Practice Of Forensic Medicine Research Articles

Forensic Medical Evaluation of Non-Fatal Traumatic Head Bone Fractures

Head bone fractures are encountered in forensic medicine practice due to their origin. In the present study, we aimed to evaluate the demographic data, injury characteristics, clinical findings accompanying bone fractures and forensic reports of cases with skull fractures and to share them with the literature. In this study, cases with non-fatal traumatic skull fractures that did not result in death admitted to our department during the 10-year period between 01.01.2014 and 31.12.2023 were included in the study. Hospital documents and investigation documents of the cases were retrospectively analyzed. It was determined that 75.6% of the cases were male and the mean age was 37±9.6 years. It was determined that 56.2% of the skull fractures occurred as a result of traffic accidents, the most common fracture was the frontal bone (n=206, 53.4%) and 54.1% of the cases were linear fractures. In our study, it was determined that skull fractures were most common in males, in the young adult age group, most commonly due to traffic accidents, and in the form of linear fractures in the frontal bone. The findings were consistent with the literature. When preparing a forensic report on skull fractures, the location of the fracture, the type of fracture and the number of fractures are important in terms of determining the life threat and the effect of the fracture on life functions.

The XI International Congress “Topical issues of forensic medicine and expert practice — 2024” dedicated to the memory of Professor Vladimir A. Klevno

In Moscow, on the basis of the Moscow Regional Research Institute named after M.F. Vladimirsky, the annual XI International Congress “Current Issues of Forensic Medicine and Expert Practice - 2024” was held on April 17–18, 2024. It was dedicated to the memory of Professor Vladimir Aleksandrovich Klevno, a talented scientist, a prominent domestic forensic physician, the first head of the Department of Forensic Medicine of MONIKI, one of the members of the Council of the National Medical Chamber, President of the Association of Forensic Experts, editor-in-chief of Forensic Medicine, Doctor of Medical Sciences, who was the ideological inspirer and organizer of this congress. For several decades V.A. Klevno was one of the country’s leading specialists in the field of forensic medicine, a major scientist and organizer of forensic science and expert practice, who made an invaluable contribution to the development of domestic forensic activity. The congress continued the proud tradition of bringing together experts, researchers, and professionals to further develop collaboration and exchange of cutting-edge research and the latest developments in the fields of forensic medicine, pathological anatomy, and legal practice. This international congress aimed to expand the knowledge of specialists in the fields of forensic medicine, pathological anatomy, and healthcare organization. The conference was distinguished by a rich program, a variety of new formats, and effective working tools that were used by the organizers this year. In particular, special projects were launched – thematic video master classes and the work of the sections “Non-state forensic activity” and “Histological studies in pathoanatomical and forensic medical expert practice.” Within the framework of the congress, a joint session of the Association of Forensic Experts and the Interregional Thanatoradiological Society “Radiation diagnostics in pathoanatomical and forensic medical expert practice” was also held. The article is devoted to an overview of the most striking and memorable events of the event.

Leverage Effective Deep Learning Searching Method for Forensic Age Estimation.

Dental age estimation is extensively employed in forensic medicine practice. However, the accuracy of conventional methods fails to satisfy the need for precision, particularly when estimating the age of adults. Herein, we propose an approach for age estimation utilizing orthopantomograms (OPGs). We propose a new dental dataset comprising OPGs of 27,957 individuals (16,383 females and 11,574 males), covering an age range from newborn to 93 years. The age annotations were meticulously verified using ID card details. Considering the distinct nature of dental data, we analyzed various neural network components to accurately estimate age, such as optimal network depth, convolution kernel size, multi-branch architecture, and early layer feature reuse. Building upon the exploration of distinctive characteristics, we further employed the widely recognized method to identify models for dental age prediction. Consequently, we discovered two sets of models: one exhibiting superior performance, and the other being lightweight. The proposed approaches, namely AGENet and AGE-SPOS, demonstrated remarkable superiority and effectiveness in our experimental results. The proposed models, AGENet and AGE-SPOS, showed exceptional effectiveness in our experiments. AGENet outperformed other CNN models significantly by achieving outstanding results. Compared to Inception-v4, with the mean absolute error (MAE) of 1.70 and 20.46 B FLOPs, our AGENet reduced the FLOPs by 2.7×. The lightweight model, AGE-SPOS, achieved an MAE of 1.80 years with only 0.95 B FLOPs, surpassing MobileNetV2 by 0.18 years while utilizing fewer computational operations. In summary, we employed an effective DNN searching method for forensic age estimation, and our methodology and findings hold significant implications for age estimation with oral imaging.

