Amanda M. Agnew

• PhD
• Professor (Full) at The Ohio State University

Despite safety advances, thoracic injuries in motor vehicle crashes remain a significant source of morbidity and mortality, and rib fractures are the most prevalent of thoracic injuries. The objective of this study was to explore sources of variation in rib structural properties in order to identify sources of differential risk of rib fracture betw...

Objectives This study characterizes sexual dimorphism in skeletal markers of upper limb mechanical loading due to lateralization as evidence of division of labor in medieval Giecz, Poland. Methods Twenty‐six dimensions for paired humeri, clavicles, and radii representing adult males ( n = 89) and females ( n = 53) were collected from a skeletal sa...

Elderly populations are particularly vulnerable to morbidity and mortality following rib fracture. Previous work has shown that rib structural properties are best explained by simplified cross-sectional geometry adjacent to the fracture location, outperforming age, sex, body size, bone mineral density, and simple whole rib geometry. Although cross-...

Growing evidence of the coordinated functional adaptation of bone suggests relationships between multiscale skeletal traits that dictate fracture risk and influence discrepancies in bone strength declines across individuals should be elucidated. The early indicators of subsequent pathological bone loss that likely exist in the radius are not well u...

Objective: This study aims to establish best practices and guidelines to ensure that experimental research utilizing Postmortem Human Subjects (PMHS) for injury prevention adheres to relevant ethical principles, which are also commonly accepted in research involving human tissues and living subjects. Furthermore, it reviews existing literature to...

A case study of childhood metabolic stress on an individual from Giecz, Poland (11th - 12th century). The child exhibited signs of scurvy, anemia, rickets, and/or non-specific infection.

Fracture classification is a standard component of trauma analysis. The Standard for Analyzing Skeletal Trauma in Forensic Anthropology (ASB 147) states that trauma should be documented using peer-reviewed methods;1 however, guidance on which methods are applicable is not provided. Further, limited methods exist to classify long bone fractures resu...

Learning Overview: After attending this presentation, participants will gain insight into the role of soft tissue and the presence of the fibula in tibial fracture characteristics resulting from blunt trauma. Impact on Forensic Science Community: This presentation will impact the forensic science community by providing data and analyses that explo...

div class="section abstract"> Thoracic injuries, most frequently rib fractures, commonly occur in motor vehicle crashes. With an increased reliance on human body models (HBMs) for injury prediction in various crash scenarios, all thoracic tissues and structures require more comprehensive evaluation for improvement of HBMs. The objective of this stu...

In recent post-mortem human subjects (PMHS) studies in a high-speed rear-facing frontal impact (HSRFFI), the PMHS sustained multiple rib fractures. The seatback structure and properties of the seats might contribute to these fractures. This study aimed to determine if a homogeneous rear-facing seat with foam-covered seatback would mitigate the risk...

div>Thorax injuries are a significant cause of mortality in automotive crashes, with varying susceptibility across sex and age demographics. Finite element (FE) human body models (HBMs) offer the potential for injury outcome analysis by incorporating anthropometric variations. Recent advancements in material constitutive models, cortical bone fract...

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Representations of femoral neck (Fem-N) bone quality and resulting assumptions of fracture risk typically use bone mineral density (BMD) as a proxy measure for mineralization.1 Measures of areal/volumetric BMD (aBMD/vBMD) are normalized by size which can obscure the influence of sex-linked differential skeletal morphometry on bone strength.2,3 Acco...

Volumetric bone mineral density (vBMD) is commonly assessed using QCT. While standard vBMD calculation methods require phantom rods that may not be available, internal reference phantomless (IPL) and direct measurements of Hounsfield units (HU) can be used to calculate vBMD in their absence. Yet, neither approach has been systemically assessed acro...

Tibia fracture characteristics (number, type, and group) have demonstrated variation in controlled experimental loading conditions. These results indicate that tibiae respond differently even in the same blunt force trauma event. Previous research has demonstrated this variation cannot be explained by individual (age, sex) or global bone (length, w...

