Congenital heart diseases (CHDs) and forensic investigations: Searching for the cause of death.

Congenital Heart Diseases (CHDs) are a group of structural abnormalities or defects of the heart that are present at birth. CHDs could be connected to sudden death (SD), defined by the WHO (World Health Organization) as "death occurring within 24 h after the onset of the symptoms" in an apparently "healthy" subject. These conditions can range from relatively mild defects to severe, life-threatening anomalies. The prevalence of CHDs varies across populations, but they affect millions of individuals worldwide. This article aims to discuss the post-mortem investigation of death related to CHDs, exploring the forensic approach, current methodologies, challenges, and potential advancements in this challenging field. A further goal of this article is to provide a guide for understanding these complex diseases, highlighting the pivotal role of autopsy, histopathology, and genetic investigations in defining the cause of death, and providing evidence about the translational use of autopsy reports. Forensic investigations play a crucial role in understanding the complexities of CHDs and determining the cause of death accurately. Through collaboration between medical professionals and forensic experts, meticulous examinations, and analysis of evidence, valuable insights can be gained. These insights not only provide closure to the families affected but also contribute to the prevention of future tragedies.

Examining the use of alternative light sources in medico-legal assessments of blunt-force trauma: a systematic review.

The ability to analyze blunt-force trauma is crucial for deciphering valuable clues concerning mechanisms of injury and as evidence for medico-legal investigations. The use of alternate light sources (ALS) has been studied over the past decade, and is proposed to outperform conventional white light (CWL) during bruise assessments. In response to the growing interest of the technology worldwide, a systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) to address the ability of ALS to detect and visualize bruising. From an initial 4055 records identified, ten studies met the eligibly criteria and were selected for this review. Evaluation also included a novel framework, referred to as SPICOT, to further systematically assess both scientific evidence and risk of bias in forensic literature. Analysis reveals that narrowband wavelengths within in the infrared or ultraviolet spectral ranges do not significantly outperform CWL in visualizing or detecting bruising. However, wavelengths within the visible spectrum, particularly 415 nm combined with longpass or bandpass yellow filters, are more effective. However, the majority of selected studies only address the sensitivity of ALS, and therefore, results may only be considered valid when the location of a bruise is known. Further investigation is required to understand the specificity of ALS, in particular how the use of topical cosmetic products, previous wounds/scar-tissue, tattoos, moles and freckles may affect detection. The ethical concern regarding the interpretation of enhanced visualized trauma should also be considered in prospect discussions prior to implementing ALS into routine practice. Nevertheless, this review finds that narrowband ALS within the visible spectrum demonstrates potential for improved injury documentation, outperforming CWL in the detection and visualization of bruising.

Automatic detection and identification of diatoms in complex background for suspected drowning cases through object detection models.

The diagnosis of drowning is one of the most difficult tasks in forensic medicine. The diatom test is a complementary analysis method that may help the forensic pathologist in the diagnosis of drowning and the localization of the drowning site. This test consists in detecting or identifying diatoms, unicellular algae, in tissue and water samples. In order to observe diatoms under light microscopy, those samples may be digested by enzymes such as proteinase K. However, this digestion method may leave high amounts of debris, leading thus to a difficult detection and identification of diatoms. To the best of our knowledge, no model is proved to detect and identify accurately diatom species observed in highly complex backgrounds under light microscopy. Therefore, a novel method of model development for diatom detection and identification in a forensic context, based on sequential transfer learning of object detection models, is proposed in this article. The best resulting models are able to detect and identify up to 50 species of forensically relevant diatoms with an average precision and an average recall ranging from 0.7 to 1 depending on the concerned species. The models were developed by sequential transfer learning and globally outperformed those developed by traditional transfer learning. The best model of diatom species identification is expected to be used in routine at the Medicolegal Institute of Paris.

External post-mortem examination in virtual reality-scalability of a monocentric application.

