Forensic Science, Medicine and Pathology最新文献

{"title":"Invasive aspergillosis leading to fatal cerebral hemorrhage: a case report and comprehensive literature review.","authors":"Nicole Pasin, Matteo Lorenzoni, Erika Velotta, Giulio Riva, Raffaella Scotto Opipari, Mara Di Pietro, Roberta Tamiozzo, Umberto Nardi","doi":"10.1007/s12024-025-00966-0","DOIUrl":"10.1007/s12024-025-00966-0","url":null,"abstract":"<p><p>Aspergillus fumigatus significantly threatens immunocompromised individuals by causing potentially fatal diseases, primarily invasive aspergillosis (IA). IA, mostly affecting the lungs, can disseminate to other organs, including the central nervous system (CNS), leading to high mortality rates. We present the case of an 84-year-old immunocompetent male with a history of significant comorbidities, who developed a lethal subarachnoid and tetraventricular hemorrhage. Initial symptoms included paroxysmal neuralgic pain and ophthalmic manifestations. Despite diagnostic efforts, the infection was confirmed only after a positive Aspergillus galactomannan antigen test on cerebrospinal fluid, post-mortem microbiological culture, and mass spectrometry (MS) authentication. The patient exhibited rapid deterioration and succumbed due to the erosion of a mycotic cerebral aneurysm of the left internal carotid artery. Diagnosing IA, particularly isolated CNS IA in immunocompetent patients, is challenging due to its nonspecific symptoms and difficulty detecting the pathogen in standard diagnostic tests. This article emphasizes the pivotal role of pathological examination to obtain a definitive diagnosis, assess fungal infiltration of brain vessels, and thus clarify the accurate source of fatal brain hemorrhages.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1256-1266"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors associated with drug-facilitated sexual assault (DFSA) compared with non-DFSA - a systematic review.","authors":"Marina Rasmussen, Johannes Rødbro Busch, Mikkel Jon Henningsen, Jytte Banner","doi":"10.1007/s12024-025-00953-5","DOIUrl":"10.1007/s12024-025-00953-5","url":null,"abstract":"<p><strong>Purpose: </strong>Criminological and interpersonal covariates are different in drug-facilitated sexual assault (DFSA) and sexual assault in general. These observations are based on retrospective survey-only data from victims who were not examined clinically in the acute setting.  This study aims to review the current literature reporting data specifically on clinically examined victims of suspected DFSA and associated interpersonal and criminological covariates.</p><p><strong>Methods: </strong>In this systematic review, we searched PubMed/Medline and Embase for studies on DFSA reporting interpersonal or criminological covariates in victims older than 15 years and clinically examined within seven days of assault. Two authors independently screened studies for inclusion and extracted data. Meta-analysis was not possible due to different definitions of DFSA in the included studies.  RESULTS: The search yielded 1,350 hits. Thirty-one observational studies, case-control studies, and descriptive studies were included for a total of 14,727 observations. Twenty-two studies reported DFSA as a covariate in other research contexts. The most reported covariates were age, sex, and injuries.</p><p><strong>Conclusion: </strong>The published data are sparse, varying, and often reported as secondary outcomes or epidemiological data. The varying definitions of DFSA preclude meta-analysis and hinder efforts to help victims of DFSA. An internationally agreed-upon consensus definition of DFSA should be established to overcome this challenge.  More knowledge regarding DFSA is necessary to investigate if DFSA victims experience different barriers to seeking both medical and judicial help than SA victims in general.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1370-1385"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of successive DNA extractions from cotton and flocked swabs.","authors":"Ella Pickell, Charlotte Arsenault, Kara L Jaremko, Georgiana Gibson-Daw, Deborah S B S Silva","doi":"10.1007/s12024-025-00960-6","DOIUrl":"10.1007/s12024-025-00960-6","url":null,"abstract":"<p><p>The use of swabs to collect biological samples is a current practice in forensic investigations. Once a sample is collected, the DNA is extracted and used for testing at the crime lab. DNA extraction can often be sub-optimal in yield, and identifying new approaches to obtain larger DNA quantities from casework samples is critical. The goal of this study was to investigate the success rate of obtaining sufficient