Homicide numbers, rates, and victims' characteristics in the Tri-City metropolitan area, Poland, between 2010 and 2019. / Liczby i wskazniki zabójstw oraz charakterystyka ofiar na terenie aglomeracji Trójmiasta w latach 2010-2019.

Despite a clear global downward trend, homicides still account for a relatively high proportion of all violent deaths, making them a serious problem both in Poland and worldwide. The discrepancy in available data prompted the authors of the study to analyse the numbers and rates of homicides and the characteristics of the homicide victims in the Tri-City area of northern Poland. The study was based on data from autopsy reports, supplemented by information from prosecutor's files on all homicides in the Tri-City area between 2010 and 2019. A total of 107 homicides were statistically analysed for age, sex, blood alcohol concentration at the time of death, time and place of death. The annual homicide rate was 1.24 per 100,000 inhabitants, with a clear downward trend over the period analysed. The average age of victims was about 48 years, and the majority of victims were male (70.1%). 92.5% of homicides were committed in the Tri-City, with a clear predominance of Gdansk (49.5%) over other, mostly rural, areas of the analysed agglomeration. The majority of victims (57.8%) whose blood alcohol concentration was measured were intoxicated, with a clear predominance of males in this group (70.9%). Victim characteristics and the homicide rates obtained from the analysed material were similar to other countries in Central and Eastern Europe, which may be related to historical, cultural, and demographic similarities. The study highlights the significant impact of alcohol abuse on the risk of homicide.

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.

Current status of undergraduate teaching in forensic & legal medicine in Europe.

The European Council of Legal Medicine (ECLM) is the body established in 1992 to represent practitioners forensic & legal medicine and is composed of delegates of the countries of the European Union (EU) and from other countries which form part of Europe to a current total of 34 member countries. The aims of this study were to determine the current status of undergraduate forensic & legal medicine teaching in the curriculum of medical studies in ECLM countries and to use the results of this study to determine whether it would be appropriate to develop new guidelines and standards for harmonising the content of undergraduate forensic medicine training across ECLM member countries. A detailed questionnaire was sent to all individuals or organisations listed on the ECLM contact database. Responses were received from 21 of 33 countries on the database. These responses showed considerable emphasis on undergraduate teaching of forensic medicine in all countries with the exception of Belgium and the United Kingdom. There was great general consistency in the subjects taught. The data from this survey provide a baseline which should assist in developing a strategy to harmonise forensic & legal medicine undergraduate training in member countries of the ECLM. The ECLM is now in a good position to establish a pan-European working group to coordinate a consensus document identifying an appropriate and modern core undergraduate forensic medicine curriculum that can be presented to the medical education authorities in each country, and which can be adapted for local requirements, based on available personnel, the forensic medicine structure in the country, and most importantly, the needs of the local population.

Estimating bloodstain age in the short term based on DNA fragment length using nanopore sequencer.

We used a nanopore sequencer to quantify DNA fragments > 10,000 bp in size and then evaluated their relationship with short-term bloodstain age. Moreover, DNA degradation was investigated after bloodstains were wetted once with water. Bloodstain samples on cotton gauze were stored at room temperature and low humidity for up to 6 months. Bloodstains stored for 1 day were wetted with nuclease-free water, allowed to dry, and stored at room temperature and low humidity for up to 1 week. The proportion of fragments > 20,000 bp in dry bloodstains tended to decrease over time, particularly for fragments > 50,000 bp in size. This trend was modeled using a power approximation curve, with the highest R2 value (0.6475) noted for fragments > 50,000 bp in size; lower values were recorded for shorter fragments. The proportion of longer fragments was significantly reduced in bloodstains that were dried after being wetted once, and there was significant difference in fragments > 50,000 bp between dry conditions and once-wetted. This result suggests that even temporary exposure to water causes significant DNA fragmentation, but not extensive degradation. Thus, bloodstains that appear fresh but have a low proportion of long DNA fragments may have been wetted previously. Our results indicate that evaluating the proportion of long DNA fragments yields information on both bloodstain age and the environment in which they were stored.

Longitudinal visibility of MRI findings in living victims of strangulation.

Initial experiences with magnetic resonance imaging (MRI) of living strangulation victims demonstrated additional findings of internal injuries compared to the standard clinical forensic examination. However, existing studies on the use of MRI for this purpose mostly focused on the first 48 h after the incident. The aims of this study were (a) to evaluate the longitudinal visibility of MRI findings after violence against the neck by performing two MRI examinations within 12 days and a minimum of four days between both MRI scans and (b) to assess which MRI sequences were most helpful for the detection of injuries. Twenty strangulation victims participated in this study and underwent one (n = 8) or two (n = 12) MRI scans. The first MRI examination was conducted during the first five days, the second five to 12 days after the incident. Two blinded radiologists assessed the MRI data and looked for lesions in the structures of the neck. In total, 140 findings were reported in the 32 MRI examinations. Most of the findings were detected in the thyroid and the muscles of the neck. T2-weighted SPACE with fat suppression, T1-weighted TSE and T1-weighted MPRAGE were rated as the most helpful MRI sequences. Subjects who showed findings in the initial scan also demonstrated comparable results in the second scan, which was performed on average 8.4 days after the incident. Our results show that even up to 12 days after the incident, the criminal proceeding of strangulation cases may greatly profit from the information provided by an MRI examination of the neck in addition to the standard clinical forensic examination.

