Forensic Sciences

Background: Among the deaths recorded during the COVID-19 pandemic, some were caused by clinical manifestations of venous thromboembolic disease, mainly pulmonary embolism. Several litigations were settled worldwide for professional malpractice associated with COVID-19 and anticoagulant therapy management. The authors aimed to discuss, as court-appointed consultants in civil court, a case settled for compensation against a healthcare facility associated with SARS-CoV-2 infection. Case report: We described the case of an old patient in therapy with a direct oral anticoagulant for thrombotic diathesis, hospitalized for COVID-19 pneumonia, who died after two intra-hospital adverse events influencing coagulation imbalance. Discussion: Two health professionals’ malpractice hypotheses were discussed related to the adverse events’ occurrence: one related to the administration of an enema, resulting in rectal perforation, and the other related to proper anticoagulant prophylaxis and comprehensive coagulation imbalance management after the rectal perforation in a patient at high risk of venous thromboembolic disease. Intra-hospital adverse events complicated the hospitalization and then significantly reduced the concrete possibility, even uncertain in terms of time and extent, of the patient’s living longer, representing the damage of reduced possibilities of survival, also called loss-of-chance damage. Conclusions: The case discussed as court advisors, characterized by clinical and legal complexity, together with SARS-CoV-2 infection, underscores the vital role of forensic examiners in cause-of-death ascertainment and as interpreters of statistical-probabilistic data according to naturalistic, logical, and scientific criteria. Full article

Background: Over the course of the last decade, cybercrime has become a significant global concern. A comprehensive approach to crimes that occur in cyber contexts needs to address not only the technological aspects of cybercrime but also the human elements. Therefore, the aim of the current research is twofold: first, to gain an in-depth understanding of the pathways that lead to criminal hacking behavior through interviews with current or former criminal hackers, and second, to explore how the lived experiences of these individuals fit within theoretical explanations of hacking. Method: Semi-structured interviews were conducted with a sample of ten current and former criminal hackers. Participants for this study were recruited through social media and hacker forums. Interviews were conducted from November 2023 to March 2024. Data collected during the interviews were analyzed through a process of thematic analysis. Focusing on the lived experiences of these hackers, a “pathway of hacking” behavior, expanding upon those proposed in research emanating from Europe, was identified. Findings: Notably, the current study found that young males who are curious and creative in childhood, experience destabilizing events, and develop an early interest in technology are well placed to follow the pathway to criminal hacking behavior. Online gaming was identified as a possible gateway to criminal hacking activities. A sense of overcoming a challenge, being elite, and having “control over the machine” encourages youth to continue criminal hacking activities. In addition to the identification of a criminal hacking pathway, an integration of existing cyberpsychological, psychological, criminological, and sociological theories is presented to provide a theoretical explanation for the initiation, continuation, and desistence of criminal hacking behavior. This work represents the first effort to present an integration of theories (e.g., Social Learning, General Theory of Crime, Flow, and the cyberpsychological theoretical construct of the “Online Disinhibition Effect”) based on the stages of the criminal hacking pathway. Full article

Background: A psychological autopsy is a post-mortem investigative tool used to carry out a retrospective reconstruction of a missing subject’s life. The method includes gathering information from all the potentially involved parties, which may indicate the relevant elements directly or indirectly to trace the victim’s experience and identify personality traits, lifestyle, and interpersonal relationships. Discussion: Psychological autopsies are mainly performed during criminal investigations to identify the cause of death and the specific circumstances (natural, accidental, suicidal, or homicidal death). In addition, from an epidemiological point of view, this method aims to collect the relevant information about an individual’s behavior, circumstances, and reasons for their death to identify common risk factors to prevent new suicides. Although less frequently, this tool can also serve other purposes, such as the legal validity estimation of pre-death actions. Moreover, it may be used to assess whether mistakes have been made in treating people undergoing medical or psychological treatment. Conclusions: Currently, this methodology still has a limited diffusion on the Italian and European scenes due to the lack of standardized guidelines and substantial relevant scientific literature. It is the main factor affecting the tool’s reliability, validity, and systematic application in forensic investigations. Full article

