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1.
Patient activity level may be an important prognostic variable relating to outcome in patients with shoulder disorders. The
purpose of this cross-sectional study was to test the hypothesis that a shoulder activity scale will detect differences in
shoulder activity based on the patient diagnosis and age. A total of 157 patients of four academic orthopedic surgeons with
a diagnosis of rotator cuff disease (86), glenohumeral instability (31) or osteoarthritis (40) were asked to fill out a previously
validated shoulder activity scale and the ASES shoulder questionnaire. The patient’s diagnosis, gender and age were recorded.
The activity level was significantly higher in patients with instability than in patients with rotator cuff disease or osteoarthritis.
Patients with rotator cuff disease were significantly more active than patients with osteoarthritis. Linear regression of
activity level on patient age and diagnosis demonstrated a statistically significant relationship between activity level and
both independent variables. Diagnosis influenced activity level independent of age. This is the first study to document diagnosis-based
differences in the shoulder activity level of patients with different shoulder disorders. Shoulder activity level should be
evaluated as a prognostic variable in studies of patients with shoulder disorders that may predict outcome and guide treatment
in these patients. 相似文献
2.
BackgroundMany countries have recently experienced a rapid increase in the demand for forensic age estimates of unaccompanied minors. Hong Kong is a major tourist and business center where there has been an increase in the number of people intercepted with false travel documents. An accurate estimation of age is only possible when a dataset for age estimation that has been derived from the corresponding ethnic population. Thus, the aim of this study was to develop and validate a Reference Data Set (RDS) for dental age estimation for southern Chinese. Materials and methodsA total of 2306 subjects were selected from the patient archives of a large dental hospital and the chronological age for each subject was recorded. This age was assigned to each specific stage of dental development for each tooth to create a RDS. To validate this RDS, a further 484 subjects were randomly chosen from the patient archives and their dental age was assessed based on the scores from the RDS. Dental age was estimated using meta-analysis command corresponding to random effects statistical model. Chronological age (CA) and Dental Age (DA) were compared using the paired t-test. ResultsThe overall difference between the chronological and dental age (CA-DA) was 0.05 years (2.6 weeks) for males and 0.03 years (1.6 weeks) for females. The paired t-test indicated that there was no statistically significant difference between the chronological and dental age (p > 0.05). ConclusionThe validated southern Chinese reference dataset based on dental maturation accurately estimated the chronological age. 相似文献
3.
BACKGROUND AND METHOD: In the measurement of glomerular filtration rate from the plasma clearance of 51Cr ethylenediamine tetraacetic acid by using the slope-intercept method, the first sample is conventionally taken at 2 h, the time by which it is generally assumed that the clearance curve has reached a single exponential. We examined this assumption by comparing the slopes, alpha 12 and alpha 23, based, respectively, on samples at 2 and 3 h, and at 3 and 4 h. RESULTS: In 421 patient studies in whom the first sample was taken between 110 and 130 min after injection, the mean ratio, alpha 12/alpha 23, was 1.101 (SEM 0.011) which is significantly higher than unity (P<0.001). The relationship between alpha 12/alpha 23 and the slope, alpha 13 (which is a measure of filtration function already indexed for body size) based on all three samples was negative. By modelling the relationship between mixing time and alpha 13 it was shown that this relationship suggests delayed mixing of the indicator throughout its distribution volume and is inconsistent with irreversible binding of indicator to plasma protein. A significant positive association was observed between alpha 12/alpha 23 and age, but this is largely explained by a generally poorer filtration function in the older age group since low levels of alpha 13 theoretically predict a longer mixing time. In 188 patient studies in whom the first sample was taken more than 130 min after injection, the mean ratio, alpha 12/alpha 23, was 1.055 (SEM 0.017) which is still significantly higher than unity (P<0.005) but significantly less than the ratio based on studies in which the first sample was taken at 110-130 min (P<0.02). The ratio alpha 12/alpha 23 still showed a significant relation (positive) with age but not with filtration function. CONCLUSION: This error in the estimation of glomerular filtration rate to which delayed mixing leads will make its greatest impact when using the simplified slope-only technique, but can be minimized by delaying the first blood sample. 相似文献
4.