Localized strain on bone tissue influences the extent of bone remodeling, which produces some net bone loss through the formation of a Haversian canal. Under particularly low strains remodeling resorbs more bone than is subsequently formed, further increasing porosity. Regional patterns of porosity should reflect bone remodeling activity and allow...

Skeletal trauma interpretation is an important duty of forensic anthropologists. The objective of this study was to investigate differences in fracture characteristics within pairs of ulnae loaded at two distinct rates to explore the predictability of loading velocity from observed fracture outcomes. Ten ulna pairs from unembalmed adult female po...

Porosity is an independent predictor of fracture risk, particularly at common sites of osteoporotic fracture. Pores concentrate mechanical stress, allowing microcracks to initiate and propagate into fracture even under low nominal stress. Localized mechanical strain also regulates the frequency and extent of bone remodeling, influencing how pore sy...

Learning Overview: After attending this presentation, attendees will understand the relationship between global tibia size and fracture characteristics through an examination of fracture outcomes in human tibiae experimentally loaded in the same blunt force bending mechanism. Impact on Forensic Science Community: This presentation will impact the f...

Rib fractures are associated with high rates of morbidity and mortality. Improved methods to assess rib bone quality are needed to identify at-risk populations. Quantitative computed tomography (QCT) can be used to calculate volumetric bone mineral density (vBMD) and bone mineral content (BMC) which may be related to rib fracture risk. The objectiv...

Pedestrian road traffic injuries are a global concern with incidences ranging from 20-50 million each year. To support equitable and applicable research into pedestrian injuries, experimental studies must incorporate female and male samples of various ages and sizes. The objective of this study was to examine relationships between tibial biomechani...

Objective: In 2020, 17% of all crash fatalities were individuals aged 65 years or older. Crash data also revealed that for older occupants, thoracic related injuries are among the leading causes of fatality. Historically, the majority of near-side impact postmortem human subjects (PMHS) studies used a generic load wall to capture external loads th...

Objective: One potential nonstandard seating configuration for vehicles with automated driving systems (ADS) is a reclined seat that is rear-facing when in a frontal collision. There are limited biomechanical response and injury data for this seating configuration during high-speed collisions. The main objective of this study was to investigate tho...

The material and morphometric properties of trabecular bone have been studied extensively in bones bearing significant weight, such as the appendicular long bones and spine. Less attention has been devoted to the ribs, where quantification of material properties is vital to understanding thoracic injury. The objective of this study was to quantify...

Assessment of skeletal trauma timing is an important component of forensic anthropological analyses. The Standard for Analyzing Skeletal Trauma in Forensic Anthropology (ASB 147) states that trauma timing should be classified as antemortem, perimortem, or postmortem based on defect characteristics. However, standardized criteria for assessing traum...

A key component of the forensic anthropological examination is skeletal trauma analysis, which accounts for the majority of forensic anthropologists’ expert testimonies. However, a major gap in the current knowledge surrounding skeletal trauma has been identified, specifically the data necessary to conduct comprehensive bone trauma analysis with es...

Learning Overview: After attending this presentation, attendees will understand the importance of investigating microstructural variables in relation to skeletal trauma. Impact on the Forensic Science Community: This presentation will impact the forensic science community by presenting innovative and unique methods to develop explanatory mechanism...

Learning Overview: After attending this presentation, attendees will understand the importance and value of multidisciplinary experimental skeletal trauma research through an examination of strain modes (e.g., tension or compression) during fracture of human tibiae in a bending loading mechanism. Impact on the Forensic Science Community: This prese...

Learning Overview: Upon completion of this workshop, attendees should be able to: (1) provide an overview of current methods across disciplines for identification and analysis of blunt force skeletal trauma; (2) identify and analyze blunt force skeletal trauma utilizing X-rays, Computed Tomography (CT) scans, photographs, and 3D virtual models; and...

