A rare case of calvarial tuberculosis from the Avar Age (8th century CE) cemetery of Kaba-Bitózug (Hajdú-Bihar county, Hungary) - Pathogenesis and differential diagnostic aspects.

The aim of our paper is to present and discuss in detail the bony changes indicative of tuberculosis (TB) that were identified in a skeleton (KB67), unearthed from grave 67 of the 8th-century-CE cemetery of Kaba-Bitózug (Hungary). Furthermore, to provide the differential diagnoses of the observed alterations, with special attention to the cranial osteolytic lesions. During the macro- and micromorphological examinations of KB67, the skull revealed three small, well-circumscribed, punched-out osteolytic lesions accompanied by endocranial granular impressions, abnormal blood vessel impressions, periosteal appositions, and cortical erosion. The postcranial skeleton exhibited osteolytic lesions, cortical remodelling and erosion, and signs of hypervascularisation in the spine. Based on the differential diagnosis of the cranial osteolytic lesions and their co-occurrence with endocranial and vertebral bony changes indicative of TB, they most likely resulted from tuberculous involvement of the frontal and left parietal bones. The morphologically established diagnosis was confirmed by a PCR analysis that provided evidence for the presence of Mycobacterium tuberculosis DNA in KB67. KB67, the first reported archaeological case with calvarial TB from the present-day territory of Hungary, gives us a unique insight into the occurrence of a rare manifestation of TB in the Avar Age of the Great Plain.

Technical note: A novel method for gentle and non-destructive removal of flesh from bones.

For bone preparation, several maceration techniques are available; however, gentle defleshing and soft tissue removal from bones without damaging the bone surface remains a challenge. The study aims to develop a novel, inexpensive, rapid, and resource-saving maceration technique that does not lead to bone surface changes and allows the study of signs of violence on the bone surface. Pig ribs and femurs were covered in aluminum foil and treated in the oven for 5 h at different temperatures with and without detergent. Additionally, femurs were placed in hot non-boiling water containing household bleach and detergents for 1 h. Examinations using macro photography, stereo and fluorescence microscopy, and micro-computed tomography showed no surface changes after treatment at 100 °C, such as flakes or bone cracks, on the ribs. The femurs showed surface changes after incubation in water, such as roughening.

Challenging definitions and diagnostic approaches for ancient rare diseases: The case of poliomyelitis.

OBJECTIVE: This paper aims to contribute to the definition of ancient rare diseases in skeletons displaying pathologies associated with paralysis. It uses a new suite of methods, which can be applied to challenging cases of possible paralysis in archaeologically-derived human skeletal material, specifically applied to the identification of poliomyelitis. MATERIALS: An adult male skeleton from Roman Halbturn, Austria. METHODS: Morphological and entheseal change analyses, CT scans, X-rays, cross-section morphology, and histology, alongside modern clinical, as well as historic, literature were used to discuss paralyses. RESULTS: The results suggest a diagnosis of poliomyelitis; now considered a rare disease, but perhaps ubiquitous in antiquity, thus complicating the definition of 'rare disease'. CONCLUSIONS: The integrated methodological procedures employed for this case constitutes a replicable and thorough approach to diagnosis, and explores the nature of ancient rare diseases. Due to the socio-environmental aspects of poliomyelitis transmission, it is likely that polio was likely not rare in the past. Therefore, the definition of 'rare diseases in the past' must include rarely occurring rarely diagnosed diseases due to biases and challenges within the archaeological and environmental record. SIGNIFICANCE: The developed suite of methods has not been applied to establish a diagnosis of polio in the past. LIMITATIONS: The individual considered in this study is fairly well-preserved; thus, this set of analyses may not be applicable to all remains where preservation is poor or highly fragmentary, and the discussion of rare diseases requires relatively secure diagnoses and context. SUGGESTIONS FOR FURTHER RESEARCH: Large collections and series of skeletal human remains are recommended to develop definitive conclusions.

Can we refine body mass estimations based on femoral head breadth?

Femoral head breadth is widely used in body mass estimation in biological anthropology. Earlier research has demonstrated that reduced major axis (RMA) equations perform better than least squares (LS) equations. Although a simple RMA equation to estimate body size from femoral head breadth is sufficient in most cases, our experiments with male skeletons from European data (including late Pleistocene and Holocene skeletal samples) and the Forensic Anthropology Data Bank data (including the W. M. Bass Donated Skeletal Collection sample) show that including femoral length or anatomically estimated stature in an equation with femoral head breadth improves body mass estimation precision. More specifically, although directional bias related to body mass is not reduced within specific samples, the total estimation error range, directional bias related to stature, and temporal fluctuation in estimation error are markedly reduced. The overall body mass estimation precision of individuals representing different temporal periods and ancestry groups (e.g., African and European ancestry) is thus improved.

