PALEOPATHOLOGY ASSOCIATION SCIENTIFIC PROGRAM VIRTUAL 48Th Annual North American Meeting April 6-23, 2021 MEETING OVERVIEW

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PALEOPATHOLOGY ASSOCIATION SCIENTIFIC PROGRAM VIRTUAL 48th Annual North American Meeting April 6-23, 2021 MEETING OVERVIEW

VIRTUAL 48th Annual North American Meeting of the Paleopathology Association April 6-23, 2021 (all times EDT)

Date Time (EDT) Session

April 6-9

Tues April 6 8:00 am Poster Hall Opens Tues April 6 11:00 am – 2:30 pm President’s Welcome – aDNA symposium podium Wed April 7 11:00 am – 1:30 pm Podium presentations April 12-16: Mentoring Week

Mon April 12 11:00 am – 1:00 pm Poster: Cockburn Student Prize & Jane E. Buikstra Early Career Award entries Poster panel discussion of pre-recorded poster presentations. 1. Trauma 2. Metabolic diseases & stress 3. Open paleopathology

Mon April 12 1:00 pm – 2:00 pm Meet-a-Mentor Tues April 13 1:00 pm – 2:00 pm Meet-a-Mentor Wed April 14 1:00 pm – 2:00 pm Student Group: 3MT event Thurs April 15 1:00 pm – 2:00 pm Meet-a-Mentor Fri April 16 11:00 am – 1:30 pm Podium: Cockburn Student Prize & Jane E. Buikstra Early Career Award entries April 19-23

Thurs Ap 22 11:00 am – 1:00 pm Poster: Regular Poster panel discussion of pre-recorded poster presentations. 1. Metabolic diseases, stress & infectious diseases 2. Trauma 3. Open paleopathology

Fri Ap 23 11:00 am – 12:00 pm Podium presentations followed by 15min break 12:15 pm – 2:00 pm Association Annual Business & Awards Meeting

48th Annual North American Meeting of the Paleopathology Association 2 PROGRAM NOTES

Virtual links: Conference registrants will be sent links to the Poster Hall and Virtual Webinar Conference from the conference facilitator, Burk & Associates. The email will be from ‘paleopathology’.

Poster Hall: Posters will be available for viewing through ePosters beginning April 6. Posters will remain available for viewing and correspondence for 1 year past the conference. To ensure that we have a lively discussion during the two scheduled Poster Sessions, viewers can post comments, but the ‘chat’ function on ePoster will be enabled after the associated Poster Session.

Poster Sessions: There will be two Live Poster Panel sessions, each with three topical sections, where presenters will be available to answer questions about their research.

Podium Sessions: These sessions will follow our traditional format, with each presenter giving a 12-minute presentation followed by 3 minutes for questions.

Meet-a-Mentor: In lieu of ‘Let’s-do-Lunch,’ participating regular members and students will be partnered and each group will arrange a 1-hour chat at a time convenient to them, ideally during the suggested times during Mento- ring Week (April 12-16). Participants should expect an email with mentor partnering information from our Direc- tor-at-Large (Student Liaison), Tracy Betsinger ([email protected]), around Tuesday, March 30.

Student Group 3MT (Three-minute thesis): Talks will be recorded and posted to the PPASG-run YouTube channel (with speaker permission).

Association Annual Business Meeting and Award Presentation: The PPA Secretary will email a Webinar link to ALL PPA members to join the conference participants in the meeting portion of the conference. This link will be sent on the evening of Thursday, April 22.

More meeting information: paleopathology-association.wildapricot.org/event-3613136

48th Annual North American Meeting of the Paleopathology Association 3 SCIENTIFIC PROGRAM

TUESDAY, April 6 11:00 am – 11:05 am President’s Welcome Annie Katzenberg

11:00 am – 2:30 pm SYMPOSIUM Ancient DNA and paleopathology: reconstructing pathogen evolutionary histories in historical and archaeological contexts. Organized by Kelly E BLEVINS

Chair Kelly E BLEVINS

11:05 Symposium opening remarks Kelly E BLEVINS

11:15 Promise and pitfalls in ancient DNA research: What can we learn from ancient pathogens? Anne C STONE

11:30 Illuminating Treponema pallidum’s evolutionary history with ancient genomes Verena SCHUENEMANN, Gülfirde AKGÜL, Kerttu MAJANDER

11:45 DNA analysis of an ancient brucellosis case from Bronze Age eastern Europe Gunnar NEUMANN, Maria SPYROU, Ayshin GHALICHI, Marcel KELLER, Joachim BURGER, Volker HEYD, Viktor I KLOCHKO, Aleksander KOŚKO, Piotr WŁODARCZAK, Danuta ŻURKIEWICZ, Alexander HERBIG, Wolfgang HAAK, Johannes KRAUSE

12:00 What we talk about when we talk about dating: Tuberculosis and the tangled evidence for its antiquity Susanna SABIN, Elizabeth A NELSON, Anne C STONE, Jane E BUIKSTRA ++

12:15 Zoonotic Mycobacterium tuberculosis complex strains from geographically dispersed pre-contact South American human populations Åshild J VÅGENE, Tanvi P HONAP, Kelly M HARKINS, Michael S ROSENBERG, Karen GIFFIN, Felipe CÁRDENAS- ARROYO, Laura Paloma LEGUIZAMÓN, Judith ARNETT, Jane E BUIKSTRA, Alexander HERBIG, Anne C STONE, Kirsten I BOS, Johannes KRAUSE

12:30 pm – 12:45 pm COFFEE BREAK

12:45 Tuberculosis in the wake of Wari imperial decline in Pre-Hispanic Peru Elizabeth NELSON, Aditya Kumar LANKALIPALLI, Maria SPYROU, Åshild VÅGENE, Susanna SABIN, James A Fellows YATES, Tiffiny A TUNG, Alexander HERBIG, Kirsten I BOS ***

1:00 Skeletal and molecular evidence of the Mycobacterium tuberculosis complex from Tenochtitlan- Tlatelolco, a late Postclassic Mesoamerican urban center (1350-1521 CE) Kelly E BLEVINS, Elizabeth A NELSON, Alexander HERBIG, Johannes KRAUSE, Jane E BUIKSTRA, Josefina Mansilla LORY, Kirsten I BOS, Anne C STONE ***

1:15 The history of tuberculosis in South Africa: Insights and challenges from a multidisciplinary study Tessa CAMPBELL, Anne C STONE, Rebecca ACKERMANN ++

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 4 SCIENTIFIC PROGRAM

1:30 Reconstructing the genomes of the red complex of pathogens from ancient dental calculus samples from the North American Wichita (500-700 BP) Tanvi HONAP, Cara MONROE, Paul SANDBERG, Rita AUSTIN, Marc LEVINE, Cecil LEWIS

1:45 Revealing the imprints of malaria in antiquity: An integrated ancient DNA and bioarchaeological framework Stephanie MARCINIAK, Tracy L PROWSE, Hendrik N POINAR

2:00 Discussant: Jane E BUIKSTRA

WEDNESDAY, April 7 11:00 am – 1:30 pm PODIUM

Chair BURK INC.

11:00 It’s only rare if you don’t care: Promising new comprehensive approaches to the paleopathological identification of neurodegenerative disorders Nivien SPEITH

11:15 Classical presentation and the spectrum of disease: The challenge of malignant neoplasms Bruce ROTHSCHILD

11:30 Parasitic infection in the Roman period: Temporal changes from the pre-Roman through medieval periods Marissa L LEDGER, Piers D MITCHELL

11:45 Osteoimmunology as new frontier in treponemal infection: Setting the ground for bioarchaeological analysis and reconstruction of host immunological status using skeletal samples Fabian CRESPO, Emily RICH, Sharon DEWITTE, Molly K ZUCKERMAN

12:00 pm – 12:15 pm COFFEE BREAK

12:15 Osteochondritis dissecans of the knee in individuals of the Coimbra Identified Skeletal Collection (19th-20th centuries): Proposal of a new classification system for paleopathology Ana Rita A SAMPAIO, Bruno M MAGALHÃES, Fernando FONSECA, Rosa Ramos GASPAR, Ana Luísa SANTOS

12:30 Diet and parasitism related to Ancestral Pueblo porotic hyperostosis Karl REINHARD, Isabel TEIXEIRA-SANTOS, Morgana CAMACHO

12:45 Extensive perimortem violence at Shamanka II, Siberia: Differential diagnosis of a probable hunter-gatherer massacre Angela LIEVERSE, Rick SCHULTING, Christopher BRONK RAMSEY, Vladimir BAZALIISKII, Artur KHARINSKII, Andrzej WEBER

1:00 Sex determination in juvenile and infant remains using dimorphic enamel peptide analysis Heidi SHAW, Rebecca GOWLAND, Kayla CROWDER, Claire HODSON, Nicolas STEWART, Kurt GRON, Janet MONTEGOMERY

48th Annual North American Meeting of the Paleopathology Association 5 SCIENTIFIC PROGRAM MONDAY, April 12 11:00 am – 1:00 pm POSTER PANELS: COCKBURN STUDENT PRIZE & JANE E. BUIKSTRA EARLY CAREER AWARD ENTRIES

Chair Tracy BETSINGER

11:00 am – 11:30 am TRAUMA

P.1 Medieval medical treatment for cranial trauma from Ilok, Croatia Eric ANDERSON, Anna OSTERHOLTZ, Mario NOVAK, Anna GREEN, Jennifer HEFFLER ***

P.2 Levels of certainty in the diagnosis of cranial blunt force trauma: A test case from the Channel Islands, California (AD1050-early historic) Alycia C DAVIS, Cynthia A Wilczak ***

P.3 Analysis of rib trauma in the Erie County poorhouse cemetery assemblage Taylor FLAHERTY, Jennifer BYRNES, Joyce E SIRIANNI ***

P.4 Anthropological analysis of vertebral trauma from the Erie County poorhouse cemetery Katherine GADDIS, Jennifer F BYRNES, Joyce E SIRIANNI ***

P.5 Surviving trauma in a pre-antibiotic era: A case-study of a mandibular injury in a medieval-modern Portuguese village Dulce NEVES, Ana Maria SILVA, Sofia WASTERLAIN ***

P.6 Ancient surgery and social identity: Osteobiography of amputees from late pre-Hispanic Túcume, Peru Megann PHILLIPS, Vanessa CRUZ, Erin K MARTIN, Dylan R SMITH, J Marla TOYNE ***

P.7 Intersecting identities and trauma in the Erie County poorhouse cemetery (1851-1913) Jennifer F BYRNES, Katherine GADDIS, Joyce E SIRIANNI ++

P.8 Unique case of coffin birth discovered in Medieval Nubia at Nuri, Sudan Abagail M BREIDENSTEIN, John PARTRIDGE, Meghan E STRONG, Pearce Paul CREASMAN ++

11:45 am – 12:15 pm METABOLIC DISEASES & STRESS

P.9 OsteoLogic: an interactive website for improving consistency in scoring orbital roof lesions Amy ANDERSON, Brianna GARDNER, Chris YANG, Larry MAI ***

P.10 Was childhood health declining in the period leading to the Black Death? A comparison of childhood health between the early, late pre-Black Death and post-Black Death periods Florencia Natalia BOTTA ***

P.11 Childhood stress and immune dysregulation: Considering a life-course approach for the assessment of frailty in skeletal remains Emilia FRANKLIN, Pia NYSTROM ***

P.12 An investigation into the prevalence of vitamin D deficiency in a 19th century London population Ruth O’DONOGHUE, Marie C WEALE, Jo BUCKBERRY, Hannah KOON ***

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 6 SCIENTIFIC PROGRAM

P.13 Femoral hypoplasia and vitamin D deficiency: A differential diagnosis of a rare disorder in a 19th century Dutch high socioeconomic status female Barbara VESELKA ++

P.14 Bone mineralisation disorders in Bronze and Iron Age skeletal assemblages from Mongolia Melandri VLOK, Erdene MYAGMA, Hallie BUCKLEY ***

P.15 Hidden evidence of deficiency: The application of multiple methods to assess vitamin D deficiency in Anglo-Saxon England Marie C WEALE, Jo BUCKBERRY, Hannah KOON ***

12:30 pm – 1:00 pm OPEN PALEOPATHOLOGY

P.16 A biocultural examination of structural violence across Missouri state mental hospitals in the 20th-century Madeline M ATWELL ***

P.17 In one ear and out the nose: Investigating correlation between otitis media and chronic maxillary sinusitis in a post-medieval population from the Netherlands (1500-1850 AD) Maia CASNA, Sarah A SCHRADER ***

P.18 Molecular screening for pathogenic disease in past populations Karen GIFFIN, Maria SPYROU, Katrien VAN DE VIJVER, Justina KOZAKAITĖ, Ron HÜBLER, Žydrūnė MILIAUSKIENĖ, Rimantas JANKAUSKAS, Alexander HERBIG, Kirsten BOS ***

P.19 The Dyck Cliff Dwelling: A lens into dietary and pathological life of the American Southwest William Darwin HERTZEL, Karl REINHARD ***

P.20 Oral pathologies in male and females from the Roman city of Dyrrachium, modern-day Albania (1st-4th centuries AD) Marlon KOCI, Britney KYLE, Laurie REITSEMA, Ulsi TOTA ***

P.21 Abscessed with macaques: Dental abscesses within a biomedical skeletal collection Robin L QUATAERT, Erin F E PINKSTON ***

P.22 A case of a medical school bone box from upstate New York: Pathology, taphonomy, & structural violence Tessa SOMOGYI, Elizabeth A DIGANGI, Kelly GARDNER ***

P.23 The impacts of racialization on skeletal manifestations of disease in migrants to 19th and 20th century St. Louis, Missouri Kristina M ZARENKO

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 7 SCIENTIFIC PROGRAM FRIDAY, April 16 11:00 am – 1:30 pm PODIUM: COCKBURN STUDENT PRIZE & JANE E. BUIKSTRA EARLY CAREER AWARD ENTRIES

Chair BURK INC.

11:00 Understanding the impact of shape change on cranial blood flow patterns: A modern-prehistoric feedback loop Tiffany W SHIEN, Sofia DANIELS, Jessica M CRONIN, Jane VANNAHEUANG, Ana SHAUGHNESSY, Rebecca S JABBOUR, Gary D RICHARDS ***

11:15 Incorporating histological methods with stable isotopes and paleopathology to examine the effects of starvation in Kilkenny, Ireland during the Great Famine (1845-52) Lauren MECKEL, Hallie BUCKLEY, Jonny GEBER ***

11:30 Childhood stress and bone health in two populations from ancient Nubia (1750-1550 BC and 1440-660 BC) Kaitlyn SANDERS ***

11: 45 Cribriotic correlation? Studying cribra orbitalia, cribra humeri, cribra femora and their association in the medieval Netherlands Rachel SCHATS ++

12:00 pm – 12:15 pm COFFEE BREAK

12:15 Diseased cities: An examination of chronic respiratory disease around the time of the Black Death Jenna M DITTMAR, Piers D MITCHELL, Sarah A INSKIP, Craig CESSFORD, John E ROBB ++

12:30 Once were warriors: Challenging occupation preconceptions in Lebanese weapon-associated burials Chris STANTIS, Arwa KHAROBI, Holger SCHUTKOWSKI ++

12:45 Paleogenomic analysis of pathogenic bacteria in hunter-gatherers from Central Coast Patagonia, Argentina Miriam BRAVO-LOPEZ, Carolina ROCHA-ARRIAGA, María Laura PAROLIN, Camila TAMBURRINI, Viridiana VILLA- ISLAS, Rosa FREGUEL, Silvia DAHINTEN, Julieta GÓMEZ-OTERO, Gabriela MILLÁN, María ÁVILA-ARCOS ++

1:00 Socioeconomic transformations of the North Caucasian Bronze Age (3700-1650 BC) written in teeth. Implications from oral health and occupational habits Katharina FUCHS, Biaslan C ATABIEV, Alexey A. KALMYKOV, Natalia BEREZINA, Julia GRESKY ++

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 8 SCIENTIFIC PROGRAM THURSDAY, April 22 11:00 am – 1:00 pm POSTER PANELS: REGULAR

Chair Piers MITCHELL

11:00 am – 11:30 am METABOLIC DISEASES, STRESS & INFECTIOUS DISEASES

P.24 Pre-Columbian (circa AD 1050 to 1250) treponemal disease in an ancestral Puebloan from Southern Utah Meghan BANTON, Derinna KOPP

P.25 Cardiovascular pathology in ancient Egypt: A comprehensive review of the literature and future perspectives Raffaella BIANUCCI, Francesco M GALASSI, Stephanie PANZER, Elena VAROTTO, Simon DONELL, Andreas G NERLICH

P.26 Paget’s disease of bone: A framework for approaching non-pathognomonic lesions Megan B BRICKLEY

P.27 Vitamin D deficiency and chronic respiratory infections in the skeleton: Evidence from the Roman period site of Ancaster, UK Laura LOCKAU, Simon MAYS, Megan B BRICKLEY

P.28 Physiological stress in 18th-19th century Victoria Gate, Leeds, England: Carbon and nitrogen stable isotope analysis of incremental dentine Paula A MONGUÍ, Janet MONTGOMERY, Julia BEAUMONT, Anwen C CAFFELL, Rebecca L GOWLAND, Darren R GRÖCKE

P.29 The case for the bioarchaeology of care: Osteomyelitis of an El Molle female from Chile’s semiarid north Maria A ROSADO, Shirley CELI-LANDEO, Anna GETLER

P.30 Exploring the impact of early-life stress on later-life outcomes in historic populations from north-east England through a Procrustean assessment of dental fluctuating asymmetry Ben WIGLEY, Elizabeth CRAIG-ATKINS, Eleanor STILLMAN

11:45 am – 12:15 pm TRAUMA

P.31 Three cases of trauma from Iron Age Dzedzvebi, Georgia Ihab AL OUMAOUI

P.32 Interpersonal violence in medieval central Italy: Portrayal of a young victim from the necropolis of Villamagna (FR) Francesca CANDILIO Gabriella CALVARUSO, Alfredo COPPA Claudio DI BIASI, Caroline GOODSON,

P.33 Early Bronze Age blunt force trauma: A case of postero-transverse transsphenoidal basilar fracture Milena GRZYBOWSKA

P.34 ‘Thrice fractur’d’: Multiple fractures and injury recidivism in 18th century London, UK Madeleine MANT

48th Annual North American Meeting of the Paleopathology Association 9 SCIENTIFIC PROGRAM

P.35 Adult mortality from warfare-related trauma and childhood stress markers on the North American Great Plains Jocelyn D MINSKY-ROWLAND

12:30 pm – 1:00 pm OPEN PALEOPATHOLOGY

P.36 Skeletal dysplasia inheritance and maternal/fetal health in the Middle Woodland Period Aviva A CORMIER, Jane E BUIKSTRA, Anna East GILLETLY

P.37 Investigating the impact of the 4200 yr BP aridification event on community health: Bioarchaeological analysis of Neolithic and Bronze Age samples from Qinghai Province, China Jacqueline T ENG, Quanchao ZHANG

P.38 The first Italian report of bilateral non-osseous calcaneonavicular coalition from Medieval Sicily (Troina) Francesco M GALASSI Elena VAROTTO, Lorenzo ZURLA, Caterina INGOGLIA

P.39 Cellular-resolution soft-tissue imaging in mummies by x-ray phase-contrast CT Jenny ROMELL, William TWENGSTRÖM, Mikael ROMELL, Sofia HÄGGMAN, Salima IKRAM, Hans M HERTZ

P.40 The embodiment of colonial strategy: Osteoarthritis in ancient Nubia Sarah SCHRADER

P.41 A case of bilateral humerus varus from the Late Antiquity Santa Mustiola’s Catacomb (Chiusi, Italy) Alessandra SPERDUTI, Matteo BRACONI, Giulia FACCHIN, Giovanna FERRI, Stella INTERLANDO

P.42 Description and frequency of the acetabular crease / supra-acetabular fossa among ossa coxae recovered from four commingled Late Intermediate Period tombs (ca. AD 1250) at Marcajirca, Ancash, Peru Anne R TITELBAUM

P.43 Isotopic variation in neoplastic conditions in ancient Peruvian (CE 1350–1450) mummified remains J Marla TOYNE, Christopher SCHOW

P.44 The lowly bunion: Identification of hallux valgus in the late 19th century on the Texas frontier Catrina Banks WHITLEY, Abigail FISHER

48th Annual North American Meeting of the Paleopathology Association 10 SCIENTIFIC PROGRAM FRIDAY, April 23 11:00 am – 12:00 pm PODIUM

Chair BURK INC.

