Morphometric analysis of the hominin talus: Evolutionary and functional implications.

The adoption of bipedalism is a key benchmark in human evolution that has impacted talar morphology. Here, we investigate talar morphological variability in extinct and extant hominins using a 3D geometric morphometric approach. The evolutionary timing and appearance of modern human-like features and their contributions to bipedal locomotion were evaluated on the talus as a whole, each articular facet separately, and multiple combinations of facets. Distinctive suites of features are consistently present in all fossil hominins, despite the presence of substantial interspecific variation, suggesting a potential connection of these suites to bipedal gait. A modern human-like condition evolved in navicular and lateral malleolar facets early in the hominin lineage compared with other facets, which demonstrate more complex morphological variation within Homininae. Interestingly, navicular facet morphology of Australopithecus afarensis is derived in the direction of Homo, whereas more recent hominin species such as Australopithecus africanus and Australopithecus sediba retain more primitive states in this facet. Combining the navicular facet with the trochlea and the posterior calcaneal facet as a functional suite, however, distinguishes Australopithecus from Homo in that the medial longitudinal arch had not fully developed in the former. Our results suggest that a more everted foot and stiffer medial midtarsal region are adaptations that coincide with the emergence of bipedalism, whereas a high medial longitudinal arch emerges later in time, within Homo. This study provides novel insights into the emergence of talar morphological traits linked to bipedalism and its transition from a facultative to an obligate condition.

Ancient genomes reveal a high diversity of Mycobacterium leprae in medieval Europe.

Studying ancient DNA allows us to retrace the evolutionary history of human pathogens, such as Mycobacterium leprae, the main causative agent of leprosy. Leprosy is one of the oldest recorded and most stigmatizing diseases in human history. The disease was prevalent in Europe until the 16th century and is still endemic in many countries with over 200,000 new cases reported annually. Previous worldwide studies on modern and European medieval M. leprae genomes revealed that they cluster into several distinct branches of which two were present in medieval Northwestern Europe. In this study, we analyzed 10 new medieval M. leprae genomes including the so far oldest M. leprae genome from one of the earliest known cases of leprosy in the United Kingdom-a skeleton from the Great Chesterford cemetery with a calibrated age of 415-545 C.E. This dataset provides a genetic time transect of M. leprae diversity in Europe over the past 1500 years. We find M. leprae strains from four distinct branches to be present in the Early Medieval Period, and strains from three different branches were detected within a single cemetery from the High Medieval Period. Altogether these findings suggest a higher genetic diversity of M. leprae strains in medieval Europe at various time points than previously assumed. The resulting more complex picture of the past phylogeography of leprosy in Europe impacts current phylogeographical models of M. leprae dissemination. It suggests alternative models for the past spread of leprosy such as a wide spread prevalence of strains from different branches in Eurasia already in Antiquity or maybe even an origin in Western Eurasia. Furthermore, these results highlight how studying ancient M. leprae strains improves understanding the history of leprosy worldwide.

Participation in sports, body composition, and fitness characteristics in children according to ethnic background.

Participation in sports has important implications, being associated with health and social features. The objectives of this study were to verify whether there were any differences in sport participation between immigrant and Italian children and whether there was any relation with their body composition and fitness characteristics. A survey was conducted on 1432 children attending primary school in the Emilia-Romagna (northern Italy). Anthropometric measurements, fitness characteristics, and data about participation in sports were considered. Italian children were more likely to participate in sports than immigrants and boys than girls. Among immigrants, the lowest values were observed in Asians. Eastern European males and Latin American females displayed the widest dimensions. Eastern Europeans generally showed the highest values of strength, while Latin Americans had the highest values of flexibility. Asian children showed the highest values of centripetal fat, and a high percentage of them exceeded the %F reference. These aspects, together with the low frequency of practicing sports, place Asians at greater risks for health. Sex and ethnic group are the most informative variables associated with participation in sports by children. Interventions including health education lessons and promoting the participation in sports for immigrant children attending schools need to be encouraged.

Dental status and 3D reconstruction of the malocclusion of the famous singer Farinelli (1705-1782).

