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  1. Ghazali L, Mohd Yusof MYP, Norman NH
    J Orthod, 2021 03;48(1):5-12.
    PMID: 33200660 DOI: 10.1177/1465312520971641
    OBJECTIVES: To investigate the effect of reducing scanning parameters of digital dental panoramic tomogram (DPT) and lateral cephalometric (LC) radiographs on quality and diagnostic performance of the images.

    DESIGN: Single-centre prospective two-arm parallel randomised controlled trial.

    SETTING: Orthodontic Clinic, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia.

    PARTICIPANTS: Adult orthodontic patients aged 18-35 years, indicated for DPT and LC, who were fit and healthy with a body mass index of 18.5-25.0, not contraindicated to radiographic examination, not pregnant, and did not have a history of facial or skeletal abnormalities or bone diseases were included.

    METHODS: Thirty-eight adult orthodontic patients were randomised into control and intervention groups. DPT and LC radiographs in the control group were obtained using standard scanning parameters as prescribed by the manufacturer using Orthopantomograph® OP300 by Instrumentarium. Scanning parameters in the intervention group were reduced by 60% for DPT (60 kV, 3.2 mA) and 30% for LC (85 kV, 8 mA). A five-point rating scale was used for the assessment of image quality. Images were evaluated for diagnostic performance by detection of anatomical landmarks. Mann-Whitney test was performed to compare the quality and diagnostic performance of the images and the observer agreement was assessed using the intraclass correlation coefficient (ICC).

    RESULTS: For image quality, the control group produced slightly lower median scores (DPT 2.0, LC 2.0) compared to the intervention group (DPT 2.0, LC 3.0). For diagnostic performance, both groups showed similar median scores (DPT 21.0, LC 32.0). The differences between control and intervention groups for both modalities were not statistically significant. The average scores for intra-observer agreement were excellent (ICC 0.917) and inter-observer agreement was good (ICC 0.822).

    CONCLUSION: Minimising radiation exposure by reducing scanning parameters on digital DPT by 60% and LC by 30% on Intsrumentarium 300 OP did not affect the quality and diagnostic performance of the images. Thus, scanning parameters on digital DPT and LC should be reduced when taking radiographs.

  2. Ramli UIS, Muhd US, Mohd Yusof MYP
    J Forensic Odontostomatol, 2021 Aug 30;2(39):38-44.
    PMID: 34419944
    The use of teeth to estimate the age of unknown bodies provides much help especially in skeletal remains with no soft tissues left for identification. However, dental age estimation utilizing degenerative changes in teeth like dentinal translucency is often hampered with large margin of error. This study aims to compare the accuracy of Kvaal's radiographic method (intraoral periapical radiograph) with modified Bang-Ramm dentinal root translucency method in estimating dental age in Malay adults. One-hundred teeth of maxillary and mandibular incisors and canine were collected following dental extraction. Date of birth, date of extraction, gender and ethnicity were documented prior to extraction. All teeth were assessed using two methods of dental age estimation: 1) The equation from Kvaal's radiographic method and 2) Formula from modified Bang-Ramm dentinal root translucency method. The results from the age estimation were compared to the chronological age of the persons from whom the teeth were extracted. The average dental age estimated using both methods significantly correlated with the chronological age for both men and women. Overestimation and underestimation with mean absolute error up to 13 years and 15 years was observed in modified Bang-Ramm and Kvaal, respectively. The estimated age calculated from both methods also showed increasing standard deviation as the patient gets older. From the obtained results it is reasonable to conclude that modified Bang-Ramm method gives better accuracy for dental age estimation in Malay adults.
  3. Mohammad N, Ahmad R, Kurniawan A, Mohd Yusof MYP
    Front Artif Intell, 2022;5:1049584.
    PMID: 36561660 DOI: 10.3389/frai.2022.1049584
    BACKGROUND: Forensic odontology may require a visual or clinical method during identification. Sometimes it may require forensic experts to refer to the existing technique to identify individuals, for example, by using the atlas to estimate the dental age. However, the existing technology can be a complicated procedure for a large-scale incident requiring a more significant number of forensic identifications, particularly during mass disasters. This has driven many experts to perform automation in their current practice to improve efficiency.

