Anne R Titelbaum

Interests

Teaching

Human anatomy, human osteology, paleopathology, bioarchaeology.

Research

Human skeletal anatomy, paleopathology, bioarchaeology. Specific research interests include pathology in ancient skeletal remains, developmental anomalies, trauma, musculoskeletal stress, prehistoric medical techniques, and mortuary practices.

Courses

No activities entered.

Scholarly Contributions

Books

• Titelbaum, A. R. (1999). The Rock River Sites: Late Woodland Occupation along the Middle Rock River in Northern Illinois. Transportation Archaeological Research Reports 4.. Urbana, IL: Illinois Transportation Archaeological Research Program, University of Illinois.
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  Abstract: This large-scale survey project was a unique opportunity to glean extensive data regarding the archaeological record of north-central Illinois. Although 46 sites were originally identified, an initial survey noted that three sites had undergone irreversible impact, and 12 were not recommended for further work, leaving 31 sites for further archaeological investigation. This report concerns the results of investigations at 12 prehistoric Rock River sites. Each of these sites is located on the floodplain and terrace system overlooking the Rock River within the vicinity of the confluence with the Kishwaukee tributary. Twelve sites were subjected to Phase III mitigation, and 127 prehistoric features were discovered on seven of these sites. The recovered materials include collared ceramics, triangular points, maize, and elk remains. Three main cultural components are represented in the assemblage: Late Archaic, Late Woodland, and Upper Mississippian.

Chapters

• Titelbaum, A. R., Burnett, S. E., & Case, D. T. (2023). Developmental conditions in paleopathology. In The Routledge Handbook of Paleopathology(pp 250-270). New York: Routledge. doi:10.4324/9781003130994-16
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  Abstract:Variations in skeletal morphology arise from factors that affect growth and development, such as mutations, chromosomal abnormalities, teratogens, or multifactorial etiologies. Although some skeletal variations may compromise an individual’s longevity, the majority do not. And while some variations are outwardly obvious in a living person, most are discovered by accident, if at all. Paleopathologists benefit from the ability to observe a skeleton in its entirety, and as a result, variations of skeletal development are frequently encountered, ranging from common and minor, to rare and, at least occasionally, incompatible with life. This chapter briefly addresses the etiology of developmental conditions and methodological considerations pertaining to their analysis. A synopsis of the past 20 years of paleopathological research concerning anomalies is then presented, followed by a discussion that considers the observed differences in clinical versus archaeological frequencies.While there is still room for case studies that describe atypical skeletal morphology, research concerning developmental anomalies has increasingly moved toward population-based investigations that consider relationships within and between populations, revealing population histories and migration patterns, and identifying familial linkages within cemeteries. Other studies have identified individual behavior and adaptation to long-term conditions, and have interpreted cultural behavior toward individuals with developmental differences. It is only through population-based investigations, however, that trait frequencies will be revealed, permitting population comparisons, and a better understanding of the reasons that clinical and archaeological frequencies differ. As such, research concerning developmental anomalies represents a growth area in paleopathology, particularly for population-based research.
• Titelbaum, A. R., & Verano, J. W. (2017). Bioarchaeology of the Huaca Prieta human remains. In Where the Land Meets the Sea: Fourteen Millennia of Human History at Huaca Prieta, Peru. University of Texas Press.
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  Huaca Prieta—one the world's best-known, yet least understood, early maritime mound sites—and other Preceramic sites on the north coast of Peru bear witness to the beginnings of civilization in the Americas. Across more than fourteen millennia of human occupation, the coalescence of maritime, agricultural, and pastoral economies in the north coast settlements set in motion long-term biological and cultural transformations that led to increased social complexity and food production, and later the emergence of preindustrial states and urbanism. These developments make Huaca Prieta a site of global importance in world archaeology.This landmark volume presents the findings of a major archaeological investigation carried out at Huaca Prieta, the nearby mound Paredones, and several Preceramic domestic sites in the lower Chicama Valley between 2006 and 2013 by an interdisciplinary team of more than fifty international specialists. The book's contributors report on and analyze the extensive material records from the sites, including data on the architecture and spatial patterns; floral, faunal, and lithic remains; textiles; basketry; and more. Using this rich data, they build new models of the social, economic, and ontological practices of these early peoples, who appear to have favored cooperation and living in harmony with the environment over the accumulation of power and the development of ruling elites. This discovery adds a crucial new dimension to our understanding of emergent social complexity, cosmology, and religion in the Neolithic period.Editorial ReviewsReview"This will be a landmark volume in the analysis and interpretation of early human occupation and exploitation of Peru’s resource-rich maritime, littoral, and near-coastal environments. The contributors are experienced investigators, and many are well-recognized specialists in their respective fields, which includes a broad spectrum of archaeological and allied disciplines. This empirically rich research will have a long-term impact on our understanding of regional historical processes in Preceramic coastal Peru, the appearance and use-history of agricultural domesticates, and the role of environmental variability and resource stratification in processes of human demographic expansion and patterning. The data presentations and interpretations dramatically expand our knowledge base concerning the origins, patterning, and complexity of early human adaptations to changing environmental regimes in coastal Peru." (Alan L. Kolata, University of Chicago, author of many books, including Ancient Inca: Case Studies in Early Societies, The Tiwanaku: Portrait of an Andean Civilization, and Valley of the Spirits: A Journey into the Lost Realm of the Aymara)"This is really two archaeology books in one―an edited volume conveying an important new interpretation of the dawn of civilization in the Andes, and a highly valuable excavation and multidisciplinary analytical report on one of the region’s most important sites. It will be an essential source for all Andean scholars and a companion to classic works such as Junius Bird’s Huaca Prieta volumes." (Paul Goldstein, University of California, San Diego, author of Andean Diaspora: The Tiwanaku Colonies and the Origins of South American Empire)
• Kushner, D., & Titelbaum, A. R. (2016). Trepanation from the Perspective of Modern Neurosurgery. In Holes in the Head: the art and archaeology of trepanation in ancient Peru(pp 253-266). Washington D.C.: Dumbarton Oaks.
