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

Deep learning in forensic gunshot wound interpretation:a proof-of-concept study

Abstract While the applications of deep learning are considered revolutionary within several medical specialties, forensic applications have been scarce despite the visual nature of the field. For example, a forensic pathologist may benefit from deep learning-based tools in gunshot wound interpretation. This proof-of-concept study aimed to test the hypothesis that trained neural network architectures have potential to predict shooting distance class on the basis of a simple photograph of the gunshot wound. A dataset of 204 gunshot wound images (60 negative controls, 50 contact shots, 49 close-range shots, and 45 distant shots) was constructed on the basis of nineteen piglet carcasses fired with a .22 Long Rifle pistol. The dataset was used to train, validate, and test the ability of neural net architectures to correctly classify images on the basis of shooting distance. Deep learning was performed using the AIDeveloper open-source software. Of the explored neural network architectures, a trained multilayer perceptron based model (MLP_24_16_24) reached the highest testing accuracy of 98%. Of the testing set, the trained model was able to correctly classify all negative controls, contact shots, and close-range shots, whereas one distant shot was misclassified. Our study clearly demonstrated that in the future, forensic pathologists may benefit from deep learning-based tools in gunshot wound interpretation. With these data, we seek to provide an initial impetus for larger-scale research on deep learning approaches in forensic wound interpretation

Sex- and site-specific, age-related changes in bone density:a Terry collection study

Abstract As modern populations are living longer, age-related health issues have become more common. One growing concern is the age-related bone density loss that increases the individual’s risk for fractures, which unfortunately seems to disproportionately afflict women. These fractures are not only detrimental to the individuals’ lives but also come with a great economic burden to the societies. Although age-related bone loss is a normal phenomenon, studies on archaeological individuals have demonstrated that the pattern how this occurs has experienced changes due to our changing lifestyles. Hence, to add to our understanding of secular trends in age-related bone loss, we studied age- and sex-related differences in vertebral and femoral bone densities of a recent past population of late 19th and early 20th century Americans. We used a sample of 114 individuals (55 males, 59 females) from the Robert J. Terry Anatomical Skeletal Collection. Peripheral quantitative computed tomography (pQCT) was used to scan the dry bones. We took one scan from the 4th lumbar vertebra and three scans from the femur. The associations between the age, sex and bone density were analyzed. We were able to detect age-related bone loss in both vertebra and femur. It was observed that men tended to lose more bone density on the vertebra, whereas bone loss in women was more pronounced in the femur. We speculate that differences to modern and earlier archaeological populations are related to the major lifestyle differences between the periods

The death of King Charles XII of Sweden revisited

Abstract 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 dimensions of the fourth lumbar vertebra in Northern Finns of 20, 30, and 46 years of age

Abstract Background: Accurate sex estimation (sexing) is crucial for successful forensic identification. For the cases in which only a part of the skeleton or individual skeletal elements are available, we investigated the sex estimation potential of the fourth lumbar vertebra (L4) among 20-, 30-, and 46-year-old Northern Finns. Material and methods: Magnetic resonance imaging scanned living subsamples of the Northern Finland Birth Cohort 1966 (scan at 46 years, n = 1363) and the Northern Finland Birth Cohort 1986 (repeated scans at 20 and 30 years, n = 375) provided the material for the study. After screening the scans for vertebral pathologies, we measured the maximum and minimum widths, depths, and heights of the L4 body. The mean vertebral width, depth and height were calculated together with vertebral cross-sectional area and volume. Sex estimations were performed using univariate and multivariate logistic regression analysis. Results: We detected marked sex discrepancy in all the studied parameters of L4 (p < 0.001). In the groups aged 20, 30, and 46 years, the regression models reached correct sex estimation rates of 86.4%, 87.7%, and 82.8%, respectively. At each time point, multivariate models proved more accurate than univariate models. Men showed consistently lower correct sex estimation rates than women. Conclusion: Among 20-, 30-, and 46 year-old Finns, combining the measurements of width, depth, and height of the L4 body can be used to estimate sex with an accuracy of >80%. Vertebral width, depth, and height seem to yield as accurate sex estimates as more complicated vertebral parameters

Potential case of gynecomastia in mummified remains of an early modern period Northern Finnish vicar

Abstract We report possibly the oldest evidence of gynecomastia in mummified human remains. Computed tomography was performed on the mummified remains of an early 17th century Northern Finnish vicar. The examination of the scans revealed large bilateral subareolar irregular masses resembling female mammary glands. The nearly septuagenarian vicar appears to have had gynecomastia, as it is a common condition in elderly men, and is sometimes associated with obesity. Gynecomastia is the most likely explanation for these findings. Clin. Anat. 31:641–644, 2018. © 2018 Wiley Periodicals, Inc

Baseline anthropometric indices predict change in vertebral size in early adulthood:a 10-year follow-up MRI study

