Ear identification: A multi-ethnic study sample.

The external human ear is considered to be highly variable among individuals. Hence, forensic applications could be explored for human identification. This research compares the usefulness of Cameriere's ear identification method, in samples originating from six different countries (Brazil, India, Japan, Russia, South Africa and Turkey) in order to examine possible differences in their accuracy values. A sample of 2,225 photographs of the external human ear (1,134 left and 1,091 right ears) from 1,411 individuals (633 females and 778 males) was collected. The samples included healthy subjects with no systemic disorders and without any craniofacial trauma, maxillofacial abnormalities, auricular anomalies, ear diseases or previous auricular surgery. Cameriere's ear identification method was applied and measurements were performed on the images of each ear, considering four anatomic regions: helix, antihelix, concha, and lobe. The quantified measurement values were converted into a proposed coded number system. A search for identical codes was accomplished to find out the distinctiveness of the morphology of the human ear. The combined codes of left and right ears of each of the 814 subjects were not repeated in this multi-ethnic study sample. Dirichlet's distribution and the inherent study equation showed that the probability of two different individuals having the same code (false-positive identification) was found to be <0.0007. Because of the distinctive metrics of the ratios of external human ears, studies with Cameriere's ear identification method may be valuable for human identification. Studying the differences between the left and right ears of the same individual and across different ethnic groups could contribute to the development of supplementary tools for human identification.

Study of the ethnicity's influence on the third molar maturity index (I3M) for estimating age of majority in living juveniles and young adults.

Estimation of age of majority has important applications in the forensic daily practice because of the increasing demand for age estimates of unaccompanied minors. Diagnostic accuracy of I3M to assess legal adult age of 18 years has been already tested in several specific population samples. The aim of this work was to compare the available data about sensitivity and specificity of the third molar maturity index (I3M) from five different regional groups' radiographic samples to study possible ethnical difference. For this purpose, a sample of 6157 orthopantomograms (OPGs), coming from 15 countries, was analysed. Data about sensitivity and specificity were pooled using a bivariate modelling approach. The one-way MANOVA analysis was applied to assess the likelihood that sensitivity and specificity of the five regional groups are sampled from the same population. The result of the one-way MANOVA showed that both sensitivity and specificity did not depend from the regional groups. The obtained sensitivity was 84% (95% CI: 82% and 85%), and its specificity was 94% (95% CI: 93% and 95%). Based on these results, the I3M was a useful statistical tool to identify whether a subject has reached the legal age of 18 years old, regardless of his or her ethnicity.

A full Bayesian calibration model for assessing age in adults by means of pulp/tooth area ratio in periapical radiography.

The Bayesian approach is being a fundamental tool in forensic and legal field where inferences and decisions are made. In this study, a full Bayesian calibration model was developed to make probabilistic inferences about age estimation in a reference sample of 891 periapical X-rays of upper and lower canines. These teeth belonged to both deceased and living adult subjects, aged between 20 and 86 years, coming from five different countries (Turkey, Italy, Portugal, Japan and Mexico). For this purpose, the narrowing of pulp chamber due to the apposition of secondary dentine was analysed by means of the pulp/tooth area ratio. To determine the agreement of the method, intra- and inter-observer differences for measuring process were calculated by means of the intraclass correlation coefficient (ICC) analysis. Observer error tests showed excellent agreement between observers and between repeated assessments. According to the results of the ANCOVA, neither nationality nor sex was associated to the secondary dentine apposition while it is associated with individual's age. The results of the present study indicated that the concept of probability is intrinsically linked to the assessment of age in a forensic context, and the Bayesian approach could be considered a robust tool to overtake the bias generated by traditional regression models, thus helping the decision-making process in a legal framework.

The efficacy of the diode laser at 800-980 nm as an aid to non-surgical therapy in periodontitis treatment: a review of literature.

