The fauna from Mughr el-Hamamah, Jordan: Insights on human hunting behavior during the Early Upper Paleolithic.

As a corridor for population movement out of Africa, the southern Levant is a natural laboratory for research exploring the dynamics of the Middle-to-Upper Paleolithic transition. Yet, the number of well-preserved sites dating to the initial millennia of the Early Upper Paleolithic (EUP; ∼45-30 ka) remains limited, restricting the resolution at which we can study the biocultural and techno-typological changes evidenced across the transition. With EUP deposits dating to 45-39 ka cal BP, Mughr el-Hamamah, Jordan, offers a key opportunity to expand our understanding of EUP lifeways in the southern Levant. Mughr el-Hamamah is particularly noteworthy for its large faunal assemblage, representing the first such assemblage from the Jordan Valley. In this paper, we present results from taxonomic and taphonomic analyses of the EUP fauna from Mughr el-Hamamah. Given broader debates about shifts in human subsistence across the Middle-to-Upper Paleolithic transition, we also assess evidence for subsistence intensification, focusing especially on the exploitation of gazelle and the use of small game. Taphonomic data suggest that the fauna was primarily accumulated by human activity. Ungulates dominate the assemblage; gazelle (Gazella sp.) is the most common taxa, followed by fallow deer (Dama mesopotamica) and goat (Capra sp.). Among the gazelle, juveniles account for roughly one-third of the sample. While the focus on gazelle and the frequency of juveniles are consistent with broader regional trends, evidence for the regular exploitation of marrow from gazelle phalanges suggests that the EUP occupants of Mughr el-Hamamah processed gazelle carcasses quite intensively. Yet, the overall degree of dietary intensification appears low-small game is rare and evidence for human capture of this game is more equivocal. As a whole, our results support a growing body of data showing gradual shifts in animal exploitation strategies across the Middle-to-Upper Paleolithic transition in the southern Levant.

Soil organic carbon, aggregation and fungi community after 44 years of no-till and cropping systems in the Central Great Plains, USA.

Implementing sustainable agricultural land management practices such as no-till (NT) and diversified crops are important for maintaining soil health properties. This study focuses on the soil health of three long-term (44 years) tillage systems, NT, reduced tillage (RT), and conventional tillage (CT), in monoculture winter wheat-fallow (W-F) (Triticum aestivum L.) and wheat-soybean (W-S) (Glycine max (L.) Merrill) rotation. Soil organic carbon (C) was higher in NT than CT in the surface 0-5 cm, but not different in the 5-15 cm, demonstrating SOC stratification on the soil profile. The soil water content was higher in NT followed by RT and CT in the top 0-5 cm. We found an association between increased carbon, aggregation, and AMF biomass. Greater soil aggregation, carbon and AMF were observed in NT at 0-5 cm soil depth. The W-S cropping system had greater soil microbial community composition based on fungi biomass, AMF and fungal to bacteria ratio from phospholipid fatty acid analysis (PLFA). Large macroaggregates were positively correlated with total C and N, microbial biomass, Gram + , and AMF. Soil water content was positively correlated with macroaggregates, total C and N, and AC. No-till increased soil carbon content even after 44 years of cultivation. By implementing conservation tillage systems and diversified crop rotation, soil quality can be improved through greater soil organic C, water content, greater soil structure, and higher AMF biomass than CT practice in the Central Great Plains.

Extended longevity of DNA preservation in Levantine Paleolithic sediments, Sefunim Cave, Israel.

Paleogenomic research can elucidate the evolutionary history of human and faunal populations. Although the Levant is a key land-bridge between Africa and Eurasia, thus far, relatively little ancient DNA data has been generated from this region, since DNA degrades faster in warm climates. As sediments can be a source of ancient DNA, we analyzed 33 sediment samples from different sedimentological contexts in the Paleolithic layers of Sefunim Cave (Israel). Four contained traces of ancient Cervidae and Hyaenidae mitochondrial DNA. Dating by optical luminescence and radiocarbon indicates that the DNA comes from layers between 30,000 and 70,000 years old, surpassing theoretical expectations regarding the longevity of DNA deposited in such a warm environment. Both identified taxa are present in the zooarchaeological record of the site but have since gone extinct from the region, and a geoarchaeological study suggests little movement of the sediments after their deposition, lending further support to our findings. We provide details on the local conditions in the cave, which we hypothesize were particularly conducive to the long-term preservation of DNA-information that will be pertinent for future endeavors aimed at recovering ancient DNA from the Levant and other similarly challenging contexts.

Managing Postoperative Nausea With an Application of Ice Pack to the Posterior Upper Neck.