An update on the progress of Forensic Medicine practice in India

An update on the progress of Forensic Medicine practice in India

Forensic, medical and legal problems and solutions on passenger and cargo ships

Marine vehicles have an important place in international trade and tourism. There are various directives and studies on the prevention of health problems in marine vessels and injuries and deaths due to occupational accidents. In the literature, not enough studies have been found in which the issues to be considered in cases of injuries, sexual assaults, accidents, suicides and murders that are common in forensic medicine practice, and there are no guidelines or recommendations of internationally accepted organizations. It is important to determine the seafarer who is responsible for intervening in health emergencies on cargo ships, and to detect faulty ones, if any, in work accidents that result in serious injury and death. In addition, injuries, suicides and murders are encountered among the crew, and crime scene findings are lost until they are evaluated by the judicial authorities. Although rare, sexual assaults on cargo ships are also reported, but there are not enough scientific studies that indicate what should be done in terms of evidence evaluation. Our study emphasizes the issues to be considered, that one of the crew should be held responsible and necessary training should be given in order to make a forensic medical evaluation in forensic events that will be encountered on cargo ships, and that physicians and health workers should be competent in the first forensic medical evaluation in case of emergency on passenger ships. It is thought that the launch of the telemedicine application, which provides uninterrupted service for forensic medical emergencies in maritime vessels, under the leadership of organizations such as the “International Maritime Organization” (IMO), will make a significant contribution. In addition, suggestions are made for legal impasses in such cases that take place in high seas.

Determination of the time of death of a domestic cat by measuring the area of a wet spot

Animal cruelty is a criminal offence under the current legislation of Ukraine. When investigating criminal proceedings related to animal cruelty, including domestic cats, it is often necessary to establish the time of death. Therefore, the development of new methods for determining it and improving existing ones is extremely relevant. The purpose of the study was to establish the relationship between the obtained values of wet spot area indicators and the time of death. To achieve this goal, the authors propose a new method for determining the age of death of domestic cats based on the results of measuring the area of a wet spot obtained from skeletal muscle tissue samples of corpses (Shkundia method). To do this, samples of muscle tissue were taken from the corpses of cats, a wet spot preparation was obtained by pressing and its area was calculated to establish a correlation between the values of this indicator and the time that has passed since death. The study of the obtained indicators established that these values are constant, and the features of fluctuations in the values of this indicator with the time elapsed since the death of the animals were established and shown graphically. Using a number of statistical methods, the absence of dependence of wet spot area indicators on the muscles from which samples were taken for research and animal breeds was determined. The nature of changes in the values of the wet spot area indicator depending on time is established and the features of their fluctuations in different periods during 27 days from the moment of animal death were explained. Reference values of these indicators depending on the time elapsed since the death of animals are presented, which can be used by forensic veterinary experts in practical work to determine the time of the occurrence of death of domestic cats. Due to a number of advantages, this method can be widely implemented in the practice of forensic veterinary medicine

Unveiling the Veil of Cognitive Bias in Forensic Medicine Decisions

Abstract The practice of forensic medicine and pathology, as other specialties that are based on cognitive abilities, is greatly impacted by cognitive bias. In this article, the effects of cognitive bias on forensic pathologists are emphasized with a particular focus on how opinions on different parts of death report might be distorted by irrelevant information, including the circumstances of death. The forensic professionals are encouraged to use structured methods for making decisions that give weight to medically pertinent data and reduce the impact of unimportant background information. The article promotes the development of frameworks for policies and training programs that lessen cognitive bias in the hope of improving the objectivity and dependability of forensic findings. Reducing cognitive bias in forensic medicine is essential for maintaining the credibility of forensic science as well as for ensuring that people are treated fairly in the legal system.