The famous castrato singer Carlo Broschi, better known as Farinelli (1705-1782), was exhumed by our research group in July 2006 to study his skeletal remains and reconstruct his osteobiography. He was castrated before puberty to preserve his high voice into adulthood. The osteological study has revealed several skeletal features probably related to the effects of castration (Hyperostosis frontalis interna, long limb bones, persistence of epiphyseal lines, osteoporosis) (Belcastro et al., 2011). Here we present the study of the teeth and maxilla-mandibular region using classic and tomographic morphological methods. Considering the subject's age and the period during which he lived, his oral health conditions were good. On the basis of the very pronounced anomalous vestibular buccal wear, a overbite visualized by 3D reconstruction, was hypothesized. This facial disharmony is of particular interest when considering Farinelli's extraordinary singing qualities and stage presence.

Variation of the anterior aspect of the femoral head-neck junction in a modern human identified skeletal collection.

The effectiveness of the so-called skeletal markers of activity as functional indicators is widely debated. Among them, certain morphological features of the anterior aspect of the femoral head-neck junction (Poirier's facet, cervical fossa of Allen, etc.) have been considered in relation to some behaviors and specific activities (e.g., squatting, horseback riding, etc.). However, disagreement on terminology and descriptions, the absence of standardized scoring methods and poor knowledge of the variability and distribution of these features make it difficult to interpret their meaning. The aim of this study is to analyze the variability of the anterior aspect of the femoral neck through a new scoring method taking into account three main traits: Poirier's facet, plaque, and cribra (including the Allen's fossa). This method has been applied to a sample of 225 adult individuals of both sexes coming from an identified modern skeletal collection, achieving low intraobserver and interobserver error values. The results highlight some significant trends: plaque, almost always bilateral, appears to be a normal condition of the femur, being present in approximately 90% of the individuals. Cribra is more frequent in females and decreases with age. Poirier's facet shows a very low frequency. This method allows the representation of both the anatomical diversity of the region already described in literature and part of the variability never considered before. Our results suggest caution in considering these features as markers related to specific activities.

Auricular surface aging: a blind test of the revised method on historic Italians from Sardinia.

Age determination from human skeletal remains is an important biological parameter in both forensic and bioarchaeological contexts. This study presents the results of a blind test of the revised auricular surface age estimation method proposed by Buckberry and Chamberlain (Am. J. Phys. Anthropol. 119 (2002) 321-329) on a large sample (n=404) of known sex and age from the Sassari collection, housed at the Museum of Anthropology, University of Bologna, Italy. Ilia were scored for five features: transverse organization, surface texture, microporosity, macroporosity, and apical changes, which combined for a composite score. The results indicated that all features and the composite score were positively correlated with known age. Composite scores were significantly different between the sexes, suggesting that males and females should be treated separately. Bias and inaccuracy varied across age intervals. Age tended to be overestimated in individuals under age 59 and underestimated for those over age 60 years. However, the revised method showed improvement over the original auricular surface method (Lovejoy et al., Am. J. Phys. Anthropol. 68 (1985) 15-28), especially for aging older individuals. Considerable variation exists in the age ranges derived from composite scores and few significant differences were found between age stages, suggesting that fewer stages with wider age ranges may be necessary. The independent, quantitative scoring of the surface features makes the revised method substantially easier to apply and the method shows significant improvement for aging older individuals.

The role of glutathione in cadmium ion detoxification: coordination modes and binding properties--a density functional study.

In this investigation the reduced form of glutathione molecule (GSH) was considered as a model in the coordination chemistry of Cd(2+) and group thiol-containing peptides. Three different forms of GSH, corresponding to the prevalent ones in gas-phase and in aqueous solution, were taken into account in the metallation process. The obtained complexes were characterized at the density functional B3LYP level with the purpose to give better insight in the chelation mechanism of GSH with heavy metal ions in living organisms. Solvent effects, whether with explicit water molecules or with polarizable continuum model (PCM), were considered on the most stable cadmium-complexes obtained by every GSH charged species examined.

Changes in the threshold of fetal lung maturity testing and neonatal outcome of infants delivered electively before 39 weeks gestation: implications and cost-effectiveness.

