The IMPACT (Internet-based Mummy Picture Archive and Communication Technology) Radiological Mummy Database Project is designed to provide mummy and medical researchers with a large-scale comparative database of medical imaging of mummified human remains. This departure from a case-study model for mummy studies will drive the field towards a large-scale comparative and epidemiological paradigm. The Canadian team will be investigating the evisceration and excerebration components of the Egyptian mummification tradition, and the US teams will  apply the database to a greatly expanded study of atherosclerosis in ancient Egyptian mummies, as part of the IMPACT Ancient Health Research Group, and to the refinement of a novel system of diagnosis by consensus for mummified remains

Randall Thompson

Humanities Commons

White Paper ReportReport ID: 105480Application Number: HJ-50069-12Project Director: Randall Thompson (rthompson@saint-lukes.org)Institution: Saint Luke's Mid-America Heart InstituteReporting Period: 1/1/2012-6/30/2014Report Due: 9/30/2014Date Submitted: 10/10/2014   1  Grant Number HJ-50069-12 Project Title IMPACT Radiological Mummy Database Division Digital Humanities Program Digging into Data Grant Status Awarded 	                   HJ-50069-12 The IMPACT Mummy Radiologic Database                                      Randall C Thompson, MD                                      Principal Investigator                         White paper           September 30, 2914                2 Project Activities This project involved the creation of a Mummy Radiologic Database, the review of large number of mummy CT scans by collaborators from various expertise, and in-person meeting to facilitate reading by consensus. Many of the findings have been published in the scholarly literature and more publications are planned (see below). The project involved a computerized database which was set up by the Canadian collaborators. Accomplishments 1. Discovery of the extensive presence of atherosclerosis, the disease which causes heart attacks and strokes, in ancient people from numerous ancient cultures. This finding was surprising to many because heart disease is thought to be a condition of modern man and caused by modern risk factors. The finding has led many specialists to re-think the importance of certain cardiovascular risk factors. 2. Large number of publications in the scholarly literature (see below) 3. Remarkable collaboration among specialists from widely disparate disciplines. 4. Development of a reading-by-consensus approach through this multidisciplinary collaboration. 5. Testimony to Congress in the Congressional Record. a. Audiences Based on the response in numerous venues, the scientific / medical community, museum curators, anthropologists, and the general public all found the results of the project to be enlightening. b. Evaluation The investigators view the project as being an overwhelming success. The grant money provided an unusual opportunity for specialists in widely disparate disciplines to collaborate and the scholarly literature contribution afforded by this grant has been remarkable. The general public has shown intense interest and great appreciation of the research work (see below). In terms of weakness, the Canadian collaborators created their own radiologic PACS and viewing system. This took much longer to develop and worked less well than systems which are now currently available commercially. An    3 approach using a commercial host server plus commercially available DICOM reading software (OsiriX) would work better, assuming security and licensing agreement concerns can be effectively solved. The team did use contemporary commercial internet communications tools (Go-to-meeting, Dropbox) with great success, however..  