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The article discusses the socio-legal aspects of the development mutual cooperation between Russia and China in the public health. This direction of the current Russian-Chinese political agenda is caused by some factors. One of them is the common nature of public health problems and challenges faced by the healthcare systems. Also the reason is the growth of cross-border mobility of the population of both countries, which necessitates coordination of efforts in the field of regulation, ensuring the quality of services, protecting patients rights and epidemiological control. In this regard, the objective of the study is to analyze the key areas, legal mechanisms and social challenges that influence the development of interaction between Russia and China in the field of public health. Based on the results of the study, the main vectors in the Russian-Chinese cooperation in the field of public health are defined. They include: 1) prevention and control of infectious diseases; 2) digital transformation of healthcare; 3) oncology and nuclear medicine; 4) medical education and science; 5) ethical problems. The main mechanisms of interaction between Russia and China in public healthcare are legal regulatory (bilateral agreements, interdepartmental protocols, harmonization of regulatory requirements) and projects in scientific and educational sphere. Overall, cooperation between Russia and China in healthcare is dynamically developing, multifaceted, and promising. However, there are a number of limitations and problems, including cultural barriers, legal restrictions and ethical challenges. To sum up, the Russian-Chinese cooperation in the field of public health has significant potential, but requires the development of a legal framework and a systematic approach. Одним из актуальных направлений в развитии отношений между Россией и Китаем на современном этапе является сотрудничество обоих государств в сфере общественного здравоохранения. Данный вектор российско-китайской политической повестки обусловлен рядом фактором, а именно: общим характером проблем здоровья населения и вызовами, с которыми сталкиваются системы здравоохранения, ростом трансграничной мобильности населения обеих стран, что вызывает необходимость координации усилий в области регулирования, обеспечения качества услуг, защиты прав пациентов и эпидемиологического контроля, которые обусловливают исследовательский интерес к изучению социально-правовых аспектов в развитии российско-китайского сотрудничества в сфере общественного здоровья. В этой связи цель данного исследования заключается в проведении анализа ключевых направлений, правовых механизмов и социальных вызовов, которые влияют на развитие взаимодействия между Россией и Китаем в сфере общественного здоровья. По результатам проведённого исследования на основе принципа методологической триангуляции были выявлены основные векторы в российско-китайском сотрудничестве в сфере общественного здоровья: 1) профилактика и борьба с инфекционными заболеваниями (в 2025 г. Россия и Китай подписали меморандум о сотрудничестве в области борьбы с инфекционными болезнями); 2) цифровая трансформация здравоохранения (в 2025 г. Минздрав России и Государственный комитет КНР по здравоохранению подписали Меморандум о взаимопонимании в области цифровой трансформации здравоохранения); 3) онкология и ядерная медицина; 4) медицинское образование и наука (образована Российско-Китайская ассоциация медицинских университетов, которая способствует обмену специалистами, разработке совместных образовательных программ и взаимному признанию дипломов о медицинском образовании). Основными механизмами взаимодействия России и Китая в сфере общественного здравоохранения выступают: нормативно-правовые (двусторонние соглашения, межведомственные протоколы, гармонизация регуляторных требований) и научно-образовательные (совместные исследования, обмен кадрами, образовательные программы). В целом, сотрудничество России и Китая в сфере здравоохранения можно охарактеризовать как динамично развивающееся, многогранное и перспективное. Однако есть ряд ограничений и проблем, включая культурные барьеры, правовые ограничения и этические вызовы. Сделан вывод о том, что российско-китайское сотрудничество в сфере общественного здоровья имеет значительный потенциал, но требует разработки правовой базы и системного подхода.
