Twenty-first century bioarchaeology: Taking stock and moving forward.

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.

Evaluating life history trade-offs through the presence of linear enamel hypoplasia at Pueblo Bonito and Hawikku: A biocultural study of early life stress and survival in the Ancestral Pueblo Southwest.

OBJECTIVES: Due to the indelible nature of enamel, bioarchaeologists use linear enamel hypoplasia (LEH) to detect early investments in surviving stress and have identified an association between LEH presence and constraints in growth and maintenance as well as an increased susceptibility to future stress events. This study evaluates heterogenous frailty and susceptibility to death in relation to episodes of early life stress, as reflected by LEH presence, in the Ancestral Pueblo Southwest. This study hypothesizes that LEH presence will be associated with decreased survivorship and an increased likelihood of mortality in both samples. MATERIALS AND METHODS: This study uses two samples, one from Pueblo Bonito (A.D. 800-1200; n = 28) and the second from Hawikku (A.D. 1300-1680; n = 103). Kaplan-Meier survival analysis with a log-rank test was used to evaluate the effect of LEH presence on survivorship for the two samples. RESULTS: Survival analysis reveals statistically significant differences in mortality risk between individuals with and without LEH for the Hawikku sample, but no significant differences for the Pueblo Bonito sample. CONCLUSION: The results demonstrate differences in the response to early life stress at the Hawikku and Pueblo Bonito sites, likely reflecting context. The Pueblo Bonito sample represents a high-status group, and survival following LEH may be the result of cultural buffering. Hawikku dates to a period associated with increased levels of disease and malnutrition as well as Spanish colonization. This environment may have exacerbated mortality risk for individuals in the region who survived early life stress and signifies the consequences of European colonialism in the New World.

An introduction to advances in Andean South American paleopathology.

In the 20 years since the publication of John Verano's foundational paper "Advances in Paleopathology of Andean South America," paleopathological and bioarchaeological investigations of human skeletal remains in the region have increased dramatically. Today, primary foci have grown to span the identification of disease, detailed reconstructions of biocultural interactions, embodied social experiences, and ancient living worlds. In this special issue, more than a dozen scholars reflect on the state of developments in the scientific analyses of ancient disease, life, and society across the region. For this introductory article, we frame the current state of Andean paleopathology by reviewing key historical contributions beginning in the last century. More recent trends since 1997 are defined via a meta-analysis of the literature. We then highlight current innovations and consider future directions of study. We then close with an overview of the papers comprising this special issue. Each article explores major theoretical, topical, and methodological advances that have transpired since 1997 and charts the course for the next two decades of work - with implications and insights that transcend the Andes and speak to key paleopathological issues around the world.

Metabolic diseases in Andean paleopathology: Retrospect and prospect.

John Verano's 1997 synthesis of Andean paleopathology guided two decades of research and was instrumental in establishing modern Andean paleopathology. This paper reviews the current state and new directions in the study of skeletal metabolic disorders in the Central Andean archaeological record. Key historical, ecological, methodological, and contextual issues intersect with the study of metabolic bone diseases in Andean paleopathology. This paper further examines known temporal and spatial distribution of these disorders, as well as the strengths and weaknesses of the record of linear enamel hypoplasias, cribra orbitalia, porotic hyperostosis, scurvy, and rickets. Many other metabolic bone diseases have yet to be documented such as pellagra, hypophosphatasia, osteomalacia, and mucopolysaccharidosis among others. This work closes with considerations in the search for these undocumented diseases, but such an effort is only one part of new wave of advancements just on the horizon. The study of metabolic diseases in Andean paleopathology can lead the development of more sophisticated approaches to data collection, analysis, and interpretation - especially regarding theoretical interpretations from various bodies of social theory to the Developmental Origins of Health and Disease hypothesis, life history approaches, and phenotypic adaptive plasticity and constraint.

Crypt fenestration enamel defects and early life stress: Contextual explorations of growth and mortality in Colonial Peru.

OBJECTIVES: This study provides a comprehensive analysis of crypt fenestration enamel defects (CFEDs) from the Eten and Mórrope communities, Colonial period (A.D. 1,530-1,750), Lambayeque Valley, Peru. The goal is to help clarify the role of these lesions as reflections of early life environments as well as relationships growth and survival at future ages. MATERIALS AND METHODS: CFED absence/presence was recorded in the mandibular canines of 105 individuals and 202 teeth. Defect prevalence was compared between the Eten and Mórrope sites using a proportions test. Femoral growth residuals were compared between CFED present and absent samples. Mortality risk was evaluated using Kaplan-Meier survival analysis. RESULTS: CFED frequencies at Eten and Mórrope were similar to previous studies. Greater frequencies of CFEDs were found at Eten compared to Mórrope. There was no association between skeletal growth and CFEDs. No differences in mortality were found between CFED present and absent individuals within each site. General survivorship at Eten was significantly greater than Mórrope. However, individuals without CFEDs at Eten had greater survivorship than those with and without CFEDs at Mórrope. Individuals with CFEDs at Eten had greater survivorship than those with CFEDs at Mórrope. These differences begin around 1.7 years. CONCLUSIONS: CFEDs may be associated with stress experience, but associations with growth and survivorship at later ages is context dependent. CFED prevalence is an ambiguous indicator of stress when used in the absence of mortality data, and even under those circumstances, appears limited by differences in local demography.

