Artificial intelligence in forensic medicine and forensic dentistry.

This review article aims to highlight the current possibilities for applying Artificial Intelligence in modern forensic medicine and forensic dentistry and present the advantages and disadvantages of its use. For this purpose, the relevant academic literature was searched using PubMed, Web of Science and Scopus. The application of Artificial Intelligence in forensic medicine and forensic dentistry is still in its early stages. However, the possibilities are great, and the future will show what is applicable in daily practice. Artificial Intelligence will improve the accuracy and efficiency of work in forensic medicine and forensic dentistry; it can automate some tasks; and enhance the quality of evidence. Disadvantages of the application of Artificial Intelligence may be related to discrimination, transparency, accountability, privacy, security, ethics and others. Artificial Intelligence systems should be used as a support tool, not as a replacement for forensic experts.

Comparison of the third molar maturity index (I3M) between left and right lower third molars to assess the age of majority: a multi-ethnic study sample.

The diagnostic accuracy of the I3M to assess the legal age of 18 years has already been tested in several specific-population samples. The left lower third molar has been extensively used for discriminating between minors and adults. This research aimed to compare the usefulness of lower third molar maturity indexes, from both left and right side (I3ML and I3MR), in samples originating from four distinct continents in order to examine possible differences in their accuracy values. For this purpose, a sample of 10,181 orthopantomograms (OPGs), from Europe, Africa, Asia and America, was analysed and previously scored in other studies. The samples included healthy subjects with no systemic disorders with both third molars and clear depicted root apices. Wilcoxon Signed Rank test for left and right asymmetry did not show any significant differences. Data about sensitivity, specificity, predictive values, likelihood ratio and accuracy were pooled together and showed similar results for I3ML and I3MR, respectively. In addition, all these quantities were high when only the I3MR was considered to discriminate between adults and minors. The present referable database was the first to pool third molar measurements using panoramic radiographs of subjects coming from different continents. The results highlighted that both I3ML and I3MR are reliable indicators for assessing the legal age of 18 years old in those jurisdictions where this legal threshold has been set as the age of majority.

Skeletonization method for vessel delineation of arteriovenous malformation.

Cerebral arteriovenous malformation (AVM) presents a great health threat due to its high probability of rupture that can cause severe brain damage. Image segmentation alone is not sufficient to support AVM embolization procedure. In order to successfully navigate the catheter and perform embolization, the segmented blood vessels need to be classified into feeding arteries, draining veins and the AVM nidus. For this reason we address here the AVM localization and vessel decomposition problem. We propose in this paper a novel AVM localization and vessel delineation method using ordered thinning-based skeletonization. The main focus of vessel delineation is the delineation of draining veins since it is essential for the embolization procedure. The main contribution is a graph-based method for exact extraction of draining veins which, in combination with our earlier work on AVM detection, allows the AVM decomposition into veins, arteries and the nidus (with an emphasis on the draining veins). We validate the proposed approach on blood vessel phantoms representing the veins and the AVM structure, as well as on cerebral 3D digital rotational angiography (3DRA) images before and after embolization, paired with digital subtraction angiography (DSA) images. Results on AVM delineation show high correspondence to the ground truth structures and indicate potentials for use in surgical planning.

Usefulness of Discarded Vitreous Samples from Routine Vitrectomy.

Purpose. To describe the histopathological features of vitreous samples obtained after vitrectomy surgery from diabetic and nondiabetic patients. Methods. Vitreous specimens from 137 patients who underwent vitrectomy for different clinical conditions were analysed. All samples were centrifuged and each resulting pellet was fixed and processed as part of routine paraffin section histopathology. The histopathological features were categorized in a semiquantitative fashion. The samples from diabetic and nondiabetic patients were compared. Results. The 125 included patients (58 diabetic, 60% males) were aged 64.2 ± 13.9 years. The presence of hemorrhage, inflammatory cells, and histiocytes was significantly higher in the diabetic group (P < 0.001, P = 0.028, and P = 0.016, resp.), showing more vessels (P < 0.001) and ghost vessels (P = 0.049). The presence of inflammatory cells was the feature with the highest sensitivity for detecting diabetes mellitus (98%) and also the highest negative predictive value (89%). In the multivariate analysis, three variables emerged as independent significant predictors of diabetes in vitrectomy samples: hemorrhage, endothelial-lined vessels, and age (P < 0.001, P < 0.001, and P = 0.019, resp.). Conclusions. Different histopathological features can be found in vitreous samples from diabetic patients. Analysis of vitrectomy samples may serve as a tool for diabetes management.