to describe the garbage codes (GCs) identified in the Global Burden of Disease Study (GBD) 2023 and their redistribution to underlying causes of death in Italy in 2021. Specifically, the study aims to: 1. compare temporal trends in the proportion of GCs in Italy with those of other Western European countries with similar population sizes; 2. identify the most frequent GC packages, analyze their geographic distribution, and determine the causes to which they are reassigned; 3. examine the relationship between the proportion of GCs and contextual factors related to death certification, including the type of certifier, place of death, and requests for autopsy. descriptive epidemiological study based on GBD 2023 estimates. the analysis focuses on the Italian population in 2021, stratified by 21 subnational units, including 19 regions and 2 autonomous provinces. total number of deaths; number of GCs, defined as deaths attributed to causes that do not represent underlying causes of death; percentage of GCs, calculated as the number of GCs divided by total deaths and multiplied by 100. the proportion of GCs in Italy gradually decreased over time, from 34.6% in 1990 to 28.8% in 2021. In 2021, the three most frequent GC packages at the national level were 'unspecified type of stroke' (4.28% of total deaths), 'unspecified type of diabetes' (2.44%), and 'heart failure, right or left' (2.38%). In the same year, the proportion of GCs was positively correlated with the share of deaths occurring at home (r 0.71; p <0.001), with missing data on the type of certifying physician (r 0.54, p=0.020), on place of death (r 0.77, p <0.001), and on autopsy requests (r 0.76, p <0.001). misreporting of causes of death arises from multiple mechanisms, reflecting errors of different nature and severity, with important implications for public health policies and health information systems. While redistribution methods are essential to produce comparable and policy-relevant estimates, improving data quality at the source remains a critical priority.
Accurate estimation of legal adulthood in undocumented individuals remains a major challenge in forensic and medico-legal contexts. This study evaluates mandibular condylar cortication and third molar apical closure assessed by cone beam computed tomography (CBCT) as potential indicators of age of majority. A retrospective observational pilot study was conducted on 142 individuals aged 13-25 years from six geographic regions (Spain, Uruguay, Peru, Mexico, Venezuela and Colombia). Two radiological variables were analyzed: the presence of cortical bone in the mandibular condyle and apical closure of the mandibular third molars. Associations with chronological age were explored descriptively, considering sex and geographic origin. Mandibular condylar cortication was identified exclusively in individuals aged 18 years or older. It showed 89.2% sensitivity, 100% specificity, 100% positive predictive value, and 89.5% negative predictive value for identifying legal adulthood. Complete third molar apical closure showed lower sensitivity (64.7%) and specificity of 96.6%. Both markers were significantly associated with legal adulthood (Fisher's exact test, p < 0.001). Within the limitations of this pilot study, mandibular condylar cortication assessed by CBCT appears to be a promising indicator of legal adulthood, potentially offering higher specificity than third molar apical closure. Further large-scale studies are required to validate these findings.
Around the 12th/thirteenth century, a burial method called "more teutonico" was used for the remains of high-ranking individuals who had died far from their homeland and had to be brought back for burial. Before transportation, the bodies or body parts were boiled (macerated) to remove all soft tissue. The question of whether a body was boiled postmortem, is of particular interest for historians (burial "more teutonico"?) and this question may also be relevant in a forensic context, even if only in rare cases. In 1989, Bada, Herrmann, Payan and Man ("Amino acid razemization in bone and the boiling of Emperor Lothar I." in Applied Geochemistry) suggested using the D-aspartic acid content of bone as an objective indicator of a postmortem exposure to heat. This approach was never substantiated by further studies, and more recent findings call the concept into question.Therefore, we tested the "Bada approach" by analysing the D-aspartic acid content in boiled bone samples (pig, human) using different "boiling recipes" of procedures "more teutonico" (using water, wine, or vinegar as boiling media), and discussed it under consideration of the recent literature. Using the boiled human bone samples, we also investigated whether the question of "boiled or not boiled?" could be answered by another parameter, namely by analysing the pentosidine content of a sample.An accumulation of D-aspartic acid was observed during boiling in both pig and human bone samples. It was considerably lower in the human samples and significantly influenced by the medium used. By contrast, boiling did not result in pentosidine accumulation.These experimental results call into question the reliability of the "Bada approach" - not least because the type of boiling medium may not be recreated in each individual case. Moreover, this approach does not take the current knowledge on the intravital accumulation of D-aspartic acid in bone samples of different origins into account, nor the influence of postmortem conditions on the D-aspartic acid content in non-heated samples (used as controls by Bada et al.). Overall, the approach of Bada et al. should not be accepted uncritically, as proving a treatment "more teutonico" based solely on the D-aspartic acid content seems hardly possible - and if so, only under very strict conditions. The analysis of pentosidine is not suitable for demonstrating a burial "more teutonico".