Conducting external post-mortem examinations is an essential skill required of physicians in various countries, regardless of their specialization. However, the quality of these examinations has been a subject of continuous debates, and notable errors were reviled. In response to these shortcomings, a virtual reality (VR) application was developed at Halle's medical department in Germany, focusing on the scene of discovery and the completion of death certificates. The initial trial of this VR application in 2020 involved 39 students and 15 early-career professionals. Based on the feedback, the application underwent improvements and was subsequently introduced to the medical department in Dresden, Germany, in 2022. Its primary objective was to showcase the VR training's adaptability and scalability across various educational structures and levels of medical expertise. Out of 73 students who participated, 63 completed the evaluation process. 93.1% (n = 58) of the evaluators reported increased confidence in conducting external post-mortem examinations, and 96.8% (n = 61) felt more assured in filling out death certificates, crediting this progress to the VR training. Additionally, 98.4% (n = 62) believed that repeating forensic medical aspects in their coursework was crucial, and 96.8% (n = 61) viewed the VR examination as a valuable addition to their academic program. Despite these positive responses, 91.6% (n = 55) of participants maintained that training with real corpses remains irreplaceable due to the insufficiency of haptic feedback in VR. Nevertheless, the potential for enhancing the VR content and expanding the training to additional locations or related disciplines warrants further exploration.

Pro-active drug-facilitated crimes (DFC): a study in the Department of Forensic Medicine of Paris, France.

INTRODUCTION: Proactive drug facilitated crime (DFC) is the administration of psychoactive substances (PAS) for criminal purposes without the victim's knowledge or by force. In Paris, France, patients who report suspected proactive DFC to the police are examined at the Department of Forensic Medicine (DFM) of the Hôtel-Dieu Hospital. Preventively blood and urine samples are collected but not systematically analyzed by the judicial authority. We aimed to assess the proportion of probable proactive DFC in patients examined at the Hôtel-Dieu DFM following a police report for suspected proactive DFC. METHOD: Blood and urine samples were collected from 100 patients. Toxicological analyses were performed by the toxicology laboratory of the Lariboisière Hospital. The results were correlated with the clinical data collected at the initial and follow-up consultations. RESULTS: At least one PAS was detected in 86% of the cases (voluntary or involuntary intake). After correlation with clinical data, 32% of the cases were classified as probable proactive DFC. In these cases, 49% of the substances identified were illicit substances (amphetamines, MDMA, etc.); 16% were benzodiazepines and related substances; 16% were antihistamines and sedatives; 14% were opioids; and 5% were antidepressants and anti-epileptics. In 90% of the cases, patients reported a voluntary ethanol consumption in the hours prior to the suspected proactive DFC. CONCLUSION: Toxicological analyses revealed a high proportion of both probable proactive DFC and probable opportunistic DFC. Our results indicate the need to perform systematical toxicological analysis in cases of suspected DFC.

Matrix- and surface-assisted laser desorption/ionization-mass spectrometry analysis of fingermark components for forensic studies: current trends and future prospects.

The chemical analysis of fingermarks (FMs) has attracted considerable attention in the realm of forensic investigations. Techniques based on direct ionization of a sample by laser irradiation, specifically matrix-assisted laser desorption ionization-mass spectrometry (MALDI-MS), have provided excellent figures of merit for analyzing high molecular-weight compounds. However, it can be challenging to analyze low molecular-weight compounds using MALDI-MS owing to potential interference produced by the organic matrices in the low molecular-weight region, which can impede the detection of small molecules (m/z < 700 Da). Alternately, surface-assisted laser desorption/ionization-mass spectrometry (SALDI-MS) has shown great promise for small molecules analysis owing to the unique properties of the nanostructures used, particularly, minimal chemical background in low m/z region improved the production of ions involved in this method. The advancement of MALDI-MS and SALDI-MS has propelled their application in the analysis of FM components, focused on gaining deep insights into individual traits. This review aims to outline the current role of MALDI-MS and SALDI-MS in the chemical analysis of FMs. It also describes the latest achievements in forensic intelligence derived from fingermark analysis using these powerful methods. The accomplishments include the understanding of certain characteristics and lifestyles of donors. The review offers a comprehensive overview of the challenges and demands in this field. It suggests potential enhancements in this rapidly expanding domain to bridge the gap between research and practical police casework.

Decrease in electrolyte after vitrectomy surgery may affect the results of forensic investigations using vitreous humor.

