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Hui R, Scheib CL, D’Atanasio E, Inskip SA, Cessford C, Biagini SA, Wohns AW, Ali MQ, Griffith SJ, Solnik A, Niinemäe H, Ge XJ, Rose AK, Beneker O, O’Connell TC, Robb JE, Kivisild T. Genetic history of Cambridgeshire before and after the Black Death. Sci Adv 2024; 10:eadi5903. [PMID: 38232165 PMCID: PMC10793959 DOI: 10.1126/sciadv.adi5903] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 12/14/2023] [Indexed: 01/19/2024]
Abstract
The extent of the devastation of the Black Death pandemic (1346-1353) on European populations is known from documentary sources and its bacterial source illuminated by studies of ancient pathogen DNA. What has remained less understood is the effect of the pandemic on human mobility and genetic diversity at the local scale. Here, we report 275 ancient genomes, including 109 with coverage >0.1×, from later medieval and postmedieval Cambridgeshire of individuals buried before and after the Black Death. Consistent with the function of the institutions, we found a lack of close relatives among the friars and the inmates of the hospital in contrast to their abundance in general urban and rural parish communities. While we detect long-term shifts in local genetic ancestry in Cambridgeshire, we find no evidence of major changes in genetic ancestry nor higher differentiation of immune loci between cohorts living before and after the Black Death.
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Affiliation(s)
- Ruoyun Hui
- Alan Turing Institute, London, UK
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
| | - Christiana L. Scheib
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
- Estonian Biocentre, Institute of Genomics, University of Tartu, Tartu, Estonia
- St John’s College, University of Cambridge, Cambridge, UK
| | | | - Sarah A. Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
- School of Archaeology and Ancient History, University of Leicester, Leicester, UK
| | - Craig Cessford
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
- Cambridge Archaeological Unit, Department of Archaeology, University of Cambridge, Cambridge, UK
| | | | - Anthony W. Wohns
- School of Medicine, Stanford University, Stanford, CA, USA
- Department of Genetics and Biology, Stanford University, Stanford, CA, USA
| | | | - Samuel J. Griffith
- Estonian Biocentre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Anu Solnik
- Core Facility, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Helja Niinemäe
- Estonian Biocentre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Xiangyu Jack Ge
- Wellcome Genome Campus, Wellcome Sanger Institute, Hinxton, UK
| | - Alice K. Rose
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
- Department of Archaeology, University of Durham, Durham, UK
| | - Owyn Beneker
- Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Tamsin C. O’Connell
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
| | - John E. Robb
- Department of Archaeology, University of Cambridge, Cambridge, UK
| | - Toomas Kivisild
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
- Estonian Biocentre, Institute of Genomics, University of Tartu, Tartu, Estonia
- Department of Human Genetics, KU Leuven, Leuven, Belgium
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2
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Dittmar JM, Mitchell PD, Inskip SA, Cessford C, Robb JE. Tuberculosis before and after the Black Death (1346-1353 CE) in the Hospital of St John the Evangelist in Cambridge, England. Tuberculosis (Edinb) 2023; 143S:102401. [PMID: 38012925 DOI: 10.1016/j.tube.2023.102401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 07/30/2023] [Accepted: 09/01/2023] [Indexed: 11/29/2023]
Abstract
This research explores how the prevalence of tuberculosis (TB) in a medieval hospital was affected by the demographic and social changes that following the Black Death (1346-1353 CE), the initial years of the Second Plague Pandemic. To do this, skeletal remains of individuals buried at the Hospital of St John the Evangelist in Cambridge, England, that could be dated to living before (n = 77) or after (n = 55) the Black Death were assessed for evidence of TB (indicated by destructive lesions of the spine, ribs, large joints, and other recognised criteria). Overall, the odds of females having skeletal lesions caused by TB were over four times higher than males. No significant difference was detected in the prevalence rates in those who lived before and after the Black Death (7.8%, 6/77 before and 11.0%, 6/55 after). However, the odds of females having skeletal evidence of TB were over five times greater after the Black Death than they were before. These findings indicate that women may have been 1) more susceptible to TB, 2) surviving longer post-infection than men, and/or 3) that women with TB were more likely to be admitted to the Hospital especially following the Black Death. It is also possible that impairment due to TB infection may have been a contributing factor for entry into the Hospital for women but not men.
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Affiliation(s)
- Jenna M Dittmar
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, CB2 3ER, UK; Department of Archaeology, University of Aberdeen, St Mary's Building Elphinstone Road, Aberdeen, AB24 3UF, UK.
| | - Piers D Mitchell
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, CB2 3ER, UK.
| | - Sarah A Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, CB2 3ER, UK; School of Archaeology and Ancient History, University of Leicester, University Road, Leicester, LE1 7RH, UK.
| | - Craig Cessford
- Cambridge Archaeological Unit, Department of Archaeology, University of Cambridge, 34 A&B Storey's Way, Cambridge, CB3 0DT, UK.
| | - John E Robb
- Department of Archaeology, University of Cambridge, Downing Street, Cambridge, CB2 3DZ, UK.
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3
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Ditmar JM, Mulder B, Tran A, Mitchell PD, Jones PD, Inskip SA, Cessford C, Robb JE. Corrigendum to "Caring for the injured: Exploring the immediate and long-term consequences of injury in medieval Cambridge, England" [Int. J. Paleopathol. 40 (2023) 7-19]. Int J Paleopathol 2023; 41:123. [PMID: 37019700 DOI: 10.1016/j.ijpp.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
| | - Bram Mulder
- Department of Archaeology, University of Cambridge, UK
| | - Anna Tran
- Department of Archaeology, University of Cambridge, UK
| | | | | | - Sarah A Inskip
- School of Archaeology and Ancient History, University of Leicester, UK
| | - Craig Cessford
- Cambridge Archaeological Unit, Department of Archaeology, University of Cambridge, UK
| | - John E Robb
- Department of Archaeology, University of Cambridge, UK
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4
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Dittmar JM, Mulder B, Tran A, Mitchell PD, Jones PM, Inskip SA, Cessford C, Robb JE. Caring for the injured: Exploring the immediate and long-term consequences of injury in medieval Cambridge, England. Int J Paleopathol 2023; 40:7-19. [PMID: 36401904 DOI: 10.1016/j.ijpp.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 07/21/2022] [Accepted: 07/24/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To combine paleopathological and biomechanical analysis to reconstruct the impact that a severe skeletal injury had on an individual's ability to function and participate in medieval society. MATERIALS Three medieval individuals from Cambridge, England with ante-mortem fractures to the lower limb were analyzed. METHODS Plain X-rays were used to determine the degree of malunion, rotation and overlap of each fracture. Cortical bone architecture of the injured individuals and 28 uninjured controls were analyzed using micro-computed tomography (µCT). Clinical and functional consequences were examined using the Bioarcheology of Care framework. RESULTS The mechanism of injury, the secondary complications, and the extent of the care received was reconstructed for each individual. Bilateral asymmetry in the cortical bone architecture revealed the long-term alterations to each individual's gait. CONCLUSION Each of these individuals survived a severe injury resulting in chronic physical impairment, though not all would have been considered 'disabled'. SIGNIFICANCE This research contributes to the discussion about medieval care provision and social constructions of disability by illustrating how an interdisciplinary approach provides insight into the experiences of those with physical impairments. The integration of µCT imaging within the Bioarcheology of Care model is a novel approach with great potential for application across the field. LIMITATIONS Biomechanical analysis was restricted to cortical geometry. SUGGESTIONS FOR FUTURE RESEARCH Further study of bilateral asymmetry in trabecular architecture could complement our understanding of altered loading modalities in past societies.
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Affiliation(s)
- Jenna M Dittmar
- Department of Archaeology, University of Aberdeen, UK; McDonald Institute for Archaeological Research, University of Cambridge, UK.
| | - Bram Mulder
- Department of Archaeology, University of Aberdeen, UK
| | - Anna Tran
- Department of Archaeology, University of Cambridge, UK
| | | | | | - Sarah A Inskip
- Department of Archaeology, University of Aberdeen, UK; School of Archaeology and Ancient History, University of Leicester, UK
| | - Craig Cessford
- Department of Archaeology, University of Aberdeen, UK; Cambridge Archaeological Unit, Department of Archaeology, University of Cambridge, UK
| | - John E Robb
- Department of Archaeology, University of Cambridge, UK
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5
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Elliott E, Saupe T, Thompson JE, Robb JE, Scheib CL. Sex bias in Neolithic megalithic burials. Am J Biol Anthropol 2023; 180:196-206. [PMCID: PMC10092627 DOI: 10.1002/ajpa.24645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/27/2022] [Accepted: 10/12/2022] [Indexed: 11/16/2023]
Abstract
Objectives A statistical study comparing osteological and ancient DNA determinations of sex was conducted in order to investigate whether there are sex biases in United Kingdom and Irish Neolithic megalithic burials. Materials and Methods Genetic and osteological information from human individuals from 32 megalithic sites in the UK and Ireland dating from 4000 to 2500 cal. BCE was collected and statistically analyzed to test whether there is a true over‐representation of males at these sites. The published dataset from the study by Sánchez‐Quinto et al. in 2019 was initially analyzed before being refined and included in a larger dataset. Osteological analysis of sex bias was limited to adults with available sex estimations, and genetic analysis limited to published data Results Two sites consistently returned significant p ‐values suggesting a potential over‐representation in osteological males at one site (Knowe of Midhowe, Orkney) and genetic males in the other (Primrose Grange, Ireland). Cumulative statistical analyses point towards a male bias in the representation of sexes in Neolithic megalithic burials, but these results do not reflect the site‐by‐site and regional variation found in this study. Discussion The interpretation of sex bias, that is, the over‐representation of one sex over another ‐ depends on other socio‐cultural variables (e.g., kinship) and the emphasis placed on statistical significance. The trend towards males being over‐represented in Neolithic megalithic burials is not as clear as previously thought, and requires further testing and data collection to uncover.
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Affiliation(s)
- Elliot Elliott
- Estonian Biocentre, Institute of GenomicsUniversity of TartuTartuEstonia
| | - Tina Saupe
- Estonian Biocentre, Institute of GenomicsUniversity of TartuTartuEstonia
| | - Jess E. Thompson
- McDonald Institute for Archaeological ResearchUniversity of CambridgeCambridgeUK
- Darwin CollegeUniversity of CambridgeCambridgeUK
| | - John E. Robb
- Department of ArchaeologyUniversity of CambridgeCambridgeUK
| | - Christiana L. Scheib
- Estonian Biocentre, Institute of GenomicsUniversity of TartuTartuEstonia
- St John's CollegeUniversity of CambridgeCambridgeUK
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6
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Guellil M, van Dorp L, Inskip SA, Dittmar JM, Saag L, Tambets K, Hui R, Rose A, D’Atanasio E, Kriiska A, Varul L, Koekkelkoren AMHC, Goldina RD, Cessford C, Solnik A, Metspalu M, Krause J, Herbig A, Robb JE, Houldcroft CJ, Scheib CL. Ancient herpes simplex 1 genomes reveal recent viral structure in Eurasia. Sci Adv 2022; 8:eabo4435. [PMID: 35895820 PMCID: PMC9328674 DOI: 10.1126/sciadv.abo4435] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/10/2022] [Indexed: 05/05/2023]
Abstract
Human herpes simplex virus 1 (HSV-1), a life-long infection spread by oral contact, infects a majority of adults globally. Phylogeographic clustering of sampled diversity into European, pan-Eurasian, and African groups has suggested the virus codiverged with human migrations out of Africa, although a much younger origin has also been proposed. We present three full ancient European HSV-1 genomes and one partial genome, dating from the 3rd to 17th century CE, sequenced to up to 9.5× with paired human genomes up to 10.16×. Considering a dataset of modern and ancient genomes, we apply phylogenetic methods to estimate the age of sampled modern Eurasian HSV-1 diversity to 4.68 (3.87 to 5.65) ka. Extrapolation of estimated rates to a global dataset points to the age of extant sampled HSV-1 as 5.29 (4.60 to 6.12) ka, suggesting HSV-1 lineage replacement coinciding with the late Neolithic period and following Bronze Age migrations.
