Rural Rickets: Vitamin D Deficiency in a Post-Medieval Farming Community from the Netherlands

ABSTRACT Rickets is caused by vitamin D deficiency as a result of limited exposure to sunlight and inadequate diet. In the 19 th century, rickets was endemic in most northern European cities. In post-Medieval Netherlands, rickets is documented in low frequencies in a few urban samples, but has not been studied in contemporaneous rural populations. Beemster is a rural farming community in the Netherlands that was established in the 17 th century upon drained land, with the Middenbeemster cemetery in use until 1866 AD. Ninety-five individuals from the ages of 32 weeks in utero to 15 years were examined for rickets in order to understand factors that can cause vitamin D deficiency in rural, non-industrialized populations. To identify rickets in the Beemster sample, ten features were scored, with bending deformities of the lower limb and one other feature, or at least three non-bending features, having to be present in order for diagnosis. Nine individuals (9.5%) had evidence of rickets-a high prevalence, especially for a rural community where ample sunlight was available. The two and three year old Beemster infants were most heavily affected with an age-specific prevalence of 30.4%. Two three-month-old infants also had rickets. Some of the affected may have developed rickets secondarily, as a result of a different illness, but cultural practices including prolonged swaddling, occlusive clothing, and keeping the young indoors, are suggested to have contributed to this high rickets prevalence. Dietary variables including poor weaning foods and common episodes of malnutrition may have also contributed to vitamin D deficiency. This study demonstrates the value of careful analysis of pathological conditions in subadults and highlights that rickets was not only a disease of cities, but affected populations that would appear to have been at low risk, because of maladaptive cultural practices

Toevalsvondst van ijzertijd urnen te Postel (gem. Mol, prov. Antwerpen) Verslag van een archeologische toevalsvondst

De vondst van deze urnen met crematieresten is het gevolg van een bijzondere samenloop van omstandigheden. Na duizenden jaren quasi onverstoord daar begraven te zijn, werden de urnen via de kluiten van een omgevallen boom uit de heuvel getrokken, wellicht kort voor de ontdekking van het grafheuvelcomplex en de bescherming ervan als archeologische site. Een rondleiding in het kader van deze bescherming was de aanleiding van de toevallige vondst. Dit toont aan dat dergelijke belangrijke en kwetsbare archeologische site nood hebben aan actief beheer en bescherming

"Memor" : créer un inventaire des restes humaines archéologiques en Flandres, Belgique

Depuis longtemps, la Flandre, comme l’ensemble de la Belgique, ne possède pas de législation bien définie ou de directives éthiques pour l’utilisation des restes humains, ni des normes uniformes pour la conservation ou l’aliénation des collections. Il n’y avait même pas d’inventaire des collections conservées aujourd’hui dans les diverses institutions. Cette problématique est devenue encore plus urgente depuis que la convention de Malte est en vigueur et suite au nombre croissant de fouilles..

Ethisch verantwoord omgaan bij onderzoek van menselijk botmateriaal in Vlaanderen

Het project MEMOR kent vele moeders en vaders, en even veelzijdig als de betrokken wetenschappers zijn ook de oorzaken en redenen van het onderzoek. Naast het feit dat archeologen, opdrachtgevers, depotverantwoordelijken steeds vaker worden geconfronteerd met menselijke resten lag de concrete aanleiding van MEMOR in een ethisch vraagstuk dat al enige tijd leeft bij sommige archeologen: is de methodiek van archeologisch veldwerk, uitwerking van onderzoeksresultaten en dagelijkse omgang bij onderzoek van menselijk botmateriaal in Vlaanderen ethisch verantwoord? Heel concreet stelden sommige archeologen zich vragen bij de manier waarop menselijk botmateriaal dat archeologisch werd opgegraven of aangetroffen, werd afgestoten nadat er werd geoordeeld dat dit wetenschappelijk niet meer relevant was of er geen ruimte (of middelen) meer waren om dit in depot te bewaren. Dit ethische vraagstuk rond archeologisch onderzoek op menselijk botmateriaal, tijdens en na het veldwerk, dat zijn kern vindt in de archeologische wereld, bleek al snel onlosmakelijk verbonden met andere vraagstukken, binnen en buiten de archeologie. Een team van specialisten verenigde zich binnen het MEMOR-project om antwoorden te vinden op deze vragen. Uiteindelijk werden deze vraagstellingen vertaald in enkele concrete producten en resultaten

Le projet CRUMBEL et l'apport de la recherche l'archéométrique

The CRUMBEL project aims to investigate the mobility of the former population in Belgium from the Neolithic period until the Early Middle Ages. To reach these research goals different topics will be studied. In a preliminary phase, the ancient collections of cremated bone will be documented. A selection of these funerary sites will be studied to understand the mobility using different archaeometric approaches as stable isotopes and radiocarbon dating to obtain reliable information on earlier mobility in Belgium

An integrative skeletal and paleogenomic analysis of stature variation suggests relatively reduced health for early european farmers

Human culture, biology, and health were shaped dramatically by the onset of agriculture ∼12,000 y B.P. This shift is hypothesized to have resulted in increased individual fitness and population growth as evidenced by archaeological and population genomic data alongside a decline in physiological health as inferred from skeletal remains. Here, we consider osteological and ancient DNA data from the same prehistoric individuals to study human stature variation as a proxy for health across a transition to agriculture. Specifically, we compared “predicted” genetic contributions to height from paleogenomic data and “achieved” adult osteological height estimated from long bone measurements for 167 individuals across Europe spanning the Upper Paleolithic to Iron Age (∼38,000 to 2,400 B.P.). We found that individuals from the Neolithic were shorter than expected (given their individual polygenic height scores) by an average of −3.82 cm relative to individuals from the Upper Paleolithic and Mesolithic (P = 0.040) and −2.21 cm shorter relative to post-Neolithic individuals (P = 0.068), with osteological vs. expected stature steadily increasing across the Copper (+1.95 cm relative to the Neolithic), Bronze (+2.70 cm), and Iron (+3.27 cm) Ages. These results were attenuated when we additionally accounted for genome-wide genetic ancestry variation: for example, with Neolithic individuals −2.82 cm shorter than expected on average relative to pre-Neolithic individuals (P = 0.120). We also incorporated observations of paleopathological indicators of nonspecific stress that can persist from childhood to adulthood in skeletal remains into our model. Overall, our work highlights the potential of integrating disparate datasets to explore proxies of health in prehistory.info:eu-repo/semantics/publishedVersio

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Gender-related vitamin D deficiency in a Dutch 19th century farming community

The most common cause of vitamin D deficiency is inadequate dermal exposure to sunlight. Residual rickets is nonadult vitamin D deficiency still evident in an adult individual, whereas osteomalacia occurs in adulthood. Previous research on the Beemster population, a 19th century rural community in the Netherlands, identified rickets in 30.4% of the nonadults between the ages of two and four years (n=7/23). Because the sex of these nonadults was not known it was not possible to determine if there were differences between boys and girls. To overcome this gap in our knowledge, the aim of this paper is to determine if there are gender related differences in vitamin D deficiency in the Beemster skeletal collection, based on adults with residual rickets and osteomalacia. Out of 200 adults (100 females; 100 males) no cases of osteomalacia were detected. However, there were 29 cases of residual rickets (14.5%), with 21 of those cases in females (21.0%; 21/100). A complex interplay of multiple factors is proposed to have affected vitamin D levels in nonadults, including sociocultural variables such as gender-based labour norms. This research highlights the importance of continuing to explore gender-based health differences in past populations