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In this study, the application of low-level fusion (LLF) and high-level fusion (HLF) strategies using a combination of Fourier transform infrared spectroscopy (FT-IR) and Raman spectroscopy in the identification of antemortem and postmortem fracture at different postmortem intervals (PMIs) was investigated. On a technical level, the same hard tissue sample can be detected using a mix of FT-IR and Raman techniques. At the method level, two cutting-edge chemometrics approaches (LLF and HLF) combining FT-IR and Raman spectroscopic data are explored. The models were ranked in accordance with their parametric quality as follows: HLF and LLF + HLF models > LLF single model > Raman single model > FT-IR single model. The LLF model performed marginally better than the Raman model, however, when compared to other models, the HLF model performed considerably better. The HLF model achieved the best performance, with both cross-validation accuracy and test data set accuracy of 0.88. The importance of the feature wavelengths in the model construction process was subsequently evaluated by intersection fusion, and it was found that the absorbance bands of amide I, PO43– ν1 ν3, and CH2 in FT-IR and phenylalanine, CO32– ν1– PO43– ν3, and amide III in Raman have outstanding contributions to the construction of antemortem and postmortem fractures identification models. Overall, the combination of FT-IR and Raman with the HLF strategy is a novel and promising approach for developing antemortem and postmortem fracture identification models at different PMIs. [ABSTRACT FROM AUTHOR]

Background. Whole slide imaging (WSI) represents a paradigm shift in pathology, serving as a necessary first step for a wide array of digital tools to enter the field. It utilizes virtual microscopy wherein glass slides are converted into digital slides and are viewed by pathologists by automated image analysis. Its impact on pathology workflow, reproducibility, dissemination of educational material, expansion of service to underprivileged areas, and institutional collaboration exemplifies a significant innovative movement. The recent US Food and Drug Administration approval to WSI for its use in primary surgical pathology diagnosis has opened opportunities for wider application of this technology in routine practice. Main Text. The ongoing technological advances in digital scanners, image visualization methods, and the integration of artificial intelligence-derived algorithms with these systems provide avenues to exploit its applications. Its benefits are innumerable such as ease of access through the internet, avoidance of physical storage space, and no risk of deterioration of staining quality or breakage of slides to name a few. Although the benefits of WSI to pathology practices are many, the complexities of implementation remain an obstacle to widespread adoption. Some barriers including the high cost, technical glitches, and most importantly professional hesitation to adopt a new technology have hindered its use in routine pathology. Conclusions. In this review, we summarize the technical aspects of WSI, its applications in diagnostic pathology, training, and research along with future perspectives. It also highlights improved understanding of the current challenges to implementation, as well as the benefits and successes of the technology. WSI provides a golden opportunity for pathologists to guide its evolution, standardization, and implementation to better acquaint them with the key aspects of this technology and its judicial use. Also, implementation of routine digital pathology is an extra step requiring resources which (currently) does not usually result increased efficiency or payment. [ABSTRACT FROM AUTHOR]

Background: ChatGPT has substantial potential to revolutionize medical education. We aim to assess how medical students and laypeople evaluate information produced by ChatGPT compared to an evidence-based resource on the diagnosis and management of 5 common surgical conditions. Methods: A 60-question anonymous online survey was distributed to third- and fourth-year U.S. medical students and laypeople to evaluate articles produced by ChatGPT and an evidence-based source on clarity, relevance, reliability, validity, organization, and comprehensiveness. Participants received 2 blinded articles, 1 from each source, for each surgical condition. Paired-sample t-tests were used to compare ratings between the 2 sources. Results: Of 56 survey participants, 50.9% (n = 28) were U.S. medical students and 49.1% (n = 27) were from the general population. Medical students reported that ChatGPT articles displayed significantly more clarity (appendicitis: 4.39 vs 3.89, P =.020; diverticulitis: 4.54 vs 3.68, P <.001; SBO 4.43 vs 3.79, P =.003; GI bleed: 4.36 vs 3.93, P =.020) and better organization (diverticulitis: 4.36 vs 3.68, P =.021; SBO: 4.39 vs 3.82, P =.033) than the evidence-based source. However, for all 5 conditions, medical students found evidence-based passages to be more comprehensive than ChatGPT articles (cholecystitis: 4.04 vs 3.36, P =.009; appendicitis: 4.07 vs 3.36, P =.015; diverticulitis: 4.07 vs 3.36, P =.015; small bowel obstruction: 4.11 vs 3.54, P =.030; upper GI bleed: 4.11 vs 3.29, P =.003). Conclusion: Medical students perceived ChatGPT articles to be clearer and better organized than evidence-based sources on the pathogenesis, diagnosis, and management of 5 common surgical pathologies. However, evidence-based articles were rated as significantly more comprehensive. [ABSTRACT FROM AUTHOR]

