Journal of forensic and legal medicine最新文献

{"title":"From over-the-counter to criminal evidence: Pharmacological profiles, analytical methods, and forensic insights into diphenhydramine's role in drug-facilitated crime","authors":"Richard Cherehani Kashindye ,&nbsp;Divya Yadav ,&nbsp;Rakesh Yadav","doi":"10.1016/j.jflm.2026.103085","DOIUrl":"10.1016/j.jflm.2026.103085","url":null,"abstract":"<div><h3>Background</h3><div>Diphenhydramine (DPH), a widely available over-the-counter antihistamine, has increasingly been implicated in DFCs, including sexual assault, pediatric abuse, and homicide. In several forensic investigations, DPH was detected in up to 13% of DFCs cases, with the highest prevalence reported in South Africa (12.1%), followed by France (10.0%) and the United States (10.2%). The sedative and amnestic effects of this drug, along with how easily it can be obtained, make it a substance of concern in DFCs. Detecting the drug can be challenging, mainly when metabolism occurs quickly, and there are delays in sample collection or case reporting.</div></div><div><h3>Methods</h3><div>A systematic review was carried out across major scientific databases, such as PubMed, and Scopus, using relevant keywords. Additionally, reports from international bodies such as the United Nations Office on Drugs and Crime (UNODC) and the Society of Hair Testing (SoHT) were also reviewed.</div></div><div><h3>Results</h3><div>The review compiles case evidence of DPH misuse, details its pharmacokinetics and toxicodynamics, and evaluates detection in biological matrices (blood, urine, hair, oral fluid). Analytical approaches, including LC-MS/MS, UHPLC-MS/MS, and LC-HRMS, are discussed, along with sample extraction methods including liquid-liquid and solid-liquid extraction.</div></div><div><h3>Conclusions</h3><div>DPH poses unique forensic challenges due to its low detectability and legal status. Hair analysis and high-resolution techniques offer extended detection capabilities in delayed cases. Increased forensic vigilance and validated analytical workflows are essential to address the covert misuse of DPH in DFCs</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103085"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114856","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":"Re: “A systematic review about the evolving role of artificial intelligence in various fields of forensic medicine.”","authors":"M. Vijayasimha ,&nbsp;M. Srikanth","doi":"10.1016/j.jflm.2026.103076","DOIUrl":"10.1016/j.jflm.2026.103076","url":null,"abstract":"","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103076"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914310","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 wound ballistic research: Computed tomography analysis of projectile effects in simulants","authors":"Dominic Gascho","doi":"10.1016/j.jflm.2025.103061","DOIUrl":"10.1016/j.jflm.2025.103061","url":null,"abstract":"<div><div>Wound ballistics, a key area within forensic medicine, focuses on the interaction between projectiles and biological tissue. Central to this is the analysis of temporary and permanent wound cavities created during projectile penetration. The aim of this article is to provide a comprehensive overview of the application of computed tomography (CT) in the analysis of ballistic wound cavities in tissue simulants. It highlights the advantages of CT over traditional destructive methods, focusing on its accuracy, reproducibility, and ability to deliver detailed three-dimensional insights into projectile-tissue simulant interactions. Simulants like ordnance gelatin and glycerin soap are commonly used for research, offering distinct advantages in representing soft tissue properties. CT has emerged as a powerful, non-destructive tool for visualizing and quantifying wound cavities, crack lengths, and projectile fragmentation within these simulants. This imaging modality provides high-resolution, three-dimensional datasets, enabling precise measurement of penetration depth, cavity volume, and energy transferred to the medium along the projectile path. Multi-planar reformations and volume rendering techniques facilitate detailed visualization, while segmentation software allows accurate cavity volume calculations. CT also enables spatial mapping of metallic fragments and fracture morphology in synthetic bone models or injuries in embedded biological organs. Compared to traditional destructive methods, CT offers superior precision, digital archiving capabilities, and detailed internal visualization, making it an increasingly indispensable tool in wound ballistic research and forensic investigations. Over the past two decades, numerous studies have validated CT-based ballistic analysis across a wide range of scenarios.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103061"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928457","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":"Family satisfaction with forensic autopsy in Japan: The role of medical explanation and supportive environment","authors":"Gentaro Yamasaki ,&nbsp;Motonori Takahashi ,&nbsp;Takeshi Kondo ,&nbsp;Ryuichi Katada","doi":"10.1016/j.jflm.2026.103090","DOIUrl":"10.1016/j.jflm.2026.103090","url":null,"abstract":"<div><h3>Introduction</h3><div>The present study aimed to assess family satisfaction with forensic autopsies. Currently, there is a scarcity of surveys on this topic.