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Improving Traditional Post Mortem Healthcare—The Cross-Sectional Use of Blood-Based Biomarkers 改进传统的死后医疗——基于血液的生物标志物的横断面使用
IF 1.3 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2023-07-10 DOI: 10.3390/forensicsci3030028
I. Šoša
Many tools of clinical medicine, such as clinical chemistry and diagnostic imaging, are prioritized for clinical diagnosis over post mortem diagnosis. Indeed, it is reasonable that the assessment of a patient’s functional status should take priority over the post mortem, cross-sectional use of diagnostic tests and laboratory equipment. In addition, these tools are sometimes expensive, and their use does not always have a reasonable cost–benefit ratio. However, some post mortem observations, such as inflammation, pulmonary edema, or infiltration and cerebral swelling, cannot be explained without using immunohistochemical markers for post mortem diagnosis. Introducing blood-based biomarkers into post mortem care could significantly reduce the rates of inconclusive post mortems and discrepancies in autopsy findings and clinical diagnoses. This is particularly relevant in relation to vascular pathology, considering the significant burden that vascular diseases represent for overall mortality. Expanding traditional autopsies with blood-based (circulating) biomarkers to avoid invasive post mortem examination would have cultural, religious, and potentially economic advantages. All of the target molecules were discussed in the context of the processes they up-regulate or down-regulate, which turned out to be the final cause of death. Ultimately, it is evident that further studies are needed to provide concrete validation for using a combination of markers for each case to reach a post mortem diagnosis with or without clinical records.
许多临床医学工具,如临床化学和诊断成像,优先用于临床诊断而不是死后诊断。事实上,对病人功能状态的评估应优先于尸检、诊断测试和实验室设备的横断面使用,这是合理的。此外,这些工具有时很昂贵,而且它们的使用并不总是具有合理的成本效益比。然而,一些死后观察,如炎症、肺水肿或浸润和脑肿胀,如果不使用免疫组织化学标志物进行死后诊断,就无法解释。在尸检护理中引入基于血液的生物标志物可以显著降低尸检不确定的发生率,以及尸检结果和临床诊断的差异。考虑到血管疾病对总死亡率的重大负担,这与血管病理学尤其相关。利用基于血液(循环)的生物标记物来扩大传统的尸体解剖,以避免侵入性的死后检查,将具有文化、宗教和潜在的经济优势。所有的目标分子都是在它们上调或下调的过程背景下讨论的,这被证明是死亡的最终原因。最终,很明显,需要进一步的研究来提供具体的验证,以使用每种病例的标记组合来达到有或没有临床记录的死后诊断。
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引用次数: 0
Prediction of chronological age and its applications in forensic casework: methods, current practices, and future perspectives. 年代预测及其在法医办案中的应用:方法、现行做法和未来展望。
IF 1.4 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2023-06-30 eCollection Date: 2023-06-01 DOI: 10.1093/fsr/owad021
Mie Rath Refn, Marie-Louise Kampmann, Niels Morling, Jacob Tfelt-Hansen, Claus Børsting, Vania Pereira

Estimating an individual's age can be relevant in several areas primarily related to the clinical and forensic fields. In the latter, estimation of an individual's chronological age from biological material left by the perpetrator at a crime scene may provide helpful information for police investigation. Estimation of age is also beneficial in immigration cases, where age can affect the person's protection status under the law, or in disaster victim identification to narrow the list of potential missing persons. In the last decade, research has focused on establishing new approaches for age prediction in the forensic field. From the first forensic age estimations based on morphological inspections of macroscopic changes in bone and teeth, the focus has shifted to molecular methods for age estimation. These methods allow the use of samples from human biological material that does not contain morphological age features and can, in theory, be investigated in traces containing only small amounts of biological material. Molecular methods involving DNA analyses are the primary choice and estimation of DNA methylation levels at specific sites in the genome is the most promising tool. This review aims to provide an overview of the status of forensic age prediction using molecular methods, with particular focus in DNA methylation. The frequent challenges that impact forensic age prediction model development will be addressed, together with the importance of validation efforts within the forensic community.