11:00 Estimating the prevalence of cancer in Medieval Britain Piers D MITCHELL, Jenna M DITTMAR, Bram MULDER, Sarah INSKIP, Craig CESSFORD, Jay T STOCK, John ROBB

11:15 Mercury ‘poisoning’ in patients with syphilis within the Ca’ Granda hospital (17th century Italy) Lucie BIEHLER-GOMEZ, Mirko MATTIA, Carlotta SALA, Gaia GIORDANO, Domenico DI CANDIA, Carmelo MESSINA, Luca Maria SCONFIENZA, Paolo Maria GALIMBERTI, Fabrizio SLAVAZZI, Cristina CATTANEO

11:30 Assessing taphonomic aspects in the recovery of A. lumbricoides and T. trichiura eggs from archaeological sediments from historical (18th-19th century) New England latrines Aida ROMERA BARBERA, W Darwin HERTZEL, Karl J REINHARD

11: 45 Paleopathology and inclusive, equitable, sustainable development Gwen ROBBINS SCHUG

12:00 pm – 12:15 pm COFFEE BREAK

12:15 pm – 2:00 pm ASSOCIATION ANNUAL BUSINESS MEETING

48th Annual North American Meeting of the Paleopathology Association 11 ABSTRACTS

Three cases of trauma from Iron Age Dzedzvebi, Georgia Ihab AL OUMAOUI Institute of Archaeological Studies, Ruhr-Universität Bochum The present study focuses on the analysis of similar trauma conditions of three individuals found during the 2019 excavations. The graves were discovered in the Iron Age sector (Late 2nd millennium to 600 BC) of Dzedzvebi Bronze Age site (5th to 2nd millennium BC) located in Georgia. A total of 23 individuals were found during the last campaigns since 2015. Macroscopic analysis for pathological conditions using conventional diagnosis methods revealed evidence of antemortem trauma, degenerative disease, and some pronounced muscle attachment markers. It seems to be that these individuals, buried in close proximity, probably suffered from similar health conditions and deleterious episodes during their lives. This indicates excessive stress and different lifestyle than in former periods of the site. The information obtained provides insight into the health conditions of ancient inhabitants of the Caucasus.

OsteoLogic: An interactive website for improving consistency in scoring orbital roof lesions ANDERSON Amy1, GARDNER Brianna2, YANG Chris3 *** 1Anthropology, University of California Santa Barbara, 2Anthropology, University of Tennessee Knoxville, 3Computer Science, University of California Santa Barbara Standardized data collection remains a challenge in paleopathology, particularly when comparing data collected by different researchers from different skeletal collections. Osteological indicators of systemic stress, such as porous cranial lesions, including porotic hyperostosis and cribra orbitalia, are often inconsistently reported. Several standard scoring systems have been developed for collecting consistent data on these lesions, but tests of interobserver agreement yield disheartening results: different researchers often generate different pathology data from the same skeletal materials. To address this fundamental issue in paleopathological rigor we introduce the OsteoLogic website, an interactive training platform for paleopathologists to 1) improve intra-observer reliability in lesion scoring and 2) improve scoring methods using user-generated data on inter-observer reliability in lesion assessment. Currently focused on orbital roof lesions, the site hones individual scoring abilities with interactive tests of lesion expression and lesion activity from high-resolution photographs. Users can compare their assessments to the original observer of the skeletal materials as well as other site users. Additionally, because images for scoring tests are chosen by random sampling with replacement, site users receive data on their own intra-observer reliability. The data generated by site users will highlight inconsistencies in current practices of scoring orbital roof lesions, crowdsourcing a comprehensive, standard method of lesion analysis with greater interobserver agreement. We invite conference-goers to test their scoring abilities, provide feedback on the site’s user interface, and consider contributing their own photos to the site’s library to build a globally and temporally diverse catalog of orbital roof lesions.

Medieval medical treatment for cranial trauma from Ilok, Croatia Eric ANDERSON1, Anna OSTERHOLTZ1, Mario NOVAK2, Anna GREEN3, Jennifer HEFFLER4, Andrea RIMPF5. James MOLYNEUX6 *** 1Mississippi State University, 2Institution for Anthropological Research, 3Boise State University, 4California State University, 5Town Museum Ilok, 6Internal Medicine Huntsville Hospital This research examines Burial 179, possible adult male (70% complete) from the site of Ilok in Croatia (dated to the 14th-16th centuries) to determine the possible amount of treatment that would have been needed and provided after exposure to a cranial trauma. We employed the Index of Care as our model. This individual was chosen because it exhibited a healed cranial depression fracture (CDF) on the superior portion of the frontal bone. The possible effects from the CDF trauma are explored by looking

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 12 ABSTRACTS

into modern medical literature on cranial trauma and frontal lobe brain damage (likely present based on the location of the CDF). Given the signs of healing present, it is likely the individual received some medical care, both at the time of the injury and afterward. Treatment for cranial trauma today can be diagnosed and treated with relative success depending on the severity. Without the medical knowledge we have today, what type of treatment could have been possible during the late medieval period? Contemporaneous treatments were found by examining texts detailing medical interventions that may have been available between the 14th and 16th centuries. Cranial trauma is specifically addressed by numerous sources; treatments ranged from surgery, bandages with spider webs, plastering, honey, wine to leaving the wound open with no treatment.

A biocultural examination of structural violence across Missouri state mental hospitals in the 20th- century Madeline M ATWELL *** Department of Anthropology, University of South Carolina Bioarchaeological research on almshouses and former state mental hospitals has grown in recent decades due to the accidental discovery of several unmarked historical asylum cemeteries, and as scholars increasingly look towards historical data to contextualize documented skeletal collections. A substantial body of bioarchaeological literature concerning almshouses, also known as poorhouses, exists. However, research into state-supported insane asylums, later known as state hospitals, are less common. This study utilized a well-documented assemblage, the Robert J. Terry Anatomical Collection, to investigate the embodied effects of structural violence on the remains of 52 Euro-American women who died across Missouri state mental institutions during the 20th-century. Macroscopic skeletal analysis of trauma and disease was paired with death certificates, census data, and historical documents to contextualize the lived experiences within these institutions. Results indicate that hip fractures were the most common injury (~21%), particularly among those labeled “psychotic”, nearly 10% of patients died of tuberculosis (TB) after treatment was available, and approximately 8% suffered from tertiary syphilis. Historical documentation further explains death certificate and skeletal results. Hip fractures were disproportionately high within institutions, worsened by osteoporosis and dismal hospital conditions. TB rates were considerably higher within state-supported institutions due to filth, overcrowding, and neglect. Other historical literature points to the asylum as a last resort for those experiencing tertiary syphilis. When skeletal evidence of trauma is carefully considered within its respective context, such as a setting of care, avoidable injury and death, structural violence is better understood.

Pre-Columbian (circa AD 1050 to 1250) treponemal disease in an ancestral Puebloan from Southern Utah Meghan BANTON, Derinna KOPP Utah State Historic Preservation Office, Utah Division of State History A skull (AS222) originally found in southern Utah was presented to the Utah Davison of State History for NAGPRA reporting. Using standard osteological methods, AS222 was determined to be a probable male between 30 to 45 years of age at time-of-death. Craniofacial morphology, cranial deformation, radiocarbon dating (Beta412136 Cal circa AD 1050 to 1250), and isotopic analysis (δ13C value -8.7 ‰; diet primarily consisting of C4 plants) suggest this individual was of Native American ancestry, with Ancestral Puebloans being the most likely affiliation. Observation of the skull revealed a mixture of active (cavitations caused by bone destruction), healing (remodeling bone), and healed (nodular/stellate scaring) lesions on the frontal, sphenoid, parietal, and temporal bones. These lesions are characteristic of caries sicca, a pathognomonic signature of tertiary stage treponemal diseases in the genus Treponema. No nasal or maxillary palatal lesions were noted, nor were the traditional deformities of congenital syphilis. The geographic location of this case suggests that endemic or venereal syphilis are the most likely diagnoses. The presence of advanced caries sicca and marked bone destruction in the cranial bones, as opposed to the facial bones, is a manifestation most consistent with venereal syphilis; however, given the considerable overlap in the expression of these conditions and the incom- plete nature of the remains, this cannot be considered a definitive diagnosis. AS222 is an intriguing paleopathological example of

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 13 ABSTRACTS

pre-Columbian treponemal disease from the North American southwest that should be considered alongside issues concerning the origin, distribution, and expression of treponemal diseases.

Cardiovascular pathology in ancient Egypt: A comprehensive review of the literature and future perspectives Raffaella BIANUCCI1, Francesco M GALASSI2, Stephanie PANZER3, Elena VAROTTO2, Simon DONELL4, Andreas G NERLICH5 1Warwick Medical School, Biomedical Sciences, The University of Warwick, 2Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, 3Department of Radiology, Trauma Clinic Murnau, 4Norwich Medical School, University of East Anglia, 5Institute of Pathology, Academic Clinic Munich-Bogenhausen The scientific interdisciplinary analysis of Ancient Egyptian mummies and skeletons has led researchers to re-evaluate the burden of cardiovascular diseases in ancient civilizations. Current knowledge shows that chronic conditions plagued ancient societies just as much as contemporary societies. This presentation addresses existing knowledge from published studies on cardiovascular diseases (CVDs) in ancient Egypt, ranging from the earliest publications by the pioneers of the discipline to the most recent ones. The epidemiology and morphology of these conditions from historical and literary sources are compared with hard biological evidence. From this a best-practice approach to assess the presence of CVDs in Egyptian mummies is suggested. The old pro-autopsy vs contra-autopsy debate is also addressed. This re-examination also presents new information on peripheral artery disease (PAD) in Egyptian mummies with a special focus on the data acquired from Tomb TT95, a Theban tomb of the necropolis of Thebes-West (Upper Egypt) built during the New Kingdom (c. 1400 BCE) and used until the Late Period (c. 350 BCE) (minimum number of individuals buried in the main complex: n=73, sex ratio m:f = 52%:48%, immature rate= 27.4%).

Mercury ‘poisoning’ in patients with syphilis within the Ca’ Granda hospital (17th century Italy) Lucie BIEHLER-GOMEZ1, Mirko MATTIA1, Carlotta SALA1, Gaia GIORDANO1, Domenico DI CANDIA2, Carmelo MESSINA3, Luca Maria SCONFIENZA3, Paolo Maria GALIMBERTI4, Fabrizio SLAVAZZI5, Cristina CATTANEO1 1Laboratory of Forensic Anthropology and Odontology (LABANOF), University of Milan, 2Section of Legal Medicine, University of Milan, 3Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, 4Service of Cultural Heritage, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 5Department of Environmental and Cultural Heritage, University of Milan The Ospedale Maggiore, called “Ca’ Granda” or “Big Home” by the Milanese, was one of the main institutions in Milan (Italy) in the 16th century and a model during the Renaissance for similar healthcare institutions across Italy and Europe because of its innovative and avant-gardist free medical assistance to the poor and scientific activity. As part of the Ca’ Granda Project undertaken by the University of Milan and the Hospital Foundation for Cultural Heritage of the Ospedale Maggiore, campaigns of archaeological excavations of the sepulchral chambers of the Ca’ Granda crypt have revealed the presence of an estimated 2.9 million commingled bones, representing the skeletonized bodies of the deceased patients of the hospital during the 17th century. During these excavations, two crania were found with pathological signs of tertiary syphilis, showing clustered pits, marked cavitation, bone destruction and nodular formation, consistent with advanced stages of caries sicca. Computed tomography (CT) imaging was undertaken for a better visualization of the extent of the lesions and bone samples of both crania were submitted to inductively coupled plasma mass spectrometry (ICP-MS) to measure the levels of mercury remaining in the bones. As a result, high levels of mercury were detected. By the 17th century, syphilis was a widespread and common condition in Italy. The finding of two cases of tertiary syphilis with high bone levels of mercury confirms the historical use of the heavy metal as a treatment for the infectious disease in the 17th century Italy, and in particular Milan.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 14 ABSTRACTS

Skeletal and molecular evidence of the Mycobacterium tuberculosis complex from Tenochtitlan- Tlatelolco, a late Postclassic Mesoamerican urban center (1350-1521 CE) Kelly E BLEVINS1, Elizabeth A NELSON2,3, Alexander HERBIG2, Johannes KRAUSE2, Jane E BUIKSTRA1, Josefina MANSILLA LORY4, Kirsten I BOS2, Anne C STONE1 *** 1School of Human Evolution and Social Change, Arizona State University, 2Department of Archaeogenetics, Max Planck Institute for the Science of Human History, 3Institute for Archaeological Sciences, University of Tübingen, 4Dirección de Antropología Física, Instituto Nacional de Antropología e Historia There is substantial bioarchaeological evidence of tuberculosis (TB) infection throughout the Americas prior to European contact. Evidence in the form of Pott’s disease, or a collapsing spine, is found dating from 700 CE in Peru and 900 CE in the Southwest United States. In 2014, three whole Mycobacterium tuberculosis complex (MTBC) genomes were recovered from pre-contact coastal Peru. These strains were most closely related to M. pinnipedii, the contemporary MTBC strain that infects seals and sea lions. This led to the hypothesis that pinnipeds introduced the MTBC into pre-contact human populations. Discovery of this zoonotic event raised questions about other cases of skeletal TB throughout the Americas and whether they resulted from a human-to-human adapted M. pinnipedii form or a different source. Here we explore this phenomenon by focusing on Tenochtitlan-Tlatelolco, the Aztec imperial capital and contiguous island cities in the Basin of Mexico. Despite its numerous densely populated urban centers, there exists little evidence of TB infection from pre-contact Central Mexico. Two skeletal assemblages from the urban marketplace Tlatelolco were examined, and 2.8% of individuals were found to have skeletal changes suggestive of TB infection. Given the low frequency at which skeletal TB cases occur, this prevalence suggests that TB was endemic in this pre-contact city. Contextualized by these paleopathological data, we present the results of whole MTBC genome in-solution capture and phylogenetic reconstruction from two Tenochtitlan-Tlatelolco samples. The implications of these results are discussed, as well as the utility of combining paleopathological and ancient DNA datasets. Funding: NSF (BCS-1063939 and BCS- 1515163), Max Planck Society, European Research Council Starting Grant CoDisEASe, Fulbright- García Robles Fellowship. Permission from the Instituto Nacional de Antropología e Histora (Oficio 401.B(4)19.2016/36/2099)

Was childhood health declining in the period leading to the Black Death? A comparison of childhood health between the early, late pre-Black Death and post-Black Death periods Florencia Natalia BOTTA *** Archaeology Department, School of Archaeology, Geography and Environmental Science, University of Reading The Black Death hit England in AD 1348-1350 and led to population mortality of at least 40%. Although the plague was considered to have started a crisis period, further studies indicated it was part of a larger crisis which began in the 12th century. Health status during this crisis in London has been previously investigated; however, little attention has been paid to health outside this major center. This study examined childhood stress in both non-surviving non-adults and surviving adults, comparing the early, late pre-Black Death, and post-Black Death periods to evaluate if childhood health outside London was declining in the period leading to the outbreak. Materials consisted of 290 individuals (0-17 years, n=163; 17-35 years, n=127) from early (AD 900-1100) and late (AD 1100-1348) pre-Black Death, and post-Black Death (AD 1350-1550) periods from three sites outside London. Methods focused on typical childhood conditions including, puberty status, broad stress indicators (cribra orbitalia, linear enamel hypoplasia), vertebral neural canal (VNC) dimensions and long bone osteometrics. Preliminary results showed statistically significant higher frequencies of individuals 0-6 years dated during the late pre-Black Death (55.26%; 84/152); this could indicate a higher mortality among children in the late pre-Black Death period. However, examination of cribra orbitalia, linear enamel hypoplasia and VNC dimensions, showed no statistically significant differences for any non-adult age group between early and late pre-Black Death periods. These results suggest that the crisis might have been experienced differ- ently outside London and highlights the need for further study of rural communities in Medieval England.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 15 ABSTRACTS