Three-dimensional reconstruction of King Henri IV's paranasal sinuses and mastoid cells.

PURPOSE: The preserved head of King Henri IV of France (life 1553-1610, reign 1589-1610) has survived to the present day thanks to high-quality embalming and favorable conservation conditions. The aim of this study was to examine Henry IV's upper resonant cavities and mastoids using an original and innovative forensic three-dimensional segmentation method. METHODS: The paranasal sinuses and mastoid cells of King Henri IV of France were studied by cross-referencing available biographical information with clinical and flexible endoscopic examination and computed tomography (CT-scan) imaging. The paranasal sinuses and mastoid cells were delineated and their volumes were assessed using ITK-SNAP 4.0 software (open-source). Graphical representations were created using Fusion 360® (Autodesk Inc., San Rafael, CA, USA) and MeshMixer® (Autodesk Inc., San Rafael, CA, USA). RESULTS: Paranasal sinus tomodensitometry revealed abnormalities in shape and number. Henri IV of France suffered from sinus aplasia. Neither the left sphenoid nor left frontal sinus contrasted sharply, and a remarkable pneumatization of the right clinoid processes extended throughout the height of the right pterygoid process. The total volumes of Henri IV's mastoid air-cells were estimated at 27 and 26 mL, respectively, for the right and left sides, exceeding the normal mean and the maximum of modern subjects by a wide margin. No sign of chronic ear or sinus condition was found. CONCLUSIONS: An innovative method has been developed in forensic medicine to establish hypotheses about the growth and respiratory conditions of the face.

The impacts of governing agency: A comparison of resources in the patchwork of medicolegal death investigation systems.

In the United States, medical examiners and coroners (MECs) fill critical roles within our public health and public safety systems. These professionals are primarily charged with determining the cause and manner of death as they investigate deaths and respond to associated scenes and mass fatalities and can also help identify trends in public health crises through medicolegal death investigations. Despite their instrumental role, they are organized in disparate systems with varying governing structures, functions, staffing, caseload, budget, and access to resources. This paper examines data from the 2018 Census of Medical Examiner and Coroners to evaluate MEC operations in the United States. The findings show that MEC offices' organizational and operational governance structures greatly influence resources, workloads, and access to information and services. Standalone MEC offices were generally better resourced than those affiliated with law enforcement, public health, forensic science, district attorneys, or other agencies.1.

[Possibilities of educational process and researches realization using organs and tissues of the deceased person]. / Vozmozhnosti realizatsii obrazovatel'nogo protsessa i nauchnykh issledovanii s ispol'zovaniem organov i tkanei umershego.

The article presents the results of analysis of doctors' practical training as well as scientific research using organs and tissues of the deceased person. The main problematic aspects preventing appropriate realization of the possibility to use the unclaimed bodies, organs and tissues of the deceased person for these purposes are highlighted based on the study of regulatory framework controlling these activities, scientific publications on defined topic, as well as the direct authors' participation in the training of resident doctors and PhD students.

[Review of age assessment methods of children and adolescents by teeth X-rays]. / Obzor metodov otsenki vozrasta detei i podrostkov po rentgenogrammam zubov.

Interest in the topic of age assessment for forensic medical identification of personality has not decreased for over the past decade. Establishing an exact age have a critical importance for law enforcement authorities, for example in case of wrongdoing by illegal migrants without identity documents. The search and systemic analysis of published researches devoted to age assessment by dental status in children and adolescents with subsequent updating of the directions of development in this scientific subject theme and the possibility of their realization in practice in the Russian Federation were carried out in order to have an objective concept of used methods of dental status assessment in the world practice.

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.

Mock court: a valuable tool to teach legal procedures to undergraduate medical students.

