From Deutsche Zeitschrift to International journal of legal medicine—100 years of legal medicine through the lens of journal articles, Part 4: International journal of legal medicine from 1990 to 2022

This is the fourth and final paper in a series related to the analysis of articles published in this journal during its first 100 years of activity. This article covers the time span from 1990 to 2022. It is important to note that, given the period covered by this analysis, it does not aim to provide a historical overview but rather an examination of the most recent trends in our discipline compared to the past. Between 1990 (Volume 104) and 2022 (Volume 136), 4004 articles were published in the International Journal of Legal Medicine (IJLM) across 33 volumes. This corresponds to 53% of all the articles published since the launch of the journal. When compared to the period from 1970 to 1990, some categories no longer appear to be as relevant (e.g., sexual medicine, 1 article; social medicine, 0 articles; biography, 3 articles; history, 4 articles). Conversely, the most recent period has shown an increasing importance in forensic genetics (1388 articles) and the emergence of new significant topics that merit their own classification, such as age estimation (286 articles), forensic anthropology (189 articles), forensic imaging (150 articles), and forensic entomology (90 articles). Supplementary Information The online version contains supplementary material available at 10.1007/s00414-023-03107-w.


Introduction
This article delves into the publications of the International Journal of Legal Medicine (IJLM) from 1990 to 2022, encompassing volumes 104 to 136.Volume 104 commenced in December 1990, leading to an overlap with the previously analyzed period , as 1990 was the last year in which the Deutsche Zeitschrift was published.Over these thirty-three years, the journal underwent a significant transformation, evolving from a prestigious regional Germanspeaking reference to a globally renowned international publication in the field of Legal Medicine and related sciences.The pivotal decision by the Editorial board, led by Bernd Brinkmann, to convert the journal into an exclusively English-speaking publication [1], marked the inception of this transformation.While historical perspectives could be drawn for the earlier parts of this series covering the time periods 1922-1944, 1948-1969, and 1970-1990 [2-4], the present part focusing on the last three decades can primarily offer an analysis of the most recent trends in our discipline when compared to the past.
To conduct this analysis, SpringerNature's Editorial team provided invaluable information on the journal's development in terms of metrics.Table 1 presents the top ten most cited articles during this analysis period (the list of the one hundred most cited papers can be found in Table 1 ESM).It is noteworthy that among the top ten, five articles relate to forensic genetics, three to age estimation, one to entomology, and only one can be classified as classical forensic pathology (related to COVID-19): a revolution has taken place.

Legal issues, expert activity, insurance medicine
This category encompasses twelve articles.Among them, six publications focused on insurance medicine and damage assessment within a civil context.Specifically, four articles addressed damage assessment after whiplash injury (118/235, 121/337, 130/13, 135/1637), while two manuscripts proposed guidelines and evaluation criteria for personal injury and damage (130/1) and for psychic and existential damage (130/1387).A group from Frankfurt explored the influence of religions on attitudes towards brain death, organ transplantation, and autopsy (134/1203).A Swiss group discussed the ethical and legal aspects of creating a body farm (134/1875) and a forensic pathology biobank in Switzerland (136/919).Another publication from Spain described the judicial consequences of completing the medical death certificate (136/365).One particularly original publication (136/963) proposed the use of model figurines during expert opinion.Finally, publication 136/1027 discussed the possibility of adopting the Bayesian approach for forensic pathology opinions.

General legal medicine
This category comprised two hundred fifty articles.Among them, sixty-nine articles focused on the estimation of the time since death.Besides

Forensic toxicology
A total of three hundred forty-eight articles could be attributed to this category.Among them, fifty-four were case reports where the primary focus was on intoxication (

Identification of unknown bodies
The establishment of this group and the attribution of pertinent articles were tricky.Indeed, the recent evolution of identification methods in different subdisciplines such as forensic age estimation, forensic anthropology, and, of course, forensic genetics make it possible to classify the articles in different categories.We decided then to attribute to this group only the articles that were explicitly inherent to the identification procedures of unknown bodies.Fiftyfour articles could be included, among which fifteen were dedicated to the identification of victims who died on occasion of mass disasters (

Forensic genetics
Forensic genetics stands out as the most prolific category, boasting a total of 1388 articles during this period.Remarkably, six articles from this category rank among the top 10 most cited articles ever published in the International Journal of Legal Medicine (Table 1).While an in-depth analysis of publications in this field is beyond the scope of this article, it may be considered for a separate publication in the future.
The advent of DNA analysis in legal medicine led to the establishment of numerous groups within national and international societies, pioneering this emerging field.The articles in this category encompass various aspects of genetic analysis.Specifically, two hundred forty-four articles focused on Autosomal Short Tandem Repeats (STRs), with two hundred nine articles related to Y-chromosome STRs and ninety-seven to X-chromosome STRs.Moreover, ninety-one papers provided information on mitochondrial DNA (mt-DNA).Single Nucleotide Polymorphisms (SNPs) featured in one hundred twenty-six articles, while Insertion-Deletion Polymorphisms (INDEL/DIP) were discussed in thirty-nine articles.
In recent years, microhaplotypes gained attention and were the subject of focus in ten articles (

Forensic psychiatry and psychology
Two articles in this category delved into the phenomenon of suicides.More in detail, one publication (107/306) examined the reliability of the Finnish national register of medicolegal autopsies as an epidemiologic tool for suicides.At that time, the autopsy rate for definite suicides was 99% in Finland.Another article explored the epidemiology of suicides in Hungary (108/150).Additionally, there was a report on two cases of transient global amnesia in legal proceedings that discussed its pathogenesis and triggers (129/223).

