Cribra orbitalia is correlated with the meningo-orbital foramen and is vascular and developmental in nature

Cribra orbitalia is a phenomenon with interdisciplinary interest. However, the etiology of cribra orbitalia remains unclear. Recently, the appearance of cribra orbitalia was identified as vascular in nature. This study assessed the relationship between anatomical variation of vasculature, as determined by the presence of meningo-orbital foramina, and the presence of cribra orbitalia in 178 orbits. Cribra orbitalia was identified in 27.5% (49:178) of orbits (22.7%, 35:154 adult orbits and 58.3%, 14:24 subadult orbits) and meningo-orbital foramina were identified in 65.8% (100:152) of orbits. Among the 150 total intact adult orbits (i.e., orbital roof and posterior orbits both intact), cribra orbitalia was found in 35 (23.3%). Of these 35 occurrences of cribra orbitalia, 32 (91.4%) had the concurrent finding of a meningo-orbital foramen. However, in the absence of the meningo-orbital foramen, cribra orbitalia was only found in three sides out of the total sample of intact orbits (3:150; 2.0%). Fisher's exact test revealed that the presence of cribra orbitalia and the meningo-orbital foramen were statistically dependent variables (p = .0002). Visual evidence corroborated statistical findings—vascular impressions joined cribra orbitalia to meningo-orbital foramina. This study identifies that individuals who possess a meningo-orbital foramen are anatomically predisposed to developing cribra orbitalia. Conversely, cribra orbitalia is unlikely to occur in an individual who does not possess a meningo-orbital foramen. Thus, the antecedent of cribra orbitalia is both vascular and developmental in nature. This report represents an important advancement in the understanding of cribra orbitalia—there is an anatomical predisposition to the development of cribra orbitalia.     

Cribra orbitalia is a vascular phenomenon unrelated to marrow hyperplasia or anemia: Paradigm shift for cribra orbitalia

The orbital phenomenon, cribra orbitalia, has long been a source of controversy, especially with regard to its nature, derivation, and relationship to anemia. Therefore, the external surfaces of orbital roofs were systematically examined microscopically in human skulls from historical collections. Superior orbital surfaces of 278 individual crania within the Hamann-Todd collection were assessed at various magnifications using epi-illumination microscopy to identify the presence of cribra orbitalia and characterize its nature. Also, 12 additional individuals with diagnosed anemia in the Hamann-Todd collection were evaluated. Orbital roof alterations, present in one-third of examined crania, had two discrete appearances: Vascular grooves (45%) and application of new bone in a vascular branching pattern on the orbit surface (55%). Porosity of the orbit was not observed. Evaluation of the orbits of 12 individuals with diagnosed anemia revealed one with a single deep defect, suggesting a space-occupying phenomenon, but no evidence of bone accretion, vascular grooves, or porosity. Cribra orbitalia has often been lumped indiscriminately as an indicator of organismal stress, rather than identified as a indicating a specific etiology. Neither that perspective nor porosity are supported by high resolution examination of orbital roof changes. Recognition of the blood vessel imprint pattern falsifies previous speculations and provides a new paradigm. The actual character of cribra orbitalia is documented and new hypotheses generated. While population prevalence of cribra orbitalia seems excessive for explanation on the basis of these hypotheses, the imprints are clearly vascular in origin.     

Cribra orbitalia visualized in computed tomography

Cribra orbitalia are sieve-like lesions of the orbital roof. While common in historic skulls, they have long been absent in those examined in the last decades. Only recently we found low-grade cribra orbitalia in some contemporary cases. Though of unknown origin, this lesion is often attributed to anemia and deficiency diseases. It is theoretically possible to visualize cribra orbitalia in living subjects by computed tomography and thus study their etiology. The aim of our study was to investigate the possibilities of computed tomography for visualizing cribra orbitalia. We used multislice computed tomography (MSCT) in the spiral and sequential mode to image medium-grade cribra orbitalia of moderate severity in a human skull. Virtual endoscopic and 3-D images were produced by post-processing. The best results were obtained by the sequential mode and 3-D reconstruction. Given a thin slice thickness and a wide slice angle between slice plane and the orbital roof, the threshold level seems to be the most important factor influencing realistic reproduction and should be finely adjusted according to bone density. Clinical research may now begin by examining relevant patients undergoing CT.     

