Accepted Manuscript Title: Craniometric analysis for estimation of stature in Nepalese population–A study on an autopsy sample Author: Rijen Shrestha Pramod Kumar Shrestha Harihar Wasti Tulsi Kadel Tanuj Kanchan Kewal Krishan PII: DOI: Reference:
S0379-0738(14)00531-3 http://dx.doi.org/doi:10.1016/j.forsciint.2014.12.014 FSI 7847
To appear in:
FSI
Received date: Revised date: Accepted date:
23-3-2014 26-10-2014 13-12-2014
Please cite this article as: R. Shrestha, P.K. Shrestha, H. Wasti, T. Kadel, T. Kanchan, K. Krishan, Craniometric analysis for estimation of stature in Nepalese populationndashA study on an autopsy sample, Forensic Science International (2014), http://dx.doi.org/10.1016/j.forsciint.2014.12.014 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
*Title Page (with authors and addresses)
Original Research Article Craniometric analysis for estimation of stature in Nepalese population – A study on an
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autopsy sample
Authors (with affiliation)
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Rijen Shrestha, Department of Forensic Medicine, Maharajgunj Medical Campus, Tribhuvan
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University, Nepal.
Pramod Kumar Shrestha, Department of Forensic Medicine, Maharajgunj Medical Campus,
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Tribhuvan University, Nepal.
Harihar Wasti, Department of Forensic Medicine, Maharajgunj Medical Campus, Tribhuvan
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University, Nepal.
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University, Nepal.
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Tulsi Kadel, Department of Forensic Medicine, Maharajgunj Medical Campus, Tribhuvan
Tanuj Kanchan, Department of Forensic Medicine, Kasturba Medical College, Mangalore (A
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Constituent College of Manipal University, Manipal), India. Kewal Krishan, Department of Anthropology, Panjab University, Chandigarh, India
Corresponding Author Dr. Tanuj Kanchan,
Associate Professor, Department of Forensic Medicine, Kasturba Medical College, Mangalore (A Constituent College of Manipal University, Manipal), India. E-mail: [email protected]; [email protected] Mobile: +91 94482 52394
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*Highlights (for review)
Highlights
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Cranial measurements were analysed for stature estimation in Nepalese population. A statistically significant correlation existed between stature and the cranial measurements. Multivariate regression models are more accurate than univariate and bivariate models in stature estimation. Cranial measurements can be utilized in stature estimation when other more accurate means are not available.
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*Manuscript (without author details)
Original Research Article Craniometric analysis for estimation of stature in Nepalese population – A study on an
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autopsy sample
Abstract
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Establishing the identity of the deceased becomes essential when highly decomposed
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bodies, mutilated body parts or skeletal remains are recovered from mass fatality sites. In these situations, estimation of stature along with other parameters such as age, sex and race/ethnicity
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becomes important to establish the biological profile of the deceased. Following the Maoist insurgency in Nepal, there have been numerous discoveries of unidentified human remains in
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mass graves or otherwise. No systemic studies and anthropological data on the Nepalese
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population however, is available posing problems in anthropologic evaluation of the remains.
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The sample of the present study consisted of 200 autopsied cases (148 males and 52 female adult cadavers). During the autopsy, the scalp was reflected after giving a coronal incision extending
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from one mastoid to the other exposing the cranium in each case. Maximum cranial length (MCL), maximum cranial breadth (MCB), bi-zygomatic breadth (BZB), minimum frontal breadth (MFB) and length of parietal chord (PC) were then measured. Stature was measured as the length of the body from head to heel in centimeters with the heel, buttocks, back of the shoulders and the head in contact with the autopsy table. Linear and stepwise multiple regression models were derived for estimation of stature from cranial measurements. Univariate, bivariate and multivariate regression models show statistically significant correlation between stature and the cranial measurements. The present study opines that the stature estimation from cranial dimensions using multivariate linear regression models is more accurate than those of the
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univariate and bivariate regression models. This study presents a rare data from Nepalese population that show typical Asian features and thus, is significant from anthropologic and genetic point of view. The study observations further contribute a baseline data bank for forensic
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pathologists and specialists.
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Keywords
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Forensic Sciences; Forensic Anthropology; Identification; Craniometry; Stature; Correlation;
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Regression models; Nepalese population
1. Introduction
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Identification is an important aspect in civil, criminal, legal, and statistical investigations.
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The task of identification becomes challenging when dismembered or skeletal remains are
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brought for examination [1]. Sex, age and stature are considered as the primary indicators in the identification of human/ skeletal remains. The somatometric, osteological and radiological
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examination of the remains help in determining these primary indicators. Anthropometric measurements of various parts of the body have been used to derive information on the primary indicators of identification. Stature estimation is one of the essential criteria towards establishing the biological profile of an individual. Promising in the process of stature estimation is the fact that various body parts are shown to have correlation with stature [2]. In the past, estimation of stature has been attempted on long bones of the upper and lower limbs [3-5], sternum [6,7] vertebral column [8,9], scapula [10,11], pelvis [12] and smaller bones [13] including metacarpals [14] and metatarsals [16]. In this regard, the literature on relationship between cranial measurements and stature is limited.
