Evidence-based palaeopathology: meta-analysis of PubMed-listed scientific studies on ancient Egyptian mummies

The role of radiology in provenance research - experiences from the collaboration between radiology and anatomy at the University of Rostock and future perspectives

Worldwide, the study and examination of human remains and the circumstances of their acquisition for anatomical collection have received great interest. As part of provenance research projects, a large number of collections are being investigated to determine whether the human remains have been acquired in a correct or unlawful way because the people could have been killed in order to be used as "anthropological objects" for research purposes and to become so-called "specimens". These topics have also been addressed by the Institute of Anatomy at the University Medical Center Rostock. The role of radiology in this interdisciplinary project will be presented using selected examples.The anatomical collection at the University of Rostock includes 40 human skulls, 14 plaster casts, 6 Egyptian mummy heads, and 1 full-body mummy. In addition to the examination by a historian, an anthropologist, and forensic pathologists, additional computed tomography was carried out on nine skulls and the full-body mummy. Micro-computed tomography was also carried out on seven skulls in order to enable a look behind the mummification material and tissue remains.(Micro-)computed tomography was able to close diagnostic gaps and the results presented some rather unexpected findings.Due to interdisciplinary collaboration, individual fates could be determined, which provided information about the individual's life and death circumstances. None of the examined individuals showed evidence of colonial-era injustice or the use of violence that would have led to their inclusion in the collection. (Micro-)computed tomography was a valuable addition to this provenance research project. · Computed tomography enhances interdisciplinary provenance research projects.. · Computed tomography enables a non-destructive examination of human remains.. · The future of research and presentation of human remains will increasingly be virtual.. · Steinhagen I, Brinker U, Kolbe V et al. The role of radiology in provenance research - experiences from the collaboration between radiology and anatomy at the University of Rostock and future perspectives. Fortschr Röntgenstr 2024; DOI 10.1055/a-2303-0312.

Effects of air pollution on human health - Mechanistic evidence suggested by in vitro and in vivo modelling

Airborne particulate matter (PM) comprises both solid and liquid particles, including carbon, sulphates, nitrate, and toxic heavy metals, which can induce oxidative stress and inflammation after inhalation. These changes occur both in the lung and systemically, due to the ability of the small-sized PM (i.e. diameters ≤2.5 μm, PM_2.5) to enter and circulate in the bloodstream. As such, in 2016, airborne PM caused ∼4.2 million premature deaths worldwide. Acute exposure to high levels of airborne PM (eg. during wildfires) can exacerbate pre-existing illnesses leading to hospitalisation, such as in those with asthma and coronary heart disease. Prolonged exposure to PM can increase the risk of non-communicable chronic diseases affecting the brain, lung, heart, liver, and kidney, although the latter is less well studied. Given the breadth of potential disease, it is critical to understand the mechanisms underlying airborne PM exposure-induced disorders. Establishing aetiology in humans is difficult, therefore, in-vitro and in-vivo studies can provide mechanistic insights. We describe acute health effects (e.g. exacerbations of asthma) and long term health effects such as the induction of chronic inflammatory lung disease, and effects outside the lung (e.g. liver and renal change). We will focus on oxidative stress and inflammation as this is the common mechanism of PM-induced disease, which may be used to develop effective treatments to mitigate the adverse health effect of PM exposure.

A Ptolemaic mummy reveals evidence of invasive dentistry in ancient Egypt

Over the last decades, it has been confirmed that computerized tomography (CT) is a valuable tool for studying mummies. In joint efforts put forth by the Mummy Research Project of the Hellenic Institute of Egyptology, the National Archaeological Museum, and the Athens Medical Center, a mummy was transported to the Radiology Department of the Athens Medical Center for study. Thus, a complete CT scanning was performed of this Ptolemaic mummy (AIG 3343: Sekhem, male, 150-30 BCE), belonging to the Egyptian Collection of the National Archaeological Museum of Athens. The most significant finding is an interproximal carious cavity packed with protective material. This is the second case of dental packing in the literature among ancient Egyptian mummies studied to date. Its remarkable resemblance to the previously published study may indicate a common dental intervention performed by ancient Egyptians. Despite the well-known early medical traditions of ancient Egypt, spanning from the Old Kingdom to the Ptolemaic and Roman Periods, little evidence remains of their practices in dentistry. Our finding represents a rare perspective on the origins of what remains today a major allied health field discipline.

Advances in paleopathology in context: A focus on soft tissue paleopathology

Skeletal and mummified remains from South America have had a significant impact on the progress of paleopathological research. In 1997, John Verano synthesized the state of paleopathological research, identifying trends and highlighting future potentials. The goal of this contribution is to consider Verano's observations on advances in soft tissue paleopathology within the context of the development of the field of mummy studies. As his article was published near the midpoint between the present and the early 1970s, when the modern form of mummy studies began to form, considering his observations in this context allows researchers the opportunity to consider how the field has progressed since the late 1990s.

