Heat-induced Bone Diagenesis Probed by Vibrational Spectroscopy.

Complementary vibrational spectroscopic techniques - infrared, Raman and inelastic neutron scattering (INS) - were applied to the study of human bone burned under controlled conditions (400 to 1000 °C). This is an innovative way of tackling bone diagenesis upon burning, aiming at a quantitative evaluation of heat-induced dimensional changes allowing a reliable estimation of pre-burning skeletal dimensions. INS results allowed the concomitant observation of the hydroxyl libration (OHlibration), hydroxyl stretching (ν(OH)) and (OHlibration + ν(OH)) combination modes, leading to an unambiguous assignment of these INS features to bioapatite and confirming hydroxylation of bone's inorganic matrix. The OHlib, ν(OH) and ν4(PO43-) bands were identified as spectral biomarkers, which displayed clear quantitative relationships with temperature revealing heat-induced changes in bone's H-bonding pattern during the burning process. These results will enable the routine use of FTIR-ATR (Fourier Transform Infrared-Attenuated Total Reflectance) for the analysis of burned skeletal remains, which will be of the utmost significance in forensic, bioanthropological and archaeological contexts.

Crystal clear: Vibrational spectroscopy reveals intrabone, intraskeleton, and interskeleton variation in human bones.

OBJECTIVES: Vibrational spectroscopy is a valuable tool for the study of burned skeletal remains. Nonetheless, most investigations have been focused on a limited number of samples as well as on faunal bones rather than human bones. Conclusions based on those investigations may lack representativeness, namely about the intrabone, intra- and interskeleton variability of several chemometric indices. We aimed to investigate this issue on a large sample of human bones. MATERIAL AND METHODS: Powder samples were collected from 168 bones from four human skeletons. The sampling targeted 47 long bones, 72 short bones, and 49 tarsal bones as well as different bone regions in a total of 638 powder samples. Bones were experimentally burned in an electric muffle furnace for two hours to maximum temperatures ranging from 400°C to 1000°C. Another 623 burned samples were then collected totaling 1261 samples subjected to FTIR-ATR analysis. The CI, BPI, C/C, and OH/P indices were calculated. RESULTS: An important intrabone, intra- and interskeleton variation was observed, especially for the BPI. The CI, C/C, and OH/P indices revealed much less variation so site-specific sampling may not be as critical in these cases. Clear differences between our results and those from previous investigations were observed, namely on the temperature increment evolution of the CI and C/C indices. DISCUSSION: The relatively large heterogeneity, especially at the intrabone level, is possibly the consequence of microstructural bone differences. The dissimilarities observed between our investigation and other published studies are probably due to the fact that the samples used here came from human rather than faunal bones. Also, our samples were buried previously to the experimental burning so this may also partly explain our contrasting results, since previous research was mostly performed on fresh bone. Future inferences based on vibrational spectroscopy analyses should take into account the possible effect of all these sources.

Dead weight: Validation of mass regression equations on experimentally burned skeletal remains to assess skeleton completeness.

In very fragmentary remains, the thorough inventory of skeletal elements is often impossible to accomplish. Mass has been used instead to assess the completeness of the skeleton. Two different mass-based methods of assessing skeleton completeness were tested on a sample of experimentally burned skeletons with the objective of determining which of them is more reliable. The first method was based on a simple comparison of the mass of each individual skeleton with previously published mass references. The second method was based on mass linear regressions from individual bones to estimate complete skeleton mass. The clavicle, humerus, femur, patella, metacarpal, metatarsal and tarsal bones were used. The sample was composed of 20 experimentally burned skeletons from 10 males and 10 females with ages-at-death between 68 and 90years old. Results demonstrated that the regression approach is more objective and more reliable than the reference comparison approach even though not all bones provided satisfactory estimations of the complete skeleton mass. The femur, humerus and patella provided the best performances among the individual bones. The estimations based on the latter had root mean squared errors (RMSE) smaller than 300g. Results demonstrated that the regression approach is quite promising although the patella was the only reasonable predictor expected to survive sufficiently intact to a burning event at high temperatures. The mass comparison approach has the advantage of not depending on the preservation of individual bones. Whenever bones are intact though, the application of mass regressions should be preferentially used because it is less subjective.

