Sawmark Analysis of Three Cases of Amputation and a Craniotomy from the Seventeenth and Eighteenth Centuries Hospital Necropolis of Forlì Campus (Forlì, Italy)

The seventeenth-eighteenth century hospital necropolis of Forlì Campus (Forlì, Italy) was discovered during the Forlì Campus building work in 2014. Three cases of limb amputation and a craniotomy are examined using the forensic approach of sawmark analysis in order to understand features of the surgical instruments employed and to gain insight into the position of the surgeon during the cutting actions. With the aid of high definition photographs and moulds, we analyzed the cut surfaces of each sample, also using stereomicroscopy and SEM (Scanning Electron Microscopy). A qualitative and quantitative approach was used in the analysis of the kerf features (e.g. breakaway spur and notch, tooth scratches and hop, exit chipping), and empirical evidence was compared against comparisons coeval surgical essays. We hypothesize that a linear hand-powered push saw and an alternated push saw with a 2mm distance between the teeth were used for amputations. The craniotomy was executed presumably using a linear hand-powered saw with the set of the blade circa 1.3mm wide. Through the application of forensic methods on individuals from archaeological context we describe early cases of surgical practice in a more technical way

Global longitudinal strain at rest predicts significant coronary artery stenosis in patients with peripheral arterial disease

Abstract Funding Acknowledgements Type of funding sources: None. Background Critical peripheral artery disease (PAD) is expression of systemic chronic atherosclerosis, it being often associated with cardiovascular events. The assessment of global longitudinal strain (GLS) at rest by speckle tracking echocardiography could be useful to unmask significant coronary artery disease (CAD) in asymptomatic PAD patients. Purpose To determine whether resting GLS is able to predict significant coronary artery stenosis in PAD patients selected for peripheral or carotid angiography. Methods One-hundred three clinically relevant PAD patients (M/F = 76/27, age = 66.8 ± 10,2 years, 72 with significant lower limb artery stenosis and 31 with carotid artery stenosis ≥50%), asymptomatic for CAD, underwent standard echo-Doppler exam at rest, comprehensive of GLS analysis, prior peripheral and coronary angiography. Information on cardiovascular (CV) risk factors and comorbidities were collected. Patients with know CAD and previous myocardial infarction, left ventricular (LV) ejection fraction < 50% and inadequate echocardiographic imaging were excluded. According to the results of coronary angiography, patients were divided in two groups: with significant coronary artery stenosis (>50% of obstruction. n = 73) and without significant coronary artery lesions (n = 30). Results No intergroup difference in the prevalence of CV risk factors and comorbidities was found. Age, body mass index and blood pressure were comparable between the two groups. LV ejection fraction (59.9 ± 4.2% in patients with significant coronary stenosis vs. 60.2 ± 4.7% in those without coronary stenosis, p = 0.75) and wall motion score index (1.02 ± 0.09 vs 1.03 ± 0.09 respectively, p = 0.67) did not differ significantly. Conversely, GLS was lower in patients with significant coronary artery stenosis than in those without (21.6 ± 2.7% vs. 22.8 ± 2%, p < 0.02) (Figure 1). This difference remained significant comparing the carotid subgroup with coronary stenosis vs. those without (p < 0.05) whereas it did not achieve the statistical significance in patients with lower limb artery lesions (p = 0.42). Conclusion In PAD patients, GLS at rest shoes the capability in identifying patients at higher probability of significant coronary artery stenosis. This involves in particular patients with carotid artery stenosis. GLS might be helpful to select patients who need to extend the peripheral angiographic evaluation to the coronary tree

The study of commingled non-adult human remains: insights from the 16th–18th centuries community of Roccapelago (Italy)

A post medieval mass grave containing hundreds of skeletons, many of which belonging to non-adults, has been discovered. A large-scale multidisciplinary study has been undertaken, thanks to the good preservation of the human remains and the availability of the parish records. This is the first study focused on the juvenile post medieval community of Roccapelago, which aims to provide new data about infant mortality and paleopathology during the 16th and 18th centuries, through the comparison of anthropological data to information available by parish records. The specimen under investigation belongs to the most ancient stratigraphic context of the crypt discovered under the floor of the church, part of an ongoing study. Standard anthropological protocols were used to assess the minimum number of individuals, age-at-death and pathologies. Results show a high mortality range between the last few weeks in utero and the first postnatal year. The comparison shows that historical records lines up with biological data, providing a unique opportunity to compare anthropological protocols for age estimation to the information registered in parish records when dealing with commingled juvenile remains

Comparing traditional and virtual approaches in the microexcavation and analysis of cremated remains.

