Journal of forensic and legal medicine最新文献

{"title":"Common errors in the completion of death certificates in teaching hospitals in northern Iran: A legal challenge","authors":"Seyed Mehran Razavipour ,&nbsp;Seyed Khosro Ghasempouri ,&nbsp;Navid Khosravi Kochaksaraei ,&nbsp;Zakaria Zakariaei ,&nbsp;Ashkan Ahodashti","doi":"10.1016/j.jflm.2024.102779","DOIUrl":"10.1016/j.jflm.2024.102779","url":null,"abstract":"<div><h3>Background</h3><div>The proper completion of death certificates (DCs) is of paramount importance for physicians, as they serve as vital medico-legal documents. The information contained within these certificates holds great significance in health statistics, as it serves as a crucial tool for epidemiological research and analysis.</div></div><div><h3>Methods</h3><div>This study comprises a descriptive cross-sectional analysis of all DCs issued in 2019 for approximately 1104 deceased patients at a teaching hospital in Mazandaran Province, in northern Iran. To conduct this research, a checklist was implemented, which contained comprehensive categories, including essential public information, and the primary and underlying causes of death (UCOD).</div></div><div><h3>Results</h3><div>The results of this study indicate that out of the 618 cases of deceased individuals, 273 (44.2 %) were women and 345 (55.8 %) were men. Notably, a total of 61 cases (9.9 %) exhibited an error in the writing of the primary cause of death (COD). Specifically, the UCOD was erroneously recorded as cardio-pulmonary arrest in 13.2 % of all DCs, thus resulting in an error in the main COD.</div></div><div><h3>Conclusion</h3><div>The findings of this study disclosed a high incidence of errors in the completion of DCs, particularly in the determination of the UCOD, which is universally recognized as the most critical aspect of these documents.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"108 ","pages":"Article 102779"},"PeriodicalIF":1.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515384","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":"Occurrence and circumstances of child sexual assault in Maputo, Mozambique","authors":"Stela Ocuane Matsinhe ,&nbsp;Shahnaaz Suffla ,&nbsp;Tiffany Joy Hector","doi":"10.1016/j.jflm.2024.102778","DOIUrl":"10.1016/j.jflm.2024.102778","url":null,"abstract":"<div><h3>Background</h3><div>Child Sexual Abuse (CSA) is a significant public health issue, with its health and social consequences well documented. While CSA has been extensively studied in high-income countries, its incidence and circumstances of occurrence in low-income countries, especially in Africa, remains under-represented in the scholarly literature.</div></div><div><h3>Methods</h3><div>This study aimed to investigate the occurrence and circumstances of CSA among victims assisted at the Forensic Service of the Hospital Central de Maputo in Mozambique. A cross-sectional, quantitative study was conducted using secondary data from 2015 to 2020, extracted from the medico-legal reports of all victims under 18 years old. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 28.0.</div></div><div><h3>Results</h3><div>2610 cases of CSA were reported for the period 2015 to 2020, of which 2588 were included for analysis. Of the cases analysed, the majority of victims were girls (93.7 %), predominantly aged 12–17 years (48.6 %). The reported types of penetration revealed that vaginal penetration was the most frequent (86 %), followed by anal (11 %) and oral (2 %). Most assaults occurred either at the victims' or perpetrators’ homes (54.8 %), primarily during the week (71.1 %), and typically in the afternoon (36.5 %) or evening (41.9 %). The assaults were predominantly perpetrated by a single individual (88.7 %), who was most often identified as an acquaintance (72.9 %). Additionally, 54.1 % of the children experienced concomitant physical violence, and approximately 74.9 % of the perpetrators did not use condoms during the assault.</div></div><div><h3>Conclusions</h3><div>The findings of this study underscore the urgent need to implement prevention measures specifically targeting adolescent girls and younger boys, aiming to promote early reporting and prevent mental, physical, and sexual and reproductive health complications. Raising awareness about all forms of child abuse, including sexual abuse, and enhancing reporting and diagnostic systems in Mozambique is crucial.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"108 ","pages":"Article 102778"},"PeriodicalIF":1.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445658","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 retrospective study of the injury patterns seen in fatal falls downstairs","authors":"Kate McGoldrick ,&nbsp;SallyAnne Collis ,&nbsp;Linda Mulligan","doi":"10.1016/j.jflm.2024.102767","DOIUrl":"10.1016/j.jflm.2024.102767","url":null,"abstract":"<div><h3>Introduction</h3><div>Fatal falls involving stairs are often associated with advanced age, intoxication, acute natural pathology and less commonly – the involvement of a third-party. The injury patterns seen in these cases are often complex and from a medico-legal standpoint, determining third-party involvement based on pathology alone can prove a significant challenge. Classifying the manner of death in such cases, can become particularly complex when the injury pattern appears inconsistent with a simple fall downstairs, or there is an absence of eye-witness testimony.