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This paper considers skeletal and dental lesions to assess the effects of aridification on two skeletal samples from the Bronze Age in what is now the United Arab Emirates (UAE), located on the eastern end of the Arabian Peninsula. This paper hypothesized that the sample from Qarn al‐Harf (QAH) Tomb 6 would show a greater prevalence of skeletal and dental lesions in comparison with that from QAH Tomb 5, because QAH Tomb 6 dates to a period of aridification when compared with the wetter Wadi Suq period (~2000 B.C.). The skeletal remains from two tombs from QAH cemetery are studied: one dated to the transition period from the Umm an‐Nar to Wadi Suq period (~2000 B.C.) (Tomb 6, n = 141) and one Wadi Suq period tomb (Tomb 5, n = 44; 2000–1600 B.C.). Skeletal and dental lesions, including carious lesions, antemortem tooth loss, dental enamel hypoplasia, periosteal new bone formation, cribra orbitalia, and porotic hyperostosis, were recorded and used to assess differential lived experience. Findings from the two tombs are compared with five contemporary sites of the Umm an‐Nar and Wadi Suq periods. Fisher's exact tests found more statistically significant differences in the prevalence of cribra orbitalia (p = 0.0050) and non‐adult mortality (p = 0.0118) for the QAH Tomb 6 skeletal sample than that from QAH Tomb 5. No other skeletal or dental lesions were significantly different according to Fisher's exact tests. While not significant, periosteal new bone formation rates in QAH 6 in conjunction with cribra orbitalia rates suggest individuals were experiencing stressors that were not impacting QAH Tomb 5 individuals. Skeletal and dental lesion rates are not directly attributable to climate change; however, we argue that intense aridification around 2000 B.C. caused desiccated crops and an increased reliance on marine sources for QAH Tomb 6. This reliance likely promoted nutritionally deficient diets manifesting as observed higher rates of cribra orbitalia and periosteal new bone formation. [ABSTRACT FROM AUTHOR]

The opposition between story and instruction set out in the preface to Samuel Richardson's Clarissa establishes a relationship between the novel's moral import and its form, genre, and style. It is a dichotomy that appears to privilege an ethical schema that is ideal, theoretic, and reflective alongside a prose style that is impersonal, emphatic, and also reflective. In this article, I show that the moral economy of the novel is, in fact, quick to display the limitations of departicularized and abstract moral thinking, and that Richardson invites his reader's suspicion of modes of reading and writing that would circumvent the linearity and particularity of story. I conclude by demonstrating that Richardson uses the italic character–particularly in the third edition of the novel–not to stress the maxim-like neutrality of moral truths, but to illuminate the expressive multivalence associated with this typography. [ABSTRACT FROM AUTHOR]

Objectives: This study examines the biological sex and geographical origins of adolescents buried at the St Mary Magdalen leprosarium (Winchester, UK). The data are combined with archaeological and palaeopathological evidence to broaden the understanding of mobility and its relationship to leprosy and leprosaria in Medieval England. Materials and Methods: Nineteen individuals (~10–25 at death) with skeletal lesions diagnostic of leprosy were analyzed using standard osteological methods. Amelogenin peptides were extracted from five individuals whose biological sex could not be assessed from macroscopic methods. Enamel samples were analyzed to produce 87Sr/86Sr and δ18O values to explore mobility histories. Results: Amelogenin peptides revealed three males and two females. Tooth enamel samples provided an 87Sr/86Sr ratio range from 0.7084 to 0.7103 (mean 0.7090, ±0.0012, 2σ). δ18OP values show a wide range of 15.6‰–19.3‰ (mean 17.8 ± 1.6‰ 2σ), with corresponding δ18ODW values ranging from −9.7‰ to −4.1‰ (mean −6.3 ± 2.4‰ 2σ). Discussion: Amelogenin peptide data reveal the presence of adolescent females with bone changes of leprosy, making them the youngest confirmed females with leprosy in the archaeological record. Results also show at least 12 adolescents were local, and seven were from further afield, including outside Britain. Since St. Mary Magdalen was a leprosarium, it is possible that these people traveled there specifically for care. Archaeological and palaeopathological data support the notion that care was provided at this facility and that leprosy stigma, as we understand it today, may not have existed in this time and place. [ABSTRACT FROM AUTHOR]

The article presents the discussion on bioarcheologists and forensic anthropologists. Topics include relating to bioarcheology education and training and research on archeological human remains in university, museum, and commercial contexts; and no ethics committee in place at the home institution or museum where the remains being curated.

