From Deutsche Zeitschrift to International Journal of Legal Medicine—100 years of legal medicine through the lens of journal articles

From volume 67 (1970) onwards, the journal appeared under the new bilingual title Zeitschrift für Rechtsmedizin—Journal of Legal Medicine. The editorial board was expanded and internationalised. From 1970 to 1990, 1416 articles were published in 36 volumes. 1036 articles were in German and 380 in English. The authors of 411 articles came from non-German-speaking countries. Compared to the periods under review in the first two parts of our article series, the proportion of papers on forensic genetics increased significantly between 1970 and 1990, with a small increase in publications on the identification of unknown dead bodies. An opposite trend was observed in the articles on forensic psychiatry and psychology, sexual medicine and social medicine. This development reflects a further sharpening of the discipline’s profile.


Introduction
On the occasion of the publication of the 100th volume of the Deutsche Zeitschrift für die gesamte gerichtliche Medizin, which continued under a new title, Gerchow [5] wrote in an editorial in 1988: "The first volume (1922) already showed the structure that was retained until 1969: congress reports, original papers and a section of abstracts. In the mid-1960s, it became apparent that this form of publication could not be carried on, especially as the section of abstracts was taking up more and more space." As a logical consequence, the abstract section was segregated and continued as a separate journal with the title Zentralblatt für die gesamte Rechtsmedizin und ihre Grenzgebiete. From volume 67 (1970) onwards, the former Deutsche Zeitschrift für die gesamte gerichtliche Medizin was published under the new title Zeitschrift für Rechtsmedizin-Journal of Legal Medicine. The change of title had become necessary because the German Society for Forensic and Social Medicine, whose publication organ the journal was, had changed its name to German Society for Legal Medicine in 1968 [16]. The new bilingual title also showed the internationalisation of the journal. In addition to the title of the articles, the abstracts and the keywords preceding the article were now also published in German and English. Efforts to internationalise the journal were also reflected in the newly formed editorial board. This board included representatives from the German-speaking countries, Belgium, Denmark, Finland, France, Japan, Yugoslavia, Sweden, the USSR, UK, Hungary and the USA. The purpose of increasing the number of editors was to allow for double reviews of each manuscript. Another new feature was the introduction of categories. The categories covered editorials, reviews, original papers, case reports, obituaries and letters to the editor.
Throughout the period under review, Joachim Gerchow ( Fig. 1) was editor-in-chief. For volumes 102 and 103, Bernd Brinkmann acted as second editor-in-chief, who then became the sole editor-in-chief from volume 104 onwards, when the journal was renamed International Journal of Legal Medicine.
In the first two parts of our article series "From Deutsche Zeitschrift to International Journal of Legal Medicine-100 years of legal medicine through the lens of journal articles", the scientific publications appearing in the Deutsche Zeitschrift für die gesamte gerichtliche Medizin between 1922 and 1969 were reviewed [21,22]. This analysis is now continued in the third part of the series for the articles published in the Zeitschrift für Rechtsmedizin-Journal of Legal Medicine between 1970 and 1990.

Analysis of scientific articles
General From 1970From to 1990, 1416 articles were published in 36 volumes. In terms of category, the articles included 3 editorials, 72 reviews, 990 original papers, 323 case reports, 10 obituaries and 18 letters to the editor. 1036 articles were in German and 380 in English. Figure 2 shows the authors' countries of origin. The authors of 411 articles came from non-German-speaking countries.
The structure of the topics and their respective subtopics in the following content analysis of the scientific articles published in the Zeitschrift für Rechtsmedizin-Journal of Legal Medicine is the same as in Part 1 of our series of articles [21]. Table 1 provides an overview of the number of publications on the individual topics in the period under review. Other countries are USA (17), Spain (13), Belgium (12), CSSR (9), Bulgaria (7), Norway (7), Yugoslavia (3), USSR (3), UK (3) and Qatar (2). Brazil, China, France, India, the Netherlands and Thailand are represented with one article each

