Journal of forensic and legal medicine最新文献

{"title":"Transforming invisible victimization into visible evidence: The role of higher education institutions as community-based observatories for mental health and victimization","authors":"Darin Jan Tindowen, Jenelyn Layugan, Jackelyn Tamang","doi":"10.1016/j.jflm.2026.103202","DOIUrl":"10.1016/j.jflm.2026.103202","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"121 ","pages":"Article 103202"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355269","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":"Clinical forensic medical assessment insights from fitness for police interview consultations","authors":"Vanita Parekh,&nbsp;Janine McMinn,&nbsp;Anna Brkic,&nbsp;Bridget Bourke,&nbsp;Anthony Williamson,&nbsp;Stephanie Leonard","doi":"10.1016/j.jflm.2026.103196","DOIUrl":"10.1016/j.jflm.2026.103196","url":null,"abstract":"<div><h3>Background</h3><div>A medical assessment to determine fitness for interview (FFI) is undertaken prior to police interview to guide officers on a suspect's interview readiness. Being fit for police interview strengthens the admissibility of evidence, supports legal compliance and integrity, and ensures that a suspect can self-advocate in a fair and honest interview process. This retrospective clinical audit describes and evaluates the biopsychosocial factors involved in FFI assessments.</div></div><div><h3>Method</h3><div>This is a retrospective clinical audit of all 215 cases who underwent fitness for interview assessments over a 10 year period.</div></div><div><h3>Results</h3><div>ACT Police referred 215 suspects for fitness for interview assessments (FFI); 6 were unable to be assessed. Physical and mental state examinations were undertaken on the remaining 209 suspects, the majority being males under the age of 40. Multiple factors were significantly associated with not being fit for interview: alcohol intoxication (41.6%), substance use (45.9%), and having less than 6 h sleep (40.2%). Mental health assessment (18.9%), administration of medications (13.9%) and transfer to a hospital (3.3%) were required in some cases. Of 122 suspects found to be initially unfit, 80.3% required a post-intervention FFI reassessment. Strong attention, concentration and clear speech were the most important medical predictors of a suspect's fitness for interview.</div></div><div><h3>Conclusions</h3><div>Point-in-time FFI medical assessments consider various biopsychosocial factors critical to ensuring a fair police interview. For suspects deemed unfit, appropriate care pathways are required to enable medical intervention and reassessment.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"121 ","pages":"Article 103196"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Livor mortis – the ‘blush of death’","authors":"Roger W. Byard","doi":"10.1016/j.jflm.2026.103191","DOIUrl":"10.1016/j.jflm.2026.103191","url":null,"abstract":"<div><div>Livor mortis refers to the pooling of blood in dependent parts of the body after death due to a gravitational effect on red blood cells. It develops over a particular time period, although there are great individual variations, and once it becomes ‘fixed’ may be a useful indicator that a body has been moved after death. The observation of patchy areas of lividity, not always in dependent areas however, suggests that the mechanism of its development must involve more than simple gravity.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"121 ","pages":"Article 103191"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148285044","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":"Corrigendum to “Technical note: Identification of the novel benzodiazepine 3-hydroxy desalkylgidazepam within PSNI tablet seizures in Northern Ireland” [J Forensic Leg Med 121 (2026) 103187]","authors":"Maurice Robert Jeffers,&nbsp;William Robert Greer","doi":"10.1016/j.jflm.2026.103199","DOIUrl":"10.1016/j.jflm.2026.103199","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"121 ","pages":"Article 103199"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catalytic role of serum albumin in decarboxylation of acetoacetate: A biochemical insight into the study by Yoshida et al.","authors":"Myu Tachibana ,&nbsp;Kei Wada ,&nbsp;Nobuhiro Yukawa","doi":"10.1016/j.jflm.2026.103163","DOIUrl":"10.1016/j.jflm.2026.103163","url":null,"abstract":"<div><div>This correspondence provides a biochemical commentary and supplementary hypothesis regarding the article by Yoshida et al. (2025) published in this journal on the relationship between blood acetone levels and gastric contents. While the original study demonstrated that blood acetone levels increase in the absence of food residue, we highlighted the catalytic role of human serum albumin (HSA) in the decarboxylation of acetoacetate (AcAc) to acetone, a non-redox process distinct from β-hydroxybutyrate formation. We hypothesized that under hypoglycaemic conditions (i.e., empty stomach), the lack of competition from glucose for HSA binding sites accelerates HSA-mediated conversion. This protein-catalytic perspective, supported by forensic data showing nearly complete conversion of AcAc to acetone, offers a more precise interpretation of ketone body profiles in forensic practice.