Age Assessment Method Research Articles

An International Consensus on Evaluation and Management of Idiopathic Genu Valgum: A Modified Delphi Survey.

Idiopathic genu valgum beyond physiological limits may require treatment, which is based on age, growth remaining, and the magnitude of the deformity. There is no consensus on clinical, or radiologic evaluation, indications, and management of idiopathic genu valgum, which can range from observation to surgical treatment using various modalities. If available, such guidelines will help surgeons offer optimal treatment to their patients. The aim of our study was to establish an expert consensus on the evaluation and treatment of idiopathic genu valgum. An international panel of 29 pediatric orthopaedic surgeons from 17 countries with clinical and research experience in the management of limb deformity participated in a modified Delphi survey. Surgeons were provided with patient and deformity characteristics and voted on 46 statements on history, clinical examination, radiographic evaluation, and treatment options for idiopathic genu valgum in round 1. Consensus was defined as when statements received ≥70% votes. Statements that were important but received <70% votes were reworded for clarity in round 2 (n=13). Consensus was achieved for 28/46 statements and included obtaining a full-length standing radiograph of the lower extremities and measuring joint orientation angles. Participants did not agree to offer surgical treatment based only on the intermalleolar distance. They recommended surgical treatment if the mechanical axis falls in zone 2 or beyond on the lateral side and using guided growth by tension-band plating when the growth remaining is at least 2 years. The panel agreed on performing common peroneal nerve decompression for specific indications such as acute, opening wedge osteotomy of >20 degrees, but not for gradual correction. Consensus was not reached for indications and methods of bone age assessment, treatment when growth remaining is <1 year, indications for implant removal after guided growth in younger children, and the type of osteotomy for acute deformity correction. We have generated consensus statements to guide the management of idiopathic genu valgum. Statements that lack consensus are areas for future multicenter research. Level V.

Aspects of Biological Age Assessment and Its Significance in Ophthalmology

This article explores the key aspects of biological age assessment and the potential of studying this parameter in ophthalmology. Biological age, as an indicator of the state of the organism, differs from chronological age and allows for a more accurate evaluation of the functional capabilities of organs and systems. In the context of ophthalmology, this parameter is particularly relevant, as eye health and visual function can vary significantly based on individual patient characteristics, including genetic factors, lifestyle choices, and the presence of comorbid conditions. The article analyzes contemporary methods for assessing biological age, including laboratory and instrumental approaches. It presents data on the impact of biological age on the development of various ophthalmological diseases. The importance of a personalized approach to diagnosis and therapy in ophthalmology is emphasized, taking into account the biological age of the patient. The authors propose the implementation of biological age assessment methods in clinical practice to improve treatment outcome predictions and enhance patients’ quality of life. Further research in this area is necessary to develop new strategies for the prevention and treatment of ophthalmopathologies that consider the parameter of biological age.

Relationship between hand and wrist bone age assessment method and application to male children

Objective: To explore the interrelationship among three simplified hand and wrist bone age assessment methods and to establish corresponding bone ages for each substage in male children. Methods: This retrospective case series study included 169 left hand and wrist X-rays from 152 male children who underwent bone age assessments at the Pediatric Orthopedics and Pediatrics Departments,Beijing Jishuitan Hospital,Capital Medical University from January 2019 to December 2023. The age at the time of X-ray was (13.7±2.0) years (range:9.1 to 17.9 years). Reasons for bone age assessment included evaluating the progress of adolescent idiopathic scoliosis in 36 cases, predicting limb length discrepancies in 28 cases, and predicting the height of healthy adolescents in 88 cases. Bone age was first graded using the Chinese hand-wrist bone age assessment method. Three simplified hand and wrist bone age assessment methods were then applied:Sanders simplified skeletal maturity staging system(Sanders stage), the distal radius and ulna classification (DRU), and e thumb ossification composite index (TOCI). Somers'delta correlation test was used to analyze the relationship among the results of the three simplified methods. The bone age and standard deviation for each sub-stage were calculated, and gender differences in bone age for the same sub-stage were compared with previous study. Results: The DRU, TOCI and Sanders stages showed a strong correlation when assessing bone age in male children, with Somers'delta correlation coefficients ranging from 0.881 to 0.876 (all P<0.01). The sub-stages with the smallest standard deviations (shorter duration) in each of the three classifications can serve as a quick reference for determining precise bone age, included proximal thumb epiphysis covered, without sesamoid (12.0 years);proximal thumb epiphysis covered with sesamoid or distal radial covered (13.0 years), early capping of the thumb epiphysis, radial epiphysis medial side capping(13.5 years), all phalangeal epiphyses capping (14.0 years), distal phalangeal physes beginning to close (14.5 years), all distal phalangeal physes closed (15.0 years), middle or proximal phalangeal physes beginning to close (15.5 years), all digital epiphyses closed (16.5 years), and nearly complete distal radius fusion with a notch (17.5 years). On average, the bone ages of males were 2 years behind those of females in the same substage. Conclusions: The DRU, TOCI, and Sanders stages can be applied to male children, and it is showed good correlation between them. The subtypes with shorter duration can be used as a quick assessment method to determine the bone age.

