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Dental data can reveal evidence for a past population's oral health, nutrition, and certain cultural activities. This study aims to explore oral health and dental attrition during the late Bronze Age in order to explore health outcomes in different subgroups as well as aspects of foodways and changes in subsistence strategies during the second millennium BCE in northwest China. To do this, the skeletal remains of adult individuals associated with the Siwa material culture (1400–1100 BC) from the Mogou site (n = 28) were macroscopically assessed and compared with previously published data derived from a subsample of individuals associated with Qijia period material culture complex (1750–1400 BC) from the same site. The results show that the Siwa‐period population experienced a high frequency of carious lesions and antemortem tooth loss associated with advanced attrition (of both molars and nonmolar teeth), which did not vary significantly by sex. Females had a higher prevalence of carious lesions and antemortem tooth loss than did males, while males had a higher prevalence of dental calculus. These male/female health outcomes are also attested during the earlier Qijia period at the Mogou site. The Siwa period differs from the Qijia in that females experienced slightly worse attrition than their predecessors. Overall, oral health does not diverge significantly between the Qijia and Siwa periods, suggesting that the factors that contributed to oral health including dietary practices may have persisted diachronically for individuals buried at this site. [ABSTRACT FROM AUTHOR]

Skeletal fluorosis is a systemic chronic disease caused by long‐term intake of excessive fluoride, which accumulates in bone tissue and causes changes to the bone and periosteal tissue. Skeletal fluorosis is rarely considered in paleopathological analyses, but in areas with relatively high fluoride in the environment, it may be an important cause of bone hyperplasia. In this study, we observed pathological lesions consistent with fluorosis on two human skeletons from the Ming Dynasty (1368–1644 CE) excavated from a cemetery in western Henan Province. By using an electron microprobe to measure the fluoride content in the teeth, and by considering the living conditions in the area during the Ming Dynasty, we conclude that the remains show evidence of skeletal fluorosis. We also consider the content of fluoride in the local groundwater, the local way of life, and other factors, to identify potential causes of skeletal fluorosis in this population and demonstrate that environmental factors were the main cause. This offers insight into the relationship between humans and their environments in China, especially western Henan Province, in the historical past. It also demonstrates the unique contributions bioarchaeology can make to environmental health studies and studies of the history of health. [ABSTRACT FROM AUTHOR]

The authors describe community mental health in Palestine from several vantage points: Palestine's historical and current context of military/political violence under Israeli occupation, its health care system and system of mental health care, and the status of its mental health staffing and training. Vignettes illustrate characteristic challenges and opportunities for Palestine within the domain of mental health. The roles of cognitive behavioral therapy and psychoanalytic thinking are discussed in terms of current practice, with an eye toward policy planning for a fully integrated model of health care delivery. The authors argue that the values of justice, freedom, and human rights are fundamental to well‐being, and that the theory and practice of community mental health must support active resistance to violation of these principles. [ABSTRACT FROM AUTHOR]

This article presents outcomes from a Workshop entitled "Bioarchaeology: Taking Stock and Moving Forward," which was held at Arizona State University (ASU) on March 6–8, 2020. Funded by the National Science Foundation (NSF), the School of Human Evolution and Social Change (ASU), and the Center for Bioarchaeological Research (CBR, ASU), the Workshop's overall goal was to explore reasons why research proposals submitted by bioarchaeologists, both graduate students and established scholars, fared disproportionately poorly within recent NSF Anthropology Program competitions and to offer advice for increasing success. Therefore, this Workshop comprised 43 international scholars and four advanced graduate students with a history of successful grant acquisition, primarily from the United States. Ultimately, we focused on two related aims: (1) best practices for improving research designs and training and (2) evaluating topics of contemporary significance that reverberate through history and beyond as promising trajectories for bioarchaeological research. Among the former were contextual grounding, research question/hypothesis generation, statistical procedures appropriate for small samples and mixed qualitative/quantitative data, the salience of Bayesian methods, and training program content. Topical foci included ethics, social inequality, identity (including intersectionality), climate change, migration, violence, epidemic disease, adaptability/plasticity, the osteological paradox, and the developmental origins of health and disease. Given the profound changes required globally to address decolonization in the 21st century, this concern also entered many formal and informal discussions. [ABSTRACT FROM AUTHOR]