PURPOSE: Vitreous humor (VH) is used for postmortem biochemical studies because it is well protected in an uncontaminated state even after death. The goal of this research was to investigate electrolyte concentrations in the VH from human eyes with and without a history of vitrectomy surgery. METHODS: We analyzed the sodium (Na), potassium (K), chloride (Cl) and magnesium (Mg) concentrations from 34 VH samples from 34 patients. Eleven samples were from eyes with a history of vitrectomy, and the remaining 23 eyes had no history of vitrectomy. The correlations of Na, K, Cl and Mg concentrations with patient age, interval between first and second vitrectomy, and lens status (history of cataract surgery) were also evaluated. RESULTS: The Na, K, Cl and Mg concentrations in VH from vitrectomized eyes were 134.1 ± 7.9 mmol/L, 3.7 ± 0.2 mmol/L, 99.7 ± 6.7 mmol/L and 0.59 ± 0.09 mmol/L, respectively; all were significantly lower than the corresponding concentrations in VH from control eyes (lower by 5.0%, 11.0%, 11.7%, and 22.6%, respectively). Na, K, Cl and Mg concentrations in VH from vitrectomized eyes did not show significant correlations with patient ages or the interval between their first and second vitrectomies. There were no significant differences in Na, K, Cl and Mg concentrations in VH between phakic eyes and intraocular lens-implanted eyes. CONCLUSIONS: With the increasing number of vitrectomies being performed, it is necessary to consider the history of vitrectomy when using a subject's VH in forensic examination.

Raman Spectroscopy for the Time since Deposition Estimation of a Menstrual Bloodstain.

Forensic chemistry plays a crucial role in aiding law enforcement investigations by applying analytical techniques for the analysis of evidence. While bloodstains are frequently encountered at crime scenes, distinguishing between peripheral and menstrual bloodstains presents a challenge. This is due to their similar appearance post-drying. Raman spectroscopy has emerged as a promising technique capable of discriminating between the two types of bloodstains, offering invaluable probative information. Moreover, estimating the time since deposition (TSD) of bloodstains aids in crime scene reconstruction and prioritizing what evidence to collect. Despite extensive research focusing on TSD estimations, primarily in peripheral bloodstains, a crucial gap exists in determining the TSD of menstrual bloodstains. This study demonstrates how Raman spectroscopy effectively analyzes biological samples like menstrual blood, showing similar aging patterns to those of peripheral blood and provides proof-of-concept models for determining the TSD of menstrual blood. While this work shows promising results for creating a universal model for bloodstain age determination, further testing with more donors needs to be conducted before the implementation of this method into forensic practice.

The Role of Molecular Investigations in Estimating the Time since Deposition (TSD) of Bloodstains: A Systematic Review of the Literature.

At many crime scenes, investigators are able to trace and find traces of blood. For many years, it was believed that such traces could only be subjected to genetic investigations, such as those aimed at comparing DNA profiling with a suspect to verify his identity, and that it was therefore not possible to backdate the traces. In recent years, various works have used experimental models to investigate the possibility of identifying markers and methodologies for estimating the time since deposition (TSD) of bloodstains. Despite the results, these methods are still not part of standard procedures, and there is no univocal analysis methodology. In this work we carried out a systematic literature review of all the papers published in the last ten years on this topic, comparing the experimental models created. This review demonstrates the potential that different molecular approaches, such as transcriptomics, metabolomics, proteomics, and spectrometry, can have in the analysis of TSD, with notable sensitivity and specificity. This paper also analyzes the intrinsic and extrinsic limits of these models and emphasizes the need to continue research work on this topic, considering the importance that this parameter can assume in forensic investigations against a suspect.

Potential Role of mRNA in Estimating Postmortem Interval: A Systematic Review.

Although the postmortem interval estimation still represents one of the main goals of forensic medicine, there are still several limitations that weigh on the methods most used for its determination: for this reason, even today, precisely estimating the postmortem interval remains one of the most important challenges in the forensic pathology field. To try to overcome these limitations, in recent years, numerous studies have been conducted on the potential use of the mRNA degradation time for reaching a more precise post mortem interval (PMI) estimation. An evidence-based systematic review of the literature has been conducted to evaluate the state of the art of the knowledge focusing on the potential correlation between mRNA degradation and PMI estimation. The research has been performed using the electronic databases PubMed and Scopus. The analysis conducted made it possible to confirm the potential applicability of mRNA for reaching a more precise PMI estimation. The analysis of the results highlighted the usefulness of some mRNAs, such as ß-actin and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNA, especially in short time frames, within a few hours or days of death. The matrices on which these analyses were conducted were also analyzed, resulting in less exposure to the external environment, including the heart, brain, and dental pulp. The major limitations were also reported, including the short time intervals analyzed in most of the articles, the lack of mathematical models, and the failure to report the error rate between the mRNA degradation time and PMI. Given the still small number of published articles, the lack of globally recognized standardized methods, and the numerous techniques used to evaluate the mRNA degradation times, numerous and larger studies are still necessary to reach more solid and shared evidence.