Sudden infant death syndrome (SIDS) is a diagnosis given to infants who die suddenly and unexpectedly before the age of one. After decades of research into SIDS, little has been conclusively determined regarding the etiology of this phenomenon. While SIDS deaths are in reality undetermined deaths, there is resistance to abandon SIDS and synonymous terminology. This paper identifies the social functions that a diagnosis of SIDS provides both to the families of the deceased, as well as the physicians who treat them. It is suggested that these social functions help to explain why, despite being inaccurate and misleading, SIDS is still widely used today. It is argued, however, that the forensic pathology and medical community as a whole should lead a systematic shift away from the use of SIDS as a diagnosis. Adopting more medically-appropriate terminology would better serve the goals of the medical profession and the families they serve. [ABSTRACT FROM AUTHOR]

Violence against women is a form of gender violence, and the lethal aspect of it, defined as femicide, is a global health and human rights problem. This study looked at 330 cases of femicide that occurred in North West Italy, between 1970 and 2020, committed by 303 male perpetrators. The victims included women who were prostitutes and those who were not. Findings show that only a small proportion of femicide occurs within an anonymous setting: Victims were mostly killed by a man they knew. The type and intensity of the relationship was likely to affect how the violence occurred. In those cases in which victims and perpetrators had an intimate relationship, the risk of overkill, that is, an excessive use of violence that goes further than what is necessary to cause death, was four times higher in comparison with the murder of unknown victims. As with non-prostitutes, the risk of overkill was almost fourfold for those prostitutes who knew their perpetrators. Furthermore, when comparing prostitutes with any unknown victims, the risk of being overkilled was almost five times higher for the former, suggesting that prostitutes are more at risk of being murdered with excessive violence. In addition, prostitutes were more likely to be victims of sexual murder, postmortem mutilation, and being killed by men who had previous criminal records. Women who are victims of violence are not a homogeneous group, although some of the psychosocial correlates are the same and relevance should be given to the features behind the type, intensity, and nature of the relationship between prostitutes and non-prostitutes and their perpetrators. These variables are what make violence against women a preventable problem. [ABSTRACT FROM AUTHOR]

The diagnosis of pulmonary fat embolism (PFE) is of great significance in the field of forensic medicine because it can be considered a major cause of death or a vital reaction. Conventional histological analysis of lung tissue specimens is a widely used method for PFE diagnosis. However, variable and labor-intensive tissue staining procedures impede the validity and informativeness of histological image analysis. To obtain complete information from tissues, a method based on infrared imaging of unlabeled tissue sections was developed to identify pulmonary fat emboli in the present study. We selected 15 PFE-positive lung samples and 15 PFE-negative samples from real cases. Oil red O (ORO) staining and infrared spectral imaging collection were both performed on all lung tissue samples. And the fatty tissue of the abdominal wall and the embolized lipid droplets in the lungs were taken for comparison. The results of the blind, evaluation by pathologists, showed good agreement between the infrared spectral imaging of the lung tissue and the standard histological stained images. Fourier transform infrared (FT-IR) spectroscopic imaging significantly simplifies the typical painstakingly laborious histological staining procedure. And we found a difference between lipid droplets embolized in abdominal wall fat and lung tissue. Graphical Abstract [ABSTRACT FROM AUTHOR]

As forensic radiology sees an exponential gain in popularity, postmortem computed tomography (PMCT) is increasingly being used in the appropriate setting, either as preautopsy guidance or as part of complementary virtual autopsy protocol. Many articles have expounded the value it adds to forensic pathology in the general setting and the appropriate technical parameters to be used for optimum benefit. We aim to put forth a concise review on the role of PMCT specifically in trauma and the pitfalls to be aware of. Reviews have shown that presumed cause of death in trauma have been proven by autopsy to be wrong in about 30% cases. Radiology applied to postmortem investigation in unnatural deaths and more specifically in trauma shares many semiotic features with emergency radiology. Therefore, in the near future, emergency radiologists might be required to integrate this type of imaging in their regular practice. Although the predominant drawbacks are time-dependent, PMCT also has some difficulty in differentiating antemortem and postmortem events. However, in many such scenarios, PMCT and autopsy play a complementary role in arriving at conclusions, and we believe understanding the benefits and role in trauma is imperative considering the expanding usage of PMCT. [ABSTRACT FROM AUTHOR]