PURPOSE: Measure effectiveness of a non-pharmacological approach to manage postoperative nausea (PON) by applying an ice pack to the posterior upper neck. DESIGN: This was an observational quality improvement project. The sample included adults 18 years old and older who received general anesthesia (inhalation and/or intravenous), recovering in Phase I or Phase II postoperative care unit (PACU) experiencing very mild to moderate nausea. Exclusion criteria were patients who experienced severe nausea or were actively vomiting; were admitted for head or neck plastic surgery; were hypothermic (< 36.0°C); patients who refused the ice pack, or the provider stated that placing an ice pack to the patient's posterior upper neck was contraindicated. METHODS: Patients who experienced mild to moderate PON had an ice pack applied to the posterior upper neck as first line management. If the patient's nausea continued to progress or did not improve within five minutes of ice pack application the patient was offered a different non-pharmacological approach or pharmacological approach to prevent vomiting as per standards of care. Demographics were collected and patient's level of nausea was documented at the time of ice pack application and after five minutes. FINDINGS: Of the 70 patients included in this study, 61% reported ice pack application as effective in mitigating their nausea, 14% were unsure, and 24% reported not effective. There was a significant decrease in nausea between baseline (2.3 ± 0.6; range 1-3) and five minutes post application (1.5 ± 1.1; range 0-4). The within subject baseline-post change (↓0.9 ± 1.1; P < .001) reflected a decrease in nausea. CONCLUSIONS: Application of an ice pack to the posterior upper neck, may effectively decrease very mild to moderate PON.

Self-Selected Motivational Music on the Performance and Perceived Exertion of Runners.

ABSTRACT: Clark, JC, Baghurst, T, and Redus, BS. Self-selected motivational music on the performance and perceived exertion of runners. J Strength Cond Res 35(6): 1656-1661, 2021-Music is used by athletes and exercisers to improve performance outcomes, but it is less known whether its properties can enhance performance at maximal intensity. This study measured subjects' performance time, average heart rate, and rating of perceived exertion (RPE) on a 1.5-mile running trial when listening to self-selected motivational music vs. no music. Subjects were 17 runners (male = 8, female = 9) who completed 2, 1.5-mile time trials in a repeated-measures randomized crossover design. For the music trial, subjects were asked to select and listen to a motivational song, which was scored by the subject for its motivational quotient using the Brunel Music Rating Inventory-2. Subjects improved mean performance time by 10 seconds and increased average heart rate by 4.5 b·min-1 in the motivational music condition, but neither were significantly different (p = 0.09, 0.10). However, the music condition significantly lowered subjects' RPE by 0.5 points (p = 0.02). That motivational music improved performance time, although not significant, is noteworthy considering the significantly lower RPE reported. Therefore, ergogenic qualities of motivational music may elicit a greater performance from experienced runners while simultaneously lowering perception of effort when working at maximal intensity.

Provider behaviors that predict motivational statements in adolescents and young adults with HIV: a study of clinical communication using the Motivational Interviewing framework.

Medical care providers' use of Motivational Interviewing (MI) is linked to improved medication adherence, viral load, and associated behaviors in adolescents and young adults living with HIV. Mastering MI is difficult for busy providers; however, tailoring MI training to the specific MI communication strategies most relevant for HIV treatment context may be a strategy to increase proficiency. The present study aimed to identify communication strategies likely to elicit motivational statements among adolescent-young adult patients living with HIV. Language used by MI-exposed providers during 80 HIV medical clinic visits was transcribed and coded to characterize patient-provider communication within the MI framework. Sequential analysis, an approach to establish empirical support for the order of behavioral events, found patients were more likely to express motivational statements after provider questions phrased to elicit motivation, reflections of motivational statements, and statements emphasizing patients' decision-making autonomy. Patients were more likely to express amotivational statements when providers asked questions phrased to elicit amotivational statements or reflected amotivational language. Training providers to strategically phrase their questions and reflections to elicit change language and to emphasize patients' autonomy may be critical skills for working with adolescents and young adults living with HIV.

Lateral Knee Compartment Portals: A Cadaveric Study Defining a Posterolateral Viewing Safety Zone.