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A thorough review of literature shows that Introna et al. [16] for the very first time evaluated the relationship of cranial measurements with stature in 358 Italian males aged between 17 to 27 years. They [16] observed a positive correlation between maximum anterior-
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posterior and lateral cranial diameters with stature and proposed a regression equation for estimation of stature from cranial measurements. Later, Chiba and Terazawa [17] conducted a
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study of relationship of somatometry of skull with stature in 124 Japanese cadavers and proposed
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population specific regression equations for estimation of stature using different parameters (distance between glabella and external protuberance, length around the skull through the
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glabella and the external protuberance and the sum of these two measurements). Patil and Mody [18] took measurements on lateral cephalograms of 150 adults ranging in age from 25–54 years
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from Central India and devised sex specific regression models for estimation of stature from
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maximum cranial length in males and females. Ryan and Bidmos [19] carried out a similar study
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on the skulls from Raymond A. Dart Collection from the University of the Witwatersrand Johannesburg, South Africa. They [19] measured six parameters on the skulls and observed a
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positive and significant correlation between skull measurements and skeletal height. They [19] proposed regression models for estimation of skeletal height from various combinations of these six measurements. Krishan and Kumar [20] measured 16 cephalo-facial measurements on a sample of 253 adolescent males from an endogamous population of North India. They [20] found a positive and strong correlation between stature and some cephalo-facial measurements and proposed regression formulae for stature estimation from each measurement separately. Krishan [21] further studied 996 adult male Gujjars from North India and established a positive and strong correlation between five cephalo-facial measurements and stature. He devised regression formulae to estimate stature from these five cephalo-facial measurements [21]. Rao et al [22]
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used curved measurements of the length of the sagittal and coronal sutures in 87 autopsied cases of South Indian origin and found significant correlation between the coronal suture length and the height of the person. Agnihotri et al. [23] in a study on 150 young Indo-Mauritian adults took
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14 cephalo-facial measurements and devised multivariate separate regression models for estimation of stature among males and females. Giurazza et al. [24] conducted a study on 200
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Caucasian adult patients using CT scans of crania. They [24] measured six parameters on each
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CT scan and devised multiple regression models for estimation of stature from these cranial measurements. Thus, the cranial measurements used by researchers in stature estimation are
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either the direct bone measurements [19, 22], percutaneous measurements of the head and face [20,21,23] or measurements based on radiographs and computed tomography (CT) scans [18,24].
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Of all the measurements techniques, craniometric analysis is the most popular in forensic
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anthropology case work.
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Nepal is just reeling out of the greatest political disaster in its history; the Maoist insurgency that started in early 1996. Following the Maoist insurgency in Nepal, there have been numerous
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discoveries of unidentified human remains in mass graves or otherwise. The identification of these bodies or body parts is one of the greatest challenges to the medicolegal experts in Nepal. The major hindrances in this regard are the lack of systemic studies and anthropological data on the Nepalese population. It is a well-established fact that population specific formulae need to be derived for the estimation of anthropometric parameters in different populations due to inherent population differences attributed to the genetic and environmental causes [25]. Besides, temporal variations in cranial measurements are reported [26], hence, a growing need to conduct anthropometric/craniometric studies in modern samples and derive models applicable to modern populations. Developing anthropometric databases are of paramount importance in the
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developing world owing to the lack of facilities and resources for conducting DNA analysis for the establishment of positive identity as used frequently in the more developed countries. Anthropometric studies on cephalo-facial dimensions in Nepalese population are limited. A
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study of facial height from Sunsari district of Nepal [27] has shown statistically significant differences of the upper and lower face height proportions among four endogamous communities
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in the region while another study was an attempt to estimate cephalic index in the Gurung
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community of Nepal [28]. None of these studies however, have utilized cranial measurements for estimation of stature. The present research was thus, conducted with an aim to establish
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correlation between stature and craniometric measurements obtained on autopsied skulls in modern Nepalese population, and to derive regression models for estimation of stature among
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2. Materials and Methods
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males and females.
The present autopsy study was conducted on 200 medico-legal autopsies at the
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Kathmandu Autopsy Center, Department of Forensic Medicine, Institute of Medicine, Kathmandu, Nepal during September 2010 and July 2011. The study sample consisted of 148 males and 52 female cadavers of Nepalese origin. The differences in sample size of males and females is attributed to the differences in the proportion of non-natural deaths among males and females in the autopsied cases at Kathmandu, Nepal. All the cases with evidence of injuries to the head, spine or lower limbs were excluded from the study. The stature was measured as the length of the body from head to heel in centimeters with the heel, buttocks, back of the shoulders and the head in contact with the autopsy table. During the autopsy, a coronal incision was made extending from one mastoid process to the other and the scalp was reflected anteriorly and
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posteriorly, thus, exposing the cranium. The measurements included in the present study were limited to those accessible on the cranium exposed on the reflection of the scalp. Cranial measurements were taken in accordance with that described in the literature [29]. The landmarks
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on the cranium used in the study are detailed in the Table 1. All the measurements were taken by the first author using standard landmarks, techniques and instruments. The following cranial
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measurements were taken in cm to the nearest millimeter in the study (Figure 1).
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1. Maximum Cranial Length (MCL): distance between glabella (g) and opisthocranion (op) in the mid-sagittal plane (g-op), measured in a straight line using the spreading caliper.
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2. Maximum Cranial Breadth (MCB): distance between both euryon (eu) perpendicular to the mid-sagittal plane (eu-eu) using the spreading caliper.
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3. Bi-Zygomatic Breadth (BZB): distance between most lateral points on the zygomatic aches
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(zy-zy) using the sliding caliper.
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4. Minimum Frontal Breadth (MFB): distance between both frontotemporales (ft) measured in straight line (ft-ft) using the sliding caliper.
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5. Parietal Chord (PC): distance from bregma (b) to lambda (l) taken in the mid-sagittal plane (b-l) using the sliding caliper.
The data collected was analyzed using SPSS (Statistical Package for Social Sciences, version 15.0) computer software (SPSS, Inc., Chicago, IL, USA). The descriptive analysis was done to obtain mean, standard deviation (S.D) and range of the measurements. Pearson’s correlation analysis was performed to determine the relationship between the cranial measurements and the length of the body. Regression analysis was performed, taking stature as the dependent variable and each cranial measurement as an independent variable. Univariate regression models were derived to estimate stature from each cranial measurement independently
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among males and females (sex-specific regression models), and for the total study sample (pooled regression models). Similarly, stepwise multiple regression models were derived to estimate stature from a combination of different cranial measurements among males, females and
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total study population. A p-value of less than 0.05 was considered as statistically significant.