c. Continuation of the Project The team plans to issue a final report of the cardiovascular system review in several months. Other investigators have asked to conduct research using the IMPACT radiologic system which is indeed a very rich database. The collaboration and partnership between the participating specialists from multiple disciplines were greatly strengthened by the project and will be continued. d. Long Term Impact The primary discovery, that atherosclerosis was present and not hard to find in ancient people, has caused many to reconsider the relative importance of cardiovascular risk factors and to consider alternative risk factors. Thus, the project has implications regarding the understanding of health and disease in ancient cultures and modern cardiovascular investigations. The research team was awarded a pilot grant this year and is applying for larger grant investment to pursue the next logical steps in this line of research. e. Grant Products Please see below for the list of publications.. Appendices  	  	  Narrative.	  NEH	  Grant  HJ-50069-12	  	  The	  IMPACT	  Study	  was	  funded	  by	  a	  grant	  from	  the	  NEH	  beginning	  in	  2011	  as	  part	  of	  the	  Digging	  Into	  Data	  Challenge	  and	  in	  collaboration	  with	  Canadian	  collaborators.	  The	  project	  involved	  the	  accumulation	  and	  archiving	  of	  CT	  scans	  and	  x-­‐rays	  of	  mummies.	  The	  US	  team	  (funded	  by	  the	  NEH)	  reviewed	  the	  images	  primarily	  focusing	  on	  signs	  of	  cardiovascular	  disease.	  After	  some	  initial	  delays	  related	  to	  the	  Canadian	  team	  solving	     4 hardware	  and	  security	  issues	  for	  the	  computer	  image	  archiving,	  the	  research	  has	  progressed	  successfully.	  The	  US	  side	  of	  the	  research	  has	  generated	  over	  20	  published	  manuscripts	  and	  abstracts	  to	  date	  and	  the	  NEH	  was	  acknowledged	  as	  the	  funding	  source	  for	  these	  scholarly	  publications.	  The	  public	  interest	  in	  the	  research	  has	  been	  intense,	  especially	  after	  the	  March	  2013	  presentation	  at	  the	  American	  College	  of	  Cardiology	  Scientific	  Sessions	  with	  simultaneous	  publication	  in	  The	  Lancet.	  At	  that	  time	  the	  work	  was	  featured	  in	  most	  of	  the	  newspapers	  of	  the	  world	  and	  covered	  by	  almost	  all	  of	  the	  major	  television	  and	  radio	  news	  outlets.	  There	  was	  also	  considerable	  media	  coverage	  in	  August	  of	  2014	  after	  additional	  features	  of	  the	  work	  were	  featured	  in	  a	  special	  edition	  of	  Global	  Heart.	  Another	  abstract	  has	  been	  accepted	  for	  presentation	  in	  March	  2015.	  That	  presentation	  and	  the	  subsequent	  manuscript	  submission	  will	  detail	  the	  cumulative	  results	  of	  all	  of	  the	  mummies	  in	  the	  study.	  Also,	  this	  NEH	  grant	  funded	  a	  “Reading	  by	  Consensus”	  meeting,	  held	  in	  Phoenix	  in	  December	  2013.	  The	  results	  of	  that	  meeting	  and	  the	  IMPACT	  Study	  collaboration	  will	  be	  detailed	  in	  6	  articles	  in	  a	  special	  edition	  planned	  for	  the	  International	  Journal	  of	  Paleopathology.	  