AGE ESTIMATION ON 2D IMAGES: APPLICATION OF THE METRICAL FACIAL APPROACH FOR THE ASCERTAINMENT OF AGE IN CASES OF SUSPECTED JUVENILE PORNOGRAPHY

Age estimation is one of the most difficult and sensitive procedure in forensic pathology, and is characterized by a long tradition and a number of fields of application: the most common cases of age estimation in the forensic scenario deal with dead people, and in detail with personal identification; however, in the last years, age estimation has begun to include also other forensic cases, especially within the so-called Clinical Forensic Medicine, which is the branch of forensic pathology dealing with the living, and consequent evaluation of clinical data for judicial purposes. The procedure of age estimation therefore is now applied to the living for the ascertainment of imputability before trial, or for the correct assignation of scholar classes of adopted children. In recent times, also the age estimation of the living adult, which in the most challenging and difficult field of application, has begun to be performed in order to verify the age of retirement, usually in old immigrants. One of the most interesting phenomena recorded during this long evolution is the constant and progressive modification of methods of age estimation according to the specific field of application: some methods cannot be applied in specific cases, and this lack of tools has led to the evolution of new procedures, or the amelioration of the existing ones. However, the more specific the field of application, the fewer are the methods which can be applied. The extreme evolution of this phenomenon concerns the most recent field of application of age estimation in the living which deals with 2D images: the ascertainment of age in case of photos may be judicially important, since most Countries state the crime of juvenile pronography, which concerns all the images reproducing minors in a pornographic context. In these cases the forensic anthropologist may be requested to provide an age estimation of the persons in the photo: this is the final evolution of any procedure of age estimation, which has passed in the last year from the dead subject (where any investigative method is substantially allowed), to the living person (where only few methods can be applied) up to the image of the living person itself. One can clearly consider the pitfalls included in such as operation, since the forensic anthropologist or pathologist is usually requested to give an indication concerning the biological profile of a real person on his photos. If in case of the living age estimation has tried to change its methods, now with photos the forensic anthropologist faces a new challenge which consists not only in the development of new tools, but also in verifying if such analyses can be performed also in photos. The tasks are therefore two, and both of them difficult to achieve: the first one consists in finding biological information related with age, and the second in ascertaining if such information is also verifiable in photo. As one can imagine, the procedure of age estimation in cases of images faces new challenges, with new questions which are still waiting for an answer. This study aims at exposing the results of different investigations performed during the PhD course, aimed at verifying the relation between facial measurements and age, in vivo and in photo: the line of research followed a project aiming first at ascertaining the reliability of linear measurements in photos, both for subjects aged under and above 18 year threshold, and then at verifying the chance of extrapolating new biological parameters from the face useful for age estimation. The first steps will consist in finding a standardization of facial metrical assessment by an analysis of reliability of collocation of facial landmarks. After this phase, the study will attempt at verifying the reliability of linear measurements for age estimation in photos in subjects aged under 18 years. A similar experiment will be applied as well to young adults aged over 18 years, after a preliminary study of in vivo measurements in order to verify the correlation of such parameters with age. In conclusion, the study will attempt at finding new biological geometrical parameters (in detail, facial surfaces) for age estimation, in vivo and in photo. This path led to interesting results which may be sumed up in the following points: 1) the study performed on facial landmarks showed that not all the points are reliable for a standardized procedure of facial assessment: in detail, the anatomical landmarks are the most trustable, probably because are defined by anatomical structures which can be easily detected, and are consequently less subjective. More interestingly, such landmarks show the same reliability in photos taken from subjects with different ages, and this means that anatomical points are crucial also for the issue of age estimation from 2D images; 2) the second study pointed out that ratios between linear measurements show a correlation with age also in photos, and therefore may be used for age estimation, although with a high error range, and only taking into consideration the main age thresholds; from this point of view, such parameters may provide a method for verifying if a subject is close to one of the chosen age limits, but data are too limited to provide adequate regression formulae useful to put in relation age and measurements. However, these results represent the first step for the development of an age estimation method useful for reconstructing age with higher precision; 3) the third study confirmed that some linear measurements show a correlation with age which may be promising for the development of regression formulae useful for age estimation in photos; however, the error range is estimated in 3-4 years, which means that age may be reconstructed in an interval of several years: however, this error range matches with difficulties to the actual forensic purposes, where an age estimation with a more limited error is often requested; the need for the search for new facial parameters is therefore even more evident; 4) the fourth study attempted at verifying the modifications of facial parameters in juvenile adults and subjects in transition phase, and pointed out that ear and mouth show a constant increase also after 18 years; from a general point of view, the parameters which are related with age in vivo should show the same relation also in photos, and therefore may be useful for age estimation; 5) the fifth study focused on verifying the applicability of ear characteristics to age estimation in photos: results show that neither the ratios between linear measurements nor the areas show a correlation with age; these results therefore confirm that photograph is an independent manner of acquisition of reality, with its own rules and relations between facial parameters and age, which not necessarily correspond to those observed in vivo. These results mean that the relation of facial parameters should be verified directly in photos, and underline the need for determining new facial measurements useful for forensic purposes; 6) the last study aimed at verifying the relation of a novel facial parameter (in detail, facial surfaces) with age; results show that the correlation are lower than those showed by linear measurements: the analysis performed in photos confirmed the independence of measurements taken in photos and in vivo (actually, on the digital 3D models of the face), since some parameters are related with age in vivo, not in photos, and vice versa. Anyway, facial surfaces are too variable and are influenced by too many environmental and individual factors to be usable for the development of an age estimation method. In conclusion, facial metrical assessment actually cannot be considered a scientifically valid method for forensic purposes: in detail, linear measurements have been widely explored by past literature which showed their constant modification with age. However, this information finds a limited importance in forensic practice, and is affected by a relevant limit in 2D images, which deals with the distorsion of measurements in two dimensions. The introduction of the new 3D acquisition systems now allows the operators to perform a more detailed analysis of face by the measurements of surfaces and volumes; however, literature concerning this topic is still at the beginning, and mainly deals with geometrical measurements which are more standardized, but also more influenced by other variability factors than age, such as the weight, etc. From this point of view, the analysis of surfaces and volumes adds precious information to the morphology of face, and it will be one of the main field of research of the modern anatomy. From the anatomical point of view, the experimental project pointed out relevant suggestions for different issues: in detail, the chromatic analysis of facial modifications may provide a new useful tool for standardizing and quantifiying variables such as increasing or decreasing of weight, the influence of facial expressions, the resemblance of children with their parents. The application of modern 3D image acquisition system may therefore radically improve the anatomical study of faces, adding new information potentially useful also for clinical purposes

