Theorising disAbility in Egyptian bioarchaeology

Archaeological and historical sources attest that tribes of semi-nomadic populations conquered the Carpathian Basin with powerful armies of mounted archers at the turn of the 9th and 10th centuries, which led to the foundation of the Kingdom of Hungary a hundred years later. Cemeteries from that period often provide cases of deposits of archery and horse riding equipment, as well as horse bones associated with the individuals in the graves. The close association between these items and the skeletons, together with the well-known historical context, allows postulating that the concerned individuals practiced horse riding during their life.
 The doctoral research had two main objectives. The first one was to contribute to the research on activity reconstructions in past populations with the identification of skeletal changes that could more reliably be associated with the practice of horse riding, in particular. The second objective was to bring an ethnoarchaeological contribution by possibly improving our understanding of the societies from the Hungarian Conquest period and their funerary practices.
 We selected a sample of 67 individuals from the 10th-century Hungarian cemetery of Sárrétudvari-Hízóföld, which was divided into two groups of individuals, according to the presence or absence of riding deposit in their graves. We also selected a modern (19–20th century) comparison group of 47 presumed non-rider individuals from the documented collection of Lisbon. We analysed different types of skeletal changes commonly used as indicators of activity and behaviour in past populations. Various direct measurements of the lower limb bones were also used to calculate indices of shape and robusticity.
 Statistical analyses mostly revealed significant differences between the Hungarian groups and the comparison group from Lisbon. They concerned some skeletal changes that can be linked to the riding practice and seem to be promising indicators for this activity. Comparisons between groups also revealed that the Hungarian individuals without riding deposit in their grave were likely riders as well. Both objectives of this research have thus been achieved.
 We took into consideration most of the pitfalls inherent to research on activity-related skeletal changes, leading to several limitations, such as relatively restricted sample sizes in the archaeological groups, which should be improved in the future. In addition, the multifactorial aetiology of the skeletal changes represented one of the main difficulties for their interpretation in terms of activity. In that regard, we performed an exploratory analysis of the microarchitecture of a muscle insertion site, of which promising results will need to be confirmed with further research with the aim of improving the reconstruction of activities in past populations.

In certain conditions, some changes observed on human bones can be related to activities practiced during life. Scholars have considered the reconstruction of activities from skeletal changes in past populations as “Bioarchaeology’s Holy Grail”. Horse riding, in particular, has interested bioarchaeologists and paleopathologists for several decades as it brought profound and lasting changes in the history of human cultural evolution. However, the existence of various confounding factors and the lack of clear contextual evidence in connection with the skeletal remains often result in limited or unreliable interpretations of skeletal changes in terms of specific activities. Archaeological and historical sources attest that tribes of semi-nomadic populations conquered the Carpathian Basin with powerful armies of mounted archers at the turn of the 9th and 10th centuries, which led to the foundation of the Kingdom of Hungary in the year 1000/1001. Cemeteries from that period often provide cases of deposits of archery and horse riding equipment as well as horse bones associated with the individuals in the graves. Those populations are, thus, among the most pertinent to be used to perform methodological investigations on activity-related skeletal changes, and, on horse riding, in particular. We selected a sample of 67 individuals from the 10th-century Hungarian cemetery of Sárrétudvari-Hízóföld, in order to analyze the individuals according to the presence or absence of riding deposit in their grave. A modern comparison group of 47 presumed non-rider individuals from the documented collection of Lisbon was also selected. Only adult males were included to limit the effect of sex and age on the changes. The main objectives were to identify skeletal changes reliably related to the practice of horse riding and to improve our understanding of the populations from the Hungarian Conquest period. Various types of skeletal changes were analyzed, including some entheseal changes (at muscles attachment sites), joint changes, vertebral changes, morphological variants, and traumatic lesions. Measurements of the lower limb bones were also used to calculate indices of shape and robusticity. Statistical analyses mostly revealed significant differences between the Hungarian groups with or without riding deposit and the comparison group from Lisbon. They concerned especially some entheseal changes at the coxal bone, femur, tibia, and calcaneus, a morphological adaptation on the femoral neck, intervertebral disc herniations at the thoracolumbar junction, or the ovalization of the acetabulum on the coxal bone. All these traits can be linked to the riding posture, and, thus, seem to be promising indicators for the practice of horse riding. On another note, comparisons between groups revealed that the Hungarian individuals without deposit in their grave were likely riding horses as well. Among the limitations calling for caution is the restricted size of our archaeological samples, which is one of the points that should be improved in the future. In addition, some skeletal changes, such as the entheseal changes, have a multifactorial etiology, which represents a limitation for their interpretation. In that regard, we performed the exploratory analysis of the microarchitecture of an enthesis, the radial tuberosity. Using micro-CT acquisitions and 3D reconstructions of the canals of the cortical bone, we observed that some microstructural variations could allow, with further research, distinguishing entheseal changes related to activity from those related to other factors, thus contributing to more reliable reconstructions of the activities in past populations. In the end, we emphasize that the selection of a pertinent anthropological collection, with direct evidence of the practice of an activity, and the application of strict methodological criteria, are determinant factors for the reliable identification of activity-related skeletal changes.