Porotic hyperostosis as a marker of health and nutritional conditions during childhood: Studies at the transition between imperial rome and the early middle ages

Porotic hyperostosis, characterized by small and localized perforations on the surface of cranial bones, is considered a good indicator for assessing the health and nutritional status of past human populations. The most widely accepted theory at present indicates that anemias, either acquired or of genetic origin, are responsible for the bony lesions described as porotic hyperostosis. In this paper, the prevalence of these lesions in two skeletal samples from Latium (central Italy) was used to evaluate health and life conditions in Italy after the collapse of the Roman Empire. One sample belongs to the Roman Imperial Age (1st–3rd centuries A.D.) rural town of Lucus Feroniae; the other comes from the 7th century A.D. Lombard necropolis of Selvicciola. The prevalence of cribra orbitalia and cribra cranii was quite similar in the two samples but slightly more frequent in the Medieval community. Differential diagnosis suggested iron deficiency anemia in early childhood as the causative agent of the hyperostotic lesions in both samples. These results may be interpreted in light of previous examinations of same samples and according to their respective historical and socio‐economical characteristics. Am. J. Hum. Biol. 13:709–717, 2001. © 2001 Wiley‐Liss, Inc.     

Prevalence and disease experience rates in Korean physicians.

This study aimed to find out the morbid status of Korean physicians living in Korea, as one part of a feasibility study on the Korean physician cohort. It was performed by mail survey using a self-administered questionnaire from Jan. 1, 1995 through Dec. 31, 1995. Study subjects were 21,552 including 17,877 (81.1%) males and 3,384 (15.5%) females. Person based prevalence rate of disease was 17.7% (18.3% for males and 13.8% for females) with the rate increasing with age. The disease group showing the highest prevalence rate was circulatory diseases (5.16%) for males, and respiratory disease (3.13%) for females. The individual disease showing the highest prevalence rates was hypertension (3.77%) for males and allergic rhinitis (2.25%) for females. The person based disease experience rate was 36.2% (36.9% for males, 32.7% for females) with the rate increasing with age. The disease group showing the highest disease experience rate was digestive disease for both sexes (10.05% for males, 7.42% for females). Individual disease showing the highest disease experience rate was hypertension (5.00%) for males and allergic rhinitis (4.08%) for females. There were different ranks of both prevalence and disease experience rate depending on age in both sexes.     

Colour-blindness and sensitivity to PTC in Hadza

211 Hadza (Tanzania) males, including members of both western and eastern groups, were tested for red-green colour blindness with the Ishihara non-numeral plates. Three closely related individuals were considered to be protanopes. It is possible that they received the gene from an Isanzu ancestor. 118 individuals (both sexes) were tested for taste-deficiency to PTC using a single solution and a sorting test. 22% of the males and 27% of the females were considered to be non-tasters. Since this appeared to be a high figure for an African population a sample of 53 eastern Hadza males was later tested using solutions 1, 3, 5, 7, 9, 11, 13. A conservative interpretation of the threshold distribution gave an estimate of 43% non-tasters. Corrections were applied for the inclusion of close relatives in the samples. The results are discussed in relation to other African data.     

Colour-blindness and sensitivity to PTC in Hadza

211 Hadza (Tanzania) males, including members of both western and eastern groups, were tested for red-green colour blindness with the Ishihara non-numeral plates. Three closely related individuals were considered to be protanopes. It is possible that they received the gene from an Isanzu ancestor. 118 individuals (both sexes) were tested for taste-deficiency to PTC using a single solution and a sorting test. 22% of the males and 27% of the females were considered to be non-tasters. Since this appeared to be a high figure for an African population a sample of 53 eastern Hadza males was later tested using solutions 1, 3, 5, 7, 9, 11, 13. A conservative interpretation of the threshold distribution gave an estimate of 43% non-tasters. Corrections were applied for the inclusion of close relatives in the samples. The results are discussed in relation to other African data.     

The relationship of sex to asthma prevalence, health care utilization, and medications in a large managed care organization.

