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Artificial intelligence in forensic medicine and related sciences - selected issues. 法医学和相关科学中的人工智能--若干问题。
Pub Date : 2024-01-01 DOI: 10.4467/16891716AMSIK.24.005.19650
Michał Szeremeta, Julia Janica, Anna Niemcunowicz-Janica

Aim: The aim of the work is to provide an overview of the potential application of artificial intelligence in forensic medicine and related sciences, and to identify concerns related to providing medico-legal opinions and legal liability in cases in which possible harm in terms of diagnosis and/or treatment is likely to occur when using an advanced system of computer-based information processing and analysis.

Material and methods: The material for the study comprised scientific literature related to the issue of artificial intelligence in forensic medicine and related sciences. For this purpose, Google Scholar, PubMed and ScienceDirect databases were searched. To identify useful articles, such terms as "artificial intelligence," "deep learning," "machine learning," "forensic medicine," "legal medicine," "forensic pathology" and "medicine" were used. In some cases, articles were identified based on the semantic proximity of the introduced terms.

Conclusions: Dynamic development of the computing power and the ability of artificial intelligence to analyze vast data volumes made it possible to transfer artificial intelligence methods to forensic medicine and related sciences. Artificial intelligence has numerous applications in forensic medicine and related sciences and can be helpful in thanatology, forensic traumatology, post-mortem identification examinations, as well as post-mortem microscopic and toxicological diagnostics. Analyzing the legal and medico-legal aspects, artificial intelligence in medicine should be treated as an auxiliary tool, whereas the final diagnostic and therapeutic decisions and the extent to which they are implemented should be the responsibility of humans.

目的:这项工作的目的是概述人工智能在法医学及相关科学中的潜在应用,并确定在使用基于计算机的先进信息处理和分析系统时,在诊断和/或治疗方面可能发生损害的情况下,与提供医学法律意见和法律责任有关的问题:研究材料包括与法医学及相关科学中的人工智能问题有关的科学文献。为此,我们搜索了 Google Scholar、PubMed 和 ScienceDirect 数据库。为了找出有用的文章,使用了 "人工智能"、"深度学习"、"机器学习"、"法医学"、"法律医学"、"法医病理学 "和 "医学 "等术语。在某些情况下,文章是根据引入术语的语义邻近性进行识别的:计算能力和人工智能分析海量数据能力的蓬勃发展,使得将人工智能方法应用于法医学和相关科学成为可能。人工智能在法医学和相关科学中有着广泛的应用,可以在解剖学、法医创伤学、死后鉴定检查以及死后显微诊断和毒理学诊断中发挥作用。从法律和医学法律方面分析,人工智能在医学中的应用应被视为一种辅助工具,而最终的诊断和治疗决定及其执行程度则应由人类负责。
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引用次数: 0
Analysis of suicide cases in post-mortem examination files of the Department of Forensic Medicine at the Medical University of Białystok in the years 2016-2021. 2016-2021 年比亚韦斯托克医科大学法医系尸检档案中的自杀案例分析。
Pub Date : 2024-01-01 DOI: 16891716AMSIK.24.010.20339
Anna Francuziak, Paulina Kulasza, Kinga Kozłowska, Julia Janica, Urszula Cwalina, Anna Niemcunowicz-Janica, Michał Szeremeta

The aim of the study: The aim of the study is the analysis of suicides based on forensic autopsies and case files from the Department of Forensic Medicine at the Medical University of Białystok.

Material and methods: The number of forensic autopsies conducted at the Department of Forensic Medicine in Białystok in the years 2016-2021 equaled 2365. On the basis of post-mortem examinations and circumstances of deaths contained in the case files, 391 cases were qualified as suicides. The analysis accounted for gender, age, time, the dynamics of changes in the number of suicides over the years, the place of suicide, the method of committing suicide, and the state of sobriety. The data were subjected to statistical analysis using the following tests: Chi-square test of independence, Shapiro-Wilk test, Mann-Whitney U test, non-parametric Kruskal-Wallis ANOVA by ranks with post hoc multiple comparisons of mean ranks for all samples. A p-value of less than 0.05 was considered statistically significant. The calculations were performed using the Statistica 13.3 package from StatSoft.

