Vol 10, No 3 (2024)

BACKGROUND: Practical observations show peculiarities of hemorrhages in rib fractures: immature cellular forms are often found in the cellular infiltrate. In nonobvious conditions and when it is crucial to determine the duration, such a polymorphic cellular infiltrate can be mistakenly considered as the result of a post-traumatic inflammatory reaction, affecting the assessment of the duration of the injury.

AIM: To study the composition of the cellular infiltrate in hemorrhages in rib fractures, taking into account their morphological features in cases of various causes of death at different periods after injury.

MATERIALS AND METHODS: A retrospective analysis of cases and an analysis of personal observations of deaths of individuals of different age and sex groups with different causes of death, but with anamnestic data of chest injuries, and of cases of isolated chest injury, aimed at forensic histological examination, were performed. The study sample was divided into main study groups according to established time intervals based on anamnestic data of brief circumstances of the case indicated in the referral documents (“those who died at the scene,” “chest injuries as a result of resuscitation measures,” “victims who lived up to 6 hours,” “victims who lived up to 12 hours,” and “victims who lived up to 24 hours”). The forensic (histological) examinations of deceased individuals with fractured pelvic bones and fractured skull bones and examinations of those with hemorrhages in soft tissues with stab wounds of the chest were compared. Additionally, the comparison sample included deaths of people of both sexes, and different age groups and with various causes of death in different periods after injury. From this sample, subgroups similar to those in the main study were formed for comparison.

RESULTS: Analysis showed that in most victims who died at the scene of the incident, immature cellular forms were found in hemorrhages in the soft tissues of the intercostal space, which gradually decreased over time. Morphological study and analysis of hemorrhages into soft tissues showed no immature cellular forms in traumatic hemorrhages of other locations in all comparison groups.

CONCLUSION: Notably, immature cellular forms in the polymorphic cellular infiltrate and hemorrhages in soft tissues from the intercostal space are not a reactive post-traumatic process and cannot be used to estimate the time and duration (survivability) of the injury. Moreover, the preservation of immature cellular forms in the hemorrhage area has been found to change over time with their gradual decrease by 12 hours.

BACKGROUND: A decree of the President of Russia defines the introduction of digital technologies as a national goal for the breakthrough development of the country. The development of digital technologies in forensic medicine ensures the success of individual expert tasks and demonstrates the possibility of digital transformation in forensic activity.

AIM: To examine the attitude of forensic experts toward digital transformation in their professional activity.

MATERIALS AND METHODS: A survey was developed for 77 forensic experts from the Bureau of Forensic Examination of the Republic of Bashkortostan and Voronezh, Kirov, and Samara regions. A questionnaire survey containing six questions with three answer options each was developed in accordance with the purpose and objectives of the study.

The methods of variation statistics, analysis, synthesis, and comparison were used.

RESULTS: This study investigated the level of experts’ understanding of the goals of digital transformation in medicine, assessed the experts’ perception of the process of digital transformation in forensic medicine, analyzed the experts’ awareness of the application of digital technologies in expert practice, determined the attitude of experts toward the digital transformation in forensic medicine, and evaluated the respondents’ opinion on the possible impact of digital technologies on the objectivity of the results of expert studies. The viewpoints of forensic practitioners on the relevance and importance of digital transformation in forensic activity were obtained. The recommendations for optimization of digital transformation in forensic medical activity were generated.

CONCLUSION: Forensic experts show a low level of interest on the issue of digital transformation in forensic activity. In the present case, experts have highlighted the relevance of digital transformation for their professional activity and cognitive importance of digital technologies for expert knowledge.

BACKGROUND: The study of gunshot damage after firing with 12-gauge cartridges loaded with expanding slugs is interesting, because it has been undescribed in the modern forensic literature.

AIM: To study clothing and the human body simulator experimental gunshot damage after firing with 12-gauge cartridges loaded with expanding and non-expanding slugs.

MATERIALS AND METHODS: Visual and metric methods were used. The process of slug penetration to target was recorded with a high-speed Phantom VEO video camera 710S, with a Zeiss Milvus 1.4/35 lens. Video shooting at a frequency of 24,000 frames per second was conducted.

RESULTS: Clothing and the human body simulators experimental gunshot injuries after firing with 12-gauge cartridges loaded with expanding and non-expanding slugs was analyzed. The main differences of the gunshot damage morphological features were determined by slug terminal ballistics.