Introduction of the modern 3d modeling method into the theory and practice of forensic medicine ballistics, caused by gunshot wounds inflicted by firearms with 9mm caliber ammunition.

OBJECTIVE: Aim: To explore the capabilities of the modern 3D modeling method for various elements of gunshot wounds caused by 9 mm caliber bullets, intending to integrate these findings into the theory and practice of forensic medicine. PATIENTS AND METHODS: Materials and Methods: The research began with a series of experimental shots, during which the morphological features were examined through their 3D spatial reconstruction. The entire series of experimental shots was conducted using an automatic pistol IZH 70-01 equipped with 9.0 mm caliber bullets. The ballistic clay Roma Plastilina No.1, manufactured in the USA, was utilized as a material for conducting standard ballistic tests according to the standards of the NIJ (National Institute of Justice) and HOSDB (Home Office Scientific Development Branch). RESULTS: Results: The research was continued during the performance of forensic examinations involving actual cases of gunshot injuries. The dimensions of individual elements of the wound channel were measured in both experimental and expert cases using conventional measuring tools, as well as after their 3D modeling, utilizing graphic editors such as "Agisoft Photoscan" and "3ds max". CONCLUSION: Conclusions: In the course of creating and studying experimental and expert 3D models, the dimensions of individual morphological elements of the wound channel were recorded with an accuracy that exceeded the results obtained through measurements using traditional measurement methods by ten times.

Research Progress of Using Canine Olfactory Search for Human Remains.

In the process of murder investigation, it is of great significance to find the discarded and buried human remains accurately. The main methods of searching for human remains include human visual search, aerial detection, geophysical technology, remote imaging technology and canine olfactory search technique. Canine olfactory search for human remains is a recognized time-effective and non-invasive search method, making dogs the most valuable search tool in forensic investigation. By systematically reviewing and summarizing relevant literature, and based on the theory of volatile organic compound produced by the decomposition of human remains, this paper explores the basic principle of the canine olfactory search technique for human remains. This paper also reviews the application of training canine search technique for human remains in forensic investigation by using human blood, tissue, cadaver putrefying fluid and odor substitutes as sniffing sources. The application prospect of canine olfactory search for human remains was prospected from the perspectives of detection of volatile organic compound during cadaver decay, development of odor substitutes and adsorption devices, and technology tactics used in canine training and use, to provide references for the relevant research of canine olfactory search for human remains in China.

Research Progress on Detection of New Psychoactive Substance Piperazines in vivo.

Piperazines are a class of new psychoactive substances with hallucinogenic effects that affect the central nervous system by affecting the level of monoamine neurotransmitters. Abuse of piperazines will produce stimulating and hallucinogenic effects, accompanied by headache, dizziness, anxiety, insomnia, vomiting, chest pain, tachycardia, hypertension and other adverse reactions, and may even cause cardiovascular diseases and multiple organ failure and lead to death, seriously affecting human physical and mental health and public safety. The abuse of new psychoactive substance piperazines has attracted extensive attention from the international community. The study of its pharmacological toxicology and analytical methods has become a research hotspot in the field of forensic medicine. This paper reviews the in vivo processes, sample treatment and analytical methods of existing piperazines, in order to provide reference for forensic identification.

Urine Metabolites Changes in Acute Myocardial Infarction Rats via Metabolomic Analysis.

OBJECTIVES: To screen biomarkers for forensic identification of acute myocardial infarction (AMI) by non-targeted metabolomic studies on changes of urine metabolites in rats with AMI. METHODS: The rat models of the sham surgery group, AMI group and hyperlipidemia + acute myocardial infarction (HAMI) group were established. Ultra-high performance liquid chromatography-mass spectrometry (UPLC-MS) was used to analyze the changes of urine metabolic spectrometry in AMI rats. Principal component analysis, partial least squares-discriminant analysis, and orthogonal partial least squares-discriminant analysis were used to screen differential metabolites. The MetaboAnalyst database was used to analyze the metabolic pathway enrichment and access the predictive ability of differential metabolites. RESULTS: A total of 40 and 61 differential metabolites associated with AMI and HAMI were screened, respectively. Among them, 22 metabolites were common in both rat models. These small metabolites were mainly concentrated in the niacin and nicotinamide metabolic pathways. Within the 95% confidence interval, the area under the curve (AUC) values of receiver operator characteristic curve for N8-acetylspermidine, 3-methylhistamine, and thymine were greater than 0.95. CONCLUSIONS: N8-acetylspermidine, 3-methylhistamine, and thymine can be used as potential biomarkers for AMI diagnosis, and abnormal metabolism in niacin and nicotinamide may be the main causes of AMI. This study can provide reference for the mechanism and causes of AMI identification.

