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Keywords = medical–legal assessment

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17 pages, 1053 KiB  
Article
Dangerousness Index in Forensic Psychiatric Examination: A Tool for Aiding Medical Decision Regarding the Risk of Antisocial Acts
by Daniela Margareta Varga, Florica Voiță-Mekeres, Gabriel Mihai Mekeres, Călin David Buzlea, Lavinia Davidescu and Camelia Liana Buhas
Diagnostics 2025, 15(8), 1004; https://doi.org/10.3390/diagnostics15081004 - 15 Apr 2025
Viewed by 284
Abstract
Background and Objectives: The assessment of dangerousness and risk of recidivism are crucial aspects of forensic psychiatric evaluations, influencing therapeutic and security measures. This study aimed to develop and validate a new tool, the Dangerousness Index in Forensic Psychiatry (IPPML), following a [...] Read more.
Background and Objectives: The assessment of dangerousness and risk of recidivism are crucial aspects of forensic psychiatric evaluations, influencing therapeutic and security measures. This study aimed to develop and validate a new tool, the Dangerousness Index in Forensic Psychiatry (IPPML), following a psychometric scale construction methodology. Materials and Methods: The sample consisted of 261 participants (157 males, 104 females) aged 19–75 years, divided into an experimental group (n = 126) with a history of forensic psychiatric examination and a control group (n = 135) diagnosed with schizophrenia. Results: Exploratory factor analysis revealed two factors, Performance and Social, explaining 45.55% of the data variance. The IPPML demonstrated adequate internal consistency (α = 0.881) for the entire sample, with Factor 1 showing strong consistency (α = 0.896) and Factor 2 exhibiting acceptable consistency (α = 0.628). Reliability ranged from 89.6% to 62.8% when administered to participants with psychoses undergoing forensic psychiatric evaluation, decreasing to 42.5% for legally evaluated patients and increasing from 58.7% to 84.3% for participants with schizophrenia without forensic psychiatric evaluation. Discriminant validity analysis indicated higher psychiatric dangerousness with forensic implications in males. Conclusions: The IPPML shows promise as a tool for assessing dangerousness in forensic psychiatry and aiding medical decision-making regarding the risk of antisocial and potentially harmful acts. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Management of Neuropsychiatric Disorders)
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14 pages, 225 KiB  
Review
Optimizing Organ Donation After Euthanasia: A Critical Appraisal
by E. A. J. Alkemade, H. D. Lam, B. J. C. Hendriks, A. E. Braat, I. P. J. Alwayn, M. J. Coenraad and A. G. Baranski
Transplantology 2025, 6(2), 10; https://doi.org/10.3390/transplantology6020010 - 7 Apr 2025
Viewed by 200
Abstract
This Critical Appraisal aims to explore the pharmacokinetics and pharmacodynamics of medications used in organ donors after euthanasia (ODE) and their impact on abdominal organ quality. With the legalization of ODE, the donor pool has expanded, but it has introduced complexities regarding organ [...] Read more.