History and development of the discipline
Six articles were published on the history of the discipline. Two papers deal with the historical development of the assessment of medical malpractice (86/303) 1 and the estimation of the time of death (95/19). Another paper was dedicated to Paolo Zacchia, the "father of forensic medicine", on the occasion of his 400th birthday (94/159). Three editorials gave a brief historical outline of the Zeitschrift für Rechtsmedizin-Journal of Legal Medicine.
In addition, there are 3 papers on the conception and development of the discipline. Berg (92/247) outlines the tasks of ethics committees at medical faculties and describes the contribution of legal medicine as follows: "It seems obvious to me that legal medicine has an important, not to say a decisive role to play in the ethics committee". Compared to the pure lawyer, the medicolegal expert not only has the advantage of possessing a specialised knowledge of medical law but also of being familiar with hospital operations in contact with the patient due to his or her own basic medical training. Janssen (100/5) analyses the significance of morphological examinations for the administration of justice. He criticises the lack of binding guidelines for assessments with morphological content. In addition, he demands that at least a basic histological status, i.e. the examination of the large parenchymatous organs, must be carried out in every autopsy. In his article entitled "Forensic Medicine and Criminalistics" (102/421), Schwerd defines "medical criminalistics" as a small but important component of criminalistics.
In doing so, he emphasises the extraordinary importance to be attributed to the inspection of the site where a corpse has been found by the medicolegal expert. Schwerd also criticises the term "forensic pathology".

Personalia
The tradition of honouring distinguished personalities of the discipline with laudations or commemorative publications was not continued during the period under review. However, 10

Legal issues, expert activities
A review paper on recent developments in medical law dealt with legal issues of the diagnosis of brain death, embryo protection, (failed) sterilization, data protection and medical liability (91/165). Other publications on medical law concerned HIV tests without the knowledge of the affected person, assisted suicide and liability issues in the context of various medical complications as well as in the case of false expert reports (84/239, 86/21, 86/281, 98/245, 99/169). Althoff and Solbach analysed the outcome of criminal
In the field of thanatology, publications on vibices (69/263) and post-mortem haemolysis (81/ 19) Table 2 gives an overview of the number of publications on all types of violent death.
Most articles on death in water concern drowning. In an autopsy study, Haarhoff and Weiler showed that temporal bone haemorrhages are non-specific and therefore not a vital sign of drowning (69/62). Reh discusses the evidential value of the lattice fibre texture of the lung as a sign of drowning (77/219). Three publications are devoted to diatoms (83/319, 85/315, 101/87). One article discusses plant elements in the blood as a sign of drowning (77/219). Five papers deal with the phenomenon of washerwoman's skin. In two animal experiments, characteristics are described to distinguish drowning in freshwater and saltwater (90/1, 91/47). Possible causes of sudden death in water are discussed in 3 papers Three autopsy studies were published on deaths due to heat (94/71, 95/51, 95/59). In animal studies, the fibrin and histamine content in various organs was investigated (71/114, 72/203, 72/213, 73/149). Maxeiner discusses congestion haemorrhages in the head and neck area of fire victims as vital signs of heat exposure (101/61). Two publications deal with heat haematoma (75/21, 103/227). Schwerd and Müller describe heat damage to hair (100/73). Endris and Beersche investigated heat-induced colour changes in teeth (94/109). In a case report, Staak et al. discuss heat shock as a possible cause of death (72/319). With regard to exposure to moist heat, there is only one publication dealing with vital signs of scalding (83/1).
11 animal studies were published on deaths due to cold. Schneider and Klug described increased acetone levels in human urine as a possible indicator of hypothermia (86/59). Madea and Oehmichen discussed haemorrhages and necrosis of the pancreas and haemorrhagic infarction of the descending colon as possible consequences of hypothermia (102/59). Sigrist et al. regarded haemorrhages and microscopic necrosis of the body's core muscles as "relatively specific signs of hypothermia" (103/463).
Seven of the articles published on forensic obstetrics relate to proof of live birth. The umbilical ring (67/119, 67/372), the Wreden-Wendt tympanic cavity test (69/173), the morphology of elastic fibres of the lungs (67/177) and the inflation of the lungs with air (83/303) were examined. Another paper deals with the determination of the body length and age of foetuses based on the size measurements of the ossicles (71/264).
A literature study on abortion in Sweden analysed the methods used for this purpose in the period 1870-1970 (70/197). One case report describes an abortion by gunshot (71/108).
Only one publication is available on filicide. Walther and Weiler concluded from the results of an autopsy study conducted at the Institute for Legal Medicine in Mainz that the frequency of the killing of newborns as well as the manner in which the offence was committed had not changed between 1948 and 1968.
Five articles concern possible medical malpractice in diagnostic procedures. These include the administration of contrast medium (74/  Of the publications on alcohology, 32 articles are concerned with alcohol metabolism and 6 with alcohol analysis. Of particular practical relevance is the work on new alcohol formation in corpses (101/21) and on the genetically determined variability of alcohol metabolism (103/169). Important work on blood alcohol determination by gas chromatography was done by Bonnichsen et al. (71/134) and Machata (75/229). Factors influencing breath alcohol measurements were investigated by Dubowski (76/93). 19  and analysis of ancestry (75/51). The determination of the degree of racemization of aspartic acid in dentin was presented as a biochemical method for age estimation with a high estimation accuracy (103/457). Other articles dealt with the estimation of the post-mortem interval of bones (87/275, 91/71). The examination of cremation ashes is covered in 2 papers (77/191, 97/227). There were 3 articles on superimposition (80/183, 80/189, 102/451) and 1 paper on facial reconstruction (89/119). In addition, identification using dentition data was discussed (76/211).

