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Journal of Forensic and Legal Medicine
Journal Prestige (SJR): 0.622
Citation Impact (citeScore): 1
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  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1752-928X
Published by Elsevier Homepage  [3161 journals]
  • Three groups of suspects in police reported rape cases: First-time
           suspects, recidivists and unidentified suspects. A comparative study
    • Abstract: Publication date: Available online 15 February 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Bjarte Frode Vik, Kirsten Rasmussen, Berit Schei, Cecilie Therese Hagemann BackgroundPrevious studies show that reported suspects in adult rape cases often have a criminal record, and that many are rape recidivists. Annual numbers of police reported rapes have dramatically increased but the proportion of rapes being prosecuted and numbers of convictions are low. To increase knowledge about the suspects in cases of police reported rapes; whether they have committed the crime before or not may inform preventive measures.AimsTo compare suspect, victim, and assault related characteristics among different groups of police-reported rape suspects (first-time suspects, recidivist suspects and unidentified suspects).MethodsRetrospective, descriptive study of suspects in cases of rape or attempted rape reported by women ≥16 years of age in the Sør-Trøndelag police district, Norway, from 2003 to 2010.ResultsAmong the 356 suspects included, 207 (58%) were first-time suspects, 75 (21%) were recidivists and 74 (21%) were unidentified. Being a first-time suspect was significantly associated with victim being
  • Living with the dead: a case report and review of the literature
    • Abstract: Publication date: Available online 7 February 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Venusia Cortellini, Gloria Brescia, Heitor Simoes Dutra Correa, Nicoletta Cerri, Paola Bin, Andrea Verzeletti The discovery of human corpses in urban domestic settings does not constitute an unusual case in criminal casework. These scenarios can be very challenging to investigate since the uninformative evidences encountered also demand a multidisciplinary effort among several specialties in the forensic sciences field. The occurrence of this incident is usually accompanied by social isolation, which is an emblematic aspect of urban modern society. The elderly population is especially susceptible to being socially isolated, which is associated with higher mortality. We present a case report of an elderly woman who had been living with her husband’s dead body, contributing to the scarce literature on the “Living with the Dead” phenomenon. The use of a multidisciplinary approach and the challenges that social isolation presents to forensic sciences and the contemporary society are discussed.
  • Anal tear in a girl due to the penetration of a dog's penis. Unusual case
    • Abstract: Publication date: Available online 6 February 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Hugo Rodríguez Almada, Irene García Maggi, Madelón Rodríguez, Joyce Stewart We present the case of a six year and two months old girl who showed a large anal tear, attributed to the penetration of pet dog’s penis. After several interviews with the child, as well as her parents, the paediatric psychiatrist assessed the account of events as authentic, understanding by that that her narration of events approaches to the subject’s truth. According with the guidelines the patient was discharged home with strict follow up by her paediatrician. The girl continued to be followed up by the same paediatrician for eight years. Currently, she is 14 years and 3 months old, without any pathologies and a good school performance. A new evaluation by a psychiatrist not involved with the healthcare team, confirmed the diagnosis of anal tear due to the penetration of the pet’s penis.The present report is the third in the literature regarding anal lesions in children caused by the penetration of a dog penis. It is the one at a youngest age and the first on a girl. It concerns a truly rare situation, but it still should be taken into account when the mechanism is alleged. The seriousness of overlooking child abuse, as well as a potential wrong diagnosis, are indications for thorough initial physical and psychosocial evaluations.
    • Abstract: Publication date: Available online 2 February 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Roger W. Byard Strongyloidiasis is an infectious disease affecting approximately 30 to 100 million people globally. The main human pathogen is Strongyloides stercoralis which may cause a brief period of acute symptoms and signs after the initial infection, and then lapse into a chronic asymptomatic carrier state for decades due to the nematode’s unique ability to autoinfect hosts. Immunosuppression from steroid therapy, T-lymphocytic viral (HTLV-1) infections, or a variety of underlying medical conditions may then result in dissemination and the highly lethal and infectious hyperinfection syndrome. Clinical suspicions for the condition are often not high in non-endemic areas, the diagnosis is difficult, and the incidence is increasing, particularly given recent mass population movements. Indications of infection at autopsy include gastrointestinal ulceration and haemorrhage, with pulmonary oedema, congestion, haemorrhage and diffuse alveolar damage.
  • Estimation of birth year by radiocarbon dating of tooth enamel: Approach
           to obtaining enamel powder
    • Abstract: Publication date: Available online 29 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Hisako Saitoh, Toru Moriya, Mirei Takeyama, Kazuyuki Yuza, Ayaka Sakuma, Fumko Chiba, Suguru Torimitsu, Namiko Ishii, Koichi Sakurada, Mitsuyoshi Iino, Hirotaro Iwase, Fuyuki Tokanai Atmospheric radiocarbon (14C) levels increased from 1955 to 1963 due to atmospheric nuclear weapon tests, and then decreased. As 14C accumulates in human tooth enamel while the enamel is being formed, 14C can be used to estimate the birth year of unidentified bodies. Measurement results of 14C content in tooth enamel using accelerator mass spectrometry vary depending on the enamel’s sample site. To address this problem, a method for equalizing samples using a pulverizer was considered in this study. Regarding the tube and cone used as the pulverizer, (1) a polycarbonate tube and stainless steel cone, (2) a stainless steel tube and cone, and (3) a tungsten carbide tube and cone, were compared. In (1), the modern carbon ratio was approximately half that of the normal ratio of 100 pMC, with which accurate dating was impossible, and in (2), a high background value was obtained for IAEA-C1, which was pulverized using a reusable tube and cone. In (3), the 14C content for IAEA-C1 pulverized using reusable tube and cone, which was washed with quartz sand, was 0.31±0.01 pMC. This result did not show any problems regarding background value. Therefore, the use of tungsten carbide products and washing with quartz sand is recommended for 14C measurement of pulverized teeth.