Applicability of Cameriere's Method for Dental Age Assessment and Its Relationship with Skeletal Age (MP3) and Chronological Age in North Indian Children.

Identification of age is imperative for diversity of reasons including disputed birth records, legal issues, etc. Several growth assessment parameters like bone age, dental age, and the combination of both have been applied for different populations with variable outcomes. It is well documented that the chronological age does not necessarily correlate with the maturational status of a child. Hence, efforts were made to determine a child's developmental age by using dental and skeletal age. The knowledge of bone age and dental age is of great importance for pediatricians and pediatric dentists. It is essential for dentists to formulate treatment plans and it is a source of complementary information for pediatricians. To assess the applicability of Cameriere's method for dental age assessment and its relationship with skeletal age (MP3) and chronological age in North Indian children. Children aged between 6 and 14 years were randomly selected. Chronological age was assessed by subtracting date of radiograph from the date of birth. The six modified MP3 stages given by Rajagopal and Kansal were used for skeletal age assessment. Dental age assessment was done based on Cameriere's method. Statistical analysis used: it was analyzed using Statistical Package for Social Sciences (SPSS) version 21. Among skeletal age subgroup of genders the calculated dental age based on Cameriere's method overestimated the chronological age significantly. Overestimated dental age by Cameriere's method in North Indian children suggests a need for new regression equation for a better correlation with skeletal age and chronological age. Jamir T, Saha S, Dhinsa K, et al. Applicability of Cameriere's Method for Dental Age Assessment and Its Relationship with Skeletal Age (MP3) and Chronological Age in North Indian Children. Int J Clin Pediatr Dent 2024;17(10):1104-1108.

Histological Observations of the Developing Human Fetal Humerus at Different Trimesters of Pregnancy

Background: Although femur length is the preferred method for fetal age assessment, the humerus is sometimes the right choice, especially in the second half of pregnancy. Fetal bone development significantly impacts adult bone quality and senescent bone disorders, including osteoporosis. Purpose of the study: The present study aimed to ascertain the histological changes in the human fetal humerus across the three trimesters. After the institutional ethical committee clearance and parent consent, the study was carried out on stillborn or medically terminated human fetuses from the 10th to the 32nd week of intrauterine life. Results: First trimester: The primary bone collar appeared with the primary ossification center, marked by more vascular invasion and a pool of mesenchymal cells. Trabeculations begin from the bony collar and insignificant periosteum. Second trimester: The changes showed longitudinal growth of periosteal bone towards the proximal and distal ends of the growing bone. Growth plate with distinguished zones and gradual fusion of epiphysis with growth plate were observed. Third trimester: Trabeculation number and thickness increase with calcification. Towards the third trimester, the marrow cavity with increased and prominent trabeculations is consistent. Conclusion: Understanding normal microstructural and cellular events chronologically is an ideal platform for future studies to develop cell-based or cell-targeted therapies for adult bone disorders, traumatic bone injuries, or bone engineering. KEYWORDS: Histology, Developing Bone, Humerus, Fetuses, Embryology.

