Facial soft tissue thickness (FSTT) constitutes one of the most critical variables in forensic craniofacial reconstruction, and the application of advanced imaging modalities such as magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) can strengthen confidence in these technologies. Using MRI, we evaluated FSTT at 29 anatomical landmarks in 36 healthy adults. We conducted standardised infrared facial imaging on the same participants to obtain 26 anthropometric measurements. We generated three digital facial reconstructions using anonymised three-dimensional skull models and ZBrush software. Under double-blinded conditions, we reconstructed two skulls, one male and one female. In the female case, we applied a postural correction factor to account for the supine imaging orientation, whereas we completed the male reconstruction without adjustment. We assessed the anatomical accuracy of both reconstructions using public recognition surveys and facial resemblance analysis with FaceVACS software. For the third case, we applied region-specific FSTT values derived from CBCT in a real forensic investigation in Karnataka, India. Investigators disseminated the reconstructed face as an investigative aid and subsequently contributed to the identification of a missing person, with identity confirmed through police records. These findings indicate that posture-corrected MRI-derived data and regionally calibrated CBCT datasets improve anatomical accuracy in three-dimensional facial reconstruction, thereby enhancing its utility in forensic identification, particularly within the Indian context.
{"title":"From skull to face: MRI vs. CBCT-based soft tissue depths in forensic 3D craniofacial reconstruction","authors":"Anurag Dubey , Raja Rupani , Garima Sehgal , Anit Parihar , Ashutosh Deo Tiwari , Shiuli Rathore , Anoop Kumar Verma , Abhishek Mishra , Sandeep Bhattacharya","doi":"10.1016/j.jflm.2026.103073","DOIUrl":"10.1016/j.jflm.2026.103073","url":null,"abstract":"<div><div>Facial soft tissue thickness (FSTT) constitutes one of the most critical variables in forensic craniofacial reconstruction, and the application of advanced imaging modalities such as magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) can strengthen confidence in these technologies. Using MRI, we evaluated FSTT at 29 anatomical landmarks in 36 healthy adults. We conducted standardised infrared facial imaging on the same participants to obtain 26 anthropometric measurements. We generated three digital facial reconstructions using anonymised three-dimensional skull models and ZBrush software. Under double-blinded conditions, we reconstructed two skulls, one male and one female. In the female case, we applied a postural correction factor to account for the supine imaging orientation, whereas we completed the male reconstruction without adjustment. We assessed the anatomical accuracy of both reconstructions using public recognition surveys and facial resemblance analysis with FaceVACS software. For the third case, we applied region-specific FSTT values derived from CBCT in a real forensic investigation in Karnataka, India. Investigators disseminated the reconstructed face as an investigative aid and subsequently contributed to the identification of a missing person, with identity confirmed through police records. These findings indicate that posture-corrected MRI-derived data and regionally calibrated CBCT datasets improve anatomical accuracy in three-dimensional facial reconstruction, thereby enhancing its utility in forensic identification, particularly within the Indian context.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103073"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.jflm.2026.103082
Charles D. Deakin
Background
Conducted Energy Devices (CEDs) or Conducted Energy Weapons (CEWs), among which the best known are the TASER® brand, are increasingly deployed by law-enforcement agencies. Their established cardiac safety is overshadowed by temporally-associated sudden deaths, which are often directly attributed to CED discharge. Concern remains that in rare cases, high-voltage CED pulses might directly induce fatal cardiac arrhythmias.
Methods
This review considers electrophysiological evidence, computational modelling, and forensic case data to understand the mechanisms governing cardiac stimulation during CED exposure. It discusses strength–duration relationships, differential excitement of neuromuscular and myocardial tissues, and compares predicted electrical stimulation thresholds with those determined by finite element modelling. This evidence is compared with clinical evidence of CED-induced malignant arrythmias.
Findings
CED pulses of 50–100 μs are both too brief and too weak to depolarise cardiac myocytes under normal anatomical conditions. Finite-element and finite-integration models show typical myocardial current densities of 0.27–0.6 mA cm−2 which are more than two orders of magnitude below the short-pulse VF threshold of ∼100–150 mA cm−2 (≈4 mA cm−2 RMS). Layered thoracic modelling demonstrates that muscle anisotropy and chest-wall thickness diverts almost 90 % of current laterally, producing cardiac field strengths far beneath depolarisation levels. Rare trans-cardiac probe alignments or thin chest walls, however, may approach capture thresholds and therefore cannot be considered completely risk-free.