估算一个人的年龄主要与临床和法医领域有关。在法医领域,从犯罪者在犯罪现场留下的生物材料中估算出个人的实际年龄可为警方调查提供有用信息。在移民案件中,年龄会影响个人的法律保护地位,因此年龄估算也很有帮助;在灾害受害者身份鉴定中,年龄估算也有助于缩小潜在失踪人员名单的范围。在过去的十年中,研究的重点是在法医领域建立新的年龄预测方法。从最初基于骨骼和牙齿宏观变化的形态学检查进行法医年龄估计,到现在的重点已转移到分子年龄估计方法上。这些方法可以使用不含形态学年龄特征的人体生物材料样本,理论上可以对仅含少量生物材料的痕迹进行调查。涉及 DNA 分析的分子方法是主要选择,而估算基因组特定位点的 DNA 甲基化水平是最有前途的工具。本综述旨在概述使用分子方法进行法医年龄预测的现状,尤其侧重于 DNA 甲基化。将讨论影响法医年龄预测模型开发的常见挑战,以及在法医界进行验证工作的重要性。
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引用次数: 0
Age-at-Death Estimation by Dental Means as a Part of the Skeletal Analysis 用牙科方法估计死亡年龄作为骨骼分析的一部分
IF 1.3 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2023-06-13 DOI: 10.3390/forensicsci3020027
Joe Adserias-Garriga
Age-at-death is one of the most valuable pieces of information in a biological profile, and is an important step in identifying remains. Age-at-death estimation by dental means is performed by forensic odontologists and forensic anthropologists in their daily casework tasks. Both forensic odontologists and forensic anthropologists must be aware of all of the age indicators and of all of the methods that can offer the sufficient scientific robusticity that forensic cases require. Osteological and dental methods of age estimation rely on developmental changes in younger individuals and on degenerative changes in older individuals. Skeletal methods based on developmental changes are highly reliable, while methods based on degenerative or post-formation changes show higher variability. From all skeletal methods, those relying on tooth formation and development are the most accurate to assess an individual’s age. Dental methods of age estimation can be implemented in the skeletal analysis of juvenile and adult remains, representing an additional indicator of age. The aim of this review paper is to provide a practical reference for applying dental age estimation to human remains as a part of skeletal analysis.
死亡年龄是生物档案中最有价值的信息之一,也是鉴定遗骸的重要步骤。通过牙科方法估计死亡年龄是由法医牙科学家和法医人类学家在他们的日常个案工作任务中进行的。法医牙科学家和法医人类学家都必须了解所有的年龄指标和所有的方法,这些方法可以提供法医案件所需的足够的科学可靠性。骨学和牙科的年龄估计方法依赖于年轻人的发育变化和老年人的退行性变化。基于发育变化的骨骼方法是高度可靠的,而基于退化或形成后变化的方法则表现出更高的可变性。在所有的骨骼方法中,那些依赖于牙齿形成和发育的方法是最准确地评估一个人的年龄。年龄估计的牙科方法可以在青少年和成人遗骸的骨骼分析中实施,代表年龄的额外指标。本文的目的是为将牙龄估计作为骨骼分析的一部分应用于人类遗骸提供实用参考。
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引用次数: 0
Accuracy comparison of tooth volume and mesiodistal diameter measurements for sex dimorphism based on cone-beam computed tomography: a study for the northern Chinese population. 基于锥束计算机断层扫描的牙齿体积和中远端直径测量性别二态的准确性比较:一项针对中国北方人群的研究。
IF 1.3 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2023-06-01 DOI: 10.1093/fsr/owad004
Wenqing Bu, Lingling Ji, Mengqi Han, Zixuan Wu, Badr Sultan, Teng Chen, Yu Tang, Yucheng Guo, Fei Wang

Sex estimation based on teeth could help to narrow the scope for individual identification. According to the different teeth morphology among both genders, we plan to establish a sex estimation method for the northern Chinese population through mesiodistal diameter and teeth volume measurements and compare the accuracy of the two methods. In this study, measurements were taken from cone-beam computed tomography images collected from 142 males and 140 females aged 21-59 years. The mesiodistal diameter and volume of the left canines and the first molars in both upper and lower jaws were measured and analyzed for suitable coefficients. We selected 80% samples as the training set to set up the logistic regression formulas and 20% as the test set to obtain accuracy. The accuracy of sex estimation by mesiodistal diameter can reach 87.50%, and the volume is up to 78.57%. The measurement of mesiodistal diameter is less time-consuming. This work established and tested a method to estimate sex for the northern Chinese population. Results showed that sex estimation based on the mesiodistal diameter of teeth has higher accuracy than the method based on teeth volume.

