Mass Fatality Research Articles

Public Mass Shootings: Counterfactual Trend Analysis of the Federal Assault Weapons Ban.

Assault weapon and large-capacity magazine bans are potential tools for policy makers to prevent public mass shootings. However, the efficacy of these bans is a continual source of debate. In an earlier study, we estimated the impact of the Federal Assault Weapons Ban (FAWB) on the number of public mass shooting events in the United States. This study provides an updated assessment with 3 additional years of firearm surveillance data to characterize the longer-term effects. This study aims to estimate the impact of the FAWB on trends in public mass shootings from 1966 to 2022. We used linear regression to estimate the impact of the FAWB on the 4-year simple moving average of annual public mass shootings, defined by events with 4 or more deaths in 24 hours, not including the perpetrator. The study period spans 1966 to 2022. The model includes indicator variables for both the FAWB period (1995-2004) and the period after its removal (2005-2022). These indicators were interacted with a linear time trend. Estimates were controlled for the national homicide rate. After estimation, the model provided counterfactual estimates of public mass shootings if the FAWB was never imposed and if the FAWB remained in place. The overall upward trajectory in the number of public mass shootings substantially fell while the FAWB was in place. These trends are specific to events in which the perpetrator used an assault weapon or large-capacity magazine. Point estimates suggest the FAWB prevented up to 5 public mass shootings while the ban was active. A continuation of the FAWB and large-capacity magazine ban would have prevented up to 38 public mass shootings, but the CIs become wider as time moves further away from the period of the FAWB. The FAWB, which included a ban on large-capacity magazines, was associated with fewer public mass shooting events, fatalities, and nonfatal gun injuries. Gun control legislation is an important public health tool in the prevention of public mass shootings.

CURRENT TRENDS IN FORENSIC ODONTOLOGY. SYSTEMATIC REVIEW

Abstract Background: Forensic odontology is a subfield of dental science that includes the relationship between dentistry and law. Forensic odontology has played a key role in famous criminal cases. Forensic odontology plays a critical role in the identification of human remains of victims (mutilated, burned and decomposed), when fingerprinting and visual recognition, cannot be fulfilled. This review article was conducted to show the implications of forensic dentistry in criminal investigations. Aim: The purpose of this article provides an overview of the evolving trends in traditional methods and the latest concepts used in forensic dentistry. Methodology: The systematic review included articles from Google Scholar, Medline, Scopus, Web Of Sciences, PubMed was conducted. For Search the following keywords: Forensic odontology, dental records, identification of human remains Estimate Age, Sex assessment, Identification following mass fatalities, assessing bite mark injuries, civil cases involving malpractice, analyze bite marks. Results: Conducted a preliminary search and reviewed 82 titles and abstracts in this review and 27 full-text articles were selected of high methodological quality. Teeth are often resistant to decay even in major accidents, crimes, burials, or other severe exposures to the elements. Therefore, a person's dentition is useful for individual identification and comparison if records exist for this purpose. Various methods have been developed forensic dentistry to determine the age, gender, and ethnicity of an individual using dental tissue. The need for documented procedures and protocols is important for the dentist to In the case of victim identification disaster identification indicators (DVI), allowing for process auditing, they also serve to ensure identification reliability. Dental professionals play a major role in keeping accurate dental records and providing all necessary information so that legal authorities may recognize malpractices, negligence, fraud child abuse and also, identify an individual. In order to serve the forensic operation and the legal authorities, dentists should be familiar with the basics of forensic dentistry, which will create awareness for the preservation of dental data. Conclusion: Forensic dentistry (odontology) plays an important role in resolving dental malpractice or negligence issues, including evaluation, report writing, and/or testifying in court. Every dentist has a responsibility to understand the forensic activities related to their dental practice and should be aware of the available technologies and their use in forensic dentistry. The data collection methods and additional technologies used in forensic dental identification have undergone significant transformation. Artificial intelligence is a technology that is still evolving in forensic dentistry, and its usefulness depends on the specific use case and implementation. New research in forensic dentistry should be encouraged.

The socioeconomic impacts of Rift Valley fever: A rapid review.

