The population history of northeastern Siberia since the Pleistocene.

Northeastern Siberia has been inhabited by humans for more than 40,000 years but its deep population history remains poorly understood. Here we investigate the late Pleistocene population history of northeastern Siberia through analyses of 34 newly recovered ancient genomes that date to between 31,000 and 600 years ago. We document complex population dynamics during this period, including at least three major migration events: an initial peopling by a previously unknown Palaeolithic population of 'Ancient North Siberians' who are distantly related to early West Eurasian hunter-gatherers; the arrival of East Asian-related peoples, which gave rise to 'Ancient Palaeo-Siberians' who are closely related to contemporary communities from far-northeastern Siberia (such as the Koryaks), as well as Native Americans; and a Holocene migration of other East Asian-related peoples, who we name 'Neo-Siberians', and from whom many contemporary Siberians are descended. Each of these population expansions largely replaced the earlier inhabitants, and ultimately generated the mosaic genetic make-up of contemporary peoples who inhabit a vast area across northern Eurasia and the Americas.

A method for estimating age of medieval sub-adults from infancy to adulthood based on long bone length.

OBJECTIVES: To develop a series of regression equations for estimating age from length of long bones for archaeological sub-adults when aging from dental development cannot be performed. Further, to compare derived ages when using these regression equations, and two other methods. MATERIAL AND METHODS: A total of 183 skeletal sub-adults from the Danish medieval period, were aged from radiographic images. Linear regression formulae were then produced for individual bones. Age was then estimated from the femur length using three different methods: equations developed in this study, data based on a modern population (Maresh: Human growth and development (1970) pp 155-200), and, lastly, based on archeological data with known ages (Rissech et al.: Forensic Sci Int 180 (2008) 1-9). As growth of long bones is known to be non-linear it was tested if the regression model could be improved by applying a quadratic model. RESULTS: Comparison between estimated ages revealed that the modern data result in lower estimated ages when compared to the Danish regression equations. The estimated ages using the Danish regression equations and the regression equations developed by Rissech et al. (Forensic Sci Int 180 (2007) 1-9) were very similar, if not identical. This indicates that the growth between the two archaeological populations is not that dissimilar. DISCUSSION: This would suggest that the regression equations developed in this study may potentially be applied to archaeological material outside Denmark as well as later than the medieval period, although this would require further testing. The quadratic equations are suggested to yield more accurate ages then using simply linear regression equations.

Patient Experiences of Patient-Clinician Communication Among Cancer Multidisciplinary Healthcare Professionals During "Breaking Bad News": A Qualitative Systematic Review.

PURPOSE: To explore patient experiences of patient-clinician communication during the critical moments of "breaking bad news" in cancer care. METHODS: A qualitative systematic review followed the Joanna Briggs Institute methodology and has been reported according to PRISMA guidelines. Databases, including APA PsycINFO, CINAHL, MEDLINE, and Scopus, were searched from the beginning of their date range coverage to April 2023. Data extraction and quality assessment were performed, and a meta-aggregation approach was used for data synthesis. RESULTS: Twenty-eight studies were included and represented 976 patients. Key themes included (1) sensing something is wrong (prior to diagnosis), (2) reaction to the diagnosis, (3) information (during breaking bad news), (4) communication with health care professionals, (5) specialist versus nonspecialist centers, (6) decision-making, and (7) feeling supported. The review underscores the need for health care professionals to adeptly navigate and respond to individual patient needs during confronting and distressing times. CONCLUSIONS: The complexity and individuality of patient-clinician communication suggest that further education is needed among the cancer multidisciplinary team to develop personalized, empathetic communication strategies in clinical practice, catering to diverse patient preferences. The findings call for more inclusive research across different cultures and languages, and a need to understand evolving communication needs, especially in the context of increasing digital communication modalities in health care. IMPLICATIONS FOR CANCER SURVIVORSHIP: This review provides valuable new insights into developing effective communication strategies that are responsive to the diverse needs of patients undergoing cancer treatment. Its findings emphasize the importance of empathy, flexibility, and a personalized approach in delivering bad news and supporting patients throughout survivorship.

