Forensic science international最新文献

{"title":"Reproducibility and validation of a targeted and flexible epigenetic clock for forensic applications","authors":"Ersilia Paparazzo ,&nbsp;Mirella Aurora Aceto ,&nbsp;Teresa Serra Cassano ,&nbsp;Francesco Bruno ,&nbsp;Davide Lagrotteria ,&nbsp;Silvana Geracitano ,&nbsp;Antonella La Russa ,&nbsp;Alessia Bauleo ,&nbsp;Elena Falcone ,&nbsp;Vincenzo Lagani ,&nbsp;Giuseppe Passarino ,&nbsp;Alberto Montesanto","doi":"10.1016/j.forsciint.2025.112409","DOIUrl":"10.1016/j.forsciint.2025.112409","url":null,"abstract":"<div><div>DNA methylation variants have been widely used as biomarkers of ageing and several mathematical models have been developed to estimate the biological age. More recently, DNA technology has triggered efforts toward the simplification of the array-based epigenetic clocks and targeted approaches, based on the assessment of a small number of CpG sites have been developed. Among the markers included in these clocks, <em>ELOVL2, FHL2, KLF14, C1orf132/MIR29B2C,</em> and <em>TRIM59</em> resulted to be the most strongly validated markers. We tested the reproducibility and validation of a previously developed targeted epigenetic clock purposely optimized for the measurement of chronological age in blood samples. The clock includes DNAm biomarkers strongly correlated with chronological age whose DNA methylation levels were measured by using a multiplex methylation SNaPshot assay. We found that epigenetic age, calculated using the developed clock, was highly correlated with age (r = 0.97) in a total of 201 blood samples covering a full spectrum of human ages. For 74 of these, methylation profiles of the whole genome were obtained through the Infinium Methylation EPIC v2.0 Kit which also allowed to estimate the most frequently used clocks of Horvath. These results show the potential of our efficient and affordable test for simultaneously measuring DNA methylation levels at multiple target CpG sites to assess chronological age. We observed a strong correlation between the prediction models for the analyzed CpG sites measured using the SNaPshot method and those obtained with the Illumina EPIC array, especially with the Horvath2 clock, which was specifically developed for DNA from skin and blood cells.</div></div>","PeriodicalId":12341,"journal":{"name":"Forensic science international","volume":"369 ","pages":"Article 112409"},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating temporal dynamics of both microbial taxonomic and functional characteristics as a tool for forensic time since deposition estimation","authors":"Qiong Lan ,&nbsp;Xiaolian Wu ,&nbsp;Qinglin Liu ,&nbsp;Qinglin Liang ,&nbsp;Xiaolong He ,&nbsp;Bofeng Zhu","doi":"10.1016/j.forsciint.2025.112406","DOIUrl":"10.1016/j.forsciint.2025.112406","url":null,"abstract":"<div><div>Predicting the time since deposition (TsD) of body fluid stain at a crime scene is highly valuable in forensic investigation, as it can connect a DNA-identified stain donor to a crime or estimate the post-mortem interval in forensic case involving cadaver. Previous study has demonstrated the applicability of microbial taxa for TsD prediction. In this proof-of-concept study, we explored the combined use of taxonomic and functional characteristics in human saliva microbiome for TsD prediction. We investigated the potential correlations between the temporal dynamics in microbial communities and the TsD of saliva stains, utilizing the relative abundance of microbial genera, amplicon sequence variants (AsVs), and the metabolic function pathway profiles. The results revealed that changes in the metabolic function pathway profiles of microbial communities could contribute to TsD estimation of the aged saliva stains. We developed ensemble models with multiple heterogeneous algorithms, also combined microbial species and metabolic function pathway profiles for TsD estimation. The TsD prediction model, developed using the relative abundance of the top 50 microbial genera and metabolic functional pathway profiles with the xgboost algorithm, achieved high accuracy (<em>R</em>^<em>2</em> = 0.76, mean absolute error = 6.28 days) in a 60-day deposition. Besides, we further interpreted the model and identified potential biomarkers for TsD estimation of saliva stains. The current study provided the first evidence to explore the potential of using multiple data modalities for predicting the TsD of aged saliva stains, offering valuable insight for forensic investigation.