Characteristics Of Bruises Research Articles

Image preprocessing techniques applied on NIR images for fruit bruise detection

This study investigates the transformative potential of image preprocessing techniques when applied to near-infrared (NIR) images for early bruise detection. It emphasizes the nuanced selection of filters to retain essential image features while accentuating bruise characteristics. Filters as noise-reduction tools, rendering bruises more visible without erasing critical details. Subsequently, the limitations of conventional edge detection filters were examined such as Sobel, Prewitt, and Canny, which excel in outlining fruit edges but fall short in delineating bruises. Adaptive thresholding methods were introduced, exemplified by Otsu’s, showcasing their capacity to distinguish objects from backgrounds while acknowledging their challenge in preserving crucial edge pixels. Image enhancement techniques, such as Histogram Equalization, Contrast Stretching, and Sigmoid Correction, enhance fruit edge visibility and elevate bruise detection. In the frequency domain, filters such as Ideal Lowpass, Bandpass, and Highpass were harnessed to accentuate diverse bruise types. The Butterworth filter was introduced, capable of concurrently highlighting all relevant features, a pivotal innovation in comprehensive bruise detection. Through extensive experimentation and analysis of NIR images of various fruit varieties, including plums, peaches, and apples, our findings underscore the significance of tailored preprocessing techniques for optimal fruit bruise detection. These insights offer promise for agricultural industries and quality control processes seeking to enhance fruit quality assessment.

Prevalence, risk factors, and main characteristics of bruises in cattle: A meta-analysis in the American continent

Bruises threaten the welfare of cattle because they cause pain, suffering, and stress during the pre-slaughter stage. Thus, we used meta-analyses to estimate the prevalence of carcass bruising in cattle from the American continent, determined the characteristics of the bruises, and calculated the odds ratio (OR) of risk factor categories associated with bruising. We searched electronic databases to retrieve primary studies conducted in the American continent, which reported cattle carcass bruising, analyzed the size, location, shape, and age of the bruises, and assessed risk factors for bruising. We included 46 studies from nine countries comprising 928 447 cattle carcasses with an overall prevalence of 59.5 % (95 % CI: 51.9 – 66-9) and 2.9 (range 3.4 – 7.4) bruises per carcass in average. The prevalence doubled from 30.7 % during 1991 – 2000 to 64.2 % during 2011 – 2020. Fresh, small-sized bruises of the lowest severity and located mainly in the hindquarter were highly prevalent (37.5 – 66.4 %). The removed meat due to bruising ranged 0.11 – 1.12 kg/carcass with an accumulated weight of condemned meat between 15.6 – 647 kg. Among intrinsic factors, older cattle, dairy cattle, and female cattle had greater odds of bruising (OR=1.57 – 1.98). For extrinsic factors, the odds for bruising increased 1.4 – 2.2 in cattle sourced from auction markets and exposed to poor handling, suboptimal transportation conditions, and deficient facilities. In cattle from America, bruises are a concern because their prevalence is growing and 60 % of cattle assessed in the studies suffered a bruise. Improving facilities and transportation conditions together with proper training of the personnel during the handling and transportation of the cattle will reduce bruising incidence.

Susceptibility of Impact Damage to Whole Apples Packaged Inside Molded Fiber and Expanded Polystyrene Trays.

Postharvest damage, leading to loss and waste, continues to be a significant problem in the fresh produce industry. Trays, designed to reduce fruit-to-fruit contact, are utilized by the apple industry to minimize bruising of whole apples. During distribution, packaged apples are subjected to various supply chain hazards, which may lead to bruising damage. Currently, molded fiber (MF) and expanded polystyrene (EPS) trays transport whole apples from the packhouse to the retail outlet. Mechanical shock, by free-fall drop method, was used to evaluate the performance differences between the two trays and quantify the bruising characteristics of the apples. Results showed that the EPS trays provided better shock protection to the apple as compared to the MF tray, reducing the impact acceleration by more than 70%. Additionally, the bruise susceptibility was 40% less for the apples packaged inside the EPS trays, regardless of drop height. However, apples packaged in the middle layer trays were most susceptible to bruising damage, regardless of tray type.