Paleogenomic analysis of pathogenic bacteria in hunter-gatherers from Central Coast Patagonia, Argentina Miriam BRAVO-LOPEZ1, Carolina ROCHA-ARRIAGA1, María Laura PAROLIN2, Camila TAMBURRINI2 Viridiana VILLA- ISLAS1, Rosa FREGUEL3, Silvia DAHINTEN2, Julieta GÓMEZ-OTERO2, Gabriela MILLÁN2, María ÁVILA-ARCOS1 ++ 1International Laboratory for Human Genome Research, Universidad Nacional Autónoma de México (UNAM), 2Instituto de Diversidad y Evolución Austral (IDEAus), CCT CONICET-CENPAT, 3Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna The Central-Northern Coast of Patagonia has been occupied by hunter-gatherers since at least the middle Holocene based on direct dating of human bones. The biogeographical and environmental conditions throughout this region would have provided abundance and diversification of the subsistence activity, influencing the hunter-gatherers’ health status. We screened teeth and bone samples from the Central-Northern Coast of Patagonia (6000-300 BP) individuals in search of ancient pathogens. We extracted aDNA, built sequencing libraries, and generated low-depth shotgun sequencing data. The resulting sequences were classified taxonomically by using complete bacterial, archaeal and viral genomes in the NCBI’s RefSeq database. We identified aDNA Erysipelothrix rhusiopathiae, which is a zoonotic pathogen that causes erythematous skin lesions known as erysipeloid. In addition, the identification of periodontopathic bacteria such as Rothia dentocariosa, Eikenella corrodens, Streptococcus sanguinis, Streptococcus gordonii, Capnocytophaga gingivalis, Capnocytophaga ochracea, Filifactor alocis, Fusobacterium nucleatum; Capnocytophaga sputigena, Veillonella parvula, Aggregatibacter aphrophilus, Filifactor alocis, Tannerella forsythia; and together with the paleopathological evidence, suggest the presence of periodontal disease in these individuals. The results obtained from stable isotope (13C and 15N) analyses showed a dietary dependence on terrestrial and marine resources, therefore, this could have influenced their oral health status. Additionally, we identified aDNA Clostridium perfringens, a causative agent of gangrene, food poisoning and non-foodborne diarrhea, and Clostridium tetani, which causes tetanus disease. Further genomic analyses will provide additional insights into how subsistence strategies influenced the hunter-gatherers’ health, and how the genomes of these pathogens have evolved in the past ca. 6000 years.

Unique case of coffin birth discovered in Medieval Nubia at Nuri, Sudan Abagail M BREIDENSTEIN1, John PARTRIDGE2, Meghan E STRONG3, Pearce Paul CREASMAN4 ++ 1Institute of Evolutionary Medicine, University of Zürich, 2Virginia Commonwealth University, 3Cleveland Natural History Museum, 4American Center of Oriental Research Recent archaeological work at the Royal Pyramids and Necropolis at Nuri, in northern Sudan, have uncovered multiple cultural horizons of Nubia spanning from the Napatan period (ca. 760 BCE) to more recent historical times (ca. 1900s CE). Excavations of an unknown feature near the edge of the pyramid plateau have uncovered a grouping of unique, sandstone “box graves,” that are likely Christian as evidenced by characteristic body treatment, use of burial shrouds, and a lack of grave goods. Tentative radiocarbon dating of another burial suggests this cemetery was in use ca. 1110 CE at the height of the Christian kingdom’s reign in northern Sudan. Within this burial ground, a young female in her early to mid-thirties was buried at the highest, most central part of the tell, possibly indicating her significance. Skeletal analyses of this individual show extensive dental pathologies including multiple teeth lost antemortem, a healed depression skull fracture, and the presence of cribra orbitalia and cribra femora indicating bouts of infections or other chronic health issues. Most notably, she died of an unknown complication, nine months pregnant, and as evidenced by the anatomical position of a fetus expelled from her pelvis, delivered it postmortem. Recognizing limitations of applicability, modern Western antenatal growth charts based on femur lengths estimate the fetus’ gestational age as 40 weeks and 6 days (+/- 2 weeks). Here, we present the findings of what we believe to be the oldest reported case from Africa of the extraordinary phenomena known as a postmortem fetal expulsion.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 16 ABSTRACTS

Paget’s disease of bone: A framework for approaching non-pathognomonic lesions Megan B BRICKLEY, Department of Anthropology, McMaster University Paget’s disease of bone (PDB) is a disorder that results in localised disruptions of bone remodelling with affected bones going through three phases of change. Over the last twenty years the number of reported cases of PDB in archaeological human remains has grown, but most have featured pathognomonic lesions found in phases two and three. This study aims review the development of earlier phase, and non-pathognomonic lesions, and set out approaches that assist in evaluation of such lesions. The comparative approach to paleopathological diagnosis, in which comparisons are made to a known reference group, has considerable strengths in confirming cases of PDB with pathognomonic radiographic and histologic lesions. To date, however, few cases with non-pathognomonic lesions have been suggested but there is potential to do so using a biological approach. In the first phase of PDB osteoclastic activity predominates, with a move to an increase in both osteoclastic and osteoblastic activity in phase two. Aspects of phase one osteoclastic activity are discernable radiographically, with lesions such as osteoporosis circumscripta occurring, and in phase two histological lesions prior to the pathognomonic ‘mosaic’ could be diagnostic in combination with other lesions. Taking a biological approach to diagnosis offers the potential to consider earlier stage lesions. Consideration of non-pathognomonic lesions in a biological framework would contribute to understanding disease development. There is much that remains to be learned regarding PDB and there is considerable potential for palaeopathological investigations to contribute to the understanding of current health questions linked to this condition.

Intersecting identities and trauma in the Erie County poorhouse cemetery (1851-1913) Jennifer F BYRNES1, Katherine GADDIS1, Joyce E SIRIANNI2 ++ 1Department of Anthropology, University of Nevada, 2Department of Anthropology, University at Buffalo The Industrial Revolution in the United States created major manufacturing centers built on the backs of the swelling immigrant population. During this period, poorhouses were established to alleviate the suffering of those who could not support themselves, including many individuals with physical impairments who were considered disabled. In this study, the Erie County Poorhouse Cemetery (1851-1913) is used to contextualize life during this historic period using traumatic injuries from the excavated portion of the cemetery. Antemortem trauma, dislocations, probable avulsion fractures, traumatic myositis ossificans, traumatic osteoarthritis, amputations, and osteochondritis dissecans are analyzed for all of the skeletal elements of 310 adults. A total of 140 individuals (45%) displayed at least one traumatic injury, including 15 females (25%) and 78 males (70%). 41 (29%) displayed hand trauma and 19 (13.5%) displayed foot trauma. 13 (9%) displayed cranial trauma excluding the nose, and 30 (21%) displayed nose trauma. Three individuals displayed fractures of the sternum (2%). 51 (36%) displayed upper limb trauma and 65 (46%) displayed lower limb trauma. In all of these instances, males had a higher incidence of trauma than females, particularly in the skull. Depending on when these traumatic injuries were incurred, they may have contributed to that individual’s decision to enter the poorhouse if it impacted their ability to sustain either themselves or their family in Buffalo, NY. Many of these individuals were already poor and marginalized immigrant populations living during a time when an injury or illness would require them to seek relief from the poorhouse.

The history of tuberculosis in South Africa: Insights and challenges from a multidisciplinary study Tessa CAMPBELL1, Anne STONE2, Rebecca ACKERMANN3 ++ 1Iziko Museums of South Africa, 2Arizona State University, 3University of Cape Town South Africa has seen an increasing number of successful ancient DNA (aDNA) studies within the last decade largely as a result of technological and methodological improvements in DNA recovery and sequencing. Studies of ancient pathogens, however, have been limited and met with less success. This study has aimed to investigate the emergence and spread of tuberculosis in South Africa using the historical literature, bioarchaeological record and aDNA. A thorough survey of archaeologically-derived, Holocene

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 17 ABSTRACTS

and historical skeletal remains (N = 3170; ca. 8000 BCE – ca. 1950 CE) housed in South African institutions was conducted. This survey identified few individuals with pathological lesions suggestive of tuberculosis (n = 12). Molecular analyses were conducted on nine of these individuals and quantitative PCR screening of multiple loci identified five individuals with Mycobacterium tuberculosis Complex (MTBC) DNA. Next-generation sequencing was attempted on five individuals, but no MTBC-specific sequences were identified. This study, while the first to report the detection of ancient pathogen DNA in South Africa, highlights the challenges facing ancient pathogen DNA research in subtropical regions. The aDNA results, in conjunction with the paleopathological and archaeological evidence, are used to discuss the emergence and spread of this disease within the historical context of South Africa. Notably, all identified skeletal cases in this study potentially date to the colonial period (1652 – 1961 CE) suggesting a colonial origin for the disease. While the global antiquity of tuberculosis is appreciated, little is known about the emergence of tuberculosis in Africa; thus, this study contributes to a better understanding of the global emergence of this disease.

Interpersonal violence in medieval central Italy: Portrayal of a young victim from the necropolis of Villamagna (FR) Francesca CANDILIO1, Gabriella CALVARUSO2, Alfredo COPPA2, Claudio DI BIASI2, Caroline GOODSON3, Corisande FENWICK4, Francesco LA PASTINA2, Mauro RUBINI5, Ferdinando SPANO’2, Elizabeth FENTRESS4 1Superintendency of Archaeology, Fine Arts and Landscape for the city of Cagliari and the provinces of Oristano and South Sardinia, 2Sapienza University of Rome, 3University of Cambridge, 4University College London, 5Superintendency of Archaeology, Fine Arts and Landscape for Lazio Excavations at the late medieval cemetery of Villamagna brought to the discovery of over 500 individuals among which those of a young (12-13 year-old) individual, perhaps female, showed particular signs of interpersonal violence and attests to living conditions, violence and care in a rural peasant community of what is today Central Italy. The presence of trauma and subsequent bone remodeling was assessed morphologically on both cranial and post cranial elements and verified by means of a CT-scan. The results clearly show the presence of indicators that attest to hardship suffered in different moments of the individual’s life. These include a small residue of a foreign object embedded in the frontal bone, dental enamel hypoplasia, the fracture of a tooth, a non-fatal sword wound that severed the left ilium, and what appear to be signs of infection, anemia and osteochondritis. Even though they could be independent, a number of such indicators could likewise point to a single violent but non-fatal attack, whereas the presence of signs of infection and anemia could indicate the individual survived with serious repercussions that could have contributed to, or determined, her early demise months later. Current research highlights the importance of multidisciplinary approaches in the understanding of past populations. In such perspective it is evident that the analysis of single individuals can not only give voice to a person that, regardless of the young age at death, must have lived extreme hardships but it, likewise, gives us a glimpse into the society he/she lived in.

In one ear and out the nose: Investigating correlation between otitis media and chronic maxillary sinusitis in a post-medieval population from the Netherlands (AD 1500-1850) Maia CASNA, Sarah A SCHRADER *** Faculty of Archaeology, Laboratory for Human Osteoarchaeology, Leiden University Otitis media (OM) and chronic maxillary sinusitis (CMS) (the inflammation of the middle ear and of the maxillary sinus, respectively) are considered among the most common diseases in children. Pediatric clinical research has shown a strong correlation between OM and CSM. In fact, the pathogenesis of these conditions is identical, with the former usually being a complication of the latter. However, while OM is today considered to be a childhood illness, previous bioarchaeological studies on the topic have shown how lesions associated with OM are also regularly found in adult individuals. The aim of this study was to observe skeletal signs of OM and CMS and their co-occurrence in a post-medieval urban population from the Netherlands (Arnhem, n=112) and to examine their distribution between adults (A) and sub-adults (SA). Both auditory canals and maxillary sinuses were examined with a medical endoscope. The general frequency of individuals presenting signs of OM was 25.9% (A: 24.4%; SA: 31.8%), while 50.9% showed

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 18 ABSTRACTS

signs of sinusitis in either one or both sinuses (A: 55.6%; SA: 31.8%). Differences in the occurrence of both conditions were examined statistically, highlighting a significant relationship between age category (adult/sub-adult) and CMS (χ²(1)=3.986, p<0.046) but not between age category and OM (χ²(1)>=0.354, p=0.552). Finally, significant correlation was found between OM and CMS for the total sample (p<0.001). Results from post-medieval Arnhem suggest that OM and CMS were common disease for both adults and sub-adults. Additional research is being considered in order to further explore the correlation between these two conditions.

Skeletal dysplasia inheritance and maternal/fetal health in the Middle Woodland Period Aviva A CORMIER1, Jane E BUIKSTRA2, Anna East GILLETLY3 1Anthropology, Brown University. 2School of Human Evolution and Social Change, Arizona State University, 3Department of Biology and Biotechnology, Central New Mexico Community College Two individuals, an adult female (EZ 3-7-1) and a fetus (EZ 3-7-2), were excavated from Mound 3 at the Elizabeth site (11PK512) in the Lower Illinois Valley and radiocarbon dated to AD 132-388. The skeletal remains of the fetus were found situated in breech position on the sacrum of EZ 3-7-1, suggesting that EZ 3-7-1 was pregnant at the time of death or possibly died during childbirth. The paleopathological evaluation of EZ 3-7-1 resulted in a differential diagnosis of combined skeletal dysplasia of achondroplasia and Leri-Weill Dyschondrosteosis, and the presence of periosteal woven bone in various stages of formation and healing, which may be indicative of osteomyelitis, primary periostitis, or treponematosis. This paper presents the estimated fetal age of EZ 3-7-2, as well as observations of active, woven bone addition on the ulnae, femora, and tibiae, and usual morphology of the long bones and the cranial elements. Using metric observations of a comparative perinatal sample, we posit that EZ 3-7-2 was outside the range of normal variation regarding the size and shape of the long bones and basioccipital, and may have inherited the skeletal dysplasia(s) from EZ 3-7-1. We explore the possibilities that the woven bone proliferation of EZ 3-7-2 was the result of an active intra-uterine infection or by non-infection-related, maternal stressors of EZ 3-7-1, such as nutritional deficiencies, maternal obesity, and maternal estrogenic levels. This study contributes to current research on inheritance of skeletal dysplasias, systemic physiological disruption in fetuses, and the possible role of fetuses and neonates as indicators of maternal health in the bioarchaeological record.

Osteoimmunology as new frontier in treponemal infection: Setting the ground for bioarchaeological analysis and reconstruction of host immunological status using skeletal samples Fabian CRESPO1, Emily RICH1, Sharon DEWITTE2, Molly K ZUCKERMAN3 1Department of Anthropology and Center of Archaeology and Cultural Heritage, University of Louisville, 2 Department of Anthropology and Biology, University of South Carolina, 3Department of Anthropology and Middle Eastern Cultures, Mississippi State University Syphilis is a chronic inflammatory and multi-stage infection caused by bacterium Treponema pallidum pallidum, and its potential impact on systemic inflammation offers an excellent model to study the long lasting interplay between immune and skeletal systems. We propose that shifts in the host inflammatory phenotype (IP) during acquired syphilis have a systemic consequence ultimately affecting most bone microenvironments that involve inflammatory processes, such as the one developed in periodontal disease (PD). Our previous studies showed that a) osteological analysis revealed a higher frequency of PD in individuals with lesions suggestive or specific to syphilis, especially in those with gummata, representing a hyper-IP; and b) early exposure of immune cells to syphilis antigens shift the inflammatory response to periodontal pathogens (Porphyromonas gingivalis). The objective of this study is to explore how osteoimmunological in vitro protocols can help to answer if immune activation by syphilis and PD pathogens can impact osteoclastogenesis (OCG) and osteoclast (OC) activity. Peripheral blood mononuclear cells from healthy donors were used in two parallel protocols: 1. immune cell activation by exposure to T. pallidum pallidum or P. gingivalis antigens; and 2. differentiation of same donor monocytes (Mo) into OC to evaluate the effect of immune activated cells in OCG. Our preliminary results show that OCG is affected when Mo are exposed to supernatants from immune cells activated by T. pallidum pallidum antigens. These results suggest that chronic syphilis infection, through systemic inflammation, can impact bone microenvironments between seemingly unrelated forms of skeletal infections such as syphilis and PD.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 19 ABSTRACTS

Levels of certainty in the diagnosis of cranial trauma: A test case from the Channel Islands, California (AD1050-early historic) Alycia C DAVIS, Cynthia WILCZAK *** Anthropology, San Francisco State University Depressed cranial fractures from blunt force trauma (BFT) can indicate interpersonal violence within past societies, but they can be a diagnostic challenge particularly when partially healed. We applied a revised Istanbul Protocol to evaluate the level of certainty in attributing depressed lesions to BFT in the subset of crania from the Channel Islands, California (AD 1050-early historic) that are curated at the Smithsonian Institution. This population was chosen because it is often cited as having one of the highest frequencies of BFT in the world. Features used in evaluating the diagnostic certainty included: presence of radiating fractures, inward displacement of fragments, inner table involvement, and the size, shape and location of the depressions. The results were cross- checked with notes in the Phillip Walker Papers at the National Anthropological Archives to determined which depressions had been classified as BFT in the original studies of Channel Island trauma. We evaluated 86 depressed lesions on 71 crania (N = 415). Thirty percent were not consistent with trauma. Of those remaining, 70% were consistent with BFT or BFT could not be excluded. Only 30% were highly consistent with or diagnostic of BFT. Thirty-two of the depressions that we evaluated were scored as BFT in Walker’s notes. For this subset of lesions, our criteria excluded 9.4%; rated 60% as consistent with or not excluded and 34.3% as highly consistent with or diagnostic of BFT. While cranial BFT is clearly present in the population, estimates of its frequency are greatly impacted by the degree of uncertainty that we are willing to accept in the diagnosis.

