Medicine, Science and the Law最新文献

Drowning is a leading cause of injury-related deaths among youth worldwide, often linked to inadequate supervision and ineffective guardianship. While paediatric studies have examined demographics and risk factors, little is known about how these variables interact to influence rescue likelihood. This study addresses that gap using a multivariate binary logistic regression model to assess the odds of not receiving a rescue attempt, using fatality records (n = 638) from coroners and medical examiners across Canada (2006-2016). This approach captures all known accidental fatal drownings but findings cannot be generalized to include incidents in which the individual survived. The best model explained 45.1% of the variance in rescue outcomes (Nagelkerke Pseudo R² = .451) with 84.6% accuracy. Findings revealed that age, sex, alcohol use, perimortem activity, water body type and urban/rural location significantly impacted rescue attempts. However, chronic medical conditions and general bystander presence showed no significant relationship at the bivariate level. When demographics and situational factors were considered, bystander type (with adult, minors only or alone/not witnessed) became a key model contributor for predicting rescue attempt likelihood. Teenagers (15-18 years) accounted for 33.5% of drownings, followed by toddlers (2-4 years, 21.9%) and children (5-11 years, 20.5%). Compared to infants, older children and teens faced greater risks of not being rescued, and bystander presence does not equate to capable guardianship. Open water environments posed the highest risk, with ocean drownings 7.9 times more likely to result in no rescue attempt, compared to domestic settings.

This study assessed the potential of the foramen magnum (FM) in the Malaysian juvenile population to estimate sex using computed tomography (CT) data. A total of 200 (male = 100; female = 100) CT images of Malaysian individuals aged between 8 and 16 were retrieved. The maximum length (FML) and width (FMW), area (FMA 1 and FMA 2), and index (FMI) of the three-dimensional image of the FM were measured and analysed using Mimics software version 20 (Materialise N.V., Heverlee, Belgium). These metric data were then used to develop sex estimation models through discriminant function analysis (DFA) and binary logistic regression (BLR). The results showed that all measurements in males were significantly higher than in females (p < 0.001), demonstrating a high potential for accurate sex classification. Additionally, females exhibited a wider FM than males, as indicated by the FM index. Based on univariate DFA analysis, FML and FMA 2 were identified as reliable variables for sex estimation, achieving an accuracy of 68.5% with a low sex bias rate of 1.2%. The multivariate DFA yielded a higher accuracy of 70.5% compared to the univariate analysis. Similarly, univariate and multivariate BLR analyses demonstrated comparable accuracies of 68.5%. Overall, the DFA showed greater accuracy and lower sex bias across all cases, including original and validation samples. This study suggests that FM parameters can complement existing sex estimation methods and be integrated with other techniques to improve skeletal sex determination.

The skull has long been recognized and utilized in forensic investigations, evolving from basic to complex analyses with modern technologies. Advances in radiology and technology have enhanced the ability to analyze biological identifiers-sex, stature, and age at death-from the skull. The use of computed tomography imaging helps practitioners to improve the accuracy and reliability of forensic analyses. Recently, artificial intelligence has increasingly been applied in digital forensic investigations to estimate sex, stature, and age from computed tomography images. The integration of artificial intelligence represents a significant shift in multidisciplinary collaboration, offering the potential for more accurate and reliable identification, along with advancements in academia. However, it is not yet fully developed for routine forensic work, as it remains largely in the research and development phase. Additionally, the limitations of artificial intelligence systems, such as the lack of transparency in algorithms, accountability for errors, and the potential for discrimination, must still be carefully considered. Based on scientific publications from the past decade, this article aims to provide an overview of the application of computed tomography imaging in estimating sex, stature, and age from the skull and to address issues related to future directions to further improvement.

