Associations between relative body fat and areal body surface roughness characteristics in 3D photonic body scans-a proof of feasibility.

INTRODUCTION: A reliable and accurate estimate of the percentage and distribution of adipose tissue in the human body is essential for evaluating the risk of developing chronic and noncommunicable diseases. A precise and differentiated method, which at the same time is fast, noninvasive, and straightforward to perform, would, therefore, be desirable. We sought a new approach to this research area by linking a person's relative body fat with their body surface's areal roughness characteristics. MATERIALS AND METHODS: For this feasibility study, we compared areal surface roughness characteristics, assessed from 3D photonic full-body scans of 76 Swiss young men, and compared the results with body impedance-based estimates of relative body fat. We developed an innovative method for characterizing the areal surface roughness distribution of a person's entire body, in a similar approach as it is currently used in geoscience or material science applications. We then performed a statistical analysis using different linear and stepwise regression models. RESULTS: In a stepwise regression analysis of areal surface roughness frequency tables, a combination of standard deviation, interquartile range, and mode showed the best association with relative body fat (R2 = 0.55, p < 0.0001). The best results were achieved by calculating the arithmetic mean height, capable of explaining up to three-quarters of the variance in relative body fat (R2 = 0.74, p < 0.001). DISCUSSION AND CONCLUSION: This study shows that areal surface roughness characteristics assessed from 3D photonic whole-body scans associate well with relative body fat, therefore representing a viable new approach to improve current 3D scanner-based methods for determining body composition and obesity-associated health risks. Further investigations may validate our method with other data or provide a more detailed understanding of the relation between the body's areal surface characteristics and adipose tissue distribution by including larger and more diverse populations or focusing on particular body segments.

High-resolution MRI of mummified tissues using advanced short-T2 methodology and hardware.

PURPOSE: Evolutionary medicine aims to study disease development from a long-term perspective, and through the analysis of mummified tissue, timescales of several thousand years are unlocked. Due to the status of mummies as ancient relics, noninvasive techniques are preferable, and, currently, CT imaging is the most widespread method. However, CT images lack soft-tissue contrast, making complementary MRI data desirable. Unfortunately, the dehydrated nature and short T2 times of mummified tissues render them practically invisible to standard MRI techniques. Specialized short-T2 approaches have therefore been used, but currently suffer severe resolution limitations. The purpose of the present study is to improve resolution in MRI of mummified tissues. METHODS: The zero-TE-based hybrid filling technique, together with a high-performance magnetic field gradient, was used to image three ancient Egyptian mummified human body parts: a hand, a foot, and a head. A similar pairing has already been shown to increase resolution and image quality in MRI of short-T2 tissues. RESULTS: MRI images of yet unparalleled image quality were obtained for all samples, reaching isotropic resolutions of 0.6 mm and SNR values above 100. The same general features as present in CT images were depicted but with different contrast, particularly for regions containing embalming substances. CONCLUSION: Mummy MRI is a potentially valuable tool for (paleo)pathological studies, as well as for investigations into ancient mummification processes. The results presented here show sufficient improvement in the depiction of mummified tissues to clear new paths for the exploration of this field.

Secular evolution of femoral morphology from a clinical perspective.

INTRODUCTION: Intramedullary nailing is the surgical method of choice for the treatment of proximal femur or femoral shaft fractures. Implant manufacturers aim to design implants fitting for the broadest possible population segment. As complete morphological data sets of long bones are not widely available, anatomical collections of historical dry bone specimens may represent abundant additional sources of morphological three-dimensional (3D) data for implant design, provided they are consistent with present populations. This study aims to investigate secular trends and age-related changes of femoral morphology of the Caucasian population over the past 800 years. MATERIALS AND METHODS: Computer graphical measurements of 3D-datasets of right and left femora derived from computed tomography (CT) scans, representative of the present Caucasian population, were compared to computer graphical measurements of 3D-datasets of right and left femora derived from CT scans of specimens from a historical medieval European bone collection. RESULTS: Clinically relevant parameters of historical medieval European femora were found mostly consistent with correlative data of the present Caucasian population. Additionally, for some of the evaluated parameters, particularly anteversion, morphological differences significantly correlated to individual age and sex could be identified, whereas other parameters such as caput-collum-diaphyseal angle or radius of anterior femoral bowing were not correlated to individual age or sex. CONCLUSION: The findings suggest that more recent historical specimen collections may be a convenient and easily accessible source of new 3D morphological data, as well as to complement existing data, to be used by researchers and manufacturers for the development of intramedullary femoral nails.