Micro-CT in a forensic examination of a fatal child abuse case: A case report.

Child abuse is a serious concern that can cause the death of a child. In such cases the medico-legal evidence is often pivotal but complex, drawing across multiple medical disciplines and techniques. One key specialism is histopathology, which is considered the gold standard for estimating the age of individual fractures. Another is micro-CT imaging, which can visualise the location of trauma across the body. This case report demonstrates how micro-CT was used to contextualise the histological evidence in the Criminal Justice Proceedings of a fatal child abuse case. This was achieved by overlaying the aged fracture evidence from histopathology onto the visuals rendered from micro-CT imaging. The case was a suspected child abuse of a deceased 1-month old infant who was reported unresponsive by their parents. The child was taken to hospital where they were pronounced dead. Suspicion was raised and post-mortem imaging confirmed head trauma and rib fractures, and the case was escalated for a forensic investigation. This case report details how the micro-CT imaging was merged with the gold standard of histopathology for visualisation of trauma, and how the court presentation was planned alongside Senior Investigating Officers and various medical experts. The presentation was used in court by the histopathologist to present the evidence. The resulting presentation provided additional clarity to jury members regarding the location, severity, frequency, and timings of the injuries. From the perspective of the investigating police force, the resulting presentation was crucial in ensuring understanding of the medico-legal evidence of how the infant died. The prosecuting lawyer noted that combining the histological and micro-CT evidence in this way allowed the evidence to be presented in a sensitive, clear, and impactful manner.

Can latent fingerprint disclose the sex of the donor? A preliminary test study using GC-MS analysis of latent fingerprints.

While fingerprints are a highly used means of identification, not every fingerprint left behind on a potential crime scene can be used for identification purposes. In some cases, the fingerprint may be smudged, partially preserved or overlapping with other prints hence distorting the ridge pattern and may therefore be not appropriate for identification. Further, fingermark residue yields a very low abundance of genetic material for DNA analysis. In such cases, the fingermark may be used to retrieve basic donor information such as sex. The focus of this paper was to assess the possibility of differentiating between the sexes of the donor of latent fingermarks. Analytical method was GC-MS analysis of the chemical compounds of latent fingermarks using 22 male and 22 female donors. Results showed 44 identified compounds. Two alcohols, octadecanol C18 and eicosanol C20 , were found to show a difference that was statistically significant between male and female donors. There is also some evidence for the possibility of distinguishing sex of the fingermark donor based on the distribution of branched chain fatty acids, as free compounds or esterified in wax esters.

Inconclusive Bone Scan in Men with Intermediate and High-risk Prostate Cancer: What next?

OBJECTIVE: To evaluate the incidence of inconclusive bone scans and down-stream imaging and clinical follow-up generated, including subsequent treatment outcomes in men affected by inconclusive bone scans with intermediate- and high-risk prostate cancer. DATA SOURCES: Retrospective study of clinical data for a Scottish population of men diagnosed with prostate cancer in the intermediate and high-risk groups. CONCLUSION: Of the 1,246 patients included, initially 81 men were identified as having an inconclusive bone scan result following multidisciplinary team discussion. After further imaging, 24 patients remained inconclusive for metastasis. Of these, two patients received no treatment; one because of a watchful waiting decision, and one because of death. Of the 13 patients receiving radical treatment (laparoscopic radical prostatectomy or radiotherapy), three patients showed relapse (23%) indicating presence of microscopic disease and failure of radical treatment alone for these patients. IMPLICATIONS FOR NURSING PRACTICE: This paper will assist nurses and multidisciplinary team members in understanding how patients diagnosed with intermediate- and high-risk prostate cancer with inconclusive bone scan results are subsequently imaged and managed in the current health care system. This raises awareness amongst nursing staff of disease recurrence and the possibility of downstream multimodality treatment for these men with inconclusive bone scans.