Bruising Characteristics to Predict Child Physical Abuse

Research Article| August 01 2021 Bruising Characteristics to Predict Child Physical Abuse AAP Grand Rounds (2021) 46 (2): 23. https://doi.org/10.1542/gr.46-2-23 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Bruising Characteristics to Predict Child Physical Abuse. AAP Grand Rounds August 2021; 46 (2): 23. https://doi.org/10.1542/gr.46-2-23 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: contusions, physical abuse of child Source: Pierce KC, Kaczor K, Lorenz DL, et al. Validation of a clinical decision rule to predict abuse in young children based on bruising characteristics. JAMA Netw Open. 2021; 4(4):e215832; doi: https://doi.org/10.1001/jamanetworkopen.2021.5832Google Scholar Investigators from multiple institutions conducted a prospective study to validate and refine a bruising clinical decision rule (BCDR), the TENS-4 (bruising to torso, ear, or neck, or any bruising in an infant <4 months old), for identifying young children at risk for being physically abused. Study participants were patients <4 years seen at 1 of 5 pediatric emergency departments (EDs) with ≥1 bruise identified on clinical examination between 2011 and 2016. A comprehensive evaluation was conducted on all study participants, including history of presentation, type of skin injury, anatomic location (within 34 predefined areas), and pattern of bruising (bite, loop, hand slap, squeeze, grab,... You do not currently have access to this content.

Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics

Bruising caused by physical abuse is the most common antecedent injury to be overlooked or misdiagnosed as nonabusive before an abuse-related fatality or near-fatality in a young child. Bruising occurs from both nonabuse and abuse, but differences identified by a clinical decision rule may allow improved and earlier recognition of the abused child. To refine and validate a previously derived bruising clinical decision rule (BCDR), the TEN-4 (bruising to torso, ear, or neck or any bruising on an infant <4.99 months of age), for identifying children at risk of having been physically abused. This prospective cross-sectional study was conducted from December 1, 2011, to March 31, 2016, at emergency departments of 5 urban children's hospitals. Children younger than 4 years with bruising were identified through deliberate examination. Statistical analysis was completed in June 2020. Bruising characteristics in 34 discrete body regions, patterned bruising, cumulative bruise counts, and patient's age. The BCDR was refined and validated based on these variables using binary recursive partitioning analysis. Injury from abusive vs nonabusive trauma was determined by the consensus judgment of a multidisciplinary expert panel. A total of 21 123 children were consecutively screened for bruising, and 2161 patients (mean [SD] age, 2.1 [1.1] years; 1296 [60%] male; 1785 [83%] White; 1484 [69%] non-Hispanic/Latino) were enrolled. The expert panel achieved consensus on 2123 patients (98%), classifying 410 (19%) as abuse and 1713 (79%) as nonabuse. A classification tree was fit to refine the rule and validated via bootstrap resampling. The resulting BCDR was 95.6% (95% CI, 93.0%-97.3%) sensitive and 87.1% (95% CI, 85.4%-88.6%) specific for distinguishing abuse from nonabusive trauma based on body region bruised (torso, ear, neck, frenulum, angle of jaw, cheeks [fleshy], eyelids, and subconjunctivae), bruising anywhere on an infant 4.99 months and younger, or patterned bruising (TEN-4-FACESp). In this study, an affirmative finding for any of the 3 BCDR TEN-4-FACESp components in children younger than 4 years indicated a potential risk for abuse; these results warrant further evaluation. Clinical application of this tool has the potential to improve recognition of abuse in young children with bruising.

Electrical and mechanical analysis to evaluate the cultivar difference in strawberries with respect to their bruising sensitivities and mass loss acceleration

This study investigated the differences in the bruising characteristics of three strawberry cultivars that were subjected to mechanical compression, while elucidating the effect of bruising on the acceleration of mass loss during storage; these investigations were aimed at achieving long-term transportation. The length of the coordinate at the top of the circular arc of Cole-Cole plots from the origin (LTO) was obtained using electrical impedance techniques and was employed as an indicator of the degree of bruising. The LTO values of the control samples were approximately 30,000 Ω; however, they decreased with the increasing compression strain, so the strain was evaluated to be the primary factor for their bruising. Further, a disparity was observed in different cultivars with regard to their fragilities to compression. Mass loss of samples during storage was approximately 0.01 – 0.03 (-); however, owing to an increase in the degree of bruising, the mass loss for each cultivar was accelerated during storage; moreover, there are significant differences among the cultivars. These findings demonstrate that selecting an appropriate cultivar alleviates bruising and deterioration during transportation. Moreover, the combination analysis using electrical analysis and measurement of quality decline rate may be advantageous for the selection of good cultivars.

