Secular trends in stature of late 20th century white South Africans and two European populations.

During the 20th century a general positive secular trend for stature is observed in developed countries around the world while shorter statures, often associated with a lack of a positive secular trend, have mostly been observed in populations with lower SES. The purpose of this study was to compare secular changes in stature between 20th century South Africans of European descent and two European populations. The comparative samples include Dutch males with which there is an assumed genetic relationship, and Swiss males for which the genetic association is less clear. The sample comprised anthropometric stature data of white South Africans (17-62 years), Swiss and Dutch males (18-21 years) obtained from military conscripts with birth cohorts of 5 years from 1946 to 1995. The stature of white South African males did not increase at a significant rate compared to those observed in Swiss and Dutch males. South African and Dutch males were of similar height following World War II, but a considerable trend was observed only in the Dutch group. The Swiss group was initially shorter than the South Africans, but due to a positive secular trend their average stature is on a par with that of South Africans in the most recent cohort. The lack of a significant positive secular trend in the South African group could suggest that factors such as gene flow and poor economic and social development in South Africa resulted in shorter statures in white South African groups than expected.

Identifications of ancient Egyptian royal mummies from the 18th Dynasty reconsidered.

For centuries, ancient Egyptian Royal mummies have drawn the attention both of the general public and scientists. Many royal mummies from the New Kingdom have survived. The discoveries of the bodies of these ancient rulers have always sparked much attention, yet not all identifications are clear even nowadays. This study presents a meta-analysis to demonstrate the difficulties in identifying ancient Egyptian royal mummies. Various methods and pitfalls in the identification of the Pharaohs are reassessed since new scientific methods can be used, such as ancient DNA-profiling and CT-scanning. While the ancestors of Tutankhamun have been identified, some identities are still highly controversial (e.g., the mystery of the KV-55 skeleton, recently most likely identified as the genetic father of Tutankhamun). The meta-analysis confirms the suggested identity of some mummies (e.g., Amenhotep III, Thutmosis IV, and Queen Tjye).

Evidence based palaeopathology: meta-analysis of Pubmed-listed scientific studies on pre-Columbian, South American mummies.

The aim of this study was to review all Pubmed(®)-listed palaeopathological studies performed on pre-Columbian South American mummies. A total of 61 studies were found (1977-2005). Review criteria included e.g. method of examination, method of mummification, palaeopathological diagnoses and individual age of mummies as well as dating, which ranged from 7500 to 500 years BP, mainly (if reported) originating from the Chiribaya and Chinchorro cultures. The average age of the 99 individually reported mummies was about 25 years. Only six studies included computed tomography, thirteen studies used classical radiography as an examination method. Three studies analysed parasite related diseases, especially caused by Trypanosoma cruzi. Among all of the reported infectious diseases (n=9), there were seven studies presenting cases of tuberculosis. The results were also compared inter-culturally. In 61 studies (37 epidemiological and 24 case reports) more than 6400 mummified individuals were analysed. By contrast, meta-analytic data for ancient Egyptian mummies (Zweifel et al., 2009) included about 3000 analysed individuals in 131 studies (85 case reports and 46 epidemiological studies). In general, ancient Egyptian mummies were shown to be intentionally mummified, whereas the Pre-Columbian American mummies showed a great diversity of spontaneous mummification. However, ritualistic mummification methods were also practised (n=2). This study's results shall assist to improve evidence-based research in palaeopathology.

Purported medical diagnoses of Pharaoh Tutankhamun, c. 1325 BC-.

King Tutankhamun is one of the most famous rulers of antiquity,thus it is not surprising that a plethora of scientific studies have put forth possible medical diagnoses and causes of his death. Diseases(autologous or infectious), metabolic disorders, trauma (possibly even murder-related), or tumorous conditions have been postulated, frequently only based on secondary data sources. The aim of this article is to critically review all these diagnoses. Since the initial examination of the mummy in the mid 1920s by Howard Carter and others, several dozens of medical diagnoses based on various levels of evidence have been proposed. While some studies did not support any sign of a major disease, others suggested diseases whose existence cannot be proven with the little tissue that is preserved for study. In the last c. five years new examinations of the mummy were performed by computed tomography and ancient DNA analyses,now allowing not only to exclude certain diagnoses that had been postulated earlier, but also to arrive at new theories with a higher degree of certainty concerning the state of health and the early death of this most famous ruler.