The aim of this literature review is to assess the effectiveness of diode laser at a wavelength of 800-980 nm in addition to non-surgical periodontal therapy in periodontitis treatment. The authors performed an electronic research on Pubmed inserting as keywords: (laser OR laser therapy OR diode laser) and (periodontitis OR periodontal disease). The field has been narrowed to select only Randomized controlled clinical trials (RCT) performed from 2010 to 2020. The result of this research was 84 articles, of which eight were included in the review because they respect the inclusion criteria. The clinical, immunological, and microbiological parameters studied in the various clinical random trials were analysed. It has been shown that four out of eight studies have achieved greater benefits, in terms of clinical parameters, with the use of diode laser compared to Scaling and Root Planing. However, the greater increase in clinical parameters in diode laser-treated patients compared to the control group was mainly detected in the short term rather than in the long term. In terms of microbiological parameters, no improvement was detected after six months. Only one study reported six-month improvements in immunological parameters in patients treated with DL compared to the Scaling and Root Planing only group. In conclusion, considering the limitations of this review of literature, there is no evidence that the diode laser at 800-980 nm in addition to non-surgical periodontal therapy is more effective than SRP alone in the long term.

Role of mast cells in oral inflammation.

Mast cells play important roles in the maintenance of many physiological functions as well as in the pathophysiology of diseases. Mast cells are involved in the inflammatory mechanisms of many systemic diseases. In this pandemic period, their role in physiological and pathological host inflammatory reactions in tissue disruption following SARS-CoV-2 infection has been stressed. A review of the literature was carried out by entering the key words "Mast Cells" AND "Oral Diseases" AND "Role of Mast Cells in Periodontitis". The results show us that mast cells are definitely involved in many oral diseases including periodontitis. Further in vivo and in vitro studies are needed to further investigate the specific role of the cells in physiological and pathological inflammation.

Imitation strategies in subjects with schizophrenia: a behavioural approach.

Imitation is a basic human ability, present early in life. Previous studies on control subjects and callosotomized patients showed that imitation occurred mainly in mirror-mode in both groups (60% controls, 66% patients) when they imitate without instructions (free sessions). In contrast, when asked to use the same or opposite limb as the model (driven sessions), controls used anatomical mode (93%), callosotomized patients mainly mirror strategy (61%). It has been suggested that callosotomized subjects prefer the mirror mode because of an impaired capacity for mental rotation, likely due to the lack of the corpus callosum (CC). The present research investigated the imitation strategies used by schizophrenic patients, who also could present anomaly in the interhemispheric connections. Fifteen hospitalized patients with diagnosis of schizophrenia participated in the study. They were asked to imitate upper limb intransitive meaningful and meaningless gestures performed by a model in a video. The results were compared with those from 20 healthy individuals. In driven imitation, controls answered in anatomical mode (95% of the responses), versus 63% of patients' responses. In free imitation sessions the answers in anatomical mode decreased to 39% in control subjects and to 46% in schizophrenic patients. In both driven and free imitation, the differences between the two proportions, conditioned to Diagnosis, resulted significantly different. The present data, in line with previous studies on psychotic and neurological patients showing impairments on imitation, suggest that the neural circuitry leading patients to perform differently from controls likely relates with the functional efficiency of the CC.

Age estimation by measuring open apices in teeth: a new formula for two samples of South African black and white children.

In this cross-sectional study, the accuracy of Cameriere's European formula was tested and a new specific model was developed for two samples of black and white South African children with known age and sex. For these purposes, 970 children of black South African ethnicity (girls 491, boys 479) and 974 with European ethnicity, living in South Africa (girls 493, boys 481), were retrospectively analyzed. The application of the European formula showed that there is a trend in the error estimates: the ages of the younger children are overestimated and those of the older children are underestimated, in both white and black children. A new model, based on the relationship between the apical width and the tooth length (maturity index) of the seven permanent mandibular teeth, was therefore constructed. The new developed equation for the South African population was able to explain 76% of total variance in white girls and 80% in white boys' subgroup. On the other side, the model explained 76% of total variance in black girls and 78% in the black boys' subgroup. The mean absolute error of the residuals (residuals = predicted age minus observed age) ranged from 0.718 to 0.769 years, with the interquartile range (IQRres) ranging from 1.19 to 1.31 years. Differently from the Cameriere's European formula, the plot did not tend to underestimate the chronological age significantly as the age increases. Cameriere's maturity index is reproducible in both samples of South African black and white children, for forensic purposes, and the Bayesian calibration approach is useful for a more accurate and precise estimation.

