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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

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Journal of forensic Science and medicine 2023年第3期9卷 236-249页

作者： Putri Dianita Ika Meilia Herkutanto Agus Purwadianto Budi Sampurna Murdani Abdullah Diantha Soemantri Aria Kekalih Doctoral Program in Medical Sciences Faculty of Medicine Universitas IndonesiaJakartaIndonesia Department of forensic medicine and Mortuary Persahabatan General HospitalJakartaIndonesia Department of forensic medicine and Medicolegal Studies Dr.Cipto Mangunkusumo General HospitalFaculty of Medicine Universitas IndonesiaJakartaIndonesia Department of Internal medicine Dr.Cipto Mangunkusumo General HospitalFaculty of Medicine Universitas IndonesiaJakartaIndonesia Department of Medical Education Faculty of Medicine Universitas IndonesiaJakartaIndonesia Department of Community medicine Faculty of Medicine Universitas IndonesiaJakartaIndonesia

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.

关键词： Evidence-based practice forensic medicine forensic pathology INFERENCE Principles of Evidence-based Reporting in forensic medicine-Pathology version

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中国法医学杂志

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中国法医学杂志

作者：闵建雄

出版社：中国法医学会;公安部物证鉴定中心

《中国法医学杂志》1986年创刊，是国内法医科学技术领域国家级国内外发行的综合性学术性期刊(双月刊)。率先报道国内法医学科各领域国家重点科技攻关项目的研究成果。主要刊载具有国内先进水平、有相当学术价值或创新性的科研成果论文...

《中国法医学杂志》1986年创刊，是国内法医科学技术领域国家级国内外发行的综合性学术性期刊(双月刊)。率先报道国内法医学科各领域国家重点科技攻关项目的研究成果。主要刊载具有国内先进水平、有相当学术价值或创新性的科研成果论文（包括阶段性成果），及新技术、新方法、新进展等。所刊载信息反映了我国法医学科领域的科研、检案技术水平和现状,反映国际法医学科领域成果和新动向。　　本刊设有论著、综述、技术交流、短篇报道、案例分析、案例报道、医疗纠纷鉴定、读者论坛、述评、讲座、法医学教育、法医学史等栏目。　　本刊为荷兰国际科学文献数据库（ELSEVIER）收录期刊/荷兰医学文摘（EMBASE）收录期刊；“万方数据—数字化期刊群”《中国核心期刊（遴选）数据库》等国内5个数据库检索机构收录期刊；《CAJ—CD规范》执行优秀期刊。

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Anatomical changes correlated with chronic pain in forensic medicine

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forensic Sciences Research 2017年第3期2卷 145-151页

作者： Henry J Carson Linn County Medical Examiner’s Office(retired) Cedar RapidsIAUSA

This study was performed to determine the relationships between chronic pain and anatomic changes that may occur in the body.Autopsies were performed on fatalities that required death investigation in Linn County,IA,or adjacent and nearby areas.Persons with chronic pain were older than the control population at the time of death.Diabetes,hypertension and depression were more common in persons with chronic pain.Certain causes of death may also have been related to chronic pain.The heart,lungs,liver,spleen and kidneys were significantly heavier in persons with chronic pain;emphysema and pleural and abdominal adhesions were more common in persons with chronic pain.There appear to have been diffuse changes in the body related to chronic pain.These changes may have been mediated by a number of systemic mechanisms that are involved with chronic pain,including cardiovascular activity,the immune system,the neuroendocrine system and others.