Leprosy is one of the most notorious diseases in history, widely associated with social stigma and exclusion. This study builds on previous work to reevaluate the medicohistorical evidence for social stigma in relation to leprosy. This is achieved by isotopic and palaeopathological analyses of adolescent skeletons (10–25 years old) from the Anglo‐Scandinavian (10th–11th centuries AD) parish cemetery of St. John at the Castle Gate in Norwich (Eastern England/East Anglia). Core enamel samples from premolar and molar teeth from 10 young individuals with diagnostic lesions for leprosy were selected for radiogenic strontium (87Sr/86Sr) and oxygen (δ18O) stable isotope analyses. Isotope data did not exclude anyone from the regional range. Palaeopathological data and archaeological contexts suggest that those with visible signs of leprosy were buried with their local community and in a normative manner, thus challenging the notion of social exclusion experienced by people with leprosy throughout the Medieval Period. This study underscores the importance of bioarchaeological data in challenging broad medicohistorical and archaeological narratives. [ABSTRACT FROM AUTHOR]

This research explores oral health indicators and stable carbon and nitrogen isotope data to explore diet, and differences in diet, between people buried in the four different contexts of the St Gertrude Church cemetery (15th– 17th centuries AD): the general cemetery, two mass graves, and a collective mass burial pit within the general cemetery. The main aim is to assess whether people buried in the mass graves were rural immigrants, or if they were more likely to be the victims of plague (or another epidemic) who lived in Riga and its suburbs. The data produced (from dental disease assessments and isotope analyses) were compared within, as well as between, the contexts. Most differences emerged when comparing the prevalence rates of dental diseases and other oral health indicators in males and females between the contexts, while isotope analysis revealed more individual, rather than context-specific, differences. The data suggested that the populations buried in the mass graves were different from those buried in the general cemetery, and support the theory that rural immigrants were buried in both mass graves. Significant differences were observed in some aspects of the data between the mass graves, however, possibly indicating that the people buried in them do not represent the same community. [ABSTRACT FROM AUTHOR]

A comprehensive study of spinal health in ancient Nubia has not been achieved to date. This study is a component of a larger survey of spinal health. It presents a comparative analysis of spondylolysis, with the aim of providing an insight into the quality of life, environmental and socio‐political stresses faced by individuals in ancient Nubia. This study provides bioarchaeological data from 515 adult individuals with preserved lumbar vertebrae (where spondylolysis is most commonly observed) from five populations that date from the Meroitic to the Medieval period (350 BC–1500 AD). Contextual data from settlements and cemeteries were used to interpret the data. The results demonstrated an overall crude prevalence of 6.6% for spondylolysis (individuals affected with vertebrae preserved) and an overall true prevalence of 1.2% (number of lumbar vertebrae affected). The data also revealed a number of possible trends, for example, that males were most affected, that there was an increase in prevalence over time, with the highest prevalence rates observed in the Medieval period, and that there was a higher prevalence rate among the populations from Mis Island compared with the other populations. It is possible that activities such as farming, building or rowing as well as socio‐political changes could have contributed to the prevalence of spondylolysis seen in this study. [ABSTRACT FROM AUTHOR]

There are many reports of ancient DNA from bacteria of the Mycobacterium tuberculosis complex (MTBC) being present in skeletons with and without osteological indications of tuberculosis. A possible complication in these studies is that extracts might also contain DNA from the microbiome of the individual whose remains are being analysed and/or from environmental bacteria that have colonised the skeleton after death. These contaminants might include ‘mycobacteria other than tuberculosis’ (MOTT), which are common in the environment, but which are not normally associated with clinical cases of tuberculosis. In this paper we show that MOTT of various types, as well as bacteria of related genera, are present in most if not all archaeological remains. Our results emphasise the complications inherent in the biomolecular study of archaeological human tuberculosis. The specificity of any polymerase chain reaction directed at the MTBC cannot be assumed and, to confirm that an amplification is authentic, a sequencing strategy must be applied that allows characterisation of the PCR product. Any variations from the reference MTBC sequence must then be checked against sequence data for MOTT and other species to ensure that the product does actually derive from MTBC. Our results also illustrate the challenges faced when assembling MTBC genome sequences from ancient DNA samples, as misidentification of MOTT sequence reads as MTBC would lead to errors in the assembly. Identifying such errors would be particularly difficult, if not impossible, if the MOTT DNA content is greater than that of the authentic MTBC. The difficulty in identifying and excluding MOTT sequences is exacerbated by the fact that many MOTT are still uncharacterized and hence their sequence features are unknown. [ABSTRACT FROM AUTHOR]

This paper considers the discipline of palaeopathology, how it has developed, how it is studied, and what limitations present challenges to analysis. The study of disease has a long history and has probably most rapidly developed over the last 40-50 years with the development of methods, and particularly ancient pathogen DNA analysis. While emphasizing that palaeopathology has close synergies to evolutionary medicine, it focuses then on three 'case studies' that illustrate the close interaction people have had with their environments and how that has impacted their health. Upper and lower respiratory tract disease has affected sinuses and ribs, particularly in urban contexts, and tuberculosis in particular has been an ever present disease throughout thousands of years of our existence. Ancient DNA methods are now allowing us to explore how strains of the bacteria causing TB have changed through time. Vitamin D deficiency and 'phossy jaw' are also described, both potentially related to polluted environments, and possibly to working conditions in the industrial period. Access to UV light is emphasized as a preventative factor for rickets and where a person lives is important (latitude). The painful stigmatizing 'phossy jaw' appears to be a condition related to the match making industries. Finally, thoughts for the future are outlined, and two key concerns: a close consideration of ethical issues and human remains, especially with destructive analyses, and thinking more about how palaeopathological research can impact people beyond academia. [ABSTRACT FROM AUTHOR]

