Knee osteoarthritis has doubled in prevalence since the mid-20th century.

Knee osteoarthritis (OA) is believed to be highly prevalent today because of recent increases in life expectancy and body mass index (BMI), but this assumption has not been tested using long-term historical or evolutionary data. We analyzed long-term trends in knee OA prevalence in the United States using cadaver-derived skeletons of people aged ≥50 y whose BMI at death was documented and who lived during the early industrial era (1800s to early 1900s; n = 1,581) and the modern postindustrial era (late 1900s to early 2000s; n = 819). Knee OA among individuals estimated to be ≥50 y old was also assessed in archeologically derived skeletons of prehistoric hunter-gatherers and early farmers (6000-300 B.P.; n = 176). OA was diagnosed based on the presence of eburnation (polish from bone-on-bone contact). Overall, knee OA prevalence was found to be 16% among the postindustrial sample but only 6% and 8% among the early industrial and prehistoric samples, respectively. After controlling for age, BMI, and other variables, knee OA prevalence was 2.1-fold higher (95% confidence interval, 1.5-3.1) in the postindustrial sample than in the early industrial sample. Our results indicate that increases in longevity and BMI are insufficient to explain the approximate doubling of knee OA prevalence that has occurred in the United States since the mid-20th century. Knee OA is thus more preventable than is commonly assumed, but prevention will require research on additional independent risk factors that either arose or have become amplified in the postindustrial era.

Effects of age and body proportions on stature estimation.

OBJECTIVES: Two issues involved in mathematical estimation of stature from long bone lengths are explored: the use of different age points for estimating maximum adult stature, and the effects of linear body proportions on stature estimation errors. Both issues were raised by a recent analysis of stature in the British Medieval Wharram Percy sample. MATERIALS AND METHODS: A large (n > 500) sample of European skeletal remains with anatomically estimated statures is used to test associations between relative lower limb length and errors in stature estimation using previously published equations for European samples. Two cadaveric samples of known ages (Terry and Bass Collections) are used to identify the most appropriate age point to employ in a linear equation with an age term for estimation of maximum adult anatomical stature. RESULTS: Relative lower limb length is positively correlated with errors in stature estimation from lower limb bone lengths. Underestimation of stature in the Wharram Percy sample by the European equations is largely attributable to the relatively short lower limbs of this sample compared to Europeans in general. Two methods for assessing and adjusting for relative lower limb length variation are presented. Maximum adult stature is best estimated using an age point of 30 years when a linear age term is employed. DISCUSSION: Body proportions may vary even within relatively closely related populations, so should be assessed and compared to those of reference samples whenever possible when applying mathematical stature equations.

The effect of age and body composition on body mass estimation of males using the stature/bi-iliac method.

The stature/bi-iliac breadth method provides reasonably precise, skeletal frame size (SFS) based body mass (BM) estimations across adults as a whole. In this study, we examine the potential effects of age changes in anthropometric dimensions on the estimation accuracy of SFS-based body mass estimation. We use anthropometric data from the literature and our own skeletal data from two osteological collections to study effects of age on stature, bi-iliac breadth, body mass, and body composition, as they are major components behind body size and body size estimations. We focus on males, as relevant longitudinal data are based on male study samples. As a general rule, lean body mass (LBM) increases through adolescence and early adulthood until people are aged in their 30s or 40s, and starts to decline in the late 40s or early 50s. Fat mass (FM) tends to increase until the mid-50s and declines thereafter, but in more mobile traditional societies it may decline throughout adult life. Because BM is the sum of LBM and FM, it exhibits a curvilinear age-related pattern in all societies. Skeletal frame size is based on stature and bi-iliac breadth, and both of those dimensions are affected by age. Skeletal frame size based body mass estimation tends to increase throughout adult life in both skeletal and anthropometric samples because an age-related increase in bi-iliac breadth more than compensates for an age-related stature decline commencing in the 30s or 40s. Combined with the above-mentioned curvilinear BM change, this results in curvilinear estimation bias. However, for simulations involving low to moderate percent body fat, the stature/bi-iliac method works well in predicting body mass in younger and middle-aged adults. Such conditions are likely to have applied to most human paleontological and archaeological samples.

Can we refine body mass estimations based on femoral head breadth?

