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Age estimation is crucial in legal and humanitarian contexts. Forensic professionals may use various procedures to estimate age, including dental analysis, bone density tests, evaluation of physical characteristics including facial bone structure and development, and image-based methods. Although images are often the only material available, visual observation of photographic material is an imprecise method in age estimation, which can compromise judicial decision-making. Analyzing 4000 photographs from the Brazilian Federal Police database, representing four age groups (6, 10, 14, and 18 years), the study employed automated analysis by marking 28 photogrammetric points. Data were used to establish facial patterns by age and sex using the facial geometric morphometrics method. Performance was assessed through a Multinomial Logistic Regression model, evaluating accuracy, sensitivity, and specificity across the categorical age groups. Analyses were conducted using R software, with a 5 % significance level. The study found that facial geometric morphometrics achieved an overall accuracy of 69.3 % in age discrimination, with higher accuracy in males (74.7 %) compared to females (65.8 %) (p < 0.001). The method excelled at predicting the age of 6-year-olds with 87.3 % sensitivity and 95.6 % specificity but had lower performance at 14 years. It showed greater accuracy in distinguishing age groups with larger age gaps, achieving up to 99.5 % accuracy between certain groups, and was particularly effective in differentiating ages of 6 and 10 years in females and 10, 14, and 18 years in males. The facial geometric morphometrics emerges as a promising approach for age estimation among children and adolescents in forensic settings.

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The objective of this study was to propose categories of morphological classification for the face and its anatomical structures, as well as to propose illustrations to support the development of an atlas that facilitates facial morphological analysis of adult Brazilians. It was a descriptive study based on the analysis of the frequency and distribution of 13 photoanthropometric facial ratios (RFAs) obtained from a representative sample of the Brazilian population. RFAs related to facial height and width, eye width, intercanthal distance, nose length and width, philtrum ridge height and width, mouth thickness and width, upper and lower lip thickness, and chin height were analyzed. The study included a sample of 5.000 individuals aged between 18 and 22 years, evenly distributed between genders. Data normality was assessed using the Shapiro-Wilk test, considering them as parametric when p > 0.05. For the RFAs that showed normal distribution, mean ± 1.5 standard deviations (SD) were used to categorize facial measurements as regular, below average, or above average. Non-parametric RFAs were analyzed based on the median and 10th and 90th percentiles of the data. Based on the established average iris diameter, which is considered the most stable facial measurement, the values of the described RFAs were converted to a numerical scale in centimeters, allowing for the illustration of female and male faces. In this way, it was possible to categorize the facial anatomical structures and, consequently, visualize the facial morphological pattern of the adult Brazilian population.

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The Yanomami population, residing in Brazil's largest indigenous reserve in the Amazon Rainforest, face significant health challenges exacerbated by external threats such as infectious diseases, malnutrition, and mercury contamination from illegal mining. These issues, coupled with inadequate healthcare provision, have led to an alarming increase in mortality rates and potentially threaten the long-term survival of the Yanomami community. This ecological study utilized demographic data from the Special Secretariat of Indigenous Health to explore the demographic evolution and natural increase of the Yanomami Indigenous population in Brazil from 2003 to 2022. Employing population pyramids, crude rates of natural increase, the Mann-Kendall test for trend analysis, and linear regression modeling, the study analyzed vital statistics to forecast demographic trends, with analysis conducted using the R statistical software. Our findings showed a substantial growth of the Yanomami population, yet with a decreasing natural increase rate (τ = -0.33; p = 0.047), suggesting a shift toward population stagnation or decline within the next century. These results call for urgent, coordinated actions to address the complex demographic trends and health challenges faced by Yanomami Indigenous people, ensuring their demographic sustainability and the preservation of their traditional ways of life amidst ongoing environmental and health crises.