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3. Results
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The age of the study sample ranged between 20 years and 91 years. The mean age of the study sample was 38.63 years with a standard deviation (SD) of 14.21 years. The mean age and
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standard deviation for the males and females are shown in Table 2. The mean stature of the study population was 163.31 cm. Stature was observed to be larger in males than females. It was
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observed that the mean stature for males and females was 166.22 cm and 155.02 cm respectively.
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The sex differences in stature were observed to be statistically significant (Table 3).
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Among the cranial measurements, maximum cranial length was observed to be the largest (Mean=17.58 cm) and minimum frontal breadth (Mean=9.47 cm) as the smallest measurement.
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Mean maximum cranial breadth, bi-zygomatic breadth, and parietal chord was 13.25 cm, 12.24 cm and 11.27 cm respectively. All the cranial measurements were found to have a normal to uniform distribution that varied mainly within ± 3 standard deviations of the mean. Maximum cranial breadth was observed to have the minimum variance while parietal chord was found to have the maximum variance among males and females. The variance however, was comparatively less amongst females than males. Cranial measurements were observed to be significantly larger in males than females. The descriptive statistics for cranial measurements among males and females are shown in Table 3.
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On correlation between stature and maximum cranial length, maximum cranial breadth, bi-zygomatic breadth, minimum frontal breadth and parietal chord, the Pearson’s co-efficient of correlation were found to be statistically significant for stature and cranial measurements for the
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entire sample. The correlation coefficients varied between 0.219 for parietal chord and 0.494 for maximum cranial length. Among males, a statistically significant correlation was observed
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between stature and all cranial measurements except for maximum cranial breadth. The
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statistically significant correlations varied between 0.162 for parietal chord and 0.327 for maximum cranial length and bi-zygomatic breadth. Among females, however, a statistically
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significant correlation was only observed between stature and maximum cranial length (Table 4). The derived univariate linear regression models showed a statistically significant
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correlation with stature among males, females and in the total study sample. The standard error
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of estimate (SEE) for the regression models derived on the entire study sample was higher when
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compared to regression models derived among males and females separately and varied between 7.437 cm (MCL) and 8.348 cm (PC). Minimum SEE was observed for the regression models
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derived from maximum cranial length and bi-zygomatic breadth (6.894 cm) in males and for maximum cranial length in females (5.692 cm). The univariate regression models that show a relatively higher correlation coefficient and lower SEE in each category (males, females and total sample) are presented in Table 5.
For bivariate and multivariate regression models derived for estimation of stature, the standard error of estimate for different possible combination of variables varied between 6.943 cm to 8.136 cm in the total study sample, between 6.640 cm and 7.041 cm among males, and between 5.538 cm and 5.746 cm in females. Multivariate linear regression models have shown a lesser standard error of estimate in stature estimation when compared to the linear and bivariate
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linear regression models. The bivariate and multivariate regression models that show a relatively higher correlation coefficient and lower SEE among males, females and total sample are
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presented in Table 6.
4. Discussion
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Cranium is an important bone that has generated considerable interest among forensic
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anthropologists in the past. Anthropologists have long been studying cranial variations among populations having bearing on age, ethnicity and sexual dimorphism. Studies have also shown
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that biological profile pertaining to age, sex and race/ethnicity can be established if the cranium or its parts are available for medico-legal examinations [30-39]. The present research on stature
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estimation from cranial measurements indicates that cranial measurements such as maximum
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cranial length (MCL) and bi-zygomatic breadth (BZB) show stronger correlation with stature
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than the other measurements such as minimum frontal breadth (MFB), maximum cranial breadth (MCB) and parietal chord (PC) in males and total study sample. On the other hand in females,
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only maximum cranial length shows stronger correlation with stature. Thus, MCL among males, females and the total study sample and BZB in males and total study sample indicate a high degree of accuracy and reliability in estimation of stature than the other measurements included in the study. This is further confirmed by a relatively lower standard error of estimate (SEE) observed for these measurements. The higher correlation values (r) for total study sample when compared to males and females can be attributed to the increased sample size because of pooling of male and female samples [40]. This however, is associated with higher SEE that can be related to the increases variance of the pooled data. Likewise, lower correlation values (r) reported for females may be attributed to the comparatively smaller female sample size when compared to
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males. The study further shows that the stature estimation from cranial dimensions using multivariate linear regression models is more accurate than those of the univariate and bivariate regression models.
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Since the studies on correlation between direct cranial measurements and stature are limited, the findings of the present study are compared with the available studies on stature
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estimation from cranial as well as cephalo-facial dimensions in different populations [17-21,
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23,24,41]. Chiba and Terazawa [17] observed a SEE of 6.96 cm in males and 6.71 cm in females in their study on Japanese cadavers using cranial length and horizontal circumference of the
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cranium for estimation of stature. Patil and Mody [18] observed a positive and strong correlation between stature and lateral cephalogram and reported a SEE of 3.71 and 4.26 in males and
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females respectively. Ryan and Bidmos [19] took six cranial diameters for estimation of stature
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in indigenous South Africans and reported a SEE ranging between 4.37 and 6.24 cm. Krishan
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and Kumar [20] in a study on stature estimation using 16 cephalo-facial dimensions in male adolescents reported SEE of 4.41–7.21 cm. Krishan [21] observed a SEE of 4.136 to 5.820 cm
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in a study on the relationship of five cephalo-facial dimensions with stature in North Indian males. Sahni et al. [41] in their study on estimation of stature from seven facial measurements in North-west Indians reported a SEE of 3.56 to 3.70 cm. Agnihotri et al. [23] in their study on stature estimation from 14 cephalo-facial measurements in Indo-Mauritian population reported the correlation between the cephalo-facial measurements with stature, however, they did not report the SEE in estimating stature. Giurazza et al. [24] conducted another study on the stature estimation from cranial measurements taken from CT scans of Italians and found an absolute error of 3.8 cm and 3.9 cm taking length of cranial base and distance from basion to nasal bone respectively. When compared to the aforementioned studies on different cranial and craniofacial
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measurements among different population groups, the present study reported a higher SEE suggesting of a lower reliability of cranial measurements for stature estimation in Nepalese population. Likewise, a study on stature estimation from cephalo-facial dimensions of Turkish
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population [42] has reported very low correlation coefficients of cephalo-facial dimensions with
cephalo-facial dimensions is not reliable in forensic practice.