This Critical Appraisal aims to explore the pharmacokinetics and pharmacodynamics of medications used in organ donors after euthanasia (ODE) and their impact on abdominal organ quality. With the legalization of ODE, the donor pool has expanded, but it has introduced complexities regarding organ quality. This study evaluates existing euthanasia protocols in the Netherlands, Belgium, Spain, and Canada, focusing on differences in the medication types and dosages. Additionally, a literature review assessed the potential hepatotoxic effects of high-dose medications like thiopental, propofol, and non-depolarizing neuromuscular blocking agents. High doses of non-depolarizing neuromuscular blocking agents, particularly rocuronium, are associated with hepatotoxic effects in vitro. Furthermore, thiopental doses exceeding 750 mg significantly increase the risk of liver dysfunction. Recent findings also indicate that high-dose propofol and lidocaine can slightly prolong the time to death, which is crucial for optimizing organ viability in ODE. This study highlights the need to optimize organ donation procedures after euthanasia. Further research is needed to achieve this balance, maintaining the integrity and ethical standards of the euthanasia process while enhancing the outcomes of organ donation. Full article
(This article belongs to the Section Organ and Tissue Donation and Preservation)
8 pages, 194 KiB  
Conference Report
ONJ (MRONJ) Update 2024: Osteonecrosis of the Jaw Related to Bisphosphonates and Other Drugs—Prevention, Diagnosis, Pharmacovigilance, Treatment—A National Italian Symposium
by Vittorio Fusco, Martina Coppini, Gaetano La Mantia, Paolo G. Arduino, Fortunato Buttacavoli, Alessio Gambino, Francesco M. Erovigni, Alberto Bedogni and Giuseppina Campisi
Oral 2025, 5(2), 25; https://doi.org/10.3390/oral5020025 - 3 Apr 2025
Viewed by 413
Abstract
On 24 February 2024, Italian physicians, dentists and oral care specialists, students, nurses, psychologists, dental hygienists, and other professionals met (live or online) to discuss controversial issues about medication-related osteonecrosis of the jaw (MRONJ). One section hosted international experts who gave lectures about [...] Read more.
On 24 February 2024, Italian physicians, dentists and oral care specialists, students, nurses, psychologists, dental hygienists, and other professionals met (live or online) to discuss controversial issues about medication-related osteonecrosis of the jaw (MRONJ). One section hosted international experts who gave lectures about MRONJ experiences in North America, Europe, and Italy. A second section summarized the principal points of an Italian MRONJ position paper published in February 2024 by experts from the Italian Societies of Oral Pathology and Medicine (SIPMO) and Maxillofacial Surgery (SICMF). The following section collates expert opinions about open issues and required fields of research: different definitions of MRONJ and impact on staging; the assessment of individual MRONJ risk before the start of antiresorptive therapy; surgery and implantology in patients at risk for MRONJ; cancer patients without metastases and prevention of cancer-treatment-induced bone Loss (CTIBL); the role of dental hygiene professionals; combined (medical and surgical) and surgical therapy for MRONJ in-patients and out-patients; and legal aspects and claims related to MRONJ diagnosis and treatment. Scientific contributions from hospitals and universities all over Italy were presented in specific sessions (epidemiology; case series; special case reports; prevention experiences; MRONJ treatment). Conclusions: the conference confirmed the importance of the adequate imaging study of bone in the diagnosis and staging of MRONJ cases, the role of surgery in MRONJ treatment, and the value of oral hygiene in the MRONJ prevention. Full article
44 pages, 551 KiB  
Review
The Dark Side of “Smart Drugs”: Cognitive Enhancement vs. Clinical Concerns
by Mariarosaria Ingegneri, Erika Smeriglio, Younes Zebbiche, Laura Cornara, Letterio Visalli, Antonella Smeriglio and Domenico Trombetta
Toxics 2025, 13(4), 247; https://doi.org/10.3390/toxics13040247 - 26 Mar 2025
Viewed by 1556
Abstract
The European Union Drugs Agency has emphasized the increasing difficulty in monitoring the drug market due to the emergence of new psychoactive substances, often marketed as legal highs. The proliferation of fake pharmacies, drugstores, and e-commerce platforms has made access to illicit substances [...] Read more.