</div></div>","PeriodicalId":12341,"journal":{"name":"Forensic science international","volume":"369 ","pages":"Article 112406"},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiling of organic and inorganic impurities in seized methamphetamine samples from Ankara, Türkiye: A chemometric implication in forensic chemistry","authors":"Çağdaş Aksoy ,&nbsp;Bayram Yüksel ,&nbsp;Nilgün Şen ,&nbsp;Fikret Ustaoğlu ,&nbsp;Gökhan Söylemez ,&nbsp;Tuna Öncü","doi":"10.1016/j.forsciint.2025.112407","DOIUrl":"10.1016/j.forsciint.2025.112407","url":null,"abstract":"<div><div>The forensic profiling of methamphetamine impurities offers critical insights into synthetic routes, geographic origins, and trafficking networks associated with illicit drug production. In this study, organic and inorganic impurities in methamphetamine samples seized in Ankara, Türkiye, were analyzed using a comprehensive chemometric approach, including Principal Component Analysis (PCA), Hierarchical Cluster Analysis (HCA). Organic impurities were detected through Gas Chromatography-Mass Spectrometry (GC–MS), while Inductively Coupled Plasma Mass Spectrometry (ICP-MS) was employed to identify trace metals (Al, As, Au, Ba, Cr, Cu, Fe, Mn, Mo, Pb, Sb, Sn, V, Zn). These inorganic impurities provide valuable information regarding the manufacturing processes and precursor materials used. Five distinct production sources were identified, with some samples linked to ephedrine-based synthesis in Iran and Afghanistan, while others were associated with non-ephedrine-based methods in Southeast Asia and Europe. The identification of unique organic impurities, such as N-formylmethamphetamine and 1-benzyl-3-methylnaphthalene, combined with the detection of trace metals like chromium and zinc, offered further insights into the production environments. This combined analysis of organic and inorganic impurity profiles enhances the ability to trace methamphetamine production back to specific geographic regions and manufacturing practices, thereby supporting law enforcement efforts to combat illicit drug trafficking. The findings demonstrate the utility of chemometric techniques in forensic drug analysis and provide a robust framework for source identification through impurity profiling.</div></div><div><h3>Data Availability</h3><div>No additional data is available for this study.</div></div>","PeriodicalId":12341,"journal":{"name":"Forensic science international","volume":"368 ","pages":"Article 112407"},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From dactyloscopy to the Minimum Surface Requirement (MSR): a metric to assess and obtain suitable human STR profiles","authors":"Michele Di Nunzio ,&nbsp;Josep De Alcaraz-Fossoul ,&nbsp;Vanessa Maroto-Nouveau ,&nbsp;Clara Camprubí-Aumatell ,&nbsp;Carme Barrot-Feixat","doi":"10.1016/j.forsciint.2025.112408","DOIUrl":"10.1016/j.forsciint.2025.112408","url":null,"abstract":"<div><div>Friction skin ridge (Dactyloscopy) and DNA analyses have both played an essential role in forensic investigations for decades. The simultaneous and successful collection of a latent fingermark ridge pattern and the respective isolation of its human DNA can be a challenging task at a crime scene. Maximizing the quantity and quality of genetic information from this type of physical evidence has become one of the objectives of forensic science. Often, friction ridge impressions may lack discriminatory power due to low visual clarity of ridges and/or insufficient pattern area. In such cases, an optimized human DNA collection and extraction becomes crucial for obtaining a genetic identity from an unsuitable fingermark. Recent studies have proven that complete Short Tandem Repeat (STR) profiles can be acquired from touch DNA specimens. Although the impact of fingermark enhancement techniques on DNA recovery has been explored, no research has yet investigated the potential quantity of DNA that could be isolated per area of a ridge pattern. Here, DNA collection and extraction methods to determine the Minimum ridge Surface Requirement (MSR) to extract suitable human STR genotypes have been studied and optimized. Twelve participants, including biological males and females, provided ink prints of their index, middle, and ring fingers from both hands to calculate an average fingertip size to create a “standard” area for analysis across all donors. A standardized cutout template was created to fit every participant’s latent fingermarks on pre-cleaned glass surfaces. Two fingermark “recharging-deposition-collecting” methods (i.e., Original Experiment and Optimized Experiment) and two swab types for DNA collection were compared (i.e., cotton swabs from Delta Lab (Spain) and 4N6FLOQSwabs® from Copan (Italy)). Then, ten participants deposited fingermarks for DNA extraction, quantification, STR amplification, and capillary electrophoresis (CE) for STR genotyping. Results showed that flocked swabs were more effective than cotton swabs at collecting DNA and produced suitable STR profiles with the optimized collection method. This research establishes the first MSR surfaces from which meaningful STR profiles can be acquired. These data provide key knowledge that assists crime investigators in prioritizing dactyloscopy, genotyping, or both analyses concurrently when examining latent fingermarks.