Possible prostate cancer in northern Peru: Differential diagnosis, vascular anatomy, and molecular signaling in the paleopathology of metastatic bone disease.

This paper describes four possible cases of metastasized prostate cancer in archaeological human skeletons from the north coast of Peru spanning the Middle Sicán to Colonial eras (roughly A.D. 900-1600). Varying combinations of exuberant abnormal new bone formation and some abnormal bone loss affecting lumbar vertebrae and the bony sacrum were observed in these individuals. Detailed lesion descriptions are followed by a differential diagnosis that systematically eliminates pseudopathology, infectious diseases, sclerosing bone disorders, and most metastatic processes. However, metastasized prostate cancer cannot be rejected and is highly consistent with the observed lesions. Metastasized pancreatic, bladder, or carcinoid tumors represent additional, though far less likely, diagnostic options. Anatomical and molecular signaling factors further validate this differential diagnosis. The paravertebral venous plexus of Baston plays an anatomical role in the metastatic seeding of lumbar vertebra from prostate cancer. Further, abundant molecular signaling mechanisms upregulate multiple bone-forming mechanisms in prostate metastases, though initially such lesions may originate as lytic phenomena. These multiple lines of evidence help demonstrate a multi-level framework for explanation in paleopathology and especially to help better elucidate the complexities of ancient neoplastic diseases.

Paleopathological rigor and differential diagnosis: Case studies involving terminology, description, and diagnostic frameworks for scurvy in skeletal remains.

Diverse pathological processes can produce overlapping or even indistinguishable patterns of abnormal bone formation or destruction, representing a fundamental challenge in the understanding of ancient diseases. This paper discusses increasing rigor in differential diagnosis through the paleopathological study of scurvy. First, paleopathology's use of descriptive terminology can strive to more thoroughly incorporate international standards of anatomical terminology. Second, improved observation and description of abnormal skeletal features can help distinguish between anemia or vitamin C deficiency. Third, use of a structured rubric can assist in establishing a more systematic, replicable, and precise decision-making process in differential diagnosis. These issues are illustrated in the study of two new cases of suspected scurvy from northern Peru. From this, it appears possible that ectocranial vascular impressions may further examined as a morphological marker of scurvy in the skeleton. Also, increased paleopathological attention to pellagra is long overdue, especially as it may produce generally comparable lesions to scurvy. This paper reflexively speaks to the process of paleopathological problem solving and the epistemology of our discipline-particularly regarding the ways in which we can continuously improve description and the construction of diagnostic arguments.

Frontiers in the bioarchaeology of stress and disease: cross-disciplinary perspectives from pathophysiology, human biology, and epidemiology.

Over the last four decades, bioarchaeology has experienced significant technical growth and theoretical maturation. Early 21st century bioarchaeology may also be enhanced from a renewed engagement with the concept of biological stress. New insights on biological stress and disease can be gained from cross-disciplinary perspectives regarding human skeletal variation and disease. First, pathophysiologic and molecular signaling mechanisms can provide more precise understandings regarding formation of pathological phenotypes in bone. Using periosteal new bone formation as an example, various mechanisms and pathways are explored in which new bone can be formed under conditions of biological stress, particularly in bone microenvironments that involve inflammatory changes. Second, insights from human biology are examined regarding some epigenetic factors and disease etiology. While epigenetic effects on stress and disease outcomes appear profoundly influential, they are mostly invisible in skeletal tissue. However, some indirect and downstream effects, such as the developmental origins of adult health outcomes, may be partially observable in bioarchaeological data. Emerging perspectives from the human microbiome are also considered. Microbiomics involves a remarkable potential to understand ancient biology, disease, and stress. Third, tools from epidemiology are examined that may aid bioarchaeologists to better cope with some of the inherent limitations of skeletal samples to better measure and quantify the expressions of skeletal stress markers. Such cross-disciplinary synergisms hopefully will promote more complete understandings of health and stress in bioarchaeological science.

Subadult scurvy in Andean South America: Evidence of vitamin C deficiency in the late pre-Hispanic and Colonial Lambayeque Valley, Peru.

