Deep learning for sex determination: Analyzing over 200,000 panoramic radiographs

The objective of this study is to assess the performance of an innovative AI-powered tool for sex determination using panoramic radiographs (PR) and to explore factors affecting the performance of the convolutional neural network (CNN). The study involved 207,946 panoramic dental X-rays and their corresponding reports from 15 clinical centers in São Paulo, Brazil. The PRs were acquired with four different devices, and 58% of the patients were female. Data preprocessing included anonymizing the exams, extracting pertinent information from the reports, such as sex, age, type of dentition, and number of missing teeth, and organizing the data into a PostgreSQL database. Two neural network architectures, a standard CNN and a ResNet, were utilized for sex classification, with both undergoing hyperparameter tuning and cross-validation to ensure optimal performance. The CNN model achieved 95.02% accuracy in sex estimation, with image resolution being a significant influencing factor. The ResNet model attained over 86% accuracy in subjects older than 6 years and over 96% in those over 16 years. The algorithm performed better on female images, and the area under the curve (AUC) exceeded 96% for most age groups, except the youngest. Accuracy values were also assessed for different dentition types (deciduous, mixed, and permanent) and missing teeth. This study demonstrates the effectiveness of an AI-driven tool for sex determination using PR and emphasizes the role of image resolution, age, and sex in determining the algorithm's performance.     

Fatal poisoning due to ingestion of boiled oleander leaf extract

Nerium oleander is an ornamental evergreen shrub belonging to the family Apocynaceae. The Apocynaceae family includes the attractive evergreen shrub known as oleander. The cardiotoxic glycoside, oleandrin, is present in all portions of the common oleander plant. Oleander consumption can result in deadly situations accidentally or as a suicide attempt. After consuming kettle-boiled oleander leaf extract as part of a suicide attempt, an 80-year-old man was discovered comatose in his home and taken to our emergency room. The patient's heart rate was 30 beats per minute, and he had hypotension. Arterial blood gas analysis revealed remarkable metabolic acidosis and hyperkalemia (K: 7.7 mEq/L). An electrocardiogram showed a wide QRS wave, similar to a sine curve. The patient collapsed following cardiac arrest soon after hospital arrival. Veno-arterial extracorporeal membrane oxygenation was initiated; however, the patient eventually died. The serum level of oleandrin at hospital arrival, subsequently measured by LC–MS/MS, was found to be 33.4 ng/mL, far above the levels reported in previous fatal cases.     

A two-level model for evidence evaluation

A random effects model using two levels of hierarchical nesting has been applied to the calculation of a likelihood ratio as a solution to the problem of comparison between two sets of replicated multivariate continuous observations where it is unknown whether the sets of measurements shared a common origin. Replicate measurements from a population of such measurements allow the calculation of both within-group and between-group variances/covariances. The within-group distribution has been modelled assuming a Normal distribution, and the between-group distribution has been modelled using a kernel density estimation procedure. A graphical method of estimating the dependency structure among the variables has been used to reduce this highly multivariate problem to several problems of lower dimension. The approach was tested using a database comprising measurements of eight major elements from each of four fragments from each of 200 glass objects and found to perform well compared with previous approaches, achieving a 15.2% false-positive rate, and a 5.5% false-negative rate. The modelling was then applied to two examples of casework in which glass found at the scene of the criminal activity has been compared with that found in association with a suspect.     

Death From Butane Inhalation Abuse in Teenagers: Two New Case Studies and Review of the Literature

The ready availability of butane makes butane abuse frequent. Fatalities are rare. This study presents two cases of death by butane overdose. The postmortem analyses were carried out using headspace gas chromatography–mass spectrometry. It revealed femoral blood butane concentrations of 18 and 22 mg/L, respectively, as well as specific combinations of adjuvants in each victim. In one of the victims, brain and fatty tissue also contained butane, pointing to chronic consumption. The originality of this study is to show that the identification of specific combinations of adjuvants can be helpful for identifying the brand of deodorant used. Also, sampling the skin and mucosa can help identify the method of drug delivery. The histological examination documented both the direct toxic effect of the gas on the respiratory mucosa and signs of chronic abuse. Volatile substance intoxications should be systematically considered in case of sudden death in a teenager.     

Classification of Glass Fragments Based on Elemental Composition and Refractive Index*

Abstract: The aim of this study was to assess the efficiency of likelihood ratio (LR)‐based measures when they are applied to solving various classification problems for glass objects which are described by elemental composition, and refractive index (RI) values, and compare LR‐based methods to other classification methods such as support vector machines (SVM) and naïve Bayes classifiers (NBC). One hundred and fifty‐three glass objects (23 building windows, 25 bulbs, 32 car windows, 57 containers, and 16 headlamps) were analyzed by scanning electron microscopy coupled with an energy dispersive X‐ray spectrometer. Refractive indices for building and car windows were measured before (RI_b), and after (RI_a) an annealing process. The proposed scheme for glass fragment(s) classification demonstrates some efficiency, although the classification of car windows (c) and building windows (w) must be treated carefully. This is because of their very similar elemental content. However, a combination of elemental content and information on the change in RI during annealing (ΔRI = RI_a?RI_b) gave very promising results. A LR model for the classification of glass fragments into use‐type categories for forensic purposes gives slightly higher misclassification rates than SVM and NBC. However, the observed differences between results obtained by all three approaches were very similar, especially when applied to the car window and building window classification problem. Therefore, the LR model can be recommended because of the ease of interpretation of LR‐based measures of certainty.     

Psychiatric disorders and management of sexual offenders in the prison psychiatric consultation unit of Marseille

Since 2017, complaints of sexual violence have increased in France. At the same time, the management of sexual offenders has been at the center of international public health policies. The prevalence of mental disorders among sexual offenders is an essential field of research. There are some published studies on the prevalence of psychiatric disorders in sexual offenders in detention, but there are few recent published studies among French individuals who were detained. Our objectives were to determine the prevalence of psychiatric disorders among persons detained for sexual offenses and the level of care received according to their diagnosis. For this purpose, we carried out a retrospective observational study from January 2017 to October 2021 of all adult sexual offenders, whether accused or convicted, who were seen in the psychiatric consultation unit of Les Baumettes prison, Marseille, France. The primary outcome measure was the psychiatric diagnosis entered in the medical records. One hundred forty-two patients were included in analysis. All patients were men, and the majority (n = 97, 68.3%) of these patients presented with at least one psychiatric disorder, principally a personality disorder (31.7%). 10.6% presented with a schizophrenic disorder, 4.9% a bipolar disorder, 3.5% a depressive disorder, 5.6% pedophilic paraphilia, and 25.4% an addictive disorder. Their management and comorbid addictions were analyzed in subgroups for each psychiatric disorder. Patients appeared to receive an appropriate level of care for their diagnosed disorder. It seems important to develop structured assessment of recidivism risk for better management of sexual offenders.