Evaluation of the Suchey-Brooks age estimation method in a white South African population.

Several studies have indicated that the time of onset of specific age-related changes throughout the human skeleton differs between populations. In this study the well-known Suchey-Brooks pubic symphyseal age estimation method was investigated to assess its performance in a white South African population. A total of 184 well-preserved os coxae were subjected to blind phase analysis, using the Suchey-Brooks descriptions and pubic symphyseal casts. The method performed well in a white South African population with statistically significant moderate positive correlations and relatively low biases in both males and females. However, due to the underperformance of the method in older individuals, new age ranges for phases IV through VI were created that are specific to the South African white population. This study indicated that Suchey-Brooks method can be used in a white South African population using the age ranges for phases I through III provided by Brooks and Suchey (1990), and the population specific age ranges for phase IV and V provided in this study.

Re-assessment of South African juvenile facial soft tissue thickness data for craniofacial approximation: A comparative analysis using central tendency statistics.

Facial soft tissue thickness (FSTT) data form the basis of craniofacial identification methods such as facial approximation in cases where unknown skeletal remains lack unique identifiers such as fingerprints, DNA and dental records. Appropriate FSTT data are said to be required to produce accurate facial approximations that may be recognised by relatives. This view led to a vast number of studies considering subdivisions of FSTT data according to ancestry, age and sex. The paucity of South African juvenile FSTT standards of particular age groups, sex and ancestry is therefore problematic as "accurate" facial approximations cannot be produced. However, the use of pooled datasets and central tendency statistics offers a unique opportunity to circumvent the problem of small or absent FSTT datasets. The aim of this study was to use central tendency statistics of previously published South African data in order to assess whether it is necessary to subdivide FSTT datasets into different subgroups. In addition, a meta-analysis using central tendency statistics of 11 datasets within the C-table repository using the free open source TDStats programme (available through CRANIOFACIALidentification.com) for midfacial landmarks was performed. These datasets comprised of raw juvenile and adult FSTT data gathered from 1895 to 2015 as measured by a variety of methods Scatter plots showed that FSTT correlation with age is rather weak, while Kernel density plots of FSTT by sex and landmark indicated no difference between South African juvenile males and females. In order to test the practical application of FSTT data, two facial approximations were constructed - one based on the shorth from South African data and C-tables and one based on an American dataset. When comparing the two facial approximations based on different datasets, geometric deviation indicated differences at midline and bilateral landmarks, but the visual presentation of the facial approximations was similar. Therefore it is suggested that differences of less than 3mm at any landmark do not result in profound practical differences in the juvenile face. Subcategorizing juvenile data is not necessary as the same result can be achieved by weighted means as presented in the sub-adult C-tables.

Forensic facial comparison in South Africa: State of the science.

Forensic facial comparison (FFC) is a scientific technique used to link suspects to a crime scene based on the analysis of photos or video recordings from that scene. While basic guidelines on practice and training are provided by the Facial Identification Scientific Working Group, details of how these are applied across the world are scarce. FFC is frequently used in South Africa, with more than 700 comparisons conducted in the last two years alone. In this paper the standards of practice are outlined, with new proposed levels of agreement/conclusions. We outline three levels of training that were established, with training in facial anatomy, terminology, principles of image comparison, image science, facial recognition and computer skills being aimed at developing general competency. Training in generating court charts and understanding court case proceedings are being specifically developed for the South African context. Various shortcomings still exist, specifically with regard to knowledge of the reliability of the technique. These need to be addressed in future research.

Ethical Issues Surrounding the Use of Modern Human Remains for Research in South Africa.

Chapter 8 of the South African National Health Act 61 of 2003 (NHA) that deals with the donation of human tissue was promulgated in 2012. The new Act is perceived to impose restrictions on low-risk research involving human remains. This study aimed to identify the issues raised by a research ethics committee (REC) when reviewing protocols where human remains are used as data source. REC minutes from 2009 to 2014 were reviewed, and issues raised by the committee were categorized. In total, 127 protocols submitted to the committee over 6 years involved human remains. Queries relating to science (22.2%) and administration (18.9%) were the most common, whereas queries relating to legal issues constituted only 10.2%. Ethical issues centered on informed consent regarding sensitive topics such as HIV, DNA, and deceased children. The change in legislation did not change the number or type of legal issues identified by the REC.