Suicidal hanging is a common case type referred to death investigation services throughout the world. It is associated with a large number of autopsy findings, but the presentation can vary significantly between cases, based on a multitude of factors related to the decedent, ligature and degree of suspension. There is also considerable variation in the reported incidence of autopsy findings within the published literature, some of which may be explained by different anthropometric characteristics of the included cases. However, study design and the thoroughness of the autopsy examination undertaken also undoubtedly influence results. This study therefore aimed to retrospectively review a series of autopsy reports from cases of suicidal hanging to assess not only the incidence of common findings identified during Coronial autopsies recently undertaken within a single region of the United Kingdom (UK), but also how the quality or thoroughness of the examination influenced their rate of detection. The results demonstrated considerable variation in the detection rates of common autopsy findings between individual consultant forensic pathologists and that the detection of neck muscle bruising (p = < 0.001), hyoid bone fractures (p = < 0.001) and thyroid cartilage fractures (p = 0.009) was greater when a layered neck dissection was undertaken. As a secondary objective, the range, incidence and impact of any natural disease and trauma additional to the ligature mark identified during the autopsy were assessed. Despite the array of natural disease and trauma recorded, none was considered critical to providing the underlying primary medical cause of death to the Coroner.
Non-thrombotic pulmonary embolism (NTPE) represents a heterogeneous and underrecognized group of conditions characterized by the obstruction of the pulmonary vasculature by non-thrombotic material, often associated with complex pathogenetic mechanisms and non-specific clinical presentations. Despite their potential to cause sudden and unexpected death, comprehensive forensic studies on NTPE remain limited. This study presents a 30-year retrospective forensic analysis (1993-2024) of autopsy cases performed at the Institute of Legal Medicine of Milan, aimed at identifying and characterizing deaths attributable to NTPE. Among 325 fatal pulmonary embolisms, 32 cases (9.8%) were classified as NTPE. Bone marrow embolism was the most frequent subtype (37.5%), followed by septic (25%), fat (21.8%), and amniotic fluid embolism (9.4%), with single cases of air and neoplastic embolism. NTPE occurred predominantly in traumatic and iatrogenic settings and were frequently associated with surgical or invasive procedures. Macroscopic findings were often non-specific, whereas histopathological examination proved decisive for diagnosis, frequently requiring targeted histochemical techniques to identify the nature of the embolic material. These findings highlight the intrinsic diagnostic complexity of NTPE and the risk of under recognition in the absence of systematic post-mortem investigation. In this context, a comprehensive forensic autopsy approach remains essential for the accurate identification and classification of these entities. Increased awareness of NTPE, together with the integration of histopathological and ancillary analyses, may contribute to improving diagnostic accuracy and to a more reliable interpretation of sudden and unexpected deaths.
Dental age estimation in adults represents an important component of forensic odontology and medicolegal practice. Recent artificial intelligence (AI) approaches have demonstrated improved performance compared to traditional morphometric techniques. This study aimed to compare the reliability and accuracy of three conventional dental age estimation methods with an AI-based approach. A total of 1000 digital orthopantomograms of adults aged 18-79 years with known chronological age were retrieved from the Department of Dental Anthropology database at the University of Zagreb School of Dental Medicine. Dental age was assessed using Kvaal's, Drusini's, and Cameriere's methods in ImageJ, and compared with an AI-based convolutional neural network model developed at the University of Zagreb Faculty of Electrical Engineering and Computing. Intraclass correlation coefficient (ICC) analysis and Bland-Altman plots demonstrated excellent reliability of the AI-based method (ICC = 0.965), with a mean bias of + 4.31 years and superior precision (CV = 4.34%, SEP = 3.64 years). In contrast, traditional methods showed poor reliability: Cameriere (ICC = 0.376; bias of + 9.16 years), Drusini (ICC = 0.331; bias of + 2.21 years), and Kvaal (ICC = 0.310; bias of + 15.7 years). Applicability rates were highest for the AI-based method (91.1%), followed by Cameriere (70.8%), Kvaal (63.1%), and Drusini (39.5%). Although the AI model demonstrated a systematic tendency toward age overestimation, it outperformed conventional methods and shows strong potential for application in forensic dental practice.