Third molar maturity index (I3M) for assessing age of majority: study of a black South African sample.

AIMS: The evaluation of the cutoff value of I3M = 0.08 for discriminating black South African minors from adults, and its relationship with chronological age. MATERIAL AND METHODS: A sample of 833 panoramic radiographs of healthy black South African subjects (500 females and 333 males), in the age range of 14 to 24 years (mean age 17.67 years in females and 17.42 years in males), was retrospectively evaluated. RESULTS: ICC values were 99.10% (95% CI 97.70 to 99.70%) and 99.20% (95% CI 98.00 to 99.60%), for the intra- and inter-observer reliability, respectively. I3M decreased as the real age gradually increased in both sexes. According to the logistic regression model, the variable sex was not significant when the probability that an individual is 18 years or older was calculated. The I3M = 0.08 was valuable in discriminating between adults and minors. The overall accuracy (ACC = fraction of accurately classified subjects) is 0.90 (95% CI 0.87-0.91); the proportion of correctly classified subjects (Se = sensitivity) is 0.80 (95% CI 0.76-0.84), and specificity (Sp) is 0.95 (95% CI 0.93-0.97). The PPV (predictive positive value) is 0.96 (95% CI 0.95-0.97), and the negative predictive value is 0.76 (95% CI 0.72-0.80). CONCLUSION: The results show that I3M is a valuable method to distinguish subjects who are around legal adult age in South Africa.

Imitation Strategies in Callosotomized Patients.

Imitation is a human ability rooted in early life. It allows people to interact with each other by observing and reproducing simple and complex movements alike. Imitation can occur in at least two forms: the rst, de ned as anatomical, seems to be based primarily on the mental construct of the "body schema" because the imitating movement corresponds precisely to the imitated movement in bodily terms, but not in terms of spatial compatibility. For example, a right arm movement of a model is imitated with a right arm movement by a facing imitator in a spatially incompatible fashion. The other form, de ned as specular or mirror-mode, involves a spatially compatible matching between imitated and imitating movements, as when an imitator moves her right arm upon viewing a corresponding left arm movement of a facing model (Chiavarino et al., 2007). In a previous study, healthy subjects showed a slight (61%) preference for the specular mode when freely imitating meaningful and meaningless gestures, whereas they strongly preferred the anatomical mode (93%) when given an intentionally ambiguous instruction such as "use the same (or the opposite) limb as the model" (Pierpaoli et al., 2014). In the present investigation it has been shown that callosotomized patients tended to favour the mirror-mode in both the free (66%) and the instructed condition (61% responses in driven sessions) regardless instructions given by the experimenter. Moreover, present data suggest that the extent of the callosotomy may in uence the patient's performance.

Analysis of immunohistochemical expression of inducible nitric oxide synthase for the evaluation of agonal time in forensic medicine.

Although establishing agony is crucial in forensic practice, the identification of specific signs indicative of a detailed duration of agony is however not of immediate execution. Nitric oxide (NO) is the most important messenger molecule in the modulation of vascular tone and it is produced during stress conditions by inducible nitric oxide synthase (iNOS), as occurs during agony. The aim of this study was to investigate the relationship between immunohistochemical expression of iNOS, and agonal time (T), defined as the interval between the onset of a hypoxic-ischemic injury and the death. INOS expression was evaluated by measuring the average of signal intensity (SI) from cytoplasm of 300 smooth muscle cells of sample of renal artery, performed by ImageJ software: high values of SI correspond to a low enzyme expression and vice versa. We aimed also to check if gender, age, type of death (violent or natural death), post mortem interval, and storage in cold chamber influenced SI. We assessed 50 autopsied cases, of which 28 violent and 22 natural deaths, with a well-known T in a range between 1 and 631 min. Statistical analysis was performed to estimate the relationship between SI and the other variables. Results pointed out that only SI is related to T, and since data showed a bi-phase relationship between T and SI, we used a piecewise regression method for estimation of T as function of SI. The transition from the first to the second phase takes place at SI = 117.5 which corresponds to a T of 29.5 min. In conclusion, the study demonstrates that iNOS is a good marker for estimating T and the final regression model can be used in many forensic activities.

