predictive modeling to address complex problems in anthropology, offfers unlimited opportunities for forensic anthropology . The technological explosion of quantitative computing and big-data analysis tools has formed an important space in anthropology, including demography, ethnography, and past and present migration studies, yet forensic anthropology has remained largely unchanged by these advancements . Despite the warnings of the National Academy of Sciences and recent computational effforts in the fijield, those who are most likely to practice forensic anthropology continue to rely on traditional techniques and personal experience rather than quantitative approaches. Here I explore some of the historical and structural reasons behind the slow acceptance of new methods based on large (and/or simulated) data sets and computational approaches highlighted in these special issues of Human Biology and offfer some guidance for moving forward. Forensic anthropology is the application of the principles of skeletal biology to medicolegal questions, such as the identifijication of unknown remainsandinterpretationof traumatothebones. Forensic anthropologists are called into the most challengingforensiccontextsinthattheyworkwith humanremainsthataredecomposed,fragmentary, burnt,cremated,incomplete,andotherwisevisibly unidentifijiable. Unlike other forensic fijields that focus on a single set of techniques and tasks (e.g., fijingerprints, DNA, ballistics), forensic anthropologists can be asked to complete four disparate tasks in a single case: search and recovery of human remains, personal identifijication, trauma analysis, and estimation of the postmortem interval. Other 000 ■ Steadman specialized tasks may include facial reproduction techniquestogarnerleadsfromthepublicconcerning the identity of unknown remains and isotope analysis of human remains to assess geographic origins and migration history that may also assist with identifijication. These distinct responsibilities preclude the ability to develop a single set of best practices and lead to a crowded playing fijield of methods. For example, the task of personal identifijication begins with assessing the biological profijile—estimationsof sex,ancestry,age,andstature from the skeleton, each of which may consist of multiple methods. While stature estimates rely on regression formulas derived from various sized reference samples, most of the other methods are historically based on qualitative observations of skeletal morphological traits. Comfort levels with methods developed in the 1980s and 1990s based exclusively on macroscopic morphological age-, sex- or populationbasedvariation (calledhere“traditionalmethods”) seem to preclude the inclusion of important new techniques that use large sample sizes (including simulated data and machine learning), quantitative data such as three-dimensional imaging techniques, and sophisticated statistical analyses. For instance, transition analysis is a maximumlikelihood approach developed for bioarchaeological samples using three skeletal indicators and choiceof priors,providinganoutputof amaximum likelihood estimate and 95% confijidence interval...

Dr. Obenson laments a lack of forensic anthropologicalexpertise in his country (Canada) [1]. I am encouraged thathe recognizes the need, albeit sporadic in most districts.However, his article fails in two respects: his valuation ofthe gravity of the problem and his proposed solution.In Dr. Obenson’s own city there are two university-basedbiological anthropologists with doctorates who teach forensiccourses. Further, a well-establ ished forensic anthropologistwho directs a Master of Science degree program in forensicanthropology and who collaborates with local medico-legalinvestigators is approximately 300 km away, which by Cana-dian standards is equivalent to being a next-door neighbor [ 2].Elsewhere in Canada forensic ant hropologists routinely travelover500 kmtoworkoncases.Dr.Obensonisnot‘‘compelled’’to analyze skeletonized remains without anthropologicalassistance, nor should any forensic scientist practice beyondtheir expertise [3]. In Canada and other countries part of theproblem is a lack of knowledge of available experts. For this,forensic anthropologists share some responsibility by way oftheir lack of professional organization [4].Dr. Obenson’s proposed solution of anthropology certifica-tion for pathologists will almost certainly create more prob-lems. For years there has been active debate in Europe amongthe Forensic Anthropology Society of Europe (FASE) aboutcertification.OncontinentalEurope,biologicalanthropologyistypically taught in university departments of biology andmedicine, which has allowed medical students to receive lim-ited training in skeletal anatomy. After protracted debate andcriticism, FASE decided to allow those who have practiced‘‘forensic anthropology’’ for the past 10 years—typicallypathologists—to continue doing so (the so-called ‘‘oldergeneration’’ [5]). Although there is no guarantee that this oldergeneration has and will continue to practice forensic anthro-pologyinaqualifiedway,thisseemstobeatokengesturemadeby FASE to appease the old guard. In contrast, the ‘‘youngergeneration’’ of mostly biological anthropologists, will be sub-jected by FASE to written and practical exams for certification.By this process, and by their reliance on two U.S. board-certi-fied forensic anthropologists (not pathologists) as adjudicators,FASE demonstrates that forensic anthropology must be pro-fessionalized and must also be p racticed by anthropologists.Shouldwedismissthesenotions andoptforDr.Obenson’sfast-track forensic anthropological education for pathologists, wewould be moving backwards. Speed-training for forensicanthropology will produce exp erts that will be no more effec-tive at forensic anthropological analysis than tele-/photo-ana-lysis by true experts.References