Scurvy is a disease caused by vitamin C deficiency and is a key paleopathological indicator of subadult health and nutritional status in the past. Yet, little is known about scurvy in human remains from South America and the Peruvian Central Andes in particular. In the Lambayeque Valley Complex on the north coast of Peru, a sample of 641 archaeologically recovered subadults (A.D. 900-1750) were scored for the skeletal manifestations of vitamin C deficiency, testing the hypotheses that scurvy was common in this region and that prevalence increased following European contact. The findings reveal only five convincing cases of scurvy; overall prevalence appears extremely low, and scurvy did not become perceptibly more common following conquest. Of diagnostic interest, complex ectocranial vascular impressions were documented in two cases. Though rarely attributed to scurvy, examination suggests they formed during scorbutic episodes. Another Colonial Period subadult may demonstrate comorbidity between scurvy and rickets. This work also provides new questions for the investigation of scurvy in Andean South America.

Treponemal infection in Peru's Early Colonial period: A case of complex lesion patterning and unusual funerary treatment.

This study describes a series of skeletal lesions observed in a mid 16th century individual of an old adult female from the Early Colonial Period of northern coastal Peru. This fragmented skeleton revealed evidence of complex, active, and systemic chronic infection that included multiple pathological foci on the cranial vault, extensive pathological new bone formation in both arms, the sternum, ribs, left scapula, clavicles, femora, and fibulae, which was paralleled by extensive endosteal obliteration of affected long bone medullary cavities. Differential diagnosis included hematogenous osteomyelitis, Paget's disease, fluorosis, melorheostosis, endosteal hyperostosis, and hypertrophic osteoarthropathy. Simultaneous periosteal and endosteal bone deposition of the clavicles, in addition to patterns of florid bone deposition on long bones and superficial cavitation, point most directly to treponemal disease. Co-morbidity with a non-specified respiratory disease and well-healed fractures of the tibiae are also considered. We also relate this person's illness to the highly informal disposal of their body to underscore how social perceptions of disease may have shaped this unusual and informal funerary ritual. Ultimately, this research cautions against overly "tibia-centric" thinking regarding treponemal syndromes, raises questions regarding the history and nature of treponemal disease in Peru, and highlights cross-disciplinary connections between paleopathology and mortuary archaeology.

The variable roads to sacrifice: Isotopic investigations of human remains from Chotuna-Huaca de los Sacrificios, Lambayeque, Peru.

This study investigates two key variables-residential context and subsistence-among sacrificial victims dating to the Late Horizon (A.D. 1450-1532) in the Huaca de los Sacrificios at the Chotuna-Chornancap Archaeological Complex in north coastal Peru. We investigate whether aspects of sacrifice in this distant coastal province mirrored that found in Inca heartland contexts such as the capacocha, or remained more typical of coastal sacrificial traditions. Stable carbon, nitrogen, and oxygen isotope values were characterized in bone carbonate, bone collagen, and hair keratin to estimate geographic residence during the decade before death and diet in the decade, versus months, before death. Bone δ18 Ocarbonate values have a mean (±SD) of 26.8 ± 1.1%, bone δ13 Ccarbonate values -6.7 ± 1.7%, and bone δ(13) Ccollagen values 11.8 ± 1.3%; bone δ15 Ncollagen values have a mean of 11.5 ± 1.3%. Combined hair δ13 Ckeratin values have a mean of -12.8 ± 1.6%, and hair δ15 Nkeratin values 10.8 ± 1.3%. In contrast to contemporaneous coastal and highland contexts, we are unable to identify immigrants among the sacrificed individuals or changes in diet that indicate provisioning with a standardized diet leading up to death. Instead, results suggest that victims were local to the area, but consumed moderately variable diets consistent with local subsistence patterns. These findings suggest a distinct pattern of human sacrifice in the Late Horizon and underscore the regional and temporal variation in sacrificial practices in the central Andes.

Paleopathology of an ovarian teratoma: Description and diagnosis of an exotic abdominal bone and tooth mass in a historic Peruvian burial.

Neoplasms are among the most rarely described categories of skeletal abnormalities in paleopathology, and of these, bone- and tooth-forming ovarian teratomas may represent the most extraordinary and exotic. In this case study, we examine a bone and tooth mass found in an Early Colonial period burial from Eten, Peru. We document a complex array of 83 bony and 37 dental elements in the abdominal cavity of an adolescent female individual. The bones possess unclassifiable and non-functional morphologies, while the teeth tended to resemble incisors, canines, premolars, and molars but were more bulbous, smaller in size, and irregularly mineralized. We examine various differential diagnoses, including ectopic pregnancy, fetus in fetu or parasitic twin, lithopedia, and ovarian teratoma. We can confidently rule out the former three options, and the evidence is highly concordant with expectations of a mature ovarian teratoma. We also discuss a range of paleopathological and archaeological considerations for the identification, recovery, analysis, and prevalence of these distinctive neoplasms that are virtually unknown in the paleopathological literature.

