I am WAY outta my depth here, but what the heck--can't let facts and expertise get in the way of a good opinion.
I come at nose shape and form factor from a different angle than a long-range specialist like Rick and others would. Most of my cast bullet R&D has to do with hunting, and the attributes that enhance "slipperyness" in flight might enhance penetration in tissue as well. Of course, the hunter wants some carnage when that bullet traverses the quarry, too--and that is where the medieval-esque arguments about "How many angels can dance on the head of a pin?" get their traction. Truncated cone? Round flat nose? Semi-wadcutter/Keith? Stuff like this has filled many a gunrag, and one of the more succinct summations made by our friend Bret 4207 some years back stated that gunrags and websites spend far too much time discussing arrows and far too little examining the Indian. For hunting with castings, I unplug a lot of the nose form magic by using Bruce B Softpoints to enhance expansion and (hopefully) lethality.
Here comes the controversial part--look for it as you pass through. I have held a California Hunting License for 52 years. During that time I have seen hundreds of large game and thousands of small game exemplars taken by self and others, and often assisted in field prep for the kitchen and freezer. (I must have been a ghoul or forensic pathologist in some past life). I also spent the majority of my career time as a cop training folks with firearms and investigating the outcomes of shootings and killings--by cops, by citizens, and by crooks. Sample population is in the "several hundred" ballpark. Does bullet shape matter in this venue? A little, maybe--but not nearly as much as location of impact. Diameter? A little, maybe--no bullet impact improves anyone's condition, but you still have to hit the assailant to have any effect at all--and you can't miss fast enough to survive a gunfight, in spite of all the high-cap hype to the contrary. And all of those high-tech uber-modern controlled expansion zombie stoppers that retain for a buck and half apiece......are they all that and a bag of chips? Resounding NO. Still gotta hit the goblin. There is that arrow/Indian thing again. My advice to folks serious about keeping one's carcass unshot is to first not venture into adventure-travel environments and recreations, and to spend your money on range time and ammo to stay sharp with your war toy(s) and use loads that run close to the carry ammo you cart around in harm's way. Long range? DUDE, PLEASE--most defensive shootings are resolved or lost within 2 yards--within 2 rounds--and within 2 seconds. Incredibly fast, incredibly close, and incredibly vicious and violent. Be fast--be first--be accurate, with 2 to center-mass and at least a third to the Brain Housing Group.
Twist rates......with the 44/40, how a 1-38" in a rifle by Winchester and 1-16" or 1-20" in a revolver by Colt can BOTH be appropriate strains logic more than a little. Why 1-10" or 4 turns/meter is right for short squatty 9mm and 40 S&W bullets is another poser. I guess consistency is the last refuge of the unimaginative.