关键词： forensic medicine pain,chronic depression emphysema adhesions tissue

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An Emergence of Dental Tissues in the forensic medicine for the Postmortem Interval Estimation:A Scoping Review

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Journal of forensic Science and medicine 2021年第2期7卷 54-60页

作者： Sridevi Ugrappa Ajay Jain Senior Lecturer Department of Oral Medicine and Radiology2Associate ProfessorDepartment of Maxillo-facial ProsthodonticsFaculty of DentistryAIMST Dental InstituteAIMST UniversityBedongKedahMalaysia

It is observed that there is not enough literature to support the usefulness of dental tissue in forensic medicine for the estimation of postmortem interval(PMI).Therefore,the authors of this article have systematically reviewed the available literature to understand the most used dental tissues,the methods employed to evaluate these tissues,and their reliability in PMI estimation.A MEDLINE-PubMed search engine was used to review the literature using the keywords“teeth,”“dental tissues,”“post‑mortem interval,”and“forensic dentistry”from 2001 until 2020.The most used tissue was dental pulp,but other cellular‑.and molecular‑level dental tissues such as enamel,dentin,cementum,periodontal ligament,odontoblast,and mitochondrial and nuclear DNA and RNA were also used.Based on this observation,the authors have provided the categorical classification to evaluate these dental tissues into morphological,histopathological,and molecular‑level examination to understand the reliability of these dental tissues.The molecular examinations to evaluate these tissues were widely employed and emerging in the estimation of PMI as this method could provide a reliable outcome when compared with others.Since the literature reviewed was not enough to answer our questions,however,to conclude,the dental pulp is the widely used tissue so far.Further,more studies are required to authenticate the role of other dental tissues to predict the PMI at an early stage with cost‑effective and most convenient techniques.

关键词： Dental tissues forensic medicine forensic odontologist postmortem interval time since death

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Clinical forensic medicine 2nd ed. 2005

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丛书名： forensic Science and medicine

2005年

作者： Margaret M. Stark

ISBN: (数字)9781592599134

ISBN: (纸本)9781588293688

This revised edition has been completely updated and expanded to address the latest developments and professional concerns in forensic medicine. There are new chapters on the medical aspects of police restraint and new material on the potential of police exposure to infection, the role of alcohol and drugs in vehicular accidents, and forensic sampling in sexual assault examinations. The chapters on fundamental principles, nonaccidental injury in children, and the care of detainees are all fully revised, as are the appendices (now containing a list of useful websites)

关键词： forensic medicine

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Modernization of medicine in the Ottoman Empire and Its Effects on forensic Sciences

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Journal of forensic Science and medicine 2018年第4期4卷 213-220页

作者： Ferat Buran Erdem Ozkara The Council of forensic medicine sanliurfa Branch OfficeSanhurfaTurkey department of forensic medicine Faculty of MedicineDokuz Eylul UniversityIzmirTurkey

Modernization in medicine began in the Ottoman Empire in the 19^(th)century.Until that time,medical education had been provided through the traditional master-apprentice practices and its methods had relied on custom or religion.The most important of these reforms was in 1827,when the first medical schools in surgical and clinical branches were opened in Istanbul.The lack of contemporary understanding in medical education until that time had caused an underdevelopment in forensic sciences as it had in various other fields.Following the reform movements,the contents of the forensic medicine curriculum,mainly influenced by the French medical schooling,touched upon all areas of forensic sciences such as pathology,toxicology,organic chemistry,neuropsychiatry,gynecology,handwriting analysis and criminalistics.It was noteworthy to see such rapid development in scientific modernization considering the fact that,before the reform movements,the religion had a repressive effect and it was forbidden to even perform laboratory tests or examinations on corpses.In the modem Turkish Republic,founded in 1923 after World War I,scientific reforms gained momentum and began competing with the modem world.Such that,after a letter sent to the Turkish Government by Albert Einstein in 1933,the contemporary Turkish universities embraced the scientists who escaped from the Nazi regime.