To reconstruct the identity of an individual, sex assessment is an essential step in the estimation of the biological profile of a skeleton. For that purpose, forensic anthropologists apply both morphological and metric methods based in skeletal elements. In 2000, Wasterlain used a sample from the Identified Skeletal Collection of the University of Coimbra (19th -20th centuries) to develop a method to estimate sex on the basis of the limb bones metrics. In the present study, a sample of 202 individuals (92 males and 110 females) from the 21st Century Identified Skeletal Collection (University of Coimbra) was used to revise the Wasterlain method to better suit the contemporary Portuguese population. In all, 22 measurements were performed in the femur, tibia, calcaneus, and talus. Although the Wasterlain method has shown satisfactory results, new cut-off points and discriminant functions were developed to promote accurate sex classifications in the contemporary Portuguese population. Regarding the cut-off points, the femoral vertical head diameter, the bilateral width of the tibia, the length of the calcaneus, and the maximum length of the talus presented the best results for sex estimation (89.8%, 88.0%, 85.6%, 85.9%, respectively). Discriminant functions presented correct classification percentages varying between 78.7% and 91.5% for femur, 83.7% and 93.0% for tibia, 84.9% and 86.6% for calcaneus, and 86.6% and 88.5% for talus. In sum, the new cut-off points and discriminant functions presented an overall good performance, constituting reliable methods to be applied in forensic cases involving individuals of Portuguese origin.
In forensic autopsies, the terminal circulatory status in the form of acute congestion or findings consistent with severe blood loss can be significant, as it may indicate different causes of death. However, the autopsy-related description of acute congestion or severe blood loss is predominantly subjective. Post-mortem computed tomography (PMCT) offers the possibility of recording metric parameters such as the cross-sectional area of blood vessels, which could be used for the objective description of acute congestion or severe blood loss. The aim of the present study was therefore to record and compare the cross-sectional areas of smaller and larger blood vessels for different causes of death in forensic PMCT. In n = 500 forensic autopsy cases (n = 250 men and n = 250 women), the cross-sectional area of various blood vessels near the heart (internal jugular veins, subclavian veins, pulmonary trunk, ascending aorta, descending thoracic aorta, superior vena cava, and inferior vena cava) was measured using PMCT. The cross-sectional area measurements were compared for different causes of death (acute cardiac arrest due to underlying myocardial disease, pulmonary embolism, pneumonia, hypothermia, central dysregulation due to head trauma, suffocation, strangulation, drowning, fatal hemorrhage, and intoxication) in each vessel examined. For all causes of death combined, significant differences (p < 0.05) between men and women were found for each individual vessel. In each vessel examined, the lowest mean cross-sectional area measurements were observed in fatal hemorrhage (HE), and the highest mean cross-sectional area measurements were observed in pulmonary embolism (PE) and acute cardiac arrest (CA) in both sexes. The PE and CA groups, as well the HE groups, differed significantly from all other causes of death in both men and women. PMCT cross-sectional area measurements of larger and smaller blood vessels near the heart can be used to objectively describe the terminal circulatory status in cases of pronounced acute blood congestion or fatal hemorrhage.
The use of postmortem computed tomography (PMCT) in forensic investigations has increased during recent years. PMCT differs from clinical CT due to the inevitable manifestation of postmortem changes that varies significantly between cases. However, differentiating between gas with an antemortem origin (e.g. gas embolism) vs. gas with a postmortem (putrefactive gas) origin presents a critical challenge in forensic medicine. This scoping review evaluated how gas distribution patterns on PMCT may aid in determining gas origin. In accordance with PRISMA-ScR guidelines, searches were conducted in PubMed, Web of Science, and CINAHL. 10,133 records were identified, of which 28 studies met the inclusion criteria. Overall, evidence was limited and heterogeneous, with substantial variation in terminology, gas assessment methods and study populations. Evidence suggests that differentiating pathological gas from putrefactive, resuscitation-related artefacts, and postmortem effects such as off-gassing remains a significant diagnostic challenge postmortem. Nevertheless, certain early PMCT patterns may assist interpretation. Within the first 24 h postmortem, intravascular and cardiac gas more commonly reflect systemic or traumatic mechanisms, although putrefaction cannot be excluded. Isolated cardiac gas may result from resuscitation efforts, whereas combined cardiac and intrahepatic gas more strongly suggests decomposition. In diving fatalities, embolic gas findings may be compounded by postmortem off-gassing as well as decomposition changes, and should be interpreted alongside dive profiles and, where available, gas sampling. Small gas collections adjacent to laryngeal structures may indicate trauma when other sources and decomposition are excluded. Overall, integrating PMCT gas distribution with contextual information and ancillary analyses may help understand gas origin, but further targeted research is required.
