Connecting a disconnected trial network with a new trial: optimizing the estimation of a comparative effect in a network meta-analysis.

BACKGROUND: In network meta-analysis, estimation of a comparative effect can be performed for treatments that are connected either directly or indirectly. However, disconnected trial networks may arise, which poses a challenge to comparing all available treatments of interest. Several modeling approaches attempt to compare treatments from disconnected networks but not without strong assumptions and limitations. Conducting a new trial to connect a disconnected network can enable calculation of all treatment comparisons and help researchers maximize the value of the existing networks. Here, we develop an approach to finding the best connecting trial given a specific comparison of interest. METHODS: We present formulas to quantify the variation in the estimation of a particular comparative effect of interest for any possible connecting two-arm trial. We propose a procedure to identify the optimal connecting trial that minimizes this variation in effect estimation. RESULTS: We show that connecting two treatments indirectly might be preferred to direct connection through a new trial, by leveraging information from the existing disconnected networks. Using a real network of studies on the use of vaccines in the treatment of bovine respiratory disease (BRD), we illustrate a procedure to identify the best connecting trial and confirm our findings via simulation. CONCLUSION: Researchers wishing to conduct a connecting two-arm study can use the procedure provided here to identify the best connecting trial. The choice of trial that minimizes the variance of a comparison of interest is network dependent and it is possible that connecting treatments indirectly may be preferred to direct connection.

The politics of testing positive: an autoethnography of media (mis)representations at the 'start' and 'end' of different pandemics.

This paper draws on an autoethnographic 'digital diary' which the author began after testing positive for HIV in July 2016, until May 2021, to critically assess (mis)representations of both the AIDS and COVID-19 pandemics in the media. Drawing on insights from art, literature, queer theory and social anthropology, the paper focuses on dominant moral and political discourses to show how narratives of blame, shame and guilt about viral transmission contribute to the stigmatisation of 'at risk' groups. Concepts of biopower and normative judgement are used to reflect on discourses which construct those who 'test positive' for HIV or SARS-CoV-2 as 'reckless', 'risky' or 'irresponsible' subjects. The paper also analyses notes on recent media appearances made by the author to discuss their participation in the PARTNER study, which showed that HIV antiretroviral therapy eliminates the possibility of HIV transmission, including reports in The Guardian, on BBC News, on Sky News, on Channel 5 News, and in the Metro. As the former had reported that the 'Covid-19 crisis raises hopes of end to UK transmission of HIV', portrayals of the two pandemics are compared to explore tensions between public health and individual responsibility as normative priorities.

Implementing a comprehensive translational oncology platform: from molecular testing to actionability.

BACKGROUND: In order to establish the workflows required to implement a real-time process involving multi-omic analysis of patient samples to support precision-guided therapeutic intervention, a tissue acquisition and analysis trial was implemented. This report describes our findings to date, including the frequency with which mutational testing led to precision-guided therapy and outcome for those patients. METHODS: Eligible patients presenting to Oregon Health and Science University Knight Cancer Institute were enrolled on the study. Patients with biopsy proven metastatic or locally advanced unresectable prostate cancer, breast cancer, pancreatic adenocarcinoma, or refractory acute myelogenous leukemia receiving standard of care therapy were eligible. Metastatic site biopsies were collected and analyzed using the Knight Diagnostic Lab GeneTrails comprehensive solid tumor panel (124 genes). CLIA certified genomic information was made available to the treating physician. RESULTS: Between 1/26/2017 and 5/30/2018, 38 patients were enrolled, with 28 successfully undergoing biopsy. Of these, 25 samples yielded sufficient tumor for analysis. The median biopsy cellularity and number of cores collected were 70% (15-90%) and 5 (2-20), respectively. No procedure-related complications occurred. GeneTrails analysis revealed that 22 of 25 (88%) tumor samples harbored at least one potentially actionable mutation, and 18 (72%) samples harbored 2 or more potentially actionable mutations. The most common genetic alterations identified involved: DNA damage repair genes, cell cycle regulating genes, PIK3CA/Akt/mTOR pathway, and FGF gene family. To date, CLIA certified genomic results were used by treating physicians for precision-guided therapy in 5 (23%) patients. CONCLUSION: We report the feasibility of real-time tissue acquisition and analysis to support a successful translational oncology platform. The workflow will provide the foundation to improve access and accrual to biomarker driven precision oncology trials.

