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Objective: To explore how medieval living conditions, occupation, and an individual's role within society impacted their risk of skeletal trauma. Materials: The skeletal remains of 314 individuals from medieval Cambridge that were buried in the parish cemetery of All Saints by the Castle (n = 84), the Augustinian friary (n = 75), and the cemetery of the Hospital of St John the Evangelist (n = 155) were analyzed. Methods: Macroscopic examination and plain radiographs were used to classify fracture type. The causative mechanisms and forces applied to a bone were inferred based on fracture morphology. Results: The skeletal trauma observed represents accidental injuries, likely sustained through occupational or everyday activities, and violence. The highest prevalence rate was observed on the individuals buried at All Saints by the Castle (44%, n = 37/84), and the lowest was seen at the Hospital of St John (27%, n = 42/155). Fractures were more prevalent in males (40%, n = 57/143) than females (26%, n = 25/95). Conclusions: Skeletal trauma was highest in All Saints parish burial ground, indicating that the poor, whether working urban or rurally, had the highest risk of injury. The pattern and types of fractures observed suggests that males experienced more severe traumatic events than females. However, females that were routinely involved in manual labor were also at increased risk of injury. Significance: This article enhances our understanding of how traumatic injuries differed by age, sex, and burial locations in the medieval period. Further research: Additional comparative studies in different geographical regions are needed to determine how representative these findings are.

BACKGROUND: To plan for cancer services in the future, the long view of cancer prevalence is essential. It might be suspected that cancer prevalence before tobacco and industrial revolution pollutants was quite different to today. METHODS: To quantify the degree to which cancer prevalence may be changing over time, the authors analyzed 143 skeletons from 6 cemeteries from the Cambridge area (6th-16th centuries). Visual inspection coupled with screening using both plain radiographs and computed tomography scans was used to detect malignant lesions. RESULTS: A total of 3.5% of individuals showed evidence for metastases. Factoring in modern data for the proportion of those with cancer that die with bone metastases, this suggests a minimum prevalence of all cancers at the time of death in medieval Britain to be approximately 9% to 14% of adults. CONCLUSIONS: This figure compares with a 40% to 50% prevalence of cancer at the time of death for modern Britain. The difference may be explained by the effects of modern carcinogens, the spread of viruses that trigger malignancy, industrial pollutants, and longer life expectancy. LAY SUMMARY: Until now, no one has been able to work out how common cancer was before the time people were exposed to tumor-inducing chemicals from tobacco and industrial factories. In this novel study, the authors have determined the percentage of people living in medieval Britain who had cancer metastases to bone at the time of their death and then compared that with modern data. It was found that cancer was approximately 25% as common in medieval times as it is today. This article suggests cancer was much more widespread in medieval times than was previously realized.

Additional file 3. Review history.

Additional file 1. Supplementary figures and text [108-142].

OBJECTIVE: To estimate the prevalence rate of gout and to explore the social factors that contributed to its development in the various sub-populations in medieval Cambridge. MATERIALS: 177 adult individuals from four medieval cemeteries located in and around Cambridge, UK. METHODS: Lesions were assessed macroscopically and radiographically. Elements with lytic lesions were described and imaged using micro-computed tomography (μCT) to determine their morphology. RESULTS: Gout was identified in 3 % of the population. Individuals buried in the friary had highest prevalence (14 %), with low prevalence rates in the Hospital (3 %) and town parish cemetery (2 %), with no cases in the rural parish cemetery. Gout was more prevalent during the 14th-15th centuries than the 10th-13th centuries. CONCLUSION: The high prevalence rate of gout in the friary is at least partly explained by the consumption of alcohol and purine-rich diets by the friars and the wealthy townsfolk. Medieval medical texts from Cambridge show that gout (known as podagra) was sometimes treated with medications made from the root of the autumn crocus. This root contains colchicine, which is a medicine that is still used to treat gout today. SIGNIFICANCE: This is one of the first studies to assess the epidemiology of gout in medieval England and suggests that gout varied with social status. LIMITATIONS: Our sample size precludes statistical analysis. SUGGESTIONS FOR FURTHER RESEARCH: Additional studies that assess the epidemiology of gout in medieval Europe is needed in order to be able to fully contextualize these findings.

OBJECTIVE: Hallux valgus, the lateral deviation of the great toe, can result in poor balance, impaired mobility and is an independent risk factor for falls. This research aims to compare the prevalence of hallux valgus in subpopulations of medieval Cambridge, England, and to examine the relationship between hallux valgus and fractures to examine the impact of impaired mobility and poor balance caused by this condition. MATERIALS: 177 adult individuals from four cemeteries located in Cambridge, England. METHODS: Human remains were macroscopically and radiographically assessed. RESULTS: Hallux valgus was identified in 18 % of individuals and was significantly more common during the 14th-15th centuries than the 11th-13th centuries. The highest prevalence was observed in the friary (43 %), followed by the Hospital (23 %), the rurban parish cemetery (10 %), and the rural parish cemetery (3%). Fractures from falls were significantly more common in those with hallux valgus than those without. CONCLUSION: The increased prevalence of hallux valgus identified in individuals from the 14th to 15th centuries coincided with the adoption of new footwear with pointed toes. Those that adopted this fashion trend appear to have been more likely to develop balance and mobility problems that resulted in an increased risk of falls. SIGNIFICANCE: This is the first study to explore the relationship between foot problems and functional ability by studying hallux valgus in archaeological assemblages. LIMITATIONS: Falls are complex and determining the mechanism of injury in human skeletal remains is not always possible. FURTHER RESEARCH: Fracture prevalence rates may have been affected by biological factors and underlying pathological conditions.

