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The origin, development, and legacy of the enigmatic Etruscan civilization from the central region of the Italian peninsula known as Etruria have been debated for centuries. Here we report a genomic time transect of 82 individuals spanning almost two millennia (800 BCE to 1000 CE) across Etruria and southern Italy. During the Iron Age, we detect a component of Indo-European–associated steppe ancestry and the lack of recent Anatolian-related admixture among the putative non–Indo-European–speaking Etruscans. Despite comprising diverse individuals of central European, northern African, and Near Eastern ancestry, the local gene pool is largely maintained across the first millennium BCE. This drastically changes during the Roman Imperial period where we report an abrupt population-wide shift to ~50% admixture with eastern Mediterranean ancestry. Last, we identify northern European components appearing in central Italy during the Early Middle Ages, which thus formed the genetic landscape of present-day Italian populations.

As a means for investigating human mobility during late the Neolithic to the Copper Age in central and southern Italy, this study presents a novel dataset of enamel oxygen and carbon isotope values (δ 18 Oca and δ 13 Cca) from the carbonate fraction of biogenic apatite for one hundred and twenty-six individual teeth coming from two Neolithic and eight Copper Age communities. The measured δ 18 Oca values suggest a significant role of local sources in the water inputs to the body water, whereas δ 13 Cca values indicate food resources, principally based on C 3 plants. Both δ 13 Cca and δ 18 Oca ranges vary substantially when samples are broken down into local populations. Statistically defined thresholds, accounting for intra-site variability, allow the identification of only a few outliers in the eight Copper Age communities, suggesting that sedentary lifestyle rather than extensive mobility characterized the investigated populations. This seems to be also typical of the two studied Neolithic communities. Overall, this research shows that the investigated periods in peninsular Italy differed in mobility pattern from the following Bronze Age communities from more northern areas.

Excavation (2008-2014) carried out under the Uffizi Gallery (Florence, Italy) led to the discovery of 75 individuals, mostly buried in multiple graves. Based on Roman minted coins, the graves were preliminarily dated between the second half of the 4th and the beginning of the 5th centuries CE. Taphonomy showed that this was an emergency burial site associated with a catastrophic event, possibly an epidemic of unknown etiology with high mortality rates. In this perspective, paleoparasitological investigations were performed on 18 individuals exhumed from 9 multiple graves to assess the burden of gastrointestinal parasitism. Five out of eighteen individuals (27.7%) tested positive for ascarid-type remains; these are considered as "decorticated" Ascaris eggs, which have lost their outer mammillated coat. Roundworms (genus Ascaris) commonly infest human populations under dire sanitary conditions. Archaeological and historical evidence indicates that Florentia suffered a period of economic crisis between the end of 4th and the beginning of the 5th centuries CE, and that the aqueduct was severely damaged at the beginning of the 4th century CE, possibly during the siege of the Goths (406 CE). It is more than plausible that the epidemic, possibly coupled with the disruption of the aqueduct, deeply affected the living conditions of these individuals. A 27.7% frequency suggests that ascariasis was widespread in this population. This investigation exemplifies how paleoparasitological information can be retrieved from the analysis of sediments sampled in cemeteries, thus allowing a better assessment of the varying frequency of parasitic infections among ancient populations.

Over the last few years, genomic studies on Yersinia pestis , the causative agent of all known plague epidemics, have considerably increased in numbers, spanning a period of about 5,000 y. Nonetheless, questions concerning historical reservoirs and routes of transmission remain open. Here, we present and describe five genomes from the second half of the 14th century and reconstruct the evolutionary history of Y. pestis by reanalyzing previously published genomes and by building a comprehensive phylogeny focused on strains attributed to the Second Plague Pandemic (14th to 18th century). Corroborated by historical and ecological evidence, the presented phylogeny, which includes our Y. pestis genomes, could support the hypothesis of an entry of plague into Western European ports through distinct waves of introduction during the Medieval Period, possibly by means of fur trade routes, as well as the recirculation of plague within the human population via trade routes and human movement., Competing Interests: The authors declare no conflict of interest., (Copyright © 2018 the Author(s). Published by PNAS.)