The European Union Drugs Agency has emphasized the increasing difficulty in monitoring the drug market due to the emergence of new psychoactive substances, often marketed as legal highs. The proliferation of fake pharmacies, drugstores, and e-commerce platforms has made access to illicit substances alarmingly rapid and inexpensive. These substances are readily available without medical prescriptions, lacking proper risk assessments or monitoring of potential adverse effects, raising significant public health concerns. Today, the relentless pursuit of validation and success—often, at any cost—has led to an exponential rise in the use of cognitive and mood enhancers. Such substances are frequently consumed to manage demands related to work, diet, sexuality, sleep, achievement, and interpersonal relationships. Consequently, investigating these phenomena is critically important for institutions, as they represent a serious threat to individual development and health. Developing effective preventive and protective systems is essential. This review provides an overview of currently available smart drugs, discussing their desired and adverse neuropharmacological effects, psychological implications, and cognitive decline resulting from their excessive and unregulated use. This review concludes that a multidisciplinary approach combining molecular identification, micro-morphological analysis, and chemical characterization is crucial for the accurate detection, monitoring, and risk mitigation of new psychoactive substances. Full article
(This article belongs to the Special Issue Toxicity of Central Nervous System (CNS) Modulators)
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13 pages, 1960 KiB  
Brief Report
Canadian Emergency Physician Attitudes Toward Somatic Symptom and Related Disorders
by Jesse H. Wells, Joel M. Town and Samuel G. Campbell
Emerg. Care Med. 2025, 2(1), 14; https://doi.org/10.3390/ecm2010014 - 16 Mar 2025
Viewed by 398
Abstract
Background: Somatic symptom disorder (SSD) involves physical symptoms that cannot entirely be explained by an organic medical cause, accompanied by persistent thoughts, feelings and behaviours relating to one’s health. SSD is common yet underdiagnosed in emergency departments (EDs). This study aimed to [...] Read more.
Background: Somatic symptom disorder (SSD) involves physical symptoms that cannot entirely be explained by an organic medical cause, accompanied by persistent thoughts, feelings and behaviours relating to one’s health. SSD is common yet underdiagnosed in emergency departments (EDs). This study aimed to assess emergency physician (EP) readiness, attitudes and perceptions toward diagnosing SSD and explore demographic trends. Methods: In total, 1339 Canadian EPs were invited to respond to a survey collecting demographic information and assessing attitudes toward SSD in four domains: perceptions of SSD, attitudes toward patients, diagnostic confidence, and physician–patient communication. Data were analyzed using t-tests and ANOVA to determine associations with demographic information. Results: Of the 96 survey respondents, 75 met the eligibility criteria. In total, 44% estimated that emotional stress was the primary cause of symptoms in 11–20% of their patients. Most felt that SSD was underdiagnosed and that effective therapies exist. Concerns included medico-legal implications, managing patients’ emotions, and potential negative reactions to non-organic diagnoses. Most respondents felt prepared and confident broaching the diagnosis. More experienced EPs felt that there was time to broach the topic of SSD, while rural EPs were less concerned about patient offence than urban counterparts. Conclusions: EPs recognize SSD as common and underdiagnosed, acknowledging its diagnosis as part of their role. Challenges identified include managing patients’ emotions, time constraints, and reliance on only diagnosing SSD once an organic etiology is excluded. Training pathway, experience, and practice setting impact perceptions and attitudes around SSD. The findings suggest opportunities for improving SSD care through targeted interventions, communication training, and enhanced diagnostic education. Full article
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10 pages, 554 KiB  
Review
Should Artificial Intelligence-Based Patient Preference Predictors Be Used for Incapacitated Patients? A Scoping Review of Reasons to Facilitate Medico-Legal Considerations
by Pietro Refolo, Dario Sacchini, Costanza Raimondi, Simone S. Masilla, Barbara Corsano, Giulia Mercuri, Antonio Oliva and Antonio G. Spagnolo
Healthcare 2025, 13(6), 590; https://doi.org/10.3390/healthcare13060590 - 8 Mar 2025
Viewed by 562
Abstract
Background: Research indicates that surrogate decision-makers often struggle to accurately interpret and reflect the preferences of incapacitated patients they represent. This discrepancy raises important concerns about the reliability of such practice. Artificial intelligence (AI)-based Patient Preference Predictors (PPPs) are emerging tools proposed to [...] Read more.