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  Trepanation is the oldest surgical procedure known from antiquity, extending back more than five thousand years in Europe and to at least the fifth century BC in the New World. Anthropologists and medical historians have been investigating ancient trepanation since the mid-nineteenth century, but questions remain about its origins, evolution, and the possible motivations for conducting such a dangerous surgical procedure. Peru is particularly important to these questions, as it boasts more trepanned skulls than the rest of the world combined. This volume presents the results of a long-term research project that examined more than 800 trepanned skulls from recent archaeological excavations and from museum collections in Peru, the United States, and Europe. It examines trepanation in ancient Peru from a broad anthropological and historic perspective, focusing on the archaeological context of osteological collections and highlighting the history of discoveries. It explores the origins and spread of the practice throughout the Central Andes, with a focus on trepanation techniques, success rates, and motivations for trepanning. It examines the apparent disappearance of trepanation in the Andes following Spanish conquest, while noting that there are reports of trepanations being performed by healers in highland Peru and Bolivia into the twentieth century.
• Verano, J. W., Titelbaum, A. R., Ibarra, B., & Lund, M. (2016). The Northern Highlands. In Holes in the Head: the art and archaeology of trepanation in ancient Peru(pp 141-174). Washington D.C.: Dumbarton Oaks.
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  Trepanation is the oldest surgical procedure known from antiquity, extending back more than five thousand years in Europe and to at least the fifth century BC in the New World. Anthropologists and medical historians have been investigating ancient trepanation since the mid-nineteenth century, but questions remain about its origins, evolution, and the possible motivations for conducting such a dangerous surgical procedure. Peru is particularly important to these questions, as it boasts more trepanned skulls than the rest of the world combined. This volume presents the results of a long-term research project that examined more than 800 trepanned skulls from recent archaeological excavations and from museum collections in Peru, the United States, and Europe. It examines trepanation in ancient Peru from a broad anthropological and historic perspective, focusing on the archaeological context of osteological collections and highlighting the history of discoveries. It explores the origins and spread of the practice throughout the Central Andes, with a focus on trepanation techniques, success rates, and motivations for trepanning. It examines the apparent disappearance of trepanation in the Andes following Spanish conquest, while noting that there are reports of trepanations being performed by healers in highland Peru and Bolivia into the twentieth century.
• Emerson, T. E., & Titelbaum, A. R. (2000). The Des Plaines phase and the Late Woodland stage of northern Illinois. In Late Woodland Societies: tradition and transformation across the midcontinent(pp 413-428). Lincoln, NE: University of Nebraska Press.
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  Book Abstract: Archaeologists across the Midwest have pooled their data and perspectives to produce this indispensable volume on the Native cultures of the Late Woodland period (approximately A.D. 300–1000). Sandwiched between the well-known Hopewellian and Mississippian eras of monumental mound construction, the Late Woodland period has received insufficient attention from archaeologists, who have frequently characterized it as consisting of relatively drab artifact assemblages. The close connections between this period and subsequent Mississippian and Fort Ancient societies, however, make it especially valuable for cross-cultural researchers. Understanding the cultural processes at work during the Late Woodland period will yield important clues about the long-term forces that stimulate and enhance social inequality. Late Woodland Societies is notable for its comprehensive geographic coverage; exhaustive presentation and discussion of sites, artifacts, and prehistoric cultural practices; and critical summaries of interpretive perspectives and trends in scholarship. The vast amount of information and theory brought together, examined, and synthesized by the contributors produces a detailed, coherent, and systematic picture of Late Woodland lifestyles across the Midwest. The Late Woodland can now be seen as a dynamic time in its own right and instrumental to the emergence of complex late prehistoric cultures across the Midwest and Southeast.
• Emerson, T. E., & Titelbaum, A. R. (1999). Excavations at the Keeshin Farm site. In The Keeshin Farm site and the Rock River Langford tradition. Transportation Archaeological Research Reports 7.(pp 47-56). Urbana, IL: Illinois Transportation Archaeological Research Program, University of Illinois.
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  Book Abstract: This study of the Upper Mississippian Keeshin Farm site is the second of two investigations at late prehistoric sites endangered by proposed expansion of the Greater Rockford Airport in Winnebago County (see Research Report #4, The Rock River Sites: Late Woodland Occupation Along the Middle Rock River in Northern Illinois). Excavations at Keeshin Farm in the middle Rock River valley uncovered multiple prehistoric pit features containing ceramic and lithic artifacts and botanical and zoological remains. The site’s inhabitants appear to have been dedicated corn agriculturalists who also exploited riverine fauna and elk. This is one of the few modern excavation/analysis projects at a Langford habitation site and the only such scientific excavation to occur outside northeastern Illinois. The project results suggest that Langford society was more sedentary and more complex than previously thought.While the Langford occupation of the middle Rock River emphasized floodplain habitats, the focus was on rich habitats [like] the Kiswaukee-Rock River confluence. The settlement-subsistence is characterized by “long-term villages [and] smaller secondary sites,” with maize cultivation becoming an important staple as tribal social-political relationships became more complex.
• Titelbaum, A. R. (1999). Introduction to the Keeshin Farm site. In The Keeshin Farm site and the Rock River Langford tradition. Transportation Archaeological Research Reports 7.(pp 1-24). Urbana, IL: Illinois Transportation Archaeological Research Program, University of Illinois.
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  Book Abstract: This study of the Upper Mississippian Keeshin Farm site is the second of two investigations at late prehistoric sites endangered by proposed expansion of the Greater Rockford Airport in Winnebago County (see Research Report #4, The Rock River Sites: Late Woodland Occupation Along the Middle Rock River in Northern Illinois). Excavations at Keeshin Farm in the middle Rock River valley uncovered multiple prehistoric pit features containing ceramic and lithic artifacts and botanical and zoological remains. The site’s inhabitants appear to have been dedicated corn agriculturalists who also exploited riverine fauna and elk. This is one of the few modern excavation/analysis projects at a Langford habitation site and the only such scientific excavation to occur outside northeastern Illinois. The project results suggest that Langford society was more sedentary and more complex than previously thought.While the Langford occupation of the middle Rock River emphasized floodplain habitats, the focus was on rich habitats [like] the Kiswaukee-Rock River confluence. The settlement-subsistence is characterized by “long-term villages [and] smaller secondary sites,” with maize cultivation becoming an important staple as tribal social-political relationships became more complex.