Background: The Lancet recently sponsored a commission examining the role of surgery in global health. There is a paucity of published information on the cost-effectiveness of surgery in low- and middle-income countries, a key metric in the prioritisation of limited resources. Methods: All patients undergoing emergency laparotomy, elective and emergency inguinal hernia repair, elective and emergency caesarean section, amputation, fracture manipulation, or fracture fixation over a 3 months period in a single district African hospital were assessed. World Health Organisation global burden of disease (GBD) methodology was used to calculate the disability-adjusted life years (DALYs) saved for each patient (using global and local life expectancy). Fully loaded costs were calculated for each patient's care and providing the overall surgical service. Cost-effectiveness was calculated in year 2012 US$ per DALY saved for each procedure and overall. Results: A total of 428 patients were included, with an overall cost-effectiveness of $10.70 per DALY averted. The cost-effectiveness of individual procedures (global life expectancy) was Conclusions: Surgery is a highly cost-effective healthcare measure in the setting of an African district hospital. The presented outcomes demonstrate that surgery is on a par with better-recognised and funded interventions such as HIV anti-retrovirals, malaria prevention and diarrhoea treatment. There are recognised limitations with the GBD methodology used here; however, this remains the best way to investigate the cost-effectiveness of health interventions. This study provides useful information on an, at present, under-studied field. [ABSTRACT FROM AUTHOR]

ABSTRACT Schmorl's nodes are depressions on vertebrae due to herniation of the nucleus pulposus of the intervertebral disc into the vertebral body. This study provides an extension of our previous study which analyzed the shape of the lower thoracic spine and found that vertebral morphology was associated with the presence of Schmorl's nodes. Ninety adult individuals from the late Medieval site of Fishergate House, York, and the Post-Medieval site of Coach Lane, North Shields, Tyne and Wear, England, were analysed using 2D geometric morphometrics to identify possible relationships between vertebral morphology and Schmorl's nodes at the thoraco-lumbar junction and in the lumbar spine. A significant correlation was found between vertebral shape and the presence of Schmorl's nodes in the twelfth thoracic vertebrae and the first to third lumbar vertebrae. The findings corroborate previous studies and suggest that vertebral shape may be an important factor in spinal health. It is hypothesized that the pedicle shape of affected vertebrae may not provide adequate structural support for the vertebral bodies, resulting in vertical disc herniation. Am J Phys Anthropol 157:526-534, 2015. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The eighteenth-century "discovery" of the buried cities of Herculaneum and Pompeii revolutionized the way in which individuals thought about their relationship with the ancient world. The accounts of British visitors between 1738 and the end of the century reflect a new historical sensibility, one predicated upon the extraordinary proximity between present and past that these sites seemed to promise. In this essay, Charlotte Roberts examines the work of four individuals-Camillo Paderni, Johann Joachim Winckelmann, Johann Wolfgang von Goethe, and Sir William Hamilton-all of whom used the prevailing vocabulary associated with Herculaneum and Pompeii in order to articulate individual and in several cases innovative arguments on subjects as diverse as the validity of Neapolitan Bourbon rule, the ideal of Greek art, and the history of the earth. Their ideas indicate that these excavations, in a small but significant way, helped to shape a diverse range of eighteenth-century thought, [ABSTRACT FROM AUTHOR]

This paper explores the dentition of individuals excavated from two post-medieval London cemeteries. Individuals from Chelsea Old Church, a middle-class group, and St. Bride's lower churchyard, a working-class group, were selected and studied. The relative dental status of each group was explored by determining the prevalence of individuals and teeth affected by dental caries. The overall dental status of both class groups was found to be poor; diet was the most likely causative factor. Access to cariogenic foods such as sugar and refined flour likely affected individuals' dental status regardless of their social class. [ABSTRACT FROM AUTHOR]

Cancer, one of the world’s leading causes of death today, remains almost absent relative to other pathological conditions, in the archaeological record, giving rise to the conclusion that the disease is mainly a product of modern living and increased longevity. This paper presents a male, young-adult individual from the archaeological site of Amara West in northern Sudan (c. 1200BC) displaying multiple, mainly osteolytic, lesions on the vertebrae, ribs, sternum, clavicles, scapulae, pelvis, and humeral and femoral heads. Following radiographic, microscopic and scanning electron microscopic (SEM) imaging of the lesions, and a consideration of differential diagnoses, a diagnosis of metastatic carcinoma secondary to an unknown soft tissue cancer is suggested. This represents the earliest complete example in the world of a human who suffered metastatic cancer to date. The study further draws its strength from modern analytical techniques applied to differential diagnoses and the fact that it is firmly rooted within a well-documented archaeological and historical context, thus providing new insights into the history and antiquity of the disease as well as its underlying causes and progression. [ABSTRACT FROM AUTHOR]