Highly degraded samples are common in forensic casework and remain among the most challenging samples for forensic genetic analysis. Conventional STR-based technologies often yield partial or null profiles from such samples, making the acquisition of complete profiles a persistent challenge. To address this limitation, we developed a six-dye Multi-InDels kit based on Multi-InDels markers characterized by short amplicon sizes, high polymorphism, and low mutation and recombination rates, while maintaining full compatibility with capillary electrophoresis platforms. The kit integrates 26 Multi-InDels loci and an amelogenin locus into a multiplex system, with all amplicons not exceeding 125 bp, and is specifically designed for personal identification and paternity testing involving highly degraded DNA. Comprehensive internal validation studies demonstrated robust system performance, with complete profiles consistently obtained from as little as 62.5 pg of input DNA. Comparative analyses with STR kits showed that the Multi-InDels kit markedly improved the recovery of complete profiles from highly degraded samples, including artificially degraded DNA and formalin-fixed paraffin-embedded tissue. Population studies yielded a combined random match probability (CMP) of 2.25 × 10⁻¹⁷ and a cumulative probability of exclusion (CPE) of 0.999925. In paternity testing, 48 confirmed trios produced an average combined paternity index (CPI) of 3.2952 × 10⁶, and all 4,800 non-biological fathers were successfully excluded. In addition, innovative investigations were conducted on Multi-InDels allele nomenclature, evaluation strategies for degraded samples, and rare alleles. Collectively, these findings demonstrate that the Multi-InDels kit provides a convenient, feasible, and robust tool for forensic analysis of highly degraded samples.
The case report is the primary means by which forensic anthropologists communicate the outcomes of their examination. Despite their central role, considerable variability currently exists in the content, structure, and clarity of such reports. Drawing on published guidelines, forensic science standards, and the collective experience of an international group of practitioners from the Board of the Forensic Anthropology Society of Europe (FASE), this paper presents practical recommendations for forensic anthropology reporting. It outlines the fundamental aims and principles of reporting, identifies essential report elements, and distinguishes minimum requirements from discretionary components. Emphasis is placed on scientific integrity, transparency of methods and reasoning, and clear communication to a diverse audience. These recommendations are meant to be applicable across jurisdictions and professional contexts, including independent practice, while remaining aligned with contemporary forensic science standards. By promoting consistency and clarity in reporting, these recommendations aim to support the reliability, interpretability, and admissibility of forensic anthropological evidence, and to strengthen the contribution of forensic anthropology to medico-legal investigations.
In forensic anthropology, skeletal materials are commonly assessed through morphological characteristics to estimate components of the biological profile. While traditional analyses relied on physical examination of skeletal remains, digital methodologies offer the potential to supplement or replace direct observations, increasing the accessibility of forensic anthropological consultation, research, and education. However, the reliability of three-dimensional (3D) documentation techniques for nonmetric assessment remained variable and required further investigation. This study provides a preliminary investigation of the applicability of handheld laser scan-derived point-cloud models for nonmetric skeletal assessment in biological profile estimation using a two-case design. Two skeletal cases were selected from the George Mason University Forensic Science Program Teaching Collection: a 40-year-old White male and an 80-year-old White female. A total of 53 participants with varying levels of forensic anthropological training and experience were recruited from the Washington metropolitan area. Participants first conducted in-person assessments of skeletal elements and subsequently evaluated 3D models after a washout period. Inter-observer agreement was generally higher for physical skeletal assessments than for virtual assessments. Skeletal sex estimation (particularly innominate traits) and age estimation via the pubic symphysis showed lower agreement and reduced inter-modality correspondence. Despite this, skeletal sex classification accuracy remained largely stable across modalities. Conversely, population affinity, despite fair inter-modality agreement, showed reduced classification accuracy in the virtual setting. These findings suggest that handheld laser scans do not fully replicate all aspects of nonmetric skeletal assessment, and their application should be considered trait-dependent and validated further before routine use.