Manuscripts	  for	  this	  special	  edition	  are	  currently	  in	  preparation.	  The	  NEH	  grant	  facilitated	  the	  collaboration	  across	  disparate	  scholarly	  disciplines	  in	  a	  way	  which	  is	  uncommon,	  but	  which	  is	  necessary	  for	  this	  sort	  of	  innovative	  work.	  Cardiologist,	  radiologists,	  anthropologists,	  palepathologists,	  aging	  biologists,	  preservationists,	  Egyptologists	  and	  archeologists	  all	  participated	  in	  the	  collaboration.	  The	  study	  was	  submitted	  as	  testimony	  to	  Congress	  and	  published	  in	  the	  Congressional	  Record	  as	  evidence	  of	  the	  large	  and	  sometimes	  unexpected	  benefits	  from	  such	  public	  Grant	  funding.	  	  	  	  	  IMPACT	  STUDY	  PUBLICATIONS	  FROM	  NEH	  Grant	  	  Original	  Research:	  1. Fritsch	  KO,	  Hamoud	  H,	  Allam	  AH,	  Grossmann	  A,	  Nur	  el-­‐Din	  AH,	  Abd	  el-­‐Maksoud	  G,	  Al-­‐Tohamy	  Soliman	  M,	  Badr	  I,	  Sutherland	  JD,	  Sutherland	  ML,	  Akl	  M,	  Finch	  CE,	  Thomas	  GS,	  Wann	  LS,	  Thompson	  RC.	  The	  Orthopedic	  Diseases	  of	  Ancient	  Egypt:	  Findings	  on	  CT	  Scans	  of	  52	  Mummies.	  Anatomic	  Record	  2014,	  in	  press.	  2. Wann	  LS,	  Thomas	  GS.	  What	  Can	  Ancient	  Mummies	  Tell	  Us	  About	  Atherosclerosis?	  Trends	  in	  Cardiovascular	  Medicine.	  In	  press.	  3. Thomas	  GS,	  Wann	  LW,	  Narula	  J.	  What	  we	  can	  learn	  about	  atherosclerosis	  from	  the	  study	  of	  ancient	  people	  and	  mummies.	  Global	  Heart,	  2014;9(2);185-­‐186.	     5 4. Sutherland	  ML,	  Cox	  SL,	  Lombardi	  GP,	  Watson	  L,	  Vallodolid	  CM,	  Finch	  CE,	  Zink	  A,	  Frohlich	  B,	  Kaplan	  HS,	  Michalik	  DE,	  Miyamoto	  MI,	  Allam	  AH,	  Thompson	  RC,	  Wann	  LS,	  Narula	  J,	  Thomas,	  GS	  Sutherland	  JD.	  Funerary	  Artifacts,	  Social	  Status,	  and	  Atherosclerosis	  in	  Ancient	  Peruvian	  Mummy	  Bundles.	  Global	  Heart	  2014:9(2),	  219-­‐228.	  5. Miyamoto	  MI,	  Djabali	  K,	  Gordon	  LB.	  Atherosclerosis	  in	  Ancient	  Humans,	  Accelerated	  Aging	  Syndromes	  and	  Normal	  Aging:	  Is	  Lamin	  A	  Protein	  a	  Common	  Link?	  Global	  Heart	  2014;9(2):211-­‐218.	  6. Thomas	  GS,	  Wann	  LS,	  Allam	  AH,	  Thompson	  RC,	  Michalik	  DE,	  Sutherland	  ML,	  Sutherland	  JD,	  Lombardi,	  GP,	  Watson	  L,	  Cox	  SL,	  Valladolid	  CM,	  Abd	  el-­‐Maksou	  G,	  Soliman	  MAT,	  Badr	  I,	  Nur	  el-­‐din	  AH,	  Clarke	  EM,	  Thomas	  IG,	  Miyamoto	  MI,	  Kaplan	  HS,	  Frohlich	  B,	  Narula	  J,	  Stewart	  AFR,	  Zink	  AR,	  Finch	  CE.	  Why	  did	  ancient	  people	  have	  atherosclerosis?	  From	  autopsies	  to	  computed	  tomography	  to	  potential	  causes.	  	  Global	  Heart	  2014;9(2):229-­‐237	  7. Zink	  A,	  Wann	  LS,	  Thompson	  RC,	  Allam	  AH,	  Finch	  CE,	  Frohlich	  B,	  Kaplan	  HS,	  Lombardi	  GP,	  Sutherland	  LM,	  Sutherland	  JD,	  Watson	  L,	  Cox	  SL,	  Miyamoto	  MI,	  Stewart	  AFR,	  Krause	  J,	  Narula	  J,	  MD,	  Thomas	  GS.	  Genomic	  Correlates	  of	  Atherosclerosis	  in	  Ancient	  Humans.	  Global	  Heart	  9	  (2),	  203-­‐209.	  8. Wann	  LS,	  Thompson	  RC,	  Allam	  AH,	  Finch	  CE,	  Zink	  A,	  Frohlich	  B,	  Kaplan	  HS,	  Lombardi	  GP,	  Sutherland	  ML,	  Sutherland	  JD,	  Watson	  L,	  Cox	  SL,	  Miyamoto	  MI,	  Stewart	  AFR,	  Krause	  J,	  Raffel	  T,	  Narula	  J,	  Thomas	  GS	  for	  the	  Horus	  Study	  Group.	  