Journal of forensic and legal medicine最新文献

{"title":"Systematic review on age assessment using Schmeling and Kellinghaus scoring of the medial end of the clavicle by various diagnostic imaging techniques","authors":"Swapnil Akhade ,&nbsp;Kiran Akhade ,&nbsp;Lina Bhoyar ,&nbsp;Pankaj Ghormade ,&nbsp;Veena Vaswani","doi":"10.1016/j.jflm.2025.102924","DOIUrl":"10.1016/j.jflm.2025.102924","url":null,"abstract":"<div><div>Estimating age is crucial in legal cases to determine if an individual has reached adulthood, with the medial clavicular epiphysis being the last skeletal part to ossify. X-rays, CT scans, and MRIs are commonly used to assess it, making the evaluation of their accuracy important. This review, adhering to PRISMA guidelines, analyses studies from PubMed, ScienceDirect, and Google Scholar published between 1990 and 2024. Of the 1927 articles initially identified, 32 met the inclusion criteria after screening. Two authors independently conducted the screening process as part of the study selection. A spreadsheet was used for data extraction, and the QUADAS-2 tool was utilized for quality assessment. The study findings indicate that CT scans provide the highest accuracy for age determination in late adolescence and early adulthood due to better imaging resolution. MRI is promising as a non-X-ray alternative, especially when combined with hand/wrist evaluations. Although useful, X-rays have their limitations. Overall, the review suggests that advancing imaging techniques, particularly CT scans, represent the most accurate method for forensic age evaluation from the medial end of the clavicle in late teens and early adolescents, and that establishing population-specific standards is also essential for improving age estimation in forensic and legal contexts.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102924"},"PeriodicalIF":1.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556819","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":"Russian forensic Medicine: Institutional evolution, operational contradictions, and their implications","authors":"Daria Nikitina ,&nbsp;Arina Gegelman ,&nbsp;Ekaterina Khodzhaeva ,&nbsp;Marina Zaitseva","doi":"10.1016/j.jflm.2025.102926","DOIUrl":"10.1016/j.jflm.2025.102926","url":null,"abstract":"<div><div>The article provides the first detailed English-language analysis of the forensic medical system in Russia, exploring its historical development and institutional design. Forensic medical experts in Russia play a crucial role in criminal and civil proceedings. With historical roots in the Russian Empire and the Soviet Union, the current system is built on an integrated and police-based model. Russian forensic medicine ensures professional specialization and standardization, but it faces challenges such as underfunding and excessive workloads. The paper highlights a funding mismatch: regional healthcare authorities are responsible for financing forensic medical services even though the primary beneficiaries are federal law enforcement and the courts. This produces systemic organizational gaps—including resource shortages, outdated infrastructure, and overworked personnel—that affect the quality and efficiency of forensic examinations. By addressing institutional path dependence and the coupling of forensic medicine with judicial and law enforcement systems, the study offers valuable insights for comparative research on forensic practices in post-Soviet countries.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102926"},"PeriodicalIF":1.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549092","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":"Perthe's syndrome in building collapse fatalities: A forensic examination","authors":"Nagendra Singh Sonwani ,&nbsp;Kishor Singh Thakur ,&nbsp;Navneet Ateriya ,&nbsp;Biliana Mileva ,&nbsp;Arvind Kumar","doi":"10.1016/j.jflm.2025.102925","DOIUrl":"10.1016/j.jflm.2025.102925","url":null,"abstract":"<div><h3>Introduction</h3><div>Perthe's syndrome, or traumatic asphyxia, is a rare form of mechanical asphyxia caused by sudden, intense chest compression, leading to cervicofacial congestion, petechiae, and subconjunctival haemorrhages. Despite its forensic significance, limited literature exists on cases resulting from building collapses.</div></div><div><h3>Objective</h3><div>This study examines forensic autopsy findings in victims of a building collapse, highlighting characteristic diagnostic features, pathophysiology, and the role of forensic experts, local authorities, and disaster management teams.</div></div><div><h3>Methods</h3><div>A forensic investigation was conducted on multiple victims who sustained fatal thoracic compression due to a collapsed building following heavy rainfall. Detailed external and internal autopsy findings were recorded, including congestion patterns, petechiae distribution, and associated injuries. The role of first responders and forensic pathologists in determining the cause of death and guiding disaster response was also evaluated.