Gay guys using gay language: friendship, shared values and the intent-context-effect matrix.

This article draws on in-depth interviews with 35 openly gay male undergraduates from four universities in England to develop an understanding of the changing nature of language related to homosexuality. In addition to finding a diminution in the prevalence of homophobic language, we demonstrate that participants maintain complex and nuanced understandings of phrases that do not use homophobic pejoratives, such as 'that's so gay'. The majority of participants rejected the notion that these phrases are inherently homophobic, instead arguing that the intent with which they are said and the context in which they are used are vital in understanding their meaning and effect. We conceptualize an intent-context-effect matrix to understand the interdependency of these variables. Highlighting the situated nature of this matrix, we also demonstrate the importance of the existence of shared norms between those saying and hearing the phrase when interpreting such language.

Clinical evaluation of the efficacy of limbus artificial intelligence software to augment contouring for prostate and nodes radiotherapy.

OBJECTIVES: To determine if Limbus, an artificial intelligence (AI) auto-contouring software, can offer meaningful time savings for prostate radiotherapy treatment planning. METHODS: Three clinical oncologists recorded the time taken to contour prostate and seminal vesicles, lymph nodes, bladder, rectum, bowel, and femoral heads on CT scans for 30 prostate patients (15 prostate, 15 prostate and nodes). Limbus 1.6.0 was used to generate these contours on the 30 CT scans. The time taken by the oncologists to modify individual Limbus contours was noted and compared with manual contouring times. The geometric similarity of Limbus and expert contours was assessed using the Dice Similarity Coefficient (DSC), and the dosimetric impact of using un-edited Limbus organs at risk contours was studied. RESULTS: Limbus reduced the time to produce clinically acceptable contours by 26 minutes for prostate and nodes patients and by 13 minutes for the prostate only patients. DSC values of greater than 0.7 were calculated for all contours, demonstrating good initial agreement. A dosimetric study showed that 5 of the 20 plans optimized using unmodified AI structures required unnecessary compromise of PTV coverage, highlighting the importance of expert review. CONCLUSIONS: Limbus offers significant time saving and has become an essential part of our clinical practice. ADVANCES IN KNOWLEDGE: This article is the first to include bowel and lymph nodes when assessing potential time savings using Limbus software. It demonstrates that Limbus can be used as an aid for prostate and node radiotherapy treatment planning.

Determination of preoperative risk factors for iliopsoas tendonitis after total hip arthroplasty: A simulation study.

This study aims to identify preoperative risk factors for iliopsoas tendonitis after total hip arthroplasty, a complication typically attributed to acetabular cup position and orientation, using a validated iliopsoas impingement detection simulation. Analyzing CT scans and X-rays of 448 patients using a validated preoperative planning protocol, patients were simulated for iliopsoas impingement and categorized into at-risk and not at-risk groups based on a prior validation study, with a 23% at-risk incidence. Implementing a propensity score matching algorithm to reduce covariate imbalance, we identified factors that may exacerbate risk of iliopsoas tendonitis. Parameters that were investigated included standing pelvic tilt, functional femoral rotation, and the difference between the planned acetabular cup diameter and native femoral head diameter (ΔC-NFH). Comparing pelvic tilt, we found a significant difference between the groups (at-risk: -6.0°, not at-risk: -0.7°; p << 0.01). A similar trend was noted for ΔC-NFH (at-risk: +5.7 mm, not at-risk: +5.1 mm; p = 0.01). Additional simulations of at-risk patients indicated increased anteversion of the acetabular cup reduces impingement risk more effectively than medialisation. These findings suggest that spinopelvic parameters may exacerbate iliopsoas irritation risk, underscoring their importance in preoperative planning and patient expectation management. Similar findings of a greater than 6 mm difference between cup size and native femoral head diameter being a significant risk for iliopsoas tendonitis have been observed before, underscoring its potential veracity. These results may provide surgeons with a simple threshold that can be used in determining a cup size to reduce the risk of iliopsoas tendonitis.