基于牙齿的性别估计有助于缩小个体识别的范围。根据两性牙齿形态的差异,我们计划通过测量中远端直径和牙齿体积建立中国北方人群的性别估计方法,并比较两种方法的准确性。在这项研究中,收集了142名男性和140名女性的锥束计算机断层扫描图像,年龄在21-59岁之间。测量左犬齿和上下颌第一磨牙的中远端直径和体积,分析适宜系数。我们选择80%的样本作为训练集来建立逻辑回归公式,20%作为测试集来获得准确性。中远端直径对性别的估计准确率可达87.50%,体积可达78.57%。测量中远端内径更省时。这项工作建立并测试了一种估计中国北方人口性别的方法。结果表明,基于牙齿中远端直径的性别估计比基于牙齿体积的性别估计具有更高的准确性。
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引用次数: 0
Sequence-based mutation patterns at 41 Y chromosomal STRs in 2 548 father-son pairs. 2548对父子对41个Y染色体STRs的序列突变模式
IF 1.3 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2023-06-01 DOI: 10.1093/fsr/owad016
Ze Liu, Guannan Long, Yubo Lang, Dahua Liu, Biao Zhang, Shaobo Yu, Fei Guo
<p><p>A total of 2 548 unrelated healthy father-son pairs from a Northern Han Chinese population were genotyped at 41 Y chromosomal short tandem repeat (Y-STRs) including DYS19, DYS388, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438, DYS439, DYS444, DYS447, DYS448, DYS449, DYS456, DYS458, DYS460, DYS481, DYS518, DYS522, DYS549, DYS533, DYS557, DYS570, DYS576, DYS593, DYS596, DYS627, DYS635, DYS643, DYS645, Y-GATA-H4, DYF387S1a/b, DYF404S1a/b, DYS385a/b, and DYS527a/b. In 2 548 father samples, 2 387 unique haplotypes were detected with the haplotype diversity and discrimination capacity values of 0.999 956 608 and 0.96 741 007. The average gene diversity (GD) value was 0.6934 with a range from 0.1051 at DYS645 to 0.9657 at DYS385a/b. When comparing alleles at 24 overlapped Y-STRs between the ForenSeq™ deoxyribonucleic acid (DNA) Signature Prep Kit on the MiSeq FGx® Forensic Genomics System and the Goldeneye® DNA ID Y Plus Kit on the Applied Biosystems™ 3730 DNA Analyzer from 308 father samples in mutational pairs, 258 alleles were detected by massively parallel sequencing (MPS) typing including 156 length-based alleles that could be obtained by capillary electrophoresis (CE) typing, 95 repeat region (RR) variant alleles and seven flanking region variant alleles. Hereof, we found 16 novel RR variant alleles and firstly identified two SNPs (rs2016239814 at DYS19 and rs2089968964 at DYS448) and one 4-bp deletion (rs2053269960 at DYS439) that had been validated by the Database of Short Genetic Variation. Sanger sequencing or MPS was employed to confirm 356 mutations from 104 468 allele transfers generated from CE, where 96.63% resulted in one-step mutations, 2.25% in two-step, and 1.12% in multi-step, and the overall ratio of repeat gains <i>versus</i> losses was balanced (173 gains <i>vs.</i> 183 losses). In 308 father-son pairs, 268 pairs occurred mutations at a single locus, 33 pairs at two loci, six pairs at three loci, and one pair at four loci. The average Y-STR mutation rate at 41 Y-STRs was ⁓3.4 × 10<sup>-3</sup> (95% confidence intervals: 3.1 × 10<sup>-3</sup>-3.8 × 10<sup>-3</sup>). The mutation rates at DYS576 and DYS627 were higher than 1 × 10<sup>-2</sup> in Northern Han Chinese, whilst the mutation rates at DYF387S1a/b, DYF404S1a/b, DYS449, DYS518, and DYS570 were lower than initially defined. In