Sadistic offenders are often described as individuals who are forensically aware, who carefully plan their offenses, and preselect the location of their crime. Despite this emphasis on strategies to avoid police detection, no study has specifically examined whether this behavior or trait was specific to sadistic offenders. Utilizing a sample of 350 cases of sexual homicide from Canada, sadistic sexual homicide offenders (SHOs) are compared with nonsadistic SHOs on their investigative awareness. Results from logistic regression analyses show that sadistic SHOs are more likely to use various precautions to avoid detection and select a deserted location, in comparison with nonsadistic offenders. In addition, sadistic SHOs, despite having a lesser time to body recovery than nonsadistic offenders, are more likely to see their case remain unsolved. Implications for the assessment of sexual sadism as well as for the police investigations will be discussed. [ABSTRACT FROM AUTHOR]

Toxicologic pathology is transitioning from analog to digital methods. This transition seems inevitable due to a host of ongoing social and medical technological forces. Of these, artificial intelligence (AI) and in particular machine learning (ML) are globally disruptive, rapidly growing sectors of technology whose impact on the long-established field of histopathology is quickly being realized. The development of increasing numbers of algorithms, peering ever deeper into the histopathological space, has demonstrated to the scientific community that AI pathology platforms are now poised to truly impact the future of precision and personalized medicine. However, as with all great technological advances, there are implementation and adoption challenges. This review aims to define common and relevant AI and ML terminology, describe data generation and interpretation, outline current and potential future business cases, discuss validation and regulatory hurdles, and most importantly, propose how overcoming the challenges of this burgeoning technology may shape toxicologic pathology for years to come, enabling pathologists to contribute even more effectively to answering scientific questions and solving global health issues. *This article is a product of a Special Interest Group of the Society of Toxicologic Pathology (STP). The views expressed in this article are those of the authors and do not necessarily represent the policies, positions, or opinions of the STP. [ABSTRACT FROM AUTHOR]

Digital pathology is defined as the ability to examine digitized microscopic slides and to generate qualitative and quantitative data. The field of digital pathology is rapidly evolving and has the potential to revolutionize toxicologic pathology. Techniques such as automated 2-D image analysis, whole slide imaging, and telepathology are already considered "mature" technologies and have been used for decades in exploratory studies; however, many organizations are reluctant to use digital pathology in regulatory toxicology studies. Innovative technologies using digitized slides including high-content imaging modalities and artificial intelligence are still under development but are increasingly used in toxicologic pathology. While software validation requirements are already described, clear guidance for application of these rules to the digital pathology field are few and the acceptance of these technologies by regulatory authorities remains necessary for successful adoption of digital pathology into the mainstream of toxicologic pathology. This topic was discussed during a roundtable at the 2018 Annual Congress of the French Society of Toxicologic Pathology. This opinion article summarizes the discussion regarding the current questions and challenges on the integration of innovative digital pathology tools within a good laboratory practice framework and is meant to stimulate further discussion among the toxicologic pathology community. *This is an opinion article submitted to the Toxicologic Pathology Forum and does not constitute an official position of the Society of Toxicologic Pathology or the journal Toxicologic Pathology. The views expressed in this article are those of the authors and do not necessarily represent the policies, positions, or opinions of their respective agencies and organizations. The Toxicologic Forum is designed to stimulate broad discussion of topics relevant to regulatory issues in Toxicologic pathology. Readers of Toxicologic Pathology are encouraged to send their thoughts on these articles or ideas for new topics to toxicologicpathologyforum@toxpath.org. [ABSTRACT FROM AUTHOR]

The terminal collection and histological processing of medical devices is an expensive, labor-, and material-intensive endeavor, which requires adequate experience, innovation, and preparation for success. It is also an exciting endeavor that continually challenges, intellectually engages, and improves the skills and knowledge of the pathologist. Awareness of the importance of the medical device pathologist's involvement, communication, and oversight throughout the development, implementation, and execution of a nonclinical assessment of a medical device is in the best interest of the test facility, the histopathology laboratory, the pathologist, the sponsor, and, ultimately, the patients. This article serves to present as a primer of key considerations for the approach and conduct of "nontoxicological" studies, defined as studies involving animal models of deployment or implantation of medical devices as well as surgical animal models. [ABSTRACT FROM AUTHOR]

This study seeks to establish whether medico-legal practitioners differ in their autopsy conclusions within and across medico-legal institutions. Data include 459 violent deaths (homicides, suicides, and accidents) autopsy reports written by more than 20 death certifiers from four medico-legal institutions in two countries (France and the United States). Multinomial models show that compared with accidental deaths, weapon use and decedents' characteristics both influence a homicide verdict, but not a suicide one. In addition, French practitioners are more likely than Americans to reach a conclusion of homicide or suicide compared with accident, and homicides are more likely to be certified by male practitioners. [ABSTRACT FROM AUTHOR]

