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.

Age-related mitochondrial lipoperoxidation in human skin.

Mitochondria were isolated from the epidermis of human subjects of different ages by a procedure that included pretreatment of the tissue with bacterial protease before homogenization. That epidermal mitochondria catalyze enzymatic lipid peroxidation in the presence of NADPH and chelated iron (ADP-Fe3+) is indicated by the production of malonaldehyde. The process does not appear to be influenced by age, and it is strongly enhanced in preparations containing a small amount of melanin.

Histochemistry of the intercellular substance of the normal and psoriatic human epidermis.

The intercellular substance of skin samples obtained from normal subjects and from psoriatic patients has been studied with histochemical methods for carbohydrate containing substances and checked with enzymatic extractions. The surface coat which makes up most of the intercellular substance was stained with colloidal iron and with Alcian Blue solutions containing up to 0.20 M magnesium chloride; the stainings were heavily affected by the previous treatment of the sections with testicular hyaluronidase, but not with neuraminidase. The staining of the intercellular substance with Alcian Blue solutions containing up to 0.20 M magnesium chloride and the action of the hyaluronidase gives strength to the hypothesis that hyaluronic acid is contained in the substance. In the skin of psoriatic patients intercellular spaces wider than in normal skin and a reduced surface coat, particularly in the higher layers, has been observed.

Histochemistry of the dermal ground substance of initial psoriatic lesions.

30 cases of initial psoriasis were studied. Pinhead-sized lesions, recently appeared, were excised and studied with histochemical methods for acid mucopolysaccharides. In all specimens a well defined reduction of the material stained with colloidal iron, with alcian blue with critical electrolyte concentrations and with toluidine blue was observed in the upper dermis, in particular in the papillary dermis in the center of the lesions, in correspondence of the squirting papillae. The more evident reduction of the staining with alcian blue with 0.1 M and 0.2 M MgCl2 suggests that the changes of the dermal ground substance are predominantly due to an alteration of the hyaluronic acid.

Lipid synthesis from the liver in patients with psoriasis.

In psoriatic patients with hyperlipidemia we studied the hepatic lipid synthesis from (1-(14)C)-acetate in human liver biopsy specimens in vitro by a thin-layer radio-chromatography. In psoriatics type IV (according to Fredrickson) a significant increase in (1-(14)C)-acetate hepatic incorporation especially into phospholipids (25%) and triglycerides (52%) was observed; in type IIb increased lipogenesis was phospholipids (24.5%), free cholesterol (44.4%) and triglycerides (29%). Abnormal lipid metabolism often coexists with glucose intolerance in psoriasis; no correlation between hyperinsulinemia and augmented (1-(14)C)-acetate incorporation into hepatic triglycerides was found.

Membrane proteins in human skin tumors.

The microsomal, mitochondrial, and nuclear fractions of cutaneous tumors have been investigated. Cutaneous tumors were homogenized and microsomal, mitochondrial, and nuclear fractions were purified. The membrane proteins were solubilized with sodium duodecyl sulfate (SDS). The membrane lipids were removed and membrane proteins were solubilized again in a small volume of SDS solution and chromatographed in SDS-acrylamide slab-gel. The plates were stained with Coomassie Brilliant Blue to show protein bands. The preliminary results show that the electrophoretic profiles of microsomal proteins are characteristic of some tumors.

Treatment of severe psoriasis with somatostatin: four years of experience.