this study, the classical molecular factors (the longer STR region, the more complex motif and the order father) were confirmed to drive Y-STR mutation rates increased, but the length of repeat unit did not conform to the convention. Lastly, the interactive graphical and installable StatsY was developed to facilitate forensic scientists to automatically calculate allele and haplotype frequencies, forensic parameters, and mutation rates at Y-STRs.</p><p><strong>Key points: </strong>308 of 2 548 father-son pairs from Northern Han Chinese occurred at least one mutation(s) across 41 Y-STRs.Sanger sequencing or MPS was employed to
短句来源采用41个Y染色体短串联重复序列(Y- strs)对来自中国北方汉族人群的2 548对无亲缘关系的健康父子进行基因分型,包括DYS19、DYS388、DYS389I、DYS389II、DYS390、DYS391、DYS392、DYS393、DYS437、DYS438、DYS439、DYS444、DYS447、DYS448、DYS449、DYS456、DYS458、DYS460、DYS481、DYS518、DYS522、DYS549、DYS533、DYS557、DYS557、DYS576、DYS593、DYS596、DYS627、DYS635、DYS643、DYS645、Y- gada - h4、DYF387S1a/b、DYF404S1a/b、DYS385a/b和DYS527a/b。2 548份父本共检测到2 387种独特单倍型,单倍型多样性和鉴别能力分别为0.999 956 608和0.96 741 007。平均基因多样性(GD)值为0.6934,DYS645位点GD值为0.1051 ~ 0.9657。在MiSeq FGx®Forensic Genomics System上的ForenSeq™脱氧核糖核酸(DNA) Signature Prep Kit和Applied Biosystems™3730 DNA分析仪上的Goldeneye®DNA ID Y Plus Kit对308个父亲样本进行突变对比对时,258个等位基因通过大规模平行测序(MPS)分型检测到,其中156个基于长度的等位基因可以通过毛细管电泳(CE)分型获得。95个重复区(RR)变异等位基因和7个侧翼区变异等位基因。本研究中,我们发现了16个新的RR变异等位基因,并首次鉴定出两个snp (DYS19位点的rs2016239814和DYS448位点的rs2089968964)和一个4 bp的缺失(DYS439位点的rs2053269960),这些缺失已被短遗传变异数据库验证。Sanger测序或MPS对来自CE的104 468个等位基因转移中的356个突变进行了确认,其中96.63%为一步突变,2.25%为两步突变,1.12%为多步突变,重复增益与损失的总体比例平衡(173个增益对183个损失)。308对父子中,单位点突变268对,2位点突变33对,3位点突变6对,4位点突变1对。41个Y-STR的平均突变率为⁓3.4 × 10-3(95%置信区间:3.1 × 10-3-3.8 × 10-3)。北方汉族DYS576和DYS627的突变率高于1 × 10-2,而DYF387S1a/b、DYF404S1a/b、DYS449、DYS518和DYS570的突变率低于最初的定义。本研究证实经典分子因素(STR区域越长、基序越复杂、父序越复杂)驱动Y-STR突变率升高,但重复单元长度不符合常规。最后,开发了交互式图形和可安装的StatsY,以方便法医科学家自动计算y - str的等位基因和单倍型频率、法医参数和突变率。重点:2 548对北方汉族父子对中有308对在41个y - str中至少发生1个突变。采用Sanger测序或MPS来确认这些由CE产生的突变。STR区域越长,基序越复杂,父序越高,Y-STR突变率越高。开发StatsY用于计算y - str的等位基因和单倍型频率、法证参数和突变率。
{"title":"Sequence-based mutation patterns at 41 Y chromosomal STRs in 2 548 father-son pairs.","authors":"Ze Liu,&nbsp;Guannan Long,&nbsp;Yubo Lang,&nbsp;Dahua Liu,&nbsp;Biao Zhang,&nbsp;Shaobo Yu,&nbsp;Fei Guo","doi":"10.1093/fsr/owad016","DOIUrl":"https://doi.org/10.1093/fsr/owad016","url":null,"abstract":"&lt;p&gt;&lt;p&gt;A total of 2 548 unrelated healthy father-son pairs from a Northern Han Chinese population were genotyped at 41 Y chromosomal short tandem repeat (Y-STRs) including DYS19, DYS388, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438, DYS439, DYS444, DYS447, DYS448, DYS449, DYS456, DYS458, DYS460, DYS481, DYS518, DYS522, DYS549, DYS533, DYS557, DYS570, DYS576, DYS593, DYS596, DYS627, DYS635, DYS643, DYS645, Y-GATA-H4, DYF387S1a/b, DYF404S1a/b, DYS385a/b, and DYS527a/b. In 2 548 father samples, 2 387 unique haplotypes were detected with the haplotype diversity and discrimination capacity values of 0.999 956 608 and 0.96 741 007. The