Displaying publications 1 - 20 of 64 in total

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  1. Jayaprakash PT, Hashim N, Yusop RA
    Forensic Sci Int, 2015 Aug;253:131.e1-10.
    PMID: 26103927 DOI: 10.1016/j.forsciint.2015.04.026
    Video vision mixer based skull-photo superimposition is a popular method for identifying skulls retrieved from unidentified human remains. A report on the reliability of the superimposition method suggested increased failure rates of 17.3 to 32% to exclude and 15 to 20% to include skulls while using related and unrelated face photographs. Such raise in failures prompted an analysis of the methods employed for the research. The protocols adopted for assessing the reliability are seen to vary from those suggested by the practitioners in the field. The former include overlaying the skull- and face-images on the basis of morphology by relying on anthropometric landmarks on the front plane of the face-images and evaluating the goodness of match depending on mix-mode images; the latter consist of orienting the skull considering landmarks on both the eye and ear planes of the face- and skull-images and evaluating the match utilizing images seen in wipe-mode in addition to those in mix-mode. Superimposition of a skull with face-images of five living individuals in two sets of experiments, one following the procedure described for the research on reliability and the other applying the methods suggested by the practitioners has shown that overlaying the images on the basis of morphology depending on the landmarks on the front plane alone and assessing the match in mix-mode fails to exclude the skull. However, orienting the skull relying on the relationship between the anatomical landmarks on the skull- and face-images such as Whitnall's tubercle and exocanthus in the front (eye) plane and the porion and tragus in the rear (ear) plane as well as assessing the match using wipe-mode images enables excluding that skull while superimposing with the same set of face-images.
  2. Hadi H, Wilkinson CM
    Forensic Sci Int, 2014 Apr;237:149.e1-149.e7.
    PMID: 24613011 DOI: 10.1016/j.forsciint.2013.12.014
    The post-mortem resilience of facial creases was studied using donated bodies in order to establish the efficacy of crease analysis for identification of the dead. Creases were studied on normal (pre-embalmed) and bloated (embalmed) cadavers at the Centre for Anatomy and Human Identification (CAHID) to establish whether facial bloating would affect facial crease visibility. Embalming was chosen to simulate the effects produced by post-mortem bloating. The results suggested that creases are resilient and changes were only detected for creases located on the periphery of the face, particularly at areas where the skin is thick, such as at the cheeks. Two new creases not previously classified were identified; these creases were called the vertical superciliary arch line and the lateral nose crease. This research suggests that facial creases may be resilient enough after death to be utilised for human identification.
  3. Jahanirad M, Anuar NB, Wahab AWA
    Forensic Sci Int, 2017 Mar;272:111-126.
    PMID: 28129583 DOI: 10.1016/j.forsciint.2017.01.010
    The VoIP services provide fertile ground for criminal activity, thus identifying the transmitting computer devices from recorded VoIP call may help the forensic investigator to reveal useful information. It also proves the authenticity of the call recording submitted to the court as evidence. This paper extended the previous study on the use of recorded VoIP call for blind source computer device identification. Although initial results were promising but theoretical reasoning for this is yet to be found. The study suggested computing entropy of mel-frequency cepstrum coefficients (entropy-MFCC) from near-silent segments as an intrinsic feature set that captures the device response function due to the tolerances in the electronic components of individual computer devices. By applying the supervised learning techniques of naïve Bayesian, linear logistic regression, neural networks and support vector machines to the entropy-MFCC features, state-of-the-art identification accuracy of near 99.9% has been achieved on different sets of computer devices for both call recording and microphone recording scenarios. Furthermore, unsupervised learning techniques, including simple k-means, expectation-maximization and density-based spatial clustering of applications with noise (DBSCAN) provided promising results for call recording dataset by assigning the majority of instances to their correct clusters.
  4. Khoo LS, Hasmi AH, Mahmood MS, Vanezis P
    Forensic Sci Int, 2016 Sep;266:e4-e9.
