Machine Learning Models for Prediction of Sex Based on Lumbar Vertebral Morphometry.

BACKGROUND: Identifying skeletal remains has been and will remain a challenge for forensic experts and forensic anthropologists, especially in disasters with multiple victims or skeletal remains in an advanced stage of decomposition. This study examined the performance of two machine learning (ML) algorithms in predicting the person's sex based only on the morphometry of L1-L5 lumbar vertebrae collected recently from Romanian individuals. The purpose of the present study was to assess whether by using the machine learning (ML) techniques one can obtain a reliable prediction of sex in forensic identification based only on the parameters obtained from the metric analysis of the lumbar spine. METHOD: This paper built and tuned predictive models with two of the most popular techniques for classification, RF (random forest) and XGB (xgboost). Both series of models used cross-validation and a grid search to find the best combination of hyper-parameters. The best models were selected based on the ROC_AUC (area under curve) metric. RESULTS: The L1-L5 lumbar vertebrae exhibit sexual dimorphism and can be used as predictors in sex prediction. Out of the eight significant predictors for sex, six were found to be particularly important for the RF model, while only three were determined to be important by the XGB model. CONCLUSIONS: Even if the data set was small (149 observations), both RF and XGB techniques reliably predicted a person's sex based only on the L1-L5 measurements. This can prove valuable, especially when only skeletal remains are available. With minor adjustments, the presented ML setup can be transformed into an interactive web service, freely accessible to forensic anthropologists, in which, after entering the L1-L5 measurements of a body/cadaver, they can predict the person's sex.

Risk Predictors of Advanced Fibrosis in Non-Alcoholic Fatty Liver Disease.

The assessment of fibrosis in chronic liver diseases using non-invasive methods is an important topic in hepatology. The aim of this study is to identify patients with non-alcoholic fatty liver disease (NAFLD) and advanced liver fibrosis by establishing correlations between biological/ultrasound markers and non-invasively measured liver stiffness. This study enrolled 116 patients with non-alcoholic fatty liver disease, which were evaluated clinically, biologically, and by ultrasound. Liver fibrosis was quantified by measuring liver stiffness by shear wave elastography (SWE). Multiple correlation analysis of predictors of liver fibrosis identified a number of clinical, biological, and ultrasound parameters (BMI, blood glucose, albumin, platelet count, portal vein diameter, bipolar spleen diameter) that are associated with advanced liver fibrosis in patients with non-alcoholic fatty liver disease. The correlations between the degree of liver fibrosis and the risk values of some serological and ultrasound markers obtained in our study could be useful in clinical practice for the identification of advanced fibrosis in patients with NAFLD.

The Vital Role of Thanatochemistry in the Postmortem Diagnostic of Diabetic Ketoacidosis-Case Report.

Diabetic ketoacidosis (DKA) is a lethal acute hyperglycemic complication of diabetes mellitus (DM) and it represents the initial manifestation of DM in about 15-20% of cases in adults and about 30-40% of cases in children. Postmortem diagnosis of DKA can only be made by applying thanatochemistry. Biochemistry applied postmortem is viewed with skepticism by many practitioners in the forensic field, completely lacking in many forensic services around the world, and especially in the national ones. This article aims to underline the importance of the postmortem application of biochemistry by reviewing the case of a person in the third decade of life who died suddenly at home due to diabetic ketoacidosis (DKA), whose autopsy was performed at an early PMI of approximately 24 h. Routine postmortem examinations (macroscopic, anatomopathological, and toxicological) could not establish a clear cause of death. When attention was turned to biochemical determinations (i.e., determination of glycated hemoglobin, glucose and ketone bodies (acetone, beta-hydroxybutyrate) in the blood, vitreous humor, and cerebrospinal fluid), the identified values clarified the thanatogenic mechanisms by establishing the diagnosis of DKA.

Thanatochemical Study of Glycated Hemoglobin in Diabetic Status Assessment.

Background and objectives. In forensic medicine, the postmortem determination of glycated hemoglobin (HbA1c) helps identify undiagnosed cases of diabetes or cases with uncontrolled glycemic status. In order to contribute to the solidification of thanatochemistry, both globally and especially nationally, we aimed to determine this biomarker postmortem, for the first time in our institution, in order to identify undiagnosed pre-mortem diabetics, as well as those with inadequate glycemic control. Materials and Methods. Our research consisted of analyzing a total number of 180 HbA1c values, 90 determinations from the peripheral blood and 90 from the central blood. The determination of HbA1c was performed by means of a fully automatic analyzer (HemoCue HbA1c 501), certified by the National Glycohemoglobin Standardization Program (NGSP)/Diabetes Control and Complications Trial (DCCT) and calibrated according to the standards developed by the International Federation of Clinical Chemistry (IFCC). According to ADA criteria, HbA1c values can provide us with the following information about the diagnosis of diabetes: normal 4.8-5.6%; prediabetes 5.7-6.4%; diabetes ≥ 6.5%. Results. A considerable number of cases with an altered glycemic status (cases that had HbA1c values equal to or greater than 5.7%) were identified-51% demonstrable by peripheral blood determinations and 41% by central blood determinations. Notably, 23 people with diabetes (25%) were identified by analyzing the peripheral blood; 18 other people with diabetes (20%) were identified by analyzing the central blood. Conclusions. Our study managed to confirm the antemortem diagnosis of DM using a simple point-of-care analyzer and applying standardized and certified criteria on HbA1c levels measured postmortem. We also identified a considerable number of cases with DM in patients with no antemortem history of glucose imbalance-at least 20% more cases. Although the two different sites used for blood collection showed a strong statistical correlation, it seems that the peripheral site could have a higher sensibility in detecting postmortem altered glycemic status.

Subdural hematoma - a cause of death in the development of a prostatic adenocarcinoma with dural metastases: case report.

Non-traumatic subdural hematoma secondary to dural metastases is a rare complication. Dural metastases from a prostate adenocarcinoma occur in the advanced stages of this pathology and may sometimes be the first manifestation of a prostate carcinoma. Less than 40 cases of subdural hematoma are reported in the literature as a consequence of dural metastases from a prostate adenocarcinoma. The authors present the case of a male patient diagnosed with stage IV prostate adenocarcinoma with bone metastasis, who is admitted for left hemisphere subdural hematoma with right hemiparesis. The evolution of the patient is unfavorable, and the autopsy shows dural metastases and a collection of subdural coagulated blood. The chronic subdural hematoma with re-bleeding is a rare cause of death in the development of a prostate adenocarcinoma.