average gene diversity (GD) value was 0.6934 with a range from 0.1051 at DYS645 to 0.9657 at DYS385a/b. When comparing alleles at 24 overlapped Y-STRs between the ForenSeq™ deoxyribonucleic acid (DNA) Signature Prep Kit on the MiSeq FGx® Forensic Genomics System and the Goldeneye® DNA ID Y Plus Kit on the Applied Biosystems™ 3730 DNA Analyzer from 308 father samples in mutational pairs, 258 alleles were detected by massively parallel sequencing (MPS) typing including 156 length-based alleles that could be obtained by capillary electrophoresis (CE) typing, 95 repeat region (RR) variant alleles and seven flanking region variant alleles. Hereof, we found 16 novel RR variant alleles and firstly identified two SNPs (rs2016239814 at DYS19 and rs2089968964 at DYS448) and one 4-bp deletion (rs2053269960 at DYS439) that had been validated by the Database of Short Genetic Variation. Sanger sequencing or MPS was employed to confirm 356 mutations from 104 468 allele transfers generated from CE, where 96.63% resulted in one-step mutations, 2.25% in two-step, and 1.12% in multi-step, and the overall ratio of repeat gains &lt;i&gt;versus&lt;/i&gt; losses was balanced (173 gains &lt;i&gt;vs.&lt;/i&gt; 183 losses). In 308 father-son pairs, 268 pairs occurred mutations at a single locus, 33 pairs at two loci, six pairs at three loci, and one pair at four loci. The average Y-STR mutation rate at 41 Y-STRs was ⁓3.4 × 10&lt;sup&gt;-3&lt;/sup&gt; (95% confidence intervals: 3.1 × 10&lt;sup&gt;-3&lt;/sup&gt;-3.8 × 10&lt;sup&gt;-3&lt;/sup&gt;). The mutation rates at DYS576 and DYS627 were higher than 1 × 10&lt;sup&gt;-2&lt;/sup&gt; in Northern Han Chinese, whilst the mutation rates at DYF387S1a/b, DYF404S1a/b, DYS449, DYS518, and DYS570 were lower than initially defined. In this study, the classical molecular factors (the longer STR region, the more complex motif and the order father) were confirmed to drive Y-STR mutation rates increased, but the length of repeat unit did not conform to the convention. Lastly, the interactive graphical and installable StatsY was developed to facilitate forensic scientists to automatically calculate allele and haplotype frequencies, forensic parameters, and mutation rates at Y-STRs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;308 of 2 548 father-son pairs from Northern Han Chinese occurred at least one mutation(s) across 41 Y-STRs.Sanger sequencing or MPS was employed to ","PeriodicalId":45852,"journal":{"name":"Forensic Sciences Research","volume":"8 2","pages":"152-162"},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10445670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10260844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Understanding the challenges of disaster victim identification: perspectives of Australian forensic practitioners. 理解灾难受害者鉴定的挑战:澳大利亚法医从业者的观点。
IF 1.3 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2023-06-01 DOI: 10.1093/fsr/owad020
Natasa Adamovic, Loene M Howes, Rob White, Roberta Julian