Conclusions
Current evidence indicates that in all but extreme probe geometries or paediatric exposures, CED are at minimal risk of inducing malignant arrhythmias. Forensic assessment of CED-related deaths should consider electrophysiological principles with probe placement, the timing of the collapse, and toxicological findings in order to distinguish coincidental from causally related events.
背景传导能量装置（ced）或传导能量武器（CEWs），其中最著名的是泰瑟®品牌，越来越多地被执法机构部署。他们建立的心脏安全性被暂时性猝死所掩盖，后者通常直接归因于CED出院。在极少数情况下，高压CED脉冲可能直接诱发致命性心律失常。方法本综述考虑了电生理证据、计算模型和法医案例数据，以了解在CED暴露期间控制心脏刺激的机制。它讨论了强度-持续时间的关系，神经肌肉和心肌组织的不同兴奋，并将预测的电刺激阈值与有限元模型确定的阈值进行了比较。这一证据与ced诱发的恶性心律失常的临床证据进行了比较。发现在正常解剖条件下，50-100 μs的sced脉冲既短又弱，无法使心肌细胞去极化。有限元和有限积分模型显示，典型的心肌电流密度为0.27-0.6 mA cm - 2，比短脉冲VF阈值约100-150 mA cm - 2 （RMS≈4 mA cm - 2）低两个数量级以上。分层胸腔模型表明，肌肉各向异性和胸壁厚度将近90%的电流侧向转移，产生远低于去极化水平的心脏场强度。然而，罕见的经心探头排列或胸壁薄可能接近捕获阈值，因此不能认为完全没有风险。结论目前的证据表明，除了极端探头几何形状或儿科暴露外，CED诱发恶性心律失常的风险很小。对ed相关死亡的法医评估应考虑探针放置的电生理学原理、崩溃的时间和毒理学结果，以区分偶然事件和因果相关事件。
{"title":"Cardiac Safety of Conducted Energy Devices: Electrophysiological mechanisms, risk assessment, and forensic interpretation","authors":"Charles D. Deakin","doi":"10.1016/j.jflm.2026.103082","DOIUrl":"10.1016/j.jflm.2026.103082","url":null,"abstract":"<div><h3>Background</h3><div>Conducted Energy Devices (CEDs) or Conducted Energy Weapons (CEWs), among which the best known are the TASER® brand, are increasingly deployed by law-enforcement agencies. Their established cardiac safety is overshadowed by temporally-associated sudden deaths, which are often directly attributed to CED discharge. Concern remains that in rare cases, high-voltage CED pulses might directly induce fatal cardiac arrhythmias.</div></div><div><h3>Methods</h3><div>This review considers electrophysiological evidence, computational modelling, and forensic case data to understand the mechanisms governing cardiac stimulation during CED exposure. It discusses strength–duration relationships, differential excitement of neuromuscular and myocardial tissues, and compares predicted electrical stimulation thresholds with those determined by finite element modelling. This evidence is compared with clinical evidence of CED-induced malignant arrythmias.</div></div><div><h3>Findings</h3><div>CED pulses of 50–100 μs are both too brief and too weak to depolarise cardiac myocytes under normal anatomical conditions. Finite-element and finite-integration models show typical myocardial current densities of 0.27–0.6 mA cm<sup>−2</sup> which are more than two orders of magnitude below the short-pulse VF threshold of ∼100–150 mA cm<sup>−2</sup> (≈4 mA cm<sup>−2</sup> RMS). Layered thoracic modelling demonstrates that muscle anisotropy and chest-wall thickness diverts almost 90 % of current laterally, producing cardiac field strengths far beneath depolarisation levels. Rare trans-cardiac probe alignments or thin chest walls, however, may approach capture thresholds and therefore cannot be considered completely risk-free.</div></div><div><h3>Conclusions</h3><div>Current evidence indicates that in all but extreme probe geometries or paediatric exposures, CED are at minimal risk of inducing malignant arrhythmias. Forensic assessment of CED-related deaths should consider electrophysiological principles with probe placement, the timing of the collapse, and toxicological findings in order to distinguish coincidental from causally related events.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103082"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Point-of-care (POC) diagnostics represent promising health-technology tools capable of providing rapid, on-site analytical support for forensic investigations. This scoping review aimed to systematically map the available evidence on applying POC diagnostics in forensic investigations. The focus is on their potential ability to act as rapid screening and triage tools to assist in determining the cause of death and exploring the challenges and opportunities associated with their implementation on a global scale.