Child abuse in its various types such as physical, emotional, sexual, and neglect has been document throughout history. However, before the mid-20th century, inflicted injuries to children was overlooked in part because children were often viewed as property. According to the World Health Organization, 57,000 children were the victims of homicide in the year 2000. In this paper we present the skeletal and radiological manifestation of physical abuse and fatal neglect and provide recommendations to assess child maltreatment from past populations. Pediatric biomechanical factors and healing are discussed as it is important to keep in mind that children are not just small adults. Skeletal and radiological indicators of nonaccidental or inflicted injuries are reviewed from the literature. Inflicted injuries are presented based on specificity to identify child abuse. In addition, skeletal indicators that could help assess fatal starvation are also reviewed and metabolic diseases are proposed as potential evidence of neglect. A recent child homicide is presented and used to illustrate the difficulty in assessing child maltreatment. Present-day clinical child abuse protocols are used to provide recommendations to assess child abuse in a bioarchaeological context. Clin. Anat. 29:844-853, 2016. © 2016 Wiley Periodicals, Inc.

Neurofibromatosis type 1 (NF1) is a dominant autosomal disorder with a variety of clinical manifestations, mild to severe, including cutaneous growths and colourings, skeletal changes, and possible mental disabilities. There is evidence, in the form of historical medical records, that NF1 existed in past populations, and yet the condition does not appear to be of interest to paleopathological researchers. This may be due to a lack of interest in the area, but also may be a result of a poor understanding of the possible skeletal manifestations of the disorder. Various recent clinical studies have discussed such possible changes, and these may be useful for the paleopathologist in diagnosing possible cases of NF1 in past populations. Additionally, the cloning of the gene that controls the disorder has allowed for the study of the sequence. This could allow for the use of the polymerase chain reaction (PCR) technique in the study of ancient DNA to give a more definite diagnosis of the disorder in individuals who seem to display the skeletal indicators of NF1. However, an understanding of the macroscopic, skeletal indicators of NF1 is important for the paleopathologist. Additionally, examining the past for evidence of this disorder may reveal some insight into its origins. as well as reveal information about the coping strategies of individuals who may have been functionally compromised and the attitudes of communities about disabilities.

Paleopathologists study the presence of diseases in the past and as such have a vast knowledge of skeletal changes associated with different conditions. Tuberculosis is one of the most studied diseases and still remains a major health problem today. Its manifestations in past populations have been extensively described, but less is known about its bony involvement in the post-antibiotic era. The aim of this study was to assess the frequency and manifestations of skeletal lesions in the post-antibiotic era in a South African sample and compare it to that found before the introduction of antibiotics. Skeletons of 205 individuals from modern skeletal collections and who are known to have died from TB were assessed. It was found that 39.2% of all individuals dying in the post-antibiotic era showed skeletal changes that could be associated with TB, while another 27.5% showed nonspecific changes. The highest incidences were found in individuals who died after 1985, when co-infection with HIV and drug resistance became common. While, as expected, vertebral and rib changes were the most common, the number of individuals who showed changes to the skull, and specifically intracranially, was surprising. These could most probably be associated with TB meningitis, although this specific cause of death was noted in only a few individuals. It seems that individuals may be living longer as a result of long-term antibiotic use, leaving more time for lesions to develop. Clin. Anat. 29:854-861, 2016. © 2016 Wiley Periodicals, Inc.