A sharp increase in forensic age estimation of living persons has been observed in recent years. However, ethnic populations residing in different countries have been insufficiently analyzed. The aim of this study was to achieve a referral database and regression equations for dental age estimation of unaccompanied minors of Iran nationality. A total of 1200 orthopantomograms were collected from original Iran and equally divided in age categories between 10 and 27 years. On the radiographs, the developmental stage of the third molars was scored applying a Demirjian et al. scoring technique. Inter- and intra-observer reliabilities were tested using kappa statistics. Correlation between the scores of all four wisdom maxillary and mandibular third molars teeth and left/right symmetry were evaluated with spearman correlation coefficient. Student’s t-test on asymmetry was performed and regression formulas were calculated. The present database was the first to assemble third molar developmental scores on radiographs of Iran individuals and provided more appropriate dental age estimation of unaccompanied Iran minors. To enhance the accuracy of forensic age estimates based on third molars mineralization, the use of population-specific standards is recommended. 相似文献
5.
Accurate estimation of the wound age is critical in investigating intentional injury cases. Establishing objective and reliable biological indicators to estimate wound age is still a significant challenge in forensic medicine. Therefore, exploring an objective, flexible, and reliable index system selection method for wound age estimation based on next-generation sequencing gene expression profiles is necessary. We randomly divided 63 Sprague-Dawley rats into a control group, seven experimental groups (n = 7 per group), and an external validation group. After rats in the experimental and external validation groups suffered contusions, we sacrificed them at 4, 8, 12, 16, 20, 24, and 48 h after contusion, respectively. We selected 54 genes with the most significant changes between adjacent time points after contusion and defined set A. The Hub genes with time-related expression patterns were set B, C, and D through next-generation sequencing and bioinformatics analysis. Four different machine learning classification algorithms, including logistic regression, support vector machine, multi-layer perceptron, and random forest were used to compare and verify the efficiency of four index systems to estimate the wound age. The best combination for wound age estimation is the Genes ascribed to set A combined with the random forest classification algorithm. The accuracy of external verification was 85.71%. Only one rat was incorrectly classified (4 h post-injury incorrectly classified as 8 h). This study demonstrated the potential advantage of the index system selection based on next-generation sequencing and bioinformatics analysis for wound age estimation. 相似文献
6.
As one of external visible characteristics (EVCs) in forensic phenotyping, age estimation is essential to providing additional information about a sample donor. With the development of epigenetics, age-related DNA methylation may be used as a reliable predictor of age estimation. With the aim of building a feasible age estimation model for Japanese individuals, 53 CpG sites distributed between 11 candidate genes were selected from previous studies. The DNA methylation level of each target CpG site was identified and measured on a massive parallel platform (synthesis by sequencing, Illumina, California, United States) from 60 forensic blood samples during the initial training phase. Multiple linear regression and quantile regression analyses were later performed to build linear and quantile age estimation models, respectively. Four CpG sites on four genes— ASPA, ELOVL2, ITGA2B, and PDE4C —, were found to be highly correlated with chronological age in DNA samples from Japanese individuals (|R| > 0.75). Subsequently, an independent validation dataset (n = 30) was used to verify and evaluate the performance of the two models. Comparison of mean absolute deviation (MAD) with other indicators showed that both models provide accurate age predictions (MAD: linear = 6.493 years; quantile = 6.243 years). The quantile model, however, can provide the changeable prediction intervals that grow wider with increasing age, and this tendency is consistent with the natural aging process in humans. Hence, the quantile model is recommended in this study. 相似文献
7.
Age-at-death estimation in adult individuals is one of the most challenging issues in forensic anthropology, namely, due to the large age intervals provided by the current methods, which demand the development of more reliable investigations. The clavicle has been studied as an age-at-death indicator in many researches for its accessibility, low biomechanical implication in locomotion and accuracy to predict age at death when other age indicators are not available. The present study was developed on a sample of 332 clavicles from adult individuals of known sex and age from the current Spanish population. They were x-rayed and digitalized, in a standardized way, using a Sedecal X-ray generator, model SHF 415. Three indices were calculated at the mid-diaphysis point (anterior index, posterior index, and total index) which relate the cortical thickness and the total clavicle thickness to age at death. The average grey level was also calculated in a 0.5-cm 2 area of the sternal and acromial ends (sternal grey average, acromial grey average), using Image J software. The data were subjected to a statistical analysis, using SPSS, version 15.0. The results show that average grey level has a weaker correlation with age than the variables which are based on the cortical thickness. On the other hand, the regression equations, which were calculated combining all the variables, provided smaller age-at-death intervals, demonstrating the usefulness of this method for adult age-at-death estimation in forensic anthropology. 相似文献
8.
