Background Hansen’s disease (leprosy), widespread in medieval Europe, is today mainly prevalent in tropical and subtropical regions with around 200,000 new cases reported annually. Despite its long history and appearance in historical records, its origins and past dissemination patterns are still widely unknown. Applying ancient DNA approaches to its major causative agent, Mycobacterium leprae, can significantly improve our understanding of the disease’s complex history. Previous studies have identified a high genetic continuity of the pathogen over the last 1500 years and the existence of at least four M. leprae lineages in some parts of Europe since the Early Medieval period. Results Here, we reconstructed 19 ancient M. leprae genomes to further investigate M. leprae’s genetic variation in Europe, with a dedicated focus on bacterial genomes from previously unstudied regions (Belarus, Iberia, Russia, Scotland), from multiple sites in a single region (Cambridgeshire, England), and from two Iberian leprosaria. Overall, our data confirm the existence of similar phylogeographic patterns across Europe, including high diversity in leprosaria. Further, we identified a new genotype in Belarus. By doubling the number of complete ancient M. leprae genomes, our results improve our knowledge of the past phylogeography of M. leprae and reveal a particularly high M. leprae diversity in European medieval leprosaria. Conclusions Our findings allow us to detect similar patterns of strain diversity across Europe with branch 3 as the most common branch and the leprosaria as centers for high diversity. The higher resolution of our phylogeny tree also refined our understanding of the interspecies transfer between red squirrels and humans pointing to a late antique/early medieval transmission. Furthermore, with our new estimates on the past population diversity of M. leprae, we gained first insights into the disease’s global history in relation to major historic events such as the Roman expansion or the beginning of the regular transatlantic long distance trade. In summary, our findings highlight how studying ancient M. leprae genomes worldwide improves our understanding of leprosy’s global history and can contribute to current models of M. leprae’s worldwide dissemination, including interspecies transmissions.

Age estimation is a major step in forensic and legal procedures. Its relevance has been increasing due to growing society issues, such as identification of missing people, crimes against minors or lack of valid identification papers from locals or foreigners. Evaluation of the cut-off value of the Third Molar Maturation Index (I3M) = 0.08 for discriminating minors from adults in the Portuguese population. The left lower third molars were analysed by applying a specific cut-off value of 0.08 determined by Cameriere et al. in 2008. A sample of 778 digital panoramic radiographs of a representative Portuguese sample (442 females and 336 males), in the age range of 12–24 years (mean age 17.7 ± 2.98 years in females and 18.1 ± 3.0 years in males), was retrospectively evaluated. I3M decreased as the real age gradually increased in both sexes. The 0.08 cut-off score was valuable in discriminating adults from minors. According to the pooled results, the accuracy, by means of area under the curve, was 92.8% (95% confidence interval (CI) 91.0–94.6%). The proportion of correctly classified subjects (sensitivity) was 90.7% (95% CI 88.7–92.8%) and the specificity was 94.9% (95% CI 93.3–96.4%). The results show that I3M is a valuable method to differentiate minors from adults in the Portuguese population.

Documentary sources refer to leprosy patients in the Portuguese territory since the first century AD, and in the Middle Ages around 70 leprosaria were established. However, prior to 2003 this historical evidence had not been confirmed by archeological findings. The excavation performed in monitoring the rehabilitation done by the Polis program in the area of the Ermida de Santo André (hermitage of Saint Andrew) allowed the exhumation of seven human skeletons, and commingled bones from at least three individuals, in the vicinity of the Beja leprosarium. The objective of this study is to present the paleopathological lesions relevant to the discussion of the differential diagnosis of leprosy. Macroscopic observation of the bones and scrutiny of lesions according to the paleopathological literature allowed the identification of a probable case of leprosy in an adult male, showing rhinomaxillary changes and concentric remodeling of hand and foot bones, and four possible cases (two young adults and two adults, all probably males), with a set of lesions in facial bones and skeletal extremities. The poor preservation of the bones precluded further confirmation of this diagnosis. According to historical data, the leprosaria functioned between the 14th and 16th centuries AD. The exact chronology of these findings was not determined either during the excavation or by radiocarbon dating because the bones presented poor collagen levels. In Portugal as a whole there are few osteological evidences of leprosy, and thus this study adds new information about this chronic infectious disease.

Accurate sex prediction is a key step in creating a postmortem forensic profile as it excludes approximately half the population. It is our goal to develop a predictive model to establish sex through teeth mesiodistal widths in a Portuguese population. The pretreatment dental casts of 168 of Portuguese orthodontics subjects (59 males and 109 females) were included. Mesiodistal widths from right first molar to left first molar were measured on each pretreatment cast to the nearest 0.01 mm using a digital caliper. Overall, the mesiodistal widths of the upper and lower canines, premolars, and molars were found to be significantly different between females and males. Conversely, no significant differences between sexes were identified for incisors. A multivariate logistic regression model for sex prediction was developed and the teeth included in the final reduced model being the upper left canine (2.3), the lower right lateral incisor (4.2) and the lower right canine (4.3). There is a prevalence of sexual dimorphism in all teeth except the incisors. The canines present the most noticeable difference between sexes. The presented sex determination predictive model exhibits an overall correct classification of 75%, outperforming all available models for this purpose and therefore is a potential tool for forensic analysis in this population.

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An archaeological survey at the church of Nossa Senhora da Anunciada (Setúbal, Portugal) uncovered the remains of 92 individuals. Historical and archaeological data suggest that the inhumations occurred between 1531 and 1839. The present work reports the pathological features of a mature male individual exhibiting multiple osseous bony projections and bone deformity, mainly affecting the meta physeal and adjacent diaphyseal regions of the long bones. The macroscopic and the radiological analy ses of the lesions suggest multiple osteochondromas as the most probable diagnosis. This is the first archaeological case of this disease known on the Portuguese territory and in southern Europe.

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Injury recidivism studies assess the lived experience of individuals who endure multiple traumatic incidents, conveying a nuanced contextualization of individual suffering within a reticulate of social and cultural processes. During a recent archaeological excavation, a skeleton of a middle‐aged male dating to the 17th–18th centuries AD was excavated in the churchyard of the Chapel of the Holy Spirit in Bucelas (Portugal). This individual exhibited a mixture of healed and healing fractures that prompted poor functional long‐term outcomes and an increase in the risk of death. Macroscopic and medical imaging (computerized tomography) analyses revealed lesions in the right shoulder, right and left ribs, fifth right proximal phalanx and right distal femur. Fracture complications include myositis ossificans and chronic osteomyelitis. The results are interpreted in the broader sociocultural circumstances of Bucelas during the early modern period, in order to investigate the causes of this individual's accumulated trauma and the possibility of health‐related care associated with it.