Effectiveness of forensic medicine practices: Rwanda facing shortage of forensic pathologists

Forensic pathology has often been disregarded in both Western and non-Western countries, including the African nations. In this article, we highlight the shortage of forensic pathologists in Rwanda and make recommendations to encourage physicians to pursue the subspecialty of forensic pathology. Critically, we analysed issues and challenges related to the inadequate supply of forensic pathologists in the healthcare sector of Rwanda. The authors referred to scientific and legal literature from books, journals, national and international reports, and electronic sources on forensic pathology training and workforce. As a result, authors have identified several reasons for the shortage, including lack of exposure to forensic pathology, absence of a direct path for forensic pathology training, and insufficient funding for fellowships in forensic pathology. It is important to note that there is a global shortage of forensic pathologists, which hinders the effective practice of forensic medicine, including examinations and assessments of various types of deaths and incidents. This ultimately affects the administration of justice. However, it is hopeful that Rwanda's efforts in the field of forensic medicine will have a positive influence on other African nations in the coming years.

The importance of diffuse axonal injury in the daily forensic medicine practice

The importance of diffuse axonal injury in the daily forensic medicine practice

Bone and Tooth: Substrates for Determining Drowning: A New Diagnostic Procedure in Forensic Medicine Practice?

IntroductionDiatom tests are rarely used during autopsy to confirm drowning as the cause of death (COD) because of limitations of the current literature involving these techniques. Instead, experts rely on physical examination by the pathologist. Due to interpretive concerns regarding Diatom tests, they are often insufficient in establishing a diagnosis, but offer the potential to be an extremely useful diagnostic tool with further understanding. The aim of study is to optimize “Diatom Tests” for use in forensic medicine in Bosnia and Herzegovina. MethodsA randomized prospective experimental study was conducted, using albino Wistar rat models (Rattus norvegicus), at the Veterinary Facility, University of Sarajevo. Thirty-two adult albino rats, were used and distributed into groups as follows: Group A (6 deceased rats with COD other than drowning, but due to mechanical asphyxia, which were then submerged for 1 hour after death); Group B (6 deceased rats with COD other than drowning, but due to mechanical asphyxia, which were then submerged for 72 hours after death); Group C (6 rats that were immediately autopsied after drowning, with COD determined as drowning); Group D (6 rats that underwent a 48-hour postmortem period after drowning); Group E (COD: drowning, post-mortem 72hrs after death, remained submerged in water until PM).Live algological material was collected for the research of the systematics of algae from the Bosna river, Sarajevo, and transported to the University of Sarajevo (Department of Biology, Faculty of Science). Periphyllon, epiphyllon and epipelon were used to collect phytobenthos. The material was fixed with 4% formalin solution. Laboratory processing of diatoms was performed using the methods described by Hustedt (16). In the process of obtaining pure diatom valves, part of the material is digested with potassium permanganate (KMnO4), sulfuric acid (H2SO4), and oxalic acid (C2H2O4). In the next step, the cleaned diatom valves were mounted in Canadian balsam. A light microscope under 1000x magnification (Best Scope 2020) was used to evaluate and analyze the species. The identification of diatoms was performed using the reference of Cantonati et al (17). The nomenclature of diatom species was performed according to Guiry & Guiry's worldwide electronic internet database. ResultsNo diatoms were found in Groups A and B. However, Navicula sp. and Sellaphora sp. cf., were discovered during bone analysis of Group C where rats were immediately autopsied after drowning. Hantzschia amphioxus taxon was present in Group D, which underwent a 48-hour postmortem period after drowning and before samples were taken.In Groups C and D, where drowning was the COD, Diatoma vulgaris i Pinnularia major, Achnanthidium minutissimum i Melosira varians were present in the tooth samples. ConclusionOptimization of the “Diatom Test” method could potentially lead to its future use as a routine method within experimental settings. This experimental study is a starting point that guides forenscic medicine pracitioners towards the optimization of tests and sampling in cases of unexplained etiology, where preserved soft tissue structures is not available. In these cases, teeth and bones serve as accessible materials for diagnosing COD, alongside standardized nonspecific findings in the absence of organs for micro- and macroanalysis.

Forensic Medicine Practices in Earthquake

Forensic Medicine Practices in Earthquake

Research progress and potential application of microRNA and other non-coding RNAs in forensic medicine.