The Forensic Anthropology Skeletal Trauma (FAST) database is a novel resource, funded by the National Institute of Justice, which provides trauma analysis data for education, training, and case comparisons. Students, academics, and practitioners can gain an interdisciplinary perspective of skeletal trauma through an examination of outcomes from exp...

Introduction: The human rib provides a vital role in the protection of thoracic contents. Rib fractures are linked to injuries and health complications that can be fatal. Current clinical methods to assess fracture risk and bone quality are insufficient to quantify intra-element differences in bone mineral density (BMD) or to identify at-risk popu...

Objective: The purpose of this study was to generate biomechanical response corridors of the small female thorax during a frontal hub impact and evaluate scaled corridors that have been used to assess biofidelity of small female anthropomorphic test devices (ATDs) and human body models (HBMs). Methods: Three small female postmortem human subject...

The objective of this study was to develop an analytical model using strain-force relationships from individual rib and eviscerated thorax impacts to predict bony thoracic response. Experimental eviscerated thorax forces were assumed to have two distinct responses: an initial inertial response and subsequently, the main response. A second order mas...

Rib fractures are common traumatic injuries, with links to increased morbidity and mortality. Finite element ribs from human body models have struggled to predict the force-displacement response, force and displacement at fracture, and the fracture location for isolated rib tests. In the current study, the sensitivity of a human body model rib with...

Bone mineral density (BMD) is often used for injury prediction and fracture risk evaluation. This study aims to determine the breadth and depth of BMD utilization in injury biomechanics research and evaluate the appropriateness of these approaches by assessing BMD sensitivity and variability throughout the human body. A scoping review was conducted...

The tibia is the most commonly fractured lower extremity bone in pedestrian versus motor vehicle crashes [1]. Specifically, the diaphysis is the most frequently fractured region of the tibia [2]. Previous studies have demonstrated considerable variation in number of fractures, fracture type, and fracture group in experimental 4-point bending of hum...

Although lower radius aBMD values may reflect increased fracture risk, the persistence of fragility fractures in those deemed at low risk 1-3 necessitates novel approaches to understanding bone quality. • The effects of whole-bone geometry on multiple skeletal traits has been shown to differentially influence strength declines with age 4-6. A multi...

Although lower radius aBMD values may reflect increased fracture risk, the persistence of fragility fractures in those deemed low risk necessitates novel approaches to understanding bone quality. Previous work has suggested early decline in bone strength occurs during the menopausal transition period particularly in the radius. Additionally, the ef...

Objectives Cortical porosity is used as a proxy of bone quality, fragility, and remodeling activity in anthropological contexts. Histological quantification is limited by time‐intensive manual annotation. Pore Extractor 2D is an ImageJ toolkit developed for computer‐assisted pore identification and automated pore morphometry. Materials and Methods...

Rib fractures are a significant source of morbidity and mortality, particularly for the elderly. Preliminary work has established that simplified cross-sectional geometry explains a moderate amount of variation in rib structural properties, out-performing age, sex, body size, bone mineral density, and simple whole rib geometry. However, cortical bo...

Novel approaches to assessing bone quality and fracture risk that move beyond isolated bone mineral density (BMD) have the potential to improve diagnostic criteria and intervention thresholds. Attempts to shift the current global paradigm away from dual x-ray absorptiometry (DXA) or assumptions of fracture risk based solely on age or sex, are drive...

Recent years have seen an increase in contributions to the criminal justice system through expert testimony regardingskeletal trauma analysis and interpretation. In order to scientifically validate skeletal trauma analysis methods and ensure the dependability of interpretations to support expert testimonies, the reliability of generally accepted co...

Vascular bone porosity is quantified in anthropological contexts as a proxy of bone quality and fragility. Pore systems result from mechanosensitive bone resorption and remodeling, suggesting that local mechanical loading influences pore morphometry. However, histological microstructural patterning and strain patterning have not been consistently l...

Bone ashing, a method that treats bone at 600°C for 18 hours, has been used to quantify inorganic bone content ex-vivo. Previous studies identified relationships between mechanical properties and inorganic bone content utilizing this technique. However, relationships between sex and body size with inorganic bone content, specifically percent minera...