    PMID: 27567043 DOI: 10.1016/j.forsciint.2016.08.019
    An underwater disaster can be declared when a maritime accident occurred or when an aircraft is plunged into water area, be it ocean, sea or river. Nevertheless, handling of human remains in an underwater recovery operation is often a difficult and demanding task as working conditions may be challenging with poor to no visibility, location of remains at considerable depths and associated hazards from surrounding water. A case of the recent helicopter crash, into a famous river in Sarawak, domiciled by huge crocodiles, is discussed in this paper. Search and recovery team as well as the combat divers from the Special Elite Troop Commando, known as VAT 69, were deployed to the scene to perform the underwater recovery to search for all the victims on board involving five Malaysians with a pilot of Philippines nationality. This paper highlights the limitations and challenges faced during the underwater search and recovery. All the bodies recovered were in moderate decomposition stage with crushed injuries and mutilated face and body. A simple and conventional fingerprint technique were used to record the fingerprint. The prints impressions were later photographed using a smartphone and transferred back to the RMP headquarters in Kuala Lumpur for fingerprint match by using WhatsApp Messenger, a phone application. All the first five victims were identified within an average of 10min. The last victim recovered was the pilot. For foreign nationals, the Immigration Department of Malaysia will record the prints of both index fingers only. The lifting of the fingerprint of the last victim was the most challenging in which only one index finger left that can be used for comparison. A few techniques were attempted using the black printer's ink, glass and tape techniques for the last victim. Subsequently, images of the prints impression were taken using the same smartphone with additional macro lens attached to it to enhance the resolution. The images were transferred to the RMP headquarters through WhatsApp Messenger. The prints were confirmed to be the pilot 20min later.
  5. Khamis MF, Taylor JA, Malik SN, Townsend GC
    Forensic Sci Int, 2014 Jan;234:183.e1-7.
    PMID: 24128748 DOI: 10.1016/j.forsciint.2013.09.019
    Information about the sex of individuals is important for human identification. This study was conducted to quantify classification rates of sex prediction models for Malaysians using odontometric profiles. Mesiodistal (MD) and buccolingual (BL) crown dimensions of the permanent dentition were studied in 400 young adult Malaysians, giving a total of 28 tooth size variables. The sample consisted of three major ethnic groups, the Malays, Chinese and Tamils, since the aim was to assess sex dimorphism in Malaysians as a whole. Results showed that the mesiodistal diameter of the lower canine was the most sexually dimorphic dimension in Malaysian Malays and Tamils. Univariate analyses showed that the magnitude and pattern of sex dimorphism varies between these three ethnic groups, with Malaysian Chinese and Tamils being more dimorphic than the Malaysian Malays. Stepwise discriminant functions were generated bearing in mind their application in practical forensic situations. The range of classification rates was from 70.2% to 78.5% for the composite Malaysian group, and 83.8%, 77.9%, 72.4% for Malaysian Chinese, Malays and Tamils, respectively. The 'Area Under the Receiver Operating Characteristic Curve statistics' indicated good classification rates for three prediction models obtained using a combination of all tooth size variables, mandibular teeth, and mesiodistal dimensions in the composite Malaysian group, and for all tooth size variables in each ethnic group. The present study provides strong support for the value of odontometry as an adjunct scientific method for sex prediction in human identification.
  6. Ismael Al-Sanjary O, Ahmed AA, Sulong G
    Forensic Sci Int, 2016 Sep;266:565-572.
    PMID: 27574113 DOI: 10.1016/j.forsciint.2016.07.013
    Forgery is an act of modifying a document, product, image or video, among other media. Video tampering detection research requires an inclusive database of video modification. This paper aims to discuss a comprehensive proposal to create a dataset composed of modified videos for forensic investigation, in order to standardize existing techniques for detecting video tampering. The primary purpose of developing and designing this new video library is for usage in video forensics, which can be consciously associated with reliable verification using dynamic and static camera recognition. To the best of the author's knowledge, there exists no similar library among the research community. Videos were sourced from YouTube and by exploring social networking sites extensively by observing posted videos and rating their feedback. The video tampering dataset (VTD) comprises a total of 33 videos, divided among three categories in video tampering: (1) copy-move, (2) splicing, and (3) swapping-frames. Compared to existing datasets, this is a higher number of tampered videos, and with longer durations. The duration of every video is 16s, with a 1280×720 resolution, and a frame rate of 30 frames per second. Moreover, all videos possess the same formatting quality (720p(HD).avi). Both temporal and spatial video features were considered carefully during selection of the videos, and there exists complete information related to the doctored regions in every modified video in the VTD dataset. This database has been made publically available for research on splicing, Swapping frames, and copy-move tampering, and, as such, various video tampering detection issues with ground truth. The database has been utilised by many international researchers and groups of researchers.
