Average thickness of the bones of the human neurocranium: development of reference measurements to assist with blunt force trauma interpretations.

The accurate interpretation of a blunt force head injury relies on an understanding of the case circumstances (extrinsic variables) and anatomical details of the individual (intrinsic variables). Whilst it is often possible to account for many of these variables, the intrinsic variable of neurocranial thickness is difficult to account for as data for what constitutes 'normal' thickness is limited. The aim of this study was to investigate the effects of age, sex and ancestry on neurocranial thickness, and develop reference ranges for average neurocranial thickness in the context of those biological variables. Thickness (mm) was measured at 20 points across the frontal, left and right parietals, left and right temporals and occipital bones. Measurements were taken from post-mortem computed tomography scans of 604 individuals. Inferential statistics assessed how age, sex and ancestry affected thickness and descriptive statistics established thickness means. Mean thickness ranged from 2.11 mm (temporal squama) to 19.19 mm (petrous portion). Significant differences were noted in thickness of the frontal and temporal bones when age was considered, all bones when sex was considered and the, right parietal, left and right temporal and occipital bones when ancestry was considered. Furthermore, significant interactions in thickness were seen between age and sex in the frontal bone, ancestry and age in the temporal bone, ancestry and sex in the temporal bone, and age, sex and ancestry in the occipital bone. Given the assorted influence of the biological variables, reference measurement ranges for average thickness incorporated these variables. Such reference measurements allow forensic practitioners to identify when a neurocranial bone is of normal, or abnormal, thickness.

The epidemiology of eye injuries in Western Australia: a retrospective 10-year study.

CLINICAL RELEVANCE: Eye injuries constitute a significant cause of preventable lifelong visual impairment or blindness. It is important to identify the context in which these injuries occur to develop intervention programs to reduce the incidence and severity of injury. BACKGROUND: To evaluate the nature, external cause, place of occurrence and incidence rate of eye injuries treated at hospitals in Western Australia. METHODS: Retrospective, population-based study of patients presenting to all emergency departments or admitted to hospital with primary or secondary eye injuries between 2005 and 2014. RESULTS: The combined incidence rate of eye injuries requiring tertiary care was 278 per 100 000 person-years (95% CI 276-280). Significantly more males (79%, 44 569) presented to emergency departments (p < 0.001), and most injuries involved the cornea and conjunctiva (83%). The injury incidence rate was 248 per 100 000 person-years (95% CI 246-250). A total of 2823 and 3951 individuals were admitted to hospital for a primary or secondary eye injury, respectively. The most frequent primary diagnosis on admission was contusion (19%). Assault (24%) was the most common cause of injury requiring inpatient treatment. Indigenous individuals were hospitalised for an eye injury at a rate of 109 per 100 000 person-years (95% CI 102-116), compared to 27 (95% CI 26-27) for non-Indigenous individuals. Each year was associated with an increase in the mean number of eye injuries (7% and 5% for emergency department and hospital admission data, respectively). CONCLUSION: Indigenous individuals and males experience eye injuries requiring tertiary management disproportionately. Indigenous female patients were conspicuously affected by eye injuries. Remedial intervention strategies should incorporate violence prevention as assault is a significant cause of eye injury.

Paediatric eye injuries during a COVID-19 pandemic lockdown.

CLINICAL RELEVANCE: Eye injuries, both accidental and non-accidental, are a significant cause of long-term visual impairment in children. An understanding of when and how such injuries occur is key to development of adequate prevention strategies. BACKGROUND: To evaluate accidental and non-accidental eye injuries in children presenting to the major tertiary emergency department and outpatient ophthalmology clinic in Western Australia during the nationwide COVID-19 lockdown and to determine whether the frequency or nature of these injuries differed from pre-pandemic presentations. METHODS: Retrospective review of the medical records of paediatric patients presenting to the emergency department and specialist ophthalmology clinic with an ocular injury and those presenting to the hospital Child Protection Unit with physical injuries during March-August 2020 and the same period in 2019. RESULTS: There was no significant difference in the total number of accidental eye injury presentations during the lockdown period despite a significant decrease in emergency department attendance overall. Closed-globe injuries were the most common accidental eye injury presentation during lockdown (70/110, 64%), followed by adnexal injuries (39/110, 35%) and open-globe injuries (1/110, 1%). In contrast, referrals to the hospital Child Protection Unit for suspicious injuries declined during lockdown.Although eye injury presentations have changed in other parts of the world since the start of the pandemic, during COVID-19 lockdown in Western Australia, accidental paediatric ocular and adnexal trauma sustained at home continues to be a significant cause for hospital attendance. Public education regarding in-home eye injury prevention must be ongoing.

Validation of the Iscan method in clinical MSCT scans specific to an Australian population.

The transposition of traditional biological profiling methods to virtual skeletal reconstructions represents a relatively novel practice that is proving to be versatile in a variety of forensic contexts. Widespread acknowledgement of the disadvantages associated with archaeological and/or other non-contemporary skeletal collections has prompted an increase in the use of medical imaging modalities for the purposes of formulating population-specific reference standards used to estimate characteristics such as chronological age. The primary aim of the present study is to statistically evaluate the reproducibility of assessment and thereafter develop age estimation standards based on the morphoscopic evaluation of the fourth right sternal rib following the phase ageing method developed as reported by Iscan et al. (J Forensic Sci 29:1094-1104, 1984, J Forensic Sci 30:853-863, 1985) in clinical multi-slice computed tomography (MSCT) scans. A total of 335 MSCT scans representing Western Australian individuals between 10 and 80 years of age (179 male and 156 female) were retrospectively reconstructed and analysed in OsiriX following the Iscan et al. sex-specific standards (J Forensic Sci 29:1094-1104, 1984, J Forensic Sci 30:853-863, 1985) for the fourth right rib. Regression and transition analyses are employed to generate standards for the estimation of chronological age and modelling of thoracic senescence, respectively. The method was also applied to right ribs three and five to evaluate intercostal variance in age-related metamorphosis. Intra- and inter-observer accordance is 'substantial' (K = 0.76) and 'almost perfect' (K = 0.825), respectively. Intercostal variances between ribs three to five were observed in the male sample only. Multiple regression using phase scores from all three ribs produced models with the highest predictive accuracy (± 10.04 years for males and ± 9.81 years for females). The transition analyses demonstrate comparable levels of age-related morphological change across ribs and male and female samples. This study presents a novel set of reference standards for a contemporary Australian population and further demonstrates the utility of virtual analysis in forensic anthropology.