</div></div><div><h3>Materials and methods</h3><div>An anonymous self-administered questionnaire survey was conducted with families whose relatives underwent autopsy at our facility.</div></div><div><h3>Results</h3><div>The response rate was 87%, and 78% of the respondents were satisfied with the process. Statistically significant differences were found between the satisfied and dissatisfied groups regarding “initial willingness for autopsy,” “atmosphere of waiting room,” “understanding of autopsy results,” and “acceptance of cause of death.”</div></div><div><h3>Discussion</h3><div>Direct medical explanations by forensic pathologists can enhance bereaved families' understanding. Additionally, providing a private and supportive environment is also essential. Such efforts can contribute to grief care and be further improved through multi-disciplinary collaboration.</div></div><div><h3>Conclusion</h3><div>These findings highlight the need for direct explanations and supportive environments to guide future forensic practice.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103090"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170099","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":"From skull to face: MRI vs. CBCT-based soft tissue depths in forensic 3D craniofacial reconstruction","authors":"Anurag Dubey ,&nbsp;Raja Rupani ,&nbsp;Garima Sehgal ,&nbsp;Anit Parihar ,&nbsp;Ashutosh Deo Tiwari ,&nbsp;Shiuli Rathore ,&nbsp;Anoop Kumar Verma ,&nbsp;Abhishek Mishra ,&nbsp;Sandeep Bhattacharya","doi":"10.1016/j.jflm.2026.103073","DOIUrl":"10.1016/j.jflm.2026.103073","url":null,"abstract":"<div><div>Facial soft tissue thickness (FSTT) constitutes one of the most critical variables in forensic craniofacial reconstruction, and the application of advanced imaging modalities such as magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) can strengthen confidence in these technologies. Using MRI, we evaluated FSTT at 29 anatomical landmarks in 36 healthy adults. We conducted standardised infrared facial imaging on the same participants to obtain 26 anthropometric measurements. We generated three digital facial reconstructions using anonymised three-dimensional skull models and ZBrush software. Under double-blinded conditions, we reconstructed two skulls, one male and one female. In the female case, we applied a postural correction factor to account for the supine imaging orientation, whereas we completed the male reconstruction without adjustment. We assessed the anatomical accuracy of both reconstructions using public recognition surveys and facial resemblance analysis with FaceVACS software. For the third case, we applied region-specific FSTT values derived from CBCT in a real forensic investigation in Karnataka, India. Investigators disseminated the reconstructed face as an investigative aid and subsequently contributed to the identification of a missing person, with identity confirmed through police records. These findings indicate that posture-corrected MRI-derived data and regionally calibrated CBCT datasets improve anatomical accuracy in three-dimensional facial reconstruction, thereby enhancing its utility in forensic identification, particularly within the Indian context.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103073"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047578","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":"Examining the role of cyanide poisoning in the autopsies of closed-space fire deaths in Istanbul (Türkiye)","authors":"Mustafa Okudan ,&nbsp;Doruktan Tufekci ,&nbsp;Fatma Ofluoglu ,&nbsp;Mahmut Asirdizer","doi":"10.1016/j.jflm.2026.103071","DOIUrl":"10.1016/j.jflm.2026.103071","url":null,"abstract":"<div><h3>Background</h3><div>Most deaths in closed-space fires occur due to inhalation of carbon monoxide, hydrogen cyanide, and other gases in the environment.</div></div><div><h3>Material and methods</h3><div>This study retrospectively examined 42 forensic autopsy reports and the associated crime scene reports of individuals who died in indoor fires. The autopsies were performed at the Morgue Department of the Forensic Medicine Institute in 2022 and 2023.</div></div><div><h3>Results</h3><div>Cyanide analysis was not conducted in 33.3 % of the 42 cases, and cyanide was detected in only 10.7 % of the 28 cases in which blood cyanide analysis was requested. All cases had positive carboxyhemoglobin levels, although 76.2 % of cases had HbCO values more than 10 %. More than half of the deaths occurred at the scene, primarily in the victims' homes. All cases had burns on their bodies, ranging from second degree to carbonization degree, and soot contamination in the upper and lower respiratory tracts was determined in 77.7 %. The toxicological analysis of blood from victims who received medical treatment, either in ambulances or hospitals, showed no evidence of antidote administration.