Comparison of iliopsoas tendonitis after hip resurfacing arthroplasty and total hip arthroplasty: A case-controlled investigation using a validated simulation.

Iliopsoas tendonitis, typically caused by impingement with the acetabular cup, occurs in up to 18% of patients after total hip arthroplasty (THA) and up to 30% of patients after hip resurfacing arthroplasty (HRA). We have developed a simulation for detecting iliopsoas impingement and validated it in a previous study of THA patients. However, due to the difference in incidence between HRA and THA, this study had two aims. First, to validate the simulation in a cohort of HRA patients and, second, to comparethe results of the HRA and THA patients to understand any differences in their etiology. We conducted a retrospective search in an experienced surgeon's database for HRA patients with iliopsoas tendonitisand control patients without iliopsoas tendonitis, resulting in two cohorts of 12 patients. Using CT scans, 3D models of the each patient's prosthetic and bony anatomy were generated, landmarked, and simulated. Regarding validation of the simulation for HRA patients, impingement significantly predicted the probability of iliopsoas tendonitis in logistic regression models and the simulation had a sensitivity of 83%, specificity of 100%, and an AUC ROC curve of 0.95. Unexpectedly, the HRA cohort exhibited less impingement than the THA cohort. Our novel simulation has now been demonstrated to detect iliopsoas impingement and differentiate between the symptomatic and asymptomatic cohorts in investigations of THA and HRA patients. This tool has the potential to be used preoperatively, to guide decisions about optimal cup placement, and postoperatively, to assist in the diagnosis of iliopsoas tendonitis.

A study of examiner accuracy in cartridge case comparisons. Part 1: Examiner error rates.

This report describes a study undertaken to estimate examiner (not laboratory) error rates for false Identifications and false Eliminations when comparing an unknown to a collection of three known cartridge cases. Volunteer active examiners with Association of Firearm and Toolmark Examiners (AFTE) membership or working in laboratories that participate in the Association of Crime Laboratory Directors (ASCLD) were provided with 15 sets of three known and one questioned cartridge cases fired from a collection of 25 new Ruger SR9 handguns. Remington 9-mm Luger (manufacturer designation L9MM3) ammunition was used and comparison sets were made up of cartridge cases fired within 100 cartridges of each other for each gun. Examiners were provided with a background survey, an answer sheet allowing for the AFTE Range of Conclusions, and return shipping materials. In addition to determining whether the known and questioned cartridge cases were fired with the same handgun, examiners were also asked to assess how many of the three knowns in each set were suitable for comparison, providing an estimated rate of how often each firearm used in the study produces useable, quality marks. The participating examiners were provided with both same-source and different-source comparison sets allowing the study to assess both error rates. Responses were received from 218 participating examiners. The overall rate of false Eliminations was estimated as 0.367% from comparisons known to be from the same firearm but reported as Eliminations. The overall rate of false Identifications was estimated as 1.01% from comparisons known to be from different firearms but reported as Identifications. The rates are not uniform across the sample population with a few examiners providing most of the false Identification responses. Rates of poor-quality mark production varied across the 25 sample handguns; those rates were 2.3% ( ± 1.4%). Both false Elimination and false Identification rates are comparable to or lower than the rate of production of poor-quality marks by the firearms used in this study.

A study of examiner accuracy in cartridge case comparisons. Part 2: Examiner use of the AFTE range of conclusions.