Results: In the studied years, suicides accounted for 16.54% of all autopsies. In 82.09% of cases, the suicides were committed by men, and in 17.91% by women. It was found that individuals who chose suicide by poisoning were statistically significantly younger than those who chose suicide by jumping from a height (p=0.0035). A statistically significant correlation was found between gender and the preferred location for committing suicide (p=0.033). A statistically significant correlation was also found between gender and sobriety or the state after alcohol consumption (p=0.00008).

Conclusions: The study shows that the main group of suicides still consists of men (82.09%). The age of women and men committing suicide did not differ significantly. Women were more likely to commit suicide in urban areas than men. Women were statistically significantly more likely to be sober or in a state after alcohol consumption at the time of committing suicide. The most commonly chosen method of suicide was death by hanging.

研究目的研究的目的是根据比亚韦斯托克医科大学法医系的法医尸检和病例档案对自杀事件进行分析:2016-2021 年间,比亚韦斯托克法医系进行的法医尸检数量为 2365 例。根据尸检结果和案卷中的死亡情况,有 391 例被认定为自杀。分析考虑了性别、年龄、时间、自杀人数的逐年动态变化、自杀地点、自杀方式和清醒状态。数据采用以下检验方法进行统计分析:对所有样本进行独立的卡方检验(Chi-square test of independence)、沙皮罗-维尔克检验(Shapiro-Wilk test)、曼-惠特尼U检验(Mann-Whitney U test)、非参数Kruskal-Wallis方差分析(Kruskal-Wallis ANOVA by ranks with post hoc multiple comparis of mean ranks)。p 值小于 0.05 即为具有统计学意义。计算使用 StatSoft 公司的 Statistica 13.3 软件包:在所研究的年份中,自杀占所有尸检的 16.54%。82.09%的自杀者为男性,17.91%为女性。据统计,选择投毒自杀的人明显比选择跳楼自杀的人年轻(P=0.0035)。性别与首选自杀地点之间存在统计学意义上的明显相关性(p=0.033)。性别与清醒或饮酒后状态之间也存在统计学意义上的相关性(p=0.00008):研究表明,自杀者的主要群体仍然是男性(82.09%)。男女自杀者的年龄差异不大。与男性相比,女性更有可能在城市地区自杀。据统计,女性自杀时处于清醒或饮酒后状态的可能性更大。最常见的自杀方式是上吊自杀。
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引用次数: 0
Fatal poisoning by dietary supplements accompanied by massive rhabdomyolysis and multiple organ failure. 膳食补充剂致命中毒,伴有大量横纹肌溶解和多器官衰竭。
Pub Date : 2024-01-01 DOI: 10.4467/16891716AMSIK.24.012.20341
Oskar Fogiel, Małgorzata Rak, Małgorzata Rak, Sebastian Picheta, Paulina Wachholz, Rafał Skowronek, Jacek Sein Anand, Natalia Pawlas

Obesity epidemic and prevailing standards of desired body shape encourage society to use weight loss aids. Thermogenics, which are dietary supplements aimed at increasing energy expenditure, are particularly gaining popularity. These preparations can be easily purchased without prescription and have a complex composition, which means they can interact with numerous substances. The article describes the case of a 31-year-old female patient who, in a suicide attempt, ingested significant amounts of the dietary supplements 'Blue Magic' and 'Purim'. Both supplements contain, among other ingredients: caffeine, yohimbine, reserpine, and synephrine. The patient developed multiple organ failure, which led to her death on the second day of hospitalization. Poisoning by dietary supplements, due to their diverse composition and the lack of correlation between the content and the composition declared by the manufacturer, can pose a significant threat to the health and life of consumers.

