1.9-million- and 2.4-million-year-old artifacts and stone tool-cutmarked bones from Ain Boucherit, Algeria.

East Africa has provided the earliest known evidence for Oldowan stone artifacts and hominin-induced stone tool cutmarks dated to ~2.6 million years (Ma) ago. The ~1.8-million-year-old stone artifacts from Ain Hanech (Algeria) were considered to represent the oldest archaeological materials in North Africa. Here we report older stone artifacts and cutmarked bones excavated from two nearby deposits at Ain Boucherit estimated to ~1.9 Ma ago, and the older to ~2.4 Ma ago. Hence, the Ain Boucherit evidence shows that ancestral hominins inhabited the Mediterranean fringe in northern Africa much earlier than previously thought. The evidence strongly argues for early dispersal of stone tool manufacture and use from East Africa or a possible multiple-origin scenario of stone technology in both East and North Africa.

Elaboración y validación de una Escala de Apoyo Profesional para cuidadores de pacientes con esquizofrenia / Elaboration and validation of a Professional Suport Scale for schizophrenic´s caregivers

Introducción: La presente investigación tuvo como objetivo elaborar y validar una escala para evaluar el apoyo profesional que reciben los cuidadores de pacientes con esquizofrenia. Se conoce bastante acerca de los factores que afectan en la percepción de carga sin haberse explorado si el apoyo profesional que reciben los cuidadores puede también influir. Hasta donde conocemos, no existen instrumentos validados que evalúen esta variable. Material y método: A partir de una revisión bibliográfica, discusión de grupos focales y entrevistas individuales se elaboraron los ítems de la escala y se validó en una muestra de 100 cuidadores. Resultados: La escala demostró una buena consistencia interna (α de Cronbach = 0,82) y adecuada estabilidad test-retest al cabo de 4 semanas (r = 0,91). Conclusiones: La Escala de Apoyo Profesional (EAP-C) es adecuada para evaluar el grado de apoyo profesional que perciben los cuidadores. Además, puede ser útil en la evaluación de la calidad asistencial que reciben los cuidadores de pacientes esquizofrénicos (AU)

Introduction: The aim of the present study was to elaborate and validate a tool to evaluate the professional support given to schizophrenics’ caregivers. The main factors involved in burden perception are well known. However, it has not been explored whether the professional support received by caregivers can influence it too. To our knowledge, we lack validated instruments to assess this variable. Material and methods: A literature review, focus group discussions and individual interviews were carried out to elaborate the items of the scale and to validate it on a sample of 100 caregivers. Results: The scale demonstrated a good internal consistency (α Cronbach = 0,82) and an acceptable test-retest reliability after four weeks (r = 0,91). Conclusions: The Professional Support Scale (EAP-C) is a useful tool to evaluate the professional support perceived by caregivers. In addition, it may be useful for the evaluation of the quality of health care received by schizophrenics’ caregivers (AU)

New luminescence ages for the Galería Complex archaeological site: resolving chronological uncertainties on the acheulean record of the Sierra de Atapuerca, northern Spain.

The archaeological karstic infill site of Galería Complex, located within the Atapuerca system (Spain), has produced a large faunal and archaeological record (Homo sp. aff. heidelbergensis fossils and Mode II lithic artefacts) belonging to the Middle Pleistocene. Extended-range luminescence dating techniques, namely post-infrared infrared stimulated luminescence (pIR-IR) dating of K-feldspars and thermally transferred optically stimulated luminescence (TT-OSL) dating of individual quartz grains, were applied to fossil-bearing sediments at Galería. The luminescence dating results are in good agreement with published chronologies derived using alternative radiometric dating methods (i.e., ESR and U-series dating of bracketing speleothems and combined ESR/U-series dating of herbivore teeth), as well as biochronology and palaeoenvironmental reconstructions inferred from proxy records (e.g., pollen data). For the majority of samples dated, however, the new luminescence ages are significantly (∼50%) younger than previously published polymineral thermoluminescence (TL) chronologies, suggesting that the latter may have overestimated the true burial age of the Galería deposits. The luminescence ages obtained indicate that the top of the basal sterile sands (GIb) at Galería have an age of up to ∼370 thousand years (ka), while the lowermost sub-unit containing Mode II Acheulean lithics (base of unit GIIa) was deposited during MIS 9 (mean age = 313±14 ka; n = 4). The overlying units GIIb-GIV, which contain the richest archaeopalaeontological remains, were deposited during late MIS 8 or early MIS 7 (∼240 ka). Galería Complex may be correlative with other Middle Pleistocene sites from Atapuerca, such as Gran Dolina level TD10 and unit TE19 from Sima del Elefante, but the lowermost archaeological horizons are ∼100 ka younger than the hominin-bearing clay breccias at the Sima de los Huesos site. Our results suggest that both pIR-IR and single-grain TT-OSL dating are suitable for resolving Middle Pleistocene chronologies for the Sierra de Atapuerca karstic infill sequences.

Luminescence dating and palaeomagnetic age constraint on hominins from Sima de los Huesos, Atapuerca, Spain.