3D surface acquisition systems and their applications to facial anatomy : let’s make a point

In the last decades 3D optical devices have gained a primary role in facial anthropometry, where they find several applications from the anatomical research to clinics and surgery. With time the number of articles focusing on 3D surface analysis has raised, as well as validation studies which aim at verifying the reliability of different devices and methods of acquisition in comparison with other methods or direct anthropometry. This review aims at making a point in the field of 3D surface acquisition systems, describing the most used types of available devices and comparing the relevant outcomes in acquiring 3D facial models. Results show that currently stereophotogrammetric devices represent the gold standard, further improved by the diffusion of portable models. Caution should be given to the use of low-cost devices, more and more frequently described by literature, as often they do not meet the basic criteria for being applied to the anatomical study of face

Students' opinion towards the Pernkopf atlas : are the Italian students ready to know the history?

The debate around Pernkopf\u2019s atlas, the origin of bodies used to create its plates and the person of Eduard Pernkopf has involved with time academic authorities and university professors, and has shaken the anatomical scenario. However, no study has been so far performed concerning the opinion of students towards this sensitive and problematic issue. This article aims at expos- ing the results of an interview performed on 42 Italian medical students, after a self-chosen course of history of human anatomy, in order to ascertain the students\u2019 opinion towards this important debate in the anatomic scenario. Results showed that 91% of students did not know the existence of Pernkopf\u2019s atlas: 51% stated they would not use it, whereas for 65% it should be preserved for didactic purposes. Subjects who preferred the atlas to be banished justified their position mainly on the base of ethical reasons (25%); however, in a third of cases students were not able to give an answer. Twenty-two percent of students who agree with a preservation of the atlas would limit its use to historical studies. In 11% ethical issues were not considered important. In 52% of cases no opinion was given. Results show that the debate concerning Pernkopf\u2019s atlas, at least among students, is at the very beginning: more efforts need to be performed in order to let the medical students know the history of the atlas and its importance in the scientific debate around the ethics in anatomy