Background: Research indicates that surrogate decision-makers often struggle to accurately interpret and reflect the preferences of incapacitated patients they represent. This discrepancy raises important concerns about the reliability of such practice. Artificial intelligence (AI)-based Patient Preference Predictors (PPPs) are emerging tools proposed to guide healthcare decisions for patients who lack decision-making capacity. Objectives: This scoping review aims to provide a thorough analysis of the arguments, both for and against their use, presented in the academic literature. Methods: A search was conducted in PubMed, Web of Science, and Scopus to identify relevant publications. After screening titles and abstracts based on predefined inclusion and exclusion criteria, 16 publications were selected for full-text analysis. Results: The arguments in favor are fewer in number compared to those against. Proponents of AI-PPPs highlight their potential to improve the accuracy of predictions regarding patients’ preferences, reduce the emotional burden on surrogates and family members, and optimize healthcare resource allocation. Conversely, critics point to risks including reinforcing existing biases in medical data, undermining patient autonomy, raising critical concerns about privacy, data security, and explainability, and contributing to the depersonalization of decision-making processes. Conclusions: Further empirical studies are needed to assess the acceptability and feasibility of these tools among key stakeholders, such as patients, surrogates, and clinicians. Moreover, robust interdisciplinary research is needed to explore the legal and medico-legal implications associated with their implementation, ensuring that these tools align with ethical principles and support patient-centered and equitable healthcare practices. Full article
(This article belongs to the Special Issue Ethics of Well-Done Work and Proposals for a Better Healthcare System)
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23 pages, 614 KiB  
Review
Revolutionising Cardio-Oncology Care with Precision Genomics
by Jun Hua Chong, Charles T. H. Chuah and Caroline G. Lee
Int. J. Mol. Sci. 2025, 26(5), 2052; https://doi.org/10.3390/ijms26052052 - 26 Feb 2025
Viewed by 675
Abstract
Cardiovascular disease is the worldwide leading cause of mortality among survivors of cancer due in part to the cardiotoxicity of anticancer therapies. This paper explores the progress in precision cardio-oncology, particularly in genetic testing and therapeutics, and its impact on cardiovascular diseases in [...] Read more.
Cardiovascular disease is the worldwide leading cause of mortality among survivors of cancer due in part to the cardiotoxicity of anticancer therapies. This paper explores the progress in precision cardio-oncology, particularly in genetic testing and therapeutics, and its impact on cardiovascular diseases in clinical and laboratory settings. These advancements enable clinicians to better assess risk, diagnose conditions, and deliver personalised, cost-effective therapeutics. Through case studies of cancer-therapy-related cardiac dysfunction, clonal haematopoiesis of indeterminate potential, and polygenic risk scoring, we demonstrate the benefits of incorporating precision genomics in individualised care in cardio-oncology. Furthermore, leveraging real-world genomic data in clinical settings can advance our understanding of long noncoding RNAs and microRNAs, which play important regulatory roles in cardio-oncology. Additionally, employing human-induced pluripotent stem cells to stratify risk and guide prevention strategies represents a promising avenue for modelling precision cardio-oncology. While these advancements showcase the significant progress in genetic approaches, they also raise substantial ethical, legal, and societal concerns. Regulatory oversight of genetic and genomic technologies should therefore evolve suitably to keep up with rapid advancements in technology and analysis. Provider education is crucial for the appropriate use of new genetic and genomic applications, including on the existing protection available for patients regarding genetic information. This can provide confidence for diverse study groups to advance genetic studies looking to develop a comprehensive understanding and effective clinical applications for heterogeneous populations. In clinical settings, the implementation of genetic and genomic applications within electronic medical records can offer point-of-care clinical decision support, thus providing timely information to guide clinical management decisions. Full article
(This article belongs to the Section Molecular Genetics and Genomics)
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15 pages, 4170 KiB  
Article
Quality of Information on Medication Abortion in Private Pharmacies: Results from a Mystery Client Study in Kinshasa, Democratic Republic of Congo
by Denise P. Ngondo, Pierre Z. Akilimali, Nguyen Toan Tran, Nadia Lobo, Dynah M. Kayembe, Francis K. Kabasubabo, Mike Mpoyi, Jean-Claude Mulunda, Grace Sheehy and Paul Samson Dikassa Lusamba
Healthcare 2025, 13(5), 491; https://doi.org/10.3390/healthcare13050491 - 24 Feb 2025
Viewed by 944
Abstract
Introduction: Pharmacies are important points of access and information for women seeking medication abortion. In the context of the Democratic Republic of Congo [DRC], where the legal conditions for abortion have expanded in recent years and now allow pharmacies to dispense medication [...] Read more.