</div></div><div><h3>Aim</h3><div>To explore the circumstances and injury patterns seen in cases of fatal falls downstairs which were classified as accidental vs. undetermined by the coroners.</div></div><div><h3>Study design</h3><div>This retrospective study explored the injury patterns present in all cases of fatal falls downstairs referred to the Office of the State Pathologist (OSP) over a 10-year-period (2012–2022) (n = 51).</div></div><div><h3>Results</h3><div>Fatal falls downstairs which were classified as undetermined were found to have a greater number of craniofacial fractures, spinal fractures and intracranial injuries when compared to accidental falls. Undetermined staircase deaths also displayed more significant fracturing involving the facial skeleton.</div></div><div><h3>Conclusion</h3><div>Ultimately, where there is a question of third-party involvement, the Post-Mortem Examination (PME) findings alone cannot determine the manner of death. The pathologist's examination may identify injuries that are inconsistent with a simple fall downstairs, but it is the coroner who must conduct a thorough investigation into the circumstances of the fatal fall and ultimately determine the classification of the death.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"108 ","pages":"Article 102767"},"PeriodicalIF":1.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445543","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":"Age estimation at death in individuals over 50 using CT images: An innovative anthropological approach","authors":"Mohamed Kenani ,&nbsp;Marwa Boussaid ,&nbsp;Oumeima Brahim ,&nbsp;Mohamed Amine Mesrati ,&nbsp;Abir Aissaoui","doi":"10.1016/j.jflm.2024.102766","DOIUrl":"10.1016/j.jflm.2024.102766","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of the present work is to develop a novel method for predicting age in individuals over 50 years old, utilizing regression models.</div></div><div><h3>Methods</h3><div>The conducted study is of an analytical cross-sectional nature, involving a sample of 44 young subjects and 107 elderly subjects. The necessary data for this research were extracted from \"The New Mexico Decedent Image Database.\" Based on the phenomenon of height shrinkage with age, we created models for young subjects and applied them to elderly subjects, allowing us to extract the variables.</div></div><div><h3>Results</h3><div>We obtained highly encouraging results with an R² of 0.73, a mean absolute error of 3.94, and stable cross-validation. We used a Student's t-test, which demonstrated no significant difference between predicted and actual values (p-value &gt;0.05). We also conducted a learning curve analysis and examined residuals against predicted values. This suggests that the forecasts are accurate, with no significant bias in predictions.</div></div><div><h3>Conclusion</h3><div>This work has allowed us to conclude that it is possible to reliably estimate the age of subjects over 50, taking into account age-related physiological and pathological changes.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"108 ","pages":"Article 102766"},"PeriodicalIF":1.2,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407407","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":"“It changed my whole entire thinking”: Identifying narrative elements in medical affidavit writing for asylum seekers","authors":"Alexandria Yap ,&nbsp;Radhika Sundararajan ,&nbsp;Andrew Milewski ,&nbsp;Mert Keceli ,&nbsp;Mohammed Alkhafaji ,&nbsp;Rachel Kowalsky","doi":"10.1016/j.jflm.2024.102759","DOIUrl":"10.1016/j.jflm.2024.102759","url":null,"abstract":"<div><div>The medical affidavit is critically significant for asylum seekers. Studies have shown that asylum seekers applying with a medical affidavit (versus without a medical affidavit) have double the success rate. There are many training resources for clinician-evaluators on the interviewing process, but little instruction exists on the affidavit writing process. Our objective was to identify the most common narrative elements in medical affidavits of successful (versus unsuccessful) asylum seekers to provide further writing guidance for clinician-evaluators. We hypothesized that these elements, when thoughtfully employed, help clinician-evaluators best represent their clients in the US immigration system. We focused on the most vulnerable applicants: those applying after the one-year deadline. Using grounded theory, we coded 23 affidavits filed after the one-year deadline for narrative elements. We identified seven narrative elements more common in medical affidavits of asylum seekers who filed after the one-year deadline and were successful: (1) Recommending specific clinical interventions; (2) Quoting elevated diction by the client; (3) Using headlines; including anecdotes that describe (4) The client forming human connections, (5) Archetypal female characters, (6) Love stories, or (7) Moments of realization.