Back-to-back: The co-occurrence of DISH and ankylosing spondylitis from early modern Poland.

OBJECTIVE: This case study evaluates an individual with skeletal changes consistent with DISH and ankylosing spondylitis. We present here an evaluation of the individual's pathological skeletal changes and a review of the potential diagnoses. Finally, we offer a differential diagnosis of co-morbidity infrequently found in the paleopathological record. MATERIALS: The skeletal remains of a male, aged 50 + years from the early modern Polish (17th-18th century CE) site of Drawsko 1. METHODS: Skeletal remains were examined for the presence of spondyloarthropathies. RESULTS: The individual presented with anterolateral fusion of the vertebral bodies of T6-T10 with a "dripping candle wax" appearance, fusion of the right costovertebral joint at rib 8, fusion of the left apophyseal joints of T8-T10, and the calcification of the supraspinous ligament at T3-T4. The left sacroiliac joint shows intra-articular and para-articular fusion; the right has bony changes consistent with ongoing fusion. Entheseal reactions were noted on the left clavicle, scapulae, first metacarpals, ulnae, and humerii. Diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis (AS), reactive arthritis (RA), psoriatic arthritis (PA), and enteropathic arthritis (EA) are considered as differential diagnoses. CONCLUSIONS: Based on the skeletal pattern of involvement, the individual suffered from both DISH and AS, which has previously been reported once in the paleopathological literature since 1950. The clinical literature indicates that co-occurrence of these two conditions is possible, with approximately 40 individuals affected. SIGNIFICANCE: This case study is significant for demonstrating the co-occurrence of DISH and AS in the paleopathological record. Additionally, this case contributes to the understanding of heterogenous frailty and syndemics. LIMITATIONS: No radiographs were taken to confirm the differential diagnosis. No aDNA analysis was conducted. SUGGESTIONS FOR FURTHER RESEARCH: The remains have been reburied; no further analysis is possible.

Toward a bioarchaeology of urbanization: Demography, health, and behavior in cities in the past.

Urbanization is one of the most important settlement shifts in human history and has been the focus of research within bioarchaeology for decades. However, there have been limited attempts to synthesize the results of these studies in order to gain a broader perspective on whether or how urbanization affects the biology, demography, and behavior of humans, and how these potential effects are embodied in the human skeleton. This paper outlines how bioarchaeology is well-suited to examine urbanization in the past, and we provide an overview and examples of three main ways in which urbanization is studied in bioarchaeological research: comparison of (often contemporaneous) urban and rural sites, synchronic studies of the variation that exists within and between urban sites, and investigations of changes that occur within urban sites over time. Studies of urbanization, both within bioarchaeology and in other fields of study, face a number of limitations, including a lack of a consensus regarding what urban and urbanization mean, the assumed dichotomous nature of urban versus rural settlements, the supposition that urbanization is universally bad for people, and the assumption (at least in practice) of homogeneity within urban and rural populations. Bioarchaeologists can address these limitations by utilizing a wide array of data and methods, and the studies described here collectively demonstrate the complex, nuanced, and highly variable effects of urbanization.

A singular case of advanced caries sicca in a pre-Columbian skull from East Tennessee.

OBJECTIVE: Documentation of an advanced case of tertiary stage treponemal disease. MATERIALS: The well-preserved cranium and mandible of an adult male (Burial G) from the Early Woodland period (900 BCE-200 CE) Wilhoite site (40GN10) from east Tennessee. METHODS: Macroscopic examination of the cranio-facial periostosis on Burial G for pathognomonic indicators of treponemal disease. RESULTS: There are extensive contiguous nodular lesions on the frontal, parietals, temporals, and occipital bones. The frontal squama additionally exhibits radial scaring and circumvallate cavitating lesions. Radial scars are also present on both zygomatic bones and the endocranial surface of the calotte. There is rounding of the nasal margins in addition to periostosis on the palate. CONCLUSIONS: Burial G unequivocally exhibits the pathognomonic reactive changes of caries sicca, radial scarring, and cavitating lesions. SIGNIFICANCE: The Early Woodland date in combination with the advanced degree of pathognomonic reactive change is exceptional, and to date, without parallel in the pre-Columbian archaeological record of North America. Any case approaching the severity displayed here is invariably late prehistoric. LIMITATIONS: The absence of postcrania does not permit assessment of frailty or synergism of secondary conditions. SUGGESTIONS FOR FURTHER RESEARCH: More comprehensive documentation of pre-Columbian treponemal cases is merited.