Introduction: Pharmacies are important points of access and information for women seeking medication abortion. In the context of the Democratic Republic of Congo [DRC], where the legal conditions for abortion have expanded in recent years and now allow pharmacies to dispense medication abortion with a prescription, little is known about medication abortion counseling and care offered by pharmacy staff. The aim of this study was to explore the quality of information provided by pharmacy staff to customers seeking medication abortion in Kinshasa. Methodology: A cross-sectional study using the mystery client (MC) approach was conducted in 480 pharmacies between April and May 2023. Trained female (n = 9) and male (n = 3) investigators played the role of mystery clients seeking abortion medication for themselves (or their partner or relative), and they asked questions to assess the performance of pharmacy staff and the quality of the provided information. The MCs recorded the results of their visits immediately after they left the pharmacy. Data were analyzed using Stata 17.0 and QGIS. The research protocol received ethical approval from the Kinshasa School of Public Health, and the need for informed consent was waived as pharmacy providers were being observed acting in their professional capacity. Results: Misoprostol was available at 40% of pharmacies visited, while mifepristone–misoprostol was available at less than 2%. Correct dosage information for misoprostol was provided by only 23% of the providers, with the lowest proportion observed in interactions involving male partners (2.4%). During discussions, only 10.6% of the providers explained what to expect during the abortion process. The quality of information differed according to the client profile, the district, and whether the client had a prescription. Conclusions: While medication abortion can provide a safe option for women seeking to manage their own abortion, the lack of adequate information on the correct dosage and administration can hinder the effectiveness of this regimen. To fully realize the potential of this medication for reducing unsafe abortion, it is essential that pharmacy staff are trained and supported to provide high-quality information and services, and that inequities in access to medications are addressed. Full article
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27 pages, 17331 KiB  
Article
RTACompensator: Leveraging AraBERT and XGBoost for Automated Road Accident Compensation
by Taoufiq El Moussaoui, Awatif Karim, Chakir Loqman and Jaouad Boumhidi
Appl. Syst. Innov. 2025, 8(1), 19; https://doi.org/10.3390/asi8010019 - 24 Jan 2025
Viewed by 871
Abstract
Road traffic accidents (RTAs) are a significant public health and safety concern, resulting in numerous injuries and fatalities. The growing number of cases referred to traffic accident rooms in courts has underscored the necessity for an automated solution to determine victim indemnifications, particularly [...] Read more.
Road traffic accidents (RTAs) are a significant public health and safety concern, resulting in numerous injuries and fatalities. The growing number of cases referred to traffic accident rooms in courts has underscored the necessity for an automated solution to determine victim indemnifications, particularly given the limited number of specialized judges and the complexity of cases involving multiple victims. This paper introduces RTACompensator, an artificial intelligence (AI)-driven decision support system designed to automate indemnification calculations for road accident victims. The system comprises two main components: a calculation module that determines initial compensation based on factors such as age, salary, and medical assessments, and a machine learning (ML) model that assigns liability based on police accident reports. The model uses Arabic bidirectional encoder representations from transformer (AraBERT) embeddings to generate contextual vectors from the report, which are then processed by extreme gradient boosting (XGBoost) to determine responsibility. The model was trained on a purpose-built Arabic corpus derived from real-world legal judgments. To expand the dataset, two data augmentation techniques were employed: multilingual bidirectional encoder representations from transformers (BERT) and Gemini, developed by Google DeepMind. Experimental results demonstrate the model’s effectiveness, achieving accuracy scores of 97% for the BERT-augmented corpus and 97.3% for the Gemini-augmented corpus. These results underscore the system’s potential to improve decision-making in road accident indemnifications. Additionally, the constructed corpus provides a valuable resource for further research in this domain, laying the groundwork for future advancements in automating and refining the indemnification process. Full article
(This article belongs to the Section Artificial Intelligence)
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26 pages, 1696 KiB  
Review
Heavy Metal and Antimicrobial Residue Levels in Various Types of Digestate from Biogas Plants—A Review
by Małgorzata Czatzkowska, Damian Rolbiecki, Ewa Korzeniewska and Monika Harnisz
Sustainability 2025, 17(2), 416; https://doi.org/10.3390/su17020416 - 8 Jan 2025
Viewed by 2562
Abstract
Global population growth generates problems relating to increasing demand for sustainable energy and waste treatment. Proper solid waste management promotes material reuse, maximizes recovery and reduces anthropological pressure on natural resources. Anaerobic digestion (AD) is an alternative method of stabilizing organic substrates and [...] Read more.
