Towards a rigorous understanding of societal responses to climate change.

A large scholarship currently holds that before the onset of anthropogenic global warming, natural climatic changes long provoked subsistence crises and, occasionally, civilizational collapses among human societies. This scholarship, which we term the 'history of climate and society' (HCS), is pursued by researchers from a wide range of disciplines, including archaeologists, economists, geneticists, geographers, historians, linguists and palaeoclimatologists. We argue that, despite the wide interest in HCS, the field suffers from numerous biases, and often does not account for the local effects and spatiotemporal heterogeneity of past climate changes or the challenges of interpreting historical sources. Here we propose an interdisciplinary framework for uncovering climate-society interactions that emphasizes the mechanics by which climate change has influenced human history, and the uncertainties inherent in discerning that influence across different spatiotemporal scales. Although we acknowledge that climate change has sometimes had destructive effects on past societies, the application of our framework to numerous case studies uncovers five pathways by which populations survived-and often thrived-in the face of climatic pressures.

Genetic assessment reveals no population substructure and divergent regional and sex-specific histories in the Chachapoyas from northeast Peru.

Many native populations in South America have been severely impacted by two relatively recent historical events, the Inca and the Spanish conquest. However decisive these disruptive events may have been, the populations and their gene pools have been shaped markedly also by the history prior to the conquests. This study focuses mainly on the Chachapoya peoples that inhabit the montane forests on the eastern slopes of the northern Peruvian Andes, but also includes three distinct neighboring populations (the Jívaro, the Huancas and the Cajamarca). By assessing mitochondrial, Y-chromosomal and autosomal diversity in the region, we explore questions that have emerged from archaeological and historical studies of the regional culture (s). These studies have shown, among others, that Chachapoyas was a crossroads for Coast-Andes-Amazon interactions since very early times. In this study, we examine the following questions: 1) was there pre-Hispanic genetic population substructure in the Chachapoyas sample? 2) did the Spanish conquest cause a more severe population decline on Chachapoyan males than on females? 3) can we detect different patterns of European gene flow in the Chachapoyas region? and, 4) did the demographic history in the Chachapoyas resemble the one from the Andean area? Despite cultural differences within the Chachapoyas region as shown by archaeological and ethnohistorical research, genetic markers show no significant evidence for past or current population substructure, although an Amazonian gene flow dynamic in the northern part of this territory is suggested. The data also indicates a bottleneck c. 25 generations ago that was more severe among males than females, as well as divergent population histories for populations in the Andean and Amazonian regions. In line with previous studies, we observe high genetic diversity in the Chachapoyas, despite the documented dramatic population declines. The diverse topography and great biodiversity of the northeastern Peruvian montane forests are potential contributing agents in shaping and maintaining the high genetic diversity in the Chachapoyas region.

Learning from the past in the COVID-19 era: rediscovery of quarantine, previous pandemics, origin of hospitals and national healthcare systems, and ethics in medicine.

After the dramatic coronavirus outbreak at the end of 2019 in Wuhan, Hubei province, China, on 11 March 2020, a pandemic was declared by the WHO. Most countries worldwide imposed a quarantine or lockdown to their citizens, in an attempt to prevent uncontrolled infection from spreading. Historically, quarantine is the 40-day period of forced isolation to prevent the spread of an infectious disease. In this educational paper, a historical overview from the sacred temples of ancient Greece-the cradle of medicine-to modern hospitals, along with the conceive of healthcare systems, is provided. A few foods for thought as to the conflict between ethics in medicine and shortage of personnel and financial resources in the coronavirus disease 2019 era are offered as well.

Gender medicine: its historical roots.

Gender medicine as a subject began with Bernadine Healy's 1991 article 'The Yentl Syndrome' which showed that women had worse outcomes following heart attacks since their symptoms are different from men. Since then gender-specific clinical research protocols have been progressively included so that evidence for guidelines can be better informed such that women are then less disadvantaged and care become more personalised. This paper traces back the historical roots of gender bias in medicine in Western culture, which is reflected in the pictorial arts and writings of each historical period, beginning with Hippocrates. It describes the changes that have led to attempts at improving the place of women, and the treatments of disease, on an equal footing with men, precipitated by Healy's paper.

La atención a la salud en Mesoamérica antes y después de 1519 / Health care in Mesoamerica before and after 1519

Resumen En este ensayo se discute la situación de la atención a la salud en Mesoamérica antes e inmediatamente después de 1519. En los primeros 50 años después de la Conquista, los españoles hicieron un uso muy extensivo de la medicina náhuatl. Sin embargo, con el tiempo, el ámbito de influencia de esta tradición se vio limitado debido a la rápida imposición de un sistema de atención muy diferente que poco aprovechó, entre otras cosas, la riqueza terapéutica de la medicina prehispánica.

