rASUDAS: A New Web-Based Application for Estimating Ancestry from Tooth Morphology

The use of crown and root morphology to estimate population relationships has a long history in dental anthropology. Over the past two decades, methods employing dental morphology within forensic anthropology have been formalized with the incorporation of statistical models. This paper presents a new web-based application (rASUDAS) that estimates the ancestry of unknown individuals based on their suite of tooth crown and root traits. The application utilizes 21 independent traits that were scored following the Arizona State University Dental Anthropology System (ASUDAS). The reference sample represents approximately 30,000 individuals from seven biogeographic regions. A naive Bayes classifier algorithm was created in the R open source programming language to assign posterior probabilities for individual group assignment. To test the application, 150 individuals were selected from the C. G. Turner II database with the proviso that an individual had to be scored for a minimum of 12 of the 21 traits. In a seven-group analysis, the model correctly assigned individuals to groups 51.8% of the time. In a four-group analysis, classification accuracy improved to 66.7%. With three groups, accuracy was at 72.7%. It is still necessary to validate the program using forensic cases and to augment the reference sample with modern skeletal data. However, results from the beta version of rASUDAS are presented as proof of concept on the potential of dental morphology in ancestry estimation in forensic contexts

rASUDAS2 A New Iteration of the Application for Assessing the Population Affinity of Individuals by Tooth Crown and Root Morphology

The web-based application rASUDAS, originally based on data from “The Anthropology of Modern Human Teeth,” has been refined since its inception in 2015, undergoing two significant updates. The initial alpha version included 12 crown and five root traits. The beta version expanded the list to 15 crown traits and six root traits. The latest iteration, rASUDAS2, has expanded to include four additional traits along with seven backup traits, allowing for flexibility in cases where certain primary traits, like shoveling on UI1, cannot be scored, so shoveling expression on UI2 is utilized. The Bayesian algorithm powering rASUDAS2 employs trait frequencies derived from archaeological finds. To evaluate its effectiveness with contemporary samples, rASUDAS2 was tasked with calculating posterior probabilities for samples of African and European descent. Utilizing between 12 and 25 traits, it assigns individuals to one of seven major biogeographic groups: Western Eurasia (WE), East Asia (EA), American Arctic (AA), non-Arctic America (n-AA), Southeast Asia (SEA), Australo-Melanesia (AM), and Sub-Saharan Africa (SSA). In a modern African sample (n = 159), the probability of classification into the Sub-Saharan African group was the highest at 68.6%, followed by Western Eurasian at 22.0%, with probabilities ranging from 0.6% to 4.4% for the other groups. Similarly, in a European-derived sample (n = 161), 75.2% were assigned to Western Eurasia and 13.0% to Sub-Saharan Africa, with the remaining 12% distributed among other groups. Approximately three out of four individuals from these regions could be accurately placed within their respective biogeographic groups. However, the likelihood of these individuals being assigned to any Asian-related group is low, at less than 10%. When assessing two mixed African and European samples, results indicated nearly equal percentages of affinity assignment, with around 40% for Sub-Saharan African and 30% for Western Eurasian

Efeitos de um programa de orientação para adultos com lombalgia

OBJETIVO: Implantar um programa de "Escola da Postura" para pacientes com lombalgia crônica. MÉTODOS: Foram avaliados 41 sujeitos (46,81 ± 13,35 anos), de ambos os gêneros, com idade entre 25-65 anos que possuíam dor lombar há mais de 6 meses. Inicialmente, foi realizado a avaliação da qualidade de vida (Medical Outcomes Study 36- Item Short-Form Health Survey- SF-36) e capacidade funcional (Oswestry Low Back Pain Disability Questionnaire - ODQ). Em seguida, todos os sujeitos participaram de cinco encontros semanais de 60 minutos, nos quais foram desenvolvidos as capacitações teórico-práticas. Após uma semana, os sujeitos foram reavaliados. Os dados obtidos nas avaliações foram analisados utilizando o teste estatístico não-paramétrico de Wilcoxon, com nível de significância de 5% (pOBJECTIVE: To implement a "Back School" program for low-back chronic pain. METHODS: Forty one subjects were evaluated (46,81 + 13,35 years old), from both genders, with the age from 25-65 years who had low-back pain for more than 6 months. Initially, the quality of life evaluation was made (Medical Outcomes Study 36- Item Short-Form Health Survey- SF-36), functional capacity (Oswestry Low Back Pain Disability Questionnaire - ODQ). Following that, every subject participated of five 60-minute weekly meetings, in which the theoretical-practical capacities were developed. After a week, the subjects were re-evaluated. The obtained data over the evaluations were analyzed using the Wilcoxon non-parametric statistics test, with a significance level of 5% (p<0,05). RESULTS: A significant improvement was observed over the functional capacity (ODQ, p<0,0001).The QV, was observed over the domains functional capacity (p=0,0016), pain (p=0,0035), general health state (p<0,0001), vitality (p<0,0001), social aspects (p<0,0001) and mental health (p=0,0007). Over the physical and emotional aspects items were a significant difference were not observed. CONCLUSION: Back School program was capable of improving the quality of life and functional capacity of the participants