This report describes an analysis of how examiners used the Association of Firearm and Toolmark Examiners (AFTE) Range of Conclusions in a controlled study undertaken to estimate examiner error rates in comparing cartridge cases. Results of the error rate analysis are reported in [1]; this paper focuses on a broader analysis of how the entire collection of classification categories, especially those in the Inconclusive range, were used by the participating examiners. Volunteer active examiners with AFTE membership or working in laboratories that participate in Association of Crime Laboratory Directors (ASCLD) were provided with 15 sets of three known and one questioned cartridge cases fired from a collection of 25 new Ruger SR9 handguns. Remington 9-mm Luger (manufacturer designation L9MM3) ammunition was used and comparison sets were made up of cartridge cases fired within 100 cartridges of each other for each gun. Examiners were provided with a background survey, an answer sheet allowing for the AFTE Range of Conclusions, and return shipping materials. The participating examiners were provided with both same-source and different-source comparison sets allowing the study to assess both error rates. Responses were received from 218 participating examiners. The overall rate of false-negatives was estimated as 0.367 % from comparisons known to be from the same firearm but reported as eliminations. The overall rate of false-positives was estimated as 1.01 % from comparisons known to be from different firearms but reported as identifications. In the case of true different-source examinations, it is clear that the three Inconclusive categories and the Elimination category are not used consistently by all examiners. We identify five different apparent patterns of use of the AFTE Range of Conclusions scale, and discuss possible reasons for and implications of these differences.

Iliopsoas tendonitis after total hip arthroplasty : an improved detection method with applications to preoperative planning.

AIMS: Iliopsoas impingement occurs in 4% to 30% of patients after undergoing total hip arthroplasty (THA). Despite a relatively high incidence, there are few attempts at modelling impingement between the iliopsoas and acetabular component, and no attempts at modelling this in a representative cohort of subjects. The purpose of this study was to develop a novel computational model for quantifying the impingement between the iliopsoas and acetabular component and validate its utility in a case-controlled investigation. METHODS: This was a retrospective cohort study of patients who underwent THA surgery that included 23 symptomatic patients diagnosed with iliopsoas tendonitis, and 23 patients not diagnosed with iliopsoas tendonitis. All patients received postoperative CT imaging, postoperative standing radiography, and had minimum six months' follow-up. 3D models of each patient's prosthetic and bony anatomy were generated, landmarked, and simulated in a novel iliopsoas impingement detection model in supine and standing pelvic positions. Logistic regression models were implemented to determine if the probability of pain could be significantly predicted. Receiver operating characteristic curves were generated to determine the model's sensitivity, specificity, and area under the curve (AUC). RESULTS: Highly significant differences between the symptomatic and asymptomatic cohorts were observed for iliopsoas impingement. Logistic regression models determined that the impingement values significantly predicted the probability of groin pain. The simulation had a sensitivity of 74%, specificity of 100%, and an AUC of 0.86. CONCLUSION: We developed a computational model that can quantify iliopsoas impingement and verified its accuracy in a case-controlled investigation. This tool has the potential to be used preoperatively, to guide decisions about optimal cup placement, and postoperatively, to assist in the diagnosis of iliopsoas tendonitis.Cite this article: Bone Jt Open 2023;4(1):3-12.

Functional Femoral Anteversion: Axial Rotation of the Femur and its Implications for Stem Version Targets in Total Hip Arthroplasty.

