Expediency of using a comprehensive approach in the identification of missing persons

of missing persons Voichenko V. V., Roshchin G. G., Dyadyk O. O., Irkin I. V., Petrochak O. Yu., Kostenko Е. Ya., Vyun V. V., Zubko M. D. PI "Dnipropetrovsk Regional Clinical Bureau of Forensic Medical Examination" DRSA, Dnipro, Ukraine P. L. Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine Uzhhorod National University of the Ministry of Education and Science of Ukraine, Uzhhorod, Ukraine SHEI "Zaporizhia State Medical University", Zaporizhia, Ukraine


Introduction
In many countries around the world, including Ukraine, the identification of the bodies of the dead remains an urgent problem due to cases of local military conflicts [24], mass catastrophes and natural disasters [25], as well as an increase in cases of unorganized migration.
Identification of the remains of missing persons includes complex scientific, technical, legal, ethnic and cultural issues. This is a huge layer of problems that has emerged in recent years and is increasingly spreading against the background of other pressing problems of today's society, and which all of us together professionals in various fields will have to solve more than one year, and perhaps more than a decade. Accordingly, this leads to an increase in the number of examinations to identify the person, as well as the need to develop new scientific and methodological approaches to solving this problem. Given the presence in the literature of systemic nature of identification tasks and ways to solve them, regardless of the causes that led to the mass death of people [1,29], today we have our own domestic experience in organizing work on identifying missing persons and determining the characteristics of the body injuries and traumatic factors [6,17,26], which includes effective approaches to odontological status [9][10][11], burnt bone remains [7,8], dermatoglyphic parameters of the palms [18][19][20] and others.
The process of identification is complex and multistage, and originates from the place of discovery of the remains of the deceased. And if the detection of remains on the earth's surface does not cause significant difficulties in the first stage, the detection of both single and mass burials is a more complex process that requires the involvement of forensic anthropologists and archaeologists [28]. At the next stage, after the evacuation of all the remains of the body, it is necessary to establish which parts of the body, the bones of the corpse are present; begins the process of gender, physique, height, ethnicity and race, identification of intravital and postmortem injuries [25], uses different types of medical imaging of soft tissues and bones [28], if possible and necessary, an autopsy with subsequent removal of materials for forensic laboratory.
It should be noted that the identification of missing persons in armed conflict and with mass casualties in emergencies has its own characteristics and to improve accuracy and objectivity requires a comprehensive approach with the appropriate amount of anthropometric, morphometric, photographic, radiological, molecular genetics and medical-criminalistics research methods.
The aim of the study was to substantiate the feasibility of a comprehensive approach to the identification of missing persons in armed conflict and with mass casualties.

Materials and methods
1509 "Expert conclusions" from the archive of PI "Dnipropetrovsk Regional Clinical Bureau of Forensic Medical Examination" were used in the work, including archival materials of the department of forensic examination of corpses, departments of forensic criminology, forensic histology, forensic immunology, forensic cytology, regarding the identification of 1509 victims of the armed conflict in eastern Ukraine during 2014-2019. The research results were processed by standard methods of variation statistics.
The following research methods were used to identify people who died in the armed conflict: anthropometric, morphometric, photographic, radiological, forensic methods, computer modeling, molecular genetics, statistical.

Results
Significant damage to the tissues and organs of corpses, which impedes their identification, makes the identification of persons killed in armed conflict or as a result of emergencies a daunting task. Our own experience has shown that during hostilities due to artillery shelling from jets, a plane or helicopter crash, or when the body has been in unfavorable conditions on the battlefield for a long time, identification is much more difficult. Under these conditions, the bodies of the dead are most often mutilated beyond recognition or burned to the ground (Fig. 1), however, hundreds of unidentified bodies and their fragments need to be identified.
Since the beginning of the armed conflict in eastern Ukraine, the Dnipropetrovsk Regional Bureau of Forensic Medical Examination has conducted 1,509 forensic medical examinations of fallen servicemen of the Armed Forces of Ukraine, law enforcement agencies, and soldiers of volunteer formations in order to identify them (Table 1).
During the examinations, 1,399 victims were identified and handed over to relatives for burial. It should be noted that 947 people were identified by visual identification. At the same time, valuable information material for identification was: 1) identification of anatomical features (presence of a trepanation hole, exostoses, antetorta - internal rotation of the thigh, signs of gigantism, etc.); 2) research of clothes, documents, jewelry, various items; 3) research of tattoos, which carry significant information loads and were valuable in identification. The use of DNA analysis ensures the reliability of identification of a person 99,999….% by confirming or excluding his identity with relatives and is highly informative compared to other traditional identification forensic methods [15,27]. The principles of identification of a person who has left biological traces, according to DNA research, are well known and widely used. However, among the 43 European countries, the CODIS system of molecular genetic test systems is used in 22 countries, 12 countries use their diagnostic panel systems, and for 9 countries, including Ukraine, only some forensic offices are available, including -in the Dnipropetrovsk regional bureau. According to the results of molecular genetic examinations, we identified 359 people. However, it should be noted that DNA analysis does not guarantee the maximum identification of a missing or unidentified person, as there may be an expert error or significant destruction of biological material found in traces on physical evidence with DNA degradation. Thus, in our study, due to DNA degradation, the biological objects of 8 people were not identifiable.
It is known that the identification of a person by dental status in world practice is one of the effective methods [9][10][11]. However, out of 1509 deaths, only 8 people were identified by dental status.
According to other types of identification: dactyloscopic examination, portrait -osteological identification of a person by the method of photocombination of the corpse skull and in vivo photograph of the missing person, X-ray examination (comparison of the radiograph of the examined part of the corpse with the lifetime radiograph of the same section of the human skeleton) was identified -85 people.
Unfortunately, 102 remains of the dead remained unidentified due to the lack of comparable biological samples from the relatives of the dead.