The effect of age and body composition on body mass estimation of males using the stature/bi-iliac method.

The stature/bi-iliac breadth method provides reasonably precise, skeletal frame size (SFS) based body mass (BM) estimations across adults as a whole. In this study, we examine the potential effects of age changes in anthropometric dimensions on the estimation accuracy of SFS-based body mass estimation. We use anthropometric data from the literature and our own skeletal data from two osteological collections to study effects of age on stature, bi-iliac breadth, body mass, and body composition, as they are major components behind body size and body size estimations. We focus on males, as relevant longitudinal data are based on male study samples. As a general rule, lean body mass (LBM) increases through adolescence and early adulthood until people are aged in their 30s or 40s, and starts to decline in the late 40s or early 50s. Fat mass (FM) tends to increase until the mid-50s and declines thereafter, but in more mobile traditional societies it may decline throughout adult life. Because BM is the sum of LBM and FM, it exhibits a curvilinear age-related pattern in all societies. Skeletal frame size is based on stature and bi-iliac breadth, and both of those dimensions are affected by age. Skeletal frame size based body mass estimation tends to increase throughout adult life in both skeletal and anthropometric samples because an age-related increase in bi-iliac breadth more than compensates for an age-related stature decline commencing in the 30s or 40s. Combined with the above-mentioned curvilinear BM change, this results in curvilinear estimation bias. However, for simulations involving low to moderate percent body fat, the stature/bi-iliac method works well in predicting body mass in younger and middle-aged adults. Such conditions are likely to have applied to most human paleontological and archaeological samples.

The impact of subsistence changes on humeral bilateral asymmetry in Terminal Pleistocene and Holocene Europe.

Analyses of upper limb bone bilateral asymmetry can shed light on manipulative behavior, sexual division of labor, and the effects of economic transitions on skeletal morphology. We compared the maximum (absolute) and directional asymmetry in humeral length, articular breadth, and cross-sectional diaphyseal geometry (CSG) in a large (n > 1200) European sample distributed among 11 archaeological periods from the Early Upper Paleolithic through the 20(th) century. Asymmetry in length and articular breadth is right-biased, but relatively small and fairly constant between temporal periods. Females show more asymmetry in length than males. This suggests a low impact of behavioral changes on asymmetry in length and breadth, but strong genetic control with probable sex linkage of asymmetry in length. Asymmetry in CSG properties is much more marked than in length and articular breadth, with sex-specific variation. In males, a major decline in asymmetry occurs between the Upper Paleolithic and Mesolithic. There is no further decline in asymmetry between the Mesolithic and Neolithic in males and only limited variation during the Holocene. In females, a major decline occurs between the Mesolithic and Neolithic, with resulting average directional asymmetry close to zero. Asymmetry among females continues to be very low in the subsequent Copper and Bronze Ages, but increases again in the Iron Age. Changes in female asymmetry result in an increase of sexual dimorphism during the early agricultural periods, followed by a decrease in the Iron Age. Sexual dimorphism again slightly declines after the Late Medieval. Our results indicate that changes in manipulative behavior were sex-specific with a probable higher impact of changes in hunting behavior on male asymmetry (e.g., shift from unimanual throwing to use of the bow-and-arrow) and food grain processing in females, specifically, use of two-handed saddle querns in the early agricultural periods and one-handed rotary querns in later agricultural periods.

Scientific analysis of a calcified object from a post-medieval burial in Vienna, Austria.

Calcifications commonly occur in association with soft tissue inflammation. However, they are not often discussed in palaeopathological literature, frequently due to problems of identification and diagnosis. We present a calcified object (40×27×27cm) found with a middle-aged male from a post-medieval cemetery in Vienna. It was not recognized during excavation, thus its anatomical location within the body remains unknown. The object was subject to X-ray, SEM and CT scanning and compared to historic pathological objects held in the collection of the Natural History Museum Vienna. Two of closest resemblance, a thyroid adenoma and goitre were subject to similar analytical techniques for comparison. Despite similarities between all objects, the structure of the object most closely conforms to a thyroid tumor. Nevertheless, due to similar pathophysiological pathways and biochemical composition of calcified soft tissue, a secure identification outside of its anatomical context is not possible. The research further highlights the fact that recognition of such objects during excavation is crucial for a more conclusive diagnosis. Historic medical records indicate that they were common and might therefore be expected to frequently occur in cemeteries. Consequently, an increasing the dataset of calcifications would also aid in extending the knowledge about diseases in past human populations.

Gradual decline in mobility with the adoption of food production in Europe.