OBJECTIVE: To compare the neonatal outcome of infants delivered before 39 weeks' gestation following documentation of fetal lung maturity before and after the lamellar body count (LBC) threshold was increased from 30,000 to 50,000 LB/ul. We discuss the algorithm employed for testing fetal lung maturity, the cost of testing and potential savings. MATERIAL AND METHODS: We studied the outcome of infants delivered electively before 39 weeks' gestation after fetal lung maturity was documented by amniotic fluid analysis. We compared the outcome of neonates born before and after the LBC threshold was increased. RESULTS: Our cohort included 527 neonates who were divided into two groups: 264 who underwent fetal lung maturity studies before the change in LBC threshold and 263 who underwent testing after the change. In the first group, 158 neonates met the criteria of LBC >30,000 LB/ul and were delivered without further testing. The second group included 154 neonates who were mature by LBC >50,000 LB/ul and were delivered. Seven of the neonates born in the first group required admission to the neonatal intensive care unit (NICU), whereas in the second group only two neonates required admission (P = 0.02). Additionally, 16 neonates in the first group required respiratory assistance compared with six in the second group (P = 0.04). The overall neonatal complication rate was significantly higher in the first group (P = 0.001). CONCLUSION: Changing the LBC threshold resulted in a significant decrease in neonatal morbidity. Employing the algorithm, we described for testing fetal lung maturity is cost effective, and more importantly, represents sound evidence-based medical management.

Interaction of cysteine with Cu2+ and group IIb (Zn2+, Cd2+, Hg2+) metal cations: a theoretical study.

The structure and energetics of complexes obtained upon interaction between cysteine and Zn2+, Cd2+, Hg2+ and Cu2+ cations were studied using quantum chemical density functional theory calculations with the 6-311++G** orbital basis set and relativistic pseudopotentials for the cations. Different coordination sites for metal ions on several cysteine conformers were considered. In their lowest energy complexes with the amino acid, the Zn2+ and Cd2+ cations appear to be three-coordinated to carbonyl oxygen, nitrogen and sulfur atoms, whereas the Cu2+ and Hg2+ ions are coordinated to both the carbonyl oxygen and sulfur atoms of one of the zwitterion forms of the amino acid. Bonds of metal cations with the coordination sites are mainly ionic except those established with sulfur, which show a small covalent character that become most significant when Cu2+ and Hg2+ are involved. The order of metal ion affinity proposed is Cu>Zn>Hg>Cd.

Dento-alveolar lesions and nutritional habits of a Roman Imperial age population (1st-4th c. AD): Quadrella (Molise, Italy).

The study of teeth is very important in archaeoanthropology for reconstruction of the nutritional habits and living conditions of past populations. We have analysed dental lesions of pathological (caries, abscesses and ante mortem tooth loss) and non-pathological origin (calculus), linear enamel hypoplasia and tooth wear in 67 adults from the Roman Imperial age necropolis (1st-4th c. AD) of Quadrella (Molise, Italy). The high frequency of caries (likely giving rise to the abscesses and ante mortem tooth loss), the abundant calculus and the low frequency of heavy wear are probably due to a limited use of hard fibrous foods and a high consumption of carbohydrates. The high frequency of linear enamel hypoplasia suggests metabolic problems during growth. Comparison of these data with those for two coeval Italian necropoleis near Rome (Latium), Isola Sacra and Lucus Feroniae, indicates poorer living conditions in the Quadrella population.

An extensively hydrolysed cow's milk formula improves clinical symptoms of gastroesophageal reflux and reduces the gastric emptying time in infants.

BACKGROUND: About 20 % of infants fed with breast-milk substitutes suffer from Gastro Esophageal Reflux (GER) and 1/3 of them also show Cow's Milk Allergy (CMA) symptoms. METHODS: We planned this study to assess by dynamic echography the usefulness of an Extensively Hydrolysed Cow's Milk Formula (eHF) in infants suffering from GER. Ten infants showing GER symptoms and 10 normal babies, all fed with breast-milk substitutes, were enrolled. Clinical symptom scores related to GER were assessed for one week. The Gastric Emptying Time (GET) was determined by means of dynamic echography after feeding with cow's milk-derived formulae and again after a week feeding with eHF in subjects previously showing GER symptoms. RESULTS: All infants with a clinical diagnosis for GER showed an abnormally high average GET in comparison to normal subjects (205 vs 124 min, p = 0.000). Switching to the eHF led to a significant clinical improvement (p = 0.0039) especially in babies skin-test and RAST positive to cow's milk, and to a significant decrease toward the normal value of the GET (167 min, p < 0.001). CONCLUSIONS: The eHF tested improves GER symptoms in infants suffering from this disease. Our experience confirms and supports the use of dynamic echography as a reliable, simple, and non-invasive diagnostic method for infants with an increased GET associated with clinical symptoms of GER.