  7. Jayaprakash PT, Srinivasan GJ
    Forensic Sci Int, 2013 Jun 10;229(1-3):166.e1-13.
    PMID: 23582744 DOI: 10.1016/j.forsciint.2013.03.038
    Forensic identification of juvenile skulls is a problem area. Although the skull suture patterns have been suggested for use in individualizing human remains by comparing antemortem and postmortem radiographs, the age at which such patterns stabilize and can be useful for identification had been indicated as 7 years. Subsequent researchers have also concurred that antemortem and postmortem radiographs taken after the 7th year would be sufficient to meet the Daubert standard criteria for identifying skulls using radiographs. The suggestions regarding the lower age limit for stabilization of suture patterns have not been verified so far. In this research, the patterns of the sutures in the ectocranial and endocranial surfaces of the lambdoid region in 22 juvenile skulls (age range 1-10 years) and 100 adult skulls (age range 17-70 years) were studied for the relative incidence of different types of suture patterns. The radiographic recordings of the suture patterns in the juvenile skulls were also compared with the patterns seen in the ectocranial and endocranial surfaces. The findings of this study support the proposition that the suture patterns are plastic during the juvenile stage and that they undergo significant remodeling during growth into adulthood. Indicating the possibility of growth related alterations in the sutural morphology, the onset of adulthood is suggested as the age for stabilization of suture patterns in the context of prescribing standards for such criteria as those relating to Daubert.
  8. Rahmat RA, Humphries MA, Austin JJ, Linacre AMT, Raven M, Self P
    Forensic Sci Int, 2020 May;310:110236.
    PMID: 32172179 DOI: 10.1016/j.forsciint.2020.110236
    Heat alters colour and crystallinity of teeth by destruction of the organic content and inducing hydroxyapatite crystal growth. The colour and crystallite changes can be quantified using spectrophotometric and x-ray diffraction analyses, however these analyses are not commonly used in combination to evaluate burned dental remains. In this study, thirty-nine teeth were incinerated at 300-1000 °C for 15 and 30 min and then measured using a spectrophotometer and an x-ray diffractometer. Response variables used were lightness, L*, and chromaticity a* and b* and luminance (whiteness and yellowness) for colour, and crystal size for crystallinity. Statistical analysis to determine the attribution of these variables revealed yellowness and crystal size were significantly affected by temperature (p < 0.05), whilst duration of heat-exposure showed no significant effect. This study suggests the inclusion of both spectrophotometric and x-ray diffraction in investigating thermal-heated teeth is useful to accurately estimate the temperature teeth are exposed to.
  9. Gan CY, Zainuddin Z, Muhamad Noh H, Rahmat R, Mohd Akir F, Mahad NH, et al.
    Forensic Sci Int, 2019 Sep;302:109865.
    PMID: 31279278 DOI: 10.1016/j.forsciint.2019.06.023
    Consumption of curry containing poppy seeds has raised an issue concerning the opiate content in the urine that might exceed the cut-off value (300ng/mL). The main objective of this study was to examine the morphine and codeine contents in the urine of the consumers after partaking poppy seed-enriched curry in. The volunteers were asked to partake: (a) a single meal and their urines were collected within 24h, or (b) Two meals a day for three consecutive days and their urines were collected within 72h. Two different dosages were also tested in this study: (a) low dosage: 1g/100ml curry (containing 138μg of morphine and 66μg of codeine) and (b) high dosage: 5g/100ml curry (containing 690μg of morphine and 330μg of codeine). The subjects were randomised into the groups using the method of stratified randomization with age and gender groups as covariates. A total of 6 subjects was allocated for each group and placebos were used as control. Results showed that all subjects who consumed low dosage of poppy seeds either in single meal or multiple meals experiment were found negative. However, 1 out of 6high dosage subjects was confirmed positive at a period of 3-6h after the consumption of curry in the single meal study. This outlier maybe due to the lack of water consumption after consuming the curry, thus the low volume of urine was collected and the opiate was concentrated in the urine. On the other hand, 5 out of 6high dosage subjects in the multiple meals experiment were found positive. Majority of these subjects were found positive on the second and third day of the experiment after the second curry meal was consumed. The outlier (negative) in this group might be due to the high consumption of water throughout the experiment and the subject's urine volumes and frequency of urine collection were much higher compared to other subjects. From the result of this study, it can be concluded that partaking high dosages of poppy seed in curry could give a positive response (>300ng/ml+uncertainty of measurement) in the urine, and the water consumption after partaking curry has significant influence for the opiate contents in the urine.