CONCLUSION: The experimental study results can be used for forensic identification of structurally similar slugs of 12-gaude cartridges UNO 35 and UNO 35E by the morphological features of the biological tissues and clothing gunshot damage.

BACKGROUND: Healthcare involves various stakeholders, including hospitals, healthcare professionals, such as doctors, nurses, and others, as well as patients. The direct relationship typically occurs between doctors and patients. In carrying out their duties, doctors always adhere to standard operating procedures, medical records, and informed consent. The COVID-19 pandemic in Indonesia has led to a surge in the number of COVID-19 patients requiring treatment by doctors. On the one hand, doctors and other healthcare professionals face numerous challenges in providing healthcare services, potentially failing to ensure legal certainty for them.

AIM: This study aimed to reconstruct legal protection for the medical profession in medical disputes during the COVID-19 pandemic from a Dignified Justice perspective.

MATERIALS AND METHODS: This research is a legal study based on the Dignified Justice Theory to understand the concept of legal protection for healthcare professionals, particularly doctors, during the COVID-19 pandemic. The research methodology includes a legislative, conceptual, and case approach.

RESULTS: The research results are subsequently analyzed. Based on the research, it is evident that legal protection is derived from regulations related to recognition, protection of rights, and other relevant legal provisions. Legal protection for the medical profession during the COVID-19 pandemic is also framed within the framework of Pancasila, integrated with the Dignified Justice Theory.

CONCLUSION: Legal protection for doctors in the COVID-19 rapid response task force is evident because healthcare professionals have received legal protection through supervision and guidance provided by local governments and their employing institutions in handling COVID-19.

BACKGROUND: According to the literature, forensic odontology is one of the most effective and affordable scientific techniques for identifying victims of mass disasters. This research methodically reviews the role and function of forensic odontologists in several global mass disasters. Forensic DNA in odontology is associated with the importance of its application in the identification of humans of mass disasters. As the crime rate continues to rise, the field of forensic medicine has evolved significantly. Forensic dentists play a pivotal role in various areas of crime scene investigations, thereby helping solve innumerable mysteries.

AIM: The study aimed to increase the body of knowledge for future research on forensic odontology by conducting a systematic review search to investigate possible forensic DNA in odontology associated with the importance of its application in the identification of humans of mass disasters.

MATERIALS AND METHODS: Six databases, including Google Scholar, PubMed, Scopus, Embase, Web of Science, and ScienceDirect, were analyzed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) quality scale. The literature search, conducted until February 2024, informed important research choices.

RESULTS: A total of 16 (100%) studies related to forensic DNA of mass disasters were identified. Of these, only seven (43.75%) articles related to dental DNA were included in this review. Of the 4,808 articles obtained, 138 duplicates or irrelevant articles were eliminated. Following a full-text review, seven studies were selected based on eligibility criteria. The highest percentage of victims was identified using dental DNA. In a few studies, some samples were insufficient for complete DNA profiling due to factors such as the method of DNA extraction.

CONCLUSION: Forensic odontology has played a significant role in the identification of victims of several mass disasters around the world. Although teeth are an excellent source of DNA for humans, future studies with larger sample sizes, appropriate control groups, and standardized techniques of DNA extraction need to be conducted.

Forensic DNA databases are beneficial for investigating crimes and allow identifying a person using biological traces, provided that information about him/her is already available in the form of a short tandem repeat profile. The same is true for unidentified corpses. When such information is missing from the database, DNA phenotyping can be used. A person’s appearance can be reconstructed based on his DNA, which is already a finding application in forensic practice. Considerable progress is achieved when the hair and eye color, skin pigmentation, and some other features are established. However, the main interest is in the human face. However, developments in this area are limited. The main issue is that multiple genes are responsible for facial features, including a pleiotropic effect. The emergence of such a method such as genome-wide association study made it possible to analyze many gene loci at once for the presence of single-nucleotide substitutions associated with certain genes involved in the formation of a person’s face. However, sequencing of two genomes (or exomes) of each person inherited from the father and mother with phased haplotype assembly of their sequences can be more informative. With this approach, the accurate selection of objects in the form of a large number of twins and their closest relatives is critical, because twins may carry the same nucleotide substitutions, which largely determine their external similarity. Another cohort should be families in which children are very similar to their parents. In this case, it is crucial to conduct triosequencing with phased assembly of their diploid genomes (exomes). Genetic information obtained in this way, which is processed using machine learning and artificial intelligence, allow us to “reach” the necessary genes, increasing the reliability of such DNA portraits.

