Medico-legal evaluation of deficiencies in the definition of wound depth in forensic reports: a retrospective study.

OBJECTIVE: One of the most important parts of accurate wound definition is wound depth. In our study, we aimed to reveal the deficiencies in the depth of wound definition in the general forensic examination forms prepared in the emergency services and to increase the awareness of the physicians responsible for preparing the general forensic examination form. MATERIALS AND METHODS: In our study, we included cases from the years 2020 to 2021 that were evaluated by our team upon seeking assistance from the Department of Forensic Medicine at Tokat Gaziosmanpasa University Medical School. These cases involved requests for final forensic reports following injuries. The general forensic reports of the cases were scrutinized concerning wound identification and whether they provided information regarding wound depth in the identification process. RESULTS: It was observed that 97 of 770 general forensic examination reports included a definition of wound depth. In only 27 of these cases, it was determined that the wound depth was specified in centimeters. CONCLUSIONS: The lack of definition of wound depth in forensic examination reports is an important deficiency. Physicians working in the emergency department are required to provide detailed information about the depth of the wound when preparing a general forensic examination report since it affects criminal law. In cases where it is not possible to measure the depth, at least information should be given about the condition of the muscle and fascia and the subcutaneous course of the wound.

Artificial intelligence and future perspectives in Forensic Medicine: a systematic review.

Objective: Artificial intelligence (AI) is the ability of a computer machine to display human capabilities such as reasoning, learning, planning, and creativity. Such processing technology receives the data (already prepared or collected), processes them, using models and algorithms, and answers questions about forecasting and decision-making. AI systems are also able to adapt their behavior by analyzing the effects of previous actions and working then autonomously. Artificial intelligence is already present in our lives, even if it often goes unnoticed (shopping networked, home automation, vehicles). Even in the medical field, artificial intelligence can be used to analyze large amounts of medical data and discover matches and patterns to improve diagnosis and prevention. In forensic medicine, the applications of AI are numerous and are becoming more and more valuable. Method: A systematic review was conducted, selecting the articles in one of the most widely used electronic databases (PubMed). The research was conducted using the keywords "AI forensic" and "machine learning forensic". The research process included about 2000 Articles published from 1990 to the present. Results: We have focused on the most common fields of use and have been then 6 macro-topics were identified and analyzed. Specifically, articles were analyzed concerning the application of AI in forensic pathology (main area), toxicology, radiology, Personal identification, forensic anthropology, and forensic psychiatry. Conclusion: The aim of the study is to evaluate the current applications of AI in forensic medicine for each field of use, trying to grasp future and more usable applications and underline their limitations.

[Russian Medical Academy of Continuing Professional Education - the leading educational institution in the country for the training of forensic medical personnel (for the 90th anniversary from the establishment of the department of forensic medicine)]. / Rossiiskaya meditsinskaya akademiya nepreryvnogo professional'nogo obrazovaniya ­ vedushchee obrazovatel'noe uchrezhdenie strany po podgotovke sudebno-meditsinskikh kadrov (k 90-letiyu so dnya obrazovaniya kafedry sudebnoi meditsiny).

The article presents a detailed analysis of the stages of formation, development and achievements of the forensic medicine department of the Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian Federation, established in 1933 yr. More than 100 resident doctors and 15 PhD students have been trained in the department for 90 years. As a part of additional professional education implementation, more than 800 cycles of training courses for forensic medical and forensic experts and more than 30 cycles of professional retraining for doctors of other specialties have been carried out. More than 160 thous. specialists have been trained at the department since its establishment. Many employees of the department were directly involved in the performance of the most complicated and socially significant forensic medical examinations. The article describes the main achievements and scientific directions of the department's staff activity, directions and prospects of improving the training of forensic medical personnel in the country.

[Conceptual approaches to defining the one-pointedness of forensic expert institutions as a factor determining the effectiveness of their interaction]. / Kontseptual'nye podkhody k opredeleniyu odnoprofil'nosti sudebno-ekspertnykh uchrezhdenii kak faktor, opredelyayushchii effektivnost' ikh vzaimodeistviya.