Background: Acetabular and femoral component positioning are important considerations in reducing adverse outcomes after total hip arthroplasty (THA). Previous assessments of femoral anteversion examined anatomic femoral anteversion (AFA) referenced to anatomic landmarks. However, this does not provide a functional understanding of the femur's relationship to the hip. We investigate a new measurement, functional femoral anteversion (FFA), and sought to measure its variability across a large sample of patients undergoing THA. Methods: A total of 1008 consecutive patients underwent THA surgery between September 2019 and July 2021. All patients were measured for supine and standing functional femoral rotation (FFR), AFA, and FFA. Results: The mean standing FFA was 13.2° ± 12.2° (-27.8° to 52.3°). The mean change in FFR from supine to standing was -2.2° ± 11.8° (-43.0° to 41.9°). Of all, 161 (16%) patients had standing FFA version greater than 25°. Four hundred sixty (46%) patients had standing FFR (internal or external) greater than 10°. One hundred twenty-three (12%) patients exhibited an increase in external rotation from supine to standing of greater than 10°. A moderate, negative linear relationship was observed between AFA and standing external femoral rotation (P <<.001, R = -0.46), indicating people may externally rotate their femur as AFA decreases with age. Conclusions: Functional alignment of the femur in patients requiring THA is understudied. It is now understood that the femur, like the pelvis, can rotate substantially between functional positions. Enhancing our understanding of FFA and FFR may improve both acetabular and femoral component positioning.

Pre- and postoperative physiotherapy using a digital application decreases length of stay without reducing patient outcomes following total knee arthroplasty.

INTRODUCTION: Total Knee Arthroplasty (TKA) for both patients and the surgical team is a journey spanning many months, rather than purely a hospital episode of care. To improve patient outcomes and reduce costs in TKA, greater emphasis should be placed on the pre- and postoperative periods as, historically, innovation has focused on the intraoperative execution of the surgery. The purpose of this study was to determine if a pre- and postoperative physiotherapy program delivered via a digital application could reduce hospital length of stay (LOS) without compromising patient outcomes. METHODS: A retrospective series of 294 patients who underwent TKA from a single-surgeon in a single-centre was examined. This included 232 patients who underwent a pre- and postoperative physiotherapist-led program delivered via a digital application and 62 patients who underwent a conventional pre- and postoperative protocol. 2:1 nearest neighbour propensity score matching was performed to establish covariate balance between the cohorts. Data collected included pre- and postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS), KOOS for Joint Replacement (KOOS, JR), and acute, rehabilitation, and total LOS. RESULTS: No significant difference in KOOS or KOOS, JR scores was observed at 12-month follow-up. A significantly reduced rehabilitation (P = 0.014) and total LOS (P = 0.015) was observed in the patients who received the digital physiotherapy program. CONCLUSIONS: There may be significant economic benefits to a pre- and postoperative physiotherapy program delivered via a digital application. Our results suggest that a digital physiotherapist-led patient program may reduce the need for inpatient rehabilitation services without compromising patient outcomes.

Leg length discrepancy assessment in total hip arthroplasty: is a pelvic radiograph sufficient?

AIMS: Leg length discrepancy (LLD) is a common pre- and postoperative issue in total hip arthroplasty (THA) patients. The conventional technique for measuring LLD has historically been on a non-weightbearing anteroposterior pelvic radiograph; however, this does not capture many potential sources of LLD. The aim of this study was to determine if long-limb EOS radiology can provide a more reproducible and holistic measurement of LLD. METHODS: In all, 93 patients who underwent a THA received a standardized preoperative EOS scan, anteroposterior (AP) radiograph, and clinical LLD assessment. Overall, 13 measurements were taken along both anatomical and functional axes and measured twice by an orthopaedic fellow and surgical planning engineer to calculate intraoperator reproducibility and correlations between measurements. RESULTS: Strong correlations were observed for all EOS measurements (rs > 0.9). The strongest correlation with AP radiograph (inter-teardrop line) was observed for functional-ASIS-to-floor (functional) (rs = 0.57), much weaker than the correlations between EOS measurements. ASIS-to-ankle measurements exhibited a high correlation to other linear measurements and the highest ICC (rs = 0.97). Using anterior superior iliac spine (ASIS)-to-ankle, 33% of patients had an absolute LLD of greater than 10 mm, which was statistically different from the inter-teardrop LLD measurement (p < 0.005). DISCUSSION: We found that the conventional measurement of LLD on AP pelvic radiograph does not correlate well with long leg measurements and may not provide a true appreciation of LLD. ASIS-to-ankle demonstrated improved detection of potential LLD than other EOS and radiograph measurements. Full length, functional imaging methods may become the new gold standard to measure LLD.Cite this article: Bone Jt Open 2022;3(12):960-968.