Stable isotope analysis in the reconstruction of human palaeodiets can yield clues to early human subsistence strategies, origins and history of farming and pastoralist societies, and intra- and intergroup social differentiation. In the last 10 years, the method has been extended to the pathological investigation. Stable isotope analysis to better understand a diet-related disease: celiac disease in ancient human bones was carried out. To do this, we analyzed the nitrogen and carbon isotopic composition of human (n = 37) and faunal (n = 8) bone remains from the archaeological site of Cosa at Ansedonia, on the Tyrrhenian coast near Orbetello (Tuscany), including the skeletal remains of a young woman (late 1st century-early 2nd century Common Era [CE]) with morphological and genetic features suggestive of celiac disease. We compared the young woman's isotopic data with those of other individuals recovered at the same site but from two later time periods (6th century CE; 11-12th century CE) and with literature data from other Italian archaeological sites dating to the same period. Her collagen δ(13) C and δ(15) N values differed from those of the samples at the same site, and from most but not all of the contemporary sites. Although the woman's diet appears distinct, chronic malnutrition resulting from severe malabsorption of essential nutrients due to celiac disease may have affected the isotopic composition of her bone collagen., (© 2014 Wiley Periodicals, Inc.)

Objective: Idiopathic brachial plexopathy is a non-progressive disorder characterized by the sudden onset of shoulder pain associated with weakness and sometimes paraesthesia of the arm. Clinical and electrophysiological examinations are the primary diagnostic tools and allow physicians to localize the site of damage. MRI neurography is rarely performed in this setting., Methods: We herein describe the cases of eight consecutive patients suffering from idiopathic brachial plexopathy. All patients underwent clinical visits, neurophysiological evaluations and MRI neurography., Results: We confirmed the primary role of clinical and neurophysiological evaluations in the diagnosis of idiopathic brachial plexopathy and demonstrate the usefulness of brachial plexus MRI neurography for confirming the presence of inflammatory changes., Conclusion: In patients with idiopathic brachial plexopathy, MR neurography is a helpful tool for excluding different aetiologies, such as compression or tumour formation, and/or confirming inflammatory changes.

We recently presented the case of a first century AD young woman, found in the archaeological site of Cosa, showing clinical signs of malnutrition, such as short height, osteoporosis, dental enamel hypoplasia and cribra orbitalia, indirect sign of anemia, all strongly suggestive for celiac disease (CD). However, whether these findings were actually associated to CD was not shown based on genetic parameters. To investigate her human leukocyte antigen (HLA) class II polymorphism, we extracted DNA from a bone sample and a tooth and genotyped HLA using three HLA-tagging single nucleotide polymorphisms for DQ8, DQ2.2 and DQ2.5, specifically associated to CD. She displayed HLA DQ 2.5, the haplotype associated to the highest risk of CD. This is the first report showing the presence of a HLA haplotype compatible for CD in archaeological specimens.

The aim of this work is to explore the pattern of craniofacial morphometric variation and the relationships among five prehistoric Sardinian groups dated from Late Neolithic to the Nuragic Period (Middle and Late Bronze Age), in order to formulate hypotheses on the peopling history of Sardinia. Biological relationships with coeval populations of central peninsular Italy were also analysed to detect influences from and towards extra-Sardinian sources. Furthermore, comparison with samples of contemporary populations from Sardinia and from continental Italy provided an indication of the trend leading to the final part of the peopling history. Finally, Upper Palaeolithic and Mesolithic samples were included in the analyses to compare the prehistoric Sardinians with some of their potential continental ancestors. The analysis is based on multivariate techniques including Mahalanobis D(2) distance, non-parametric multidimensional scaling (MDS) and principal component analysis (PCA). The results showed the tendency to progressive differentiation between Sardinian groups and peninsular Italian groups, with the possible exception of a discontinuity showed by the Bonnànaro (Early Bronze Age) Sardinian sample. Several aspects of the morphological results were found to agree with the current genetic evidence available for the present-day Sardinian population and a Nuragic sample: (1) biological divergence between the Sardinian and peninsular Italian populations; (2) similarity/continuity among Neolithic, Bronze Age and recent Sardinians; (3) biological separation between the Nuragic and Etruscan populations; (4) contribution of a Palaeo-Mesolithic gene pool to the genetic structure of current Sardinians., (Copyright © 2010 Elsevier GmbH. All rights reserved.)