THE OBJECTIVE OF THE STUDY: Is to identify the effectiveness of cooperation between forensic expert institutions on the basis of approaches to determining their one-pointedness. Legislative and regulatory legal acts regulating forensic expert activity have been studied. Methods of synthesis, analysis and comparison have been used for their processing. The comparison of the carrying out of targeted diversified studies has been conducted. The article substantiates a necessity of uniform approaches to determination of one-pointedness of forensic expert institutions in order to increase the effectiveness of interdepartmental interaction.

[Substantive approach to ensuring infectious safety in forensic medical expert practice]. / Predmetnyi podkhod k obespecheniyu infektsionnoi bezopasnosti v sudebno-meditsinskoi ekspertnoi deyatel'nosti.

The objective of the study is to analyze existing measures and identify problematic aspects of ensuring the organization of infectious safety activity in forensic medical expert institutions, to develop ways of their solution. Documents regulating the functional principles of forensic medical expert institutions in cases of detection or suspicion of infectious pathology have been examined. Specific proposals for the development of a system to ensure infectious safety in the organization of work in the bureau of forensic medical expertise have been formulated.

[Interdepartmental communication training for forensic medical experts]. / Trening mezhvedomstvennoi kommunikatsii vrachei ­ sudebno-meditsinskikh ekspertov.

THE OBJECTIVE OF THE STUDY: Is to identify the main communication problems encountered by forensic medical experts and specialists during the interdepartmental interaction, and to develop proposals to overcome them. A comprehensive approach was used to achieve the aim of the research, including the carrying out of a qualitative focus group interview of forensic medical experts and resident doctors. The main communicative problems have been determined and proposals for their elimination have been formulated, the types of communication trainings on interdepartmental interaction have been identified.

[Educational trajectory of forensic medical expert in the system of continuous medical education]. / Obrazovatel'naya traektoriya sudebno-meditsinskogo eksperta v sisteme nepreryvnogo meditsinskogo obrazovaniya.

The objective of the study is to determine the possibility and the right to choose the directions of self-education and self-development by forensic medical experts within the framework of personal and professional development program in the educational trajectory formation. The materials of special and encyclopaedic literature including pedagogical and sociological sciences, as well as legal framework regulating the processes of continuing medical education have been studied. The choice of educational trajectory of forensic physician depending on personal benchmarks, self-education building and participation in educational activities has been defined.

MEDICO-LEGAL APPLICATIONS OF FRACTURE HEMATOMA: REVIEW.

This review aimed to elucidate the critical role of fracture hematoma in forensic medicine, with a specific focus on its utility in differentiating antemortem from postmortem fractures. The study seeks to provide a comprehensive synthesis of current knowledge on the subject, highlighting the biological and medico-legal implications of fracture hematoma analysis in forensic investigations. A systematic review of literature was conducted, encompassing various scientific databases including PubMed, Scopus, and Web of Science, focusing on studies published from 2000 to 2024. The search employed keywords such as "fracture hematoma," "antemortem fractures," "perimortem fractures" and "postmortem fractures," among others, to explore relevant data. Selected studies were scrutinized based on their relevance, the presence of substantial data on fracture hematoma, and their contribution to forensic analysis. The review underscores the significance of fracture hematoma as an indicator of antemortem injuries, revealing that active blood circulation at the time of injury facilitates hematoma formation. Detailed analyses within the selected studies illustrate the interplay of cellular and molecular dynamics within fracture hematomas, emphasizing the roles of cytokines, particularly IL-6, and cellular constituents in the healing process. Fracture hematoma analysis emerges as a vital forensic tool in establishing the vitality of bone fractures, enhancing the accuracy of forensic assessments. However, the review also acknowledges the challenges posed by individual healing variability and postmortem changes, suggesting a need for further research to refine the interpretative frameworks used in forensic hematoma analysis.

Realistic three-dimensional imaging of injuries in forensic medicine - Survey-based method comparison of CRT and VRT.