Soft tissue thickness values for black and coloured South African children aged 6-13 years.

In children, craniofacial changes due to facial growth complicate facial approximations and require specific knowledge of soft tissue thicknesses (STT). The lack of South African juvenile STT standards of particular age groups, sex and ancestry is problematic. According to forensic artists in the South African Police Service the use of African-American values to reconstruct faces of Black South African children yields poor results. In order to perform a facial approximation that presents a true reflection of the child in question, information regarding differences in facial soft tissue at different ages, sexes and ancestry groups is needed. The aims of this study were to provide data on STT of South African Black and Coloured children and to assess differences in STT with respect to age, sex and ancestry. STT was measured using cephalograms of South African children (n=388), aged 6-13 years. After digitizing the images, STT measurements were taken at ten mid-facial landmarks from each image using the iTEM measuring program. STT comparisons between groups per age, sex and ancestry were statistically analyzed. The results showed that STT differences at lower face landmarks are more pronounced in age groups per ancestry as opposed to differences per age and sex. Generally, an increase in STT was seen between 6-10 year old groups and 11-13 year old groups, regardless of ancestry and sex, at the midphiltrum, labiale inferius, pogonion, and beneath chin landmarks. This research created a reference dataset for STT of South African children of Black and Coloured ancestry per age and sex that will be useful for facial reconstruction/approximation of juvenile remains.

The anatomical basis of venographic filling defects of the transverse sinus.

Obstruction of the intracranial dural venous sinuses would result in an increase in intracranial dural venous pressure. This intracranial hypertension is not only the result of poor cerebral venous drainage but also life threatening. The aim of this study was to identify the structures, which may show signs of potential venographic filling defect qualities, including trabeculae/septa (also described as "fibrous bands") and arachnoid granulations, which ultimately can lead to increased intracranial dural sinus venous pressure. A total of 102 cadavers and living patients were used for the study. Fifty-three percent of the subjects presented with structures in their transverse sinuses that could be potential venous filling defects. Thirty percent of the subjects presented with arachnoid granulations in the right transverse sinus, which were found to be significantly dominant (Chi-square; p < 0.05). The study also revealed the presence of 1 to 5 septa in 29.4% of the subjects. The septa were found to be more dominant in the central (30%) and lateral (22%) thirds of the right transverse sinuses, while the central third of the left transverse sinus proved to be the least dominant occurring site (8%). In general, the right transverse sinus is highly more significantly dominant in septal occurrence (Chi-square; p < 0.01) than the left transverse sinus. We conclude from the statistical evidence that the right transverse sinus demonstrates significantly more potential venographic filling defects than the left sinus and submit that this information may assist in management options for patients diagnosed with idiopathic intracranial hypertension as well as direct future research.

Proximal great saphenous vein cut down: an evaluation of techniques and anatomical considerations.

Cut-down techniques by which emergency venous access can be achieved are important, particularly, in the resuscitation of haemodynamically depleted patients where percutaneous access to collapsed veins is a problem. The aim was to evaluate the efficacy of different methods that are used to locate the proximal great saphenous vein in the thigh and to describe the vein's immediate course. A further component was to identify the position of the valves in the proximal great saphenous vein. Needles were placed in 42 cadaver thighs as defined by the techniques identified from the literature and surgical practice. After a detailed dissection, the vein's relation to these needles was measured and the course of the vein and number of valves noted in relation to easily identifiable landmarks. Landmarks in 2.5-cm intervals on a line from the pubic tubercle to the adductor tubercle of the femur were used. The rule of two's, an experimental method by one of the authors, along with Dronen's second method localized the vein most successfully. The course of the vein was scrutinized and found to have a rather direct course as it proceeded medially toward the saphenous hiatus. The largest population of valves could be found in the proximal 5 cm (76%) with a valve in the confluence of the great saphenous vein and the femoral vein being the most common. Valve populations were found to decrease in number from proximal to distal, which would have implications with the placement of catheters into the vein for fluid resuscitation.