Disaster victim identification (DVI) is an important process in the aftermath of disasters to provide answers for the families and communities of victims. Australian forensic practitioners contribute to such processes internationally under difficult post-disaster circumstances. The aim of the study was to better understand the challenges experienced by forensic practitioners in international DVI operations. Participants (N = 20) included DNA analysts, fingerprint examiners, forensic odontologists, forensic pathologists, and mortuary technicians who had experience in DVI operations. Participants were interviewed about their experiences and perceptions of the challenges of DVI. The findings provide valuable insights into the types of DVI operations in which Australian forensic practitioners have been involved internationally. Thematic analysis of interview data resulted in five main themes: the post-disaster work environment; DVI management and processes; political and financial influences; teamwork in intercultural and interdisciplinary contexts; and confronting the emotional realities of DVI work. The analysis highlights the interrelated challenges associated with DVI operations in international contexts. Practitioners also provided suggestions for improvement, which generally aligned with the themes and reflected an ethos of learning and continuous improvement in DVI. Further research on education and training and capacity-development initiatives is warranted.

灾害受害者身份识别(DVI)是灾后为受害者家庭和社区提供答案的重要过程。澳大利亚法医从业者在困难的灾后情况下为国际上的这类进程作出贡献。本研究的目的是为了更好地了解法医从业者在国际DVI操作中遇到的挑战。参与者(N = 20)包括DNA分析师、指纹检验员、法医牙科医生、法医病理学家和有DVI操作经验的太平间技术人员。参与者接受了关于他们的经历和对DVI挑战的看法的采访。这些发现为澳大利亚法医从业人员参与的国际DVI操作类型提供了有价值的见解。对访谈数据的专题分析产生了五个主题:灾后工作环境;DVI管理和流程;政治和金融影响;跨文化和跨学科的团队合作;面对DVI工作的情感现实。分析强调了在国际背景下与DVI业务相关的相互关联的挑战。从业人员还提供了改进建议,这些建议与主题基本一致,反映了DVI学习和持续改进的精神。有必要进一步研究教育和培训以及能力发展倡议。
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引用次数: 0
When the antidote for cyanide poisonings becomes a nightmare: an alarming outbreak of suicides using kits containing sodium nitrite. 当治疗氰化物中毒的解药变成了一场噩梦:使用含有亚硝酸钠的药箱自杀的惊人爆发。
IF 1.3 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2023-06-01 DOI: 10.1093/fsr/owad015
Ricardo Jorge Dinis-Oliveira, Carlos Durão
Dear editor, It was in 1936 that Lancet first published three cases of intoxication by nitrites [1]. The authors mentioned that poisoning by sodium nitrite was rare, and they were not able to trace any other record of fatal poisoning in the UK. Then, in 1939, three fatal cases due to sodium nitrite poisonings were reported in Journal of the American Medical Association (JAMA) [2]. That reality was maintained rare and virtually unheard of until very recently [3, 4]. Indeed, as forensic experts, we are very alarmed at how easily is being advertised and purchased this suicide means in different countries that ended in several series of fatal events [5–7]. In other words, more fatal cases of intoxication by sodium nitrite were published in the last 2 years than before. The toxicovigilance data justify urgent and restrictive regulations for the use of sodium nitrite, but perhaps the market around this substance restraints further measures to be undertaken. Indeed, since sodium nitrite has several industrial applications, accidental exposure to contaminated water and food but especially intentional ingestion has been associated with severe toxicity and deaths. Moreover, since routine tests for this substance are rarely available in different clinical and forensic settings, several other cases are certainly being missed. The tip of the iceberg as we unfortunately anticipated is becoming reality [7]. However, how people were aware of this possible means of suicide? Who is advertising? What kind of websites and services are helping the “exit”? We tried to obtain some answers, which were compiled here to alert clinical and forensic practitioners and toxicologists to this new trend of poisoning: (i) the networks supporting euthanasia provide receipts, step-by-step instructions, and recommendations on how to use exit suicide kits containing sodium nitrite. Some websites demonstrate a high number of views. For instance, the Sanctioned Suicide website drew over 10 million page views in September 2022 and as of March 2023, the forum has over 30 000 members; (ii) sodium nitrite also gained attractiveness through online pro-suicide forums probably due to efficacy and easy access; (iii) sodium nitrite is advertised as a peaceful suicide means due to its mechanism of toxicity; and (iv) this food additive for meat curing can be easily purchased with a high level of purity (98%–99%) via different online vendors and consumer marketplaces. For instance, Amazon, already in 2022 and 2023, has been accused in multiple lawsuits of selling “suicide kits” to vulnerable teens and young adults. The taboo cannot be further ignored. Nevertheless, since the food industry uses sodium nitrite for legitimate and legal applications, it will be a major challenge to restrict and find real solutions for sodium nitrite worldwide access. UK has deemed sodium nitrite a “reportable substance”, meaning that retailers must report suspicious purchases of the compound by individuals to local au
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引用次数: 0
Hidden lesions: a case of burnt remains. 隐蔽性病变:烧残病例。
IF 1.3 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2023-06-01 DOI: 10.1093/fsr/owad019
Negahnaz Moghaddam, Lorenzo Campana, Claudine Abegg, Raquel Vilarino, Christelle Voland, Fabrice Dedouit, Pia Genet, Tony Fracasso