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stature (ranging between 0.012 and 0.229) and concluded that the stature estimation from
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The differences in the reliability of the cranial and cephalo-facial measurements in stature estimation between studies can be attributed to the differences in measurements included in
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earlier studies and the differences in the methodologies adopted for taking measurements i.e. direct measurements, measurements on lateral cephalogram, CT scans etc. Besides, population
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differences may also be related to the differences in the observations reported in the studies.
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Most of the Asians such as Mongols, Manchus, Chinese, Koreans, Japanese, Annamese,
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Siamese, Burmese, Tibetans, and Nepalese are known to have flatter faces [43-45] and shorter stature. The Nepalese population thus, displays typical Asian characteristics of flatter faces and
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shorter stature when compared to their counterparts from other parts of the world. In this regard, the present study on autopsied skulls in Nepalese population by means of univariate and multivariate regression models for estimation of stature reports a SEE similar to that reported in a cadaveric study on ethnically similar Japanese population [17]. This lower accuracy and reliability in estimation of stature from cranio-facial measurements may be attributed to the longer craniums, flatter faces and short stature in Nepalese population. The stature estimation may help in establishing the biological profile of the deceased along with other methods of estimation of sex, age and ethnicity from examination of the cranium. Considering the higher SEE observed in the study on Nepalese population, we suggest
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that cranial measurements can be utilized for estimating stature of a person using multivariate analysis in cases when other more accurate means of stature estimation and identification are not available. In such scenario, sex-specific regression models can be applied when the sex is
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known/ estimated using morphological/ morphometric methods. In cases when the sex is unassigned, universal regression formula can be used for estimation of stature. Since the present
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study is conducted on an autopsy sample, it presents standards for estimation of cadaveric length/
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stature from skull measurements. The cadaveric stature is known to show variations from the living stature. Using Fully’s method of stature estimation, Bidmos [46] in a study, showed that
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the documented cadaver lengths were significantly higher than the estimated living stature. Therefore, it is suggested that the formulae derived in the study should be used with caution for
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stature estimation.
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Nepal is a small country with a population having typical Asian features. The database
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pertaining to anthropometric variables from the skeletal elements is scanty in Nepal due to nonavailability of skeletal collections. The present study is an important one in the sense that it
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provides rare data of the autopsied sample on modern Nepalese population which can be helpful in the identification of mutilated and dismembered skeletal remains especially when the skull vault is brought for examination. Moreover, the data represents an endogamous population which is also significant from forensic, genetic and anthropologic point of view by providing a database for comparison with further studies. It is suggested that similar studies are conducted among different population groups in Nepal to see if any variations exist between these groups.
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skeletal remains using Fordisc based on a recent skull collection, Int J. Legal Med. 121 (2007) 477-482. [31]
R. Thapar, P.V. Angadi, S. Hallikerimath, A.D. Kale, Sex assessment using odontometry and cranial anthropometry: evaluation in an Indian sample, Forensic Sci. Med. Pathol. 8 (2012) 94–100.
[32]
Y.P. Raghavendra Babu, T. Kanchan, Y.
Attiku, P.N. Dixit, M.S. Kotian, Sex
estimation from foramen magnum dimensions in an Indian population, J. Forensic Leg. Med. 19 (2012) 162-167.
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[33]
T. Kanchan, A. Gupta, K. Krishan, Estimation of sex from mastoid triangle - a craniometric analysis, J. Forensic Leg. Med. 20 (2013) 855-860.
[34 ]
F. Chiba, Y. Makino, A. Motomura, G. Inokuchi, S. Torimitsu, N. Ishii, A.
Iwase, Age estimation by multidetector CT images of the
sagittal suture. Int. J. Legal
Med. 127 (2013) 1005- 1011
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R.B. Bassed, C. Briggs, O.H. Drummer, Analysis of time of closure of the spheno-
us
[35]
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Sakuma, S. Nagasawa, H. Saitoh, D. Yajima, M. Hayakawa, Y. Odo, Y. Suzuki, H.
occipital synchondrosis using computed tomography. Forensic Sci. Int. 200 (2010): 161-
[36]
an
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Y. Ogawa, K. Imaizumi, S. Miyasaka, M. Yoshino, Discriminant functions for sex
D. Franklin, A. Cardini, A. Flavel, A. Kuliukas, Estimation of sex from cranial
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[37]
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estimation of modern Japanese skulls, J. Forensic Leg. Med. 20 (2013) 234-248.
[38]
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measurements in a Western Australian population, Forensic Sci. Int. 229 (2013) 158.e1-8. C.E. Hughes, M.L. Tise, L.H. Trammell, B.E. Anderson, Cranial morphological variation
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among contemporary Mexicans: Regional trends, ancestral affinities, and genetic comparisons, Am. J. Phys. Anthropol. 151 (2013) 506-517. [39]
L. Kallenberger, V. Pilbrow, Using CRANID to test the population affinity of known crania, J. Anat. 221 (2012) 459-464.
[40]
T. Kanchan, R.G. Menezes, R. Moudgil, R. Kaur, M.S. Kotian, R.K. Garg, Stature estimation from foot length using universal regression formula in a North Indian population, J. Forensic Sci. 55 (2010) 163–166.
[41]
D. Sahni, Sanjeev, P. Sharma, H. Kaur, A. Aggarwal, Estimation of stature from facial measurements in northwest Indians, Leg. Med (Tokyo) 12 (2010) 23-27.
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[42]
C. Pelin, R. Zağyapan, C. Yazici, A. Kürkçüoğlu, Body height estimation from head and face dimensions: a different method, J. Forensic Sci. 55 (2010) 1326-1330.