At present, epigenetic markers have been extensively studied in various fields and have a high value in forensic medicine due to their unique mode of inheritance, which does not involve DNA sequence alterations. As an epigenetic phenomenon that plays an important role in gene expression, non-coding RNAs (ncRNAs) act as key factors mediating gene silencing, participating in cell division, and regulating immune response and other important biological processes. With the development of molecular biology, genetics, bioinformatics, and next-generation sequencing (NGS) technology, ncRNAs such as microRNA (miRNA), circular RNA (circRNA), long non-coding RNA (lncRNA), and P-element induced wimpy testis (PIWI)-interacting RNA (piRNA) are increasingly been shown to have potential in the practice of forensic medicine. NcRNAs, mainly miRNA, may provide new strategies and methods for the identification of tissues and body fluids, cause-of-death analysis, time-related estimation, age estimation, and the identification of monozygotic twins. In this review, we describe the research progress and application status of ncRNAs, mainly miRNA, and other ncRNAs such as circRNA, lncRNA, and piRNA, in forensic practice, including the identification of tissues and body fluids, cause-of-death analysis, time-related estimation, age estimation, and the identification of monozygotic twins. The close links between ncRNAs and forensic medicine are presented, and their research values and application prospects in forensic medicine are also discussed.

Metabonomics Analysis of Brain Stem Tissue in Rats with Primary Brain Stem Injury Caused Death.

To explore the potential biomarkers for the diagnosis of primary brain stem injury (PBSI) by using metabonomics method to observe the changes of metabolites in rats with PBSI caused death. PBSI, non-brain stem brain injury and decapitation rat models were established, and metabolic maps of brain stem were obtained by LC-MS metabonomics method and annotated to the HMDB database. Partial least square-discriminant analysis (PLS-DA) and random forest methods were used to screen potential biomarkers associated with PBSI diagnosis. Eighty-six potential metabolic markers associated with PBSI were screened by PLS-DA. They were modeled and predicted by random forest algorithm with an accuracy rate of 83.3%. The 818 metabolic markers annotated to HMDB database were used for random forest modeling and prediction, and the accuracy rate was 88.9%. According to the importance in the identification of cause of death, the most important metabolic markers that were significantly up-regulated in PBSI group were HMDB0038126 (genipinic acid, GA), HMDB0013272 (N-lauroylglycine), HMDB0005199 [(R)-salsolinol] and HMDB0013645 (N,N-dimethylsphingosine). GA, N-lauroylglycine, (R)-salsolinol and N,N-dimethylsphingosine are expected to be important metabolite indicators in the diagnosis of PBSI caused death, thus providing clues for forensic medicine practice.

Identification of time of death of cats according to histological changes in some organs

Determining the time of an animal’s death is an extremely relevant subject in the practice of modern forensic medicine, because the issue often arises when investigating crimes related to animal abuse, in particular, with domestic cats Felis silvestris catus (Linnaeus, 1758). Methods of identifying time of cats’ death are currently developed insufficiently and their introduction into the veterinary-forensic practice has been limited, including the histological method we have employed. We used five corpses of cats, from which we periodically, after certain time periods, gathered the material for histological study, sampling such organs as the liver, kidneys, lungs, heart (myocardium), and the skeletal muscles. From the collected material, we made histological sections and stained them with hematoxylin and eosin. We determined the general patterns in changes occurring in the internal organs of cats over time, namely changes in the staining intensity of the cell elements and intercellular structures on the histopreparations; formation of detritus-filled cavities; a number of distinctive changes in the connective-tissue stroma of the organs; emergence of baciliform bacteria in the tissues and formation of their colonies. In the muscle tissue, we found specific features such as loss of alignment and emergence of transversal grooves with subsequent fragmentation. The study revealed that the development of those changes in each organ clearly correlated with time that has passed since each animals had died. Thus, a complex evaluation of detected changes can give a more accurate – compared with other existing methods – assessment of the time of death of a corpse submitted to forensic veterinary examination. We recommend using the histological method for animals presumed to have been dead for no more than 18 days, because later the tissue disintegration reaches such a level that complicates the correlation of changes with time. We consider it promising to study the time of death of domestic cats using other methods for identifying criteria for postmortem intervals longer than 18 days, and also identifying time of death in other species of animals.