Closure of cranial sutures progresses with age; therefore, macroscopic assessment of cranial sutures has been used as one method of age estimation. Postmortem computed tomography (PMCT), which many forensic medical departments and institutes have begun to adopt, has the potential to simplify the gathering of information from cranial sutures for both surface and cross-sectional evaluation. To examine the feasibility of age estimation by cross-sectional multidetector computed tomography images of the sagittal suture, PMCT findings of 125 subjects of known age and sex were retrospectively reviewed. The sagittal suture was divided into four segments, and 20 cross-sectional slices from each segment were analyzed. These slices were each categorized by visual evaluation into one of the seven stages defined by Harth et al. according to the degree of closure. The mean stage value of 20 slices was calculated for each segment. We were able to evaluate cross-sectional images of the sagittal suture by PMCT, and a positive correlation between age and closure degree was observed. Despite the prediction interval achieved with this method not being superior to traditional macroscopic or flat-panel CT assessment, multidetector CT is a potentially useful tool, in conjunction with other methods, for age estimation, particularly in adult females and in cases where only a skull is the sole remain. 相似文献
9.
Aspartic acid racemisation (AAR) results in an age-dependent accumulation of d-aspartic acid in durable human proteins and can be used as a basis for age estimation. Routinely, age estimation based on
AAR is performed by analysis of dentine. However, in forensic practise, teeth are not always available. Non-dental tissues
for age estimation may be suitable for age estimation based on AAR if they contain durable proteins that can be purified and
analysed. Elastin is such a durable protein. To clarify if purified elastin from arteries is a suitable sample for biochemical
age estimation, AAR was determined in purified elastin from arteries from individuals of known age ( n = 68 individuals, including n = 15 putrefied corpses), considering the influence of different stages of atherosclerosis and putrefaction on the AAR values.
AAR was found to increase with age. The relationship between AAR and age was good enough to serve as basis for age estimation,
but worse than known from dentinal proteins. Intravital and post-mortem degradation of elastin may have a moderate effect
on the AAR values. Age estimation based on AAR in purified elastin from arteries may be a valuable additional tool in the
identification of unidentified cadavers, especially in cases where other methods cannot be applied (e.g., no available teeth
and body parts). 相似文献
10.
OBJECTIVE: The purpose of this study was to assess the efficacy of Borg's rating of perceived exertion (RPE) scale to predict maximal exercise levels to control exercise intensity in patients taking atenolol for the treatment of essential hypertension. Normally, a standard formula (220-age) is used for calculating a percentage of exercise intensity, but beta blockade can cause reductions in maximal heart rate of between 20 and 30%. METHODS: Patients were split into a control group-10 men and 10 women, aged 50 (SD 12) and 46 (9) respectively, who had risk factors for cardiovascular disease but were not taking any drugs, and a treatment group-11 men and 11 women, aged 53 (13) and 55 (13) respectively, who were established on 25-100 mg of atenolol. All patients performed two submaximal tests on a cycle ergometer. Test 1 was an estimation test, during which the RPE was reported for each increment in work rate. Test 2 was an RPE production test, during which the patient regulated the work rate according to his/her perception of effort at four predetermined points on the RPE scale (RPE 9, 13, 15, 17). RESULTS: In both tests the individual correlations (r) between RPE, heart rate, and work rate ranged from 0.96 to 0.99. Analysis of variance showed no significant difference in maximal heart rate and maximal power output for the control group when predicted from the regression lines of RPE versus heart rate and RPE versus power output in the estimation test. However, the prediction of maximal power output was lower in the women in the control group and patients in the treatment group when this was predicted from the effort production protocol (P < 0.01). When exercise intensity at each RPE was expressed relative to maximal power output there were no differences between treatment and control groups. CONCLUSION: The findings from this study confirmed the strong positive relation between RPE, heart rate, and work rate in these patients in both passive effort estimation and active effort production protocols. However, caution in applying these procedures is required because the prediction of maximal exercise levels may be lower when effort production procedures are used. 相似文献
11.