    OBJECTIVE: This article aims to evaluate current artificial intelligence applications and discuss their performance concerning the algorithm architecture used in forensic odontology.

    METHODS: This study summarizes the findings of 28 research papers published between 2010 and June 2022 using the Arksey and O'Malley framework, updated by the Joanna Briggs Institute Framework for Scoping Reviews methodology, highlighting the research trend of artificial intelligence technology in forensic odontology. In addition, a literature search was conducted on Web of Science (WoS), Scopus, Google Scholar, and PubMed, and the results were evaluated based on their content and significance.

    RESULTS: The potential application of artificial intelligence technology in forensic odontology can be categorized into four: (1) human bite marks, (2) sex determination, (3) age estimation, and (4) dental comparison. This powerful tool can solve humanity's problems by giving an adequate number of datasets, the appropriate implementation of algorithm architecture, and the proper assignment of hyperparameters that enable the model to perform the prediction at a very high level of performance.

    CONCLUSION: The reviewed articles demonstrate that machine learning techniques are reliable for studies involving continuous features such as morphometric parameters. However, machine learning models do not strictly require large training datasets to produce promising results. In contrast, deep learning enables the processing of unstructured data, such as medical images, which require large volumes of data. Occasionally, transfer learning was used to overcome the limitation of data. In the meantime, this method's capacity to automatically learn task-specific feature representations has made it a significant success in forensic odontology.

  4. Affendi NHK, Babiker J, Mohd Yusof MYP
    J Periodontal Implant Sci, 2023 Dec;53(6):453-466.
    PMID: 37038832 DOI: 10.5051/jpis.2105000250
    PURPOSE: This study aimed to quantify alveolar bone morphology, demonstrate the relationship between tooth angulation and alveolar bone thickness, and introduce a new classification for anterior mandibular teeth related to immediate implant placement (IIP).

    METHODS: Cone-beam computed tomography (CBCT) images of 211 anterior mandibular teeth were analyzed in sagittal slices to measure the thickness of the facial alveolar bone crest (FAB1) and apex (FAB2), and the lingual alveolar bone crest (LAB1) and apex (LAB2). Tooth angulation was classified as 1°-10°, 11°-20°, and >20° according to the tooth's long axis and alveolar bone wall. Spearman correlation coefficients were used to evaluate correlations between the variables.

    RESULTS: FAB1 and LAB1 were predominantly thin (<1 mm) (84.4% and 73.4%, respectively), with the lateral incisors being thinnest. At the apical level, FAB2 and LAB2 were thick in 99.5% and 99.1% of cases, respectively. Significant differences were documented in FAB2 (P=0.004), LAB1 (P=0.001), and LAB2 (P=0.001) of all mandibular teeth. At all apical levels of the inspected teeth, a significant negative correlation existed between TA and FAB2. Meanwhile, TA showed a significant positive correlation with LAB2 of the lateral incisors and canines. These patterns were then divided into class I (thick facial and lingual alveolar bone), class II (facially inclined teeth) with subtype A (1°-10°) and subtype B (11°-20°), and class III (lingually inclined teeth) with subtype A (1°-10°) and subtype B (11°-20°).

    CONCLUSIONS: Mandibular anterior teeth have predominantly thin facial and lingual crests, making the lingual bone apical thickness crucial for IIP. Although anchorage can be obtained from lingual bone, tooth angulation and tooth types had an impact on IIP planning. Hence, the new classification based on TA and alveolar bone wall may enable rational clinical planning for IIP treatment.