Does the experience of anatomical dissections change the mind of students? The opinion of Milanese undergraduate students towards the donation of bodies for didactic purposes

Anatomical dissections have always represented an important cornerstone of medical education, especially in anatomy [1,2]. However, in several universitary context their practice has been abandoned or even not yet introduced. In the University of Milan a limited program of body donation has existed since 2014 (PANDORA, Programma Anatomico di Donazione di Cadaveri a Scopo di Ricerca Antropologica e Biomedica) and therefore only in the last four years medical students have been able to take advantage from this crucial experience. This study aims at exploring the willingness of Italian undergraduate students towards whole body donation in order to ascertain the role of dissection in modifying the opinion: two groups of students belonging to the degree course in medicine and surgery were recruited. The first group included 43 students who were informed concerning the importance of dissection in anatomy through a specific course. The second group included 29 students admitted to a didactic autopsy. Students belonging to the two groups were then requested to specify if they would give their consent to the donation of their bodies, and why. Results showed that students who attended the dissection were more likely to show willingness towards body donation (60.7% versus 39.5%). Among positive opinions towards donation the percentage of persons who found the experience useful increased from 47.1% in the first group to 80% in the second group. On the other hand, among negative opinions, percentages of persons reporting bad feeling towards the dissection increased from 16.7% in the first group to 27.2% in the second group. This study shows that experience of dissection is a crucial step for emotional and professional improvement of medical students and contributes in a more detailed definition of their own opinion concerning body donation

Does the experience of anatomical dissections change the mind of students? The opinion of Milanese undergraduate students towards the donation of bodies for didactic purposes

Anatomical dissections have always represented an important cornerstone of medical education, especially in anatomy [1,2]. However, in several universitary context their practice has been abandoned or even not yet introduced. In the University of Milan a limited program of body donation has existed since 2014 (PANDORA, Programma Anatomico di Donazione di Cadaveri a Scopo di Ricerca Antropologica e Biomedica) and therefore only in the last four years medical students have been able to take advantage from this crucial experience. This study aims at exploring the willingness of Italian undergraduate students towards whole body donation in order to ascertain the role of dissection in modifying the opinion: two groups of students belonging to the degree course in medicine and surgery were recruited. The first group included 43 students who were informed concerning the importance of dissection in anatomy through a specific course. The second group included 29 students admitted to a didactic autopsy. Students belonging to the two groups were then requested to specify if they would give their consent to the donation of their bodies, and why. Results showed that students who attended the dissection were more likely to show willingness towards body donation (60.7% versus 39.5%). Among positive opinions towards donation the percentage of persons who found the experience useful increased from 47.1% in the first group to 80% in the second group. On the other hand, among negative opinions, percentages of persons reporting bad feeling towards the dissection increased from 16.7% in the first group to 27.2% in the second group. This study shows that experience of dissection is a crucial step for emotional and professional improvement of medical students and contributes in a more detailed definition of their own opinion concerning body donation

Effects of acetylsalicylic acid on adiposity in a mouse model of diet-induced obesity

Obesity is a growing public health problem and its prevalence has reached epidemic proportions in recent decades [1]. Several studies have demonstrated that obesity modifies the metabolic and endocrine functions of adipose tissue and is closely associated with chronic, low grade inflammation [2]. Because inflammation was proposed to be involved in the pathophysiology of obesity [1,2], we decided to evaluate the effects of the antinflammatory drug acetylsalicylic acid (ASA) in a mouse model of diet-induced obesity. We performed the experiments using C57BL/6J female mice fed for three months with Standard Diet (SD) or with High Fat Diet (HFD). At the end of three months, mice fed with HFD were separated in four groups and fed for other two months as follows: one group continued with HFD, one group returned to SD, one group continued with HFD with the addition of 30mg/kg of ASA and, finally, the last group returned to SD with the addition of 30mg/kg of ASA. ASA was administered in the drinking water. The metabolic and inflammatory status was evaluated by histological, molecular and biochemical analysis in all mice. As expected, HFD induced an increase in body weight and insulin resistance with a consequent reduction of glucose tolerance. Measurement of adipocyte size revealed that ASA significantly reduced HFD-induced adipocyte hypertrophy and it was able to revert insulin resistance with amelioration of glucose tolerance. Moreover, gene expression profiles of pro- and anti-inflammatory cytokines as well as the expression of macrophage and lymphocyte markers showed that HFD led to a significant increase in macrophages accumulation and an increase of inflammatory cytokines. However, we observed a significant trend for reduction of these molecules after treatment with ASA. The level of the anti-inflammatory molecules were also significantly increased after ASA administration. In conclusion, our results suggest that ASA can be proposed as pharmacologic option for reducing adipose tissue inflammation associated with obesity