</div></div><div><h3>Observations</h3><div>The autopsies revealed hallmark features of traumatic asphyxia, including cervicofacial congestion, petechiae, subconjunctival haemorrhages, and lung edema. Additional injuries such as rib fractures and intracranial haemorrhages were noted in select cases. The investigation emphasized the need for rapid rescue operations and improved building safety regulations.</div></div><div><h3>Conclusion</h3><div>This study reinforces the importance of forensic pathology in diagnosing traumatic asphyxia and underscores the necessity of coordinated emergency response strategies in structural collapse disasters.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102925"},"PeriodicalIF":1.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517443","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":"Analysis of 14 years (2009–2022) of suicides and homicides involving the use of weapons recorded at the Milan medicolegal institute: update and comparison with the period 1993–2008","authors":"Stefano Tambuzzi ,&nbsp;Elvira Florio ,&nbsp;Carlo Alfredo Clerici ,&nbsp;Riccardo Primavera ,&nbsp;Raffaella Calati ,&nbsp;Guendalina Gentile ,&nbsp;Riccardo Zoja","doi":"10.1016/j.jflm.2025.102921","DOIUrl":"10.1016/j.jflm.2025.102921","url":null,"abstract":"<div><div>Firearms and cutting/stubbing weapons continue to be primary methods through which both self-inflicted and interpersonal violence manifest with forensic and judicial consequences. Hence, conducting an updated study on suicide and homicide involving these weapons in Milan, Italy, during 2009–2022 was deemed appropriate. This study includes comparisons with a similar analysis spanning 1993–2008, allowing for a comprehensive exploration of changes over a 30-year period in the misuse of firearms and cutting/stubbing weapons within the same geographical area. Overall, there has been a notable decrease in homicides overall (from 54 % to 44 %), particularly those involving firearms (from 53.5 % to 36.5 %), alongside an increase in homicides committed with cutting/stubbing weapons (from 46.5 % to 63.5 %). However, when considering homicides and suicides together, firearms still account for the majority of deaths (56.7 % vs 43.3 %, ratio 1.3:1), though the gap has narrowed compared to previous years. Moreover, there has been a rise in homicides occurring in domestic settings (&gt;40 %) with family members as perpetrators (37 %), and an increase in cases involving legally owned firearms (from 18 % to 34 %). Concurrently, the proportion of suicides has also increased (from 46 % to 56 %), highlighting the prevalent use of firearms (72.5 %). Overall, a different scenario emerges compared to the past, yet the misuse of firearms and cutting/stubbing weapons remains a persistent issue in society. This underscores the need for ongoing monitoring of such incidents and targeted efforts for prevention and regulation.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102921"},"PeriodicalIF":1.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502595","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":"Fulminant pulmonary fat embolism – undetected silent killer","authors":"Lucia Ihnát Rudinská ,&nbsp;Patricie Delongová ,&nbsp;Jana Vaculová ,&nbsp;Farkašová Iannaccone Silvia ,&nbsp;Peter Ihnát","doi":"10.1016/j.jflm.2025.102918","DOIUrl":"10.1016/j.jflm.2025.102918","url":null,"abstract":"<div><h3>Background</h3><div>Fulminant pulmonary fat embolism (PFE) is the most severe form of fat embolism. The aim of the study was to assess the presence/severity of PFE in individuals following major blunt trauma with no plausible cause of death identified at autopsy.</div></div><div><h3>Methods</h3><div>This was a prospective cohort study conducted at the University Hospital Ostrava, Czech Republic. During the study period, all persons who died after major trauma and were brought to the Department of Forensic Medicine were assessed for the study eligibility.</div></div><div><h3>Results</h3><div>A total of 134 deaths were due to major blunt trauma (road traffic accident victims, crime victims, suicide victims). Of these, the autopsy didn't reveal an obvious gross traumatic cause of death in 19 people who were included in the study. The mechanisms of trauma included falls (6 cases) and road traffic accidents (13 cases).</div><div>Severe injuries were found in 57.8 % of cases and multiple severe injuries in 36.8 % of cases. However, none of these serious injuries were considered fatal/lethal. Heart failure and brain swelling were the most common causes of death in the study group; fulminant PFE was the main cause of death in 4 (21.1 %) of cases.</div><div>Microscopic examination of lung cryosections revealed PFE grade I – III in all study cases. That's why the pathologists pronounced PFE as an important factor contributing to the onset of death in all study cases. In addition, massive PFE (grade III) was identified as the main cause of death in 21.1 % of cases.</div></div><div><h3>Conclusions</h3><div>PFE is a common injury in persons following major blunt trauma, occurring acutely within the first few minutes after the insult. In individuals in whom no other plausible cause of death is found at autopsy, the forensic pathologist must consider PFE as a potential cause of death or as an important factor contributing to the onset of death.