Diseased cities: An examination of chronic respiratory disease around the time of the Black Death Jenna M DITTMAR1, Piers D MITCHELL2, Sarah A INSKIP1, Craig CESSFORD1,3, John E ROBB2 ++ 1McDonald Institute for Archaeological Research, University of Cambridge, 2Department of Archaeology, University of Cambridge, 3Cambridge Archaeological Unit, Department of Archaeology, University of Cambridge The 14th-century bubonic plague epidemic, also known as the Black Death, was one of the most devastating epidemics in the history of the world and much of the research on life during the medieval period focuses on the consequences of this catastrophic event. As such, much about the presence and persistence of other diseases within medieval communities remains unknown. This research investigates trends in chronic respiratory diseases including tuberculosis, in medieval Cambridge. Human skeletal remains (n= 286) from three burial grounds in Cambridge dating to c. 950-1538 were macroscopically assessed, including: the Hospital of St John the Evangelist (n=169), the urban parish of All Saints by the Castle (n=91), and an Augustinian Friary (n=26). 23.3% (n=64/286) of individuals had skeletal lesions suggestive of a chronic respiratory disease. Of these, 12.2% (n=35/286) had evidence of tuberculosis and 10.8% (n=29/268) of individuals with well-preserved ribs had periosteal new bone formation on the visceral surfaces. When analyzed by site, no significant difference in prevalence rate was identified between the hospital, parish and friary. Individuals that could be accurately dated to either pre- or post-1348 (n=184) were then analyzed to determine if there was a difference in the prevalence of these diseases following the Black Death, and no significant difference in prevalence was found before (n=25/126) or after (n=16/58). This suggests that the inhabitants of medieval Cambridge were uniformly affected by tuberculosis and other chronic respiratory conditions, which were a consistent threat both before and after the Black Death. Funding: Wellcome Trust (Award no 2000368/Z/15/Z)

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 20 ABSTRACTS

Investigating the impact of the 4200 yr BP aridification event on community health: Bioarchaeological analysis of Neolithic and Bronze Age samples from Qinghai Province, China Jacqueline T ENG1, Quanchao ZHANG2 1Department of Biological Sciences, Western Michigan University, 2Research Center for Chinese Frontier Archaeology, Jilin University Approximately 4200 yr BP, global climatic changes purportedly resulted in drought conditions that have been implicated in major disruptions among Neolithic cultures, including those in China. Bioarchaeological research into the health status of populations who lived during and after this event provide insight into the potential impact of climatic conditions upon community health. Skeletal data from this study derive from Qinghai Province, northwestern China. The Neolithic sites (ca. 4500-4000 BP) of Mapai (n=6) and Yangshan (n=56) were compared to samples from a nearby Bronze Age site (ca. 3500-3000 BP), Xiaohandi (n=81). Data analyses examined adult long bone measures and crural index as indicators of childhood stress, tibial osteoperiostitis as a general stress indicator, and fractures of the skull and long bones as an indicator of activity. Fisher’s Exact tests show no significant differences between the Neolithic and Bronze Age sites for tibial osteoperiostitis, nor for fractures. Independent-samples t-tests examining long bone measures show significant differences in the male comparisons for the humerus (t(12)=-2.386, p=0.034), femur (t(23)=-2.466, p=0.022), and tibia (t(9)=-2.494, p=0.034), where the Bronze Age sample had longer measures. These data for male long bone measures are suggestive of better health during the Bronze Age period. However, the opposite trend is seen among the female data, which points to more complex factors influencing growth and stress in these samples. Overall, these findings do not support the hypothesis that there was increased stress and declines in health among Qinghai communities following the 4200 yr BP event.

Analysis of rib trauma in the Erie County poorhouse cemetery assemblage Taylor FLAHERTY1, Jennifer BYRNES1, Joyce E SIRIANNI2 1Department of Anthropology, University of Nevada Las Vegas, 2Department of Anthropology, University at Buffalo Paleopathological analyses of rib trauma can yield valuable information about past behavior and morbidity complications associated with rib injuries. Analysis of the skeletal assemblage from the Erie County Poorhouse Cemetery (1851-1913), in Buffalo, New York, provides a case study that demonstrates the utility of paleopathological analyses of rib trauma. Fifty-nine individuals within the Erie County Poorhouse Cemetery sample had at least one (x̄=10.4) rib which could be sided, sequenced, and assessed for evidence of trauma. This included 36 males, 14 females, 6 ambiguously sexed individuals, and 3 indeterminately sexed individuals. A total of 18 individuals (30.5%) exhibited at least one instance of rib trauma, including 13 males (36.1%) and three females (21.4%). Seventeen individuals (28.8%) had antemortem rib fractures, making this the most prevalent trauma category. One individual (1.7%) had traumatic myositis ossificans and another (1.7%) had traumatic osteoarthritis without fracture or dislocation. Four individuals (6.8%) had traumatic osteoarthritis with associated fracture or dislocation. These data suggest that thoracic trauma and associated morbidity complications were significant components of the lived experience for many of the people buried in the Erie County Poorhouse Cemetery. Additionally, the seldom attempted interpretation of fractures on unidentified rib fragments will be discussed.

Childhood stress and immune dysregulation: Considering a life-course approach for the assessment of frailty in skeletal remains Emilia FRANKLIN, Pia NYSTROM *** The University of Sheffield Frailty is a state underpinned by immunological dysfunction, and its identification in skeletal remains is of growing interest within palaeodemography. Stress markers are frequently used to study frailty osteologically, but are limited in their application. Elucidation of new frailty indicators would facilitate greater understanding of the causes and consequences of frailty in past populations. Analysis of periodontitis, an immunologically mediated form of periodontal disease, may permit the osteological identification of intrinsic frailty. This study assessed the utility of a life-course approach, centred on the combination of periodontal

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 21 ABSTRACTS

disease and linear enamel hypoplasia, to aid the identification of frail individuals from skeletal remains. Prevalence and severity of linear enamel hypoplasia, calculus and periodontitis was recorded from 56 adults from the 18th-19th century ‘Coronation Street’ skeletal assemblage from South Shields. Associations between dental pathologies and demographic groups were identified and assessed using Chi-square tests. All individuals had periodontal disease in some form. No associations between enamel hypoplasia and periodontal disease existed, therefore no evidence supported that childhood stressors had any visible influence on frailty. The identification of frail individuals was not possible. Calculus prevalence was significantly associated with periodontitis severity, demonstrating that external risk factors such as diet, environmental pollution and oral hygiene substantially influenced periodontal disease, limiting any interpretation of intrinsic frailty. The importance of external risk factor identification and quantification for future frailty studies is emphasised, and the application of biomolecular and isotopic approaches is recommended to aid assessment of exogenous risk factors in the future.

Socioeconomic transformations of the North Caucasian Bronze Age (3700-1650 BC) written in teeth. Implications from oral health and occupational habits Katharina FUCHS1, Biaslan C ATABIEV2, Alexey A KALMYKOV3, Natalia BEREZINA4, Julia GRESKY5 ++ 1Kiel University, Institute of Clinical Molecular Biology, 2Institute for Caucasus Archaeology, 3Heritage Organization Ltd, ‘Nasledie’, 4Research Institute and Museum of Anthropology, Moscow State University, 5German Archaeological Institute, Department of Natural Science/Central This paper examines to what extent oral health and the occupational use of teeth reflect socioeconomic transformations during the North Caucasian Bronze Age (3700-1650 BCE). Within 2000 years, crucial shifts from mobile pastoralists to sedentary agricul- turalists and from hierarchical to more egalitarian societies took place. We investigated skeletal remains dating from the Early to the Late Bronze Age, associated with four archaeological cultures. The study is based on detailed macroscopic and microscopic examinations of 190 sets of permanent dentition from adult individuals with respect to six categories of oral health. Some dental modifications, such as interproximal grooving and heavy frontal wear, are common extramasticatory features across time and regions. Yet varying degrees of these alterations might be related to different socioeconomic backgrounds. More specific modifications, such as polished surfaces and notching, occur in individuals from a large foothill cemetery dating to the Late Bronze Age transition, indicating an increase in the specialization of the occupational use of teeth. In addition, in terms of overall oral health, a distinct relative increase of periapical lesions and antemortem tooth loss were observed. These are not only associated with the intensification of non-alimentary tooth use, but also with a higher consumption of cariogenic food. With the caries rate of 49.5 %, the transition to the Late Bronze Age forecasts the establishment of agricultural lifeways of the Koban Culture. We here present the first diachronic study on Bronze Age populations from the Northern Caucasus that explores patterns within archaeological and paleopathological data. Funding: Deutsche Forschungsgemeinschaft (DFG, German Research Foundation - Projektnummer 2901391021 – SFB 1266)

Anthropological analysis of vertebral trauma from the Erie County poorhouse cemetery Katherine GADDIS1, Jennifer F BYRNES1, Joyce E SIRIANNI2 *** 1 Department of Anthropology, University of Nevada Las Vegas, 2Department of Anthropology, University at Buffalo Trauma of the vertebrae and ribs are typically underrepresented in the paleopathology literature compared to appendicular and cranial trauma, even though these injuries can also be anthropologically relevant. Analysis of the skeletal sample from the Erie County Poorhouse Cemetery (1851-1913) demonstrates the utility of vertebral trauma for studies of past cultural behavior. A sample of 197 adults that had greater than 50% of their skeleton represented were selected from a total of 310 adults (MNI of excavated adults) to be included in this study. This sample included 101 males, 51 females, and 45 ambiguously sexed individuals. The skeletal remains were macroscopically analyzed for evidence of trauma, including signs of healing and associated complications. Of the 197 individuals, 25 (12.7%) displayed a total of 56 instances of antemortem spinal trauma. No perimortem vertebral trauma was observed. Of the 56 traumatic injuries, 66.1% were antemortem fractures, 8.9% were dislocations, and 25%

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 22 ABSTRACTS

were antemortem avulsion fractures. The majority of these lesions were identified in the thoracic (67.9%), followed by the lumbar (17.9%), and lastly the cervical (12.5%) vertebrae. No evidence of trauma to the sacra was observed. The remaining 1.8% of trauma was observed in unidentified vertebral fragments. Traumatic injuries were identified more often in males (14.85%, n=15) than females (7.8%, n=4).Variation in traumatic injuries among sex cohorts suggests cultural patterning of injury, potentially related to occupational and other socially mediated risk factors during the height of the Industrial Revolution.

The first Italian report of bilateral non-osseous calcaneonavicular coalition from Medieval Sicily (Troina) Francesco M. GALASSI1, Elena VAROTTO1, Lorenzo ZURLA2, Caterina INGOGLIA2 1Archaeology, College of Humanities, Arts and Social Sciences, Flinders Universit, 2Department of Ancient and Modern Civilizations, University of Messina This communication presents a unique case of bilateral non-osseous calcaneonavicular coalition in the osteological remains of an individual from the medieval cemetery of the Catena district of Troina (Enna, Sicily). After subjecting the burial containing the skeleton (Burial 2) to a multisciplinary archaeological and anthropological analysis, a comprehensive paleopathological study inclusive of a paleoradiological assessment and 3D virtual reconstructions was made. The skeleton, presenting in a good state of preservation, was found to belong to an adult female individual, with an estimated stature of about 150 cm. Radiocarbon dating attributed this individual to the period AD 1250-1301 (1σ). Both calcanei and navicular bones present with an abnormal morphology: the anterior talar articular facets have almost disappeared and show pitting, cystic formations and irregular margins with the exposure of internal trabecular bone; the facets form an abnormally oblique angle between the calcanei and navicular bones; the latter also have a matching lesion, are larger in size than usually seen and on their inferior surface include some part of the articular talar facet of the calcanei. A full length discussion of the case and its framing within the broader context of published literature on tarsal coalition, starting from the 9,300-year-old Kennwick Man, ensues and introduces this case as the first reported one as well as, to the best of our knowledge, the earliest known so far in Italian paleopathological studies.

Molecular screening for pathogenic disease in past populations Karen GIFFIN1, Maria SPYROU1, Katrien VAN DE VIJVER2, Justina KOZAKAITĖ3, Ron HÜBLER1, Žydrūnė MILIAUSKIENĖ3, Rimantas JANKAUSKAS3, Alexander HERBIG1, Kirsten BOS1 *** 1Max Planck Institute for the Science of Human History, 2Royal Belgian Institute of Natural Sciences, 3Vilnius University Determination of the presence of disease in past populations faces several difficulties, including absence or incompleteness of historical documentation, absence of skeletal lesions, or, in the presence of lesions, absence of pathognomonic indicators. Molecular methods can be employed to mitigate these difficulties, but face the challenge that pathogen DNA levels are usually in trace amounts compared to host and environmental DNA. Enrichment techniques can overcome this but require targeting specific pathogens. Recent advances in parallelization of sensitive laboratory procedures and computational approaches allow for non-targeted, accurate detection of pathogen DNA in archaeological contexts. These new methodologies also permit simultaneous detection of multiple pathogens within a population, a simultaneous multiple burial or a single individual. Here we will describe the screening of burial populations from two cemeteries for the presence of pathogen DNA. The first, a parish cemetery, was located in Mechelen, Belgium and in use between the 10th and 18th centuries (CE). The second, discovered in Vilnius, Lithuania, is a possible plague burial, and individuals from it have been radiocarbon-dated to the mid-15th and early 17th centuries CE. From these two collections, 176 individuals were analyzed using metagenomic shotgun sequencing and our computational pathogen screening pipeline. Several pathogens were detected, including Yersinia pestis and Salmonella enterica. This investigation highlights the capability of these techniques to reveal the presence of disease in individuals where context information and skeletal indicators were minimal, and additionally gives insight into the disease landscape of Europe between the Middle Ages and the Early Modern period.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 23 ABSTRACTS

Early Bronze Age blunt force trauma: A case of postero-transverse transsphenoidal basilar fracture Milena GRZYBOWSKA Archaeological Research Services Ltd An archaeological excavation undertaken by Archaeological Research Services Ltd in 2019, of an Early Bronze Age ring-ditch burial monument in Northumberland, England, revealed an adolescent and an adult with cranial and postcranial fractures. The aim of the study was to establish the timing, type and etiology of the cranial fractures. The skulls were examined using macroscopic and microscopic methods of investigation and three-dimensional digital modelling. The criteria applied to differentiate perimortem from postmortem events included signs of elastic response, presence of bone flakes, edge morphology, fracture angle and texture, preponderant outline, bevelling, cortical delamintation and cranial bone remodelling. To differentiate violent assault from accidental trauma, the location of impact in relation to hat brim line, side lateralization, as well as evidence of facial and post-cranial trauma were investigated. Both individuals sustained perimortem blunt force trauma. The adult individual suffered high impact bilateral comminuted parietal cranial fractures. The adolescent individual displayed a postero-transverse transsphenoidal basilar skull fracture, typically related to a serious traumatic brain injury. The latter trauma constitutes the first example of this type of cranial fracture in the published palaeopathological record. Basilar skull fractures are caused by high-velocity blunt force trauma predominantly associated with motor vehicle accidents in modern settings followed by intepersonal violence and falls. On balance, the features of BFT fractures of both individuals, considered in combination with the perimortem facial and post-cranial trauma, likely resulted from interpersonal violence rather than accidental injuries.

The Dyck Cliff Dwelling: A lens into dietary and pathological life of the American Southwest William Darwin HERTZEL1, Karl REINHARD2 *** 1Anthropology, University of Nebraska-Lincoln, 2School of Natural Resources, University of Nebraska-Lincoln Parasitism has been observed in coprolite collections in most archaeological sites of the American Southwest, and nearly univer- sally at agricultural sites on the Colorado Plateau. In this region, several studies have approached different explanations based on Ancestral Pueblo lifeways in the region. For the first time, we present parasitological evidence from a region south of the Colorado Plateau. Coprolites from the Dyck Cliff Dwelling (DCD) near Montezuma’s Castle, Camp Verde, Arizona were submitted for analysis. This site is attributed to the Sinagua culture and dietary analysis of the DCD coprolite reveals a distinct adaptation to desert plants endemic to the Verde River Valley. However, like Ancestral Pueblo sites, pinworm (Enterobius vermicularis) dominates the DCD parasite spectrum. Jean-Pierre Hugot led a group of researchers who explained that pinworm airborne infection resulted in tightly enclosed living spaces. It may be that this aspect of life was shared by Sinagua and Ancestral Pueblo peoples and resulted in similar parasitism patterns. We believe that further inspection of the biological remains from the Dyck site will increase our understanding of parasitic infection within the American Southwest and is of worthy note. In conjunction with dietary analysis, we will be able to assess the roles of parasitism and nutrition in defining the paleopathology of the Verde River Valley between 1150 and 1250 AD.

Reconstructing the genomes of the red complex of pathogens from ancient dental calculus samples from the North American Wichita (500-700 BP) Tanvi HONAP1, Cara MONROE1, Paul SANDBERG2, Rita AUSTIN1, Marc LEVINE2, Cecil LEWIS1 1Anthropology, University of Oklahoma, 2Sam Noble Oklahoma Museum of Natural History The red complex comprises the bacterial species Tannerella forsythia, Treponema denticola, and Porphyromonas gingivalis, and is considered indicative of periodontal disease. However, recent research shows that these species are abundant in mature oral biofilms, and their presence in modern as well as historic and archaeological contexts is not necessarily indicative of disease state. Genomic studies of the red complex show that T. forsythia and T. denticola have low intraspecies genetic diversity and relatively stable genomes, whereas P. gingivalis has undergone major genome rearrangements. Surprisingly, little is known about their

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 24 ABSTRACTS

evolutionary histories, such as where these species originated, how these genomes have evolved over time, and whether there is evidence of biogeographic structuring. This study aimed to reconstruct the genomes of red complex bacteria from ancient dental calculus samples. Here, in partnership with The Wichita and Affiliated Tribes from Oklahoma, we present the results of screening dental calculus samples from ten Wichita ancestors (500-700 YBP) using shotgun sequencing. All ten samples yielded bacterial taxonomic profiles consistent with those expected for dental calculus. Using a reference-based mapping approach, we reconstructed partial genomes of T. forsythia from three samples, with approximately 60% of the genome recovered at 4- to 8- fold coverage. We also reconstructed a T. denticola genome from one these samples (approximately 83% of the genome at 4-fold mean coverage). All genomes showed DNA damage profiles consistent with ancient DNA. Phylogenetic analyses using these data will help us understand the evolutionary relationships between the ancient and modern red complex strains.

