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      Disability and Care in Late Medieval Lund, Sweden: An Analysis of Trauma and Intersecting Identities, Aided by Photogrammetric Digitization and Visualization

      1 , 1 , 1 , 2 , 1
      Open Archaeology
      Walter de Gruyter GmbH

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          Abstract

          This article is a Bioarchaeology of Care and Disability focused analysis of an individual who suffered a severe fracture of the left knee in Late Medieval Lund, Scania (1300–1536 CE). We question the degree to which written sources from the period represent the reality of the disability experience, and to that end how identities intersect in the Medieval urban landscape. Following an index of care model methodology, we provide an interpretation of the pathological evidence within the archaeological and historical context of Medieval Lund. In this case, the individual received both short and long-term care, which included treatment of pain and inflammation, assistance with hygiene and nutrition, and the management of disability as a result of physical impairment for the remainder of the individual’s life. Their treatment in death with a prominent burial position close to the church, a symbol of upper social status during the Medieval period, demonstrates that the identity of disability in the past is a much more complex process than can be gleaned from the written sources. Our analysis also employed 3D online visualization and annotation solutions to aid in the analysis and dissemination of our results, making data more accessible to readers and researchers alike.

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          A newly developed visual method of sexing the os pubis.

          T Phenice (1969)
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            Pathological mechanisms and therapeutic outlooks for arthrofibrosis

            Arthrofibrosis is a fibrotic joint disorder that begins with an inflammatory reaction to insults such as injury, surgery and infection. Excessive extracellular matrix and adhesions contract pouches, bursae and tendons, cause pain and prevent a normal range of joint motion, with devastating consequences for patient quality of life. Arthrofibrosis affects people of all ages, with published rates varying. The risk factors and best management strategies are largely unknown due to a poor understanding of the pathology and lack of diagnostic biomarkers. However, current research into the pathogenesis of fibrosis in organs now informs the understanding of arthrofibrosis. The process begins when stress signals stimulate immune cells. The resulting cascade of cytokines and mediators drives fibroblasts to differentiate into myofibroblasts, which secrete fibrillar collagens and transforming growth factor-β (TGF-β). Positive feedback networks then dysregulate processes that normally terminate healing processes. We propose two subtypes of arthrofibrosis occur: active arthrofibrosis and residual arthrofibrosis. In the latter the fibrogenic processes have resolved but the joint remains stiff. The best therapeutic approach for each subtype may differ significantly. Treatment typically involves surgery, however, a pharmacological approach to correct dysregulated cell signalling could be more effective. Recent research shows that myofibroblasts are capable of reversing differentiation, and understanding the mechanisms of pathogenesis and resolution will be essential for the development of cell-based treatments. Therapies with significant promise are currently available, with more in development, including those that inhibit TGF-β signalling and epigenetic modifications. This review focuses on pathogenesis of sterile arthrofibrosis and therapeutic treatments.
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              Survival against the odds: Modeling the social implications of care provision to seriously disabled individuals

                Author and article information

                Journal
                Open Archaeology
                Walter de Gruyter GmbH
                2300-6560
                April 10 2025
                April 10 2025
                January 01 2025
                April 10 2025
                April 10 2025
                January 01 2025
                : 11
                : 1
                Affiliations
                [1 ]Department of Archaeology and Ancient History, Lund University, LUX , Helgonavägen 3, 22100 , Lund , Sweden
                [2 ]Digital Heritage Innovation Lab (DHiLab), National Research Council – Institute of Heritage Science (CNR-ISPC), Area della Ricerca di Roma 1 , 00015 , Monterotondo , Italy
                Article
                10.1515/opar-2025-0043
                c2f51053-6ddf-4847-b3ce-d9703cb55f7f
                © 2025

                http://creativecommons.org/licenses/by/4.0

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