  5. Ismail N, Mohd Yusof MYP, Wan Mokhtar I
    J Clin Pediatr Dent, 2024 May;48(3):6-14.
    PMID: 38755976 DOI: 10.22514/jocpd.2024.053
    Exploring parental opinions regarding the use of passive immobilisation during dental treatment is critical when identifying behaviour guidance application priorities. Instead of being dismissed as an inappropriate and less favourable option, this article aims to systematically evaluate factors affecting parental acceptance toward the use of passive immobilisation as behaviour guidance among children during dental treatment in various populations and regions. This research follows Arksey and O'Malley framework and updated by Joanna Briggs Institute Framework for Scoping Reviews methodology to summarise 40 research papers from 1984 to 2022 in PubMed, Web of Science, Science Direct, EBSCO Host, Scopus, grey literature and Google search outlining the research trend of parental acceptance toward passive immobilisation as behaviour guidance. Factors influencing parental acceptance toward the use of passive immobilisation were classified into parental socio-economic and demographic characteristics, exposure method of the devices to the parents, type of dental procedures, and children's cooperation and cognitive level. In conclusion, the current explorative review of the parental perspective toward passive immobilisation proposed a recommendation and facilitate the dentist to consider this technique as an alternative option for behaviour guidance in paediatric dentistry.
  6. Zamasry MS, Hilmi Z, Mohd Yusof MYP, Razali HSA, Nawawi H, Mahmood MS
    Trop Biomed, 2019 Dec 01;36(4):845-849.
    PMID: 33597456
    Infective endocarditis (IE) is a relatively uncommon disease, but has been challenging to diagnose over the years. With the increasing incidence, variety of causative agents and the resistance of microorganisms towards antibiotics, there is still an occurrence of sudden death due to undiagnosed IE. The most common microorganism causing IE is Staphylococcus aureus. However, there is increasing prevalence of other microorganisms causing IE. This case report highlights a case of sudden death due to IE caused by a rare pathogen, Streptococcus constellatus which belongs to the Streptococcus anginosus group (Milleri group). A study noted the crude incidence of IE in 6 world regions ranged between 1.5 and 11.6 cases per 100,000 people. To date, there has been no previous report on sudden death due to IE caused by Streptococcus constellatus in Malaysia, neither in the forensic nor clinical setting. This case report underlined the characteristics and pathological features of this microorganism. The increasing incidence and variety of causative organisms in IE are important public health issues. It is vital for future studies to examine the risk factors of IE related to Streptococcus constellatus, to enhance better understanding, insight and awareness regarding the course of this disease. This in turn may facilitate preventive measures to avoid morbidity and mortality from this condition.
  7. Adam FA, Mohd N, Rani H, Baharin B, Mohd Yusof MYP
    J Ethnopharmacol, 2021 Jun 28;274:113882.
    PMID: 33513418 DOI: 10.1016/j.jep.2021.113882
    ETHNOPHARMACOLOGICAL RELEVANCE: Salvadora persica L. chewing stick, commonly known as miswak is still being used as an oral hygiene tool for plaque control and prevention against gingivitis. Various studies have reported on the therapeutics and prophylactic effects particularly on periodontal disease. This review aimed to evaluate the effectiveness of S. persica chewing stick compared to the standard toothbrush for anti-plaque and anti-gingivitis.

    MATERIAL AND METHODS: A PRISMA-compliant systematic search of literature was done from the MEDLINE, CENTRAL, Science Direct, PubMed and Google Scholar. Literature that fulfilled eligibility criteria was identified. Data measuring plaque score and bleeding score were extracted. Qualitative and random-effects meta-analyses were conducted.

    RESULTS: From 1736 titles and abstracts screened, eight articles were utilized for qualitative analysis, while five were selected for meta-analysis. The pooled effect estimates of SMD and 95% CI were -0.07 [-0.60 to 0.45] with an χ2 statistic of 0.32 (p = 0.0001), I2 = 80% as anti-plaque function and 95% CI were -2.07 [-4.05 to -0.10] with an χ2 statistic of 1.67 (p = 0.02), I2 = 82%.

    CONCLUSION: S. persica chewing stick is a tool that could control plaque, comparable to a standard toothbrush. Further, it has a better anti-gingivitis effect and can be used as an alternative.