Global population growth generates problems relating to increasing demand for sustainable energy and waste treatment. Proper solid waste management promotes material reuse, maximizes recovery and reduces anthropological pressure on natural resources. Anaerobic digestion (AD) is an alternative method of stabilizing organic substrates and generating biogas as a source of environmentally friendly energy. In addition, digestate is not only a waste product of that process but also a renewable resource with many potential applications. The circular economy concept encourages the use of digestate as a source of nutrients that promotes plant growth and improves soil properties. However, the stabilized substrates often contain various contaminants, including heavy metals (HMs) and antibiotics that are also detected in digestate. Therefore, the agricultural use of digestate obtained by AD could increase the pool of these pollutants in soil and water environments and contribute to their circulation in these ecosystems. Moreover, digestate may also increase the co-selection of genes determining resistance to HMs and antibiotics in environmental microorganisms. This article comprehensively reviews published data on the residues of various HMs and antimicrobial substances in different digestates around the world and maps the scope of the problem. Moreover, the potential risk of residual levels of these contaminants in digestate has also been evaluated. The review highlights the lack of legal standards regulating the concentrations of drugs introduced into the soil with digestate. The results of the ecological risk assessment indicate that the presence of medically important antimicrobials in digestate products, especially those used in agriculture, should be limited. Full article
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12 pages, 287 KiB  
Communication
Psychological Autopsy: A Powerful Tool in Forensic Investigations
by Sara Sablone, Mara Bellino, Andrea Nicola Cardinale, Maria Grazia Violante, Roberta Risola, Antonella Magno, Vincenzo Pierro and Ignazio Grattagliano
Forensic Sci. 2024, 4(4), 635-646; https://doi.org/10.3390/forensicsci4040044 - 2 Dec 2024
Viewed by 2595
Abstract
Background: A psychological autopsy is a post-mortem investigative tool used to carry out a retrospective reconstruction of a missing subject’s life. The method includes gathering information from all the potentially involved parties, which may indicate the relevant elements directly or indirectly to trace [...] Read more.
Background: A psychological autopsy is a post-mortem investigative tool used to carry out a retrospective reconstruction of a missing subject’s life. The method includes gathering information from all the potentially involved parties, which may indicate the relevant elements directly or indirectly to trace the victim’s experience and identify personality traits, lifestyle, and interpersonal relationships. Discussion: Psychological autopsies are mainly performed during criminal investigations to identify the cause of death and the specific circumstances (natural, accidental, suicidal, or homicidal death). In addition, from an epidemiological point of view, this method aims to collect the relevant information about an individual’s behavior, circumstances, and reasons for their death to identify common risk factors to prevent new suicides. Although less frequently, this tool can also serve other purposes, such as the legal validity estimation of pre-death actions. Moreover, it may be used to assess whether mistakes have been made in treating people undergoing medical or psychological treatment. Conclusions: Currently, this methodology still has a limited diffusion on the Italian and European scenes due to the lack of standardized guidelines and substantial relevant scientific literature. It is the main factor affecting the tool’s reliability, validity, and systematic application in forensic investigations. Full article
11 pages, 226 KiB  
Article
The Medico-Legal and Social Aspects of the Eligibility Examination for Enrolment in the Seafarers Registry: A Single-Center Retrospective Study
by Antonietta Porzio, Alessandro Feola, Edoardo Mazzini, Angelo Lauro, Maria Rosaria Forte, Marco Trabucco Aurilio and Carlo Pietro Campobasso
Healthcare 2024, 12(23), 2410; https://doi.org/10.3390/healthcare12232410 - 30 Nov 2024
Viewed by 760
Abstract
Background: Working on board presents unique healthcare challenges for maritime personnel. Italian Law mandates a medical fitness assessment for seafarers registry enrolment. The Port Health Officer assesses seaworthiness and, against this judgment, the applicants can appeal to the First-degree Medical Commission. Studies on [...] Read more.
