Journal of forensic and legal medicine最新文献

Synthetic cannabinoids (SCs) represent a diverse class of new psychoactive substances characterized by extensive substance variety and severe abuse implications. The current situation of synthetic cannabinoid abuse in China is getting worse, with an increasing number of SC variants emerging. Therefore, it is imperative to improve synthetic cannabinoid detecting methods to align with the prevalent abuse situation in the region. In this study, a reliable and validated liquid chromatography-tandem mass spectrometry method was developed for the qualitative and quantitative analysis of 65 SC analogues in human hair samples. The validation results demonstrated satisfactory linearity (r ≥ 0.99) within the range of 25–2500 pg/mg for each SC analogue. The method exhibited limits of detection ranging from 10 to 15 pg/mg and limits of quantification ranging from 25 to 40 pg/mg. The relative standard deviations of intra-day precision and inter-day precision were below 15 %. Furthermore, negligible matrix effects were observed, with recovery rates ranging from 85.70 % to 119.43 %. Analysis of abuser demographics revealed that the primary group engaged in SC analogue abuse consisted of adolescents, predominantly males, accounting for 79.5 % of cases. Among the suspected individuals, ADB-BUTINACA and MDMB-4en-PINACA were the most frequently detected substances. The present study develops a highly sensitive analytical method and provides a comprehensive overview of the prevalence of SC abuse in the eastern region of China.

Fibromuscular dysplasia of the coronary is an uncommon coronary defect with a range of pathological alterations and unpredictable clinical description that can cause sudden death.

We present an autopsy case of sudden cardiac death due to a rupture of a coronary artery aneurysm in a 59-year-old woman. Postmortem autopsy revealed two huge saccular aneurysms located at the right coronary artery, one of which was ruptured leading to a fatal hemopericardium. Histopathological examination revealed coronary artery fibromuscular dysplasia with fibromyxoid dissociation of the media causing saccular aneurysms. The involvement of coronary arteries in fibromuscular dysplasia with aneurysmal features has been rarely reported in the literature and is most likely an underdiagnosed finding. Due to the little number of published studies, the etiology is not fully understood and data on pathogenesis, risk factors, manifestation, disease course, and mortality are still unclear, which is a gap that needs to be filled in order to avoid under-diagnosis of the disease.

Our case report aimed to discuss the mechanisms of sudden death attributed to coronary fibromuscular dysplasia.

The potential for recreational abuse of the analgesic and antiepileptic drug pregabalin is now well established in the literature. The potential minimum lethal dose in post mortem cases is however less defined. All post mortem examinations in Northern Ireland where the cause of death was found to be due to pregabalin were examined for demographic and toxicological analysis. Deaths are generally seen in young men, especially 30-39-year-olds, many of whom have a history of substance misuse and are often prescribed pregabalin. Until recently, prescription rates have been on the rise regionally. The overall median post mortem peripheral blood concentration of pregabalin found in this study is 10.6 mg/L, however this rises when concurrent drugs and alcohol are considered and in cases where pregabalin is considered responsible for death alone (i.e. outside of multidrug toxicity). Pregabalin peripheral blood concentrations returned in this study suggest previously offered minimum lethal dosages may need to be revised downward.

In forensic cases for which the time of death is unknown, several methods are used to estimate the postmortem interval. The quotient (Q) defined as the difference between the rectal and ambient temperature (Tr − Ta) divided by the initial difference (T0 − Ta) represents the progress of postmortem cooling: Q = (Tr − Ta)/(T0 − Ta), (1 ≥ Q ≥ 0). Henssge was able to show that with the body weight and its empirical corrective factor, Q can be reasonably predicted as a double exponential decay function of time (Qp(t)). On the other hand, actual Q is determined as Qd by measuring Tr and Ta under an assumption of T0 = 37.2 °C. Then, the t value at which Qp(t) is equal to Qd ($Qd=Qp\left(t\right)$) would be a good estimate of the postmortem interval (the Henssge equation). Since the equation cannot be solved analytically, it has been solved using a pair of nomograms devised by Henssge. With greater access to computers and spreadsheet software, computational methods based on the input of actual parameters of the case can be more easily utilized. In this technical note, we describe two types of Excel spreadsheets to solve the equation numerically. In one type, a fairly accurate solution was obtained by iteration using an add-in program Solver. In the other type (forward calculation), a series of Qp(t) was generated at a time interval of 0.05 h and the t value at which Qp(t) was nearest to Qd was selected as an approximate solution using a built-in function, XLOOKUP. Alternatively, a series of absolute values of the difference between Qd and Qp(t) (|Dq(t)| = |Qd − Qp(t)|) was generated with time interval 0.1 h and the t value that produces the minimum |Dq(t)| was selected. These Excel spreadsheets are available as Supplementary Files.