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Affiliation(s)
- Meriam Guellil
- Estonian Biocentre, Institute of Genomics, University of Tartu, Riia 23B, Tartu 51010, Estonia
| | - Lucy van Dorp
- UCL Genetics Institute, Department of Genetics, Evolution, and Environment, University College London, London WC1E 6BT, UK
| | - Sarah A. Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
- Department of Archaeology and Ancient History, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - Jenna M. Dittmar
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
- Department of Archaeology, University of Aberdeen, UK
| | - Lehti Saag
- Estonian Biocentre, Institute of Genomics, University of Tartu, Riia 23B, Tartu 51010, Estonia
- UCL Genetics Institute, Department of Genetics, Evolution, and Environment, University College London, London WC1E 6BT, UK
| | - Kristiina Tambets
- Estonian Biocentre, Institute of Genomics, University of Tartu, Riia 23B, Tartu 51010, Estonia
| | - Ruoyun Hui
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
- Alan Turing Institute, 2QR, John Dodson House, 96 Euston Rd., London NW1 2DB, UK
| | - Alice Rose
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
| | | | - Aivar Kriiska
- Department of Archaeology, Institute of History and Archaeology, University of Tartu, Tartu 51014, Estonia
| | - Liivi Varul
- Archaeological Research Collection, School of Humanities, Tallinn University, Tallinn 10130, Estonia
| | | | - Rimma D. Goldina
- Department History of Udmurtia, Archaeology and Ethnology, Udmurt State University, 1, Universitetskaya St. 1, 426034 Izhevsk, Russia
| | - Craig Cessford
- Cambridge Archaeological Unit, Department of Archaeology, University of Cambridge, Cambridge, UK
| | - Anu Solnik
- Core Facility, Institute of Genomics, University of Tartu, Riia 23B, Tartu 51010 Estonia
| | - Mait Metspalu
- Estonian Biocentre, Institute of Genomics, University of Tartu, Riia 23B, Tartu 51010, Estonia
| | - Johannes Krause
- Department of Archaeogenetics, Max Planck Institute for the Science of Human History, Jena, Germany
- Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Alexander Herbig
- Department of Archaeogenetics, Max Planck Institute for the Science of Human History, Jena, Germany
- Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - John E. Robb
- Department of Archaeology, University of Cambridge, Cambridge, UK
| | | | - Christiana L. Scheib
- Estonian Biocentre, Institute of Genomics, University of Tartu, Riia 23B, Tartu 51010, Estonia
- St. John’s College, University of Cambridge, Cambridge, CB2 1TP, UK
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Mitchell PD, Dittmar JM, Mulder B, Inskip S, Littlewood A, Cessford C, Robb JE. Assessing the relative benefits of imaging with plain radiographs and microCT scanning to diagnose cancer in past populations. Int J Paleopathol 2022; 36:24-29. [PMID: 34923213 DOI: 10.1016/j.ijpp.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/19/2021] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To determine the degree to which plain radiographs (x-rays) and microCT scans can improve accuracy in the diagnosis of cancer in human remains from past populations. MATERIALS The skeletal remains of 143 individuals from medieval Cambridgeshire, dating from 6th-16th century CE. METHODS Visual inspection of the skeletons for lesions compatible with malignancy, coupled with plain radiographs and microCT scans of the pelvis, femora and vertebra. RESULTS Three individuals had visually apparent metastases on their skeletons. Plain radiographs did not identify further individuals with cancer, but did show further lesions in bones with normal external appearance. MicroCT scans identified cancer in two further individuals with normal visual appearance and normal plain radiographs. CONCLUSIONS Imaging human skeletal remains increases the detection rate of cancer in human skeletal remains. We found microCT scanning to be a much more sensitive imaging modality than plain radiography. It improved our diagnostic accuracy and enabled us to more reliably distinguish between malignant lesions and taphonomic change. SIGNIFICANCE Future studies investigating the prevalence and nature of malignancy in past populations would benefit from systematic microCT scanning of pelvis, femora and vertebrae of skeletons to optimise their diagnostic accuracy. LIMITATIONS MicroCT scanning is more expensive than plain radiographs, and may not be easily accessible to biological anthropologists. SUGGESTIONS FOR FURTHER RESEARCH To apply this approach to skeletal series from different time periods and geographical regions, where the types of cancer existing in the local population may differ from those we studied in medieval Britain.
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Affiliation(s)
- Piers D Mitchell
- Department of Archaeology, University of Cambridge, Downing Street, Cambridge CB2 3DZ, UK.
| | - Jenna M Dittmar
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge CB2 3ER, UK
| | - Bram Mulder
- Department of Archaeology, University of Cambridge, Downing Street, Cambridge CB2 3DZ, UK
| | - Sarah Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge CB2 3ER, UK
| | - Alastair Littlewood
- Department of Radiology, Peterborough City Hospital, Bretton Gate, Peterborough PE3 6GZ, UK
| | - Craig Cessford
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge CB2 3ER, UK; Cambridge Archaeological Unit, University of Cambridge, Downing Street, Cambridge CB2 3DZ, UK
| | - John E Robb
- Department of Archaeology, University of Cambridge, Downing Street, Cambridge CB2 3DZ, UK
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8
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Guellil M, Keller M, Dittmar JM, Inskip SA, Cessford C, Solnik A, Kivisild T, Metspalu M, Robb JE, Scheib CL. An invasive Haemophilus influenzae serotype b infection in an Anglo-Saxon plague victim. Genome Biol 2022; 23:22. [PMID: 35109894 PMCID: PMC8812261 DOI: 10.1186/s13059-021-02580-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/13/2021] [Indexed: 12/16/2022] Open
Abstract
Background The human pathogen Haemophilus influenzae was the main cause of bacterial meningitis in children and a major cause of worldwide infant mortality before the introduction of a vaccine in the 1980s. Although the occurrence of serotype b (Hib), the most virulent type of H. influenzae, has since decreased, reports of infections with other serotypes and non-typeable strains are on the rise. While non-typeable strains have been studied in-depth, very little is known of the pathogen’s evolutionary history, and no genomes dating prior to 1940 were available. Results We describe a Hib genome isolated from a 6-year-old Anglo-Saxon plague victim, from approximately 540 to 550 CE, Edix Hill, England, showing signs of invasive infection on its skeleton. We find that the genome clusters in phylogenetic division II with Hib strain NCTC8468, which also caused invasive disease. While the virulence profile of our genome was distinct, its genomic similarity to NCTC8468 points to mostly clonal evolution of the clade since the 6th century. We also reconstruct a partial Yersinia pestis genome, which is likely identical to a published first plague pandemic genome of Edix Hill. Conclusions Our study presents the earliest genomic evidence for H. influenzae, points to the potential presence of larger genomic diversity in the phylogenetic division II serotype b clade in the past, and allows the first insights into the evolutionary history of this major human pathogen. The identification of both plague and Hib opens questions on the effect of plague in immunocompromised individuals already affected by infectious diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s13059-021-02580-z.
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Affiliation(s)
- Meriam Guellil
- Estonian Biocentre, Institute of Genomics, University of Tartu, Riia 23B, 51010, Tartu, Estonia.
| | - Marcel Keller
- Estonian Biocentre, Institute of Genomics, University of Tartu, Riia 23B, 51010, Tartu, Estonia.
| | - Jenna M Dittmar
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, CB2 3ER, UK.,Department of Archaeology, University of Aberdeen, St. Mary's, Elphinstone Road, Aberdeen, Scotland, AB24 3UF, UK
| | - Sarah A Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, CB2 3ER, UK.,School of Archaeology and Ancient History, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - Craig Cessford
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, CB2 3ER, UK.,Cambridge Archaeological Unit, University of Cambridge, 34 A&B Storey's Way, Cambridge, CB3 0DT, UK
| | - Anu Solnik
- Core Facility, Institute of Genomics, University of Tartu, Riia 23B, 51010, Tartu, Estonia
| | - Toomas Kivisild
- Estonian Biocentre, Institute of Genomics, University of Tartu, Riia 23B, 51010, Tartu, Estonia.,Department of Human Genetics, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium
| | - Mait Metspalu
- Estonian Biocentre, Institute of Genomics, University of Tartu, Riia 23B, 51010, Tartu, Estonia
| | - John E Robb
- Department of Archaeology, University of Cambridge, Downing Street, Cambridge, CB2 3DZ, UK
| | - Christiana L Scheib
- Estonian Biocentre, Institute of Genomics, University of Tartu, Riia 23B, 51010, Tartu, Estonia. .,St John's College, University of Cambridge, St John's Street, Cambridge, CB2 1TP, UK.
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9
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Dittmar JM, Mitchell PD, Cessford C, Inskip SA, Robb JE. Fancy shoes and painful feet: Hallux valgus and fracture risk in medieval Cambridge, England. Int J Paleopathol 2021; 35:90-100. [PMID: 34120868 PMCID: PMC8631459 DOI: 10.1016/j.ijpp.2021.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 04/21/2021] [Accepted: 04/29/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Hallux valgus, the lateral deviation of the great toe, can result in poor balance, impaired mobility and is an independent risk factor for falls. This research aims to compare the prevalence of hallux valgus in subpopulations of medieval Cambridge, England, and to examine the relationship between hallux valgus and fractures to examine the impact of impaired mobility and poor balance caused by this condition. MATERIALS 177 adult individuals from four cemeteries located in Cambridge, England. METHODS Human remains were macroscopically and radiographically assessed. RESULTS Hallux valgus was identified in 18 % of individuals and was significantly more common during the 14th-15th centuries than the 11th-13th centuries. The highest prevalence was observed in the friary (43 %), followed by the Hospital (23 %), the rurban parish cemetery (10 %), and the rural parish cemetery (3%). Fractures from falls were significantly more common in those with hallux valgus than those without. CONCLUSION The increased prevalence of hallux valgus identified in individuals from the 14th to 15th centuries coincided with the adoption of new footwear with pointed toes. Those that adopted this fashion trend appear to have been more likely to develop balance and mobility problems that resulted in an increased risk of falls. SIGNIFICANCE This is the first study to explore the relationship between foot problems and functional ability by studying hallux valgus in archaeological assemblages. LIMITATIONS Falls are complex and determining the mechanism of injury in human skeletal remains is not always possible. FURTHER RESEARCH Fracture prevalence rates may have been affected by biological factors and underlying pathological conditions.