OBJECTIVE: A comparison between Cinematic Rendering Technique (CRT) and Volume Rendering Technique (VRT) in cases with postmortem CT-angiography (PMCTA) was carried out. METHODS: For different injuries seen in PMCTA, a VRT and a CRT image of exactly the same pathological section was generated. Two questionnaires were created, one with CRT and one with VRT reconstructions, with the same questions per 3D-image. The questionnaires were sent to forensic pathologists, lawyers and police officers. In total eleven different injuries had to be analyzed. RESULTS: In total 109 questionnaires were answered fully. Of these returnees, 36 stated that they were forensic pathologists. Seventy-three people were assigned to the group of medical laypersons, in the study this group consists mainly of police officers, judges and lawyers. Between the two software programs CRT and VRT that were compared, no significant difference could be identified in any of the participating groups with regard to the assessment of the life-threatening nature of the injury images shown. When asked about the comprehensibility of pathology, there was a significant difference in favour of CRT. This advantage was apparent to named medical laypersons and to forensic pathologists. CONCLUSIONS: The study showed a positive trend that CRT may be more understandable than VRT. Not only the medical laypersons, but also the forensic physicians found CRT to be beneficial.

The Forensic Assessment for Immigration Relief (FAIR) clinic: A faculty-led, pediatric clinic model.

Since 2019, the number of children apprehended by the United States Custom and Border Patrol at the southern border continues to increase. Many of these children are fleeing violence and extreme poverty and qualify for several forms of humanitarian relief. Trained pediatric health professionals have an essential role to play in documenting evidence to support their petitions. The goal of a forensic medical and psychological evaluation is to establish the facts related to the reported incident(s), provide forensic evidence to support these claims, and provide an expert opinion on the degree to which a finding correlates with the client's reports through a written affidavit. Research studies have demonstrated a significant increase in asylum grant rate for cases that include an evaluation. As demand for forensic evaluations has grown, multiple clinic models have emerged, including volunteer networks, student-led clinics, and faculty-led clinics. The Forensic Assessment for Immigration Relief (FAIR) Clinic offers a sustainable infrastructure while emphasizing the training of pediatric healthcare professionals on the conduct of trauma-informed, culturally attuned, and developmentally appropriate forensic evaluations. This paper outlines the year-long process of developing and launching a clinic specializing in pediatric forensic medical and psychological evaluations as a blueprint for replication.

Demographic analysis of the suicide method by gender and age of the deceased between 2001 and 2010. / Analiza demograficzna metody samobójstwa z uwzglednieniem plci oraz wieku zmarlych w latach 2001-2010.

Aim: AAnalysis of the choice of suicide method by gender and age of the deceased. Material and methods: The study presented here was based on a retrospective analysis of autopsy reports from the years 2001-2010 in the Department of Forensic Medicine of the Jagiellonian University Collegium Medicum in Kraków. The basis of the research work conducted was the collection and extensive analysis of cases of suicide deaths. Subsequently, a preference analysis of the choice of suicide method was conducted, taking into account the age and gender of the deceased. The statistical analysis performed used logistic regression in Excel's XLSTAT as an analysis tool. Results: A total of 2,073 suicide cases were collected from the time frame under discussion. The predominant method of suicide was hanging (1524 cases, 1329 men and 195 women), the second most common method was jumping from the roof or window of a high floor of a building (jumping from heights; 171 cases, 100 men, 71 women). A statistically significant correlation of suicide method with gender was found for: hanging [odds ratio (OR) male (M) vs. female (F) = 3. 4; confidence interval (CI) = 2.7-4.3; p0.001]; drowning [OR: M/F =4.1; CI = 2.6-6.4; p0.001]; jumping from heights [OR: M/F=4.1; CI=2.9-5.7; p0.001] and poisoning [OR: M/F=3.2; CI = 2.1-4.9]. Suicide with the use of firearms occurred exclusively in the case of men (40 cases). The age of the victims correlated with the method of committing suicide by jumping from heights [0R=0.98; CI=0.97-0.99; p0.001] and rail suicide [OR=0.98; CI=0.96-0.99; p0.001]. Conclusions: The study revealed that both age and gender have a significant impact on the choice of suicide method. According to available epidemiological data and the authors' predictions, a predominance of male over female sex was observed in the case of hanging, while jumping from heights was relatively more often chosen by women. The elderly were less likely to choose jumping from heights and rail suicide.