Experimental mummification-In the tracks of the ancient Egyptians.

Understanding natural and artificial postmortem alterations in different tissues of the human body is essential for bioarchaeology, paleogenetics, physical anthropology, forensic medicine, and many related disciplines. With this study, we tried to gain a better understanding of tissue alterations associated with the artificial mummification techniques of ancient Egypt, in particular for mummified visceral organs. We used several entire porcine organs and organ sections (liver, lung, stomach, ileum, and colon), which provided a close approximation to human organs. First, we dehydrated the specimens in artificial natron, before applying natural ointments, according to the ancient literary sources and recent publications. We periodically monitored the temperature, pH value, and weight of the specimens, in addition to radiodensity and volumetric measurements by clinical computed tomography and sampling for histological, bacteriological, and molecular analyses. After seven weeks, mummification was seen completed in all specimens. We observed a considerable loss of weight and volume, as well as similar courses in the decay of tissue architecture but varying levels of DNA degradation. Bacteriologically we did not detect any of the initially identified taxa in the samples by the end of the mummification process, nor any fungi. This feasibility study established an experimental protocol for future experiments modeling ancient Egyptian mummification of visceral organs using human specimens. Understanding desiccation and mummification processes in non-pathological tissues of specific visceral organs may help to identify and interpret disease-specific alterations in mummified tissues in ancient Egyptian canopic jars and organ packages contained in whole mummies.

The earliest known case of frontal sinus osteoma in man.

Frontal sinus osteoma is a relatively common finding in the modern clinical setting. Although, its paleopathological record is not in dispute, its presence in Ancient Egypt has never been clarified. The aim of this article is to contribute to the debate. An Egyptian mummy head from the Musée d'Éthnographie de Neuchâtel (Switzerland) was studied radiologically and the obtained evidence was contextualized in the wider frame of multidisciplinary paleopathology. A 128-slice CT scanner was used for further investigation; datasets were processed with OsiriX-64 bit (version 5.8.5), and multiplanar (MPR) and volumetric reconstructions were performed. A small hyperdense and well-defined structure, most likely an osteoma, was identified in the right frontal sinus. Frontal sinus osteoma definitely existed in Ancient Egypt. Finally, this represents the oldest case in anatomically modern humans so far reported. Clin. Anat.32:105-109, 2019. © 2018 Wiley Periodicals, Inc.

Egyptian Canopic Jars at the Crossroad of Medicine and Archaeology: Overview of 100 Years of Research and Future Scientific Expectations.

Ancient Egyptian human remains have been of interest in the fields of both medical and Egyptological research for decades. However, canopic jar holders for internal organs (liver, lungs, stomach, intestines) of Egyptian mummies appear to be but a very occasional source of data for such investigations. The few medical approaches focusing on the content of these jars are summarized and listed according to pathogens and diseases to give a structured overview of this field of study. An extensive search of the literature has been conducted from different bibliographic databases with a total of n = 26 studies found. The majority of diseases found consisted of infectious diseases and internal medicine conditions such as schistosomiasis or emphysema. These are just 2 examples of many that, instead of primarily affecting bone, muscle or skin, specifically target internal organs. Hence, a better understanding of the evolution of diseases that still affect mankind could be gained. In conclusion, this reassessment shows that canopic jars represent a highly underestimated source for histological, radiological and ancient DNA examination of Ancient Egyptian remains and should, thus, be more and more brought back into the focus of retrospective medical research.

Application of a Colored Multiexposure High Dynamic Range Technique to Radiographic Imaging: An Experimental Trial to Show Feasibility.

PURPOSE: The aim of this study was to evaluate the feasibility of applying the high dynamic range (HDR) technique to radiographic imaging to expand the dynamic range of conventional radiographic images using a colored multiexposure approach. MATERIAL AND METHODS: An appropriate study object was repeatedly imaged using a range of different imaging parameters using a standard clinical x-ray unit. An underexposed image (acquired at 80 keV), an intermediate exposed image (110 keV), and an overexposed image (140 keV) were chosen and combined to a 32-bit colored HDR image. To display the resulting HDR image on a regular color display with typically 8 bits per channel, the Reinhard tone mapping algorithm was applied. The source images and the resulting HDR image were qualitatively evaluated by 5 independent radiologists with regard to the visibility of the different anatomic structures using a Likert scale (1, not visible, to 5, excellent visibility). Data were presented descriptively. RESULTS: High dynamic range postprocessing was possible without malalignment or image distortion. Application of the Reinhardt algorithm did not cause visible artifacts. Overall, postprocessing time was 7 minutes 10 seconds for the whole process. Visibility of anatomic structure was rated between 1 and 5, depending on the anatomic structure of interest. Most authors rated the HDR image best before individual source images. CONCLUSIONS: This experimental trial showed the feasibility of applying the HDR technique to radiographic imaging to expand the dynamic range of conventional radiographic images using a colored multiexposure approach.

