Journal of forensic and legal medicine最新文献

英文中文

Corrigendum to “Emerging global trends and development in forensic toxicology: A review” [J Forensic Legal Med 103 (2024) 1–9 102675]

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jflm.2024.102798

Saurabh Shukla , Sakshum Khanna , Tahir ul Gani Mir , Jyoti Dalal , Deeksha Sankhyan , Kushagra Khanna

引用次数: 0

Enhancing foundational validity of forensic findings in nonlethal medico-legal strangulation examinations 提高非致死法医学绞杀检查中法医鉴定结果的基础有效性。

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jflm.2025.102800

Reanna Panagides , Karen Kafadar , Kathryn Laughon

Background

Nonlethal strangulation occurs when the brain is deprived of oxygen because of external compression leading to the occlusion of the neck's blood vessels and/or airway. The current state of strangulation science confines expert testimony to merely describing injuries attributed to strangulation ‘based on the expert's experience and training.’ Expert testimony that can quantify the likelihood that observed injuries are attributable to strangulation would strengthen the scientific validity of such testimony.

Purpose

This study aims to identify those documented features, or clusters of features, that are associated with cases where strangulation is reported versus cases where strangulation is not reported. Methods: This study is a retrospective analysis of medical record data from patients seeking forensic examinations for strangulation and/or sexual assault who presented to the emergency department of an academic medical center from January 2018 to June 2022.

Results

Among the 170 cases, 77 were documented as strangulation-absent and 93 were documented as strangulation-present. A simple classification algorithm was developed to identify these cases where strangulation was present. Prominent features of this algorithm included: presence of petechiae, observed number of injuries around the mouth, face, head and neck, and total number of injuries. This algorithm has a false positive rate of 5 % and a false negative rate of 32 %.

Discussion

To our knowledge, this is the first medico-legal research study to produce an algorithm to assist with classifying cases of strangulation given specific forensic examination characteristics. The study demonstrates the value of data collection in medico-legal research for developing an algorithm that enables forensic examiners to use data-driven methods to verify victims’ reports of strangulation.

背景：由于外部压迫导致颈部血管和/或气道闭塞，大脑缺氧时发生非致死性窒息。掐死科学的现状限制了专家的证词仅仅是根据专家的经验和训练来描述掐死造成的伤害。专家证词如果能量化观察到的伤害是由勒死造成的可能性，将加强这种证词的科学有效性。目的：本研究的目的是确定那些记录的特征，或特征集群，这些特征与报告绞杀的病例有关，而不是报告绞杀的病例。方法：本研究回顾性分析了2018年1月至2022年6月在某学术医疗中心急诊科就诊的因勒死和/或性侵犯而寻求法医检查的患者的病历数据。结果：170例患者中，有93例有掐死，77例无掐死。开发了一种简单的分类算法来识别这些存在勒死的病例。该算法的突出特征包括：斑点的存在，观察到的口腔、面部、头部和颈部周围的受伤数量，以及受伤总数。该算法的假阳性率为5%，假阴性率为32%。讨论：据我们所知，这是第一个产生算法的医学法律研究，以协助在特定法医检查特征下对绞杀案件进行分类。该研究证明了数据收集在医学法律研究中的价值，它有助于开发一种算法，使法医能够使用数据驱动的方法来核实受害者的绞杀报告。

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引用次数: 0

Adolescent and children suicides in Turkey: Analysis of data from the Turkish Statistical Institute (2002–2022) 土耳其青少年和儿童自杀：土耳其统计研究所数据分析（2002-2022）。

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jflm.2025.102809

Ufuk Akın , Naime Meriç Konar

Suicides in children and adolescents have different characteristics from other age groups because of their unique physical and psychosocial dynamics. Having more information on childhood and adolescent suicides and knowing their characteristics will lead to the development of prevention strategies. This study aimed to evaluate demographic characteristics, suicide methods, and causes of suicides in individuals aged <19 years using 2002 and 2022 data from the Turkish Statistical Institute. Of 1746 suicide cases, 813 (46.6 %) were recorded in male teens and 933 (53.4 %) in female teens aged <15 years. Of 7698 suicide cases, 4041 (52.5 %) were reported in male teens and 3657 (47.5 %) in female teens aged 15–19 years. Family incompatibility was the most common cause of suicides in children and adolescents. The most common suicide method was hanging. Population data show a decreasing trend, particularly in developed and developing countries, among children and adolescents. Therefore, suicide is an important problem in children and adolescents, who constitute a critical dynamic population for the socioeconomic future of societies.