Trends in mortality and biological stress in a medieval polish urban population.

Urbanization in pre-modern populations may have had a variety of consequences related to population crowding. However, research on the effects of urbanization have provided inconsistent results regarding the biological impact of this transition on human populations. The purpose of this study is to test the hypothesis that urbanization caused an increase in overall biological stress in a medieval (10th-13th centuries AD) Polish population. A human skeletal sample (n=164) was examined for the presence of porotic hyperostosis, cribra orbitalia, linear enamel hypoplasia, periosteal reaction, and specific infectious diseases. Prevalence rates were compared among three temporal samples: initial urbanization, early urbanization, and later urbanization. Results indicate no significant trends for any of the pathological conditions. Cox proportional hazards analyses, however, revealed a significant increase in the risk of death over time, which supports the hypothesis. These results reflect the necessity of using multiple analyses to address bioarchaeological questions. The lack of significant results from skeletal indicators may be due to an earlier urbanization trend in the population. This study illustrates that the association of urbanization with elevated biological stress is complicated and dependent on various factors, including culture and time period.

Deviant burials and social identity in a postmedieval Polish cemetery: An analysis of stable oxygen and carbon isotopes from the "vampires" of Drawsko.

OBJECTIVES: Deviant burials can reveal important information about both social and individual identity, particularly when the mortuary record is supplemented by an examination of skeletal remains. At the postmedieval (17th to 18th c. AD) cemetery of Drawsko (Site 1), Poland, six individuals (of n = 285) received deviant, anti-vampiristic mortuary treatment. A previous study using radiogenic strontium isotope ratios ( x¯= 0.7112 ± 0.0006, 1σ, n = 60) found that these "vampires" were in fact locals, not migrants to the region targeted for deviant burial due to their status as immigrant outsiders. However, considerable geologic overlap in strontium isotope ratios across the North European Plain may have masked the identification of at least some nonlocal individuals. This study further contextualizes strontium isotope ratios using additional biogeochemical data to test the hypothesis that additional nonlocals were present in the Drawsko cemetery. METHODS: Stable oxygen and carbon isotopes from the dental enamel of 58 individuals interred in both normative and atypical burials at Drawsko were analyzed. RESULTS: Both δ18 Oc(VPDB) ( x¯= -4.5 ± 0.7‰) and δ13 Cap isotope values ( x¯= -13.6 ± 0.8‰) displayed little variability and were not significantly different between vampire and normative burials, supporting prior strontium results of a largely local population. Nevertheless, homogeneity in oxygen isotope values across other northern European sites makes it difficult to speculate about isotopic regional diversity, leaving open the possibility that additional migrants to the region remain undetected. Additionally, carbon isotope values point to a locally sourced diet dominated by C3 resources but with some supplementation by C4 goods that likely included millet, fitting with historic descriptions of postmedieval diet in Poland. CONCLUSIONS: Those interred as vampires appear local to the region and thus likely underwent deviant funerary treatment due to some other social stigma not apparent from the skeleton.

Post-Cranial Traumatic Injury Patterns in Two Medieval Polish Populations: The Effects of Lifestyle Differences.