Forensic anthropology has traditionally relied on two-dimensional (2D) images, such as photographs and sketches, to perform analyses, and disseminate findings. However, as 3D imaging technology advances, it has become more widely implemented into forensic anthropology analysis and practice. Teaching and learning in forensic anthropology still often relies on 2D images, but increasingly three-dimensional (3D) models are available to be used by students training in anatomy and osteology. Additionally, 3D models have been found to be beneficial to comprehension in other contexts within forensic anthropology, such as in the courtroom. The use of these models in the teaching of forensic anthropology is not yet widely implemented and more importantly, the impact on learning is not yet understood. The use of 3D imaging and visualisation in other educational contexts has seen positive results, for example in medical training. To explore this further, a study was conducted using an online activity to compare the comprehension scores of students educated using 2D textbook style images or 3D models on Sketchfab. The results showed that the use of 3D images was not detrimental to comprehension. Students using the 3D models were more consistent in their performance and reported an increase in confidence regardless of prior experience. The results of this study are of particular importance when distance learning due to the COVID-19 pandemic which means that students cannot always learn in a laboratory environment.

In the current era, it is a great challenge for the teachers to identify effective ways to aid undergraduate medical students to accomplish the learning outcomes successfully. In order to achieve this as well as assist an Indian Medical Graduate to acquire five basic roles, the use of case-based learning (CBL) is an effective approach, as it not only imparts subject content but also engages the students in real-life case scenarios. Further, CBL should be considered as a supplementary tool in our conventional teaching; otherwise, it will not deliver the desired outcomes. To conclude, CBL is an effective method of teaching–learning and the prospects of incorporating the same within the curriculum to make the learning more simplified and authentic should be explored by medical colleges in India.

The History of Medical Ethics in India

ABSTRACTIn November 2008, human skeletal remains were discovered during construction works undertaken by Carlop Properties in the Chloorkop industrial area, Kempton Park, Gauteng. The Forensic Anthropology Unit of the University of Pretoria, Forensic Anthropology Research Centre (FARC) was notified, and rescue excavations of both the exposed and the undisturbed remains were undertaken. The skeletonised remains of at least 18 individuals were recovered and sent to the Department of Anatomy at the University of Pretoria for standard anthropological analysis. The identity and the time period of these human remains are unknown, and during social consultation, no relatives could be identified. Excavations revealed a formal burial pattern, which suggests a formal cemetery, probably associated with a historic institution. All individuals were buried in wooden coffins in an extended, supine position. The remains consist of both adult and juvenile remains. Some of the remains were found in a commingled state because of disturbance caused by construction work. The minimum number of individuals was determined by the visual pair matching of skeletal elements on the basis of similarities observed in bone morphology, age and sex, trauma and pathology and taphonomic alterations. Bioarchaeological techniques were used, and the following results were obtained. Of the 18 individuals, at least 15 were identified to be males, one possibly female and two juveniles. At least five of the adult male individuals presented with cut marks associated with standard autopsy procedures. No reference to the individuals' identity or to the context of the cemetery within the historical span of the Chloorkop area has been located. However, the burial pattern observed, as well as the demographic profile and pathology observed on the skeletal remains, suggests that these individuals could be linked to the Klipfontein Organic Products Factory (ca 1941s–1970s), which employed many migrant labourers, most to whom lived in compounds on the factory premises. Copyright © 2011 John Wiley & Sons, Ltd.