PURPOSE: This study attempted to define a reproducible "safe zone" based on extra- and intra-articular knee anatomy for placing one or 2 accessory portals in the lateral tibiofemoral compartment for posterolateral region viewing. METHODS: Standard portals were created in 10 cadaveric knees to enable posterolateral region arthroscopic lateral tibiofemoral joint compartment viewing. After identifying the lateral knee surface tissue "soft spot," an accessory posterolateral portal (A) was created using an 18-gauge spinal needle and 4-mm cannula under direct visualization of a 70° arthroscope through the anteromedial portal. A second accessory portal (B) was then created 1 cm posterior and 1 cm superior to portal A. Accessory portal locations were measured relative to capsular fold and popliteus tendon locations. Distances from the peroneal nerve, lateral collateral ligament, popliteus tendon, and the biceps tendon were determined. Statistical analysis compared portal location differences from key anatomical structures (P < .05). RESULTS: Accessory portal A (mean ± 95% confidence interval) was located 8.8 ± 2.7 mm from the popliteus tendon, 11.6 ± 2.7 mm from the lateral collateral ligament (LCL), 26.8 ± 2.3 mm from the peroneal nerve, and 4.9 ± 2.5 mm from the biceps tendon. Accessory portal B was located 17.3 ± 2.8 mm from the popliteus tendon, 20 ± 2.8 mm from the LCL, 30.3 ± 3.3 mm from the peroneal nerve, and 7.0 ± 4.8 mm from the biceps tendon. Accessory portal B was located a greater distance from the LCL and the popliteus tendon than portal A (P < .0001). CONCLUSIONS: Using intra- and extra-articular anatomic landmarks, both accessory portals could be safely placed in the lateral tibiofemoral joint compartment to enable posterolateral region viewing. Accessory portals used individually or in combination may enable easier posterolateral region viewing for arthroscopic repair of lateral tibiofemoral compartment structures. CLINICAL RELEVANCE: Lateral tibiofemoral compartment portals can be safely created to enable improved visibility for complex arthroscopic procedures in the posterolateral viewing region.

The Howieson's Poort fauna from Sibudu Cave: Documenting continuity and change within Middle Stone Age industries.

The Howieson's Poort (HP; ∼65-59 ka) continues to be a source of interest to scholars studying human behavioral evolution during the Late Pleistocene. This is in large part because the HP preserves evidence for a suite of innovative technologies and behaviors (including geometric backed tools and engraved ostrich eggshell), but also because the disappearance of the innovative behaviors associated with this phase is not well understood. Here, I present taphonomic and taxonomic data on the full sample of macromammal remains excavated from the HP deposits at Sibudu Cave under the direction of Lyn Wadley. With a total number of identified specimens (NISP) of 5921, Sibudu provides the largest sample of HP fauna published to date. Taken as a whole, the data suggest a focus on a diverse range of prey. Ungulates dominate the assemblage, as do taxa that preferentially inhabit closed (particularly forested) environments. Small bovids are common throughout; blue duiker (Philantomba monticola) alone comprises ∼33% of the total NISP. A diverse smaller game assemblage is also present. Taphonomic data implicate humans as the primary contributor to the fauna; however, low levels of gastric etching (∼1% of the NISP) suggest that non-human agents may have played some role in the accumulation of the smaller game. Despite broad similarities in the fauna, a number of directional trends are evidenced. Most notably, the lowermost deposits of the HP contain the highest frequency of blue duiker and other small ungulates, taxa which prefer closed environments, and miscellaneous smaller game. All of these decline throughout the HP, and these differences are statistically significant. After considering possible explanations for these trends, I discuss the potential implications of the variation evidenced in the assemblage to our understanding of the onset-and disappearance-of this important substage of the MSA.

Early Upper Paleolithic chronology in the Levant: new ABOx-SC accelerator mass spectrometry results from the Mughr el-Hamamah Site, Jordan.

Methodological developments and new paleoanthropological data remain jointly central to clarifying the timing and systemic interrelationships between the Middle-Upper Paleolithic (MP-UP) archaeological transition and the broadly contemporaneous anatomically modern human-archaic biological turnover. In the recently discovered cave site of Mughr el-Hamamah, Jordan, in situ flint artifacts comprise a diagnostic early Upper Paleolithic (EUP) assemblage. Unusually well-preserved charcoal from hearths and other anthropogenic features associated with the lithic material were subjected to acid-base-wet oxidation-stepped combustion (ABOx-SC) pretreatment. This article presents the ABOx-SC accelerator mass spectrometry (AMS) radiocarbon dates on nine charcoal specimens from a single palimpsest occupation layer. Date calibration was carried out using the INTCAL13 radiocarbon calibration dataset. With the bulk of the material dating to 45-39 ka cal BP (thousands of years calibrated before present), the Mughr el-Hamamah lithic artifacts reveal important differences from penecontemporaneous sites in the region, documenting greater technological variability than previously known for this time frame in the Levant. The radiocarbon data from this EUP archaeological context highlight remaining challenges for increasing chronological precision in documenting the MP-UP transition.