DNA yields from previously extracted swabs. Reference and case-type samples were collected using different types of swabs and genomic DNA was extracted from samples multiple times using only the QIAamp^® DNA Investigator Kit or using this kit in combination with the Investigator Lyse&Spin Basket Kit. DNA samples were amplified using the GlobalFiler™ PCR Amplification Kit and separated on a SeqStudio Genetic Analyzer. All types of swabs and extraction methods yielded DNA after three extractions, and complete DNA profiles were produced for reference and case-type samples up to the third extraction. This provides a proof-of-concept that it is possible to recover DNA from previously extracted swabs in sufficient yield for full STR profiles. Also, trace DNA casework swabs can be extracted twice in succession and extracts pooled to increase yields for necessary DNA tests.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1589-1593"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new robust AI/ML based model for accurate forensic age estimation using DNA methylation markers.","authors":"Jinsu Ann Mathew, Geetha Paul, Joe Jacob, Janesh Kumar, Neelima Dubey, Ninan Sajeeth Philip","doi":"10.1007/s12024-025-00985-x","DOIUrl":"10.1007/s12024-025-00985-x","url":null,"abstract":"<p><p>CpG sites are regions of DNA where a cytosine nucleotide is followed by a guanine nucleotide in the 5' → 3' direction. Epigenetic markers based on methylation values at CpG sites are valuable for accurate age prediction and have become essential in forensic science, supporting criminal investigations and human identification. The present study identified 12 CpG sites from a collection of 476,366 CpG sites based on the following criteria: (a) CpG sites were retained if the Pearson correlation coefficient between the methylation values and the chronological age of the individual is greater than 0.85, and (b) if the mutual correlation coefficient between a pair of selected CpG sites is greater than 0.15, only one of them is retained. The identified CpG sites are associated with genes FHL2, ELOVL2, TRIM59, PCDHB1, KLF14, C1orf132, ACSS3, and CCDC102B. To ensure that the predictive accuracy is intrinsic to the selected CpG sites and not model dependent, the identified CpG sites were passed to three different Neural network models. All models achieved comparable accuracy across diverse populations, genders, and health conditions. The model's accuracy and reliability were validated through age predictions on independent datasets. By utilizing a minimal set of CpG sites, this approach offers a robust and efficient solution for forensic age estimation, significantly enhancing the precision and reliability of forensic investigations.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1145-1162"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden unexpected death due to B-cell acute lymphocytic leukaemia (B-ALL) in a 3-year-old child.","authors":"Elke Doberentz, Glen Kristiansen, Marit Bernhardt, Frank Musshoff, Burkhard Madea","doi":"10.1007/s12024-025-00998-6","DOIUrl":"10.1007/s12024-025-00998-6","url":null,"abstract":"<p><p>Sudden unexpected death due to haematologic disease in children is unusual. A 3-year-old girl had been ill for several weeks, but her parents did not consult a doctor. Her complaints included a cough, fever, vomiting and fatigue. On the day of her death, the girl fell from the toilet and was unresponsive. In hospital, severe dyspnoea and a haemoglobin value of only 1.7 mg/dl were diagnosed, as well as hypothermia and haemorrhaging from mouth and nose. Despite intensive medical care and cardiopulmonary resuscitation, the girl died. Main autopsy findings were severe anaemia and the underlying disease, B-cell acute lymphocytic leukaemia (B-ALL). In particular, liver, spleen, lymph nodes, kidneys and bone marrow showed marked infiltration of atypical mononuclear cells replacing haematopoiesis. Intra-alveolar exudation, consistent with the early phase of acute pneumonia, was identified as cause of death. Toxicological investigations revealed positive findings of morphine (53.3 ng/ml), as well as amphetamine and THC in femoral blood, respectively, in hair samples. This paper discusses the medicolegal implications of the case (omitted duty of care by the parents).