Femoral head breadth is widely used in body mass estimation in biological anthropology. Earlier research has demonstrated that reduced major axis (RMA) equations perform better than least squares (LS) equations. Although a simple RMA equation to estimate body size from femoral head breadth is sufficient in most cases, our experiments with male skeletons from European data (including late Pleistocene and Holocene skeletal samples) and the Forensic Anthropology Data Bank data (including the W. M. Bass Donated Skeletal Collection sample) show that including femoral length or anatomically estimated stature in an equation with femoral head breadth improves body mass estimation precision. More specifically, although directional bias related to body mass is not reduced within specific samples, the total estimation error range, directional bias related to stature, and temporal fluctuation in estimation error are markedly reduced. The overall body mass estimation precision of individuals representing different temporal periods and ancestry groups (e.g., African and European ancestry) is thus improved.

Age-related trends in vertebral dimensions.

Several studies have demonstrated age-related changes in vertebral dimensions. Vertebral size has been reported to increase among elderly adults, with periosteal apposition resulting in increased cross-sectional area (CSA) of the vertebral corpus combined with reduction in bone mineral density. These changes in CSA are observed to be sex-specific, as the pronounced increase of vertebral CSA is found only in elderly males. However, the reduction in bone mineral density in old age is apparent within both sexes. It is thus hypothesized that higher fracture risk in elderly women is a result of their incapacity to increase vertebral size and thus adapt to bone mineral reduction. In this study, our aim was to explore whether the onset of these changes could be ascribed to specific age intervals and whether the proposed differences between the sexes are as great as previously suggested. To conduct this study we utilized two large early 20th century skeletal collections known as Terry and Bass (n = 181). We also utilized data from two lumbar spine magnetic resonance imaging samples as a modern-day reference (n = 497). Age, sex and ethnicity of all individuals were known. Vertebral CSA was determined by measuring three width and length dimensions from the corpus of the fourth lumbar vertebra (L4). Our results indicate only a moderate association between age and vertebral CSA. This association was observed to be relatively similar in both sexes, and we thus conclude that there is no clear sex-specific compensatory mechanism for age-related bone loss in vertebral size.

Musket ball injuries to the head - Experimental CT-study.

A smoothbore musket firing a round ball was the primary weapon of the infantry from the 16th to mid 19th century. Musket ball injuries are thus relatively common when archaeological remains of battlefield victims from that period are studied. Several experimental studies have focused on terminal ballistics of a musket ball. In addition, there is a good supply of historical records directly from the battlefield and military hospitals. Studies and historical records have both concluded that head injuries are among the most lethal types of musket ball damage. In this study we utilized modern day research methods, including Synbone ballistic skull phantoms and computed tomography (CT) imaging, to examine more closely the head injuries and tissue damage caused by a musket ball. We were especially interested to observe how different musket ball velocities and shooting distances would influence bone and soft tissue defects. Our experiments clearly demonstrated that musket ball was a lethal projectile even from a longer distance. Already at low velocities, the musket ball perforated through the skull. Velocity also influenced the appearance of entrance and exit wounds. CT imaging provided us with a three-dimensional view of the wound channel, skull fragments and lead remnants inside the skull phantom. According to our findings, musket ball velocity influenced defect size and cavitation. In addition, velocity influenced the size and distribution of skull fragments and lead remnants in the wound channel. Combining all these aspects could aid us in studies of archaeological musket ball victims. In particular, they could help us to estimate the shooting distance and shed light on the potential course of events in the battlefield.

Application of the anatomical method to estimate the maximum adult stature and the age-at-death stature.

This study focuses on the age adjustment of statures estimated with the anatomical method. The research material includes 127 individuals from the Terry Collection. The cadaveric stature (CSTA)-skeletal height (SKH) ratios indicate that stature loss with age commences before SKH reduction. Testing three equations to estimate CSTA at the age at death and CSTA corrected to maximum stature from SKH indicates that the age correction of stature should reflect the pattern of age-related stature loss to minimize estimation error. An equation that includes a continuous and linear age correction through the entire adult age range [Eq. (1)] results in curvilinear stature estimation error. This curvilinear stature estimation error can be largely avoided by applying a second linear equation [Eq. (2)] to only individuals older than 40 years. Our third equation [Eq. (3)], based on younger individuals who have not lost stature, can be used to estimate maximum stature. This equation can also be applied to individuals of unknown or highly uncertain age, because it provides reasonably accurate estimates until about 60/70 years at least for males.

Advances in commingled human remains analysis between 2014 and 2023.