  • The Effect of Cold Chamber Temperature on the Cadaver’s Electrolyte
           Changes in Vitreous Humor and Plasma
    • Abstract: Publication date: Available online 23 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Abilash Srinivasa Murthy, Siddhartha Das, Harichandrakumar Kottyen Thazhath, Vinod Ashok Chaudhari, Prashant Shankarrao Adole Determination of time since death is one of the important objectives of a medicolegal autopsy. The level of electrolytes present in the body fluids acts as a helpful indicator in this regard. Nowadays cold chambers are present in most of the autopsy centres where the body is stored for a variable period of time at a temperature which is different from the environmental temperature. This study was undertaken to know the effect of the cold chamber temperature on the changes in sodium, potassium and chloride levels of vitreous humor and plasma and also to estimate the time since death from the levels of these electrolytes. For this, the study subjects were exposed to the cold chamber temperature (in a range of +2°C to +4°C) for a variable duration of time before beginning the autopsy. The results obtained substantiate the fact that the temperature of the cold chamber has a significant effect on the change in vitreous humor potassium level. In subjects exposed to the cold chamber, there was a statistically significant negative correlation between the sodium and chloride levels of vitreous humor with time since death. The R-squared value for the regression equation to predict time since death from vitreous humor sodium level was found to be 0.0916 and was considered a significant predictor of time since death.
  • Sex estimation from skull base radiographs in a contemporary Colombian
    • Abstract: Publication date: Available online 20 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Gretel González-Colmenares, César Sanabria Medina, Martha Patricia Rojas-Sánchez, Katherine León, Anderson Malpud The aim is to study the sexual dimorphism of the base of the skull in radiographs of a bone collection of contemporary Colombian adults, with the intention of formulating discriminant functions capable of classifying sex in this population. The sample consisted of 115 skull base radiographs, (44 females and 71 males), which originated from the Colombian Human Skeletals Collection. Radiographs with good contrast were selected. Images of skulls with asymmetries and fractures were excluded. Five measures: Maximum cranial base length, Foramen magnum length, Maximum cranial breadth, Bizygomatic breadth, Foramen magnum breadth length, were preformed using ImageJ5 software ®; an intra-observer error was determined using paired t-test. Statistical analysis showed a sexual dimorphism for all variables (p< 0.05). The step-by-step procedure of the discriminant function selected 2 variables from the 5 (Foramen magnum length and Bizygomatic breadth) and the precision was between 86.4% and 88.6% in the determination of sex. However cross-validation showed an accuracy of 85.7% to male and 87.2% to female. The skull base is highly dimorphic. The established discriminant functions can be used to estimate sex in the Colombian population.
  • Unusual case of a fatal upper esophageal trauma caused by a toothpick
    • Abstract: Publication date: Available online 19 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): César Lares dos Santos, Rosa Henriques de Gouveia, Duarte Nuno Vieira The authors report the case of the unexpected death of a fifty-year-old female found by her partner in the bathroom floor. External examination revealed some contusions dispersed by different corporal areas and an unusually placed green discoloration of the anterior cervical region. After neck dissection and opening the esophagus, a three and a half centimeter wooden toothpick fragment was found at the upper region, covered by a purulent substance associated with puncture wounds. Histopathological and microbiological studies revealed “acute bilateral cervical cellulitis” and Klebsiella Oxytoca, respectively. Further investigation revealed that during the five days prior to her death, the victim was observed twice in an emergency department with complains of throat discomfort after eating some bread with salami. X-Ray and a laryngoscopy were performed but did not reveal any significant findings. Due to the victim’s medical history, she was evaluated by a psychiatrist that dismissed a non-somatic setting due to the type of complains and the elevation of blood inflammatory parameters. Rinopharyngitis was then assumed as the most likely diagnosis and was treated accordingly. The victim died the following day. This case reports an unusual fatal traumatic lesion to the upper esophagus that is a very important remainder, particularly for clinical practitioners, to maintain a high degree of suspicion, avoid diagnostic biases such as those related to psychiatric disorders and meticulously evaluate patients in order to deliver the most evidence-based diagnosis possible. To the best of the authors’ knowledge there are no other cases described in the literature of a death caused by esophageal toothpick lesion.
  • The advantage of the virtual forensic autopsy - a new approach which could
           benefit forensic expertise
    • Abstract: Publication date: Available online 18 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Pavel Timonov, Stoyan Novakov, Stefan Sivkov, Antoaneta Fasova, Ivan Novakov, Svetlozar Spasov We aimed to assess the accuracy and advantages of postmortem CT examination and three-dimensional (3D) view of the cadaver with the Sectra Visualization Table compared to the full conventional autopsy of a forensic suicidal case. Our survey concerned unusual case of self-strangulation where a body was found in the stage of mummification with a nylon cable tie around the neck and another around the feet. The case was initially determined as a homicide, but later reconsidered a suicide based on objective scene investigation, virtual autopsy and the positions of knots. Unlike the physical autopsy in case of mummification 3D examination does not alter evidence and can revisit the body for additional investigation.