Effect of stress during slaughter on carcass characteristics and meat quality in tropical beef cattle.

ObjectiveThis study aimed to determine the effects of stress during slaughter of beef cattle on physiological parameters, carcass, and meat quality at a Federal Inspection Type slaughterhouse located in the southeast of Mexico.MethodsA total of 448 carcasses of male Zebu×European steers with an average age of 36 months were included. Carcass assessment of presence of bruises and bruise characteristics was carried out on each half-carcass. Blood variable indicators of stress (packed cell volume, neutrophil to lymphocyte ratio, glucose, cortisol concentration) and meat quality parameters (pH, color, shear force, drip loss) were evaluated.ResultsOf the 448 carcasses evaluated, 81% of the carcasses showed at least one bruise; one bruise was detected in 36.6% and two bruises in 27.0% of animals. Of the 775 bruises found, 69.2% of the bruises were grade 1 in region 3. Of the 448 carcasses studied, 69.6% showed hyperglycemia (6.91 mmol/L); 44.3% and 22.7% showed high (74.7 ng/mL) and extremely high (108.8 ng/mL) cortisol levels, respectively, indicative of inadequate handling of animals during preslaughter and slaughter. Of the carcasses evaluated, 90.4% had a pH ≥5.8 with an average of pH 6.3. In both pH groups, meat samples showed L* values >37.0 (81.6%) and a shear force >54.3 N; meat pH≥5.8 group showed a drip loss of 2.5%. These findings were indicative of dark, firm, and dry (DFD) meat. According to principal component analysis, grades 1 and 2 bruises in region 3 and grade 1 bruises in region 5 were highly associated with cortisol, drip loss, and color parameters b* and h* and were negatively associated with L*, a*, and C*.ConclusionThe bruises probably caused by stress-inducing situations triggered DFD meat. Appropriate changes in handling routines in operating conditions should be made to minimize stress to animals during the slaughter process to improve animal welfare and meat quality.

Bone Bruise and Anterior Cruciate Ligament Tears: Presence, Distribution Pattern, and Associated Lesions in the Pediatric Population

Background: Bone bruise characteristics after anterior cruciate ligament (ACL) injury have been correlated with the level of joint derangement in adults. However, the literature lacks information about younger patients, whose higher ligamentous laxity may lead to different lesion patterns. Purpose: To investigate the prevalence, size, location, and role of bone bruise associated with ACL rupture in the pediatric population. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Knee magnetic resonance imaging scans (MRIs) of patients aged 8 to 16 years with ACL tears from 2010 to 2018 were selected from the institution database. Inclusion criteria were open or partially open physes, less than 90 days between trauma and MRI, and no history of injury or surgery. Presence, localization, and size of bone bruise were analyzed by 2 blinded researchers and scored with the Whole-Organ Magnetic Resonance Imaging Score (WORMS) bone bruise subscale. Ligamentous, cartilaginous, meniscal, and other lesions were documented. Results: Of the 78 pediatric patients selected from the database, 54 (69%) had bone bruise. The mean area of bone bruise was larger in males than in females (femur, 3.8 ± 2.8 vs 2.2 ± 1.4 cm2, respectively, P = .006; tibia, 2.6 ± 1.6 vs 1.5 ± 0.8 cm2, respectively, P = .007). The subregions most affected by bone bruise were the lateral posterior tibia and the lateral central femur (in 83% and 80% of the knees affected, respectively). A low correlation was found between age and bone bruise area (biggest areas r = 0.30, P = .03, and sum of areas r = 0.27, P = .04), but no correlation was found between age and WORMS (femur, r = −0.03, P = .85; tibia, r = −0.04, P = .76). The injuries most associated with bone bruise were 23 meniscal lesions (43%), 10 lesions of other ligaments (19.0%), 2 cartilage lesions (3.7%), and 2 patellar fractures (3.7%). Conclusion: The prevalence of bone bruises in pediatric patients with ACL tears is high, although it seems slightly lower than the prevalence documented in adults but with similar localization. The area and the distribution pattern of bone bruises are similar among different ages. The pediatric patients had a lower presence of cartilage and meniscal lesions compared with that reported in adults, which suggests a different effect of this trauma on the knee of pediatric patients.