</div></div>","PeriodicalId":12341,"journal":{"name":"Forensic science international","volume":"368 ","pages":"Article 112408"},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the capabilities of DART-MS compared to FTIR spectroscopy and SEM-EDS for the analysis of architectural paint mixtures","authors":"John Laetsch III,&nbsp;Morgan Carpenter,&nbsp;Alleigh N. Couch,&nbsp;Patrick Buzzini,&nbsp;J. Tyler Davidson,&nbsp;Geraldine Monjardez","doi":"10.1016/j.forsciint.2025.112405","DOIUrl":"10.1016/j.forsciint.2025.112405","url":null,"abstract":"<div><div>Architectural paint is a type of transferred trace material typically encountered by forensic laboratories, mostly in cases of forced entry. Forensic analysis of architectural paint generally consists of bright field microscopy followed by Fourier transform infrared (FTIR) spectroscopy. Further characterization can be achieved using additional techniques such as scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS), Raman spectroscopy, and pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS). This study aimed to evaluate the effectiveness of DART-MS compared to FTIR spectroscopy and SEM-EDS for the analysis of architectural paint analysis, as well as investigate how DART-MS could be incorporated into a paint analysis workflow. A total of 45 architectural mixed paint samples were obtained by preparing combinations of five base color paints as binary mixtures in known proportions. DART-MS detected multiple organic compounds, including tributyl citrate (TBC), polyethylene glycol (PEG), dioctyl maleate (DOM), and tert-butyldiethanolamine (TBDEA) which are common plasticizers, additives, and solvents in architectural paints. DART-MS also showed the ability to identify the black paint in mixed paints above 10 % at both 350 °C and 500 °C, unlike FTIR and SEM-EDS. Meanwhile, FTIR spectroscopy identified several organic and inorganic compounds in each of the base color paints, including binders, pigments, and extenders, and was generally able to determine which base color paints were present in a mixture. In addition to supporting the identification of the inorganic compounds detected using FTIR, SEM-EDS also demonstrated greater sensitivity for small concentrations of inorganic compounds in the mixed paints. Overall, the compounds detected through DART-MS analysis were not found with either FTIR or SEM-EDS, highlighting the complementary nature of these techniques. Furthermore, DART-MS demonstrated the capability to identify and monitor ions specific to the black base paint within mixed paint samples, supporting the adoption of a combined approach for enhanced architectural paint discrimination.</div></div>","PeriodicalId":12341,"journal":{"name":"Forensic science international","volume":"368 ","pages":"Article 112405"},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late discovery of bodies in indoor settings: A forensic practitioner’s view on recognizing cases of social isolation in eastern Attica, Greece","authors":"Christina Karydi,&nbsp;Christiana Leventaki,&nbsp;Konstantinos Katsos,&nbsp;Emmanouil I. Sakelliadis,&nbsp;Chara Spiliopoulou,&nbsp;Konstantinos Moraitis","doi":"10.1016/j.forsciint.2025.112395","DOIUrl":"10.1016/j.forsciint.2025.112395","url":null,"abstract":"<div><div>The late discovery of a deceased is an observable phenomenon in urban centers and is highly associated with unaccompanied deaths. The aim of this study is to investigate the socio-demographic patterns and circumstances surrounding the late discovery of deceased individuals in indoor settings within urban areas, in Greece. The studied sample included 217 decomposing individuals discovered indoors in eastern Attica between the years 2012–2021. The majority of cases involved Greek males aged above 65, single, childless, and living alone. A history of illegal substance and alcohol abuse, psychiatric disorders and atypical behavior was recorded in some cases, however these represented the minority of the sample. The majority of bodies were discovered inside their permanent homes by relatives or neighbors at the stage of early decomposition within a month of their death. Manner of death was in most cases natural. Statistically significant associations between the examined variables were noted. Differences in the death circumstances between individuals with and without socially reprehensible behaviors were illuminated. Ultimately, the study seeks to identify risk factors leading to social disengagement and contribute to the development of protective measures against this phenomenon.</div></div>","PeriodicalId":12341,"journal":{"name":"Forensic science international","volume":"368 ","pages":"Article 112395"},"PeriodicalIF":2.