Journals/Publications

• Nesbitt, J., Weber, S., Washburn, E., Ibarra Asencios, B., Titelbaum, A. R., Schroll, A., & Fehren-Schmitz, L. (2023). Diet during the late Initial Period (1100-800 BC) in the Chavín heartland: New data from Canchas Uckro (north-central Peru). Journal of Ethnobiology. doi:10.1177/02780771231176477
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  Abstract: During the late Initial Period (c. 1100-800 BC), the Conchucos region of highland Peru witnessed the formation of the ceremonial and “proto-urban” center of Chavín de Huántar (c. 1000-500/400 BC). An important question regarding Chavín de Huántar centers on the nature of its subsistence economy during the time when it was first founded. In this paper, we present new results from zooarchaeological, starch granule, and stable isotope (δ13C and δ15N) analyses to reconstruct diet from Canchas Uckro, a settlement located in Chavín de Huántar's heartland region. Founded c. 1100 BC and abandoned just after 800 BC, Canchas Uckro provides insight into socioeconomic processes during the early phases of Chavín de Huántar. Extant faunal remains suggest deer comprised an important component of the diet, while camelids constitute a minor proportion of the assemblage. Starch granules recovered from the pottery indicate that domesticated cultigens (maize, potato, and manioc) were obtained from different highland production zones. δ13C and δ15N analysis of a sample of human skeletal remains, coupled with Stable Isotope Analysis in R (SIAR) mixing models, demonstrate that C3 plants constitute most of the diet, while maize was not intensively consumed. δ13C and δ15N further indicate that deer made up 25-50% of the diet. The results of this study add to a growing corpus of data on subsistence practices in the north-central and northern highlands of Peru prior to the widespread adoption of domesticated camelids.
• Washburn, E., Ibarra Asencios, B., Titelbaum, A. R., Fehren-Schmitz, L., Nesbitt, J., & Oelize, V. M. (2022). A multi-isotope approach to the study of residential mobility and diet in the Late Intermediate Period in highland Ancash, Peru. Journal of Archaeological Science: Reports, 41, 103291. doi:10.1016/j.jasrep.2021.103291
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  Abstract: The Late Intermediate Period (LIP, c. 1000–1450 CE) was a time of cultural change in the Peruvian highlands. During this time, interpersonal violence increased, and settlements were placed in defensive locations at high elevations. High altitude settlement was also a proxy for agropastoral economies. Coinciding with these cultural and economic transformations were shifts in mortuary practices in which the deceased were buried in above-ground tombs, known as chullpas, and in caves. In this paper, we examine the implications of these changes with respect to diet and mobility through a multi-isotopic analysis of human burials from three LIP sites in the Conchucos region. We analyzed strontium (87Sr/86Sr), and carbon and nitrogen (δ13C and δ15N) isotopes in human skeletal remains (n = 101) from burials at the sites of Marcajirca (n = 66), Jato Viejo (n = 9), and Ushcugaga (n = 26). At all three sites, dietary mixing models using δ13C and δ15N values suggest a diet based largely on maize and camelids, with minor consumption of C3 plants and guinea pig. Human enamel 87Sr/86Sr values ranged from 0.7095 to 0.7125 and varied significantly between sites. All human 87Sr/86Sr values resembled those found in the regional geology, suggesting that individuals buried at the three sites were probably from the Conchucos region. In addition, patterns in 87Sr/86Sr values may indicate that the individuals buried in chullpas, and caves were members of extended kin groups. We conclude that groups living in Conchucos during the LIP created and maintained local exchange networks that exploited vertically stacked production zones.
• Titelbaum, A. R., Fresh, S., McNeil, B. E., & Ibarra Asencios, B. (2021). Three cases of brachydactyly type E from two commingled tombs at the Late Intermediate period - Late Horizon site of Marcajirca, Ancash, Peru. International Journal of Paleopathology, 33, 146-157. doi:10.1016/j.ijpp.2021.04.006
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  Abstract: Objective: Here we present the first known examples of brachydactyly from an Andean archaeological context by describing the affected bones, presenting a differential diagnosis, and discussing the cultural implications of there being shortened metapodials in multiple tombs.Materials: 3232 well-preserved tubular bones representing an MNI of 250 human adults.Methods: Each bone was visually inspected. Measurements were taken with an osteometric board, sliding calipers, and a flexible tape measure.Results: Of 1210 metapodials excavated from eight burial contexts, ten were atypically short.Conclusions: The ten shortened elements represent an MNI of three individuals with brachydactyly from two tombs. The presence of at least two individuals with brachydactyly in one tomb adds support to a previous suggestion that tombs were used for familial interment. It is plausible that the third individual from a different tomb was related to the other two, and the different burial contexts may reflect postmarital practices.Significance: These cases offer insight into tomb use and underscore the importance of identifying rare developmental anomalies in the archaeological record as their presence may indicate genetic relationships within or among archaeological cemeteries.Limitations: With commingled contexts and incomplete recovery of skeletal remains, individualizing the brachydactylous elements was not possible. There is also a lack of comparative data from other Andean sites.Suggestions for further research: Identify more Andean cases of brachydactyly to learn if the relatively frequent involvement of the first digit is more common among Andean skeletal samples than North American, or if it is unique to Marcajirca.
• Titelbaum, A. R. (2020). Developmental anomalies and South American paleopathology: a comparison of block vertebrae and co-occurring axial anomalies among three skeletal samples from the El Brujo Archaeological Complex of northern coastal Peru. International Journal of Paleopathology. doi:10.1016/j.ijpp.2019.07.001
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  Though developmental anomalies have been noted for over a century in South American paleopathology, they have received less attention than other pathological conditions. When anomalies are reported, they tend to be unusual case studies or incidental findings. Paleopathological research should also consider anomalies from a population perspective, to broaden our understanding about the frequency of specific anomalies, and potentially offer insight into genetic relationships, cultural behavior, or environmental factors. This investigation compared block vertebrae and co-occurring postcranial axial anomalies among three skeletal samples reflecting an occupational sequence at the El Brujo Archaeological Complex of Peru. Block vertebrae demonstrate both considerable antiquity and persistence through time, though frequencies, vertebral level, and co-occurring anomalies varied by sex and cultural period. Among the Late Preceramic sample, the frequency of C2-C3 block vertebrae was highest and only seen among females, which may suggest familial influence, genetic isolation, and potentially matrilocality. The Moche sample demonstrated a moderate frequency of blocks, which in combination with the frequencies of other developmental anomalies, may suggest population continuity paired with an influx of new genes, demographic expansion, and possible cultural change with regard to postmarital residence. The Lambayeque sample demonstrated the lowest frequency of blocks and the highest frequency and greatest diversity of anomalies, which may suggest genetic continuity from the Moche, an expanded gene pool, broader opportunities for mate choice, and cultural change. It is hoped that this investigation will provide data for future comparisons and call attention to the need for the broader study of developmental anomalies in South America.