Diversity in auxology: between theory and practice. Proceedings of the 18th Aschauer Soiree, 13th November 2010.

Auxology has developed from mere describing child and adolescent growth into a vivid and interdisciplinary research area encompassing human biologists, physicians, social scientists, economists and biostatisticians. The meeting illustrated the diversity in auxology, with the various social, medical, biological and biostatistical aspects in studies on child growth and development.

Growth variation, final height and secular trend. Proceedings of the 17th Aschauer Soiree, 7th November 2009.

Growth and body height have always been topics interesting to the public. In particular, the stupendous increase of some 15-19cm in final adult height during the last 150 years in most European countries (the "secular trend"), the concomitant changes in body and head proportions, the tendency towards early onset of sexual maturation, the changes in the age when final height is being reached, and the very recent trend in body mass index, have generated much scientific literature. The marked plasticity of growth in height and weight over time causes problems. Child growth references differ between nations, they tend to quickly become out of date, and raise a number of questions regarding fitting methods, effects caused by selective drop-out, etc. New findings contradict common beliefs about the primary importance of nutritional and health related factors for secular changes in growth. There appears to be a broad age span from mid-childhood to early adolescence that is characterised by a peculiar insusceptibility. Environmental factors that are known to influence growth during this age span appear to have only little or no impact on final height. Major re-arrangements in height occur at an age when puberty has almost been completed and final height has almost been reached, implying that factors, which drive the secular trend in height, are limited to early childhood and late adolescence.

Without 'informed consent'? Ethics and ancient mummy research.

Ethical issues are of foremost importance in modern bio-medical science. Ethical guidelines and socio-cultural public awareness exist for modern samples, whereas for ancient mummy studies both are de facto lacking. This is particularly striking considering the fact that examinations are done without informed consent or that the investigations are invasive due to technological aspects and that it affects personality traits. The aim of this study is to show the pro and contra arguments of ancient mummy research from an ethical point of view with a particular focus on the various stakeholders involved in this research. Relevant stakeholders in addition to the examined individual are, for example, a particular researcher, and the science community in general, likely descendents of the mummy or any future generation. Our broad discussion of the moral dilemma of mummy research should help to extract relevant decision-making criteria for any such study in future. We specifically do not make any recommendations about how to rate these decision-factors, since this is highly dependent on temporal and cultural affiliations of the involved researcher. The sustainability of modern mummy research is dependent on ethical orientation, which can only be given and eventually settled in an interdisciplinary approach such as the one we attempt to present here.

BMI distribution/social stratification in Swiss conscripts from 1875 to present.

BACKGROUND/OBJECTIVES: We aimed to extend the actual overweight discussion with new unbiased Swiss conscript data from 2005 to 2006, and to present for the first time Swiss data on body mass index (BMI) before 1950 and for the late-nineteenth century. SUBJECTS/METHODS: For this study, 19-year-old Swiss male conscripts (draft army; Cantons Bern, Zurich, Basel-Stadt and Basel-Land) from the census of 1875-1879, 1933-1939 and 2005-2006 (N=28 033; 2005-2006 census) were included. BMI distribution (World Health Organization (WHO) classification) and social stratification (International Labour Organization classification) were main outcome measures. RESULTS: Mean BMI of 19-year-old men in Switzerland increased in the 50 years between the 1870s and the 1930s by 0.80 kg/m(2) and between the 1930s and 2005 by 1.45 kg/m(2). The modern BMI sample is much more right skewed and s.d. is higher. Obesity prevalence (according to modern WHO classification) has increased by a factor of 105 from 1870s until present. Over 23% of our representative sample of Swiss men in 2005-2006 had a BMI of over 25 kg/m(2). In 2005-2006, contrary to the nineteenth century, unskilled workers had articulately higher BMI values at the 75th, 90th and 95th percentile than students; 12% of unskilled workers were obese against 2% of students. CONCLUSIONS: It thus seems that BMI relations between the upper and the lower end of the socio-economic strata changed inversely from the late-nineteenth century to 2005-2006. We further propose that the phenomenon of massive right-skewing BMI distribution between the 1930s and 2005-2006 affected the lower socio-economic strata to a far greater extent than the higher socio-economic group.