Rift Valley fever (RVF) is a neglected vector-borne disease which is endemic in many countries across Africa and has seen recent geographical expansions into the Arabian Peninsula. RVF can cause severe infections in both animals and humans. RVF infections in livestock can lead to mass fatalities. In humans, the symptoms are nonspecific and can often lead to misdiagnosis. However, a small proportion progresses to haemorrhagic infection with a significantly higher mortality rate. The culmination of this can cause severe socioeconomic impacts. This review aims to identify the main socioeconomic impacts caused by RVF outbreaks as well as existing knowledge gaps. Ninety-three academic and grey papers were selected, covering 19 countries and 10 methodological approaches. A variety of socioeconomic impacts were found across all levels of society: Livestock trade disruptions consequently impacted local food security, local and national economies. Most livestock farmers in endemic countries are subsistence farmers and so rely on their livestock for sustenance and income. RVF outbreaks resulted in a variety of socioeconomic impacts, e.g., the inability to pay for school fees. Main barriers to vaccine uptake in communities were lack of access, funds, interest along with other social aspects. The occupational risks for women (and pregnant women) are largely unknown. To our knowledge, this is the first review on RVF to highlight the clear knowledge gap surrounding the potential gender differences on risks of RVF exposure, as well as differences on occupational health risk in pastoral communities. Further work is required to fill the gaps identified in this review and inform control policies.

A review of the contributions of forensic archaeology and anthropology to the process of disaster victim identification.

Forensic archaeology and anthropology have developed significantly over past decades and now provide considerable assistance to the investigation process of disaster victim recovery and identification. In what are often chaotic death and crime scenes, the formal process of utilizing archaeological methods can bring control, order, and ensure systematic search. Procedures assist in defining scene extent, locating victims and evidence, rule out areas for consideration, and provide standardized recording and quality assurance through dedicated use of standardized forms (pro formas). Combined archaeological and anthropological search methods maximize opportunities to recovery the missing through identifying remains, mapping distributions, and providing accounting of victims at the scene. Anthropological assistance in examinations contributes to individual assessment, resolving commingling and fragmentation issues, and utilizing DNA sampling methods and matching data to reassociate and account for the missing. Utilization of archaeology, anthropology, and DNA matching data provides scope to review crime scene recovery and determine requirements and potential for further survey and retrieval. Adopting the most suitable methods for a particular context can maximize recovery, efficiency, and resource use. Case studies demonstrate the utility of archaeological methods in a range of scenarios. They exemplify the success of multidisciplinary analysis in providing evidence of the sequence of events, the timing of events, the impact of taphonomic processes, the location and accounting of victims, and the demonstration of systematic scene search. The considerations provided in this article, utilizing archaeology and anthropology processes, may assist investigators in planning and implementing responses to mass fatalities.

A Statistical Analysis of the Impact of Gun Ownership on Mass Shootings in the USA Between 2013 and 2022

Mass shootings (incidents with four or more people shot in a single event, not including the shooter) are becoming more frequent in the United States, posing a significant threat to public health and safety in the country. In the current study, we intended to analyze the impact of state-level prevalence of gun ownership on mass shootings—both the frequency and severity of these events. We applied the negative binomial generalized linear mixed model to investigate the association between gun ownership rate, as measured by a proxy (i.e., the proportion of suicides committed with firearms to total suicides), and population-adjusted rates of mass shooting incidents and fatalities at the state level from 2013 to 2022. Gun ownership was found to be significantly associated with the rate of mass shooting fatalities. Specifically, our model indicated that for every 1-SD increase—that is, for every 12.5% increase—in gun ownership, the rate of mass shooting fatalities increased by 34% (p value < 0.001). However, no significant association was found between gun ownership and rate of mass shooting incidents. These findings suggest that restricting gun ownership (and therefore reducing availability to guns) may not decrease the number of mass shooting events, but it may save lives when these events occur.

Navigating a world in conflict: The mental health implications of contemporary geopolitical crises.