BACKGROUND: Teaching through role-plays is a preferred modality when certain behaviours or skills need to be taught. They provide a risk-free environment that simulates a real-life scenario. For a clinician, appearance in a Court of Law as an expert witness is a part of his/her legal obligation. OBJECTIVE: To explore the utility of Mock Court as an additional teaching tool for undergraduate medical students, in understanding and familiarizing with legal procedures, specifically the courtroom procedures. METHODOLOGY: We conducted Mock Court sessions with the students playing various roles, following which feedback was collected from the students, teachers and guest assessors. The data was statistically analysed by comparison of frequencies and paired t-test (pre- and post-session comparison). RESULTS: The study revealed a positive effect of the Mock Court sessions on the students, based on their increased confidence, motivation and a better grasp of legal procedures. There was a statistically significant (p < 0.001) improvement in the understanding of specific aspects of courtroom procedures after the session. CONCLUSION: The authors recommend the active implementation of Mock Court as a teaching aid for undergraduate medical students, and the use of PDSA (Deming) cycle as a tool for quality-checks and self-improvement in subsequent sessions.

[To the 100th anniversary of the birth of MD, PhD, professor Lyusik Oganesovna Barsegyants]. / K 100-letiyu so dnya rozhdeniya doktora meditsinskikh nauk, professora Lyusik Oganesovny Barsegyants.

The article presents information about the life and activity of the outstanding scientist, professor L.O. Barsegyants.

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.

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.

Misinterpretation of a Gunshot Injury by a Non-forensic Medicine Expert: A Case Report of Misguidance in a Criminal Investigation Involving the Unusual Firearm Injury 'Kronlein Shot'.

In India, the majority of postmortem examinations are conducted by medical professionals who lack expertise in the field of forensic medicine. Medicolegal autopsy services that are done by forensic experts are primarily confined to tertiary care centers, although a significant portion of medicolegal postmortem examinations occurs in non-tertiary healthcare setups. In this context, postmortem examination reports occasionally fail to encompass essential medicolegal features, resulting in dissatisfaction among both crime investigators and the deceased's relatives. As the doctors managing these postmortem examinations are not experts in the field of forensic medicine, if a case involves an unusual pattern of injury, the situation becomes further complicated. The absence of proper forensic assessments heightens the risk of the crime investigation heading in the wrong direction. Firearm injuries are well known for their varied pattern of injury. The present case reports one of the unusual patterns of firearm injury where a gunshot injury with close contact on the head resulted in the bursting of the skull, which is commonly referred to as a Kronlein shot. Such injuries involve extreme skull mutilation. Unlike typical contact gunshot injuries, in cases of extensive facial and cranial destruction, locating the entry wound and detecting other typical features of firearm injury become challenging. This complexity confused the autopsy surgeons of this case who were not experts in forensic medicine and mis-framed the opinion regarding the causative weapon which in turn confused the police official in the crime investigation. The case was later on referred to our institute for forensic medicine expert opinion and opinion was given after consideration of postmortem examination findings mentioned in the postmortem report, photographs of the deceased, circumstantial evidence gathered by police, and correlating all these facts with standard published literature. The case underscores the essential role of forensic experts in decoding complex medicolegal mysteries and ensuring accurate justice delivery. The case also highlights the importance of the need for comprehensive forensic examinations and considering circumstantial evidence in drawing various conclusions in a medicolegal autopsy.

Anaphylactic deaths: A retrospective study of forensic autopsy cases from 2009 to 2019 in Shanghai, China.

Anaphylaxis is a rare but well-known cause of sudden unexpected death, although data from forensic autopsies in anaphylactic deaths are limited. Herein, a retrospective study of a series of allergic deaths from 2009 through 2019 in Shanghai, China, was conducted to investigate the demographic, medical, and forensic pathological characteristics of fatal anaphylaxis to improve medicolegal understanding on anaphylactic death. Sixty-two autopsy cases of anaphylactic death were registered in this study. Males dominated the cases (74.2%) against females (25.8%), with an average age of 38.8 years. Medications (98.4%), particularly antibiotics (72.6%), were the most frequent cause of anaphylaxis, and 44 cases (71.0%) occurred in clinics administered illegally by unlicensed clinicians. The anaphylactic symptoms began within a few minutes to less than 1 h in 53 cases, with dyspnea (56.5%) and sudden shock (46.8%) being the most common clinical signs. Thirty cases (48.4%) of anaphylaxis resulted in death within 1 h. Laryngeal edema and multiple tissue eosinophil infiltration (85.5%) were the most prevalent autopsy findings, followed by pulmonary edema and congestion (24.2%), which were considered to be non-specific but suggestive. The comorbidities were mainly cardiovascular disease (33.9%), pneumonia (8.1%) and asthma (8.1%). Serum IgE were measured in 11 of 62 cases, ranging from 43.3 to 591 IU/ml, severed as a helpful marker. Therefore, we suggested a thorough analysis of allergen exposure, clinical history and autopsy findings is required for the diagnosis of anaphylactic death currently.

Taser-Related Ocular Injuries: A Review of the Literature and Medico-Legal Implications.