This study reviews recent advances in osteometric, genetic, geochemical, and digital modeling applications since 2014 to demonstrate the expanded range of analyses and skeletal elements that can be used to separate individuals from commingled contexts. While traditional methods remain foundational to commingling resolution, new advances allow increased individuation, identification of human versus non-human remains, and an amplified scale of assemblages that can be analyzed. This summary offers ways for practitioners to consider the juxtaposition of analytical goals, time, financial concerns, and methods when managing commingled assemblages. Forensic anthropology and bioarchaeology case studies illustrate differences related to application of methods in terms of recovery environments, project goals, and recovered materials. Whether the goal is to isolate and individuate only major elements or as many bones as possible, in nearly all cases, it is best practice to combine several types of methods to fulfill the project scope within the established parameters. This review can help practitioners identify the most appropriate analytical protocols and methods for their projects.

Sex estimation from humeral and femoral head diameters using CT-scans of living Finns.

This study used 155 computed tomography (CT) scans of Finns (81 males, 74 females) for creating population-specific sectioning points from femoral and humeral head diameters for the purposes of sex estimation. The study included four measurements: vertical and transverse diameter of the femoral head and vertical and transverse diameter of humeral head. All the measured dimensions were sexually dimorphic and the following sectioning points were calculated: Femur: vertical diameter 46.2 mm, transverse diameter 46.3 mm; Humerus: vertical diameter 46.8 mm, transverse diameter 43.6 mm. These sectioning points correctly classified sexes with overall classification rates over 92%. The female diameters were classified more often correctly than males. Discriminant function analysis was also used but it did not improve the classification rates. This study gives new standards for humeral and femoral head dimensions for Finnish population and can be used for sex estimation in forensic cases if only major long bones, femur or humerus with a proximal end, are present or the skeletal remains are commingled.

Deep learning in sex estimation from knee radiographs - A proof-of-concept study utilizing the Terry Anatomical Collection.

Although knee measurements yield high classification rates in metric sex estimation, there is a paucity of studies exploring the knee in artificial intelligence-based sexing. This proof-of-concept study aimed to develop deep learning algorithms for sex estimation from radiographs of reconstructed cadaver knee joints belonging to the Terry Anatomical Collection. A total of 199 knee radiographs were obtained from 100 skeletons (46 male and 54 female cadavers; mean age at death 64.2 years, range 50-102 years) whose tibiofemoral joints were reconstructed in standard anatomical position. The AIDeveloper software was used to train, validate, and test neural network architectures in sex estimation based on image classification. Of the explored algorithms, an MhNet-based model reached the highest overall testing accuracy of 90.3%. The model was able to classify all females (100.0%) and most males (78.6%) correctly. These preliminary findings encourage further research on artificial intelligence-based methods in sex estimation from the knee joint. Combining radiographic data with automated and externally validated algorithms may establish valuable tools to be utilized in forensic anthropology.

Stature and body mass estimation from skeletal remains in the European Holocene.

Techniques that are currently available for estimating stature and body mass from European skeletal remains are all subject to various limitations. Here, we develop new prediction equations based on large skeletal samples representing much of the continent and temporal periods ranging from the Mesolithic to the 20th century. Anatomical reconstruction of stature is carried out for 501 individuals, and body mass is calculated from estimated stature and biiliac breadth in 1,145 individuals. These data are used to derive stature estimation formulae based on long bone lengths and body mass estimation formulae based on femoral head breadth. Prediction accuracy is superior to that of previously available methods. No systematic geographic or temporal variation in prediction errors is apparent, except in tibial estimation of stature, where northern and southern European formulae are necessary because of the presence of relatively longer tibiae in southern samples. Thus, these equations should bebroadly applicable to European Holocene skeletal samples.

The death of King Charles XII of Sweden revisited.

The death of King Charles XII of Sweden has remained as a mystery for more than three centuries. Was he assassinated by his own men or killed by the enemy fire? Charles was killed by a projectile perforating his skull from left to right. In this study, we utilized a Synbone ballistic skull phantom and modern radiological imaging to clarify the factors behind the observed head injuries. We examined whether a musket ball fired from the enemy lines would be the most potential projectile. Our experiments with a leaden 19.5 mm musket ball demonstrated that at velocities of 200 to 250 m/s, it could cause similar type of injuries as observed in the remains of Charles . The radiological imaging supported the theory that the projectile was not a leaden but of some harder metal, as we could detect remnants of lead inside the wound channel unlike in Charles' case. In addition, our experiments showed that a 19.5mm musket ball produces max. 17mm hole into a felt material . The main evidence supporting 19.5 mm projectile size has been a 19-19.5mm bullet hole in a hat that Charles was wearing during his death. Additional experiments with a 25.4 mm steel ball produced approximately 20 mm hole in the felt. As our musket ball experiments also resulted in considerably smaller cranial injuries than those in Charles' case, we can conclude that the deadly projectile wasn't leaden and was more than 19.5 mm in diameter, potentially an iron cartouche ball that was shot from the enemy lines.