Discussion
According to the definition of INTERPOL Disaster Victim Identification [16], personal identification is the identification of a person by a set of all the properties that distinguish him from other people. Therefore, as today's practice shows, the most effective and objective is a comprehensive approach to identifying the bodies of persons killed in armed conflict and missing persons, which should include the following basic methods and techniques [5,15,18]: 1 ) fixation of facial features; 2) dactyloscopic examination; 3) detection of anatomical features (congenital anomalies of the skeletal system and internal organs, trauma (trepanation), gigantism and dwarfism, etc.; 4) recognition of pathological changes; 5) research of special signsscars, ulcers, congenital spots, deformations of parts of the face, prostheses, defects of the musculoskeletal system, etc.; 6) study of the structure of the auricle, which, in terms of information, corresponds to dactyloscopic studies; 7) research of various subjects: clothes, documents, jewelry; 8) research of the person on bone remains which remains even after action of high temperature can be sufficient for diagnosis of lifelong fractures, malformations, diseases, etc.; 9) carrying out portrait-osteological identification [17], which includes the method of photo-combining the skull of a corpse and a lifelong photograph of a missing person.
The dermatoglyphic method along with the descriptive method of research is the most widespread and most often applied in cases of need of identification of persons. This method has become especially popular as a result of its cheapness and simplicity, and at the same time considerable informativeness, allowing not only to identify a particular person, but also his regional affiliation [13,23]. Thus, for the male population of Ukraine it is established that such indicators as Cummins index, size of palm angles, localization and saturation of the palm with patterns, length of c-t segment and presence/absence of additional axial triradii have high value for regional differentiation [14].
Thus, the inappropriate use of only one specific method of research is indicated by the authors who analyze the work of forensic services in identifying the dead after the earthquake and tsunami in 2004 in Southeast Asia [25]. As a result of the lack of basic methods of storing corpses and mass destruction, there was a need to identify a large number of people. In Thailand, one of the main methods of identifying the dead was dermatoglyphic and odontological methods. In Sri Lanka -photographic and dermatoglyphic method as well. At the same time -DNA analysis was practically not used.
Extremely important identification value is the study of the chemical composition of the factors accompanying the shot, as part of these objects, using laboratory methods both traditional -contact-diffusion method (color imprint method), Vladimir's physical test, Aidlin's chemical test and microscopic method [2], and the newest, which have high technological capabilities, in particular -X-ray fluorescence spectral analysis and scanning electron microscopy. It is their use that provides the possibility of partial species identification of firearms according to the peculiarities of the shape of the cut of the channel of its barrel; the ability to establish the position of the muzzle relative to the surface of the skin when firing; determine the sequence of shots; to determine the elemental composition of shell and nonshell metals, fired and unfired bullets for their identification [3,4,12,22].
Finding the right, unified algorithm for identifying the dead in different situations -from natural to man-made disasters, the discovery of mass graves, etc., has long been a task of many organizations, including INTERPOL, the International Committee of the Red Cross, the Academy of Forensic Medicine and Science and forensic associations. However, experience shows that often existing protocols and approaches to solving these problems do not work at full capacity, forcing researchers to further seek and improve existing algorithms and create new ones.

Conclusions
Analysis of archival material of the PI "Dnipropetrovsk Regional Clinical Bureau of Forensic Medical Examination", including materials of the Department of Forensic Medical Examination of Corpses, Departments of Forensic Criminology, Forensic Histology, Forensic Immunology, Forensic Cytology, regarding the identification of 1509 dead persons, whose bodies were distorted by traumatic factors or disappeared in an armed conflict, indicates the effectiveness of a comprehensive approach that improves the objectivity and accuracy of the study.