Orocraniofacial (OCF) trauma includes injuries to the oral cavity, cranial structures, and facial skeleton caused by road traffic accidents, interpersonal violence, falls, and other high-energy events. Dental injuries are an often underreported component of OCF trauma despite their important forensic value in victim identification, documentation of violence, and determination of cause of death. This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 guidelines. Five electronic databases (PubMed, Scopus, Web of Science, ProQuest, and Cochrane Library) were searched from inception to March 2026 without language restrictions. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and Risk of Bias 2 (RoB-2) tools. A random-effects meta-analysis was applied, and heterogeneity was quantified using the I² statistic. Out of 1,860 records, 18 studies involving 46,247 participants across 12 countries met the inclusion criteria. The pooled prevalence of dental injuries in OCF trauma was 24.3% (95% CI: 19.8-29.1%), with substantial heterogeneity (I² = 81.2%). Crown fractures were the most common injury type (OR 2.09; 95% CI: 1.74-2.51). Interpersonal violence showed the strongest association (OR 2.61; 95% CI: 1.98-3.44). Male gender (OR 1.58) and individuals under 18 years (OR 1.45) were consistently associated risk factors. Maxillary anterior teeth accounted for 82.7% of injuries. In conclusion, dental injuries are significantly associated with OCF trauma and hold substantial forensic importance. Routine dental examination should be integrated into trauma assessment and forensic investigations, with future research focusing on standardized classification systems and multicenter prospective studies.
This study developed a magnetic resonance imaging (MRI)-based artificial intelligence (AI) framework for ordered pubertal olecranon bone age (BA) staging and evaluated internal performance and preliminary cross-centre transportability. This retrospective two-centre study included a development cohort of 197 elbow MRI examinations from Shengjing Hospital of China Medical University and an independent external-validation cohort of 72 elbow MRI examinations from Handan Central Hospital. The development cohort comprised 77 girls aged 9.5-13 years and 120 boys aged 11.5-15 years, whereas the external-validation cohort comprised 30 girls aged 9.5-13 years and 42 boys aged 11.5-15 years. Manually delineated olecranon ROIs were used for preprocessing and YOLO-v8m detector training. Localized images were processed using ResNet-50 feature extraction, Fisher score-based feature selection, and an NN classifier. The locked development-centre pipeline was applied unchanged to the external-validation cohort without retraining, repeated feature selection, hyperparameter tuning, or checkpoint selection based on external data. Automated localization achieved a mean average precision of 1.0. The final NN classifier reached internal-validation accuracies of 94.12% in girls and 93.75% in boys, with stage-mapped mean absolute error (MAE)/root mean square error (RMSE) values of 0.029/0.121 and 0.062/0.250 years, respectively. In the external cohort, girls achieved an accuracy of 86.67%, MAE of 0.233 years, and RMSE of 0.658 years, weighted kappa of 0.922, and ICC of 0.969, whereas boys achieved an accuracy of 90.48%, MAE of 0.095 years, RMSE of 0.309 years, unweighted kappa of 0.890, weighted kappa of 0.963, and ICC of 0.991. The MRI-based framework provided stage-consistent internal performance and preliminary evidence of cross-centre transportability within the studied pubertal age window. It should be interpreted as a supplementary maturity marker rather than a stand-alone forensic age-estimation tool. Chinese Clinical Trial Registry (ChiCTR2500109735), retrospectively registered on September 24, 2025.