Over a period of 4 years, 20 patients suffering from severe forms of psoriasis (erythrodermic, sub-erythrodermic, resistant generalized forms and/or forms associated with acute arthropathy) were treated with 96 h of continuous i.v. infusion of somatostatin (Stilamin, Serono) diluted in D5W at 250 micrograms/h. In addition to the usual blood chemistry parameters, circadian levels of growth hormone (GH) and epidermal growth factor (EGF) were measured before, during, and after therapy. Approximately 2-3 weeks after termination of therapy, erythrodermic and suberythrodermic symptoms had disappeared. In some patients, a few lesions of psoriasis vulgaris remained, although they were much less severe. Remission of acute arthropathy was impressive. Blood chemistry parameters were unchanged after therapy. Circadian levels of GH and EGF, normal before therapy, were significantly decreased after therapy. The infusion was well-tolerated. Infusion rates of greater than 250 micrograms/h caused only some complaints of abdominal pain, nausea, and vomiting. During the 4 years, erythrodermic symptoms reappeared only in seven patients, three of whom were also arthropathic. After 6-8 months, they underwent a second course of somatostatin therapy with good results. The other patients are still able to control their disease with tar-based products alone or with low-dose 8-methoxypsoralen + UVA (PUVA) or UV therapy. The arthropathic patients control their symptoms with periodic low-dose nonsteroidal antiinflammatory drug therapy.

Validation of the Edinburgh Postnatal Depression Scale in Italy.

Validation of the Italian version of the Edinburgh Postnatal Depression Scale (EPDS) is described. Sixty-one post-partum women (aged 22-43 years) were evaluated. Degree of accuracy of the Italian EPDS was carried out by comparing results with those obtained by means of the clinical interview Present State Examination (PSE). Nine women (15%) were suffering from clinically significant depression. The best cut-off score of the Italian EPDS was between 9 and 10; this showed the highest sensitivity (100%) with a good specificity (83%). These results are concordant with the validation of the original English scale and of other translated versions. This study confirms that the EPDS is an extremely useful screening instrument that shows consistent psychometric features when translated and used in different community contexts.

Insulinogenic indexes in psoriasis.

We have earlier demonstrated that in psoriasis there exists a reduced tolerance to carbohydrates in association with hyperinsulinism. To pursue this problem further, we felt it worthwhile to deal with the results of the oral glucose tolerance test performed on 78 subjects (divided into homogenous groups of normal, obese and psoriatic groups, both with and without diabetic genetic history and obesity) with determinations of both blood glucose and blood insulin levels. We have calculated the insulinogenic indexes by using the techniques elaborated by various authors (I/G, delta I/delta G, AI/AG) and we have then carried out a statistical evaluation both of these indexes and of the ratio between the various indexes employing not only the usual techniques but also that of correlation and simple and multiple regression. We have done this in order to evaluate which of these indexes is better suited to demonstrate the physiopathological mechanism concerning the relationship between insulin hypersecretion and reduced carbohydrate tolerance in the various pathological conditions which we have dealt with.

Reactive oxygen species production in circulating polymorphonuclear leukocytes in psoriasis.

Metabolic burst of polymorphonuclear leukocytes was evaluated by means of a luminol-enhanced chemiluminescence assay. Patients affected with active psoriasis showed a higher response than patients with chronic disease and controls when the neutrophils were stimulated with opsonized zymosan or phorbol myristate acetate.

Possible involvement of increased susceptibility of LDL to oxidation in age-related platelet activation.

Fifteen long-lived and fifteen young healthy subjects were enrolled in this study to verify the involvement of age-associated oxidative challenge in the mechanisms that control platelet activation. Our results showed in old subjects an enhancement of ex vivo platelet responsiveness to ADP and collagen, measured both in whole blood and in platelet rich plasma, an increased cytosolic calcium content, a decreased membrane fluidity and a lower intraplatelet nitrate/nitrite (NO(x)) amount. Additionally, an increased plasma content of peroxidative by-products (TBARS) and a decreased antioxidant plasma capacity together with a reduced lag time for in vitro oxidation of low density lipoprotein (LDL) and a diminished plasma NO(x) bioavailability were observed in aged subjects. Lag time for LDL oxidation was negatively correlated with plasma TBARS level, and positively correlated with intraplatelet NO(x) content. Findings of this study may support the speculation that advancing age increases the susceptibility of LDL to oxidative modifications and favors platelet activation by oxidized LDL-induced decrease of nitric oxide bioactivity.