BACKGROUND: Age-related sex differences in asthma hospitalizations and emergency department (ED) visits have been reported, but relationships of these differences to disease prevalence and outpatient management have not been defined. OBJECTIVE: To define the relationships of sex to asthma-related health care utilization and medications, accounting for age-related differences in asthma prevalence. METHODS: Computerized data from Southern California Kaiser-Permanente were used to identify asthmatic patients, aged 2 to 64 years, enrolled continuously during 1999 and 2000. Age-specific asthma prevalence in 1999 was calculated to identify ages of male or female predominance. Males and females were compared with regard to asthma-related health care utilization outcomes (outpatient clinic visits, ED visits, and hospitalizations) and medication use (beta-agonists, inhaled steroids, and oral steroids). Hospitalizations, ED visits, and oral steroid use were considered markers of disease severity. RESULTS: Of the 60,694 subjects, the female-male prevalence ratio was approximately 35:65 at each age between 2 and 13 years, it was inverse (65:35) between the ages of 23 and 64 years, and prevalences were relatively similar at the ages of 14 to 22 years. In patients aged 2 to 13 years, most utilization and medication variables were significantly greater in males (P < .01). Females aged 14 to 22 years had more outpatient and ED visits and used more oral steroids than males. In patients aged 23 to 64 years, all utilization variables were significantly greater in females, except beta-agonist use and mean inhaled steroid dispensings. CONCLUSIONS: Asthma utilization and severity appear greater in males aged 2 to 13 years, somewhat greater in females aged 14 to 22 years, and definitely greater in females aged 23 to 64 years. The mechanisms for these striking sex differences merit further investigation.     

Analysis of mutations at the fragile X locus using the DNA probe Ox1.9.

In this study, 40 families segregating for fragile X [fra (X)] syndrome were examined for the presence of a mutation within the FMR-1 gene. Using the DNA probe Ox1.9, both carriers and affected individuals were found to contain an insertion/amplification-type of mutation with somatic instability. Variability in the size of the mutation, which ranged from less than 0.2 kb to approximately 13 kb, was observed both between individuals (even from the same family) and within individuals, who showed a smear rather than a discrete band(s) on Southern blot analysis. Transmission of the mutation by males resulted in little change of its size, while transmission by females usually resulted in an increase in size. Correlations were observed between the size of inserted/amplified DNA and the level of chromosome fragility and the presence or absence of mental impairment. Overall, a mutation was detected in 66 of 67 (99%) clinically affected males, in 12 of 13 (92%) transmitting males and in 95 of 112 (85%) carrier females. Equivocal results were obtained in 12 (11%) of the carrier females. No mutation was detected in 58 females and 33 males predicted to be normal by linkage, or in one female and 36 normal control males. These results strongly suggest that the mutation detected by Ox1.9 is closely associated with the cytogenetic and clinical expression of fra (X) syndrome. Additionally, the use of this probe along with other probe/enzyme combinations should provide a sensitive clinical assay for the detection of carriers of fra (X) syndrome.     

Autoimmunity in a rural community

As part of a long term prospective study, sera from 3492 subjects, over 90% of the adult population of the rural Australian town of Busselton, were tested by indirect immunofluorescence for various autoantibodies, and by latex particle agglutination for rheumatoid factor. Autoantibodies were detected in 21·6% of all subjects and the overall prevalence increased with age in both sexes. A dip in the age prevalence curve of autoantibodies amongst subjects aged 75–80 years preceded a terminal sharp rise. The greater prevalence in females, 27·5%, than in males, 13·7%, was accounted for by autoantibodies to nuclei, gastric parietal cells and thyroid epithelial cells; the prevalence of smooth muscle antibody (SMA) and rheumatoid factor (RF) was similar in females and males, and the prevalence of SMA did not increase with age. Thus development of `age-sex dependent' autoantibodies, to gastric and thyroid antigens, may have a considerable genetic component, whereas the non `age-sex dependent' autoantibodies, SMA and RF, may have a considerable extrinsic component, e.g. infection. Autoantibodies were associated in two groups, a `nuclear' group and a `thyrogastric' group; these groups were neither positively nor negatively associated, implying independent genetic or other causes for their appearance.     

A nationwide survey of hepatitis E virus infection in the general population of Japan

