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技术说明:尸体骨骼肌死后机械刺激的实际应用,现场研究。

Technical note: Practical application of post-mortem mechanical stimulation of skeletal muscle, a field study.

机构信息

Faculty of Law and Criminology, Maastricht University, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands.

Ars Cogniscendi Foundation for Legal and Forensic Medicine, Wezep, The Netherlands.

出版信息

Int J Legal Med. 2024 Jan;138(1):55-60. doi: 10.1007/s00414-022-02873-3. Epub 2022 Aug 13.

Abstract

BACKGROUND

Estimation of the post-mortem interval (PMI) is a crucial aspect in crime scene investigation. PMI is defined as the time between the moment of death and the moment of finding the dead body. A combination of methods for estimating the PMI in forensic casework is internationally mostly used. Supravital muscle reaction (SMR) is one of those methods. SMR is an idiomuscular contraction and can be provoked by mechanical stimulation.

OBJECTIVES

A field study was carried out with the aim to investigate whether a reflex hammer can be used as tool for triggering an idiomuscular contraction and, furthermore, to determine if a learning period has to be taken into account by a forensic physician for appropriate application of a reflex hammer to trigger SMR.

METHODS

From January 2017 to January 2022, four forensic physicians used this SMR by mechanically stimulating the musculus brachioradialis and musculus biceps brachii. In total, 332 cases were included with a PMI less than 24 h. The cases were divided in chronological clusters of 20 cases. The ratio of the number of positive SMR versus the total number stimulations per forensic physician was used as a measure of accuracy of a reflex hammer for triggering SMR. The distribution of the data was analyzed by comparing the clusters in chronological order to assess whether a learning curve applies.

RESULTS

In 55.7%, a muscle reaction could be provoked by mechanical stimulation. Comparable outcome of SMR between the participating physicians was observed after 40 stimulations.

CONCLUSION

A reflex hammer is usable for provoking SMR. A learning period has to be taken in to account during the first forty cases per forensic physician.

摘要

背景

死后间隔时间(PMI)的估计是犯罪现场调查的一个关键方面。PMI 定义为死亡时刻和发现尸体时刻之间的时间。国际上大多采用组合方法来估计法医工作中的 PMI。存活肌肉反应(SMR)就是其中一种方法。SMR 是一种肌肉无意识收缩,可以通过机械刺激引起。

目的

进行了一项现场研究,旨在调查反射锤是否可用于触发无意识肌肉收缩,并进一步确定法医是否需要考虑学习期,以便正确应用反射锤触发 SMR。

方法

从 2017 年 1 月至 2022 年 1 月,四名法医使用这种 SMR 通过机械刺激肱二头肌和肱桡肌。总共纳入了 332 例 PMI 小于 24 小时的案例。这些案例按 20 例为一组的时间顺序进行分组。每个法医触发 SMR 的正反射锤刺激次数与总刺激次数的比值作为反射锤触发 SMR 的准确性的衡量标准。通过按时间顺序比较组来分析数据的分布,以评估是否存在学习曲线。

结果

在 55.7%的情况下,可以通过机械刺激引起肌肉反应。在进行 40 次刺激后,观察到参与医生之间的 SMR 结果相似。

结论

反射锤可用于引发 SMR。在每位法医的前四十例案件中,需要考虑学习期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/801a/10771997/cad0f2000311/414_2022_2873_Fig1_HTML.jpg

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