Age estimation using medial clavicle by histomorphometry method with artificial intelligence: A review.

This review research critically assesses the evolving landscape of age estimation methodologies, with a particular focus on the innovative integration of histomorphometry and artificial intelligence (AI) in the analysis of the medial clavicle. The medial clavicle emerges as a crucial skeletal feature for predicting age, offering valuable insights into the morphological changes occurring throughout an individual's lifespan. Through an in-depth exploration of histological complexities, including variations in osteons, trabecular structures, and cortical thickness, this review elucidates their utility as viable indicators for age-related evaluations. This framework is augmented by the incorporation of AI technology, which enables automatic picture identification, feature extraction, and complicated pattern analysis. Our review of previous research highlights the promise of AI in improving prediction models for nuanced age estimates, highlighting the importance of large-scale, diversified datasets and thorough cross-validation. This thorough study, which addresses ethical concerns as well as the influence of population-specific characteristics, moves the debate around age estimate ahead, presenting insights with consequences for forensic anthropology, clinical diagnoses, and future research avenues.

Age Prediction Using Pixel Value Sum from Radiographic Proximal Femur in a Thai Population / Predicción de la Edad Utilizando la Suma de Valores de Pixeles del Fémur Proximal Radiográfico en una Población Tailandesa

SUMMARY: The present study aimed to investigate the utility of the proximal femur in the forensic age estimation by assessing changes in bone densities through radiographs. Using Otsu's threshold, bone density was quantified by counting all white pixel values within selected regions of interest, which include femoral head (FH), femoral neck (FN), Ward's triangle (WT), and greater trochanter (GT) from 354 left femora of Northern Thai descent. The pixel width of medullary cavity (MC) was also estimated. Furthermore, the study evaluated the performance of linear regression (LR) models for age estimation from radiographic images of proximal femora. Negative correlations were observed between FH, FN, WT, and GT pixel intensity with the age-at-death of the samples, with females exhibiting stronger correlations than males. Moreover, a positive correlation was found between age and MC width in female samples, while male MC widths did not show any relationship with increasing age. The results showed a slight difference between the LR model applied to both sexes, which integrated all variables, and the alternative configuration that only utilized relevant attributes. Both models exhibited similar performance, with a narrow range of root mean square error (RMSE) values, ranging from 12.67 to 12.71 years, and a correlation coefficient range of 0.51 to 0.52. For females, the LR model with FN and WT as selected attributes (RMSE = 11.85 years, correlation coefficient = 0.65) performed decently, while for males, the LR model with all variables showed RMSE of 12.52 years and correlation coefficient of 0.46. This study showcased the potential application of pixel intensity in predicting age.

El presente estudio tuvo como objetivo investigar la utilidad del fémur proximal en la estimación forense de la edad mediante la evaluación de cambios en las densidades óseas a través de radiografías. Utilizando el umbral de Otsu, la densidad ósea se cuantificó contando todos los valores de pixeles blancos dentro de regiones de interés seleccionadas, que incluyen la cabeza femoral (CF), el cuello femoral (CF), el triángulo de Ward (WT) y el trocánter mayor (TM) de 354 fémures izquierdos de ascendencia del norte de Tailandia. También se estimó el ancho de pixeles de la cavidad medular (CM). Además, el estudio evaluó el rendimiento de modelos de regresión lineal (RL) para la estimación de la edad a partir de imágenes radiográficas de fémur proximal. Se observaron correlaciones negativas entre la intensidad de los pixeles CF, CF, WT y TM con la edad de muerte, y las mujeres exhibieron correlaciones más fuertes que los hombres. Además, se encontró una correlación positiva entre la edad y el ancho del CM en muestras de mujeres, mientras que el ancho del CM del hombre no mostró ninguna relación con el aumento de la edad. Los resultados mostraron una ligera diferencia entre el modelo RL aplicado a ambos sexos, que integraba todas las variables, y la configuración alternativa que sólo utilizaba atributos relevantes. Ambos modelos mostraron un rendimiento similar, con un rango estrecho de valores del error cuadrático medio (RMSE), que oscilaba entre 12,67 y 12,71 años, y un rango de coeficiente de correlación de 0,51 a 0,52. Para las mujeres, el modelo RL con CF y WT como atributos seleccionados (RMSE = 11,85 años, coeficiente de correlación = 0,65) tuvo un desempeño satisfactorio, mientras que para los hombres, el modelo RL con todas las variables mostró un RMSE de 12,52 años y un coeficiente de correlación de 0,46. Este estudio mostró la posible aplicación de la intensidad de los pixeles en la predicción de la edad.