Forensic genetics
The main focus of the articles on forensic genetics during the period under review was blood group science. 20 papers covered erythrocyte membrane systems. 46 papers dealt with serum proteins. Special mention should be made of a paper on the polymorphism of complement factor 6 by Rittner et al. (83/17) and the description of a method for subtyping haptoglobin by Patzelt and Schröder that is suitable for forensic practice (94/207). With 61 articles, the majority of publications were on enzyme groups. A review article by Brinkmann on red cell enzyme polymorphisms in forensic serology (69/83) and a paper on the determination of PGM 1 subtypes by agarose gel isoelectrofocusing by Weidinger and Schwarzfischer (84/221) are worth mentioning. Three papers (74/121, 75/81, 87/267) were devoted to the HLA system, with which conventional, i.e. gene product-linked, blood group science reached its peak in terms of predictive reliability.
With 58 articles, most of the papers on trace analysis are concerned with blood. Three papers deal with blood detection. Seven papers address the determination of species specificity. 46 publications discuss various possibilities of individualising blood traces. Of these, two publications are about sex diagnosis. 29 articles are devoted to blood groups used for trace analysis. Publications on other physiological group properties relate to foetal haemoglobin and alpha-fetoprotein (74/81, 79/79, 79/81, 102/437) as well as pregnancyspecific proteins (69/65, 95/255, 101/9, 102/353). Finally, pathological group characteristics were also described. Studies on the detection of syphilis (91/247) or HIV antibodies (102/487) in blood traces are worth mentioning. 19 articles refer to the examination of semen traces. 13 of them deal with semen detection and 6 with the determination of blood group characteristics in semen. Other publications on trace analysis deal with tissues and organs (20 articles), hair (11 articles), saliva and other body fluids (8 articles), bones (4 articles), teeth (2 articles) and finger and toe nails (1 article).
The largest number of articles on parentage testing (35 articles) related to work on calculating the paternity probability of blood group reports (serological reports) using various statistical methods, with some articles announcing the entry of computers into the calculation of paternity probability as well (78/227, 78/243). One paper deals with the calculation of maternity probability in blood group assessment (68/53). Only very few articles were still published on the evidential value of expert opinions on fertility (74/141) and chromosomes (74/17, 84/179, 99/249). In addition, special phenomena relating to blood group serology, such as unequal crossing-over with the risk of misinterpretation, were pointed out (90/27). Furthermore, there are some case reports, for example a twin case with probable superfetation (84/319).
At the end of the period under review, the first publications on DNA analysis appeared. First, a paper on sex diagnosis was published (97/21). Studies on the use of DNA polymorphisms in parentage testing and for identification purposes followed (

Clinical legal medicine
In a review paper, Naeve and Lohmann (72/79) discuss the "Methodology and legal relevance of immediate physical examination of living persons after criminal offences" on the basis of cases from the Hamburg Institute for Forensic Medicine and Criminalistics. As a reason for the fact that in West Germany medicolegal experts were relatively seldom entrusted with the clinical examination of living persons, the authors point to the consequences of the "Law for the Unification of the Public Health System" of 1934, on the basis of which some medicolegal tasks were transferred to the public health offices. As a result of their considerations, the authors conclude that the examination of victims of violence and accused persons belongs into the field of legal medicine, since knowledge and experience in legal medicine are required for the proper collection and assessment of findings usable in court.