ABSTRACT Tuberculosis is known to have afflicted humans throughout history and re-emerged towards the end of the 20th century, to an extent that it was declared a global emergency in 1993. The aim of this study was to apply a rigorous analytical regime to the detection of Mycobacterium tuberculosis complex (MTBC) DNA in 77 bone and tooth samples from 70 individuals from Britain and continental Europe, spanning the 1st-19th centuries AD. We performed the work in dedicated ancient DNA facilities designed to prevent all types of modern contamination, we checked the authenticity of all products obtained by the polymerase chain reaction, and we based our conclusions on up to four replicate experiments for each sample, some carried out in an independent laboratory. We identified 12 samples that, according to our strict criteria, gave definite evidence for the presence of MTBC DNA, and another 22 that we classified as 'probable' or 'possible.' None of the definite samples came from vertebrae displaying lesions associated with TB. Instead, eight were from ribs displaying visceral new bone formation, one was a tooth from a skeleton with rib lesions, one was taken from a skeleton with endocranial lesions, one from an individual with lesions to the sacrum and sacroiliac joint and the last was from an individual with no lesions indicative of TB or possible TB. Our results add to information on the past temporal and geographical distribution of TB and affirm the suitability of ribs for studying ancient TB. Am J Phys Anthropol 153:178-189, 2014. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

ABSTRACT The main goal of this paper is to describe and discuss pathological lesions observed in a Roman skeleton (between 2nd and 3rd century AD) from the north-east region of the Iberian Peninsula (St Nicasi 18-24 site. Gavà, Barcelona), which may be compatible with treponematosis. Most of the skeleton, with the exception of the neurocranium, was recovered. Only the left tibia was affected, whereas the rest of the recovered skeletal remains were unaffected. Macroscopic examination revealed a male individual between 25 and 30 years of age at death with a sabre-shaped left tibia. The proximal half of the diaphysis was pitted and the bone overall enlarged. The surface of the tibia showed occasional vascular impressions where, in some instances, small raised plaques of new bone appeared to bridge over them, specifically in the most affected area of the proximal half of the tibia. No destructive lesions were observed. Radiographic examination and gross inspection at the cross section of the tibia showed encroachment into the medullary cavity of coarse cancellous bone and cancellization of the cortex. The observed lesions indicate that the tibia was affected by a chronic infectious disease. Differential diagnoses were considered, and these included other infectious diseases, fibrous dysplasia, Paget's disease, chronic varicose ulcers affecting bone and trauma, with the conclusion that the disease affecting the tibia could have been treponematosis. This could be significant in the history of the treponematoses being one of the oldest examples of treponematosis in pre-Columbian Europe. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

TANK-binding kinase 1 (TBK1) serves as a key convergence point in multiple innate immune signaling pathways. In response to receptor-mediated pathogen detection, TBK1 phosphorylation promotes production of pro-inflammatory cytokines and type I interferons. Increasingly, TBK1 dysregulation has been linked to autoimmune disorders and cancers, heightening the need to understand the regulatory controls of TBK1 activity. Here, we describe the mechanism by which suppressor of IKKϵ (SIKE) inhibits TBK1-mediated phosphorylation of interferon regulatory factor 3 (IRF3), which is essential to type I interferon production. Kinetic analyses showed that SIKE not only inhibits IRF3 phosphorylation but is also a high affinity TBK1 substrate. With respect to IRF3 phosphorylation, SIKE functioned as a mixed-type inhibitor (Ki, app = 350 nM) rather than, given its status as aTBK1substrate, as a competitive inhibitor. TBK1 phosphorylation of IRF3 and SIKE displayed negative cooperativity. Both substrates shared a similar Km value at low substrate concentrations (∼50 nM) but deviated >8-fold at higher substrate concentrations (IRF3 = 3.5 μM; SIKE = 0.4 μM). TBK1-SIKE interactions were modulated by SIKE phosphorylation, clustered in the C-terminal portion of SIKE (Ser- 133, -185, -187, -188, -190, and -198). These sites exhibited striking homology to the phosphorylation motif of IRF3. Mutagenic probing revealed that phosphorylation of Ser-185 controlled TBK1-SIKE interactions. Taken together, our studies demonstrate for the first time that SIKE functions as a TBK1 substrate and inhibits TBK1-mediated IRF3 phosphorylation by forming a high affinity TBK1-SIKE complex. These findings provide key insights into the endogenous control of a critical catalytic hub that is achieved not by direct repression of activity but by redirection of catalysis through substrate affinity. [ABSTRACT FROM AUTHOR]