Atherosclerosis	  -­‐	  a	  Longue	  Durée	  Approach.	  Global	  Heart	  9	  (2),	  239-­‐244.	  9. Thompson	  RC,	  Allam	  AH,	  Zink	  A,	  Wann	  LS,	  Lombardi	  GP,	  Cox	  SL,	  Frohlich	  B,	   Sutherland	   ML,	   Sutherland	   JD,	   Frohlich	   TC,	   King	   SL,	   Miyamoto	   MI,	  Monge	  JM,	  Vallodolid	  CM,	  Nur	  el-­‐din	  AH,	  Narula	  J,	  Finch	  CE,	  Thomas	  GS.	  CT	   Evidence	   of	   Atherosclerosis	   in	   the	   Mummified	   Remains	   of	   Humans	  from	  Around	  the	  World.	  Global	  Heart.	  2014:9(2):187-­‐196.	  10. Allam	  AH,	  Mandour	  Ali	  MA,	  Wann	  LS,	  Thompson	  RC,	  Sutherland	  ML,	  Sutherland	  JD,	  Frohlich	  B,	  Michalik	  DE,	  Zink	  A,	  Lombardi	  GP,	  Watson	  L,	  Cox	  SL,	  Narula	  J,	  Miyamoto	  MI,	  Sallam	  SL,	  Finch	  CE,	  Thomas	  GS.	  Atherosclerosis	  in	  Ancient	  and	  Modern	  Egyptians:	  The	  Horus	  Study,	  Global	  Heart.	  2014;9(2):197-­‐202.	  11. Clarke	  EM,	  Thompson	  RC,	  Allam	  AH,	  Wann	  LS,	  Lombardi,	  GP,	  Sutherland	  ML,	  Sutherland	  JD,	  Cox	  SL,	  Soliman	  MAT,	  Abd	  el-­‐Maksou	  G,	  Badr	  I,	  Miyamoto	  MI,	  Frohlich	  B,	  Nur	  el-­‐din	  AH,	  Stewart	  AFR,	  Narula	  J,	  Zink	  AR,	  Finch	  CE,	  Michalik	  DE,	  Thomas	  GS.	  Is	  atherosclerosis	  fundamental	  to	  human	  aging?	  Lessons	  from	  ancient	  mummies.	  J	  Cardiol	  2014;63(5):329-­‐3.	  	  12. Thompson	  RC,	  Allam	  AH,	  Lombardi	  GP,	  Wann	  LS,	  Sutherland	  ML,	  Sutherland	  JD,	  Soliman	  MAT,	  Frohlich	  B,	  Mininberg	  DT,	  Monge	  JM,	  Vallodolid	  CM,	  Cox	  SL,	  Abd	  el-­‐Maksoud	  G,	  Badr	  I,	  Miyamoto	  MI,	  Nur	  el-­‐din	  AE,	  Narula	  J,	  Finch	  CE,	  Thomas	  GS.	  Atherosclerosis	  across	  4000	  years	  of	  human	  history:	  the	  Horus	  study	  of	  four	  ancient	  populations.	  Lancet.	  2013;381;1211-­‐22.	     6 13. Abdelfattah	  A,	  Allam	  AH,	  Wann	  S,	  Thompson	  A,	  Adelmaksoub	  G,	  Badr	  I,	  Amer	  HA,	  Nurledin	  H,	  Finch	  C,	  Miyamoto	  MI,	  Sutherland	  ML,	  Sutherland	  JD,	  Thomas	  GS.	  Atherosclerotic	  cardiovascular	  disease	  in	  Egyptian	  women:	  1570	  BCE–2011	  CE.	  Int	  J	  Cardiol	  2013;167(2):	  570–574.	  	  Abstracts:	  1. Thompson	  RC,	  Allam	  AH,	  Lombardi	  GP,	  Wann	  LS,	  Sutherland,	  Sutherland	  JD,	  	  Zink	  A,	  	  Al-­‐Tohamy	  Soliman	  M,	  Frohlich	  B,	  Monge	  JM,	  Vallodolid	  CM,	  Cox	  S,	  Abd	  el-­‐Maksoud	  G,	  Badr	  I,	  Miyamoto	  MI,	  Nu	  red-­‐din	  A,	  Watson	  L,	  Michalik	  DE	  ,	  King	  SI,	  NarulaJ,	  Finch	  C,	  Thomas	  GS.	  CT	  Evidence	  of	  Atherosclerosis	  in	  Ancient	  Mummies:	  The	  Horus	  Study	  of	  220	  Mummies	  from	  5	  Continents.	  Accepted,	  Scientific	  Sessions	  of	  The	  American	  Association	  of	  Physical	  Anthropology.	  St.	  Louis,	  March	  2015	  2. Allam	  A,	  Thompson	  RC,	  Wann	  LS,	  Sutherland	  ML,	  Sutherland	  J,	  Frohlich	  B,	  Miyamoto	  M,	  Sallam	  SL,	  Mandour	  Ali	  MA,	  Finch	  C,	  Thomas	  GS.	  Atherosclerosis	  In	  Ancient	  And	  Modern	  Egyptians:	  The	  HORUS	  Study.	  Accepted	  for	  presentation,	  ACC	  2014.	  Published	  in	  J	  Am	  Coll	  Cardiol	  2014.	  3. Thompson	  RC,	  Lombardi	  GP,	  Abd	  el-­‐	  Maksoud	  G,	  Cox	  SL,	  Badr	  I,	  Thomas	  IG,	  Finch	  CE,	  Thomas	  GS.	  