Avaliação da concavidade lombar pelo método radiográfico e pela cifolordometria / Evaluation of lumbar concavity using a radiographic method and kypholordometry

CONTEXTUALIZAÇÃO: A avaliação clínica é a base para tomada de decisão referente ao tratamento. Quando não é possível obter a radiografia, poucos recursos permitem ao fisioterapeuta avaliar quantitativamente o estado do indivíduo, um deles é o cifolordômetro, um instrumento não invasivo, de baixo custo, proposto para mensuração das curvas da coluna vertebral no plano sagital. OBJETIVOS: Avaliar a confiabilidade intra e interexaminador do cifolordômetro, verificar sua concordância com a radiografia e se há correlação entre a medida da curva lombar pelo método radiográfico e pelo cifolordômetro. MÉTODOS: Foram avaliados 20 indivíduos saudáveis de ambos os sexos, com idade entre 21 e 27 anos. Os voluntários foram submetidos à radiografia da coluna lombar, incidência perfil direito e em ortostatismo. As radiografias foram avaliadas por um radiologista pelo método de Cobb, tendo como pontos de referência T12 e S1. A cifolordometria foi realizada no mesmo posicionamento e por três avaliadores em dois momentos, tendo como referência as mesmas vértebras. Foi traçada uma reta de T12 à vértebra menos proeminente e outra de S1 à mesma, identificando o grau de concavidade lombar. RESULTADOS: Os resultados demonstram que a cifolordometria apresenta níveis excelentes de confiabilidade, tanto inter quanto intraexaminador, baixa concordância com a radiografia, porém há correlação positiva, estatisticamente significativa entre os dois métodos estudados (r=0.88). CONCLUSÃO: A cifolordometria apresentou-se como um método quantitativo, com excelente confiabilidade intra e interexaminador para a avaliação da curvatura lombar, podendo contribuir de sobremaneira para a prática clínica do fisioterapeuta.

BACKGROUND: Clinical evaluation is the basis for making decisions regarding treatments. When radiographic images cannot be obtained, few resources allow physical therapists to quantitatively evaluate an individual's condition. One of these is the kypholordometer, a low-cost noninvasive instrument proposed for measuring spinal curvature in the sagittal plane. OBJECTIVES: To evaluate the intra- and inter-examiner reliability of the kypholordometer, to investigate its agreement with radiography, and to determine whether there is any correlation between measurements of lumbar curvature using the radiographic method and the kypholordometer. METHODS: Twenty healthy individuals of both sexes aged between 21 and 27 years were evaluated. They underwent radiographic examination of the lumbar spine in right lateral view while standing up. The radiographic images were evaluated by a radiologist using Cobb's method, with T12 and S1 as the reference points. The kypholordometry was carried out in the same position by three evaluators on two occasions, with the same vertebrae as the reference points. A straight line was drawn from T12 to the least prominent vertebra and another from S1 to the same vertebra, thus identifying the degree of lumbar concavity. RESULTS: The results demonstrated that kypholordometry presented excellent levels of reliability (both intra- and inter-examiner), but low agreement with radiography. However, there was a statistically significant positive correlation between the two methods studied (r=0.88). CONCLUSION: Kypholordometry is a quantitative method with excellent intra- and inter-examiner reliability for evaluating lumbar curvature. It may contribute greatly towards the clinical practice of physical therapists.

Gonadotropin-releasing hormone for infertility in women with primary hypothalamic amenorrhea. Toward a more-interventional approach.

OBJECTIVE: To assess the effectiveness of a protocol of pulsatile gonadotropin releasing-hormone (GnRH) in treating infertility in women with primary hypothalamic amenorrhea. STUDY DESIGN: Retrospective analysis of 44 cycles treated at an infertility center. Twenty-four patients with primary hypothalamic amenorrhea were treated intravenously with pulsatile GnRH using 5 micrograms per bolus every 90 minutes. Ultrasound monitoring and cervical assessment by Insler's scoring system allowed timed injection of human chorionic gonadotropin (hCG) and intrauterine insemination if needed. Luteal support was provided with hCG. RESULTS: The ovulation rate was 95% with the 5-microgram dose. A single follicle was produced in 91% of cycles. The overall pregnancy rate per ovulatory cycle was 45%, and the pregnancy rate per patient was 83%. In patients treated previously with exogenous gonadotropins, poor results were observed. Only one case of mild overstimulation was reported. CONCLUSION: Pulsatile GnRH is an effective and safe method of treating infertility in women with primary hypothalamic amenorrhea, thus simulating normal ovulation; however, more-interventional management, including the qualitative estrogenic response, may lead to optimal results and increase the pregnancy rate.