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102918"},"PeriodicalIF":1.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502673","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":"The lasting impact of COVID-19 on forensic mental health: A review of shifts in patient profiles, service delivery, and legal considerations","authors":"Titus Oloruntoba Ebo ,&nbsp;David B. Olawade ,&nbsp;Dolapo Mary Ebo ,&nbsp;Eghosasere Egbon ,&nbsp;Folasayo I. Ayoola","doi":"10.1016/j.jflm.2025.102920","DOIUrl":"10.1016/j.jflm.2025.102920","url":null,"abstract":"<div><div>The COVID-19 pandemic has had a profound and lasting impact on forensic mental health, reshaping patient profiles, disrupting service delivery, and introducing new legal and ethical challenges. This narrative review examines the long-term implications of the pandemic on forensic psychiatric populations, mental health service provision, and the justice system. Evidence suggests that rates of severe mental illness, including psychosis, depression, and anxiety, have increased among forensic patients, exacerbated by isolation, stress, and reduced access to care. Additionally, substance use disorders, and co-occurring psychiatric conditions have become more prevalent, complicating treatment and rehabilitation efforts. The pandemic also accelerated the adoption of telepsychiatry in forensic settings, improving accessibility but raising concerns about the reliability of remote assessments for competency evaluations and risk assessments. Inpatient and prison-based forensic psychiatric services experienced staff shortages, increased patient aggression, and limited access to therapeutic programs, further straining the system. Court closures and legal case backlogs delayed forensic evaluations, raising human rights concerns for detained individuals. Ethical dilemmas emerged regarding involuntary hospitalization, treatment prioritization, and resource allocation. As the forensic mental health field transitions into a post-pandemic landscape, key lessons include the need for hybrid forensic assessment models, strengthened forensic infrastructure, and better integration of legal and clinical perspectives. Future research should focus on developing resilient forensic mental health policies and ensuring equitable access to care while maintaining legal and ethical standards.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102920"},"PeriodicalIF":1.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510648","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":"Hepatovascular manifestation of Takayasu arteritis presenting as sudden cardiac death","authors":"Hubert Anton Small ,&nbsp;Natasha Richards ,&nbsp;Rory Thompson ,&nbsp;Trudy-Ann Brown-Ennevor","doi":"10.1016/j.jflm.2025.102917","DOIUrl":"10.1016/j.jflm.2025.102917","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102917"},"PeriodicalIF":1.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320838","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":"Understanding and mitigating the risks that environmental DNA contamination poses to the recovery of forensic evidence from victims and suspects of rape and sexual assault","authors":"Michelle Gaskell ,&nbsp;June Guiness ,&nbsp;Kevin Sullivan","doi":"10.1016/j.jflm.2025.102911","DOIUrl":"10.1016/j.jflm.2025.102911","url":null,"abstract":"<div><div>The high sensitivity of current DNA analysis technologies poses significant anti-contamination challenges when recovering evidence from individuals in sexual assault referral centres (SARC)s and police custody forensic medical examination rooms where background DNA levels cannot be controlled as effectively as within a DNA laboratory setting. In response to reported instances of DNA evidence becoming compromised during recovery within SARCs, the UK Forensic Science Regulator (FSR) established anti-contamination guidelines for these facilities including requirements for environmental monitoring (EM) and target levels for air replacement with a view to managing the risk of air-borne contamination.</div><div>Forensic samples were recovered from different volunteers during 24 forensic medical examinations across four SARC and four police custody suites, all utilising different cleaning and air replacement regimes. Of the 144 EM samples taken from high contamination risk areas of the forensic medical room, DNA was present in 84 % of these swabs. Significantly less DNA was found to be present in the SARC when compared to custody suites.</div><div>Despite the high environmental DNA levels observed, none resulted in contamination of the forensic evidence recovered from the volunteer patients. This study assessed the real-life risk to evidential samples and the results demonstrated that provided appropriate anti-contamination measures were used in recovering and handling evidential samples, the risk of DNA contamination was effectively managed, even within facilities displaying high background levels of DNA. The results from this assessment of risk have enabled target levels of cleanliness to be defined in FSR guidelines¹ together with revised requirements for airflow rates.