Continuing education mitigates the negative consequences of adolescent childbearing.

Beginning childbearing during adolescence is consistently linked with negative outcomes for both children and parents. Many have attributed this association to maternal background characteristics which are often difficult to change through policy. Though maternal educational attainment is often a side effect of adolescent childbearing, it also represents a potential avenue through which we can help young mothers overcome the obstacles associated with an early birth. The data for this study come from the 1997 Child Development Supplement of the Panel Study of Income Dynamics, a nationally representative sample of mothers and their children (N = 3,193). Data are used to explore the cognitive stimulation and emotional support in the home, measured using the HOME Scale (Caldwell and Bradley in Home observation for measurement of the environment. University of Arkansas at Little Rock, Little Rock, 1984). OLS regression models how maternal education moderates the association between age at first birth and quality of children's home environment. Adolescent mothers scored significantly lower on the indicator of home environment than older mothers. However, when continuing education was considered, maternal age at first birth was no longer significantly associated with the home environment. The negative consequences of early births were mediated by adolescent mothers' continuing education efforts. While interventions are needed to reduce adolescent childbearing, these results highlight the need to ensure that adolescent mothers are provided support to continue their education following delivery. The negative consequences of adolescent births are not inevitable. Encouraging school retention may help young mothers form a safe, healthy, nurturing, and developmentally appropriate home environment.

Men's attitudes toward breastfeeding: findings from the 2007 Texas Behavioral Risk Factor Surveillance System.

Past research on breastfeeding demonstrates that male partners' support is a significant factor in mothers' decisions to breastfeed. This study explored the diversity of men's opinions about breastfeeding, for the purpose of increasing breastfeeding support among men. This study used the Texas sample of the 2007 Behavioral Risk Factor Surveillance System (BRFSS) to examine whether men's attitudes toward breastfeeding varied by their demographic characteristics and whether fathers' breastfeeding attitudes were related to couples' choice of infant feeding method. Descriptive statistics and linear regression estimated the influence of each demographic characteristic on breastfeeding attitudes. Among a subsample of fathers, multinomial logistic regression analyzed the influence of men's breastfeeding attitudes on their choice of infant feeding method. Findings showed that Spanish-speaking Hispanic men were most likely to agree that breastfeeding had social limitations (e.g. interfere with social life) for mothers, yet they viewed public images of breastfeeding as more acceptable compared with other men. In comparison to U.S.-born men, foreign-born men were in greater agreement that employers should accommodate breastfeeding. Among fathers, support of public images of breastfeeding and attitudes toward employers' accommodations were positively associated with the choice to use breast milk. Men's ethnicity, country of origin, education level, and socioeconomic status all contribute to different norms and expectations about breastfeeding. Men's attitudes about public images of breastfeeding and employers' accommodations for breastfeeding mothers influence the choice of breast milk as the sole infant-feeding method.

Scales for assessing nonmotor symptom severity changes in Parkinson's disease patients with symptom fluctuations.

UNLABELLED: ABSTRACT Background: In Parkinson's disease (PD), the impact of nonmotor symptoms can outweigh the effect of worsening physical mobility on Health-Related Quality of Life (HRQoL). As PD progresses, patients may experience more severe changes in fluctuating nonmotor symptoms. OBJECTIVE: This review summarizes nonmotor symptom assessments in patients with fluctuating symptoms, focusing on scales utilizing a daily-diary format for a broad spectrum of nonmotor symptoms. METHODS: Medline on PubMed and EMBASE were searched for relevant articles published between January 2002 and October 2009. RESULTS: Several nonmotor symptom scales were found, but no single scale with all desirable characteristics was identified. The Scales for Outcomes in Parkinson's Disease (SCOPA) battery of assessments, the Nonmotor Symptoms Scale (NMSS), and the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part I offered a majority of the desirable characteristics, while practical, valid, and reliable. CONCLUSION: A single daily-diary instrument for assessing a broad spectrum of fluctuating nonmotor symptoms was not identified; however, the battery of SCOPA scales, the NMSS, and the MDS-UPDRS Part I provide useful nonmotor symptom severity assessment. The development of a diary assessment would be helpful in evaluating treatment interventions to improve HRQoL in patients with fluctuating symptoms.

Prevalence and risk factors for adult paternity among adolescent females ages 14 through 16 years.

