Climatic and environmental conditions in the Western Galilee, during Late Middle and Upper Paleolithic periods, based on speleothems from Manot Cave, Israel.

Early Ahmarian, Levantine Aurignacian and Post-Levantine Aurignacian archeological assemblages show that the karstic Manot Cave, located 5 km east of the Mediterranean coast in the Western Galilee region of Israel, was intensively occupied during the Early Upper Paleolithic. The coexistence of these rich archaeological layers with speleothems in Manot Cave provides a window of opportunity for determining the relationships between climatic conditions and the nature of human activity and mobility patterns in the Western Galilee region during the Early Upper Paleolithic period. This study, based on four stalagmites that grew almost continuously from ∼75 to 26.5 ka, covers most of the last glacial, and overlaps with the human occupation of the cave. The speleothems oxygen (δ18O) and carbon (δ13C) isotopic records indicate that climate and environmental conditions fluctuated during the last glacial, some of which correspond with Dansgaard-Oeschger (D-O) cycles 12, 10, 7 and Heinrich (H) events VI and V. Consistent with independent evidence from botanic and faunal remains, these climatic shifts brought about significant environmental changes in the region, ranging from dominant thick Mediterranean forest to more open landscape. A good correlation with less negative δ13C values is most pronounced during the Early Ahmarian time period, but there was also a change to less negative δ13C values during the Levantine Aurignacian and Post-Levantine Aurignacian industries in the Levant. These positive δ13C shifts suggest that environmental transformation towards a more open grassy landscape dominated by C4 vegetation might have played an important role in the development of these cultural entities (mainly the Early Ahmarian) in Manot Cave region.

Levantine cranium from Manot Cave (Israel) foreshadows the first European modern humans.

A key event in human evolution is the expansion of modern humans of African origin across Eurasia between 60 and 40 thousand years (kyr) before present (bp), replacing all other forms of hominins. Owing to the scarcity of human fossils from this period, these ancestors of all present-day non-African modern populations remain largely enigmatic. Here we describe a partial calvaria, recently discovered at Manot Cave (Western Galilee, Israel) and dated to 54.7 ± 5.5 kyr bp (arithmetic mean ± 2 standard deviations) by uranium-thorium dating, that sheds light on this crucial event. The overall shape and discrete morphological features of the Manot 1 calvaria demonstrate that this partial skull is unequivocally modern. It is similar in shape to recent African skulls as well as to European skulls from the Upper Palaeolithic period, but different from most other early anatomically modern humans in the Levant. This suggests that the Manot people could be closely related to the first modern humans who later successfully colonized Europe. Thus, the anatomical features used to support the 'assimilation model' in Europe might not have been inherited from European Neanderthals, but rather from earlier Levantine populations. Moreover, at present, Manot 1 is the only modern human specimen to provide evidence that during the Middle to Upper Palaeolithic interface, both modern humans and Neanderthals contemporaneously inhabited the southern Levant, close in time to the likely interbreeding event with Neanderthals.

Voluntary medical male circumcision and HIV in Zambia: expectations and observations.

The study analysed the HIV/AIDS situation in Zambia six years after the onset of mass campaigns of Voluntary Medical Male Circumcision (VMMC). The analysis was based on data from Demographic and Health Surveys (DHS) conducted in 2001, 2007 and 2013. Results show that HIV prevalence among men aged 15-29 (the target group for VMMC) did not decrease over the period, despite a decline in HIV prevalence among women of the same age group (most of their partners). Correlations between male circumcision and HIV prevalence were positive for a variety of socioeconomic groups (urban residence, province of residence, level of education, ethnicity). In a multivariate analysis, based on the 2013 DHS survey, circumcised men were found to have the same level of infection as uncircumcised men, after controlling for age, sexual behaviour and socioeconomic status. Lastly, circumcised men tended to have somewhat riskier sexual behaviour than uncircumcised men. This study, based on large representative samples of the Zambian population, questions the current strategy of mass circumcision campaigns in southern and eastern Africa.

Weakened AMOC related to cooling and atmospheric circulation shifts in the last interglacial Eastern Mediterranean.

There is limited understanding of temperature and atmospheric circulation changes that accompany an Atlantic Meridional Overturning Circulation (AMOC) slowdown beyond the North Atlantic realm. A Peqi'in Cave (Israel) speleothem dated to the last interglacial period (LIG), 129-116 thousand years ago (ka), together with a large modern rainfall monitoring dataset, serve as the base for investigating past AMOC slowdown effects on the Eastern Mediterranean. Here, we reconstruct LIG temperatures and rainfall source using organic proxies (TEX86) and fluid inclusion water d-excess. The TEX86 data show a stepwise cooling from 19.8 ± 0.2° (ca. 128-126 ka) to 16.5 ± 0.6 °C (ca. 124-123 ka), while d-excess values decrease abruptly (ca. 126 ka). The d-excess shift suggests that rainfall was derived from more zonal Mediterranean air flow during the weakened AMOC interval. Decreasing rainfall d-excess trends over the last 25 years raise the question whether similar atmospheric circulation changes are also occurring today.