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102911"},"PeriodicalIF":1.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291400","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":"Effects of deferred prosecution on psychological well-being in individuals with substance use disorders","authors":"Chih-Chieh Chang ,&nbsp;Hung-Chi Wu ,&nbsp;Su-Ying Chung ,&nbsp;Kuan-Shang Chung ,&nbsp;Chih-Yao Hsu ,&nbsp;Yu-Shi Lu ,&nbsp;Chih-Hsiang Chiu ,&nbsp;Keng-Chang Lin ,&nbsp;Pei-Ti Chen ,&nbsp;Frank Huang-Chih Chou ,&nbsp;Dian-Jeng Li","doi":"10.1016/j.jflm.2025.102915","DOIUrl":"10.1016/j.jflm.2025.102915","url":null,"abstract":"<div><div>Deferred prosecution treatment is a legally restrictive alternative to incarceration for individuals with substance use disorders (SUDs). The present study examined efficacy of treatment, and psychological outcomes in individuals undergoing deferred prosecution. We evaluated patients with SUDs under deferred prosecution by retrospectively reviewing their treatment records over three years. Outcome measures and predictors were assessed through pre- and posttreatment psychological evaluations. Statistical analyses included Pearson's chi-squared test, independent <em>t</em>-test, generalized estimating equations (GEEs), and descriptive statistics to analyze the predictive effects of deferred prosecution. Significant reductions were observed in Drug Abuse Screening Test (DAST), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) scores post-treatment, but no significant changes in self-efficacy. Predictors of high DAST scores included revoked deferred prosecution, positive urinalysis, higher education, and incarceration history. GEE results showed lower self-efficacy among those with revoked deferred prosecution. Additionally, comorbid medical conditions predicted higher BDI and BAI scores. Deferred prosecution treatment can reduce substance use and improve psychological outcomes, particularly when structured support is provided. Tailoring interventions to address legal and medical challenges can enhance the recovery of patients with SUDs, and the study results can inform legal and health-care strategies, providing benefits for individuals with SUDs.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102915"},"PeriodicalIF":1.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271619","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":"Computational modeling of blunt force trauma to the atlanto-occipital joint: Implications for Forensic Pathology","authors":"Andreas Bourantanis ,&nbsp;Konstantinos Katsos ,&nbsp;Alexandros Samolis ,&nbsp;Dimitrios Vlachodimitropoulos ,&nbsp;George Troupis ,&nbsp;Emmanouil I. Sakelliadis ,&nbsp;Weijie Wang","doi":"10.1016/j.jflm.2025.102910","DOIUrl":"10.1016/j.jflm.2025.102910","url":null,"abstract":"<div><h3>Background</h3><div>The biomechanical response of the atlanto-occipital joint to blunt force trauma is an under-researched area in forensic pathology. This study investigates the joint's behavior under various impact scenarios using computational modeling, aiming to provide insights for enhancing postmortem examinations and injury analysis in forensic investigations.</div></div><div><h3>Materials and methods</h3><div>A computational model of the atlanto-occipital joint was developed, incorporating ligament properties, muscle forces, and equations of motion. Simulations were performed under 3000N and 5000N forces at 45°, with original and reduced damping conditions. Ligament tearing likelihood was assessed by comparing deformation to literature thresholds, and data were analyzed using Chi-square statistics and relative risk analysis.</div></div><div><h3>Results</h3><div>The study revealed that reduced damping significantly increased the vulnerability to tearing in the LAO and AAOL ligaments (p &lt; 0.05), with the Barkow Ligament demonstrating an inherent susceptibility to traumatic disruption. Relative risk analysis showed that reducing damping had a higher risk of tearing compared to increasing force. The findings demonstrate that fatal joint damage can occur without excessive force or concurrent skeletal injuries.</div></div><div><h3>Conclusion</h3><div>This study provides a computational model for simulating the atlanto-occipital joint's response to blunt force trauma and introduces an innovative action table to guide postmortem examinations based on simulation results. The action table offers a systematic approach for forensic pathologists to examine injuries, identify patterns, assess forces, consider substance effects, and evaluate fatality risks and enhances the precision and reliability of forensic assessments in cases involving atlanto-occipital joint injuries.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"114 ","pages":"Article 102910"},"PeriodicalIF":1.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297551","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}