The Y chromosome plays a crucial role in understanding the overall landscape of male health. Incorporating the Y chromosome into genomic and epigenomic research may elucidate the male-specific mechanisms behind aging and the pathogenesis of certain conditions, both acute and chronic. Present epigenetic research focuses on the effects of modifications like methylation on autosomal chromosomes. However, little research has been conducted to further these investigations in sex chromosomes, especially the Y chromosome. Epigenetic analyses can identify age-associated CpG sites that may offer potential biomarkers for age estimation and disease risk assessment, among others. This review emphasizes interdisciplinary efforts that have been made in the construction of an assembly and the application of “epigenetic clocks” to the Y chromosome. The studies reviewed here examined the effects of aging on genes such as NLGN4Y, DDX3Y, and TBL1Y, and on male-specific health disparities and disease etiologies, as well as the potential for the use of these genes to assess the diagnostic and age algorithmic potential of Y-specific genes. Full article

Background: The SARS-CoV-2 pandemic led to an enormous global health, social and economic crisis. The pandemic caused considerable upheaval and considerable difficulties due to an unforeseen and devastating health condition. Materials and Methods: We discuss the numerous challenges encountered in the fields of forensic medicine and public health during the COVID-19 pandemic. Particularly during the first wave of the pandemic, forensic pathologists faced significant difficulties due to the lack of safe autopsy protocols and insufficient personal protective equipment. Mainly in Europe, they had to manage a substantial number of potential cases of medical liability related to COVID-19. The widespread outbreak of the virus in residential care homes and prisons posed another significant challenge. Furthermore, forensic pathologists had to address the issue of complications arising from vaccination campaigns. Conclusions: This article underscores the need for continued efforts in scientific research and healthcare preparedness to effectively manage such complex crises. Forensic pathologists must be equipped with the necessary resources and training to address unpredictable, complex situations with far-reaching social implications. Full article

Forensic Odontology is a critical field within forensic science, with significant importance in legal contexts and the identification of victims in mass disasters or cases of abuse. This article focuses on the efforts made by the European University Cyprus (EUC) School of Dentistry to raise awareness among dental students regarding legal and forensic dentistry practices. Through voluntary visits to the Anthropological Laboratory of the Committee on Missing Persons (CMP) in Cyprus, students gain firsthand experience and insights into anthropological analysis for identifying missing individuals. These visits provide students with practical application opportunities, emphasizing record-keeping practices, oral tissue morphology analysis, and unique aspects of restorative work during identification processes. Feedback from participating students highlights the value of experiential learning in increasing awareness about forensic odontology’s importance and relevance in real-world scenarios. The initiatives undertaken by the EUC School of Dentistry contribute to enhancing legal and forensic dentistry awareness among future dental professionals in Cyprus. Full article

Defense wounds generally occur when a victim attempts to protect vital organs and blood vessels during an assault, and are therefore typically located on the forearms or hands. Gunshot-induced defense wounds are less frequent compared to stab wounds, which have been extensively described in the literature. We present three cases where victims unsuccessfully attempted to defend themselves from gunshots, and where the detailed description of injuries played a key role in the reconstruction of the crime scenes. In the first case, a man was shot with a smooth-bore shotgun, presenting a “through-and-through” gunshot wound on the lateral surface of the left forearm and a large gaping wound on the posterior surface of the same forearm. The second and third cases involved two men who were shot with handguns. The first displayed an entrance wound on the dorsal surface of the right hand, with burned edges and smoke soiling, and an exit wound on the palmar surface. The second case involved two wounds on the left hand: one on the dorsum and the other on the palm. To the best of our knowledge, few studies in the literature emphasize the role of gunshot defense wounds in aiding the reconstruction of crime dynamics. The cases presented in this study highlight the importance of precisely defining the pathological and morphological features of the wounds, as well as the bullet trajectories, to accurately identify defense wounds. These findings are valuable for reconstructing the dynamics of the assault and providing critical information to the public prosecutor. Full article

