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Situated at a geographic crossroads, the eastern Tianshan Mountain region in northwest China is crucial to understanding various economic, social, and cultural developments on the Eurasian Steppes. One promising way to gain a better knowledge of ancient subsistence economy, craft production, and social change in the eastern Tianshan Mountain region is to study the artifact assemblages from archaeological contexts. Here, we present an analysis of 488 worked animal bones from the large site of Shirenzigou (ca. 1300-1 BCE), to date the largest assemblage of this kind uncovered in the eastern Tianshan Mountain region. We classified these worked bones into six categories, including "ritual objects", "ornaments", "tools", "worked astragali", "warfare and mobility", and "indeterminate". The identification of animal species and skeletal elements indicates that worked bones from Shirenzigou are characterized by a predominance of caprine products, particularly worked astragali, which is consistent with the large proportion of caprine fragments found in animal remains associated with food consumption. This demonstrates the contribution of caprine pastoralism to bone working activities at Shirenzigou. The making of most worked bones does not appear to have required advanced or specialized skills. Considering the absence of dedicated bone working space, alongside the variability in raw material selection and in dimensions of certain types of artifacts, we infer that worked bone production at Shirenzigou was not standardized. In terms of raw material selection and mode of production, Shirenzigou differed from their settled, farming counterparts in the Yellow River valley of northern China. In addition, along with the evidence for violence and horseback riding, the increasing use of bone artifacts associated with warfare and mobility during the late occupation phase of Shirenzigou reflects growing social instability and implies the likely emergence of single mounted horsemen, equipped with light armors, in the region during the late first millennium BCE. Our results provide new insights into animal resource exploitation and changing lifeways of early pastoral societies in the eastern Tianshan Mountain region, expanding our knowledge of the economic, social, and political milieu of late Bronze Age and early Iron Age eastern Eurasia., Competing Interests: The authors have declared that no competing interests exist.

Objectives: This study uses osteological and radiocarbon datasets combined with formal quantitative analyses to test hypotheses concerning the character of conflict in the Nasca highlands during the Late Intermediate Period (LIP, 950-1450 C.E.). We develop and test osteological expectations regarding what patterns should be observed if violence was characterized by intragroup violence, ritual conflict, intermittent raiding, or internecine warfare., Materials and Methods: Crania (n = 267) were examined for antemortem and perimortem, overkill, and critical trauma. All age groups and both sexes are represented in the sample. One hundred twenty-four crania were AMS dated, allowing a detailed analysis of diachronic patterns in violence among various demographic groups., Results: Thirty-eight percent (102/267) of crania exhibit some form of cranial trauma, a significant increase from the preceding Middle Horizon era. There are distinct trauma frequencies within the three subphases of the LIP, but Phase III (1300-1450 C.E.) exhibits the highest frequencies of all trauma types. Males exhibit significantly more antemortem trauma than females, but both exhibit similar perimortem trauma rates., Discussion: There was chronic, internecine warfare throughout the Late Intermediate Period with important variations in violence throughout the three temporal phases. Evidence for heterogeneity in violent mortality shows a pattern consistent with social substitutability, whereby any and all members of the Nasca highland population were appropriate targets for lethal and sublethal violence. We argue that by testing hypotheses regarding the targets and types of conflict we are better able to explain the causes and consequences of human conflict., (© 2020 Wiley Periodicals LLC.)

Objectives: Warfare is assumed to be one of the defining cultural characteristics of steppe nomads in Eastern Eurasia. For the first-centuries CE, a period of political turmoil in Northern China and Southern Siberia, relatively few data are, however, available about the degree and variability of violence in these communities. Here, we provide new data on violence among steppe nomads during the first-centuries CE by analyzing the type, anatomical distribution, and demographic distribution of perimortem trauma at Tunnug1 (Tuva, Southern Siberia-second to fourth c. CE)., Materials and Methods: Perimortem traumas were assessed on 87 individuals representing both sexes and different age classes. The timing of the lesions was assessed based on morphological criteria, including the absence and presence of bone reactive processes and the relative plasticity of the bone at the moment of impact. The distribution by age, sex, and anatomical location of trauma was analyzed by means of logistic models, Fisher's exact tests, and 3D visualizations., Results: A total of 130 perimortem traumas, including chop marks, slice marks, penetrating lesions, and blunt traumas were identified on 22 individuals. Chop marks were mostly at the level of the skull and vertebrae and were likely caused by bladed weapons. Slice marks were found on the cervical vertebrae and cranium and may be the result of throat slitting and scalping by means of smaller bladed implements. Traumas were more frequent in males, and their presence is not correlated with age., Discussion: This study adds new data to the few available regarding violence among steppe nomadic cultures and provides new insights about the effects of political instability on the life of the people inhabiting Eastern Eurasia during the early centuries CE., (© 2020 Wiley Periodicals LLC.)