An extensively hydrolysed cow's milk formula improves clinical symptoms of gastroesophageal reflux and reduces the gastric emptying time in infants

Background: About 20 % of infants fed with breast-milk substitutes suffer from Gastro Esophageal Reflux (GER) and 1/3 of them also show Cow's Milk Allergy (CMA) symptoms. Methods: We planned this study to assess by dynamic echography the usefulness of an Extensively Hydrolysed Cow's Milk Formula (eHF) in infants suffering from GER. Ten infants showing GER symptoms and 10 normal babies, all fed with breast-milk substitutes, were enrolled. Clinical symptom scores related to GER were assessed for one week. The Gastric Emptying Time (GET) was determined by means of dynamic echography after feeding with cow's milk-derived formulae and again after a week feeding with eHF in subjects previously showing GER symptoms. Results: All infants with a clinical diagnosis for GER showed an abnormally high average GET in comparison to normal subjects (205 vs 124 min, p = 0.000). Switching to the eHF led to a significant clinical improvement (p = 0.0039) especially in babies skin-test and RAST positive to cow's milk, and to a significant decrease toward the normal value of the GET (167 min, p < 0.001). Conclusions: The eHF tested improves GER symptoms in infants suffering from this disease. Our experience confirms and supports the use of dynamic echography as a reliable, simple, and non-invasive diagnostic method for infants with an increased GET associated with clinical symptoms of GER (AU)

Antecedentes: Alrededor del 20 por ciento de los niños alimentados con sustitutivos de leche materna padecen reflujo gastroesogáfico (GER) y un tercio de ellos además muestran síntomas de alergia a la leche de vaca (CMA). El estudio fue diseñado para, mediante ecografía dinámica, evaluar la utilidad de la fórmula de leche de vaca ampliamente hidrolizada (eHF) en niños que padecen GER. Métodos: Fueron reclutados 10 pacientes que mostraban síntomas de GER y 10 bebés normales, todos ellos alimentados con sustitutivos de leche materna. Los valores de síntomas clínicos relacionados con el GER fueron evaluados durante una semana. El tiempo de vaciamiento gástrico (GET) fue determinado mediante ecografía dinámica después de alimentar con fórmula derivada de leche de vaca a pacientes que mostraban previamente GER, y otra vez después de una semana, en pacientes alimentados con eHF. Resultados: Todos los niños con diagnóstico clínico de GER mostraron un nivel anormalmente alto de GET en comparación con los niños normales (205 vs 124 min, p = 0,000). El cambio a la alimentación con eHF indujo a una mejora clínicamente significativa (p = 0,0039) especialmente en bebés con pruebas cutáneas y RAST positivo a leche de vaca y un descenso significativo a valores normales del GET (167 min, p < 0,001).Conclusiones: El eHF estudiado mejora los síntomas de GER en niños que padecen dicha enfermedad. Nuestra experiencia confirma y apoya el uso de la ecografía dinámica como un método de diagnóstico fidedigno, simple y no invasivo para niños con un aumento del GET asociado a síntomas clínicos del GER (AU)

Acute exposure to arsenite induces metallothionein isoform-specific gene expression in human proximal tubule cells.

The expression of metallothionein (MT) mRNA and protein was determined in human proximal tubule cells (HPT) following acute exposure to the classic stimulators of the stress response, heat and sodium arsenite (As3+). Treatment of the cells with 100 microM As3+ for 4 h resulted in a significant increase in the MT-1 and MT-2 proteins immediately preceding and following removal of the stress. The level of the MT-3 isoform protein was unchanged as a result of As3+ treatment. An analysis of the MT isoform-specific mRNA demonstrated that control cells express the MT-1E, MT-1F, MT-1X, MT-2A, and MT-3 genes, but not the MT-1A, MT-1B, MT-1C, MT-1H, and MT-4 genes. Treatment with As3+ resulted in a significant increase in the expression of the MT-1X gene and appearance of mRNA for the MT-1A gene. Expression of the other MT genes was unaffected by As3+ exposure, except one isolate expressed a low level of MT-1G mRNA at several time points. It is likely that the increase in MT protein seen in As3+-treated cells is due to the increased expression of the MT-1X gene because its expression is much greater than the MT-1A isoform. Treatment of the HPT cells with heat shock had no marked effect on the levels of MT protein or mRNA. This study demonstrates that acute exposure to As3+ increases the levels of MT protein and that this elevation most likely arises from increased expression of the MT-1X isoform.