  • Promoting the Qualitative Research Approach in the Discipline of Forensic
           and Legal Medicine: Why more qualitative work should be promoted and how
           that can be achieved
    • Abstract: Publication date: Available online 17 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Dr Kieran M Kennedy Much of the existing published research in Forensic and Legal Medicine is based upon the quantitative approach, which is derived from the positivist paradigm and generally employs pre-determined data collection tools to gather data for statistical analysis with a view to testing hypotheses. It must always be remembered that clinicians are concerned not only with diagnosing and treating medical problems in a vacuum, but rather they must empathise with patients and provide care in a holistic fashion. Too narrow a focus on the quantitative approach to research will significantly limit the evidence base upon which the Discipline of Forensic and Legal Medicine can develop. Wider adoption of the qualitative approach, which stems from the interpretivist paradigm and harnesses research methods that allow in-depth exploration of the meaning and understanding that individuals ascribe to the world around them, would generate rich insight in to patients’ experiences of forensic healthcare, which could be utilised to advance quality improvement. This article outlines how qualitative research can benefit the Discipline, identifies barriers to its use and suggests brief, targeted solutions.
  • Age Estimation by Measurement of Open Apices in Tooth Roots: Study Using
           Saudi Arabian Samples
    • Abstract: Publication date: Available online 17 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Ibrahim AlShahrani, Syed M. Yassin, Rafi Ahmed Togoo, Shreyas Tikare, Mohasin Abdul Khader, Zuhair M. Alkahtani The aim of this study was to verify Cameriere’s regression formula to predict chronologic age in Saudi Population and if proven to be inaccurate, develop a new algorithm specific for Saudi children.A total of 788 Orthopantamographs(495 boys and 293 girls) were analyzed. The tooth measurement parameters were: number of teeth with closed apex (N0), open apex width (a), crown length (l), A/L ratio for each tooth (x1to x7) and summation of all open apex width (s). The radiographic measurements were substituted in the formula:Age = 8.971 + 0.375g + 1.631 x5 + 0.674 N0 – 1.034s – 0.176s * N0The mean dental age assessed by Cameriere’s method was significantly lower than chronologic age in Saudi population and with both genders and total study population (p
  • Potential forensic application of receptor for advanced glycation end
           products (RAGE) and aquaporin 5 (AQP5) as novel biomarkers for diagnosis
           of drowning
    • Abstract: Publication date: Available online 17 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): So-Yeon Lee, Eun-Ju Ha, Hye-Won Cho, Hye-Lim Kim, Dongup-Lee, Yong-Bin Eom Drowning is the most common cause of unnatural death worldwide. There is no single biomarker to diagnose drowning, so the diagnosis of drowning is one of the most difficult tasks in forensic medicine. Especially, distinguishing a victim of drowning from a body disposed of in water following death remains a problem. The objective of this study was to identify specific biomarkers of drowning compared with other causes of death such as hypoxia and postmortem submersion. The present study investigated the intrapulmonary expression of receptor for advanced glycation end products (RAGE), aquaporin-5 (AQP5), surfactant protein-A (SP-A), interleukin 6 (IL-6) and interleukin 1β (IL-1β) as markers of drowning. In animal experiments, all rats (n=45) were classified into four groups (drowning, postmortem-submersion, hypoxia and control group). The lungs of experimental animals were analyzed as mRNA expression, immunoblot expression and immunohistochemical staining. qRT-PCR demonstrated increased mRNA expression of RAGE and AQP5 in drowning group compared with that in control, hypoxia and postmortem-submersion group, but not other molecules. Western blotting also showed high expression of RAGE and AQP5 in drowning group, immunostaining of RAGE and AQP5 was highly detected in a linear pattern in type I alveolar epithelial cells, compared with control and postmortem-submersion group. These observations indicate a difference of expression in pulmonary molecular pathology compared with other causes, suggesting RAGE and AQP5 may be useful for differentiation between drowning and postmortem-submersion.
  • Contemporary Understanding of Zoophilia — a Multinational Survey
    • Abstract: Publication date: Available online 4 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Damian Jacob Sendler IntroductionPeople with paraphilias have sexual interests that are unusual, including inanimate objects, places, or individuals (children, corpses). This study explores zoophiles (=PSA, people who have sex with animals) recruited from the Internet.MethodWe administered a survey of own design via the Internet on popular discussion forums targeting the communities of PSA. All responses were quantified as the percentage of agreeing with one of the possible answer choices, plus the interpretation of qualitative data that may have been supplied in additional space.ResultsSurvey questions were thematically categorized into four groups — worldview, personal space, sex life, and online space. PSA are remarkably self-aware of their sexuality and recognize that their behavior is illegal (even though they perceive it as an expression of love); they often relate their struggles with finding social acceptance to homosexuality, believing that one way of de-stigmatizing them would be to remove zoophilia from the list of disorders listed in the DSM. Concerning sex life, PSA believe that the quality of sex with animals is much higher than with humans, and physical features, such as the presence of a fur, can be sexually arousing to PSA, especially when seeing animals in public. PSA utilize the Internet to network and connect with other PSA; these Internet-based friendships usually do not extend beyond online conversations, given that PSA tend to be mistrustful of other zoophiles particularly in the area of personal safety.ConclusionsOne of the most essential basis of zoophilia is relationship seeking behavior as well as interest in forming a long-term relationship with an animal partner.
  • Management of victims occurred in mass disaster: the experience of center
           Italy earthquake 2016
    • Abstract: Publication date: Available online 4 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Cipolloni Luigi, Baldari Baldari, Besi Livia, Scopetti Matteo, Di Sanzo Mariantonia, Ursu Simona, Fineschi Vittorio
  • Artificial intelligence for sex determination of skeletal remains:
           Application of a deep learning artificial neural network to human skulls
    • Abstract: Publication date: Available online 4 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): James Bewes, Andrew Low, Antony Morphett, F. Donald Pate, Maciej Henneberg A deep learning artificial neural network was adapted to the task of sex determination of skeletal remains. The neural network was trained on images of 900 skulls virtually reconstructed from hospital CT scans. When tested on previously unseen images of skulls, the artificial neural network showed 95% accuracy at sex determination. Artificial intelligence methods require no significant expertise to implement once trained, are rapid to use, and have the potential to eliminate human bias from sex estimation of skeletal remains.
