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- Gael Strack, chief executive of the Training Institute on Strangulation Prevention in San Diego, says the mere presence of strangulation in a situation of domestic abuse increases the chances of homicide sevenfold. It is a clear trajectory from escalating violence to homicide, of which strangulation is the penultimate act. “Statistically, we know that once the hands are on the neck, the very next step is homicide,” Strack said. “They don’t go backwards.”