Medicine, Science and the Law最新文献

There is a debate over whether the effect of prone restraint on respiration can lead to cardiac arrest. In itself, the prone or prone restrained posture does not likely compromise ventilation to any clinically significant degree for a detainee who is passive and calm, as a number of prone restraint studies have shown. However, these studies were not able to replicate an anxious, distressed or intoxicated (alcohol or drugs) detainee who is struggling and being actively held down. This review examines the physiology and biomechanics of respiration, highlighting the differences between upright position respiration and prone respiration and the effect of restraint on respiration. In addition, the findings of research on the effects of struggling, obesity, anxiety or panic and drug intoxication on the consequent carbon dioxide (CO₂) production and the work of breathing are presented. The limitations which each of these factors place on the ability to remove CO₂ from the blood are discussed. The evidence suggests that severe respiratory or metabolic acidosis could arise as the result of the combined effects of several factors and that cardiac arrest, if it occurs, would be more likely due to hypercapnia than hypoxia.

The diversity of dental patterns is a fundamental topic in disaster victim identification. The current scientific literature, however, is scarce of data regarding young individuals. This study aimed to assess the radiographic diversity of dental patterns, considering missing, unrestored, and filled teeth in young individuals. The sample consisted of 7219 panoramic radiographs of individuals between 12 and 22.9 years. The permanent teeth, except third molars, were coded as missing, unrestored, or filled and odds ratios (OR) were calculated based on sex, dental arch, and age. The sex-combined sample had 1.116 distinctive dental patterns. "All unrestored" teeth was the most common pattern (OR: 0.437) followed by the sequence of unrestored teeth except restored mandibular first molars (OR: 0.021). Females had more distinctive dental patterns than males (p < .001), while males had more unrestored teeth (p < .001). In the age category of 12-12.9 years, the OR for finding a distinctive dental pattern was 11%, while in the age category of 22-22.9 years it increased to 58%. On the other hand, the OR for "all unrestored" gradually decreased according to age (74% in the younger category, and 23% in the older age category). The distinctiveness of dental patterns among young individuals is affected by the predominance of unrestored teeth. However, registering a single filled tooth in a remaining unrestored dentition can reduce exponentially the probability of finding an identical pattern of missing, unrestored and filled teeth.

The aim of the present study was to provide a forensic psychiatric characterization of perpetrators of parricide who were found not guilty by reason of insanity (NGRI). We conducted a study involving 52 NGRI patients who had committed homicide or attempted homicide within the Department of Forensic Psychiatry in Thessaloniki, Greece, between January 2015 and 2020. Subjects were categorized into two groups: parricide (n = 21) and a control group (n = 31). Our findings revealed that in the parricide group, the majority of patients were unmarried males in their thirties, with a history of prior contact with mental health services and nonadherence to treatment. Additionally, they had a background of substance abuse and exhibited violent behavior before the index crime. A notable trend observed among parricide offenders was the tendency to seek hospitalization, possibly as a means of distancing themselves from stressful family environments, based on information obtained in the interviews conducted as a part of this research. All instances of parricide involved the use of sharp weapons, and the crimes were consistently committed in private settings. Symptomatology among parricide patients was assessed as moderate to severe, with a significant long-term risk observed following the crime. The primary differences identified between the two groups were the higher pre-crime voluntary admissions and the elevated estimated postcrime risk observed in the parricide group. Early intervention, comprehensive assessment of risk factors, family support, and assistance in resolving conflicts and reintegrating patients into society are emphasized as critical interventions that can potentially prevent future tragedies.

In June 2023, a mentally ill man stabbed to death three people in the street and seriously injured three others. A plea of guilty to manslaughter on the grounds of diminished responsibility (DR) was accepted by the Crown Prosecution Service and he subsequently received a restricted hospital order (sections 37 & 41) under the Mental Health Act 1983. There has been considerable public discussion around this case. This paper sets out the background to the partial defence to murder of DR as well as the current approach to the sentencing of mentally ill defendants convicted of manslaughter. The Court of Criminal Appeal later considered a referral that the sentence had been 'unduly lenient'. The court considered the legal factors of the degree of retained responsibility and the extent to which a penal element should be reflected in the sentence. From the psychiatric perspective, the release regimes of the two options of a restricted hospital order or a hybrid order were also examined by the Court, as these related directly to protection of the public.