The present study describes human skeletal remains from Riparo della Rossa, a rock shelter in the Marche region (Central Italy). The remains consist of a cranial vault and a few non-articulated postcranial bones, possibly belonging to the same adult individual. As the cranial vault showed some morphological features that are unusual for a modern human (marked prominence of the supraorbital region, very prominent nasal bones and rather high thickness of the vault), an accurate anthropological analysis and quantification of the antiquity of the bones were required. The remains were dated with two different absolute dating methods, AMS (14)C and (235)U-(231)Pa non-destructive gamma-ray spectrometry (NDGRS), which produced discordant results: the uncalibrated (14)C dating produced 5690 +/- 80 BP for the cranial vault and 6110 +/- 80 BP for the clavicle; the NDGRS dating produced 10,000 +/- 3000 BP for the cranial vault. The sex discriminant morphological characters on the skull are not unequivocal, though the masculine ones appear more evident. The aims of the present paper are: to provide a morphological and metric description of the remains; to interpret their unusual morphological features; to attempt to attribute them to male or female sex and to one of the possible prehistoric cultural groups, according to dating results (Upper Palaeolithic, Mesolithic or Neolithic). The attribution was obtained by a Bayesian procedure taking into account the reliability of the combined information of morphological/metric features and absolute dating results. The results suggest that the Riparo della Rossa remains are best attributed to a male individual of the Neolithic age.

This work is part of a more extensive, still ongoing, research which aims to provide a morphological assessment and interpretation of congenital malformations on ancient bones. The study of the frequency and distribution of congenital malformations on juvenile osteological remains may provide interesting insight and critical observations in assessing the role of those factors that are responsible for child's mortality. In the present study we describe and discuss two cases of congenital spinal malformation refer to failure in the separation of vertebral arch elements between contiguous vertebrae. The skeletons belonging to two children who died in early childhood, between 0 and 6 years of age. The research was conducted on 132 juvenile individuals came from nine necropolises located in north an middle Italy, from ancient and late Roman times to late medieval times.

Cervicogenic headache is a little-known clinical condition whose true importance has only recently been recognized. A number of causes may lie at the basis of the onset of headache (symptomatic cervicogenic headache). However, despite exhaustive attempts, sometimes it is not possible to identify a clear cause responsible for the onset of the syndrome (primitive cervicogenic headache). The genesis of symptomatic cervicogenic headaches sometimes may be easy to identify as a result of a close, pre-existing, cause-effect relationship (i.e. trauma). On other occasions it may be much more laborious to pinpoint the pathology responsible for headache (some cranio-cervical anomalies, etc.). Clinically, it is necessary to perform a thorough preliminary clinical and anamnestic evaluation which can orient subsequent investigations to achieve a diagnosis in the least time possible with the minimum discomfort to the patient and his relatives, not to mention lower costs for society.

Introduction: Early slipped capital femoral epiphysis (ESCFE) can be treated surgically, with excellent results, if it is diagnosed in its initial stage; however, the rate of late or missed diagnoses remains surprisingly high., Purpose: We compared radiography, US and MR sensitivity in ESCFE diagnosis., Material and Methods: We examined 21 symptomatic overweight patients (15 boys and 6 girls) aged 9 to 15 years with anteroposterior radiographs; frog leg images were not acquired in 3 cases only. US was performed in 19 cases and the images acquired with 5-7.5 MHz probes on the sagittal plane parallel to the femoral neck. MRI was performed in 9 cases, with coronal and sagittal T1 SE and T2* GE images., Results: Our sensitivity rates were 66% for anteroposterior radiography (6 false negatives), 80% for combined anteroposterior and frog leg images (3 false negatives), 95% for US (1 false negative) and 88% for MRI (1 false negative)., Discussion and Conclusion: We believe that US is the method of choice in ESCFE diagnosis; if it is negative, but pain persists, MRI should be performed.

Patients with spontaneous neck pain, headache, dizziness and/or pain to the upper limbs are frequently observed. Common cervicodynia, due to the involvement of arthromuscular structures of the cervical spine, was diagnosed in the patients with these symptoms in the absence of trauma or neurologic signs. The authors investigated the clinical-radiologic correlation in a series of 130 symptomatic patients and considered it a metameric disorder. The frequent association of many radiographic signs at the same level often prevents single radiographic signs from being assessed individually; therefore, the authors selected some patients with just one radiographic change per functional unit, to assess its relationship with clinical symptoms. The patients underwent anteroposterior, lateral and functional (flexion-extension) radiographs of the cervical spine. Vertebral rotation, detected on antero-posterior views as a spinous process deviation, was the most frequent isolated sign (79/130 cases) per metameric level, with strong clinical correlation (70/79 cases). Vertebral rotation was probably due to unilateral muscular stiffness. Other single radiologic signs per functional unit with strong clinical correlation follow: atloaxial rotation (13/130 with clinical-radiologic agreement of 12/13), functional blockage (13/130 with clinical-radiologic agreement of 11/13), angular flexion (21/130 with clinical-radiologic agreement of 19/21) and overall disc space thinning (12/130 with clinical-radiologic agreement of 10/12). Atloaxial rotation is represented as an asymmetry of the spaces between the odontoid and the lateral masses of the atlas; functional blockage consists of insufficient or lacking physiological width of the occipito-atlantoid or interspinous space in functional tests. Angular flexion consists of a single flexion angle of the cervical spine in functional tests; two or more angles indicate normal flexion of the cervical spine. This study confirmed the poorer clinical impact of degenerative changes, mostly interapophyseal arthrosis, than of other radiologic signs. Interapophyseal arthrosis alone was isolated in single functional units in 46/130 patients, mostly at C7-D1, with clinical-radiologic agreement in 19/46 patients. Clinical-radiologic correlation proved the high diagnostic value of anteroposterior, lateral and functional radiographs of the cervical spine in common cervicodynia, which make them a valuable tool for the clinician.