  • The mental health of foreign national prisoners
    • Abstract: Publication date: Available online 2 January 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Alex Till, Piyal Sen, Lucia Chaplin, Edward Grange, Tim Exworthy, Andrew Forrester Foreign national prisoners include people who are subject to criminal proceedings and have been deprived of their liberty in a state in which they are neither a national nor a resident. In the United Kingdom, they constitute approximately 10,000 individuals and represent around 12% of the total prison population. Significant health disparity exists within the general prison population compared to society at large and foreign national prisoners suffer even higher rates of both physical and mental health disorders. The impact of detention; extradition, deportation and administrative removal legislation; and mental health service provision for foreign national prisoners is discussed. The right to health encompasses access to appropriate healthcare independent of legal status and like all human rights, extends to foreign national prisoners. Change is required and the provision of equivalent care for foreign national prisoners requires global attention.
  • Postmortem IgE determination in coronary artery disease
    • Abstract: Publication date: Available online 24 December 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Karine Lambert, Rexson Tse, Camilla Tettamanti, Maria Pia Scarpelli, Guillaume Rousseau, Alessandro Bonsignore, Cristian Palmiere Allergic, IgE-mediated inflammation is thought to play a role in atherogenesis and atherosclerotic disease progression. In this study, total IgE and mast cell tryptase were measured in a series of forensic autopsy cases including non-allergic cardiac deaths (14 cases with minimal or no coronary atherosclerosis, 14 cases with significant coronary artery atherosclerosis without acute coronary thrombosis, and 14 cases with significant coronary artery atherosclerosis and acute coronary thrombosis or myocardial infarction) and non-allergic non-cardiac deaths (21 cases with death due to hanging and 21 cases with death due to intracranial gunshot wounds), in order to correlate laboratory results with morphological findings and compare them to conclusions reported in the clinical setting. In cardiac death cases, postmortem serum total IgE levels were increased in 7 out of 42 cases and mast cell tryptase levels were increased in 3 out of 42 cases. In non-cardiac death cases, postmortem serum total IgE levels were not increased in 39 out of 42 cases and mast cell tryptase levels were not increased in any of these cases. These preliminary findings seem to indicate that a portion of coronary deaths characterized by coronary artery atherosclerosis of various severities are also characterized by increased total IgE and mast cell tryptase levels, thus corroborating the data previously reported in both clinical and forensic literature on this topic as well as the necessity of combining morphological investigations focusing on the heart and coronary arteries with biochemical analyses.
  • Stature estimation from different combinations of foot measurements using
    • Abstract: Publication date: Available online 23 December 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Bahadur Singh, Kewal Krishan, Kawaljit Kaur, Tanuj Kanchan Establishing the identity of the deceased is the most important task for forensic anthropologists in forensic case-work involving unidentified human remains. In such cases, forensic anthropologists examine the remains to derive the biological profile of the deceased i.e. estimation of age, sex, stature, and ethnicity to narrow down the search of the missing. Dismembered remains are recovered in mass disasters such as train mishaps, airplane crashes, earthquakes, and terrorists’ attacks or in homicidal cases where perpetrator intentionally mutilates the dead body to conceal the identity of the victim. Stature estimation is considered as one of the most important tasks when a mutilated foot is recovered in process of narrowing down the pool of possible suspects/victims. Allometry is the underlying principle for estimation of stature from foot dimensions. It has been learnt from the published literature that multiple regression models including more than one factor enhances the estimation accuracies. Among the various foot dimensions, foot length is the most frequent parameter used in the estimation of stature in forensic literature. In the present study, an attempt has been made to standardize the stature estimation models from various possible combinations of foot dimensions. For this purpose, 388 Jatt Sikh males aged between 18 and 30 years were recruited from various villages of Ludhiana district of Punjab State in Northern India. Stature, five foot length measurements, and two foot breadth measurements were taken on each subject. Linear and multiple regression models were derived for the estimation of stature from various foot measurements. The highest coefficient of determination and estimation accuracy (the least standard error of estimation S.E.E) was observed from T1 (R2 = 0.397, S.E.E = 4.7109) when a single foot dimension was included in the model, (R2 = 0.416, S.E.E = 4.6425) from (T1, T3) when two-foot lengths were taken, (R2 = 0.418, S.E.E = 4.6426) from (T1, T3, T4) when three-foot lengths were included, (R2 = 0.418, S.E.E = 4.6473) from (T1, T3, T4, T5) when four-foot lengths were included, and (R2 = 0.418, S.E.E = 4.6531) when all the five foot lengths (T1, T2, T3, T4, T5) were included in the regression model. It has been concluded that multiple regression models provide more accurate results than linear regression models. However, inclusion of a factor having a weak correlation with stature in the regression model, decreases the accuracy of the model.