Computational modelling of the impact of AIDS on business.

OBJECTIVES: An overview of computational modelling of the impact of AIDS on business in South Africa, with a detailed description of the AIDS Projection Model (APM) for companies, developed by the author, and suggestions for further work. OVERVIEW: Computational modelling of the impact of AIDS on business in South Africa requires modelling of the epidemic as a whole, and of its impact on a company. This paper gives an overview of epidemiological modelling, with an introduction to the Actuarial Society of South Africa (ASSA) model, the most widely used such model for South Africa. METHODS: The APM produces projections of HIV prevalence, new infections, and AIDS mortality on a company, based on the anonymous HIV testing of company employees, and projections from the ASSA model. A smoothed statistical model of the prevalence test data is computed, and then the ASSA model projection for each category of employees is adjusted so that it matches the measured prevalence in the year of testing. FURTHER WORK: Further techniques that could be developed are microsimulation (representing individuals in the computer), scenario planning for testing strategies, and models for the business environment, such as models of entire sectors, and mapping of HIV prevalence in time and space, based on workplace and community data.

Modelling HIV and MTB co-infection including combined treatment strategies.

A new host-pathogen model is described that simulates HIV-MTB co-infection and treatment, with the objective of testing treatment strategies. The model includes CD4+ and CD8+ T cells, resting and activated macrophages, HIV and Mycobacterium tuberculosis (MTB). For TB presentation at various stages of HIV disease in a co-infected individual, combined treatment strategies were tested with different relative timings of treatment for each infection. The stages were early HIV disease, late HIV disease and AIDS. The main strategies were TB treatment followed by anti-retroviral therapy (ART) after delays of 15 days, 2 months and 6 months. ART followed by TB treatment was an additional strategy that was tested. Treatment was simulated with and without drug interaction. Simulation results were that TB treatment first followed by ART after a stage-dependent delay has the best outcome. During early HIV disease a 6 month delay is acceptable. During late HIV disease, a 2 month delay is best. During AIDS it is better to start ART after 15 days. However, drug interaction works against the benefits of early ART. These results agree with expert reviews and clinical trials.

Fitting the HIV epidemic in Zambia: a two-sex micro-simulation model.

BACKGROUND: In describing and understanding how the HIV epidemic spreads in African countries, previous studies have not taken into account the detailed periods at risk. This study is based on a micro-simulation model (individual-based) of the spread of the HIV epidemic in the population of Zambia, where women tend to marry early and where divorces are not frequent. The main target of the model was to fit the HIV seroprevalence profiles by age and sex observed at the Demographic and Health Survey conducted in 2001. METHODS AND FINDINGS: A two-sex micro-simulation model of HIV transmission was developed. Particular attention was paid to precise age-specific estimates of exposure to risk through the modelling of the formation and dissolution of relationships: marriage (stable union), casual partnership, and commercial sex. HIV transmission was exclusively heterosexual for adults or vertical (mother-to-child) for children. Three stages of HIV infection were taken into account. All parameters were derived from empirical population-based data. Results show that basic parameters could not explain the dynamics of the HIV epidemic in Zambia. In order to fit the age and sex patterns, several assumptions were made: differential susceptibility of young women to HIV infection, differential susceptibility or larger number of encounters for male clients of commercial sex workers, and higher transmission rate. The model allowed to quantify the role of each type of relationship in HIV transmission, the proportion of infections occurring at each stage of disease progression, and the net reproduction rate of the epidemic (R(0) = 1.95). CONCLUSIONS: The simulation model reproduced the dynamics of the HIV epidemic in Zambia, and fitted the age and sex pattern of HIV seroprevalence in 2001. The same model could be used to measure the effect of changing behaviour in the future.

Multinomial logistic regression.

BACKGROUND: When the dependent variable consists of several categories that are not ordinal (i.e., they have no natural ordering), the ordinary least square estimator cannot be used. Instead, a maximum likelihood estimator like multinomial logit or probit should be used. OBJECTIVES: The purpose of this article is to understand the multinomial logit model (MLM) that uses maximum likelihood estimator and its application in nursing research. METHOD: The research on "Racial differences in use of long-term care received by the elderly" (Kwak, 2001) is used to illustrate the multinomial logit model approach. This method assumes that the data satisfy a critical assumption called the "independence of irrelevant alternatives." A diagnostic developed by Hausman is used to test the independence of irrelevant alternatives assumption. Models in which the dependent variable consists of several unordered categories can be estimated with the multinomial logit model, and these models can be easily interpreted. CONCLUSIONS: This method can handle situations with several categories. There is no need to limit the analysis to pairs of categories, or to collapse the categories into two mutually exclusive groups so that the (more familiar) logit model can be used. Indeed, any strategy that eliminates observations or combines categories only leads to less efficient estimates.