儿童和青少年的自杀行为具有不同于其他年龄组的特点，因为他们具有独特的生理和心理动态。掌握更多关于儿童和青少年自杀的信息并了解其特点将有助于制定预防战略。本研究旨在评估老年人的人口学特征、自杀方式和自杀原因

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引用次数: 0

The importance of outliers in forensic practice

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jflm.2025.102810

Roger W. Byard , Melissa Humphries

Forensic pathologists and practitioners are well aware of the number of unique or unusual cases that are not infrequently seen in a busy medicolegal practice. Unfortunately the importance of isolated cases is sometimes dismissed by those who feel that such outliers merely skew datasets and provide nothing useful in terms of analyses. Applying a statistical approach to forensic observations does, however, run the risk of losing quite valuable information that assists in understanding mechanisms and outcomes of disease and injury. Data derived from randomised controlled trials and observational studies should not be mutually exclusive as a single outlier may give much clearer understanding of possible pathophysiological mechanisms than a group of more mainstream cases. Clearly both have their uses in contributing to the literature and in helping to evaluate and analyse cases.

引用次数: 0

Ethyl alcohol consumption characteristics of deceased individuals in Lithuania 立陶宛死者的乙醇消费特点

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.jflm.2024.102785

Augustinas Stasiunas , Sigitas Chmieliauskas , Jurgita Stasiuniene , Sigitas Laima , Diana Vasiljevaite , Rokas Simakauskas , Dmitrij Fomin , Ineta Dvarvytyte

The number of alcohol-related deaths in Lithuania has fallen by almost one-third in the last decade; however, the number of deaths has been on the rise since 2019. Data on the postmortem investigation of victims between 2018 and 2022 were obtained from the Lithuanian State Forensic Medicine Service database. This study analyzed data from 1200 autopsies. The deceased victims were categorized based on their cause of death and blood alcohol concentration (sober, legally intoxicated, mild, medium, or heavy). The causes of death were diseases (54.17 %, n = 650), suicides (12.08 %, n = 145), homicides (2.5 %, n = 30), and accidents (31.25 %, n = 375). Toxicological tests for alcohol were performed in all cases. Alcohol levels in the blood and urine were measured using gas chromatography. A significant correlation was observed between blood alcohol concentration and age (r = −0.13, p = 0.007). A statistically significant difference was observed in the proportions of men and women who were intoxicated. Among the causes of death, the group of individuals who died because of accidents exhibited the highest average blood alcohol concentration. Alcohol intoxication is undoubtedly a contributing factor to fatalities resulting from accidents and homicides. These findings assist in determining the intoxication level of victims and in assessing any potential links that may contribute to or predispose victims to lethal outcomes in cases of disease, suicide, homicide, or accident.

在过去十年中，立陶宛与酒精有关的死亡人数下降了近三分之一；然而，自2019年以来，死亡人数一直呈上升趋势。有关 2018 年至 2022 年期间受害者尸检调查的数据来自立陶宛国家法医服务数据库。本研究分析了 1200 例尸检数据。死者根据死因和血液中酒精浓度（清醒、合法醉酒、轻度、中度或重度）进行了分类。死亡原因包括疾病（54.17%，n = 650）、自杀（12.08%，n = 145）、他杀（2.5%，n = 30）和意外（31.25%，n = 375）。对所有病例都进行了酒精毒理学检测。血液和尿液中的酒精含量是通过气相色谱法测定的。血液中的酒精浓度与年龄之间存在明显的相关性（r = -0.13，p = 0.007）。从统计学角度看，醉酒的男女比例存在明显差异。在死亡原因中，死于意外事故的人群平均血液酒精浓度最高。酒精中毒无疑是导致事故和凶杀死亡的一个因素。这些研究结果有助于确定受害者的醉酒程度，并评估在疾病、自杀、凶杀或意外事故中可能导致或易导致受害者死亡结果的任何潜在联系。

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引用次数: 0

Systematic forensic identification of a homicide by brodifacoum poisoning: A case report 溴鼠灵中毒杀人案的系统法医鉴定：案例报告。

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.jflm.2024.102784

Zhonghao Yu , Yuhao Yuan , Qing Shi , Hang Gao , Erjuan Zhao , Jinghong Ma , Yiwu Zhou

Brodifacoum, a long-acting anticoagulant rodenticide, exerts inhibitory effects on blood coagulation factor synthesis, leading to abnormal clotting function and potential fatality. Poisoning of accidental exposure to brodifacoum is not rare, but death from brodifacoum poisoning can be largely avoided with timely and long-term effective treatments, consequently, forensic data on fatalities due to brodifacoum poisoning may be limited. This paper presents a case of brodifacoum-induced homicide, detailing the medial records and pathological changes observed in multiple organs. Furthermore, t liquid chromatography–tandem mass spectrometry (LC-MS/MS) was employed to measure the concentrations of brodifacoum in blood, hydropericardium, and urine 40 days post-poisoning (1 day post-mortem), yielding values of 0.097 μg/mL, 0.089 μg/mL, and 0.007 μg/mL respectively. The aim of this article is to contribute towards forensic identification of fatalities resulting from brodifacoum poisoning while also serving as a reference for clinical diagnosis in similar cases.

