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  1. Article ; Online: Subject-specific finite element head models for skull fracture evaluation-a new tool in forensic pathology.

    Henningsen, Mikkel Jon / Lindgren, Natalia / Kleiven, Svein / Li, Xiaogai / Jacobsen, Christina / Villa, Chiara

    International journal of legal medicine

    2024  

    Abstract: Post-mortem computed tomography (PMCT) enables the creation of subject-specific 3D head models suitable for quantitative analysis such as finite element analysis (FEA). FEA of proposed traumatic events is an objective and repeatable numerical method for ... ...

    Abstract Post-mortem computed tomography (PMCT) enables the creation of subject-specific 3D head models suitable for quantitative analysis such as finite element analysis (FEA). FEA of proposed traumatic events is an objective and repeatable numerical method for assessing whether an event could cause a skull fracture such as seen at autopsy. FEA of blunt force skull fracture in adults with subject-specific 3D models in forensic pathology remains uninvestigated. This study aimed to assess the feasibility of FEA for skull fracture analysis in routine forensic pathology. Five cases with blunt force skull fracture and sufficient information on the kinematics of the traumatic event to enable numerical reconstruction were chosen. Subject-specific finite element (FE) head models were constructed by mesh morphing based on PMCT 3D models and A Detailed and Personalizable Head Model with Axons for Injury Prediction (ADAPT) FE model. Morphing was successful in maintaining subject-specific 3D geometry and quality of the FE mesh in all cases. In three cases, the simulated fracture patterns were comparable in location and pattern to the fractures seen at autopsy/PMCT. In one case, the simulated fracture was in the parietal bone whereas the fracture seen at autopsy/PMCT was in the occipital bone. In another case, the simulated fracture was a spider-web fracture in the frontal bone, whereas a much smaller fracture was seen at autopsy/PMCT; however, the fracture in the early time steps of the simulation was comparable to autopsy/PMCT. FEA might be feasible in forensic pathology in cases with a single blunt force impact and well-described event circumstances.
    Language English
    Publishing date 2024-02-22
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1055109-8
    ISSN 1437-1596 ; 0937-9827
    ISSN (online) 1437-1596
    ISSN 0937-9827
    DOI 10.1007/s00414-024-03186-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Un I Zs.312: Show issues Location:
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  2. Article ; Online: Sensitivity and specificity of post-mortem computed tomography in skull fracture detection-a systematic review and meta-analysis.

    Henningsen, Mikkel Jon / Larsen, Sara Tangmose / Jacobsen, Christina / Villa, Chiara

    International journal of legal medicine

    2022  Volume 136, Issue 5, Page(s) 1363–1377

    Abstract: Post-mortem computed tomography (PMCT) has been increasingly used as routine examination in forensic pathology. No recent review of the growing number of papers on the ability of PMCT to detect skull fracture exists, and original papers report ... ...

    Abstract Post-mortem computed tomography (PMCT) has been increasingly used as routine examination in forensic pathology. No recent review of the growing number of papers on the ability of PMCT to detect skull fracture exists, and original papers report sensitivities from 0.85 to 1.00. This systematic review (PROSPERO: CRD42021233264) aims to provide a meta-analysis of sensitivity and specificity of PMCT in skull fracture detection. We searched PubMed, MEDLINE and Embase for papers published between January 2000 and August 2021 reporting raw numbers, sensitivity and specificity or Abbreviated Injury Score for PMCT compared to autopsy. Papers without both PMCT and autopsy, no separate reporting of the neuro-cranium, exclusively on children, sharp trauma, gunshot or natural death as well as case reports and reviews were excluded. Two authors independently performed inclusion, bias assessment and data extraction. QUADAS-2 was used for bias assessment and a random effects models used for meta-analysis. From 4.284 hits, 18 studies were eligible and 13 included in the meta-analysis for a total of 1538 cases. All deceased were scanned on multi-slice scanners with comparable parameters. Images were evaluated by radiologists or pathologists. Intra- and inter-observer analyses were rarely reported. In summary, sensitivity of PMCT for detection of fractures in the skull base was 0.87 [0.80; 0.92] with specificity 0.96 [0.90; 0.98], and sensitivity for the vault was 0.89 [0.80; 0.94] with specificity 0.96 [0.91; 0.98]. The mixed samples are a limitation of the review.
    MeSH term(s) Autopsy/methods ; Child ; Forensic Pathology/methods ; Humans ; Sensitivity and Specificity ; Skull Fractures/diagnostic imaging ; Tomography, X-Ray Computed/methods
    Language English
    Publishing date 2022-03-14
    Publishing country Germany
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ZDB-ID 1055109-8
    ISSN 1437-1596 ; 0937-9827
    ISSN (online) 1437-1596
    ISSN 0937-9827
    DOI 10.1007/s00414-022-02803-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Un I Zs.312: Show issues Location:
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  3. Article ; Online: Fractures of the neuro-cranium: sensitivity and specificity of post-mortem computed tomography compared with autopsy.