关键词： forensic medicine history of forensic medicine legal medicine medical history Ottoman Empire Turkish Republic

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Epidemio-toxicological profile of suicide cases:analysis from a forensic unit in Brazil

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forensic Sciences Research 2022年第4期7卷 643-649页

作者： Carolina de Castro Martins Yara Viera Lemos Maycoln Leoni Martins Teodoro Ana Paula Drummond-Lage Department of Phsycology Universidade Federal de Minas GeraisBelo HorizonteMGBrazil Department of forensic Anthropology Polícia Civil de Minas GeraisBelo HorizonteMGBrazil School of medicine Faculdade de Ciências Médicas de Minas GeraisBelo HorizonteMGBrazil Post-Graduation Department Faculdade de Ciências Médicas de Minas GeraisBelo HorizonteMGBrazil

The suicide phenomenon involves complex interactions between psychological,biological,cultural and socio-environmental factors.This study aimed to assess the epidemiological and toxicological profiles of officially confirmed suicide victims.Aretrospective study was performed using autopsy reports,forensic anthropology examinations and police summaries of all suicide cases that underwent toxicological analysis at an Official forensic Laboratory(Minas Gerais,Brazil)in 1 year.The sample set was composed of 351 suicide victims,predominantly men(70.32%),most of them were adults between 31 and 64 years old(62.11%),with mixed skin colour(48.89%)and low educational level(66.44%).The most common suicide method was hanging(57.79%),followed by intoxication(30.45%).Most victims presented positive toxicological results(56.41%),especially for the presence of medicines(37.6%),illicit drugs(36.3%)and pesticides(26.1%).Our study corroborated previous data that most suicide victims have low educational levels.The most common toxicological findings were medicines,especially prescription drugs,followed by illicit drugs and pesticides.We hope this study contributes to reflections and planning of preventive suicide programmes,considering the described profiles of victims.

关键词： forensic sciences forensic toxicology forensic medicine forensic anthropology suicide

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Histopathological,histochemical and biochemical postmortem changes in induced fatal hypothermia in rats

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forensic Sciences Research 2022年第2期7卷 211-227页

作者： Mahrous Abdelbasset Ibrahim Sally Salem Mohammed Hany Goda Tammam Rehab Ibrahim Abdel-Karim Medhat Mohammed Farag forensic medicine&Clinical Toxicology College of MedicineJouf UniversitySakakahSaudi Arabia forensic medicine&Clinical Toxicology Department Faculty of MedicineSuez Canal UniversityIsmailiaEgypt Histology and Cell Biology Department Faculty of MedicineSuez Canal UniversityIsmailiaEgypt forensic medicine and Clinical Toxicology Department Faculty of MedicineAl-Azhar UniversityCairoEgypt Medical biochemistry Department College of MedicineShaqra UniversityShaqraaSaudi Arabia Medical Biochemistry&Molecular Biology Department Faculty of MedicineBenha UniversityBenhaEgypt

Reaching a postmortem diagnosis of hypothermia is challenging in forensic practice.Therefore,this study was conducted to detect the histopathological,histochemical and biochemical changes that occur in adult albino rats following exposure to induced fatal hypothermia.Twenty-four adult albino rats were divided into the negative control,moderate hypothermia,severe hypothermia and hypoxia groups.Rats in the control group were euthanized when those in the moderate hypothermic group died.Blood samples were collected via heart puncture,and the cerebrum,heart,suprarenal gland,kidney,liver and skeletal muscle were removed to investigate the biochemical,histochemical and histopathological changes.Postmortem assessment depicted significant changes in lipid peroxidation,represented by increased malondialdehyde levels in the studied organs of the rats in hypothermic and hypoxia groups.Histopathological examination of the rats’organs revealed degeneration and necrosis in the hypothermia and hypoxia groups.Sections taken from the severe hypothermic rats revealed a loss of normal cardiac tissue architecture,necrotic changes in the pyramidal cells in the cerebral cortex,and massive necrosis,mainly in the tubules of the renal cortex and medulla.These findings suggest that histological changes might be used as biochemical markers for postmortem diagnosing of fatal hypothermia,particularly in severe hypothermic conditions.