溴鼠灵是一种长效抗凝血杀鼠剂，对凝血因子的合成有抑制作用，导致凝血功能异常，可能造成死亡。意外接触溴鼠灵而中毒的情况并不罕见，但只要及时进行长期有效的治疗，溴鼠灵中毒死亡在很大程度上是可以避免的，因此，溴鼠灵中毒致死的法医数据可能有限。本文介绍了一例溴敌隆诱发的凶杀案，详细介绍了多器官的医学记录和病理变化。此外，本文还采用液相色谱-串联质谱法（LC-MS/MS）测定了中毒 40 天后（死后 1 天）血液、心包积水和尿液中溴敌隆的浓度，结果分别为 0.097 μg/mL、0.089 μg/mL和 0.007 μg/mL。本文旨在帮助法医鉴定溴鼠灵中毒死亡病例，同时也为类似病例的临床诊断提供参考。

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引用次数: 0

Cold shock proteins CIRBP and RBM3 may indicate hypothermia death: A case report 冷休克蛋白 CIRBP 和 RBM3 可能预示着低体温死亡：病例报告。

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.jflm.2024.102786

Zhe Zheng , Hongwei Li , Caiyuan Liu , Qiannan Xu , Zhenqian Zhang , Xinmin Pan , Haojie Qin

Cold-inducible RNA-binding protein (CIRBP) and RNA binding motif protein 3 (RBM3) are both members of the cold shock protein family expressed in response to low-temperature induction. However, their usefulness in the diagnosis of fatal hypothermia in forensic has not been reported. In this study, we report the case of a female who died of fatal hypothermia. Through detailed case investigation, scene examination, autopsy testing and tissue observation, we ultimately determined that the woman died of hypothermia. We further examined the expression of CIRBP and RBM3 in the postmortem brain, heart, lung and kidney via immunohistochemistry. The high expression of CIRBP and RBM3 in the brain, lungs, and kidneys suggested the possibility of hypothermia. This study may provide new auxiliary diagnostic indicators for the diagnosis of fatal hypothermia in forensic medicine.

冷诱导 RNA 结合蛋白（CIRBP）和 RNA 结合基调蛋白 3（RBM3）都是冷休克蛋白家族的成员，在低温诱导下表达。然而，它们在法医致命性低体温症诊断中的作用尚未见报道。在本研究中，我们报告了一例死于致命性低体温症的女性病例。通过详细的案件调查、现场检查、尸检测试和组织观察，我们最终确定该女性死于低体温症。我们通过免疫组化进一步检测了 CIRBP 和 RBM3 在尸检脑、心、肺和肾中的表达。CIRBP 和 RBM3 在脑、肺和肾中的高表达提示了低体温症的可能性。这项研究可为法医学诊断致命性低体温症提供新的辅助诊断指标。

引用次数: 0

Reflections on editorial and peer review in the forensic medical literature 对法医学文献编辑和同行评审的思考

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.jflm.2024.102760

Michael D. Freeman

引用次数: 0

Anthropometric weight estimation is less accurate than visual weight estimation in forensic postmortem cases in a Swiss population 在瑞士法医尸体解剖案例中，人体测量体重估计的准确性低于目测体重估计的准确性。

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.jflm.2024.102787

Tim Merriam , Markus Enders , Stephan A. Bolliger , Wolf Schweitzer , Michael J. Thali , Lars Ebert , Barbara Fliss

When the time since death must be calculated forensic pathologists often consider a calculation based on the Henssge nomogram. This calculation requires an estimated body weight. Previous research has indicated that healthcare workers generally inaccurately guessed patients’ body weights. In recent years, weight estimation methods based on anthropometric parameters, such as mid-arm or waist circumference, have been shown to improve estimation accuracy. This study aimed to examine whether anthropometric weight estimation methods could improve weight estimation accuracy compared to visual estimation in forensic pathology.

In 199 cases from a Swiss population, we measured the actual body weight, mid-arm circumference, waist circumference, and body height before autopsy. Additionally, two forensic pathologists visually estimated the body weight. We found mid-arm circumferences to correlate the strongest with actual body weight (Pearson ’sr 0.87, 95 % CI 0.83–0.90). However, all mid-arm circumference-based estimation methods performed worse than those previously described. A statistical bias between −12.3 % and −14.5 % indicated a systematic weight underestimation. Combined two-physician visual estimation performed significantly better than anthropometric measurements in our population but showed no difference from anthropometric estimation methods previously described in the literature. Further research is needed on novel body weight estimation methods that are currently not applicable for the global population.