Three fragments of the upper jaw of an Etruscan adolescent of the 6th century B.C. discovered at the necropolis of Cancellone 1 (Magliano in Tuscany, Grosseto, Italy) were examined. A triad of associated dental anomalies was found: congenitally missing second premolars, "peg-shaped" permanent lateral incisors, and ectopic (palatal) eruption of a permanent canine. These findings provided the opportunity to discuss etiopathogenetic aspects of the associations among different types of tooth abnormalities.

The patients affected with cervical injuries often complain of cervical pain, headache and dizziness even when no bone fractures are detected. Such patients are likely to have a post-traumatic injury of the cervical ligaments. Twenty-five symptomatic patients (19 women and 6 men) were examined with upper spine CT and functional CT scans (right and left rotation) to detect ligament injuries and hypermotility of the craniocervical junction, both related to traumatic events. Eleven patients showed no alterations, while unilateral densitometric alterations of the alar ligaments were observed in 14 cases and thought to be related to trauma. On axial CT scans, the normal alar ligaments were identified as paramedian, quadrangular soft-tissue structures at the apex of the dens epistrophei and right above it. In 14 patients with alar ligament injuries, CT showed incomplete ligament interruption and thinning in 12 cases and its total absence on all images in 2 cases. The laterodental space in the affected side was hypodense due to fat tissue replacement. Of 14 patients with alar ligament injuries, only 14 patients with alar ligament injuries, only 4 exhibited rotatory hypermotility at C0-C1 and C1-C2. The low frequency of rotatory hypermotility is probably due to the high rate of incomplete alar ligament injuries as well as to cervical muscle stiffness, which is marked in some subjects. In conclusion, static and functional CT of the upper spine is not only useful to predict trauma outcome, but also allows the detection of the alar ligaments, of their morphodensitometric changes and of the segmental instability of the craniocervical junction.

A sample representing a population of the Florence district of middle 19th century was studied to determine the age of occurrence of enamel hypoplasias. The age interval most affected was that between 1.5 and 3.5 years. Historical sources on weaning habits of 19th-century Italian populations indicate a weaning period between 12 and 18 months. This is in agreement with the data on enamel defects, showing that children of post-weaning age are more subject to stress. Wide "grooves", with prolonged duration, are concentrated between 2 and 2.5 years, whereas "lines" occur primarily between 2.5 and 3 years. We suggest that this distribution could reflect the gradual introduction of dietary supplements until weaning is complete.

Specimens dating back to the VIII Century B.C. indicate Etruscans may have been the first people to employ orthodontic bands to improve tooth alignment. A survey of dental occlusion in Etruscan cranial remains, however, shows very good typical occlusion and almost no crowding. Thus, these people do not represent the earliest development of epidemiologically high prevalence of malocclusion, a feature instead reserved for the later industrial world.

Based on a study of 132 patients suffering from lumbar spinal stenosis, the authors propose a simple classification aimed at providing the surgeon with the maximum essential information on which to plan surgery. This is based on an analysis of standard radiographic and radiculographic findings, and stresses the importance of diagnosing the correct type and level of the stenosis. Certain physiopathological aspects of the subarachnoid space which have a bearing on the use of contrast radiography are also discussed.

Five cases of osteoid osteoma and five cases of osteoblastoma of the spine are reported. All the patients underwent surgery and the radiographic diagnosis was always histologically confirmed. Conventional radiographic technique using tomography constantly permitted the diagnosis. Computed tomography was primarily useful for spatial localization of the lesion. The authors evaluate the radiographic findings of the two lesions discussing the symptoms which are suspected for these pathologic conditions. Bone scintigraphy must precede radiological examination.