In archaeological sciences, the macroscopic morphology of distinct dry bone structures, such as tubercles, ridges, epicondyles, and fossae, is routinely used to infer habitual activity patterns in past human populations, extinct hominins, and other animals. This study introduces "Validated Entheses-based Reconstruction of Activity 2.0" (VERA 2.0), a new method for precisely quantifying 3D surface irregularities on enthesis-bearing bone structures. Building on VERA 1.0, first introduced by the same author in 2016 and later named in a 2021 literature review, VERA 2.0 enhances the previous approach by incorporating a semi-automated image segmentation technique that reduces manual input while maintaining accuracy. The method involves selecting a predefined broad bone surface region, after which an algorithm automatically detects subtle surface irregularities (see example video in the step-by-step protocol at dx.doi.org/10.17504/protocols.io.5jyl82z8dl2w/v3). Validation analyses confirm VERA 2.0's precision and reliability for activity reconstruction through intra- and inter-observer repeatability tests, experimental research comparing activity and control laboratory specimens, and analyses of historical human skeletons with extensively detailed long-term occupational data. Moreover, while this anthropological 3D measuring protocol paper cannot and does not aim to analyze the anatomical and histological nature of bone surface irregularities, preliminary anatomical dissection and virtual analysis of a cadaveric thumb enthesis suggest a possible association with attaching muscles and ligaments. Future anatomical and histological research aiming to explore soft-hard tissue interactions could clarify how these identified surface changes exactly relate to the attaching tissues. Overall, VERA 2.0 provides a robust, efficient quantitative tool for inferring activity patterns from skeletal remains, with applications across paleontological, paleoanthropological, and bioarchaeological contexts.

In skeletal remains, teeth are valuable sources of information regarding age, diet, and health. Dental wear is especially helpful in reconstructions of dietary patterns in populations of varying subsistence. In past societies, teeth have also been used as "a third hand" or as a "tool." The present article examines this type of dental wear and traits attributed to habitual behavior during prehistoric and historic times. Terminology and classification of habitual dental wear are described mainly by appearance, for instance, notching, grooving, cuts, scrapes, and polished surfaces, and their characteristics are illuminated by different case studies. Secondary health effects caused by the extramasticatory use of teeth, such as periapical lesions, tilting, skeletal changes at the temporomandibular joint, chipping, and antemortem tooth loss are also examined. During the examination of extramasticatory dental wear, information should be recorded on morphology, size, frequency, intensity, and location within the dental arch, as well as descriptions and detailed photographic documentation. The advantage of using a low- to medium-resolution microscope in all dental examination is emphasized. By categorizing the wear marks, characteristics are emphasized rather than an exact causing agent. In this way, tentative analogies for the origin of different extramasticatory wear, and consequently for human behavior in the past, can be avoided.

Osteological evidence of short-limbed dwarfism in a nineteenth century Dutch family: Achondroplasia or hypochondroplasia

This study presents an integrative approach to chronic disease and disability in a Portuguese nun who died in 1779. The aim is to interpret her condition by combining osteopathological and burial context evidence with written sources. It offers a concise example of how bringing these sources together can enhance pathological interpretation and support the reconstruction of soft tissue disease, disability, and the lived experience of disease in past populations. This older woman was exhumed from the Convent of Jesus in Setúbal, Portugal. Her atypical burial position, also noted in the convent chronicles, indicates the remains likely belong to Michaela Archangela do Ceo. Osteopathological analysis revealed several changes, including atheromas, while the burial showed a crouched position, presumably related to stroke sequelae. The chronicles describe lifelong frailty and disease, followed in later life by a stroke with right‐sided hemiplegia, pressure ulcers, and myiasis. Apart from the atheromas, which may be associated with the stroke, the skeletal changes show no correspondence with the signs reported in the account. The chronicles further document the attentive care she received, reflecting communal support within the convent, and the religious meaning of suffering. In conclusion, this case demonstrates the value of integrating multiple sources to interpret pathological conditions and the lived experience of disease, while emphasizing the relevance of soft tissue disease that leaves no skeletal trace. It also illustrates the careful application of retrospective diagnosis as an interpretive tool for historical documentation. Altogether, it highlights key methodological considerations for interpreting disease in osteoarchaeological contexts.