Age estimation in children and young adolescents for forensic purposes using fourth cervical vertebra (C4).

The aim of this study was to evaluate the applicability of using the growth of the body of C4 vertebra for the estimation of age in children and young adolescents. We used the fact that the proportions between the radiologic projections of the posterior and anterior sides of the C4 vertebral body, which forms a trapezoidal shape, differ with age: in younger individuals, the posterior side is higher, whereas in older individuals, the projections of the sides of the vertebral body form a rectangular shape with the two sides equal or with the anterior side slightly higher. Cephalograms of 444 Italian subjects (214 female and 230 male individuals) aged between 5 and 15 years and with no obvious development abnormalities were analyzed. The projections of the anterior side (a) and of the posterior side (b) of each C4 body were measured, and their ratio (Vba), as a value of the C4 body development, was used for age estimation. Distribution of the Vba suggested that it does not change after 13 years in female and 14 years in male subjects. Consequently, we restricted our analysis of the Vba growing model until 14 years in both sexes. We used a Bayesian calibration method to estimate chronological age as function of Vba as a predicting variable. The intra- and inter-observer agreement was satisfactory, using intra-class correlation coefficient of Vba on 30 randomly selected cephalograms. The mean absolute errors were 1.34 years (standard deviation 0.95) and 1.01 years (standard deviation 0.71), and the mean inter-quartile ranges of the calibrating distribution were 2.32 years (standard deviation 0.25) in male and 1.72 years (standard deviation 0.39) in female individuals, respectively. The slopes of the regression of the estimated age error to chronological age were 0.02 in male and 0.06 in female individuals, where both values did not result significantly different from 0 (p > 0.12). In conclusion, although our Bayesian calibration method might not really outperform the classical regression models in the precision of its estimates, it appears to be more robust, to greatly reduce the typical bias inherent in the regression model approach, and to have the ability to incorporate multiple predictors.

Pancreatic involvement in Legionella pneumonia.

Legionella-associated pancreatitis has been rarely reported. Since this condition is very rarely suspected and investigated in patients with Legionella pneumonia, its incidence is probably underestimated. Here we report a case of Legionella pneumonia-associated pancreatitis and review the relevant related literature.

CD133 EXPRESSION COULD BE A PREDICTIVE MARKER OF PERIODONTAL REGENERATION.

Periodontal regeneration needs formation of new connective tissue at the root surface, involving periodontal fibre development and angiogenesis. CD133 or prominin-1, is an important regulator of apoptosis, proliferation and angiogenesis. CD133 positive cells seem to be influenced in number and distribution by periodontal inflammatory changes. Studies showed different clinical and radiographic outcomes achieved with the used of Demineralized Freeze-Dried Bone Allografts (DFDBA) for periodontal intrabony defects treatment. Our aim was to investigate the relationship between CD133 expression in gingival biopsies before periodontal treatment and periodontal tissue response in the same site at 12 months post-surgery. We selected fifty-six patients with at least one intrabony defect with clinical attachment level (CAL)≥6 mm and needing periodontal regeneration. A gingival biopsy for each patient was obtained for CD133 immunostaining. Clinical and radiographical parameters were taken at baseline and 12 months post-surgery. We found a positive correlation between gingival CD133 expression and CAL gain achieved by use of DFDBA and measured 12 months post-surgery. Our results suggest that gingival CD133 expression could be a predictive marker of favourable periodontal healing. The CAL gain after periodontal regeneration seems to be related with a native gingival regenerative capacity.

p63 and Ki-67 immunostainings in laryngeal squamous cell carcinoma are related to survival.