Abstract This paper discusses the situation of healthcare in Mesoamerica before and immediately after 1519. In the first 50 years after the Conquest, the Spaniards made extensive use of Nahuatl medicine. However, the influence of this medical tradition was limited due to the rapid imposition of a very different medical system which took little advantage of, among other things, the therapeutic wealth of pre-Hispanic healing traditions.

[Health care in Mesoamerica before and after 1519]. / La atención a la salud en Mesoamérica antes y después de 1519.

This paper discusses the situation of healthcare in Mesoamerica before and immediately after 1519. In the first 50 years after the Conquest, the Spaniards made extensive use of Nahuatl medicine. However, the influence of this medical tradition was limited due to the rapid imposition of a very different medical system which took little advantage of, among other things, the therapeutic wealth of pre-Hispanic healing traditions.

En este ensayo se discute la situación de la atención a la salud en Mesoamérica antes e inmediatamente después de 1519. En los primeros 50 años después de la Conquista, los españoles hicieron un uso muy extensivo de la medicina náhuatl. Sin embargo, con el tiempo, el ámbito de influencia de esta tradición se vio limitado debido a la rápida imposición de un sistema de atención muy diferente que poco aprovechó, entre otras cosas, la riqueza terapéutica de la medicina prehispánica.

Is Crohn's Disease the Price to Pay Today for Having Survived the Black Death?

BACKGROUND AND AIMS: Nucleotide Oligomerisation Domain 2 [NOD2] is a key gene of innate immunity which participates in the host defence against pathogens. Several loss-of-function NOD2 mutations are associated with Crohn's disease [CD]. Their high frequencies in populations of European ancestry suggest a model of balancing selection. Because NOD2 deficiency has been associated with a resistance to Yersinia pseudotuberculosis in mice, we hypothesised that NOD2 mutations have been selected during past plague outbreaks due to the closely related bacterium Yersinia pestis. METHODS: Contemporary frequencies of the main CD-associated NOD2 mutations [R702W, G908R, and 1007fs], measured in healthy people from European and Mediterranean countries, were collected from 60 studies via a PubMed search. Plague exposure was calculated from a dataset providing outbreaks from 1346 to 1860 in Europe and the Mediterranean Bassin. A plague index was built to capture the intensity of plague exposure in the studied geographical areas. RESULTS: NOD2 mutation frequencies were associated with the past exposure to plague. Statistical significance was obtained for the most frequent mutation [R702W, p = 0.03] and for the pooled three mutations [p = 0.023]. The association remained significant when putative demographic biases were considered. CONCLUSIONS: This result argues for a selection of CD-associated NOD2 mutations by plague outbreaks and further questioned the role of exposure to enteropathogenic Yersinia species in CD.

The historical process of the masonry city walls construction in China during 1st to 17th centuries AD.

Masonry city walls were common defense facilities in the cities of the Eurasian before the industrial revolution. However, they were not widespread in China until the Ming Dynasty (1368-1644). Limited in research methods, previous studies failed to make convincing arguments on this phenomenon. We collected, organized and analyzed relevant historical documents to reconstruct the spatio-temporal process of the construction of masonry walls from 1st to 17th century in China. We conducted a time series analysis primarily based on factors such as wars, garrisons, economy, and natural disasters. Analysis of the correlation among the construction of masonry walls and these factors provides insights into this process. From the 1st to 14th century, only 125 masonry city walls were built in China and the annual average number was below 0.1. While in the Ming Dynasty, a total of 1,493 masonry walls were built, with an annual average of 5.41. The construction activities in 1368-1456 spread throughout the country, but mainly appeared in the high-grade administrative cities and garrisons, as a result of the planned implementation of the central government. The construction activities in 1457-1644 had corresponding cluster areas during different periods, mainly at county-level. We found that the wall construction was stimulated by external factors such as wars and disasters. We believe that the mass construction of masonry walls in the Ming Dynasty is a phenomenon of cultural diffusion. The central government plan, the complex interactions between local governments and community, and the stimulation of external factors worked together to contribute to the diffusion of masonry city walls in the Ming Dynasty.

Body size and social status in medieval Alba (Cuneo), Italy.