CT	  Imaging	  of	  Ancient	  Mummies	  Shows	  that	  Atherosclerosis	  Predates	  Modern	  Cultures.	  The	  Gerontologist	  2013:53(S1):400.	  4. Thompson	  RC,	  Allam	  AH,	  Lombardi	  GP,	  Wann	  LS,	  Sutherland	  ML,	  Sutherland	  JD,	  Soliman	  MAT,	  Frohlich	  B,	  Mininberg	  DT,	  Monge	  JM,	  Vallodolid	  CM,	  Cox	  SL,	  Abd	  el-­‐Maksoud	  G,	  Badr	  I,	  Miyamoto	  MI,	  Nur	  el-­‐din	  AE,	  Narula	  J,	  E	  CE,	  Thomas	  GS.	  Atherosclerosis	  across	  3800	  years	  of	  Human	  History:	  The	  HORUS	  Study	  of	  4	  Ancient	  Populations.	  ACC	  2013	  Late	  Breaking	  Featured	  Research	  presentation.	  5. Thomas	  GS.	  The	  HORUS	  Study	  –	  The	  hunt	  for	  atherosclerosis.	  Presented	  at	  the	  7th	  	  World	  Congress	  on	  Mummy	  Studies,	  June	  11-­‐15,	  2011,	  San	  Diego	  CA	  6. Allam	  AH,	  Wann	  LS,	  Thompson	  RC,	  Nureldin	  A,	  Gomaa	  A,	  Badr	  I,	  Soliman	  MAT,	  Hany	  HAR,	  Sutherland	  ML,	  Thomas	  GS.	  Atherosclerosis	  was	  common	  in	  ancient	  humans:	  Results	  of	  the	  Horus	  study	  of	  ancient	  Egyptian	  mummies.	  Eur	  Heart	  J	  2011:13	  (Supplement	  A):	  A49.	  7. Thompson	  RC,	  Allam	  AH,	  Wann	  LS,	  Nureldin	  AH,	  Adelmaksoub	  G,	  I.	  Badr	  I,	  Sutherland	  ML,	  Sutherland	  JD,	  Miyamoto	  MI,	  Thomas	  GS.	  The	  search	  for	  heart	  disease	  in	  ancient	  Egyptians:	  CT	  scan	  results	  in	  52	  mummies.	  Eur	  Heart	  J	  2011:13	  (Supplement	  A):	  A6.	  8. Thomas	  GS,	  Allam	  AH,	  Thompson	  RC,	  Nureldin	  A,	  Abdel-­‐maksoud	  G,	  Badr	  I,	  Soliman	  MAT,	  Amer	  HAR,	  Sutherland	  ML,	  Sutherland	  JD,	  Miyamoto	  MI,	  Wann	  LS.	  Atherosclerosis	  is	  common	  In	  ancient	  humans:	  Results	  of	  the	  Horus	  study	  of	  ancient	  Egyptian	  mummies.	  	  J	  Am	  Coll	  Cardiol	  2011;57(15):E1416.	     7 9. Wann	  LS,	  Thompson	  RC,	  Allam	  AH,	  Miyamoto	  MI,	  Badr	  I,	  Abdel-­‐maksoud	  G,	  Nureldin	  A,	  Thomas	  JJ,	  Thomas	  GS.	  	  Atherosclerosis:	  Not	  just	  a	  disease	  of	  contemporary	  humans.	  Circulation	  2009;120:S354.	  10. Thompson	  RC,	  Allam	  A,	  Wann	  LS,	  Miyamoto	  MI,	  Abdelmaksoud	  G,	  Badr	  I,	  Clarke	  KA,	  Amer	  HAR,	  Nureldin	  A,	  Hawas	  Z,	  Thomas	  GS.	  The	  Use	  of	  CT	  Scanning	  to	  Explore	  the	  Presence	  and	  Extent	  of	  Atherosclerosis	  in	  Ancient	  Egyptians:	  The	  HORUS	  Study.	  Journal	  of	  Cardiovascular	  Computed	  Tomography,	  Vol	  3,	  No	  4S:S28	  July/Aug	  2009.	   Letters to the Editor: 11. Thompson RC, Allam AH, Wann LS, Finch CE, Thomas GS. Atherosclerosis in ancient populations -- Authors reply. Lancet 2013:382. No. 9887 pp 123-124.   Selected news coverage of 2013 Lancet article and others  1. New York Times, “CT Scans Find Vascular Disease in Ancient Mummies” by Nicholas Bakalar, March 10, 2013. 2. Wall Street Journal, “Telltale Finding on Heart Disease” by Ron Winslow. Wall Street Journal, March 10, 2013.  3. Pringle, H. “Long Live the Humans.” Scientific American. Oct 2013, pp. 48-55.  4. Coverage worldwide including NPR, BBC, Times of London, CBS, NBC, ABC, CNN, Nature, National Geographic, USA Today, Washington Post, LA Times, The Atlantic, New Scientist, Huffington Post.    

IMPACT Radiological Mummy Database

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IMPACT Radiological Mummy Database

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