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Objectives: Puberty is a crucial part of life, representing the biological transition from childhood to adulthood. With the aim of expanding current knowledge of pubertal development and the life course in past populations, this study provides the first investigation of puberty in pre‐Roman Italy. Materials and methods: Nine skeletal and dental puberty indicators were assessed in a sample of 84 Etruscan and Samnite individuals (8.0–23.9 years) from Pontecagnano (southern Italy, seventh–fourth centuries BC) to garner insights into the timing and duration of different pubertal stages. Results: Adolescents from Pontecagnano entered puberty at 10–12 years and completed pubertal development at approximately 20–21 years. Menarche occurred between 14 and 17 years. Remarkable variability in pubertal timing and an overall prolonged pubertal tempo were observed. Unexpectedly, females completed puberty at the same age as males. Discussion: The onset and completion of puberty in Pontecagnano are mostly in line with pubertal trends emerging from other bioarchaeological studies and historical sources. The considerable inter‐individual variability in pubertal timing seen at the site probably reflects its great sociocultural heterogeneity, whilst the prolonged pubertal tempo could represent an adaptive mechanism in response to environmental disruptors. These may have included endemic diseases characteristic of Pontecagnano's marshy environment and pollutants produced by the Etruscan and Samnite metallurgical industries. Moreover, the role of catch‐up growth in favouring better pregnancy outcomes could explain why female puberty appears particularly stretched. The importance of exploring pubertal development in past societies without culturally biased assumptions is emphasised. [ABSTRACT FROM AUTHOR]

Assessment and management of children with growth failure has improved greatly over recent years. However, there remains a strong potential for further improvements by using novel digital techniques. A panel of experts discussed developments in digitalization of a number of important tools used by pediatric endocrinologists at the third 360° European Meeting on Growth and Endocrine Disorders, funded by Merck KGaA, Germany, and this review is based on those discussions. It was reported that electronic monitoring and new algorithms have been devised that are providing more sensitive referral for short stature. In addition, computer programs have improved ways in which diagnoses are coded for use by various groups including healthcare providers and government health systems. Innovative cranial imaging techniques have been devised that are considered safer than using gadolinium contrast agents and are also more sensitive and accurate. Deep-learning neural networks are changing the way that bone age and bone health are assessed, which are more objective than standard methodologies. Models for prediction of growth response to growth hormone (GH) treatment are being improved by applying novel artificial intelligence methods that can identify non-linear and linear factors that relate to response, providing more accurate predictions. Determination and interpretation of insulin-like growth factor-1 (IGF-1) levels are becoming more standardized and consistent, for evaluation across different patient groups, and computer-learning models indicate that baseline IGF-1 standard deviation score is among the most important indicators of GH therapy response. While physicians involved in child growth and treatment of disorders resulting in growth failure need to be aware of, and keep abreast of, these latest developments, treatment decisions and management should continue to be based on clinical decisions. New digital technologies and advancements in the field should be aimed at improving clinical decisions, making greater standardization of assessment and facilitating patient-centered approaches. [ABSTRACT FROM AUTHOR]

In this study Cameriere’s normalized measurements (CNM) of a single mandibular tooth were evaluated for age estimation on a sample of ortopantomographies (OPTs) of 2223 Italian children aged between 4 and 15 years. Dental maturity was radiographically evaluated by CNM of the seven left permanent mandibular teeth (CNMi = Ai/Li, i = 1,…,7); in monoradicular teeth, the distance (Ai, i = 1,…,5) between the inner sides of the open apex was measured while in biradicular teeth (Ai, i = 6, 7), the sum of the distances between the inner sides of the two open apices was calculated. Ai was normalized by the tooth length (Li, i = 1,…,7). The intra- and inter-observer agreement of CNM measurements was almost perfect. Overall, analyzed mandibular teeth finished their development up to the age of 13, but the distribution of CNM varied among different locations. The final models included a tooth-specific CNM as the independent variable and explained from 76% (second molars) to 39% (first incisors) of the variance in chronological age. The bias and accuracy of these models, when applied to real-life data with no age limitation, were within acceptable range of differences in the forensic anthropology of children. Specifically, in all models mean of absolute differences between estimated and real age was within one year (0.67 for first incisors to 1.00 for canines). In conclusion this study showed that all mandibular teeth do not have equal applicability for age estimation suggesting that further evaluation on different samples is necessary to evaluate the usefulness of a single mandibular tooth for age estimation. [ABSTRACT FROM AUTHOR]

Background Dental and skeletal maturation have proved to be reliable evidence for estimating age of children and prior studies and internationally accredited guidelines recommend to evaluate both evidence in the same subject to reduce error in age prediction. Nevertheless the ethical and legal justification of procedures that imply a double exposition of children stands as a relevant issue. This study aims to evaluate the accuracy of age estimation provided by a combination of skeletal and dental methods applied in the same sample of children. Materials and methods The sample consisted of 274 orthopantomographies and left hand-wrist X-rays of Italian children, (aged between 6 and 17 years) taken on the same day. Greulich and Pyle’s (GP), Tanner-Whitehouse’s version 3 (TW3) and Willems’ (W) and the Demirjian’s (D) methods were respectively applied for estimating skeletal and dental age. A combination of skeletal and dental age estimates through Linear Discriminant Analysis (LDA) is proposed to obtain a classifier respect to an age threshold. Results The combination of D and TW3 obtained an improvement of accuracy in classifying female subjects respect to the 12 years threshold respect to the original methods (from about 77% using either original methods to 83.3% combining TW3 + D) as well as a consistent reduction of false positives rate (from 17% to 21% for original methods to 5.6% with TW3 + D). For males the LDA classifier (based on TW3 and W) enable a small improvement in accuracy, whilst the decreasing of false positives was as noticeable as for females (from 17.6 to 14.1% for original methods to 6.2% combining TW3 + W). Conclusions Although the study is influenced by the limited size and the uneven age distribution of the sample, the present findings support the conclusion that age assessment procedures based on both dental and skeletal age estimation can improve the accuracy and reduce the occurrence of false positives. [ABSTRACT FROM AUTHOR]

