Sex differences in the distribution of entheseal changes: Meta‐analysis of published evidence and its use in Bayesian paleopathological modeling

Abstract

Objectives We studied the sex differences in the distribution of entheseal changes (EC) in an archeological population through a Bayesian approach that allows incorporating existing knowledge while controlling for confounder factors that may affect EC development. Materials and methods We performed a meta‐analysis of published research on sex differences in EC frequencies from archeological populations. Also, EC were assessed for fibrocartilaginous entheses following the “New Coimbra Method” in a Spanish population that dates from the 15th to the 18th century. Data were analyzed with multivariate generalized linear mixed models (MGLMM). Results Meta‐analysis showed a consistent but small effect of males usually manifesting higher EC frequencies. Similarly, our MGLMM analysis showed that bone formation and erosion is unequally distributed in the archeological population we studied, with bone formation more present in male lower limbs and erosion more frequent in male upper limbs. Discussion Bayesian inference makes it possible to assess more complex models than traditional frequentist methods, and can be informed by meta‐analysis to reflect the current state of knowledge on any given topic. MGLMM are an appropriate technique for the study of EC as they can accommodate several response variables in a single model, controlling for well‐known confounders of EC formation to infer sex differences that could be attributed to daily behavior.

Testing the guidelines of the New Coimbra Method for recording entheseal changes via interobserver agreement in a Bronze Age skeletal sample from Kültepe‐Kanesh, Türkiye

“…The first independent IOA test of the New Coimbra Method ‐ although the authors were trained by the developers of the method ‐ was carried out by Jorgensen et al (2020). In some applications of the Coimbra Method, data was collected by a single observer to avoid interobserver bias and maximize the information obtained (Alonso‐Llamazares et al, 2022; Henderson et al, 2017; Michopoulou et al, 2017).…”

“…We stress two points; the insufficiency of the photographs in the publication mentioned above, and the difficulty or unfeasibility of in‐person training for every researcher. Additionally, we noticed that studies that have utilized the New Coimbra Method have mainly used either collections where demographic information is known/recorded or skeletal samples dating to not earlier than the medieval period (Alonso‐Llamazares et al, 2022; Henderson et al, 2016, 2017; Jorgensen et al, 2020; Michopoulou et al, 2017; Palmer & Waters‐Rist, 2019; Wilczak et al, 2017). The method's suitability has not been tested yet on fragmentary or poorly preserved skeletal remains from earlier periods, in which small sample sizes appear to be a problem.…”

Emerging inequality in the San Pedro de Atacama oases (Chile): An investigation of entheseal patterns using ANCOVA and factorial ANOVA

“…Finally, within the context of this special volume, we want to expand upon prior literature that applied multivariate methods in past studies of entheseal changes (e.g., Villotte et al, 2010; Milella et al, 2015; Karakostis et al, 2017; Laffranchi et al, 2020; Kubicka & Myszka, 2020; Alonso‐Llamazares et al, 2022) by highlighting the relevance of the multivariate analytical approach adopted here and encourage others to build on this practice to generate more powerful analyses and interpretations of bioarcheological data. One of the downfalls of simpler statistical designs that are traditionally applied to bioarcheological studies of entheses (e.g., Mann Whitney u tests and Kruskall Wallis tests) is that there is little opportunity to control for the impact of covariates unless samples are subdivided multiple times.…”

“…Finally, within the context of this special volume, we want to expand upon prior literature that applied multivariate methods in past studies of entheseal changes (e.g., Villotte et al, 2010;Milella et al, 2015;Karakostis et al, 2017;Laffranchi et al, 2020;Kubicka & Myszka, 2020;Alonso-Llamazares et al, 2022) by highlighting the relevance of the multivariate analytical approach adopted here and encourage others to build on this practice to generate more powerful analyses and interpretations of bioarcheological data. (Buikstra & Ubelaker, 1994), while ANCOVA used point estimates from Transition Analysis (Boldsen et al, 2002).…”

Sex differences in workload in medieval Poland: Patterns of asymmetry and biomechanical adaptation in the upper limb at Giecz

“…In addition to directional asymmetry, degenerative joint disease (DJD) and entheseal changes (ECs) have been used to infer behavior in past populations as representations of the interrelated processes of bone formation, maintenance, and pathology associated with biomechanical stress (Acosta et al, 2017; Alonso‐Llamazares et al, 2022; Becker, 2020). The manifestation and advancement of DJD are dependent on various factors including age, genetic predisposition, trauma, and behavior (Becker, 2020; Domett et al, 2017; Hunter et al, 2014; Rojas‐Sepúlveda et al, 2008).…”