Collagen and elastic fibers assessment of the human heart valves for age estimation in Thais using image analysis.

The study investigated the relationship between the histological compositions of the tricuspid, pulmonary, mitral, and aortic valves, and age. All 85 fresh human hearts were obtained with an age range between 20 and 90 years. The central area of the valves was conducted to analyze the density of collagen and elastic fibers by using an image analysis program. Neural network function in MATLAB was used for classification data and accuracy test of the age predictive model. Overall, a gradual increase in the density of collagen and elastic fibers was demonstrated with age in all valve types. The pulmonary valve cusps had the least density of collagen and elastic contents, whereas the most dense of collagen was found in the mitral leaflets. A similarity was noted for the elastic fibers in the tricuspid, mitral, and aortic valves. The highest correlation between the collagen (r = 0.629) and elastic fibers (r = 0.713) and age was found in the noncoronary cusp of the aortic valve. The established predictive equations using collagen and elastic fibers in the noncoronary cusp provided the standard error of ± 14.0 and 12.5 years, respectively. A 60.9% of accuracy was found in all age groups using collagen, while accuracy in elastic fibers showed 70.0% in the classification process using the neural networks. The current study provided additional data regarding age-associated changes of collagen and elastic fibers in the human heart valves in Thais and the benefits and application in age forensic identification.

The underlying mechanism of calcium toxicity-induced autophagic cell death and lysosomal degradation in early stage of cerebral ischemia.

Cerebral ischemia is the important cause of worldwide disability and mortality, that is one of the obstruction of blood vessels supplying to the brain. In early stage, glutamate excitotoxicity and high level of intracellular calcium (Ca2+) are the major processes which can promote many downstream signaling involving in neuronal death and brain tissue damaging. Moreover, autophagy, the reusing of damaged cell organelles, is affected in early ischemia. Under ischemic conditions, autophagy plays an important role to maintain energy of the brain and its function. In the other hand, over intracellular Ca2+ accumulation triggers excessive autophagic process and lysosomal degradation leading to autophagic process impairment which finally induce neuronal death. This article reviews the association between intracellular Ca2+ and autophagic process in acute stage of ischemic stroke.

Optimal retractor insertion point for nerve safety during total hip arthroplasty: an anatomical study on the femoral and sciatic nerves in relation to hip motion.

BACKGROUND: Nerve injury is one of the most serious complications of total hip arthroplasty (THA). It is suspected to be a result from nerve compression or direct injury caused by an acetabular retractor. The anatomical relationship between the acetabular rim and the femoral and sciatic nerves, including hip motion, has not been investigated. This study aimed to identify the optimal position for retractor insertion during THA to prevent nerve damage. METHODS: A total of 28 hip joints from 14 freshly frozen cadavers were used. Using an anterolateral approach, each cadaver was immobilised in the lateral decubitus position and deployed to measure the distance between the nerves and the acetabular rim, while the hip joint was changed to the extension, neutral, and flexion positions. RESULTS: Three femoral nerves were closest to the anterior margin of the acetabulum at 90° and 120° of extension and farthest away at 30° of flexion. The sciatic nerve was closest to the posterior margin of the acetabulum at 90° and 120° of flexion and farthest away at 30° and 150° of extension compared with the other points. CONCLUSIONS: To prevent nerve damage during THA, we suggest that the retractor be inserted at the points where the nerves are the farthest away, such as at 30° and 150°. The femoral and sciatic nerves vary in their movements depending on the hip position. Therefore, the safe insertion of a retractor is recommended for hip flexion of the femoral nerve and extension of the sciatic nerve. Additionally, it is important to carefully insert the retractor along the acetabular margin without penetrating the joint capsule. Overall, this study provides valuable insights into the anatomical location and movement of the femoral and sciatic nerves in relation to hip motion and can help inform surgical techniques for safer THA.