</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1520-1525"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dog bites or knife wounds? A case report of atypical neck injuries.","authors":"Eulalie Pefferkorn, Fabrice Dedouit, Frédéric Savall, Pauline Saint-Martin","doi":"10.1007/s12024-024-00924-2","DOIUrl":"10.1007/s12024-024-00924-2","url":null,"abstract":"<p><p>A 24-year-old woman was brought to the emergency department after suffering dog bites, as reported by a witness. Autopsy revealed 21 deep wounds of the neck, along with unclear injuries to both carotid arteries, extensive damage to neck muscles, a wound to the larynx, and the right lobe of the thyroid gland had been avulsed. The forensic pathologist initially concluded that the cause of death was asphyxia and haemorrhagic syndrome. Furthermore, due to the nature of some wounds resembling stab wounds, as well as facial injuries and marks consistent with gripping, the death was initially considered a possible homicide rather than attributing it to dog bites. Following these findings, the investigation took a drastic turn, resulting in the arrest of the witness. Three years later, our team was consulted for a second opinion. Reviewing the medical records confirmed dissection of both carotid and vertebral arteries without complete section, and fractures of cervical transverse processes, with the left and right vertebral arteries occluded by a bone fragment as seen on a CT scan from the emergency department. The second forensic expert supported the conclusion that the cervical injuries were consistent with dog bites, particularly due to the torn appearance of the muscle masses and soft tissue avulsion. Additionally, the vascular dissections and cervical fractures were attributed to hyperextension and/or compression of the neck, consistent with the dynamics of a dog attack involving shaking or grabbing the neck. Similar types of injuries have been documented in the scientific literature in cases of dog attacks. Furthermore, instances of wounds resembling stab wounds following dog bites have also been reported. The experts conclude that death was secondary to cerebral anoxia resulting from multiple dissections of neck vessels, aggravated by blood spoliation and asphyxia related to the laryngeal wound. All of the wounds were consistent with dog bites, leading to the release of the defendant.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1273-1280"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the postmortem diagnosis of alcoholic ketoacidosis.","authors":"John A Daniels, Michael Caplan","doi":"10.1007/s12024-025-00978-w","DOIUrl":"10.1007/s12024-025-00978-w","url":null,"abstract":"<p><p>Alcoholic ketoacidosis (AKA) is an underreported and underrecognized complication of chronic alcohol use disorder, which may present as a sudden death with few diagnostic clues. The most frequent history is that the affected individual stops eating and uses alcohol as one's primary source of nutritional intake, with the subsequent development of nausea, vomiting, and general malaise. Chronic alcoholics may also stop drinking days or weeks before death, precipitating a terminal ketoacidotic state, of which beta-hydroxybutyrate (BHB) is the principal ketoacid. The postmortem toxicology and chemistry findings may be low to absent (undetectable) blood and vitreous ethanol concentrations, elevated blood and vitreous acetone, and elevated BHB levels. We present a case series of 19 deaths of AKA at the Franklin County, Ohio Forensic Science Center that is characterized by an essentially bimodal distribution due to the introduction of an algorithm designed to facilitate the detection of ketoacids, and specifically, BHB, by two principal measures: (1) substantially lowering the detection threshold of acetone; and (2) prompting reflex testing for BHB when that threshold has been achieved. The result of this change in laboratory protocol has been a noticeably enhanced ability to make the diagnosis of AKA and to offer a feasible mechanism by which chronic alcoholics die suddenly, over the purely morphologic but mechanistically vacuous designation of \"fatty liver\".</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1138-1144"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in postmortem interval estimation: A systematic review of machine learning and metabolomics across various tissue types.","authors":"Abdulkreem Abdullah AlJuhani, Rodan Mahmoud Desoky, Abdulaziz A Binshalhoub, Mohammed Jamaan Alzahrani, Mofareh Shubban Alraythi, Farouq Faisal Alzahrani","doi":"10.1007/s12024-025-01026-3","DOIUrl":"10.1007/s12024-025-01026-3","url":null,"abstract":"<p><strong>Background: </strong>Traditional postmortem interval (PMI) estimation methods rely on observable changes such as rigor mortis, livor mortis, and algor mortis but are often affected by environmental factors. Metabolomics, combined with techniques like nuclear magnetic resonance (NMR) and mass spectrometry, improves accuracy by identifying biochemical changes postmortem. Machine learning methods such as Principal Component Analysis (PCA), Partial Least Squares (PLS), and Support Vector Machines (SVMs), enhance PMI predictions by analyzing metabolite data. This review aims to summarize advances in using machine learning for PMI estimation and identify the optimal combination of tissue samples and algorithms for accurate predictions.