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Affiliation(s)
- Jenna M Dittmar
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK; Department of Archaeology, University of Aberdeen, Aberdeen, UK.
| | - Piers D Mitchell
- Department of Archaeology, University of Cambridge, Cambridge, UK
| | - Craig Cessford
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK; Cambridge Archaeological Unit, Department of Archaeology, University of Cambridge, Cambridge, UK
| | - Sarah A Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK; School of Archaeology and Ancient History, University of Leicester, Leicester, UK
| | - John E Robb
- Department of Archaeology, University of Cambridge, Cambridge, UK
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10
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Mitchell PD, Dittmar JM, Mulder B, Inskip S, Littlewood A, Cessford C, Robb JE. Reply to Air pollution was high centuries before industrial revolutions and may have been responsible for cancer rates in medieval Britain. Cancer 2021; 127:3699. [PMID: 34287832 DOI: 10.1002/cncr.33680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Piers D Mitchell
- Department of Archaeology, University of Cambridge, Cambridge, United Kingdom
| | - Jenna M Dittmar
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, United Kingdom
| | - Bram Mulder
- Department of Archaeology, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, United Kingdom
| | - Alastair Littlewood
- Department of Radiology, Peterborough City Hospital, Peterborough, United Kingdom
| | - Craig Cessford
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, United Kingdom.,Cambridge Archaeological Unit, University of Cambridge, Cambridge, United Kingdom
| | - John E Robb
- Department of Archaeology, University of Cambridge, Cambridge, United Kingdom
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Dittmar JM, Mitchell PD, Jones PM, Mulder B, Inskip SA, Cessford C, Robb JE. Gout and 'Podagra' in medieval Cambridge, England. Int J Paleopathol 2021; 33:170-181. [PMID: 33962231 PMCID: PMC8214166 DOI: 10.1016/j.ijpp.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/11/2021] [Accepted: 04/20/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To estimate the prevalence rate of gout and to explore the social factors that contributed to its development in the various sub-populations in medieval Cambridge. MATERIALS 177 adult individuals from four medieval cemeteries located in and around Cambridge, UK. METHODS Lesions were assessed macroscopically and radiographically. Elements with lytic lesions were described and imaged using micro-computed tomography (μCT) to determine their morphology. RESULTS Gout was identified in 3 % of the population. Individuals buried in the friary had highest prevalence (14 %), with low prevalence rates in the Hospital (3 %) and town parish cemetery (2 %), with no cases in the rural parish cemetery. Gout was more prevalent during the 14th-15th centuries than the 10th-13th centuries. CONCLUSION The high prevalence rate of gout in the friary is at least partly explained by the consumption of alcohol and purine-rich diets by the friars and the wealthy townsfolk. Medieval medical texts from Cambridge show that gout (known as podagra) was sometimes treated with medications made from the root of the autumn crocus. This root contains colchicine, which is a medicine that is still used to treat gout today. SIGNIFICANCE This is one of the first studies to assess the epidemiology of gout in medieval England and suggests that gout varied with social status. LIMITATIONS Our sample size precludes statistical analysis. SUGGESTIONS FOR FURTHER RESEARCH Additional studies that assess the epidemiology of gout in medieval Europe is needed in order to be able to fully contextualize these findings.
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Affiliation(s)
- Jenna M Dittmar
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK; Department of Archaeology, University of Aberdeen, Aberdeen, UK.
| | - Piers D Mitchell
- Department of Archaeology, University of Cambridge, Cambridge, UK
| | - Peter M Jones
- King's College, University of Cambridge, Cambridge, UK
| | - Bram Mulder
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
| | - Sarah A Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK; School of Archaeology and Ancient History, University of Leicester, Leicester, UK
| | - Craig Cessford
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK; Cambridge Archaeological Unit, Department of Archaeology, University of Cambridge, Cambridge, UK
| | - John E Robb
- Department of Archaeology, University of Cambridge, Cambridge, UK
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Mitchell PD, Dittmar JM, Mulder B, Inskip S, Littlewood A, Cessford C, Robb JE. The prevalence of cancer in Britain before industrialization. Cancer 2021; 127:3054-3059. [PMID: 33942897 DOI: 10.1002/cncr.33615] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/15/2021] [Accepted: 04/05/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND To plan for cancer services in the future, the long view of cancer prevalence is essential. It might be suspected that cancer prevalence before tobacco and industrial revolution pollutants was quite different to today. METHODS To quantify the degree to which cancer prevalence may be changing over time, the authors analyzed 143 skeletons from 6 cemeteries from the Cambridge area (6th-16th centuries). Visual inspection coupled with screening using both plain radiographs and computed tomography scans was used to detect malignant lesions. RESULTS A total of 3.5% of individuals showed evidence for metastases. Factoring in modern data for the proportion of those with cancer that die with bone metastases, this suggests a minimum prevalence of all cancers at the time of death in medieval Britain to be approximately 9% to 14% of adults. CONCLUSIONS This figure compares with a 40% to 50% prevalence of cancer at the time of death for modern Britain. The difference may be explained by the effects of modern carcinogens, the spread of viruses that trigger malignancy, industrial pollutants, and longer life expectancy. LAY SUMMARY Until now, no one has been able to work out how common cancer was before the time people were exposed to tumor-inducing chemicals from tobacco and industrial factories. In this novel study, the authors have determined the percentage of people living in medieval Britain who had cancer metastases to bone at the time of their death and then compared that with modern data. It was found that cancer was approximately 25% as common in medieval times as it is today. This article suggests cancer was much more widespread in medieval times than was previously realized.
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Affiliation(s)
- Piers D Mitchell
- Department of Archaeology, University of Cambridge, Cambridge, United Kingdom
| | - Jenna M Dittmar
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, United Kingdom
| | - Bram Mulder
- Department of Archaeology, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, United Kingdom
| | - Alastair Littlewood
- Department of Radiology, Peterborough City Hospital, Peterborough, United Kingdom
| | - Craig Cessford
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, United Kingdom.,Cambridge Archaeological Unit, University of Cambridge, Cambridge, United Kingdom
| | - John E Robb
- Department of Archaeology, University of Cambridge, Cambridge, United Kingdom
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Dittmar JM, Mitchell PD, Cessford C, Inskip SA, Robb JE. Medieval injuries: Skeletal trauma as an indicator of past living conditions and hazard risk in Cambridge, England. Am J Phys Anthropol 2021; 175:626-645. [PMID: 33496027 PMCID: PMC8629122 DOI: 10.1002/ajpa.24225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 12/07/2020] [Accepted: 12/20/2020] [Indexed: 11/15/2022]
Abstract
Objective To explore how medieval living conditions, occupation, and an individual's role within society impacted their risk of skeletal trauma. Materials The skeletal remains of 314 individuals from medieval Cambridge that were buried in the parish cemetery of All Saints by the Castle (n = 84), the Augustinian friary (n = 75), and the cemetery of the Hospital of St John the Evangelist (n = 155) were analyzed. Methods Macroscopic examination and plain radiographs were used to classify fracture type. The causative mechanisms and forces applied to a bone were inferred based on fracture morphology. Results The skeletal trauma observed represents accidental injuries, likely sustained through occupational or everyday activities, and violence. The highest prevalence rate was observed on the individuals buried at All Saints by the Castle (44%, n = 37/84), and the lowest was seen at the Hospital of St John (27%, n = 42/155). Fractures were more prevalent in males (40%, n = 57/143) than females (26%, n = 25/95). Conclusions Skeletal trauma was highest in All Saints parish burial ground, indicating that the poor, whether working urban or rurally, had the highest risk of injury. The pattern and types of fractures observed suggests that males experienced more severe traumatic events than females. However, females that were routinely involved in manual labor were also at increased risk of injury. Significance This article enhances our understanding of how traumatic injuries differed by age, sex, and burial locations in the medieval period. Further research Additional comparative studies in different geographical regions are needed to determine how representative these findings are.
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Affiliation(s)
- Jenna M Dittmar
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
| | - Piers D Mitchell
- Department of Archaeology, University of Cambridge, Cambridge, UK
| | - Craig Cessford
- Department of Archaeology, University of Cambridge, Cambridge, UK.,Cambridge Archaeological Unit, Department of Archaeology, University of Cambridge, Cambridge, UK
| | - Sarah A Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, UK
| | - John E Robb
- Department of Archaeology, University of Cambridge, Cambridge, UK
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14
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Mulder B, Stock JT, Saers JPP, Inskip SA, Cessford C, Robb JE. Intrapopulation variation in lower limb trabecular architecture. Am J Phys Anthropol 2020; 173:112-129. [DOI: 10.1002/ajpa.24058] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 02/20/2020] [Accepted: 03/21/2020] [Indexed: 01/05/2023]
Affiliation(s)
- Bram Mulder
- University of Cambridge, McDonald Institute for Archaeological Research Cambridge UK
| | - Jay T. Stock
- University of Cambridge, McDonald Institute for Archaeological Research Cambridge UK
- Department of Anthropology University of Western Ontario London Canada
- Department of Archaeology Max Planck Institute for the Science of Human History Jena Germany
| | - Jaap P. P. Saers
- University of Cambridge, McDonald Institute for Archaeological Research Cambridge UK
| | - Sarah A. Inskip
- University of Cambridge, McDonald Institute for Archaeological Research Cambridge UK
| | - Craig Cessford
- University of Cambridge, McDonald Institute for Archaeological Research Cambridge UK
| | - John E. Robb
- University of Cambridge, McDonald Institute for Archaeological Research Cambridge UK
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15
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Scheib CL, Hui R, D'Atanasio E, Wohns AW, Inskip SA, Rose A, Cessford C, O'Connell TC, Robb JE, Evans C, Patten R, Kivisild T. East Anglian early Neolithic monument burial linked to contemporary Megaliths. Ann Hum Biol 2019; 46:145-149. [PMID: 31184205 PMCID: PMC6816495 DOI: 10.1080/03014460.2019.1623912] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In the fourth millennium BCE a cultural phenomenon of monumental burial structures spread along the Atlantic façade. Megalithic burials have been targeted for aDNA analyses, but a gap remains in East Anglia, where Neolithic structures were generally earthen or timber. An early Neolithic (3762–3648 cal. BCE) burial monument at the site of Trumpington Meadows, Cambridgeshire, UK, contained the partially articulated remains of at least three individuals. To determine whether this monument fits a pattern present in megalithic burials regarding sex bias, kinship, diet and relationship to modern populations, teeth and ribs were analysed for DNA and carbon and nitrogen isotopic values, respectively. Whole ancient genomes were sequenced from two individuals to a mean genomic coverage of 1.6 and 1.2X and genotypes imputed. Results show that they were brothers from a small population genetically and isotopically similar to previously published British Neolithic individuals, with a level of genome-wide homozygosity consistent with a small island population sourced from continental Europe, but bearing no signs of recent inbreeding. The first Neolithic whole genomes from a monumental burial in East Anglia confirm that this region was connected with the larger pattern of Neolithic megaliths in the British Isles and the Atlantic façade.