Harm Reduction and Decriminalization of Sex Work: Introduction to the Special Section.

INTRODUCTION: This special section of Sexuality Research and Social Policy, edited by Belinda Brooks-Gordon, Max Morris and Teela Sanders, has its origins in a colloquium sponsored by the University of Cambridge Socio-Legal Group in 2020. The goal was to promote the exchange of ideas between a variety of disciplinary research fields and applied perspectives on harm reduction and the decriminalization of sex work. The colloquium took place during the emergence of the coronavirus pandemic in February 2020. METHODS: We explore the impact of Covid-19 on understandings of sex work, outline the basic underpinning legal philosophical question, explore the intersectional politics of decriminalization, summarize contemporary international health and human rights campaigns, explore contemporary public opinion trends on the issue, and illustrate the universal principles. Finally, we summarize the special section papers (N=12). RESULTS: The Covid pandemic provided a lens through which to analyse the changes that have occurred in sex work and sex work research in the past decade and it also exacerbated intersecting inequalities, accelerated many social shifts already in motion whilst changing the course of others. In combination the papers in this special issue examine sex work policy and research across 12 countries in four continents to provide and important space for international and cross-cultural comparison. CONCLUSIONS: We present the timely contributions of diverse authors and comment on the significance of their research projects which support a decriminalization policy agenda for the benefit of academics, policymakers and practitioners to improve public health strategies and international responses. POLICY IMPLICATIONS: The research here amplifies the focus on harm reduction and strengthens the case for public policy that decriminalizes commercial sex between consenting adults as the best strategy to reduce harm.

Behaviour influences thermoregulation of boreal moose during the warm season.

Management of large herbivores depends on providing habitats for forage supply and refuge from risks of temperature, predation and disease. Moose (Alces alces) accumulate body energy and nutrient stores during summer, while reducing the impact of warm temperatures through physiological and behavioural thermoregulation. Building on the animal indicator concept, we used rumen temperature sensors and GPS collars on captive moose (n = 6) kept in large natural enclosures to evaluate how behaviour and habitat selection influence the rate of change in rumen temperature during the growing season on the Kenai Peninsula, Alaska, USA. We compared movement and habitat selection of individual females during tolerance days (daily amplitude in rumen temperature was ≥1.2°C in 24 h) with those of control days (daily amplitude in rumen temperature was < 1.2°C) before and after the tolerance day. Moose moved more during tolerance days (172 m • h-1; 95% confidence intervals (CI) = 149-191 m • h-1) than on control days (151 m • h-1; 95% CI = 128-173 m • h-1). The rate of change in rumen temperature (°C • h-1) declined with low to moderate movement rates that were probably associated with foraging in all habitats. Movement only increased the rate of change in rumen temperature at high activity (~ > 500 m • h-1). Additionally, the relationship between rate of change in rumen temperature and movement rate was different during tolerance and control days in open meadow and wetland habitats. In all habitats except wetlands, the rate of change in rumen temperature increased while resting, which probably is a result of diet-induced thermogenesis. Our study demonstrates that the behavioural choices of moose on the landscape are associated with the rate of change in rumen temperature and their ability to thermoregulate. Wildlife managers must consider high-value habitats where wildlife can employ both behavioural and physiological mechanisms to tolerate warm ambient conditions in a landscape of forage, predators and pests.

Modeling Abundance of Culicoides stellifer, a Candidate Orbivirus Vector, Indicates Nonrandom Hemorrhagic Disease Risk for White-Tailed Deer (Odocoileus virginianus).