To investigate nationwide the prevalence of hepatitis E virus (HEV) infection in the general population of Japan, serum samples were collected from 22,027 individuals (9,686 males and 12,341 females; age, mean ± standard deviation: 56.8 ± 16.7 years; range: 20–108 years) who lived in 30 prefectures located in Hokkaido, mainland Honshu, Shikoku, and Kyushu of Japan and underwent health check‐ups during 2002–2007, and were tested for the presence of IgG, IgM, and IgA classes of antibodies to HEV (anti‐HEV) by in‐house ELISA and HEV RNA by nested RT‐PCR. Overall, 1,167 individuals (5.3%) were positive for anti‐HEV IgG, including 753 males (7.8%) and 414 females (3.4%), the difference being statistically significant (P < 0.0001). The prevalence of anti‐HEV IgG generally increased with age and was significantly higher among individuals aged ≥50 years than among those aged <50 years (6.6% vs. 2.7%, P < 0.0001). Although 13 individuals with anti‐HEV IgG also had anti‐HEV IgM and/or anti‐HEV IgA, none of them had detectable HEV RNA. The presence of HEV RNA was further tested in 50 or 49‐sample minipools of sera from the remaining 22,014 individuals, and three individuals without anti‐HEV antibodies tested positive for HEV RNA. The HEV isolates obtained from the three viremic individuals segregated into genotype 3 and were closest to Japan‐indigenous HEV strains. When stratified by geographic region, the prevalence of anti‐HEV IgG as well as the prevalence of HEV RNA or anti‐HEV IgM and/or anti‐HEV IgA was significantly higher in northern Japan than in southern Japan (6.7% vs. 3.2%, P < 0.0001; 0.11% vs. 0.01%, P = 0.0056; respectively). J. Med. Virol. 82:271–281, 2010. © 2009 Wiley‐Liss, Inc.     

Comparison of male and female meiotic segregation patterns in translocation heterozygotes: a case study in an animal model (Sus scrofa domestica L.)

BACKGROUND: The comparison of male and female meiotic segregation patterns for individuals carrying identical reciprocal translocations has been rarely reported in mammalian species. The main comparative study involving males and females with comparable genetic background has been performed in the mouse. Swine is another relevant animal model species for meiotic studies. Here we present the segregation patterns determined for sows carrying one of the two following reciprocal translocations: 38, XX, rcp(3;15)(q27;q13), and 38, XX, rcp(12;14)(q13;q21). These segregation data were compared to those previously obtained for closely related boars carrying the same balanced chromosomal rearrangements. METHODS: Dual colour in situ hybridization of whole chromosome painting probes was carried out on metaphases of in vitro-matured oocytes II. Segregation results were obtained for 118 and 206 metaphases II respectively for the two translocations. RESULTS: Significant differences between sexes were demonstrated for both rearrangements. For instance, for the 3/15 translocation, the chromosomally unbalanced gametes were of different origin: preponderance of the adjacent-I segregation in the male (31.4%), and of the adjacent-II (14.3%) and 3:1 (14.3%) segregations in females. For the 12/14 translocation, the proportion of balanced gametes was greater in males than in females (75.9 and 59.4% respectively). CONCLUSION: This study is a new scientific contribution to compare the segregation patterns of male and female carriers of identical chromosomal rearrangements. The results obtained are consistent with those previously reported in mice. Hypotheses to interpret the observed differences between the two translocations, as well as between the male and female segregation patterns, are formulated and discussed.     

Striking prevalence of ankylosing spondylitis in "healthy" w27 positive males and females.

Ankylosing spondylitis is diagnosed once or twice in each 1000 males and one tenth as frequently in females, but the true prevalence is unknown. Indentification of genetic marker, HL-A W27, for susceptible persons has provided a tool facilitating epidemiologic studies and allowing identification of "control" populations without the marker. Evaluation by postal questionnaires, and pelvic radiography of 78 HL-A 27W-positive blood donors selected from a group of apparently healthy subjects revealed 14 who satisfied the criteria for definite ankylosing spondylitis. The prevalence was similar in both sexes. One hundred and twenty-six W27-negative controls matched for race, sex, and age failed to yield a single case. For a person of either sex with HL-A W27, there appears to be about a 20 per cent chance that ankylosing spondylitis will develop, suggesting a prevalence of 10 to 15 per thousand. Hitherto accepted figures may underestimate the frequency by a factor of 10 to 20.     