Methods
A comprehensive literature search was conducted across multiple databases, including PubMed, ProQuest Central, Academic Search Complete, Africa Wide, CINAHL, MEDLINE, and Web of Science. Out of the 7603 records screened, four studies met the eligibility criteria and were included in the review. Reporting adhered to the PRISMA-ScR guidelines.
Results
These studies demonstrated the expanding role of POC devices in various aspects of forensic investigations, including rapid triage in overdose cases, malaria diagnosis in travel-related deaths, SARS-CoV-2 screening, and hemoglobin testing in child deaths. These studies also highlighted the limitations of POC devices in the postmortem context, emphasizing the need for careful calibration, confirmation, and interpretation of the results. This review identified POC diagnostics as a potential bridge between forensic investigations and public health surveillance, with findings indicating both cause-of-death determination and broader public health strategies. Operational, ethical, and policy considerations for using POC devices in forensic investigations were also discussed.
Conclusion
This review revealed challenges in ensuring the standardization, accuracy, and integration of POC diagnostics into established forensic practices. Further research is required to evaluate the diagnostic accuracy, cost-effectiveness, and performance of POC tools in forensic settings. Comprehensive guidelines and standardized operating procedures should be developed to ensure the successful implementation of POC diagnostics in forensic investigations. Given the limited and heterogeneous evidence, POC devices in forensic death investigations should be seen as preliminary aids rather than diagnostic instruments.
医疗点诊断是有前途的卫生技术工具，能够为法医调查提供快速的现场分析支持。该范围审查旨在系统地绘制在法医调查中应用POC诊断的现有证据。重点是它们作为快速筛查和分类工具的潜在能力，以协助确定死亡原因，并探讨在全球范围内实施这些工具所面临的挑战和机遇。方法在PubMed、ProQuest Central、Academic search Complete、Africa Wide、CINAHL、MEDLINE、Web of Science等数据库中进行综合文献检索。在筛选的7603份记录中，有4项研究符合资格标准，被纳入本综述。报告遵循PRISMA-ScR指南。结果这些研究表明，POC设备在法医调查的各个方面发挥着越来越大的作用，包括药物过量病例的快速分诊、旅行相关死亡的疟疾诊断、SARS-CoV-2筛查和儿童死亡的血红蛋白检测。这些研究还强调了POC装置在死后情况下的局限性，强调需要仔细校准、确认和解释结果。本次审查确定POC诊断是法医调查和公共卫生监测之间的潜在桥梁，其调查结果表明了死因确定和更广泛的公共卫生战略。还讨论了在法医调查中使用POC设备的操作、道德和政策方面的考虑。结论本综述揭示了在确保POC诊断的标准化、准确性和整合到现有法医实践中的挑战。需要进一步的研究来评估法医环境中POC工具的诊断准确性、成本效益和性能。应制定全面的指导方针和标准化的操作程序，以确保在法医调查中成功实施POC诊断。鉴于证据有限且种类繁多，法医死亡调查中的POC装置应被视为初步辅助工具，而不是诊断工具。
{"title":"Evidence of point-of-care diagnostics in forensic death investigations: A scoping review","authors":"Sebueng Ramatsokotla , Bathabile Soul , Evans Duah , Letlhogonolo Sekwele , Gabrielle Thompson , Kuhlula Maluleke , Linda Mbonambi , Tivani Mashamba-Thompson","doi":"10.1016/j.jflm.2026.103086","DOIUrl":"10.1016/j.jflm.2026.103086","url":null,"abstract":"<div><h3>Background</h3><div>Point-of-care (POC) diagnostics represent promising health-technology tools capable of providing rapid, on-site analytical support for forensic investigations. This scoping review aimed to systematically map the available evidence on applying POC diagnostics in forensic investigations. The focus is on their potential ability to act as rapid screening and triage tools to assist in determining the cause of death and exploring the challenges and opportunities associated with their implementation on a global scale.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across multiple databases, including PubMed, ProQuest Central, Academic Search Complete, Africa Wide, CINAHL, MEDLINE, and Web of Science. Out of the 7603 records screened, four studies met the eligibility criteria and were included in the review. Reporting adhered to the PRISMA-ScR guidelines.</div></div><div><h3>Results</h3><div>These studies demonstrated the expanding role of POC devices in various aspects of forensic investigations, including rapid triage in overdose cases, malaria diagnosis in travel-related deaths, SARS-CoV-2 screening, and hemoglobin testing in child deaths. These studies also highlighted the limitations of POC devices in the postmortem context, emphasizing the need for careful calibration, confirmation, and interpretation of the results. This review identified POC diagnostics as a potential bridge between forensic investigations and public health surveillance, with findings indicating both cause-of-death determination and broader public health strategies. Operational, ethical, and policy considerations for using POC devices in forensic investigations were also discussed.