Oral pathologies in male and females from the Roman city of Dyrrachium, modern-day Albania (1st–4th centuries AD) Marlon KOCI1, Britney KYLE2, Laurie REITSEMA3, Ulsi TOTA4 *** 1University of Central Florida, 2University of Northern Colorado, 3University of Georgia, 4University of Avignon Dyrrachium (modern Durrës, in Albania), was founded in Illyrian territory as a Greek colony in the seventh century BCE and has been an important city ever since, especially during the Roman period. Ancient authors describe information about political, economical, and social life of Roman Dyrrachium, but information about population health is lacking. A recent bioarchaeological campaign studied 33 skeletons from a cemetery in Durres excavated in 2012, and identified dental pathologies, including dental caries, antemortem tooth loss (AMTL), periodontal diseases, and abscesses. Analyzing these oral pathologies, we test the hypothesis that oral health is better among males than females. In the Roman period, males typically consumed more meat and fish than did females, and bioarchaeologists have documented sex-based variation in oral pathology in other contexts due to both dietary differences and physiological factors (i.e., hormones; pregnancy). In our sample, oral pathologies are more prevalent among males than females. However, none of these differences were statistically significant(male/female for each comparison: periodontal disease: 33.0%/7.6%p=0.10; caries: 10.7%/10.0% , p=0.88; AMTL: 8.4%/5.0% , p=0.66; abscesses: 2.3%/0.8% , p=0.35). The fact that oral health is generally worse among males contradicts the hypothesis that females consumed relatively more plant- based foods in the Roman period, and also contradicts the observation that females have worse oral health due to sex-based hormonal factors. We explore how our findings compare with other sites around Mediterranean during the Roman period. The impacts of small sample sizes and unequal age distributions are also discussed. Funding: University of Georgia Sarah Moss Fellowship and the University of Northern Colorado

Parasitic infection in the Roman period: Temporal changes from the pre-Roman through medieval periods Marissa L LEDGER1, Piers D MITCHELL2 1Faculty of Medicine and Dentistry, University of Alberta, 2Department of Archaeology, University of Cambridge The main aim of this study is to characterize human parasite diversity across the Roman empire and to compare this with earlier and later time periods. Comparison of taxonomic diversity with that in pre- and post-Roman periods is used to determine if there were changes in parasite species causing infections in the Roman period, which may have been a result of the expansion of the Roman empire and subsequent cultural and social changes. We will present new evidence from understudied regions and time periods including Neolithic and Roman period Turkey, Bronze Age Britain, as well as Roman period sites in the Mediterranean. This data is combined with previously published studies to begin to compare taxonomic diversity in the pre-Roman period, the Roman period, and the post-Roman period. Preserved parasite eggs and cysts were identified from archaeological sediments using microscopy and enzyme-linked immunosorbent assay (ELISA). Current data suggests a taxonomic shift in parasite presence from

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 25 ABSTRACTS

the pre-Roman to Roman period, characterized by a decrease in zoonotic parasites and an increase in parasites transmitted by faecal contamination of food and water, including roundworm and protozoa which can cause dysentery. The taxonomic diversity seen in the Roman period is very similar to that in the Medieval period. We will discuss factors that may have contributed to the establishment of the parasite diversity found in the Roman period including diet, urbanization, and human-animal interactions.

Extensive perimortem violence at Shamanka II, Siberia: Differential diagnosis of a probable hunter-gatherer massacre Angela LIEVERSE1, Rick SCHULTING2, Christopher BRONK RAMSEY2, Vladimir BAZALIISKII3, Artur KHARINSKII4, Andrzej WEBER5 1University of Saskatchewan, 2University of Oxford, 3Irkutsk State University, 4Irkutsk State Technical University, 5University of Alberta Thirteen individuals interred in the large Early Neolithic (7500–6800 cal. BP) cemetery of Shamanka II, located in the Baikal region of Siberia (Russia), date to the much later Early Bronze Age (EBA) period (4600–3700 cal. BP). Eleven (or 85%) of these 13 EBA individuals exhibit evidence of perimortem violent trauma, largely in the form of projectile wounds and blunt force cranial trauma. This level of perimortem violence far exceeds what is typical for Neolithic and EBA populations in the Baikal region, and radiocarbon dates suggest that these deaths are consistent with one or possibly two episodes. With excavations at Shamanka II completed in 2019, a differential diagnosis of the remains, in combination with Bayesian modeling of the radiocarbon dates, leads us to determine that the EBA burials represent a probable massacre event (or events). It is worth noting that, despite the use of the term “Bronze Age,” populations in the Baikal region retained a hunter-gatherer lifestyle until the appearance of pastoralism around 2800 cal. BP. Massacres among hunter-gatherer populations, while not unknown, are nevertheless quite unusual. In the Baikal region specifically, violent deaths are very uncommon (<2% during the EBA), raising questions about the nature of the Shamanka II EBA community and its interactions with surrounding groups.

Vitamin D deficiency and chronic respiratory infections in the skeleton: Evidence from the Roman period site of Ancaster, UK Laura LOCKAU1, Simon MAYS2, Megan BRICKLEY1 1Anthropology, McMaster University, 2 Historic England Modern clinical data have increasingly recognized a broad range of extra-skeletal actions of vitamin D, including a positive association between vitamin D deficiency and chronic respiratory infection. Immune actions and disease interactions associated with vitamin D and its deficiency have been a recent focus of paleopathological research as well; however, there has been little detailed discussion of how co-occurrence might affect the appearance of skeletal features of these two conditions, and few paleopathological data have been collected to date with this purpose specifically in mind. Using a biological approach that considers how the absence of vitamin D might alter the skeletal response to chronic respiratory infections, this paper synthesizes current epidemiological and molecular evidence in order to model potential interactions between these two conditions in the past, and to discuss how co- occurrence might manifest in the skeleton. This model is contextualized using human skeletal remains from the Roman period site of Ancaster in the UK (3rd-4th centuries AD), where detailed paleopathological examination revealed skeletal evidence for both vitamin D deficiency and a chronic respiratory infection in three individuals (one non-adult, two adults). Skeletal lesions observed raise the strong possibility that vitamin D deficiency played a role in the contraction or development of respiratory infection in two of these individuals. A discussion of the potential relationships between the lesions observed here highlights the complexities involved both in determining the relative timing of skeletal lesion development and in considering how vitamin D deficiency might shape the development of proliferative infectious skeletal lesions.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 26 ABSTRACTS

‘Thrice fractur’d’: Multiple fractures and injury recidivism in 18th century London, UK Madeleine MANT University of Toronto Mississauga Injury recidivism is a critical modern health issue and it is an area of growing interest in bioarchaeology. Determining whether healed injuries were accrued in one incident or accumulated over the life course is a challenge. This research analyzed the skeletal remains of 721 adults (402 males, 319 females) from five post-medieval cemeteries in London, UK, known to include working class individuals, for evidence of skeletal trauma – fractures, myositis ossificans, subluxations/dislocations, blunt force trauma, and sharp force trauma. A total of 164 individuals had more than two fractures; males were significantly more likely to have multiple (2+) fractures than females. It was possible to investigate fracture recidivism because 14 individuals (12 males, 2 females) had a combination of antemortem healed, antemortem healing, and/or perimortem fractures. Contemporary hospital records from the voluntary general hospitals in London were also assessed for evidence of recidivism. The admittance and discharge registers from the Middlesex Hospital, St. Thomas’s Hospital, and Guy’s Hospital reveal evidence of patients re-entering hospitals multiple times with varied injuries. These contemporary clinical details contextualize the distribution and relative timing of these fractures; the majority were likely caused by accidental etiologies. This research lends credence to the idea that in bioarchaeology the term recidivist needs to be context-based and used only when it is certain that fractures were accumulated in more than one incident.

Revealing the imprints of malaria in antiquity: An integrated ancient DNA and bioarchaeological framework Stephanie MARCINIAK1, Tracy L PROWSE2, Hendrik POINAR2 1Anthropology, Pennsylvania State University, 2Anthropology, McMaster University Improvements in ancient pathogen detection and characterization have enabled increasingly hypothesis-driven research to explore the human history of disease, particularly for under-represented pathogens that are not easily identified in the bioarchaeological record. Malaria is one such example, as this parasite has a paradoxical connection with Imperial period Italy (1st-4th c. CE), as a harbinger of the downfall of the Empire, with only a patchwork of supporting evidence that cannot establish the causal Plasmodium species, or when/where the parasite was present. By harnessing a RNA-based hybridization capture strategy to recover minute pathogen fractions in a subset of 11 individuals from three locales (Velia, Vagnari and Portus Romae), we implicated P. falciparum in two adults from disparate locations – a rural estate (Vagnari) and a minor port city (Velia), rather than an urban coastal locale (Portus) historically within the malaria belt. Although our recovered 50.8% of the P. falciparum mitochondrial genome grouped exclusively with modern P. falciparum isolates, we were unable to draw inferences about the evolutionary history of human Plasmodium. We then focused on proxies of the human-parasite relationship through a multivariate approach that integrated paleopathology, isotopes, archaeology, and bioarchaeology as part of a biosocial framework. Our integrative approach helped highlight the dynamic context of human-environment interactions (e.g., land-use patterns) and disease ecology (e.g., climate, geomorphology) potentially hindering or accentuating malaria in the varied central-southern locales. Although much remains unknown about malaria epidemiology in antiquity, interdisciplinary approaches are crucial to study synergistic interactions that underscore the multifaceted experience of disease.

Incorporating histological methods with stable isotopes and paleopathology to examine the effects of starvation in Kilkenny, Ireland during the Great Famine (1845-52) Lauren MECKEL1, Hallie BUCKLEY1, Jonny GEBER2 1Department of Anatomy, University of Otago, 2School of History, Classics, and Archaeology, University of Edinburgh In 2005, an archaeological excavation at the location of the former union workhouse in Kilkenny City, Ireland revealed skeletal remains of individuals who died at the height of the notorious Great Famine. Pathological lesions consistent with scurvy and other non-specific metabolic diseases were observed on the skeletons, such as dental caries, cribra orbitalia, and cranial pitting. In the past, these lesions have also been described in groups who died as a result of pellagra, a niacin deficiency disease associated

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 27 ABSTRACTS

with a high maize, low-protein diet. Historical records explain that maize was imported from North America to Ireland as a relief food during the Famine, while evidence from δ13C isotopes indicate a shift from potatoes to maize consumption. The aim of this research is to incorporate rib bone histomorphometry, stable isotopic ratios, and gross pathological lesions of the skeleton to elucidate how features of bone remodelling can help discriminate pellagra from other nutritional deficiency disorders such as scurvy. Early results from bone histology show a correlation between Haversian canal size and maize consumption, which may indicate imported maize played a role in the observed increase in bone remodelling. This study will examine the effect of diet on bone remodelling and explore the potential for histology to aid in paleopathological diagnosis. This research is unique in that it is the first to use bone histology and δ13C isotopic ratios combined with skeletal pathology to understand how social marginalisation, poverty, and starvation affected the health of the poor in 19th-century Ireland.

Adult mortality from warfare-related trauma and childhood stress markers on the North American Great Plains Jocelyn D MINSKY-ROWLAND Anthropology, Howard Community College Anthropologists have used childhood skeletal stress markers to estimate adult mortality from biological factors, such as infectious disease or age. However, these markers can also be used to estimate mortality from social factors, such as warfare-related trauma. The historic Arikara Native Americans (AD 1600-1832) experienced interpersonal warfare and exhibit childhood stress markers. This project investigates whether the experience of a childhood stress event, increased the risk of death, later in life, from warfare-related trauma. Three-hundred and sixty-six individuals were skeletally complete enough to be analyzed for age, sex, the presence of a skeletal stress marker (linear enamel hypoplasias, cribra orbitalia, porotic hyperostosis or short stature) and skeletal evidence of warfare-related trauma. Selective mortality was investigated using Kaplan-Meier estimates and cox proportional hazards in SPSS version 22. Analyses were conducted separately for each sex. No statistically significant results were found. The survivorship curves indicate that females without a trauma, but who do have a stress marker, exhibit increased survivorship after age 40, compared to females without a stress marker. Survivorship decreases after age 40 for females with a stress and trauma. Males with a skeletal stress marker exhibit decreased survivorship throughout adulthood. This is true regardless if a skeletal indicator of trauma is present. Overall, survivorship decreases in the presence of skeletal stress markers and trauma for both males and females. These results suggest that while it is important to consider biological data when interpreting the health of past populations, it is equally significant to recognize the impact of social factors.

Estimating the prevalence of cancer in Medieval Britain Piers D MITCHELL1, Jenna M DITTMAR2, Bram MULDER1, Sarah INSKIP2, Craig CESSFORD2,3, Jay T STOCK,4 John ROBB1 1Department of Archaeology, University of Cambridge, 2McDonald Institute for Archaeological Research, University of Cambridge, 3Cambridge Archaeological Unit, University of Cambridge, 4Department of Anthropology, Western University It is likely that the prevalence of cancer in medieval Britain was quite different to today, as tobacco had not been imported from the Americas, industrial revolution pollutants had yet to occur, and life expectancy was shorter. However, as cancer may also be present within the medulla of bones, invisible to osteoarchaeologists on inspection, the prevalence in pre-industrial societies remains unclear. Our aim is to estimate the prevalence of cancer in medieval Britain. We analyzed the spine, pelvis and both femora of 112 skeletons from six cemeteries from the medieval Cambridge area (6th-15th century), as these bones have been shown to most commonly contain metastases when malignancy is present. Visual inspection, plain radiographs (x-rays) and CT scans were used to detect malignant lesions. Two individuals showed macroscopic evidence of metastases. A further 2 individuals were found to have metastases only identifiable using imaging. This gave a minimum prevalence of 3.6% of medieval individuals having metastases from cancer at the time of their death. Clinical studies show radiographs and CT only pick up around 75% of metastases, so true prevalence could be around a third higher, at 4.8%. Since about a third to a half of modern people who die with cancer have metastases to bone, this might suggest a minimum prevalence of all cancers at the time of death in medieval Britain of around 10-15%. This compares with post mortem data indicating 40-50% prevalence of cancer at the time of death for modern Britain.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 28 ABSTRACTS

Physiological stress in 18th-19th century Victoria Gate, Leeds, England: Carbon and nitrogen stable isotope analysis of incremental dentine Paula A MONGUÍ1, Janet MONTGOMERY2, Julia BEAUMONT3, Anwen C CAFFELL4, Rebecca L GOWLAND2, Darren R GRÖCKE5 1Anthropology, Universidad de Santander, 2Department of Archaeology, Durham University, 3School of Archaeological Sciences, University of Bradford, 4York Osteoarchaeology, 5Department of Earth Sciences, Durham University Skeletal evidence of metabolic disease and historical records of poor living conditions in Victoria Gate, England indicated exposure to a stressor-loaded environment. Thus, carbon (δ13C) and nitrogen (δ15N) isotope ratio analysis of incremental dentine was performed to establish whether markers for nutritional and physiological distress such as opposing covariance or unusually high δ15N were present. Childhood, and when possible adolescent, δ13C and δ15N were obtained from 8 non-adults and 3 adults. δ13C remained mainly stable, whereas δ15N showed some small variation. δ13C and δ15N opposing covariance was only seen in the final-forming increment in all adults and one non-adult. In infants, δ13C and δ15N ratios were higher than the sample mean until death. In juveniles and adults, the profiles remained mostly flat. It is possible the persistently altered homeostasis (evidenced by the elevated δ15N and metabolic disease) resulted in the apparent absence of an isotopic marker for physiological stress. An isotope ratio change may only appear with stressor overload, for example a sudden increase in pathogen load. While the severe growth stunting in some non-adults, and the combined δ13C and δ15N shift at critical periods of growth indicates limited macro- nutrient intake in this population, these results also suggest isotopic markers of metabolic disease may not always occur. Sufficient calorie/protein intake would prevent catabolic changes in the isotope ratios of dentine collagen, as observed in data from other unpublished sites. Overall, the findings underscore the importance of combining skeletal evidence and local context in the interpretation of isotopic profiles. Funding: Stable Isotope Biogeochemistry Laboratory and Durham University

Tuberculosis in the wake of Wari imperial decline in Pre-Hispanic Peru Elizabeth NELSON1,2, Aditya Kumar LANKALIPALLI1, Maria SPYROU1,2, Åshild VÅGENE3, Susanna SABIN4, James A Fellows YATES1, Tiffiny A TUNG, Alexander HERBIG1 , Kirsten I BOS1 *** 1Department of Archaeogenetics, Max Planck Institute for the Science of Human History, 2Institute for Archaeological Sciences, University of Tübingen, 3Section for Evolutionary Genomics, The GLOBE Institute, Faculty of Health and Medical Sciences, University of Copenhagen, 4Arizona State University, 5Department of Anthropology, University of Vanderbilt Demographic patterns of tuberculosis (TB) are structured by environmental and socio-political factors, including malnutrition, socio-political distress and climatic variability. Such trends may also be observed in past archaeological contexts such as the Late Intermediate period (LIP, 1000–1400 CE) of the Andes, a period characterized by climatic and socio-political transitions. This time period began with the decline of the first Andean empire, the Wari, which was followed by a shift to more dispersed settlements, dietary changes, an increase in violence, and skeletal changes suggestive of TB. LIP archaeological contexts present the largest number of paleopathological reports of Andean TB. Here, we present an investigation of TB in LIP contexts from Huari, the former administrative center of the Wari Empire. Using morphological and molecular methods, we analyzed comingled human remains from three sectors of Huari, and identified TB in communities from Terminal Wari (950-1050 CE) and post-Wari (1275-1400 CE) contexts. We employed a broad pathogen screening method that allowed for the identification of Mycobacterium tuberculosis complex (MTBC) DNA, followed by the successful reconstruction of seven MTBC genomes. Our phylogenetic analysis reveals that MTBC strains recovered from these highland communities are closely related to those recovered from contemporaneous contexts in coastal Peru over 500 km away, and demonstrate TB genomic diversity in a narrow geographic region. Our results provide insight into disease patterns during significant climatic and socio-political shifts, and provide additional information on the ecology and evolution of TB in the Andes.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 29 ABSTRACTS

DNA analysis of an ancient brucellosis case from Bronze Age eastern Europe Gunnar NEUMANN1, Maria SPYROU1, Ayshin GHALICHI1, Marcel KELLER2, Joachim BURGER3, Volker HEYD4, Viktor I KLOCHKO5, Aleksander KOŚKO6, Piotr WŁODARCZAK7, Danuta ŻURKIEWICZ6, Alexander HERBIG1, Wolfgang HAAK1, Johannes KRAUSE1 1Max Planck Institute for the Science of Human History, 2University of Tartu 3Johannes Gutenberg-Universität Mainz, 4University of Helsinki, 5National University of Kyiv - Mohyla Academy, 6Institute of Archaeology, Adam Mickiewicz University Poznań 7Instytut Archeologii I Ethnologii PAN Krakow The onset of domestication during the Neolithic transition is hypothesized to have increased and given rise to a number of zoonotic diseases. One such zoonosis is brucellosis caused by different species of the proteobacterial genus of Brucellae which infect a wide variety of wild and domesticated animals such as cattle, sheep, goat and pig. It is transmitted to humans mainly through the consumption of unpasteurized milk products but also via inhalation or direct contact with infected animal fluids. Here, we extracted DNA from a calcified thoracic nodule which was found in a c. 4,800 year old kurgan burial of an individual associated with the Yamnaya culture in modern-day Ukraine. After shotgun sequencing and with the metagenomic screening pipeline HOPS we identified Brucella abortus as the primary causative agent of an infection leading to formation of this nodule. In addition, exceptional bacterial DNA preservation allowed for the reconstruction of a whole genome without further enrichment. Phylogenetic analysis with all known Brucella species positions the ancient genome within a basal lineage of B. abortus. Moreover, integration of a previously published ancient B. melitensis genome allowed for the comparative investigation of the evolutionary histories of both pathogens, through Bayesian molecular dating. Our analysis provides prime DNA evidence for zoonotic infections in humans dating as far back as ~5,000 years ago in Eurasia. In addition, it highlights the potential of calcified nodules as a rich archaeological source material that could aid investigations on the deep evolutionary history of clinically and economically important bacterial pathogens.