Abstract The vertebral cross-sectional area (CSA) has an independent effect on vertebral strength. Recent evidence has shown that vertebral dimensions significantly increase in the third decade of life, and that lifestyle factors such as body size and composition are clearly associated with vertebral CSA. This study aimed to test the hypothesis that general anthropometric traits (stature, total body mass, lean body mass, fat mass, body mass index, waist circumference), each objectively measured at baseline, predict the change in vertebral CSA over the subsequent decade. A representative sample of young Northern Finnish adults was used (n = 371) with repeated magnetic resonance imaging (MRI) scans from ~20 and ~30 years (baseline and follow-up, respectively). Vertebral CSA was measured from the MRI scans with high reliability and low measurement error. The statistical analysis was performed using linear regression models adjusted for sex and exact length of MRI interval. According to the regression models, in descending order of effect size, lean body mass (standardized beta coefficient 0.243 [95% confidence interval 0.065—0.420]), total body mass (0.158 [0.043—0.273]), body mass index (0.125 [0.026—0.224]), waist circumference (0.119 [0.010—0.228]), and fat mass (0.104 [0.004—0.205]) were positively and significantly associated with CSA gain over the follow-up, whereas stature (0.079 [−0.066—0.224]) was not associated with CSA change. The results of this study suggest that anthropometric indices may be used for estimating subsequent change in vertebral size. In particular, greater lean body mass seems to be beneficial for vertebral size and thus potentially also for vertebral strength. Future studies should aim to replicate these associations in a dataset with longitudinal anthropometric trajectories and identify the potential common factors that influence both anthropometric traits and vertebral CSA gain

Lifelong smoking trajectories of Northern Finns are characterized by sociodemographic and lifestyle differences in a 46-year follow-up

Abstract Smoking remains among the leading causes of mortality worldwide. Obtaining a comprehensive understanding of a population’s smoking behaviour is essential for tobacco control. Here, we aim to characterize lifelong smoking patterns and explore underlying sociodemographic and lifestyle factors in a population-based birth cohort population followed up for 46 years. Our analysis is based on 5797 individuals from the Northern Finland Birth Cohort 1966 who self-reported their tobacco smoking behaviour at the ages of 14, 31 and 46. Data on sex, education, employment, body mass index, physical activity, alcohol consumption, and substance addiction were also collected at the follow-ups. We profile each individual’s annual smoking history from the age of 5 to 47, and conduct a latent class trajectory analysis on the data. We then characterize the identified smoking trajectory classes in terms of the background variables, and compare the heaviest smokers with other classes in order to reveal specific predictors of non-smoking and discontinued smoking. Six smoking trajectories are identified in our sample: never-smokers (class size 41.0%), youth smokers (12.6%), young adult quitters (10.8%), late adult quitters (10.5%), late starters (4.3%), and lifetime smokers (20.7%). Smoking is generally associated with male sex, lower socioeconomic status and unhealthier lifestyle. Multivariable between-class comparisons identify unemployment (odds ratio [OR] 1.28–1.45) and physical inactivity (OR 1.20–1.52) as significant predictors of lifetime smoking relative to any other class. Female sex increases the odds of never-smoking and youth smoking (OR 1.29–1.33), and male sex increases the odds of adult quitting (OR 1.30–1.41), relative to lifetime smoking. We expect future initiatives to benefit from our data by exploiting the identified predictors as direct targets of intervention, or as a means of identifying individuals who may benefit from such interventions

Possible case of partial postmortem fetal extrusion:preliminary observations on the mummified remains of a turnof-the-19th-century noblewoman in Finland

Abstract We report a plausible case of partial postmortem fetal extrusion dating to the turn of the 19th century. A fetal skull protruded from the obstetric canal of the partially mummified remains of an adult woman buried in a private burial chapel in Vihti, South Finland. The fetal size implies the mother having died during the early third trimester of her pregnancy. The cause of death was not obvious from the limited external examination of her remains, but the underdeveloped state of the fetal remains renders it unlikely that this case represents a maternal death resulting from dystocia. Rather, the finding should be interpreted as a case of partial postmortem fetal extrusion, a process probably interrupted by decelerated decomposition of the maternal remains before full expulsion of the fetus

The association of body size, shape and composition with vertebral size in midlife:the Northern Finland Birth Cohort 1966 study

Abstract Small vertebral size increases the risk of osteoporotic vertebral fractures. Obese individuals have larger vertebral size and potentially lower fracture risk than lean individuals, but scarce data exist on the association between vertebral size and anthropometric measures beyond height, weight, and body mass index (BMI). Here, we evaluated several anthropometric measures (height, weight, BMI, waist circumference, hip circumference, waist-to-hip ratio [WHR], waist-to-height ratio [WHtR], fat mass [FM], lean body mass [LBM], percentage FM [%FM], percentage LBM [%LBM]) as predictors of vertebral cross-sectional area (CSA). We used a representative sample from the Northern Finland Birth Cohort 1966 (n = 1087), with anthropometric measurements from the ages of 31 and 46, bioimpedance analysis from the age of 46, and lumbar magnetic resonance imaging from the age of 46 years. In our data, height and LBM correlated most strongly with vertebral CSA among both sexes (0.469 ≤ r ≤ 0.514), while WHR, WHtR, %FM, and %LBM had the weakest correlations with vertebral CSA (|r| ≤ 0.114). We conclude that height and LBM have the highest, yet only moderate correlations with vertebral size. High absolute LBM, rather than FM or abdominal mass accumulation, correlates with large vertebral size and thus potentially also with lower osteoporotic vertebral fracture risk