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This study summarized the available evidence on the differences in volume, density, electrolyte concentration, and total proteins in paranasal sinus fluid between freshwater and saltwater drowning victims. A systematic search was conducted in electronic databases and gray literature, resulting in the inclusion of five studies with 234 drowning victims (92 saltwater incidents and 142 freshwater incidents). Meta-analyses using the inverse-of-variance method and a random-effects model were performed, reporting effect sizes as standardized mean differences (SMD) with 95% confidence intervals (CI). The findings showed a significantly higher sinus density in saltwater drowning cases compared to freshwater drowning cases (SMD 0.91, 95% CI 0.50 to 1.32). However, no significant differences were observed in sinus fluid volume. Saltwater drowning victims exhibited higher electrolyte concentrations (sodium: SMD 3.77, 95% CI 3.07 to 4.48; potassium: SMD 0.78, 95% CI 0.07 to 1.49; chloride: SMD 3.48, 95% CI 2.65 to 4.31; magnesium: SMD 4.01, 95% CI 3.00 to 5.03) and lower total protein concentrations (SMD - 1.20, 95% CI - 1.82 to - 0.58) in sinus fluid compared to freshwater drowning victims. This meta-analysis highlights the importance of analyzing the characteristics and composition of sinus fluid in forensic investigations of drowning cases. While no differences were found in sinus fluid volume, saltwater drowning victims exhibited higher sinus density, elevated electrolyte concentrations, and lower total protein concentrations compared to freshwater drowning victims.

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Drowning is a significant global cause of unintentional injury fatalities, and accurate forensic diagnosis of drowning remains a challenge due to the nonspecific nature of post-mortem findings obtained through classical autopsy methods. Our manuscript addresses this issue by focusing on the emerging use of paranasal sinus fluid as a valuable tool in determining the cause of death, specifically in distinguishing drowning from non-drowning cases. The study provided a comprehensive summary of available evidence from observational studies that compared findings in the paranasal sinuses between drowning and non-drowning victims, analyzing parameters such as the presence of fluid, fluid volume, and density. The study encompassed a total of 14 selected studies involving 1044 subjects and utilized rigorous risk of bias assessment and data synthesis techniques. The meta-analysis demonstrated a strong association between the presence of fluid in the paranasal sinuses and drowning (OR = 17.1; 95% CI 7.2 to 40.5; p < 0.001). In addition, drowning victims had a significantly greater volume of fluid (SMD = 0.8; 95% CI 0.5 to 1.2; p < 0.001) and lower fluid density (SMD = -1.4; 95% -2.5 to -0.4; p = 0.008) compared to non-drowning cases. The results support the utility of paranasal sinus fluid analysis as a valuable diagnostic method in cases where drowning is suspected but cannot be definitively confirmed through traditional approaches.

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This retrospective ecological study investigated malaria incidence among Brazilian Yanomami children and adolescents from 2003 to 2022. Of the 145,573 recorded cases, 75.9% occurred in the Yanomami pediatric population. Moreover, an increase in the proportion of cases among the 10-19 age group has been observed, potentially associated with the recruitment of Indigenous adolescents to mining areas in recent years.

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Facial geometric morphometrics is a non-invasive method that has recently shown potential applications, including age estimation, diagnosis of facial abnormalities, monitoring facial development, and evaluating treatment outcomes. A systematic review identified two studies that demonstrated the use of facial geometric morphometrics for age estimation in children and adolescents, showing promising results in terms of accuracy and error. This finding could be particularly relevant in forensic investigations. However, a research agenda should be established to prioritize the assessment of the diagnostic accuracy of facial morphometric geometrics in estimating age among children and adolescents.

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INTRODUCTION: Chikungunya virus was detected in cases of acute chikungunya fever in renal tissue. However, chikungunya virus-related kidney injury still lacks characterization, and it is unknown whether the kidneys are reservoirs for the virus. We sought to detect histopathological changes and viral antigens in renal tissue, and to evaluate kidney injury markers in different phases of chikungunya fever. METHODS: Two groups were evaluated in this exploratory study: patients with biopsy-proven kidney injury established after chikungunya fever, and patients with post-chikungunya fever chronic joint manifestations without known kidney injury, in whom we actively searched for kidney injury markers. RESULTS: In the first group, 15 patients had kidney injury 0.5-24 months after chikungunya fever. The most frequent histopathological diagnoses were glomerular lesions. No viral antigens were detected in renal tissue. High-risk genotypes were detected in patients with atypical hemolytic uremic syndrome and focal and segmental glomerulosclerosis. In the second group, 114 patients had post-chikungunya fever joint manifestations on average for 35.6 months. Mean creatinine and proteinuria were 0.9 mg/dl and 71.5 mg/day, respectively. One patient had isolated hematuria. There was no indication for renal biopsy in this group. CONCLUSIONS: Several histopathological features were found after chikungunya fever, without virus detection in renal tissue. These findings suggest that chikungunya virus may trigger kidney lesions with varying degrees of severity at different stages of infection. However, the probability that this virus replicates in the renal tissue seems unlikely.