Anatomical Relations of the Perforators from the Descending Lateral Femoral Circumflex Artery and Vastus Lateralis Motor Nerve Branches.

Background: The anterolateral thigh (ALT) flap, which is nourished by perforators from the descending branch of the lateral femoral circumflex artery (P), is one of the most commonly used flaps in soft tissue reconstruction. With the growing use of ALT flaps, attention toward donor-site morbidity has increased in recent years. Damage to the motor nerve branches of the vastus lateralis muscle (N) is one of the causes of donor-site morbidity, particularly muscle weakness. This study investigated the anatomical locations of the P and N in fresh-frozen cadaveric specimens. Methods: This study included 43 cadaver limbs. A silicone rubber compound (30 mL) was injected into the femoral artery to visualize the vessel. The locations of the P and motor points of N were measured to assess the risk of N injury during ALT flap harvesting. Results: There were one to six (mean, 2.7) P and two to seven (mean, 4) N. When the two most proximal perforators were used for flap harvesting, an average of 1.5 motor nerve branches (42%) was damaged because transection of the motor nerve branches was required for flap harvesting. In 33% of the limbs, only one motor nerve branch remained after the flap harvest. However, there were no cases where all motor nerve branches were severed. Conclusion: When an ALT flap with two perforators is harvested, weakness of the vastus lateralis muscle may occur in cases with a small number of motor nerve branches.

Biological Identification of Skulls in Indonesian and Thai Populations: Ancestry Estimation, Sex Determination, Stature Estimation, and Age Estimation / Identificación Biológica de Cráneos en Poblaciones de Indonesia y Tailandia: Estimación de Ascendencia, Determinación del Sexo, Estimación de Estatura y Estimación de Edad

SUMMARY: This review article will present an overview of biological profiles in forensic utilities. The biological profile of the skull in the existing literature can help to identify humans, especially if the condition of the victim found is a result of mutilation or a bomb explosion. When it comes to the precision of identifying skeletal remains, the human skull is frequently cited as being first in the estimation of age and ancestry and second in terms of sex and stature. It can be an alternative to assessing the following biological parameters: sex, age, stature, and ancestry. The implementation of biological profiles in the identification process is very important considering that some cases require the assistance of forensic anthropology. This review article shows the importance of the value of skulls. The method that can be applied is craniometry which can be used to determine sex, age, stature, and estimated ancestry. Different results will occur depending on the completeness of the skull. Therefore, estimation formulas have different accurate results. Discriminant function analysis has been performed on various measurement sets and its discriminant power has been validated by many researchers. Geometric morphometric analysis has become the main tool for shape analysis and many attempts have been made to use it in analyzing skulls. Several methods supported by technology have also been developed. It is hoped that the review article will show significant differences in results between studies in Thailand and Indonesia, even though they are in the same racial group.

Este artículo presenta una descripción general de los perfiles biológicos en las utilidades forenses. El perfil biológico del cráneo en la literatura existente puede ayudar a identificar a los humanos, especialmente si la condición en la que se encuentra la víctima es el resultado de una mutilación o la explosión de una bomba. Cuando se trata de la precisión en la identificación de restos óseos, el cráneo humano se cita con frecuencia como el primero en la estimación de edad y ascendencia y el segundo en términos de sexo y estatura. Puede ser una alternativa para evaluar los siguientes parámetros biológicos: sexo, edad, estatura y ascendencia. La implementación de perfiles biológicos en el proceso de identificación es importante considerando que algunos casos requieren la asistencia de la antropología forense. Este artículo de revisión muestra la importancia del valor de las cnezas óseas. El método que se puede aplicar es la craneometría para determinar el sexo, la edad, la estatura y la ascendencia estimada. Se pueden obtener diferentes resultados dependiendo de la integridad del cráneo. Por lo tanto, las fórmulas de estimación tienen resultados precisos diferentes. Se ha realizado un análisis de función discriminante en varios conjuntos de medidas y muchos investigadores han validado su poder discriminante. El análisis a través de la morfometría geométrica se ha convertido en la principal herramienta para el análisis de formas y se ha utilizado frecuentemente en el análisis de cráneos. También se han desarrollado varios métodos apoyados en la tecnología. Se espera que este trabajo muestre diferencias significativas en los resultados entre los estudios realizados en Tailandia e Indonesia, aunque pertenezcan al mismo grupo racial.