• Titelbaum, A. R., Ibarra Asencios, B., & McNeil, B. E. (2019). A circular depression at the spinoglenoid notch of a prehistoric Andean scapula: Plausible evidence of suprascapular nerve entrapment by a paralabral cyst. International Journal of Paleopathology, 24, 19-24. doi:10.1016/j.ijpp.2018.08.007
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  While intraosseous cysts have been described in the paleopathological literature, it is rare to find reports concerning effects of soft tissue cysts, although they are relatively common in clinical contexts. Here we present plausible evidence of an extraosseous paralabral cyst, seen in an adult scapula from a Late Intermediate period commingled tomb (ca. AD 1200) at the northern highland site of Marcajirca, Ancash, Peru. The scapula demonstrated a smooth-sided concave depression at the spinoglenoid notch. The depression was notable for its regular appearance, with no bone deposition or destruction. Rather than reflect an intraosseous pathology, the defect likely resulted from pressure erosion from a space-occupying mass. A narrow strip of flattened bone connected the depression to the posterior-superior aspect of the glenoid. The location and morphology of the depression and its connection with the glenoid are consistent with the effects of a paralabral cyst that arose secondary to a tear of the posterior-superior glenoid labrum. A labral tear may act as a one-way valve permitting fluid to flow along a path of least resistance, often to the spinoglenoid notch. A cyst at the spinoglenoid notch would compress the suprascapular nerve, causing weakened function of infraspinatus and its eventual atrophy.
• Kushner, D. S., Verano, J. W., & Titelbaum, A. R. (2018). Trepanation procedures/outcomes: comparison of prehistoric Peru with other ancient, medieval, and American Civil War cranial surgery. World Neurosurgery, 114, 245-251. doi:10.1016/j.wneu.2018.03.143
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  More prehistoric trepanned crania have been found in Peru than any other location worldwide. We examine trepanation practices and outcomes in Peru over nearly 2000 years from 400 BC to provide a perspective on the procedure with comparison with procedures/outcomes of other ancient, medieval, and American Civil War cranial surgery. Data on trepanation demographics, techniques, and survival rates were collected through the scientific analysis of more than 800 trepanned crania discovered in Peru, through field studies and the courtesy of museums and private collections in the United States and Peru, over nearly 3 decades. Data on procedures and outcomes of cranial surgery ancient, medieval, and during 19th-century through the American Civil war were obtained via a literature review. Successful trepanations from prehistoric times through the American Civil War likely involved shallow surgeries that did not pierce the dura mater. Although there are regional and temporal variations in ancient Peru, overall long-term survival rates for the study series were about 40% in the earliest period (400-200 BC), with improvement to a high of 91% in samples from AD 1000-1400, to an average of 75%-83% during the Inca Period (AD 1400s-1500). In comparison, the average cranial surgery mortality rate during the American Civil war was 46%-56%, and short- and long-term survival rates are unknown. The contrast in outcomes highlights the astonishing success of ancient cranial surgery in Peru in the treatment of living patients.
• Titelbaum, A. R., & Uceda Castillo, S. (2015). A Rare Case of Os Odontoideum from an Early Intermediate tomb at the Huacas de Moche, Peru. International Journal of Paleopathology, DOI: 10.1016/j.ijpp.2015.08.001(11), 23-29.
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  Abstract: Os odontoideum is an uncommon vertebral anomaly where there is a smoothly corticated ossicle independent from a shortened odontoid peg. An example of os odontoideum was observed in an Early Intermediate period skeleton excavated from the Huacas de Moche (Moche IV, AD 400–700), Peru. The affected individual is a middle adult male who presents additional minor developmental anomalies of the axial skeleton. This individual was interred with a middle adult female who also has developmental anomalies of the axial skeleton, including block cervical vertebra (Klippel–Feil). Os odontoideum is infrequently reported in the medical literature and there continues to be debate about whether it is acquired or congenital. Unlike clinical cases, archaeological cases present an opportunity to examine the entirety of the skeleton. In the present case, there does not appear to be macroscopic or radiographic evidence for a healed fracture, and since the individual has multiple minor axial developmental anomalies, a con-genital etiology is plausible. This case is the first to be described from the archaeological context of South America and one of few paleopathological examples worldwide.
• Titelbaum, A. R., Ibarra, B., & Naji, S. (2015). Madelung’s deformity and possible Leri-Weill dyschondrosteosis: two cases from a Late Intermediate period tomb, Ancash, Peru. International Journal of Paleopathology, DOI: 10.1016/j.ijpp.2014.11.004(9), 8-14.
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  Abstract: Two individuals with bilateral Madelung’s deformity were identified in a Late Intermediate period comingled tomb at the northern highland site of Marcajirca, Ancash, Peru (ca. AD 1250). Comparisons of the size and robusticity of the radii and ulnae suggest the individuals represent a male and a female. The difference in the severity of the changes is thought to represent variability in the expression of the deformity seen in males and females in clinical cases. Three comparatively short, thick tibiae were also recovered from this tomb, which may suggest that the individuals demonstrate Léri-Weill dyschondrosteosis, a type of dwarfism characterized by mesomelic shortening. These are the first examples of Madelung’s deformity to be described from an archaeological context in South America and offer an insight into the use of tombs (chullpas) in Late Intermediate period Ancash.
• Titelbaum, A. R., & Verano, J. (2015). A Case of Congenital Radioulnar Synostosis from Prehispanic Peru. International Journal of Osteoarchaeology, DOI: 10.1002/oa.2353(25), 968-975.
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  A rare example of congenital radioulnar synostosis was observed in a sample of 160 male, female, and juvenile Lambayeque (Sicán) skeletons excavated from Huaca Cao Viejo, a mud brick platform mound built during the Early Intermediate Period and later utilized by a Late Intermediate Period Lambayeque population (ca. AD 950–1250) for interments. The affected individual was a young female, estimated to be 16–18 years of age at the time of death. To date, this is the first case of congenital radioulnar synostosis to be described from an archaeological context in South America, and one of 13 reported archaeological cases worldwide. Copyright © 2013 John Wiley & Sons, Ltd.
• Dillehay, T., Bonavia, D., Goodbred, S., Pino, M., Vasquez, V., Tham, R., Conklin, W., Splitstoser, J., Piperno, D., Iriarte, J., Grobman, A., Levi-Lazzaris, G., Moreira, D., Lopez, M., Tung, T., Titelbaum, A. R., Verano, J., Adovasio, J., Tombret, O., , Ramirez, M., et al. (2012). Chronology, mound-building and environment at Huaca Prieta, coastal Peru, from 13,700 to 4000 years ago. Antiquity, 48-70.
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  Abstract: Renewed in-depth multi-disciplinary investigation of a large coastal mound settlement in Peru has extended the occupation back more than 7000 years to a first human exploitation ∼13 720 BP. Research by the authors has chronicled the prehistoric sequence from the activities of the first maritime foragers to the construction of the black mound and the introduction of horticulture and monumentality. The community of Huaca Prieta emerges as innovative, complex and ritualised, as yet with no antecedents.