Throughout history, armed conflicts have profoundly affected individuals and societies, with recent events in Ukraine, the Middle East, and beyond bringing into sharp focus the severe mental health and humanitarian consequences of geopolitical crises. Such situations often result in mass fatalities, destruction, displacement, forced migration, and other critical life events. Amid these scenarios, the adverse outcomes for mental health and well-being in both the short and long term must be emphasized. As a conceivable example of the latter, the proposed concept of intergenerational trauma could have far-reaching implications. In particular, in certain regions, civilians have repeatedly experienced instances of violence and may have continually been exposed to critical life events and traumatic stress. In this context, the consequences of these events for individual well-being and global mental health will likely be registered for years to come. Accordingly, urgent help and actions to address the mental health burdens within contemporary conflicts should be accentuated in humanitarian, political, and diplomatic interventions. Equally, health policies must adopt a long-term approach to support initiatives under the purview of global and public mental health objectives.

코로나19에 대한 낙관적 편견에 영향을 미치는 요인

The purpose of this study is to figure out the factors that affect optimistic bias of COVID-19 risk. This study investigated the effects of media use, interpersonal communication, and self-efficacy, risk characteristics and social trust on two dimensions of the optimistic bias, vulnerability and general risk. The finding showed that optimistic bias, in the dimension of vulnerability, was affected by mass media use(+), interpersonal communication(-), self-efficacy(+), and uncertainty(+), and optimistic bias, in the dimension of general risk, was influenced by mass media use(+) and fatality(-). Furthermore it indicated that social trust was not the significant factor of optimistic bias in both dimensions. This study suggested that mass media use, interpersonal communication and self-efficacy as well as risk characteristics were the major factors affecting optimistic bias of COVID-19 risk. Therefore, it expands a theoretical ground for how optimistic bias is created and provides a meaningful insight on how to reduce optimistic bias and to promote preventive behavior for the public healthcare practitioners.

Exploring the challenges and risks of dead body handling faced by healthcare professionals during the coronavirus pandemic: Cross sectional survey study

The coronavirus pandemic shocked the already overwhelmed global healthcare system, challenging its preparedness to deal with mass fatalities. Our research examines the safety issues faced by healthcare workers when handling dead (deceased) bodies, highlighting the need for better strategies in the event of mass fatalities. Healthcare providers involved in dead body handling during the COVID-19 pandemic in the U.S. were eligible to participate in our study. Using a web-based survey, we analyzed responses of 206 participants across 43 U.S. states. We used the Systems Engineering Initiative for Patient Safety (SEIPS) framework to deduce themes from participants’ open-ended responses. The study showed how routine tasks become extraordinarily challenging during pandemic due to increased workload, emotional stress, and resource constraints. Tasks such as lifting and transferring bodies, underscored physical and emotional toll on workers. The mental strain induced by mass fatalities and the complexities of communicating with families and peers were also prominent, adding to the overall burden on healthcare workers. The participants emphasized the importance of specialized training, policy refinements, and improvements in its implementation. In conclusion, our study contributes to understanding the complexities of dead body handling during a pandemic. It underscores the need for emergency response planning and systemic changes in healthcare policies and practices to ensure the safety and well-being of healthcare workers engaged in these critical tasks.

Advances in postmortem fingerprinting: Applications in disaster victim identification.

Postmortem fingerprinting is the fastest and most reliable way to scientifically identify unknown decedents from mass fatality incidents. In disaster victim identification (DVI), fingerprints, DNA, and dental examinations are the three primary methods of identification. Additional secondary identifiers such as comparative medical radiography, scars, marks, and tattoos can also be used if viable antemortem information can be located. As DNA technology continues to evolve, RAPID DNA may now identify a profile within 90 min if the remains are not degraded or comingled. When there are true unknowns, however, there is usually no DNA, dental, or medical records to retrieve for a comparison without a tentative identity. It is imperative to understand how to properly collect postmortem prints following various postmortem changes, which databases are available to search against, and what additional resources are available prior to any such event occurring. With advances in technology, automated fingerprint searching is faster than ever before. Mobile devices can now search all the major databases within a matter of minutes from a cell phone or tablet utilizing a peripheral fingerprint scanner. Preliminary research into the application of WD-40® when utilizing optical-capacitive scanners has shown to greatly increase the efficacy of capturing usable fingerprints. This additional step allows for the digital capture of fingerprints in even complicated settings, both in daily cases and DVI incidents. This article outlines all the available ways to obtain postmortem fingerprints in complex cases, and how they can be applied to efficiently and effectively used in the DVI process.