What Are the Experiences of Men Affected by Prostate Cancer Participating in an Ecological Momentary Assessment Study?

BACKGROUND: Within the cluster of self-report methodologies, ecological momentary assessment (EMA) is a method used in health services research whereby a participant repeatedly reports on affect, behaviors, symptoms, and cognitions as they occur in real time in the participant's natural environment. However, little is known about the impact of participating in an EMA study on individuals' experiences who are affected by prostate cancer. OBJECTIVES: The aims of this study were to explore the lived experiences of men affected by prostate participating in an EMA study and assess whether their participation in EMA alters their representation of their condition. METHODS: Participants (n = 12) were purposively recruited from 2 university teaching hospitals in Scotland. Semistructured interviews were conducted with men affected by prostate cancer following the completion of EMA data collection. Data were analyzed using thematic analysis. RESULTS: The lived experience of prostate cancer included 6 superordinate themes: isolation in the healthcare system, lack of shared care plans, informational support, coping with prostate cancer, fear of death and dying, and vocational rehabilitation. The organizing theme electronic diary as an intervention included 4 superordinate themes: changing self-management behaviors, habitual experience, changing perceptions, and diary in daily life. CONCLUSION: We observed that men participating in the EMA study described several methodological complexities, which need to be addressed through future research. IMPLICATIONS FOR PRACTICE: Importantly, there is a need for the health system to prioritize research and develop a more holistic approach to prostate cancer care in line with men's preferences and needs in the future.

Experiences of Unmet Need and Access to Supportive Care for Men Receiving Androgen Deprivation Therapy for Prostate Cancer: A Bi-national Study.

OBJECTIVE: The number of men affected by incurable prostate cancer is expected to increase worldwide. Research is needed to enable men to share their experiences of unmet supportive care needs in current care delivery. We aimed to identify the most frequently reported domains of unmet supportive care needs, levels of anxiety, depression, distress, health-related quality of life, and to identify any perceived barriers to receiving supportive care. DATA SOURCES: Men diagnosed with prostate cancer who had received a minimum of 6 months of ADT were recruited into a cross-sectional study. Participants completed standardised questionnaires; clinical and demographic data was also collected. CONCLUSION: Two hundred seventy-two patients were invited, and 102 participated. No statistically significant differences were found between participant scores from Australia and UK in relation to anxiety and depression, exercise, health-related quality of life, or distress scores. Perceived barriers include service delivery related to information provision and difficulties in the navigation of complex care systems. IMPLICATIONS FOR NURSING PRACTICE: Men affected by prostate cancer receiving ADT reported unmet supportive care needs, specifically related to sexual, informational, and psychological aspects of care. Mapping future trajectories of needs and identifying men at high risk can significantly improve timely and tailored interventions.

What are the unmet supportive care needs of men affected by penile cancer? A systematic review of the empirical evidence.

PURPOSE: To systematically evaluate evidence regarding the unmet supportive care needs of men affected by penile cancer and their partners to create a holistic model of care and inform clinical practice guidelines. METHODS: We searched CINAHL, MEDLINE, PsychINFO, Embase, and the Cochrane Library (CCRT and CDSR) controlled trials databases and clinicaltrial.gov from 1990 to April 2020. This review was reported according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. RESULTS: 18 articles were included, reporting the results from 17 studies. Included reports used qualitative (seven studies) and survey (ten studies). Across these studies, men reported that the diagnosis and subsequent treatment of penile cancer affected physical, psychological and sexual well-being with each facet impacting and being intertwined with the other at varying degrees. There was varying complexity of unmet needs in men and partners pre-surgery, post-surgery and into survivorship. CONCLUSIONS: Moderate evidence exists that men affected by penile cancer experience a range of unmet supportive care needs across the international literature. Further work to evaluate the impact of penile cancer on partners is required.

A tale of two cities: A comparison of urban and rural trauma in Medieval Denmark.