TANK-binding kinase 1 (TBK1) serves as a key convergence point in multiple innate immune signaling pathways. In response to receptor-mediated pathogen detection, TBK1 phosphorylation promotes production of pro-inflammatory cytokines and type I interferons. Increasingly, TBK1 dysregulation has been linked to autoimmune disorders and cancers, heightening the need to understand the regulatory controls of TBK1 activity. Here, we describe the mechanism by which suppressor of IKKϵ (SIKE) inhibits TBK1-mediated phosphorylation of interferon regulatory factor 3 (IRF3), which is essential to type I interferon production. Kinetic analyses showed that SIKE not only inhibits IRF3 phosphorylation but is also a high affinity TBK1 substrate. With respect to IRF3 phosphorylation, SIKE functioned as a mixed-type inhibitor (Ki, app = 350 nM) rather than, given its status as aTBK1substrate, as a competitive inhibitor. TBK1 phosphorylation of IRF3 and SIKE displayed negative cooperativity. Both substrates shared a similar Km value at low substrate concentrations (∼50 nM) but deviated >8-fold at higher substrate concentrations (IRF3 = 3.5 μM; SIKE = 0.4 μM). TBK1-SIKE interactions were modulated by SIKE phosphorylation, clustered in the C-terminal portion of SIKE (Ser- 133, -185, -187, -188, -190, and -198). These sites exhibited striking homology to the phosphorylation motif of IRF3. Mutagenic probing revealed that phosphorylation of Ser-185 controlled TBK1-SIKE interactions. Taken together, our studies demonstrate for the first time that SIKE functions as a TBK1 substrate and inhibits TBK1-mediated IRF3 phosphorylation by forming a high affinity TBK1-SIKE complex. These findings provide key insights into the endogenous control of a critical catalytic hub that is achieved not by direct repression of activity but by redirection of catalysis through substrate affinity. [ABSTRACT FROM AUTHOR]

Schmorl's nodes are the result of herniations of the nucleus pulposus into the adjacent vertebral body and are commonly identified in both clinical and archaeological contexts. The current study aims to identify aspects of vertebral shape that correlate with Schmorl's nodes. Two-dimensional statistical shape analysis was performed on digital images of the lower thoracic spine (T10-T12) of adult skeletons from the late medieval skeletal assemblages from Fishergate House, York, St. Mary Graces and East Smithfield Black Death cemeteries, London, and postmedieval Chelsea Old Church, London. Schmorl's nodes were scored on the basis of their location, depth, and size. Results indicate that there is a correlation between the shape of the posterior margin of the vertebral body and pedicles and the presence of Schmorl's nodes in the lower thoracic spine. The size of the vertebral body in males was also found to correlate with the lesions. Vertebral shape differences associated with the macroscopic characteristics of Schmorl's nodes, indicating severity of the lesion, were also analyzed. The shape of the pedicles and the posterior margin of the vertebral body, along with a larger vertebral body size in males, have a strong association with both the presence and severity of Schmorl's nodes. This suggests that shape and/or size of these vertebral components are predisposing to, or resulting in, vertically directed disc herniation. Am J Phys Anthropol, 2012. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Ovarian cancer is the most lethal gynecological cancer. Here we show that innate immune agonist, dsRNA, directly induces ovarian cancer cell death and identify biomarkers associated with responsiveness to this targeted treatment. Nuclear staining and MTT assays following dsRNA stimulation revealed two subpopulations, sensitive (OVCAR-3, CAOV-3; patient samples malignant 1 and 2) and resistant (DOV-13, SKOV-3). Microarray analysis identified 75 genes with differential expression that further delineated these two subpopulations. qPCR and immunoblot analyses showed increased dsRNA receptor expression after stimulation as compared to resistant and immortalized ovarian surface epithelial cells (e.g., 70-fold with malignant 2, 43-fold with OVCAR-3). Using agonists, antagonists, and shRNA-mediated knockdown of dsRNA receptors, we show that TLR3, RIG-I, and mda5 coordinated a caspase 8/9- and interferon-dependent cell death. In resistant cells, dsRNA receptor overex-pression restored dsRNA sensitivity. When dsRNA was combined with carboplatin or paclitaxel, cell viability significantly decreased over individual treatments (1.5-to 7.5-fold). Isobologram analyses showed synergism in dsRNA combinations (CI = 0.4-0.82) vs. an additive effect in carboplatin/paclitaxel treatment (CI = 1.5-2). Our data identify a predictive marker, dsRNA receptor expression, to target dsRNA responsive populations and show that, in dsRNA-sensitive cells, dsRNA induces apoptosis and enhances the potency of cytotoxic chemotherapeutics. [ABSTRACT FROM AUTHOR]