Informative vision characteristics of bruises in the diagnostic algorithm durability of their appearance

Objective. The purpose of the work was to analyze the informativeness of the criteria for establishing the limitation of the appearance of bruises and to determine their suitability for inclusion in the algorithm for the development of a computer diagnostic program.Material and methods. Has been processed 4289 "Experts Conclusions" on the definition of the nature and severity of bodily harm, in 523 of them described 2290 bruises. Statistical analysis was performed using computer programs with the Cox model processing function.Results. It has been established that the age of victims significantly affects the dynamics of color changes of the bruises, especially in the last stage of its development, and the gender does not affect it. Bruises that are located on the upper limbs heal faster than in other localizations, the bruises located on the hips and buttocks heal slower. With the increase in the area of damage, the time for its healing slows down. The aging of a bruise correlates with its color. It allows determining these diagnostic criteria as the most informative. The presence of the skin swelling reliably depends on its age and characterizes the initial stages of its development.Conclusions. Thus, the analysis of 6 diagnostic signs showed that 5 criteria could be used to establish the age of occurrence of bruising: age of the victim, localization, area, color of the bruise and the presence of the skin swelling. The more informative value is the type of color of the damage. These criteria can be included in the algorithm of developing a computer diagnostic program.

Classifying Injuries in Young Children as Abusive or Accidental: Reliability and Accuracy of an Expert Panel Approach

To assess interrater reliability and accuracy of an expert panel in classifying injuries of patients as abusive or accidental based on comprehensive case information. Data came from a prospective, observational, multicenter study investigating bruising characteristics of children younger than 4 years. We enrolled 2166 patients with broad ranges of illnesses and injuries presenting to one of 5 pediatric emergency departments in whom bruises were identified during examination. We collected comprehensive data regarding current and past injuries and illnesses, and provided deidentified, standardized case information to a 9-member multidisciplinary panel of experts with extensive experience in pediatric injury. Each panelist classified cases using a 5-level ordinal scale ranging from definite abuse to definite accident. Panelists also assessed whether report to child protective services (CPS) was warranted. We calculated reliability coefficients for likelihood of abuse and decision to report to CPS. The interrater reliability of the panelists was high. The Kendall coefficient (95% CI) for the likelihood of abuse was 0.89 (0.87, 0.91) and the kappa coefficient for the decision to report to CPS was 0.91 (0.87, 0.94). Reliability of pairs and subgroups of panelists were similarly high. A panel composite classification was nearly perfectly accurate in a subset of cases having definitive, corroborated injury status. A panel of experts with different backgrounds but common expertise in pediatric injury is a reliable and accurate criterion standard for classifying pediatric injuries as abusive or accidental in a sample of children presenting to a pediatric emergency department.

Risk Factors for Bruises and High Muscle pH in Lamb Carcasses of Tierra Del Fuego, Chilean Patagonia

The aim of the study was to relate some pre-slaughter handling factors for lambs in a slaughterhouse, with the presence of bruises and high muscle pH in carcasses. Stocking density, transport distance and time, and type of slaughter (Conventional or Kosher) were registered in a sample of 1150 lambs that corresponded to 23 loads originated from different farms (Tierra del Fuego, Chilean Patagonia), distance and time of transport to slaughterhouse. The presence and characteristics of bruises were randomly registered in 50 carcasses per load, and muscle pH measured in loin and leg at 24 hpostmortem. Transport distance fluctuated between 50 and 190 km, transport time between 1.5 and 12 h and a mean stocking density of 164 ± 32 kg/m2 for lambs with an average live weight of 31 ± 6 kg was recorded. Of all the carcasses 22.7% showed some degree of bruising and the loin was the most affected anatomical region, accounting for 47.1% of lesions. Transport time and live weight showed association (P 30 kg) and those travelling for more than 4 h. In the leg a pH < 5.8 was predominant, while the predominant range in the loin was 5.8 to 6.3. Transport time, presence and number of bruises were the factors that had a significant association (P < 0.05) with pH. Due to this association, both bruising and meat pH in lamb carcasses should be used at slaughter plants as indicators of meat quality and also of animal welfare.

