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Because they are understudied in contemporary populations, their relationship to disease experience is poorly understood. This paper examines the relationship between length of childhood illness and CO\/PH formation in a clinically documented sample. \u201cTurning points,\u201d which identify the window for lesion formation for CO\/PH, are defined, implications for hidden heterogeneity in frailty are considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data are from 333 (199 males; 134 females) pediatric postmortem computed tomography scans. Individuals died in New Mexico (2011\u20132019) and are 0.5 to 15.99\u2009years (mean\u00a0=\u00a07.1). Length of illness was estimated using information from autopsy and field reports. Logistic regression was used to estimate predicted probabilities, odds ratios, and the temporal window for lesion formation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Illness, single bouts, or cumulative episodes lasting over 1\u2009month is associated with higher odds of CO; individuals who were never sick have lower odds of having PH. This relationship was consistent for fatal and incidental illnesses that did not cause death. The developmental window for CO formation appears to close at 8\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Those ill for over 1\u2009month are more likely to have CO\/PH than those with acute illnesses. Some individuals lived sufficiently long to form CO\/PH but died of illness. Others with lesions died of circumstances unrelated to disease. This indicates hidden variation in robusticity even among ill individuals with CO\/PH, which is vital in interpreting lesion frequencies in the archeological record.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajhb.23896","type":"journal-article","created":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T08:46:13Z","timestamp":1679993173000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Skeletal manifestations of disease experience: Length of illness and porous cranial lesion formation in a contemporary juvenile mortality sample"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4514-772X","authenticated-orcid":false,"given":"Lexi","family":"O'Donnell","sequence":"first","affiliation":[{"name":"College of Population Health University of New Mexico Health Sciences Center  Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0206-0165","authenticated-orcid":false,"given":"Jane E.","family":"Buikstra","sequence":"additional","affiliation":[{"name":"Center for Bioarchaeological Research, School of Human Evolution and Social Change Arizona State University  Tempe Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6899-2152","authenticated-orcid":false,"given":"Ethan C.","family":"Hill","sequence":"additional","affiliation":[{"name":"Division of Physical Therapy, Department of Orthopaedics and Rehabilitation University of New Mexico School of Medicine  Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9204-9076","authenticated-orcid":false,"given":"Amy S.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Anthropology University of California \u2013 Santa Barbara  Santa Barbara California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4146-8668","authenticated-orcid":false,"suffix":"Jr","given":"Michael J.","family":"O'Donnell","sequence":"additional","affiliation":[{"name":"Bureau of Business &amp; Economic Research University of New Mexico  Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2011.25.3552"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.2709"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpp.2021.04.008"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.74B1.1732267"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2010.04.001"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1556-4029.13131"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajpa.24391"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajpa.10431"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200206000-00033"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajpa.23701"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajpa.20265"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-08-101020-4.00002-1"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-809738-0.00015-6"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2013.00106"},{"key":"e_1_2_11_16_1","first-page":"1933","volume-title":"Diet and immune function","author":"Childs C. 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