OBJECTIVE: This study explores the differences in frequency and type of trauma found in two Medieval cemeteries in Denmark, as well as the cultural and community implications of those differences. MATERIALS: We examined 235 skeletons from the cemetery at Tjærby (rural) and 170 skeletons from the cemetery at Randers (urban) for trauma from the Medieval period in Denmark, 1050 to 1536 CE. METHODS: Trauma was assessed through macroscopic examination and odds ratio and relative risk assessments were run to assess the difference in trauma. RESULTS: There was no significant difference in the presence of trauma between the rural and urban cemeteries or between males and females. There were some significant differences in relative risk for trauma between the two cemeteries. CONCLUSIONS: The division and variation in trauma between the two cemeteries is most likely related to differences in economy and occupation. SIGNIFICANCE: There are relatively few studies that examine the difference in inherent risk of trauma between rural and urban Medieval communities, especially in Denmark. This research also adds to the growing body of literature in paleopathology that uses epidemiology to explore the parallels between patterns of trauma and community lifeways. LIMITATIONS: The cemeteries are approximately 5 km distance from each other so similarities in the sample could be a result of location. SUGGESTIONS FOR FURTHER RESEARCH: A wider sample of Medieval cemeteries in Denmark needs be added to this analysis to provide a more complete picture of trauma patterns during this time period.

Temporal changes in childhood health during the medieval Little Ice Age in Denmark.

OBJECTIVE: This study examines the evidence of three skeletal markers of childhood health that leave permanent observable changes in the adult skeleton during two climate events, the Medieval Warm Period (MWP) and the Little Ice Age (LIA) that occurred in the medieval period (1050-1536 CE). MATERIAL: A total of 241 adult skeletons from the Danish medieval period were included. METHODS: Linear enamel hypoplasia (LEH) was examined macroscopically. Harris lines (HL) and infectious middle ear disease (IMED) were examined from CT imaging. The skeletons were segregated by the mortuary pattern of arm position that coincidentally changes between the MWP to the LIA. RESULTS: LEH and IMED increase in frequency from the MWP to the LIA while there is a reverse trend for HL. SIGNIFICANCE: This is the first study that examines childhood health as reflected on skeletal remains of adults using a combination of CT imaging and macroscopic examination for temporal changes in the medieval period. LIMITATIONS: The study did not include any sub-adults due to limitation of methods, i.e. the method of IMED is not yet developed to assess sub-adults. Neither was time-of-occurrence for the skeletal marker included as there is conflicting information from different methods for HL and neither has it been developed yet for IMED. SUGGESTIONS FOR FURTHER RESEARCH: A sample of sub-adults from both time periods could be compared by sub-adult mortality, as well as for differences in the timing of skeletal age markers.

Development of a Prehabilitation Multimodal Supportive Care Interventions for Men and Their Partners Before Radical Prostatectomy for Localized Prostate Cancer.

BACKGROUND: An important question revolves around when the most opportune time is to introduce recovery-optimizing behaviors for men opting for radical prostatectomy (RP) for localized prostate cancer (PCa). An emerging field of research describes the role of preoperative strategies to improve treatment tolerance and overall physical and psychological recovery. OBJECTIVE: The aim of this study was to explore the perceptions of a multimodal prehabilitation intervention for men and their partners before RP for localized PCa. METHODS: Thirty-four patients who opted for RP for localized PCa and their partners (19) were identified and recruited into the study. The multimodal intervention was composed of educational materials, physiotherapy instruction, and a self-management group-based seminar. RESULTS: The multimodal prehabilitation intervention was perceived as overall helpful with demonstrated acceptability (91.9%). Beneficial themes related to the quality of the information provided to support self-management, open forum questions with multidisciplinary healthcare professionals, and increased knowledge among partners to help with their understanding of how to look after their partners. CONCLUSION: The intervention was feasible and beneficial for the PCa dyad. A future pilot randomized controlled trial study is needed to provide sufficient evidence on the long-term physical and psychological outcomes and cost-effectiveness. IMPLICATIONS FOR PRACTICE: Oncology nurses play a key role in the development of prehabilitation care delivery. Prehabilitation interventions can have a positive effect on improving health outcomes for cancer patients and their partners after surgery and into survivorship.