</div></div><div><h3>Conclusion</h3><div>This review revealed challenges in ensuring the standardization, accuracy, and integration of POC diagnostics into established forensic practices. Further research is required to evaluate the diagnostic accuracy, cost-effectiveness, and performance of POC tools in forensic settings. Comprehensive guidelines and standardized operating procedures should be developed to ensure the successful implementation of POC diagnostics in forensic investigations. Given the limited and heterogeneous evidence, POC devices in forensic death investigations should be seen as preliminary aids rather than diagnostic instruments.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103086"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.1016/j.jflm.2026.103084
Margaret Stark , Bernadette Butler , Michael Devlin , Alex Gorton
Professional judgement in forensic & legal medicine (FLM) refers to the ability of healthcare professionals (HCPs) to use their knowledge, experience, and critical thinking skills to make informed decisions about patient care, often in complex or ambiguous situations.
Clinicians must keep patients the focus of any assessment and HCPs need to use professional judgement when interpreting Guidelines and/or Recommendations and when there is a clear and justifiable requirement to deviate from a Standard Operating Procedure because of patient need. Only with training and supervision by expert educators will quality standards be maintained with a workforce that is skilled in using professional judgement.
{"title":"Professional judgement in Forensic & Legal Medicine (FLM)","authors":"Margaret Stark , Bernadette Butler , Michael Devlin , Alex Gorton","doi":"10.1016/j.jflm.2026.103084","DOIUrl":"10.1016/j.jflm.2026.103084","url":null,"abstract":"<div><div>Professional judgement in forensic & legal medicine (FLM) refers to the ability of healthcare professionals (HCPs) to use their knowledge, experience, and critical thinking skills to make informed decisions about patient care, often in complex or ambiguous situations.</div><div>Clinicians must keep patients the focus of any assessment and HCPs need to use professional judgement when interpreting Guidelines and/or Recommendations and when there is a clear and justifiable requirement to deviate from a Standard Operating Procedure because of patient need. Only with training and supervision by expert educators will quality standards be maintained with a workforce that is skilled in using professional judgement.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103084"},"PeriodicalIF":1.2,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-14DOI: 10.1016/j.jflm.2026.103081
Aaro Mäkelä
Purpose
This study investigates the prevalence of sexually transmitted infections (STIs) among individuals suspected of rape in the Helsinki metropolitan area, focusing on the immediate aftermath of the alleged incidents.
Methods
A retrospective observational analysis was conducted using data from 472 forensic examinations performed at the Finnish Institute for Health and Welfare (THL) between 2020 and 2024. Biological samples were tested for chlamydia, gonorrhea, syphilis, hepatitis B, hepatitis C, and HIV. The mean interval between the alleged incident and sample collection was calculated to assess the temporal relationship.
Results
Of the 456 individuals tested, 108 (23.68 %) exhibited STI-related findings, with 54 (11.84 %) deemed probably contagious. Prevalence rates were 6.92 % for chlamydia, 1.11 % for gonorrhea, 2.64 % for contagious hepatitis B, and 2.57 % for active hepatitis C. HIV was detected in 1.10 % of individuals, with none deemed contagious. Fewer than 5 syphilis cases were deemed to be contagious. The mean interval between the alleged incident and sample collection was 1.04 days.