The forensic odontology in Milan : a 20 year experience

Forensic odontology has a relevant importance in several fields of forensic sciences, from personal identification of corpse sand the living from video-surveillance systems, to the evaluation of lesions and odontoiatric damage and professional malpractice. In the last time forensic odontology has known a decisive improvement in the field of age estimation of the living for the ascertainment of imputability and age in adopted children, and from 2D images in cases of suspected juvenile pornographic material. The association with forensic odontologists has a relevant importance also in the assessment of bite marks and lesions in refugees seeking asylum. This poster aims at exposing some examples of the reliability of odontological techniques applied to the forensic scenario, chosen within the 20 year experience of LABANOF (Laboratorio di Antropologia e Odontologia Forense), which highlight the increasing requests from privates and the judicial authorities for expert witnesses concerning forensic odontology and the crucial role of university centers which may provide a reference point for assessing topics concerning this wide and crucial field of application of forensic sciences

A novel approach to the assessment of anatomical uniqueness of ears: application of 3D-3D surface registration

Uniqueness of body structures can be defined as the anatomical property consisting in the development of a unique and individual shape. From this point of view, the ear has always represented a field of particular interest for anatomy, especially for its individuality and the large variability in size and shape: however, its uniqueness has been assessed so far only through morphological methods, with limitations in quantifying the probability of finding the same shape within the sample [1,2]. The introduction of modern devices for 3D image acquisition and 3D models elaboration may provide additional data, especially through the 3D-3D registration of surfaces and calculation of respective distances. Ten adults were recruited for the study. The right and left ear from each individual was acquired twice by stereophotogrammetry at the distance of few seconds. The ear surface obtained from the first acquisition was then superimposed onto the same structure derived from the second acquisition of the same subject (group of matches) and onto the ear surface from the second acquisition of all the other subjects taking part to the project (group of mismatches). In all the cases registration was reached according to the least point-to-point distance between the two 3D models. Point-to-point RMS (root mean square) distance was then calculated between the two surfaces. Possible statistically significant differences according to side and group were assessed by two-way ANOVA test (

Variations of midfacial soft-tissue thickness between 6 and 18 years for the reconstruction of the profile: a help for facial reconstruction of children

Facial approximation techniques used in forensic anthropology are based on soft-tissue thickness databases. However most of articles deal with adult populations, and very few studies were conducted on minors. This study aims at providing data concerning facial thickness for George reconstruction, preliminary to the 3D facial approximation. Diagnostic cephalometric X-ray films were obtained from 222 healthy Caucasoid children (91 boys and 131 girls), aged between 6 and 18 years, treated in a Department of Orthodontics of Northern Italy. After setting the Frankfurt plane horizontal, 14 measurements were taken at the mid-facial landmarks: supraglabella, glabella, nasion, nasale, subnasale, superior labial sulcus, labrale superius, stomion, labrale inferius, inferior labial sulcus, suprapogonion, pogonion, gnathion, menton. Mean and standard deviation of soft -tissues thickness at each point were calculated. A two-way analysis of variance (ANOVA) was performed to test the modifications of facial parameters with age and sex (p < 0.01). The results demonstrated that there is an increase in tissue thickness as individuals grow; in most occasions, males showed thicker soft tissues than females of the same age, especially after the adolescent growth spurt. Facial thicknesses at subnasale, superior labial sulcus, labrale superius, labrale inferius, inferior labial sulcus, suprapogonion, pogonion and gnathion significantly modified with age, whereas the same parameters at subnasale, superior labial sulcus, labrale superius, labrale inferius, stomion and suprapogonion were significantly sexually dimorphic. In addition, a database for soft-tissue thicknesses in children aged between 6 and 18 years was created, which may be of interest in cases of facial approximation of Italian minors