THE APPLICABLE VALUE OF 3D MODELING IN THE ASPECT OF FORENSIC MEDICAL DIFFERENTIAL DIAGNOSTICS OF THE TYPE OF A TRAUMATIC TOOL IN INJURIES FROM FIREARMS AND APPROXIMATE TO IT BY ITS CHARACTERISTICS

Implementation of up-to-date evidenced-based research methods is rather important in the process of conducting forensic expertise. One of them is 3D-modeling of body injuries of various genesis. The method has been widely applied into theory and practice of forensic medicine both by Ukrainian and foreign scientists. The article demonstrates new possibilities during making differential diagnostics of a traumatic tool type, which become informative due to the application of 3D modeling in the process of examination of injuries from firearms or other weapon approximate to it by its characteristics.
 Aim of the work. To improve the process of forensic differential diagnostics of the type of a traumatic tool by means of 3D-modelling of body injuries caused by small-caliber firearms or other weapon approximate to it by its characteristics, to create opportunities for the implementation of 3D-modelling techniques in the everyday practical work of forensic medical experts and forensic criminologists with the possibility of further adding the obtained results to the materials of criminal proceedings.
 Materials and methods. The material of the research was the results of experimental study when fired from small-caliber firearms and a gun for firing Flaubert cartridges. At the same time, measurements were made both by traditional measuring technique and in the process of 3D-modeling of the entrance gunshot wound on the skin of a pig and on the side of the subcutaneous fat tissue and the wound channel at its various intervals in ballistic plasticine Roma Plastilina №1, produced in the USA, used for ballistic tests according to NIJ, HOSDB standards. The results obtained were processed by means of the common methods of variation statistics applicable in medicine.
 Results. The study presents the major parameters and determines interdependence between the parameters when fired from a gun for firing Flaubert cartridges and small-caliber firearms, and morphological signs of gunshot injuries. Direct moderate and strong correlations are found between the initial speed, kinetic and specific energy of the bullet, and the length of the wound channel, diameter of the entrance wound, diameter of the wound channel in its middle portion and on exit measured by means of traditional measuring methods and those discovered in the process of their 3D-modeling (р≤0,05).
 Conclusions. The use of modern 3D-modeling techniques in the practice of forensic medical examination makes it possible to create 3D-models of both individual components of gunshot damage and the wound channel as a whole.
 At the same time, it becomes possible to study individual elements of gunshot damage and measure their sizes with significantly increased accuracy, store and re-analyze them if necessary.
 As a result, we get an improvement in the process of performing forensic medical examinations in cases of gunshot injuries with the possibility of conducting differential diagnosis of the type of traumatic projectile, studying new signs of gunshot injuries, increasing the visibility and objectivity of forensic medical conclusions during such examinations.

X anniversary international congress “Topical Issues of Forensic Medicine and Expert Practice, 2023”

The 10th Anniversary International Congress, Topical Issues of Forensic Medicine and Expert Practice, 2023, was held at the Moscow Regional Research Institute on April 1920, 2023. This article is an overview of the most important events of the Congress.

How to sample a seizure plant: the role of the visualization spatial distribution analysis of Lophophora williamsii as an example.

An accurate in situ MSI method for fresh water-rich succulent plants was obtained based on multi-parameter comparative experiments.Spatial imaging analysis of mescaline in Lophophora williamsii was performed using the above method.Based on the above results and previous results, a sampling proposal for forensic medicine practice is tentatively proposed.

Evaluation of distal tibial epiphysis and calcaneal epiphysis according to the Vieth method in 3.0T magnetic resonance images: a pilot study.

In forensic medicine practice, age estimation-both in living and deceased individuals-can be requested due to legal requirements. Radiologic methods, such as X-rays, for the estimation of bone age have been discussed, and ethical concerns have been raised. Given these factors, radiologic methods that reduce radiation exposure have gained importance and have become one of the research topics in forensic medicine. In this study, the MR images of the ankles of patients aged between 8 and 25years, obtained with a 3.0T MR scanner, were evaluated retrospectively according to the staging method defined by Vieth et al. In the study, the ankle MR images of 201 cases (83 females and 118 males) with sagittal T1-weighted turbo spin echo and T2-weighted short tau inversion recovery sequences were evaluated independently by two observers. According to the results of our study, the intra- and inter-observer agreements are at a very good level for both the distal tibial and calcaneal epiphyses. All the cases detected as stages 2, 3, and 4 in both sexes for both the distal tibial and the calcaneal epiphyses have been determined to be under the age of 18years. According to the data obtained from our study, we consider that stage 5 for males and stage 6 for both sexes in the distal tibial epiphysis and stage 6 for males in the calcaneal epiphysis can be used to estimate the age of 15years. As far as we know, our study is the first to evaluate ankle MR images with the method defined by Vieth et al. Further studies should be conducted to evaluate the validity of the procedure.