The introduction of gas warfare in World War One was impactful, as it both expanded the breadth of warfare and fueled the invention of techniques required to treat these new injuries. Gas injuries were responsible for 91,000 of 1.3 million deaths in World War One. Gassed soldiers had wounds which the world had never seen. They presented in large scale to medical tents and base hospitals across Europe. As gas casualties poured in, doctors and nurses had to treat these conditions in the best way they knew. Gas warfare changed how war was performed and how casualties of this attack were treated. The techniques learned from treating the multitudes of men with gas burns led to advances in the field of burn care, which have helped to improve mortality and reduce morbidity in hospitals across the world., (Copyright © 2021 Anesthesia History Association. All rights reserved.)

Accounts of Spanish nursing and nurses during the Spanish Civil War (1936-1939) that appear in the memoirs and correspondence of International Brigade volunteers, and are subsequently repeated in the secondary literature on the war, give little indication of existence of trained nurses in country. We set out to examine this apparent erasure of the long tradition of skilled nursing in Spain and the invisibility of thousands of Spanish nurses engaged in the war effort. We ask two questions: How can we understand the narrative thrust of the international volunteer accounts and subsequent historiography? And what was the state of nursing in Spain on the Republican side during the war as presented by Spanish participants and historians? We put the case that the narrative erasure of Spanish professional nursing prior to the Civil War was the result of the politicization of nursing under the Second Republic, its repression and reengineering under the Franco dictatorship, and the subsequent national policy of "oblivion" or forgetting that dominated the country during the transition to democracy. This policy silenced the stories of veteran nurses and prevented an examination of the impact of the Civil War on the Spanish nursing profession., (© Copyright 2020 Springer Publishing Company, LLC.)

Paleomagnetic analysis of archaeological materials is crucial for understanding the behavior of the geomagnetic field in the past. As it is often difficult to accurately date the acquisition of magnetic information recorded in archaeological materials, large age uncertainties and discrepancies are common in archaeomagnetic datasets, limiting the ability to use these data for geomagnetic modeling and archaeomagnetic dating. Here we present an accurately dated reconstruction of the intensity and direction of the field in Jerusalem in August, 586 BCE, the date of the city's destruction by fire by the Babylonian army, which marks the end of the Iron Age in the Levant. We analyzed 54 floor segments, of unprecedented construction quality, unearthed within a large monumental structure that had served as an elite or public building and collapsed during the conflagration. From the reconstructed paleomagnetic directions, we conclude that the tilted floor segments had originally been part of the floor of the second story of the building and cooled after they had collapsed. This firmly connects the time of the magnetic acquisition to the date of the destruction. The relatively high field intensity, corresponding to virtual axial dipole moment (VADM) of 148.9 ± 3.9 ZAm2, accompanied by a geocentric axial dipole (GAD) inclination and a positive declination of 8.3°, suggests instability of the field during the 6th century BCE and redefines the duration of the Levantine Iron Age Anomaly. The narrow dating of the geomagnetic reconstruction enabled us to constrain the age of other Iron Age finds and resolve a long archaeological and historical discussion regarding the role and dating of royal Judean stamped jar handles. This demonstrates how archaeomagnetic data derived from historically-dated destructions can serve as an anchor for archaeomagnetic dating and its particular potency for periods in which radiocarbon is not adequate for high resolution dating., Competing Interests: The authors have declared that no competing interests exist.