Sexual medicine
In one article, the phenomenon of female exhibitionism is described and compared with the characteristics of male exhibitionism on the basis of personal observations and a literature review (71/126).

Traffic medicine
Most of the publications in traffic medicine concerned the examination of traffic accidents under medicolegal aspects. Special accident constellations, such as pedestrian-car accidents (67/282) and accidents involving a two-wheeled vehicle (101/1), were presented. A study examined the importance of crash helmets worn on the survival chances of riders and passengers of motorised two-wheelers (75/235

Social medicine
One publication examines the circumstances of death of opiate addicts in outpatient care (96/215). Another paper discusses social medical aspects of fatal cancers (100/259).

Criminology
Most articles concern alcohol and drug delinquency (70/25, 82/1, 83/209, 92/169, 97/141, 102/509, 103/63). Other papers analyse homicide situations in loose partnerships (71/39) and defensive body dismemberments (81/151). In addition to 990 original papers, 323 case reports, 72 reviews, 18 letters to the editor, 10 obituaries and 3 editorials were published. The relatively high proportion of case reports in the total number of scientific articles (23 percent) is remarkable. Madea et al. [10] pointed out the special importance of case reports for legal medicine, which is also due to structural features of the discipline. For example, medicolegal research is often observational research as opposed to the experimental research that predominates in clinical trials. Medicolegal research can largely only be observational research, since relevant facts, such as violent bodily harm, violation of sexual self-determination or the effect of alcohol and drugs on driving ability and criminal responsibility, can often not be simulated for ethical reasons. Moreover, individual case reports often act as pacemakers for generating hypotheses or for carrying out systematic investigations. Table 3 compares the percentage shares of the topics covered in the three periods under review so far. In the period 1970-1990, the number of papers on forensic genetics increased significantly, and there was a small increase in publications on the identification of unknown dead bodies. An opposite trend was observed in the articles on forensic psychiatry and psychology, sexual medicine and social medicine. This development reflects a further sharpening of the discipline's profile.

General
Without claiming to be representative or even complete, some of the key areas of medicolegal research in the period under review will be discussed below.

History and development of the discipline
Significant articles on the history of legal medicine were not published. However, there are three papers on the conception and development of the discipline, in which thoughts were expressed that are still relevant today. Two papers deal with the role of legal medicine in ethics committees (92/247) and the significance of morphological, especially histological, examinations (100/5). However, the article "Forensic Medicine and Criminalistics" (102/421) by Schwerd deserves special emphasis. The article is not entirely without historical considerations. The starting point of Schwerd's reflections is the question of how the existential crisis of the discipline could have come about, which induced the German Science Council in 1966 to recommend dissolving the discipline of legal medicine and assigning the individual fields to other disciplines. Schwerd sees the cause of this crisis in the disunity of the discipline in the first half of the twentieth century, which in particular lacked a clear demarcation of legal medicine from social medicine and criminalistics. This disunity was expressed by 5 different names for the institutes in Germany: Institute of Legal Medicine, Institute of Legal and Social Medicine, Institute of Legal Medicine and Criminalistics, Institute of Legal Medicine and Scientific-Technical Criminalistics and Institute of Legal Medicine and Insurance Medicine. Schwerd sees a return to the two core areas of legal medicine as a way out of the crisis. The first core area, he said, was the inspection of the scene of death, followed by the autopsy. In particular, in cases of homicide, Schwerd considers the inspection of the scene of death to be indispensable. Because, if the medicolegal expert doing the autopsy does not have a detailed knowledge of the circumstances of the case at the beginning of the autopsy, let alone has been able to form his own impression of the situation, then a useful result becomes a matter of chance. In this context, Schwerd objects to the autopsy of the "naked body", in which he sees the concept of "forensic pathology" which originally came from the Anglo-American sphere. Moreover, he rejects the term "forensic pathology" for three reasons. First, violent death is not a disease. Second, the term suggests that legal medicine is a branch of pathology, which it has never been. Third, the term "forensic pathology" has often become synonymous with superficiality and should therefore be rejected by medicolegal experts, who should apply special thoroughness. As the second core area of legal medicine, Schwerd identifies medical trace analysis, which he understands to mean the examination of medical evidence using special methods, including histological and toxicological examinations.  1922-1944 1948-1969 1970-1990 History and development of the discipline 1.6 0.5 0.