Maxillary sinusitis was studied as an indicator of poor air quality. Seven skeletal samples were examined from North America, England, and Nubia, and selected to represent different geographic locations, environments, and subsistence economies. Frequency rates varied from 17.2 to 51.5% of individuals affected with one or both sinuses preserved. Hardin Village had the highest frequency (51.5%), followed by the Aleuts (42.9%), "Illinois" (38.6%), Indian Knoll (38.5%), Kulubnarti (21.8%), Christchurch, Spitalfields (18.0%), and "South Dakota" (17.2%). Male frequencies ranged from 16.7 to 36.7%, but the female frequency ranged more widely from 18.0 to 76.5%. At most sites female rates exceeded male. The effect of urban and rural environment on sinusitis occurrence, and also subsistence economy, biological sex, and social status were explored, and comparative sites also considered; urban agricultural sites had a mean frequency of 48.5%, rural agricultural sites had a mean frequency of 45.0%, and hunter-gatherer sites had a mean frequency of 40.0%. In the urban sites male and female frequencies were near equal, but in the rural agricultural and hunter-gatherer sites female frequencies exceeded male frequencies. Dental disease was not found to have much impact on sinusitis frequency. The importance of the link between poor air quality and respiratory health is highlighted in clinical studies in both developed and developing countries, but also in bioarcheological studies. [ABSTRACT FROM AUTHOR]

Bone fractures were analyzed from skeletal remains of 861 adult individuals from six cemeteries dating to the Late Medieval period in Serbia. Results of the study were compared to other cemetery populations (635 individual skeletons) of the same date and region in an attempt to understand fracture patterns. The association of types of fractures and their prevalence with sex, age at death, cemetery site, and information deriving from historical sources are discussed. Results showed that the long bone fracture frequency was 0.7%, and the majority of the fractures were the result of direct force. This rate is similar to some studies of contemporary British skeletal samples. However, it is much lower than for some other Old World sites. Cranial vault fractures had a rate of 6.7%, and of the facial skeleton, 1.3%; the frontal bone was the most affected of bones of the cranial vault. Injuries were more common on the upper extremities (0.8%) compared to the lower (0.6%). However, the fibula was the most fractured bone (2.8%), followed by the ulna (2.4%). This pattern is similar to three of six Late Medieval urban sites in Britain. These findings suggest that this rural community was exposed to a low risk of trauma, probably related mostly to accidents sustained during farming, and rarely to interpersonal violence. [ABSTRACT FROM AUTHOR]

The role of new bone formation on visceral surfaces of ribs in the diagnosis of tuberculosis (TB) in past human populations has been explored by many researchers, using both skeletal remains with known causes of death and archaeological samples. This study focuses, firstly, on adult skeletons from the Coimbra Identified Skeletal Collection in Portugal and investigates the skeletal manifestations of individuals known to have died from TB; secondly, this study focuses on the role of rib lesions in the diagnostic criteria for TB. One hundred and fifty-seven males and 106 females aged between 22–87 years were examined; causes of death were assigned as pulmonary TB, extrapulmonary TB, and pulmonary non-TB; a control group, extrapulmonary non-TB, was selected from the remaining individuals. Of individuals with rib lesions, 85.7% (69/81) had pulmonary or extrapulmonary TB as an assigned cause of death, while 17.8% (16/90) of individuals with rib lesions had a non-TB cause of death. Rib lesions were significantly more common in individuals who had died from TB, although the lesions cannot be considered pathognomonic for TB. In individuals dying from pulmonary TB, ribs in the central part of the rib cage were most affected, at their vertebral ends. The lower part of the rib cage may be a marker for peritoneal TB, and ‘coral- like’ new bone formation on ribs may be an indicator of neoplastic disease. Further work on rib involvement in TB in clinical contexts, and the study of further documented skeletal collections, are recommended. [ABSTRACT FROM AUTHOR]

Microscopic analyses served to complement the macroscopic identification of venereal syphilis in two of four pre-Columbian skeletons from the site Hull Magistrates Court in England. Diagnosis was based on parameters presented by Schultz ([1994] Origin of Syphilis in Europe, Toulon: Centre Archaeologique du Var, p. 63-67; [2001] Yrbk. Phys. Anthropol. 44:106-147; [2003] Identification of Pathological Conditions in Human Remains, New York: Academic Press, p. 73-109), which characterized venereal syphilis at a histological level. Observation of the microarchitecture of these samples allowed a more comprehensive approach to identification of the disease (processes). In most samples, Polsters and Grenzstreifen (or remnants of such structures) could be identified, suggesting the presence of a chronic, inflammatory disease such as venereal syphilis. Sinous lacunae were also observed in all histological samples, pointing to lytic activity (osteitis). The combination of both proliferative and destructive processes is pathognomonic for syphilis, and histological analyses provided a more accurate diagnosis of this infectious disease in these four individuals. As a result, the histological evidence suggests that venereal syphilis was present in England prior to 1492. This secondary form of evidence supports the macroscopic identification of the disease, and shows the power of a multimethodological approach to paleopathological diagnoses. [ABSTRACT FROM AUTHOR]