Background: This scoping review examines the risk factors considered in assessing the dangerousness of individuals found Not Criminally Responsible on Account of Mental Disorder (NCRMD) in Canadian administrative courts. This review aims to identify the factors used by mental health review boards during annual case reviews to guide decisions on detention or release. Methods: Using a scoping review approach following PRISMA guidelines, this study analyzed research across multiple databases to identify relevant studies focusing on risk assessment for NCRMD cases. Results: The findings indicate that five primary categories of risk factors—historical, clinical, behavioral, legal, and miscellaneous—are influential in the decision-making process. Historical factors, such as past violence and early psychiatric contacts, are critical in predicting future risk. Clinical factors, including psychiatric diagnosis and treatment adherence, are key to evaluating current and potential future risks. This study reveals variability in the application of standardized risk assessment tools, highlighting a need for more consistent practices across Canadian jurisdictions. Conclusion: This review concludes that, while a multifaceted approach to risk assessment is essential for balancing public safety with individual rehabilitation, further research is needed to refine these processes and establish more uniform standards for managing NCRMD cases in forensic psychiatry. Full article

In scenarios when the morphological identification of samples is not feasible, the utilization of molecular analyses becomes an imperative. However, that can often be challenging in conditions where standard molecular laboratories cannot be established. In this study, we present a simplified and field-friendly protocol of the previously published Triplex PCR Assay for the identification of mammalian and plant sample origin using a fully portable molecular laboratory from Bento Lab (Bento Bioworks Ltd., London, UK), effectively eliminating the need for a traditional laboratory setup. The protocol in combination with correctly selected kits enables DNA extraction, result evaluation based on electrophoresis, and direct use of the PCR products for downstream analyses such as Sanger sequencing and third-generation sequencing; therefore, enabling the use of molecular analysis directly in situ or for educational purposes in a classroom. Full article

Background: When the body temperature falls below 35 °C, a condition known as hypothermia occurs. This renders it impossible to regulate the body temperature and produce heat. In these cases, death is due to a cessation of vital functions and is triggered by a body temperature below 25 °C. A multidisciplinary approach is typically required when hypothermia is suspected to combine circumstantial evidence, external examination, autopsy, microscopic and biochemical findings, and other data useful to assess the diagnosis of fatal hypothermia. Post-mortem diagnosis of death by hypothermia frequently presents a medico-legal dilemma. Methods and Results: The authors present a case of hypothermia in which site inspection, autopsy, and histological examination simultaneously revealed the forensic and anatomopathological characteristic findings of hypothermia with some peculiar evidence: paradoxical undressing, thanatochronological phenomena, frost erythema, polyvisceral congestion and Wischnewski spots, and subnuclear vacuolization of renal tubular epithelial cells. Full article

The use of cerebrospinal fluid (CSF) in post-mortem (PM) toxicological analysis is an under-addressed topic, likely due to the technical complexity of the collection of a proper sample. However, it is a matrix of significant interest since it has similar chemical and physical properties to the blood and it is less exposed to risks like PM redistribution and diffusion due to its anatomical location. This study aimed to validate a sensitive analytical method for the quantification of drugs of abuse and their metabolites (i.e., cocaine, ketamine, amphetamine, MDPV, 6-monoacetylmorphine, morphine, codeine, and methadone) through liquid chromatography–tandem mass spectrometry (LC-MS/MS). CSF was collected through ventricular puncture, and 200 µL was deproteinated with acetonitrile (600 µL). Quantification was carried out, acquiring two MRM transitions for each compound in positive ionization mode. Chromatographic separation was achieved with a C18 column. Limits of quantification ranged from 0.05 to 5 ng/mL. Bias and precision were always within the acceptance criteria. Ion enhancement and suppression effects were observed depending on the substance. The method validated here was applied to a real case, proving to be suitable for PM analysis. CSF and blood were positive for methadone (460 vs. 280 ng/mL), cocaine (125 vs. 69 ng/mL), benzoylecgonine (4640 vs. 3160 ng/mL), and lorazepam (19 vs. 25 ng/mL). In the future, this will be useful for the evaluation of CSF as a valuable alternative matrix in PM investigations. Full article