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights from the 7th of October massacre: Forensic odontology in mass disasters","authors":"Esi Sharon ,&nbsp;Ilana Engel ,&nbsp;Nurit Beyth ,&nbsp;Lital Malihi ,&nbsp;Tzipi Kahana","doi":"10.1016/j.forsciint.2025.112394","DOIUrl":"10.1016/j.forsciint.2025.112394","url":null,"abstract":"<div><div>On October 7, 2023, an attack on Israel led to 1200 Israeli fatalities, creating a critical need for victim identification under challenging conditions of the remains, which ranged from fresh to severely burnt and fragmented. This study examines the role of forensic odontology within a multidisciplinary approach to disaster victim identification, a key element in handling mass casualty events. Ante-mortem dental data, obtained from various sources, were matched with postmortem information, such as full mouth X-rays and cone-beam computed tomography scans, utilizing dental identification software and visual comparison methods. A total of 970 victims were examined, leading to the successful identification of 166 individuals, representing 17 % of the overall identifications made through all scientific means. These findings emphasize the value of dental interventions and morphological features in forensic identifications, depicted in computed tomography-generated panoramic images which can provide an effective alternative to full mouth X-rays when direct oral access was restricted. These insights contribute to advancing forensic practices in response to complex mass disaster situations.</div></div>","PeriodicalId":12341,"journal":{"name":"Forensic science international","volume":"368 ","pages":"Article 112394"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143286663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of contamination by indirect DNA transfer in a sexual assault case: A taste of déjà vu?","authors":"Vincent Castella ,&nbsp;Tacha Hicks ,&nbsp;Lydie Samie ,&nbsp;Patrick Basset","doi":"10.1016/j.forsciint.2025.112393","DOIUrl":"10.1016/j.forsciint.2025.112393","url":null,"abstract":"<div><div>In this article, we explore, through a casework example, when it is both appropriate and beneficial to provide possible explanations for contradictory information in a forensic context. We demonstrate that the challenges faced in forensic genetics are similar to those described decades ago in disciplines dealing with trace materials, such as fibres. This case, involving a DNA contamination within police premises by a blanket used by the two persons involved, serves as a reminder that all key players involved at the scene or working with complainants and defendants must remain vigilant in minimizing undesirable transfers of DNA or other traces. We show that rather than working in silos, DNA scientists should capitalise on the knowledge that has been acquired in other forensic disciplines. Based on Best Practice Manuals from several disciplines, we suggest general recommendations to prevent contaminations that can be potentially incriminating. Additionally, this case highlights the importance for members of the judiciary to recognize that all forensic results (e.g., fibres, DNA, mobile phone records), regardless of their strength, must be assessed within the broader context of the case, considering all available evidence rather than relying on a single forensic element.</div></div>","PeriodicalId":12341,"journal":{"name":"Forensic science international","volume":"368 ","pages":"Article 112393"},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicolegal evaluation of asylum seekers alleging torture and ill-treatment: A 4-year retrospective study in Montpellier, France","authors":"Stavroula Papadodima ,&nbsp;Quentin Rebillard ,&nbsp;Claire Villard ,&nbsp;Pierre-Antoine Peyron ,&nbsp;Fanchon Herman ,&nbsp;Maria Tsellou ,&nbsp;Eric Baccino ,&nbsp;Laurent Martrille","doi":"10.1016/j.forsciint.2024.112357","DOIUrl":"10.1016/j.forsciint.2024.112357","url":null,"abstract":"<div><div>The history of torture and other forms of ill-treatment or abuse is relied largely upon asylum seekers' self-reporting given that several forms of torture don’t leave permanent marks. To the extent, however, that physical findings exist they are valuable confirmatory evidence in support of an asylum application. The aim of this study was to retrospectively document the self-reported history of torture and other forms of abuse, alongside the physical evidence and the degree of consistency observed during examinations of asylum seekers conducted at the Department of Legal Medicine, University Hospital of Montpellier, France, during a 4-year period. The information was retrieved through retrospective analysis of all consecutive cases of the asylum seekers examined from January 1, 2019, to December 30, 2022. Exclusion criterion was age under 18 years old. A total number of 495 asylum seekers were included in the study for the aforementioned period (males 68.1 % and females 31.9 %). Mean of age was 29.90 years. The majority of the sample was originated from Sub-Saharan Africa (76.6 %). The most common method of torture/abuse was blunt force impact (88.5 %). A history of incised wounds (stabs and cuts), burns, gunshot use, and food deprivation