To investigate sociodemographic factors associated with adolescent females ages 14-16 years having children fathered by males age 20 years or older and identify differences in correlates across rural, urban, and border areas. The method section was a cross-sectional study using Texas birth record data. From 2000 through 2004, there were 29,186 births to adolescent females aged 14-16 years with valid paternal age. Prevalence of and adjusted odds of paternal age of 20 years or older were identified by paternal and maternal factors. The Results section Having both parents born outside of the U.S. was associated with a 5.29 (95% CI: 4.82, 5.80) times increase in the odds of paternal age of 20 years or older as compared to having both parents born in the U.S. Parental place of birth was associated with greater odds of paternal age of 20 years or older in urban areas compared to rural or border areas. Compared to those with average or high educational attainment relative to age, low educational attainment relative to age was associated with an increase in the odds of paternal age of 20 years or older. This association was present whether maternal or paternal educational attainment was low relative to age. Messages are needed to help adolescent females avoid pregnancy with adult males. In addressing this specific prevention challenge, it is important to consider maternal/paternal place of birth and its association with adolescent births with adult males.

Postexposure prophylaxis for deadly bloodborne viral infections.

The purpose of this report is to discuss management of operating room personnel who have had occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and human T-cell lymphotropic virus type I (HTLV-I). HBV postexposure prophylaxis includes starting hepatitis B vaccine series in any susceptible unvaccinated operating room personnel who sustain an exposure to blood or body fluid during surgery. Postexposure prophylaxis with hepatitis B immune globulin (HBIG) is an important consideration after determining the hepatitis B antigen status of the patient. Ideally, all operating room personnel should be vaccinated with hepatitis B vaccine before they pursue their career in surgery. Immune globulin and antiviral agents (eg, interferon with or without ribavirin) should not be used for postexposure prophylaxis of operating room personnel exposed to patients with HCV; rather, follow-up HCV testing should be initiated to determine if infection develops. Postexposure prophylaxis for HIV involves a basic four-week regimen of two drugs (zidovudine and lamivudine; lamivudine and stavudine; or didanosine and stavudine) for most exposures. An expanded regimen that includes a third drug must be considered for HIV exposures that pose an increased risk for transmission. When developing a postexposure prophylaxis regimen, it is helpful to contact the National Clinicians' Postexposure Prophylaxis Hotline, (888) 448-4911. Prevention should be a major consideration in postexposure prophylaxis with the use of the double-glove hole indication system by all operating room personnel.

Reducing accidental injuries during surgery.

All surgical healthcare professionals and their patients should be aware of exposure to blood from individuals infected with potentially transmissible disease. The site that was most susceptible to sharp injuries was the index finger of the surgeon's hand. It is also important to note that needles cause the vast majority of sharp injuries. During the last two decades, there have been two revolutionary advances in preventing accidental needlestick injuries during surgery that include the development of blunt tapering point needles as well as the double-glove hole indication systems. During the innovative development of blunt taper point needles, a glove manufacturer, Molnlycke, Inc., devised non-latex and latex double-glove hole puncture indication systems that are being used throughout the world. The reliability of these double-glove hole indication systems in detecting holes in the outer glove has been reliably documented by scientific studies that are published in peer-reviewed journals. On the basis of these extensive quantitative studies, the authors recommended that the double-glove hole indication system be used in all operative procedures to prevent the transmission of deadly bloodborne viral infections.

Scientific basis for the selection of surgical staples and tissue adhesives for closure of skin wounds.

During the last four decades, there have been revolutionary advances in the development of skin staples as well as tissue adhesives. One of the purposes of this collective review is to provide an overview of recent advances in the development of metal and absorbable skin staples and tissue adhesives. In addition, we will provide technical considerations in the use of metal and absorbable skin staples and tissue adhesives during surgery. On the basis of extensive experimental studies, we would recommend the Autosuture™ Multifire Premium™ metal skin stapler. During a surgical operation, the rotating head of this skin stapler can have its skin stapling cartridge removed once for additional stapling. The revolutionary Insorb™ subcuticular skin stapler is designed to combine the cosmetic result of absorbable sutures with the rapid closure times associated with metal skin staplers, while eliminating the need for metal staple removal postoperatively. The Insorb™ absorbable staple is composed of a copolymer that is predominantly polylactide, which is absorbed over a period of a few months. The superior performance of the Insorb™ absorbable staple has been confirmed by experimental and clinical studies. In the last 20 years, surgeons have become increasingly interested in replacing sutures by means of adhesive bonds in the closure of surgical wounds. A recent collective review of clinical studies done with tissue adhesive has recommended that there is a need for well-designed randomized, controlled trials comparing tissue adhesives and alternate methods of closure, especially in patients whose health may interfere with wound healing.