The collection and analysis of biological samples for DNA profiling have become indispensable tools in forensic investigations, facilitating both the incrimination and exoneration of individuals implicated in criminal activities. Every individual constantly release traces of their DNA into their surroundings, depositing genetic material in the environment. Recent advancements in DNA technology have enabled the detection and profiling of these trace samples containing minimal cellular material. These evidences expand the scope of forensic analysis to a new concept of environmental DNA (eDNA) which refers to genetic material recovered from environmental matrices such as water, soil, and air. While eDNA has traditionally been utilized in ecological contexts-such as non-invasive species monitoring and population genetics-its forensic applications are now garnering significant attention. Between 2005 and 14th February, 2026 different keyword searches in Google Scholar, Scopus and PubMed revealed that about 25% of eDNA studies focused on biodiversity, 27% on conservation, and only 10% on forensic applications-with a mere 0.08% dedicated to human eDNA. This review, therefore, concentrates on human eDNA analysis from environmental sources such as water, air, and soil, along with their downstream applications. The approach offers a promising, non-invasive avenue for collecting biological evidence, potentially transforming forensic investigation methods. At the same time where eDNA research grows, it must also address key legal and ethical issues such as consent, data ownership, and privacy. This review summarizes recent advances and future directions in forensic eDNA, emphasizing the need for strong ethical and regulatory frameworks for its responsible use.
Aim: To show the increase of corruption risks in healthcare during the war, their negative impact on the protection of human rights, and to outline legal ways to minimize these risks. Materials and Methods: The study was conducted in 2025 and is based on international and humanitarian law, Ukrainian legislation and regulations in the areas of human rights, healthcare, and anti-corruption, interviews with medical professionals and wounded combatants, content analysis of media publications, and Ukrainian judicial practice and statistics. A total of 47 documents were analyzed, and interviews were conducted with three medical professionals and five combatants. The methods used were legal analysis and systemic-structural analysis, interviews, statistical analysis, content analysis of media information, and analytical methods, including induction and deduction. Artificial intelligence was used as an auxiliary tool for information search; Grammarly was used to edit the text. Conclusions: While international law has not yet established a binding norm defining corruption as a human rights violation, corruption in healthcare systems constitutes a significant threat to the realization of human rights. No derogation from commitments to the rights to life and health is legally permissible during wartime. To minimize corruption risks, the healthcare system, including military medicine, must be adequately prepared in advance. Digitalization serves as a crucial tool for transparent assessment of functional/ADL status, and the management of humanitarian aid requires a more effective oversight system.
Determining attainment of 18 years is a critical task in forensic age estimation. This study evaluated and compared the sex-specific diagnostic performance of conventional and refined third-molar maturation cut-offs, Demirjian stages G and H, and the refined stage G1 for identifying individuals aged ≥ 18 years in a South Indian population. Panoramic radiographs of 599 individuals aged 14-22 years were retrospectively assessed. Mandibular left third molars were staged using the conventional Demirjian system and the Solari and Abramovitch modification. Diagnostic performance was evaluated separately for males and females using sensitivity, specificity, predictive values, likelihood ratios, accuracy, and post-test probabilities. Intra- and inter-examiner agreement was assessed using kappa statistics. Third-molar maturation effectively discriminated attainment of 18 years in both sexes, with stage-dependent trade-offs between sensitivity and specificity. Stages G and above and stages G1 and above demonstrated high sensitivity and strong exclusion of adulthood when negative, whereas stage H showed higher specificity and greater confirmatory value when present, particularly among females. Diagnostic performance of the refined G1 stage was comparable to that of stage G, with modest improvement in specificity and post-test probability in females. Inter-examiner agreement was excellent for stages G and H but only moderate for G1, indicating reduced reproducibility for the refined stage. In conclusion, conventional Demirjian stages G and H remain reliable and reproducible indicators for assessing attainment of 18 years. Although the refined G1 stage offers increased developmental resolution and supports probabilistic interpretation, its forensic utility is constrained by reduced inter-observer agreement.