[43]
W.M. Bass, Developments in the Identification of Human Skeletal Material, Am. J. Phys.
[44]
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Anthropol. 51 (1979) 555-562.
W.M. Bass, Human Osteology: A Laboratory and Field Manual, Columbia:
J. Blumenfeld, Racial Identification in the Skull and Teeth. Totem: The Univ.
us
[45]
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Missouri Archaeological Society, Inc. 1995.
Western Onta. J. Anthropol. 8 (2000), Available at: http://ir.lib.uwo.ca/totem/vol8/iss1/4.
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M.A. Bidmos, On the non-equivalence of documented cadaver lengths to living stature
te
d
Forensic Sci. 50 (2005) 501-506.
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estimates based on Fully's method on bones in the Raymond A. Dart Collection, J.
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[46]
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Table 1: The landmarks on cranium used in the study Description
Euryon (eu)
The two points on the opposite sides of the cranium that form termini of the lines of greatest cranial breadth.
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Landmark
The most laterally positioned point on the zygomatic arch.
Frontotemporale (ft)
The point where the temporal line reaches its most antero-medial position
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Zygion (zy)
Glabella (g)
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on the frontal bone.
The most forward projecting point in the midline of the forehead at the
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level of the supra-orbital ridges and above the naso-frontal suture. The intersection of the coronal and sagittal sutures in the midline.
Lambda (l)
The intersection of the sagittal and lambdoidal sutures in the midline.
Opisthocranion (op)
The most posterior point on the cranium.
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d
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Bregma (b)
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Table 2: Descriptive statistics: Age distribution of the study sample
Males
148
20
91
39.6
14.4
Females
52
20
79
35.9
13.4
20
91
38.6
14.2
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M
an
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Both Sexes 200
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Sample Size (N) Minimum Maximum Mean Standard Deviation
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Table 3: Descriptive statistics: Stature and cranial measurements among males and females Males (N=148)
Females (N=52) Maximum
Mean
S.D
155.0
6.1
S0379-0738(14)00531-3 http://dx.doi.org/doi:10.1016/j.forsciint.2014.12.014 FSI 7847
To appear in:
FSI
Received date: Revised date: Accepted date:
23-3-2014 26-10-2014 13-12-2014
Please cite this article as: R. Shrestha, P.K. Shrestha, H. Wasti, T. Kadel, T. Kanchan, K. Krishan, Craniometric analysis for estimation of stature in Nepalese populationndashA study on an autopsy sample, Forensic Science International (2014), http://dx.doi.org/10.1016/j.forsciint.2014.12.014 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
*Title Page (with authors and addresses)
Original Research Article Craniometric analysis for estimation of stature in Nepalese population – A study on an
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autopsy sample
Authors (with affiliation)
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Rijen Shrestha, Department of Forensic Medicine, Maharajgunj Medical Campus, Tribhuvan
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University, Nepal.
Pramod Kumar Shrestha, Department of Forensic Medicine, Maharajgunj Medical Campus,
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Tribhuvan University, Nepal.
Harihar Wasti, Department of Forensic Medicine, Maharajgunj Medical Campus, Tribhuvan
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University, Nepal.
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University, Nepal.
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Tulsi Kadel, Department of Forensic Medicine, Maharajgunj Medical Campus, Tribhuvan
Tanuj Kanchan, Department of Forensic Medicine, Kasturba Medical College, Mangalore (A
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Constituent College of Manipal University, Manipal), India. Kewal Krishan, Department of Anthropology, Panjab University, Chandigarh, India
Corresponding Author Dr. Tanuj Kanchan,
Associate Professor, Department of Forensic Medicine, Kasturba Medical College, Mangalore (A Constituent College of Manipal University, Manipal), India. E-mail: [email protected]; [email protected] Mobile: +91 94482 52394
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*Highlights (for review)
Highlights
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Cranial measurements were analysed for stature estimation in Nepalese population. A statistically significant correlation existed between stature and the cranial measurements. Multivariate regression models are more accurate than univariate and bivariate models in stature estimation. Cranial measurements can be utilized in stature estimation when other more accurate means are not available.
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*Manuscript (without author details)
Original Research Article Craniometric analysis for estimation of stature in Nepalese population – A study on an
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autopsy sample
Abstract
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Establishing the identity of the deceased becomes essential when highly decomposed
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bodies, mutilated body parts or skeletal remains are recovered from mass fatality sites. In these situations, estimation of stature along with other parameters such as age, sex and race/ethnicity
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becomes important to establish the biological profile of the deceased. Following the Maoist insurgency in Nepal, there have been numerous discoveries of unidentified human remains in
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mass graves or otherwise. No systemic studies and anthropological data on the Nepalese
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population however, is available posing problems in anthropologic evaluation of the remains.
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The sample of the present study consisted of 200 autopsied cases (148 males and 52 female adult cadavers). During the autopsy, the scalp was reflected after giving a coronal incision extending
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from one mastoid to the other exposing the cranium in each case. Maximum cranial length (MCL), maximum cranial breadth (MCB), bi-zygomatic breadth (BZB), minimum frontal breadth (MFB) and length of parietal chord (PC) were then measured. Stature was measured as the length of the body from head to heel in centimeters with the heel, buttocks, back of the shoulders and the head in contact with the autopsy table. Linear and stepwise multiple regression models were derived for estimation of stature from cranial measurements. Univariate, bivariate and multivariate regression models show statistically significant correlation between stature and the cranial measurements. The present study opines that the stature estimation from cranial dimensions using multivariate linear regression models is more accurate than those of the
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univariate and bivariate regression models. This study presents a rare data from Nepalese population that show typical Asian features and thus, is significant from anthropologic and genetic point of view. The study observations further contribute a baseline data bank for forensic
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pathologists and specialists.
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Keywords
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Forensic Sciences; Forensic Anthropology; Identification; Craniometry; Stature; Correlation;
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Regression models; Nepalese population
1. Introduction
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Identification is an important aspect in civil, criminal, legal, and statistical investigations.