An evolutionary perspective to intramedullary nail fit - comparing present-day data with a historical specimen collection.

Manufacturers aim to design implants fitting for the broadest possible population segment. Due to the scarcity of available morphological data of intact long bones, anatomical collections of historical bone specimens may represent valuable additional sources. Previous work on femoral morphology measurements suggests that historical specimens are widely consistent with data from present-day populations. This study aimed to investigate whether this also applies to the anatomical fitting of a clinically used femoral nail. Nail fit was computer-graphically quantified through virtual implantation into CT-based 3D models of 52 femora, comprising a subset representative of the present-day Caucasian population (n = 31), a subset from a historical medieval European bone collection (n = 20), and additionally, a dataset from a natural ice mummy from the Neolithic period. Nail fit was assessed by nail protrusion (area and distance) to the inner cortex surface and the distal nail tip's position in the medullary canal. Assessed measurements and parameters of the present-day Caucasian subset were mostly consistent with those of the medieval European subset. After adjusting for multiple testing, only the distance from lateral nail entry point to shaft axis remained significantly (p = 0.03) different when comparing our modern and medieval subsets. Subsequent bivariate (Spearman) correlation analyses for both subsets (modern and medieval) combined showed that of the three variables representing basic demographic parameters, individual age, biological sex, and femur length, most statistically significant associations to the examined nail fit measurements were found for age (six measurements at a level of p < 0.05), however, with a relatively weak monotonic correlation (rho values ranging between ±0.31 and ±0.37). The measurements for the Iceman's femur lie within the range of the modern and historical subgroups, but in some cases, differ by more than one standard deviation from the mean. Our results confirm previous findings, suggesting that more recent historical bone specimen collections may indeed be a convenient and easily accessible source of new 3D morphological data and complement existing data to be used for the development of femoral nails.

Insights into medieval rural lives: A paleo-odontological investigation of two central European communities.

OBJECTIVE: Oral status is an important indicator of past lifestyles. Determining the presence and extent of oral pathologies helps reconstruct average oral health, paramasticatory activities and diet of ancient and historical populations. DESIGN: In this study, the dental remains from the early medieval cemetery of Früebergstrasse in Baar (Canton of Zug, Switzerland) and the high medieval Dalheim cemetery (North Rhine-Westphalia, Germany) were analyzed. Caries, periodontal condition, periapical lesions, antemortem tooth loss, and enamel hypoplasia were assessed in 654 teeth (993 observable loci) from 68 individuals (Baar: n = 36; Dalheim: n = 32). RESULTS: The oral status of both populations was affected by age with higher values of tooth wear in advanced age individuals. High tooth wear values in both populations point towards the consumption of abrasive foods. Pronounced anterior tooth wear in Baar may also be due to non-masticatory tooth usage. Finally, possible nutritional deficiencies were hypothesized for the Baar population. A higher caries prevalence was observed in the Baar group, probably due to differences in carbohydrate intake. The oral conditions observed in the two studied populations exhibited several analogies, suggesting comparable lifestyles despite their separation in space and time. The only differences observed are related to the use of teeth as "tools" and are thus determined by behavioral choices rather than diverse socioeconomic factors. CONCLUSIONS: Using multiple dental parameters to examine the oral health of premodern individuals can provide useful insights into the interactions between humans and their environment, from dietary patterns to paramasticatory activities.

The Mummy Explorer-a self-regulated open-access online teaching tool.

Background and objectives: Virtual teaching tools have gained increasing importance in recent years. In particular, the COVID-19 pandemic has reinforced the need for media-based and self-regulated tools. What is missing are tools that allow us to interlink highly interdisciplinary fields such as evolutionary medicine and, at the same time, allow us to adapt content to different lectures. Methodology: We designed an interactive online teaching tool, namely, the Mummy Explorer, using open-access software (Google Web Designer), and we provided a freely downloadable template. We tested the tool on students and lecturers of evolutionary medicine using questionnaires and improved the tool according to their feedback. Results: The tool has a modular design and provides an overview of a virtual mummy excavation, including the subfields of palaeopathology, paleoradiology, cultural and ethnographic context, provenance studies, paleogenetics, and physiological analyses. The template allows lecturers to generate their own versions of the tool for any topic of interest by simply changing the text and pictures. Tests undertaken with students of evolutionary medicine showed that the tool was helpful during their studies. Lecturers commented that they appreciated having a similar tool in other fields. Conclusions and implications: Mummy Explorer fills a gap in the virtual teaching landscape of highly interdisciplinary fields such as evolutionary medicine. It will be offered for free download and can be adapted to any educational topic. Translations into German and possibly other languages are in progress.