肥胖症的流行和理想体形标准的盛行鼓励社会使用减肥辅助工具。热能补充剂,即旨在增加能量消耗的膳食补充剂,尤其受到人们的青睐。这些制剂无需处方即可轻松购买,而且成分复杂,可能与多种物质发生相互作用。文章描述了一名 31 岁女性患者的案例,她在自杀未遂时摄入了大量膳食补充剂 "Blue Magic "和 "Purim"。这两种保健品除其他成分外,还含有咖啡因、育亨宾、利血平和脱氧肾上腺素。患者出现多器官衰竭,住院第二天死亡。由于膳食补充剂的成分多种多样,而且其含量与制造商宣称的成分之间缺乏关联,因此膳食补充剂中毒会对消费者的健康和生命构成严重威胁。
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引用次数: 0
Evaluation of gunshot injuries to long bones from pneumatic weapons using a human thigh model. Part II. Presentation and discussion of the detailed results of tests of gunshots of the anterior surface of the femur with 5.5 mm and 6.35 mm caliber shot. 使用人体大腿模型评估气动武器对长骨造成的枪伤。第二部分.介绍和讨论用 5.5 毫米和 6.35 毫米口径子弹射击股骨前表面的详细测试结果。
Pub Date : 2024-01-01 DOI: 10.4467/16891716AMSIK.24.003.19648
Mateusz Wilk, Elżbieta Chowaniec, Małgorzata Chowaniec, Czesław Chowaniec

Introduction: The development of pneumatic shooting has led to the construction of technologically advanced devices with discharge energies similar to those of firearms. The pneumatic weapons ammunition market offers a variety of shot which varies in penetration properties and the extent of gunshot damage. In view of the ease of "tuning" of air rifles, a study was conducted of the inlet damage to the anterior femoral surface after pneumatic gunshots. The paper shows the differences in damage parameters depending on the type of shot.

Material and methods: In the study, Air Arms Hi-Power Xtra FAC cal. 5.5 mm and FX Bobcat Mk II cal. 6.35 mm pneumatic carbines were used and lead shot by Haendler&Natterman's Spitzkugel type, Hollow Point and Baracuda cal. 5.5 mm and 6.35 mm, as well as lead-free shot Excite Apollo cal. 5.5 mm and Black Max Lead-Free cal. 6.35 mm. Measurements were taken of the extent of inlet damage to the anterior surface of the femoral shaft with X-ray and CT imaging.

Results: HollowPoint shot caused the greatest range of gunshot penetration damage in both bone and periosteum, Apollo lead-free shot caused the least. At the same time, HollowPoint shot showed the greatest susceptibility to ricocheting.

Conclusions: 1. The type of shot used influences diversified morphology of the holes and the nature of gunshot damage to the femoral shaft. The differences concern both the gunshot holes and the nature, course and extent of associated fractures. 2. The smallest inlet holes and damage to the periosteum with a regular shape are caused by gunshots with pointed and pointed tip pellets. The greatest extent of bone and periosteum inlet damage was observed in gunshots with Hollow Point type shot due to its predisposition to deformation and fragmentation. 3. Radio-imaging studies are a valuable complement to macroscopic visual assessment providing a useful value for identifying the type of shot used.