(1) Background: Hemorrhagic diseases in white-tailed deer (Odocoileus virginianus) are caused by orbiviruses and have significant economic impact on the deer ranching industry in the United States. Culicoides stellifer is a suspected vector of epizootic hemorrhagic disease virus (EHDV), with recent field evidence from Florida, but its natural history is poorly understood. Studying the distribution and abundance of C. stellifer across the landscape can inform our knowledge of how virus transmission can occur locally. We may then target vector management strategies in areas where viral transmission can occur. (2) Methods: Here, we used an occupancy modeling approach to estimate abundance of adult C. stellifer females at various physiological states to determine habitat preferences. We then mapped midge abundance during the orbiviral disease transmission period (May-October) in Florida. (3) Results: We found that overall, midge abundance was positively associated with sites in closer proximity to large-animal feeders. Additionally, midges generally preferred mixed bottomland hardwood and agricultural/sand/water habitats. Female C. stellifer with different physiological states preferred different habitats. (4) Conclusions: The differences in habitat preferences between midges across states indicate that disease risk for deer is heterogeneous across this landscape. This can inform how effective vector management strategies should be implemented.

An Improved Version of a Tool Mark Comparison Algorithm.

Chumbley et al. (2010) described a statistically based algorithm for comparing pairs of tool marks. They presented empirical evidence that the algorithm produces well-separated similarity score values for "matching" and "non-matching" pairs of tool marks. However, the algorithm has two substantial weaknesses. First, it is "uncalibrated" in the sense that error rates can be determined only through empirical investigation. Second, it relies on a randomized test and can lead to different similarity scores when the algorithm is repeatedly applied to the same pair of tool marks. We present an improved version of the procedure, which eliminates the randomized scores and yields more consistent and predictable error rate control. This is accomplished by replacement of a random sampling step from the original algorithm with a deterministic process. We demonstrate the improved algorithm and compare its performance to the original by applying to known "matching" and "non-matching" pairs of tool marks.

Development of a Mobile Toolmark Characterization/Comparison System.

Since the development of the striagraph, various attempts have been made to enhance forensic investigation through the use of measuring and imaging equipment. This study describes the development of a prototype system employing an easy-to-use software interface designed to provide forensic examiners with the ability to measure topography of a toolmarked surface and then conduct various comparisons using a statistical algorithm. Acquisition of the data is carried out using a portable 3D optical profilometer, and comparison of the resulting data files is made using software named "MANTIS" (Mark and Tool Inspection Suite). The system has been tested on laboratory-produced markings that include fully striated marks (e.g., screwdriver markings), quasistriated markings produced by shear-cut pliers, impression marks left by chisels, rifling marks on bullets, and cut marks produced by knives. Using the system, an examiner has the potential to (i) visually compare two toolmarked surfaces in a manner similar to a comparison microscope and (ii) use the quantitative information embedded within the acquired data to obtain an objective statistical comparison of the data files. This study shows that, based on the results from laboratory samples, the system has great potential for aiding examiners in conducting comparisons of toolmarks.

Validation of tool mark comparisons obtained using a quantitative, comparative, statistical algorithm.

A statistical analysis and computational algorithm for comparing pairs of tool marks via profilometry data is described. Empirical validation of the method is established through experiments based on tool marks made at selected fixed angles from 50 sequentially manufactured screwdriver tips. Results obtained from three different comparison scenarios are presented and are in agreement with experiential knowledge possessed by practicing examiners. Further comparisons between scores produced by the algorithm and visual assessments of the same tool mark pairs by professional tool mark examiners in a blind study in general show good agreement between the algorithm and human experts. In specific instances where the algorithm had difficulty in assessing a particular comparison pair, results obtained during the collaborative study with professional examiners suggest ways in which algorithm performance may be improved. It is concluded that the addition of contextual information when inputting data into the algorithm should result in better performance.