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Affiliation(s)
- Christiana L Scheib
- a Estonian Biocentre, Institute of Genomics , University of Tartu , Tartu , Estonia.,b McDonald Institute for Archaeological Research , University of Cambridge , Cambridge , UK
| | - Ruoyun Hui
- b McDonald Institute for Archaeological Research , University of Cambridge , Cambridge , UK
| | | | | | - Sarah A Inskip
- b McDonald Institute for Archaeological Research , University of Cambridge , Cambridge , UK
| | - Alice Rose
- b McDonald Institute for Archaeological Research , University of Cambridge , Cambridge , UK
| | - Craig Cessford
- b McDonald Institute for Archaeological Research , University of Cambridge , Cambridge , UK.,e Cambridge Archaeological Unit , Cambridge , UK
| | | | - John E Robb
- f Department of Archaeology , University of Cambridge , Cambridge , UK
| | | | - Ricky Patten
- e Cambridge Archaeological Unit , Cambridge , UK
| | - Toomas Kivisild
- a Estonian Biocentre, Institute of Genomics , University of Tartu , Tartu , Estonia.,b McDonald Institute for Archaeological Research , University of Cambridge , Cambridge , UK.,c Department of Human Genetics , KU Leuven , Leuven , Belgium
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16
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Spyrou MA, Keller M, Tukhbatova RI, Scheib CL, Nelson EA, Andrades Valtueña A, Neumann GU, Walker D, Alterauge A, Carty N, Cessford C, Fetz H, Gourvennec M, Hartle R, Henderson M, von Heyking K, Inskip SA, Kacki S, Key FM, Knox EL, Later C, Maheshwari-Aplin P, Peters J, Robb JE, Schreiber J, Kivisild T, Castex D, Lösch S, Harbeck M, Herbig A, Bos KI, Krause J. Phylogeography of the second plague pandemic revealed through analysis of historical Yersinia pestis genomes. Nat Commun 2019; 10:4470. [PMID: 31578321 PMCID: PMC6775055 DOI: 10.1038/s41467-019-12154-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 08/15/2019] [Indexed: 12/30/2022] Open
Abstract
The second plague pandemic, caused by Yersinia pestis, devastated Europe and the nearby regions between the 14th and 18th centuries AD. Here we analyse human remains from ten European archaeological sites spanning this period and reconstruct 34 ancient Y. pestis genomes. Our data support an initial entry of the bacterium through eastern Europe, the absence of genetic diversity during the Black Death, and low within-outbreak diversity thereafter. Analysis of post-Black Death genomes shows the diversification of a Y. pestis lineage into multiple genetically distinct clades that may have given rise to more than one disease reservoir in, or close to, Europe. In addition, we show the loss of a genomic region that includes virulence-related genes in strains associated with late stages of the pandemic. The deletion was also identified in genomes connected with the first plague pandemic (541-750 AD), suggesting a comparable evolutionary trajectory of Y. pestis during both events.
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Affiliation(s)
- Maria A Spyrou
- Max Planck Institute for the Science of Human History, 07745, Jena, Germany.
- Institute for Archaeological Sciences, University of Tübingen, 72070, Tübingen, Germany.
| | - Marcel Keller
- Max Planck Institute for the Science of Human History, 07745, Jena, Germany
- SNSB, State Collection for Anthropology and Palaeoanatomy Munich, 80333, Munich, Germany
| | - Rezeda I Tukhbatova
- Max Planck Institute for the Science of Human History, 07745, Jena, Germany
- Laboratory of Structural Biology, Kazan Federal University, Kazan, Russian Federation, 420008
| | | | - Elizabeth A Nelson
- Max Planck Institute for the Science of Human History, 07745, Jena, Germany
- Institute for Archaeological Sciences, University of Tübingen, 72070, Tübingen, Germany
| | | | - Gunnar U Neumann
- Max Planck Institute for the Science of Human History, 07745, Jena, Germany
| | - Don Walker
- MOLA (Museum of London Archaeology), London, N1 7ED, UK
| | - Amelie Alterauge
- Department of Physical Anthropology, Institute for Forensic Medicine, University of Bern, 3007, Bern, Switzerland
| | - Niamh Carty
- MOLA (Museum of London Archaeology), London, N1 7ED, UK
| | - Craig Cessford
- Department of Archaeology, University of Cambridge, Downing St, Cambridge, CB2 3ER, UK
| | - Hermann Fetz
- Archaeological Service, State Archive Nidwalden, 6371, Nidwalden, Switzerland
| | - Michaël Gourvennec
- Archeodunum SAS, Agency Toulouse, 8 allée Michel de Montaigne, 31770, Colomiers, France
| | - Robert Hartle
- MOLA (Museum of London Archaeology), London, N1 7ED, UK
| | | | - Kristin von Heyking
- SNSB, State Collection for Anthropology and Palaeoanatomy Munich, 80333, Munich, Germany
| | - Sarah A Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Downing St, Cambridge, CB2 3ER, UK
| | - Sacha Kacki
- PACEA, CNRS Institute, Université de Bordeaux, 33615, Pessac, France
- Department of Archaeology, Durham University, South Rd, Durham, DH1 3LE, UK
| | - Felix M Key
- Institute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | | | - Christian Later
- Bavarian State Department of Monuments and Sites, 80539, Munich, Germany
| | | | - Joris Peters
- SNSB, State Collection for Anthropology and Palaeoanatomy Munich, 80333, Munich, Germany
- ArchaeoBioCenter and Department of Veterinary Sciences, Institute of Palaeoanatomy, Domestication Research and the History of Veterinary Medicine, Ludwig Maximilian University Munich, Kaulbachstr. 37/III, 80539, Munich, Germany
| | - John E Robb
- Department of Archaeology, University of Cambridge, Downing St, Cambridge, CB2 3ER, UK
| | | | - Toomas Kivisild
- Institute of Genomics, University of Tartu, Riia 23b, 51010, Tartu, Estonia
- Department of Human Genetics, Katholieke Universiteit Leuven, 3000, Leuven, Belgium
| | - Dominique Castex
- PACEA, CNRS Institute, Université de Bordeaux, 33615, Pessac, France
| | - Sandra Lösch
- Department of Physical Anthropology, Institute for Forensic Medicine, University of Bern, 3007, Bern, Switzerland
| | - Michaela Harbeck
- SNSB, State Collection for Anthropology and Palaeoanatomy Munich, 80333, Munich, Germany
| | - Alexander Herbig
- Max Planck Institute for the Science of Human History, 07745, Jena, Germany
| | - Kirsten I Bos
- Max Planck Institute for the Science of Human History, 07745, Jena, Germany.
| | - Johannes Krause
- Max Planck Institute for the Science of Human History, 07745, Jena, Germany.
- Institute for Archaeological Sciences, University of Tübingen, 72070, Tübingen, Germany.
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Keller M, Spyrou MA, Scheib CL, Neumann GU, Kröpelin A, Haas-Gebhard B, Päffgen B, Haberstroh J, Ribera I Lacomba A, Raynaud C, Cessford C, Durand R, Stadler P, Nägele K, Bates JS, Trautmann B, Inskip SA, Peters J, Robb JE, Kivisild T, Castex D, McCormick M, Bos KI, Harbeck M, Herbig A, Krause J. Ancient Yersinia pestis genomes from across Western Europe reveal early diversification during the First Pandemic (541-750). Proc Natl Acad Sci U S A 2019; 116:12363-12372. [PMID: 31164419 PMCID: PMC6589673 DOI: 10.1073/pnas.1820447116] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The first historically documented pandemic caused by Yersinia pestis began as the Justinianic Plague in 541 within the Roman Empire and continued as the so-called First Pandemic until 750. Although paleogenomic studies have previously identified the causative agent as Y. pestis, little is known about the bacterium's spread, diversity, and genetic history over the course of the pandemic. To elucidate the microevolution of the bacterium during this time period, we screened human remains from 21 sites in Austria, Britain, Germany, France, and Spain for Y. pestis DNA and reconstructed eight genomes. We present a methodological approach assessing single-nucleotide polymorphisms (SNPs) in ancient bacterial genomes, facilitating qualitative analyses of low coverage genomes from a metagenomic background. Phylogenetic analysis on the eight reconstructed genomes reveals the existence of previously undocumented Y. pestis diversity during the sixth to eighth centuries, and provides evidence for the presence of multiple distinct Y. pestis strains in Europe. We offer genetic evidence for the presence of the Justinianic Plague in the British Isles, previously only hypothesized from ambiguous documentary accounts, as well as the parallel occurrence of multiple derived strains in central and southern France, Spain, and southern Germany. Four of the reported strains form a polytomy similar to others seen across the Y. pestis phylogeny, associated with the Second and Third Pandemics. We identified a deletion of a 45-kb genomic region in the most recent First Pandemic strains affecting two virulence factors, intriguingly overlapping with a deletion found in 17th- to 18th-century genomes of the Second Pandemic.