Introduction Dual x-ray absorptiometry (DXA), the gold standard for diagnosing fracture risk in clinical settings, evaluates bone quality via areal bone mineral density (aBMD). Bone ashing is an invasive technique used to measure inorganic bone content by burning away organic bone material (e.g., collagen) to isolate the inorganic bone content (e.g...

In bones of the appendicular skeleton that may be at risk for fragility fractures in the aging population, previous work has identified evidence of functional compensation between mineralization and cross-sectional geometry. Additionally, the importance of considering the interaction between the hierarchical scales of bone in assessing fracture ris...

Tibia fractures are the most common injury in vehicle-to-pedestrian impacts. To provide accurate injury risk predictions, sex differences in tibia properties should be investigated. The objective of this study was to identify the relationship between structural properties and cortical bone morphometric parameters of tibiae in males and females. Ten...

Persistently high frequency of forearm fractures in frontal and side impacts coupled with their long-term deleterious effects demands an in-depth understanding of variation in skeletal response to loading. Previous work has highlighted the differential impact of subject-level variables on bone quality between males and females. The purpose of this...

The objectives of this study were to develop novel methods for quantifying human rib cortical bone material properties in compression and to compare the compressive material property data to existing tensile data for matched subjects. Cylindrical coupons were obtained from the rib cortical bone of 30 subjects (M = 19, F = 11) ranging from 18 to 95...

Bone quality, and therefore fracture risk, can be evaluated through bone density values obtained from isolating bone mineral content via bone ashing. The literature has identified two main variations of density calculations from bone ashing including apparent density, which accounts for the presence of bone marrow, and true density, which does not...

Introduction/Background Bone ashing is a technique used to estimate inorganic bone content by burning away organic material (i.e., water, collagen, proteins, and lipids). Inorganic bone content (i.e., calcium, magnesium, and other minerals) is left after burning away organic material. Overall, the new ashing protocol developed in this project aims...

Rib fractures are common thoracic injuries in motor vehicle crashes. Several human finite element (FE) human models have been created to numerically assess thoracic injury risks. However, the accurate prediction of rib biomechanical response has shown to be challenging due to human variation and modeling approaches. The main objective of this study...

Finite element human body models (HBMs) are used to assess injury risk in a variety of impact scenarios. The ribs are a key structural component within the chest, so their accuracy within HBMs is vitally important for modeling human biomechanics. We assessed the geometric correspondence between the ribs defined within five widely used HBMs and meas...

Medieval Poland (tenth-thirteenth centuries CE) experienced substantial change, including increasing urbanization, which has been associated with detrimental health effects, such as higher rates of infectious disease due to population crowding. This may have led to higher rates of mortality and lower survivorship in urban compared to rural populati...

The objective of this study was to generate biomechanical corridors from post-mortem human subjects (PMHS) in two different seatback recline angles in 56 km/h sled tests simulating a rear-facing occupant during a frontal vehicle impact. PMHS were placed in a production seat which included an integrated seat belt. To achieve a repeatable configurati...

Thorax injuries mainly due to rib fractures have been associated with high rates of morbidity and mortality in motor vehicle crashes. Thoracic biomechanics has been studied extensively, but there are no robust biomechanical response targets for ribs that consider age, sex, body size, and vulnerability factors. The objective of this study was to gen...

Due to high-rate loads placed on the torso during motor vehicle crashes, the human thorax is commonly injured, and resulting rib fractures are linked to fatalities. The goal of this study was to explore the variation in strain modes, magnitudes, and rates of rib levels 3-8 in a dynamic, distributed loading scenario in a series of hierarchical tissu...

Fracture prediction requires an understanding of multiple contributors to strength augmented by using a systems approach. Functional compensation has been demonstrated in the tibia suggesting a coupling of the amount of bone and its mineralization. Furthermore, whole bone geometry has been shown to affect age-related changes in the radius. The purp...