Presentations

• Titelbaum, A. R., Lucking, M. K., & Standley, C. A. (2024, April). Interpreting Research Through an Artist’s Eyes: The Artist + Researcher Program. Health Humanities Consortium 2024 Annual Conference. Phoenix, Arizona.
• Titelbaum, A. R., Lucking, M. K., & Standley, C. A. (2024, March). Communicating paleopathological research to the public via artistic representation: experience as a participant in an artist-researcher collaboration. 51st Annual North American Meeting of the Paleopathology Association (2024). Los Angeles, CA.
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  Abstract: Communicating research to the public is an important part of the scientific process. Sharing paleopathological discoveries with non-scientists helps the community understand what we do and how we do it, promotes science and STEM education, fosters community engagement, creates advocates for our discipline, and conveys information that is often behind academic or publisher paywalls. That said, one of the major challenges of speaking to non-scientist audiences is using language that is approachable and free from technical jargon. A way to do this is through artistic representation. At UACOM-P, the Artist + Researcher (ARx) program pairs scientists with local artists to collaborate on translational pieces of art over the course of nine months. Upon completion, the public is invited to view the resulting work, where teams of researchers and artists use the artwork to educate the public about the research. This presentation will explain the ARx program, describe the experience of participating on an ARx team, and relate what was learned from the process. Moreover, it will showcase an artist’s translation of paleopathological research in the Peruvian Andes. A beautifully executed suite of cloisonné jewelry pays homage to Moche metalwork, illustrates the process of conducting excavation and skeletal analysis in the Andes, and communicates paleopathological findings such as traumatic injuries, trepanation, and developmental conditions. Participating in this form of collaboration gives scientists an opportunity to enhance their ability to describe their research in clear language, so that artists can translate research for nonacademic audiences and provide a pathway for public engagement.
• Titelbaum, A. R., McNeil, B. E., Fresh, S., & Ibarra Asencios, B. (2024, April). Chullpa use in in the Ancash region of Peru: insights from the discovery of multiple rare developmental conditions at Marcajirca (AD 1000-1650). 89th Annual Meeting of the Society for American Archaeology (2024). New Orleans, LA.
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  Abstract: Situated on a steep-sided mountain slope on the eastern side of the Cordillera Blanca in the Ancash region of Peru, the Late Intermediate-to-Early Colonial period (AD 1000-1650) site of Marcajirca consists of residential, public, and funerary areas. Interment contexts include 35 above-ground walled tombs (chullpas). While it is logical to suggest these open sepulchers were used by kin groups, such suggestions of tomb use and prehistoric social structure tend to be based on Colonial records and ethnographic analogy, and less frequently on the human remains themselves. Archaeological testing of 8 tombs produced an MNI of 250 adults and 110 subadults. Among the remains, two rare heritable developmental conditions were observed among multiple individuals from different tombs: brachydactyly (MNI=3, 2 tombs) and Madelung’s deformity (MNI=2, 1 tomb). Given the rarity of each of these conditions, it is likely the individuals were related. This presentation will consider these findings in the context of understanding chullpa use. These cases offer insight into cultural practices, suggest the continued use of the site over time by an extended kin group, and underscore the importance of identifying rare developmental conditions in the archaeological record as their presence may indicate genetic relationships within or among archaeological cemeteries.
• Titelbaum, A. R. (2023, January). The importance of language when discussing paleopathological conditions. Paleopathology Association Webinar Series #3: Rare Diseases: good words make good science. Virtual.
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  Abstract:Language has meaning and can communicate conscious or unconscious bias. The ethical treatment of human remains must therefore include consideration of the language we use to approach them, describe them, and discuss them. A consideration for ethical and empathetic discussion should be introduced on day 1 of student’s learning and reinforced thereafter. Like clinically-oriented gross anatomy courses, osteological contexts provide the opportunity for students to observe human variation and disease processes, and it is essential that instructors establish a safe space for discussion to take place in order to guide students toward an understanding of the condition, and how to empathetically and ethically consider it and discuss it. Language is particularly important when considering rare diseases, where the condition may be unfamiliar and not immediately identified. How do we describe what we observe? How do we interpret how the condition may have affected the individual? Do we focus on and emphasize the individual’s abilities (i.e., positives), or their disabilities (i.e., negatives)? Another important consideration is that the public has access to many of our discussions and publications, and may turn toward our archives for information. We must therefore be mindful and empathetic about the language we use when we present our research. This presentation will draw from experiences teaching first year medical and allied health students in the context of a clinically-oriented gross anatomy course to foster discussion for ways to make empathetic discussion and mindful language relevant in paleopathology.
• Titelbaum, A. R. (2023, October). Managing reviewer feedback and crafting a "Response to Reviewers". Paleopathology Association Webinar Series #6: Publish Your Research in the IJPP!. Virtual.
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  Publish your research in the IJPP!Writing and submitting manuscripts for publication can be a daunting and intimidating process. In this webinar, the Editors of the IJPP will de-mystify the publication process by sharing tips on best practices for creating a manuscript, explaining the submission and review process, and offering helpful hints for success. There will also be ample time allotted for questions!Participants:Dr. Anne L. Grauer, Editor-in-ChiefDr. Angela Lieverse, Associate EditorDr. Megan Perry, Associate EditorDr. Richard Thomas, Associate EditorDr. Anne Titelbaum, Associate Editor
• Titelbaum, A. R., Washburn, E., Verano, J. W., Fehren-Schmitz, L., Nesbitt, J., Lund Valle, M., McNeil, B. E., Fresh, S., Herrera, S., & Ibarra Asencios, B. (2023, April). Trauma, Trepanation, Developmental Conditions, Diet, and DNA: Multiple strategies to learn from commingled interments at Marcajirca, a Late Intermediate period (ca. AD 1020-1620) highland site in Ancash, Peru. 50th Annual North American Meeting of the Paleopathology Association (2023). Reno, NV.
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  Abstract: Commingled human remains have been found in 35 accessible above-ground walled tombs (chullpas) and 22 funerary caves at Marcajirca, a Late Intermediate period (ca. AD 1020-1620) highland site in the Ancash region of Peru. Excavation and analysis of several tombs and caves has been accomplished by an annual bioarchaeological field school. While these commingled assemblages may present limitations to paleopathological investigations, they also present opportunities for case-based and population-based studies. Thus far, investigations have explored taphonomic comparisons among the chullpas, traumatic injuries, trepanation, nonmetric traits, developmental conditions, and diet through isotope analysis. In addition to documenting interesting pathological case studies, this research has identified injuries from falls and interpersonal violence, supported the suggestion that trepanation was done to treat traumatic head injuries, provided insight into residential mobility in the region, and revealed that tombs were used for familial interment. Drawing on our experience working with the commingled human remains at Marcajirca, we will present the archaeological context, describe a subset of the research projects that have been completed, and discuss avenues for future research.
• Riesgo, M., Koch, Z., Ivy, C., & Titelbaum, A. R. (2022, April). Refining anatomy teaching for first year occupational therapy students: development of a clinically relevant course. AOTA Inspire 2022 Annual Conference and Expo. San Antonio, Texas.
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  Abstract: OT students would benefit from an anatomy curriculum tailored to their needs. Our study identified relevant anatomical content necessary for student competency by examining clinicians' perspectives of fieldwork students' anatomy knowledge. Five themes emerged: (1) critical thinking and functional application, (2) use of resources, (3) interprofessional education, (4) course structure, and (5) setting-specific anatomy knowledge. This research has potential for guiding a standard template for OT anatomy education.