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Affiliation(s)
- Marcel Keller
- Department of Archaeogenetics, Max Planck Institute for the Science of Human History, 07745 Jena, Germany;
- State Collection of Anthropology and Palaeoanatomy Munich, Staatliche Naturwissenschaftliche Sammlungen Bayerns, 80333 Munich, Germany
| | - Maria A Spyrou
- Department of Archaeogenetics, Max Planck Institute for the Science of Human History, 07745 Jena, Germany
| | - Christiana L Scheib
- Department of Archaeology, University of Cambridge, Cambridge CB2 3ER, United Kingdom
- Institute of Genomics, University of Tartu, 51010 Tartu, Estonia
| | - Gunnar U Neumann
- Department of Archaeogenetics, Max Planck Institute for the Science of Human History, 07745 Jena, Germany
| | - Andreas Kröpelin
- Department of Archaeogenetics, Max Planck Institute for the Science of Human History, 07745 Jena, Germany
- Friedrich Schiller University Jena, 07743 Jena, Germany
| | | | - Bernd Päffgen
- Institute for Pre- and Protohistoric Archaeology and Archaeology of the Roman Provinces, Ludwig Maximilian University Munich, 80799 Munich, Germany
| | - Jochen Haberstroh
- Bavarian State Department of Monuments and Sites, 80539 Munich, Germany
| | | | - Claude Raynaud
- CNRS, UMR5140, Archéologie des Sociétés Méditerranéennes, 34199 Montpellier, France
| | - Craig Cessford
- Department of Archaeology, University of Cambridge, Cambridge CB2 3ER, United Kingdom
| | - Raphaël Durand
- Service d'Archéologie Préventive de l'Agglomération de Bourges Plus, 18023 Bourges Cedex, France
| | - Peter Stadler
- Department of Pre- and Protohistory, University of Vienna, 1190 Vienna, Austria
| | - Kathrin Nägele
- Department of Archaeogenetics, Max Planck Institute for the Science of Human History, 07745 Jena, Germany
| | - Jessica S Bates
- Department of Archaeology, University of Cambridge, Cambridge CB2 3ER, United Kingdom
| | - Bernd Trautmann
- State Collection of Anthropology and Palaeoanatomy Munich, Staatliche Naturwissenschaftliche Sammlungen Bayerns, 80333 Munich, Germany
| | - Sarah A Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Cambridge CB2 3ER, United Kingdom
| | - Joris Peters
- State Collection of Anthropology and Palaeoanatomy Munich, Staatliche Naturwissenschaftliche Sammlungen Bayerns, 80333 Munich, Germany
- ArchaeoBioCenter, Ludwig Maximilian University Munich, 80539 Munich, Germany
- Department of Veterinary Sciences, Institute of Palaeoanatomy, Domestication Research and the History of Veterinary Medicine, Ludwig Maximilian University Munich, 80539 Munich, Germany
| | - John E Robb
- Department of Archaeology, University of Cambridge, Cambridge CB2 3ER, United Kingdom
| | - Toomas Kivisild
- Department of Archaeology, University of Cambridge, Cambridge CB2 3ER, United Kingdom
- Department of Human Genetics, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | | | - Michael McCormick
- Initiative for the Science of the Human Past, Department of History, Harvard University, Cambridge, MA 02138
- Max Planck-Harvard Research Center for the Archaeoscience of the Ancient Mediterranean, 07745 Jena, Germany
| | - Kirsten I Bos
- Department of Archaeogenetics, Max Planck Institute for the Science of Human History, 07745 Jena, Germany
| | - Michaela Harbeck
- State Collection of Anthropology and Palaeoanatomy Munich, Staatliche Naturwissenschaftliche Sammlungen Bayerns, 80333 Munich, Germany;
| | - Alexander Herbig
- Department of Archaeogenetics, Max Planck Institute for the Science of Human History, 07745 Jena, Germany;
| | - Johannes Krause
- Department of Archaeogenetics, Max Planck Institute for the Science of Human History, 07745 Jena, Germany;
- Max Planck-Harvard Research Center for the Archaeoscience of the Ancient Mediterranean, 07745 Jena, Germany
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Finlayson L, Czuba T, Gaston MS, Hägglund G, Robb JE. The head shaft angle is associated with hip displacement in children at GMFCS levels III-V - a population based study. BMC Musculoskelet Disord 2018; 19:356. [PMID: 30286753 PMCID: PMC6172714 DOI: 10.1186/s12891-018-2275-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 09/24/2018] [Indexed: 11/29/2022] Open
Abstract
Background An increased Head Shaft Angle (HSA) has been reported as a risk factor for hip displacement in children with cerebral palsy (CP) but opinions differ in the literature. The purpose of this study was to re-evaluate the relationship between HSA and hip displacement in a different population of children with CP. Methods The Cerebral Palsy Integrated Pathway Scotland surveillance programme includes 95% of all children with CP in Scotland. The pelvic radiographs from 640 children in GMFCS levels III-V were chosen. The most displaced hip was analysed and the radiographs used were those taken at the child’s first registration in the database to avoid the potential effects of surveillance on subsequent hip centration. A logistic regression model was used with hip displacement (migration percentage [MP] ≥40%) as outcome and HSA, GMFCS, age and sex as covariates. Results The MP was ≥40% in 118 hips with a mean HSA of 164° (range 121–180°) and < 40% in 522 hips with a mean HSA of 160° (range 111–180°). The logistic regression analysis showed no significant influence of age and sex on MP in this population but a high GMFCS level was strongly associated with hip displacement. An increased HSA was also associated with hip displacement, a 10° difference in HSA for children adjusted for age, sex, and GMFCS gave an odds ratio of 1.26 for hip displacement equal or above 40% (p = 0.009) and hips with HSA above 164.5 degrees had an odds ratio of 1.96 compared with hips with HSA below 164.5 degrees (p = 0.002). Conclusion These findings confirm that HSA is associated with hip displacement in children in GMFCS levels III-V.
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Affiliation(s)
- L Finlayson
- University of Edinburgh, Edinburgh, Scotland
| | - T Czuba
- Epidemiology and Register Center South, Lund, Sweden
| | - M S Gaston
- Department of Orthopaedic Surgery, Royal Hospital for Sick Children, Edinburgh, Scotland
| | - G Hägglund
- Lund University Department of Clinical Sciences, Orthopedics, Lund, Sweden.
| | - J E Robb
- School of Medicine, University of St Andrews, St. Andrews, Scotland
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19
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Tsang STJ, McMorran D, Robinson L, Herman J, Robb JE, Gaston MS. A cohort study of tibialis anterior tendon shortening in combination with calf muscle lengthening in spastic equinus in cerebral palsy. Gait Posture 2016; 50:23-27. [PMID: 27559938 DOI: 10.1016/j.gaitpost.2016.08.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/21/2016] [Accepted: 08/12/2016] [Indexed: 02/02/2023]
Abstract
The aim of this study was to evaluate the outcome of combined tibialis anterior tendon shortening (TATS) and calf muscle-tendon lengthening (CMTL) in spastic equinus. Prospectively collected data was analysed in 26 patients with hemiplegic (n=13) and diplegic (n=13) cerebral palsy (CP) (GMFCS level I or II, 14 males, 12 females, age range 10-35 years; mean 16.8 years). All patients had pre-operative 3D gait analysis and a further analysis at a mean of 17.1 months (±5.6months) after surgery. None was lost to follow-up. Twenty-eight combined TATS and CMTL were undertaken and 19 patients had additional synchronous multilevel surgery. At follow-up 79% of patients had improved foot positioning at initial contact, whilst 68% reported improved fitting or reduced requirement of orthotic support. Statistically significant improvements were seen in the Movement Analysis Profile for ankle dorsi-/plantarflexion (4.15°, p=0.032), maximum ankle dorsiflexion during swing phase (11.68°, p<0.001), and Edinburgh Visual Gait Score (EVGS) (4.85, p=0.014). Diplegic patients had a greater improvement in the EVGS than hemiplegics (6.27 -vs- 2.21, p=0.024). The originators of combined TATS and CMTL showed that it improved foot positioning during gait. The present study has independently confirmed favourable outcomes in a similar patient population and added additional outcome measures, the EVGS, foot positioning at initial contact, and maximum ankle dorsiflexion during swing phase. Study limitations include short term follow-up in a heterogeneous population and that 19 patients had additional surgery. TATS combined with CMTL is a recommended option for spastic equinus in ambulatory patients with CP.
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Affiliation(s)
- S T J Tsang
- Department of Orthopaedics, Royal Hospital for Sick Children Edinburgh, 9 Sciennes Place, Edinburgh EH9 1LF, United Kingdom.
| | - D McMorran
- University of Edinburgh, College of Medicine and Veterinary Medicine, 49 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SB, United Kingdom
| | - L Robinson
- University of Edinburgh, College of Medicine and Veterinary Medicine, 49 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SB, United Kingdom
| | - J Herman
- The Anderson Gait Laboratory, SMART Centre, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh EH9 2, United Kingdom
| | - J E Robb
- The Anderson Gait Laboratory, SMART Centre, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh EH9 2, United Kingdom
| | - M S Gaston
- Department of Orthopaedics, Royal Hospital for Sick Children Edinburgh, 9 Sciennes Place, Edinburgh EH9 1LF, United Kingdom; The Anderson Gait Laboratory, SMART Centre, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh EH9 2, United Kingdom
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McMorran D, Robinson LW, Henderson G, Herman J, Robb JE, Gaston MS. Using a goal attainment scale in the evaluation of outcomes in patients with diplegic cerebral palsy. Gait Posture 2016; 44:168-71. [PMID: 27004652 DOI: 10.1016/j.gaitpost.2015.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 10/11/2015] [Accepted: 12/02/2015] [Indexed: 02/02/2023]
Abstract
A goal attainment scale (GAS) was used to evaluate outcomes of surgical and non-surgical interventions to improve gait in 45 children with diplegic cerebral palsy. Personal goals were recorded during pre-intervention gait analysis in two groups. Twenty children underwent orthopaedic surgery (Group 1) and 25 children received a non-operative intervention (Group 2). Children and/or their carers were contacted post-intervention by telephone to complete a GAS questionnaire, rating the achievement of goals on a 5-point scale. The goals were similar in both groups. The composite GAS was transformed into a standardised measure (T-score) for each patient. Both groups on average achieved their goals (mean T-score for Group 2 was 56.3, versus 47.1 for Group 1). The difference between these two means was significant (p=0.010). Additionally, 16 children had undergone a follow-up gait analysis during the study period, but the relationship between their Gait Profile Score and GAS was not statistically significant. Both surgical and non-surgical interventions enabled children to achieve their goals, although Group 1 reported higher achievements. The GAS reflects patient's/parent's/carer's aspirations and may be as relevant as post-intervention kinematic or kinetic outcomes.
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Affiliation(s)
- D McMorran
- University of Edinburgh, Edinburgh, United Kingdom
| | - L W Robinson
- University of Edinburgh, Edinburgh, United Kingdom
| | - G Henderson
- Anderson Gait Laboratory, Edinburgh, United Kingdom
| | - J Herman
- Anderson Gait Laboratory, Edinburgh, United Kingdom
| | - J E Robb
- Anderson Gait Laboratory, Edinburgh, United Kingdom
| | - M S Gaston
- Anderson Gait Laboratory, Edinburgh, United Kingdom.
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Robinson LW, Clement N, Fullarton M, Richardson A, Herman J, Henderson G, Robb JE, Gaston MS. The relationship between the Edinburgh Visual Gait Score, the Gait Profile Score and GMFCS levels I-III. Gait Posture 2015; 41:741-3. [PMID: 25684144 DOI: 10.1016/j.gaitpost.2015.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/27/2014] [Accepted: 01/23/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the relationship between the Edinburgh Visual Gait Score (EVGS) and the Gait Profile Score (GPS). METHOD Three dimensional gait data and EVGS scores from 151 diplegic children (Gross Motor Function Classification System (GMFCS) levels I-III) were used for analysis. RESULTS The EVGS correlated strongly with GPS (r=0.816). There was a significant difference in both gait scores between each level of the GMFCS. CONCLUSIONS The strong correlation of GPS with EVGS implies that any advantages of using GPS can also be applied to centres without 3-dimensional gait analysis facilities if the EVGS is used.
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Affiliation(s)
- L W Robinson
- The University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom
| | - N Clement
- Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh EH9 1LF, United Kingdom
| | - M Fullarton
- The University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom
| | - A Richardson
- The Anderson Gait Analysis Laboratory, SMART Centre, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh EH9 2HL, United Kingdom
| | - J Herman
- The Anderson Gait Analysis Laboratory, SMART Centre, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh EH9 2HL, United Kingdom
| | - G Henderson
- The Anderson Gait Analysis Laboratory, SMART Centre, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh EH9 2HL, United Kingdom
| | - J E Robb
- The Anderson Gait Analysis Laboratory, SMART Centre, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh EH9 2HL, United Kingdom
| | - M S Gaston
- Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh EH9 1LF, United Kingdom.