BACKGROUND: The determination of age at the time of death is an important method in forensic anthropology and paleodemography. The possible postmortem investigation of the teeth and jaws enables the determination of age at the time of death, as the bones and teeth are both resistant to degradation in soil and characterized by age-related morphological changes. The aim of this study was to determine whether the age-related changes visible on panoramic radiography correlated with age, and enabled the assessment of individual age. METHODS: Seven radiographic parameters were used in the study: tooth loss, occlusal tooth wear, pulp stones, carious teeth, periapical disease, tooth restoration, and alveolar bone loss associated with periodontal disease. RESULTS: The material comprised 314 dental panoramic tomograms of living patients of both sexes with documented age (18 to 77 years). Multiple regression equations were constructed for the age estimation, including four parameters (the number of missing teeth, the number of intact teeth, the distance of cement-enamel junction from the alveolar ridge, the number of abraded teeth). The nature of data treated by regression analysis required the careful choice of parameters, appropriate functional model for each parameter, and the experience of the investigator. With the four parameters included in equations, the error was +/- 2.55 years. CONCLUSION: This preliminary analysis showed that the conventional regression technique could be appropriate for the age estimation based on panoramic radiography, and that an additional study with a larger sample and on wider population was required. 相似文献
12.
AIM: To evaluate the experience in our institution with ultrasound-guided transrectal and transvaginal (endocavitary) drainage of pelvic abscesses. MATERIALS AND METHODS: Eighteen patients (four male, 14 female; mean age 55 years, range 30-78 years) presenting with pelvic abscesses were referred to our institution for therapeutic drainage over a 4 year period. Patients received broad-spectrum antibiotics prior to drainage, which was performed by either the transvaginal or transrectal route under ultrasound guidance. Patients were given sedo-analgesia in the form of midazolam and fentanyl and local anaesthesia was also employed. Eight French catheters were inserted into the abscess cavities, and patients were subsequently monitored on a daily basis by a member of the interventional radiology team until such time as it was deemed appropriate to remove the catheter. RESULTS: Eighteen catheters were placed in 17 patients, and transvaginal aspiration alone was performed in one patient. Drainage was successful in 16 of 17 patients, but a transgluteal approach was ultimately required in the remaining patient to enable passage of a larger catheter into an infected haematoma. The mean duration of drainage was 5 days, mean time to defervesce 2 days. Spontaneous catheter dislodgement occurred in four patients associated with straining, but this did not have any adverse effect in three of the four patients. CONCLUSION: Endocavitary drainage is an effective method of treatment for pelvic abscesses. Spontaneous catheter dislodgement does not affect patient outcome. 相似文献
13.
The estimation of the minimum postmortem interval can be implemented by age estimation of corpse-associated primary colonizers such as the blow flies (Diptera: Calliphoridae). In cases where pupae represent the oldest stages found on a body, their age must be added to the duration of prepupal development to estimate the minimum postmortem interval. Although methods to age blow fly larvae have been well established using morphology, length or weight and age estimation of pupae has proved challenging. In a previous work, we quantified the changes in mRNA levels of four differentially expressed genes during the metamorphosis of Calliphora vicina pupae, hence representing molecular markers for pupal age (i.e., time elapsed since pupariation). Here, we demonstrate how these data can be used to estimate pupal age with inverse prediction. We present three blind studies conducted under various conditions and show that age of C. vicina pupae can be well estimated based on gene expression data. As these data are quantitative and can be processed automatically, gene expression has the potential to outperform morphological analysis in age estimation of forensically relevant blow fly pupae. 相似文献
14.