Analysis of cases of suicide by self-immolation in the post-mortem material of the Department of Forensic Medicine in Cracow. / Analiza przypadków samobójstw przez podpalenie w materiale sekcyjnym Zakladu Medycyny Sadowej w Krakowie.

Aim: Analysis of self-immolation cases and distribution of the resulting burns and their degree. Material and methods: The study included 16 cases from the Department of Forensic Medicine, Jagiellonian University Medical College in Cracow from 2000-2022 in which the cause of death was self-immolation. Based on the analysis of photographs and autopsy reports, drawings were made showing the exact distribution and nature of the injuries, moreover, the approximate percentage of body surface area affected was determined as well as the frequency of involvement of specific areas of the body, and the presence of previous diseases and mental disorders including previous suicide attempts. Results: 81% of victims were male. Two age groups were predominant among the cases analyzed, namely, individuals around the age of 20, and those between 50 and 60 years of age. 44% of the deceased had burns exceeding 80% of total body surface. The most frequently involved body areas were the extremities and chest as well as head and neck. Fourth-degree burns were most prevalent on the head and neck, third-degree burns prevailed on the upper and lower extremities, second-degree burns were mostly found on the chest, and first-degree burns - on the lower extremities. There were no cases of fourth-degree burns of the buttocks. 38% of the subjects had a history of substance abuse, 56% suffered from mental illnesses, whereas 31% attempted suicide in the past. Conclusions: The distribution of burns in self-immolation cases is inhomogeneous. The most frequently affected area was the head, neck, chest and extremities, most likely due to victims dousing themselves with a flammable substance from the top of the head through the chest. In all cases, the immediate cause of death was burn disease, regardless of the size of the body surface area affected by the burns. The majority of victims had a history of mental illness, substance abuse or suicide attempts.

About Polish forensic medicine based on archival material described in scientific literature. / O polskiej medycynie sadowej na kanwie materialu archiwalnego opisanego w literaturze naukowej.

The need for medical assessment of murder victims and the establishment of rules for this assessment became the driving force behind the creation of forensic medicine, while the non-medical area of crime assessment, including crime scene examination, became the driving force behind the creation and development of criminalistics. Polish forensic medicine has been developing for over 200 years, and the Kraków Chair of Forensic Medicine is the oldest unit of this type. It is therefore not surprising that the archive which collects protocols of expert and scientific research is quite extensive. This material is a valuable foundation for scientific work including not only numerous publications in national and international journals, but also books. The author of the work selected several books on medical and forensic topics that appeared in recent decades on the Polish publishing market, indicating the value and importance of archival material in the literature of this area of science.

Abstracts of the International Convention of Forensic Medicine & Science, Langkawi 2023: Towards Quality and Accountability in Forensic Practice, co-organised by Ministry of Health, Malaysia, Malaysian Society of Forensic Medicine and Science and Hospital Sultanah Bahiyah, Kedah and held on 25th - 27th July 2023.

No abstract available.

Men after the sexual assault: The journey from medical service to court.

BACKGROUND: There may be significant physical and psychological consequences and impacts for males who experience sexual assault as adults, however, published literature in this context is sparse, specifically for the investigative outcomes in the criminal legal process. METHOD: This clinical audit tracked 138 adult males who presented for forensic and medical sexual assault care from initial presentation to ACT Police investigation and court outcome from 2004 to 2022. RESULTS: There were 103/138 (74.6%) males who attended for medical and forensic care within 72 h of the reported assault. Pre-existing mental health conditions were self-reported in 59/138 (42.7%) males. Nearly half of males 67/138 (48.5%) had a medical evidence kit collected. Males presenting for medical care 44/138 (31.2%) went on to report to ACT Policing, 36/44 (81.2%) of cases did not proceed to court. The most common clearance type was inadequate evidence to proceed (17/44, 38.6%). In 8/44 (18.2%) of adult male cases who subsequently reported to ACT Police, the investigation resulted in entry to the judicial process with a suspect charged with a sexual offence. Five of those cases resulting in a conviction. CONCLUSIONS: Many adult male patients presented within timeframes that enabled the provision of time critical medical care and provided an opportunity for forensic medical evidence collection. Many adult males 59 (42.7%) self-reported pre-existing mental health conditions upon initial presentation. Attrition occurred throughout the patient journey with many males not reporting to police and thus not presenting in the legal process. This further emphasises the need for independent sexual violence patient advisors to support adult male victims through the medical and criminal justice process.