Conclusion
This study provides an examination of STI prevalence among suspects of rape, offering insights into transmission risks immediately following alleged incidents. The findings underscore the importance of routine STI screening in forensic examinations and highlight the potential for such data to inform public health interventions and forensic practices.
{"title":"Sexually transmitted infections of sexual crime suspects","authors":"Aaro Mäkelä","doi":"10.1016/j.jflm.2026.103081","DOIUrl":"10.1016/j.jflm.2026.103081","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigates the prevalence of sexually transmitted infections (STIs) among individuals suspected of rape in the Helsinki metropolitan area, focusing on the immediate aftermath of the alleged incidents.</div></div><div><h3>Methods</h3><div>A retrospective observational analysis was conducted using data from 472 forensic examinations performed at the Finnish Institute for Health and Welfare (THL) between 2020 and 2024. Biological samples were tested for chlamydia, gonorrhea, syphilis, hepatitis B, hepatitis C, and HIV. The mean interval between the alleged incident and sample collection was calculated to assess the temporal relationship.</div></div><div><h3>Results</h3><div>Of the 456 individuals tested, 108 (23.68 %) exhibited STI-related findings, with 54 (11.84 %) deemed probably contagious. Prevalence rates were 6.92 % for chlamydia, 1.11 % for gonorrhea, 2.64 % for contagious hepatitis B, and 2.57 % for active hepatitis C. HIV was detected in 1.10 % of individuals, with none deemed contagious. Fewer than 5 syphilis cases were deemed to be contagious. The mean interval between the alleged incident and sample collection was 1.04 days.</div></div><div><h3>Conclusion</h3><div>This study provides an examination of STI prevalence among suspects of rape, offering insights into transmission risks immediately following alleged incidents. The findings underscore the importance of routine STI screening in forensic examinations and highlight the potential for such data to inform public health interventions and forensic practices.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103081"},"PeriodicalIF":1.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/j.jflm.2026.103075
Myrsini Voulgari , Ioanna Anastopoulou , Elena Kranioti , Christina Papageorgopoulou , Konstantinos Moraitis
The methods for reassociating and sequencing the thoracic vertebrae are based mainly on the morphological characteristics of the bones and the expertise of the forensic anthropologist. However, the thoracic vertebrae T2-T9 show no morphological differences, and therefore, it is challenging to reassociate and sequence them, especially in cases of commingling or extensive trauma. The aim of this study was to develop a new method based on the integration of 3D geometric morphometric analysis from 3D models to provide accurate results regarding the sequencing of the thoracic vertebrae. The sample consisted of 98 individuals from three different skeletal assemblages from various contexts of Greece and was scanned with a handheld 3D scanner. A total of 28 landmarks were placed on the 3D models of the vertebrae. The shape of each vertebra was compared to a reference sample. The identification rates showed that T2 had the highest identification rates and T6 the lowest. Each vertebra was matched to its anatomical counterpart within the first three possible selections of the reference skeleton, in a percentage greater than 67% and in most cases, more than 81%. On the contrary, T6 had a rate lower than 50%. It is proposed that the presented method be examined in other samples to see its application as a tool for sequencing the typical thoracic vertebrae.