Large bilateral auditory exostoses were recorded in the skeleton of an adult male buried in the Roman period necropolis of Zadar-Relja (the Roman colony of Iader) in southern Croatia. As the occurrence of auditory exostoses in both past and modern populations has been correlated with prolonged exposure to cold water, the authors propose that during his lifetime this individual performed activities requiring frequent contact with cold water for an extended period of time. Apart from auditory exostoses, this individual also exhibits other pathological changes including pronounced skeletal robustness, benign cortical defects at the insertion of the pectoralis major muscles on both humeri and at the attachment sites of the costo-clavicular ligaments on both clavicles, and vertebral osteoarthritis in the cervical and thoracic vertebrae. The most plausible explanation for all these changes is that this person spent most of his life working aboard a sea vessel as a sailor, boat builder or fisherman, and whose duties included frequent and intensive use of oars. This observation is based on the geographic and climatic location of Zadar, the described skeletal changes, the archaeological context of the site, recovered material artifacts and written historic sources and comparisons with similar studies.

The investigation of the record of growth locked in dental enamel provides a unique opportunity to build a comprehensive picture of growth disruption episodes during childhood. This study presents a new methodological basis for the analysis of enamel growth disruptions (enamel hypoplasia) using incremental microstructures of enamel. A three-dimensional technique based upon use of an Alicona 3D Infinite Focus imaging microscope and software is used to record developmental features in the enamel of human permanent mandibular lateral incisors of one individual from the Neolithic site of Çatalhöyük (Turkey). Using this new technique, perikymata are measured down the longitudinal axis of the crown from the incisal margin to the cervix and perikyma spacing profiles are constructed with this new technique. A mathematical basis for the detection of spacing anomalies, which serve as indicators of enamel hypoplasia is presented based upon these profiles. Three clearly delineated defects were identified visually, then matched and confirmed metrically using the enamel surface and perikyma spacing profiles. Human growth has often been used as an indicator of health in past societies because of developmental sensitivity to fluctuations in nutritional status and disease load. Hence, standardization of furrow-form defect identification is of crucial importance for reducing the amount of current subjectivity in the determination of a threshold for the identification of defects among individuals of past populations. The method presented here, which is based on microscopic images of the tooth crown as well as recorded measurements of incremental structures, represents a combined visual-metric approach using LOWESS residuals, and as such provides a substantial advancement to previous methods. It is therefore recommended that additional studies be carried out with this methodology to determine whether this method improves the reliability of enamel defect identification among individuals recovered from bioarchaeological contexts.

Menarche is an indicator frequently used to study variation in growth, development, and related health conditions among members of living populations. As a life event, menarche is often associated with changes in an individual's social identity. The reproductive lifespan, which for females starts with menarche, is a paramount feature of palaeodemographic studies. Determination of menarche status from the skeletal remains of individuals of past populations can be obtained by assessing the developmental status of the iliac crest, as well as the hand and wrist bones, which are, unlike teeth, often poorly recovered in bioarchaeological contexts. The present study seeks to evaluate the link between dental mineralization and menarche in a population of known menarche status. The relationship between permanent teeth mineralization and menarche status was investigated by using data of developing permanent teeth (167 radiographs) rated in accordance with the well-known standards of Demirjian et al. and Moorrees et al. collected among 73 living French females of known menarcheal status. Using correlation ratios, GLMM and CART algorithm, menarcheal status is correlated with mineralization of the premolars. Menarcheal status is predicted correctly for 92 and 77% of radiographs of the learning and validation samples, respectively. Although promising, the results require caution prior to generalization to other populations. The age of menarche in this particular sample may simply coincide with the development of the premolars in this particular sample. Therefore, further investigation applied to populations with various mean ages of menarche is required in order to provide new evidence of variation in human growth and development from the correspondence between the mineralization of the permanent teeth and menarche.