Anatomical quantitative evaluation of popliteal artery visualization during medial approach in supine position.

PURPOSE: The medial approach to the popliteal artery has been less commonly used than the posterior approach in surgical repair of traumatic popliteal injury. This study was performed to quantitatively evaluate the visual field of the popliteal artery obtained by staged myotendotomy in the medial approach to the popliteal artery. METHODS: Twenty legs of fresh-frozen adult cadavers were dissected using the medial approach to the popliteal artery. In stage 1, the popliteal artery was exposed between the vastus medialis and sartorius muscles without myotendotomy. In stage 2, the medial head of the gastrocnemius muscle was dissected. In stage 3, the tendons of the sartorius and semimembranosus muscles were dissected. In stage 4, the tendons of the gracilis and semitendinosus muscles were dissected to fully expose the popliteal artery. The length of the popliteal artery that could be visualized in each stage was measured. RESULTS: The anatomical length of the popliteal artery from the hiatus of the adductor magnus to the tendinous arch of soleus muscle ranged from 15 to 20 cm (mean, 16.3 cm). On average, 45%, 59%, 72%, and 100% of the popliteal artery were visualized in stage 1, 2, 3, and 4, respectively. CONCLUSIONS: The medial approach to the popliteal artery has the advantage of being performed in the supine position, but it requires multiple myotendotomies around the knee. The results of this study may serve as a reference for myotendotomy depending on the site of injury to the popliteal artery.

Sex determination using the clavicle by deep learning in a Thai population.

Determining sex is a critical process in estimating biological profiles from skeletal remains. The clavicle is interesting in studying sex determination because it is durable to the environment, slow to decay, challenging to destroy, making the clavicle useful in autopsies and identification which can then lead to verification. The goal of this study was to use deep learning in determining sex from clavicles within the Thai population and obtain the accuracies for the validation set using a convolutional neural network (GoogLeNet). A total of 200 pairs of clavicles were obtained from 200 Thai persons (100 males and 100 females) as part of a training group. For the deep learning approach, the clavicle was photographed, and each clavicle image was submitted to the training model for sex determination. Training groups of 200 samples were made. Images of the same size were input into the training model. The percentage of the validation set accuracy was calculated from the MATLAB program. GoogLeNet was the best training model and get the result of validation set accuracy. The results of this study found accuracies for a validation set with the highest overall right lateral view of the clavicle with an accuracy of 95%. Accuracy from the validation set of each view of the clavicle can demonstrate the forensic value of sex determination. A deep learning approach with clavicles can determine the sex and is simple to utilize for forensic anthropology professionals.

Age estimation in the combined long bones and ribs by histomorphometry: Past, present, and future.

Numerous age estimation methods in unidentified bone have been a long time developing for application in forensic anthropology. The histomorphometric technique is one of the alternative methods that relied upon the evaluation of the cortical bone microstructure over the lifespan as a result of the remodeling process in bone. Remodeling is a sophisticated event occurring from the coupled function of bone formation and resorption cells for maintaining mineral homeostasis and repairment of microdamage in bone tissue. Products derived from remodeling are primary changes in the osteon or haversian system in various regions in the cortical bone, including periosteum, endosteum, and trabecular bone. Throughout life, bone remodeling rate with osteon alteration can be predictable. In the forensic field, histological methods are getting more attention due to the unavailability of macroscopic methods. Histomorphometry approach can be accomplished in fragmentary or incomplete bone remains indicating the limited use of gross morphological methods. In addition, the microscopic methods can aid to increase the more accuracy of analyses and diminish the biased subjective assessment for determining age. Most histomorphometry method utilizes a cross-section of the midshaft of the long bones including the mandible, rib, and clavicle. This review provides the basic knowledge of bone biology and anatomy, several age-estimating methods of histology, and crucial factors for age methods. Studies regarding overall age determination methods from the past until now contribute to obtaining more benefits for developing methods of histomorphometry using human bone in forensic identification.