A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention for managing unmet supportive care needs in men with metastatic prostate cancer on hormonal treatment and their partner/caregivers.

PURPOSE: Men with metastatic prostate cancer experience high levels of unmet supportive care needs in current healthcare delivery. We set out to determine the effectiveness of a multimodality supportive care (ThriverCare) intervention on the prevalence of unmet supportive care needs for men and their partner/caregivers. METHODS: A prospective parallel group, pilot randomised controlled pilot trial in 4 hospitals in Scotland. 38 participants with radiologically proven metastatic prostate cancer disease and 10 partners/caregivers were recruited into the study. A two arm 1:1 study design compared the usual standard of care (SC) approach to SC plus ThriverCare intervention. The primary outcome was the Supportive Care Needs Survey at 3 months of intervention. RESULTS: There was no statistical significant difference in the prevalence of unmet supportive care needs between the intervention group and the usual SC group at baseline p = 0.112, however a statistically significant difference was observed at 3 months, indicating that the prevalence of unmet supportive care needs were less in the intervention group (1.13, SD 2.5) compared to the usual SC (6.17, SD 7.05), p = 0.002. CONCLUSION: ThriverCare appears to improve the supportive care experience of men with metastatic prostate cancer on hormonal treatment and their partner/caregivers. Our results accentuate that no longer one size of care delivery fits all, care must be responsive and adaptable to meet the individual needs of people affected by cancer to thrive.

Early human dispersals within the Americas.

Studies of the peopling of the Americas have focused on the timing and number of initial migrations. Less attention has been paid to the subsequent spread of people within the Americas. We sequenced 15 ancient human genomes spanning from Alaska to Patagonia; six are ≥10,000 years old (up to ~18× coverage). All are most closely related to Native Americans, including those from an Ancient Beringian individual and two morphologically distinct "Paleoamericans." We found evidence of rapid dispersal and early diversification that included previously unknown groups as people moved south. This resulted in multiple independent, geographically uneven migrations, including one that provides clues of a Late Pleistocene Australasian genetic signal, as well as a later Mesoamerican-related expansion. These led to complex and dynamic population histories from North to South America.

A Qualitative Study Exploring Models of Supportive Care in Men and Their Partners/Caregivers Affected by Metastatic Prostate Cancer.

PURPOSE/OBJECTIVES: To explore the experiences of patients with metastatic prostate cancer and their partners/caregivers, as well as an interprofessional team, with a nurse-led multimodality supportive care intervention. 
. RESEARCH APPROACH: Qualitative study. 
. SETTING: National Health Service (NHS), Tayside, Scotland.
. PARTICIPANTS: 19 patients, 7 partners/caregivers, and 7 interprofessional members from four hospitals in NHS, Tayside, Scotland.
. METHODOLOGIC APPROACH: 33 semistructured interviews were conducted to explore patients' and partners/caregivers' experiences of supportive care, and a framework approach was used to analyze the data. 
. FINDINGS: Men and their partners/caregivers experienced a range of unmet physical, psychological, and informational supportive care needs. The participants in the intervention group reported overall high satisfaction with the use of holistic needs assessments and self-management plans, with a decrease in unmet needs compared to the standard of care over time. The prostate cancer specialist nurse was perceived as the hub of survivorship care. Members of the interprofessional team perceived benefit in the nurse-led multimodal supportive care intervention.
. INTERPRETATION: An emphasis needs to be placed on personalizing care, with supportive care interventions targeted to individual needs. 
. IMPLICATIONS FOR NURSING: Care can be improved by incorporating holistic needs assessment to target specialized interventions for optimized, individualized care plans. An intervention seminar encouraged self-management and self-efficiency, leading to greater satisfaction for participants.

Body surface area determined by whole-body CT scanning: need for new formulae?