Sex estimation from knee breadth dimensions in a Finnish population.

Sex estimation is an important part of osteological analysis of skeletons and forensic identification process. Traditionally cranial and pelvic traits are utilized for accurate sex estimation. However, post-cranial measurements have also been proven to accurately estimate sex especially from robust bones such as the femur. In this study, we investigated the potential of knee breadth dimensions in sex estimation in a Finnish population. To conduct this study we utilized a study sample (n = 1654) belonging to the Northern Finland Birth Cohort 1966. All individuals were 46 years of age at the time of the examination. Three knee breadth dimensions were measured from subjects' knee posteroanterior radiographs: femoral biepicondylar breadth (FBEB), mediolateral breadth of the femoral condyles (FCML), and mediolateral breadth of the tibial plateau (TPML). Sex estimation was performed using logistic regression. The study clearly demonstrated that all three measurements were different between males and females. Sectioning points for individual knee breadth measurements were 82.9 mm for FBEB, 76.6 mm for FCML and 75.4 mm for TPML. The classification rates ranged from 90.9% to 93.6%. The less commonly used measurements of FCML and TPML showed higher accuracy than FBEB in sex estimation. Our study confirmed that knee breadths can be successfully utilized to improve sex estimation in cases where the skeleton is only partially preserved and other major components of sex estimation are absent. We can also provide new standards for sex estimation from the knee joint in a Finnish population.

Analysis of Three Commonly Used Tibia Length Measurement Techniques.

This study analyzes three tibia length measurement techniques on a sample of 107 tibiae. Two of the techniques meet published criteria by resting the tibia on its posterior surface with the longitudinal axis parallel to an osteometric board. The third technique does not adequately keep the longitudinal axis parallel to the board. Statistical analyses show low levels of interobserver error for all techniques and statistically significant differences between the third technique and the other two techniques. Results report a maximum difference of 6 mm between measurement techniques with the third technique having greater than 95% directional bias. A survey sent out to the American Academy of Forensic Sciences forensic anthropology community reported more than 50% of respondents having been taught the third technique when an osteometric board with a slot/hole is not available. The intermixing of the third technique with the other two has likely contributed to higher levels of interobserver error in tibia length measurements.

Reanalysis of the Trotter Tibia Quandary and its Continued Effect on Stature Estimation of Past-Conflict Service Members.

Forensic casework from past-conflicts relies on the corrected historical Trotter data for stature estimation in Fordisc. For roughly 10 years', stature estimation using this data has produced point estimates for the tibia that are on average 1.25 inches less than the other long bones. This issue was identified after applying the equations derived from Fordisc to the USS Oklahoma commingled assemblage. Reevaluation of Fordisc revealed that a correction factor of 20 mm, instead of 10 mm, was mistakenly applied to the Trotter tibia data. Historical forensic anthropology reports written at the Defense POW/MIA Accounting Agency were utilized to identify that the overcorrection is isolated to Fordisc 3 with an error rate of 5% of known antemortem statures falling outside of the prediction intervals that relied on the tibia. Further evaluation of the Oklahoma sample indicates the 10 mm correction is still producing point estimates less than the other long bones.

Error quantification of osteometric data in forensic anthropology.

This study evaluates the reliability of osteometric data commonly used in forensic case analyses, with specific reference to the measurements in Data Collection Procedures 2.0 (DCP 2.0). Four observers took a set of 99 measurements four times on a sample of 50 skeletons (each measurement was taken 200 times by each observer). Two-way mixed ANOVAs and repeated measures ANOVAs with pairwise comparisons were used to examine interobserver (between-subjects) and intraobserver (within-subjects) variability. Relative technical error of measurement (TEM) was calculated for measurements with significant ANOVA results to examine the error among a single observer repeating a measurement multiple times (e.g. repeatability or intraobserver error), as well as the variability between multiple observers (interobserver error). Two general trends emerged from these analyses: (1) maximum lengths and breadths have the lowest error across the board (TEM<0.5), and (2) maximum and minimum diameters at midshaft are more reliable than their positionally-dependent counterparts (i.e. sagittal, vertical, transverse, dorso-volar). Therefore, maxima and minima are specified for all midshaft measurements in DCP 2.0. Twenty-two measurements were flagged for excessive variability (either interobserver, intraobserver, or both); 15 of these measurements were part of the standard set of measurements in Data Collection Procedures for Forensic Skeletal Material, 3rd edition. Each measurement was examined carefully to determine the likely source of the error (e.g. data input, instrumentation, observer's method, or measurement definition). For several measurements (e.g. anterior sacral breadth, distal epiphyseal breadth of the tibia) only one observer differed significantly from the remaining observers, indicating a likely problem with the measurement definition as interpreted by that observer; these definitions were clarified in DCP 2.0 to eliminate this confusion. Other measurements were taken from landmarks that are difficult to locate consistently (e.g. pubis length, ischium length); these measurements were omitted from DCP 2.0. This manual is available for free download online (https://fac.utk.edu/wp-content/uploads/2016/03/DCP20_webversion.pdf), along with an accompanying instructional video (https://www.youtube.com/watch?v=BtkLFl3vim4).