were mentioned in 31.2 %, 21.4 %, 7.9 % and 5.6 % of the cases, respectively. Psychological abuse and sexual abuse were reported by 58.0 % and 22.9 % of the asylum seekers, respectively. Female genital mutilation was reported by 34.0 % of the female asylum seekers, coming almost exclusively from Sub-Saharan Africa. The perpetrator was a member of the family in 30.6 % of the cases, followed by police/army (27.7 %). Old injuries were observed on head in 56.4 %, on neck in 3.6 %, on trunk in 58.8 %, on upper extremities in 77.2 %, on lower extremities in 74.3 % and on genital/anal area in 13.3 % of the cases. Regarding the type of injuries observed during forensic clinical examination, history of blunt forces was positively associated with scars (<em>p</em> = 0.004), teeth injuries (<em>p</em> = 0.014) and fractures (<em>p</em> = 0.009). A positive statistical association was shown between compatibility grading 2–4 and burns (<em>p</em> = 0.015), as well as female genital mutilation (<em>p</em> &lt; 0.001). A positive statistical association was shown between compatibility grading 1 and the method of torture/abuse when this was reported to be sexual abuse ((<em>p</em> = 0.008) and blunt force impact (<em>p</em> &lt; 0.001). The results of the study will contribute to the gained knowledge about torture invoked injuries, improving thus the capability of forensic examiners to conduct comprehensive medical evaluations regarding alleged torture survivors.</div></div>","PeriodicalId":12341,"journal":{"name":"Forensic science international","volume":"367 ","pages":"Article 112357"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143097941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to assess fitness to drive in patients with cardiac rhythm disturbances through an applicable decision support system","authors":"Monia Lusetti,&nbsp;Antonia Nini,&nbsp;Matteo Iori,&nbsp;Antonella Battista,&nbsp;Nicola Bottoni,&nbsp;Fabio Quartieri","doi":"10.1016/j.forsciint.2024.112338","DOIUrl":"10.1016/j.forsciint.2024.112338","url":null,"abstract":"<div><div>Disturbances in cardiac rhythm affect a significant fraction of the population; they can have an ample range of repercussions on one person's quality of life, from negligible to lethal. As an implication, arrhythmias concern many private, commercial and public-passenger-vehicle driving licence holders. In their practice, medical professionals can be asked to assess an arrhythmia patient's fitness to drive effectively. Due to the subject's complexity (requiring an extent of multidisciplinary competencies), the current guidances' heterogeneity and the possible ethical conflicts, the decision-making process becomes challenging and of particular concern to the doctor. To offer an applicable decision support system to doctors of various backgrounds to implement in their practice when asked to assess for fitness to drive in a patient with a suspected disease, a formulated diagnosis or subjected to therapy for cardiac rhythm disturbances, we started gathering the issues concerning the fitness assessment of drivers (or candidates) who present with any condition, symptom or treatment possibly or knowingly caused by cardiac rhythm disturbances. Subsequently, we reviewed the English-based literature, including various countries' published medical standards. Then, the overview was revised by local medical experts in clinical arrhythmology, electrophysiology and traffic medicine to reach a consensus statement at a local level. The result is an easily consultable operational protocol that lists conditions, symptoms or treatments caused or possibly caused by cardiac rhythm disturbances; the certifications required for the assessment of the driver (or candidate); the orientation about the fitness or unfitness to drive under the enlisted medical conditions (distinguishing between private and professional drivers); and the recommended time limits to revise the case. A particular focus is applied to patients subject to the remote monitoring system of an implantable cardiac device, as this innovative approach constitutes a solid and efficient instrument for an accurate evaluation of the patient's cardiovascular situation. Despite some limitations, mainly concerning the lack of information at the moment of the evaluation or the infrequency of the medical condition, this proposal offers a ready-to-use solution for doctors who are asked to give their professional (clinical or medico-legal) opinion about the fitness to drive of patients with an arrhythmia problem. As an advantage, the constant cooperation among professionals from different backgrounds, like electrophysiologists and traffic medicine experts, allows a more individual, less predetermined evaluation of the specific case.</div></div>","PeriodicalId":12341,"journal":{"name":"Forensic science international","volume":"367 ","pages":"Article 112338"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}