{"title":"A novel landmark-based morphometric approach for sequencing typical thoracic vertebrae","authors":"Myrsini Voulgari , Ioanna Anastopoulou , Elena Kranioti , Christina Papageorgopoulou , Konstantinos Moraitis","doi":"10.1016/j.jflm.2026.103075","DOIUrl":"10.1016/j.jflm.2026.103075","url":null,"abstract":"<div><div>The methods for reassociating and sequencing the thoracic vertebrae are based mainly on the morphological characteristics of the bones and the expertise of the forensic anthropologist. However, the thoracic vertebrae T2-T9 show no morphological differences, and therefore, it is challenging to reassociate and sequence them, especially in cases of commingling or extensive trauma. The aim of this study was to develop a new method based on the integration of 3D geometric morphometric analysis from 3D models to provide accurate results regarding the sequencing of the thoracic vertebrae. The sample consisted of 98 individuals from three different skeletal assemblages from various contexts of Greece and was scanned with a handheld 3D scanner. A total of 28 landmarks were placed on the 3D models of the vertebrae. The shape of each vertebra was compared to a reference sample. The identification rates showed that T2 had the highest identification rates and T6 the lowest. Each vertebra was matched to its anatomical counterpart within the first three possible selections of the reference skeleton, in a percentage greater than 67% and in most cases, more than 81%. On the contrary, T6 had a rate lower than 50%. It is proposed that the presented method be examined in other samples to see its application as a tool for sequencing the typical thoracic vertebrae.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103075"},"PeriodicalIF":1.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/j.jflm.2026.103079
Florent Ferrer , Damien Richard , Nicolas Authier , Nicolas Kerckhove , Bruno Pereira , Vincent Lopez , Frédéric Abriat , Baptiste Boyer , Célian Bertin
{"title":"Psychoactive substances in a general forensic autopsy population: prevalence and associations with cause and manner of death","authors":"Florent Ferrer , Damien Richard , Nicolas Authier , Nicolas Kerckhove , Bruno Pereira , Vincent Lopez , Frédéric Abriat , Baptiste Boyer , Célian Bertin","doi":"10.1016/j.jflm.2026.103079","DOIUrl":"10.1016/j.jflm.2026.103079","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103079"},"PeriodicalIF":1.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/j.jflm.2026.103072
Omar Al Farsi , Raniya Al Kiyumi , Akram Al Adawi , Faiz Al Harmali
Background
Accurate mortality statistics are vital for establishing health policies. However, reporting numerous undetermined causes of death especially in the primary healthcare hinder the accuracy and usefulness of vital statistics, impacting resource allocation for disease prevention and control. Utilizing International Classification of Diseases (ICD-10) coding systems and addressing physician-related challenges are essential to improve the quality of mortality data and support effective policymaking. Therefore, this study aims to assess physicians' awareness in assigning accurate causes of death at the primary healthcare institutions.
Methods
A cross-sectional study conducted with 202 physicians from the primary health care institutions in Muscat and South Batinah governorates. A convenience sampling method has been used to distribute self-administered questionnaire.
Results
The findings indicated that a higher proportion of physicians were familiar with the ICD-10 coding and World Health Organization (WHO) guidelines, with (41.9 %) of non-Omani physicians demonstrating awareness, compared to (22 %) of Omani physicians. Both groups showed limited knowledge about the use of garbage codes, with a notable proportion unaware of their implications. Additionally, challenges in determining the underlying cause of death (UCOD) were reported, with (48.6 %) Omani physicians facing difficulties, compared to (40.9 %) of the other group. Training gaps and lack of feedback from the Ministry of Health (MoH) were identified as contributing factors affecting both groups.
Conclusion
The findings highlight key implications for policy and practice in coding mortality data. Ongoing awareness programs for physicians on ICD-10 coding system are essential, and establishing structured feedback channels with the MoH is crucial to improve data quality.
{"title":"Physician awareness of the ICD-10 coding system for assigning the cause of death in primary health centers in Muscat and South Batinah governorates, Oman","authors":"Omar Al Farsi , Raniya Al Kiyumi , Akram Al Adawi , Faiz Al Harmali","doi":"10.1016/j.jflm.2026.103072","DOIUrl":"10.1016/j.jflm.2026.103072","url":null,"abstract":"<div><h3>Background</h3><div>Accurate mortality statistics are vital for establishing health policies. However, reporting numerous undetermined causes of death especially in the primary healthcare hinder the accuracy and usefulness of vital statistics, impacting resource allocation for disease prevention and control. Utilizing International Classification of Diseases (ICD-10) coding systems and addressing physician-related challenges are essential to improve the quality of mortality data and support effective policymaking. Therefore, this study aims to assess physicians' awareness in assigning accurate causes of death at the primary healthcare institutions.</div></div><div><h3>Methods</h3><div>A cross-sectional study conducted with 202 physicians from the primary health care institutions in Muscat and South Batinah governorates. A convenience sampling method has been used to distribute self-administered questionnaire.</div></div><div><h3>Results</h3><div>The findings indicated that a higher proportion of physicians were familiar with the ICD-10 coding and World Health Organization (WHO) guidelines, with (41.9 %) of non-Omani physicians demonstrating awareness, compared to (22 %) of Omani physicians. Both groups showed limited knowledge about the use of garbage codes, with a notable proportion unaware of their implications. Additionally, challenges in determining the underlying cause of death (UCOD) were reported, with (48.6 %) Omani physicians facing difficulties, compared to (40.9 %) of the other group. Training gaps and lack of feedback from the Ministry of Health (MoH) were identified as contributing factors affecting both groups.</div></div><div><h3>Conclusion</h3><div>The findings highlight key implications for policy and practice in coding mortality data. Ongoing awareness programs for physicians on ICD-10 coding system are essential, and establishing structured feedback channels with the MoH is crucial to improve data quality.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103072"},"PeriodicalIF":1.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aims to investigate whether a relationship exists between craniofacial structures and bite marks, thereby enabling the prediction of facial type based on bite mark characteristics.