The objective of the present study is to identify spatial and temporal aspects that enable the synergistic potential inherent in sports tourism. It relies on a theoretical framework based on the principles of open systems theory, synergetics, and systems thinking. This framework implies a flexible and multivalent interaction of various factors, including spatial layout, seasonality, infrastructure, and social context. The research builds the foundation for a deeper understanding of the scope, diversity, and structure of the sports tourism phenomenon. Facilitated by the proposed theoretical models, the research then relies on a qualitative analysis of secondary sources from scientific journals in the field of sports, tourism, and management in sports and tourism, with the application of a set of keywords. The findings indicate that the spatial dimension, encompassing aspects such as location, accessibility, landscape, and regional distribution, and the temporal dimension, including seasonality, duration, and development patterns of activities, serve as fundamental indicators in the conceptualization and theoretical underpinnings of sports tourism. These indicators facilitate the harmonization of intricate relationships within the sports tourism system. The discussion underscores the necessity for the establishment of flexible and adaptable models that facilitate synergy through the proposed sets of spatio-temporal aspects. These models are intended to promote sustainability, competitiveness, and resilience. Conclusions indicate the significance of incorporating elements of spatial and temporal dimensions into the planning process, thereby establishing the foundation for the formulation and advancement of sports tourism strategies that are oriented towards responsibility.

Hereditary hypophosphatemic rickets with hypercalciuria (HHRH) represents an FGF23-independent disease caused by biallelic variants in the solute carrier family 34-member 3 (SLC34A3) gene. HHRH is characterized by chronic hypophosphatemia and an increased risk for nephrocalcinosis and rickets/osteomalacia, muscular weakness, and secondary limb deformity. Biochemical changes, but no relevant skeletal changes, have been reported for heterozygous SLC34A3 carriers. Therefore, we assessed the characteristics of individuals with biallelic and monoallelic SLC34A3 variants. In 8 index patients and 5 family members, genetic analysis was performed using a custom gene panel. The skeletal assessment comprised biochemical parameters, areal bone mineral density (aBMD), and bone microarchitecture. Pathogenic SLC34A3 variants were revealed in 7 of 13 individuals (2 homozygous, 5 heterozygous), whereas 3 of 13 carried monoallelic variants of unknown significance. Whereas both homozygous individuals had nephrocalcinosis, only one displayed a skeletal phenotype consistent with HHRH. Reduced to low-normal phosphate levels, decreased tubular reabsorption of phosphate (TRP), and high-normal to elevated values of 1,25-OH2 -D3 accompanied by normal cFGF23 levels were revealed independently of mutational status. Interestingly, individuals with nephrocalcinosis showed significantly increased calcium excretion and 1,25-OH2 -D3 levels but normal phosphate reabsorption. Furthermore, aBMD Z-score <-2.0 was revealed in 4 of 8 heterozygous carriers, and HR-pQCT analysis showed a moderate decrease in structural parameters. Our findings highlight the clinical relevance also of monoallelic SLC34A3 variants, including their potential skeletal impairment. Calcium excretion and 1,25-OH2 -D3 levels, but not TRP, were associated with nephrocalcinosis. Future studies should investigate the effects of distinct SLC34A3 variants and optimize treatment and monitoring regimens to prevent nephrocalcinosis and skeletal deterioration. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

CHILDHOOD IS A TIME of rapid biological growth and development, and a stage of the life course during which bodies are particularly sensitive to social and environmental stressors. As a consequence, events which may impact upon a child’s care and treatment can become physically embodied within their bones and teeth. The skeletal remains of children have been neglected within archaeological discourse until recently, but they are, in fact, a particularly important demographic for understanding the impact of social processes on past population health. This research examines the prevalence of skeletal disease in children (≤16 years) in Britain (England, Wales and Scotland) between ad 1000 and 1700. Data for a total of 4,626 children from 95 sites were collated from published and unpublished skeletal reports and analysed for evidence of skeletal changes reflecting disease. A biocultural approach was adopted in which the evidence was interpreted in relation to ecological, social, economic and environmental conditions. It was observed that childhood levels of skeletal stress did increase significantly after 1540. It was noted that during the Reformation sociocultural and economic factors added to stressors in the ecology of the medieval child. The effects of the Reformation were found to be the greatest aggravator in the rise of morbidity prevalence over seven centuries. Differences in morbidity patterns between non-adult age categories indicated that a state of ‘childhood’ existed until at least eleven years of age, after which there appears to have been a gradual transition into adolescence and adulthood.