  8. 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.
  9. Adam FA, Mohd N, Rani H, Mohd Yusof MYP, Baharin B
    J Ethnopharmacol, 2023 Feb 10;302(Pt A):115863.
    PMID: 36283639 DOI: 10.1016/j.jep.2022.115863
    ETHNOPHARMACOLOGICAL RELEVANCE: Salvadora persica L., also known as miswak, is an indigenous plant most prevalent in the Middle Eastern, some Asian, and African countries. It has medicinal and prophylactics function for numerous illnesses, including periodontal disease. Various trials, apart from World Health Organization encouragement have contributed to the production and use of S. persica in extract form in the formulation of mouthwash. This systematic review and meta-analysis aimed to compare the clinical effect of Salvadora persica-extract mouthwash and chlorhexidine gluconate mouthwash for anti-plaque and anti-gingivitis functions.

    METHODS: Using the PRISMA 2020 Protocol, a systematic search of the publications was undertaken from the MEDLINE, CENTRAL, Science Direct, PubMed, and Google Scholars for randomized control trials published through 31st January 2022 to determine the effectiveness of Salvadora persica-extract mouthwash relative to chlorhexidine gluconate as anti-plaque and anti-gingivitis properties.

    RESULTS: A total of 1809 titles and abstracts were screened. Of these, twenty-two studies met the inclusion criteria for the systematic review while only sixteen were selected for meta-analysis. The overall effects of standardized mean difference and 95% CI were 0.89 [95% CI 0.09 to 1.69] with a χ2 statistic of 2.54, 15 degrees of freedom (p 

  10. Anwar DS, Mohd Yusof MYP, Ahmad MS, Md Sabri BA
    Children (Basel), 2022 Nov 29;9(12).
    PMID: 36553300 DOI: 10.3390/children9121855
    Oral health is a likely source of health inequalities in children with special health care needs (CSHCN), according to multiple studies. This systematic review aimed to explore the evidence of family influence—as well as family features, such as societal variables and parents’ perspectives—on these children’s dental caries status. Embase, Ebsco, Scopus, PubMed, and Web of Science databases were all searched. All cross-sectional research published on the variables of family impact ranging from 2010 to 2021 were considered. The DMFT and dmft index was utilised for the report data of dental caries, whereas the National Heart, Lung, and Blood Institute (NHLBI) was used for the purposes of assessing quality. Of the 3861 records identified, 14 were eligible. Further, most of the studies had a caries prevalence of over 50%, (p-value < 0.005). Family influences imparted a significant relationship and association towards the dental caries status of the demographic being studied. The influences on the children included tooth brushing behaviour, parents’ education level, parents’ occupation level, diet pattern, dental visit, snacking frequency, parents’ psychological status, family size, and parents’ knowledge towards oral health. Future research should further explore the family functioning domains, specifically among the CSHCN population. This study was registered on PROSPERO, number CRD42021274923.
  11. Affandi TYIMS, Wan Mokhtar I, Mohd Yusof MYP, Ahmad MS
    J Int Soc Prev Community Dent, 2023;13(3):256-263.
    PMID: 37564173 DOI: 10.4103/jispcd.JISPCD_228_22
    AIMS AND OBJECTIVES: Special care dentistry (SCD) provides oral health care to disabled individuals in an environmental, cultural or social setting that supports their oral health. This study aimed to analyze the profiles of patients managed at an SCD clinic in a teaching hospital based on their sociodemographic background, medical condition or disability, dental diagnosis and treatment provided.

    MATERIALS AND METHODS: This retrospective audit study included patients seen from the clinic's inception in January 2017 until June 2022, retrieved from the faculty's record management system. The pattern of patients seen was arranged on an Excel sheet and analyzed using SPSS. Quantitative data were analyzed via descriptive analysis (frequency) and chi-square test (P < 0.05).

    RESULTS: A 220% surge in the number of patients treated between January 2017 and June 2022, from two to 91 years old, with more male patients seen. Most patients had an intellectual disability (49.7%), followed by medical compromised (16.4%) and genetic conditions or syndromes (12.0%). 43% of had caries, which is more prevalent in women, and 31.6% had periodontal disease, with the majority being between the ages of 21 and 40. Periodontal treatment accounted for most of the dental treatment (76.1%). Even though only a small percentage of endodontic therapy was performed (2.4%), a significant association was found between the treatment, gender and age group of patients seen in the clinic.