Hanging is violent asphyxial death. The objective of this study is to assess the data of hanging cases. A descriptive-retrospective study was conducted. We studied 244 hanging cases autopsied in Forensic Division, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, between January 2001 and December 2013. The study included 197 men (80.7%) and 47 women (19.2%). Their age ranged from 14 to 93 years. Most of these cases were incomplete hanging (83.6%). Features of hanging victims, such as tongue protrusion; congestion of face; petechial hemorrhage of face, conjunctiva, and internal organs; and neck injuries, significantly correlated with complete hanging. The predominant occupation of hanging victims was in the service industry (63.1%). Suicides usually occurred in private homes or apartments (84.8%). A suicide note was found in 6.1% of cases. The most common ligature material used was nylon rope, found in 61.1% of cases. The most underlying diseases of the victims in hanging cases were tuberculosis and human immunodeficiency virus infection, 9 cases each. Blood ethanol levels of 29 cases (11.8%) were detected to be higher than 150 mg%. Methamphetamine and benzodiazepine were detected in 5.3% and 3.3% of cases, respectively. This study provides comprehensive baseline data of hanging cases in central Bangkok. [ABSTRACT FROM AUTHOR]

The increased awareness of Autism Spectrum Disorders (ASD) over the last few decades as well as the potential association between ASD and offending behaviors has spurred a need for increased research in this area. In order to explore any possible relationship between ASD and violent or sexual crime the present study examines all forensic examination reports over a 10-yr. period in Norway where the charged persons were diagnosed with ASD and charged with either a violent (N=21) or a sexual (N=12) offense. Differences between these two groups regarding previous contact with child welfare and confessions to the offense were found. There was also a tendency toward more severe mental health problems and less intellectual problems among the violent offenders than the sexual offenders. [ABSTRACT FROM AUTHOR]

Methanol poisoning has become a considerable problem in Iran. Liver can show some features of poisoning after methanol ingestion. Therefore, our concern was to examine liver tissue histopathology in fatal methanol poisoning cases in Iranian population. In this study, 44 cases of fatal methanol poisoning were identified in a year. The histological changes of the liver were reviewed. The most striking features of liver damage by light microscopy were micro-vesicular steatosis, macro-vesicular steatosis, focal hepatocyte necrosis, mild intra-hepatocyte bile stasis, feathery degeneration and hydropic degeneration. Blood and vitreous humor methanol concentrations were examined to confirm the proposed history of methanol poisoning. The majority of cases were men (86.36%). In conclusion, methanol poisoning can cause histological changes in liver tissues. Most importantly in cases with mean blood and vitreous humor methanol levels greater than 127 ± 38.9 mg/dL more than one pathologic features were detected. [ABSTRACT FROM AUTHOR]

The increased valuation of children’s lives characteristic of modern society emphasizes the problem of child abuse. Beginning in the 1960s, increased public awareness of child abuse led to increased attention to the professions concerned with child homicide. This attention has taken the form of inquiries into children’s deaths that historically concentrated on social work ‘error’. Recent inquiries have expanded their attention to other professions, particularly the medical and policing professions. Ontario’s Goudge Inquiry centred on paediatric forensic pathology but, rather than focusing concern on murdered children, considered the moral hazard of wrongful convictions stemming from an overzealous concern with child abuse. The inquiry thus raises the problem of what evidence is certain, and how this certainty is evaluated. In turn, this makes the risk of child abuse reflexive insofar as under conditions of uncertainty professional medical judgement contains reflexive risk conditions. Because of these reflexive conditions, professional willingness to engage in child protection is being undermined and therefore threatens to paralyse the larger child protection project. [ABSTRACT FROM AUTHOR]

Among 112 homicides involving sexual intimates that occurred in Hong Kong between 1989 and 2002, 38% ( n = 42) of offenders remained voluntarily at the homicide scene, 21% (n = 24) committed suicide, 20% (n = 22) escaped and denied involvement, 13% (n = 14) disposed or hid the body of their victim, and 9% (n = 10) escaped but later voluntarily surrendered. This study used police investigation reports, coroner’s reports, witness statements, and other relevant documents to compare these five types of postkilling behavior. The type of response was explained by the offender’s characteristics, the strength of attachment to the victim, and situational factors. The offender’s prior criminal conduct or history of violence was not significant in predicting the type of postkilling response. [ABSTRACT FROM PUBLISHER]

Discusses the evolution of modern day medical examiners in the United States. Origin of the official office of the coroner; Judicial and administrative functions of coroners; Background on Philadelphia physician William Scott Wadsworth, one of the pioneers in the area of forensic pathology.