    Henningsen, Mikkel Jon / Harving, Mette Lønstrup / Jacobsen, Christina / Villa, Chiara

    International journal of legal medicine

    2022  Volume 136, Issue 5, Page(s) 1379–1389

    Abstract: Post-mortem computed tomography (PMCT) is a routine tool in many forensic pathology departments as it is fast and non-destructive and allows less gruesome visualization than photographs, and the images are indefinitely storable. Several studies ... ...

    Abstract Post-mortem computed tomography (PMCT) is a routine tool in many forensic pathology departments as it is fast and non-destructive and allows less gruesome visualization than photographs, and the images are indefinitely storable. Several studies investigated congruence between PMCT and autopsy for skull fracture but registered only the presence or absence of fracture systems. The objective of this study was to determine location-specific sensitivity and specificity of PMCT for individual fracture lines in blunt force head trauma. Accurate 3D models based on PMCT data with all fracture lines visible are important for future studies on fractures, applying finite element analysis (FEA). We retrospectively sampled adult cases from 2013 to 2019 with skull fracture mentioned in the autopsy report. PMCT was on a Siemens 64-slice scanner and autopsy according to international guidelines. The location and direction of all fracture lines at autopsy and at de novo interpretation of scans were registered and compared. Ninety-nine cases with 4809 individual findings were included. Age ranged from 18 to 100 years. The overall sensitivity was 0.58, and specificity was 0.91. For individual locations, sensitivity ranged from 0.24 to 0.85, and specificity ranged from 0.73 to 1.00. Intra-observer agreement was 0.74, and inter-observer agreement ranged from 0.43 to 0.58. In conclusion, PMCT is suited for detection of fracture systems, but not for detection of all individual fracture lines. Our results differed from the existing literature due to the methodological choices of registering individual fracture lines. Future studies utilising FEA must supplement PMCT with autopsy data.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Autopsy/methods ; Forensic Pathology/methods ; Humans ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Skull/pathology ; Skull Fractures ; Tomography, X-Ray Computed/methods ; Wounds, Nonpenetrating/pathology ; Young Adult
    Language English
    Publishing date 2022-01-27
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1055109-8
    ISSN 1437-1596 ; 0937-9827
    ISSN (online) 1437-1596
    ISSN 0937-9827
    DOI 10.1007/s00414-022-02779-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Un I Zs.312: Show issues Location:
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  4. Article ; Online: 3D printed skulls in court - a benefit to stakeholders?

    Henningsen, Mikkel Jon / Thorlacius-Ussing, Lykke / Jensen, Lotte Groth / Hansen, Kasper / Jacobsen, Christina / Lou, Stina / Villa, Chiara

    International journal of legal medicine

    2023  Volume 137, Issue 6, Page(s) 1865–1873

    Abstract: Forensic pathologists may use 3D prints as demonstrative aids when providing expert testimony in court of law, but the effects remain unclear despite many assumed benefits. In this qualitative study, the effects of using a 3D print, demonstrating a blunt ...

    Abstract Forensic pathologists may use 3D prints as demonstrative aids when providing expert testimony in court of law, but the effects remain unclear despite many assumed benefits. In this qualitative study, the effects of using a 3D print, demonstrating a blunt force skull fracture, in court were explored by thematic analysis of interviews with judges, prosecutors, defence counsels, and forensic pathologists with the aim of improving the expert testimony. Five semi-structured focus groups and eight one-to-one interviews with a total of 29 stakeholders were transcribed ad verbatim and analysed using thematic analysis. The study found that a highly accurate 3D print of a skull demonstrated autopsy findings in detail and provided a quick overview, but sense of touch was of little benefit as the 3D print had different material characteristics than the human skull. Virtual 3D models were expected to provide all the benefits of 3D prints, be less emotionally confronting, and be logistically feasible. Both 3D prints and virtual 3D models were expected to be less emotionally confronting than autopsy photos. Regardless of fidelity, an expert witness was necessary to translate technical language and explain autopsy findings, and low-fidelity models may be equally suited as demonstrative aids. The court infrequently challenged the expert witnesses' conclusions and, therefore, rarely had a need for viewing autopsy findings in detail, therefore rarely needing a 3D print.
    Language English
    Publishing date 2023-07-01
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1055109-8
    ISSN 1437-1596 ; 0937-9827
    ISSN (online) 1437-1596
    ISSN 0937-9827
    DOI 10.1007/s00414-023-03054-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Un I Zs.312: Show issues Location:
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  5. Article ; Online: Translational deep phenotyping of deaths related to the COVID-19 pandemic: protocol for a prospective observational autopsy study.

    Henningsen, Mikkel Jon / Khatam-Lashgari, Apameh / Olsen, Kristine Boisen / Jacobsen, Christina / Brøchner, Christian Beltoft / Banner, Jytte

    BMJ open

    2021  Volume 11, Issue 8, Page(s) e049083

    Abstract: Introduction: The COVID-19 pandemic is an international emergency with an extreme socioeconomic impact and a high mortality and disease burden. The COVID-19 outbreak is neither fully understood nor fully pictured. Autopsy studies can help understand the ...