Surviving trauma in a pre-antibiotic era: a case-study of a mandibular injury in a medieval-modern Portuguese village Dulce NEVES, Ana Maria SILVA, Sofia WASTERLAIN *** CIAS, Department of Life Sciences, University of Coimbra Mandibular traumatic injuries are rarely documented in bioanthropological literature. This study aims to present an antemortem mandibular fracture of an adult exhumed from a medieval-modern rural ossuary located next to Torre Sineira of Alto do Calvário (Miranda do Corvo, Portugal). The mandibular fragment, composed by the mental region and the left side body, was analyzed both macroscopically and through x-ray imaging. The mandible presented a well-defined fracture line between the left molar and premolar regions, with misalignment. Apart from bone remodeling, no evidence of infection, reactive bone tissue formation, or abnormal porosity were observed. All teeth surrounding the fracture’s region were lost ante-mortem. The bone remodeling and the presence of a fracture line are pathognomonic of an ante-mortem trauma. Medical assistance would not be accessible to this inland Portuguese population living in a poor village. Such a severe lesion would be highly debilitating, in terms of capability of eating, drinking, and speaking, following the injury, being suggestive of some help and of an adapted diet. The literature has shown the existence of accessible methods to stabilize mandibular fractures and plant-based medicines to ease with the pain and somehow prevent infections, during the pre-antibiotic era. One possibility for this individual’s survival without evidence of major medical treatment nor infection is if this severe injury was inflicted during their childhood, when the mandibular bone remodeling capacity is higher. Clinical case-studies have shown the healing of mandibular fractures in children without the need of substantial

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 30 ABSTRACTS

An investigation into the prevalence of vitamin D deficiency in a 19th century London population Ruth O’DONOGHUE, Marie C WEALE, Jo BUCKBERRY, Hannah KOON *** School of Archaeological and Forensic Sciences, University of Bradford This project aimed to assess the macroscopic and radiographic evidence for vitamin D deficiency within a 19th century urban population group. Significant differences in pulp horn morphology have been identified in those with vitamin D deficiency, suggesting that radiographic analysis of teeth may be used as a screening tool to identify deficiency disease, and therefore provide a more accurate estimation of disease prevalence than macroscopic analysis alone (D’Ortenzio et al. 2018). To investigate this, individuals from the 19th century London burial ground of New Bunhill Fields, Southwark (1821-53) were assessed. This population consists of 514 individuals, 357 non-adults and 157 adults. Macroscopic analysis was performed to assess for rickets, residual rickets and osteomalacia, and the first permanent molar was chosen for radiographic analysis following the method established by D’Ortenzio et al. (2018). Macrosopic assessment of the adult population has identified marked bowing of the lower limbs consistent with residual rickets in two individuals. However, changes in pulp horn morphology associated with vitamin D deficiency during dental development have been found in 29 of 30 adults radiographed. Macroscopic cases of rickets within the non-adult population have been confirmed at 20. Radiographic analysis of the non-adult and remaining adult population is currently underway. This innovative technique has the potential to identify periods of childhood vitamin D deficiency in cases where the bone has since re-modelled and skeletal evidence is lost. The initial results for New Bunhill Fields suggest that vitamin D deficiency was more prevalent during industrialisation than previously thought. Funding: AHRC Heritage Consortium

Ancient surgery and social identity: Osteobiography of amputees from late pre-Hispanic Túcume, Peru Megann PHILLIPS, Vanessa CRUZ, Erin K MARTIN, Dylan R SMITH1, J Marla TOYNE *** University of Central Florida, Department of Anthropology This poster describes two cases of successful pedal amputation found at Túcume, an ancient religious and administrative center on the Peruvian north coast, dated to the Late Intermediate Period (CE 1000 – 1470) and the Late Horizon (CE 1470 – 1535). Individuals with amputated feet were variously depicted in regional ceramic vessels associated with the earlier Moche (CE 100 – 700) and Wari (CE 600 – 1100) cultures, and skeletal remains of Moche and Wari foot amputees have been found previously. Interpretations of those amputations have included medical intervention, punitive measures, and ritualistic dismemberment. An osteobiographical approach to the analysis of the sequentially later amputees from Túcume yields new insights regarding the lived experiences of ancient north coast Peruvians whose feet were removed. Each of these young adult female amputees was found without left foot bones. Distal remodeling of their otherwise unmodified left tibiae and fibulae, as well as radiographically evidenced asymmetrical cortical bone density, suggest amputation via ankle joint disarticulation followed by moderate mobility after long-term healing. These individuals were buried in mortuary contexts typical of middle elite females during their respective time periods and not indicative of punitive or unusual ritualistic action. Therefore, foot removal was likely therapeutic and did not drastically affect social integration. Amputees might have relied on accommodation or assistance after amputation, but burial with weaving tools suggests continued participation gendered economic activities. Osteological and mortuary evidence of these amputees’ life experiences improves understandings of ancient social identity related to functional impairment in pre-Hispanic north coast Peru.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 31 ABSTRACTS

Abscessed with macaques: Dental abscesses within a biomedical skeletal collection Robin L QUATAERT¹, Erin F E PINKSTON² *** ¹Comparative Primate Anatomy Laboratory, Department of Anthropology, University at Buffalo, ²Buffalo Human Evolutionary Morphology Lab, Department of Anthropology, University at Buffalo Previous studies have reported that wild macaques develop dental abscesses at rates nearing 10%, whereas they occur in biomedical macaque populations with modified canines (e.g. removed or filed) at rates close to 80%. Further, males experience dental abscess more frequently than females. However, how frequently biomedical populations experience abscesses, where variables such as diet and veterinary care may be controlled for, has not been studied. This study elucidates how biomedical care may affect the oral health of non-human primates. This study evaluated prevalence, location, and severity of dental abscesses in five sample populations of macaques from the University at Buffalo Primate Skeletal Collection, a collection of biomedical specimens: Macaca fascicularis (n=332), Macaca mulatta (n=111), and macaques of unknown species (n=120), of which thirty had modified canines. Severity and location were recorded, where the latter was classified as periapical, periodontal, or a combination of the two. The data were transformed and analyzed using Chi-Square, Kruskal-Wallis and Mann-Whitney U tests. Dental abscesses occurred in approximately 6% of the unaltered sample populations, regardless of species. However, rates of dental abscesses in individuals with modified canines were significantly higher, potentially as a result of bacterial infection arising from their modification. Researchers found a significant difference in prevalence amongst males and females, with abscesses being more common amongst males. While biomedical macaques receive dental care, other standard practices in biomedical research centers, such as canine modification, appear to produce negative health outcomes to rates similar of those documented in wild populations.

Diet and parasitism related to ancestral Pueblo porotic hyperostosis Karl REINHARD1, Isabel TEIXEIRA-SANTOS1, Morgana CAMACHO2 1Pathoecology Laboratory, School of Natural Resources, University of Nebraska-Lincoln, 2Laboratório de Inovações em Terapias, Ensino e Bioprodutos, IOC/FIOCRUZ Porotic hyperostosis and cribra orbitalia are common Ancestral Pueblo conditions. In 2009, Walker and colleagues suggested that megaloblastic anemia, due to chronic deficiency of folic acid and vitamin B12, was responsible for these lesions. They hypothesized that depleted folic acid and vitamin B12 resulted from high maize dependency with high intestinal parasitism. In order to evaluate these parallel hypotheses concerning diet and parasitism, we applied quantification methods to define dietary components and parasitism in Ancestral Pueblo populations from Turkey Pen Cave (0-100 AD), Salmon Ruins (1088-1250 AD) and two latrines from Aztec Ruins (1110-1275 AD). A total of 123 coprolites were analyzed. Extremely high parasitism with Enterobius vermicularis (pinworm) was evident for all contexts. Four different diets were defined: 1) squash, physalis fruits and pollen from wild and cultivated plants; 2) maize, wild plant seeds, and sumac fruits; 3) wild grasses and maize; and 4) fermented maize, sumac berries, wild grass seeds and maize truffles. We suggest that time spent in crowded, communal living facilitated pinworm transmission through the air and contributed to spread the infection. Furthermore, infant care involving cradle boards possibly contributed to auto-infection. High pinworm parasitism is associated with vitamin B12 deficiency today. Although maize was a significant food, the coprolite data show that it was complemented seasonally with other foods. Analysis of the foods shows no source of folic acid and vitamin B12, thus indicating a chronic deficiency of both. Therefore, both diet and parasitism can be implicated as parallel causes of megaloblastic anemia.

Paleopathology and inclusive, equitable, sustainable development Gwen ROBBINS SCHUG Anthropology, University of North Carolina, Greensboro Climate change is already having an impact on global public health, human security (including food and water security) and migration flows. Sustainable development and climate change are mutually reliant upon one another and thus, based on the Paris Climate Agreement, in 2016 the United Nations has defined 17 major goals for global sustainable development as part of their

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 32 ABSTRACTS

agenda for 2030. These goals can be considered a framework for organizing research that will have relevance and impact beyond academia. Paleopathology has potential to provide insights into historical and evolutionary aspects on a number of these research priorities, including past human responses to climate change, the meaning of resilience in human communities, social inequality, the role of food insecurity and sanitation in shaping human health, among others. This project reviews a selection of paleopathological contributions that fit into the research goals of the UN Sustainable Development Research Paradigm, with the goal of demonstrating a nuanced representation of these aspects of human life through time and their relevance to development goals today.

Cellular-resolution soft-tissue imaging in mummies by x-ray phase-contrast CT Jenny ROMELL1, William TWENGSTRÖM1, Mikael ROMELL2, Sofia HÄGGMAN3, Salima IKRAM4, Hans M HERTZ1 1Department of Applied Physics, Biomedical & X-Ray Physics, KTH Royal Institute of Technology, 2Department of Orthopaedics, Hospital of Varberg, 3Museum of Mediterranean and Near Eastern Antiquities in Stockholm, 4Department of Sociology, Egyptology and Anthropology, American University in Cairo Since their discovery in 1896, x-rays have been an important diagnostic tool, used for the living as well as the dead. Classical x-ray radiography and computed tomography (CT) are absorption-based techniques, and enable imaging of hard and dense materials, such as bone, teeth and metal, as well as the gross anatomy of a body. Materials exhibiting low absorption, especially ancient soft tissues, often escape detailed analysis. Other non-destructive imaging methods have been proposed to overcome this issue, most notably magnetic resonance imaging (MRI) and terahertz imaging, both with their respective limitations. We instead propose an x-ray method known as phase-contrast imaging for analysing the soft tissues of ancient human remains. This method measures not only the absorption, but also the phase shift of an x-ray beam that passes through a sample, and gives higher contrast and resolution for low-absorbing materials. Combined with CT, the resulting data is 3-dimensional and can be viewed as a volume or sectioned in arbitrary directions. Using a MetalJet D2 x-ray source (Excillum AB, Sweden), we imaged a 2400 year old mummified human hand in a laboratory phase-contrast CT arrangement, and demonstrated a detailed view of the microanatomy of mummified soft tissue; tendons, nerves, blood vessels, the different layers of the skin, and adipose tissue with the remains of adipose cells could be visualised. This proof-of-principle study opens up for virtual histology of ancient soft tissue using phase-contrast CT and adds to the toolbox of non-destructive imaging methods available for paleopathology.

Assessing taphonomic aspects in the recovery of A. lumbricoides and T. trichiura eggs from archaeological sediments from historical (18th-19th century) New England latrines Aida ROMERA BARBERA1, Darwin W HERTZEL2, Karl J REINHARD3 1The Graduate Center, City University of New York, 2Department of Anthropology, University of Nebraska-Lincoln, 3Pathoecology Laboratory, School of Natural Resources, University of Nebraska-Lincoln Trichuris trichiura and Ascaris lumbricoides eggs are two of the most ubiquitous parasites remains recovered from archaeological deposits, but are dependent on preservation conditions, laboratory processing methods and secure identification of the egg’s diagnostic features. Nematode eggs of both species contain an internal lipid layer surrounded by a chitinous layer which is itself surrounded by a vitelline layer. The inner layer provides impermeability whereas the chitinous layer is a very resistant coat that protects the eggs against desiccation and most acids. In addition, eggs of A. lumbricoides possess a fourth layer that has an albuminous (mamillated) appearance and is the key diagnostic feature. Recently, there has been an increasing reporting of A. lumbricoides eggs missing this characteristic albuminous coat, a phenomenon known as “decortication”. The sources of described decortication are all sediments. However, few studies have addressed the taphonomy of eggs from archaeological soils. This study explores taphonomic aspects that alter the appearance of the eggs and offers a recovery method that preserves the egg’s morphology. Here we present the results of our investigation in which we analyzed soil from historical (18th-19th) latrines from the state of Albany using a method derived from palynology analysis. The method used was efficacious in recovering parasite eggs from archaeological soils and the results demonstrated that decortication is a rare occurrence. The study discusses the high occurrence of decorticated eggs in the archaeoparasitology literature and offers a tentative explanation to why this is happening.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 33 ABSTRACTS

The case for the bioarchaeology of care: Osteomyelitis of an El Molle female from Chile’s semiarid north Maria A ROSADO1,2, Shirley CELI-LANDEO1, and Anna GETLER2 1Sociology and Anthropology, Rowan University, 2 Museo Arqueológico de La Serena The bioarcheology of care for people disabled by disease and trauma establishes a formal framework to analyze past care cases in a contextualized and systematic way. In bioarcheology, health-related care is deduced from the evidence in human remains that indicate survival with a disabling pathology when the individual probably would not have reached the oldest age without care, and from the application of forensic anthropological techniques that estimate the age range at the time of death. In archaeology, health-related care has not had much scientific treatment in Chile’s semiarid north region. The skeletal collections housed at the Museo Arqueológico, La Serena, Chile (comprising different cultural periods and subsistence patterns), lend themselves to the bioarchaeology of care analysis and interpretations via paleopathology due to their excellent preservation and well-documented archaeological contexts. One such case is that of a female individual estimated to be 50+years (skeleton QC2) of the Molle culture (0 to ca. 600) who exhibits osteomyelitis of the right humerus, both radii, and both tibiae. The criteria for diagnosis included the presence of cloacae in the distal portion of the tibiae and proximal portions of the radii, and appearance of woven bone (ridge and furrow system) on the periosteal surfaces. Based on the classification of Weri (2009), the severity of the infection, moderate to severe, was determined via the hyperostosis present in the bones. It is inferred that the osteomyelitis likely resulted in disability for which the individual may have required on-going care.

Classical presentation and the spectrum of disease: The challenge of malignant neoplasms Bruce ROTHSCHILD Carnegie Museum Diseases generally are neither standard nor classical in presentations, but represent a spectrum, not only severity, but also of which characteristics are expressed. The classic image of disease is one which the illustrator sought for years, if not decades. It illustrates many of the disease manifestations in a single view, but that view is not its typical presentation. Any individual that fulfills that challenge thus represents the tip of the iceberg. Absence of an individual with classic findings has no implication as to disease distribution or epidemiology in general. Furthermore, outliers with another disease may have characteristics highly suggestive of the disease of interest, resulting in erroneous diagnosis. Fortunately, disease spectra are highly reproducible, as has been documented for various forms of arthritis, metabolic and infectious disease. If one identifies multiple individuals with apparently classic manifestations attributable to a given disease, but no individuals manifesting other aspects of its spectrum, there is a problem. Either the diagnostic criteria have been erroneously applied or the sample is somehow biased, such that it is not representative of the population from which it was drawn. One would not anticipate that only isolated cases of arthritis or infectious disease would be found, without the epidemiologic footprint of those diseases. Neoplasia, rarely suspected on macroscopic evaluation (without routine radiologic examination of all skeletons) of the archeologic and histologic record, may be an exception. Any consideration of malignant neoplasia requires consideration of 20 or 30 possible categories (e.g., metastasis, osteosarcoma), some with their own subcategories.