Medicolegal methods
According to Schwerd, legal medicine is a medical discipline that involves the application of medical knowledge and methods in teaching, research and practice for juridical purposes (102/421). In medicolegal research, new methods are often adopted from other disciplines and tested for forensic applications. However, this adoption does not always prove successful. For example, electron microscopy was tested for various forensic issues during the period under review. Thrombi (74/47, 75/217), cut wounds (72/11, 74/197), electric marks (67/293), gunshot wounds in bones (73/137) and burnt bones (77/191) were examined under the electron microscope, but it was not possible to establish the use of electron microscopy in medicolegal practice. According to Adebahr, this is because electron microscopic examinations are suitable for recognising normal structures, but not for assessing structural abnormalities. Because in the orders of magnitude achieved by these investigations, an abnormality or damage appears almost uniform (103/477). Another reason is the artefacts of ultrastructural formations caused by autolysis and putrefaction, which can lead to problems in the evaluation of examination material taken during forensic autopsies (92/77). More successful was the use of new radiological methods for post-mortem imaging. The first publications on CT (80/227) and MRI scans (102/185) of corpses appeared during the period under review. These papers can be seen as pioneers of virtopsy, which has experienced its breakthrough in the next period under review [19].

Time of death
In the field of general legal medicine, works on thanatology and estimating the time of death were also published. A significant research contribution to the estimation of the time of death in the early post-mortem interval was made by the working group led by Claus Henssge. As early as 1962, Marshall and Hoare [11] had published a two-exponential model for body cooling. However, the feedback was extremely low [6].  [6]. With the nomogram method, time-of-death estimation has been raised to a higher quality level [20]. In a recent review, Potente and Wirth [15] assume that the Henssge method will continue to make important contributions to criminal investigations of deaths in the years to come.

Forensic toxicology
The challenges of forensic toxicology at the beginning of the 1970s were the multitude of new pharmaceutical drugs, a change in analytical methods and a lack of substancespecific measurement parameters [14]. Among the newly approved pharmaceutical drugs were the benzodiazepines, the detection of which, according to Daldrup and Klug [1], marked the "beginning of modern forensic toxicology". The chemist Leo Sternbach had synthesised chlordiazepoxide, the first benzodiazepine approved as a tranquilliser, in Basel in 1958. Shortly afterwards, the synthesis of the now widely used diazepam followed. Benzodiazepines represented a special challenge for forensic toxicology, as the low amounts of active substances could no longer be detected with conventional analytical methods and as the formation of active metabolites made their detection absolutely necessary [1]. In particular, Harald Schütz from the Institute of Legal Medicine in Giessen did intensive and systematic work on the detection of benzodiazepines. An example is the paper "Gaschromatographic data of 19 derivatives of hydrolysis from 12 important benzodiazepines and 17 main metabolites" (82/43), published in 1978.
Another research focus in forensic toxicology was the development of alternative examination materials such as hair or sweat. The examination of hair to detect the consumption of narcotic drugs, but also of other pharmaceutical substances, alkaloids and even alcohol, plays an essential role in today's forensic toxicology [1]. One of the first papers to detect morphine in hair was published by Klug in 1980 (84/189). The detection of drugs and medicines in sweat is also significant for the practice of forensic toxicology, as the active participation of the person to be examined is not necessary for the collection of the sample. As early as 1979, Ishiyama et al. published a paper on the detection of morphine and methamphetamine in sweat (82/251).
Pioneering activities for external quality control of forensic toxicological analyses were the organisation of proficiency tests [14]. The results of the first proficiency test for barbiturate determination were published by Machata [9] in 1970. A proficiency test for the determination of thallium in urine was conducted by Geldmacher-von Mallinckrodt et al. (93/219). Since 1995, the Society of Toxicological and Forensic Chemistry (GTFCh) has been organising proficiency tests relating to forensic and clinical toxicology as well as to therapeutic drug monitoring in cooperation with ARVECON GmbH. In 2017, 76 proficiency tests were conducted [17].

