Journal of forensic and legal medicine最新文献

{"title":"Exploration of \"out of hours\" calls to the Child and Adolescent Sexual Assault Treatment Service in Galway over a one-year period to quantify need for continued extended hours service.","authors":"Erica Lahoud, Joanne Nelson, Cathy Bergin","doi":"10.1016/j.jflm.2025.102978","DOIUrl":"https://doi.org/10.1016/j.jflm.2025.102978","url":null,"abstract":"<p><strong>Introduction: </strong>The Galway Child and Adolescent Sexual Assault Treatment Service (CASATS) operates within a Barnahus model on site on weekdays from 08.00 to 16.00 h with 24/7/365 out of hours on call availability. The service is localised to West and Mid-West Ireland for \"in hours\" examinations but covers the whole of Southern Ireland for \"out of hours\" examinations. Whilst CASATS supports children under 18 years of age, \"out of hours\" forensic medical examinations (FME) are predominantly children under 14 years of age as the adult sexual assault treatment units (SATU) in Ireland offer acute FME to patients from 14 years up. The overlapping 14-18 age group between adult SATU and CASATS makes commissioning challenging. Service specifications in Ireland recommend working towards provision of a 12/7 (08.00-20.00 h) service for paediatric FME, but do not detail recommendations for \"out of hours\" care for children under 14 years after 20.00 h. This review sought to quantify the number of \"out of hours\" telephone queries from professionals exploring the need for a paediatric FME for suspected sexual harm and the number of children subsequently examined \"out of hours\" by Galway CASATS in 2024 to determine the need for a continued extended hours service. \"Out of hours\" included Saturdays, Sundays, bank or public holidays and between 16.00 and 08.00 on weekdays.</p><p><strong>Methods: </strong>Data were collected anonymously through retrospective review of medical notes and from records of telephone queries received from January 01, 2024 to December 31, 2024. Inclusion criteria were (a) All telephone queries to Galway CASATS (\"in\" and \"out of hours\") relating to the need for FME in children (<18 years) where sexual harm had been disclosed, witnessed or strongly suspected (b) All \"in\" and \"out of hours\" FMEs undertaken in Galway CASATS for children (<18 years) including those where agreement had been reached that FME would be beneficial, following discussion (\"in hours\") at Barnahus West Interagency planning meetings. Exclusion criteria were (i) Children for whom FME was not indicated, following \"in hours\" interagency Barnahus discussion (ii) The 41 Children 14-18 years in 2024 supported through the adult sexual assault treatment units, all eligible for Barnahus support.</p><p><strong>Results: </strong>The number of telephone queries and requests for FME arising from Barnahus West in 2024 related to 126 children. Thirty-eight telephone queries concerning 42 children were received outside of Galway CASATS' normal workday of 08.00-16.00 h. Seventeen calls concerning 20 children were received outside the 08.00-20.00 h 12/7 paediatric FME service specifications for Ireland. Of the 93 children who attended for FME in Galway CASATS in 2024, 19 (19/93 = 20 %) required urgent \"out of hours\" examination (outside of 08:00-16:00 Monday to Friday workweek) of whom 5 (5/93 = 5 %) required examination outside of 08.00-20.00 h 12/7 paediatric FME servic","PeriodicalId":94078,"journal":{"name":"Journal of forensic and legal medicine","volume":"116 ","pages":"102978"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical gunshot injuries: A review of case reports and case series.","authors":"Alok Atreya, Bijeta Pokharel, Dipika Khadka, Prerana Basnet, Sharmila Gurung, Neelu Hirachan, Ritesh G Menezes","doi":"10.1016/j.jflm.2025.102981","DOIUrl":"https://doi.org/10.1016/j.jflm.2025.102981","url":null,"abstract":"<p><strong>Background and aim: </strong>Gunshot injuries are important public health concerns that contribute significantly to disability and mortality, but atypical cases remain underexplored. This review synthesizes the published literature to identify factors that experts/authors use to classify gunshot injuries as atypical, intending to deepen insights and improve forensic interpretations and clinical outcomes.</p><p><strong>Methods: </strong>Following a scoping review framework, we searched PubMed using keywords related to the terms \"atypical,\" \"gunshot,\" and \"case report.\" We included peer-reviewed case reports and case series in English with no date restrictions. We excluded reviews, typical injury studies, animal studies, and non-English publications. Data were extracted into an Excel spreadsheet to identify patterns in injury characteristics and forensic/clinical implications.</p><p><strong>Results: </strong>From the 390 records identified, 237 records spanning 1977-2024 were analyzed after screening. Cases were predominantly concentrated in North America and Europe. The classifications of atypical entities fall into four main categories or themes: unusual anatomical locations, aberrant wound patterns, unconventional weapons or ammunition, and unanticipated clinical presentations or complications and unique treatment.</p><p><strong>Conclusions: </strong>These findings challenge standard ballistic and clinical assumptions and emphasize the need for enhanced forensic tools and individualized treatment approaches in the management of such patients. This scoping review addresses a critical gap by providing forensic experts with better interpretation frameworks and clinicians with refined care strategies.