Materials and methods
Thirty-eight volunteers (aged 19–25) without orthodontic treatment, craniofacial anomalies, or temporomandibular dysfunction participated. Bite marks were created on wax-covered sponge rollers. Intercanine distance, arch depth, and arch length were measured from wax models using a caliper and from intraoral scans using the iTero Scanner. Facial profile photographs were analyzed using GIMP software to calculate FH/GoMe angle and LFH/TFH ratio (Lower face height/Total face height). Statistical analyses included intraclass correlation, Wilcoxon and paired t-tests, and Spearman's correlation (p < 0.05).
Results
Significant differences were found between wax and digital measurements except for arch lenght. FH/GoMe angle correlated with upper and lower wax arch lengths, and LFH/TFH ratio correlated with lower arch length. No correlation was found between the facial type parameters and intercanine and arch depth measurements.
Conclusion
Although distortion may influence wax impressions, the correlations observed suggest that certain bite mark metrics—particularly lower arch length—may provide morphologic indicators of facial phenotype. These findings are preliminary and not intended for individual identification; larger, diverse samples are needed to validate their forensic relevance.
{"title":"From bite marks to vertical facial phenotype: Investigating the relationship between craniofacial and dental arch parameters using conventional wax and digital models","authors":"Elis Dayan , Merve Kurnaz , Özgür Önder Kuşçu , Sibel Biren , Elif Sepet","doi":"10.1016/j.jflm.2026.103078","DOIUrl":"10.1016/j.jflm.2026.103078","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate whether a relationship exists between craniofacial structures and bite marks, thereby enabling the prediction of facial type based on bite mark characteristics.</div></div><div><h3>Materials and methods</h3><div>Thirty-eight volunteers (aged 19–25) without orthodontic treatment, craniofacial anomalies, or temporomandibular dysfunction participated. Bite marks were created on wax-covered sponge rollers. Intercanine distance, arch depth, and arch length were measured from wax models using a caliper and from intraoral scans using the iTero Scanner. Facial profile photographs were analyzed using GIMP software to calculate FH/GoMe angle and LFH/TFH ratio (Lower face height/Total face height). Statistical analyses included intraclass correlation, Wilcoxon and paired t-tests, and Spearman's correlation (p < 0.05).</div></div><div><h3>Results</h3><div>Significant differences were found between wax and digital measurements except for arch lenght. FH/GoMe angle correlated with upper and lower wax arch lengths, and LFH/TFH ratio correlated with lower arch length. No correlation was found between the facial type parameters and intercanine and arch depth measurements.</div></div><div><h3>Conclusion</h3><div>Although distortion may influence wax impressions, the correlations observed suggest that certain bite mark metrics—particularly lower arch length—may provide morphologic indicators of facial phenotype. These findings are preliminary and not intended for individual identification; larger, diverse samples are needed to validate their forensic relevance.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103078"},"PeriodicalIF":1.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of this study was to investigate whether linear, angular, and area measurements derived from lateral cephalometric radiographs can serve as an additional method for determining sex in a sample of Greek population.
Materials and methods
The study sample comprised digital lateral cephalometric radiographs from 150 Greek individuals aged 18–65 years, who sought orthodontic treatment at the School of Dentistry, National and Kapodistrian University of Athens, Greece. Patient records were screened based on eligibility criteria for inclusion in the study. The sample was categorized by sex and age, with age intervals of 5 years. An equal number of lateral cephalometric radiographs for males and females were distributed within each age group. Twelve cephalometric points visible on lateral cephalometric radiographs were digitally traced using ViewBox software, including glabella, nasion, orbitale, sella, basion, porion, anterior nasal spine, posterior nasal spine, anterior, superior, posterior and inferior points of sinus. The present cross-sectional study used a binary logistic regression (BLR) model.