The Specific Anatomical Morphology of Lateral Ankle Ligament: Qualitative and Quantitative Cadaveric based Study.

OBJECTIVE: The accurate understanding in morphological features of the lateral ankle ligaments is necessary for the diagnosis and management of ankle instability and other ankle problems. The purpose of this study was to evaluate the anatomical morphology and the attachment areas of lateral ligament complex of ankle joint based on the cadaveric study. METHODS: Fifty-four fresh frozen cadaveric ankles were dissected to evaluate the lateral ankle ligaments. Each ligament was separated into two or three small bundles. In the investigated footprint areas, acrylic colors were used as a marker point to locate specific areas of ligament bundle attached to the bone. The Image J software was used to measure and analyze the sizes of the specific footprint areas to achieve descriptive statistical analysis. RESULTS: The double bands of anterior talofibular ligament (ATFL) were found as a major type in the present study with 57.41% (31 of 54 ankles) while the single band of ATFL was observed in 42.59% (23 of 54 ankles). The attachment sizes of the ATFL, posterior talofibular ligament (PTFL) and calcaneofibular ligament (CFL) were evaluated into two areas; proximal and distal attachments. The average of proximal or fibular part of ATFL, PTFL and CFL were 85.06, 134.27, 93.91 mm2 respectively. The average of distal part of ATFL, PTFL and CFL were 100.07, 277.61, 249.39 mm2 respectively. CONCLUSION: Considering the lateral ankle ligament repaired or reconstruction especially using arthroscopy, the precise understanding in specific detail of the lateral ankle ligament may help both diagnose and select the appropriate treatment for solving the ankle problems. These observations may help the surgeon to perform the surgical procedure for determining the appropriate techniques and avoid complication to patients.

Optimal techniques of ultrasound-guided superficial and deep parasternal intercostal plane blocks: a cadaveric study.

INTRODUCTION: The optimal techniques of a parasternal intercostal plane (PIP) block to cover the T2-T6 intercostal nerves have not been elucidated. This pilot cadaveric study aims to determine the optimal injection techniques that achieve a consistent dye spread over the second to sixth intercostal spaces after both ultrasound-guided superficial and deep PIP blocks. We also investigated the presence of the transversus thoracis muscle at the first to sixth intercostal spaces and its sonographic identification agreement, as well as the location of the internal thoracic artery in relation to the lateral border of the sternum. METHODS: Ultrasound-guided superficial or deep PIP blocks with single, double, or triple injections were applied in 24 hemithoraces (three hemithoraces per technique). A total volume of dye for all techniques was 20 mL. On dissection, dye distribution over the first to sixth intercostal spaces, the presence of the transversus thoracis muscle at each intercostal space and the distance of the internal thoracic artery from the lateral sternal border were recorded. RESULTS: The transversus thoracis muscles were consistently found at the second to sixth intercostal spaces, and the agreement between sonographic identification and the presence of the transversus thoracis muscles was >80% at the second to fifth intercostal spaces. The internal thoracic artery is located medial to the halfway between the sternal border and costochondral junction along the second to sixth intercostal spaces. Dye spread following the superficial PIP block was more localized than the deep PIP block. For both approaches, the more numbers of injections rendered a wider dye distribution. The numbers of stained intercostal spaces after superficial block at the second, fourth, and fifth intercostal spaces, and deep block at the third and fifth intercostal spaces were 5.3±1.2 and 5.7±0.6 levels, respectively. CONCLUSION: Triple injections at the second, fourth, and fifth intercostal spaces for the superficial approach and double injections at the third and fifth intercostal spaces for the deep approach were optimal techniques of the PIP blocks.

A web application for sex and stature estimation from radiographic proximal femur for a Thai population.