Short-termed changes in quantitative ultrasound estimated bone density among young men in an 18-weeks follow-up during their basic training for the Swiss Armed Forces.

Background: Quantitative Ultrasound (QUS) methods have been widely used to assess estimated bone density. This study aimed to assess changes in estimated bone density in association with changes in body composition, physical activity, and anthropometry. Methods: We examined changes in anthropometry, body composition, and physical activity associated with changes in estimated bone mineral density (measured using quantitative ultrasound with a heel ultrasound device indicating broadband ultrasound attenuation BUA and speed of sound SOS) in a follow-up sample of n = 73 young men at the beginning and again 18 weeks later at the end of basic military training. Results: At the end of the basic training, the subjects were on average significantly heavier (+1.0%), slightly taller (+0.5%) and had a higher fat mass (+6.6%) and grip strength (+8.6%). A significant decrease in mean physical activity (-49.5%) and mean estimated bone density calculated with BUA (-7.5%) was observed in the paired t-test. The results of the multivariable linear regressions (backward selection) show that changes in skeletal muscle mass (delta = 2nd measurement minus 1st measurement) have negative and body weight (delta) have positive association with the speed of sound SOS (delta), while fat mass (delta) and physical activity (delta) had the strongest negative associations with estimated bone mineral density (delta). In particular, we found a negative association between fat mass (delta) and estimated bone mineral density (delta, estimated with BUA). Conclusion: Our study suggests that estimated bone density from the calcaneus can change within a few months even in young and mostly healthy individuals, depending upon physical activity levels and other co-factors. Further studies including other troop types as control groups as well as on women should follow in order to investigate this public health relevant topic in more depth. To what extent the estimated bone density measurement with quantitative ultrasound is clinically relevant needs to be investigated in further studies.

Assessment of median nerve with MR neurography by using diffusion-tensor imaging: normative and pathologic diffusion values.

PURPOSE: To determine normative diffusion values of the median nerve at several anatomic locations in healthy men and women of variable age and to compare these normative values with those in patients with carpal tunnel syndrome. MATERIALS AND METHODS: After ethics board approval and written informed consent were obtained, 45 healthy volunteers (30 women, 15 men) and 15 patients (10 women, five men) were studied. Volunteers were divided into three age groups. Magnetic resonance (MR) neurography with diffusion-tensor imaging (DTI) was performed in all study participants at 3.0 T by using a single-shot echo-planar imaging sequence (repetition time msec/echo time msec, 10 123/40; b=1200 sec/mm2). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the median nerve were determined by two readers at three locations: the levels of the distal radioulnar joint, pisiform bone, and hamate bone. RESULTS: Normative FA and ADC values were calculated for men and women, different age groups, and different anatomic locations. FA and ADC did not differ between men and women (P=.28 and P=.38, respectively). FA decreased and ADC increased when moving from proximal to distal locations (P<.001). FA decreased and ADC increased significantly with age (P<.001). There was a significant difference between healthy volunteers and patients with carpal tunnel syndrome (P<.001 for both FA and ADC). An FA threshold of 0.47 and an ADC threshold of 1.054×10(-3) mm2/sec might be used in the diagnosis of carpal tunnel syndrome. CONCLUSION: Normative diffusion values for MR neurography of the median nerve with DTI depend on the anatomic location and age but not on sex. Age-specific FA and ADC threshold values might be used to diagnose carpal tunnel syndrome.

The importance of the nasopharynx and anterior skull base in excerebration techniques from KV40, a New Kingdom Egyptian site.

In ancient Egypt, a unique technique for removing the brain was invented as part of the mummification practice and refined over the centuries. This usually involved piercing the anterior skull base through a nasal passage to remove the brain remnants through that perforation. From 2010 to 2018, an interdisciplinary team of the Universities of Basel and Zurich investigated tomb no. 40 (KV40) in the Valley of the Kings, Luxor, Egypt. Archaeological findings indicate a first burial phase during the mid-18th Dynasty (ca. 1400-1350 BCE) and a second in the 22nd to 25th Dynasty (approx. 900-700 BCE). Repeated looting since ancient times severely damaged and commingled the human remains of the two burial phases. The detailed examination of the skulls showed evidence of different transnasal craniotomy practices. This study aims to provide a systematic presentation of the evidence for different excerebration techniques found in the mummy heads, skulls, and skull fragments from KV40, reflecting the long period of occupancy of this tomb by individuals of different social classes.