  10. Jayaraman J, Roberts GJ
    Forensic Sci Int, 2018 Nov;292:61-70.
    PMID: 30269046 DOI: 10.1016/j.forsciint.2018.09.005
    Understanding dental maturation in ethnically distinct populations is important in forensic age estimations and the presence of population differences in dental maturation was highly debated. No such comparison had been performed between two major populations; Caucasian and Chinese. This study aims to analyze and compare the maturation of permanent teeth from a sample of Caucasian and Chinese populations. Dental panoramic radiographs of subjects aged 2-24years belonging to United Kingdom (UK) Caucasian and Hong Kong (HK) Chinese populations were obtained from a teaching hospital. The teeth were scored and reference datasets were developed separately for males and females. Statistical significance was set at p<0.05 and independent sample t-test was conducted between the average ages at assessment for each stage of development for all the teeth in both groups. The HK Chinese were dentally advanced than the UK Caucasians by an average of 5 months, however, reverse trend was observed in third molars (p<0.05). These findings must be considered whilst utilising population specific reference dataset for dental age estimation.
  11. Baharum MI, Kuppuswamy R, Rahman AA
    Forensic Sci Int, 2008 May 20;177(2-3):221-7.
    PMID: 18313246 DOI: 10.1016/j.forsciint.2008.01.004
    A study has been made of the characteristics of restoration of obliterated engraved marks on aluminium surfaces by etching technique. By etching different reagents on 0.61mm thick sheets of aluminium (99wt%) on which some engraved marks had been erased to different depths it was found that the reagent 60% hydrochloric acid and 40% sodium hydroxide on alternate swabbing on the surfaces was found to be the most sensitive one for these metal surfaces. This reagent was able to restore marks in the above plates erased down to 0.04mm below the bottom of the engraving. The marks also presented excellent contrast with the background. This reagent was further experimented with similar aluminium surfaces, but of relatively greater thickness of 1.5mm. It was noticed that the recovery depth increased slightly to 0.06mm; this suggested the dependence of recovery depth on the thickness of the sheet metal. Further, the depth of restoration decreased in cases where the original number was erased and over which a new number was engraved; the latter results are similar to those of steel surfaces reported earlier [M.A.M. Zaili, R. Kuppuswamy, H. Harun, Restoration of engraved marks on steel surfaces by etching technique, Forensic Sci. Int. 171 (2007) 27-32].
  12. Tan GJ, Sulong G, Rahim MSM
    Forensic Sci Int, 2017 Oct;279:41-52.
    PMID: 28843097 DOI: 10.1016/j.forsciint.2017.07.034
    This paper presents a review on the state of the art in offline text-independent writer identification methods for three major languages, namely English, Chinese and Arabic, which were published in literatures from 2011 till 2016. For ease of discussions, we grouped the techniques into three categories: texture-, structure-, and allograph-based. Results are analysed, compared and tabulated along with datasets used for fair and just comparisons. It is observed that during that period, there are significant progresses achieved on English and Arabic; however, the growth on Chinese is rather slow and far from satisfactory in comparison to its wide usage. This is due to its complex writing structure. Meanwhile, issues on datasets used by previous studies are also highlighted because the size matter - accuracy of the writer identification deteriorates as database size increases.
  13. Poshyachinda V
    Forensic Sci Int, 1993 Nov;62(1-2):15-28.
    PMID: 8300028
    Opium dependence was indigenous to countries in the Golden Triangle area in south-east Asia (SA). Heroin epidemics developed in most SA countries in the 1960s and early 1970s and remained a significant problem particularly in Myanmar, Thailand and Malaysia until now. In contrast, the island countries in SA seemed quite free from opiate abuse. Intravenous injection (IV) of drugs appeared after the heroin epidemic and currently prevails in countries with a significant opiate abuse problem. IV of opium was particularly common in the highly urbanized cities in Vietnam. Most SA countries started HIV seroscreening in IV drug users (IVDU) around the middle of the 1980s. Rapid epidemic spread of HIV infection was observed in 1988-89 in Thailand and Myanmar. The Highest prevalence of more than 80% was reported from a study of IVDUs in Yangon, Myanmar, followed by Thailand at about 40%. Although HIV infected IVDUs were identified at the same time in Malaysia and later in Singapore and the Philippines, there was no evidence of such a rapid and severe epidemic.