In both forensic and archaeological domains, the discovery of incomplete human remains is a frequent occurrence. Nevertheless, the estimation of biological profiles from such remains presents a challenge due to the absence of crucial skeletal elements, such as the skull and pelvis. This study aimed to assess the utility of the proximal femur in the forensic identification process by creating a web application for osteometric analysis of the proximal femur. The aim was to determine the sex and stature of an individual from radiographs of the left anteroposterior femur. To accomplish this, an automated method was developed for acquiring linear measurements from radiographic images of the proximal femur using Python tools. The application of Hough techniques and Canny edge detection was utilized to generate linear femoral dimensions from radiographs. A total of 354 left femora were radiographed and measured by the algorithm. The sex classification model employed in this study was the Naïve Bayes algorithm (accuracy = 91.2 %). Results indicated that Gaussian process regression (GPR) was the most effective method for estimating stature (mean error = 4.68 cm, SD = 3.93 cm). The proposed web application holds the potential to serve as a valuable asset in the realm of forensic investigations in Thailand, particularly in the estimation of biological profiles from fragmentary skeletal remains.

Estimation of Stature Based on Metatarsal Bones in a Thai Population / Estimación de la Estatura Basada en los Huesos Metatarsianos en una Población Tailandesa

SUMMARY: Stature estimation is one of the essential procedures for personal identification in forensic osteology. Therefore, the purposes of this study are to analyze the correlation between length and width of metatarsal measurements and stature, and to develop the regression equations for a Thai population. In this study, the samples were divided into two groups. The first group was called the "training group" for generating stature estimation equations, comprised of 200 skeletons, aged between 19-94 years. The second group was called the "test group" for evaluating the accuracy of generated equations, comprising 40 skeletons. The correlation between metatarsal parameters and stature were moderate to high, and all variables had positive significant correlation with stature. For males, the left ML2 is the length variable that showed the most correlation degree against stature (r=0.702), and the left MSW4 is the width variable that had the most correlation degree against stature (r=0.483). For females, right ML1 is the length variable that had the most correlation degree against stature (r=0.632), and right PW3 is the width stature that had the most correlation degree against stature (r=0.481). For all samples, left ML1 was the length variable that had the most correlation degree against stature (r=0.796) and right PW3 was the width variable that had the most correlation degree against stature (r=0.712). The results of generating multiple regression equations using a stepwise method reveals that the correlation coefficient (R) and standard error of estimate (SEE) were 0.761 and 4.96 cm, respectively, for males, and 0.752 and 4.93 cm for females, with 0.841 and 5.26 cm for all samples, respectively. According to these results, the mean of absolute error from the test group ranged from 3 to 5 cm. Therefore, stature estimation equations using length and width of metatarsals from our study can be applied to estimate stature in the Thai population.

La estimación de la estatura es uno de los procedimientos esenciales para la identificación personal en osteología forense. Por lo tanto, los propósitos de este estudio fueron analizar la correlación entre la longitud y el ancho de las medidas metatarsianas y la estatura, y desarrollar las ecuaciones de regresión para una población tailandesa. Las muestras se dividieron en dos grupos. El primer grupo se denominó "grupo de entrenamiento" para generar ecuaciones de estimación de estatura, compuesto por 200 esqueletos, con edades comprendidas entre los 19 y los 94 años. El segundo grupo se denominó "grupo de prueba" para evaluar la precisión de las ecuaciones generadas, que comprende 40 esqueletos. La correlación entre los parámetros metatarsianos y la estatura fue de moderada a alta, y todas las variables tuvieron una correlación significativa positiva con la estatura. Para el sexo masculino, la variable longitud ML2 izquierda es la que mayor grado de correlación presentó con la estatura (r=0,702), y la izquierda MSW4 fue la variable ancho la que mayor grado de correlación presentó con la estatura (r=0,483). Para el sexo femenino, ML1 derecho fue la variable longitud que tuvo mayor grado de correlación con la estatura (r=0,632), y PW3 derecha fue la variable ancho estatura que tuvo mayor grado de correlación con la estatura (r=0,481). Para todas las muestras, ML1 izquierdo fue la variable longitud que tuvo mayor grado de correlación con la estatura (r=0,796) y PW3 derecha fue la variable ancho que tuvo mayor grado de correlación con la estatura (r=0,712). Los resultados de generar ecuaciones de regresión múltiple usando un método paso a paso revela que el coeficiente de correlación (R) y el error estándar de estimación (SEE) fueron 0,761 y 4,96 cm, respectivamente, para los hombres y 0,752 y 4,93 cm para las mujeres, con 0,841 y 5,26 cm para todas las muestras, respectivamente. De acuerdo con estos resultados, la media del error absoluto del grupo de prueba osciló entre 3 y 5 cm. Por lo tanto, las ecuaciones de estimación de la estatura que utilizan la longitud y el ancho de los metatarsianos de nuestro estudio se pueden aplicar para estimar la estatura en la población tailandesa.