Histological Characteristics of Bruises with Different Age.

BACKGROUND:In forensics bruises as injuries take an important part in the interpretation of the causes of death. Since activating the inflammatory response of the body in their formation, histological analysis of the bruised tissue can provide data on the determination the time when the injury occurred.AIM:The aim of this study is to compare the histological features of 1-day and 5-days old bruises.MATERIAL AND METHODS:Bruised human skin samples, 1-day old in group A and 5-day-old in group B, obtained at autopsy from individuals who died from a violent death, were analyzed in this study. The qualitative microscopic analysis was performed on serial paraffin sections of tissues stained with Hematoxylin-eosin and Pearls Prussian Blue method, using a light microscope connected to a digital camera.RESULTS:Qualitative histological analysis of the studied group A presented with fresh bruises, less than 24 hours old, showed ruptured smaller vessels and extravasated red blood cells in the connective tissue of the skin, with subsequent expansion and infiltration of fibrous septa of the skin. In the area of bleeding an initial infiltration by macrophages was observed. In the studied group B, presented with bruises 3-7 days old, histological analysis showed a marked presence of hemosiderin-laden macrophages and presence of hematoidin granules in the area of bleeding, as well as ruptured small blood vessels and red blood cells extravasation in the dilated fibrous septa.CONCLUSION:A detailed analysis of tissue changes in bruises every day from the initiation until their recovery, a detailed description of the histological finding can be given, which will be supported in the precise determination of the age of the injuries themselves.

025 Prevalence and characteristics of bruises of beef cattle carcasses from two regions of northwest Mexico

025 Prevalence and characteristics of bruises of beef cattle carcasses from two regions of northwest Mexico

Bruising in Children: Exploring the Attitudes, Knowledge and Training of Child Protection Social Workers and the Interface with Paediatricians regarding Childhood Bruising

While child protection social workers (CPSWs) make decisions about which children with an injury need a medical examination, we do not know how they make these decisions. We aimed to ascertain the knowledge, attitudes and training of CPSWs in regards to assessing childhood bruising. Paediatricians' views on the bruising knowledge and training of CPSWs were also explored, as well as the relationship and communication between the two professions.‘Aimed to ascertain the knowledge, attitudes and training of CPSWs in regards to assessing childhood bruising’Semi‐structured, face‐to‐face interviews were conducted with 39 CPSWs and 16 paediatricians across South Wales and South West England. Interviews were recorded and transcribed until data saturation was reached. Using NVivo, two independent assessors conducted a thematic analysis, identifying themes emerging from the data with group comparisons where appropriate.CPSWs lack confidence in assessing bruising with knowledge gaps regarding bruise patterns and the lack of evidence for ageing bruises. This appears to be linked to an almost complete lack of training. An important theme was that CPSWs regard the clinician's view as paramount, yet paediatricians feel that there is an over‐expectation of what a child protection medical can conclude; this exemplified some of the communication issues between the professions. Evidence‐based training of CPSWs is needed jointly by health and social care professionals, including an understanding of the respective roles. Copyright © 2017 John Wiley &amp; Sons, Ltd.Key Practitioner Messages CPSWs lack confidence in assessing bruising characteristics associated with physical abuse, largely due to their lack of training. CPSWs' decisions to refer for medical examinations are strongly influenced by an exploration of history and key social factors, including chastisement strategies and the home environment. Paediatricians are unaware of CPSWs' training or knowledge, and thus have unrealistic expectations of their assessment of bruising characteristics. Communication between professionals could be improved by joint professional training in this area, providing current scientific evidence relating to bruises and an explicit explanation of the role of each in this assessment. ‘Paediatricians are unaware of CPSWs' training or knowledge, and thus have unrealistic expectations of their assessment of bruising characteristics’

Are Bone Bruise Characteristics and Articular Cartilage Pathology Associated with Inferior Outcomes 2 and 6 Years After Anterior Cruciate Ligament Reconstruction?