PURPOSE: Electric weapons have dangers associated with their use, such as burns and trauma related with the impacts of uncontrolled falls, even though they often minimize morbidity and mortality. The exact visual outcome of the damage inflicted is unknown, even though numerous studies have been documented in the literature about the ocular damage induced by the use of these tools. METHODS: We present a narrative review of types of eye damage associated with the use of the Taser. The following search terms were used to identify eligible articles through the PubMed database: "TASER", "Conducted Electric Weapons", "CEWs". RESULTS: A total of 15 articles were included with information about 38 patients with eye damage associated with the use of taser. The majority of patients were males. In most cases the mechanism of injury was the penetration of the probe inside the eye. Clinical manifestations of ocular damage were present in only 18 out of 38 cases and varied according to the type of damage mechanism. Indeed, the cases in which the probe had penetrated the eye showed more severe clinical manifestations with a poor visual outcome. CONCLUSION: In conclusion, the introduction of taser use for law enforcement requires serious consideration and adequate training for officers.

Case report: Death caused by multi-organ metastatic calcifications as a result of intramuscular injections with paraffin oil.

In this forensic case report, we present autopsy findings from a young male in his thirties who had been self-injecting paraffin oil into his upper extremities 8 years prior to death. The injections induced an inflammatory response, leading to granuloma formation. This, in turn, resulted in severe hypercalcemia. The external autopsy examination revealed gross macroscopic ulcerations and enlargement of upper extremities, while calcifications of ligaments, heart, kidneys and dura mater was revealed on postmortem CT-scans. Histopathological examination showed extensive multiorgan metastatic calcifications in several tissues including the lungs, heart and kidney. Cause of death was estimated to be the extensive calcific deposits in the heart likely resulting in cardiac arrest. To our knowledge this is the first case reporting findings from an autopsy in which the cause of death was linked to cosmetic oil injections.

Correlation Analysis and Comparison of Adult CE-Chirp ABR Response Threshold and Pure Tone Hearing Threshold.

OBJECTIVES: To study the application of CE-Chirp in the evaluation of hearing impairment in forensic medicine by testing the auditory brainstem response (ABR) in adults using CE-Chirp to analyze the relationship between the V-wave response threshold of CE-Chirp ABR test and the pure tone hearing threshold. METHODS: Subjects (aged 20-77 with a total of 100 ears) who underwent CE-Chirp ABR test in Changzhou De'an Hospital from January 2018 to June 2019 were selected to obtain the V-wave response threshold, and pure tone air conduction hearing threshold tests were conducted at 0.5, 1.0, 2.0 and 4.0 kHz, respectively, to obtain pure tone listening threshold. The differences and statistical differences between the average pure tone hearing threshold and V-wave response threshold were compared in different hearing levels and different age groups. The correlation, differences and statistical differences between the two tests at each frequency were analyzed for all subjects. The linear regression equation for estimating pure tone hearing threshold for all subjects CE-Chirp ABR V-wave response threshold was established, and the feasibility of the equation was tested. RESULTS: There was no statistical significance in the CE-Chirp ABR response threshold and pure tone hearing threshold difference between different hearing level groups and different age groups (P>0.05). There was a good correlation between adult CE-Chirp ABR V-wave response threshold and pure tone hearing threshold with statistical significance (P<0.05), and linear regression analysis showed a significant linear correlation between the two (P<0.05). CONCLUSIONS: The use of CE-Chirp ABR V-wave response threshold can be used to evaluate subjects' pure tone hearing threshold under certain conditions, and can be used as an audiological test method for forensic hearing impairment assessment.

Rapid Screening of 34 Emerging Contaminants in Surface Water by UHPLC-Q-TOF-MS.

OBJECTIVES: To establish a rapid screening method for 34 emerging contaminants in surface water by ultra-high performance liquid chromatography-quadrupole-time of flight mass spectrometry (UHPLC-Q-TOF-MS). METHODS: The pretreatment conditions of solid phase extraction (SPE) were optimized by orthogonal experimental design and the surface water samples were concentrated and extracted by Oasis® HLB and Oasis® MCX SPE columns in series. The extracts were separated by Kinetex® EVO C18 column, with gradient elution of 0.1% formic acid aqueous solution and 0.1% formic acid methanol solution. Q-TOF-MS 'fullscan' and 'targeted MS/MS' modes were used to detect 34 emerging contaminants and to establish a database with 34 emerging contaminants precursor ion, product ion and retention times. RESULTS: The 34 emerging contaminants exhibited good linearity in the concentration range respectively and the correlation coefficients (r) were higher than 0.97. The limit of detection was 0.2-10 ng/L and the recoveries were 81.2%-119.2%. The intra-day precision was 0.78%-18.70%. The method was applied to analyze multiple surface water samples and 6 emerging contaminants were detected, with a concentration range of 1.93-157.71 ng/L. CONCLUSIONS: The method is simple and rapid for screening various emerging contaminants at the trace level in surface water.