当必须计算死亡时间时，法医病理学家通常会考虑根据亨斯格提名图进行计算。这种计算方法需要估计体重。以往的研究表明，医护人员对病人体重的猜测通常不准确。近年来，基于人体测量参数（如中臂围或腰围）的体重估算方法已被证明可提高估算的准确性。本研究旨在探讨在法医病理学中，与目测法相比，人体测量体重估计方法能否提高体重估计的准确性。在 199 例瑞士人中，我们在解剖前测量了实际体重、中臂围、腰围和身高。此外，两名法医病理学家目测了体重。我们发现中臂围与实际体重的相关性最强（Pearson 'sr 0.87, 95 % CI 0.83-0.90）。然而，所有基于中臂围度的估算方法都比之前描述的方法表现更差。-12.3%到-14.5%之间的统计偏差表明存在系统性的体重低估。在我们的研究人群中，两位医生的联合目测估算结果明显优于人体测量方法，但与之前文献中描述的人体测量估算方法没有区别。对于目前还不适用于全球人口的新型体重估算方法，还需要进一步研究。

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引用次数: 0

Biochemical analysis of vitreous humor and synovial fluid in the estimation of early postmortem interval: A meta-analytical approach 对玻璃体和滑膜液进行生化分析以估算死后早期间隔：荟萃分析法。

IF 1.2 4区医学 Q3 MEDICINE, LEGAL

Journal of forensic and legal medicine

Pub Date : 2024-10-22 DOI: 10.1016/j.jflm.2024.102782

Raíssa Bastos Vieira , Carlos Antonio Vicentin-Junior , Nicole Prata Damascena , Melina Calmon Silva , Analany Pereira Dias Araujo , Rafael Queiroz da Trindade , Maria Gabriela Duarte Morais Vieira , Eugénia Cunha , Alexandre Raphael Deitos , Bianca Marques Santiago , Paulo Ricardo Martins-Filho , Carlos Eduardo Palhares Machado

The estimation of the postmortem interval (PMI) is a significant challenge in legal medicine and forensic sciences due to the dynamic and continuous decomposition of organisms after death. Thanatochemistry has emerged as a promising area to estimate PMI by measuring the concentrations of postmortem biochemical markers. This systematic review and meta-analysis aimed to summarize evidence on postmortem biochemical alterations in vitreous humor (VH) and synovial fluid (SF) to estimate early PMI. Comprehensive searches of electronic databases identified studies measuring postmortem biomarker concentrations in both matrices. Our analysis included three meta-analytical approaches: calculating standardized mean differences to assess variations in biochemical parameters, executing correlation meta-analysis (ρ) to explore relationships between these parameters and PMI, and conducting meta-regression to derive a predictive model. Results from five eligible studies indicated no correlation between sodium levels and PMI in both matrices. However, a strong correlation was found between potassium levels and PMI in VH (ρ = 0.69; 95 % CI 0.52 to 0.86) and SF (ρ = 0.81; 95 % CI 0.75 to 0.87), with the meta-regression yielding the optimal predictive equation for SF: [K+] = 6.15 + 0.21 × PMI. These findings support the use of potassium as a reliable biomarker for PMI estimation, particularly in SF.

由于生物体在死后会发生动态和持续的分解，因此估算死后间隔时间（PMI）是法律医学和法医学面临的一项重大挑战。通过测量死后生化标志物的浓度来估算死后间隔时间是一个很有前景的领域。本系统综述和荟萃分析旨在总结有关玻璃体（VH）和滑膜液（SF）中死后生化变化的证据，以估算早期死亡原因指数。通过对电子数据库的全面检索，我们发现了测量两种基质中死后生物标志物浓度的研究。我们的分析包括三种元分析方法：计算标准化平均差以评估生化参数的变化；执行相关元分析（ρ）以探讨这些参数与 PMI 之间的关系；以及进行元回归以得出预测模型。五项符合条件的研究结果表明，在两个矩阵中，钠水平与 PMI 之间没有相关性。然而，在 VH（ρ = 0.69；95 % CI 0.52 至 0.86）和 SF（ρ = 0.81；95 % CI 0.75 至 0.87）中，钾水平与 PMI 之间存在很强的相关性，元回归得出了 SF 的最佳预测方程：[K+] = 6.15 + 0.21 × PMI。这些发现支持将钾作为估计 PMI 的可靠生物标志物，特别是在 SF 中。

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