Sexual medicine
The author of the single article in this category described a retrospective investigation on 186 expert-appraised pedophile sexual delinquents (111/133).).This category also included a review of the effects of low blood alcohol concentration (BAC) on fitness to drive and international legislation (106/69).

Social medicine
None of the published papers could be categorized under social medicine.

Criminology
Six articles were included in this category (131/1055, 132/897, 133/1251, 133/1295, 134/1195, 134/1511).Two articles from a French group reported data on the social and health conditions of arrestees in Paris, with the second article focusing on adolescent arrestees (132/897, 133/1251).Two articles investigated the phenomenon of violence against women in Italy (133/1295) and Montenegro (134/1511).One paper from a German group investigated the relevance of medicolegal reports in criminal investigations in cases of suspected child abuse (131/4).Additionally, a Danish study explored the reliability of police reports concerning health information in cases of medicolegal autopsy (134/3).

Age estimation
Age estimation is one of the most extensively researched topics in recent years, with a total of two hundres eightysix articles dedicated to this subject.

Forensic anthropology
The field of forensic anthropology has seen a significant increase in relevance within the medicolegal community over the past three decades.This rise in prominence led to the creation of a dedicated section, the Forensic Anthropology Society of Europe (FASE), within the International Academy of Legal Medicine during the 19th IALM meeting held in Milan in September 2003.The establishment of FASE was driven by Eric Baccino, who announced its creation in the newsletter of the IALM published in this journal (118/N1).
In November 2007, an editorial by Bernd Brinkmann (121/431) introduced Issue 5 of Volume 121, which featured 12 articles related to forensic anthropology.A total of one hundred eighty-nine articles have been attributed to this category, reflecting the growing importance of this discipline.These articles cover various aspects of forensic anthropology, including sex estimation of skeletal remains (sixty-seven articles), age-at-death estimation (thirty-seven articles), and stature estimation (ten articles).
A notable focus in this field is facial and cranial reconstruction for identification purposes, with fourteen articles dedicated to this topic (

Forensic imaging
Within the domain of forensic imaging, we have identified a total of one hunfred fifty pertinent papers.These publications explore various investigative techniques, with computed tomography (CT-scan) as the primary focus in ninety-eight articles.Seven of these articles provide a comparison between CT-scan findings and autopsy results (

Forensic entomology
With the editorial (118/187), Bernd Brinkmann opened issue 118 in which ten paper dealt with forensic entomology, at that time (2004) still an emerging field.The examination of flies (Diptera) is a prominent theme, with 40 papers dedicated to these insects, notably featuring thirty papers focusing on blow flies (Calliphoridae).Coleoptera, another insect group, is described in eleven papers (

