The objective of the study is to develop scientific criteria for the analytical and synthesizing part of the expert report on \'medical cases.\' We studied 15 conclusions of expert panels. The following research methods were used: logical and analytical, logical and synthetic (generalization), comparative, systemic and analytical (analysis of relations between facts). For the first time, a new algorithm for the analytical and synthesizing part of the expert report was proposed; and also ways to improve the quality of forensic reports for all types of expert examinations, including those involving non-state forensic experts, were described. These improvements make the results of expert examinations and reviews more convenient and objective. They are intended for non-state forensic experts, attorneys who use them, and state forensic experts, including during the training and professional development.
UNASSIGNED: Разработка научных критериев аналитико-синтезирующей части заключения эксперта по «врачебным делам». Материалом послужили 15 заключений экспертных комиссий. Использовали следующие методы исследования: логико-аналитический, логико-синтетический (обобщение), сравнительный, системно-аналитический (анализ связей между фактами). Впервые предложены новый алгоритм аналитико-синтезирующей части заключения эксперта, а также пути повышения качества составления судебно-медицинских заключений для всех видов экспертных исследований, в том числе с привлечением негосударственных судебно-медицинских экспертов. Данные разработки позволяют сделать более удобными и объективными результаты экспертиз и рецензий. Они предназначены как для негосударственных судебных экспертов и пользующихся их услугами адвокатов, так и для государственных судебных экспертов, в том числе в сфере подготовки и повышения квалификации.

OBJECTIVE: The study contributes to human reliability analysis (HRA) by proposing a method that focuses more on human error causality within a sociotechnical system, illustrating its rationality and feasibility by using a case of the Minuteman (MM) III missile accident.
BACKGROUND: Due to the complexity and dynamics within a sociotechnical system, previous analyses of accidents involving human and organizational factors clearly demonstrated that the methods using a sequential accident model are inadequate to analyze human error within a sociotechnical system.
METHODS: System-theoretic accident model and processes (STAMP) was used to develop a universal framework of human error causal analysis. To elaborate the causal relationships and demonstrate the dynamics of human error, system dynamics (SD) modeling was conducted based on the framework.
RESULTS: A total of 41 contributing factors, categorized into four types of human error, were identified through the STAMP-based analysis. All factors are related to a broad view of sociotechnical systems, and more comprehensive than the causation presented in the accident investigation report issued officially. Recommendations regarding both technical and managerial improvement for a lower risk of the accident are proposed.
CONCLUSIONS: The interests of an interdisciplinary approach provide complementary support between system safety and human factors. The integrated method based on STAMP and SD model contributes to HRA effectively.
CONCLUSIONS: The proposed method will be beneficial to HRA, risk assessment, and control of the MM III operating process, as well as other sociotechnical systems.

It is recognized that immunosuppression may lead to reduced immune surveillance and tumor formation. Because of the immunosuppressive properties of tumor necrosis factor (TNF)-alpha (TNF-α) antagonists, it is plausible that these biologics may increase the risk of the occurrence of malignancies or the reactivation of latent malignancies. TNF-α antagonists have gained momentum in the field of dermatology for treating rheumatoid arthritis and psoriasis, and they have revolutionized the treatment of other inflammatory autoimmune diseases such as refractory Crohn\'s disease. However, there is accumulating evidence that TNF-α inhibitors slightly increase the risk of cancer, including malignant melanoma (MM). The authors herein report the case of a 54-year-old female patient who developed a primary MM during treatment with adalimumab for severe Crohn\'s disease resistant to successive medical therapies. The patient had been receiving this TNF-α blocker therapy for 3 years before the occurrence of MM. After wide surgical excision of the lesion and staging (based on Breslow thickness and Clark level), evaluation with a whole-body computed tomography scan was negative for metastatic disease. The long duration of the adalimumab therapy and the patient\'s lack of a predisposition to skin cancer suggest an association between anti-TNF-α drugs and melanocytic proliferation. The authors also review the literature on the potential association between anti-TNF regimens and the occurrence of malignancies such as melanocytic proliferations. There is a substantial hypothetical link between anti-TNF-α regimens such as adalimumab and the potential for cancers such as melanoma. However, the risk of malignancy with biological therapy remains to be established, and most of the relevant studies have lacked the statistical power and randomization required for large clinical trials. Further long-term controlled clinical trials and registries are required to investigate this potentially serious association.