What we talk about when we talk about dating: Tuberculosis and the tangled evidence for its antiquity Susanna SABIN1, Elizabeth A NELSON2, Anne C STONE1, Jane E BUIKSTRA1 ++ 1Arizona State University, 2Max Planck Institute for the Science of Human History Attempts to uncover simple narratives for the origins of even recently-emerged human infectious diseases have instead uncovered complicated webs of biocultural and ecological interactions. Revealing the origin of tuberculosis (TB), one of humanity’s most ubiquitous pathogens, has attracted the attention of multiple disciplines with potential applications to public health, human history, host-pathogen co-evolution and migration. However, the evolutionary narratives for the emergence of tuberculosis have shifted over time and across disciplines. The definition of “tuberculosis” itself shifts across disciplinary contexts, as an infectious disease with associated signs and symptoms, genetic group of bacteria, or historical phenomenon. Studies in paleopathology

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 34 ABSTRACTS

incorporating molecular techniques have contributed to our understanding of the complexity of tuberculous mycobacteria while also challenging previously accepted concepts in tuberculosis evolution and ecology, ultimately leading to the construction of sometimes seemingly contradictory complex global histories of TB. Here we aim to disentangle this web established by tuberculosis researchers with a focus on paleopathology and paleogenetics by reviewing their methods of inference. We a) delineate the existing hypotheses for the emergence of tuberculosis according to different sources of evidence, and b) articulate what “tuberculosis” means within different frameworks and what “origin” means according to their methods of inference. We propose that most lines of evidence for the antiquity of tuberculosis can be reconciled when viewed as evidence for different social, medical, epidemiological, and biological entities. This definition-conscious framework can be applied to other pathogens as the field of biomolecular archaeology continues to mature and guide interdisciplinary communication.

Osteochondritis dissecans of the knee in individuals of the Coimbra Identified Skeletal Collection (19th-20th centuries): proposal of a new classification system for paleopathology Ana Rita A SAMPAIO1, Bruno M MAGALHÃES2, Fernando FONSECA3, Rosa Ramos GASPAR2,3, Ana Luísa SANTOS2 1Department of Life Sciences, University of Coimbra, 2CIAS and Department of Life Sciences, University of Coimbra, 3Coimbra Hospital and University Centre (CHUC) Osteochondritis dissecans (OCD) is a pathological condition that affects the subchondral bone and surrounding cartilage of syno- vial joints, most frequently the knee. This work aims to study OCD of the knee in a Portuguese Identified Skeletal Collection and to propose a classification system to be used in paleopathology. The sample comprises 296 individuals aged 7-50 years old (x̅=31.58; s.d.=10.97), 54.4% (n=161) males and 45.6% (n=135) females. The lesions were observed macroscopically and classified according to the proposed method, which is adapted from clinical classification systems and considers four stages: early to nearly complete detachment of the necrotic bone (1A;1B), crater-like (2A), and remodeling lesions (2B). Postero-anterior radiographs were taken to assess the validity of the diagnoses. Both inter- (14/15; κ=0.89) and intra- (14/15; κ=0.90) rater agreements are almost perfect. Ten (3.4%) individuals (5 females=3.7%, 5 males=3.1%, Fisher’s Exact Test p=0.517) present 16 lesions: in the medial (n=9) and lateral (n=4) femoral condyles, medial tibial plateau (n=2) and patella (n=1). The medial femoral condyle is the most affected location, which is in accordance with clinical data. Age at death does not play a significant role in OCD (presence=10, x̅=38.00, s.d.=10.81; absence=287, x̅=31.32, s.d.=10.92; Mann-Whitney U=1955.0; p=0.051). This research constitutes one of the few systematic studies regarding OCD in skeletal material and its results are mostly in agreement with clinical data. Due to the lack of specific diagnostic guidelines for OCD in paleopathology, we believe that the classification system can assist in the identification of lesions and stan- dardize the publication of results.

Childhood stress and bone health in two populations from Ancient Nubia (1750-1550 BC and 1440-660 BC) Kaitlyn SANDERS Purdue University This study analyzes non-specific childhood stress and adult bone loss in two populations from Ancient Nubia. By comparing the relationship between metacarpal bone loss, vertebral neural canal size, as well and age and sex, this study aims to highlight population specific patterns. Anterior-posterior and transverse measurements of T11-L5 vertebrae were gathered from males and females from Kerma (1750-1550 BC) and Tombos (1440-660 BC) and bone loss was examined using digital radiogrammetry of the 2nd metacarpal. Age estimation was performed using Transition Analysis and individuals were grouped into five age categories based on maximum likelihood age. Statistical analyses were performed using SPSS. Within the Kerma sample, neither sex nor age has a significant relationship on the cortical index (CI), though males display consistently higher means in each age group. Conversely, age does have a significant role on the CI in the Tombos sample with a significant correlation between the CI and age in the female group, though sex does not. In general, older groups have larger VNC size, with multiple vertebrae showing significant differences and positive correlations between age and VNC size. A negative correlation was found, namely within transverse

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 35 ABSTRACTS

measures of the lower lumbar, between CI and VNC size. Overall, while similar patterns of VNC size and age appear in both groups, there are different patterns of bone loss. In the Kerma sample, females seem to be more affected by age-related bone loss than males; in the Tombos sample, age-related bone loss seems to affect both males and females more similarly.

Cribriotic correlation? Studying cribra orbitalia, cribra humeri, cribra femora and their association in the medieval Netherlands Rachel SCHATS ++ Leiden University, Faculty of Archaeology, Laboratory for Human Osteoarchaeology Cribriotic lesions such as cribra orbitalia, cribra humeri, and cribra femora are often encountered in archaeological skeletons. Yet, the aetiology or aetiologies of these lesions is heavily debated. Most commonly, they are associated with specific types of anaemia, although, as of yet, the evidence to suggest that they are caused by the same condition is poor. Therefore, this paper aims to macroscopically investigate the prevalence and co-occurrence of cribra orbitalia, cribra humeri, and cribra femora in non-adults and adults (n=232) from 10 sites of the medieval Netherlands (800-1600 CE) At least one orbit, one proximal humerus, and one proximal femur (left or right) had to be observable for an individual to be included. Results from loglinear analysis executed on all individuals combined indicate that there is no clear interaction between all three cribriotic lesions. Yet, significant interactions between cribra orbitalia and cribra femora, and between cribra humeri and cribra femora separately are observed, which is confirmed by individual Chi-square tests. When we study the non-adults (n=53) separately, there is only a significant association between cribra humeri and cribra femora. No significant associations between the lesions are found for the adult individuals (n=179). This tentatively indicates that cribra orbitalia is not associated with cribra humeri and femora, which may suggest a different aetiology, yet, more complex explanations taking into account the physiology of marrow hypertrophy need to be considered. Cribra humeri and femora appear to be associated, albeit only in non-adults, suggesting that a common cause for these two post-cranial lesions may exist. Funding: Dutch Research Council (NWO) and by the Leiden University Fund/Stichting Elise Mathilde Fund.

The embodiment of colonial strategy: Osteoarthritis in ancient Nubia Sarah SCHRADER Faculty of Archaeology, Leiden University The Egyptian Empire conquered and colonized Nubia, what is today northern Sudan, on multiple occasions. The colonization strategy employed was highly variable through time, ranging from the construction of militarized fortresses (Middle Kingdom 2050- 1650 BCE) to an amicable co-existence approach (New Kingdom 1550-1050 BCE). Egyptian tactics also varied spatially, depending on several factors including a colonized community’s utility to the empire and the potential for revolt. Using a large dataset (n=540), this paper compares osteoarthritis between seven Nubian communities to (1) evaluate whether imperial strategy impacted physical activity, and (2) assess whether levels of activity differed between cotemporary colonized communities. Age-controlled ANCOVA analysis suggests there was significant variation in the frequency and severity of osteoarthritis throughout the empire. The Middle Kingdom C-Group, an indigenous Nubian population that lived outside the Egyptian built and occupied fortresses, displayed the highest rates of osteoarthritis for nearly all joint systems. Osteoarthritis then decreased during the post-colonial Second Intermediate Period (1650-1550 BCE) and again increased during the recolonization of the New Kingdom. However, there is significant variation of osteoarthritis at three New Kingdom sites, each of which experienced a differing colonization approach. This study suggests that the varying imperial strategies utilized by the Egyptian Empire may have impacted the physical activities and daily lives of Nubians and that these approaches were not equal throughout Nubia, but were tailored to communities. It is therefore difficult to discuss a singular outcome of colonization; rather, these interpretations need to be nuanced with community-level archaeological context. Funding: National Science Foundation, National Geographic Society

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 36 ABSTRACTS

Illuminating Treponema pallidum’s evolutionary history with ancient genomes Verena SCHUENEMANN, Gülfirde AKGÜL, Kerttu MAJANDER Institute of Evolutionary Medicine, University of Zurich Treponemal diseases are globally prevalent, with syphilis standing out as a re-emerging public health threat. The origins of these diseases are yet unresolved and subject to intensive scholarly debate. Until recently, assumptions on past etiology and dispersal routes could only be drawn from palaeopathological cases, historical sources, and genetic analysis of contemporary Treponema pallidum genomes, while archaeogenetic studies remained rare and lacked the informative genome-level data. This changed when we recovered the first historical T. pallidum genomes from human skeletons of infants excavated in Mexico City. The results indicated a parallel past distribution of yaws and syphilis, and showcased other T. pallidum subspecies causing similar diagnostic presentations in archaeological remains to those associated with syphilis. Now, altogether six genomes from historic Northern and Central Europe have been included in our two new studies, which further elucidate T. pallidum’s past. Obtained from archaeological human remains, these genomes demonstrate a high diversity of strains related to syphilis and yaws. Strikingly, a previously unknown T. pallidum lineage was recovered among the strains and found to represent a sister group to the endemic types of treponematoses (yaws and bejel). Likely divergence times of existing subspecies were assessed by molecular dating, with an improved resolution from our ancient genomes, which would allow for the possibility of treponemal pathogens’ pre-Columbian presence in the Old World. Overall, our studies represent major contributions towards a better understanding of treponemal diseases’ evolutionary history and point to a more complex pattern in their diversity and distribution than previously understood.

Sex determination in juvenile and infant remains using dimorphic enamel peptide analysis Heidi SHAW1, Rebecca GOWLAND1, Kayla CROWDER1, Claire HODSON1, Nicolas STEWART2, Kurt GRON1, Janet MONTGOMERY1 1University of Durham, 2University of Brighton The determination of sex is fundamental to the study of past human populations. Traditional sex determination methods in bioarchaeology are reliant on the presence of sexually dimorphic skeletal elements, which are not always preserved in archaeological contexts, and are not reliable for assessing the sex of non-adults. While ancient DNA analysis provides a potential solution to this problem, it is too expensive and destructive to undertake routinely, and does not always preserve in archaeological contexts. The inability to reliably determine the sex of non-adults has placed profound constraints on studies of infancy and childhood in the past and has contributed to their marginalization in bioarchaeology. This study utilizes an innovative new method published by Stewart and colleagues (2016; 2017) for sex determination and tests its utility for non-adults. The method identifies sex chromosome-linked isoforms of the peptide amelogenin from human tooth enamel using a minimally destructive acid etching procedure and subsequent nanoLC-MS. This study aimed to test the efficacy of this method on incompletely mineralized non-adult teeth, including those of perinates. Enamel peptide samples were collected from 29 non-adult individuals aged from 40 gestational weeks to 19 years old excavated from four different sites from across England. Overall, it was possible to identify the sex of 28 non-adult remains (M=20, F=8, indeterminant=1). Results revealed that sufficient peptide material can be recovered for sex estimation, even from incompletely developed perinatal teeth. We discuss the implications of this method for our understanding of childhood mortality and morbidity in the past.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 37 ABSTRACTS

Understanding the impact of shape change on cranial blood flow patterns: A modern-prehistoric feedback loop Tiffany W SHIEN1, Sofia DANIELS2, Jessica M CRONIN3, Jane VANNAHEUANG4, Ana SHAUGHNESSY1, Rebecca S JABBOUR5, Gary D RICHARDS6 1Department of Molecular and Cell Biology, University of California, Berkeley, 2Department of Anthropology, University of California, Berkeley, 3Department of Integrative Biology, University of California, Berkeley, 4Department of Public Health, University of California, Berkeley, 5Department of Biology, Saint Mary’s College of California, 6Department of Biomedical Sciences, A A Dugoni School of Dentistry, University of the Pacific Unintentional cranial deformation in modern children is linked to neurological deficits, suggested to result from modified blood flow induced by shape change. It’s known that restricted blood flow leads to vascular changes during brain growth in embryon- ic-fetal development. Questions have been raised about whether these changes occur in intentionally-induced deformations. We examined this issue by assessing blood flow patterns and shape change in both normal and pathologic individuals. Our sample includes modern (biological supply) and prehistoric (North America, ~1000-1700 AD) cases of premature sutural fusions, microcephaly, hydrocephaly, achondroplasia, intentional and unintentional deformations, and normal individuals (n=67, children-adults). We used a GE LightScribe VCT scanner to obtain CT images. Following segmentation, skull isosurfaces and surface maps of the endocranial vascular system were created in Amira (v. 6.1). Each condition possesses evidence of increased intracranial pressure and modifications of the middle meningeal neurovascular and dural venous sinus tracks. Changes include reduced transverse/sigmoid sinuses, occluded jugular foramina, and modified emissary venous channels. All pathologic conditions and prehistoric “intentional” deformations have shape change restricted to the superior vault. Plagiocephalics additionally show cranial base asymmetry. Shape change and increased intracranial pressure are shared in pathologic and cultural deformations, as are changes to the vascular system. However, all pathologic and culturally deformed crania lack evidence suggesting neurological deficits. In plagiocephaly the case for neurological deficits is documented as is asymmetrical twisting of the cranial base. We hypothesize that the asymmetric cranial base impacts basal ganglia and/or spinal tracts, resulting in the co-occurrence of neurological deficits with specific culturally-induced cranial shape.

A case of a medical school bone box from upstate New York: Pathology, taphonomy, & structural violence Tessa SOMOGYI, Elizabeth A DIGANGI, Kelly GARDNER *** Department of Anthropology, Binghamton University This presentation reports what is likely a medical school bone box recently discovered in the basement of the Milton J. Rubenstein Museum of Science & Technology in Syracuse, New York. We interpret the human remains in this box through a lens of structural violence, and draw on concepts from the literature to describe particular after-death treatment related to social inequalities. The high demand for medical school cadavers in the 19th century prompted a rise in grave robbing, most often from African Americans, Native Americans, immigrants, and the poor. In New York, medical schools were also allowed to take unclaimed bodies from almshouses. Structural inequality therefore paved the way for poor and marginalized people to be seen as legitimate cadaver sources. The discovered medical school bone box contains a variety of different elements from at least four individuals, roughly representing most of the human skeleton. To support the medical school origin of this box, we describe evidence of postmortem examination and modification including labeling, articulation, likely grave-robbing, and possible dissection. A number of bones have penciled labels, and one crudely articulated foot is held together by mummified tissue and wire. Several arm and leg bones were never processed and retain grease and odor. A postmortem transection through the distal third of a humerus is likely evidence of dissection. A few bones also displayed pathological conditions consistent with inequality including slight bilateral periosteal new bone formation on tibiae from a young adult, indicating systemic stress likely beginning at a young age.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 38 ABSTRACTS

It’s only rare if you don’t care: Promising new comprehensive approaches to the palaeopathological identification of neurodegenerative disorders Nivien SPEITH School of Human Sciences, College of Science and Engineering, University of Derby Tracing chronic and eventually fatal neurodegenerative disorders characterised by severe muscle degeneration and loss of movement, such as Motor Neurone Disease (MND), in the human skeleton presents a great challenge due to their complex differential diagnosis on clinical and osteological level. Establishing descriptors for skeletal changes associated with such conditions has long been considered a near impossible task, leading to the invisibility of individuals suffering from these disorders in the past. However, even though relatively rare, considering the immense physical, psychological, social and emotional effects of such diseases their identification in the bioarchaeological record is vital to our understanding of the lived experience of patients and their community of care. This study presents a critical review of the available evidence provided by clinical, biomedical and skeletal data and offers first insights towards novel comprehensive palaeopathological approaches to identifying neurodegenerative disorders. The analysis of the complex interplay of biomechanical, neurological and systemic mechanisms influencing bone health and a rigorous evaluation of both pathophysiological pathways and clinically pathognomonic findings for MND suggest that it is possible to establish diagnostic criteria for mapping skeletal manifestations of this group of conditions. It is hypothesised that this multi-dimensional paleopathological appraisal of bone health can not only improve our general understanding of dynamics at the bone-muscle interface but facilitate a holistic understanding of such rare conditions. In the frameworks of a bioarchaeology of care and the bioarchaeological investigation of rare diseases, this study paves the way toward a new and intriguing field of bioarchaeological enquiry.