Studying eruption patterns of mandibular third molars for forensic age assessment: Introducing current reference data from a population of black South Africans

IntroductionEvaluation of the eruption of mandibular third molars in orthopantomograms (OPGs) is a method of forensic age assessment. The objective of our study was to provide valid reference data for this trait within a population of black South Africans. The study was guided by the criteria for reference studies in age assessment.Materials and methodsA study population from Pretoria, South Africa comprising 670 OPGs obtained from 338 black females and 332 black males aged between 15.00 and 25.97 years was analysed. All OPGs were performed for medical indication during the period from 2011 to 2022 and were retrospectively evaluated. From the 670 OPGs, a total of 1021 mandibular third molars were evaluated. The assessment of mandibular third molars was conducted using the staging scale presented by Olze et al. in 2012. Two experienced dentists evaluated the OPGs independently of each other. If the two examiners diverged in their assessments, a consensus stage was assigned.ResultsAs expected, the mean, median and minimal age increased with higher stages for both teeth and both sexes. The minimum age recorded for stage D, indicating complete tooth eruption, was 15.79 years in females and 16.62 years in males.ConclusionAs it is the case for previous reference studies in other countries, placing exclusive reliance on the evaluation of mandibular third molar eruption is inadequate for ascertaining the age of majority among Black South Africans. Future studies need to examine if our results are transferable to other countries in Sub-Saharan Africa.

Biological age assessment method teenage students

To assess the biological age of adolescents, the special literature offers 9 methods for boys and 14 methods for girls. The aim of the article was to determine the more informative methods for boys and girls. Methods: anthropometry, somatometry, somatoscopy, tonometry, spirometry, dynamometry, Hench and Shtange tests, Ruffier and Robinson indices. The interaction of the results of different methods for the assessment of biological age was analysed using factor analysis (principal components method) for groups of subjects of the same gender and age. Boys aged 14-15 (n=102) and girls aged 12-13 (n=101) were studied. The choice of these age groups was explained by the presence of the most significant individual differences in morpho-functional features in the school students of this age. Results: among the methods for assessment of biological age in adolescent school students proposed in the literature, there is not a single one that would be statistically siginificantly related to the other methods. This applies to both boys and girls. The biological age of adolescents can be reliably determined using a set of three components: an assessment of physical development, the heterochronicity index, and the degree of manifestation of secondary sexual characteristics (for boys with a probability of 90.2%, for girls - 92.1%). The percentage ratio of these components has gender peculiarities. Methods for assessing biological age for scientific purposes and quick assessment for use in the practice of physical education and sports are proposed. The indicators in quick assessment technique include body length and the degree of development of the axillary hair. The reliability of the quick assessment technique is 81.4% for boys and 83.2% for girls. Conclusion: the development of adequate physical activity for adolescents of different biological ages will help to improve the physical health of the younger generation.

Evaluating legal age of 18 years through observation of third molars using Gambier et al. method in an orthopantomographic sample of subadults from South India

In forensic practice, medicolegal physicians are often tasked with estimating age using dental evidence. This calls for an uncomplicated, reliable, and reproducible method for dental age estimation, enabling physicians to proceed without specific odontological expertise. Among various dental methods, third molar eruption analyses are less complicated and easier to perform. In our study, we explored the effectiveness of Gambier et al.'s scoring system, which examines the eruption of all third molars. We retrospectively analysed 1032 orthopantomograms (528 males and 504 females) of individuals aged between 15 and 24 years. The mean chronological age increased with the progression of stages (1 to 3) and phases (A to D) of the third molar eruption for both sexes. In terms of stages, none showed significant discrimination between minors (<18 years) and adults (>18 years), especially for males. However, Gambier’s phase D displayed a relatively high likelihood of being 18 years or older, with an overall 85.9 % of males and 95.7 % of females having all third molars in stage 3 being 18 years or older. While the tested method could be helpful in indicating the completion of the 18th year of life, caution is advised (due to a high percentage of false positives), and it should be used alongside other age assessment methods by experts.