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103163"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847948","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":"Gross and histopathological study of pituitary gland in cases of suicidal deaths: A case-control study","authors":"Fathima Harsha ,&nbsp;Krishna Nishad ,&nbsp;Mousami Singh ,&nbsp;Pratibha Singh ,&nbsp;Malti kumari maurya ,&nbsp;Anoop kumar Verma","doi":"10.1016/j.jflm.2026.103160","DOIUrl":"10.1016/j.jflm.2026.103160","url":null,"abstract":"<div><h3>Introduction</h3><div>Suicide is a growing global concern, happening impulsively during moments of intense crisis. The pituitary gland, often referred to as the “master gland,” plays a central role in regulating the body's hormones, particularly through the hypothalamic-pituitary-adrenal (HPA) axis, which governs the stress response. HPA axis dysregulation can lead to structural and functional changes in the pituitary gland, and changes in this gland offer <strong>a</strong> meaningful pathological correlate in the forensic investigation of suicidal death. As published literature on this subject is scarce, especially in the Indian context, the study adds novel regional data and may help improve understanding of neuroendocrine alterations associated with suicide.</div></div><div><h3>Method</h3><div>An observational case control study in which 200 cases of suicidal deaths and 200 non-suicidal deaths were taken as control. The data on relevant epidemiological, demographic factors, and variables was collected. The pituitary gland was dissected, and gross examination and histopathological evaluation of the gland done.</div></div><div><h3>Result</h3><div>Demographic analysis revealed that most cases were young adults (aged 20–30), predominantly male, from urban areas, and had low to middle socio-economic backgrounds. Additional risk factors identified among suicide victims included family history of mental illness, prior suicide attempts, psychiatric history, and substance abuse. Statistical analysis revealed a strong association between suicide and the presence of histopathological abnormalities in the pituitary gland, with a highly significant odds ratio. These findings suggest that stress-related neuroendocrine dysfunction may be a contributing factor in suicide and highlight the potential forensic value of pituitary examination in autopsies of suspected suicide cases.</div></div><div><h3>Conclusion</h3><div>The study highlights the importance of routine endocrine evaluations in mental health assessments and advocates for interdisciplinary collaboration among forensic pathologists, psychiatrists, and endocrinologists. A more integrated approach could improve early identification of individuals at risk and ultimately help reduce suicide rates.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103160"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847963","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":"Tuberculous coronary arteritis as a rare cause of sudden cardiac death in young adults: a case report and a literature-based review","authors":"Youssef Nouma ,&nbsp;Jaweher Kamoun ,&nbsp;Zied Chaari ,&nbsp;Moez Hamdani ,&nbsp;Abdelmajid Khabir ,&nbsp;Wiem Ben Amar","doi":"10.1016/j.jflm.2026.103165","DOIUrl":"10.1016/j.jflm.2026.103165","url":null,"abstract":"<div><h3>Background</h3><div>Sudden Cardiac Death (SCD) is generally attributed to coronary atherosclerosis. Tuberculous Coronary Arteritis (TCA), an exceptionally rare manifestation of tuberculosis (TB), is a severe, often unrecognized, infectious cause of SCD. This report highlights TCA as a fatal etiology of SCD and reviews its key clinical and pathological features to enhance diagnostic awareness.</div></div><div><h3>Methods</h3><div>A regular narrative literature review was performed using the MEDLINE, Scopus, Embase, and Web of Science databases, with the following search terms: (“Tuberculous Coronary Arteritis” OR “Coronary Tuberculosis”) AND (“Sudden Cardiac Death” OR “Myocardial Infarction”). We included histologically confirmed TCA cases in which arteritis was the direct cause of a fatal acute ischemic event or SCD, with a focus on young patients.</div></div><div><h3>Case report</h3><div>A 28-year-old previously healthy man collapsed at work and died despite resuscitation. Autopsy revealed diffusely thickened coronary arteries (CA) with periarterial fibrosis and grayish perihilar pulmonary consolidation. No other significant gross abnormalities were identified. Histological examination showed granulomatous inflammation in CA, lungs, and mediastinal lymph nodes with caseating necrosis involving only the lungs and mediastinal lymph nodes. PCR confirmed <em>Mycobacterium tuberculosis</em> despite negative Ziehl–Neelsen staining. Death was attributed to TCA complicated by thrombosis, stenosis, and myocardial infarction.</div></div><div><h3>Conclusion</h3><div>TCA is a rare, life-threatening extrapulmonary manifestation of TB that may cause SCD in young individuals without cardiovascular risk factors. Its nonspecific presentation means it is rarely suspected during life and is usually diagnosed postmortem. Increased clinical and forensic awareness, especially in TB-endemic areas, is essential for accurate cause-of-death determination and appropriate public health action.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103165"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847993","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 subpubic angle and palpable pelvic parameters in sex estimation using machine learning algorithms in a Turkish population","authors":"Seda Sertel Meyvaci ,&nbsp;Beyza Celik ,&nbsp;Handan Ankarali ,&nbsp;Siddika Halicioglu ,&nbsp;Buse Karabacak","doi":"10.1016/j.jflm.2026.103168","DOIUrl":"10.1016/j.jflm.2026.103168","url":null,"abstract":"<div><h3>Purpose</h3><div>This retrospective cross-sectional study aimed to estimate sex in the Turkish adult population using the multidimensional characteristics of pelvic morphometry derived from computed tomography (CT) images analyzed through machine learning algorithms (MLAs) based on palpable parameters.