Objective: Since its birth in 1895, radiology has been used to study ancient mummies. The purpose of this article is to present paleoradiological investigations conducted on several medieval human remains in Varese province. Anthropological (generic identification) and paleopathological analyses were carried out with the support of diagnostic imaging (X-ray and CT scans).Materials and Methods: Human remains were discovered during excavations of medieval archaeological sites in northwest Lombardy. Classical physical anthropological methods were used for the macroscopic identification of the human remains. X-ray and CT scans were performed on the same scanner (16-layer Hitachi Eclos 16 X-ray equipment). Results Radiological analysis permitted investigating (1) the sex, (2) age of death, (3) type of trauma, (4) therapeutic interventions and (5) osteomas in ancient human remains. In particular, X-ray and CT examinations showed dimorphic facial traits on the mummified skull, and the same radiological approaches allowed determining the age at death from a mummified lower limb. CT analyses allow investigating different types of traumatic lesions in skulls and postcranial skeleton portions and reconstructing the gait and functional outcomes of a fractured femur. Moreover, one case of possible Gardner’s syndrome (GS) was postulated from observing multiple osteomas in an ancient skull.Conclusion: Among the medical tests available to the clinician, radiology is the most appropriate first-line procedure for a diagnostic approach to ancient human remains because it can be performed without causing any significant damage to the specimen. [ABSTRACT FROM AUTHOR]

Study Design: A paleopathological case of posterior arch defect of the atlas associated to the absence of costal element of the foramen transversarium.Objective: In living patients as well as in postmortem analysis it should be difficult to distinguish between a congenital and an acquired anomaly. Any anomaly in the anatomy of atlas should be taken into consideration by clinicians, surgeons, radiologists, and anatomists in order to avoid misinterpretations and clinical complications.Summary Of Background Data: Posterior arch defect has a current occurrence of approximately 4%. Posterior arch schisis is attributed to the defective or absent development of the cartilaginous preformation of the arch rather than a disturbance of the ossification. The absence of costal element of the foramen transversarium has an incidence of ranging from 2% to 10% and is attributed to a developmental defect or to variations in the course of the vertebral artery.Methods: The skeleton of a man aged 20-30 years, brought to light in the plague cemetery of 16th century Alghero (Sardinia), showed anomalies of the atlas, consisting in failure of the midline fusion of the 2 hemiarches with a small gap and an open anterior foramen trasversarium on the left side. A macroscopic, radiological, and stereomicroscopic study was carried out.Results: The study allowed to rule out a traumatic origin of the defects and to diagnose an association of 2 congenital anomalies.Conclusion: Osteoarchaeological cases provides with a valuable opportunity to examine and describe variations in the anatomy of the atlas.Level Of Evidence: N/A. [ABSTRACT FROM AUTHOR]

Background/Aims: Skeletal maturation is considered a reliable variable in evaluating the ‘tempo’ of growth. It is important in the diagnosis of endocrinological diseases, in chronic diseases, in hormonal therapy follow-up and in computing height prediction for prognostic and therapeutic purposes. It is also used when chronological age is not available for minors without known birth dates. There are different methods to evaluate skeletal maturation and height prediction. The Tanner-Whitehouse (TW) method 2 (TW2) has been considered to be the most useful method so far, and has recently been updated with modified height prediction equations (TW2-Mark II). TW3 is the newest method. The aim of this study is to evaluate whether TW3 is more accurate in the assessment of height prediction than TW2-Mark II in a sample of healthy north Italian subjects. Methods: Anthropometrical data were collected as part of a survey in 1977–1978 in Turin. The sample involved 1,384 healthy children. The children, now adults, have been traced and recalled to measure their final height in order to test height prediction reliability. At present, we have collected 118 adult heights. Results: According to the TW2 method 40% of the males had a height prediction error larger than ± residual SD (4.1 cm), and with TW3 this was 32.9%. The female height prediction error with TW2 was larger than ± residual SD (3.6 cm) in 29.2% of girls, and the same value was found with TW3. Conclusion: According to our preliminary data, TW3 does not represent any real progress. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Recently, 1997, Tanner and co-workers provided a new scale converting TW-RUS standard maturity scores to skeletal age for European North American youths (US90). The aim of the present study was to test if the accuracy of TW-RUS bone age assessments in the Italian population could be improved by evaluating the estimates obtained with this new scale in comparison with other standards (UK60: original British series, B70: Belgian series and S80: Spanish series). 1,831 hand-wrist radiographs (Italian healthy subjects aged from 8 to 16.8 years) were evaluated. The US90 reference values are resulted the most suitable TW-RUS standards. Therefore, it seems useful to update the reference values of TW-RUS SMS in Italian youths, using this new scale. [ABSTRACT FROM AUTHOR]