  14. Chainchel Singh MK, Abdul Rashid SN, Abdul Hamid S, Mahmood MS, Feng SS, Mohd Nawawi H, et al.
    Forensic Sci Int, 2020 Mar;308:110171.
    PMID: 32032870 DOI: 10.1016/j.forsciint.2020.110171
    BACKGROUND: Post-mortem Computed Tomography (PMCT) allows non-invasive or minimally invasive detection of findings that may or may not be visible during conventional autopsy, however, it does not allow the investigator to draw any conclusions regarding patency of the vessel's lumen. To address this deficiency, Post-mortem Computed Tomography Angiography (PMCTA) utilizing different contrast media and techniques have been introduced with various studies looking at the correlation between PMCTA, autopsy (gross) findings and coronary artery histology in diagnosing coronary artery disease.

    OBJECTIVES: The aim of this study is to investigate the sensitivity and specificity of PMCTA in diagnosing coronary artery stenosis using water-based contrast media introduced though the vessels of the neck, compared to the gold standard of diagnosis i.e. gross and histological evaluation of the coronary artery.

    METHOD: This was a cross sectional study of 158 arterial sections involving 37 subjects recruited from the National Institute of Forensic Medicine (IPFN), Hospital Kuala Lumpur (HKL). An unenhanced PMCT was performed followed by PMCTA using water-based contrast media introduced though the vessels of the neck. Coronary artery stenosis was determined using multiplanar reconstructionD while the degree of stenosis was determined by calculating the percentage of luminal diameter divided by the diameter of the vessel internal elastic.

    RESULTS: The analysis of PMCTA and histopathology examinations revealed a sensitivity of 61.5%, specificity of 91.7%; positive predictive value (PPV) of 40.0% and negative predictive value (NPV) of 96.4%.

    CONCLUSION: PMCTA utilizing water-based contrast introduced though the vessels of the neck yielded similar results as other methods and techniques of PMCTA. We would therefore conclude that PMCTA utilizing this technique could be used to assess the degree of calcification and the presence of significant stenosis.

  15. Zuha RM, See HW, Disney RH, Omar B
    Forensic Sci Int, 2014 Dec;245:e36-7.
    PMID: 25466156 DOI: 10.1016/j.forsciint.2014.10.034
    Scuttle flies of genus Puliciphora Dahl (Diptera: Phoridae) are recorded for the first time in Malaysia from rabbit carcasses placed in concealed environments. They consist of Puliciphora borinquenensis Wheeler ♂♀, Puliciphora obtecta Meijere ♀ and Puliciphora beckeri Meijere ♀. All species were obtained from rabbit carcasses in used luggage and garbage bin placed at Forensic Science Simulation Site, Universiti Kebangsaan Malaysia, Bangi, Selangor. The specimens were collected from the carcasses using a modified Malaise trap, an entomological aspirator and preserved in 70% ethanol. This report expands the geographical distributions of these species and their microhabitat, suggests its possible important role in forensic entomology.
  16. Balla SB, Banda TR, Galic I, N NM, Naishadham PP
    Forensic Sci Int, 2019 Apr;297:243-248.
    PMID: 30844636 DOI: 10.1016/j.forsciint.2019.02.009
    The aims of the present study were to validate the discriminatory potential of Cameriere's third molar maturity index (I3M) cut-off value of I3M 
  17. Jothee S, Shafie MS, Mohd Nor F
    Forensic Sci Int, 2018 Aug 31.
    PMID: 30217665 DOI: 10.1016/j.forsciint.2018.08.038
    We present a case of a fatal motor vehicle collision of a 22-year-old car driver, who died at the scene after losing control of his car, and subsequently collided with a tree by the roadside. The subsequent autopsy revealed penetrating injuries on the neck, severing the larynx, carotid artery, jugular vein and fracturing the cervical vertebrae. Internal examination showed the offending material to be a semi-cylindrical metal fragment, which had lodged within the paravertebral muscle. Examination of the car with the authorities found that the metal fragment originated from a defective airbag booster cannister, which shattered upon deployment.