Traumatic injuries can be used as general indicators of activity patterns in past populations. This study tests the hypothesis that contemporaneous (10th-12th century) rural and urban populations in medieval Poland will have a significantly different prevalence of non-violent fractures. Traumatic injuries to the post-cranial skeleton were recorded for 180 adults from rural Giecz and for 96 adults from urban Poznan-Sródka. They were statistically analyzed by body region and individual skeletal element. Results reveal that Giecz had a significantly higher rate of trunk fractures than Poznan-Sródka (Fisher's exact, p<0.05). In particular, rib and vertebral fractures were more common in Giecz males and females than in their Poznan-Sródka counterparts. Traumatic injuries in the extremities were comparable between the two samples, suggesting similar risks of trauma to these regions. These results indicate that in early medieval Poland, activities associated with a rural lifestyle resulted in more injuries. These stress or accidental fractures, which are related to a high-risk setting, were not consistent with an urban lifestyle. Overall, agricultural populations like Giecz were engaged in a laborious lifestyle, reflected in a variety of injuries related to repetitive, high-risk activities. Although urban populations like Poznan engaged in craft specialization participated in repetitive activities, their lifestyle resulted in lesser fracture-risk.

Apotropaic practices and the undead: a biogeochemical assessment of deviant burials in post-medieval poland.

Apotropaic observances-traditional practices intended to prevent evil-were not uncommon in post-medieval Poland, and included specific treatment of the dead for those considered at risk for becoming vampires. Excavations at the Drawsko 1 cemetery (17th-18th c. AD) have revealed multiple examples (n = 6) of such deviant burials amidst hundreds of normative interments. While historic records describe the many potential reasons why some were more susceptible to vampirism than others, no study has attempted to discern differences in social identity between individuals within standard and deviant burials using biogeochemical analyses of human skeletal remains. The hypothesis that the individuals selected for apotropaic burial rites were non-local immigrants whose geographic origins differed from the local community was tested using radiogenic strontium isotope ratios from archaeological dental enamel. 87Sr/86Sr ratios ( = 0.7112±0.0006, 1σ) from the permanent molars of 60 individuals reflect a predominantly local population, with all individuals interred as potential vampires exhibiting local strontium isotope ratios. These data indicate that those targeted for apotropaic practices were not migrants to the region, but instead, represented local individuals whose social identity or manner of death marked them with suspicion in some other way. Cholera epidemics that swept across much of Eastern Europe during the 17th century may provide one alternate explanation as to the reason behind these apotropaic mortuary customs, as the first person to die from an infectious disease outbreak was presumed more likely to return from the dead as a vampire.

Diffuse idiopathic skeletal hyperostosis (DISH) in pre-Columbian North America: Evidence from the eastern Tennessee River Valley.

Diffuse idiopathic skeletal hyperostosis (DISH or Forestier's disease) is a pathological condition of unknown etiology characterized by the exuberant antero-lateral flowing ('dripping candle wax') ossification of the anterior spinal ligaments. Clinical data indicate it is a progressive male-predilected pathology manifested in middle age, which steeply rises in prevalence after aged 60. It has become paleopathologically relevant because it has been clinically associated with an affluent lifestyle. Archeological examination of the prevalence of DISH is often undertaken on European samples and frequently in monastic contexts. There are no prevalence data for pre-Columbian samples from North America. The present study establishes baseline information from four prehistoric Late Mississippian period (AD 1300-1600) samples (N=389) from the upper Tennessee River Valley. Two probable cases and one possible case of DISH (all male) are identified, reflecting less than one percent of the adult sample, and 1.2 percent (2/172) of males. The low prevalence compared to European monastic samples and non-New World cemetery contexts suggests socioeconomic or interpopulational genetic differences that may be tested with subsistence and community health-status controlled osteoarchaeological comparisons within and outside of North America.

Differential visibility of treponemal disease in pre-Columbian stratified societies: does rank matter?