Tumor budding (TB) is an independent prognostic biomarker for colorectal cancer (CRC), yet its clinical adoption is limited by labor-intensive and subjective visual scoring. Computational pathology (CPath) algorithms using deep learning offer potential to improve efficiency and reproducibility. Using an international Delphi study, we established consensus requirements to guide validation and clinical adoption of CPath algorithms, aiming to enhance diagnostic accuracy and patient care. A two-round international Delphi process was conducted, involving international experts, to reach consensus on predefined statements. In round 1, baseline characteristics were collected and participants were asked to rank statements representing the minimal requirements for the implementation of a CPath algorithm for TB assessment. After completion of this round, participants received a personalized feedback report summarizing interim results for items that lacked consensus. In round 2, participants re-evaluated their initial responses to statements without consensus, in the light of anonymized group feedback provided in their personalized report. Fifty-nine pathologists participated in round 1, with a 90% response rate in round 2. Consensus was reached for 21 of 29 (72%) minimal requirements. All reached consensus by agreement. Eight statements (28%) remained without consensus after round 2. Agreement was reached on the technical, organizational, ethical, and legal aspects, although some requirements were not agreed upon. This highlights the importance of evaluations that take specific contexts into account, as well as the need for continuous stakeholder engagement throughout the development and implementation phases.
IntroductionAdvance Care Planning (ACP) is a patient-centered process that enables individuals to consider their goals and priorities and make plans with their healthcare team for future care. Oncology clinicians care for critically ill patients and are central to facilitating and documenting ACP. While Australian and international guidelines strongly support ACP in oncology, clinician engagement and documentation of ACP remain suboptimal. This study aimed to explore oncology clinicians' ACP knowledge, decision-making, and practice, including factors influencing engagement in ACP.MethodsA qualitative study was conducted using semi-structured interviews with oncology clinicians from three metropolitan hospitals in New South Wales, Australia. Participants were purposefully sampled and interviewed between November 2021 and March 2022. Interviews were audio-recorded, transcribed, and analyzed using deductive thematic analysis guided by the Theoretical Domains Framework (TDF). An inductive approach was subsequently applied to develop explanatory subthemes within identified domains.ResultsEleven clinicians participated, including Medical/Radiation Oncology Consultants (54.5%) and Advanced Trainees (45.5%). Interview length ranged from 17.5 to 35.5 minutes. A total of 380 quotes were coded across all 14 TDF domains, generating 33 explanatory subthemes. Four domains were most influential: Knowledge and Skills, Social/Professional Role and Identity, Environmental Context and Resources, and Social Influences. Although all participants recognized ACP as best-practice care, engagement was influenced by limited formal training and legal literacy, uncertainty regarding responsibility for initiating and documenting ACP, variable inconsistent interdisciplinary communication, workload and time constraints, electronic medical record functionality, and patient characteristics (i.e.,psychological state, health literacy, cultural complexity).ConclusionACP in oncology is shaped by complex, interdependent socio-cultural and organizational factors. Applying the TDF identified key behavioral and contextual determinants. Improving ACP requires multilevel strategies targeting clinician capability, role clarity, and system-level supports, including structured education, clearer documentation processes, improved electronic medical record functionality, and integration of ACP into routine multidisciplinary care. Advance care planning (ACP) helps people think about and discuss the care they would want in the future. For people with advanced cancer, ACP can improve quality of care, reduce unwanted treatments, and help patients and their families feel more supported. Although guidelines recommend early ACP in cancer care, it does not always happen consistently. This study explored why, by interviewing 11 cancer clinicians (both senior specialists and junior clinicians) from New South Wales, Australia. Researchers asked about their experiences with ACP conversations, documentation, and what helps or prevents them from doing ACP. The interviews were analyzed using a behavioral framework to identify key influences on practice. All clinicians agreed ACP is an important part of patient care. However, several challenges were identified. Many clinicians reported limited formal training in ACP, especially around legal aspects and how to document plans correctly in electronic medical records. Most had learned through experience. There was uncertainty about who is responsible. While senior cancer specialists were seen as best placed to lead discussions, junior clinicians often completed documentation. System barriers played a major role. Time pressures in busy outpatient clinics made it difficult to have early ACP conversations. Some clinicians found hospital electronic medical record systems hard to use or not well integrated with systems used in oncology. Finally, patient factors influenced timing. Clinicians found ACP more difficult to navigate when patients were distressed or not ready to have ACP conversations. The study concludes that improving ACP in cancer care requires better training, clearer role definitions, improved electronic systems, and stronger integration of ACP into routine care.