On 11 February 2025, Tuscany became the first region in Italy to approve a law regulating medically assisted suicide. However, the law makes no provision for psychological support or educational and training programs for healthcare professionals involved in the procedure. Studies from countries where assisted suicide has long been legal highlight its significant psychological and emotional impact on care providers. In response, various forms of psychological support have been implemented to help and protect healthcare staff from the side effects of these events. Moreover, specialized training programs have been developed to equip healthcare providers with the necessary skills to handle assisted suicide requests appropriately. Tuscany's initiative may pave the way for other regions to adopt similar measures and, ideally, for a parliamentary law to regulate the practice nationwide. Therefore, this paper strongly argues that the inclusion of structured psychological support and specialized training programs is a fundamental requirement for developing an ethical, sustainable, and comprehensive end-of-life framework in Italy.

The phenomenon of missing persons draws the attention of authorities, who implement measures to address the issue. Missing Children Argentina (MCA) is a non-profit organization that supports the families of missing individuals in Argentina. MCA receives support with age progression techniques from the Italian non-profit organization Italian Missing Children (IMC). MCA and IMC have been collaborating since 2020, processing nine cases of digital aging. This paper presents the case of a missing girl, and her age progression is reported as an example to document the collaborative work between the two organizations. The age progression technique, performed due to photographs of the missing person's relatives, is based on scientific standards of facial aging. Through the use of Adobe Photoshop (2022^®), specific facial morphological features were identified in high-resolution reference photos and combined to create an updated image of the missing individual. The digitally aged image is then included in a poster and shared on social media. The poster includes the time and place of the disappearance, personal details of the missing person, contact information for potential sightings, original photos taken closest to the time of disappearance, and the digitally age-progressed images. It is crucial to inform the public about the possibility of requesting age progression for long-term missing persons. This technique can update the appearance of the individual and significantly support search efforts.

The microbiome has been at the center of a cross-section of disciplines with a wide range of applications and research methodologies, the impact of which is also reflected in forensic science. The skin microbiome is considered a "microbial fingerprint" due to its highly personalized characteristics and can be used for forensic individual identification. This narrative review systematically combs through the literature on skin microbiome and forensic applications, focusing on the characteristics, current applications, challenges, and future prospects of the skin microbiome in the field of forensic individual identification. It first explores host specificity, temporal stability, and marker characteristics. Then, by linking individuals with objects, individuals, and the environment, it analyzes the applications in forensic scenarios. It also introduces two commonly used main analytical techniques and their respective advantages and disadvantages. With the development of technology, machine learning has gradually been applied to forensic work. However, there are still four major challenges in practical application, namely ethical, technical, database and biological challenges. In this context, we provide a standardized process through a hypothetical case and propose a multi-omics collaborative analysis framework for the first time, combining metagenomics, metabolomics, and non-omics data (such as geographical information, image records) to illustrate its enhanced effects in scenarios such as sexual assault and disaster victim identification. Overall, despite the challenges, the application of skin microbiome in forensic science is promising and is expected to play an important role in the future of forensic practice.

Paper spray ionization (PSI) has emerged as a key ambient ionization technique in microanalysis over the past decade, valued for its ease of use and minimal sample preparation. This study reviews PSI's applications in forensic science, covering areas such as biomolecules, drugs of abuse, inks, explosives, toxicology, and trace evidence. To achieve these objectives, electronic searches were performed across several databases-Scopus, Web of Science, Science Direct, and PubMed-covering publications from 2010 through December 2023, with a focus on English-language articles. This search strategy yielded 40 relevant studies, which were reviewed to assess PSI-MS's current capabilities and advancements. The review underscores Paper Spray Ionization Mass Spectrometry's (PSI-MS) versatility, particularly its compatibility with various sampling methods like dried blood spots, which enhances its utility for rapid point-of-care (POC) analysis. This capability facilitates the efficient analysis of biochemical and forensic samples while bypassing lengthy separation procedures, marking a significant advancement in forensic analysis techniques.