    Abstract Introduction: The COVID-19 pandemic is an international emergency with an extreme socioeconomic impact and a high mortality and disease burden. The COVID-19 outbreak is neither fully understood nor fully pictured. Autopsy studies can help understand the pathogenesis of COVID-19 and has already resulted in better treatment of patients. Structured and systematic autopsy of COVID-19-related deaths will enhance the mapping of pathophysiological pathways, not possible in the living. Furthermore, it provides an opportunity to envision factors translationally for the purpose of disease prevention in this and future pandemics. This is the protocol for an autopsy study that offers an umbrella for deep and diverse investigations of COVID-19-related deaths, including a systematic investigation of 'long' COVID-19 by means of extensive and systematic tissue sampling.
    Methods and analysis: A COVID-19-specific autopsy algorithm has been created to cover all cases undergoing clinical or forensic autopsy in Denmark. The algorithm describes advanced tissue sampling and a translational analytical follow-up for deep phenotyping. The translational approach covers registry data, postmortem imaging, gross autopsy findings, microscopic organ changes, postmortem toxicology, postmortem biochemical investigation, microbiological profiling and immunological status at the time of death, and future research projects covering genetics and epigenetics on an organ level.
    Ethics and dissemination: This study has been approved by the Regional Ethics Committee of the Region of Greater Copenhagen (No: H-20078436) and the Danish Data Protection Agency (No: 2002-54-1080). Next of kin gave informed consent to research. The study results will be published in peer-reviewed journals.
    Trial registration number: This study is purely observational and, as such, does not meet the criteria of the International Committee of Medical Journal Editors for clinical trials; thus, there is no need for registration in a database of research trials, such as clinical trials. To facilitate cooperation in research, provide transparency on case recruitment for publications to come and to avoid unnecessary duplicate work, we nevertheless wish to publish our protocol.
    MeSH term(s) Autopsy ; COVID-19 ; Humans ; Pandemics ; Prospective Studies ; SARS-CoV-2
    Language English
    Publishing date 2021-08-27
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2021-049083
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Autopsies in pandemics - a perspective on barriers and benefits. Is it time for a revival?

    Khatam-Lashgari, Apameh / Henningsen, Mikkel Jon / Olsen, Kristine Boisen / Jacobsen, Christina / Hasselby, Jane Preuss / Colville-Ebeling, Bonnie / Banner, Jytte

    APMIS : acta pathologica, microbiologica, et immunologica Scandinavica

    2021  Volume 129, Issue 7, Page(s) 324–339

    Abstract: Influenza virus and coronavirus pandemics regularly sweep the globe, at great cost of health and economy. Our aim was to conduct a PubMed search for autopsy studies on influenza and coronavirus to investigate the contribution of autopsies during ... ...

    Abstract Influenza virus and coronavirus pandemics regularly sweep the globe, at great cost of health and economy. Our aim was to conduct a PubMed search for autopsy studies on influenza and coronavirus to investigate the contribution of autopsies during pandemics, focussing on autopsy methods and procedures and the role of autopsy findings in pandemics. The retrieved autopsy studies generally relied on microscopy, polymerase chain reaction (PCR), immunostaining and electron microscopy. Most were small and reported on lung effects, including diffuse alveolar damage (DAD), pneumonia and tracheobronchitis. Antibiotic therapy has diminished a role for bacterial pneumonia, whereas obesity is an emerging risk factor. Autopsy studies have provided new insights into coronavirus disease 2019 (COVID-19) treatments like anti-coagulative therapy. Unfortunately, autopsies during pandemics are hampered by lack of guidelines, facilities and expertise for handling potentially infectious corpses and by widely varying recommendations for personal protective equipment and procedures. The Department of Forensic Pathology, at the Forensic Institute, at the University of Copenhagen in Denmark has, in collaboration with the Department of Pathology, Rigshospitalet, Copenhagen, initiated a prospective observational study on COVID-19-related deaths encompassing postmortem imaging, standardized autopsy procedures/reporting and extensive tissue sampling for histological, chemical, microbiological and genetic analysis. The study involves a diverse array of research groups at the University of Copenhagen, and the clinical field.
    MeSH term(s) Autopsy ; COVID-19/pathology ; Coronavirus Infections/pathology ; Humans ; Influenza, Human/pathology ; Pandemics ; SARS-CoV-2 ; Severe Acute Respiratory Syndrome/pathology
    Language English
    Publishing date 2021-03-01
    Publishing country Denmark
    Document type Journal Article ; Review
    ZDB-ID 93340-5
    ISSN 1600-0463 ; 0903-4641
    ISSN (online) 1600-0463
    ISSN 0903-4641
    DOI 10.1111/apm.13111
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Ud II Zs.73: Show issues Location:
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