• Titelbaum, A. R. (2021, August). The Importance of Being Empathetic: Experiences Teaching Virtual Clinical Anatomy. Paleopathology Association Webinar Series #1: Paleopathology in a Digital World. Virtual.
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  Abstract: For many medical schools, the pandemic necessarily altered the manner in which dissection-based clinical anatomy was taught. At the Phoenix Biomedical Campus, this lab-based course was shifted to a virtual format, and it relied upon the use of accurate online interactive 3D anatomical models that depict “normal” human anatomy, supplemented with professional illustrations and dissection images. In addition to giving a brief demonstration of the models, this presentation will consider lessons learned from this experience. While there were positive outcomes from the use of the online platform, it was found that the greatest challenges included gaining an appreciation of anatomical variation and pathological processes, and instilling and maintaining a sense of empathy to the virtual donor and to those affected by pathology. While the first issue can be addressed through the continued building of 3D databases of pathological cases, the second is not as easily overcome, and merits discussion in anatomical, osteological, and paleopathological courses, particularly those that use digital elements.
• Nesbitt, J., Ibarra, B., Weber, S., Johnson, R., Schroll, A., & Titelbaum, A. R. (2017, November). Canchas Uckro: A Late Initial Period (1100-800 B.C.) Site in the Chavin Hinterland. 5th Meeting of the Society for Amazonian and Andean Studies. Jackson, MS.
• Titelbaum, A. R., Lucas, L., & Fisher, R. (2014, April). Sowing the seeds of integrative health care: implementation of an interprofessional anatomy curriculum for first year students. Interprofessional Education in the Anatomical Sciences at the annual meeting of the American Association of Anatomists at Experimental Biology. San Diego, CA.
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  Abstract: The University of Arizona (UA) College of Medicine Phoenix campus opened in 2006 and has since partnered with Arizona State University (ASU) and Northern Arizona University (NAU) to provide an integrated anatomy curriculum for medical, physician assistant, physical therapy, and bioengineering and anthropology graduate students. Divided into two class groups (UA and ASU/NAU), students utilize the same gross anatomy laboratory and dissect the contralateral sides of the same willed body donors. In order to foster collaboration and a greater understanding and appreciation for all members of the health care team, an interprofessional anatomy curriculum was developed for the 2013 fall semester that included a meet the donor session, maintenance of a donor (patient) chart, four clinically oriented workshops, and a ceremony of appreciation. Assessment of the new curriculum included quantitative measures related to workshop activities and exam performance as well as student and instructor feedback. Results indicate that the integrated curriculum increases student engagement and fosters an attitude of interprofessional cooperation and respect, which enhances student support systems and lays the groundwork for future professional development.
• Verano, J. W., Pearson, B., & Titelbaum, A. R. (2008, February). Left hanging in Mandeville: multiple approaches in search of a positive identification.. American Association of Forensic Sciences. Washington D.C..
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  Abstract: The goal of this presentation is to illustrate how multiple lines of investigation can be used to develop an identification in cases where decomposed remains of unknown decedents are found. Particularly in cases of indigent or transient individuals, few leads may be available. In such cases, if no potential matches can be made with missing persons reports, alternative strategies such as facial reproduction, press conferences, and DNA analysis may be necessary. This presentation will impact the forensic community by illustrating the importance of multidisciplinary collaboration in the identification of unknown skeletal remains.This presentation highlights a case from Louisiana which presented few leads and little hope for a successful identification. In 2006, a boy riding an ATV through a wooded area found what appeared to be a human skull and other bones underneath a large tree. Still hanging from a branch above was a largely skeletonized trunk and limbs, wearing jeans and a shirt. The boy returned home and notified the St. Tammany Parish Sheriff’s Office, which sent officers to the scene, along with death investigators from the St. Tammany Parish Coroner’s Office. The remains in the tree were found to be hanging from a nylon rope with a simple slip knot encircling the neck area, suggesting that the death may have been a suicide. The scene was photographed and described, and the human remains and clothing were collected. Staff from the coroner’s office brought the human remains and clothing to Tulane University’s Forensic Anthropology Laboratory on April 12, 2006, requesting assistance with developing a biological profile of the individual and an estimate of time since death. Analysis by Verano and Titelbaum indicated that the remains were those of an edentulate white male approximately 45-55 years of age, of  relatively short stature (est. 5’5”). Time since death was estimated as between eight months to a year, based on multiple criteria, including the position of the body (suspended) during decomposition, as well as evidence that the tree had been damaged by Hurricane Katrina (August 29, 2005), resulting in two distinct clusters of skeletal  remains on the ground. Although the skeleton was mostly complete, it was noted that some bones were missing, and offered to assist with another search of the scene.The second search produced another sixteen skeletal elements, including four vertebrae, eleven hand and foot bones, and a fragment of costal cartilage. Some of the bones found on the ground showed carnivore gnawing, and some elements that were not found in either search, including the hyoid bone, may have been scattered or destroyedby carnivores.A search of missing persons records by the St. Tammany Parish Sheriff’s Office produced some preliminary leads, but all were excluded based on a lack of correspondence in age, stature, or antemortem injuries. Given the lack of progress in identification, a bone sample was sent to the FBI DNA Laboratory for possible matching with data in the National Missing Person DNA Database, and the Coroner requested that we do a facial reproduction. A three-dimensional facial reproduction was done by Pierson, and was presented in a local press conference in October, 2006. Following the press conference the sheriff’s office received numerous phone calls, including one strong lead towards identifying the individual. A landlord reported that he had rented a trailer to a man matching the description of the decedent, and that he subsequently had left without notice and had not been seen again. With this information, investigators located a possible relative in another state who agreed to provide a DNA sample for comparison.A bone sample from the decedent and a buccal swab from the possible relative were submitted to the FBI DNA Laboratory in Quantico, Virginia, for analysis and comparison. Mitochondrial DNA comparison revealed a match between the two samples, although unfortunately, the sequence identified was not a particularly rare one (observedin 8.65% of Caucasians in the FBI database). Nuclear DNA analysis is now being done in an attempt to provide a more secure identification, although based on their investigation, the St. Tammany Parish Sheriff’s Office is convinced they now have a secure presumptive identification.
• Titelbaum, A. R., & Emerson, T. E. (1998, October). Filling the Void: Understanding the Late Woodland of North Central Illinois. Midwest Archaeological Conference. Muncie, Indiana.
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  Abstract: Until recently, North central Illinois posed a grey area with regard to understanding the Late Woodland period. Excavations conducted along the Rock River in Winnebago County, Illinois shed light on this period, by yielding information concerning the late Late Woodland, and in particular, Starved Rock Collared. This paper will discuss attributes of the Starved Rock Collared culture, and examine its placement within a broader, regional context. The Des Plaines Phase, to describe the late Late Woodland manifestation of this region, is proposed.
• Titelbaum, A. R., & Emerson, T. E. (1996, October). Current Late Woodland Research Along the Rock River, Winnebago County. Midwest Archaeological Conference. Beloit, Wisconsin.
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  Abstract: From 1993 to 1995, the Illinois Transportation Archaeological Research Program (ITARP) was involved with the Greater Rockford Regional Airport Expansion Project in Winnebago County of northern Illinois. The project area encompassed  approximately 1,000 acres containing 46 sites situated within the vicinity of the confluence of the Rock and Kishwaukee rivers. Preliminary analysis of the Rock River assemblage indicates a series of Late Woodland occupations along the river terraces. Recovered material includes collared ceramics, triangular projectile points, and maize. This paper will introduce preliminary results from 13 sites along the Rock River.