Forensic genetics
In the field of forensic genetics, the serological research already reported in the first two parts of the article series was continued in the period under review and reached its quantitative peak. New research results were presented on the erythrocyte membrane systems, on serum proteins and on enzyme groups, which accounted for the largest share in terms of quantity. Since the discovery of the first trait of a genetic polymorphism on leukocytes by Dausset [2], the HLA traits had evolved into the most polymorphic conventional blood group system. Three papers on the HLA system were published in the Zeitschrift für Rechtsmedizin-Journal of Legal Medicine (74/121, 75/81, 87/267). The diagnostic possibilities of blood tests on biological traces have been expanded to include the detection of foetal blood as well as physiological and pathological group characteristics. Today, however, serological papers on trace analysis and parentage testing are mainly of historical interest. In 1985, the discovery of genetic fingerprinting by Alec Jeffreys ushered in a new era in forensic genetics [4]. At the end of the period under review, the first articles on genetic fingerprinting also appeared in the Zeitschrift für Rechtsmedizin-Journal

Traffic medicine
The preventive function of medicolegal research was perhaps most evident in the field of traffic medicine during the period under review. In view of the sharp rise in the number of traffic accident fatalities, which reached its maximum in 1970 (see Fig. 3), medicolegal research on road accidents was intensified in order to increase vehicle safety. Traumatomechanics was established as a new field of research at the Heidelberg Institute for Legal Medicine and Traffic Medicine [13]. Traumatomechanics deals with the study of the quantitative relationship between mechanical stress and injuries to the human body. For traumatomechanical experiments, a deceleration sled system was installed at the Heidelberg Institute (74/25). The results of the investigations on corpses protected by seat belts accelerated the introduction of the obligation to wear seat belts in Germany and contributed to the optimisation of seat belts and airbags (72/8, 72/22, 74/31). Child restraint devices, side impact protection, safety helmets and crash barriers have also been improved through research into the traumatomechanical properties of the human body [12]. By 1990, the number of traffic accident fatalities in West Germany was more than halved in spite of an increasing volume of traffic (see Fig. 3). Traumatomechanical research achievements played a significant role in this result. It is estimated that, based on all studies on corpses worldwide, 60 lives have been saved  [18] per investigated corpse in the US alone, and a multitude of injuries have been mitigated or prevented [7].
The prevention of road accidents also involved fundamental research into the assessment of the fitness to drive, which can be impaired by alcohol, other intoxicants, medication or physical deficiencies. Toxicological research in Germany and Switzerland benefited from the locational advantage that it was legally possible to take a blood sample if there was reasonable initial suspicion of drunken driving without the consent of the person concerned [1]. In extensive series of tests on these blood samples, for example, the influence of benzodiazepines and other pharmaceuticals on road users has been demonstrated (80/319, 93/95). These investigations had only become possible because new procedures allowed the processing of even small amounts of residual blood from blood alcohol determinations [8].
On the occasion of the 100th anniversary of the German Society of Legal Medicine, Eisenmenger [3] paid tribute to the achievements of German-language research in traffic medicine as follows: "All legal regulations on the question of the fitness to drive under the influence of alcohol and drugs, but also the compulsory use of seat belts and helmets, would be inconceivable without scientific research of legal medicine."

Conclusions
The articles published in the Zeitschrift für Rechtsmedizin-Journal of Legal Medicine between 1970 and 1990 show how the main research areas in legal medicine developed through the interaction between the requirements of the administration of justice and the technological possibilities. While electron microscopic examinations could not establish themselves in medicolegal practice, first publications appeared on the use of CT and MRI in post-mortem imaging, which became very important in the following decades. A large number of original papers and case reports have expanded the body of knowledge on the diagnosis of forensically relevant forms of violence. These findings were of benefit to the administration of justice and thus to legal certainty. The analytical methods commonly used in forensic toxicology at the beginning of the 1970s were improved and supplemented by new methods. Not only was it possible to significantly reduce the detection limits of pharmaceuticals and drugs but also to examine new analytical materials. The relative proportion of serological papers grew in comparison to the periods under review in the first two parts of our article series and reached its maximum. With the introduction of the DNA analysis at the end of the 1980s, however, the serological techniques lost all practical significance. When the number of traffic fatalities reached a peak in 1970, traumatomechanical research to increase vehicle safety and basic toxicological research to improve the assessment of the fitness to drive were intensified. The results of these efforts contributed significantly to a reduction in road accident fatalities.