Oral health and the postcontact adaptive transition: A contextual reconstruction of diet in Mórrope, Peru.

This work explores the effects of European contact on Andean foodways in the Lambayeque Valley Complex, north coast Peru. We test the hypothesis that Spanish colonization negatively impacted indigenous diet. Diachronic relationships of oral health were examined from the dentitions of 203 late-pre-Hispanic and 175 colonial-period Mochica individuals from Mórrope, Lambayeque, to include observations of dental caries, antemortem tooth loss, alveolar inflammation, dental calculus, periodontitis, and dental wear. G-tests and odds ratio analyses across six age classes indicate a range of statistically significant postcontact increases in dental caries, antemortem tooth loss, and dental calculus prevalence. These findings are associated with ethnohistoric contexts that point to colonial-era economic reorganization which restricted access to multiple traditional food sources. We infer that oral health changes reflect creative Mochica cultural adjustments to dietary shortfalls through the consumption of a greater proportion of dietary carbohydrates. Simultaneously, independent skeletal indicators of biological stress suggest that these adjustments bore a cost in increased nutritional stress. Oral health appears to have been systematically worse among colonial women. We rule out an underlying biological cause (female fertility variation) and suggest that the establishment of European gender ideologies and divisions of labor possibly exposed colonial Mochica women to a more cariogenic diet. Overall, dietary change in Mórrope appears shaped by local responses to a convergence of colonial Spanish economic agendas, landscape transformation, and social changes during the postcontact transition in northern Peru. These findings also further the understandings of dietary and biocultural histories of the Western Hemisphere.

Economic intensification and degenerative joint disease: life and labor on the postcontact north coast of Peru.

This study tests the hypothesis that the colonial economy of the Lambayeque region of northern coastal Peru was associated with a mechanically strenuous lifestyle among the indigenous Mochica population. To test the hypothesis, we documented the changes in the prevalence of degenerative joint disease (or DJD) in human remains from the late pre-Hispanic and colonial Lambayeque Valley Complex. Comparisons were made using multivariate odds ratios calculated across four age classes and 11 principle joint systems corresponding to 113 late pre-Hispanic and 139 postcontact adult Mochica individuals. Statistically significant patterns of elevated postcontact DJD prevalence are observed in the joint systems of the shoulder, elbow, wrist, and knee. More finely grained comparison between temporal phases indicates that increases in prevalence were focused immediately following contact in the Early/Middle Colonial period. Analysis of DJD by sex indicates postcontact males experienced greater DJD prevalence than females. Also, trends between pre- and postcontact females indicate nearly universally elevated DJD prevalence among native colonial women. Inferred altered behavioral uses of the upper body and knee are contextualized within ecological, ethnohistoric, and ethnoarchaeological frameworks and appear highly consistent with descriptions of the local postcontact economy. These patterns of DJD appear to stem from a synergism of broad, hemispheric level sociopolitical alterations, specific changes to Mochica activity and behavior, regional economic intensification, and local microenvironmental characteristics, which were all focused into these biological outcomes by the operation of a colonial Spanish political economy on the north coast of Peru from A.D. 1536 to 1751.

Contact in the Andes: bioarchaeology of systemic stress in colonial Mórrope, Peru.

The biocultural interchange between the Eastern and Western Hemispheres beginning in the late fifteenth century initiated an unprecedented adaptive transition for Native Americans. This article presents findings from the initial population biological study of contact in the Central Andes of Peru using human skeletal remains. We test the hypothesis that as a consequence of Spanish colonization, the indigenous Mochica population of Mórrope on the north coast of Peru experienced elevated systemic biological stress. Using multivariate statistical methods, we examine childhood stress reflected in the prevalence of linear enamel hypoplasias and porotic hyperostosis, femoral growth velocity, and terminal adult stature. Nonspecific periosteal infection prevalence and D(30+)/D(5+) ratio estimations of female fertility characterized adult systemic stress. Compared to the late pre-Hispanic population, statistically significant patterns of increased porotic hyperostosis and periosteal inflammation, subadult growth faltering, and depressed female fertility indicate elevated postcontact stress among both children and adults in Mórrope. Terminal adult stature was unchanged. A significant decrease in linear enamel hypoplasia prevalence may not indicate improved health, but reflect effects of high-mortality epidemic disease. Various lines of physiological, archaeological, and ethnohistoric evidence point to specific socioeconomic and microenvironmental factors that shaped these outcomes, but the effects of postcontact population aggregation in this colonial town likely played a fundamental role in increased morbidity. These results inform a model of postcontact coastal Andean health outcomes on local and regional scales and contribute to expanding understandings of the diversity of indigenous biological variation in the postcontact Western Hemisphere.