Poster Presentations

• Gilbank, J. R., Vasavilbaso, K. Y., Ivy, C., & Titelbaum, A. R. (2024, March). Integrating ultrasound into anatomy education for first year occupational therapy students: preliminary results. Anatomy Connected: Annual Meeting of the American Association for Anatomy (2024). Washington DC.
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  Abstract: Ultrasonography (US) is increasingly being added to 1st year anatomy education so students may gain experience using this technology and visualizing 2-D anatomy on living individuals. Introducing Occupational Therapy (OT) students to US is relevant, as US is used in OT practice to visualize structures, monitor changes over time, enhance patient engagement and advance clinical outcomes. This study explored the value of integrating an US workshop to the context of anatomy for 1st year OT students. It was hypothesized that the workshop would reinforce anatomy content, make the course more relevant for future clinical practice, and that students would benefit from introduction to US during their 1st year, in preparation for their 2nd year studies. Led by an OT who uses US as part of their clinical practice and assisted by 2nd & 3rd year OT students, the workshop included an anatomical review of the carpal tunnel, overview of ultrasound physics and operation, and small group hands-on practice using an US probe to identify the structures of the carpal tunnel in standardized patients. Pre & post surveys were completed to assess their knowledge of US and the carpal tunnel, and the impact of the workshop on student learning. Surveys consisted of 5-point Likert-style questions as well as fields for qualitative feedback. Both surveys had 42 respondents. In addition to increasing awareness of the use of US in OT practice, the Likert scores indicate the students felt they learned something valuable in the workshop (4.71), it helped to reinforce the musculoskeletal anatomy they were learning in the gross lab (4.50), it helped to improve their understanding of the carpal tunnel structures (4.50), and it was a good companion to the gross anatomy course (4.50). The majority of respondents indicated interest in using US in future practice (4.24). Qualitative feedback identified aspects of the workshop that helped students understand and use US, reinforcement of anatomical structures, suggestions for improvement, and expressions of enjoyment of the workshop.Data from this investigation suggests that introducing an US workshop within anatomy education is beneficial for 1st year OT students. The workshop introduced students to US, reinforced anatomy content, provided clinical relevance for future practice, included the opportunity to learn from a practicing OT, near-peer mentorship, and hands-on active learning.The next phase of this study will occur in 2024, to assess the impact of the workshop on the students in their 2nd year coursework when they are introduced to US in the context of clinical practice. Surveys will assess if the 1st year workshop prepared the students to use and understand therapeutic US during their 2nd year of study, and if the workshop helped them retain knowledge of carpal tunnel anatomy.
• Koch, Z., Riesgo, M., Ivy, C., & Titelbaum, A. R. (2023, March). Refining clinically relevant anatomy education for entry-level occupational therapy students. Anatomy Connected: Annual Meeting of the American Association for Anatomy (2023). Washington DC.
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  Abstract:Clinical anatomy is an essential component of allied health education to ensure competent and safe practice. While previous studies have examined pedagogical approaches to anatomy education in allied health fields, few have specified clinically-relevant anatomy content appropriate for occupational therapy (OT) students. This research seeks to identify relevant anatomy content for OT student competency for entry-level clinical practice by asking: 1) Does the current Northern Arizona University (NAU) allied health anatomy curriculum cover what is needed for OT clinical practice? 2) Are practicing OT clinicians satisfied with fieldwork students’ competency regarding clinically relevant anatomy knowledge?A mixed-method study included a recruitment survey (n=41), anatomy content surveys with five point Likert-style questions (n=25), and focus groups with OT clinicians practicing in Arizona (n=12). Anatomy content surveys were based on the anatomy curriculum currently taught to allied health students at NAU. Study participants who completed the survey were placed into 4 focus groups based on their self-identified area of practice/expertise: 1) nervous system, thorax, abdomen; 2) pelvis, perineum, lower extremity; 3) back, upper extremity; 4) head, neck. The Likert data was analyzed by calculating the overall average from each of the four anatomy content surveys to determine the level of relevance for each anatomical region. Qualitative data from focus group transcripts were analyzed through individual and group review to discern themes that OT clinicians identified as being relevant for anatomical education.Results from the surveys indicate that back & upper extremity (4.53) consisted of the most relevant content followed by head & neck (4.01); pelvis, perineum, lower extremity (3.72); and nervous system, thorax, abdomen (3.56). Differences in survey results may be due to factors such as participant specialty areas and practice settings, job availability, popularity of subspecialties, and participants’ anatomy background. Thematic interpretation of focus group discussions identified five key themes: critical thinking & functional application, setting-specific anatomy knowledge, interprofessional education, course structure, and use of resources.The data suggest the current NAU anatomy curriculum adequately prepares OT students with essential anatomical knowledge for competent clinical practice based on local OT practitioners’ feedback. Participating OT clinicians with Fieldwork Educator experience also highlighted the importance of OT students developing knowledge of functional anatomy. In-depth learning of specific anatomical structures should therefore be supplemented with clinical correlates related to various OT practice settings to enhance clinical practice skills. OT clinicians subjectively reported greater satisfaction with fieldwork students who were able to demonstrate both relevant anatomy knowledge and functional application within their practice setting. This research underscores the need for a comprehensive clinical anatomy course for entry-level OT students that provides foundational knowledge for their careers. Continued research in this area can lead to the development of a standard template for OT anatomy education to enhance future clinicians’ competency and critical application skills essential for entry-level practice. This research was funded by NAU's College of Health and Human Services.
• Titelbaum, A. R. (2021, April). Description and frequency of the acetabular crease / supra-acetabular fossa among ossa coxae recovered from four commingled Late Intermediate Period tombs (ca. AD 1250) at Marcajirca, Ancash, Peru. 48th Annual North American Meeting of the Paleopathology Association. Virtual.
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  An acetabular crease is a focal defect in the subchondral bone of the lunate surface, typically found in the anterosuperior aspect of the acetabulum near the 12 o’clock position. Manifesting as a small indentation, this feature has been considered a postcranial nonmetric trait in paleopathology, although a suggestion that it may be linked to biomechanical stress has been proposed (Mafart 2005). In the medical literature, this defect is known as a supra-acetabular fossa, and it has been observed in approximately 10.5% of MR arthrograms of the hip (Dietrich et al. 2012). In the paleopathological literature, frequencies have ranged from 6% to 43.4%, with lower incidence found among historic populations and higher incidence among rural French medieval and prehistoric Canadian populations (Mafart 2005). This investigation will present the first comparative data from South America, from a Late Intermediate (ca. AD 1250) highland site in Ancash, Peru. Here, four commingled tombs have yielded 152 ossa coxae (79 right, 73 left), of which 9.87% demonstrated an acetabular crease. Average size of the trait was 3.3 mm wide x 3.46 mm long x 2 mm deep. Frequency of the trait by sex, side, age, and tomb will be reported. Discussion will consider the suggestion that the trait may be associated with greater biomechanical stress. In addition, this investigation will clarify some confusion concerning the terminology and description of this trait observed in the paleopathological and forensic literature.ReferencesDietrich TJ, Suter A, Pfirrmann CWA, Dora C, Fucentese SF, Zanetti M. 2012. Supraacetabular fossa (pseudodefect of acetabular cartilage): frequency at MR arthrography and comparison of findings at MR arthrography and arthroscopy. Radiol. 263:484-491Marfart B. 2005. Description, significance and frequency of the acetabular crease of the hip bone. Int. J. Osteoarch. 15:208-215
• Titelbaum, A. R. (2020, April 14-15). Description and frequency of the acetabular crease / supra-acetabular fossa among ossa coxae recovered from four commingled Late Intermediate Period tombs (ca. AD 1250) at Marcajirca, Ancash, Peru. 47th Annual North American Meeting of the Paleopathology Association, Cleveland, Ohio. Los Angeles, CA.