The automated Greulich and Pyle: a coming-of-age for segmental methods?

The well-known Greulich and Pyle (GP) method of bone age assessment (BAA) relies on comparing a hand X-ray against templates of discrete maturity classes collected in an atlas. Automated methods have recently shown great success with BAA, especially using deep learning. In this perspective, we first review the success and limitations of various automated BAA methods. We then offer a novel hypothesis: When networks predict bone age that is not aligned with a GP reference class, it is not simply statistical error (although there is that as well); they are picking up nuances in the hand X-ray that lie "outside that class." In other words, trained networks predict distributions around classes. This raises a natural question: How can we further understand the reasons for a prediction to deviate from the nominal class age? We claim that segmental aging, that is, ratings based on characteristic bone groups can be used to qualify predictions. This so-called segmental GP method has excellent properties: It can not only help identify differential maturity in the hand but also provide a systematic way to extend the use of the current GP atlas to various other populations.

Average weighted estimate of health of forest trees as a criterion for the sanitary condition of a stand

The issue of using a weighted average assessment of the health of trees condition Kср as a criterion for the sanitary condition of a stand on the example of spruce and birch forests. Based on the growth tables, Kср developed for five categories of tree health status with differentiation of results by age groups and assessment methods (by stock volume or by number of trees). It showed that exceeding Kср of 1.5 is not a sufficient criterion for the unsatisfactory sanitary condition of the stand. For a stand with natural thinning by age the estimations Kср are increase from Ia to V quality of locality and are decrease with age groups. The estimates Kср by number of trees may exceed similar estimates by stock volume by 0.1-0.3 points. For a young and middle age of healthy stands with natural thinning, the evaluations Kср usually exceed 1.5 points. Proposed the criteria Kср with the differentiation on age groups and assessment methods. As rough criterion of unsatisfactory sanitary state it is possible to accept excess of average weighted of estimations (on a stock volume/on number of trees): Kср :in middle-aged stands - 1,7/2,0, in ripening stand - 1,5/1,7, in ripe and maturity and old-growth stand 1,2/1,4. Keywords: CONDITION OF FOREST STAND, WEIGHTED AVERAGE ESTIMATE

Comparison of bone age assessment methods using a hand radiography in patients with active growth plate and anteromedial knee instability

Background Bone age is essential for pediatric patients with active growth zones and anteromedial instability to facilitate optimal treatment strategy and minimize postoperative complications. However, many people are unaware of various tools for determining bone age, including classical methods and modern machine learning techniques.The objective was to show and compare different methods for calculating bone age and determining surgical strategy for patients with anteromedial instability of the knee joint.Material and methods All-Inside anterior cruciate ligament reconstruction was performed for 20 patients. Wrist radiographs were performed for bone age assessment using the "point scoring system" of Tanner and Whitehouse and the "atlas matching" method of Greulich and Pyle. Machine learning programs were used in addition to standard bone age assessments.Results The findings showed an average difference of 21 months (80 %) in a group of 20 individuals with bone age ahead of the passport age and an average difference of 18 months (20 %) in patients with retarded bone age.Discussion The findings showed the difference between chronological and bone age and could be encountered in scientific articles on endocrinology and pediatrics. No scientific studies on the use of the methods could be found in the specialty “trauma and orthopaedics”.Conclusion Bone age assessment, prediction of children's target height are essential for surgical treatment of patients with open growth plates.

Individual age determination based on computed tomography knee analysis using artificial neural networks and computer vision: Preliminary results