Anthropological and cultural features of a skeletal sample of horsemen from the medieval necropolis of Vicenne-Campochiaro (Molise, Italy).

In the medieval necropolis of Vicenne (Italy) among 130 skeletons, thirteen horsemen, recognized on the basis of the contextual burials with horse, have been found. This rite, rarely found in Europe, recalls an Asian rite, attested from the Iron Age to the Age of Migration in nomadic Asian populations. Local and Germanic goods were also found. In order to study the anthropological composition of this population, some morphometrical skeletal features have been analyzed. Heterogeneity both in the horsemen and in the other males of the necropolis has been observed. Besides the multicultural context testified by archaeological data, a multiethnic society seems to emerge by the anthropological analysis. In these Italian territories, involved by migrations, Asian and Germanic population probably crossed with the local ones.

[Locoregional anesthesia in inguinal hernia surgery]. / L'anestesia locoregionale nella chirurgia dell'ernia inguinale.

BACKGROUND: It is a current opinion that local anesthesia (LA) is the primary choice in surgical treatment of the inguinal region, particularly herniorrhaphy. The LA technique personally used for herniorrhaphy is described: it consists of iliohypogastric, ilioinguinal and genito-femoral nerve blocks, and incision line anesthetic infiltration. METHODS: From January 1998 to April 1999, 95 patients underwent inguinal herniorrhaphy employing LA: 77 (81%) in elective surgery, 18 (19%) in emergency; 2 cases with bilateral hernia (97 total LA procedures). RESULTS: Partial success was obtained in only 8 cases (8.4%), which required an association with a hypnotic drug ("blended anesthesia": propofol or midazolam): there were no cases of conversion to general anesthesia. Specific complications of local anesthetic drugs infiltration developed in 8 cases on 97 LA procedures (8.2%), but none required reoperation: 6 inguinal hematomas, 1 female external genitalia hematoma, 1 hematocele. CONCLUSIONS: In conclusion, it is stressed that LA is the technique of choice in herniorrhaphy and surgery of other inguinal pathologies, associating high success rates, rare complications and rapid dismissal: this allows for easy management of the patients and a very important reduction of sanitary costs. The association of LA-hypnotic drugs (blended anesthesia) represents another important resource, since it avoids general anesthesia in many cases and allows a rapid psychophysical recovery.

Morphological and biomechanical analysis of a skeleton from Roman imperial necropolis of Casalecchio di Reno (Bologna, Italy, II-III c. A. D.). A possible case of crutch use.

A Roman skeleton (T.130) from the roman necropolis of Casalecchio di Reno has been studied in order to understand if the hypothesis of crutch use, suggested by the severe articular degeneration at the hip joint that caused evident reduction of his locomotory possibilities, could be supported by the morphological alterations of other bones and joints. The pathological changes and muscular development of the upper limbs and shoulder girdle bones suggest that these parts were submitted to a great mechanical stress. The observations are consistent with the hypothesis of crutch use that would have involved a new weight-bearing function of the upper limbs in order to help locomotion, even though it is difficult to assess the number and type of the crutches. The comparison with other possible cases of crutch use reported in literature gives an additional support to the interpretation of the findings.

Transient neonatal diabetes mellitus or an exaggerated steroid response? A case study.

Hyperglycemia is a common finding in the extremely premature neonate, especially during the first several days of life. Premature neonates have difficulty maintaining normal blood glucose levels in spite of normal or below-normal glucose infusion rates. Some infants experience intermittent episodes of hyperglycemia throughout the course of hospitalization that typically can be related to infection, medications, overinfusion of glucose, or episodes of stress. Transient neonatal diabetes mellitus (TNDM) is an uncommon diagnosis that is utilized when other reasons for the hyperglycemia cannot be determined. The article presents a case study describing an episode of hyperglycemia that could have been TNDM or an exaggerated response to the use of dexamethasone.