Calculation of the estimated body surface area (BSA) by body height and weight has been a challenge in the past centuries due to lack of a well-documented gold standard. More recently, available techniques such as 3D laser surface scanning and CT scanning may be expected to quantify the BSA in an easier and more accurate way. This study provides the first comparison between BSA obtained from post-mortem whole-body CT scans and BSA calculated by nine predictive formulae. The sample consisted of 54 male cadavers ranging from 20 to 87 years old. 3D reconstructions were generated from CT scans using Mimics software, and BSA values were automatically extracted from the program. They were compared with nine predictive equations from the literature. Remarkably, close correlations (r > 0·90) were found between BSA values from CT scans and those from the predictive formulae. A mean BSA of the 54 cadavers of 1·84-1·87 m2 was calculated by all formulae except one, SD values varying between 0·171 and 0·223 m2 . T-tests revealed significant differences between mean BSA values calculated with CT and three of the formulae. Regression analyses showed intercepts >(0;0) and slopes <1·0 using all predictive equations, with the CT scan determination as gold standard. It is concluded that DuBois and DuBois' equation can be safely used in normal-weight male subjects with high accuracy, but it seems likely that BSA is underestimated in underweight subjects and overestimated in overweight individuals. Creation of new formulae specific for overweight subjects and children may be needed.

CT imaging vs. traditional radiographic imaging for evaluating Harris Lines in tibiae.

SUMMARY: This paper is the first to systematically investigate computer tomography (CT) images vs. ordinary flat plane radiography for evaluating Harris Lines (HL) on tibiae. Harris Lines are traditionally investigated using radiographic images and recorded as either present or absent, or by counting the number of HL. Seventy-four pairs of human sub-adult and adult archaeological tibiae were used in this study. Both image methods were tested for intra- and inter-observer agreement and the methods were then compared. Analysis was performed with the tibiae divided into younger (n = 19) and older sub-adults (n = 26) and adults (n = 29), as well as all tibiae combined (n = 74). This study found that the intra- and inter-observer agreement was very similar for each method, but both image methods performed less well for counting the number of HL. Direct comparison between CT images and radiographic images showed good agreement for presence or absence of HL and less agreement for counting HL. There appeared to be no systematic pattern for dividing the material according to bone length (and thereby age). Overall, this paper concludes that the performance of CT images is comparable to traditional flat plane radiography for evaluating HL on archaeological dry bone specimens of tibiae. Further, due to the lower performance of counting the number of HL, it appears advisable to only record the presence or absence of HL rather than counting the number of HL.

A method for estimating age of Danish medieval sub-adults based on long bone length.

The preferred method for aging archaeological sub-adult skeletons is by dental examination. In cases where no dental records are available, age estimation may be performed according to epiphyseal union, skeletal elements or diaphyseal lengths. Currently no data have been produced specifically for aging archaeological Danish sub-adults from the medieval period based on diaphyseal lengths. The problem with using data on Danish samples, which have been derived from a different population, is the possibility of skewing age estimates. In this study 58 Danish archaeological sub-adults were examined, aged from approximately six years to twenty-one years. The samples were aged according to two dental methods: Haavikko and Ubelaker. Regression formulae were constructed for aging according to their diaphyseal lengths both for individual long bones and combinations of upper and lower long bones. This study indicated that with the regression formulae developed, estimation of age can be done with reasonable results on Danish sub-adults. The Danish data were then compared to data from a different archaeological sample and a modern sample. It showed that the modern data indicated a consistently lower age compared to this sample which increased until reaching a maximum of nearly five years and six months. When comparing the archaeological data to this study, the growth profile crossed over at 12.5 years with a maximum age difference before the cross point of two years and three months lower for the archaeological data. After the cross point there was a maximum difference of three years and four months higher for the archaeological data. This study has shown the importance of using data for age estimation for archaeological material which has been developed specifically for that population. In addition it has presented a possible solution for Danish sub-adult material when dental material is not available.