Increased sedentism during the Holocene has been proposed as a major cause of decreased skeletal robusticity (bone strength relative to body size) in modern humans. When and why declining mobility occurred has profound implications for reconstructing past population history and health, but it has proven difficult to characterize archaeologically. In this study we evaluate temporal trends in relative strength of the upper and lower limb bones in a sample of 1,842 individuals from across Europe extending from the Upper Paleolithic [11,000-33,000 calibrated years (Cal y) B.P.] through the 20th century. A large decline in anteroposterior bending strength of the femur and tibia occurs beginning in the Neolithic (∼ 4,000-7,000 Cal y B.P.) and continues through the Iron/Roman period (∼ 2,000 Cal y B.P.), with no subsequent directional change. Declines in mediolateral bending strength of the lower limb bones and strength of the humerus are much smaller and less consistent. Together these results strongly implicate declining mobility as the specific behavioral factor underlying these changes. Mobility levels first declined at the onset of food production, but the transition to a more sedentary lifestyle was gradual, extending through later agricultural intensification. This finding only partially supports models that tie increased sedentism to a relatively abrupt Neolithic Demographic Transition in Europe. The lack of subsequent change in relative bone strength indicates that increasing mechanization and urbanization had only relatively small effects on skeletal robusticity, suggesting that moderate changes in activity level are not sufficient stimuli for bone deposition or resorption.

Earliest evidence for social endogamy in the 9,000-year-old-population of Basta, Jordan.

The transition from mobile to sedentary life was one of the greatest social challenges of the human past. Yet little is known about the impact of this fundamental change on social interactions amongst early Neolithic communities, which are best recorded in the Near East. The importance of social processes associated with these economic and ecological changes has long been underestimated. However, ethnographic observations demonstrate that generalized reciprocity - such as open access to resources and land - had to be reduced to a circumscribed group before regular farming and herding could be successfully established. Our aim was thus to investigate the role of familial relationships as one possible factor within this process of segregation as recorded directly in the skeletal remains, rather than based on hypothetical correlations such as house types and social units. Here we present the revealing results of the systematically recorded epigenetic characteristics of teeth and skulls of the late Pre-Pottery Neolithic community of Basta in Southern Jordan (Figure S1). Additionally, mobility was reconstructed via a systematic strontium (Sr) isotope analysis of tooth enamel of the Basta individuals. The frequency of congenitally missing maxillary lateral incisors in the 9,000-year-old community of Basta is exceptionally high (35.7%). Genetic studies and a worldwide comparison of the general rate of this dental anomaly in modern and historic populations show that the enhanced frequency can only be explained by close familial relationships akin to endogamy. This is supported by strontium isotope analyses of teeth, indicating a local origin of almost all investigated individuals. Yet, the accompanying archaeological finds document far-reaching economic exchange with neighboring groups and a population density hitherto unparalleled. We thus conclude that endogamy in the early Neolithic village of Basta was not due to geographic isolation or a lack of exogamous mating partners but a socio-cultural choice.

Stature and body mass estimation from skeletal remains in the European Holocene.

Techniques that are currently available for estimating stature and body mass from European skeletal remains are all subject to various limitations. Here, we develop new prediction equations based on large skeletal samples representing much of the continent and temporal periods ranging from the Mesolithic to the 20th century. Anatomical reconstruction of stature is carried out for 501 individuals, and body mass is calculated from estimated stature and biiliac breadth in 1,145 individuals. These data are used to derive stature estimation formulae based on long bone lengths and body mass estimation formulae based on femoral head breadth. Prediction accuracy is superior to that of previously available methods. No systematic geographic or temporal variation in prediction errors is apparent, except in tibial estimation of stature, where northern and southern European formulae are necessary because of the presence of relatively longer tibiae in southern samples. Thus, these equations should bebroadly applicable to European Holocene skeletal samples.

Technical note: The effect of midshaft location on the error ranges of femoral and tibial cross-sectional parameters.

In comparing long-bone cross-sectional geometric properties between individuals, percentages of bone length are often used to identify equivalent locations along the diaphysis. In fragmentary specimens where bone lengths cannot be measured, however, these locations must be estimated more indirectly. In this study, we examine the effect of inaccurately located femoral and tibial midshafts on estimation of geometric properties. The error ranges were compared on 30 femora and tibiae from the Eneolithic and Bronze Age. Cross-sections were obtained at each 1% interval from 60 to 40% of length using CT scans. Five percent of deviation from midshaft properties was used as the maximum acceptable error. Reliability was expressed by mean percentage differences, standard deviation of percentage differences, mean percentage absolute differences, limits of agreement, and mean accuracy range (MAR) (range within which mean deviation from true midshaft values was less than 5%). On average, tibial cortical area and femoral second moments of area are the least sensitive to positioning error, with mean accuracy ranges wide enough for practical application in fragmentary specimens (MAR = 40-130 mm). In contrast, tibial second moments of area are the most sensitive to error in midshaft location (MAR = 14-20 mm). Individuals present significant variation in morphology and thus in error ranges for different properties. For highly damaged fossil femora and tibiae we recommend carrying out additional tests to better establish specific errors associated with uncertain length estimates.