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"107 ","pages":"Article 102759"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396344","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":"Fatality from Firework-Induced Trauma: A Case Report","authors":"Antun Ferenčić,&nbsp;Tomaž Zupanc,&nbsp;Martin Mervic","doi":"10.1016/j.jflm.2024.102761","DOIUrl":"10.1016/j.jflm.2024.102761","url":null,"abstract":"<div><div>This case report presents the tragic death of a 56-year-old Slovenian woman who sustained fatal injuries from a stray firework during a New Year's Eve celebration in January 2024. The firework, launched by a relative, struck the woman in the right eye, causing extensive cranial and cerebral trauma. Despite immediate medical intervention, including attempted resuscitation, the woman was pronounced dead at the scene. The autopsy revealed severe damage, including fractures extending from the right orbital cavity to the occipital region and a penetrating brain injury affecting multiple regions of the brain. The case is complicated by the removal of the firework from the injury site before the arrival of emergency services, making the reconstruction of the exact sequence of events challenging. The findings emphasize the devastating consequences of fireworks-related injuries and the unique forensic challenges they present in determining the precise cause of death.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"107 ","pages":"Article 102761"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335245","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":"Facial growth parameters in Down syndrome: Review of the literature and forensic application for missing persons age progression","authors":"Laura Donato ,&nbsp;Douglas H. Ubelaker ,&nbsp;Valentina Bugelli ,&nbsp;Jessika Camatti ,&nbsp;Michele Treglia ,&nbsp;Luigi Tonino Marsella ,&nbsp;Rossana Cecchi","doi":"10.1016/j.jflm.2024.102756","DOIUrl":"10.1016/j.jflm.2024.102756","url":null,"abstract":"<div><h3>Purpose</h3><div>Individuals with Down syndrome (DS) show growth trajectories which deviate from standard ones due to variations in the growth of facial structures. Studying the effect of aging on the faces of DS individuals is necessary to obtain an accurate result through age progression, a technique based on the study of physiognomic features and used in cases of missing persons. Here we present scientific publications that delve into the rhythms of aging and morphological characteristics of facial features in DS individuals to enable appropriate age progression in cases of missing DS individuals.</div></div><div><h3>Results</h3><div>The scientific literature considered in this review studies the growth of soft tissue and bone substrate by comparing standard growth values with those measured through anthropometric measurements of individuals with DS. Growth trajectories are described by considering morphological trends both by comparing standard values with those found in individuals with DS and by observing individual physiognomic traits.</div></div><div><h3>Conclusions</h3><div>When a young individual with DS goes missing, the realization of an age progression requires knowledge of the aging dynamics peculiar to the DS face. Therefore, physical, cognitive, and clinical factors must be considered. Delayed physical development and early aging, such as the onset of puberty and weight gain, have an important impact on the realization of age progression. In fact, depending on the life period to be considered, the effects of aging must be calibrated based on the knowledge gathered from scientific research.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"107 ","pages":"Article 102756"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356792","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 study to determine a practical method for weight estimation of deceased persons","authors":"Tess M. Wemeijer ,&nbsp;Inez Moorman ,&nbsp;Tristan Krap ,&nbsp;(H) Erik Stigter ,&nbsp;Wilma L.J.M. Duijst","doi":"10.1016/j.jflm.2024.102765","DOIUrl":"10.1016/j.jflm.2024.102765","url":null,"abstract":"<div><h3>Background</h3><div>Body weight is an important parameter for estimating the postmortem interval (PMI) at a crime scene. However, a challenge arises at crime scenes when a weight scale for measuring the total body weight is unavailable. Anthropometry-based models to estimate body weight have been developed in previous studies. This study aims to determine the accuracy of body weight estimations by practitioners, test the anthropometry-based models for applicability to deceased individuals, and examine a potential new method based on applying heel weight.</div></div><div><h3>Methods</h3><div>A prospective study was conducted at the Isala Hospital in the Netherlands. During the study period, deceased people that were admitted to the hospital mortuary were included consecutively. The body weight of deceased persons estimated by practitioners was compared to the actual body weight. Anthropometric measurements were taken and used to perform eight sex dependant anthropometry-based models, with accuracy for the actual body weight calculated using RMSE values. A Pearson's correlation test was used to determine the correlation between heel weight and total body weight.