Background/Objectives: DNA-based identification of degraded human remains represents a major challenge in forensic science, particularly in cases involving burned, fragmented, or commingled bodies. Advances in forensic genetics have expanded the analytical capabilities for such samples; however, the effectiveness of different approaches and their integration within Disaster Victim Identification (DVI) workflows remain heterogeneous. This systematic review aims to critically evaluate current evidence on DNA-based identification of degraded remains, focusing on methodological strategies, emerging genomic technologies, and DVI applications, while integrating laboratory evidence and operational forensic practice into a structured analytical framework. Methods: A systematic literature search was conducted in Scopus and Web of Science from database inception to 5 June 2026, following PRISMA 2020 guidelines. Eligible studies included original research addressing DNA analysis of degraded, thermally altered, or highly compromised human remains in forensic or DVI contexts. After a multistep screening process involving title/abstract and full-text evaluation, 37 studies were included. Data were extracted and organized into three thematic categories: (i) core DNA analysis, (ii) advanced molecular technologies, and (iii) DVI case applications. Results: The findings demonstrate that DNA recovery from degraded remains is influenced by thermal exposure, tissue type, and sampling strategy. Teeth and dense cortical bone consistently provide higher DNA yield. While autosomal STR profiling remains the primary analytical approach, its limitations in highly degraded samples are mitigated through the complementary use of mitochondrial DNA (mtDNA), Y-chromosome STRs (Y-STRs), and SNP markers, together with advanced sequencing technologies such as massively parallel sequencing (MPS). Emerging technologies, including rapid DNA systems and predictive models based on macroscopic indicators, significantly enhance efficiency and success rates. DVI studies report identification rates exceeding 90–95% when multidisciplinary and structured workflows are applied. The evidence further supports a flexible triage-based analytical strategy, in which marker selection is guided by tissue preservation and degradation level. Conclusions: DNA-based identification of degraded human remains has evolved into an adaptive, multi-level forensic process. Successful outcomes rely on the integration of optimized sampling, hierarchical genetic analysis, and coordinated DVI strategies. The findings support a triage-based framework that links tissue selection, degradation assessment, and analytical methodology to maximize identification success. Future developments should focus on predictive models, advanced genomic tools, and standardized workflows to further improve identification in challenging forensic scenarios.

Background: Healthcare liability litigation has increased substantially, highlighting the need for structured and evidence-based medico-legal evaluations. While generative artificial intelligence (AI) has been extensively studied in clinical medicine, its application in medico-legal consultancy remains limited. Objective: To assess whether two customized GPT-based models, simulating opposing medico-legal perspectives (“patient-oriented” and “hospital-oriented”), can analyze real clinical documentation and generate reports comparable to those produced by human experts. Methods: Ten real healthcare liability cases were retrospectively analyzed. For each case, complete anonymized clinical records and human-authored medico-legal reports were available. Two GPT-based models were configured using domain-specific instructions and authoritative medico-legal references, without retraining. Both models generated simulated reports from identical documentation. Outputs were evaluated using structured qualitative scores assessing argumentative coherence, clinical synthesis, bibliographic accuracy and relevance, and concordance of permanent impairment estimates. Results: No significant difference in overall argumentative coherence was observed between models (Wilcoxon test, p = 0.844). Orientation-consistent trends emerged after stratification by liability status. Agreement was substantial for clinical synthesis (Cohen’s κ = 0.804) but slight for permanent impairment estimates (κ = 0.167). The patient-oriented model produced significantly more fabricated or non-verifiable references (OR = 3.74; p = 0.0065), while citation relevance did not differ significantly between models ( p = 0.195). Conclusions: Generative AI can simulate divergent medico-legal reasoning and rapidly produce structured reports. However, expert human oversight remains essential, particularly for source verification and medico-legal interpretation.

Distinguishing antemortem from postmortem thermal injury remains one of the most challenging tasks in forensic pathology, particularly in cases involving rapid death, extensive charring, or advanced tissue degradation. Classical macroscopic and histological findings provide essential information but often lack sensitivity or specificity when considered in isolation. This review critically examines current evidence on burn vitality markers, with a primary focus on histological and immunohistochemical findings supported by human forensic studies, while contextualizing molecular and microRNA-based (miRNA-based) approaches as largely experimental and translational. Established indicators in forensic casework include erythrodiapedesis, fibrin deposition, inflammatory cell infiltration, and glycophorin-confirmed hemorrhage, together with selected immunohistochemical markers such as HSP70 (Heat Shock Protein 70) and aquaporin-3 (AQP3), which provide supportive evidence of tissue viability. In contrast, molecular biomarkers, such as cytokine gene expression, oxidative stress products, mitochondrial DNA (mtDNA) release, and miRNA signatures, offer mechanistic insight into early cellular responses to thermal injury but currently lack sufficient forensic validation in human autopsy-based studies to support routine medico-legal interpretation. The available evidence indicates that histological and selected immunohistochemical findings constitute the most reliable basis for burn vitality assessment, whereas molecular approaches should be interpreted cautiously as adjunctive and investigational. Diagnostic conclusions therefore rely on the integration of multiple independent findings, evaluated in relation to survival time, tissue preservation, and postmortem artifacts. Overall, this review emphasizes that burn vitality determination requires a cautious, multimodal, and context-driven approach, grounded in validated forensic evidence and supported, where appropriate, by complementary experimental data. Further progress in this field will depend on the systematic validation of emerging markers in human forensic autopsy cohorts.

Background: Postmortem redistribution (PMR) is a major challenge in forensic toxicology, particularly when drug concentrations are measured in central blood rather than peripheral blood. Although peripheral blood remains the preferred specimen for postmortem interpretation, it is not always available in routine forensic practice. Methods: This retrospective descriptive study evaluated postmortem central blood drug findings from judicial autopsies analyzed at the Forensic Toxicology Laboratory of the University of Catania between 2017 and 2024. Approximately, 700 forensic toxicological investigations were reviewed. Overall, 52 therapeutic drugs were identified, resulting in a final dataset of 313 individual drug findings. For each finding, central blood concentrations were compared with published reference ranges and cautiously classified as normal/therapeutic, high but non-toxic, toxic, or potentially lethal. Results: Most findings were classified as normal/therapeutic (84.3%), while 28 (8.9%) were high but non-toxic, 15 (4.8%) toxic, and 6 (1.9%) potentially lethal. The distribution remained broadly consistent in sensitivity analyses restricted to drugs represented by more than 3, 5, or 8 findings. In cases with toxic or potentially lethal findings and available paired peripheral blood data, observed C/P ratios were moderate, ranging from 1.07 to 2.15. Conclusions: These findings do not indicate that central blood can replace peripheral blood or that PMR can be disregarded. However, they suggest that central blood drug concentrations are not intrinsically uninterpretable and may retain practical forensic value when interpreted cautiously within the broader medico-legal context. Central blood results should not be used in isolation to diagnose poisoning, estimate the ingested dose, or reconstruct exact ante mortem concentrations.