[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.

[Experience of Data Analysis application for proceeding research data in solving the problem of target age group establishment]. / Opyt ispol'zovaniya Data Analysis issledovatel'skikh dannykh pri reshenii zadachi ustanovleniya tselevoi vozrastnoi gruppy.

The article presents the experience of artificial intelligence application in research process. The article contains general information about basic concepts of machine learning (clustering and visualization), as well as considers more detaily an experience of clinical testing. The effectiveness of applying Data Analysis methods and means as one of the research stages is demonstrated on the example of a case on processing medical information using algorithms of machine learning: solving the problem on diagnostic value of the proposed indicator (FTF) for determining target age groups. Implementation of such approach of digital transformation improves the operational effectiveness of researches, as well as quality and availability of final technological products being developed - software for solving expert problems.

[Causal links in forensic medicine in cases of acute enteric infections]. / Prichinno-sledstvennye svyazi v sudebnoi meditsine v sluchayakh ostrykh kishechnykh infektsii.

One of the main tasks in expertise of living persons is to determine the harm caused to human health. According to the regulations, only harm to human health caused by an injury and causally related with it is taken into account in the forensic examination of a living person. The establishment of a causal link allows to assess correctly the harm severity caused to human health. In this respect, the study of the effect of biological damaging factor on human body (cause) and the result of this interaction (effect) is a new step in modern science. The article presents the analysis of data from the reports of the Russian Reference Center on monitoring of enteric infection agents for 2016-2021; the results of examinations of subjects who suffered from acute enteric infections for 2018-2019 to study causal links in forensic medicine in cases of acute intestinal infections.

[Vibrational spectroscopy use for forensic purposes combined with machine learning]. / Ispol'zovanie kolebatel'noi spektroskopii v sochetanii s mashinnym obucheniem dlya zadach sudebnoi meditsiny.

Vibrational spectroscopy combined with machine learning has a great potential for forensic research. Portable Raman spectrometers are already being used by law-enforcement agencies to identify drugs. Several new technologies based on vibrational spectroscopy, that can be used in forensic science to analyze documents, gunshot traces, cloths, soil, hair, nails and lacquer, are being developed nowadays. The article considers the use of vibrational spectroscopy in forensic practice for conducting serological studies with an emphasis on the development of a universal method of identifying the main secretions of the body. The method allows to determine the time elapsed since the trace was made, as well as the phenotypic profile of host, including sex, race and age.

[Laboratory examinations in forensic medical expertises on crimes against sexual integrity and sexual freedom]. / Laboratornye issledovaniya v sudebno-meditsinskikh ekspertizakh po prestupleniyam protiv polovoi neprikosnovennosti i polovoi svobody lichnosti.

The article presents the results of analysis of 482 forensic biological and forensic cytological expertises on cases of sexual crimes. A presence of different types of such crimes has been noted. Expertises' effectiveness when examining content of vagina, oral cavity and rectum, impression smears and lavages from suspects' genital organs, subungual content of victims and suspects and other objects has been determined. The dependence of expertises' effectiveness on the terms of object removal has been noted. The article presents a number of objects' examination methods (luminescent-microscopic spermatozoids' identification, diagnosis of cells origin from mucous membranes of the vagina and oral cavity, determination of group belonging of specific cells in specimens, diagnosis of fecal masses presence) allowing to improve expertises' quality.

[Forensic characteristic of drowning cases in the Russian Federation for the period from 2013 to 2022]. / Sudebno-meditsinskaya kharakteristika sluchaev utopleniya v Rossiiskoi Federatsii s 2013 po 2022 god.

OBJECTIVE: To study forensic characteristic of drowning mortality cases in the Russian Federation for the period from 2013 to 2022. MATERIAL AND METHODS: Dynamics and territorial specificity of drowning (in absolute values and in terms of 100 thous. population), proportion of histological examinations, cases of ethanol detection in the blood upon the occurrence of death by drowning and the proportion of children under 14 years among deceased from drowning. RESULTS AND CONCLUSION: The evidence suggests the necessity for intersectoral approaches of preventive measures creation. The results of the study could be used to establish a monitoring system as part of a national water safety strategy.