A multicenter randomized masked comparison trial of synthetic surfactant versus calf lung surfactant extract in the prevention of neonatal respiratory distress syndrome.

OBJECTIVE: To compare the efficacy and safety of a synthetic surfactant (Exosurf Neonatal, Burroughs Wellcome Co) and a surfactant extract of calf lung lavage (Infasurf, IND #27,169, ONY, Inc) in the prevention of neonatal respiratory distress syndrome (RDS). DESIGN AND SETTING: Ten-center randomized masked comparison trial. PATIENTS: Premature infants (n = 871) <29 weeks gestational age by best obstetric estimate. INTERVENTIONS: Infants were randomly assigned to a course of treatment with Exosurf Neonatal (n = 438) or Infasurf (n = 433) at birth, and if still intubated, at 12 and 24 hours of age. Crossover treatment was allowed within 72 hours of age if severe respiratory failure (defined as two consecutive a/A PO2 ratios

Research project on the treatment of anorexia and bulimia: an integrative, multidimensional approach.

This research project tries to test a therapeutic strategy that could improve the prognosis of anorexic and bulimic syndrome, by reducing their tendency to chronicity. The hypothesis is that, whenever we deal with complex, multifactoral syndromes, such as anorexia and bulimia, a therapy based upon the association of different kinds of treatments (medical-biological-nutritional treatments plus family therapy) helps to obtain better results than one type of treatment only (medical-biological-nutritional alone). The selection of the samples (experimental and control samples), the materials and methods of the research project, and the follow-up series are described.

A multicenter randomized, masked comparison trial of natural versus synthetic surfactant for the treatment of respiratory distress syndrome.

OBJECTIVE: To compare the efficacy and safety of two surfactant preparations in the treatment of respiratory distress syndrome (RDS). METHODS: We conducted a randomized, masked comparison trial at 21 centers. Infants with RDS who were undergoing mechanical ventilation were eligible for treatment with two doses of either a synthetic (Exosurf) or natural (Infasurf) surfactant if the ratio of arterial to alveolar partial pressure of oxygen was less than or equal to 0.22. Crossover treatment was allowed within 96 hours of age if severe respiratory failure (defined as two consecutive arterial/alveolar oxygen tension ratios < or = 0.10) persisted after two doses of the randomly assigned surfactant. Four primary outcome measures of efficacy (the incidence of pulmonary air leak (< or = 7 days); the severity of RDS; the incidence of death from RDS; and the incidence of survival without bronchopulmonary dysplasia (BPD) at 28 days after birth) were compared by means of linear regression techniques. RESULTS: The primary analysis of efficacy was performed in 1033 eligible infants and an analysis of safety outcomes in the 1126 infants who received study surfactant. Preentry demographic characteristics and respiratory status were similar for the two treatment groups, except for a small but significant difference in mean gestational age (0.5 week) that favored the infasurf treatment group. Pulmonary air leak (< or = 7 days) occurred in 21% of Exosurf- and 11% of infasurf-treated infants (adjusted relative risk, 0.53; 95% confidence interval, 0.40 to 0.71; p < or = 0.0001). During the 72 hours after the initial surfactant treatment, the average fraction of inspired oxygen (+/-SEM) was 0.47 +/- 0.01 for Exosurf- and 0.39 +/- 0.01 for infasurf-treated infants (difference, 0.08; 95% confidence interval, 0.06 to 0.10; p < 0.0001); the average mean airway pressure (+/-SEM) was 8.6 +/- 0.1 cm H2O; for Exosurf- and 7.2 +/- 0.1 cm H2O for Infasurf-treated infants (difference, 1.4 cm H2O; 95% confidence interval, 1.0 to 1.8 cm H2O; p < 0.0001). The incidences of RDS-related death, total respiratory death, death to discharge, and survival without bronchopulmonary dysplasia at 28 days after birth did not differ. The number of days of more than 30% inspired oxygen and of assisted ventilation, but not the duration of hospitalization, were significantly lower in Infasurf-treated infants. CONCLUSION: Compared with Exosurf, Infasurf provided more effective therapy for RDS as assessed by significant reductions in the severity of respiratory disease and in the incidence of air leak complications.