Background: Working on board presents unique healthcare challenges for maritime personnel. Italian Law mandates a medical fitness assessment for seafarers registry enrolment. The Port Health Officer assesses seaworthiness and, against this judgment, the applicants can appeal to the First-degree Medical Commission. Studies on maritime personnel’s medical fitness are limited and primarily focus on the health conditions of individuals already employed in the maritime sector. Methods: A retrospective study reviewed 459 medical reports of 361 seafarers from Naples’ Port Authority First-degree Medical Commission (2013–2022). Characteristics such as sex, age, diseases, and suitability judgments were analyzed. Results: Out of the 361 candidates, most were male with an average age of 28.67 years. A total of 160 (44.32%) were deemed suitable for matriculation in both the first and second categories, 79 (21.88%) were approved for one category, 53 (14.68%) were found not suitable, and 69 (19.11%) are still under assessment. Eye diseases were most common (50.83%), followed by cardiovascular and orthopedic conditions. Applicants with poorly controlled diabetes mellitus, epilepsy, psychiatric disorders, and advanced tumors were declared unsuitable. Conclusion: Our study provides opportunities to improve applicants’ awareness of the physical requirements for pursuing a career in navigation and to update the list of illnesses and physical impairments used for this medico-legal evaluation. Full article
(This article belongs to the Special Issue Health and Readiness of Tactical Populations)
15 pages, 2681 KiB  
Review
Diagnosis of Child Sexual Abuse
by Roland Csorba, Zeynep Atas Elfrink and Panagiotis Tsikouras
J. Clin. Med. 2024, 13(23), 7297; https://doi.org/10.3390/jcm13237297 - 30 Nov 2024
Viewed by 2238
Abstract
Child sexual abuse (CSA) is a widespread and alarming issue, with an estimated global prevalence of 12–13% (affecting 18% of girls and 8% of boys). Despite its prevalence, many physicians working with children have insufficient knowledge of the medical diagnosis of CSA. This [...] Read more.
Child sexual abuse (CSA) is a widespread and alarming issue, with an estimated global prevalence of 12–13% (affecting 18% of girls and 8% of boys). Despite its prevalence, many physicians working with children have insufficient knowledge of the medical diagnosis of CSA. This lack of expertise, combined with the sensitive and complex nature of these cases, often hampers proper identification and management. Diagnosing CSA is particularly challenging and requires specialized skills. A majority of children assessed for suspected sexual abuse present with normal genital and anal findings, which complicates the diagnostic process. Barriers such as professional isolation, societal taboos, and the sensitive nature of the subject often result in diagnostic failures. Accurate medical history taking, diagnosis, and documentation of findings are essential for ensuring a precise diagnosis, safeguarding children, and supporting legal proceedings. However, achieving these goals remains elusive without standardized guidelines and adequately trained healthcare professionals. Training of professionals in observing and reporting child sexual abuse is badly needed. This review explores the current state of medical diagnosis in suspected cases of CSA. This article is based on a selective review of pertinent literature retrieved from various databases, including PubMed and the overall index of the Quarterly Update. Full article
(This article belongs to the Section Clinical Pediatrics)
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10 pages, 924 KiB  
Article
Forensic STR Loci and Schizophrenia: An Exploration of Implications for Forensic Applications and Genetic Privacy
by Qi Yang, Chun Yang, Zhiqi Hua, Qi Shen, Anqi Chen, Huajie Ba and Suhua Zhang
Genes 2024, 15(12), 1525; https://doi.org/10.3390/genes15121525 - 27 Nov 2024
Viewed by 924
Abstract
Background/Objectives: Short tandem repeat (STR) loci are widely used in forensic genetics for identification and kinship analysis. Traditionally, these loci were selected to avoid medical associations, but recent studies suggest that loci such as TH01 and D16S539 may be linked to psychiatric conditions [...] Read more.