Human manipulative behavior in the Central European Late Eneolithic and Early Bronze Age: humeral bilateral asymmetry.

It is assumed that the transition from the Late Eneolithic to the Early Bronze Age in Central Europe was associated with substantial changes in subsistence and the perception of gender differences. However, the archeological record itself does not entirely support this model. Alternatively, this transition may be interpreted as a continuous process. We used asymmetry in external dimensions, and asymmetry in size and distribution of cortical tissue of humeri to elucidate the nature of this transition with respect to differences in manipulative behavior. The total sample of 67 individuals representing five archaeological cultures was used. The results indicate that the pattern of asymmetry of the humeral external measurements and the cross-sectional parameters taken at 35% of humeral biomechanical length remain stable during the Late Eneolithic and Early Bronze Age. However, females of both periods show fluctuating asymmetry for all of the cross-sectional parameters, but directional asymmetry for biomechanical length. Males are nonsignificantly shifted from the line of equivalence for biomechanical length, but exhibit directional asymmetry for the cortical area and polar moment of area. Only distal articular breadth yields fluctuating asymmetry for both females and males in both periods. Thus, the transition from the Late Eneolithic to the Early Bronze Age can be seen as a continuous process that probably affected only a limited part of human activities. We interpret the differences between females and males of both periods as evidence of gender-specific activities; males might have been associated with extra-domestic agricultural labor that resulted in asymmetrical manipulative loading and females with domestic labor with symmetrical manipulative loading in both periods.

Body size, body proportions, and mobility in the Tyrolean "Iceman".

Body mass and structural properties of the femoral and tibial midshafts of the "Iceman," a late Neolithic (5,200 BP) mummy found in the Tyrolean Alps, are determined from computed tomographic scans of his body, and compared with those of a sample of 139 males spanning the European early Upper Paleolithic through the Bronze Age. Two methods, based on femoral head breadth and estimated stature/bi-iliac (pelvic) breath, yield identical body-mass estimates of 61 kg for the Iceman. In combination with his estimated stature of 158 cm, this indicates a short but relatively wide or stocky body compared to our total sample. His femur is about average in strength compared to our late Neolithic (Eneolithic) males, but his tibia is well above average. His femur also shows adaptations for his relatively broad body (mediolateral strengthening), while his tibia shows adaptations for high mobility over rough terrain (anteroposterior strengthening). In many respects, his tibia more closely resembles those of European Mesolithic rather than Neolithic males, which may reflect a more mobile lifestyle than was characteristic of most Neolithic males, perhaps related to a pastoral subsistence strategy. There are indications that mobility in general declined between the European Mesolithic and late Neolithic, and that body size and shape may have become more variable throughout the continent following the Upper Paleolithic.

Mobility in Central European Late Eneolithic and Early Bronze Age: femoral cross-sectional geometry.

Some scholars explain the absence of settlements in the Bohemian and Moravian Late Eneolithic (Corded Ware archaeological culture) as a consequence of pastoral subsistence with a high degree of mobility. However, recent archaeological studies argued that the archaeological record of the Late Eneolithic in Central Europe exhibits evidence for sedentary subsistence with mixed agriculture, similar to the subsequent Early Bronze Age. Because the archaeological data do not allow us to address unambiguously the mobility pattern in these periods, we used cross-sectional analysis of the femoral midshaft to test mobility directly on the human skeletal record. The results of femoral midshaft geometry do not support a high degree of mobility in the Late Eneolithic in Central Europe. This conclusion is supported mainly by no significant differences in male groups between the Late Eneolithic and Early Bronze Age in mechanical robusticity and shape of the femoral midshaft, although Corded Ware males still exhibit the highest absolute mean values of the diaphyseal shape (I(A-P)/I(M-L)) ratio and antero-posterior second moment of area. However, Late Eneolithic females have significantly higher torsional and overall bending rigidity because of a significantly higher medio-lateral second moment of area. This finding cannot be directly linked with a higher degree of long-distance mobility for these females. A significant difference was also found in overall decrease of size parameters of the femoral midshaft cross section for one of the Early Bronze Age samples, the Wieselburger females. Since the decrease of size and mechanical robusticity for Wieselburger females does not correspond with the parameters of Early Bronze Age females, we can expect a mosaic pattern of changes during the Late Eneolithic and Early Bronze Age period, instead of a simple unidirectional (diachronic) change of the mechanical environment.