Background: For patients with breast cancer undergoing breast‐conserving surgery (BCS), adjuvant radiation (RT) and hormonal therapy (HT) reduce the risk of locoregional recurrence (LRR). Although several studies have evaluated adjuvant HT ± RT, the outcomes of HT versus RT monotherapy remain less clear. In this study, the risk of LRR is characterized among older patients with early‐stage breast cancer following adjuvant RT alone, HT alone, neither, or both. Methods: This study included female patients from the Memorial Sloan Kettering Cancer Center (New York, New York) who were aged ≥65 years with estrogen receptor–positive (ER+)/human epidermal growth factor receptor 2–negative (HER2–) T1N0 breast cancer treated with BCS. The primary endpoint was time to LRR evaluated by Cox regression analysis. Results: There were 888 women evaluated with a median age of 71 years (range, 65‐100 years) and median follow‐up of 4.9 years (range, 0.0‐9.5 years). There were 27 LRR events (3.0%). Five‐year LRR was 11% for those receiving no adjuvant treatment, 3% for HT alone, 4% for RT alone, and 1% for HT and RT. LRR rates were significantly different between the groups (P <.001). Compared with neither HT nor RT, HT or RT monotherapy each yielded similar LRR reductions: HT alone (HR, 0.27; 95% CI, 0.10‐0.68; P =.006) and RT alone (HR, 0.32; 95% CI, 0.11‐0.92; P =.034). Distant recurrence and breast cancer–specific survival rates did not significantly differ between groups. Conclusions: LRR risk following BCS is low among women aged ≥65 years with T1N0, ER+/HER2– breast cancer. Adjuvant RT and HT monotherapy each similarly reduce this risk; the combination yields a marginal improvement. Further study is needed to elucidate whether appropriate patients may feasibly receive adjuvant RT monotherapy versus the current standards of HT monotherapy or combined RT/HT. Among early‐stage favorable‐risk patients with breast cancer, it remains unclear how locoregional recurrence risk is affected by adjuvant radiation therapy, endocrine therapy, neither, or both. This study shows adjuvant monotherapy yields favorable outcomes comparable to combining endocrine and radiation therapy, but forgoing both treatments may yield unacceptably high locoregional recurrence risk. [ABSTRACT FROM AUTHOR]

The authors report on episodes in which five professional mental health organizations—for the most part associations for psychoanalysis and psychoanalytically oriented psychotherapy—have covertly tried to silence members who bring attention to the issue of human rights abuses inflicted by the Israeli occupation of Palestine. These various vignettes illustrate how the leadership of these organizations systematically attempts to limit the activism of their members, even in their "free time," and to forbid the introduction of discussion of Israel/Palestine into their newsletters, meetings, chatrooms, and other organizational venues—despite the fact that these organizations profess their commitment to exploring themes of social justice and to the principle of open dialogue. Implications and recommendations are discussed, particularly the practical need for transparency on the part of our organizations and the intellectual need for a more complete theoretical understanding of the roles of history, ideology, and collective meaning within mental life. [ABSTRACT FROM AUTHOR]

Objectives This study examines human adaptation to the 4000 BP climate change event, which is said to have increased the marginality of Inner Asian environments. We propose to define 'marginal' environments not in relation to a specific economic activity (e.g., agriculture), but in relation to whether humans living there are physiologically stressed. Methods Three sites in the Hexi Corridor of Gansu were studied, one from the early and two from the late Bronze Age (N = 125). The study includes three indicators of physiological stress: linear enamel hypoplasias (LEH); tibial periosteal lesions; and fertility. The early and late Bronze Age groups were compared to examine whether human physiological stress increased. Results The percent of individuals with LEH declined dramatically, indicating fewer growth disruptions. Tibial periosteal reactions also changed, from mostly active to mostly healing at the time of death, indicating that frailty declined. Fertility, which is sensitive to changes in population health and resource availability, did not change significantly. Conclusions Counter to the dominant narrative of environmental deterioration and subsistence system collapse, the Bronze Age residents of the Hexi Corridor show no skeletal evidence that they suffered from resource shortages or struggled to adapt in the fluctuating climate that pertained after the 4000 BP climate event. In fact, this study found that people suffered from less frailty and fewer growth disruptions after the unstable climate had persisted for some time. Therefore, in human biological terms, the Hexi Corridor did not become more marginal for human habitation during the Bronze Age. [ABSTRACT FROM AUTHOR]