导言:气动射击的发展促使人们制造出技术先进的装置,其发射能量与枪支类似。气动武器弹药市场提供的各种弹丸在穿透性能和枪弹损伤程度方面各不相同。鉴于气步枪易于 "调试",我们对气动枪弹射击后股前部表面的入射损伤进行了研究。本文显示了不同射击类型造成的损伤参数差异:在研究中,使用了 Air Arms Hi-Power Xtra FAC 5.5 毫米口径和 FX Bobcat Mk II 6.35 毫米口径气动卡宾枪和 Haendler&Natterman 的 Spitzkugel 型铅弹、空尖弹和 Baracuda 5.5 毫米口径和 6.35 毫米口径铅弹,以及 Excite Apollo 5.5 毫米口径和 Black Max 6.35 毫米口径无铅铅弹。通过 X 射线和 CT 成像测量了股骨干前表面的入口损伤程度:结果:空心箭对骨骼和骨膜造成的枪弹穿透损伤范围最大,阿波罗无铅子弹造成的损伤最小。同时,空尖弹显示出最大的跳弹敏感性:1.所使用的枪弹类型会影响股骨干上不同形态的枪弹孔和枪弹损伤的性质。这些差异既与枪眼有关,也与相关骨折的性质、过程和程度有关。2.2. 尖头和尖头弹丸造成的入孔和骨膜损伤最小,且形状规则。由于空尖弹容易变形和碎裂,因此在使用空尖弹射击时观察到的骨和骨膜入口损伤程度最大。3.3. 放射成像研究是对宏观目测评估的重要补充,为确定所用枪弹的类型提供了有用的价值。
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引用次数: 0
The role of computed tomography in post-mortem examinations. 计算机断层扫描在尸检中的作用。
Pub Date : 2024-01-01 DOI: 10.4467/16891716AMSIK.24.011.20340
Wojciech Modzelewski, Jacek Janica

In the study, data from the literature regarding the use of computed tomography in post-mortem examinations (post-mortem computed tomography - PMCT) were analyzed. Literature data indicate that PMCT should be used as a complementary tool rather than an alternative to autopsy, detecting additional changes that may have been unnoticed due to anatomical location or the need to extend traditional autopsy techniques. The ability to save, create and reconstruct images is very helpful in creating documentation and final opinions. There is a need to develop standards for the evaluation of post-mortem computed tomography images, which will enable further development of virtual autopsy techniques in the field of forensic medicine, supported by artificial intelligence.

这项研究分析了有关在尸检中使用计算机断层扫描(尸检计算机断层扫描--PMCT)的文献数据。文献数据表明,PMCT 应作为尸检的补充工具而非替代品,可检测出因解剖位置或需要扩展传统尸检技术而未被注意到的其他变化。保存、创建和重建图像的能力对创建文档和最终意见非常有帮助。有必要制定评估死后计算机断层扫描图像的标准,这将有助于在人工智能的支持下进一步发展法医学领域的虚拟尸检技术。
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引用次数: 0
Evaluation of gunshot injuries to long bones from pneumatic weapons using a human thigh model. Part I. Introduction and assumptions. Discussion of shot ballistics. Human thigh model. 使用人体大腿模型评估气动武器对长骨造成的枪伤。第一部分:导言和假设。射击弹道学讨论。人体大腿模型。
Pub Date : 2024-01-01 DOI: 10.4467/16891716AMSIK.24.002.19647
Mateusz Wilk, Elżbieta Chowaniec, Małgorzata Chowaniec, Czesław Chowaniec

Introduction: In accordance with the Polish law, pneumatic weapons are weapons that use compressed gas to set a bullet in motion and generate a discharge energy of more than 17J. In recent years, Poland has seen an increase in crimes committed with pneumatic weapons. The research aim of the present study was to measure the velocity of selected 5.5 mm and 6.35 mm caliber shot and to create a model of a human thigh using a pig femur.

Material and methods: This study used Air Arms Hi-Power Xtra FAC cal. 5.5 mm and FX Bobcat Mk II cal. 6.35 mm carbines and Haendler& Natterman's Spitzkugel, Hollow Point and Baracuda cal. 5.5 mm and 6.35 mm lead shot and Excite Apollo cal. 5.5 mm and Black Max Lead-Free cal. 6.35 mm lead-free shot. The velocity of the shot at a distance of 10 m was measured and its kinetic energy was calculated; pig femurs were measured and CT imaging was performed.

Results: The 5.5mm caliber shot reached velocities between 253 m/s and 278 m/s, obtaining energies between 27J and 44J. The 6.35 mm cal. shot reached velocities between 242 m/s and 254 m/s and energies between 52J and 59J. Pig femurs had an average weight of 410 g, a length of 239 mm, and a shaft diameter at mid-length of 30.6mm. The thickness of pig femur shaft walls was variable. A ballistic model of the human thigh was created using gelatin available in Poland.