Treponemal disease is known to be associated with the compromised community health of permanent village settlement. This association explains its high visibility in the village-based, arguably chiefdom level, agriculturalist societies of late prehistoric (AD 1300-1600) North America. Within chiefdom-level societies, health differences have often been demonstrated between mortuary-defined "elite" and "nonelite" individuals. This theoretically should predict status-based differences in treponemal disease visibility. The prediction is tested in a five-site osteological sample (N = 650) from the Dallas phase (AD 1300-1550), a simple mortuary-defined two-tiered presumptive chiefdom level maize agriculturalist socioeconomic context from lower east Tennessee. The Dallas phase results affirm a general pre-Colombian North American pattern of no sex differences and display comparable adult to subadult frequencies. The study also reveals that given a sufficient sample size, "elites" do indeed exhibit a significantly lower frequency of tertiary stage treponemal disease. This can be attributed to better baseline health, which has been previously demonstrated in this sample. It may also be affected by the mortuary inclusion of achieved status individuals whose good health may have facilitated sociopolitical advancement. Another pattern that emerged is an apparent young adult age bias in disease visibility. This suggests that tertiary treponemal disease morbidity may either directly or synergistically factor in early adult age at death. Future research will address the veracity of this association.

Model of tooth morphogenesis predicts carabelli cusp expression, size, and symmetry in humans.

BACKGROUND: The patterning cascade model of tooth morphogenesis accounts for shape development through the interaction of a small number of genes. In the model, gene expression both directs development and is controlled by the shape of developing teeth. Enamel knots (zones of nonproliferating epithelium) mark the future sites of cusps. In order to form, a new enamel knot must escape the inhibitory fields surrounding other enamel knots before crown components become spatially fixed as morphogenesis ceases. Because cusp location on a fully formed tooth reflects enamel knot placement and tooth size is limited by the cessation of morphogenesis, the model predicts that cusp expression varies with intercusp spacing relative to tooth size. Although previous studies in humans have supported the model's implications, here we directly test the model's predictions for the expression, size, and symmetry of Carabelli cusp, a variation present in many human populations. METHODOLOGY/PRINCIPAL FINDINGS: In a dental cast sample of upper first molars (M1s) (187 rights, 189 lefts, and 185 antimeric pairs), we measured tooth area and intercusp distances with a Hirox digital microscope. We assessed Carabelli expression quantitatively as an area in a subsample and qualitatively using two typological schemes in the full sample. As predicted, low relative intercusp distance is associated with Carabelli expression in both right and left samples using either qualitative or quantitative measures. Furthermore, asymmetry in Carabelli area is associated with asymmetry in relative intercusp spacing. CONCLUSIONS/SIGNIFICANCE: These findings support the model's predictions for Carabelli cusp expression both across and within individuals. By comparing right-left pairs of the same individual, our data show that small variations in developmental timing or spacing of enamel knots can influence cusp pattern independently of genotype. Our findings suggest that during evolution new cusps may first appear as a result of small changes in the spacing of enamel knots relative to crown size.

Dental crown size and sex hormone concentrations: another look at the development of sexual dimorphism.

Previous researchers hypothesized that tooth types forming during early childhood should be less sexually dimorphic than those forming during later childhood, if sex hormone concentration differences between males and females increase progressively throughout childhood and can affect tooth size. Descriptive tooth size data have recently been cited in support of this hypothesis, particularly with respect to differences in sexual dimorphism among the tooth types of tooth classes. The present study tests this hypothesis for the mesiodistal dimension of human permanent teeth using published data for incisor, premolar, and molar tooth classes from seven diverse populations. The sample size for each tooth type per population was at least 50. This study also tests a modification of this hypothesis which takes into account the postnatal testosterone surge in males and the low levels of sex hormones in both sexes prior to puberty. Predictions are developed for both the original and modified hypotheses. The "D" statistic, the total area of nonoverlap between the phenotypic distributions of males and females, is used to quantify sexual dimorphism. Comparison of D values for different tooth types within tooth classes across these seven populations does not strongly support either hypothesis. These results suggest that gross changes in sex hormone concentrations during development are not related to population-wide patterns of sexual dimorphism among the tooth types of human permanent tooth classes, as recent studies indicate. This finding is consistent with other studies which suggest that sex hormones have only a minor role in generating crown size sexual dimorphism.