Forensic microbiology is a subject of interest and research development across the forensic community. Studies of pathogen outbreaks, biocrime or bioterrorism attacks, and analyses of crime scenes fall within this field. Significant progress has been made in evolving DNA sequencing technologies in recent decades. These newly emerged transformative tools have become available to both biomedicine and forensics. Based on the published literature, this review provides an overview of the current trends and developments of NGS (next-generation sequencing) technologies applied to forensic microbiology. These new methods present numerous advantages over traditional sequencing technology and are useful in several practical applications within this forensic field. This article then examines the main challenges and limitations of this technology in forensics, providing a comprehensive review of NGS technology capabilities in expanding the precision and effectiveness of microbial forensic investigations—with the aim of inspiring scientists, forensic experts, lawyers, public health professionals, and policymakers alike to approach this newly powerful sequencing tool appropriately. Full article

Background/Objectives: Forensic anthropological age estimations are often limited by a lack of diversity in reference samples, imprecision, and, for certain populations, inaccuracy. This study aims to explore the relationship between health, as indicated by cause of death, and skeletal age estimation, with the goal of determining whether including health information can improve accuracy and precision in age estimation. Methods: Skeletal age data were collected from the Maxwell Museum Documented Skeletal Collection using the Lovejoy et al. method for the auricular surface and the Suchey-Brooks method for the pubic symphysis. All individuals had a known cause of death, which was categorized into two broad groups: disease-related and trauma-related. Cause of death category served as a proxy for health status. Results: Individuals who died from disease-related causes often fell within the upper end of the age ranges for both the auricular surface and pubic symphysis methods. In contrast, those who died from trauma-related causes tended to fall within the lower end of these age ranges. Conclusions: These results indicate that incorporating factors such as health into existing forensic age estimation methods could enhance the precision of age estimates, particularly by addressing the influence of environmental and lifestyle factors on skeletal aging. Full article

Forensic dentistry and sexual dimorphism are distinct concepts. Still, they are related due to the usefulness that the first may have in the second, and this review focuses on them. A scoping review will be performed according to the Joanna Briggs Institute’s methodology. Scientific databases and grey literature will be used, and the following keywords will be applied: amelogenin, analyses, sex determination, and human identification. This scoping review will include in vitro studies concerning the goal of this review. This scoping review will deepen our knowledge concerning using teeth and amelogenin genes in sex identification in a forensic context. According to the available data, it will help implement guidelines for human remains identification. This protocol was registered with the Open Science Framework. Full article

Postmortem dark scleral spots, first described by Sommer in 1833, are well-known in forensic pathology. Background/Objectives: Despite this, their presence is currently considered a nonspecific sign, and their pathogenesis has received little attention in forensic literature. In recent years, however, preliminary studies have suggested new mechanisms in their pathogenesis and links to specific types of death. This study aims to create an experimental model for studying scleral spots. Methods: Twenty sheep, already slaughtered for food, were used. After decapitation, the heads were transported to a room with known temperature and humidity. The right eye underwent eyelid excision, while the left eye’s eyelids were sutured. Continuous observation for approximately 24 h was conducted, with brief interruptions to observe the closed eyes. Results: Dark scleral spots appeared in all open eyes (20/20) after an average of 240.96 ± 58.36 min. The spots did not appear in any of the closed eyes. Conclusions: Experimental data indicate that despite the different location compared to human cadavers, this model serves as an excellent experimental framework for studying postmortem scleral spots. Full article