Conclusions: 1. The number of registered crimes with pneumatic weapons and the wide access to pneumatic devices with the possibility of design modifications justify the initiation of experimental studies on the assessment of gunshot injuries from pneumatic weapons. 2. The parameters of the shaft of a pig femur obtained from pigs weighing about 115 kg are similar to those of a human adult femur, which makes it possible to create a human thigh model. 3. Of the 5.5 mm cal. shot, the highest impact energies were generated by barracuda type shot, and of the 6.35 mm cal. shot, it was barracuda type and lead-free shot. 4. The thickness of the bony layer of the pig femur shaft is heterogeneous; the posterior wall of the shaft is the thickest, the lateral wall is the thinnest; however, it shows the greatest individual variability.

导言:根据波兰法律,气动武器是指使用压缩气体使子弹运动并产生超过 17 焦耳放电能量的武器。近年来,波兰使用气动武器实施犯罪的案件有所增加。本研究的目的是测量选定的 5.5 毫米和 6.35 毫米口径子弹的速度,并使用猪股骨制作人体大腿模型:本研究使用了 Air Arms Hi-Power Xtra FAC 5.5 毫米口径和 FX Bobcat Mk II 6.35 毫米口径卡宾枪、Haendler& Natterman 的 Spitzkugel、Hollow Point 和 Baracuda 5.5 毫米和 6.35 毫米口径铅弹以及 Excite Apollo 5.5 毫米和 Black Max Lead-Free 6.35 毫米口径无铅弹。测量了 10 米距离上的射击速度并计算了其动能;测量了猪的股骨并进行了 CT 成像:结果:5.5 毫米口径子弹的速度介于 253 米/秒和 278 米/秒之间,能量介于 27 焦耳和 44 焦耳之间。6.35 毫米口径子弹的射速介于 242 米/秒和 254 米/秒之间,能量介于 52 焦耳和 59 焦耳之间。猪股骨的平均重量为 410 克,长度为 239 毫米,中段直径为 30.6 毫米。猪股骨轴壁的厚度各不相同。利用波兰的明胶制作了人大腿的弹道模型:1.登记在册的使用气动武器的犯罪数量,以及气动装置的广泛使用和设计修改的可能性,都证明有理由启动气动武器枪伤评估的实验研究。2.从体重约 115 千克的猪身上获得的猪股骨轴的参数与人类成人股骨的参数相似,这使得制作人类大腿模型成为可能。3.在 5.5 毫米口径弹丸中,梭鱼型弹丸产生的冲击能量最高;在 6.35 毫米口径弹丸中,梭鱼型弹丸和无铅弹丸产生的冲击能量最高。4.猪股骨柄骨层的厚度是不均匀的,柄后壁最厚,侧壁最薄,但个体差异最大。
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引用次数: 0
Rare consequences of a single fist punch to the orbital region - a description of two cases. 一拳打在眼眶上的罕见后果--两个病例的描述。
Pub Date : 2024-01-01 DOI: 10.4467/16891716AMSIK.24.013.20342
Ewa Toruńska, Piotr Engelgardt, Maria Szwajkowska, Maciej Krzyżanowski

A direct punch with a clenched fist to the face most often results in soft tissue damage, which is usually not serious enough to be considered a severe health impairment. This article presents two cases in which a single punch to the orbital region led to a blowout fracture. The first case resulted in additional displacement of the right lens into the vitreous body, secondary glaucoma and retinal detachment. In the second case, the victim sustained retinal concussion and subretinal haemorrhage due to choroidal rupture at the level of the macula resulting in temporary, almost complete loss of vision. Such injuries, although possible, are not typical of the mechanism described. In both cases, the effects meet the legal definition of impairment of the functioning of a bodily organ or disturbance of health lasting longer than 7 days within the meaning of the relevant article of the Polish Penal Code. Additionally, in the second case, we deal with exposure to direct danger - loss of vision in one eye (another severe disability) within the meaning of the relevant articles of the Polish Penal Code.