An intervention to support adherence to inhaled medication in adults with cystic fibrosis : the ACtiF research programme including RCT

Background People with cystic fibrosis frequently have low levels of adherence to inhaled medications. Objectives The objectives were to develop and evaluate an intervention for adults with cystic fibrosis to improve adherence to their inhaled medication. Design We used agile software methods to develop an online platform. We used mixed methods to develop a behaviour change intervention for delivery by an interventionist. These were integrated to become the CFHealthHub intervention. We undertook a feasibility study consisting of a pilot randomised controlled trial and process evaluation in two cystic fibrosis centres. We evaluated the intervention using an open-label, parallel-group randomised controlled trial with usual care as the control. Participants were randomised in a 1 : 1 ratio to intervention or usual care. Usual care consisted of clinic visits every 3 months. We undertook a process evaluation alongside the randomised controlled trial, including a fidelity study, a qualitative interview study and a mediation analysis. We undertook a health economic analysis using both a within-trial and model-based analysis. Setting The randomised controlled trial took place in 19 UK cystic fibrosis centres. Participants Participants were people aged ≥ 16 years with cystic fibrosis, on the cystic fibrosis registry, not post lung transplant or on the active transplant list, who were able to consent and not using dry-powder inhalers. Intervention People with cystic fibrosis used a nebuliser with electronic monitoring capabilities. This transferred data automatically to a digital platform. People with cystic fibrosis and clinicians could monitor adherence using these data, including through a mobile application (app). CFHealthHub displayed graphs of adherence data as well as educational and problem-solving information. A trained interventionist helped people with cystic fibrosis to address their adherence. Main outcome measures Randomised controlled trial – adjusted incidence rate ratio of pulmonary exacerbations meeting the modified Fuchs criteria over a 12-month follow-up period (primary outcome); change in percentage adherence; and per cent predicted forced expiratory volume in 1 second (key secondary outcomes). Process evaluation – percentage fidelity to intervention delivery, and participant and interventionist perceptions of the intervention. Economic modelling – incremental cost per quality-adjusted life-year gained. Results Randomised controlled trial – 608 participants were randomised to the intervention (n = 305) or usual care (n = 303). To our knowledge, this was the largest randomised controlled trial in cystic fibrosis undertaken in the UK. The adjusted rate of exacerbations per year (primary outcome) was 1.63 in the intervention and 1.77 in the usual-care arm (incidence rate ratio 0.96, 95% confidence interval 0.83 to 1.12; p = 0.638) after adjustment for covariates. The adjusted difference in mean weekly normative adherence was 9.5% (95% confidence interval 8.6% to 10.4%) across 1 year, favouring the intervention. Adjusted mean difference in forced expiratory volume in 1 second (per cent) predicted at 12 months was 1.4% (95% confidence interval –0.2% to 3.0%). No adverse events were related to the intervention. Process evaluation – fidelity of intervention delivery was high, the intervention was acceptable to people with cystic fibrosis, participants engaged with the intervention [287/305 (94%) attended the first intervention visit], expected mechanisms of action were identified and contextual factors varied between randomised controlled trial sites. Qualitative interviews with 22 people with cystic fibrosis and 26 interventionists identified that people with cystic fibrosis welcomed the objective adherence data as proof of actions to self and others, and valued the relationship that they built with the interventionists. Economic modelling – the within-trial analysis suggests that the intervention generated 0.01 additional quality-adjusted life-years at an additional cost of £865.91 per patient, leading to an incremental cost-effectiveness ratio of £71,136 per quality-adjusted life-year gained. This should be interpreted with caution owing to the short time horizon. The health economic model suggests that the intervention is expected to generate 0.17 additional quality-adjusted life-years and cost savings of £1790 over a lifetime (70-year) horizon; hence, the intervention is expected to dominate usual care. Assuming a willingness-to-pay threshold of £20,000 per quality-adjusted life-year gained, the probability that the intervention generates more net benefit than usual care is 0.89. The model results are dependent on assumptions regarding the duration over which costs and effects of the intervention apply, the impact of the intervention on forced expiratory volume in 1 second (per cent) predicted and the relationship between increased adherence and drug-prescribing levels. Limitations Number of exacerbations is a sensitive and valid measure of clinical change used in many trials. However, data collection of this outcome in this context was challenging and could have been subject to bias. It was not possible to measure baseline adherence accurately. It was not possible to quantify the impact of the intervention on the number of packs of medicines prescribed. Conclusions We developed a feasible and acceptable intervention that was delivered to fidelity in the randomised controlled trial. We observed no statistically significant difference in the primary outcome of exacerbation rates over 12 months. We observed an increase in normative adherence levels in a disease where adherence levels are low. The magnitude of the increase in adherence may not have been large enough to affect exacerbations. Future work Given the non-significant difference in the primary outcome, further research is required to explore why an increase in objective normative adherence did not reduce exacerbations and to develop interventions that reduce exacerbations. Trial registration Work package 3.1: Current Controlled Trials ISRCTN13076797. Work packages 3.2 and 3.3: Current Controlled Trials ISRCTN55504164