BACKGROUND: Currently, studies have focused on the modernization of existing methods of forensic age assessment (bone and skeletal) through the active use of modern methods of medical imaging (e.g., computed tomography) and artificial intelligence for their analysis. This approach enables the creation of new methods for assessing biological age, which is characterized by increased accuracy and reproducibility.&#x0D; AIM: To develop and test an algorithm for predicting the biological age of an individual based on computed tomography analysis of the knee joint using artificial neural networks and computer vision.&#x0D; MATERIALS AND METHODS: This observational retrospective transverse (one time) study analyzed computed tomography scans (334) of the knee joint performed in the Departments of Radiation Diagnostics of the Priorov Central Institute for Trauma and Orthopedics, Vreden National Medical Center for Traumatology and Orthopedics, between 2018 and 2021. The study enrolled persons of both sexes aged 13–45 years. Cases of developmental abnormalities, knee injuries, signs of general connective tissue pathology were excluded. Research methods include the use of intelligent information technologies (a formalized set of mathematical and software solutions).&#x0D; RESULTS: Based on the experiments conducted, an algorithm for assessing age according to the computed tomography scans of the knee joint has been developed. The main components of the developed system are as follows: a preprocessing module, an intelligent computing core, a data analysis module, a three-dimensional reconstruction module, a property extraction module, and a final age assessment module. The essence of the proposed method is the simultaneous use of artificial neural networks and clearly formalized mathematical procedures for calculating the properties of the epiphyseal line. To obtain the results and conduct primary experimental studies that confirmed the feasibility, correctness, and operability of the method, software using the YOLOv5 neural network was developed. The result of the error matrix analysis after training shows a probability of correct recognition of the order of 80%. Verification of experimental studies was performed on 46 cases. At present, the age estimation error is approximately 1 year for children and adolescents.&#x0D; CONCLUSIONS: The experimental results have confirmed the adequacy of the age estimates obtained to the actual age of the individual and, consequently, the applicability of the proposed method in forensic medical institutions. The proposed method is currently implemented as a set of software components with subsequent manual integration of automatically calculated data. The plan was to supplement the database of computed tomography images to increase the training sample and the accuracy of age prediction.

Accuracy of different dental age assessment methods to determine chronological age among children with special needs.

This study aimed to validate the accuracy of dental age (DA) based on the dental development of permanent teeth in children with special needs using Demirjian, Willems, and London Atlas methods and to correlate the dental and chronological age (CA) of children with special needs in Malaysia. The panoramic radiographic images belonging to children with special needs from the two teaching dental hospitals in Malaysia aged between 5 and 16 years were included in the study. The evaluation was performed by two observers using three methods (London Atlas, Demirjian, and Willems methods) to estimate the accurate DA. The outcome was determined by comparing the mean of the DA and CA. A total of 52 panoramic radiographs were available for the analysis. The London Atlas and Demirjian methods overestimated the DA with a mean of 0.05 and 0.20 years, respectively, while the Willems method underestimated by 0.19 years. The London Atlas method was highly precise and accurate, while Demirjian and Willems methods were the least precise and accurate. The London Atlas method of DA estimation is highly accurate and valid for children with special needs in the Malaysian population, followed by the Willems and Demirjian methods.

Validation of method for estimation age of majority by the third molar maturity index on the sample of Ufa population

To test diagnostic accuracy of majority age assessment method by 3rd molar (Cameriere index) in the Ufa sample. The number of orthopantomograms equal 120 from males and females aged from 14 to 23 years without apparent pathological changes of the pulp of teeth 38 and 48 was examined. The measures were conducted using the standard R. Cameriere method. The method of logistic regression, determination of predictive values of sensitivity and specificity were used. The Im3 cut-off point, that was equal 0.08, had a sensitivity of 89% and specificity of 95% in the male sample, accuracy of age group determination was 93%. In the female sample the method sensitivity was 93%, specificity - 97%, accuracy - 97%. The study results confirmed the absence of population variability of the Cameriere index value, that makes it possible to use the majority age determination method by 3rd molar for practical application in the examination of a living person at the territory of the Russian Federation.

Discharge Monitoring and Aging Assessment Method for Metallized Film Capacitor Based on Acoustic Signal

Discharge Monitoring and Aging Assessment Method for Metallized Film Capacitor Based on Acoustic Signal

Review of age assessment methods of children and adolescents by teeth X-rays

Interest in the topic of age assessment for forensic medical identification of personality has not decreased for over the past decade. Establishing an exact age have a critical importance for law enforcement authorities, for example in case of wrongdoing by illegal migrants without identity documents. The search and systemic analysis of published researches devoted to age assessment by dental status in children and adolescents with subsequent updating of the directions of development in this scientific subject theme and the possibility of their realization in practice in the Russian Federation were carried out in order to have an objective concept of used methods of dental status assessment in the world practice.