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.

Accuracy and reliability of pulp/tooth area ratio in upper canines by peri-apical X-rays.

Due to the real need for careful staff training in age assessment, in order to improve capacity, consistency and competence, new research on the reliability and repeatability of methods frequently used in age assessment are required. The aim of this study was twofold: first, to test the accuracy of this method for age estimation; second, to obtain data on the reliability of this technique. A sample of 81 peri-apical radiographs of upper canines (44 men and 37 women), aged between 19 and 74years, was used; the teeth were taken from the osteological collection of Sassari (Sardinia, Italy). Three blinded observers used the technique in order to perform the age estimation. The mean real age of the 81 observations was 37.21 (CI95% 34.37 40.05), and estimated ages ranged from 36.65 to 38.99 (CI95%-Ex1 35.42; 41.28; CI95%-Ex2 33.89; 39.41; CI95%-Ex3 35.92; 42.06). The module differences found by the three observers were 3.43, 4.24 and 4.45, respectively for Ex1×Ex2, Ex1×Ex3 and Ex2×Ex3. The module differences observed among real and observed ages were 2.55 (CI95% 1.90; 3.20), 2.22 (CI95% 1.65; 2.78) and 4.39 (CI95% 3.80; 5.75), respectively for Ex1, Ex2 and Ex3. No differences were observed among measurements. This technique can be reproduced and repeated after proper training, since it was found high reliability and accuracy.

Validation of autism spectrum quotient adult version in an Australian sample.

The Autism Spectrum Quotient is used to assess autistic spectrum traits in intellectually competent adults in both the general population and the autism spectrum community. While the autism spectrum Quotient has been validated in several different cultures, to date no study has assessed the psychometrics of the Autism Spectrum Quotient on an Australian population. The purpose of this study was to assess the psychometrics of the autism spectrum Quotient in an Australian sample of both typically developing individuals (n = 128) and individuals with autism spectrum disorder (n = 104). The results revealed that the internal consistency and the test-retest reliability were satisfactory; individuals with autism spectrum disorder scored higher on total Autism Spectrum Quotient score and its subscales than typically developing individuals; however, gender differences were not apparent on total score. Possible cultural differences may explain some of the psychometric variations found. The results of this analysis revealed that the Autism Spectrum Quotient was a reliable instrument for investigating variation in autistic symptomology in both typically developing and Autism Spectrum Disorders populations within an Australian population.

Carabelli's trait in Croatian populations over 1800 years.

Examination and comparison of the morphological features of tooth crown in archaeological and recent samples can be difficult due to the different levels of tooth wear seen both within and between populations. These differences make the comparison of frequency data for Carabelli trait problematic. The aim of the present study is to detect the frequency and degree of expression of Carabelli's trait in Croatian populations from late antiquity to recent times and to use these data as supplementary evidence of complex population migration. A total of 1287 individuals from the late antiquity, medieval, early modern and modern periods were examined. Correlation between the presence of Carabelli's trait and tooth crown size was tested. The results of our analyses show that the frequency of Carabelli's trait is significantly greater in the early modern period (51.3%) and in the 21st century (43.1%) than in the late antiquity (20.4%) and medieval periods (23.4%). These results are consistent with historical evidence of migration and population change in the territory of present-day Croatia throughout the almost 1800 years covered by this study. The results also provide additional evidence for the complex nature of population change in the transition from the late antiquity to the early medieval period.

Age estimation in archaeological skeletal remains: evaluation of four non-destructive age calculation methods.

Estimation of age at death is an essential part of reconstructing information from skeletal material. The aim of the investigation was to reconstruct the chronological age of an archaeological sample from Croatia using cranial skeletal remains as well as to make an evaluation of the methods used for age estimation. For this purpose, four age calculation methods were used: palatal suture closure, occlusal tooth wear, tooth root translucency and pulp/tooth area ratio. Cramer's V test was used to test the association between the age calculation methods. Cramer's V test showed high association (0.677) between age determination results using palatal suture closure and occlusal tooth wear, and low association (0.177) between age determination results using palatal suture closure and pulp/tooth area ratio. Simple methods like palatal suture closure can provide data about age at death for large number of individuals, but with less accuracy. More complex methods which require qualified and trained personnel can provide data about age for a smaller number of individuals, but with more accuracy. Using different (both simple and complex) age calculation methods in archaeological samples can raise the level of confidence and percentage of success in determining age.