In his review article John W. Verano covered trauma, warfare, trophy taking, and human sacrifice, but his discussion mostly focused on the results of studies of museum or private collections and the recent discovery of the mass human sacrifice from Huaca de la Luna. Due to the renewed interest in the paleopathology of South America, a trend which Verano observed, these types of investigations have grown exponentially in the past twenty years since his initial publication. Here we synthesize the published data on the study and interpretation of traumatic injuries across time and space and we tease out some of the themes that have emerged in the twenty odd years since the seminal paper written by Verano. We searched and analyzed publications from 1997 to 2017 that pertained specifically to Andean South America through the review of library databases and then narrowed our search to trauma-related topics. In our literature review and meta-analysis of published studies on traumatic injuries, we found that nearly one-third of publications related to the field of paleopathology in Andean South America dealt with subjects we classified under trauma (N = 116/378), such as trephination, violence, sacrifice, warfare, etc. Large sample sizes, population-focused research, advances in methods of analysis, and hypothesis driven investigations have led to sophisticated and nuanced interpretations along a wide range of themes so that we understand a great deal more about violence, sacrifice, trephination, warfare and their sociopolitical and environmental contexts in prehistoric and early colonial Andean South America., (Copyright © 2019. Published by Elsevier Inc.)

Background: During the Kosovo War (1998-99) approximately 31,000 rounds with Depleted Uranium (DU) were fired on 85 targets in Kosovo. The number of haematological malignancies (HM) increased after the war and the concern was the use of DU during the war. The aim of this study was to analyse the incidence rates of HM in Kosovo throughout a 20-year that includes pre- and post- war period (1995-2015); and to examine if there is any association between the use of DU rounds and incidence rates of HM in different regions of Kosovo., Methods: In this retrospective register-based study, 1,798 new patients diagnosed with leukaemia, Hodgkin lymphoma, non-Hodgkin lymphoma and Multiple myeloma were analysed over a 20 year period. Incidence rates were calculated focusing on specific time periods, regions and age-groups. In addition, the correlation between the use of DU in different regions and their incidence of HM was analysed., Results: The average annual crude rate of all HM in Kosovo was 5.02 cases per 100,000 persons. Incidence rates of HM in first post-war period (2000-2003) increased by 0.37 cases/100,000 persons (9.51%) compared to the pre-war period (1995-1998) whereas in the last post-war period (2012-2015), incidence of HM increased by 3.19/100,000 persons (82%). Gjakova and Peja, the first and third most exposed regions to DU ordnance ranked first and second in difference in HM. Prishtina, Gjilan and Ferizaj, regions with the least number of rounds/km2, were characterized by a decline of incidence rates., Conclusions: After the war, the increase in incidence rate of HM was higher in two regions with most DU rounds/km2 expended Despite these findings, this study warrants further investigation and does not lead us to a conclusive finding on the existence of a causal relationship between the use of DU during the war and the rise in incidence of HM in Kosovo., Competing Interests: The authors have declared that no competing interests exist.

Before Europeans arrived to Eastern North America, prehistoric, indigenous peoples experienced a number of changes that culminated in the development of sedentary, maize agricultural lifeways of varying complexity. Inherent to these lifeways were several triggers of social stress including population nucleation and increase, intergroup conflict (warfare), and increased territoriality. Here, we examine whether this period of social stress co-varied with deadlier weaponry, specifically, the design of the most commonly found prehistoric archery component in late pre-contact North America: triangular stone arrow tips (TSAT). The examination of modern metal or carbon projectiles, arrows, and arrowheads has demonstrated that smaller arrow tips penetrate deeper into a target than do larger ones. We first experimentally confirm that this relationship applies to arrow tips made from stone hafted onto shafts made from wood. We then statistically assess a large sample (n = 742) of late pre-contact TSAT and show that these specimens are extraordinarily small. Thus, by miniaturizing their arrow tips, prehistoric people in Eastern North America optimized their projectile weaponry for maximum penetration and killing power in warfare and hunting. Finally, we verify that these functional advantages were selected across environmental and cultural boundaries. Thus, while we cannot and should not rule out stochastic, production economizing, or non-adaptive cultural processes as an explanation for TSAT, overall our results are consistent with the hypothesis that broad, socially stressful demographic changes in late pre-contact Eastern North America resulted in the miniaturization-and augmented lethality-of stone tools across the region., Competing Interests: The authors have declared that no competing interests exist.