To examine the prognostic significance of the immunohistochemical expression of p63 and Ki-67 oncoproteins in patients with laryngeal squamous cell carcinoma, a retrospective evaluation was carried out on a cohort of 108 patients with primary laryngeal squamous cell carcinoma (LSCC) treated by primary surgery. For the immunohistochemical evaluation, tissue section obtained by formalin-fixed and paraffin-embedded tissue blocks from resection of each patient was used. Clinicopathologic data were associated with the immunostaining results. The association among the considered variables was assessed by Fisher's exact test, Mann-Whitney test, non-parametric χ(2) test, and Spearman's rho rank test was used to assess the relations among them. Differences in p63 and Ki-67 immunoreactivity among the different groups were compared via Kruskal-Wallis test and post hoc tests were performed using Mann-Whitney test with Bonferroni correction. The overall survival rate was estimated via Kaplan-Meier method, and the cumulative incidence functions for different groups were compared using log-rank statistics. Cox proportional hazard model was employed in a multivariate analysis to assess the effect of prognostic factors in the overall survival rate. Furthermore, taking into account death due to other causes, we estimated LSCC-related survival and disease-free survival rates using competing risk analysis. The results of immunohistochemical examination showed a statistically significant relationship between the up-regulation of P63 and Ki-67, an increase in histological grading, and primary tumours associated with lymph node metastases. p63 and Ki-67 up-regulation was related to a shorter disease-free survival and a significant association was found between p63 and Ki-67 percentage of positive cells and patient survival. Finally, we noticed a significant relation between p63 and Ki-67 (ρ = 0.87). On the other hand, no statistically significant associations were found between p63 and Ki-67 down-regulation and clinicopathologic data. Our findings suggest that abnormal p63 and Ki-67 immunoreactivity may be involved in the early phases of laryngeal tumorigenesis and may become a significant prognostic predictor for both overall and disease-free survivals. These biomarkers could thus help in the selection of high-risk patients with LSCC who may benefit from more aggressive therapy or chemoprevention.

Anatomical or mirror mode imitation? A behavioral approach.

Imitation can occur in at least two forms: one, which can be defined as anatomical, is based primarily on the mental construct of the body schema and allows recognition of correspondences between own body anatomy and that of other individuals. The other form, defined as specular or mirror mode, is most probably based on the allocation of some form of attention to the same region of the environmental space both by model and imitator, and to the objects it contains. This study investigated the behavioral strategy of imitation in normal subjects, to assess whether they carried out task instructions using an anatomical or a mirror perspective. Twenty seven adults were asked to imitate intransitive meaningful and meaningless gestures shown by a model in video clips. Instructions about how to perform them were provided before each trial. Trials were free (intended to produce spontaneous imitation) or driven (intended to produce anatomical imitation); further driven trials were administered to verify participants' knowledge of bodily laterality and were used as control. Performances were interpreted as anatomical or mirror imitation, according to the observation of anatomical or spatial reference frames between stimulus and imitator. The results revealed that in spontaneous imitation the mirror mode was more frequent (61% of responses), in line with previous studies. The novel finding was the prevalence (93% of responses) of anatomical imitation in tasks involving detailed driven instructions.

Atypical dermoid cyst of the corpus callosum: a case report.

BACKGROUND: Intracranial dermoid cysts (DCs) represent an infrequent subset of congenital ectodermal inclusion cysts predominantly observed near the midline structures. In spite of their benign nature, they can cause clinical manifestations, necessitating surgical removal as the main therapeutic measure. CASE REPORT: We present here an extremely rare case characterized by a radiologically atypical dermoid cyst located within the corpus callosum, an extremely rare location for such tumors. Successful surgical excision resulted in good clinical outcomes. CONCLUSIONS: This paper underscores the importance of a timely, proper radiological diagnostic process, which sees magnetic resonance imaging (MRI) as the main step, as well as the fact that interpretation of MRI data can sometimes be challenging, as it was in the patient of this report.

p63 expression in laryngeal squamous cell carcinoma is related to tumor extension, histologic grade, lymph node involvement and clinical stage.