Existing histological age estimation methods using the rib were developed mainly from the midshaft; however, in forensic practice, uncertainty of sampling location often arises due to fragmented or previously sampled ribs. The potential for error increases when sampling location is uncertain and utilizing a section beyond the midshaft (either anter...

Skeletal fractures, a common injury in physically abused children, often go undetected and untreated for significant lengths of time and are sometimes incidentally discovered radiographically. Our objective was to review current literature for scientific studies of pediatric fracture healing with associated timelines. We conducted a search of Embas...

The preauricular sulcus’ presence and morphology is used in forensic contexts for sex estimation of human remains. The traditional method of assessing the preauricular sulcus requires examination of clean physical skeletal elements, which are not always readily available in forensic contexts. The development and application of clinical imaging tech...

Bone remodeling produces a complex, highly interconnected network of cortical pores that transmit vasculature. Stochastic remodeling renews bone under low strain, while targeted remodeling repairs microdamage under high strain. With age, senescing bone cells become uncoupled from these mechanical stimuli, increasing cortical porosity. We describe a...

Rib fractures have substantial effects on morbidity and mortality yet little work has investigated variation contributing to their injury risk. Functional compensation has been demonstrated in the appendicular skeleton but not yet investigated in the rib. The purpose of this study is to determine if co-variation of bone morphometrics with volumetri...

Learning Overview: This presentation introduces a novel suite of image processing macros for micro-CT images of bone tissue, for application in ImageJ and CT-Analyzer. The goals of this presentation are to: (1) visually demonstrate the completely automated extraction of cortical porosity, a predictor of spontaneous fracture risk; and (2) describe a...

Thoracic injuries, specifically rib fractures, are of significant clinical and forensic interest and occur in high frequencies in homicides, accidents, and motor vehicle crashes. However, current analysis of rib fractures lacks a systematic method for characterizing and interpreting these injuries. The goal of the present research is to provide a s...

Thoracic injuries are frequently observed in motor vehicle crashes, and rib fractures are the most common of those injuries. Thoracic response targets have previously been developed from data obtained from post-mortem human subject (PMHS) tests in frontal loading conditions, most commonly of mid-size males. Traditional scaling methods are employed...

Objective: The current state of the art human body models (HBMs) underpredict the number of fractured ribs. Also, it has not been shown that the models can predict the fracture locations. Efforts have been made to create subject specific rib models for fracture prediction, with mixed results. The aim of this study is to evaluate if subject-specific...

This study investigated the response of the Global Human Body Models Consortium (GHBMC) M50-O v4.5 model in a simulated thoracic impact and compared to the responses of post-mortem human subjects (PMHS) in physical experiments. The model was simulated in four tissue states: intact, intact with upper limbs removed, denuded (superficial tissue remove...

Thoracic injuries, specifically rib fractures, are prevalent in motor vehicle crashes and are a significant source of morbidity and mortality. Rib fractures present in a variety of patterns, ranging in severity from minor to severe. The number of fractures also contributes to the injury assessment; as fracture number increases, severity increases....

The objective of this study was to evaluate the effects of sex, loading rate, and age on the tensile material properties of human rib cortical bone over a wide range of subject demographics. Sixty-one (n = 61) subjects (M = 32, F = 29) ranging in age from 17 to 99 years of age (Avg. = 56.4 ± 26.2 yrs) were used in this study. Two rectangular coupon...

Microdamage is a component of bone quality believed to play an integral role in bone health. However, comparability between existing studies is fraught with issues due to highly variable methods of sample preparation and poorly defined quantification criteria. To address these issues, this article has two aims. First, detailed methods for preparati...

Here we present detailed regional bone thickness and cross‐sectional measurements from full adult ribs using high resolution CT scans processed with a cortical bone mapping technique. Sixth ribs from 33 subjects ranging from 24 to 99 years of age were used to produce average cortical bone thickness maps and to provide average ± 1SD corridors for ex...

Exploring various factors on why ribs did not fail on dynamic impact