In forensic science and in modern times, impalement is a rare event. When this occurrence involves the head, it is even more unusual since this region is very small compared to the rest of the body. Although impalements are rare, they represent scenarios that must be treated with great care by forensic pathologists. They may involve a mixture of blunt and penetrating wounds, and the injuries observed at autopsy must be interpreted correctly. For this reason, if possible, the interconnection between the body and the impaling object should be maintained until the autopsy table. In this report, it is presented a case of cranial penetrating trauma that occurred after a suicidal fall from a great height with impact on the railing below, by reporting both the on-site scene inspection and autopsy data. The critical forensic issues that may arise in the practical management of such cases are discussed, starting from the fact that there is still no clear and unambiguous definition of impalement.

Donepezil is one of the primary treatments options for patients suffering from Alzheimer's Disease. In a review of more than 2200 postmortem donepezil positive blood specimens, 76% of concentrations were higher than the proposed therapeutic range. Means and medians were similar between central blood specimens and peripheral specimens, indicating minimal postmortem redistribution.

Postmortem concentrations may not reflect those circulating antemortem. Mean and median postmortem blood concentrations were approximately 3-fold higher than those in antemortem blood specimens. Additionally, in cases where antemortem blood was available for testing, large increases in donepezil concentrations were reported between antemortem and postmortem specimens without documented administration by medical personnel. Elevated blood donepezil concentrations have been reported in multiple postmortem cases where cause of death was unrelated. The blood concentrations reported in cases where donepezil did not contribute to death overlapped with those in suspected drug overdose cases where other drugs may have been present. In 4 out of 5 suspected donepezil overdose cases, blood concentrations greater than 1000 ng/mL were reported, whereas less than 1% of all postmortem blood samples reviewed achieved these concentrations. Blood concentrations greater than 1000 ng/mL should be considered contributory when a drug overdose is suspected. Postmortem donepezil concentrations should be interpreted with caution in the context of a comprehensive case history.

South Africa is experiencing a scourge of violence against women and children, with alarming levels of violence, and as such, juvenile cases are sometimes encountered in a forensic anthropological setting. The aim of this research was to assess the cases of juveniles (under 20 years) presenting at the Human Variation and Identification Research Unit (HVIRU) for a 6-year period (2016–2022), in order to assess patterns and types of cases referred. A total of 19 cases were assessed, of which 10 were 16–20 years old, 3 between the ages of 5 and 15 years and 6 less than 5 years old at the time of death. Of the 14 children with known sex, 12 were female with features suggesting that they fell prey to sexual violence. Many of the individuals were either known (and referred for trauma analysis) or identified following investigation. Of the 19 juveniles, 11 (58 %) had evidence of perimortem trauma (sharp and/or blunt), attesting to the violent nature of their deaths. Two cases had both sharp and blunt force trauma, of which one is a possible case of dismemberment. The remains of two individuals showed signs of perimortem burning, which may or may not be related to the cause of death. Three individuals had signs of antemortem (healed) trauma, which may suggest a longer period of abuse. Five of the individuals showed signs of disease – two had cribra orbitalia, while two others had various porous lesions indicative of chronic disease or malnutrition. One individual had advanced osteomyelitis, suggesting a natural cause of death. Some of these cases had unusual trauma and pathology, highlighting the contribution of forensic anthropologists.