Data for validation of osteometric methods in forensic anthropology.

Many techniques in forensic anthropology employ osteometric data, although little work has been done to investigate the intrinsic error in these measurements. These data were collected to quantify the reliability of osteometric data used in forensic anthropology research and case analyses. Osteometric data (n = 99 measurements) were collected on a random sample of William M. Bass Donated Collection skeletons (n = 50 skeletons). Four observers measured the left elements of 50 skeletons. After the complete dataset of 99 measurements was collected on each of the 50 skeletons, each observer repeated the process for a total of four rounds. The raw data is available on Mendeley Data ( DCP Osteometric Data, Version 1. DOI: 10.17632/6xwhzs2w38.1). An example of the data analyses performed to evaluate and quantify observer error is provided for the variable GOL (maximum cranial length); these analyses were performed on each of the 99 measurements. Two-way mixed ANOVAs and repeated measures ANOVAs with pairwise comparisons were run to examine intraobserver and interobserver error, and relative and absolute technical error of measurement (TEM) was calculated to quantify the observer variation. This data analysis supported the dissemination of a free laboratory manual of revised osteometric definitions (Data Collection Procedures 2.0[1], pdf available at https://fac.utk.edu/wp-content/uploads/2016/03/DCP20_webversion.pdf) and an accompanying instructional video (https://www.youtube.com/watch?v=BtkLFl3vim4). This manual is versioned and updatable as new information becomes available. Similar validations of scientific data used in forensic methods would support the ongoing effort to establish valid and reliable methods and protocols for proficiency testing, training, and certification.

Storm-Related Postmortem Damage to Skeletal Remains.

In April 2011, human skeletons were exposed to heavy storms at the outdoor Anthropology Research Facility (ARF) in Knoxville, Tennessee. Of the approximate 125 skeletons at the ARF in April 2011, 30 donations exhibited postmortem damage that could be attributed to the storms. At least 20 of the affected donations exhibit postmortem damage clearly associated with hailstones due to the oval shape and similar small size of the defects observed. The irregular shape and larger size of other defects may be a product of other falling objects (e.g., tree branches) associated with the storms. Storm-related damage was observed throughout the skeleton, with the most commonly damaged skeletal elements being the scapula and ilium, but more robust elements (i.e., femora and tibiae) also displayed characteristic features of hailstone damage. Thus, hailstone damage should be considered when forensic practitioners observe unusual postmortem damage in skeletal remains recovered from the outdoor context.

Testing anatomical methods for stature estimation on individuals from the W. M. Bass Donated Skeletal Collection.

This study compared eight versions of the anatomical method for stature estimation on a white male sample (n = 34) from the W. M. Bass Donated Skeletal Collection. The aim was to evaluate errors in the estimates and to discuss how useful the methods are in forensic context. The average error estimating living stature was less than 1 cm for six of the methods. The correlations between the estimates were high (r = 0.982-0.999). In practice, differences between the versions as well as those between long bone-based equations and anatomical methods were small. Anatomical method is nevertheless more accurate than long bone regressions when individuals with atypical body proportions are examined.

Temporal trends in vertebral size and shape from medieval to modern-day.

Human lumbar vertebrae support the weight of the upper body. Loads lifted and carried by the upper extremities cause significant loading stress to the vertebral bodies. It is well established that trauma-induced vertebral fractures are common especially among elderly people. The aim of this study was to investigate the morphological factors that could have affected the prevalence of trauma-related vertebral fractures from medieval times to the present day. To determine if morphological differences existed in the size and shape of the vertebral body between medieval times and the present day, the vertebral body size and shape was measured from the 4th lumbar vertebra using magnetic resonance imaging (MRI) and standard osteometric calipers. The modern samples consisted of modern Finns and the medieval samples were from archaeological collections in Sweden and Britain. The results show that the shape and size of the 4th lumbar vertebra has changed significantly from medieval times in a way that markedly affects the biomechanical characteristics of the lumbar vertebral column. These changes may have influenced the incidence of trauma- induced spinal fractures in modern populations.