Metagenomic analysis of Ancient Egyptian canopic jars.

Ancient Egyptian remains have been of interest for anthropological research for decades. Despite many investigations, the ritual vessels for the internal organs removed during body preparation-liver, lungs, stomach, and intestines, of Egyptian mummies are rarely used for palaeopathological or medical investigations. These artifacts, commonly referred to as canopic jars, are the perfect combination of cultural and biological material and present an untapped resource for both Egyptological and medical fields. Nevertheless, technical challenges associated with this archeological material have prevented the application of current ancient DNA techniques for both the characterization of human and pathogenic DNA. We present shotgun-sequenced metagenomic profiles and ancient DNA degradation patterns from multiple canopic jars sampled from several European museum collections and enumerate current limitations and possible solutions for the future analysis of similar material. This is the first-ever recorded evidence of ancient human DNA found in Ancient Egyptian canopic jars and the first associated metagenomic description of bacterial taxa in these funerary artifacts. OBJECTIVES: In this study, our objectives were to characterize the metagenomic profile of the Ancient Egyptian funerary vessels known as canopic jars to retrieve endogenous ancient human DNA, reconstruct ancient microbial communities, and identify possible pathogens that could shed light on disease states of individuals from the past. METHODS: We applied ancient DNA techniques on 140 canopic jars to extract DNA and generate whole-genome sequencing libraries for the analysis of both human and bacterial DNA. The samples were obtained from museum collections in Berlin (DE), Burgdorf (DE), Leiden (NE), Manchester (UK), Munich (DE), St. Gallen (CH), Turin (IT), and Zagreb (HR). RESULTS: Here we describe the first isolated DNA from the Egyptian artifacts that hold human viscera. No previous work was ever conducted on such material, which led to the first characterization of human DNA from Ancient Egyptian canopic jars and the profiling of the complex bacterial composition of this highly degraded, challenging, organic material. However, the DNA recovered was not of enough quality to confidently characterize bacterial taxa associated with infectious diseases, nor exclusive bacterial members of the human microbiome. DISCUSSION: In summary, we present the first genomic survey of the visceral content of Ancient Egyptian funerary artifacts and demonstrate the limitations of current molecular methods to analyze canopic jars, such as the incomplete history of the objects or the presence of uncharacterized compounds that can hamper the recovery of DNA. Our work highlights the main challenges and caveats when working with such complicated archeological material - and offers sampling recommendations for similarly complex future studies, such as incrementing the amount of starting material and sampling from the less exposed parts of the jar content. This is the first-ever recorded evidence of ancient human DNA found in Ancient Egyptian canopic jars, and our results open new avenues in the study of neglected archeological artifacts.

A critical assessment of proposed outbreaks of plague and other epidemic diseases in Ancient Egypt.

The current coronavirus disease 2019 (COVID-19) pandemic has reminded us of past epidemics. Pharaonic Egypt has often been associated with epidemics and disasters through the 10 plagues in the Bible. The aim of this study was to examine which epidemics and serious diseases can be effectively proven for Ancient Egypt through mummies and historical source texts. The biblical plagues cannot be proven because there is no agreement on the dating of the Exodus, or the Exodus is a conglomeration of memories of different events. Other diseases such as malaria and schistosomiasis have been proven for Ancient Egypt, while polio and smallpox are still uncertain. There are indications of a bubonic disease from the time of the middle 18th Dynasty, but its exact nature cannot be determined from source texts or mummies, as they are too vague.

The Oshu Fujiwara-An interdisciplinary study on the history, culture and medical assessment of the oldest known mummified human remains in Japan (late Heian, 12th century AD).

This study documents a rare case of mummified human remains from Japan, dating to the late Heian period, 12th Century AD. The remains have only been scientifically investigated once in 1950 so far. The results of this investigation were translated, analyzed, and interpreted using methods of the 21st century. The remains have been traditionally identified as the four ruling generations of the Oshu Fujiwara clan, who built a cultural and economic center in Hiraizumi. Accordingly, this paper will first examine the historical and cultural significance of Hiraizumi and its ruling class before re-evaluating the findings of the 1950 investigation. This study is the first in the Western scientific literature to provide a comprehensive historical, cultural, and medical evaluation of these mummies.