Quantification of bone surface textures: exploring a new method of ontogenetic ageing

Identification of ontogenetic age classes plays an important role in the fields of zoology, palaeontology and archaeology, where accurate age classifications of (sub)fossil remains are a crucial component for the reconstruction of past life. Textural ageing—the identification of age-related bone surface textures—provides a size-independent method for age assessment of vertebrate material. However, most of the work so far is limited to qualitative results. While qualitative approaches provide helpful insights on textural ageing patterns, they are heavily subject to observer bias and fall short of quantitative data relevant for detailed statistical analyses and cross-comparisons. Here, we present a pilot study on the application of 3D surface digital microscopy to quantify bone surface textures on the long bones of the grey heron (Ardea cinerea) and the Canada goose (Branta canadensis) using internationally verified roughness parameters. Using a standardised measuring protocol, computed roughness values show a strong correlation with qualitative descriptions of textural patterns. Overall, higher roughness values correspond to increased numbers of grooves and pits and vice versa. Most of the roughness parameters allowed distinguishing between different ontogenetic classes and closely followed the typical sigmoidal animal growth curve. Our results show that bone texture quantification is a feasible approach to identifying ontogenetic age classes.

Estimation of Dental Age by Mandibular Third Molar Through Digital Orthopantomogram Using Modified Demirjian Method In South Indian Population Visiting A Dental College- A Retrospective Study

Aim: The aim of this study was to evaluate the applicability of Demirjian’s method for dental age assessment in a group of South Indian population and to develop an age-predictive equation suitable for the studied group. Subjects and methods: In this retrospective, blind, cross-sectional study, 120 Digital Orthopantomograms were selected from the archived medical files of patients attending Dental College and evaluated to estimate dental age. Results: Age was over estimated for almost all of the studied subjects with an accuracy range from 0.18 to 1.19 years for males and from 0.08 to 0.87 years for females, with the exception of two age subgroups Conclusion: Demirjian’s method is very useful and suitable for the South Indian population. The development of a prediction equation and the introduction of adaptable conversion tables to transform the maturity score into a dental age for the South Indian population with population-specific samples may be suitable alternatives.

SVTNet: Automatic bone age assessment network based onTW3method and vision transformer

AbstractThis study aims to develop a proficient and clinically applicable algorithm that can accurately assess bone age. This algorithm is based on the principles of the Tanner‐Whitehouse 3 (TW3) integral approach, and aims to achieve efficiency, scalability, and interpretability. We developed a model for bone age prediction in children. The model was tested on a pediatric dataset from a tertiary care hospital consisting of left‐hand radiographs of children between the age of 0 and 18. Our model consists of removing the arm portion using a pre‐trained YOLO network, localizing 37 key points in the hand bone portion using a spatial configuration network, and segmenting the original image through 20 of these points to obtain 20 fixed‐size patches. Finally, each of the 20 bone images is classified by training a visual transformer (ViT) model. In this study, a hybrid network, SVTNet, was developed that incorporates visual transformers to obtain estimates of bone age in the carpal (C series) and metacarpal (RUS series) bones. The sum of the clinical TW3 scoring region scores and bone maturity scores were utilized to determine the bone age for each corresponding region. The performance of the algorithm was evaluated in terms of both training and testing by evaluating 3871 left hand X‐ray micrographs obtained from a tertiary hospital in China. The results showed that the average absolute error of bone age estimation was 0.50 years for the RUS series of bones and 0.47 years for the C series of bones. The main contribution of this study is to propose, for the first time, a ViT‐based bone age assessment method that automates the entire process of the TW3 algorithm and is clinically interpretable, with predictive accuracy comparable to that of an experienced orthopedic surgeon.

A pediatric bone age assessment method for hand bone X-ray images based on dual-path network

A pediatric bone age assessment method for hand bone X-ray images based on dual-path network