This contribution is focused on analysing the power of 'masculinization' through which traditional humanitarian storytelling has been shaped. Strongly marked by a patriarchal vision, humanitarian accounts have traditionally hidden the work of women while stressing that performed by men, who appeared represented as true protagonists and, even, as heroes. In particular, this article analyses the professional career of a Spanish female surgeon named María Gómez (1914-1975) between 1944 and 1950, when she worked in a small charitable hospital based in Toulouse (France) for improving the health-care conditions of Spanish Republican refugees. Known as Hospital Varsovia or as Walter B. Cannon Memorial Hospital in the United States, it was supported by several humanitarian agencies, such as the Unitarian Service Committee (USC) and the Joint Anti-Fascist Refugee Committee (JAFRC). In order to get funds, both entities filmed a propaganda documentary in 1946, Spain in Exile , which deliberately ignored Gómez's work as a surgeon in this hospital. By examining this visual record, this article attempts to reconstruct the life and the professional career of this female physician, which was at the crossroads of the Spanish Civil War, the Second World War and the ideological polarization emerging in the Cold War period.

The toll of civilian deaths in current wars and conflicts has been building for decades. Civilian populations, particularly since WWII, have suffered most of the consequences of armed violence and today represent the most at-risk population. This is attributed to the rise of religious and ethnic hatreds, the collapse of State structures, the battle for control of natural resources, the vast availability of weapons, the proliferation of acts of terrorism, and the spread of so-called asymmetric conflicts. Protections provided to innocent civilians under International Humanitarian Law and the Geneva Conventions have been ignored. This commentary captures the experience of the immediate care and transportation provided to military casualties of the Battle of Solferino in 1859 with civilian casualties recently documented in a Stanford-led study during the "golden hour" after injury in 13 conflicts from 1990 to 2017. Despite many advances in triage and management of war injuries over the intervening decades, the common thread of these 2 scenarios is that transport times and early resuscitation capacity and capabilities, first recognized in the 19th century wars and now accepted as global norms and markers for survival from trauma, are as unavailable today to civilians caught up in war and conflict as they were to soldiers in the 19th century.

On 4 July 1918, at the Battle of Hamel, the Australian Medical Services used a Field Ambulance Resuscitation Team for the first time, delivering life-saving blood transfusion and early definitive surgery to badly wounded soldiers very soon after their wounds had been inflicted. During the closing months of the war, many lives and limbs were saved by early resuscitation and effective surgery, an achievement that stands out in marked contrast to the situation in 1914, when inadequate resuscitation, outdated surgical methods and appalling delays in delivering treatment resulted in great numbers of unnecessary deaths., (© 2019 Royal Australasian College of Surgeons.)

Despite over a century of archaeological research, the nature and broader consequences of Maya warfare remain poorly understood. Classic period (250-950 CE) Maya warfare has largely been viewed as ritualized and limited in scope 1-6 . Evidence of violent warfare in the Terminal Classic period (800-950 CE) is interpreted as an escalation of military tactics that played a role in the socio-economic collapse of the Classic Maya civilization 7,8 . The implications of specific textual references to war events (war statements) remain unknown, however, and the paucity of field data precludes our ability to test collapse theories tied to warfare. Here we connect a massive fire event to an attack described with a Classic period war statement. Multiple lines of evidence show that a large fire occurred across the ancient city of Witzna, coincident with an epigraphic account describing an attack and burning of Witzna in 697 CE. Following this event, evidence shows a dramatic decline in human activity, indicating extensive negative impacts on the local population. These findings provide insight into strategies and broader societal impacts of Classic period warfare, clarify the war statement's meaning and show that the Maya engaged in tactics akin to total warfare earlier and more frequently than previously thought.

Since 1945, the reason for humanitarian crises and the way in which the world responds to them has dramatically changed every 10 to 15 years or less. Planning, response, and recovery for these tragic events have often been ad hoc, inconsistent, and insufficient, largely because of the complexity of global humanitarian demands and their corresponding response system capabilities. This historical perspective chronicles the transformation of war and armed conflicts from the Cold War to today, emphasizing the impact these events have had on humanitarian professionals and their struggle to adapt to increasing humanitarian, operational, and political challenges. An unprecedented independent United Nations-World Health Organization decision in the Battle for Mosul in Iraq to deploy to combat zones emergency medical teams unprepared in the skills of decades-tested war and armed conflict preparation and response afforded to health care providers and dictated by International Humanitarian Law and Geneva Convention protections has abruptly challenged future decision-making and deployments. (Disaster Med Public Health Preparedness. 2019;13:109-115).