Diabetic retinopathy has recently become associated with complications similar to chronic inflammatory diseases. Although it is clear that tumor necrosis factor‐α is increased in diabetes, the role of innate immunity is only recently being investigated. As such, we hypothesized that diabetes would increase Toll‐like receptor 4 (TLR4) signaling, which could be inhibited by a β‐adrenergic receptor agonist (Compound 49b) previously shown to have anti‐inflammatory actions. In order to investigate β‐adrenergic receptor signaling and TLR4 in the diabetic retina, streptozotocin‐injected diabetic mice, as well as human primary retinal endothelial cells (RECs) and rat retinal Müller cells (rMC‐1) exposed to high glucose (25 mm), were treated with a novel β‐adrenergic receptor agonist, Compound 49b (50 nm), or phosphate‐buffered saline (control). TLR4 and its downstream signaling partners (MyD88, IL‐1 receptor‐associated kinase 1, TNF receptor‐associated factor 6 and total and phosphorylated nuclear factor‐κB) were examined. In addition, we assessed high‐mobility group box 1 (HMGB1) protein levels. Our data showed that diabetes or high‐glucose culture conditions significantly increased TLR4 and downstream signaling partners. Compound 49b was able to significantly reduce TLR4 and related molecules in the diabetic animal and retinal cells. HMGB1 was significantly increased in RECs and Müller cells grown in high‐glucose culture conditions, which was subsequently reduced with Compound 49b treatment. Our findings suggest that high glucose may increase HMGB1 levels that lead to increased TLR4 signaling. Compound 49b significantly inhibited this pathway, providing a potential mechanism for its protective actions. [ABSTRACT FROM AUTHOR]

Reply to Impact of radiation and hormonal therapy on the locoregional recurrence of elderly breast cancer: Are these necessary after breast conserving surgery? Similarly, we included those receiving accelerated partial breast irradiation (9.8% of our RT group) rather than only those who received whole breast irradiation, although this latter point is unlikely to have influenced associations with LRR. The RT classes in our studies also differed to some extent: our RT monotherapy group included 118 patients (13.3% of the cohort), whereas theirs included only 26 patients (2.4% of the entire cohort). [Extracted from the article]

An introduction is presented in which the editor discusses various reports within the issue including consequences for human health with adaptation to high altitude, ancient high-altitude settlement in Nepal and skeletal remains from early farming communities in Bolivia.

Summary Background: We developed a portfolio framed by the CanMEDS roles for use in a paediatric fellowship programme. The portfolio includes four components: a record of participation and achievement; career goals and professional development; physical evidence; and reflective writing. Methods: Once the portfolio was in use for 6 months, we studied how fellows and faculty members were using the portfolio, and what they found to be its advantages and disadvantages. Results: Fellows reported that it kept them organised and assisted them in setting their goals. They appreciated having a central place to record their accomplishments, as this allowed them to keep a thorough curriculum vitae. The portfolio was helpful in giving them the opportunity to honestly reflect on their achievements and setbacks, and, after reviewing this in their own minds, they were in a strong position to set an agenda for their meetings with supervisors. Both the fellows and supervisors were in agreement that the portfolio led to improved discussions at their meetings. Both groups also reported that this new tool was useful in furthering the career development of trainees, which was one of the main goals in its inception. Faculty supervisors also had a stronger sense of the fellows' work, and also of any gaps in training, as a result of using this tool. Discussion: We hope that this reflection tool will be adapted for use in other training programmes. If it is introduced elsewhere, we would recommend that learners and staff receive ample training in its use so that it can be maximally effective. [ABSTRACT FROM AUTHOR]

This article aims to understand the impact of a condition causing multiple benign neoplasms on a historical individual, and increase understanding of disease processes using a paleopathological case. We present the case of an adult male from the Balizhuang site in Weifang City, Changle County, Shandong Province, China, dated by the burial artifacts to the Qing period (1644–1911 CE). The individual has multiple bony growths found on both long and flat bones, which were also observed radiographically. Imaging revealed that the lesions show continuity with the medullary cavity of the host bone. The individual also exhibited short stature, upper limb length asymmetry, and hip and ankle deformities. Conditions included in a differential diagnosis are myositis ossificans, parosteal osteosarcoma, and osteochondroma, with multiple osteochondromas (MO) being the most likely diagnosis. We also present historical texts suggesting the presence of osteochondromas in China. This may be the first case of adult MO reported in Chinese bioarcheology, helping to expand paleopathological data on benign tumors. [ABSTRACT FROM AUTHOR]