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Forensic anthropologists perform specialised analysis, mainly involving skeletonised human remains, cadavers in advanced stages of decomposition, disassociated elements from the human body, and human remains in extreme carbonisation. The main objectives of the forensic anthropology expertise are human identification and assisting in determining the cause and manner of death. Estimating the time since death is also a priority for some cases, especially ones involving missing persons. This science works on individual cases, violent deaths, missing persons, mass disasters, suspected violations of human rights, and crimes against humanity. Forensic anthropological evidence is, in general, very sensitive. Thus, it is important to detail aspects relevant to the maintenance of the chain of custody at all phases of the investigation, as well as standardise the actions of the individuals involved. This aims to preserve the evidence integrity and sameness (Sameness: free translation of the Portuguese word "mesmidade", derived from a Spanish word that does not possess a translation to Portuguese. Sameness of evidence is understood as the guarantee that the evidence under valuation (or under analysis of its probative value) is exactly and integrally the same one which was collected, corresponding, therefore, to "the same" (and not "part of", "derived from"), safeguarding its value. Brazil Law No. 13.964 of 14 December 2019 establishes and lists 10 phases related to the evidence chain of custody that must be followed. These newly introduced requirements resulted in the need for adaptation of the forensic, investigative, and legal actors involved in an investigation, and in the detailed description of the procedures for the different areas related to criminalistics, including forensic anthropology. The information provided in this article should be interpreted as recommendations, even though their non-compliance may weaken the investigative and forensic analysis processes in whole or in part.

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Radiocarbon analysis with reference to the modern bomb-curve was conducted using 68 bone samples of a vertebral body, femoral diaphysis, occipital bone, and parietal bone of 17 adults from Brazil. All individuals were born in 1963, thus analysis focused on the correlation with atmospheric values during the more recent, falling portion of the curve. Ages at death ranged from 43 to 54 years with representation of both sexes. Lag time (difference between the actual death date and the year of correspondence of the radiocarbon value with the curve) was evaluated for each individual and each tissue. The mean of the lag time values was 20.2 years, and the median was 22.0 years. The femur had the highest lag time median (29.5 years) among the bone groups, followed by the occipital (25.5 years), parietal (23.5 years) and the vertebra (8.0 years). The same pattern was observed for both sexes, but females tended to have lower lag time values than males. Different tissues presented considerable variation in lag time with vertebral bodies the least and the femoral diaphysis the greatest. These data suggest that individual age at death and the associated lag time must be considered in estimating the approximate death date. The lag time values for vertebral bodies were lower and with less variability in comparison with values for the occipital, parietal, and femur indicating greater consistency of that bone group for time since death estimation in the studied sample.

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Dengue fever and chikungunya are viral diseases that have spread rapidly throughout the world in recent decades. The occurrence of complications is well known, including prerenal acute kidney injury (AKI), which is usually thought to be caused by dehydration and fluid loss. Thrombotic microangiopathy (TMA) is an uncommon aggravation of dengue fever and chikungunya, with only a few cases described in the medical literature. The aim of this study is to present 3 cases of TMA associated with arboviral infection. Three patients with clinical history, laboratory test, and kidney biopsy results compatible with TMA were selected for the study, 2 of whom had a serological diagnosis of dengue fever and 1 of chikungunya. The 3 patients were followed up at the Federal University of Maranhão Hospital's Nephrology Service in 2018. A targeted gene panel sequencing (TGPS) plus multiple to atypical hemolytic uremic syndrome (aHUS) multiplex ligation-dependent probe amplification (MLPA) was performed in 2 of the patients and revealed in the patient 1 a heterozygous pathogenic variant in the gene THBD, as well as heterozygous deletions in CFH, CFHR1, and CFHR3. In the patient 2, there were heterozygous pathogenic variant in the genes CFI and CFB, in addition to heterozygous deletions in the genes CFHR1 and CFHR3. Both received treatment with eculizumab and undergone recovery of renal function. The third patient had TMA not classified as either aHUS or thrombotic thrombocytopenic purpura (TTP); he abandoned the treatment and returned to the service after 2 years for a dialysis emergency. Patients with arboviral infectious disease and changes that suggest TMA should have appropriate support to establish early diagnosis and useful treatment.