Inflammation Markers in Individuals with History of Mental Health Crisis

The association between temporary emotional states and systemic inflammation has never been studied. We measured the levels of systemic inflammation markers in the peripheral blood of individuals with history of mental health crisis. Erythrocyte sedimentation rate (ESR), fibrinogen plasma level, high-sensitivity C-reactive protein (hs-CRP) serum level, and white blood cell count (WBCC) were measured for each individual during routine screening examinations. History of mental health crisis was self-reported. Individuals taking psychotropic agents were excluded. A total of 4,669 males and 2,576 females were included. One hundred forty-eight (2.0%) individuals (77 males and 71 females) reported a history of mental health crisis, and 7,097 (98.0%) individuals (4,592 males and 2,505 females) did not report a history of mental health crisis. After adjustment for multiple confounders which had been associated with elevated systemic inflammation markers, the levels of systemic inflammation markers were significantly higher among males with history of mental health crisis compared with males with no history of mental health crisis, including fibrinogen plasma levels (294+/-6.1 vs. 279+/-1.9 mg/dl, p=0.010), and WBCC (7.2+/-0.2 vs. 6.8+/-0.1 x 10(3) cells/dl, p=0.039). The levels of systemic inflammation markers were not significantly higher among females with history of mental health crisis compared with females with no history of mental health crisis. History of mental health crisis might be associated with systemic inflammation in males. This finding may be relevant to the pathophysiology of cardiovascular disease in males.     

A case study of a high-status human skeleton from Pacopampa in Formative Period Peru

The Pacopampa site is located in the northern highlands of Peru and is an archaeological site belonging to the Formative Period (2500?C1?BC). The excavation of the Pacopampa site yielded unusual human skeletons from the main platform of a ceremonial center of the site during the 2009 field season. The skeletal remains were associated with a pair of gold earplugs, a pair of gold earrings, and shell objects. This specimen is possibly a female aged 20?C39?years. Detailed examination of the neurocranium revealed the presence of artificial cranial deformation with decreased cranial length, increased cranial breadth, and lateral bulging of the parietal bones. The estimated stature of this individual was 162?cm, which is about 15?cm higher than that of contemporary females of Pacopampa and about 20?C25?cm higher than that of other Formative Period sites in northern Peru. The peculiarity of this individual, detected not only in the cultural artifacts but also in the physical features, is possible evidence for social stratification in the Formative Period.     

The longitudinal development of running economy in males and females aged between 13 and 27 years: The Amsterdam Growth and Health Study

The purpose of this study was to describe the longitudinal development of running economy [defined as the oxygen uptake (V˙O₂) at a submaximal running speed] in males and females from teenage to young adult age using data from the Amsterdam Growth and Health Study. Submaximal V˙O₂ (in ml · kg^?1· min^?1) was measured in 84 males and 98 females while they ran on a treadmill at a constant speed of 8 km · h^?1 for 6 min at three different treadmill slopes (0%, 2.5% and 5%). This test was carried out six times, on the same subjects at the ages of 13, 14, 15, 16, 21, and 27 years. The longitudinal development of running economy in males and females was analysed using a two-way analysis of variance for repeated measurements. At all three slopes, a significant decrease in V˙O₂ with increasing age was found for both males and females, implying a significant increase in running economy for both sexes. Males showed significantly higher V˙O₂ values than females at all ages measured and for all three slopes, suggesting that females have a significantly higher running economy than males. In order to make a better comparison of the V˙O₂ of individuals of different sizes, allometric models were used; power function ratios were constructed in which body mass was expressed to an exponential power. Following this analysis the difference in submaximal V˙O₂ and running economy between males and females appeared even larger.     

Age-related changes in cortical porosity of the midshaft of the human femur

Complete cross-sections from the femoral midshaft of 180 individuals of known height and weight, aged 21–97 y, from a modern Australian population were examined using automatic video image analysis to quantify total subperiosteal porosity (TSPP). More specifically, the aim was to investigate whether age changes were similar in both sexes in (1) total subperiosteal area (TSPA), cortical area (CA) and medullary area (MA), (2) intracortical porosity (ICP), and (3) the respective contributions to TSPP made by MA and intracortical void area (ICVA). Our findings indicated that both sexes showed a significantly greater height normalised TSPA in the 70s as compared with the 20s. Males had consistently larger bones with a greater height normalised CA. In both sexes CA showed a tendency to increase till the 7th decade and then to decline, more so in females. MA approximately trebled in females and doubled in males over the age range studied. Although ICP also increased, from 4–6% in young adults to over 9% in the elderly, it showed a significant difference between the sexes only in the 3rd decade, being greater in males at this stage. By contrast, TSPP became significantly greater in females (from that recorded in the 3rd decade) by the time they reached the 50s, while in males this did not occur till the 80s. It increased from ∼25% in young adults of both sexes to ∼50% in females and ∼37% in males in their 80s. However, in the elderly there was great variability in both sexes in the appearance of bones from individuals of similar chronological age. Some bones differed little from those in younger subjects, others showed greatly increased ICP, still others displayed reduced cortical widths with low ICP. The femoral midshaft resembles other skeletal sites in that age changes in TSPP are more marked in females than males.     