</p>","PeriodicalId":94078,"journal":{"name":"Journal of forensic and legal medicine","volume":"116 ","pages":"102981"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of artificial intelligence in analyzing clinical malpractice disputes through medical record management.","authors":"Lucio Di Mauro, Emanuele Capasso, Camilla Tettamanti, Claudia Casella, Martina Francaviglia, Gianpietro Volonnino, Raffaella Rinaldi, Massimiliano Esposito, Mario Chisari","doi":"10.1016/j.jflm.2025.102941","DOIUrl":"https://doi.org/10.1016/j.jflm.2025.102941","url":null,"abstract":"<p><p>The integration of Artificial Intelligence (AI) into healthcare has revolutionized various aspects of clinical practice, including the management of medical malpractice disputes. AI-driven technologies, particularly machine learning (ML) and natural language processing (NLP), enable the automated analysis of electronic health records (EHRs) and other medical documentation, improving the efficiency, accuracy, and transparency of malpractice investigations. By systematically identifying inconsistencies, detecting patterns of errors, and evaluating compliance with clinical guidelines, AI systems offer valuable insights into potential negligence claims. This study examines the impact of AI on medical record management in malpractice disputes, addressing its role in mitigating human biases, enhancing forensic assessments, and supporting legal decision-making. AI-powered algorithms facilitate objective analysis by cross-referencing vast datasets of patient histories, diagnostic reports, and treatment protocols, thus strengthening the evidentiary basis for malpractice claims. However, despite its advantages, the use of AI in forensic and legal medicine raises significant ethical and legal concerns, including issues of accountability, data privacy, and algorithmic bias. Questions regarding liability in AI-assisted medical decision-making and the potential risk of over-reliance on automated assessments must be critically addressed. To maximize AI's benefits while minimizing risks, robust regulatory frameworks, interdisciplinary collaboration, and ethical oversight are essential. Ensuring transparency in AI-driven decision-making and safeguarding patient rights will be crucial in fostering trust in these technologies. The findings suggest that AI-assisted medical record analysis can significantly enhance dispute resolution processes by providing standardized, data-driven evaluations of malpractice claims, ultimately contributing to more equitable and efficient healthcare litigation.</p>","PeriodicalId":94078,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"102941"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"As precisely as possible! Molecular methods of postmortem interval prediction - current prospects and limitations.","authors":"Magdalena Mróz, Martyna Miodońska, Julia Cieśla, Rafał Skowronek, Marcin Tomsia","doi":"10.1016/j.jflm.2025.102946","DOIUrl":"https://doi.org/10.1016/j.jflm.2025.102946","url":null,"abstract":"<p><p>Determining the time passing since death, also known as post-mortem interval (PMI), is one of the primary duties of forensic medicine. However, standard methods of PMI estimation only sometimes allow for accurate determination of its value because many internal and external factors influence the estimate's accuracy. In recent years, several studies have reported using molecular biology and genetics methods in PMI estimation. Due to the promising results obtained in both animal and human models, these methods can replace existing techniques in the future and allow PMI to be determined more precisely. The presented narrative review analyzes methods of molecular biology already available and used to estimate PMI, outlines the latest reports on determining PMI using molecular methods, and summarizes research on using RNA, DNA, and other biochemical molecules for PMI estimation. Moreover, the presented review indicates limitations of using molecular methods for molecular PMI estimation that need to be solved before entering forensic practice and underlines prospects for further research in this area.</p>","PeriodicalId":94078,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"102946"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in forensic neuropathology: A systematic review.","authors":"Michele Treglia, Raffaele La Russa, Gabriele Napoletano, Alessandro Ghamlouch, Fabio Del Duca, Biancamaria Treves, Paola Frati, Aniello Maiese","doi":"10.1016/j.jflm.2025.102944","DOIUrl":"https://doi.org/10.1016/j.jflm.2025.102944","url":null,"abstract":"<p><strong>Background and objectives: </strong>In recent years, Artificial Intelligence (AI) has gained prominence as a robust tool for clinical decision-making and diagnostics, owing to its capacity to process and analyze large datasets with high accuracy. More specifically, Deep Learning, and its subclasses, have shown significant potential in image processing, including medical imaging and histological analysis. In forensic pathology, AI has been employed for the interpretation of histopathological data, identifying conditions such as myocardial infarction, traumatic injuries, and heart rhythm abnormalities. This review aims to highlight key advances in AI's role, particularly machine learning (ML) and deep learning (DL) techniques, in forensic neuropathology, with a focus on its ability to interpret instrumental and histopathological data to support professional diagnostics.</p><p><strong>Materials and methods: </strong>A systematic review of the literature regarding applications of Artificial Intelligence in forensic neuropathology was carried out according to the Preferred Reporting Item for Systematic Review (PRISMA) standards. We selected 34 articles regarding the main applications of AI in this field, dividing them into two categories: those addressing traumatic brain injury (TBI), including intracranial hemorrhage or cerebral microbleeds, and those focusing on epilepsy and SUDEP, including brain disorders and central nervous system neoplasms capable of inducing seizure activity.