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The task of identification becomes challenging when dismembered or skeletal remains are
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brought for examination [1]. Sex, age and stature are considered as the primary indicators in the identification of human/ skeletal remains. The somatometric, osteological and radiological
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examination of the remains help in determining these primary indicators. Anthropometric measurements of various parts of the body have been used to derive information on the primary indicators of identification. Stature estimation is one of the essential criteria towards establishing the biological profile of an individual. Promising in the process of stature estimation is the fact that various body parts are shown to have correlation with stature [2]. In the past, estimation of stature has been attempted on long bones of the upper and lower limbs [3-5], sternum [6,7] vertebral column [8,9], scapula [10,11], pelvis [12] and smaller bones [13] including metacarpals [14] and metatarsals [16]. In this regard, the literature on relationship between cranial measurements and stature is limited.
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A thorough review of literature shows that Introna et al. [16] for the very first time evaluated the relationship of cranial measurements with stature in 358 Italian males aged between 17 to 27 years. They [16] observed a positive correlation between maximum anterior-
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posterior and lateral cranial diameters with stature and proposed a regression equation for estimation of stature from cranial measurements. Later, Chiba and Terazawa [17] conducted a
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study of relationship of somatometry of skull with stature in 124 Japanese cadavers and proposed
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population specific regression equations for estimation of stature using different parameters (distance between glabella and external protuberance, length around the skull through the
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glabella and the external protuberance and the sum of these two measurements). Patil and Mody [18] took measurements on lateral cephalograms of 150 adults ranging in age from 25–54 years
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from Central India and devised sex specific regression models for estimation of stature from
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maximum cranial length in males and females. Ryan and Bidmos [19] carried out a similar study
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on the skulls from Raymond A. Dart Collection from the University of the Witwatersrand Johannesburg, South Africa. They [19] measured six parameters on the skulls and observed a
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positive and significant correlation between skull measurements and skeletal height. They [19] proposed regression models for estimation of skeletal height from various combinations of these six measurements. Krishan and Kumar [20] measured 16 cephalo-facial measurements on a sample of 253 adolescent males from an endogamous population of North India. They [20] found a positive and strong correlation between stature and some cephalo-facial measurements and proposed regression formulae for stature estimation from each measurement separately. Krishan [21] further studied 996 adult male Gujjars from North India and established a positive and strong correlation between five cephalo-facial measurements and stature. He devised regression formulae to estimate stature from these five cephalo-facial measurements [21]. Rao et al [22]
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used curved measurements of the length of the sagittal and coronal sutures in 87 autopsied cases of South Indian origin and found significant correlation between the coronal suture length and the height of the person. Agnihotri et al. [23] in a study on 150 young Indo-Mauritian adults took
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14 cephalo-facial measurements and devised multivariate separate regression models for estimation of stature among males and females. Giurazza et al. [24] conducted a study on 200
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Caucasian adult patients using CT scans of crania. They [24] measured six parameters on each
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CT scan and devised multiple regression models for estimation of stature from these cranial measurements. Thus, the cranial measurements used by researchers in stature estimation are
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either the direct bone measurements [19, 22], percutaneous measurements of the head and face [20,21,23] or measurements based on radiographs and computed tomography (CT) scans [18,24].
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Of all the measurements techniques, craniometric analysis is the most popular in forensic
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anthropology case work.
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Nepal is just reeling out of the greatest political disaster in its history; the Maoist insurgency that started in early 1996. Following the Maoist insurgency in Nepal, there have been numerous
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discoveries of unidentified human remains in mass graves or otherwise. The identification of these bodies or body parts is one of the greatest challenges to the medicolegal experts in Nepal. The major hindrances in this regard are the lack of systemic studies and anthropological data on the Nepalese population. It is a well-established fact that population specific formulae need to be derived for the estimation of anthropometric parameters in different populations due to inherent population differences attributed to the genetic and environmental causes [25]. Besides, temporal variations in cranial measurements are reported [26], hence, a growing need to conduct anthropometric/craniometric studies in modern samples and derive models applicable to modern populations. Developing anthropometric databases are of paramount importance in the
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developing world owing to the lack of facilities and resources for conducting DNA analysis for the establishment of positive identity as used frequently in the more developed countries. Anthropometric studies on cephalo-facial dimensions in Nepalese population are limited. A
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study of facial height from Sunsari district of Nepal [27] has shown statistically significant differences of the upper and lower face height proportions among four endogamous communities
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in the region while another study was an attempt to estimate cephalic index in the Gurung
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community of Nepal [28]. None of these studies however, have utilized cranial measurements for estimation of stature. The present research was thus, conducted with an aim to establish
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correlation between stature and craniometric measurements obtained on autopsied skulls in modern Nepalese population, and to derive regression models for estimation of stature among
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2. Materials and Methods
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males and females.
The present autopsy study was conducted on 200 medico-legal autopsies at the
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Kathmandu Autopsy Center, Department of Forensic Medicine, Institute of Medicine, Kathmandu, Nepal during September 2010 and July 2011. The study sample consisted of 148 males and 52 female cadavers of Nepalese origin. The differences in sample size of males and females is attributed to the differences in the proportion of non-natural deaths among males and females in the autopsied cases at Kathmandu, Nepal. All the cases with evidence of injuries to the head, spine or lower limbs were excluded from the study. The stature was measured as the length of the body from head to heel in centimeters with the heel, buttocks, back of the shoulders and the head in contact with the autopsy table. During the autopsy, a coronal incision was made extending from one mastoid process to the other and the scalp was reflected anteriorly and
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posteriorly, thus, exposing the cranium. The measurements included in the present study were limited to those accessible on the cranium exposed on the reflection of the scalp. Cranial measurements were taken in accordance with that described in the literature [29]. The landmarks
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on the cranium used in the study are detailed in the Table 1. All the measurements were taken by the first author using standard landmarks, techniques and instruments. The following cranial
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measurements were taken in cm to the nearest millimeter in the study (Figure 1).