One of the many challenging cases that forensic pathologists, anthropologists, and forensic imaging experts have to face are burnt human remains. Perpetrators frequently attempt to hide/destroy evidence and make the body unidentifiable by exposing it to fire. We present a case of a partially burnt body found in an apartment after an explosion. First, multidetector computed tomography (MDCT) images and the following autopsy revealed several lesions on the cranium. Forensic anthropologists were involved in order to specify the aetiology of the lesions observed on the cranium. Through an interdisciplinary approach bringing together MDCT scans, 3D surface scans, and anthropological analysis, it was possible to answer the questions raised during the autopsy. Analyses demonstrated that there were signs of blunt force trauma on the cranium vault that the perpetrator likely attempted to hide by exposing the body to fire. This case demonstrates the importance of close collaboration between forensic anthropologists, imaging experts, and forensic pathologists. This multidisciplinary approach allows for a better, more complete reconstitution of forensic cases.

Key points: The analyses of burnt human remains are one of the many challenging tasks that forensic pathologists and anthropologists have to face.We present an occurrence of a partially burnt body after an explosion and forensic anthropologists were asked whether the nature of the lesions observed on the cranium could be further specified.Anthropological analyses of the skull were consistent with the radiological and autopsy report. It was possible to reconstruct the various lesions on the dry bone.The case demonstrates the importance of an interdisciplinary approach and the close collaboration between forensic anthropologists, imaging experts, and forensic pathologists.

法医病理学家、人类学家和法医成像专家必须面对的许多具有挑战性的案例之一是烧焦的人类遗骸。肇事者经常试图隐藏/销毁证据,并通过将尸体暴露在火中使其无法识别。我们呈递一个爆炸后在公寓里发现一具部分烧焦的尸体的案件。首先,多探测器计算机断层扫描(MDCT)图像和随后的尸检显示颅骨上有几个病变。法医人类学家参与其中,以确定在头盖骨上观察到的病变的病因。通过将多层螺旋ct扫描、3D表面扫描和人类学分析结合起来的跨学科方法,有可能回答尸检过程中提出的问题。分析表明,头骨顶有钝器外伤的痕迹,凶手可能试图通过将尸体暴露在火中来隐藏这些痕迹。这个案例证明了法医人类学家、成像专家和法医病理学家之间密切合作的重要性。这种多学科的方法允许一个更好的,更完整的重建法医案件。重点:对烧焦的人类遗骸的分析是法医病理学家和人类学家不得不面对的许多具有挑战性的任务之一。我们提出了一个爆炸后部分烧伤的尸体,法医人类学家被问及是否可以进一步说明在头盖骨上观察到的病变的性质。对头骨的人类学分析与放射学和尸检报告一致。可以重建干骨上的各种损伤。该案例表明了跨学科方法的重要性,以及法医人类学家、成像专家和法医病理学家之间密切合作的重要性。
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引用次数: 0
Work-related stress amongst legal medical doctors: the need for systematic psychological support. An Italian perspective. 法律医生的工作压力:需要系统的心理支持。意大利人的视角。
IF 1.3 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2023-06-01 DOI: 10.1093/fsr/owad018
Sara Sablone, Matthew Groicher, Tamara Patrizia Fanco, Roberta Risola, Grazia M Violante, Mara Bellino, Valeria Lagona, Ignazio Grattagliano

Legal medical doctors (LMDs) expertise encompasses a wide range of responsibilities. Work-related stress amongst LMDs is an extremely relevant factor, which affects the quality of LMDs life and work. Whilst it is a better-known problem abroad, this issue is poorly debated in Italy, as demonstrated by this literature analysis. The aim of this paper is to better understand the main sources of stress in the practice of legal medicine in Italy, highlighting the need for systematic psychological support. The risks of work-related stress for the social and health professions are well known in literature. In Italy, however, due to a series of complex circumstances and cultural and research delays, forensic practitioners often seem to be excluded from these kinds of complex issues. The authors, after a series of considerations drawn from a review of the literature and from experience in the forensic and medical field, point out how work in this area entails risks for workers, on par with all others belonging to the helping and social-health professions. They conclude their contribution with a series of proposals for appropriate protocols to cope with such problems for workers in the forensic and medical field.

Key points: Work-related risks for the social and health professionals are widely recognized in the literature.Although legal medical doctors are often thought to be safe from these types of issues, significant risks exist for this category as well.It is important to create appropriate protocols to address outcomes for legal medical doctors.