The utility of Bayes' theorem in paleopathological diagnoses is explored. Since this theorem has been used heavily by modern clinical medicine, its usefulness in that field is described first. Next, the mechanics of the theorem are discussed, along with methods for deriving the prior probabilities needed for its application. Following this, the sources of these prior probabilities and their accompanying problems in paleopathology are considered. Finally, an application using prehistoric rib lesions is presented to demonstrate the utility of this method to paleopathology. [ABSTRACT FROM AUTHOR]

Examines the evidence and considers the differential diagnosis for tuberculosis (TB) in juvenile individuals from early 20th century documented skeletons. Studies conducted on the these individuals in the Coimbra Identified Skeletal Collection; Skeletal manifestations caused by the different types of TB.

Deals with the significance of DNA analysis indicative of tuberculosis and leprosy from ancient human remains. Background on the study of paleopathology; Diagnosis of tuberculosis and leprosy in skeletal remains; Discussion on the biomolecular analysis of ancient human remains.

Presents information on a study conducted to determine if there is a significant difference in frequencies and patterns of longbone fracture trauma observed between rural and urban activity bases that distinguish farming as a particularly dangerous occupation during the medieval period. Materials and methods; Results; Discussion.

Studies the role of health in fracture patterns in ancient populations. Method used to gather the information; Reference made to the constant risk of bone fractures in humans; Examination of 212 sexed adults from the medieval leper hospital to conduct the study; Findings of the examination.

Identifies an activity-related lesion called the clay-shoveller's fracture during osteological analysis in three human populations dating from the Roman to the later medieval period in England, circa fourth to 14th centuries A.D. Osteological indicator for several possible manual activities; Males as preferentially affected subjects.

Investigates the frequency of periosteal new bone formation on the visceral surfaces of ribs of individuals from the Terry Collection, Smithsonian Institution. Aetiological factors producing the lesions; Bone changes in tuberculosis; Lesions as a general non-specific indicator of stress.

A letter to the editor is presented in response to the article which describes the first Homo erectus finding from Turkey, published in the 2008 issue.

The aim of this research was to consider differential diagnoses for extensive skeletal deformities in the skeletal remains of a child, suggestive of a severe condition compromising the bone structure. The individual was excavated from a medieval cemetery in Riga, Latvia (15th-16th centuries AD) in 2004. Macroscopic, radiographic and biomolecular analyses were carried out on the remains. Macroscopic analysis revealed that the anterior deciduous dentition was missing ante-mortem, with the alveoli almost completely remodelled. Cortical thickening was observed on the long bones of the arms and legs, and on the ribs, and thickening of the diploic space was observed in the skull. Most bones of the skeleton were enlarged and porous. Marked bending deformities of the long bone shafts, as well as the os coxae and ribs, were also present. Radiographic analysis revealed healed fractures of the right humerus and left tibial diaphyses. Biomolecular analysis confirmed that the child was a girl. Based on the appearance of the lesions, diagnosis concentrated on healed rickets (childhood vitamin D deficiency), while juvenile Paget's disease and osteogenesis imperfecta were considered as differential diagnoses. In the palaeopathological literature, it is rare to find such a severe expression and long-standing form of possible healed rickets, especially in a population with a low prevalence of the condition. Poor DNA preservation prevented the ability to explore whether the differential diagnoses had any genetic origin. [ABSTRACT FROM AUTHOR]

B Learning Objectives: b Pregnant patients with underlying cardiovascular disease (CVD) and cardiomyopathy represent an increasing proportion of the obstetrics population and make up 25% of maternal death in the U.S. As such, they require more intensive management, both pre-and post-delivery. B Methods: b In Jan 2018 we formed a multi-disciplinary team composed of members from general, pediatric and critical care cardiology, cardiac and obstetric anesthesiology, maternal fetal medicine, and obstetrics (OB) to assist in the evaluation and management of pre-and post-partum care for high-risk cardiac OB patients. B Conclusions: b Implementation of a multi-disciplinary team-based approach to complex cardiac OB patient using our Cardiac-OB planning tool was successful. [Extracted from the article]