Discussion
Complexity is probably the term that best describes the evolution of medicolegal sciences in the last three decades.It has often been tricky to categorize articles into a specific discipline, as many of them could be attributed to more than one category, depending on the angle of evaluation.For example, imaging techniques (forensic imaging) may be used for detecting vital reactions (general legal medicine) in skeletal remains (forensic anthropology) or to assess the age of a migrant (age estimation).This example can be multiplied by mixing up numerous different investigation strategies and aims.Therefore, the distribution of the articles that we propose is based on the main aspect emerging from each publication; this approach necessarily reflects the authors' opinion.
The first result worth commenting on is the number of publications: four thousand ans four papers were published in IJLM in the considered period, corresponding to 53% of all the articles published in IJLM since its launch.The mean number of articles published in each issue during this period was one hundred twenty-one.In comparison, it was fortysix between 1922 and 1944, thirty-three between 1948 and 1969, and thirty-nine between 1970 and 1990 (volume 103).Landhuis [5] already indicated in 2016 that the number of published scientific papers had climbed by 8-9% per year over the past decades and that about two papers per minute were published in PubMed in the biomedical field alone.Our observations align perfectly with these data.
Table 3 compares the distribution of articles in different categories over four periods.The categories: history, personalia, legal issues, forensic psychiatry, sexual medicine, social medicine, and criminology collectively accounted for less than 1% of publications between 1990 and 2022, whereas articles attributed to the same categories constituted 23.3% during the period 1922-1944.This shift is likely a result of the increased specialization observed in all medical disciplines in recent decades.Articles in fields less closely related to classical legal medicine have progressively migrated towards other more specialized journals.Consequently, IJLM has also evolved into a more specialized publication.
Conversely, we observed a significant increase in papers in the field of forensic genetics (36.9%).Many of these articles presented the frequencies and distribution of various markers in different populations.The publication of this data became necessary due to the growing complexity of caseworks faced by forensic laboratories worldwide.One reason for this complexity is the migration phenomenon that has made Western societies increasingly multiethnic, requiring the identification of individuals or traces in this emerging context.Furthermore, over the last three decades, medicolegal scientific communities in Asia, Central and South America, and Africa have become more active, resulting in the publication of scientific data from these regions in IJLM, significantly broadening the journal's international horizons.
Four new subdisciplines were introduced in this analysis: forensic age estimation (7.6%), forensic anthropology (5.1%), forensic imaging (4%), and forensic entomology (2.4%).The increasing interest of the medicolegal scientific community in these fields is evident.However, the reasons for this growing interest are less clear.A significant portion of the papers in these categories could have been attributed to other subdisciplines already listed in the first three articles of this series.For example, anthropology papers aimed at discriminating sex, estimating age-at-death, or stature could ultimately fall under the category 'Identification of unknown bodies.'Similarly, many papers reporting DNA investigations aimed at identifying human remains could be included in this category.While this would be a technically correct but superficial analysis, it is likely that, initially, new methods were tested to address existing questions.However, over time and with increasing experience, scientists began to explore other innovative applications, creating new avenues of development.A notable example is forensic entomology, whose initial applications were related to estimating the time of colonization of a cadaver, indirectly allowing for the estimation of the time since death.However, quite soon, forensic entomologists began to explore the potential of insects as surrogates for toxicological analyses in cases of advanced putrefaction [6].
Forensic age estimation has become one of the primary topics published in this journal, with articles related to this area ranking among the most cited.Once again, migration and the specific need to identify and protect unaccompanied minor migrants may explain this development.However, it's important to note that this topic is ethically highly sensitive and susceptible to political instrumentalization.In such a context, the rigorous work carried out by specific societies such as AGFAD and FASE has allowed medicolegal experts to gain the specific competencies and expertise required for this task [7,8].
The introduction of forensic imaging in the medicolegal context sparked intense debates in the early years of this century.Those who were already in the field at the time will recall spirited discussions between those who considered forensic imaging a revolutionary tool capable of replacing the autopsy and those who, more conservative, did not see the need for such additional, expensive, and time-consuming methods in the autopsy room.Twenty years later, we can objectively observe that no revolution has occurred, and forensic pathologists still perform autopsies.However, many institutes of legal medicine have acquired their own CT scanners or have established collaborations with radiologists to conduct postmortem CT scans before a forensic autopsy.The benefits of forensic imaging as a complement to the autopsy are no longer debated, and current research is now exploring the potential of MRI in postmortem investigations [9].Imaging techniques have become a common tool in legal medicine, extending beyond the specific context of postmortem investigations.Anthropology and age assessment primarily rely on the interpretation of radiological investigations.
The development of the category clinical legal medicine merits comment.With forty-nine articles, it represents only 1.2% of the papers published between 1990 (volume 104) and 2022.However, when compared to previous periods, there is evident progress in clinical examinations for forensic purposes.Brinkmann et al. [10] emphasized as early as 1994 the importance of this activity as a fundamental component of postgraduate education in legal medicine.Over time, the field has evolved towards increased protection of vulnerable individuals, leading forensic physicians to be increasingly involved in investigations on living victims of violence, such as child abuse, sexual abuse, and torture.
In recent years, numerous papers have presented new approaches, exploring the potential of proteomics, metabolomics, neural networks, and deep learning in legal medicine.Testing these newly available methods for age-old but still relevant questions is an intelligent way to strike the necessary balance between relevance and novelty that qualifies a paper for publication.In the coming years, we will see whether these methods become commonplace in medicolegal practice.What is already certain, however, is that classical topics, such as the determination of wound vitality or the estimation of time since death, continue to appear in recent publications.
Classical legal medicine, in contrast, has seen relatively little evolution over the last quarter of a century.While many articles have been published in various fields of classical forensic medicine, these have often been isolated studies, studies with too few cases, or studies on animal models with results difficult to apply routinely.In contrast, forensic toxicologists, geneticists, anthropologists, entomologists, and age estimation experts have worked intensively within their specialist communities to develop a common knowledge base and recommend best practices in their sub-disciplines [e.g., 7,[11][12][13][14][15][16].Forensic pathologists have often preferred an individual, patchy approach, often due to specific local opportunities or personal interests.The result is that internationally validated and recognized methods for estimating time since death or determining the age of a skin wound (just to mention two evident examples) simply do not exist.As suggested by Ferrara et al. [17], the solution to this situation is the establishment of multicentric research groups capable of collecting more relevant case numbers and thus publishing more robust results.Meanwhile, national and international medicolegal societies should pool their expertise and resources to produce recommendations in key areas of interest.
The International Journal of Legal Medicine would remain the preferred medium for disseminating these publications.