用紧握的拳头直接击打面部通常会导致软组织损伤,但这种损伤通常并不严重,不足以被视为严重的健康损害。本文介绍了两例一拳击打眼眶导致爆裂性骨折的病例。第一个案例导致右晶状体移位到玻璃体内,继发青光眼和视网膜脱落。在第二个案例中,受害人因黄斑处脉络膜破裂而造成视网膜震荡和视网膜下出血,导致暂时性几乎完全丧失视力。这种伤害虽然有可能发生,但在所述机制中并不典型。在这两起案件中,其后果均符合《波兰刑法典》相关条款中 "身体器官功能受损或健康受损超过 7 天 "的法律定义。此外,在第二种情况下,我们处理的是直接危险--《波兰刑法典》相关条款意义上的单眼视力丧失(另一种严重残疾)。
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引用次数: 0
Sex determination and odontometric dimensions - A study of a North Indian population. 性别决定与牙齿尺寸--对北印度人口的研究。
Pub Date : 2024-01-01 DOI: 10.4467/16891716AMSIK.24.009.20338
Nandini Chitara, Kewal Krishan

Sex determination is an indispensable parameter in identifying unknown deceased individuals. It can narrow down the chances of possible matches by 50%, providing a crucial lead in personal identification. In cases of commingled, decomposed, fragmented, charred and unidentifiable corpses, the importance of dental morphometrics cannot be overlooked due to the resistance of teeth to post-mortem degradation. Addressing this quality of teeth, a descriptive cross-sectional study was conducted in a North Indian population to evaluate sexual variations in dental dimensions and to identify the most sexually dimorphic dental dimension. The study included 207 participants (114 females and 93 males) in the age group of 21 to 45 years. Dental casts were prepared after obtaining informed consent from the participants and ethical clearance from the institute's ethical committee. Six odontometric dimensions, namely incisor-incisor distance, inter canine distance, combined width of central incisors, inter-premolar distance, inter-molar distance, and dental arch height of each participant were recorded on the dental casts using standard procedures. Analysis of the data elucidated the existence of statistically significant sexual dimorphism in the dental dimensions of the participants. The results of the discriminant function analysis show a sex determination accuracy of 68.1%, with a cross-validation accuracy of 65.2%. The study found the incisor-incisor distance to be the most sexually dimorphic trait, making it the best predictor of sex in the present population. The results of the present study may be helpful in sex determination and personal identification from dental remains in medico-legal and disaster victim identification cases.

性别鉴定是识别未知死者不可或缺的参数。它可以将可能匹配的几率缩小 50%,为个人身份鉴定提供重要线索。对于混杂、腐烂、支离破碎、烧焦和无法辨认的尸体,牙齿形态计量学的重要性不容忽视,因为牙齿可以抵抗死后退化。针对牙齿的这一质量问题,我们在北印度人群中进行了一项描述性横断面研究,以评估牙齿尺寸的性别差异,并确定最具性别二态性的牙齿尺寸。这项研究包括 207 名 21 至 45 岁年龄组的参与者(114 名女性和 93 名男性)。在获得参与者的知情同意和研究所伦理委员会的伦理许可后,我们制作了牙模。采用标准程序在牙模上记录了每位受试者的六个牙体测量尺寸,即门牙与门牙之间的距离、犬齿之间的距离、中切牙的合并宽度、臼齿之间的距离、臼齿之间的距离和牙弓高度。对数据的分析表明,受试者的牙齿尺寸在统计学上存在明显的性别二态性。判别函数分析结果显示,性别判定准确率为 68.1%,交叉验证准确率为 65.2%。研究发现,门牙-门牙间距是最具性别二态性的特征,因此它是目前人群中预测性别的最佳指标。本研究的结果可能有助于在医疗法律和灾难受害者身份鉴定案件中从牙齿遗骸中确定性别和个人身份。
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引用次数: 0
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Archiwum medycyny sadowej i kryminologii
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