OBJECTIVES: Previous work by Vercellotti et al. in 2011 found significant status-related differences in body size in males but not in females from the Italian bioarchaeological assemblage of San Michele di Trino (8th-14th centuries CE). The purpose of the present work is twofold: (a) to determine if status-related body size differences could be observed in the nearby collection of San Lorenzo di Alba (7th-15th centuries CE) and (b) to add to the emerging narrative of medieval Italians. MATERIALS AND METHODS: Osteometric data (maximum length for the humerus, radius, ulna, femur, tibia, and fibula; bicondylar length of the femur, condylo-malleolar length of the tibia, foot height, maximum vertebral heights, and basion-bregma height) were collected for 50 (20 female, 30 male) individuals from Alba, and Monte Carlo analysis was used to assess differences in skeletal element size, skeletal height, living stature, and body mass across sex and status. RESULTS: Significant differences were detected between high status and low status males in Alba for radial maximum length (p = 0.013), tibial maximum length (p = 0.011), tibial condylo-malleolar length (p = 0.012), skeletal height estimated from condylo-malleolar tibial length (p = 0.002), and stature estimated from condyle-malleolar tibial length with the age component (p = 0.003). In contrast, no significant status-based differences were observed between female subsamples (p > 0.05). DISCUSSION: The patterns of intrapopulation variation observed at Alba are similar but not as pronounced as those observed at Trino, suggesting that overall life conditions experienced by the two groups were comparable.

Conceptualizations of suicide through time and socio-economic factors: a historical mini-review.

OBJECTIVES: Suicide is a complex phenomenon determined by the interplay of an articulated network of factors including socio-economic factors which have a decisive role. This paper investigates the development of the modern conceptualization of suicide in Europe, its sociological understandings and its intertwinement with economic cycles throughout time. METHODS: MEDLINE, SCHOLAR, EMBASE using the keywords 'socioeconomic factors AND suicide'; 'economic cycles AND suicide'; 'history AND suicide' without timeframe limitations. Moreover, journal-by-journal search in journals of related areas was performed. RESULTS: In total, 51 historical studies focusing on the subjects in European countries were included. Three main areas arose: (a) development of the conceptualization of suicide over time; (b) sociological understandings of suicide according to the structure of society and its economy of power; (c) economic theories explaining the intertwinement of economic cycles and suicides. CONCLUSIONS: Suicide is a deeply human phenomenon inescapably linked to and grounded in society and economic cycles. Understandings from the past show the importance of accurate analysis of socio-economic contexts that shape societies together with man's own sense of self in order to organize multi-layered tangible and intangible support strategies to better understand and prevent suicide in this day and age.

Mississippian subadults from the Middle Cumberland and Eastern regions of Tennessee: Biological indicators of population interaction.

OBJECTIVES: Human subadult skeletal remains can provide a unique perspective into biosocial aspects of Mississippian period population interactions within and between the Middle Cumberland (MCR) and Eastern Tennessee Regions (ETR). The majority of previous studies have concentrated on adult skeletal remains, leaving out a large and extremely important population segment. METHODS: Skeletal indicators of disease, growth, body proportions, and metabolic stress were collected from subadult remains from five archaeological sites over several temporal periods. Crucial to overcoming limitations associated with the osteological paradox, the biological results were placed into an archaeological context based on prior studies as well as paleoclimatological data. RESULTS: Results reveal homogeneity both within and between regions for most skeletal indicators. However, MCR individuals exhibit a higher frequency of pathology than those from ETC, while stature is significantly lower in younger subadults from the MCR. Within the ETR, there is no evidence for biological differences between Early Dallas and subsequent Late Dallas and Mouse Creek cultural phases. Despite presumed signs of increased conflict at the Dallas site, frequencies and types of skeletal pathology and growth disruptions are comparable to other regional sites. CONCLUSIONS: These findings suggest that despite cultural differences between the ETR and MCR, there was no large-scale intrusion from an outside population into the ETR during the Late Mississippian Period, or if one occurred, it is biologically invisible. Combined with climatic and archaeobotanical data, results suggest the MCR subadults were under increased stress in their earlier years. This may have been associated with increased interpersonal violence and dependence on few food sources occurring with greater scarcity.

The history of risk: a review.

In the USA alone, around 22 million patients annually discuss the need for surgical procedure with their surgeon. On a global scale, more than 200 million patients are exposed to the risk of undergoing a surgical procedure every year. A crucial part of the informed consent process for surgery is the understanding of risk, the probability of complications, and the predicted occurrence of adverse events. Ironically, risk quantification, risk stratification, and risk management are not necessarily part of a surgeon's core skillset, considering the lengthy surgical training curriculum towards technical excellence. The present review was designed to provide a concise historic perspective on the evolution of our current understanding of risk and probability, which represent the key underlying pillars of the shared decision-making process between surgeons and patients when discussing surgical treatment options.