COVID-associated acute mesenteric ischaemia is a rare event that has a high mortality rate, particularly in the elderly. Despite gastrointestinal symptoms being relatively common in COVID-19 infections, however, lethal gut complications are often not considered. Two cases with fatal COVID-associated acute mesenteric ischaemia are therefore reported. Case 1: A 74-year-old woman who died following a presentation with diarrhoea and abdominal pain was found at autopsy to have extensive ischaemic changes of her small and large intestines. The superior mesenteric artery and its major branches were widely patent. Histologically acute inflammation and necrosis of the mucosa and intramucosal haemorrhage were found with fibrin thrombi in intramucosal and submucosal vessels. Respiratory viral nucleic acid testing performed on a retronasal swab obtained at autopsy was positive for COVID-19 (SARS-CoV-2). Death was due to multi-organ failure complicating mesenteric ischaemia associated with COVID-19 infection. Case 2: A 94-year-old woman with COVID-19 infection died after developing abdominal pain with melaena and bright red rectal bleeding. At autopsy there was focal transmural acute inflammation of the small intestine with multiple fibrin microthrombi. Death was also due to multi-organ failure complicating mesenteric ischaemia associated with COVID-19 infection. In the absence of obstructive vascular lesions at autopsy in cases of intestinal ischaemia, COVID-19 should be considered with appropriate swabbing and careful histological sampling of the intestine and mesentery to check for microvascular fibrin thrombi.

Missing persons are a major part of everyday policing. However, some missing person cases can be highly emotive and challenging such as missing women and girls. Women who go missing have a greater risk of coming to harm. This study focused on 38 long-term missing women and girls from the Irish Republic from 1971 to 2023 of which 12 cases are now classified as homicides, and the whereabouts of the bodies remain unknown. The majority of cases are in Leinster with 25. Eight missing persons are under 18 years, and 22 are between the ages of 18 and 45 years. Domestic violence was a feature in five cases, involvement in a fight prior to disappearance in seven cases, and inconsistencies in statements by intimate partners and close family members regarding the victim's mental health were noted in seven cases. In nine cases, the personal belongings of the victim remained in the home. In seven cases, there was suggestive evidence that the victim entered water. These factors were seen in both the missing and classified homicide cases. The suicide narrative is heavily implied in many of these cases. A woman's mental health and stage of life such as pregnancy, childbirth and menopause can be exploited and used as an advantage to a potential killer. It is therefore paramount that missing women who are considered to have taken their own lives should be thoroughly investigated, with a special focus on cases where evidence suggests drowning and jumping from a height.

Prostate-specific antigen (PSA) tests are used in forensic science to perform rapid semen screening on vaginal swab samples from suspected victims of sexual assault. In some sexual assault cases, clothing or bedding is key evidence. A pre-trial investigation was launched following a complaint by an 85-year-old woman, who alleged that she had been raped by her 63-year-old son-in-law with whom she lives. Traces of seminal fluid were found in the vaginal swab (following a PSA test), and traces of seminal fluid, along with the victim's DNA and a partial DNA profile of the suspect, were found on the victim's underwear. The first-instance court (district court) found the man guilty and sentenced him to 3 years and 6 months of imprisonment for rape. Although PSA is produced in the prostate and secreted into seminal fluid, it is not exclusive to the prostate. PSA can be detected in women's bodies in various pathological conditions. In cases of sexual violence, the proper interpretation of laboratory tests is essential, taking into account all the circumstances of the incident as well as the victim's medical history.

One-punch deaths draw considerable legal and media attention due to the nature of catastrophic events and their impact on victims and families. Empirical research on the sentencing outcomes and offence categories faced by the perpetrators is non-existent. This Australian study examined judicial sentencing reviews to unpack perpetrator characteristics, offence patterns and sentencing outcomes for one-punch fatalities over a 30-year period. Two hundred and eighty-seven perpetrator convictions were reported by various parameters such as median sentencing length, injury mechanism and maximum sentencing categories. Secondary outcomes were details of concentrations of alcohol and illicit drug usage and usage of one-punch specific laws, hitherto unelucidated for one-punch assaults. Nearly all perpetrators were male with a median age of 26 years, with 61% charged in New South Wales and Victoria alone. The median sentence length of imprisonment was 3.8-11.5 years for a manslaughter conviction. Median sentence length when categorized by injury mechanism demonstrated variation in both life sentence and one-punch offence categories. About 40% of Australian perpetrators were convicted under one-punch laws in states where these were introduced. The study will increase knowledge and public awareness regarding the impact of one-punch violence and outcomes.