  • Metabolism And Metabolomics Of Opiates: A Long Way Of Forensic
           Implications To Unravel
    • Abstract: Publication date: Available online 19 December 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Ricardo Jorge Dinis-OliveiraABSTRACTOpium poppy has important medical, socioeconomic, forensic and political implications. More than 80 benzylisoquinoline alkaloids have been described, many of them with relevant therapeutic properties such as morphine, codeine, papaverine and noscapine. Heroin, a semi-synthetic drug produced from morphine, has become a serious worldwide morbidity and mortality problem to solve. Addiction to heroin is complex phenomenon with environmental and genetic influence, and several biomarkers of exposure have been proposed. This works aims to review the metabolism and metabolomics of opiates with particular interest to their relevance as potential clinical and forensic antemortem and postmortem biomarkers. It is known that the heroin is mainly a prodrug that is rapidly deacetylated in blood to its active metabolite, 6-acetylmorphine, which is then subsequently slowly deacetylated to morphine. Therefore, 6-acetylmorphine has been used as the main target metabolite to prove heroin abuse in clinical, but mostly in forensic routine. Nevertheless, its applicability is limited due to the reduced detection window. Therefore, morphine (and its metabolites morphine-3-glucuronide and morphine-6-glucuronide), codeine, codeine-6-glucuronide, 6-acetylcodeine, noscapine (and its metabolites meconine, desmethylmeconine, and cotarnine), papaverine (and its metabolites 6-desmethylpapaverine, hydroxypapaverine, dihydroxypapaverine, 6-desmethylpapaverine-glucuronide) and thebaine (and acetylthebaol and the non-acetylated analog thebaol) have been additionally recommended to obtain the most reliable results possible. More recently, the metabolomics identification of several endogenous compounds offered an alternative approach of significant importance to uncover toxic effects. Profound alterations in the neurotransmitters levels and energy and amino acid metabolism have been reported with l-tryptophan, 5-hydroxytryptamine and 5-hydroxyindoleacetate being suggested as potential non-specific biomarkers of long-term heroin addiction. These endogenous metabolic profiles and exogenous components that together comprise the exposome will certainly help to uncover metabolic disturbances and patterns that may be associate to addiction with relevant clinical and forensic implications.Graphical abstractImage 1
  • Estimation of the postmortem interval based on the human decomposition
    • Abstract: Publication date: Available online 13 December 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Gelderman HT, Kruiver CA, Oostra RJ, Zeegers MP, Duijst WLJM Postmortem interval (PMI) estimations which are used as evidence in Dutch court are sometimes solely based on the experience of the forensic physician without a scientific background. The aim of this study was to investigate the degree of agreement between forensic physician and their PMI estimations.Fifteen cases were selected from 1534 external postmortem investigations. Photographs of the human remains were presented to 89 forensic physicians in the Netherlands with the instruction to estimate the PMI based on their experience, knowing the remains were found indoors and in which season. Data analysis was conducted by using an interclass correlation (ICC) and Spearman’s rank correlation coefficient.This study shows a poor correlation (ICC = 0.254) between the PMI estimations of the 89 forensic physicians. It is therefore not advised that PMI estimations based on experience be used as evidence in court.
  • Optimizing Denaturing HPLC as a Robust Technique for Identification of
           Short Tandem Repeats (STR) in Forensic Medicine
    • Abstract: Publication date: Available online 10 December 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Mohammad Reza Eskandarion, Taghi Golmohamadi, Arash Alipour Tabrizi, Reza Nasr, Mohsen Tabasi, Armin Attaranzadeh, Mohammad Reza Akbari Eidgahi IntroductionShort Tandem Repeats (STRs) are defined as short lengths of 2-7 base pairs spreading through human genome which due to their highly diverse individually distribution are widely applied for identity detection and other forensic medicine purposes. Burdening considerable costs by the conventional methods such as capillary electrophoresis, we aimed to compare concomitant usage of multiplex PCR and denaturing high-performance liquid chromatography (DHPLC) as cheap, fast, highly accurate, and more accessible methods, with capillary electrophoresis (CE) to evaluate their potential for early screening of STRs.Materials and methodsThe present study randomly included 20 blood samples from the subjects referred to forensic medicine of Semnan, Iran. According to the size and allele frequency, we selected 8 major STR loci including CSF1PO, VWA, D18S51, TPOX, Amelogenin, FGA, SE33, and Penta D. A quad-STR multiplex PCR was performed for each locus and the PCR products were then analyzed using DHPLC machine and compared with the basic genetic properties obtained by capillary electrophoresis.ResultsBy optimizing the PCR and DHPLC conditions, our findings suggest this strategy as an effective method for STR detection. The genotypes were determined using size of loci which led to comparable results with capillary electrophoresis confirming an insignificant variation in the detection of TOPX, Amelogenin, CSF1PO, and D18S5 (p=0.331), but discrepant results for FGA and VWA loci (p=0.002).ConclusionOur study proposed DHPLC method as an effective screening method to characterize TOPX, Amelogenin, CSF1PO, and D18S51 as frequently used STR loci during identity detection in forensic medicine.
  • Why We Can't Determine Reliably The Age Of A Subject On The Basis Of His
           Maturation Degree
    • Abstract: Publication date: Available online 5 December 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Silvano Milani, Lodovico Benso BackgroundMaturation is the irreversible biological process leading to adult form or function. The degree of maturation can be derived from the examination of maturity indicators, i.e. of particular aspects of the overall maturation, such as pubertal status, skeletal and dental morphology. Rhythm of maturation of each indicator differs between populations and individuals, because of genetic, nutritional and environmental factors. Skeletal maturation is usually expressed as skeletal age, which is the median age at which a given degree of maturation is attained. Despite its name, skeletal age indicates a degree of maturation and not a chronological age. This misinterpretation still results in a confused, unprofitable, and endless debate about the reliability of forensic age and its ethical, deontological, legal and scientific aspects, while its estimation is gaining raising importance in forensic practice, due to increasing migration movements towards Europe.ContentsThis paper clarifies the meaning of biological age compared to chronological age, quantifies the uncertainty associated with forensic age in terms of biological variability (differences in the degree of maturation of subjects with the same chronological age), bias (systematic differences between ethnic groups), and lack of precision (random errors made in the evaluation of an X-ray image). Because of the inter-individual variability, the interval between the 3rd and 97th centile of chronological age distribution of healthy adolescents sharing the same skeletal age and belonging to a given population has width of at least ±2 years about the skeletal age (uncertainty interval). This – and not others – uncertainty interval (±2 years) is the only interval that should be specified by the expert witness, when he presents his estimate of the age of an adolescent without identification documents.ConclusionsExpert witnesses should be aware that the age of an adolescent can be determined only with rough approximation, even when they assess maturation with the most reliable method, and that, when they produce their conclusions to the judicial or public security authorities who requested to determine the age of an adolescent, they are determining for ever the fate of a young human being.