The excavation and micro-excavation of archaeological contexts are, and always have been, destructive operations by definition. This study, although preliminary, has allowed the experimentation and application of computed tomography and engineering softwares (used for the creation and manipulation of three-dimensional surfaces) in micro-stratigraphic archaeological excavations, with the objective to overcome the very destructiveness that is intrinsic to the traditional method. For this purpose, a Roman cremation urn from the monumental necropolis in Via Emilia est \u2013 Tangenziale Pasternak (Modena) was chosen as a test subject. The application of this approach consented the analysis of both context and remains as close as possible to their original condition, exhibiting minor fragmentation in comparison with the traditional method which in turn allowed a clearer determination of the individual\u2019s biological profile. Moreover, also in virtue of the observation of elements which were not detected by the traditional method, virtual micro-excavation is to be considered a promising approach for the investigation of particular archaeological contexts, enabling greater preservation and enhancing both documentation and analysis

Analisi Antropologica delle necropoli tardoantiche di Modena

Il presente contributo prende in esame i reperti osteologici provenienti da tre distinte aree sepolcrali in uso durante il periodo tardoantico esterne alle mura della citt\ue0 romana di Mutina. Nello specifico sono stati analizzati 101 scheletri: 13 provenienti dalla necropoli rinvenuta all\u2019incrocio tra Via Ciro Menotti e via Bellini nel 2009; 64 dalla necropoli di Piazza Grande messa in luce nel 1988 nella zona retrostante l\u2019abside del duomo e 24 dalla necropoli scoperta nel corso dei lavori per la riqualificazione della piazza XX Settembre effettuati nel 1997. In tutti i casi \ue8 stata messa in luce solo parte delle necropoli perch\ue9 gli scavi sono stati effettuati in circostanza di emergenza . L\u2019analisi antropologica dei resti ha permesso di trarre conclusioni su diversi aspetti quali ad esempio il numero minimo di individui, la distribuzione di sesso ed et\ue0 all\u2019interno della popolazione, lo stile di vita e le attivit\ue0 lavorative svolte, le abitudini alimentari, la provenienza geografica, il grado di violenza interpersonale. Tutti questi dati hanno permesso di trarre conclusioni, seppur preliminari, circa le comunit\ue0 che popolavano la citta di Mutina durante il Tardoantico, mettendo un accento sulle loro similitudini o differenze. Ovviamente si tratta solo di interpretazioni basate su dati parziali che dovranno essere messi in relazione con quanto emerso dagli studi delle altre discipline e necessariamente approfonditi ampliando il campione dei reperti sottoposti alle diverse analisi

A multianalytic investigation of weapon-related injuries in a Late Antiquity necropolis, Mutina, Italy

Human skeletal remains from archaeological contexts occasionally present signs of traumatic injuries from weapons, revealing, for example, the degree of interpersonal violence, the type of weapon and the sequence of events of a specific historical context. Traumatic lesions are generally analyzed using macroscopic and microscopic methods, which are not necessarily integrated in the same study. In this study, we employed a multi-analytical approach to determine if new, or more refined information could be gained compared to traditional analyses. Here, we describe and analyze interpersonal skeletal peri-mortem sharp-force trauma in remains recovered in 2009 during archaeological excavations of a cemetery in the 4th to 6th century AD the city of Modena (Italy). Evidence for sharp force trauma was observed in four of the 13 individuals recovered at site. The traumatic lesions were analyzed using an integrated multi-analytical approach that combines traditional macroscopic examination, light microscopy, and three-dimensional digital modeling. We aimed to determine the number, size, and the position of the lesions, and the direction (angles) of weapon penetration in the bone. In particular, we applied digital protocols for the orientation of the skeletal regions of interest involved in the trauma to provide useful results for future comparisons and investigations

Sawmark Analysis of Three Cases of Amputation and a Craniotomy from the Seventeenth and Eighteenth Centuries Hospital Necropolis of Forlì Campus (Forlì, Italy)

The seventeenth-eighteenth century hospital necropolis of Forlì Campus (Forlì, Italy) was discovered during the Forlì Campus building work in 2014. Three cases of limb amputation and a craniotomy are examined using the forensic approach of sawmark analysis in order to understand features of the surgical instruments employed and to gain insight into the position of the surgeon during the cutting actions. With the aid of high definition photographs and moulds, we analyzed the cut surfaces of each sample, also using stereomicroscopy and SEM (Scanning Electron Microscopy). A qualitative and quantitative approach was used in the analysis of the kerf features (e.g. breakaway spur and notch, tooth scratches and hop, exit chipping), and empirical evidence was compared against comparisons coeval surgical essays. We hypothesize that a linear hand-powered push saw and an alternated push saw with a 2mm distance between the teeth were used for amputations. The craniotomy was executed presumably using a linear hand-powered saw with the set of the blade circa 1.3mm wide. Through the application of forensic methods on individuals from archaeological context we describe early cases of surgical practice in a more technical way