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1. Maximum Cranial Length (MCL): distance between glabella (g) and opisthocranion (op) in the mid-sagittal plane (g-op), measured in a straight line using the spreading caliper.
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2. Maximum Cranial Breadth (MCB): distance between both euryon (eu) perpendicular to the mid-sagittal plane (eu-eu) using the spreading caliper.
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3. Bi-Zygomatic Breadth (BZB): distance between most lateral points on the zygomatic aches
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(zy-zy) using the sliding caliper.
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4. Minimum Frontal Breadth (MFB): distance between both frontotemporales (ft) measured in straight line (ft-ft) using the sliding caliper.
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5. Parietal Chord (PC): distance from bregma (b) to lambda (l) taken in the mid-sagittal plane (b-l) using the sliding caliper.
The data collected was analyzed using SPSS (Statistical Package for Social Sciences, version 15.0) computer software (SPSS, Inc., Chicago, IL, USA). The descriptive analysis was done to obtain mean, standard deviation (S.D) and range of the measurements. Pearson’s correlation analysis was performed to determine the relationship between the cranial measurements and the length of the body. Regression analysis was performed, taking stature as the dependent variable and each cranial measurement as an independent variable. Univariate regression models were derived to estimate stature from each cranial measurement independently
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among males and females (sex-specific regression models), and for the total study sample (pooled regression models). Similarly, stepwise multiple regression models were derived to estimate stature from a combination of different cranial measurements among males, females and
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total study population. A p-value of less than 0.05 was considered as statistically significant.
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3. Results
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The age of the study sample ranged between 20 years and 91 years. The mean age of the study sample was 38.63 years with a standard deviation (SD) of 14.21 years. The mean age and
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standard deviation for the males and females are shown in Table 2. The mean stature of the study population was 163.31 cm. Stature was observed to be larger in males than females. It was
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observed that the mean stature for males and females was 166.22 cm and 155.02 cm respectively.
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The sex differences in stature were observed to be statistically significant (Table 3).
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Among the cranial measurements, maximum cranial length was observed to be the largest (Mean=17.58 cm) and minimum frontal breadth (Mean=9.47 cm) as the smallest measurement.
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Mean maximum cranial breadth, bi-zygomatic breadth, and parietal chord was 13.25 cm, 12.24 cm and 11.27 cm respectively. All the cranial measurements were found to have a normal to uniform distribution that varied mainly within ± 3 standard deviations of the mean. Maximum cranial breadth was observed to have the minimum variance while parietal chord was found to have the maximum variance among males and females. The variance however, was comparatively less amongst females than males. Cranial measurements were observed to be significantly larger in males than females. The descriptive statistics for cranial measurements among males and females are shown in Table 3.
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On correlation between stature and maximum cranial length, maximum cranial breadth, bi-zygomatic breadth, minimum frontal breadth and parietal chord, the Pearson’s co-efficient of correlation were found to be statistically significant for stature and cranial measurements for the
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entire sample. The correlation coefficients varied between 0.219 for parietal chord and 0.494 for maximum cranial length. Among males, a statistically significant correlation was observed
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between stature and all cranial measurements except for maximum cranial breadth. The
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statistically significant correlations varied between 0.162 for parietal chord and 0.327 for maximum cranial length and bi-zygomatic breadth. Among females, however, a statistically
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significant correlation was only observed between stature and maximum cranial length (Table 4). The derived univariate linear regression models showed a statistically significant
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correlation with stature among males, females and in the total study sample. The standard error
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of estimate (SEE) for the regression models derived on the entire study sample was higher when
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compared to regression models derived among males and females separately and varied between 7.437 cm (MCL) and 8.348 cm (PC). Minimum SEE was observed for the regression models
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derived from maximum cranial length and bi-zygomatic breadth (6.894 cm) in males and for maximum cranial length in females (5.692 cm). The univariate regression models that show a relatively higher correlation coefficient and lower SEE in each category (males, females and total sample) are presented in Table 5.
For bivariate and multivariate regression models derived for estimation of stature, the standard error of estimate for different possible combination of variables varied between 6.943 cm to 8.136 cm in the total study sample, between 6.640 cm and 7.041 cm among males, and between 5.538 cm and 5.746 cm in females. Multivariate linear regression models have shown a lesser standard error of estimate in stature estimation when compared to the linear and bivariate
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linear regression models. The bivariate and multivariate regression models that show a relatively higher correlation coefficient and lower SEE among males, females and total sample are
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presented in Table 6.
4. Discussion
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Cranium is an important bone that has generated considerable interest among forensic
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anthropologists in the past. Anthropologists have long been studying cranial variations among populations having bearing on age, ethnicity and sexual dimorphism. Studies have also shown
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that biological profile pertaining to age, sex and race/ethnicity can be established if the cranium or its parts are available for medico-legal examinations [30-39]. The present research on stature
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estimation from cranial measurements indicates that cranial measurements such as maximum
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cranial length (MCL) and bi-zygomatic breadth (BZB) show stronger correlation with stature
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than the other measurements such as minimum frontal breadth (MFB), maximum cranial breadth (MCB) and parietal chord (PC) in males and total study sample. On the other hand in females,
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only maximum cranial length shows stronger correlation with stature. Thus, MCL among males, females and the total study sample and BZB in males and total study sample indicate a high degree of accuracy and reliability in estimation of stature than the other measurements included in the study. This is further confirmed by a relatively lower standard error of estimate (SEE) observed for these measurements. The higher correlation values (r) for total study sample when compared to males and females can be attributed to the increased sample size because of pooling of male and female samples [40]. This however, is associated with higher SEE that can be related to the increases variance of the pooled data. Likewise, lower correlation values (r) reported for females may be attributed to the comparatively smaller female sample size when compared to
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males. The study further shows that the stature estimation from cranial dimensions using multivariate linear regression models is more accurate than those of the univariate and bivariate regression models.