  • Fatal atlantoaxial dislocation due to an odontoid synchondrosis fracture
           in a child with chromosome 9 abnormality: A case report
    • Abstract: Publication date: Available online 29 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Rutsuko Yamaguchi, Yohsuke Makino, Go Inokuchi, Shinya Hattori, Fumiko Chiba, Suguru Torimitsu, Naoki Saito, Takashi Kishimoto, Hirotaro Iwase A 5-year-old boy with a chromosome-9 abnormality and multiple external and visceral malformations was found in cardiopulmonary arrest during a regular visit to the hospital; he did not respond to cardiopulmonary resuscitation and died. An odontoid process fracture and calcification and fibrosis of the muscles around the superior cervical vertebra were observed during the autopsy. Postmortem computed tomography revealed an anterior dislocation of the atlas; odontoid synchondrosis fracture; and delayed, incomplete bony fusion of the odontoid process relative to his age. The cause of his death was a superior spinal cord injury. The tissue surrounding the upper cervical spine presented with myositis ossificans, suggesting a prior injury. He experienced a minor traffic accident 3 months before his death. It was concluded that the odontoid synchondrosis fracture occurred during the accident based on the incomplete bony fusion and atlantoaxial instability, which were consistent with the findings of myositis ossificans. Delayed fatal dislocation may then have occurred under the influence of a minor external force. Odontoid process abnormalities and atlantoaxial instability are common in patients with trisomy 21 and other congenital diseases; however, the condition’s association with chromosome-9 abnormalities has not been reported. In children with various chromosomal abnormalities, periodic assessment of instability and morphology of the cervical spine, and a lowered examination threshold for the children at risk, could prove useful in the prevention injuries leading to fatality, and provide additional information to rule out abuse.
  • Sudden and unexpected death due to intracranial sellar extramedullary
    • Abstract: Publication date: Available online 26 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Jozef Sidlo, Henrieta Sidlova The incidence of sudden death caused by undiagnosed primary intracranial neoplasm in young adults is extremely low. The aim of the work is to present a case report of the sudden death of a 24-year-old woman. The autopsy has revealed enlargement of sella turcica with an intrasellar tumorous mass extending into the adjacent basal parts of the brain. A tumour was diagnosed as an extramedullary plasmacytoma. The cause of death was established as a failure of the central nervous system. Toxicological analyses of biological materials were negative. According to the case history, a woman reportedly had no serious health problems. Finding of an extensive intracranial tumour in the sella turcica was random and surprising. The presented case is an extremely rare case of sudden death caused by intracranial intrasellar extramedullary plasmacytoma without previous clinical manifestation.
  • Biomechanical analysis in osteoarchaeology: Reconstruction of
           pathomechanics, treatment and gait caused by a femur fracture in the late
           middle ages
    • Abstract: Publication date: Available online 24 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Marta Licata, Silvia Iorio, Piergiorgio Benaglia, Adelaide Tosi, Melania Borgo, Giuseppe Armocida, Alessandra Ruspi, Andrea Verzeletti, Chiara Rossetti In paleopathology, biomechanics allows us to investigate traumas in ancient skeletal remains. The aim of our current research is to reconstruct pathomechanics, treatment and gait of an individual from a Late Medieval femur with evident bone callus. In particular, to reconstruct the dynamic of the trauma that caused the injury and the adopted therapeutic measures, taking into account medical knowledges of that time.The femur was recovered during the archaeological investigation in the Sanctuary of Sacro Monte, Varese (Northern Italy). Classical physical anthropological methods and CT scans were used for macroscopic and radiological measurements of the bone. Finally, the reconstruction of the static and dynamic functional outcomes of the lesion were performed by Observation Gait Analysis (OGA) procedure.The femur shows an important callus at the middle third proximal of the shaft. The antemortem fracture was oblique and caused by a direct trauma probably related to occupational activities. The alignment of the segments in the frontal plane lead us to assume that the fracture was treated and the femur was immobilized with splints. The overlap and the angle of the segments indicate that the subject was not submitted to traction or fracture reduction. Good bone remodeling and consolidation of the fracture suggest that the subject had gradually led to the resumption of load and walking, although with important effects on posture and movement.The use of the OGA allow us to highlight the subject's kind of gait after healing.