Disruptive, dangerous, and dirty: active travel measures as a ‘cause’ of car-related externalities

Automobility centred on private car use generates various externalities – or ‘antagonisms’ – that threaten its sustainability as a mobility regime. Through expanding the practice and spaces of driving, mass immobility can result. With increased car use, comes increased energy use, generating an ecological antagonism for this regime. Finally, greater car use has resulted in mass road traffic injuries and fatalities, which presents another threat to the growth and maintenance of this unique form of automobility. While these antagonisms present a risk, they have also been leveraged as a means to establish and secure the dominance of automobility. As part of a wider study exploring discourses of opposition to redistributive active travel measures in Dún Laoghaire-Rathdown, Ireland, this paper illustrates how active travel measures that present a challenge to automobility are depicted as disruptive, dangerous and dirty. These measures, precisely designed to mitigate the antagonisms of mass car use, are construed instead as primary causes of these systemic externalities. This study thereby reveals how active travel spaces themselves – and spatial regulations that favour active travellers – can be unfavourably represented as a means of politically sustaining automobility.

Long-Term Tissue Preservation at Ambient Temperature for Post-Mass Fatality Incident DNA-Based Victim Identification.

In a mass fatality incident (MFI), effective preservation of tissue samples is the cornerstone for downstream DNA-based identification of victims. This is commonly achieved through freezing of tissue samples excised from bodies/fragmented remains which may be buried or stored in refrigerated containers. This may, however, not be possible depending on the nature of the MFI; in particular, during armed conflict/war where extended periods of electrical outages would be expected. The present study compared the effectiveness of long-term tissue preservation at ambient temperatures using two commercial products (non-iodized kitchen salt and a 40% alcoholic beverage) against a chemical preservative (Allprotect™ Tissue Reagent (Qiagen, Germantown, MD, USA)) and freezing at -20 °C. Bovine muscle tissue, used as a proxy for human tissue, was treated with the four preservation methods and sampled at six different time-points over a 24-month period. All four methods were able to preserve the bovine tissue, generally yielding STR-PCR (Short Tandem Repeat-Polymerase Chain Reaction) amplicons > 200 bp in size even at the end of 24 months. Gel electrophoresis, however, indicated that salt was more effective in preserving DNA integrity with high-molecular-weight DNA clearly visible as compared to the low-molecular-weight DNA smears observed in the other methods. This study also proposes a simple process for the rapid and low-cost preservation of tissue samples for long-term storage at ambient temperatures in support of post-incident victim identification efforts.

Mass fatality and disaster response preparedness across medical examiner and coroner offices in the United States

With the rise of mass fatalities and disasters, access to mass fatality and disaster planning trainings and resources available to medical examiners and coroners (MECs) in the United States should be reviewed. This paper provides a necessary update on the extent of access to these resources by analyzing data from the 2018 Census for Medical Examiner and Coroner Offices (CMEC). Results show that a high percentage of respondents have access to mass fatality and disaster planning trainings/resources; however, the access is disproportionate. Respondents in the Midwest and South—and those with smaller populations—have less access to resources, while agencies with larger budgets and more full-time staff have more access to resources. This paper discusses potential contributing factors for these disparities, but the data only begin to elucidate gaps in access to mass fatality and disaster planning trainings/resources for MECs and where further research should be conducted.

The impacts of governing agency: A comparison of resources in the patchwork of medicolegal death investigation systems

In the United States, medical examiners and coroners (MECs) fill critical roles within our public health and public safety systems. These professionals are primarily charged with determining the cause and manner of death as they investigate deaths and respond to associated scenes and mass fatalities and can also help identify trends in public health crises through medicolegal death investigations. Despite their instrumental role, they are organized in disparate systems with varying governing structures, functions, staffing, caseload, budget, and access to resources. This paper examines data from the 2018 Census of Medical Examiner and Coroners to evaluate MEC operations in the United States. The findings show that MEC offices’ organizational and operational governance structures greatly influence resources, workloads, and access to information and services. Standalone MEC offices were generally better resourced than those affiliated with law enforcement, public health, forensic science, district attorneys, or other agencies.1

Innovations in forensic medicine: accuracy, evidence and effectiveness of expertises in emergencies in case of mass fatality

The article presents the main innovative methods used in forensic expert practice at the current stage, reveals the principle and algorithms of the developed software complex for registration and identification of the deceased. The proposed program automatically generates four documents, which reduces the time required for forensic expertise in the conditions of mass admission of deceased. The article's authors substantiate prospects of further application of computer technologies in forensic practice to improve organizational and methodological activities in emergencies with a large number of deceased.