</div></div><div><h3>Material and methods</h3><div>Abdominal CT scans of 301 adults (150 females, 151 males) were retrospectively evaluated. Six measurements were obtained from the pelvis, including five palpable anatomical landmarks representing the distances between the right and left anterior superior iliac spines, posterior superior iliac spines, the highest posterior points of the iliac crests, the most lateral points of the iliac crests, the ischial tuberosities and the subpubic angle. Independent samples <em>t</em>-test and multivariate logistic regression were used to assess sex differences. Supervised learning algorithms Logistic Regression (LR), Classification and Regression Tree (CART), Multilayer Perceptron (MLP) and the unsupervised K-means clustering algorithm (KM) were applied for sex estimation (p &lt; 0.05).</div></div><div><h3>Results</h3><div>The LR model achieved 94.7% overall accuracy. All variables except the distance between the right and left anterior superior iliac spines, significantly contributed to sex estimation. MLP achieved the highest accuracy (100% for females, 96% for males), while CART reached &gt;93% accuracy using only subpubic angle. KM classified sexes with 92% accuracy.</div></div><div><h3>Conclusion</h3><div>CT-based pelvic morphometry analyzed by MLAs provides a highly accurate and objective approach for sex estimation. The developed model can be applied for sex estimation in the Turkish population, particularly in forensic studies, involving living individuals or partially preserved skeletal remains.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103168"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876792","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":"APACHE II score as a predictor of mortality following acute paraquat poisoning: A retrospective cohort study","authors":"Mohan Kumar Hanumanthappa ,&nbsp;Aarti Vaid ,&nbsp;Saurabh C. Sharda ,&nbsp;Ashish Behera ,&nbsp;Valliappan Muthu ,&nbsp;Navneet Sharma","doi":"10.1016/j.jflm.2026.103156","DOIUrl":"10.1016/j.jflm.2026.103156","url":null,"abstract":"<div><h3>Background</h3><div>Paraquat poisoning carries a high mortality rate. The absence of an effective treatment and standardised prognostic tools necessitates a robust, accessible method for early risk stratification. This study aimed to evaluate whether the baseline Acute Physiology and Chronic Health Evaluation II (APACHE II) score can predict seven-day mortality in patients with acute paraquat poisoning and distinguish survivors from non-survivors.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, 98 patients with confirmed paraquat poisoning admitted between January 2014 and December 2023 were included. Demographic, clinical, and laboratory data, including APACHE II scores, were extracted from medical records. Seven-day outcomes were compared using univariate and multivariable logistic regression analyses. ROC analysis was performed to assess the discriminative ability of the APACHE II score, and the optimal cut-off was determined using Youden's index.</div></div><div><h3>Results</h3><div>The seven-day mortality rate was 55.1% (54/98). Non-survivors exhibited significantly higher median APACHE II scores than survivors (10 vs. 8; p = 0.005). In multivariable analysis, the APACHE II score independently predicted mortality (OR, 1.16; 95% CI, 1.02–1.35; p = 0.030), along with elevated serum bilirubin levels (OR, 1.12; 95% CI, 1.02–1.24; p = 0.030). ROC analysis revealed an AUC of 0.675, and Youden's index identified an optimal APACHE II cut-off of 6.5, yielding a sensitivity of 88% and a specificity of 39.5%.</div></div><div><h3>Conclusion</h3><div>The baseline APACHE II score effectively and independently predicts early mortality in paraquat poisoning. However, its modest discriminative performance, particularly the low specificity of 39.5% and the retrospective design of this study are important limitations. Further prospective multicentre validation studies and integration with other clinical tools may enhance early risk stratification and support prompt clinical decision-making, particularly when specialised assays are unavailable.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103156"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984832","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":"Sarcophaga africa (Diptera: Sarcophagidae): A forensically significant flesh fly","authors":"Fengqin Yang,&nbsp;Jiao Xiao,&nbsp;Xiangyan Zhang,&nbsp;Yanjie Shang,&nbsp;Yadong Guo","doi":"10.1016/j.jflm.2026.103169","DOIUrl":"10.1016/j.jflm.2026.103169","url":null,"abstract":"<div><div><em>Sarcophaga africa</em>, a member of the genus <em>Sarcophaga</em> within the family Sarcophagidae, is a flesh fly frequently associated with fecal matter and decaying organic substrates. This species is commonly observed in forensic casework and necrophagous insect succession studies involving cadavers, highlighting its forensic utility. However, systematic research on <em>S. africa</em> remains limited, posing challenges for its effective application in forensic contexts. This review synthesizes current findings on its nomenclature, geographical distribution, biological characteristics, forensic significance, and other research content. This work aims to provide a foundation for future research and to promote more targeted and standardized use of <em>S. africa</em> in forensic science.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"120 ","pages":"Article 103169"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950527","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}