  • Successful analysis of a 100 years old semen stain generating a complete
           DNA STR profile
    • Abstract: Publication date: Available online 19 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Alessandro Mameli, M.S.; Carmine Maria Scudiero, Giovanni Delogu, Maria Elena Ghiani We performed forensic investigations on a handkerchief containing seminal fluid deposited 100 years earlier. The aim was to verify the possibility to achieve a complete genetic profile exceeding the limit of success reached until today with a partial semen stain profile stored up to 50 years. The current forensic methods were carried out: Alternative Light Source (ALS), Prostate-Specific Antigen (PSA) Test, autosomal and Y-chromosome Short Tandem Repeats (STRs). ALS inspection was a crucial method in the success of the analysis. On a dried semen stain, fluorescence remains constant for a very long time, allowing possibility to minimize the fabric sample to analyze, in order to preserve specimen for future defense guarantees or to protect historical finding. We achieved positive results in 3 of 6 traces, PSA and DNA results were concordant, only those cuttings that tested positive for PSA yielded DNA profiles. A complete male profile was generated by AmpFlSTR Identifiler Plus and 16 loci profile by AmpFLSTR Yfiler. Considering some historical sources that attributed this handkerchief dated 1916, to a famous Italian poet, the DNA profile found on the handkerchief was compared with a living male descendant, and the comparison of the Y-STR between the two gave positive results, confirming the reliability of the outcomes. The findings achieved by the current forensic method empower the application of this methodology to other forensic cases, especially in past unresolved cases.
  • Not quite anyone's guess: Brexit, forensic science and legal medicine
    • Abstract: Publication date: Available online 15 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Tim J. Wilson Six months before 29th March 2019 - the date when the UK is due to leave the EU (‘Brexit’) - the nature of the future UK-EU relationship is highly uncertain. Some of the consequences of the new relationship – whatever form it takes - for legal cooperation and everything (including forensic science and legal medicine) that underpins it can be anticipated. Further analysis, however, of the scope and significance of Brexit for the professional and academic scientific and clinical work covered by this journal is needed urgently. This commentary ends with an invitation to its readers to join a new academic and professional network (including professional corporate bodies and NGOs) intended to help facilitate this.
  • Title: The Danger of a Single Story about Forensic Humanitarianism
    • Abstract: Publication date: Available online 15 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Adam Rosenblatt
  • Can pulmonary foam arise after postmortem submersion in water' An
           animal experimental pilot study
    • Abstract: Publication date: Available online 10 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Guido Reijnen, Petra Vos, Marcel Buster, Udo Reijnders It is difficult to differentiate drowning from postmortem submersion. Pulmonary foam can be found in bodies retrieved from water. It is unknown whether foam is a result of drowning or if it also forms after postmortem submersion. We divided deceased piglets into three groups: postmortem saltwater submersion (N = 20), postmortem freshwater submersion (N = 20) and dry-land controls (N = 20). All carcasses underwent endoscopic examination within 24 hours of death and the presence of external and internal pulmonary foam was scored. No external foam was detected in the postmortem freshwater or the postmortem saltwater group. Internal foam was seen in 35% of the postmortem freshwater and 40% of the postmortem saltwater group. No external or internal foam was detected in the dry land control group. The literature shows external as well as internal foam in drowned humans. Internal foam is seen in postmortem submersion in the current piglet study and antemortem submersion in the literature in humans, and can therefore not be used to support/refute the diagnosis of drowning. No external foam was present in the postmortem submersed piglets, yet has been described in drowned humans. Hence the presence of external foam in bodies recovered from water may be indicative for drowning. The presence of external foam is a potentially valuable clinical sign in distinguishing drowning from postmortem submersion.
  • Toxicological Findings in 1000 Cases of Suspected Drug Facilitated Sexual
           Assault in the United States
    • Abstract: Publication date: Available online 10 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Taís Regina Fiorentin, Barry Kerr Logan The purpose of this study was to identify the extent and types of drugs found in alleged drug facilitated sexual assaults (DFSA) in 37 states and 1 territory of the United States. In total, 1000 cases were reviewed. Between the cases that gender was provided (613), most of the victims (91.68%) were woman, mean age of 26.8 years old. Blood and/or urine samples were tested. Twenty-one point six percent of the cases were negative for intoxicating substances. A hundred and one different substances were detected. Overall, ethanol was the most prevalent substance, detected in 30.9% of the cases (309 cases), followed by cannabinoids (THC/THCCOOH/11-OH-THC) (28.8% of cases), amphetamine/methamphetamine (16.5% of cases), cocaine/metabolites (10.4% of cases), and clonazepam/metabolite (7.6% of cases). The mean, median and range concentrations of ethanol in blood (n=309) were 98.6 mg/dL, 82.0 mg/dL and 9.2 – 366 mg/dL, respectively. Ethanol and cannabinoids were the most frequent combination found. The absence of alcohol and drugs in some cases may represent delay in collecting samples.
  • Comparison of post-mortem ethanol level in blood and bone marrow
    • Abstract: Publication date: Available online 10 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): M. Iskierka, M. Zawadzki, P. Szpot, T. Jurek
  • The multi-factorial determinism of forensic expertise regarding sentence
           interruption on medical grounds and decision
    • Abstract: Publication date: Available online 10 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Cristian Gherman, Alexandra Enache, Cristian Delcea The topic proposed by this research is the complex determinism or requesting forensic expertise for the purpose of postponing or interrupting a sentence in medical ground. Within the topic, it was necessary to perform a complex analysis on several aspects of inmate life, from the point of view of their rights and especially the right to medical assistance. We have included aspects related to the evolution of the legal framework and current regulations, to the status of medical assistance in the penitentiary environment (illustrating realities related to morbidity and mortality) and to the doctor-patient relationship during a forensic expertise. To this end, this paper aims to reveal the realities of how inmates are informed about the framework in which the institution of forensic expertise operates, as well as to analyse the inmates’ perception on the accessibility and usability of this type of expertise. At the same time, we aimed to identify cases which abusively exceed the boundaries of requesting sentence interruption on medical grounds and the causes of these situations. In the first part, a retrospective statistical study was performed in mortality within the penitentiary population in the area included in the study. The characteristics particular to the doctor-inmate patient relationship were also explored.