Evidence of cranial surgery, in the form of trepanations, has been found at prehistoric archaeological sites from all over the world. Within this large body of evidence, it is clear that trepanations vary in size, location and the reason for which they were performed. Numerous trepanations have been discovered at archaeological sites across China, but very few have come from Qijia Culture (2300-1500 BC) sites in Northwest China. This research describes a wellhealed trepanation on an adult male individual(M179:R2) from the Mogou site and compares it to contemporaneous examples from China that date from 3000~0 BC in order to elucidate how and why this procedure was performed. A small circular opening with slightly irregular, but well-healed, margins was identified on the left parietal bone, immediately posterior to the coronal suture. The characteristics of the lesion suggest that the scraping method was employed to create the opening. Unfortunately, the advanced stage of healing made the identification of the specific instrument used in the trepanation impossible. The characteristics of the incision and the archaeological context led the authors to propose that the trepanation on M179:R2 was performed as part of a magicoritual, rather than for a non-ritual medical purpose. This is supported by the presence of multiple individuals, mainly men, from the Mogou site with similar well-healed trepanations. 作为脑外科手术的一种，开颅术在世界多地史前遗址中均有发现。大量发现表明开颅术在颅骨上的尺寸、位置及手术原因千差万别。开颅术在中国境内亦有发现；但在齐家文化（2300-1500BC）遗址中十分少见。位于甘肃省甘南藏族自治区临潭县陈旗乡的磨沟遗址是一处重要的齐家文化墓葬遗址。本文将重点讨论一例磨沟出土的开颅个体，该成年男性个体 (M179:R2) 颅骨上有愈合程度较高的开颅术的痕迹；同时，将其与其他同时期（3000~0 BC）中国出土的开颅术个体进行比较分析，从而论证阐述开颅术实行的原因及过程。该个体左侧顶骨冠状缝后侧位置处有一圆形穿孔，其小孔边缘不甚规则，且有明显愈合痕迹。穿孔切口的特征显示该穿孔由刮削法完成。但由于该穿孔高度愈合，我们无法准确判断完成穿孔所使用的工具。该个体上开颅术的特征以及相关考古学资料使得作者们认为 M179:R2 进行开颅术的原因或与巫术仪式有关。同时，磨沟出土的其他带有开颅术个体（大多数是男性，且颅骨开颅处愈合程度较高）也支持这一观点。 Accepted version

Funder: Wellcome Trust, Human herpes simplex virus 1 (HSV-1), a lifelong infection spread by oral contact, infects a majority of adults globally. Phylogeographic clustering of sampled diversity into European, pan-Eurasian, and African groups has suggested the virus codiverged with human migrations out of Africa, although a much younger origin has also been proposed. We present three full ancient European HSV-1 genomes and one partial genome, dating to the 3rd-17th century CE, sequenced to up to 9.5× with paired human genomes up to 10.16×. Considering a dataset of modern and ancient genomes we apply phylogenetic methods to estimate the age of sampled modern Eurasian HSV-1 diversity to 4.68 (3.87 - 5.65) kya. Extrapolation of estimated rates to a global dataset points to the age of extant sampled HSV-1 as 5.29 (4.60-6.12) kya, suggesting HSV-1 lineage replacement coinciding with the late Neolithic period and following Bronze Age migrations.

Funder: Darwin College, University of Cambridge; Id: http://dx.doi.org/10.13039/501100000595, During a salvage excavation conducted by the Israel Antiquities Authority, a mass grave containing the skeletal remains from 124 individuals, many with evidence of weapon injuries, was discovered in a water cistern outside the Old City of Jerusalem. Radiocarbon dates derived from human bone and the date of the material finds suggest the skeletal remains date to the end of the 2nd century or the beginning of the 1st century BCE. The aim of this research is to analyze the weapon injuries in order to reconstruct the nature and context of this violence. The human skeletal remains from 23 individuals recovered from the cistern were selectively retained and examined macroscopically in a laboratory setting. Silicone casts of selected weapon injuries (n = 5) were analyzed using scanning electron microscopy. Numerous examples of peri‐mortem blunt‐ and sharp‐force trauma were observed including evidence that at least 16 individuals were decapitated. The extent and nature of the observed injuries as well as the evidence of their haphazard deposition into the cistern suggest that these individuals were the victims of a massacre. As a highly visible act of violence, massacres are often used as a mechanism for social control. When contextualized, this skeletal assemblage is most likely evidence of a massacre that occurred during the reign of the Hasmonean king Alexander Jannaeus. This is the first archeological evidence for the use of socially sanctioned violence to legitimize the Hasmonean state and to maintain social control at the end of the 2nd century–early 1st century BCE.