Medicolegal evaluation of geriatric deaths in Bursa, Turkey

Aim: Differentiation of natural and forced deaths observed in this age group is very important in the forensic medicine practice. According to the address based population registration system, population rate of 65 years and older has been 9.5% of the total population in 2020. In the present study, we aimed to medicolegal evaluation of demographic data and autopsy findings of judicial geriatric deaths in Bursa and around.Material and Method: Autopsy reports of the cases who have been taken to Morgue Specialization Office of Council of Forensic Medicine Institution and at 65 years and over, crime scene and deceased examination reports and data in the prosecution documents were assessed retrospectively between 2003-2008 in our study. Results: During 6-year period, totally 5155 autopsies have been investigated in Morg Specialization Office of Bursa Council of Forensic Medicine Institution. Among such cases, 870 (16.8%) were 65 years old and older. Cases who were 65 years old and older included 640 (73.6%) were male, 230 (26.4%) were female. In terms of death origin, 434 (49.9%) were natural deaths, 267 (30.7%) were accidents, 102 (11.7%) were suicides and 52 (6%) were homicides. Origin of death of the remaining 15 (1.7%) could not be detected. According to the information obtained from the statements of the witnesses in crime scene investigation and dead body examination reports, a previous disease existed in 336 (38.6%) cases before death. Diseases which have been existing before death includes cardiac diseases, hypertension, central nervous system pathologies, diabetes mellitus, respiratory system pathologies, undefined psychiatric disorders, gastrointestinal system pathologies and malignancies, respectively to frequency.Conclusion: In line with prolongation of life expectancy and increase in the geriatric population, it is observed according to our outcomes that an increase is detected in judicial geriatric death cases due to neuropsychiatric disease, leading a solitary life and psychomotor imbalance.

Improving Evidence-Based Practice in Forensic Medicine: Validation of INtegration of Forensic Epidemiology and the Rigorous EvaluatioN of Causation Elements and Principles of Evidence-Based Reporting in FORensic Medicine-Pathology version in Indonesia

Abstract Introduction Expert opinions presented in legal proceedings should be scientifically accountable, which is known as evidence-based practice (EBP). Although forensic medical expert opinions are essential in legal proceedings, the methods used to formulate them are not always evidence based or based on standard methods. In forensic medicine, EBP has not been explicitly applied, including in Indonesia. One potential approach to formulate evidence-based expert opinions is called INtegration of Forensic Epidemiology and the Rigorous EvaluatioN of Causation Elements (INFERENCE). In addition, there is also no universal guideline for making forensic pathological reports. One prospective guideline is named the Principles of Evidence-based Reporting in FORensic Medicine-Pathology version (PERFORM-P). Methods This article describes the validation process of INFERENCE and PERFORM-P in Indonesia. This study uses a mixed method through three interrelated phases, i.e., (1) a cross-sectional survey to determine the characteristics of Indonesian forensic doctors and their current practice, (2) the adaptation and validation process of the two tools through a review by the Indonesian College of Forensic Medicine, and (3) a one-group pre–postintervention study to assess the validity and reliability of forensic medical expert opinions formulated using Indonesian-INFERENCE (i-INFERENCE) and reported using Indonesian-PERFORM-P (i-PERFORM-P). Results and Discussion In general, both tools received a positive reception and can potentially be used in the Indonesian setting with some additions/clarifications in the user manuals. Participants envision that both tools will be most useful in complex cases. Conclusions By obtaining the i-INFERENCE and the i-PERFORM-P, it is hoped that Indonesian forensic medical doctors are better equipped in analyzing and reporting complex cases, and the implementation of EBP can be improved.