Contribuição da aplicação do ultrassom de baixa potência na prevenção de osteopenia em tíbias de ratos sob ausência de carga

Este trabalho objetivou verificar se o ultrassom de baixa potência (US) previne a ocorrência de osteopenia em tíbias de ratos sob ausência de carga. Foram utilizados 45 Rattus novergicus albinus, Wistar adultos, machos, distribuídos em cinco grupos iguais: C - animais-controle livres em gaiolas por 21 dias; S - animais suspensos pela cauda por 21 dias; ST - suspensos pela cauda por 21 dias e concomitantemente tratados com US; S→C - suspensos por 21 dias e depois permanecendo livres em gaiolas por mais 21 dias; S→CT - suspensos por 21 dias e depois permanecendo livres em gaiolas por mais 21 dias e concomitantemente tratados com US. O tratamento foi realizado com US de 1,5MHz, ciclo de trabalho 1:4, 30mW/cm², na tíbia direita, por 15 sessões de 20 minutos cada, cinco sessões por semana. Ainda vivos, os animais foram submetidos a exame de densitometria óssea para verificação da densidade mineral óssea (DMO) e do conteúdo mineral ósseo (CMO). Após a eutanásia dos animais, as tíbias foram desarticuladas, dissecadas e submetidas a ensaio mecânico destrutivo para análise da força máxima (Fmáx) e da rigidez (R). Foram avaliados também o comprimento (L) e o diâmetro (D) no ponto médio da tíbia. O grupo S apresentou valores de DMO, CMO, Fmáx, R, L e D menores em relação ao grupo C, demonstrando que a suspensão pela cauda é prejudicial a estas variáveis. O tratamento dos animais suspensos com o US, grupo ST, elevou os valores de CMO e DMO em relação aos do grupo S, igualando-os aos do grupo C. A Fmáx, R e L do grupo ST aumentou em relação ao grupo S e também em relação ao grupo C (p0,05). Os resultados obtidos neste estudo permitem concluir que o US de baixa potência contribuiu na prevenção e reversão da ocorrência da osteopenia nos animais submetidos à suspensão pela cauda, demonstrando que a ausência do estímulo mecânico causada pela impossibilidade da deambulação pode ser minimizada pela ação mecânica deste.This work intended to verify if the low power ultrasound (US) prevents the occurrence of osteopenia on the tibia of rats under the absence of load. 45 adult male Wistar Rattus novergicus albinus were used, separated in five equal groups: C - control free animals in cages for 21 days; S - animals suspended by the tail for 21 days; ST - animals suspended by the tail for 21 days and concurrently treated with US; S→C - animals suspended for 21 days and then free in cages for another 21 days; S→CT - animals suspended for 21 days and then free in cages for another 21 days and concurrently treated with US. The treatment was performed with US with 1.5 MHz, work cycle 1:4, 30 mW/cm², on tibia, for 15 sessions of 20 minutes each, 5 sessions per week. While still alive, the animals underwent bone densitometry examination to verify the Bone Mineral Density (BMD) and the Bone Mineral Content (BMC). After the euthanasia of the animals, the tibias were disjointed, dissected and underwent destructive mechanical testing for the analysis of the maximum force (Fmax) and Rigidity (R). The length (L) and the diameter (D) of the middle point of the tibia were also measured. In group S, BMD, BMC, Fmax, R, L and D were smaller than in group C, demonstrating that the suspension by the tail is detrimental to these variables. The treatment of the suspended animals with the US, in group ST, increased the BMD and BMC compared to group S, leveling them to group C. The Fmax, R and L of group ST increased compared to group S and compared to group C as well (p0.05). The results obtained in this study lead to the conclusion that the low power US contributes to the prevention of the occurrence of osteopenia on animals under suspension by the tail, showing that the absence of the mechanical stimulation caused by the impossibility of deambulation can be minimized by its action.Universidade Estadual PaulistaUniversidade Estadual Paulist