Results
Sex was predicted with an overall accuracy of 74.7 %. A value lower than 0.41 identified a male participant, and a value higher than 0.41 a female participant. The estimated sensitivity and specificity are 85.3 % and 64.0 %, respectively, indicating that the model has satisfactory adjustment. The area under the Receiver Operating Characteristic (ROC) curve (area under the curve - AUC) was 0.80, indicating good discriminative ability.
Conclusions
Cephalometric analysis using radiographs for sex estimation could be useful as a complementary method to conventional sex estimation approaches and may serve as a reliable sex predictor in the Greek population, particularly when alternative techniques cannot be used to estimate sex.
本研究的目的是研究从侧位头颅x线片获得的线性、角度和面积测量是否可以作为确定希腊人口样本性别的额外方法。材料和方法研究样本包括150名年龄在18-65岁的希腊人的数字侧位头颅x线片，他们在希腊雅典国立和卡波迪特里安大学牙科学院寻求正畸治疗。根据纳入研究的资格标准筛选患者记录。样本按性别和年龄分类，年龄间隔为5年。在每个年龄组中，男性和女性的侧位头颅x线片的数量相等。采用ViewBox软件对侧位头颅x线片上可见的12个点进行数字追踪，包括眉间、鼻鼻、眶、鞍、基底、部分、鼻前棘、鼻后棘、鼻窦前、上、后、下点。本横断面研究采用二元逻辑回归（BLR）模型。结果预测性别的总体准确率为74.7%。低于0.41的值为男性，高于0.41的值为女性。估计灵敏度和特异度分别为85.3%和64.0%，表明该模型具有满意的调整效果。受试者工作特征（ROC）曲线下面积（area under curve - AUC）为0.80，判别能力较好。结论：使用x线片进行脑测量分析的性别估计可以作为传统性别估计方法的补充方法，并且可以作为希腊人群中可靠的性别预测器，特别是当替代技术无法用于估计性别时。
{"title":"Is lateral cephalometric analysis useful to sex estimation in forensic science? A cross-sectional study","authors":"Anastasia Mitsea , Ioanna Pouliezou , Nikolaos Christoloukas , Iosif Sifakakis","doi":"10.1016/j.jflm.2026.103077","DOIUrl":"10.1016/j.jflm.2026.103077","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to investigate whether linear, angular, and area measurements derived from lateral cephalometric radiographs can serve as an additional method for determining sex in a sample of Greek population.</div></div><div><h3>Materials and methods</h3><div>The study sample comprised digital lateral cephalometric radiographs from 150 Greek individuals aged 18–65 years, who sought orthodontic treatment at the School of Dentistry, National and Kapodistrian University of Athens, Greece. Patient records were screened based on eligibility criteria for inclusion in the study. The sample was categorized by sex and age, with age intervals of 5 years. An equal number of lateral cephalometric radiographs for males and females were distributed within each age group. Twelve cephalometric points visible on lateral cephalometric radiographs were digitally traced using ViewBox software, including glabella, nasion, orbitale, sella, basion, porion, anterior nasal spine, posterior nasal spine, anterior, superior, posterior and inferior points of sinus. The present cross-sectional study used a binary logistic regression (BLR) model.</div></div><div><h3>Results</h3><div>Sex was predicted with an overall accuracy of 74.7 %. A value lower than 0.41 identified a male participant, and a value higher than 0.41 a female participant. The estimated sensitivity and specificity are 85.3 % and 64.0 %, respectively, indicating that the model has satisfactory adjustment. The area under the Receiver Operating Characteristic (ROC) curve (area under the curve - AUC) was 0.80, indicating good discriminative ability.</div></div><div><h3>Conclusions</h3><div>Cephalometric analysis using radiographs for sex estimation could be useful as a complementary method to conventional sex estimation approaches and may serve as a reliable sex predictor in the Greek population, particularly when alternative techniques cannot be used to estimate sex.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103077"},"PeriodicalIF":1.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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