Objective To determine (1) if bone bruise characteristics seen on magnetic resonance imaging are associated with patient-reported outcomes prior to and following anterior cruciate ligament reconstruction and (2) if the combined presence of bone bruises with articular cartilage pathology results in inferior 2- or 6-year outcomes. Design Bone bruise volume and severity were measured on 81 patients' preoperative magnetic resonance imaging in the medial and lateral femoral condyle (MFC, LFC) and medial and lateral tibial plateau (MTP, LTP) using the Costa-Paz classification and a modified version of Roemer and Bohndorf's technique. The relationships between bone bruise volume and severity with Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) scores were assessed, and pre- and postoperative KOOS and IKDC scores were compared between those with bone bruises either with or without combined local articular cartilage pathology. Results All 81 patients had a bone bruise in at least 1 region and 70 (86%) had bone bruises in ≥2 regions. LTP bruises were the most common (76/81, 94%), followed by the LFC (66, 81%), MTP (46, 57%), and MFC (20, 25%). Neither bone bruise volume nor severity was associated with inferior postoperative outcomes. The subset of 17 patients with bone bruises and combined articular cartilage pathology were 3.4 times more likely to be symptomatic at 6-year follow-up than those without articular cartilage pathology ( P = 0.04). Conclusions The volume and severity of preoperative bone bruises alone were not associated with 2- or 6-year outcomes; however, bone bruises combined with local articular cartilage pathology appear to be more symptomatic after ACL reconstruction.

Ultrasound characteristics of bruises and their correlation to cutaneous appearance

ObjectiveThe primary objective of this study was to compare the cutaneous size of a bruise on gross exam to the subcutaneous depth and height of the hematoma ascertained by ultrasound. The hypothesis was that there would be little correlation between the area of the bruise on cutaneous exam and the height when measured with ultrasound. MethodsAdult and pediatric patients with bruising were prospectively identified in the emergency department. Photographs and ultrasound images were collected of the bruises and epidemiologic information collected from the patients. The cutaneous area of the bruise was compared with the sonographic characteristics. ResultsThe subcutaneous depth and height of the hematomas defined by ultrasound did not correlate with the cutaneous area. ConclusionsThe cutaneous appearance of a bruise gives little indication of the depth and size of the subcutaneous bruise. Ultrasound can add information regarding these parameters.

Bruising and child protection investigation outcomes

Journal of Paediatrics and Child HealthVolume 50, Issue 2 p. 161-161 Heads UpFree Access Bruising and child protection investigation outcomes First published: 16 February 2014 https://doi.org/10.1111/jpc.12521_2AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Building on previous work by this esteemed group of child protection researchers, this study explores the relationship between bruising characteristics and outcomes of child protection investigations of children referred for suspected physical abuse (PA). This work used complete assessment and multiagency case conferences to determine outcomes of cases referred for witnessed abuse, alleged abuse, unexplained injuries, concerning histories, domestic abuse or sibling abuse. Of those with bruising, there was no effect of developmental stage between cases where PA was confirmed and cases where PA was excluded. Confirmed abuse cases had more bruises and more sites affected than the PA-excluded group. Odds of PA-confirmed bruises on buttocks, genitalia, cheeks, neck, trunk, head, front of thighs or upper arms were significantly greater than in PA-excluded children. Petechiae, linear or patterned bruises and clustered bruising were significantly greater in the PA-confirmed group. The strength of this study is the decision made by multiagency assessment in determining outcome, which minimises circular reasoning where outcome is based on characteristics of the bruises themselves. The authors put this study into context as a population study highlighting distinct patterns of bruising emerging that differ between children with confirmed PA and those where is PA excluded after assessment. Reference 1 Kemp AM, Maguire SA, Nuttall D, Collins P, Dunstan F. Bruising in children who are assessed for suspected physical abuse. Arch. Dis. Child. 2014; 99: 108– 113. Reviewer: Catherine Skellern, Catherine_Skellern@health.qld.gov.au Volume50, Issue2February 2014Pages 161-161 ReferencesRelatedInformation

Intra- and inter-observer reliability of a protocol for post mortem evaluation of bruises in Chilean beef carcasses

The objective of this study was to test the reliability of the post-mortem evaluation of bruise characteristics using a newly extended protocol. Intra-observer reliability of the observations was assessed with three meat graders, each of whom blindly examined 50 photos of bovine carcasses in two sessions, with 1week in between. The agreement was “substantial” for number of bruises per carcass, and size and shape of the bruises; whereas it was “moderate” for colour and severity grade. Inter-observer reliability of the observations was assessed with four meat graders who each examined the same 46 carcasses at the slaughter-line. Inter-observer agreement for number of bruises per carcass ranged between observer pairs from “fair” to “moderate.” The agreement for number of bruises scored per anatomical site was “very low” for all observers. The most concordant bruise feature was size, followed by colour and shape. The bruise scoring protocol was associated with high level of intra-observer reliability and low inter-observer reliability. A further calibration of the observer judgments is needed to reach a more uniform scoring of the observers.