Evidence-based palaeopathology: meta-analysis of PubMed-listed scientific studies on ancient Egyptian mummies.

There is a plethora of published scientific studies on ancient Egyptian mummies. Surprisingly, hitherto there is no systematic review of this research, which would help to assess the quality of this vast body of published literature and thus to increase "evidence" in palaeopathological research. The aim of this study was to review all PubMed-listed scientific studies performed on Ancient Egyptian mummies. A total of 131 studies were found in the database for the selected time period, 1977-2005. Our "meta-analysis" showed that the number of publications per year varies enormously. The majority of mummies examined date to the third intermediate and Ptolemaic periods; data from other time periods were lacking. Identification of the cause of death and (14)C-dating of the mummy or funeral goods were rarely addressed. There was a tendency towards an increased use of non-invasive examination methods in more modern times. Our meta-analysis addressed both scientific content (e.g. palaeopathological findings/examination methods) and publication issues (e.g. location of the first author or year of publication) in these studies. Based on our experience, we recommend some minimum publication standards for palaeopathologic studies on ancient mummies, which shall improve evidence-based research in palaeopathology in general.

Technical note: standardized and semiautomated Harris lines detection.

Arrest in long bone growth and the subsequent resumption of growth may be visible as radiopaque transverse lines in radiographs (Harris lines, HL; Harris, HA. 1933. Bone growth in health and disease. London: Oxford University Press). The assessment of individual age at occurrence of such lines, as part of paleopathological skeletal studies, is time-consuming and shows large intra- and interobserver variability. Thus, a standardized, automated detection algorithm would help to increase the validity of such paleopathological research. We present an image analysis application facilitating automatic detection of HL. On the basis of established age calculation methods, the individual age-at-formation can be automatically assessed with the tool presented. Additional user input to confirm the automatic result is possible via an intuitive graphical user interface. Automated detection of HL from digital radiographs of a sample of late Medieval Swiss tibiae was compared to the consensus of manual assessment by two blinded expert observers. The intra- and interobserver variability was high. The quality of the observer result improved when standardized detection criteria were defined and applied. The newly developed algorithm detected two-thirds of the HL that were identified as consensus lines between the observers. It was, however, necessary to validate the last one-third by manual editing. The lack of a large test series must be noted. The application is freely available for further testing by any interested researcher.

Diagnostic value of micro-CT in comparison with histology in the qualitative assessment of historical human skull bone pathologies.

Cases of pathologically changed bone might constitute a diagnostic pitfall and frequently need histological methods to be etiologically properly evaluated. With micro-computed tomography (microCT), a new epoch of 2D and 3D imaging has been launched. We evaluated the diagnostic investigation of this analytical method versus well established histological investigations of historical human bone. Pathological changes due to various etiologies (infectious, traumatic, endocrinological, neoplasia) observed in autopsy-based macerated human skulls (Galler Collection, Natural History Museum Basel, Switzerland) were investigated by microCT and compared with histological thin ground sections using polarized light. Micro-CT images visualize the architecture of the bone with high spatial resolution without preparation or destruction of the sample in the area to be sectioned. Changes in the bone surfaces as well as alterations of the diploë can be assessed. However, morphological patterns caused by reactive response, such as typical arrangements of collagen fibers, can only be visualized by the microscopic investigation of thin ground sections using polarized light. A great advantage of microCT is the high number of slices obtained so that spatial differences within the areas of the specimen become visible. Micro-CT is a valuable tool for the diagnosis of vestiges of skull bone diseases. Its advantages over histology are the fast, automated image acquisition and the fact that the specimen is not completely destroyed. Only excision of the area to be scanned is necessary, if the specimen is too large to be scanned as a whole. Further, the 3D visualization of the micro-architecture allows an easy orientation within the sample, for example, for the choice of the location of the histological slices. However, the need to differentiate woven from lamellar bone still makes histology an indispensable method.