BackgroundDental age estimation in children plays an important role in forensic dentistry. The most commonly used method for age estimation was developed by Demirjian in 1973 on a French–Canadian sample. It generally overestimates dental age in many populations. International maturity standards were formed to obtain a predicted age with more confidence when ethnic origin was not available. ObjectivesThe aim of this study was to evaluate the applicability of Chaillet's international scores in the dental age assessment on Bosnian Herzegovinian (BH) children. MethodsOrthopantomograms of 1772 children, 980 girls and 792 boys aged 6.04–14.90 years, were assessed using Chaillet's international maturity tables and curves. The dental ages for both genders were compared to the chronological ages through a paired t-test. ResultsMean overestimation using Chaillet's international maturity standards were 0.09 ± 0.83 for girls and 0.28 ± 0.90 for boys. The absolute accuracy of residuals between the dental and chronological age were 0.65 ± 0.52 years for girls (Median: 0.52 years) and 0.73 ± 0.60 years for boys (Median: 0.57 years). ConclusionThe Polynomial compound formula was recommended to predict dental age with more accuracy for results of international maturity standards on BH children. 相似文献
15.
BACKGROUND: Aims of this study were: a) to identify anthropometric variables correlated with gymnastic performance, and b) to predict performance scores from a combination of anthropometric dimensions. METHODS: Experimental design: correlational analysis and a stepwise multiple regression were used. Setting: Subjects were participants at the 24th World Championships Artistic Gymnastics, Rotterdam, The Netherlands, in 1987. Participants: A total of 168 female gymnasts (mean age: 16.5 +/- 1.8 years) were investigated. Each gymnast participated in all events. Measures: An extensive battery of anthropometric dimensions was taken on each athlete. The somatotype was estimated. Skeletal maturation of the hand-wrist was assessed. Competition scores for the four individual gymnastic events (balance beam, floor exercise, vault, uneven bars) and a composite score for each gymnast were the dependent variables. RESULTS: Moderately high, significant correlations (p < 0.01) were observed between skinfolds and endomorphy, and gymnastics performance scores, r varying from -0.38 to -0.60, for biceps skinfold and the score on balance beam, and for endomorphy and the total score, respectively. The correlations suggest that gymnasts with more subcutaneous fat and higher endomorphy have lower performance scores. About 32% to 45% of the variance in gymnastic performance scores could be explained by anthropometric dimensions and/or derived variables, but endomorphy and chronological age are the most important predictors. CONCLUSIONS: There is a relatively strong relationship between several anthropometric variables and gymnastic performance in a sample of elite female gymnasts, but the associations are not sufficiently high to predict performance scores on an individual basis. 相似文献
16.
Precise age determination of unidentified bodies and human remains is one of the essential tasks of forensic science. The aim of this study was to assess the applicability of using the enantiomeric composition of aspartic acid racemization in root and crown dentin for dental age estimation using a Polish population sample. Coronal and root dentin from four teeth groups from the mandible were studied using gas chromatography with mass spectrometry. The results demonstrated a very high correlation between the chronological age and enantiomeric composition in both of the dentin samples. Individual linear equations of root dentin with correlation coefficients between 0.96 and 0.98 and a standard estimation error of ±2.95–4.84 years validated the application of aspartic acid racemization as a significant practical contribution to everyday forensic medical practice. Discrepancies in methodological aspects and modifications that simplify the protocol are presented. 相似文献
17.
Within the literature pertaining to skeletal age estimation, there is a paucity of statistically validated methods of age estimation from the foot. Given the prevalence of recovery of pedal elements in isolation, it is critical that methods exist to facilitate the estimation of age from this anatomical region and that those methods be tested to ensure they are reliable, repeatable and statistically robust. A study was carried out to determine the validity of using the Whitaker method of age estimation from the bones of the foot as a tool in forensic age estimation within a modern Scottish population. Two-hundred and sixty radiographs from individuals aged between birth and 18 years were assessed according to the Whitaker method; the results were compared with chronological age. The results of this study suggest that the method of Whitaker et al. is highly unlikely to estimate the age of females below 16 years of age or males below 18 years of age correctly. When the methodology was altered to correspond with best practice principles of age estimation, the estimated age ranges were found to be too wide to be of practical value in forensic age estimation. The results of this study therefore suggest that the Whitaker method for estimating age from the bones of the foot should not be used in forensic age assessment. 相似文献
18.