  18. Tan SH, Rizman-Idid M, Mohd-Aris E, Kurahashi H, Mohamed Z
    Forensic Sci Int, 2010 Jun 15;199(1-3):43-9.
    PMID: 20392577 DOI: 10.1016/j.forsciint.2010.02.034
    Insect larvae and adult insects found on human corpses provide important clues for the estimation of the postmortem interval (PMI). Among all necrophagous insects, flesh flies (Diptera: Sarcophagidae) are considered as carrion flies of forensic importance. DNA variations of 17 Malaysian, two Indonesian and one Japanese flesh fly species are analysed using the mitochondrial COI and COII. These two DNA regions were useful for identifying most species experimented. However, characterisation of the species was not sufficiently made in the case of Sarcophaga javanica. Seventeen Malaysian species of forensic importance were successfully clustered into distinct clades and grouped into the six species groups: peregrina, albiceps, dux, pattoni, princeps and ruficornis. These groups correspond with generic or subgeneric taxa of the subfamily Sarcophaginae: Boettcherisca, Parasarcophaga, Liosarcophaga, Sarcorohdendorfia-Lioproctia, Harpagophalla-Seniorwhitea and Liopygia. The genetic variations found in COI and COII can be applied not only to identify the species of forensic importance, but also to understand the taxonomic positions, generic or subgeneric status, of the sarcophagine species.
  19. Nayak VC, Rastogi P, Kanchan T, Yoganarasimha K, Kumar GP, Menezes RG
    Forensic Sci Int, 2010 Apr 15;197(1-3):67-9.
    PMID: 20071110 DOI: 10.1016/j.forsciint.2009.12.055
    The fingerprints are very typical for a human being. The present study was undertaken to study the gender differences in fingerprint ridge density in Chinese and Malaysian population. The study done on 200 subjects (100 males and 100 females) of Chinese origin and 100 subjects (50 males and 50 females) of Malaysian origin revealed that significant gender differences occur in the finger ridge density. Fingerprint mean ridge density of 12 ridges/25 mm(2) or less is found to be more likely to be of males and a mean ridge count of more the 13 ridges/25 mm(2) is more likely of female origin in Chinese subjects. Fingerprint mean ridge density of 11 ridges/25 mm(2) or less is found to be more likely to be of males and a mean ridge count of more the 13 ridges/25 mm(2) is more likely of female origin in Malaysian subjects.
  20. Mohd Yusof MYP, Wan Mokhtar I, Rajasekharan S, Overholser R, Martens L
    Forensic Sci Int, 2017 Nov;280:245.e1-245.e10.
    PMID: 28958768 DOI: 10.1016/j.forsciint.2017.08.032
    Through numerous validation and method comparison studies on different populations, the Willems method exhibited a superior accuracy. This article aims to systematically examine how accurate the application of Willems dental age method on children of different age groups and its performance based on various populations and regions. A strategic literature search of PubMed, MEDLINE, Web of Science, EMBASE and hand searching were used to identify the studies published up to September 2014 that estimated the dental age using the Willems method (modified Demirjian), with a populations, intervention, comparisons and outcomes (PICO) search strategy using MeSH keywords, focusing on the question: How much Willems method deviates from the chronological age in estimating age in children? Standardized mean differences were calculated for difference of dental age to chronological age by using random effects model. Subgroup analyses were performed to evaluate potential heterogeneity. Of 116 titles retrieved based on the standardized search strategy, only 19 articles fulfilled the inclusion criteria for quantitative analysis. The pooled estimates were separately kept as underestimation (n=7) and overestimation (n=12) of chronological age groups for both genders according to primary studies. On absolute values, females (underestimated by 0.13; 95% CI: 0.09-0.18 and overestimated by 0.27; 95% CI: 0.17-0.36) exhibited better accuracy than males (underestimated by 0.28; 95% CI: 0.14-0.42 and overestimated by 0.33; 95% CI: 0.22-0.44). For comparison purposes, the overall pooled estimate overestimated the age by 0.10 (95% CI: -0.06 to 0.26) and 0.09 (95% CI: -0.09 to 0.19) for males and females, respectively. There was no significant difference between the young and older child in subgroup analysis using omnibus test. The mean age between different regions exhibited no statistically significant. The use of Willems method is appropriate to estimate age in children considering its accuracy among different populations, investigators and age groups.
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