Objectives: Inflammatory periosteal reaction (IPR) on the visceral surfaces of the ribs has been used in bioarchaeology as an indicator of lower respiratory tract disease. This article presents a detailed method for recording IPR on the ribs, even those in severely fragmented states, with the objectives of increasing the consistency of recording and producing true prevalence rates for skeletons so as to improve data comparability between future bioarchaeological studies of lower respiratory tract disease. Materials and methods: The presence and prevalence of respiratory‐related IPR were recorded from three different Sudanese cemetery sites using a detailed method for identifying and recording IPR. Sites with variable preservation were chosen to test the applicability of the method. A flowchart to aid in identification of bony changes is presented. The method requires the recording of IPR on three separate sections of the rib (neck, angle, and shaft) and the allocation of ribs into rib cage regions of upper, upper‐middle, middle, lower‐middle, and lower. Results: Results demonstrate differences in the distribution of IPR between sites and verify the method's applicability to archeological sites with various levels of skeletal preservation. Discussion: While crude prevalence rates can indicate the number of individuals experiencing lower respiratory tract disease within a site, this method can provide information about the distribution of IPR within the rib cage. This should lead to new ways of distinguishing respiratory diseases within archeological populations. This method also allows for comparability between well‐preserved and lesser‐preserved sites by accommodating for rib fragmentation. [ABSTRACT FROM AUTHOR]

Stable isotope analysis of archaeological human remains is routinely applied to explore dietary habits and mobility patterns. The isotope information pertaining to the period prior to death may help in identifying locals and non-locals, especially when investigating individuals from the same funerary context but believed to have been highly mobile across the landscape. Based on the variety of the funerary goods in graves and what it is believed their diets comprised, it is thought that both local and non-local individuals were buried at the inland funerary site of Pica 8 (northern Chile, Late Intermediate Period, ∼1050–500 BP); however, uncertainties over the dietary intakes and mobility histories of these individuals still persist. The aim of this study is to refine the dietary characterization of a subset of Pica 8 individuals by increasing the temporal resolution of their dietary reconstructions, specifically throughout the last period of their life, and by identifying the multiple sources of food in their overall diets. This is achieved by analysing the amino acid carbon isotope composition of hair keratin and, for the first time, that of tendon collagen. This study proposes a new method for identifying the predominant food source (terrestrial or marine) in a mixed diet using phenylalanine, valine and leucine δ 13 C values measured in collagenous tissues. Herein, tendon is proven to be an ideal tissue for isotopically characterising the final year of an individual's life. Our results show that individuals previously identified as non-locals, based on long-term food consumption, had in reality abandoned their original dietary habits typical of distant regions many months before death, and hence had presumably relocated to the locality of Pica. [ABSTRACT FROM AUTHOR]

Reports a case of possible pituitary dwarfism by analyzing specimens from the ancient Roman cemetery in Gloucester, England. Discovery of a skeleton of abnormally small proportion; Examination of the skeleton; Estimation of the stature using the maximum length of the right femur.

The evolutionary history of the Mycobacterium tuberculosis complex (MTBC) has previously been studied by analysis of sequence diversity in extant strains, but not addressed by direct examination of strain genotypes in archaeological remains. Here, we use ancient DNA sequencing to type 11 single nucleotide polymorphisms and two large sequence polymorphisms in the MTBC strains present in 10 archaeological samples from skeletons from Britain and Europe dating to the second–nineteenth centuries AD. The results enable us to assign the strains to groupings and lineages recognized in the extant MTBC. We show that at least during the eighteenth–nineteenth centuries AD, strains of M. tuberculosis belonging to different genetic groups were present in Britain at the same time, possibly even at a single location, and we present evidence for a mixed infection in at least one individual. Our study shows that ancient DNA typing applied to multiple samples can provide sufficiently detailed information to contribute to both archaeological and evolutionary knowledge of the history of tuberculosis. [ABSTRACT FROM AUTHOR]

The aims of this study were to explore the origins of 19 children buried in two mass graves and the general cemetery at the post‐medieval St Gertrude Church cemetery in Riga, Latvia, using strontium isotope analysis (87Sr/86Sr), and to establish local soil Sr biosphere ranges from faunal samples from two areas of Latvia. The results confirmed the presence of one clear outlier in the population and one child who may have had originated from the region of Vidzeme. The lack of significant differences in 87Sr/86Sr between the other individuals analysed suggested that they were representative of one population. A strong correlation between 87Sr/86Sr ratios and previously obtained mean δ13C and δ15N values in children from mass graves suggested possible short‐term dietary changes with increased proportion of marine resources and food sources subject to sea spray. The study has yielded the first comparative 87Sr/86Sr data from archaeological skeletons in Latvia, which will be essential for future research addressing comparative mobility studies in the region. [ABSTRACT FROM AUTHOR]

Abstract: Tuberculosis (TB) and leprosy are infections caused by Mycobacteria. This paper documents new skeletal evidence in Italy from the Iron Age site of Corvaro (Central Italy; 5th century BCE) and the Roman site of Palombara (Central Italy; 4th–5th century CE), and briefly reviews the extant evidence for these infections in Italy. The skeletal evidence for TB in Italy is more ancient than for leprosy, and is more common. The oldest evidence for both mycobacterial diseases is in the North of Italy, but this could be by chance, even if biomolecular models suggest a land route from the East to central Europe, especially for leprosy. [Copyright &y& Elsevier]