SPINNE: An app for human vertebral height estimation based on artificial neural networks

The absence or poor preservation of vertebrae often prevent the application of the anatomical method for stature estimation. The main objective of this paper was to develop a web app based on artificial neural network (ANN) models to estimate the vertebral height of absent or poorly preserved vertebrae from other vertebrae and thus enable the application of anatomical methods. Artificial neural models were developed based on the vertebral height of vertebrae C2 to S1 of a sample composed of 56 adult male and 69 adult female individuals. The skeletons belong to the Identified Skeletal Collection of the University of Coimbra and the ages at death of these individuals ranged from 22 to 58 years old. Statistical analysis and algorithmic development were performed with the R language, R Core Team (2018). Intra- and inter-observer errors regarding the vertebral height were small for all vertebrae (<0.45 mm). Significant models to estimate vertebral height were obtained for both sexes and for the sex-pooled group, although none with an R2 higher than 0.48 and 0.34 for the C2 and the S1, respectively. The root mean square error (RMSE) regarding the predicted vertebral height and the observed vertebral height was almost always smaller than 1.0 mm while most R2 values were higher than 0.6 although models with worse performances were obtained for some vertebrae located at the ends of the vertebral column (C3, L4, and L5). The ANN models have clear potential to predict vertebral height. This mathematical approach may be used to enable the application of the anatomical method for stature estimation when some vertebrae are absent or poorly preserved. The application of the ANN models can be carried out by using the new web based app SPINNE

Ancestry Estimation Based on Morphoscopic Traits in a Sample of African Slaves from Lagos, Portugal (15th-17th Centuries)

In 2009, a skeletal collection of 158 individuals was excavated in Valle da Gafaria, Lagos, Portugal. These individuals were buried in an unusual way, having been discarded in an urban dump located outside the medieval city walls, dated from the 15th-17th centuries. Lagos was, at the time, an important slave trade harbour, and during the excavation, the morphological appearance of the skulls and the presence of intentionally modified teeth in some individuals raised suspicion that they were African slaves. Despite the extensive historical information about the Atlantic slave trade, so far skeletal remains identified as slaves were scarce, especially in Europe. The aim of the present study is to estimate the ancestry of a sample of 33 adult individuals (28 females and 5 males) recovered in the Valle da Gafaria applying the eleven morphological characteristics recommended by Hefner (2009) using the naïve Bayes classifier. When comparing the individuals with four groups of classification (European, African, American Indian, and Asian), 24 (72.7%) specimens were classified as Africans with a posterior probability greater than 0.90. When only two groups were considered (the African and the European), 31 (93.9%) individuals were classified as Africans with a posterior probability greater than 0.90. These results are in accordance with the historical record and previous genetic studies suggesting that this sample represents a rare archaeological sample of great interest to the history of the Atlantic slave trade, i.e., the Lagos individuals were probably of African ancestry. Although the ancestry is a parameter of the biological profile mainly estimated in forensic Anthropology, this study confirms the importance of its investigation in past populations