Female genital mutilation (FGM) refers to all procedures that partially or totally remove the external female genitalia, or to all other deliberate injuries to the female genital organs for non-medical reasons. It is thought that over 200 million girls and women have had some form of FGM, with more than three million girls being at risk annually. The procedure varies in severity from partial or complete removal of the clitoris (Type 1) to oversewing of the vaginal opening, so-called infibulation (Type 3). There are no medical benefits from FGM, with complications increasing with the amount of tissue damage that has been inflicted. Side effects may be psychological and physical including excessive scarring, pain, infections, sexual dysfunction with significant obstetrical complications such as fistulas and increased risks of stillbirth, as well as increased neonatal and maternal morbidity and mortality. Although primarily originating in countries in Africa, the Middle East and Asia, mass migrations in recent years have made FGM a feature in most societies. For this reason, forensic practitioners and pathologists should be aware of the anatomical features of FGM and the potential medical and psychological side effects. Accurate recording of cases is required to enable appropriate resources to be allocated for instituting preventive measures.

Screening and care for victims of sexual violence (SV) among asylum seekers and refugees (ASRs) living in High-income host countries were prioritized by the WHO in 2020. The lack of stabilized prevalence findings on lifetime SV among ASRs in High-income countries hinders the development of adequate health management. The objective of this study was to determine the lifetime prevalence of SV experienced by ASRs living in High-income countries. We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included in the meta-analysis if the sample consisted exclusively of asylum seekers or refugees over the age of 16 living in High-income countries and if they reported a lifetime prevalence of experienced SV. The results of the meta-analysis were expressed with 95 % confidence intervals (CIs) as estimates of lifetime SV prevalence using a random-effects model. The estimated lifetime prevalence of SV among women ASRs was 44 % (95 % CI, 0.24–0.67) and 27 % (95 % CI, 0.18–0.38) for both sexes. This meta-analysis revealed a high prevalence of SV among ASRs hosted in High-income countries and suggest the importance of developing specific screening and care programs in these host countries.

Machine learning methods for the identification of child sexual abuse materials (CSAM) have been previously studied, however, they have serious limitations. Firstly, the training sets used to train the appropriate machine learning algorithms were not previously annotated by a forensic expert in anthropology. Secondly, previously presented solutions have rarely used models trained using real pornographic content involving children. Thirdly, previous studies have not presented a detailed justification for the classification decisions made, which is important due to the recent guidelines of the European Commission (Artificial Intelligence Act).

The aim of the study was to train convolution neural networks (CNNs) using expert-labelled CSAM images and thereby identify the elements of the body and/or the environment that are critical for classifications by the neural network. To train and evaluate machine learning models, we used 60,000 images equally divided into four classes (CSAM images, images displaying sexual activity involving adults, images of people without sexual activity, and images not containing people). We used four neural network architectures: MobileNet, ResNet152, xResNet152 and its modification ResNet-s, designed for the purpose of research.

The trained models provided high accuracy of classifying CSAM images: xResNet152 (F1 = 0.93, 92,8%), xResNet-s (F1 = 0.93, 93,1%), ResNet152 (F1 = 0.90, 91,39%), MobileNet (F1 ranged from 0.85 to 0.87, accuracy ranged from 86% to 87%).

The results of the conducted research suggest that using expert knowledge (in sexology and anthropology) significantly improved the accuracy of the models. In regard to further anthropological analysis, the results indicate that the breasts, face and torso are crucial areas for the classification of pornographic content with children's participation. Results suggests that the ResNet-s neural network may be a reliable tool for clinical work and to support the work of experts witnesses in the field of anthropology.

The study design received a positive opinion of the Ethics Committee of the Faculty of Mathematics, Informatics and Mechanics of the University of Warsaw. The clinical material was used for research purposes with the consent of the relevant prosecutor's offices. Authors provided free version of Windows application to classify CSAM for forensic experts, policemen and prosecutors at the OSF repository (DOI: 10.17605/OSF.IO/RU7JX).