A case of bilateral humerus varus from the Late Antiquity Santa Mustiola’s Catacomb (Chiusi, Italy) Alessandra SPERDUTI1, Matteo BRACONI2, Giulia FACCHIN3, Giovanna FERRI3, Stella INTERLANDO1 1Service of Biarcheology, Museum of the Civilizations, 2Pontifical Commission for Sacred Archaeology,3 Roma Tre University The recent stratigraphic excavation campaigns of the Catacomb of Santa Mustiola, at Chiusi (Tuscany region, IV-VI cent. CE) have investigated dozens of intact tombs within the early Christian funerary complex. Single and multiple burials yielded over 150 skeletal individuals of both sexes and different age classes. One tomb (L4) contained a single deposition of a 30-35 years old female. Her skeleton is almost complete, missing some elements and showing some minor diagenetic changes. The macroscopic examination revealed an evident deformity of both humeri. The proximal epiphyses are elongated, distally dislocated, and flattened on the shaft. The slippage of the caput humeri resulted in the complete loss of the anatomical neck, a strong angulation of the upper diaphysis, and the maximum bone length reduction. The condition also affects the surface (with erosive lesions) and orientation of the glenoid cavity of the scapulae. All the alterations are more evident on the left than the right side. The individual does not show any other evidence of severe pathological changes on the rest of the skeleton. All the observations lead to a diagnosis of bilateral separation of the proximal humeral epiphysis, possibly related to an old traumatic event. The clinical obstetrical literature reports cases of bilateral epiphyseal injuries resulting from delivery complications, suggesting that this might be the case for the woman buried in the catacomb.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 39 ABSTRACTS

Once were warriors: Challenging occupation preconceptions in Lebanese weapon-associated burials Chris STANTIS1, Arwa KHAROBI2, Nina MAARANEN2, Holger SCHUTKOWSKI2 ++ 1Department of Anthropology, Smithsonian Institution, 2Department of Archaeology and Anthropology, Bournemouth University This research focuses on the elite burials of College Site, Sidon (Lebanon). Of the 82 burials from the Middle Bronze Age (c. 2000– 1600 BCE), seven are classified as ‘warrior burials’: single interments in constructed tombs with associated bronze weaponry. These burials are purportedly males with associated social status and cultural values awarded to the warrior elite. Found throughout the ancient Near East around this time, many modern scholars emphasize that these grave goods are ideological and symbolic associations, not reflections of occupation. However, the term ‘warrior burial’ still carries interpretive value that misinforms popular perception. Utilizing bioarchaeological and funerary evidence to address questions around diet, trauma, occupation, and resi- dence, the seven burials are compared with each other and with the larger assemblage to consider whether there is an identifiable pattern of elite lifestyle. All are estimated osteologically as male, with the exception of a young child (~5 years old). Our pathological examination shows that the weapon-associated burials are similar to the “non-warriors”. Further, none display common patterns of interpersonal violence (e.g. trauma, sharp forces). Additionally, the “warriors” do not present specific entheseal changes suggestive of frequent weaponry use. Multi-isotope analyses also suggest that these seven lived lives largely indistinguishable from the rest of the assemblage. All weaponry burials except Burial 25 are likely locals, and all except Burial 12 consumed a diet similar to the wider assemblage. Therefore, we conclude that associating those individuals with bronze weaponry is a funerary gesture reflecting more their sociocultural status than their occupation.

Ancient DNA and paleopathology: Reconstructing pathogen evolutionary histories in historical and archaeological contexts Anne STONE School of Human Evolution and Social Change, Arizona State University Ancient DNA research has benefited from multiple technical advances in the last ten years including targeted capture and improved methods of DNA extraction and library preparation. These methods have allowed the capture and sequencing of pathogen genomes including Yersina pestis, Mycobacterium leprae, M. tuberculosis and Vibrio cholerae. However, many challenges remain including recovery of pathogens that affect only small compartments within the body (that may not commonly preserve) or from individuals from warmer environments or with low pathogen loads. In addition, characteristics of the evolution of many bacteria and viruses such as lateral gene transfer, recombination, and complex population dynamics can make it challenging to analyze and interpret results. In this presentation, I will review the technical advances that have led to current successes as well as discuss the current challenges for interpreting infectious disease history in the past.

Description and frequency of the acetabular crease / supra-acetabular fossa among ossa coxae recovered from four commingled Late Intermediate Period tombs (ca. AD 1250) at Marcajirca, Ancash, Peru Anne R TITELBAUM University of Arizona College of Medicine – Phoenix An acetabular crease is a focal defect in the subchondral bone of the lunate surface of the os coxae, typically found in the anterosu- perior aspect of the acetabulum near the 12 o’clock position. Manifesting as a small indentation, this feature has been considered a postcranial nonmetric trait in paleopathology, although a suggestion that it may be linked to biomechanical stress has been proposed (Mafart 2005). In the medical literature, this variant is known as a supra-acetabular fossa, and it has been observed in approximately 10.5% of MR arthrograms of the hip (Dietrich et al. 2012). In the paleopathological literature, frequencies have ranged from 6% to 43.4%, with lower incidence found among French historic populations and higher incidence among rural

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 40 ABSTRACTS

French medieval and prehistoric Canadian populations (Mafart 2005). This investigation will present the first comparative data from South America, from Marcajirca, a Late Intermediate (ca. AD 1250) highland site in Ancash, Peru. Here, four commingled tombs have yielded 152 adult ossa coxae (79 right, 73 left), of which 9.87% demonstrated an acetabular crease. Average size of the trait was 3.3 mm wide x 3.46 mm long x 2 mm deep. Frequency of the trait by sex, side, age, and tomb will be reported. Discussion will consider the suggestion that the trait may be associated with greater biomechanical stress. In addition, this investigation will clarify some confusion concerning the terminology and description of this trait observed in the paleopathological, forensic, and medical literature.

Isotopic variation in neoplastic conditions in ancient Peruvian (CE 1350–1450) mummified remains J Marla TOYNE1, Christopher SCHOW2 1The University of Central Florida, Department of Anthropology, 2Health Sciences Center, University of New Mexico This research explores expectations of pathology-influenced isotopic variation in skeletal samples where different cancers have been diagnosed and considers the impact of these chronic conditions on dietary interpretations. Previous studies have modeled chronic nitrogen imbalance as impacting the stable isotope ratios systemically and locally in bone. Two individuals were interred within the same cliff-tomb at Diablo Wasi in the Chachapoyas region of Peru (CE 1350-1450) prior to the Inca conquest. Both are adult males approximately 25 to 40 years of age. Individual A (INDA) presents significant thoracic kyphosis resulting from the collapse of T6-T7 vertebral bodies with medium to large coalescing focal lesions on the anterior bodies of T3-T12. Differential diagnosis corroborates hemangioma. Individual B (INDB) is partially complete, but demonstrates systemic osteopenia and osteoporosis. The proliferation of smooth-edged macroporosity and reticulating perforations especially of the thoracic skeletal elements suggests a neoplastic/hyperproliferative condition like leukemia. Isotopic analysis of δ13C and δ15N of bone collagen in INDA (δ13C –19.3‰, δ15N +6.7‰) and INDB (δ13C –16.9‰ and δ15N +7.9‰) are not significantly different from the range of other samples (n=7, δ13C –19.28‰ to –14.96‰ and δ15N +6.65‰ to +8.0‰) at the site, suggesting that the progressive development of these chronic conditions did not dramatically alter rib bone isotopic signatures. These mummified remains advance our understanding of the range of conditions present across the Central Andes and as a small preliminary sample suggest that these individuals’ isotopic compositions did not deviate from local expectations and can be used to infer dietary patterns at the site.

Zoonotic Mycobacterium tuberculosis complex strains from geographically dispersed pre-contact South American human populations Åshild J VÅGENE1, Tanvi P HONAP2, Kelly M HARKINS3, Michael S ROSENBERG2, Karen GIFFIN1, Felipe CÁRDENAS- ARROYO 4, Laura Paloma LEGUIZAMÓN4, Judith ARNETT3, Jane E BUIKSTRA3, Alexander HERBIG1, Anne C STONE 3, Kirsten I BOS1, Johannes KRAUSE1 1Department of Archaeogenetics, Max Planck Institute for the Science of Human History, 2School of Life Sciences, Arizona State University, 3School of Human Evolution and Social Change, Arizona State University, 4Colombian Institute of Anthropology and History (ICANH) In addition to several human-adapted lineages, the Mycobacterium tuberculosis complex (MTBC) includes strains adapted to a broad range of animal hosts. Today, zoonotic transmissions of animal-adapted MTBC strains pose an increasing threat to human health. Recently, MTBC strains (M. pinnipedii) commonly found in modern seals and sea lions (pinnipeds) were isolated from coastal Peruvian human remains pre-dating European arrival in the Americas. This was interpreted to result from an ancient zoonotic event where the bacterium was transferred from pinnipeds to humans as a consequence of frequent human contact with infected living pinnipeds or their tissues. Across the Americas, human skeletal remains pre-dating European arrival are found to exhibit lesions consistent with prolonged MTBC infection. However, many individuals are from inland sites, and thus are geographically incompatible with zoonotic transmission via direct contact with infected pinnipeds. Here we present three new pre-contact M. pinnipedii genomes, two from inland highland Colombia and one from inland Peru. These are regions where contact with marine mammals, or their infected tissues, would have been limited or non-existent. Our

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 41 ABSTRACTS

new genomes expand the phylogenetic diversity of the M. pinnipedii clade by contributing two new branches, both of which diverge before the split between the previously published ancient Peruvian and modern genomes. Our data also highlight the difficulties of analyzing ancient MTBC DNA in the presence of a complex background of contaminant environmental DNA. We discuss multiple scenarios that may account for M. pinnipedii’s transmission to inland areas.

Femoral hypoplasia and vitamin D deficiency: A differential diagnosis of a rare disorder in a 19th century Dutch high socioeconomic status female Barbara VESELKA ++ MARI Research Group, Department of Arts, Sciences, and Archaeology, Vrije Universiteit Brussel Rare diseases are seldom found in archaeological collections but must have influenced daily life in the past. This case study contributes to our understanding of the prevalence of rare diseases in the past and how past societies dealt with affected individuals. Skeletal remains of a high socioeconomic status adult female from inside the “Broere” Church in Zwolle, the Netherlands, was macro- and microscopically analyzed. Female V95 displays multiple skeletal deformities, such as markedly short femora, and severe bending of both tibiae and fibulae in different directions. Microscopic analysis of the teeth of this female displayed inter- globular dentine (IGD), a mineralization defect. Differential diagnosis of the skeletal deformities of V95 suggests a combination of diseases. The relatively short femur may be the result of a rare congenital malformation, such as a form of proximal focal femoral deficiency. The bending of the tibiae and fibulae, however, most likely can be attributed to vitamin D deficiency, as confirmed by the presence of IGD in the teeth. The limited mobility of the hips and the destruction of the knee joints, must have limited the female’s movement. This may have decreased the amount of sunlight exposure for V95 further complicating her situation. Green staining on the shafts of the lower limbs suggests the use of metal braces that would have enabled her to walk, most likely available to her because of her high socioeconomic status, and despite her malformed legs, she was considered to be part of society.

Bone mineralisation disorders in Bronze and Iron Age skeletal assemblages from Mongolia Melandri VLOK1, Erdene MYAGMAR2, Hallie BUCKLEY1 *** 1Anatomy, University of Otago, 2 Archaeology and Anthropology, National University of Mongolia This research aimed to assess whether skeletal assemblages from prehistoric Mongolia, a country situated at high latitudes, presented with bone mineralisation disorders associated with rickets and osteomalacia, and whether there were diachronic changes in frequency from the Bronze Age (2500-300BC) to Iron Age (300BC-AD200). The transition from the Bronze to the Iron Age involves the formation of the first state in Mongolia, the Xiongnu Empire. Ninety-two Bronze and 69 Iron Age individuals, representing adults and nonadults, were assessed for macroscopic lesions, and radiographs were taken of lesions with diagnostic potential. The Brickley and Ives (2010) criteria for diagnosis of rickets and osteomalacia was employed. Overall 4.3% of Bronze and 16.2% of Iron Age individuals presented with lesions consistent with diagnosis of probable rickets, and 6.2% of Bronze and 21.7% of Iron Age individuals presented with lesions consistent with diagnosis of probable osteomalacia. The mineralisation disorders affected individuals of all ages in both time periods. However, variation in the frequencies across sex occurred between the two time periods. Bronze Age females had higher frequencies of osteomalacia than males, whereas the converse trend occurs for the Iron Age. In regards to probable osteomalacia, this change is statistically significant (Fisher’s exact, p=0.0027). Considering a pastoral diet high in meat and dairy, calcium and phosphorus deficiency are unlikely causes for the mineralisation disorders, and seasonal Vitamin D deficiency is proposed as the most likely cause. This research achieved its aims in identifying the presence of mineralisation disorders in prehistoric Mongolia across two time periods.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 42 ABSTRACTS

Hidden evidence of deficiency: The application of multiple methods to assess vitamin D deficiency in Anglo-Saxon England Marie C WEALE, Jo BUCKBERRY, Hannah KOON *** University of Bradford Populations located above 50˚N of the equator can spend at least five months of the year with inadequate UVB exposure to synthesize subcutaneous vitamin D, its primary source. A deficiency of vitamin D can be defined as a lack of a pro-hormone which disrupts calcium homeostasis and the mineralization of bone. This manifests as two conditions in the skeleton; rickets, a condition of bone growth and osteomalacia, a condition of bone turnover. The assessment of vitamin D deficiency in the archaeological record has proven challenging. It is well documented that an amal- gamation of lesions is necessary for diagnosis, many of which remodel as part of bone turn over with little macroscopic evidence remaining. Recent advancements have shown that individuals with vitamin D deficiency also fail to mineralize dentine within teeth and cause changes to pulp. The late Anglo-Saxon population of Raunds Furnell, Northamptonshire consists of 351 well preserved skeletons, of which 162 are non-adults. This small agricultural community situated in the Nene Valley sits at a latitude of 52.24°N. Previous analysis revealed no cases of vitamin D deficiency. The re-assessment for evidence of deficiency has found macropscopic evidence of both rickets (n=2) and osteomalacia (n=5) as well as changes in the pulp horn morphology suggestive of deficiency (n=23). This research has identified that using a multi-method approach aids in the diagnosis of vitamin D deficiency in the archaeological record.

The Lowly Bunion: Identification of hallux valgus in the late 19th century on the Texas Frontier Catrina Banks WHITLEY1, Abigail E FISHER2 1AR Consultants, Inc., Bioarchaeology Support, 2AR Consultants, Inc., Southern Methodist University This poster will present cases of bunions (i.e. hallux valgus) in two females who lived on a rural farm in Fannin County, Texas in the late 19th century. These women were approximately 30 years old and biologically unrelated, with one living AD 1853-1887 and the other AD 1872-1901. Historical records indicate they were sequentially married to the same man. Pathological changes consistent with bunions include accessory facets, lateral deviation of the joint, and basal phalanx lateral subluxation and are evident. Biomechanical pressure is a principal factor for bunion development. Additional osteological changes present in these two females suggest activities in their daily routine that may have led to the condition, including activities required to run a farmstead, such as milking cows, causing squatting facets from crouching on a stool. Constrictive footwear, particularly at the toes, is a risk factor for bunions. Small feet were fashionable during the late 1800s, so shoes were narrow, pointed with high insteps shorting the length of the foot. Subtle osteological changes associated with mild cases of bunions may be overlooked, particularly with the absence of osteoarthritis and bony activity, and reconstruction of the foot aids in the identification of the disease.

Exploring the impact of early-life stress on later-life outcomes in historic populations from north- east England through a Procrustean assessment of dental fluctuating asymmetry Ben WIGLEY1, Elizabeth CRAIG-ATKINS1, Eleanor STILLMAN2 1Department of Archaeology, University of Sheffield,2 School of Mathematics and Statistics, University of Sheffield Stress experienced in utero and soon after birth plays a significant role in life-course trajectories, yet exploring such dynamic processes in past populations is challenging. However, as first permanent molars (M1s) form perinatally without remodeling in later-life they preserve a record of early-life stress in skeletal remains. It is proposed that this record can be unlocked by quantifying the random deviations to symmetry between antimeric molar pairs known as fluctuating asymmetry (FA). To test this hypothesis and explore the long-term impact of early-life stressors, this project investigates the relationship between FA in the M1 and later-life outcomes in north-east English skeletal assemblages spanning the early-medieval to industrial periods. Procrustean analyses were used to explore M1 morphological variation and quantify FA. Dental development and the ADBOU

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 43 ABSTRACTS

program were utilized to estimate age-at-death in subadults and adults. Long bone measurements and non-specific skeletal stress markers were employed to investigate growth and health. Preliminary findings show FA is higher in males than females, suggesting a sex differential in stress experience. It also appears that FA is associated with smaller long bone lengths, an increased prevalence in stress markers, and is higher in subadults than adults. Consequently, it is inferred that early-life adversity resulted in long-term trade-offs that included constrained growth, a compro- mised response to later-life perturbations, and a shortened life expectancy. Future work will expand the project’s sample, bioarchaeologically explore the contextual factors contributing to between-group FA variance, and evaluate M1 FA as a proxy for early-life stress and predictor of life-course trajectories.

The impacts of racialization on skeletal manifestations of disease in migrants to 19th and 20th century St. Louis, Missouri Kristina M ZARENKO *** Edward Via College of Osteopathic Medicine This research explores the biological impact of racialization on German, Irish, and African American migrants to late nineteenth and early twentieth century St. Louis, Missouri. This study, conducted on a sample of 505 individuals from the Robert J. Terry Anatomical Skeletal Collection, investigates whether observable skeletal evidence of infectious disease, trauma, and nutritional deficiencies follow patterns of structural violence and discrimination evident in historical sources. The process of racialization by broader society, in which real or perceived physical differences contribute to the creation of hierarchical racial categories along a “continuum of whiteness” (Orser 2007), translated into different experiences of prejudice and inequality and therefore also exposure to risk of disease among migrant groups. Variable experiences with prejudice and inequality could include degrees of exposure to discrimination, overcrowded and poorly ventilated housing, long hours in factories, low wages, reduced access to healthcare, and interpersonal violence. Results indicate that African American migrants, located on the extreme “non-white” end of the continuum of perceived whiteness, had a higher prevalence of tuberculosis (n=12, 6.3%). The European immigrants presented more evidence of trauma (n=58, 62.4%). My research demonstrates that low socioeconomic status exposes all individuals to an increased risk of disease, but social mechanisms related to migration, including racialization and structural violence, contributed to adverse experiences that resulted differential disease impacts.

*** Cockburn Student Prize Entrant ++ Jane E. Buikstra Early Career Prize Entrant 48th Annual North American Meeting of the Paleopathology Association 44