</div></div><div><h3>Results</h3><div>During the study period, a total of 100 cases, 56 males and 44 females, were included. Overall, only 33.3 % of practitioners' estimations were within 5 % of the actual measured weight. The model based on abdominal and thigh circumference performed best for weight estimation in males and the models based on mid-arm circumference, abdominal circumference, calf circumference and, in one model, subscapular skinfold performed best in females. A Pearson's correlation test revealed a weak positive correlation between weight of the heel and total body weight (Pearson's correlation coefficient: 0.214).</div></div><div><h3>Discussion</h3><div>Estimations of underweight or obese patients posed a challenge for weight estimation. Especially in these cases, study results showed that anthropometry-based models have potential for daily practice. However, additional research is required to assess the reliability of the best performing models before implementation in forensic casework. The correlation between the weight of the heel and body weight was low, therefore implementation of the current method is not recommended, and further research is required.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"107 ","pages":"Article 102765"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396345","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":"In vitro β-hydroxybutyrate stability evaluation in femoral blood and vitreous humor for integration into forensic toxicology practices","authors":"Aurélien Bauduin ,&nbsp;Chadi Abbara ,&nbsp;Antoine Baudriller ,&nbsp;Laurent Leuger ,&nbsp;Séverine Ferec ,&nbsp;Stéphane Malbranque ,&nbsp;Nathalie Jousset ,&nbsp;Marie Briet ,&nbsp;Guillaume Drevin","doi":"10.1016/j.jflm.2024.102764","DOIUrl":"10.1016/j.jflm.2024.102764","url":null,"abstract":"<div><div>Thanatological biochemistry has gained prominence in determining causes of death, especially when suspected fatal pathologies do not exhibit clear postmortem macroscopic and/or microscopic features, such as in cases of ketoacidosis. Indeed, in these cases, the measurement of β-hydroxybutyrate (BHB) in femoral blood and/or vitreous humor is of particular importance. However, data on its in vitro stability remain scarce, especially in vitreous humor. In this context, the study reported here aims to assess the in vitro stability of BHB. BHB quantification was performed using a liquid chromatography coupled with tandem mass spectrometry method. To investigate BHB stability, two different postmortem matrices were considered: femoral blood and vitreous humor. These matrices were pooled, aliquoted and spiked with BHB at three different concentrations (50 mg/L, 100 mg/L, and 200 mg/L; n = 3). Initial BHB concentrations were established on day 1. Each sample was then divided into two aliquots for storage under two conditions: 20 °C and 4 °C. Analyses were performed on Day 3, 7, 14, and 28. The study revealed no significant degradation of BHB in femoral blood or vitreous humor over time (days 1–28), confirming the robustness and reliability of BHB measurement in these matrices as a postmortem biomarker of ketoacidosis under the tested temperature conditions (+4 °C or −20 °C). These results support a systematic integration of BHB measurement into the routine workflow of forensic toxicology laboratories<strong>.</strong></div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"107 ","pages":"Article 102764"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356793","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":"Between blunt, sharp and hacking trauma: Observing the characteristics of pickaxe injuries","authors":"Alberto Amadasi ,&nbsp;Lorenzo Franceschetti ,&nbsp;Julia Babigian ,&nbsp;Antonia Locatelli ,&nbsp;Larissa Amadasi","doi":"10.1016/j.jflm.2024.102763","DOIUrl":"10.1016/j.jflm.2024.102763","url":null,"abstract":"<div><div>Pickaxe injuries have never been thoroughly investigated in forensic science. This case, involving the fatal wounding of a 28-year-old individual by pickaxe blows to the head, abdomen, and hand, highlights the unique injury patterns associated with such an instrument. The injuries observed in the frontal skull exhibited characteristics akin to typical chop wounds, while those on the parietal skull bore similarities to blunt force trauma. The pickaxe penetrated the hands and the abdomen, with the depth of penetration directly correlating to the force applied. Consequently, pickaxe injuries can be considered a hybrid of different injury mechanisms, a fact that should be carefully considered in forensic analysis.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"107 ","pages":"Article 102763"},"PeriodicalIF":1.2,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327220","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}