</div></div><div><h3>Conclusion</h3><div>The findings of this study highlight the importance of collecting blood samples from the bodies of those who have died at the fire scene, administering cyanide antidotes to survivors via immediate intravenous injection after smoke exposure, and testing survivors for metabolites due to the short half-life of cyanide. For the prevention of cyanide poisoning exposure, and implementation of the administrative actions and training that medical professionals in Türkiye should undertake to assist victims who survive smoke exposure, a brief review is also provided of the legal requirements that must be followed in the construction and interior design of buildings where people congregate.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103071"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914283","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 post-mortem audit of the prevalence of ketoacidosis in diabetes and alcohol dependency","authors":"Peter Vanezis ,&nbsp;Rebecca Andrews ,&nbsp;Limon Nahar ,&nbsp;Ganesh Raj Selvaraja ,&nbsp;Andrew Vanezis","doi":"10.1016/j.jflm.2026.103088","DOIUrl":"10.1016/j.jflm.2026.103088","url":null,"abstract":"<div><h3>Introduction</h3><div>Ketoacidosis is a form of metabolic acidosis caused by the excess production of ketone bodies. It can be commonly found in the context of both diabetes mellitus and alcohol dependency but is also associated with a myriad other aetiologies. To date the extent of risk of developing ketoacidosis is unclear in diabetic persons who are alcohol dependent and/or have abused alcohol acutely as in ‘binge drinking’.</div></div><div><h3>Methodology</h3><div>We performed a retrospective analysis of consecutive coroners' autopsies between 2015 and 2023 in a London Coroner's jurisdiction of individuals aged 18 years and above to assess whether significant ketoacidosis, when present, was of diabetic or alcoholic aetiology or a combination of both. Data was obtained from the medical history, circumstances of death, histology, toxicology and biochemical markers. The deceased individuals were surveyed and categorised into the following three groups: 1. Individuals with diabetes mellitus type 1or 2 and with no known history of alcohol dependency according to their medical history; 2. Alcohol dependent persons or persons abusing alcohol acutely, without diabetes mellitus; 3. Diabetic individuals with known alcohol dependency or acute abuse as in ‘binge drinking’. Individuals suffering from other causes of ketoacidosis were excluded.</div></div><div><h3>Results</h3><div>From an overall total of 3873 autopsies performed of persons 18 years or above over a 9-year period (2015-2023), 1021 cases were analysed and divided into three groups as stated above. Group 1 consisted of 635 diabetic individuals, with ketoacidosis present in 23 (3.6%). Group 2 consisted of 333 individuals with alcohol dependency, in which ketoacidosis was present in 17 (5.1%). Group 3 consisted of 56 individuals, with both diabetes and alcohol dependency, in which ketoacidosis was present in 7 (13%).</div></div><div><h3>Conclusions</h3><div>This study demonstrated a statistically significant risk of developing ketoacidosis in all individuals with both diabetes mellitus and alcohol dependency (Group 3) when compared to diabetics alone (Group 1): Risk ratio = 3.8; p = .0001). There was less but significant increased risk when females alone were compared in these two groups. Less but significant increased risk was also found in all Group 3 individuals when compared to those in the alcohol alone category (Group 2) or when all individuals or males alone were compared between Group 1 + Group 2 with those in (Group 3). There was no significant increased risk when diabetics in Group 1 were compared to persons with alcohol dependency in Group 2.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103088"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170205","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":"Post-mortem CT scan reveals sequential self-inflicted gunshot wounds to the head: Initial non-lethal followed by fatal injury","authors":"Sylvain Grange ,&nbsp;Carolyne Bidat-Callet ,&nbsp;Elodie Hattat ,&nbsp;Claire Boutet ,&nbsp;Natalia Gorelik","doi":"10.1016/j.jflm.2026.103092","DOIUrl":"10.1016/j.jflm.2026.103092","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-mortem imaging plays a crucial role in forensic investigations. While self-inflicted gunshot wounds to the head are common, cases involving multiple shots, especially with a clear sequential pattern, are extremely rare.</div></div><div><h3>Case presentation</h3><div>We report the case of an 82-year-old man found deceased by his wife, seated in a chair with a 9mm firearm on his lap. Two ejected shell casings were found nearby. No signs of struggle or forced entry were noted. The decedent had a known history of metastatic prostate cancer and had previously expressed suicidal ideation.</div></div><div><h3>Technique and imaging findings</h3><div>Post-mortem CT-scan (PMCT) allowed precise visualization of entrance and exit wounds, fractures, bullet paths, and hemorrhagic patterns. The fractures from the second shot stopped against the fractures from the first shot, revealing the direction and chronology of the injuries: a non-lethal submental gunshot followed by a fatal right temporal shot.