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The facial analysis permits many investigations, some of the most important of which are craniofacial identification, facial recognition, and age and sex estimation. In forensics, photo-anthropometry describes the study of facial growth and allows the identification of patterns in facial skull development, for example, by using a group of cephalometric landmarks to estimate anthropological information. Previous works presented, as indirect applications, the use of photo-anthropometric measurements to estimate anthropological information such as age and sex. In several areas, automation of manual procedures has achieved advantages over and similar measurement confidence as a forensic expert. This manuscript presents an approach using photo-anthropometric indexes, generated from frontal faces cephalometric landmarks of the Brazilian population, to create an artificial neural network classifier that allows the estimation of anthropological information, in this specific case age and sex. This work is focused on four tasks: (i) sex estimation on ages from 5 to 22 years old, evaluating the interference of age on sex estimation; (ii) age estimation from photo-anthropometric indexes for four age intervals (1 year, 2 years, 4 years, and 5 years); (iii) age group estimation for thresholds of over 14 and over 18 years old; and; (iv) the provision of a new data set, available for academic purposes only, with a large and complete set of facial photo-anthropometric points marked and checked by forensic experts, measured from over 18,000 faces of individuals from Brazil over the last 4 years. The proposed binary classifier obtained significant results, using this new data set, for the sex estimation of individuals over 14 years old, achieving accuracy values higher than 0.85 by the F1 measure. For age estimation, the accuracy results are 0.72 for the F1 measure with an age interval of 5 years. For the age group estimation, the F1 measures of accuracy are higher than 0.93 and 0.83 for thresholds of 14 and 18 years, respectively.

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An indirect anthropometric study was conducted to find out whether neoclassical facial canons could be applied to the population of Brazilian white young adults. The study was based on standardized facial photographs of 689 women and 666 men aged 30 years ± 6 months. The findings were compared to those observed for the North American Caucasian population. The frequency of 5 canons was assessed: facial thirds; interorbital width; nose and eye widths; mouth and nose widths; and face and nose widths. The assessed population showed the following ratios: tr-n > n-sn (96.01%), n-sn < sn-gn (95.90%), tr-n = sn-gn (42.06%), en-en < al-al (58.08%), en-en < ec-en (59.92%), ch-ch = 1½ al-al (52.61%), and al-al = 1/4 zy-zy (56.67%). When compared to North American Caucasians, only tr-n/n-sn and n-sn/sn-gn were identical. In conclusion, neoclassical facial canons cannot be applied to the Brazilian population, but they could serve as parameters for application in clinical practice and in forensic sciences.

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Child pornography on the internet is one of the crimes with highest increasing incidence worldwide. In this specific type of crime, the victim's age has important legal implications. To overcome the lack of scientifically established protocols, European researchers explored and proposed a set of facial proportions obtained from images to estimate age. Within a validation scope, the present study aimed to test the applicability of morphological proportions from frontal photographs of the face to estimate age in a Brazilian population. Standardized frontal view photographs from 800 Brazilians (400 females and 400 males) homogeneously distributed in 4 age groups (6, 10, 14 and 18 years ± 30 days) were randomly selected from a Civilian Database of the Brazilian Federal Police. The selected images were analyzed with the aid of cephalometric landmarks. After landmarking the photographs, eighteen metric relations pre-established by Cattaneo et al. (C. Cattaneo, Z. Obertová, M. Ratnayake, L. Marasciuolo, J. Tutkuviene, P. Poppa, D. Gibelli, P. Gabriel, S. Ritz-Timme, Can facial proportions taken from images be of use for ageing in cases of suspected child pornography? A pilot study, Int. J. Leg. Med. 126 2012 139-144) were assessed and analyzed through parametric statistical tests and discriminant analysis. Two indexes had a moderate correlation with age, while ten had a weak correlation and six were not correlated with age. Eleven indexes were statistically different between sexes (p < 0.05). The discriminant analysis showed that 49.6% of the pooled sample was correctly classified into the respective age group. This percentage increased when each sex was analyzed separately: 50.2% for females and 53.5% for males. The set of facial proportions from frontal images proposed by Cattaneo et al. (2012) is related to facial development. As expected, the discriminant power of this approach did not reach optimal effectiveness in the Brazilian sample. In practice, this age estimation method must be adapted for more reliable application in Brazilians.