Bi-objective covering salesman problem with uncertainty

Humanitarian relief transportation and mass fatality management activities are the most strenuous tasks after a natural or artificial disaster. A feasible and realistic transport model is essential for accomplishing the tasks in a planned way. Covering Salesman Problem (CSP) is a variant of Traveling Salesman Problem (TSP) which has been used in many application areas, including disaster management. In this paper, we consider a bi-objective CSP in an uncertain environment where Interval Type 2 fuzzy numbers represent the costs of the edges. A new local search technique is introduced in the memetic algorithm, which has been used to solve the problem. A computational experiment on a set of instances indicates the effectiveness of the introduced local search technique along with the proposed methodology.

Management of unidentified and unclaimed bodies: a comparison of model from four countries in the Asia Pacific Region.

Managing mass fatality incidents or disasters involving multiple deaths are not uncommon among forensic practitioners. In fact, management of unidentified or unknown bodies is also a vital component of the day-to-day mortuary work practice. The unidentified and subsequently unclaimed bodies have always been a "silent mass disaster," a problem that needs to be tackled within the forensic community and raises the global issue of ethics, law, and human rights. Unidentified bodies' in Malaysia make up an average of 4.02% of all death cases where a total postmortem examination was performed which is comparable with other developing countries within 4-10% which can go up to 25%. Moreover, unstandardized procedures in all mortuaries in different states and districts in Malaysia have worsened the scenario even with guidelines in place. This study aims to address the issues surrounding unidentified and unclaimed bodies including body disposal from a social and legal perspective using case study methodology by comparing four different countries in the Asia Pacific Region through document analysis and interview methods. One of the major findings is evident in 3 out of the 4 models, whereby there is a considerable gap in consolidating the missing person report and information to match with the unidentified bodies received in forensic institutions in an attempt to enhance the identification process which ultimately intends as a closure for the family members. It is also timely to think out of the box beyond dental records and DNA profiling to improve the identification rate for skeletonized remains through means of anthropology biometrics comparison. With the limited literature published surrounding this domain, it is hoped that the suggestions and recommendations to standardize the management of unidentified and unclaimed bodies can benefit many forensic institutions and public mortuaries in this region.

Evaluation of intercanine arch width, intermolar arch width and the canine fossa width in the determination of gender of an individual between 18 and 35 years – An in vitro analytical retrospective study