Diagnostic value of micro-CT in comparison with histology in the qualitative assessment of historical human postcranial bone pathologies.

Micro-computed tomography (muCT) is of great interest for palaeopathological examination because it is less invasive than histology. This study evaluates the diagnostic value of muCT for postcranial macerated bones. We investigated five specimens (osteomyelitis, tuberculosis, trauma, osteosarcoma and hypertrophic osteoarthropathy) of a pathology reference series by muCT and polarised light microscopy. The 3D muCT images allow an easy orientation within the specimen. Surface structures, thickness, continuity of the cortex and number, thickness and orientation of the trabeculae can be evaluated. The high number of muCT slices helps to choose the most interesting areas for further investigations. Grey value images display the degree of mineralisation. Yet, the differentiation between woven and lamellar bone is only possible using polarised light microscopy. muCT is a tool of high value for the examination of postcranial bone disorders. It cannot replace histological examinations completely because it cannot assess the bone quality (woven or lamellar). For the choice of the optimal location where slices for the microscopic investigation are later cut in heterogeneous samples, muCT is very useful. Therefore, we suggest performing the muCT examination first, followed by histology if necessary.

Human osseous intervertebral foramen width.

Alterations of the width of the human intervertebral foramen can play a pathophysiological role in low back pain. Osseous dimensions of the human intervertebral foramen are rarely recorded. Therefore, we present reference data obtained from skeletal samples of known lifestyle, population affinity, sex, and age at death. Cervical, thoracic, and lumbar vertebrae of functional transition zones of 71 macroscopically normal spines from early 19th century AD Swiss burial sites were selected. The intervertebral foramen widths (IFW) were analyzed with respect to possible lateralization and the impact of sex, individual age, and stature. Neither a significant side difference nor a correlation of IFW with individual age or stature could be found. Females show somewhat larger IFW than males, especially in the lumbar region. Data comparisons with earlier studies are limited due to methodological differences and possible interpopulational variations. Furthermore, the osseous intervertebral foramen only reveals a glimpse of the clinically relevant in vivo structure. Nevertheless, more focus on the osseous dimensions of the intervertebral foramen will provide baseline data of this important anatomical landmark. These data could also explore the peculiarities of the intervertebral foramen, such as its reverse sex dimorphism.

Age-dependent changes of the normal human spine during adulthood.

The impact of aging on the morphology of the osseous spine is still debated. Clinical studies usually record combined aging effects, as well as age-related degenerative changes. The aim of this study was to determine the impact of (degeneration-independent) aging on the morphology of the osseous human spine during adulthood. Various osseous dimensions of human spinal landmarks at all major vertebral levels have been assessed in macroscopically normal Swiss skeletons (N = 71), with historically known sex and age at death, as well as in larger Central European skeletal samples (N = 277) with anthropologically determined individual age and sex. All measurements were correlated with individual age (or age group) by linear regression and analyzed separately for each sex. Only few osseous spinal dimensions, and only in men, correlate significantly with individual age. Generally, the significant dimensions show an increase in size during adulthood. Similar tendencies, but with significant alterations of spinal measurements in women as well, can be found in the larger samples with anthropologically determined sex and age group. Increase of certain spinal dimensions found in this study may be a reflection of an increase in the robustness of individuals with age. Because of the absence of a significant secular alteration of stature within the well-recorded sample, we exclude secular change in body dimensions as a major bias.

Hyperostosis frontalis interna: archaeological evidence of possible microevolution of human sex steroids?

Hyperostosis frontalis interna is a restricted bilateral thickening of the frontal endocranial surface, which is frequently found in postmenopausal females today. Surprisingly, this condition had a higher male prevalence in its rare archaeological records. This is again highlighted by the oldest known male European hyperostosis frontalis interna case in an adult Celtic from 100 BC presented here. This unique specimen supports earlier suggestions of the possible microevolution of human endocrine regulation, e.g. by sex steroids, and its pathoanatomical impact.