Empirical investigation of passive blood drop trajectory and first point of contact on inclined surfaces.

The first point of contact between a spherical blood drop and a surface is related to the angle between the trajectory of the blood drop and the surface being struck. This angle is often referred to as the impact angle which can be estimated by knowing the width and length of the resultant elliptical bloodstain. Most software programs dedicated to area of origin analysis indicate the location of the backtracked bloodstain trajectory to be at the geometric centre or at the tip of the bloodstain ellipse. However, it is unknown how the first point of contact and the blood drop trajectory (here defined as the locus of the centre of mass of the drop as it travels) are related empirically. Thus, this study aims to look at how the initial point of contact and the trajectory at the impact of a blood drop relates to the formed bloodstain ellipse. Two volumes of blood (0.013 ml and 0.071 ml) were dropped from a height of 10 cm and 40 cm onto an inclined surface at 0°, 15°, 30°, 45°, 60°, and 75°. The transition from a spherical blood drop to an elliptically shaped bloodstain was recorded using a high-speed camera for all tests. A total of 72 ellipses were analyzed to determine the location of the first point of contact and trajectory point of the blood drop and how they relate to the formed elliptical bloodstain. A relationship was found between the first point of contact and the bloodstain trajectory which was dependent on the impact angle. However, there were clear deviations from theoretical assumptions due to blood drop oscillations, the effects of gravity, and the natural fluid characteristics of blood. The results of this study may assist bloodstain pattern analysts and software developers by more accurately applying the location of the blood drop trajectory based on empirical data.

Forensic aspects of condom evidence: Analysis, interpretation, and recent trends.

In recent years, collection and analysis of condom evidence in sexual assault investigations are becoming more common in forensic caseworks. Condom analysis can provide investigative leads or establish potential contact between the suspect and victim in the absence of DNA evidence or supplement biological evidence. Recent forensic literature shows significant advancements in the analysis of condom lubricants, including casework samples. There is an increasing trend in the use of chemometric tools for the comparison and interpretation of the results. This review highlights the advances in common analytical techniques used for the analysis of condom lubricants with a particular focus on the developments occurring in recent years, including chemometric interpretation. The analysis of reference and casework samples (swab samples, samples on skin, clothing and fingermark) are discussed separately. For casework samples, the transfer and persistence of different lubricant formulations are discussed, along with their detection with various analytical approaches. The issues with the interpretation of lubricants are also discussed in another section, with particular emphasis on samples such as personal hygiene products which have similar formulations with sexual lubricants and the interpretation of negative profiles. The current challenges in the field and prospects for future research are also discussed.

Cost-effective 3D documentation device in forensic medicine.

3D documentation in forensics and forensic medicine is being introduced more frequently in various institutes around the world. However, several institutes lack capacity in finances as well as staff to perform 3D documentations regularly. This technical paper aims to present a 3D documentation device that is low cost and easy to use and is a viable entry level solution for forensic medical departments. For this the small single-board computer Raspberry Pi 4 was used in conjunction with its high quality (HQ) camera module to create the 3DLamp - a flexible, low cost and easy to use documentation device. Besides a detailed description of the device this paper also presents four case examples where a 3D documentation was performed and analyses the acquired data and the created 3D models. It was found that the device returns feasible 3D models that appear usable for forensic 3D reconstructions.

Bodies of evidence: The 'Excited Delirium Syndrome' and the epistemology of cause-of-death inquiry.

"Excited Delirium Syndrome" (ExDS) is a controversial diagnosis. The supposed syndrome is sometimes considered to be a potential cause of death. However, it has been argued that its sole purpose is to cover up excessive police violence because it is mainly used to explain deaths of individuals in custody. In this paper, we examine the epistemic conditions giving rise to the controversial diagnosis by discussing the relation between causal hypotheses, evidence, and data in forensic medicine. We argue that the practitioners' social context affects causal inquiry through background assumptions that enter inquiry at multiple stages. This analysis serves to better understand the wide usage of the controversial diagnosis of ExDS.