  • Cranial sutures and age estimation – A few reflections
    • Abstract: Publication date: Available online 9 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Rutwik Shedge, Tanuj Kanchan
  • Review of a Forensic Pseudoscience: Identification of Criminals from
           Bitemark Patterns
    • Abstract: Publication date: Available online 3 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): C. Michael Bowers The forensic sciences are a combination of laboratory procedures and physical comparisons of objects associated with victims, perpetrators, and crime scenes. The former is largely university-based protocols adopted by crime labs. The latter is predominantly pattern-matching tools originally developed by police examiners or experts deemed by courts to be relevant to forensic matters. These Court accepted experts bring their reasoning and conclusions into the legal arena. This subgroup of forensics has undergone significant scrutiny in regards to its history of exaggerated claims and weak scientific foundations. This paper addresses the rise and fall of bitemark pattern analysis (i.e. “matching” bitemarks in human flesh to human teeth) in the environment of opposing interests and agendas.
  • Ethical Challenges of Kidney Sale: A Review of Three Major Assumptions
           Based on the Theories of Ṭabāṭabā’ī
    • Abstract: Publication date: Available online 1 November 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Rahim Dehghan This paper seeks to provide an ethical assessment of kidney sale based on the theories of a contemporary Shiite theologian, Muḥammad Ḥussain Ṭabāṭabā’ī. It aims to offer a mechanism to decide the justifiability or unjustifiability of kidney sale in ethical terms. Ṭabāṭabā’ī considers ''Divine Consent'' as the criterion for the morality of an action. An action meets the “Divine Consent” requirement if it is done with a sincere intention, confirmed by reason and Divine revelations, brings about an internal peace for the agent, and preserves the agent’s dignity and autonomy. Given this criterion and through an analytic and qualitative method, this paper aims to evaluate kidney sale in three cases: during one’s lifetime, during brain death when the agent has left no will, and during brain death when the agent has left a will. It seems that, based on the theories of Ṭabāṭabā’ī, the above requirements are only met in the first two cases. Thus, kidney sale is morally justifiable in the first two cases but not in the third.
  • Domestic-setting corpses, an urban problem'
    • Abstract: Publication date: Available online 25 October 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Natalie F. Runtuwene, Marcel C.A. Buster This study describes the domestic-setting corpses that remain unnoticed for two weeks or more. It compares the occurrence of this phenomenon in the city of Amsterdam with the surrounding municipalities of Amsterdam (SMA). Data of 437 cases were extracted from the forensic medical register of Amsterdam. Data of size and household situation of the population were extracted from Statistics Netherlands. A 3.7 (95%CI 2.8–4.9) times higher incidence rate, was observed in the city of Amsterdam (n = 379; 5.3/100,000 personyears) compared to the SMA (n = 58; 1.4/100,000 personyears). All but three cases lived alone. After limiting both cases and reference data to single households, the crude rate ratio was 2.1 (95%CI 1.6–2.7). Further adjustment for age and gender resulted in a Standardized Mortality Ratio of 0.36 (95%CI 0.28–0.47). This means the occurrence of domestic-setting corpses (14 + days) among people living alone is 2.7 times higher in the city of Amsterdam (95%CI 2.1–3.5).We conclude domestic-setting corpses are more likely to occur in an urban environment. This is partly explained by the higher proportion of single households in the city compared to the more rural areas. However, differences in social cohesion and architecture between urban and rural areas are expected to be important too.
  • The appearance of breast cancer metastases on dry bone: implications for
           forensic anthropology
    • Abstract: Publication date: Available online 25 October 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Lucie Biehler-Gomez, Gaia Giordano, Cristina Cattaneo Breast carcinoma is a major cause of morbidity and mortality in women. The study of bone pathologies presents considerable potential in anthropology, paleopathology, forensic science and medicine. In this paper, we present and discuss metastatic lesions found in the skeletons of known individuals from the CAL Milano Cemetery Skeletal Collection, clinically diagnosed with breast cancer during life. Fourteen skeletons from a contemporary and identified collection were macroscopically studied and metastases were identified by comparison with clinical literature. As a result, bone metastases were observed in 43% of the study sample. They were located most commonly on the ribs (28.1%), pelvic girdle (19.8%), vertebrae (15.6%), skull (15.6%), scapulae (10.2%) as well as proximal segment of the femora (8.4%) and humeri (2.4%) respectively, favoring sites of high vascularization. The majority of the lesions were osteolytic, although osteoblastic and mixed metastases did occur. Osteolytic metastases appear as coalescent porosity or round to oval perforating lesions on bones with denticulated margins and pitted surrounding bone, whereas osteoblastic metastases thickened the existing trabecula (spongiosclerosis). Mixed metastases were perforating lytic lesions exposing the osteoblastic activity in the underlying trabecular bone. These results, consistent with the data from the literature, strengthen the diagnostic criteria for metastases and illustrate the aspect of bone metastases in breast carcinoma.
  • Homicidal Poisoning in India: A Short Review
    • Abstract: Publication date: Available online 23 October 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Asit Kumar Sikary This review has analysed various studies and case reports on homicide by poison from different parts of India till date. This review shows that homicidal poisoning prevalence varies from 0.3% to 3.7% having varied prevalence from different regions with no homicidal cases too. The poisons used in homicide were mainly organophosphates, aluminium phosphide, paraquat, and arsenic. No age-group or gender was spared and the perpetrators were first degree relatives.
    • Abstract: Publication date: Available online 10 September 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Roger W. Byard
  • Thymic changes and sudden infant death syndrome (SIDS)
    • Abstract: Publication date: Available online 10 September 2018Source: Journal of Forensic and Legal MedicineAuthor(s): Roger W. Byard
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