Computed Tomography-Detected Paleopathologies in Ancient Egyptian Mummies

OBJECTIVE

Computed tomography (CT)-based analyses of mummies have been performed since the 1970s but, until now, no systematic summary of PubMed®-published data has been performed. The aim was to perform a systematic review of previously published cases and summarize artificial changes and detectable paleopathologies.

MATERIALS AND METHODS

Data collection from publications on CT analyses of mummies from ancient Egypt until the Greco-Roman period (up to 700 ad) from the PubMed® database (1973-2013) and descriptive data analysis.

RESULTS

Forty-seven publications on CT-based analyses have been identified, which reported on 189 mummies. Commonly reported artificial changes were destruction of the nasal bone and left-sided lateral abdominal incision for removal of inner organs. Dental and jaw pathologies (n = 42), chronic degenerative changes of skeletal bones (n = 39), and arteriosclerosis (n = 36) were reported in a subfraction of cases while traumatic fractures (n = 16) and other diseases were less often identified. The cause of death was rarely detectable by CT, but a cut through the throat, arrowheads, and bone fracture could be verified by CT.

CONCLUSION

Standards in documentation of CT devices have changed over the past 40 years, and insufficient documentation limits the interpretation of findings. In ancient Egyptian mummies, most organs have been removed during the mummification process while teeth and jaws are often preserved. Dental pathologies were frequent in ancient Egypt and can indicate personal circumstances and diet. The cause of death is rarely verifiable, but CT scan could be the clue. Although well known in Egyptian mummies, artificial changes may lead to misinterpretation of CT findings.

Analysis of a long-term measurement of air pollutants (2007-2011) in North China Plain (NCP); Impact of emission reduction during the Beijing Olympic Games

Five years measurements were used to evaluate the effect of emission controls on the changes of air pollutants in Beijing and its surroundings in the NCP during 2008 Olympic Games (2008OG). The major challenge of this study was to filter out the effect of variability of meteorological conditions, when compared the air pollutants during the game to non-game period. We used four-year (2007, 2009-2011) average as the Non-2008OG to smooth the temporal variability caused by meteorological parameters. To study the spatial variability and regional transport, 6 sites (urban, rural, a mega city, a heavy industrial city, and a remote site) were selected. The result showed that the annually meteorological variability was significantly reduced. Such as, in BJ the differences between 2008OG and 5-years averaged values were 2.7% for relative humidity and 0.6% for wind speed. As a result, the anomaly of air pollutants between 2008OG and Non-2008OG can largely attribute to the emission control. The comparison showed that the major pollutants (PM10, PM2.5, NO, NOx) at the 6 sites in 2008OG were consistently lowered. For example, PM2.5 in BJ decreased from 75 to 45 μg/m(3) (40% reduction). However, the emission controls had minor effect on O3 concentrations (1% reduction). In contrast, the O3 precursor (NOx) reduced from 19.7 to 13.2 ppb (33% reduction). The in-sensitivity between NOx and O3 suggested that the O3 formation was under VOCs control condition in NCP, showing that strong VOC emission control is needed in order to significantly reduce O3 concentration in the region.

Tutankhamun's Dentition: The Pharaoh and his Teeth

Tutankhamun was a Pharaoh of the 18th Dynasty (New Kingdom) in ancient Egypt. Medical and radiological investigations of his skull revealed details about the jaw and teeth status of the mummy. Regarding the jaw relation, a maxillary prognathism, a mandibular retrognathism and micrognathism have been discussed previously. A cephalometric analysis was performed using a lateral skull X-ray and a review of the literature regarding King Tutankhamun´s mummy. The results imply diagnosis of mandibular retrognathism. Furthermore, third molar retention and an incomplete, single cleft palate are present.

Invasive versus Non Invasive Methods Applied to Mummy Research: Will This Controversy Ever Be Solved?

Advances in the application of non invasive techniques to mummified remains have shed new light on past diseases. The virtual inspection of a corpse, which has almost completely replaced classical autopsy, has proven to be important especially when dealing with valuable museum specimens. In spite of some very rewarding results, there are still many open questions. Non invasive techniques provide information on hard and soft tissue pathologies and allow information to be gleaned concerning mummification practices (e.g., ancient Egyptian artificial mummification). Nevertheless, there are other fields of mummy studies in which the results provided by non invasive techniques are not always self-explanatory. Reliance exclusively upon virtual diagnoses can sometimes lead to inconclusive and misleading interpretations. On the other hand, several types of investigation (e.g., histology, paleomicrobiology, and biochemistry), although minimally invasive, require direct contact with the bodies and, for this reason, are often avoided, particularly by museum curators. Here we present an overview of the non invasive and invasive techniques currently used in mummy studies and propose an approach that might solve these conflicts.

Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies

The purpose of this study was to develop a checklist for standardized assessment of soft tissue preservation in human mummies based on whole-body computed tomography examinations, and to add a scoring system to facilitate quantitative comparison of mummies. Computed tomography examinations of 23 mummies from the Capuchin Catacombs of Palermo, Sicily (17 adults, 6 children; 17 anthropogenically and 6 naturally mummified) and 7 mummies from the crypt of the Dominican Church of the Holy Spirit of Vilnius, Lithuania (5 adults, 2 children; all naturally mummified) were used to develop the checklist following previously published guidelines. The scoring system was developed by assigning equal scores for checkpoints with equivalent quality. The checklist was evaluated by intra- and inter-observer reliability. The finalized checklist was applied to compare the groups of anthropogenically and naturally mummified bodies. The finalized checklist contains 97 checkpoints and was divided into two main categories, “A. Soft Tissues of Head and Musculoskeletal System” and “B. Organs and Organ Systems”, each including various subcategories. The complete checklist had an intra-observer reliability of 98% and an inter-observer reliability of 93%. Statistical comparison revealed significantly higher values in anthropogenically compared to naturally mummified bodies for the total score and for three subcategories. In conclusion, the developed checklist allows for a standardized assessment and documentation of soft tissue preservation in whole-body computed tomography examinations of human mummies. The scoring system facilitates a quantitative comparison of the soft tissue preservation status between single mummies or mummy collections.

Air pollution and public health: emerging hazards and improved understanding of risk

Despite past improvements in air quality, very large parts of the population in urban areas breathe air that does not meet European standards let alone the health-based World Health Organisation Air Quality Guidelines. Over the last 10 years, there has been a substantial increase in findings that particulate matter (PM) air pollution is not only exerting a greater impact on established health endpoints, but is also associated with a broader number of disease outcomes. Data strongly suggest that effects have no threshold within the studied range of ambient concentrations, can occur at levels close to PM2.5 background concentrations and that they follow a mostly linear concentration-response function. Having firmly established this significant public health problem, there has been an enormous effort to identify what it is in ambient PM that affects health and to understand the underlying biological basis of toxicity by identifying mechanistic pathways-information that in turn will inform policy makers how best to legislate for cleaner air. Another intervention in moving towards a healthier environment depends upon the achieving the right public attitude and behaviour by the use of optimal air pollution monitoring, forecasting and reporting that exploits increasingly sophisticated information systems. Improving air quality is a considerable but not an intractable challenge. Translating the correct scientific evidence into bold, realistic and effective policies undisputedly has the potential to reduce air pollution so that it no longer poses a damaging and costly toll on public health.

First insights into the metagenome of Egyptian mummies using next-generation sequencing

We applied, for the first time, next-generation sequencing (NGS) technology on Egyptian mummies. Seven NGS datasets obtained from five randomly selected Third Intermediate to Graeco-Roman Egyptian mummies (806 BC-124AD) and two unearthed pre-contact Bolivian lowland skeletons were generated and characterised. The datasets were contrasted to three recently published NGS datasets obtained from cold-climate regions, i.e. the Saqqaq, the Denisova hominid and the Alpine Iceman. Analysis was done using one million reads of each newly generated or published dataset. Blastn and megablast results were analysed using MEGAN software. Distinct NGS results were replicated by specific and sensitive polymerase chain reaction (PCR) protocols in ancient DNA dedicated laboratories. Here, we provide unambiguous identification of authentic DNA in Egyptian mummies. The NGS datasets showed variable contents of endogenous DNA harboured in tissues. Three of five mummies displayed a human DNA proportion comparable to the human read count of the Saqqaq permafrost-preserved specimen. Furthermore, a metagenomic signature unique to mummies was displayed. By applying a "bacterial fingerprint", discrimination among mummies and other remains from warm areas outside Egypt was possible. Due to the absence of an adequate environment monitoring, a bacterial bloom was identified when analysing different biopsies from the same mummies taken after a lapse of time of 1.5 years. Plant kingdom representation in all mummy datasets was unique and could be partially associated with their use in embalming materials. Finally, NGS data showed the presence of Plasmodium falciparum and Toxoplasma gondii DNA sequences, indicating malaria and toxoplasmosis in these mummies. We demonstrate that endogenous ancient DNA can be extracted from mummies and serve as a proper template for the NGS technique, thus, opening new pathways of investigation for future genome sequencing of ancient Egyptian individuals.