High prevalence of tarsal coalitions and tarsal joint variants in a recent cadaver sample and its possible significance.

Tarsal coalitions (TC) are defined as fibrous (beyond normal ligaments), cartilaginous, or osseous unions of at least two tarsal bones. Most of the clinical studies report the prevalence of TC as <1%, but they disregard the asymptomatic coalitions. Because TC have been associated with pathologic conditions, including degenerative arthritic changes, knowledge of their prevalence has clinical importance. The aim of our study was to establish the prevalence of TC and tarsal joint variants. A total of 114 feet from 62 cadavers (average age = 78 years) without obvious foot pathologies were dissected at the Department of Anatomical Sciences, The University of Adelaide. Ten non-osseous TC in eight subjects were identified: two talocalcaneal and eight calcaneonavicular (occurred twice bilaterally). Variant calcaneonavicular and cuboideonavicular joints were found in 8% and 31% of feet, respectively. Other joint variants included a variable number of talocalcaneal joint surfaces and sesamoid bones. No secondary TC (due to trauma, infections, or neoplasm) were found. Our study demonstrated that the overall prevalence of TC is higher (13%) than previously thought; tarsal joint variations (39%) and sesamoid bones (42%) were common as well. The supposed secular increase in the prevalence of TC as well as the high number of anatomical variants could reflect a short-term response to altered life-style or a microevolutionary trend due to relaxed selection.

A dissection and computer tomograph study of tarsal coalitions in 100 cadaver feet.

Most of the clinical studies report the incidence of tarsal coalitions (TC) as less than 1% but they disregard the asymptomatic coalitions. TC have been associated with degenerative arthritic changes. After X-rays, computer tomography (CT) is the most commonly used diagnostic test in the detection of TC. The aims of our study were to establish the incidence of TC; the association between TC and accessory tarsal bones and between TC and tarsal arthritis; and to assess the sensitivity of CT as a diagnostic tool in TC. We performed spiral CT scans of 100 cadaver feet (mean age at death 77.7+/-10.4), which were subsequently dissected. The dissections identified nine non-osseous TC: two talocalcaneal and seven calcaneonavicular. There was no osseous coalition. Tarsal arthritis was identified in 31 cases. Both talocalcaneal coalitions were associated with arthritis while none of the calcaneonavicular coalitions were associated with tarsal arthritis. The CT diagnosed an osseous talocalcaneal coalition and was suspicious of fibrocartilaginous coalitions in eight cases. There was correlation between dissection and CT in two talocalcaneal coalitions and three calcaneonavicular coalitions thus CT identifying 55.5% of the coalitions. CT did not diagnose four non-osseous coalitions and diagnosed errouresly four possible coalitions. In conclusion our study demonstrated that the incidence of non-osseous TC is higher than previously thought (12.72%). The calcaneonavicular coalitions are the most common single type (9.09%) and they do not seem to be associated with arthritic changes in the tarsal bones. Our CT results suggest that spiral CT has a low sensitivity in the detection of non-osseous coalitions and questions if multislice CT should be used routinely when TC are suspected.

Are hyperostosis frontalis interna and leptin linked? a hypothetical approach about hormonal influence on human microevolution.

It is striking that evidence for hyperostosis frontalis interna - a phenomenon of exclusive bilateral thickening of frontal endocranial surface - in archaeological samples is very rare in contrast to its modern prevalence. Because microevolutionary changes have been shown for various human characteristics any alteration of hormonal levels is very likely. Selection pressure was definitively higher in earlier times. This favoured prolonged alertness in order to access sufficient food, shorter feeling of satiety, lower level of fat metabolism, lower metabolic rates and, therefore, lower level of leptin - a 167 amino acid peptide mainly involved in human total body fat regulation. Its effects on bone metabolism are still debated. Nevertheless, we postulate the following hypothesis: In humans a decrease of selective pressure favoured an increased metabolic rate. This, being related to the higher level of leptin caused an increase of localized bony overgrowth like hyperostosis frontalis interna.