    CONCLUSION: Considering their health profile, oral diagnosis and therapy, this study demonstrated the varied sorts of patients encountered in an SCD specialist clinic. This useful information will be beneficial in the development of a comprehensive care dentistry center for this community.

  12. Zainuddin MZ, Mohamad NS, Su Keng T, Mohd Yusof MYP
    J Forensic Sci, 2023 Nov;68(6):2048-2056.
    PMID: 37529884 DOI: 10.1111/1556-4029.15352
    Conventional dental age estimation relies on destructive methods such as sectioning and staining, which are unpreferable when the tooth is required for evidential or archeological preservation. MicroCT is a non-destructive, high-resolution imaging technique that allows for accurate morphometrical measurement. Although microCT technology has been applied in a variety of dental studies, studies focusing on dental age-related change and dental age estimation based on microCT imaging remain lacking. Based on the question: "How has microCT technology been applied in studying human age-related tooth morphological change and dental age estimation studies?", the authors conducted a scoping review in accordance with the Arksey and O'Malley (2005) and the PRISMA-ScR guidelines. A literature search using five major scientific databases identified 452 articles, with 11 full-text articles being eligible to be included in the scoping review. Furthermore, 6 out of the 11 studies performed dental age estimation modeling. An overview of the parameters used in the selected articles revealed a variety of tooth characteristics, such as pulp cavity to whole tooth volume ratio, secondary dentin, as well as the diameter of root canal orifice. The findings of this scoping review highlight the extent microCT is used in studying dental age-related changes, as well as the effectiveness of microCT in dental age estimation studies. This review serves as a guide for future forensic odontology age estimation studies.
  13. Tabassum A, Chainchel Singh MK, Ibrahim N, Ramanarayanan S, Mohd Yusof MYP
    Biology (Basel), 2022 Oct 18;11(10).
    PMID: 36290424 DOI: 10.3390/biology11101521
    The aim of this study is two-fold: first, to correlate the values for each of the trabecular bone microstructure (TBM) parameters to the individual’s chronological age and sex, thereby facilitating the assessment of potential age and sex-related changes in trabecular bone microstructure parameters in the mandible; and second, to quantify the trabecular microstructural parameters in relation to chronological age. Twenty cone-beam computed tomographic (CBCT) scans were retrieved retrospectively from a database of adult patients with ages ranging in age from 22 to 43 years. In the mandible, the volume of interest included the inter-dental space between the second mandibular premolar and the first mandibular molar, as well as the trabecular space beneath and between the apices. Using the AnalyzeDirect 14.0 software, the DICOM images of CBCT scans were pre-processed, transformed, segmented using a novel semi-automatic threshold-guided method, and quantified. In addition, TBM parameters were derived, and statistical analysis was conducted using a Pearson correlation test with two tails. All parameters exhibited no statistically significant differences (p > 0.05) between chronological age and sex. Statistically significant negative correlations were found between Tb. N (r = −0.489), BS/TV (r = −0.527), and chronological age (p = 0.029 and p = 0.017, respectively). Only Tb. N and BS/TV exhibited an inverse relationship with chronological age. Numerous studies have quantified the trabecular architecture of the jaw bones, but none have found a correlation between the quantified trabecular parameters and chronological age. The digital imprints produced by radiographic imaging can serve as biological profiles for data collection.
  14. Mohd Daud SMS, Mohd Yusof MYP, Heo CC, Khoo LS, Chainchel Singh MK, Mahmood MS, et al.
    Sci Justice, 2022 Jan;62(1):30-42.
    PMID: 35033326 DOI: 10.1016/j.scijus.2021.11.002