</div></div><div><h3>Discussion</h3><div>This case highlights the forensic value of PMCT in determining the chronological order of gunshot wounds. The imaging confirmed the cause of death and established the sequence of injuries, crucial for medico-legal investigations.</div></div><div><h3>Conclusion</h3><div>PMCT provides non-invasive, high-resolution insights into bone trauma. In cases of multiple self-inflicted gunshots, it can help establish the precise chronology of injuries, supporting forensic analysis.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103092"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170098","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 clonazepam on developmental stages of Calliphora vicina Robineau-Desvoidy 1830 (Diptera: Calliphoridae) and its implications for PMI estimation","authors":"Bahriye Ayaz ,&nbsp;Ferhat Altunsoy","doi":"10.1016/j.jflm.2026.103093","DOIUrl":"10.1016/j.jflm.2026.103093","url":null,"abstract":"<div><div>Clonazepam (Rivotril®) is among the most widely prescribed benzodiazepines. However, its non-therapeutic use carries a substantial risk of misuse, dependence, and fatal overdose. The presence of such substances in tissues has the potential to complicate post-mortem interval (PMI) estimations in forensic entomology by altering insect growth rates. The present study investigated the effects of clonazepam on the developmental duration, larval weight and length of <em>Calliphora vicina</em> Robineau-Desvoidy 1830 (Diptera: Calliphoridae) under controlled laboratory conditions. Larvae were reared on bovine lung tissues treated with varying concentrations of clonazepam, and developmental duration, larval weight, and length were systematically recorded until adult emergence. The results demonstrated that Clonazepam exposure produced significant, concentration-dependent alterations in development. At the highest concentration tested, larval development was prolonged by 40 h, with a total developmental delay of up to 64 h compared with the control group. Furthermore, larval weight and length were significantly reduced, with developmental responses varying across larval, pupal, and post-feeding stages. Notably, this study reveals for the first time that clonazepam significantly delays the developmental stages of <em>C</em>. <em>vicina</em>. These findings underscore the necessity of correcting PMI estimates in cases of benzodiazepine intoxication, as ignoring this delay could lead to an underestimation of the time since death.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103093"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215222","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":"Physician awareness of the ICD-10 coding system for assigning the cause of death in primary health centers in Muscat and South Batinah governorates, Oman","authors":"Omar Al Farsi ,&nbsp;Raniya Al Kiyumi ,&nbsp;Akram Al Adawi ,&nbsp;Faiz Al Harmali","doi":"10.1016/j.jflm.2026.103072","DOIUrl":"10.1016/j.jflm.2026.103072","url":null,"abstract":"<div><h3>Background</h3><div>Accurate mortality statistics are vital for establishing health policies. However, reporting numerous undetermined causes of death especially in the primary healthcare hinder the accuracy and usefulness of vital statistics, impacting resource allocation for disease prevention and control. Utilizing International Classification of Diseases (ICD-10) coding systems and addressing physician-related challenges are essential to improve the quality of mortality data and support effective policymaking. Therefore, this study aims to assess physicians' awareness in assigning accurate causes of death at the primary healthcare institutions.</div></div><div><h3>Methods</h3><div>A cross-sectional study conducted with 202 physicians from the primary health care institutions in Muscat and South Batinah governorates. A convenience sampling method has been used to distribute self-administered questionnaire.</div></div><div><h3>Results</h3><div>The findings indicated that a higher proportion of physicians were familiar with the ICD-10 coding and World Health Organization (WHO) guidelines, with (41.9 %) of non-Omani physicians demonstrating awareness, compared to (22 %) of Omani physicians. Both groups showed limited knowledge about the use of garbage codes, with a notable proportion unaware of their implications. Additionally, challenges in determining the underlying cause of death (UCOD) were reported, with (48.6 %) Omani physicians facing difficulties, compared to (40.9 %) of the other group. Training gaps and lack of feedback from the Ministry of Health (MoH) were identified as contributing factors affecting both groups.</div></div><div><h3>Conclusion</h3><div>The findings highlight key implications for policy and practice in coding mortality data. Ongoing awareness programs for physicians on ICD-10 coding system are essential, and establishing structured feedback channels with the MoH is crucial to improve data quality.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"118 ","pages":"Article 103072"},"PeriodicalIF":1.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968213","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}