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Abstract
This population-based study aimed to analyse the demographic, clinical and histological features of patients with a malignant primary bone tumour of the femur presenting with a pathological fracture. Eighty-four patients were identified from a prospectively gathered national tumour database between 1960 and 2004. Demographic data, presenting features, tumour location, histological diagnosis, treatment, local recurrence, metastasis and survival data were gathered. An estimate of the annual incidence was obtained using population data from the General Register Office and was 0.4 per million population per annum. The mean age was 56 years (range 4-87 years) with a bimodal distribution and 46% were men or boys. Forty-one percent of patients presented with a history of trauma. The average duration of symptoms before presentation was 1-3 months. The most common histological diagnoses were osteosarcoma (14 patients) and Paget's sarcoma (12 patients). The local recurrence rate was 38% and the overall five-year survival was 22%. The prognosis was made worse by local tumour recurrence, the development of metastasis and age at diagnosis greater than 21 years. Limb salvage surgery did not alter the prognosis. Patients who present with pathological fracture of a primary malignant bone tumour, carry a poor prognosis in all tumour types and no improvement in survival was identified over the period of the study.
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Affiliation(s)
- K Godley
- Bute Medical School, University of St Andrews, Scotland, UK
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Rose GE, Lightbody KA, Ferguson RG, Walsh JC, Robb JE. Natural history of flexed knee gait in diplegic cerebral palsy evaluated by gait analysis in children who have not had surgery. Gait Posture 2010; 31:351-4. [PMID: 20116253 DOI: 10.1016/j.gaitpost.2009.12.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2009] [Revised: 12/20/2009] [Accepted: 12/22/2009] [Indexed: 02/02/2023]
Abstract
Eighteen children with diplegic cerebral palsy and no history of orthopaedic surgery had two gait analyses a mean of 6.3 years apart to analyse the effects of time on their gait. The mean age of the children at first analysis was 7.7 years (range 4.4-13.3 years). The data was analysed as a whole group (18 children) and as two sub-groups of nine children: those with a shorter follow-up (mean 5.0 years) and those with a longer follow-up (mean 7.5 years) between analyses. The following significant bilateral changes were seen in the whole group and longer follow-up sub-group: deterioration in the range of knee flexion, mid-stance knee flexion, peak knee extension in stance and hamstring length and an improvement in mean and maximum hip rotation. Temporal data showed no significant changes once normalised. There were no bilateral significant changes in data from children evaluated at a mean of 5 years follow-up. GMFCS scores generally improved over time despite the significant increase in flexed knee gait. There was no significant change in gait deviation index in any group over time. There was an increase in body mass index in 16 children but there was no correlation between this and the degree of mid-stance knee flexion. These findings may have implications for longer term follow-up of children with cerebral palsy into adulthood.
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Affiliation(s)
- G E Rose
- Anderson Gait Analysis Laboratory, Edinburgh, United Kingdom
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Brown CR, Hillman SJ, Richardson AM, Herman JL, Robb JE. Reliability and validity of the Visual Gait Assessment Scale for children with hemiplegic cerebral palsy when used by experienced and inexperienced observers. Gait Posture 2008; 27:648-52. [PMID: 17913500 DOI: 10.1016/j.gaitpost.2007.08.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Revised: 07/10/2007] [Accepted: 08/22/2007] [Indexed: 02/02/2023]
Abstract
This study investigated the reliability and validity of the Visual Gait Assessment Scale when used by experienced and inexperienced observers. Four experienced and six inexperienced observers viewed videotaped footage of four children with hemiplegic cerebral palsy on two separate occasions. Validity of the Scale was obtained by comparison with three-dimensional gait analysis (3DGA). The experienced observers generally had higher inter-observer and intra-observer reliability than the inexperienced observers. Both groups showed higher agreement for assessments made at the ankle and foot than at the knee and hip. The experienced observers had slightly higher agreement with 3DGA than the inexperienced observers. The inexperienced observers showed a learning effect and had higher inter-observer agreement and higher agreement with 3DGA in the second assessment of the videotapes. This scale can be used by inexperienced observers but is limited to observations in the sagittal plane and by poor reliability at the knee and hip for experienced and inexperienced observers.
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Affiliation(s)
- C R Brown
- University of Edinburgh, Edinburgh, Scotland, United Kingdom
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25
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Moreton ML, Proctor I, Henderson A, Robb JE. The K Wire Project: removal of percutaneous kirschner wires from children without general anaesthetic. ACTA ACUST UNITED AC 2008. [DOI: 10.12968/jcyn.2008.2.2.28199] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | - JE Robb
- Royal Hospital for Sick Children, Edinburgh EH91
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Whitehead CL, Hillman SJ, Richardson AM, Hazlewood ME, Robb JE. The effect of simulated hamstring shortening on gait in normal subjects. Gait Posture 2007; 26:90-6. [PMID: 16949826 DOI: 10.1016/j.gaitpost.2006.07.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2006] [Accepted: 07/28/2006] [Indexed: 02/02/2023]
Abstract
The purpose of this study was to determine the effect of simulated hamstring shortening on gait in normal subjects. Six normal subjects wore an adjustable brace to simulate three different hamstring lengths. Evaluation of the physiological cost index (PCI) and gait analysis revealed that simulated hamstring shortening produced adverse affects in the gait of normal subjects. Significant effects were only observed when the popliteal angle exceeded 85 degrees (p<0.001) and included increased effort of walking (PCI), decreased speed, stride and step length; decreased hip flexion and increased knee flexion in stance, increased posterior pelvic tilt, decreased pelvic obliquity and rotation and premature ankle dorsi- and plantar-flexion in stance. These results emphasise the need to consider the effects of changing the length of the hamstrings on joints other than the hip and knee when assessing patients for hamstring lengthening.
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Affiliation(s)
- C L Whitehead
- College of Medicine and Veterinary Medicine University of Edinburgh, Scotland, UK
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27
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Hazlewood ME, Simmons AN, Johnson WT, Richardson AM, van der Linden ML, Hillman SJ, Robb JE. The Footprint method to assess transmalleolar axis. Gait Posture 2007; 25:597-603. [PMID: 16904892 DOI: 10.1016/j.gaitpost.2006.06.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2005] [Revised: 06/20/2006] [Accepted: 06/22/2006] [Indexed: 02/02/2023]
Abstract
Torsional deformities of the lower extremities are a common reason for an orthopaedic consultation and are also part of the evaluation of a patient in gait analysis. This study assessed the level of agreement between, and the repeatability of, the Footprint method and two other methods (Prone and Jig) of measuring the transmalleolar axis (TMA) clinically. The Footprint method measures the TMA as the patient sits by projecting the position of the malleoli downwards onto lined paper while the lines of the paper are aligned with the knee axis. The Prone method projects the position of the malleoli upwards onto the sole of the foot and this is related to the visually estimated knee axis. The Jig method uses a tropometer to relate the angle between the tibial tubercle and the two malleoli. Two assessors measured twelve subjects using the three methods and six subjects were re-measured approximately 1 week later for repeatability. There was poor agreement between the three methods but the Footprint method was the most repeatable (coefficient of repeatability: 5.4). One observer then assessed the repeatability of the effect of simulated equinus on the Footprint method in 10 normal subjects on 2 separate occasions 1 week apart. Equinus was obtained by having the subjects sit and firstly extend their knee and place the foot on the floor and secondly by placing the foot under consideration on a wedge. Both conditions introduced an offset into the measurement of the TMA when compared to the measurements with the ankle at neutral in the same subjects. The reliability of the Footprint method was then assessed using 10 inexperienced observers who measured nine normal subjects each on 2 separate occasions and their results compared with those from an experienced observer. The inexperienced observers were less repeatable than an experienced observer (coefficients of repeatability 9.2 and 6.9, respectively). We recommend that different methods of measuring TMA should not be used interchangeably in clinical practice. The Footprint method was the most repeatable of the three methods tested and can be used for patients who have fixed equinus but the measurement was less repeatable when used by inexperienced observers.
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Elson DW, Whiten S, Hillman SJ, Johnson RJ, Lo SS, Robb JE. The conjoint junction of the triceps surae: Implications for gastrocnemius tendon lengthening. Clin Anat 2007; 20:924-8. [PMID: 17879312 DOI: 10.1002/ca.20544] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Forty embalmed cadaver lower limbs were dissected to identify the morphology of the conjoint junction of the tendons of gastrocnemius and soleus and the location of the gastrocnemius tendon relative to bony landmarks. Five patterns of conjoint junction morphology were found: transverse (25%), oblique passing distally and medially (45%), oblique passing distally and laterally (5%) and arcuate as an inverted U (17.5%) and a U-shape (7.5%). Left-right asymmetry of the junction was observed in 31.6% of 19 paired cadaver legs. On the medial side of the calf the gastrocnemius tendon could be located between 38 and 46% of the proportion of the distance between the upper border of the calcaneus and the fibular head. Corresponding values for the midline and lateral side of the calf were 45-58% and 48-51%. The location of the gastrocnemius tendon relative to bony landmarks may help to guide incision planning for open or endoscopic division of the tendon.
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Affiliation(s)
- D W Elson
- Bute Medical School, University of St. Andrews, St. Andrews, Scotland, United Kingdom
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Abstract
A total of 47 non-walking patients (52 hips) with severe cerebral palsy and with a mean age of 14 years, (9 to 27) underwent a Dega-type pelvic osteotomy after closure of the triradiate cartilage, together with a derotation varus-shortening femoral osteotomy and soft-tissue correction for hip displacement which caused pain and/or difficulties in sitting. The mean follow-up was 48 months (12 to 153). The migration percentage improved from a pre-operative mean of 70% (26% to 100%) to 10% (0% to 100%) post-operatively. In five hips the post-operative migration percentage was greater than 25%, which was associated with continuing pain in two patients. Three patients had persistent hip pain and a migration percentage less than 25%. In five hips a fracture through the acetabulum occurred, and in another there was avascular necrosis of the superior acetabular segment, but these had no adverse effect on functional outcome. We conclude that it is possible to perform a satisfactory pelvic osteotomy of this type in these patients after the triradiate cartilage has been closed.
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Affiliation(s)
- J E Robb
- Royal Hospital for Sick Children, Edinburgh EH9 1LF, UK.
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Stansfield BW, Hillman SJ, Hazlewood ME, Robb JE. Regression analysis of gait parameters with speed in normal children walking at self-selected speeds. Gait Posture 2006; 23:288-94. [PMID: 15978813 DOI: 10.1016/j.gaitpost.2005.03.005] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2004] [Revised: 03/01/2005] [Accepted: 03/17/2005] [Indexed: 02/02/2023]
Abstract
Dimensionless analysis ensures that differences in sizes (e.g. height and weight) of children have a minimal influence on gait parameters. The results of changes in speed on gait parameters were examined using dimensionless analysis on data from a prospective 5-year study of 16 children. Linear regression analysis of peak and trough values of temporal distance parameters, ground reaction forces, joint angles, moments and powers provide a quantitative description of gait development with normalised speed. These linear relationships can be used to estimate gait parameters from speed measurements for normal subjects. However, caution is advised in using the data to attempt to predict an individual's gait parameters due to the wide spread of data about the regression lines and we do not recommend that the data be used to extrapolate the regression data to wider speed ranges.