    The use of drones has rapidly evolved over the past decade involving a variety of fields ranging from agriculture, commercial and becoming increasingly used in disaster management or humanitarian aid. Unfortunately, the evidence of its use in mass disasters is still unclear and scarce. This article aims to evaluate the current drone feasibility projects and to discuss a number of challenges related to the deployment of drones in mass disasters in the hopes of empowering and inspiring possible future work. This research follows Arksey and O'Malley framework and updated by Joanna Briggs Institute Framework for Scoping Reviews methodology to summarise the results of 52 research papers over the past ten years, from 2009 to 2020, outlining the research trend of drone application in disaster. A literature search was performed in Medline, CINAHL, Scopus, individual journals, grey literature and google search with assessment based on their content and significance. Potential application of drones in disaster are broad. Based on articles identified, drone application in disasters are classified into four categories; (1) mapping or disaster management which has shown the highest contribution, (2) search and rescue, (3) transportation and (4) training. Although there is a significant increase in the number of publications on use of drone in disaster within the last five years, there is however limited discussion to address post-disaster healthcare situation especially with regards to disaster victim identification. It is evident that drone applications need to be further explored; to focus more on drone assistance to humans especially in victim identification. It is envisaged that with sufficient development, the application of drones appears to be promising and will improve their effectiveness especially in disaster management.
  15. Mohammed IE, Shariff N, Mohd Hanim MF, Mohd Yusof MYP, Md Sabri BA, Md Bohari NF, et al.
    Children (Basel), 2022 Dec 09;9(12).
    PMID: 36553379 DOI: 10.3390/children9121936
    Apart from the major drawback of black staining once lesion is arrested, few studies have indicated that dental personnel's perception and attitude towards silver diamine fluoride (SDF) influences its usage. This report aims to provide a systematic review presenting dental personnel's knowledge, attitudes, and perceptions, (KAPs) regarding SDF. A search of multiple electronic literature databases and a manual search were performed. The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. A comprehensive search yielded 719 publications and 14 cross-sectional studies matching the inclusion criteria. Awareness of SDF among respondents ranged from 29.6% to 87.8%, whereas awareness of its use in dentistry ranged from 14.4% to 94.5%. Regarding attitude towards SDF, the mean score ranged from 3.39 to 14.35. An increase in knowledge of and attitude towards SDF is significantly associated with the usage of SDF and may increase the usage of SDF. This review provides vital information on dental personnel's KAPs regarding SDF. It is anticipated that the adaptation of SDF usage will be more widespread in the future, especially among children. Findings from the review may assist intervention programs to change misperceptions and to enhance awareness regarding SDF among dental personnel.
  16. Tuan Soh TY, Nik Mohd Rosdy NMM, Mohd Yusof MYP, Azhar Hilmy SH, Md Sabri BA
    J Pers Med, 2022 Nov 01;12(11).
    PMID: 36579540 DOI: 10.3390/jpm12111814
    The utilization of digital personal health records is considered to be appropriate for present-time usage; it is expected to further enhance primary care's quality-of-service delivery. Despite numerous studies conducted on digital personal health records, efforts in a systematic evaluation of the topic have failed to establish the specific benefits gained by patients, health providers, and healthcare systems. This study aimed to conduct a systematic review regarding the impact of digital personal health records in relation to the delivery of primary care. The review methods included five methodological elements that were directed by the review protocol 2020 (PRISMA). Over a time period of 10 years (2011-2021), 2492 articles were retrieved from various established databases, including Scopus, Web of Science, PubMed, EBSCO-Medline, and Google Scholar, and based on reference mining. The Mixed Method Appraisal Tool (MMAT) was used for quality appraisal. A thematic analysis was performed to develop the themes in this study. The thematic analysis performed on 13 articles resulted in seven main themes, which were empowering the patient, helping with communication, improving relationships, improving the quality of care, maintaining health records, sharing records, and saving time. We concluded the study by expanding the seven themes into 26 sub-themes, of which each served as answers to our main research question that prompted this systematic review.
  17. Syed Mohd Daud SM, Heo CC, Mohd Yusof MYP, Khoo LS, Chainchel Singh MK, Mahmood MS, et al.
    J Forensic Sci, 2024 Mar;69(2):542-553.
    PMID: 38402526 DOI: 10.1111/1556-4029.15466