Introduction: on-fatal strangulation (NFS) is a dangerous mechanism that can produce injuries with varying levels of severity. NFS-related injuries can range from low severity, such as simple contusions, to very severe, with convulsions and major forms of impairment. It is often difficult to gauge the severity of injuries from external and initial manifestations alone; it is therefore necessary to assess the possibility of misdiagnosed injuries or subsequent manifestations. Case report: In this study, we describe the case of a 71-year-old man with several injuries, mainly in the craniofacial region, following an assault by his flatmate. Not only did the subject suffer a concussive head injury and a fracture of the zygomatic bone, but he was also subjected to NFS. The patient was examined three times, and the third examination was carried out directly by us 40 days after the assault. Discussion: We concluded that NFS-related injuries are not always clearly visible and recognized after some time. It would therefore be necessary to standardize the clinical investigation procedure in suspected or confirmed cases of NFS. Conclusion: Clinical investigation should be done from the first hours after the injury event, with the help of forensic experts, with the use of dedicated instrumentation and the acquisition of photographic images, all carried out in a systematic manner for use in court, and a search performed for after-effects that cannot be identified by other methods. Psychological evaluation should also be considered as part of the broader assessment process as victims of NFS often experience significant psychological trauma. Full article

Human urine and its detection are of interest in forensic studies in numerous contexts. Both crystalline urea and 1.0 M solutions of urea, as synthetic analog endmember components of human urine, were investigated as a proof-of-concept study to determine if detailed lab spectroscopy would be viable. Urea was reliably detected on Ottawa sand at concentrations of approximately 3.2% in dried experiments. Urea was detectable after 1 week of solution evaporation under lab conditions, at 9.65 wt.% 1 M solution. This investigation successfully establishes urea as a material of interest for reflective spectroscopy and hyperspectral remote sensing/image spectroscopy on a wide range of spatial scales, from specific centimeter-scale areas in a crime scene to searching large outdoor regions > 1 km². In addition, this investigation is relevant to improving the monitoring of human trafficking, status and condition of refugee camps, and monitoring sewage. Full article

Amyloidosis is defined as a rare group of 30 protein-folding diseases characterized by the extracellular deposition of a specific soluble precursor protein that aggregates in the form of insoluble fibrils. The gastrointestinal tract (GI) is a common site for amyloid deposits: Among patients with systemic amyloidosis, at least 70% present with gastrointestinal deposition. Rarely, the deposition is exclusively localized in this area, leading to various gastrointestinal symptoms (bleeding, weight loss, etc.). In this case report, we present a rare and unusual form of localized gastrointestinal amyloidosis, diagnosed after a post-mortem examination of an 83-year-old woman who died due to septic shock resulting from post-colonoscopy iatrogenic perforation of the sigma, in a suspected medical liability case. Morphological examination revealed AL amyloid deposits within the muscular wall of the submucosal vessels of the rectum, which caused increased friability of the vessels and ischemic changes in the intestinal mucosa. A renal cell carcinoma (RCC) was found, which might be related to amyloid deposits, as reported by the literature. Amyloid deposits are an unknown and unpredictable pathological substrate that increase the risk of iatrogenic perforation. Analysis of the medical documentation did not reveal any censurable conduct in terms of prescribing the procedure, technical execution, or subsequent management of the patient following the perforation. GI amyloidosis should be part of the risk stratification of patients with rectal bleeding and gastrointestinal symptoms, and awareness is essential to guide subsequent diagnostic and therapeutic approaches and investigate underlying causes. Full article

Continuous probabilistic genotyping (PG) provides a means to estimate the probative value of DNA mixtures tendered as evidence in court and subject to alternative propositions about the contributors to the mixtures. The weight of that evidence, however, may be valued differently, depending on which forensic laboratory undertook the DNA analysis. There is a need, therefore, to have a means for the comparison of likelihood ratios (LRs) generated by continuous PG amongst different laboratories for the same initial DNA sample. Such a comparison would enable the courts and the public to make judgements about the reliability of this type of evidence. There are particular mixtures and methods for which such a comparison is meaningful, and this study explores them for the short tandem repeat (STR) electropherograms of two-person mixtures obtained from the PROVEDIt Database. We demonstrate a common maximum attainable LR for a given set of common STR loci and a given DNA mixture that is consistent across three different STR profiling assays and two different capillary electrophoresis instruments. Full article