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Affiliation(s)
- B W Stansfield
- Anderson Gait Analysis Laboratory, Edinburgh, Scotland, UK.
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Robb JE. PAST BODIES: McDonald Institute for Archaeological Research, Cambridge, 13 January 2006. Anthropology Today 2006. [DOI: 10.1111/j.1467-8322.2006.00432.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Walmsley PJ, Kelly MB, Robb JE, Annan IH, Porter DE. Delay increases the need for open reduction of type-III supracondylar fractures of the humerus. ACTA ACUST UNITED AC 2006; 88:528-30. [PMID: 16567791 DOI: 10.1302/0301-620x.88b4.17491] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Recent reports have suggested that a delay in the management of type-III supracondylar fractures of the humerus does not affect the outcome. In this retrospective study we examined whether the timing of surgery affected peri-operative complications, or the need for open reduction. There were 171 children with a closed type-III supracondylar fracture of the humerus and no vascular compromise in our study. They were divided into two groups: those treated less than eight hours from presentation to the Accident and Emergency Department (126 children), and those treated more than eight hours from presentation (45 children). There were no differences in the rate of complications between the groups, but children waiting more than eight hours for reduction were more likely to undergo an open reduction (33.3% vs 11.2%, p < 0.05) and there was a weak correlation (p = 0.062) between delay in surgery and length of operating time. Consequently, we would still recommend treating these injuries at the earliest opportunity.
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Affiliation(s)
- P J Walmsley
- The Royal Hospital for Sick Children, Sciennes Road, Edinburgh EH9 1LF, UK.
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Elliot KJ, Millward-Sadler SJ, Wright MO, Robb JE, Wallace WHB, Salter DM. Effects of methotrexate on human bone cell responses to mechanical stimulation. Rheumatology (Oxford) 2004; 43:1226-31. [PMID: 15238642 DOI: 10.1093/rheumatology/keh296] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Methotrexate (MTX), which is prescribed in the treatment of malignancy and autoimmune disease, has detrimental effects on a number of organ systems, including bone. At present, the exact mechanism of action of MTX on bone at the cellular level is unclear. Mechanical stimuli imparted by stretch, pressure, fluid flow and shear stress result in a variety of biochemical responses that are important in bone metabolism. Cyclical mechanical stimulation at 0.33 Hz induces rapid cell membrane hyperpolarization of human bone cells (HBC) via an integrin-mediated pathway which includes an IL-1beta autocrine/paracrine loop. This study was undertaken to investigate the effect of MTX on responses of HBC to 0.33 Hz mechanical stimulation. METHODS Electrophysiological responses of HBC were measured before and after mechanical stimulation at 0.33 Hz in the presence or absence of MTX. Semiquantitative RT-PCR was used to investigate effects of MTX on relative levels of type-1 collagen and bone morphogenetic protein-4 (BMP-4) following 0.33 Hz mechanical stimulation. RESULTS MTX dose-dependently inhibited HBC hyperpolarization in response to 0.33 Hz mechanical stimulation. Production/release of IL-1beta was inhibited by MTX, whereas its effects on target cells were not. Mechanical stimulation of HBC at 0.33 Hz caused a significant decrease in relative levels of BMP-4 mRNA, whereas relative levels of type-1 collagen mRNA were consistently increased, although these increases did not reach statistical significance. These trends were unaffected by MTX. CONCLUSIONS These studies show that MTX affects HBC mechanotransduction by interfering with integrin-mediated signalling. The data also suggest that the mechanotransduction pathway responsible for the regulation of type-1 collagen and BMP-4 gene expression may be distinct from the IL-1beta-mediated signalling pathway.
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Affiliation(s)
- K J Elliot
- Division of Pathology, Edinburgh University Medical School, Teviot Place, Edinburgh EH8 9AG, UK
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van der Linden ML, Hazlewood ME, Aitchison AM, Hillman SJ, Robb JE. Electrical stimulation of gluteus maximus in children with cerebral palsy: effects on gait characteristics and muscle strength. Dev Med Child Neurol 2003; 45:385-90. [PMID: 12785439 DOI: 10.1017/s0012162203000732] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The purpose of this study was to determine whether electrical stimulation of the gluteus maximus would improve hip extensor strength, decrease excessive passive and dynamic internal hip rotation, and improve gross motor function in children with cerebral palsy (CP). Twenty-two ambulant children (15 females, 7 males, mean age 8 years 6 months, SD 2 years 9 months, aged 5 to 14 years) with diplegic (n = 14), hemiplegic (n = 7), and quadriplegic (n = 1) CP participated in this study. All were randomly assigned to either the stimulation or control group. The stimulation group (n = 11) received electrical stimulation of the gluteus maximus of the most affected legs for 1 hour a day, 6 days a week for a period of 8 weeks. Electrodes were applied proximally and distally over the gluteus maximus, with the active electrode initially positioned over the motor points. The control group (n = 11) did not receive any extra treatment. Measurements of hip extensor strength, gait analysis, passive limits of hip rotation, and section E of the Gross Motor Function Measure were made before and after treatment for both groups. Subjectively, 7 of the 11 parents thought that the treatment made a difference to their child. However, no statistically or clinically significant improvement was found in the stimulation group when compared with the control group.
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Abstract
The comparative effect of semi-dimensional (SD) and non-dimensional (ND) normalisation on the results of a longitudinal study of gait in 5-12-year old children was investigated. The use of both height and leg length in the normalisation was examined. Only ND analysis could be used to identify subjects with the same accelerations. ND analysis of the children's gait indicated that there was little change in the combination of step length and cadence used to achieve a particular velocity between 5 and 12. The first peak and mid-stance trough values of the vertical component of ground reaction force did not change with age. We recommend the use of ND normalisation rather that SD to allow comparisons between individuals of differing size and mass.
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Affiliation(s)
- B W Stansfield
- Anderson Gait Analysis Laboratory, Princess Margaret Rose Orthopaedic Hospital, Edinburgh, UK.
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McLauchlan GJ, Cowan B, Annan IH, Robb JE. Management of completely displaced metaphyseal fractures of the distal radius in children. A prospective, randomised controlled trial. J Bone Joint Surg Br 2002; 84:413-7. [PMID: 12002503 DOI: 10.1302/0301-620x.84b3.11432] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
In a prospective, randomised controlled trial, 68 children who had a completely displaced metaphyseal fracture of the distal radius were treated either by manipulation (MUA) and application of an above-elbow cast alone or by the additional insertion of a percutaneous Kirschner (K-) wire. Full radiological follow-up to union was obtained in 65 children and 56 returned for clinical evaluation three months after injury. Maintenance of reduction was significantly better in the K-wire group and fewer follow-up radiographs were required. There was no significant difference in the clinical outcome measured three months after injury. Seven of 33 patients in the MUA group had to undergo a second procedure because of an unacceptable position compared with none of the 35 in the K-wire group (chi-squared test, p < 0.01). One patient in the K-wire group required exploration for recovery of a migrated wire. We conclude that the use of a percutaneous K-wire to augment the reduction of the fracture in children who have a completely displaced metaphyseal fracture of the distal radius is a safe and reliable way of maintaining alignment of the fracture.
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Affiliation(s)
- G J McLauchlan
- Department of Orthopaedic Surgery, Royal Hospital for Sick Children, Edinburgh, Scotland, UK
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Stansfield BW, Hillman SJ, Hazlewood ME, Lawson AA, Mann AM, Loudon IR, Robb JE. Sagittal joint kinematics, moments, and powers are predominantly characterized by speed of progression, not age, in normal children. J Pediatr Orthop 2001; 21:403-11. [PMID: 11371829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Twenty-six healthy 7-year-old children were enrolled in a 5-year longitudinal study to examine the importance of age and speed in the characterization of sagittal joint angles, moments, and powers. In 740 gait trials, children walking at self-selected speeds were examined on the basis of age and normalized speed [speed/(height x g)1/2]. The kinematics and kinetics in these children were characterized predominantly by normalized speed of progression and not age. The clinical relevance of these findings is that normalized speed of walking, rather than age, should be considered when comparing normal with pathologic gait.
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Affiliation(s)
- B W Stansfield
- Anderson Gait Analysis Laboratory, Princess Margaret Rose Orthopaedic Hospital, Edinburgh, United Kingdom
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Stansfield BW, Hillman SJ, Hazlewood ME, Lawson AA, Mann AM, Loudon IR, Robb JE. Normalized speed, not age, characterizes ground reaction force patterns in 5-to 12-year-old children walking at self-selected speeds. J Pediatr Orthop 2001; 21:395-402. [PMID: 11371828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Twenty-six healthy 5-year-old children were enrolled in a 7-year longitudinal study to examine the importance of age and speed in the characterization of ground reaction forces. One thousand forty gait trials of children walking at self-selected speeds were examined on the basis of age and normalized speed [speed/(height x g)(1/2)]. Results, presented as discrete peak and trough values and as continuous trace plots over the stance phase, indicated that there was little change in ground reaction forces with age, but there were significant changes in vertical force and anterior-posterior force values with normalized speed. The ground reaction force patterns in these children were characterized predominantly by normalized speed of progression and not age. The clinical relevance of these findings is that normalized speed of walking, rather than age, should be considered when comparing normal with pathological gait.
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Affiliation(s)
- B W Stansfield
- Anderson Gait Analysis Laboratory, Princess Margaret Rose Orthopaedic Hospital, Edinburgh, United Kingdom
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Salter DM, Wallace WH, Robb JE, Caldwell H, Wright MO. Human bone cell hyperpolarization response to cyclical mechanical strain is mediated by an interleukin-1beta autocrine/paracrine loop. J Bone Miner Res 2000; 15:1746-55. [PMID: 10976994 DOI: 10.1359/jbmr.2000.15.9.1746] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Mechanical stimuli imparted by stretch, pressure, tension, fluid flow, and shear stress result in a variety of biochemical responses important in bone (re)modeling. The molecules involved in the recognition and transduction of mechanical stimuli that lead to modulation of bone cell function are not yet fully characterized. Cyclical pressure-induced strain (PIS) induces a rapid change in membrane potential of human bone cells (HBC) because of opening of membrane ion channels. This response is mediated via integrins and requires tyrosine kinase activity and an intact actin cytoskeleton. We have used this electrophysiological response to further study the signaling events occurring early after mechanical stimulation of HBC. Stimulation of HBC at 0.33 Hz PIS, but not 0.104 Hz PIS, results in the production of a transferable factor that induces membrane hyperpolarization of unstimulated HBC. The production of this factor is inhibited by antibodies to beta1-integrin. Interleukin-1beta (IL-1beta and prostaglandin E2 (PGE2) were identified as candidate molecules for the transferable factor as both were shown to induce HBC hyperpolarization by opening of small conductance calcium-activated potassium channels, the means by which 0.33 Hz PIS causes HBC hyperpolarization. Antibodies to IL-1beta, but not other cytokines studied, inhibit the hyperpolarization response of HBC to 0.33 Hz PIS. Comparison of the signaling pathways required for 0.33 Hz PIS and IL-1beta-induced membrane hyperpolarization shows that both involve the phospholipase C/inositol triphosphate pathway, protein kinase C (PKC), and prostaglandin synthesis. Unlike 0.33 Hz PIS-induced membrane hyperpolarization, IL-1beta-induced hyperpolarization does not require tyrosine kinase activity or an intact actin cytoskeleton. These studies suggest that 0.33 Hz PIS of HBC induces a rapid, integrin-mediated, release of IL-1beta with a subsequent autocrine/paracrine loop resulting in membrane hyperpolarization. IL-1beta production in response to mechanical stimuli is potentially of importance in regulation of bone (re)modeling.