Cadaveric study investigating the femoral nerve-sparing volume for pericapsular nerve group (PENG) block.

BACKGROUND: This cadaveric study investigated the maximum effective volume of dye in 90% of cases (MEV90) required to stain the iliac bone between the anterior inferior iliac spine (AIIS) and the iliopubic eminence (IPE) while sparing the femoral nerve during the performance of pericapsular nerve group (PENG) block. METHODS: In cadaveric hemipelvis specimens, the ultrasound transducer was placed in a transverse orientation, medial and caudal to the anterior superior iliac spine in order to identify the AIIS, the IPE and the psoas tendon. Using an in-plane technique and a lateral-to-medial direction, the block needle was advanced until its tip contacted the iliac bone. The dye (0.1% methylene blue) was injected between the periosteum and psoas tendon. Successful femoral-sparing PENG block was defined as the non-staining of the femoral nerve on dissection. Volume assignment was carried out using a biased coin design, whereby the volume of dye administered to each cadaveric specimen depended on the response of the previous one. In case of failure (ie, stained femoral nerve), the next one received a lower volume (defined as the previous volume with a decrement of 2 mL). If the previous cadaveric specimen had a successful block (ie, non-stained femoral nerve), the next one was randomized to a higher volume (defined as the previous volume with an increment of 2 mL), with a probability of b=1/9, or the same volume, with a probability of 1-b=8/9. RESULTS: A total of 32 cadavers (54 cadaveric hemipelvis specimens) were included in the study. Using isotonic regression and bootstrap CI, the MEV90 for femoral-sparing PENG block was estimated to be 13.2 mL (95% CI: 12.0 to 20.0). The probability of a successful response was estimated to be 0.93 (95% CI: 0.81 to 1.00). CONCLUSION: For PENG block, the MEV90 of methylene blue required to spare the femoral nerve in a cadaveric model is 13.2 mL. Further studies are required to correlate this finding with the MEV90 of local anesthetic in live subjects.

Effect of sex on the APOE4-aging interaction in the white matter microstructure of cognitively normal older adults using diffusion-tensor MRI with orthogonal-tensor decomposition (DT-DOME).

The influence of the apolipoprotein E ε4 allele (APOE4) on brain microstructure of cognitively normal older adults remains incompletely understood, in part due to heterogeneity within study populations. In this study, we examined white-matter microstructural integrity in cognitively normal older adults as a function of APOE4 carrier status using conventional diffusion-tensor imaging (DTI) and the novel orthogonal-tensor decomposition (DT-DOME), accounting for the effects of age and sex. Age associations with white-matter microstructure did not significantly depend on APOE4 status, but did differ between sexes, emphasizing the importance of accounting for sex differences in APOE research. Moreover, we found the DT-DOME to be more sensitive than conventional DTI metrics to such age-related and sex effects, especially in crossing WM fiber regions, and suggest their use in further investigation of white matter microstructure across the life span in health and disease.

Facial reconstruction using 3-D computerized method: A scoping review of Methods, current Status, and future developments.