</p><p><strong>Methods: </strong>We retrieved relevant articles up to September 2024 from PubMed, Scopus, Web of Science, IEEE, and Cochrane Library. Data were extracted from eligible studies by two independent reviewers. This included the number and species of subjects, tissue sample used, PMI range in the study, metabolic profiling technique, machine learning algorithms, potential PMI markers, and model performance.</p><p><strong>Results: </strong>We compared machine learning models for PMI estimation across various tissues. Zhang et al. (2022) had the best performance with a random forest (RF) model using cardiac blood, achieving a mean absolute error (MAE) of 1.067 h by selecting key metabolites. Wu et al. (2017) followed with an orthogonal signal-corrected PLS model (R² > 0.99, MAE 1.18-2.37 h). Lu et al. (2022) achieved 93% accuracy with a multi-organ stacking model. Other promising models include Zhang et al.'s (2017) nu-SVM on pericardial fluid (RMSE = 2.38 h) and Sato et al.'s (2015) PLS model on cardiac blood (MAE = 5.73 h).</p><p><strong>Conclusion: </strong>Cardiac blood is best for short PMIs with random forest models, while skeletal muscle and stacking models excel for longer PMIs. Future studies should refine and validate these findings as well as extend the findings to human subjects.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1428-1446"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel insights into estimating the postmortem interval: red cell distribution width - standard deviation.","authors":"Hiroki Kondou, Kaori Shintani-Ishida, Hiroshi Ikegaya","doi":"10.1007/s12024-025-00957-1","DOIUrl":"10.1007/s12024-025-00957-1","url":null,"abstract":"<p><p>Estimation of the postmortem interval (PMI) is highly significant, and many estimation methods have been developed. However, as no estimation method is determinate, several methods must be combined to achieve an accurate estimation. Therefore, the more methods available, the more accurate the estimation. To facilitate this, we examined whether red cell distribution width standard deviation (RDW-SD) was associated with PMI. We compared the RDW-SDs of blood samples from hospitals and autopsies in the same cadavers using a paired test. Additionally, we performed an unpaired test with multiple regression analysis to confirm the relationship between PMI and RDW-SD. Eighteen cases were included in the paired analysis, and a significant difference between hospital and autopsy RDW-SDs was confirmed. The 95% confidence interval for the difference was between 11.7 and 17.4. In the multiple regression analysis of the 756 cadavers, the 95% confidence interval of the regression coefficient of PMI for RDW-SD was 1.63-3.43. Our results suggest that RDW-SD may have a positive relationship with PMI. However, further research is required to determine the accuracy of this estimation method.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1191-1195"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forensic identification of fatal mushroom poisoning: a case report.","authors":"Zhonghao Yu, Yuhao Yuan, Jiaxin Zhang, Qing Shi, Hang Gao, Yiwu Zhou","doi":"10.1007/s12024-025-00956-2","DOIUrl":"10.1007/s12024-025-00956-2","url":null,"abstract":"<p><p>Mushroom poisoning incidents happen infrequently, yet owing to the non-lethal nature of most toxins and the efficacy of timely treatment, fatalities from mushroom poisoning are uncommon, leading to a scarcity of pertinent clinical and pathological data. Here, we reported a case of death caused by the consumption of raw mushrooms, alongside detailed clinical data and multi-organs pathological alterations, which underscored its potential significant reference value in forensic practice. Futhermore, ibotenic acid, a type of mushroom toxin, was detected both in the patient's blood and gastric lavage fluid about 19 h after the consumption of mushrooms, and was successfully quantified at concentrations of 0.381 µg/mL and 0.202 µg/mL, respectively, indicating a relatively significant finding.</p>","PeriodicalId":12449,"journal":{"name":"Forensic Science, Medicine and Pathology","volume":" ","pages":"1313-1320"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}