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Affiliation(s)
- D M Salter
- Department of Pathology, Edinburgh University Medical School, United Kingdom
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Robb JE, Gordon L, Ferguson D, Dunhill Z, Elton RA, Minns RA. A comparison of hip guidance with reciprocating gait orthoses in children with spinal paraplegia: results of a ten-year prospective study. Eur J Pediatr Surg 1999; 9 Suppl 1:15-8. [PMID: 10661784 DOI: 10.1055/s-2008-1072305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Twenty-two children with spinal paraplegia were entered into a prospective randomised study to assess the efficacy of two reciprocating orthoses and to identify any prognostic factors that might affect continuing use of the devices. Thirteen received a hip guidance orthosis (HGO) and nine a reciprocating gait orthosis (RGO). They were followed for a mean of ten years. At one year follow-up there were three statistically significant differences between the two groups at the 5% level: repairs were commoner in the RGO group, the RGO group improved in their ability to walk over difficult outdoor surfaces and the HGO group improved more in their ability to rise from a sitting to standing position. At one year follow-up there was a positive parental and child's view of the benefits of the orthoses, but by ten years only 24% of the patients were still using the orthoses. We were not able to show any definite advantage of one device over the other or any statistically significant prognostic factors for walking in the longer term with a reciprocating orthosis. We question whether or not the routine provision of these types of orthosis is justifiable when it appears that, in the longer term, the patients we studied preferred wheelchair mobility.
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Affiliation(s)
- J E Robb
- Royal Hospital for Sick Children, Edinburgh, Scotland, UK
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McLauchlan GJ, Walker CR, Cowan B, Robb JE, Prescott RJ. Extension of the elbow and supracondylar fractures in children. J Bone Joint Surg Br 1999; 81:402-5. [PMID: 10872355 DOI: 10.1302/0301-620x.81b3.9194] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
We tested the hypothesis that children who sustain a supracondylar fracture have a greater range of elbow hyperextension than those with a fracture of the distal radius. Three observers made 358 measurements in 183 children (114 boys and 69 girls). There were 119 fractures of the distal radius and 64 supracondylar fractures. Initially, the group with a supracondylar fracture appeared to have extension 1.7 degrees greater than that of the group with fracture of the distal radius. On average, there was a maximum variation of 3 degrees between observers. After allowing for age, gender and observer, there was no significant difference between the groups. Our study had greater than 80% power to detect a difference in hyperextension of 2 degrees at the 5% level with the above observer variability. When age and gender are taken into account, any variation in the amount of hyperextension at the elbow is not sufficient to explain the occurrence of a supracondylar fracture.
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Affiliation(s)
- G J McLauchlan
- Department of Orthopaedics, Royal Hospital for Sick Children, Edinburgh, UK
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42
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Abstract
▪ Abstract Why should archaeologists deal with symbols and how can they do so? This article outlines three major traditions archaeologists have followed in conceptualizing symbols, each with its own preferred topics of study, understanding of power and social relations, and epistemology. These include the processual view of symbols as tokens that represent reality, the structuralist view of symbols as mental girders framing a cultural reality, and the postmodern view of symbols as arbitrary fragments incorporated into phenomenological experience. The primary conclusions are that (a) any serious consideration of ancient society requires us to deal with its symbols; (b) human symbolism is so diverse (it includes cognitive structures; ritual icons; identities such as gender, prestige, and ethnicity; technological knowledge; and political ideologies) that multiple approaches are needed to deal adequately with it; and (c) a major problem in the archaeology of symbols is understanding how varied kinds of symbols relate to each other.
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Affiliation(s)
- John E. Robb
- Department of Archaeology, University of Southampton, Southampton SO17 1BJ, United Kingdom
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Abstract
The use of video tape in gait analysis is widespread and is frequently used when more sophisticated 3-dimensional analysis systems are not available or cannot be used. Its major shortcoming however is that it does not readily yield information about rotations in the transverse plane which may be amongst the most diagnostically significant features of pathological gait. This paper describes an inexpensive device which may be used, in conjunction with video taping, to aid visual estimation of transverse plane rotations, and quantifies the accuracy with which this was done by experienced observers. Copyright 1998 Elsevier Science B.V.
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Affiliation(s)
- SJ Hillman
- The Anderson Gait Analysis Laboratory, Princess Margaret Rose Orthopaedic Hospital, Edinburgh, UK
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Abstract
The MRI appearances of synovial involvement from non-Hodgkin's lymphoma are described in a 61-year-old man. These appearances have not previously been described and the differential diagnosis is discussed.
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Affiliation(s)
- K A Jamieson
- Department of Clinical Radiology, Royal Infirmary of Edinburgh, UK
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Salter DM, Robb JE, Wright MO. Electrophysiological responses of human bone cells to mechanical stimulation: evidence for specific integrin function in mechanotransduction. J Bone Miner Res 1997; 12:1133-41. [PMID: 9200014 DOI: 10.1359/jbmr.1997.12.7.1133] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Bone cells respond to mechanical stimuli, but the transduction mechanisms responsible are not fully understood. Integrins, a family of heterodimeric transmembrane glycoproteins, which link components of the extracellular matrix with the actin cytoskeleton, have been implicated as mechanoreceptors. We have assessed the roles of integrins in the transduction of cyclical mechanical stimuli to human bone cells (HBCs), which results in changes in membrane potential. HBC showed membrane depolarization following 0.104 Hz mechanical stimulation and membrane hyperpolarization following stimulation at 0.33 Hz. The membrane depolarization response involved tetrodotoxin-sensitive sodium channels and could be inhibited by antibodies against alpha V, beta 1, and beta 5 integrins. In contrast, the hyperpolarization response was inhibited by gadolinium and antibodies to the integrin-associated protein (CD47), alpha 5 and beta 1 integrin. Both responses could be abrogated by ARg-Gly-Asp (RGD)-containing peptides, inhibition of tyrosine kinase activity, and disruption of the cytoskeleton. These results demonstrate differential electrophysiological responses of HBC to different frequencies of mechanical strain. Furthermore, they suggest that integrins act as HBC mechanoreceptors with distinct signaling pathways being activated by different frequencies of mechanical stimuli.
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Affiliation(s)
- D M Salter
- Department of Pathology, Edinburgh University Medical School, United Kingdom
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Robb JE. Expanding Archaeology:Expanding Archaeology. American Anthropologist 1997. [DOI: 10.1525/aa.1997.99.1.199.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Six patients (seven hips) with total-body-involvement cerebral palsy were assessed for a hip reconstruction. Four patients (five hips) underwent three-dimensional computerized tomographic (3D CT) scans, and in two patients, faux profile views were obtained. The femoral head was subluxed or dislocated anteriorly in all seven hips. The migration percentage (MP) and center-edge angle (CEA) underestimated the pathology. We conclude that the MP and CEA do not exclude an anterior displacement of the femoral head and calls into question the accuracy of methods relying on two-dimensional imaging in assessing hip containment in this group of patients. The faux profile view is sufficient to show an anterior hip displacement but a 3D CT gives superior detail to help in planning a surgical reconstruction.
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Affiliation(s)
- R Brunner
- Department of Orthopaedic Surgery, Basler Kinderspital, Switzerland
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Abstract
Twenty-six nonoperated spastic hemiplegic children underwent three-dimensional kinetic gait analysis. We identified five patterns based on sagittal plane kinetics. Group I had a minimal gait disturbance, a drop foot pattern, and normal kinetics, Group II had a flexed knee but normal hip extension, Group III a flexed knee and hip, Group IV knee hyperextension and tibial arrest, and Group V knee hyperextension and persistent ankle dorsiflexion. We concluded that Group I had weak anterior tibial muscles, and in stance Group II a functionally tight gastrocnemius, Group III a functionally tight gastrocnemius and hip flexors, and Group IV a functionally tight soleus, and in Group V the patients generated an abnormally large fore-aft shear force and the gastrocnemius and soleus were not tight. Kinetics help in the understanding of gait aberrations in spastic hemiplegia.
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Affiliation(s)
- M G Hullin
- Princess Margaret Rose Orthopaedic Hospital, Edinburgh, Scotland, UK
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Hardman PD, Robb JE, Kerr GR, Rodger A, MacFarlane A. The value of internal fixation and radiotherapy in the management of upper and lower limb bone metastases. Clin Oncol (R Coll Radiol) 1992; 4:244-8. [PMID: 1377932 DOI: 10.1016/s0936-6555(05)81063-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Fifty-four consecutive patients underwent 61 orthopaedic operations for metastatic bone disease affecting the upper and lower limbs. These patients were subsequently managed using a consistent postoperative radiotherapy (RT) policy. There were 27 prophylactic internal fixations and 34 internal fixations of pathological fractures. There was a marked difference in survival between these groups. The median postoperative survival of the prophylactic (P) group was 15 months whereas that of the fracture (F) group was 2 months (P less than 0.0001). Ninety-three per cent of the P group and 59% of the F group were able to be discharged home following treatment. Subsequent local fracture requiring further surgical intervention occurred in 11% of the P group and in none of the F group. Seventy-eight per cent of the P group and 62% of the F group did not suffer any further sequelae at the operation site until the time of death or last follow-up. Patient mobility following surgery and RT for metastatic lesions occurring in the lower limb was significantly improved in both the P group (P less than 0.05) and in the F group (P less than 0.0001) such that 91% and 58%, respectively, of these patients were subsequently able to walk.
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Affiliation(s)
- P D Hardman
- Department of Clinical Oncology, Western General Hospital, Edinburgh, UK
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50
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Hullin MG, Robb JE, Loudon IR. Ankle-foot orthosis function in low-level myelomeningocele. J Pediatr Orthop 1992; 12:518-21. [PMID: 1613099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Six children with low-level myelomeningocele underwent gait analysis. All showed excessive ankle dorsiflexion and knee flexion when walking barefoot. A rigid thermoplastic ankle-foot orthosis (AFO) improved gait by preventing ankle dorsiflexion and reducing knee flexion. Biomechanically, the AFO caused a reduction in external knee moment by aligning the knee with the ground reaction force. Small changes in the foot-shank angle of the orthosis had profound effects on knee mechanics. Knee hyperextension could be controlled by a rocker sole. Kinetic gait analysis permits understanding of the biomechanical effects of orthoses.
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Affiliation(s)
- M G Hullin
- Princess Margaret Rose Orthopaedic Hospital, Edinburg, Scotland
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