关键词： forensic sciences forensic medicine legal medicine autopsy forensic pathology histochemical hypothermia

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forensic Study on Objective Evaluation of Visual Acuity of Ametropia with the Event-related Potential P3

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当代医学科学(英文) 2023年第3期43卷 609-614页

作者： Fu-quan JIA Fang-liang LUO Yan-he XIONG Long-long CHENG Zhi-qiang DANG Ji-hui LIU Department of forensic medicine Inner Mongolia Medical UniversityHohhot 010059China Judicial Authentication Research Institute Liaoning UniversityShenyang 110036China Shanghai Love Nursing Station Shanghai 200030China Affiliated Zhongshan Hospital of Dalian University Dalian 116001China Dian Regional forensic Science Institute(Nei Mongol) Hohhot 010041China

Objective In this study,we aimed to assess the characteristics of the P3 component from an event-related potential(ERP)that was induced by visual acuity(VA)processing.Furthermore,we sought to provide electrophysiological evidence for the objective evaluation of VA.Methods We recruited 32 participants with myopia-related ametropia.They reported no other ocular diseases and had an uncorrected VA of 4.0 in both eyes.We used the block letter“E”at different visual angles and orientations as the graphic stimuli.The oddball paradigm,consisting of 4 modules,was used for ERP analysis.The standard stimuli of each module were identical,with a visual angle of 1°15′.The visual angles of the target stimuli were 1°15′,55′,24′,and 15′.The VA test was performed on each eye separately for all participants,and all characteristics of the P3 component were analyzed.Results There was no significant difference in the P3 peak letencies between the target stimulation angle 1°15′group and the 55′group,or between the target stimulation angle 24′group and the 15′group.There was a significant difference in the P3 peak letencies between the target stimulation angle 1°15′group and the 24′group as well as the 15′group.There was a significant difference in the P3 peak letencies between the target stimulation angle 55′group and the 24′group as well as the 15′group.No significant differences were observed in the P3 amplitude between modules.Conclusion In the oddball paradigm,P3 elicitation indicated a cognitive response to the target stimuli.These data showed that the characteristics of P3 can be used as an objective evaluation of VA.

关键词： event-related potential P3 visual acuity forensic medicine amplitude

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Sudden Death in Goldenhar Syndrome

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Journal of forensic Science and medicine 2023年第1期9卷 84-87页

作者： Basappa Subhas Hugar Jayanth SHosahally Kalpana Kumari Samiya Chisti Department of forensic medicine MS Ramaiah Medical CollegeBengaluruKarnatakaIndia Department of forensic medicine Dr.Chandramma Dayananda Sagar Institute of Medical Education and ResearchDayananda Sagar UniversityBengaluruKarnatakaIndia Department of forensic Pathology MS Ramaiah Medical CollegeBengaluruKarnatakaIndia

Goldenhar syndrome(GS)is a rare congenital disorder that is characterized by incomplete development of the ear,eye,nose,soft palate,lip,and jaw.It is also called oculo-auriculo-vertebral syndrome of Goldenhar,the name describes the common structural problems seen with the eyes,ears,and vertebrae.The outlook for children with GS varies but is generally very positive.Most children can expect to live a healthy life once treatments have been administered.However,certain congenital heart defects seen in this syndrome such as ventricular septal defect(VSD),persistence of arterial conduct,tetralogy of Fallot,and big vessel transposition can lead to sudden death during childhood.These defects are usually diagnosed during intrauterine life by means of fetal echography,leading to termination of such pregnancy or necessary corrective measures after the birth of such child.If such a child dies,it will be certified by the treating pediatrician.Thus,an autopsy pathologist rarely comes across such deaths.One such case of a 45-day-old female infant suffering from craniofacial deformity who became breathless,cyanotic,and died on the way to the hospital is being discussed here.The right ventricle showed double outlets,arising from it were the pulmonary artery and aorta.A small subaortic VSD was seen.Generalized hypoplasia of all internal viscera on the right side was observed.

关键词： Congenital heart defects forensic medicine forensic pathology Goldenhar syndrome sudden death

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