A community mental health survey in Cantabria: a general description of morbidity

A two-stage mental illness survey of a random sample of persons aged 17 years and over from a rural community in Cantabria, Spain, is described. In the first stage newly qualified doctors and final year medical students interviewed 1223 respondents (583 males and 640 females) at their homes, using the General Health Questionnaire (GHQ-60) and other psychopathological and social questionnaires. In the second stage senior psychiatrists carried out an at-home interview on a sample composed of all those who in the first stage scored above the cut-off point on the GHQ, and of a similar number of persons selected at random from two independent batches of below-threshold scorers on the GHQ. Because of this design the prevalence figures have to be weighted in order to represent the whole first stage sample. Of the total population, 14.7% (8.1% of the men and 20.6% of the women) had psychiatric disorders as defined by the PSE-ID system. In males depression accounted for about twice as many cases as anxiety states, but in females there was a predominance of a combination of anxiety, phobic and obsessive conditions. Men presented a higher prevalence of disorders over the age of 35, with a peak around the age of forty, while in women the rise of prevalence was over the age of 45. There was, however, no significant association with marital status. Unemployment was related to mental illness in males but not in females, while the reverse was true of the type of work. In both sexes the presence of children under fourteen in the household was not related to a rise in prevalence. Women exhibited a high rate of mental illness in the low educational level and in the low social and religious integration groups, but in men a rise in prevalence was found in the low social status, low educational level and low social integration groups. Lastly, in both sexes the presence of physical illness was related to mental disorders.     

HTLV-I in the general population of Salvador, Brazil: a city with African ethnic and sociodemographic characteristics

The city of Salvador has the highest prevalence of HTLV-I among blood donors in Brazil. To study the prevalence of HTLV-I among the general population of Salvador, 30 "sentinel surveillance areas" were selected for the investigation of various infectious diseases, and 1385 individuals within these areas were surveyed according to a simple random sample procedure. ELISA was used to screen plasma samples for antibodies to HTLV-I, and the positive samples were tested by a confirmatory assay (Western blotting). The overall prevalence of HTLV-I was 1.76% (23/1385). Infection rates were 1.2% for males and 2.0% for females. Specific prevalence demonstrated an increasing linear trend with age. No one younger than 13 years of age was infected. Multivariate analysis estimated adjusted odds ratios for the association of HTLV-I with age of 9.7 (3.3; 30.4) for females and 12.3 (1.47; 103.1) for males. Less education and income might be associated with HTLV-I infection in females. Phylogenetic analysis of the long terminal repeat fragments showed that most of the samples belonged to the Latin American cluster of the Transcontinental subgroup (Cosmopolitan subtype). For the entire city of Salvador, it is estimated that approximately 40000 individuals are infected with HTLV-I. Our results suggest multiple post-Colombian introductions of African HTLV-Ia strains in Salvador.     

Skeletal manifestations of disease experience: Length of illness and porous cranial lesion formation in a contemporary juvenile mortality sample

Objectives

Porous lesions of the orbit (cribra orbitalia [CO]) and cranial vault (porotic hyperostosis [PH]) are used as skeletal indicators of childhood stress. Because they are understudied in contemporary populations, their relationship to disease experience is poorly understood. This paper examines the relationship between length of childhood illness and CO/PH formation in a clinically documented sample. “Turning points,” which identify the window for lesion formation for CO/PH, are defined, implications for hidden heterogeneity in frailty are considered.

Methods

Data are from 333 (199 males; 134 females) pediatric postmortem computed tomography scans. Individuals died in New Mexico (2011–2019) and are 0.5 to 15.99 years (mean = 7.1). Length of illness was estimated using information from autopsy and field reports. Logistic regression was used to estimate predicted probabilities, odds ratios, and the temporal window for lesion formation.

Results

Illness, single bouts, or cumulative episodes lasting over 1 month is associated with higher odds of CO; individuals who were never sick have lower odds of having PH. This relationship was consistent for fatal and incidental illnesses that did not cause death. The developmental window for CO formation appears to close at 8 years.

Conclusions

Those ill for over 1 month are more likely to have CO/PH than those with acute illnesses. Some individuals lived sufficiently long to form CO/PH but died of illness. Others with lesions died of circumstances unrelated to disease. This indicates hidden variation in robusticity even among ill individuals with CO/PH, which is vital in interpreting lesion frequencies in the archeological record.