    Manual ground searches and cadaver dogs are traditional methods for locating remains, but they can be time- and resource-intensive, resulting in the decomposition of bodies and delay in victim identification. Therefore, thermal imaging has been proposed as a potentially useful tool for detecting remains based on their temperature. This study investigated the potential of a novel search technique of thermal drones to detect surface remains through the detection of maggot mass temperatures. Two trials were carried out at Selangor, Malaysia, each utilizing 12 healthy male Oryctolagus cuniculus European white rabbits and DJI Matrice 300 RTK drone China, equipped with a thermal camera; Zenmuse H20T to record the thermal imaging footage of the carcasses at various heights (15, 30, 60-100 m) for 14 days for each trial. Our results demonstrated that the larval masses and corresponding heat emissions were at their largest during the active decay stage; therefore, all the carcasses were observable in thermal images on day 5 and remained until day 7. Statistical analyses showed that (1) no statistically significant differences in thermal images between clothed and unclothed subjects (p > 0.05); (2) 15 m above ground level was proven to be the optimal height, as it showed the greatest contrast between the carcass heat signature and the background (p 
  18. Angelakopoulos N, Galić I, Balla SB, Kiş HC, Gómez Jiménez L, Zolotenkova G, et al.
    Int J Legal Med, 2021 Nov;135(6):2423-2436.
    PMID: 34228192 DOI: 10.1007/s00414-021-02656-2
    The diagnostic accuracy of the I3M to assess the legal age of 18 years has already been tested in several specific-population samples. The left lower third molar has been extensively used for discriminating between minors and adults. This research aimed to compare the usefulness of lower third molar maturity indexes, from both left and right side (I3ML and I3MR), in samples originating from four distinct continents in order to examine possible differences in their accuracy values. For this purpose, a sample of 10,181 orthopantomograms (OPGs), from Europe, Africa, Asia and America, was analysed and previously scored in other studies. The samples included healthy subjects with no systemic disorders with both third molars and clear depicted root apices. Wilcoxon Signed Rank test for left and right asymmetry did not show any significant differences. Data about sensitivity, specificity, predictive values, likelihood ratio and accuracy were pooled together and showed similar results for I3ML and I3MR, respectively. In addition, all these quantities were high when only the I3MR was considered to discriminate between adults and minors. The present referable database was the first to pool third molar measurements using panoramic radiographs of subjects coming from different continents. The results highlighted that both I3ML and I3MR are reliable indicators for assessing the legal age of 18 years old in those jurisdictions where this legal threshold has been set as the age of majority.
  19. Angelakopoulos N, De Luca S, Oliveira-Santos I, Ribeiro ILA, Bianchi I, Balla SB, et al.
    Int J Legal Med, 2023 Mar;137(2):403-425.
    PMID: 36520207 DOI: 10.1007/s00414-022-02930-x
    Identification of living undocumented individuals highlights the need for accurate, precise, and reproducible age estimation methods, especially in those cases involving minors. However, when their country of origin is unknown, or it can be only roughly estimated, it is extremely difficult to apply assessment policies, procedures, and practices that are accurate and child-sensitive. The main aim of this research is to optimize the correct classification of adults and minors by establishing new cut-off values for four different continents (Africa, America, Asia, and Europe). For this purpose, a vast sample of 10,701 orthopantomographs (OPTs) from four continents was evaluated. For determination and subsequent validation of the new third molar maturity index (I3M) cut-off values by world regions, a cross-validation by holdout method was used and contingency tables (confusion matrices) were generated. The lower third molar maturity indexes, from both left and right side (I3ML and I3MR) and the combination of both sides (I3ML_I3MR) were calculated. The new cut-off values, that aim to differentiate between a minor and an adult, with more than 74.00% accuracy for all populations were as follows (I3ML; I3MR; I3ML_I3MR, respectively): Africa = (0.10; 0.10; 0.10), America = (0.10; 0.09; 0.09), Asia = (0.15; 0.17; 0.14), and Europe = (0.09; 0.09; 0.09). The higher sensitivity (Se) was detected for the I3ML for male African people (91%) and the higher specificity (Sp) of all the parameters (I3ML; I3MR; I3ML_I3MR) for Europeans both male and female (> 91%). The original cut-off value (0.08) is still useful, especially in discriminating individuals younger than 18 years old which is the goal of the forensic methods used for justice.
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