Facial reconstruction (otherwise known as facial approximation) is an alternative method that has been widely accepted in forensic anthropological and archaeological circumstances. This method is considered useful for creating the virtual face of a person based on skull remain. Three-dimensional (3-D) traditional facial reconstruction (known as sculpture or manual method) has been recognized for more than a century; however, it was declared to be subjective and required anthropological training. Until recently, with the progression of computational technologies, many studies attempted to develop a more appropriate method, so-called the 3-D computerized facial reconstruction. This method also relied on anatomical knowledge of the face-skull relationship, divided into semi- and automated based computational method. The 3-D computerized facial reconstruction makes it more rapid, more flexible, and more realistic to generate multiple representations of faces. Moreover, new tools and technology are continuously generating fascinating and sound research as well as encouraging multidisciplinary collaboration. This has led to a paradigm shift in the 3-D computerized facial reconstruction to a new finding and new technique based on artificial intelligence in academia. Based on the last 10-years scientific-published documents, this article aims to explain the overview of the 3-D computerized facial reconstruction and progression as well as an issue relating to future directions to encourage further improvement.

A comparison of effectiveness of sex estimation from the calcaneus and talus in a Thai population / Comparación de la efectividad de la estimación del sexo a partir del calcáneo y el talus en una población tailandesa

SUMMARY: Sex estimation is an important aspect of skeletal identification. In addition, previous studies have found that the sex estimation of each race is different. Thus, it is necessary to develop discriminant function equations for the estimation of sex for the Thai population. This study aims to investigate the relationship between width, length and height of the calcaneus and talus with regards to sex and compare the effectiveness of sex estimation between the calcaneus alone, the talus alone, and between both the calcaneus and talus. A total of 200 individuals (100 males and 100 females) were used in this study; ages ranged from 19 to 94 years. Thirteen variables of calcaneus and ten variables of talus were measured. The authors created discriminant function equations for the estimation of sex and tested the efficiency of the equations obtained by using a test group of 40 individuals (20 males and 20 females). By analyzing the mean values of the variables in the calcaneus and the talus, it was shown that males were significantly different from females (p0.05). A stepwise method was used to create 6 equations for sex estimation. The equations were categorized from between the calcaneus alone, the talus alone, and between both the calcaneus and the talus, providing a sex estimation accuracy of between 88.5 and 93.0 %. Using the test group, it was shown that discriminant function equations from the calcaneus alone, the talus alone, and the calcaneus and the talus together, can estimate sex at a high level of accuracy. Sex estimation accuracy was greater than 85 % in all equations. Therefore, the discriminant function equations from the calcaneus alone, the talus alone, and between both the calcaneus and the talus, from this study can be applied to the Thai population.

La estimación del sexo es un aspecto importante de la identificación esquelética. Estudios previos han encontrado que la estimación del sexo de cada raza es diferente. Por lo tanto, es necesario desarrollar ecuaciones de funciones discriminantes para la estimación del sexo de la población tailandesa. Este estudio tuvo como objetivo investigar la relación entre el ancho, el largo y la altura de los huesos calcáneo y talus con respecto al sexo y comparar la efectividad de la estimación del sexo entre el calcáneo solo, el talus solo y entre el calcáneo y el talus. Se utilizaron un total de 200 huesos de individuos adultos (100 hombres y 100 mujeres), cuyas edades oscilaron entre 19 y 94 años. Se midieron trece variables del calcáneo y diez variables del talus. Los autores crearon ecuaciones de funciones discriminantes para la estimación del sexo y probaron la eficiencia de ellas usando un grupo de prueba de huesos de 40 individuos (20 hombres y 20 mujeres). Al analizar los valores medios de las variables en el calcáneo y el talus, se demostró que los huesos de los hombres eran significativamente diferentes al de las mujeres (p0.05). Se utilizó un método paso a paso para crear 6 ecuaciones para la estimación del sexo. Las ecuaciones se clasificaron entre el calcáneo solo, el talus solo y entre el calcáneo y el talus, lo que proporcionó una precisión de estimación del sexo de entre 88,5 y 93,0 %. Usando el grupo de prueba, se demostró que las ecuaciones de funciones discriminantes del calcáneo solo, el talus solo y el calcáneo y el talus juntos pueden estimar el sexo con un alto nivel de precisión. La precisión de la estimación del sexo fue superior al 85 % en todas las ecuaciones. Por lo tanto, las ecuaciones de la función discriminante del calcáneo solo, el talus solo y entre el calcáneo y el talus de este estudio se pueden aplicar a la población tailandesa.