Objective s: The aim of this study is to verify and assess the usefulness of intercanine arch width, intermolar arch width, and canine fossa width in maxilla and intercanine and intermolar width in mandible for gender determination in the adult population. In medicolegal cases, estimation of gender using the skeletal remains of victims is imperative. The identity of an individual can be verified by examination of teeth and surrounding tissues from skeletal remains. Measurements from teeth and skull can help a Forensic Odontologist to identify deceased victims by age, gender, or race. The association of skeletal remains with gender gains utmost importance in cases of mass fatality such as earthquakes, tsunami, accidents, cyclones, and floods. If an individual is not in a condition to be identified, then they can be identified from the dentition or remains of dentition during any natural or manmade calamities. The benefit of determining gender in mass calamities is that accurately determined gender confines the number of missing individuals to one-half of the population in the majority cases. Many studies pertaining to maxillary arch widths have been performed yet the literature regarding mandibular arch widths remains scarce. Furthermore, in the literature, very few studies have been carried out to correlate canine fossa width and gender of an individual. Material and Methods: The study was carried out on a sample size of 120 study models, between 18 to and 35 years in department of orthodontics and dentofacial orthopedics and the samples had equal male and female distribution. A digital vernier caliper measured the intercanine arch width, intermolar arch width and canine fossa width and the parameters were measured by a single observer and statistical analysis was performed. Results: Intercanine arch width in maxillary arch was 36.38 ± 3.08 mm and 33.44 ± 2.72 mm for males and females correspondingly with P &lt; 0.001 which is statistically highly significant. Intermolar arch width in maxillary arch was 47.81 ± 3.02 mm and 45.2 ± 2.64 mm for males and females correspondingly with P &lt; 0.001 which is statistically highly significant. Canine fossa width in maxillary arch was 43.42 ± 2.58 mm and 40.36 ± 2.32 mm for males and females correspondingly with P &lt; 0.001 which is statistically highly significant. Intercanine arch width in mandibular arch was 27.43 ± 2.96 mm and 26.2 ± 1.97 mm for males and females correspondingly with P &lt; 0.05 which is statistically significant. Intermolar arch width in mandibular arch was 41.88 ± 3.47 mm and 39.89 ± 2.48 mm for males and females correspondingly with P &lt; 0.001 which is statistically highly significant. After employing the receiver operating curve, to figure out specificity and sensitivity of the parameters, high specificity of 97%, with the best sensitivity of 78% was recorded for the maxillary canine fossa width. Conclusion: The results show that in cases of mass calamities, maxillary canine fossa width will prove to be useful tool in gender determination accurately after analyzing the dental remains of young missing adults with multiple missing teeth. This will further aid the forensic odontologist to determine identity of the missing individual.

Death managers, public health, and COVID‐19: An exploratory study

AbstractThe ongoing COVID‐19 pandemic has exacerbated cracks in the United States' healthcare systems—along with its deathcare systems. The pandemic as an ongoing mass fatality incident highlights the need to understand the public servants engaged in deathcare work, as they are a vital part of the emergency response equation. This exploratory, descriptive study focuses on the ways in which medical examiners and coroners (ME/Cs) in the United States provide core emergency management services to communities, relying on findings from interviews with 18 ME/Cs throughout the country. Findings indicate how COVID‐19 cases are counted is difficult, the pandemic changed how ME/Cs operate in response, and burnout is eminent for these public servants.

Contributions and advances of forensic genetics in mass fatality incidents

Disaster victim identification is crucial for humanitarian and legal reasons. Forensic genetics plays an important role in these situations which often become a challenge for the different professionals involved due to their complexity. The establishment of guidelines and recommendations makes it easier to follow standardised protocols that make it possible to guarantee the reliability of the identification final result. Likewise, advances in forensic genetics contribute to speeding up the response, providing new analysis strategies and bioinformatic tools. This article aims to provide an overview of how forensic genetics and its advances can contribute in these situations, as well as some keys to understanding the work of forensic genetics laboratories in the identification of corpses in events with multiple victims.

Analyzing the impact of state gun laws on mass shootings in the United States from 2013 to 2021

ObjectivesMass shooting incidents have drastically increased in the United States in the last 10 years, with a disproportionate number of incidents occurring in some states. Gun laws vary greatly by state, but little research has been conducted to examine the association between the strength of state gun laws and mass shootings. This study aims to explore the aggregate effect of state gun laws on the rate of mass shooting incidents and fatalities. Study designThis was a cross-sectional time series. MethodsThis study applied the negative binomial generalized linear mixed model to assess the impact of state gun laws restrictiveness—as measured by the total number of active gun laws—on the rate of mass shooting incidents and fatalities. ResultsThe restrictiveness of state gun laws was significantly associated with the rate of mass shooting fatalities; specifically, for every 1 standard deviation (SD) increase in the state gun law restrictiveness score (i.e. for every additional 27 gun laws in place), the rate of mass shooting fatalities was decreased by 24% (P-value <0.0001), controlling for other predictor variables in the model. However, no significant association was found between the restrictiveness of state gun laws and rate of mass shooting incidents. ConclusionsState gun laws may not decrease the number of mass shooting events, but they appear to help reduce the number of deaths when these mass shootings occur. Better data collection on mass shootings and further research on the impacts of specific gun laws are needed to help understand the effectiveness of gun laws and inform law-based interventions.