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Since the studies on correlation between direct cranial measurements and stature are limited, the findings of the present study are compared with the available studies on stature
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estimation from cranial as well as cephalo-facial dimensions in different populations [17-21,
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23,24,41]. Chiba and Terazawa [17] observed a SEE of 6.96 cm in males and 6.71 cm in females in their study on Japanese cadavers using cranial length and horizontal circumference of the
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cranium for estimation of stature. Patil and Mody [18] observed a positive and strong correlation between stature and lateral cephalogram and reported a SEE of 3.71 and 4.26 in males and
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females respectively. Ryan and Bidmos [19] took six cranial diameters for estimation of stature
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in indigenous South Africans and reported a SEE ranging between 4.37 and 6.24 cm. Krishan
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and Kumar [20] in a study on stature estimation using 16 cephalo-facial dimensions in male adolescents reported SEE of 4.41–7.21 cm. Krishan [21] observed a SEE of 4.136 to 5.820 cm
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in a study on the relationship of five cephalo-facial dimensions with stature in North Indian males. Sahni et al. [41] in their study on estimation of stature from seven facial measurements in North-west Indians reported a SEE of 3.56 to 3.70 cm. Agnihotri et al. [23] in their study on stature estimation from 14 cephalo-facial measurements in Indo-Mauritian population reported the correlation between the cephalo-facial measurements with stature, however, they did not report the SEE in estimating stature. Giurazza et al. [24] conducted another study on the stature estimation from cranial measurements taken from CT scans of Italians and found an absolute error of 3.8 cm and 3.9 cm taking length of cranial base and distance from basion to nasal bone respectively. When compared to the aforementioned studies on different cranial and craniofacial
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measurements among different population groups, the present study reported a higher SEE suggesting of a lower reliability of cranial measurements for stature estimation in Nepalese population. Likewise, a study on stature estimation from cephalo-facial dimensions of Turkish
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population [42] has reported very low correlation coefficients of cephalo-facial dimensions with
cephalo-facial dimensions is not reliable in forensic practice.
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stature (ranging between 0.012 and 0.229) and concluded that the stature estimation from
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The differences in the reliability of the cranial and cephalo-facial measurements in stature estimation between studies can be attributed to the differences in measurements included in
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earlier studies and the differences in the methodologies adopted for taking measurements i.e. direct measurements, measurements on lateral cephalogram, CT scans etc. Besides, population
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differences may also be related to the differences in the observations reported in the studies.
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Most of the Asians such as Mongols, Manchus, Chinese, Koreans, Japanese, Annamese,
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Siamese, Burmese, Tibetans, and Nepalese are known to have flatter faces [43-45] and shorter stature. The Nepalese population thus, displays typical Asian characteristics of flatter faces and
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shorter stature when compared to their counterparts from other parts of the world. In this regard, the present study on autopsied skulls in Nepalese population by means of univariate and multivariate regression models for estimation of stature reports a SEE similar to that reported in a cadaveric study on ethnically similar Japanese population [17]. This lower accuracy and reliability in estimation of stature from cranio-facial measurements may be attributed to the longer craniums, flatter faces and short stature in Nepalese population. The stature estimation may help in establishing the biological profile of the deceased along with other methods of estimation of sex, age and ethnicity from examination of the cranium. Considering the higher SEE observed in the study on Nepalese population, we suggest
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that cranial measurements can be utilized for estimating stature of a person using multivariate analysis in cases when other more accurate means of stature estimation and identification are not available. In such scenario, sex-specific regression models can be applied when the sex is
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known/ estimated using morphological/ morphometric methods. In cases when the sex is unassigned, universal regression formula can be used for estimation of stature. Since the present
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study is conducted on an autopsy sample, it presents standards for estimation of cadaveric length/
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stature from skull measurements. The cadaveric stature is known to show variations from the living stature. Using Fully’s method of stature estimation, Bidmos [46] in a study, showed that
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the documented cadaver lengths were significantly higher than the estimated living stature. Therefore, it is suggested that the formulae derived in the study should be used with caution for
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stature estimation.
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Nepal is a small country with a population having typical Asian features. The database
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pertaining to anthropometric variables from the skeletal elements is scanty in Nepal due to nonavailability of skeletal collections. The present study is an important one in the sense that it
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provides rare data of the autopsied sample on modern Nepalese population which can be helpful in the identification of mutilated and dismembered skeletal remains especially when the skull vault is brought for examination. Moreover, the data represents an endogamous population which is also significant from forensic, genetic and anthropologic point of view by providing a database for comparison with further studies. It is suggested that similar studies are conducted among different population groups in Nepal to see if any variations exist between these groups.
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18 Page 20 of 27
Table 1: The landmarks on cranium used in the study Description
Euryon (eu)
The two points on the opposite sides of the cranium that form termini of the lines of greatest cranial breadth.
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Landmark
The most laterally positioned point on the zygomatic arch.
Frontotemporale (ft)
The point where the temporal line reaches its most antero-medial position
cr
Zygion (zy)
Glabella (g)
us
on the frontal bone.
The most forward projecting point in the midline of the forehead at the
an
level of the supra-orbital ridges and above the naso-frontal suture. The intersection of the coronal and sagittal sutures in the midline.
Lambda (l)
The intersection of the sagittal and lambdoidal sutures in the midline.
Opisthocranion (op)
The most posterior point on the cranium.
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te
d
M
Bregma (b)
19 Page 21 of 27
Table 2: Descriptive statistics: Age distribution of the study sample
Males
148
20
91
39.6
14.4
Females
52
20
79
35.9
13.4
20
91
38.6
14.2
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te
d
M
an
us
cr
Both Sexes 200
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Sample Size (N) Minimum Maximum Mean Standard Deviation
20 Page 22 of 27
Table 3: Descriptive statistics: Stature and cranial measurements among males and females Males (N=148)
Females (N=52) Maximum
Mean
S.D
155.0
6.1