Characteristics of bruises in carcasses of cows sourced from farms or from livestock markets

Bruises in cattle develop after the application of force, and they provide evidence for sub-optimal animal welfare. The aim of this study was to describe the gross characteristics of bruises in cows arriving at the slaughterhouse directly from farms or through the livestock market. The number of bruises and their distribution on the carcass as well as their severity, shape, size and colour were assessed post mortem in a slaughterhouse in Chile. A total of 258 cow carcasses were evaluated, and a total of 846 bruises were found on 243 of the carcasses. Cows that had passed through a livestock market (M-carcasses) had in total 563 bruises (mean 3.8 bruises/carcass, s.d. 2.0), whereas cows transported directly from farms (F-carcasses) had in total 283 bruises (mean 2.5 bruises/carcass, s.d. 1.8). The backs of F-carcasses had twice as many bruises as M-carcasses (32.9% and 16.2%, respectively), whereas bruises in the rib area were more frequently observed in M-carcasses (13.1%) than in F-carcasses (8.1%). Superficial bruises (grade 1) were the most frequently observed (66.2% of all bruises). Regarding the size of the bruises, 64 (7.6%) were classified as large, 271 (32.0%) as medium and 511 (60.4%) as small. Irregularly shaped bruises were the most frequent (91.1%, n = 771), followed by linear (3.8%, n = 32), circular (3.1%, n = 26) and tramline-shaped bruises (1.9%, n = 16). The latter were noticed only in M-carcasses, which may indicate that these animals were beaten more frequently with sticks or other rod-shaped objects. Fresh, bright red-coloured bruises were found more frequently on all the animals (69.5% from farms and 70.5% from market) compared with bluish (29.7% and 29.3%, respectively) and yellow bruises (0.4% and 0.2%, respectively). The method of selling was significantly associated with the number of bruises on the carcass (P < 0.001) and the anatomical site (P < 0.05), but not with the severity, shape and colour of the bruises. Increased fat coverage reduced the severity of bruises (P < 0.001). This study shows that, in Chile, market animals have more bruises than those sourced directly from farms, and their distribution is different. More information about the causes of infliction may help reduce bruises and it may also improve their welfare. Further studies are required to elucidate whether the causes of the high bruising in the case of animals passing through markets are related only to extra handling (repeated loading, unloading, transportation, eventual mixing) or to the way of handling by personnel and inadequate design.

Bruising Characteristics Discriminating Physical Child Abuse From Accidental Trauma

Our objective was to conduct a pilot study to identify discriminating bruising characteristics and to model those findings into a decision tool for screening children at high risk for abuse. A case-control study of children 0 to 48 months of age who were admitted to a PICU because of trauma was performed. Case subjects (N = 42) were victims of physical abuse, and control subjects (N = 53) were children admitted because of accidental trauma during the same time period. Bruising characteristics (total number and body region) and patient age were compared for children with abusive versus accidental trauma. The development of a decision rule for predicting abusive trauma was accomplished with the fitting of a classification and regression tree through binary recursive partitioning. Ninety-five patients were studied. Seventy-one (33 of 42 patients in the abuse group and 38 of 53 in the accident group) were found to have bruising, and the characteristics were modeled. Characteristics predictive of abuse were bruising on the torso, ear, or neck for a child <or=4 years of age and bruising in any region for an infant <4 months of age. A bruising clinical decision rule was derived, with a sensitivity of 97% and a specificity of 84% for predicting abuse. Discriminating differences exist in bruising characteristics for abusive versus accidental trauma. The body region- and age-based bruising clinical decision rule model functions as a clinically sensible screening tool to identify young children who require further evaluation for abuse.