BACKGROUND: Creatinine clearance has been reported to be inaccurate for the estimation of glomerular filtration rate (GFR) in patients with sickle cell anaemia (SCA). Inulin clearance, the reference method for GFR estimation, is impractical for routine use in these patients, and 51Cr-EDTA measurements of the GFR have been rarely reported in this disease. METHODS: In order to obtain reference 51Cr-EDTA values in this disease, we studied 70 patients (40 females; 13-59 years of age, mean: 31.6 years) with homozygous SCA, normal serum creatinine and urinary albumin excretion < or =200 microg x min(-1). All patients were submitted to single-injection 51Cr-EDTA GFR, urinary albumin and haematocrit measurements. 51Cr-EDTA clearances were calculated in different age groups (<20, 20-29, 30-39, 40-49 and >50 years). RESULTS: The mean GFR (+/-standard deviation) obtained for the 70 patients was 111.5+/-23.1 ml x min(-1). Analysis of variance for evaluation of the possible interaction effect between 51Cr-EDTA clearance and sex, age, urinary albumin and haematocrit demonstrated patient age as the only factor influencing 51Cr-EDTA clearance (P < 0.001). The Spearman correlation coefficient showed a significant relationship between 51Cr-EDTA clearance and patient age (r = -0.44, P = 0.0001), but not between 51Cr-EDTA and urinary albumin (r = -0.17, P = 0.1546) or haematocrit (r = 0.079, P = 0.5121). The group aged 20-29 years presented the highest 51Cr-EDTA clearance mean value (126.7+/-20.4 ml x min(-1)), with a progressive reduction in the older groups. CONCLUSION: Young adults with homozygous SCA, normal serum creatinine and micro-albuminuria or normo-albuminuria present supranormal 51Cr-EDTA GFR values. These values rapidly decrease after 30 years of age. We did not find association between urinary albumin and GFR in these patients. 相似文献
19.
Fragmented human remains present a challenge for forensic experts as they attempt to identify individuals using standard forensic methods. Several histological age estimation techniques have been developed during the last fifty years to aid in this process. However, very few validation studies have been conducted in order to test their accuracy and bias, and thus, validation assessment is required as we employ them while testifying in court.Histological variables are assessed from rib thin sections from two Mediterranean samples; Cretans (N = 41) and Greek-Cypriots (N = 47). Intra and inter-observer errors are assessed through TEM analysis and Intra-class Correlation Coefficient by testing observers with different levels of experience as they collected data on osteon counts and area measurements. The relation between the variables and age is determined using correlation coefficients. Histomorphometric data are applied to four widely used age estimation formulas assessing the performance of the methods for the entire sample. Inaccuracy and bias are calculated with age estimations and known age tested for significance and proportional bias assessed.Overall, histological parameters presented acceptable intra- and inter-observer errors. All variables exhibited statistically significant correlation with age (P < 0.01). For three of the techniques, data showed a systematic underestimation of age with an increase in inaccuracy in older individuals. One of the age estimation formulas produced overestimation of young individuals yet, it more accurately estimated the age of older individuals.This validation study explores inter-population variation in bone remodeling dynamics and presents a critical evaluation on methodological issues that can affect the performance of existing histological techniques. 相似文献
20.
The age-at-death estimation thresholds have recently been shifted towards a more objective assessment of the aging process. Such a non-subjective approach offers quantitative methods of age estimation; for instance, the method relating to the surfaces of pubic symphyses of males published by Stoyanova et al. (J Forensic Sci 62:1434–1444, 2017). A validation study was conducted to test the method performance in European samples. The sample consisted of 96 meshes of pubic symphyses of male individuals (known sex and age) that came from four different samples (two Portuguese collections, one Swiss, and one Crete). Stoyanova’s method based on five regression models (three univariate and two multivariate models) performed worse in our sample, but only when the whole sample (without age limitation) was included. A sample limited to individuals under 40 years of age achieved better results in our study. The best results were reached through the thin plate spline algorithm (TPS/BE) with a root mean square error of 5.93 years and inaccuracy of 4.47 years. Generally, the multivariate regression models did not contribute to better age estimation. In our sample in all age categories, age was systematically underestimated. The quantitative method tested in this study works best for individuals under 40 years of age and provides a suitable basis for further research. 相似文献
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