Background/Objectives: Short tandem repeat (STR) loci are widely used in forensic genetics for identification and kinship analysis. Traditionally, these loci were selected to avoid medical associations, but recent studies suggest that loci such as TH01 and D16S539 may be linked to psychiatric conditions like schizophrenia. This study explores these potential associations and considers the privacy implications related to disease susceptibility. Methods: We analyzed 19 STR loci, including CODIS core loci and additional loci like Penta D and Penta E. Statistical analyses were conducted on a dataset of schizophrenia patients and matched control individuals to assess the relationship between STR polymorphisms and schizophrenia risk. Results: No significant associations were found between the 19 analyzed loci and schizophrenia in this dataset. While initial analyses revealed minor allele frequency differences at the D3S1358, D13S317, and TPOX loci between the schizophrenia and control groups, these differences did not retain statistical significance following Bonferroni correction (corrected p < 0.0026 for all loci). Conclusions: Although no significant associations were found between STR loci and schizophrenia, this study highlights the importance of considering the potential for forensic DNA data to reveal health-related information. As forensic DNA databases continue to expand, there is a growing need to reassess ethical and legal guidelines to ensure the protection of individual privacy. Future research should continue exploring these genetic associations with larger, more diverse samples to further understand their implications. Full article
(This article belongs to the Special Issue Forensic Genetics: Human DNA Database and Genetic Structure)
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11 pages, 643 KiB  
Article
Assessing the Performance of Chatbots on the Taiwan Psychiatry Licensing Examination Using the Rasch Model
by Yu Chang, Chu-Yun Su and Yi-Chun Liu
Healthcare 2024, 12(22), 2305; https://doi.org/10.3390/healthcare12222305 - 18 Nov 2024
Cited by 1 | Viewed by 1276
Abstract
Background/Objectives: The potential and limitations of chatbots in medical education and clinical decision support, particularly in specialized fields like psychiatry, remain unknown. By using the Rasch model, our study aimed to evaluate the performance of various state-of-the-art chatbots on psychiatry licensing exam questions [...] Read more.
Background/Objectives: The potential and limitations of chatbots in medical education and clinical decision support, particularly in specialized fields like psychiatry, remain unknown. By using the Rasch model, our study aimed to evaluate the performance of various state-of-the-art chatbots on psychiatry licensing exam questions to explore their strengths and weaknesses. Methods: We assessed the performance of 22 leading chatbots, selected based on LMArena benchmark rankings, using 100 multiple-choice questions from the 2024 Taiwan psychiatry licensing examination, a nationally standardized test required for psychiatric licensure in Taiwan. Chatbot responses were scored for correctness, and we used the Rasch model to evaluate chatbot ability. Results: Chatbots released after February 2024 passed the exam, with ChatGPT-o1-preview achieving the highest score of 85. ChatGPT-o1-preview showed a statistically significant superiority in ability (p < 0.001), with a 1.92 logits improvement compared to the passing threshold. It demonstrated strengths in complex psychiatric problems and ethical understanding, yet it presented limitations in up-to-date legal updates and specialized psychiatry knowledge, such as recent amendments to the Mental Health Act, psychopharmacology, and advanced neuroimaging. Conclusions: Chatbot technology could be a valuable tool for medical education and clinical decision support in psychiatry, and as technology continues to advance, these models are likely to play an increasingly integral role in psychiatric practice. Full article
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