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  An acetabular crease is a focal defect in the subchondral bone of the lunate surface, typically found in the anterosuperior aspect of the acetabulum near the 12 o’clock position. Manifesting as a small indentation, this feature has been considered a postcranial nonmetric trait in paleopathology, although a suggestion that it may be linked to biomechanical stress has been proposed (Mafart 2005). In the medical literature, this defect is known as a supra-acetabular fossa, and it has been observed in approximately 10.5% of MR arthrograms of the hip (Dietrich et al. 2012). In the paleopathological literature, frequencies have ranged from 6% to 43.4%, with lower incidence found among historic populations and higher incidence among rural French medieval and prehistoric Canadian populations (Mafart 2005). This investigation will present the first comparative data from South America, from a Late Intermediate (ca. AD 1250) highland site in Ancash, Peru. Here, four commingled tombs have yielded 152 ossa coxae (79 right, 73 left), of which 9.87% demonstrated an acetabular crease. Average size of the trait was 3.3 mm wide x 3.46 mm long x 2 mm deep. Frequency of the trait by sex, side, age, and tomb will be reported. Discussion will consider the suggestion that the trait may be associated with greater biomechanical stress. In addition, this investigation will clarify some confusion concerning the terminology and description of this trait observed in the paleopathological and forensic literature. References Dietrich TJ, Suter A, Pfirrmann CWA, Dora C, Fucentese SF, Zanetti M. 2012. Supraacetabular fossa (pseudodefect of acetabular cartilage): frequency at MR arthrography and comparison of findings at MR arthrography and arthroscopy. Radiol. 263:484-491 Marfart B. 2005. Description, significance and frequency of the acetabular crease of the hip bone. Int. J. Osteoarch. 15:208-215
• Fresh, S., Fresh, S., McNeil, B., McNeil, B., Ibarra Asencios, B., & Ibarra Asencios, B. (2019, March). Three Cases of Brachydactyly from Two Tombs at the Late Intermediate Period Site of Marcajirca, Department of Ancash, Peru. 46th Annual North American Meeting of the Paleopathology Association. Cleveland, OH.
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  Previously, two possible cases of mesomelic dwarfism (Léri-Weill dyschondrosteosis) recovered from one commingled tomb were reported from Marcajirca, a Late Intermediate Period (ca. AD 1250) highland site in Ancash, Peru (Titelbaum et al. 2015). Since that publication, 10 additional shortened skeletal elements representing a minimum number of three individuals from two additional commingled tombs have been discovered that may be related to a different heritable form of dwarfism, one that involves the distal segments of the extremities. The recovered shortened elements include two metacarpals (one right MC1, one left MC5) and eight metatarsals (three right and one left MT1, two right and one left MT4, one right MT5). No bones of the proximal or intermediate segments of the extremities from these tombs appeared to be shortened; rather, all shortening appeared to be limited to the distal segment. The affected metacarpals and metatarsals do not represent known patterns of shortened bones of the hands and feet and therefore may represent skeletal dysplasia, brachydactyly Type E, pseudohypoparathyroidism, or pseudopseudohypoparathyroidism. This presentation will describe the affected bones, present a differential diagnosis to better understand the condition, and discuss the cultural implications of there being various forms of heritable shortened bones in multiple tombs at this site. In addition to providing evidence that tombs were utilized for familial interment, the occurrence of possible dwarfism over time and across tombs likely reflects the endogamous exchange of alleles and the continued use of the site over time by an extended kingroup.Reference: Titelbaum, A.R., Ibarra, B., Naji, S. 2015. Madelung’s deformity and possible Leri-Weill dyschondrosteosis: two cases from a Late Intermediate period tomb, Ancash, Peru. International Journal of Paleopathology 9:8-14. (DOI: 10.1016/j.ijpp.2014.11.004).
• Phillips, S., & Titelbaum, A. R. (2019, March). Patellar variants: frequency and etiology in pre-Hispanic Peru. 46th Annual North American Meeting of the Paleopathology Association. Cleveland, OH.
• Thomas, T. C., Gulati, M., Hartmark-Hill, J. R., Mallin, E., Lucio, F., Parrish, J., Muhammad, S., Nelson, L. R., Omalley, C. W., Garcia-Filion, P., Mahnert, N., Federico, G., Titelbaum, A. R., Gonzales, R. J., Herbst-Kralovetz, M., Hale, T., & Gallitano-Mendel, A. L. (2019, November). Strategic initiative to create a Women in Medicine and Science (WIMS) program at a recently established and independently accredited College of Medicine. AAMC-Learn, Serve, Lead. Phoenix: AAMC.
• Titelbaum, A. R., Ibarra Asencios, B., & McNeil, B. E. (2018, April). A circular depression at the spinoglenoid notch of a Prehistoric Andean scapula: plausible evidence of suprascapular nerve entrapment by a paralabral cyst. 45th Annual Meeting of the Paleopathological Association. Austin, TX.
• Titelbaum, A. R. (2017, April). Developmental Variations and the Andean Past: the Cultural and Demographic Implications of C2-C3 Block Vertebrae. 44th Annual Meeting of the Paleopathological Association. New Orleans, LA.
• Titelbaum, A. R., Querevalú, J., Rios, N., & Chirinos, R. (2017, April). An Analysis of Human Remains from an Inca Ushnu: Polydactylism, Infection, Blunt Force Trauma, and Sharp Force Trauma at Soledad de Tambo, Huachis, Ancash Peru. 86th Annual Meeting of the American Association of Physical Anthropologists. New Orleans, LA.
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  Abstract: Soledad de Tambo is located in the northern Andes of Peru in the Huachis district, Huari province, region of Ancash. The site is characterized by the presence of an ushnu or ceremonial platform with a stone lined basin and the typical stepped appearance of Inca administrative centers or structures of importance. According to chroniclers, Soledad de Tambo was one of the nine Royal Tambos that existed between Huánuco Pampa and Huamachuco[1]. From these places the Inca controlled the local population, and at the ushnu, complex elite rituals took place, involving the libation of chicha (maize beer) [2], animal sacrifices [3], and sacrifices of young children (Qhapaq hucha)[4], as well as astronomical observations[5].While undertaking the Archaeological Research Project for the Conservation of the Ceremonial Platform (Ushnu) of Soledad de Tambo -Project Qhapaq Ñan, archaeologists encountered a burial containing the remains of two individuals, about 30 cm below surface and about 1.20 m west of the ceremonial basin. The individuals were found in a stone lined pit that intruded into the construction fill of the structure. Both individuals were supine, and oriented with the head toward the west and the feet to the east.Although human remains have occasionally been reported from ushnu, relatively few cases have been published. This investigation then, is an opportunity to present an analysis of the human remains excavated from an ushnu, and as such is an important case for understanding the funerary use of these structures and gaining insight into the social and symbolic influence of the Inca in the region of Callejon de Conchucos of eastern Ancash.References:[1] GuamanPomaF. 2005 [1615] Nueva Crónicay BuenGobierno. Fondode CulturaEconómica, Lima[2] BetanzosJ. 2010 [1551] Suma y Narraciónde losIncas. UNMSM, Lima[3] Hernández Príncipe R. 2003 [1621] Idolatríadel pueblo de Ocroscabezadestacomunidad. Añode 1621 Visitade Rodrigo Hernández Príncipe a Ocros(1621), Procesosy Visitasde Idolatrías, Cajatambo, SigloXVII, (Pierre Duviols, editor),PUCP-IFEA, Lima.[4] Ciezade León P. 1995 [1553] Crónicadel Perú. PrimeraParte, FondoEditorial de la PUCP, Academia Nacional de Historia. Lima.[5] Anonymous. 1906[1565] Discursode la sucesióny gobiernode losyngas, En: Juiciode límitesentre el Perúy Bolivia; pruebaperuana presentadaal gobiernode la RepúblicaArgentina, Vol 8, (V. M. Maúrtua, editor), Madrid.
• Titelbaum, A. R., & Ibarra, B. (2016, April). Preliminary Analysis of Fracture Patterns from an Atypical Late Horizon/Early Colonial Period Pit Burial with Comparison to Trauma Observed Among Typical Late Intermediate Period (Ca AD 1250) Above-Ground Tombs in the Ancash Region Peru. American Association of Anatomists at Experimental Biology. San Diego, CA.
• Titelbaum, A. R., & Ibarra, B. (2016, April). Traumatic Injury or Infectious Disease? Differential Diagnosis of a Deformed Subadult Scapula from a Late Intermediate Highland Tomb from Marcajirca, Department of Ancash, Peru. 43rd Annual Meeting of the Paleopathological Association. Atlanta, GA.
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  Abstract: An atypical subterranean pit burial discovered under a house floor at a prehistoric highland site in Ancash, Peru contains the skeletonized remains of adults and children who appear to have been deposited in a single event. It was hypothesized that the mass grave represents a deposit of individuals who were killed in a situation associated with warfare. To test this hypothesis, a macroscopic analysis of the traumatic injuries of a minimum number of 34 adult skeletons from the pit burial was compared to the pattern of injuries sustained by individuals from an earlier time period who were interred in more typical above-ground tombs. Results demonstrate that the skeletons from the pit burial demonstrate healed and unhealed traumatic injuries, many of which are found on the posterior aspects of the crania. In contrast, the individuals from the earlier time period demonstrate a low prevalence (1.6%) of postcranial fractures related to falling injuries, and relatively high frequency (33%) of healed and unhealed cranial injuries that cluster on the front left side of the face. Whereas this latter pattern of injury is reflective of face-to-face combat, the pattern of injury sustained by the individuals from the pit burial may suggest that the individuals were fleeing their assailants. Implications of these findings are explored.
• Titelbaum, A. R., & Uceda Castillo, S. (2015, March). A Rare Case of Os Odontoideum from the Huacas de Moche, Peru. 42st annual meeting of the Paleopathological Association. St. Louis, MO.
• Titelbaum, A. R., Ibarra, B., & Naji, S. (2014, April). Madelung’s Deformity and Possible Dyschondrosteosis: two cases from one tomb at the Late Intermediate Period site of Marcajirca, Department of Ancash, Peru. 41st annual meeting of the Paleopathological Association. Calgary, Alberta.
• Titelbaum, A. R., Ibarra, B., Naji, S., Azàldegui, O., & Valladares, K. (2013, April). Challenges of Terrain and Human Interaction: fracture patterns from a Late Intermediate highland sample from Marcajirca, Department of Ancash, Peru. 40th annual meeting of the Paleopathological Association. Knoxville, TN.