Operation Reinhard (1942-1943) was the largest single murder campaign of the Holocaust, during which some 1.7 million Jews from German-occupied Poland were murdered by the Nazis. Most perished in gas chambers at the death camps Belzec, Sobibor, and Treblinka. However, the tempo, kill rates, and spatial dynamics of these events were poorly documented. Using an unusual dataset originating from railway transportation records, this study identifies an extreme phase of hyperintense killing when >1.47 million Jews-more than 25% of the Jews killed in all 6 years of World War II-were murdered by the Nazis in an intense,100-day (~3-month) surge. Operation Reinhard is shown to be an extreme event, based on kill rate, number, and proportion (>99.9%) of the population murdered in camps, highlighting its singularly violent character, even compared to other more recent genocides. The Holocaust kill rate is some 10 times higher than estimates suggested by authorities on comparative genocide.

The origins of warfare have long been of interest for researchers across disciplines. Did our earliest ancestors engage in forms of organized violence that are appropriately viewed as approximations, forms of, or analogs for more recent forms of warfare? Assessed in this article are contrasting views that see warfare as being either a product of more recent human societies or a phenomenon with a much deeper chronology. The article provides an overview of current debates, theories, and methodological approaches, citing literature and data from archaeological, ethnographic, genetic, primatological, and paleoanthropological studies. Synthetic anthropological treatments are needed, especially in efforts to inform debates among nonacademic audiences, because the discipline's approaches are ideally suited to study the origins of warfare. Emphasized is the need to consider possible forms of violence and intergroup aggression within Pleistocene contexts, despite the methodological challenges associated with fragmentary, equivocal, or scarce data. Finally, the review concludes with an argument about the implications of the currently available data. We propose that socially cooperative violence, or "emergent warfare," became possible with the onset of symbolic thought and complex cognition. Viewing emergent warfare as a byproduct of the human capacity for symbolic thought explains how the same capacities for communication and sociality allowed for elaborate peacemaking, conflict resolution, and avoidance. Cultural institutions around war and peace are both made possible by these changes. Accordingly, we suggest that studies on warfare's origins should be tied to research on the advent of cooperation, sociality, and communication., (© 2018 American Association of Physical Anthropologists.)

The effect of World War 1 military service on composers has been neglected in comparison with poets and artists. This article describes the wartime service of Arthur Bliss, Ralph Vaughan Williams, Ivor Gurney, EJ Moeran, Gordon Jacob, Patrick Hadley, and Maurice Ravel. The relationship between experiences of combat and the psychological health of these men is examined, with consideration being given to predisposition and possible causative influences of military service on their later careers, examined from individual and societal perspectives.

Agostino Gemelli (1878-1959) is known as the founder of the Catholic University in Italy. Franciscan monk and doctor he had a central role in promoting studies on human behavior, thanks to his solid scientific training as a student of Camillo Golgi at the University of Pavia. His research activities during the years of the First World War involved studying the motivation, courage and psychological adaptation of the soldiers, engaged in trench warfare, laying the foundations of modern studies of behavior and trauma.

Objectives: This paper addresses the prevalence and pattern of physical violence in the prehispanic society of Gran Canaria and discusses its link with the social structure and insular context in which that people lived., Materials and Methods: 347 prehispanic crania from Guayadeque Ravine (575-1415 AD) have been examined in order to determine the frequency, types, location, and timing of trauma., Results: Craniofacial injuries are present in 27.4% of the crania examined. Only 2% display perimortem trauma. Most of the injuries (84.3%) correspond to depressed blunt force trauma, with an ellipsoidal or circular shape. Most of these are in the anterior aspect of the cranium. Males are significantly more affected than females., Discussion: The aboriginal population of Gran Canaria show a high frequency of traumatic injuries to the skull compared to other archaeological groups. Their frequent location in the anterior aspect suggests regular face-to-face confrontations. However, the lethal injuries typically occurring in large-scale combat are scarce. Practices such as ritualized combat, mentioned in ethnohistorical sources, would help to channel and mitigate inter-group conflict. The predominance of depressed blunt force trauma is in accordance with the weapons used by those populations: hand-thrown stones, clubs and sticks. The higher frequency in males indicates that they took part in direct violence more than females did. The hierarchical organization of their society may have led to frequent situations of conflict. The insular nature of a territory barely 1,500 m 2 in size was a determining factor in competition for access to food resources, especially at times of climate crises or population growth., (© 2018 Wiley Periodicals, Inc.)