法律医生(lmd)的专业知识包括广泛的职责。工作压力是影响残疾人生活和工作质量的重要因素。虽然这是一个众所周知的问题在国外,这一问题是在意大利辩论不足,证明了这一文献分析。本文的目的是为了更好地了解压力在意大利法律医学实践的主要来源,强调需要系统的心理支持。在文献中,与工作有关的压力对社会和卫生专业人员的风险是众所周知的。然而,在意大利,由于一系列复杂的情况以及文化和研究的延迟,法医从业者似乎经常被排除在这类复杂问题之外。作者从文献综述和法医和医学领域的经验中得出一系列考虑后,指出这一领域的工作如何给工人带来风险,就像所有其他属于帮助和社会卫生专业的人一样。最后,他们提出了一系列关于适当议定书的建议,以便为法医和医疗领域的工作人员解决这些问题。重点:社会和卫生专业人员的工作相关风险在文献中得到广泛认可。虽然法律医生通常被认为不会出现这类问题,但这类医生也存在重大风险。重要的是制定适当的协议,以解决合法医生的结果问题。
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引用次数: 0
Sex estimation from virtual models: exploring the potential of stereolithic 3D crania models for morphoscopic trait scoring. 虚拟模型的性别估计:探索立体3D颅骨模型形态学特征评分的潜力。
IF 1.3 4区 医学 Q3 MEDICINE, LEGAL Pub Date : 2023-06-01 DOI: 10.1093/fsr/owad017
Madeline Robles, Rachael M Carew, Carolyn Rando, Sherry Nakhaeizadeh, Ruth M Morgan

Modern computed tomography (CT) databases are becoming an accepted resource for the practice and development of identification methods in forensic anthropology. However, the utility of 3D models created using free and open-source visualization software such as 3D Slicer has not yet been thoroughly assessed for morphoscopic biological profiling methods where virtual methods of analysis are becoming more common. This paper presents a study that builds on the initial findings from Robles et al. (2020) to determine the feasibility of estimating sex on stereolithic (STL) 3D cranial models produced from CT scans from a modern, living UK population (n = 80) using equation 2 from the Walker's (2008) morphoscopic method. Kendall's coefficients of concordance (KCC) indicated substantial agreement using cranial features scores in an inter-observer test and a video-inter-observer test. Fleiss' Kappa scores showed moderate agreement (0.50) overall between inter-observer sex estimations, and for observer sex estimations in comparison to recorded sexes (0.56). It was found that novice users could virtually employ morphoscopic sex estimation methods effectively on STL 3D cranial models from modern individuals. This study also highlights the potential that digital databases of modern living populations can offer forensic anthropology.

Key points: First example of Walker's (2008) method applied to a living UK population.Open-source software is a valuable resource for crime reconstruction approaches.Male scoring bias was observed in method application.Forensic anthropologists would benefit from virtual anthropology training to use and interpret 3D models.Digital databases offer more ethical, diverse, modern populations for future research.

现代计算机断层扫描(CT)数据库正在成为法医人类学鉴定方法实践和发展的公认资源。然而,使用免费和开源可视化软件(如3D切片器)创建的3D模型的效用尚未被彻底评估为形态生物学分析方法,而虚拟分析方法正变得越来越普遍。本文提出了一项基于Robles等人(2020)的初步研究结果的研究,以确定使用Walker(2008)形态学方法中的公式2对现代英国人口(n = 80)的CT扫描产生的立体石器(STL) 3D颅骨模型估计性别的可行性。肯德尔的一致性系数(KCC)表明,在观察者间测试和视频观察者间测试中使用颅骨特征得分具有实质性的一致性。Fleiss的Kappa分数在观察者之间的性别估计之间显示出适度的一致性(0.50),并且与记录的性别相比,观察者的性别估计(0.56)。研究发现,新手可以有效地将形态学性别估计方法应用于现代个体的STL三维颅骨模型。这项研究还强调了现代生活人口的数字数据库可以提供法医人类学的潜力。重点:沃克(2008)方法应用于生活的英国人口的第一个例子。开源软件是犯罪重建方法的宝贵资源。方法应用中存在男性评分偏倚。法医人类学家将受益于虚拟人类学培训,以使用和解释3D模型。数字数据库为未来的研究提供了更多伦理的、多样化的、现代的人群。
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引用次数: 0
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Forensic Sciences Research
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