In recent years, the number of complications associated with orthopedic dental treatment has increased, which can lead to serious pathologies and conflict situations and negatively affect the quality of life of patients, which entails the professional responsibility of medical workers. A crucial piece of evidence when considering and investigating civil cases to hold medical workers accountable for providing improper medical care (services) in the field of orthopedic dentistry is the conclusion of commission (complex) forensic medical examinations.

During the forensic medical examination of patients’ claims against dental institutions and dentists, issues regarding their organization and production remains to be determined and studied. Scientifically based objective criteria for evaluating professional errors and defects in dental care have not been developed, and effective methods for analyzing therapeutic and diagnostic processes are not used in forensic medical practice, which makes it challenging to comprehensively analyze a specific clinical situation.

This article provides detailed information on the clinical condition of existing teeth and fixed and removable dentures, characteristics of their position in the oral cavity, defects in fixation, and stabilization of dentures. A comprehensive analysis of the possible use of existing removable and nonremovable dental structures for full-fledged chewing function and their aesthetic condition was performed. Significant errors and limitations in the planning, manufacture, and fixation of removable and nonremovable dentures were identified. A comprehensive assessment and recommendations for forensic medical examination in a civil case are provided.

Injuries from tourist and hunting knives are rare in forensic practice. The design of the blades of tourist and hunting knives have a significant impact on the morphological picture of stab wounds, which can cause difficulties to experts in resolving some issues.

At the time of the forensic examination of the corpse, the expert established that the man at home had been stabbed twice in the chest and stomach with one knife. Medical and forensic study showed that the wound on the chest was caused by a flat piercing-cutting instrument such as a knife, the blade of which in its mark-forming parts had a tip, one cutting blade, and a U-shaped butt in cross-section with clearly defined ribs, and the wound on the stomach was caused by a flat piercing-cutting weapon, the blade of which in its mark-forming parts had a tip and two cutting blades. Thus, the wounds were caused by different knives. However, after the investigator provided the probable instrument of injury (a tourist knife), it became clear that both injuries may have been caused by the same object.

The present case shows that in the absence of information about the traumatic stabbing and cutting object and use of only the data of forensic medical examination of the corpse and results of medical and forensic examination of the morphology of skin wounds, erroneous judgments are possible. Therefore, caution should be exercised when considering the possibility of wounding by one or more knives.

The year 2024 marks the 235th anniversary of the birth of Ilya Vasilyevich Buyalsky, an outstanding Russian surgeon, anatomist, and forensic physician and Honored Professor of the Imperial Medical and Surgical Academy and academician of the Imperial Academy of Arts. Another anniversary date of this year is associated with Buyalsky’s name: exactly 200 years ago, “The doctors guide to the correct examination of dead human bodies for finding the cause of death, especially in forensic cases,” which was the first original domestic manual on forensic medical examination, was published in the Military Medical Journal. This article comprehensively examined the history of the creation of this work, its main points, and its significance for subsequent generations of Russian forensic medical experts.

The article provides information about the activities of Buyalsky in the field of forensic medical examination. An analysis of his work “The doctors guide to the correct examination of dead human bodies...” is presented.

The present study shows that Buyalsky was one of the founders of forensic thanatology in our country, and the main provisions of “The doctors guide to the correct examination of dead human bodies...” remain relevant to date.

The year 2023 marked the 120th year of the first domestic, scientifically based work on forensic dentistry conducted in Russia. This work was Vilga’s dissertation for the degree of Doctor of Medicine “On teeth in forensic medicine.” The publication of this work indicated the start of the century of forensic dentistry in Russia. Vilga provided the main directions for the future development of forensic dentistry: personal identification, dental injuries, and improper provision of dental care.

Forensic medical identification of a person involves obtaining objective information about the characteristics and biological properties of an unidentified object and comparing them with materials displaying similar characteristics of the wanted person. The theoretical basis for forensic medical identification of a person is forensic medicine and anthropology. In world practice, identification studies to establish an individual’s identity are based on the examination of odontological status, as a source of significant information for establishing the age, sex, and race of a person, identifying individual characteristics and establishing identity. Forensic dentistry is one of the new branches of forensic medicine. It has its own specific features and requires knowledge that goes beyond the scope of forensic education.

This article provides information on the initial stage of personal identification and use of tools required to solve this problem.

At present, many provisions of the doctoral dissertation of Vilga “On teeth in forensic medicine” remain relevant. Thus, the formation of personal identification by dental status in Russia is directly related to the work of Vilga.