</p><p><strong>Results: </strong>In both cases, the application of AI techniques demonstrated promising results in the forensic investigation of cerebral pathology, providing a valuable computer-assisted diagnostic tool to aid in post-mortem computed tomography (PMCT) assessments of cause of death and histopathological analyses.</p><p><strong>Conclusions: </strong>In conclusion, this paper presents a comprehensive overview of the key neuropathology areas where the application of artificial intelligence can be valuable in investigating causes of death.</p>","PeriodicalId":94078,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"102944"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From risk to resilience: Understanding and mitigating juvenile delinquency.","authors":"İnci Yağmur Tezbasan Arslan, Murat Nihat Arslan, Mehmet Korkut","doi":"10.1016/j.jflm.2025.102940","DOIUrl":"https://doi.org/10.1016/j.jflm.2025.102940","url":null,"abstract":"<p><p>Juvenile delinquency is a significant global issue that impacts individuals, families, and communities, necessitating an understanding of its underlying causes for effective intervention. This study aims to identify the demographic, educational, familial, and social factors contributing to juvenile delinquency among adolescents in Turkey, with the goal of informing comprehensive prevention and rehabilitation strategies. A prospective, interview-based study was conducted involving 225 adolescents aged 12-15 years who were referred for mental evaluation due to criminal activities. Data were collected through structured interviews by forensic medicine specialists, covering aspects such as the type of crime, educational status, family structure, prior criminal behaviors, substance use, and mental maturity examination results. The findings reveal a significant gender disparity in delinquent behaviors, with males predominantly involved in theft, physical assault, and drug trafficking, while females were more engaged in theft and drug use. Lower educational attainment was strongly linked to higher rates of delinquency, underscoring the need for improved educational support and vocational training as preventive measures. Family dynamics also played a crucial role, with children from single-parent families or those with poor parental supervision being more prone to criminal activities. Additionally, a significant association was found between the criminal history of parents and the likelihood of juveniles committing crimes, highlighting the importance of comprehensive family support programs. Substance use, particularly smoking and drug addiction, was associated with higher rates of theft, drug trafficking, and physical assault, indicating the necessity of psychological support and substance abuse treatment in addressing juvenile delinquency. The study emphasizes the importance of rehabilitative measures, including family support, education, vocational training, psychosocial support, and community involvement, to reduce offending tendencies and facilitate the reintegration of juveniles into society. This study highlights the complex interplay of factors influencing juvenile delinquency and advocates for targeted, multifaceted interventions to promote the well-being and rehabilitation of young offenders.</p>","PeriodicalId":94078,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"102940"},"PeriodicalIF":0.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood extravasations in the vaginal and rectal mucosa: probably underdiagnosed findings in female victims of sexual homicide.","authors":"M Große Perdekamp, S Pollak, U Schmidt, V Thoma","doi":"10.1016/j.jflm.2025.102936","DOIUrl":"https://doi.org/10.1016/j.jflm.2025.102936","url":null,"abstract":"<p><p>In suspected sex-related homicides, special attention is paid to morphological and trace evidence suggesting a sexual assault. As far as anogenital lesions are concerned, injuries may be located externally (affecting the vulva, perineum and anus) or internally. In the latter case, the vagina, the cervix and the rectal wall can be involved. Among the findings associated with sexual homicides, mainly striking injuries such as perforations, lacerations and deep abrasions of the vagina and/or rectum are mentioned in textbooks and autopsy reports. In contrast, the presence of non-penetrating mucosal lesions such as petechiae, ecchymoses and more extensive blood extravasation is rarely noticed. Based on two exemplary cases, the macroscopic and histological appearance of haemorrhages within the vaginal and rectal mucosa are demonstrated in synopsis with concomitant signs of anogenital trauma. Locally acting shear forces followed by ruptures of small vessels are considered to be the most important injury mechanism. Contributing factors may result from special circumstances of the individual case such as the offender's modus operandi.</p>","PeriodicalId":94078,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"102936"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A primary study of ethanol production in postmortem liver and muscle tissue of rats","authors":"Qing Gao, Fanggang He, Hao Wang, Weisheng Huang, Hongmei Dong","doi":"10.1016/j.jflm.2024.102653","DOIUrl":"https://doi.org/10.1016/j.jflm.2024.102653","url":null,"abstract":"","PeriodicalId":94078,"journal":{"name":"Journal of forensic and legal medicine","volume":"206 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139824534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the prevalence of genital injuries amongst patients attending Saint Mary's sexual assault referral centre following an allegation of digital penetration","authors":"R. Majeed‐Ariss, Glen P. Martin, Catherine White","doi":"10.1016/j.jflm.2024.102656","DOIUrl":"https://doi.org/10.1016/j.jflm.2024.102656","url":null,"abstract":"","PeriodicalId":94078,"journal":{"name":"Journal of forensic and legal medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139812073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}