To analyse the relationship of the immunohistochemical p63 expression with tumoral extent, histologic grade, lymph node involvement and clinical stage in laryngeal squamous cell carcinoma (LSCC), a series of 81 patients with primary LSCC treated by primary surgery was retrospectively evaluated. Immunohistochemistry was performed on formalin-fixed and paraffin-embedded tissue blocks from surgical samples. Clinicopathologic data were correlated with the p63 staining results. Differences in p63 immunoreactivity between the different groups were compared using both parametric analysis of variance (ANOVA) and non-parametric Kruskal-Wallis test. Statistical significance was set at p less than 0.05. All statistical analyses were performed using the R statistical package. We found a statistically significant association between p63 protein expression and increase of tumor extension (T1 vs T3), of histological grading, of level of lymph node involvement (N0 vs N1 and N2), and clinical stage (I vs IV). Our findings suggest that abnormal expression of p63 may be involved in the early phases of laryngeal tumorigenesis and this oncoprotein might become a useful predictor of clinical outcome.

Immunohistochemical correlation between microvessel density and lymphoid infiltrate in radicular cysts.

OBJECTIVE: Radicular cysts occur as a result of the immunological response to continuous antigenic stimulation from root canals. We correlated the immunophenotypical composition of the lymphoid infiltrate to the microvessel density expressed by the count of CD34 reactive endothelial cells in radicular cysts. SUBJECTS AND METHODS: Thirty-four cases of radicular cysts were evaluated by immunohistochemistry, using antibodies against B- and T-cell antigens (CD20, CD3, CD4, CD8) and against the endothelial cell marker CD34. Statistical analysis was performed. RESULTS: In the epithelium, we observed a low amount of lymphoid infiltrate in all 34 radicular cysts, and a strong significant negative correlation between T and B lymphocytes and between T-helper and T-cytotoxic/suppressor lymphocytes. In the cyst capsule, we observed a significant positive correlation between B and T lymphocytes, B and T-cytotoxic/suppressor lymphocytes, T and T-helper lymphocytes and between the number of CD34+ blood vessels and T and T-helper lymphocytes, respectively. We observed a statistically significant correlation between percentage of CD34+ vessels and inflammatory infiltrate grade. CONCLUSIONS: Both humoral and cellular immune reactions and neovascularization are likely to occur in the complex events of tissue destruction. The inflammatory infiltrate has an important role in neoangiogenesis and consequently in radicular cysts development and growth.

Radiographic analysis of epiphyseal fusion at knee joint to assess likelihood of having attained 18 years of age.

Radiological analysis of the epiphyses of the knee joint provides new valuable information, which may be used in combination with these well-established techniques in order to maximise the accuracy in the assessment of age of 18 years. A total of 215 antero-posterior radiographs of the knee was reviewed retrospectively in patients aged between 14 and 24 years old (99 boys, 116 girls). Fusion was scored as stage 1, epiphysis not fused; stage 2, epiphysis is fully ossified and epiphyseal scar is visible; and stage 3, epiphysis is fully ossified and epiphyseal scar is not visible. Scores of 0, 1 and 2 were assigned to stages 1, 2 and 3, respectively. Lastly, the score related to epiphyseal fusion at the knee joint was obtained by adding the three scores of the distal femur, proximal tibia and proximal fibula. Age distribution gradually increased with each score, for both genders. The mean age (±standard error) in each score category varied between genders, but the differences were not significant (p > 0.11). Five tests were performed to discriminate between individuals who were or were not at age 18 years or more, according to the receiver operating curve. For boys, the highest value of accuracy was obtained with score 3, with high sensitivity (Se = 93.33 %) and specificity (Sp = 89.29 %). For girls, it was obtained with score 4, with high accuracy (Acc = 85.86 %). These results indicate that radiographic analysis of the knee is a valuable alternative as a non-invasive method of estimation of 18 years of age.