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The aim of the present study is to describe the simplified facial pattern of young Brazilian men and women using the facial index (FI), upper face index (UFI), and nasal index (NI) in indirect anthropometric measurements applied to frontal photographic images. The images were obtained from 660 adult white men and 689 adult white women aged 30 years ± 6 months, and classified according to regions of birth, as follows: south (S), southeast (SE), midwest (MW), northeast (NE), and north (N). The nasion, zygion, gnathion, stomion, subnasale, and alare landmarks were labeled on the images using the SAFF 2D® software. Based on the coordinates, the linear distances between the landmarks of interest were calculated and presented as indices. The analysis of variance and Student's t-test were used for assessing the regions of birth and gender, respectively. The collected data allowed obtaining the facial profile of the young adult Brazilian population. There were differences in the facial profiles between men and women and also between some regions, especially between the N and the other Brazilian regions (p<0.05). The UFI did not show a statistically significant difference (p>0.05) between genders for any of the regions. The discriminant analysis for gender assessment demonstrated higher accuracy when the three indices were analyzed together. In the decision tree for gender assessment, the NI showed better results than the other indices.

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Abstract The aim of the present study is to describe the simplified facial pattern of young Brazilian men and women using the facial index (FI), upper face index (UFI), and nasal index (NI) in indirect anthropometric measurements applied to frontal photographic images. The images were obtained from 660 adult white men and 689 adult white women aged 30 years ± 6 months, and classified according to regions of birth, as follows: south (S), southeast (SE), midwest (MW), northeast (NE), and north (N). The nasion, zygion, gnathion, stomion, subnasale, and alare landmarks were labeled on the images using the SAFF 2D® software. Based on the coordinates, the linear distances between the landmarks of interest were calculated and presented as indices. The analysis of variance and Student's t-test were used for assessing the regions of birth and gender, respectively. The collected data allowed obtaining the facial profile of the young adult Brazilian population. There were differences in the facial profiles between men and women and also between some regions, especially between the N and the other Brazilian regions (p<0.05). The UFI did not show a statistically significant difference (p>0.05) between genders for any of the regions. The discriminant analysis for gender assessment demonstrated higher accuracy when the three indices were analyzed together. In the decision tree for gender assessment, the NI showed better results than the other indices.

Resumo O objetivo do estudo é verificar o padrão facial simplificado a partir dos índices facial (IF), da face superior (IFS) e nasal (IN) de homens e mulheres jovens brasileiros a partir da antropometria indireta aplicada em imagens fotográficas em norma frontal. Foram utilizadas imagens de adultos brancos de 30 anos (± 6 meses), sendo 689 do gênero feminino e 660 do masculino, divididos pela região de nascimento, sendo Sul, Sudeste, Centro-oeste, Nordeste e Norte. Os pontos: násio, zígio, gnátio, estômio, subnasal e alar foram marcados nas imagens por meio do software SAFF 2D®. A partir das coordenadas geradas em pixels, foram calculadas as distâncias lineares entre os pontos de interesse, que foram transformadas em índices. Os índices foram analisados estatisticamente de acordo com a região do nascimento pela análise de variância e o gênero pelo teste t de Student. Com os dados foi possível traçar o perfil simplificado da face da população brasileira de adultos jovens por meio da fotoantropometria. Foram observadas diferenças no perfil facial entre os gêneros e também entre algumas regiões, com maior frequência entre a região N e as demais partes do país (p<0,05). Quando separados por regiões do país, o IFS não mostrou diferença estatisticamente significante (p>0,05) entre os gêneros para nenhuma região. A análise discriminante para estimativa de gênero mostra que melhores taxas de acerto são alcançadas quando considerados os três índices em conjunto. Para a árvore de decisão de estimativa de gênero, o IN desempenhou os melhores resultados, quando comparado aos demais índices analisados.

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