Establishing a reliable chronology on the extensive hominin remains at Sima de los Huesos is critical for an improved understanding of the complex evolutionary histories and phylogenetic relationships of the European Middle Pleistocene hominin record. In this study, we use a combination of 'extended-range' luminescence dating techniques and palaeomagnetism to provide new age constraint on sedimentary infills that are unambiguously associated with the Sima fossil assemblage. Post-infrared-infrared stimulated luminescence (pIR-IR) dating of K-feldspars and thermally transferred optically stimulated luminescence (TT-OSL) dating of individual quartz grains provide weighted mean ages of 433 ± 15 ka (thousands of years) and 416 ± 19 ka, respectively, for allochthonous sedimentary horizons overlying the hominin-bearing clay breccia. The six replicate luminescence ages obtained for this deposit are reproducible and provide a combined minimum age estimate of 427 ± 12 ka for the underlying hominin fossils. Palaeomagnetic directions for the luminescence dated sediment horizon and underlying fossiliferous clays display exclusively normal polarities. These findings are consistent with the luminescence dating results and confirm that the hominin fossil horizon accumulated during the Brunhes Chron, i.e., within the last 780 ka. The new bracketing age constraint for the Sima hominins is in broad agreement with radiometrically dated Homo heidelbergensis fossil sites, such as Mauer and Arago, and suggests that the split of the H. neanderthalensis and H. sapiens lineages took place during the early Middle Pleistocene. More widespread numerical dating of key Early and Middle Pleistocene fossil sites across Europe is needed to test and refine competing models of hominin evolution. The new luminescence chronologies presented in this study demonstrate the versatility of TT-OSL and pIR-IR techniques and the potential role they could play in helping to refine evolutionary histories over Middle Pleistocene timescales.

The oldest human fossil in Europe, from Orce (Spain).

The Orce region has one of the best late Pliocene and early Pleistocene continental paleobiological records of Europe. It is situated in the northeastern sector of the intramontane Guadix-Baza Basin (Granada, Andalusia, southern Spain). Here we describe a new fossil hominin tooth from the site of Barranco León, dated between 1.02 and 1.73 Ma (millions of years ago) by Electron Spin Resonance (ESR), which, in combination with paleomagnetic and biochronologic data, is estimated to be close to 1.4 Ma. While the range of dates obtained from these various methods overlaps with those published for the Sima del Elefante hominin locality (1.2 Ma), the overwhelming majority of evidence points to an older age. Thus, at the moment, the Barranco León hominin is the oldest from Western Europe.

Use of red ochre by early Neandertals.

The use of manganese and iron oxides by late Neandertals is well documented in Europe, especially for the period 60-40 kya. Such finds often have been interpreted as pigments even though their exact function is largely unknown. Here we report significantly older iron oxide finds that constitute the earliest documented use of red ochre by Neandertals. These finds were small concentrates of red material retrieved during excavations at Maastricht-Belvédère, The Netherlands. The excavations exposed a series of well-preserved flint artifact (and occasionally bone) scatters, formed in a river valley setting during a late Middle Pleistocene full interglacial period. Samples of the reddish material were submitted to various forms of analyses to study their physical properties. All analyses identified the red material as hematite. This is a nonlocal material that was imported to the site, possibly over dozens of kilometers. Identification of the Maastricht-Belvédère finds as hematite pushes the use of red ochre by (early) Neandertals back in time significantly, to minimally 200-250 kya (i.e., to the same time range as the early ochre use in the African record).

Varicose vein surgery: stripping versus the CHIVA method: a randomized controlled trial.

OBJECTIVE: The objective of this randomized study was to compare the efficacy of the CHIVA method for the treatment of varicose veins with respect to the standard treatment of stripping. CONTEXT: Varicose veins are a sign of chronic venous disorder. For over a century, varicose veins have been treated with surgical ablative techniques, with stripping being the standard treatment. Currently, postsurgical varicose veins recurrence (20%-80%) is a common, complex, and costly problem. Ambulatory Conservative Hemodynamic Management of Varicose Veins (CHIVA) is a new option for treating chronic venous disorder. METHODS: In this open-label, randomized controlled trial, 501 adult patients with primary varicose veins were treated in a single center. They were assigned to an experimental group, the CHIVA method (n = 167) and 2 control groups: stripping with clinic marking (n = 167) and stripping with duplex marking (n = 167). The outcome measure was clinical recurrence within 5 years, assessed clinically by previously trained independent observers. Duplex ultrasonography was also used to assess recurrences and causes. RESULTS: In an intention-to-treat analysis, clinical outcomes in the CHIVA group were better (44.3% cure, 24.6% improvement, 31.1% failure) than in both the stripping with clinic marking (21.0% cure, 26.3% improvement, 52.7% failure) and stripping with duplex marking (29.3% cure, 22.8% improvement, 47.9% failure) groups. The ordinal odds ratio between the stripping with clinic marking and CHIVA groups, of recurrence at 5 years of follow-up, was 2.64, (95% confidence interval [CI]: 1.76-3.97, P < 0.001). The ordinal odds ratio of recurrence at 5-years of follow-up, between the stripping with duplex marking and CHIVA group, was 2.01 (95% CI: 1.34-3.00, P < 0.001). This trial is registered at ISRCTN and carries the following ID number: ISRCTN52861672, available at: http://isrctn.org. CONCLUSIONS: The present results indicate that, thanks to specific venous hemodynamic evaluation, the CHIVA method is more effective than stripping with clinical marking or stripping with duplex marking to treat varicose veins. When carrying out a stripping intervention, Duplex marking does not improve the clinical results of this ablative technique.

The first hominin of Europe.

The earliest hominin occupation of Europe is one of the most debated topics in palaeoanthropology. However, the purportedly oldest of the Early Pleistocene sites in Eurasia lack precise age control and contain stone tools rather than human fossil remains. Here we report the discovery of a human mandible associated with an assemblage of Mode 1 lithic tools and faunal remains bearing traces of hominin processing, in stratigraphic level TE9 at the site of the Sima del Elefante, Atapuerca, Spain. Level TE9 has been dated to the Early Pleistocene (approximately 1.2-1.1 Myr), based on a combination of palaeomagnetism, cosmogenic nuclides and biostratigraphy. The Sima del Elefante site thus emerges as the oldest, most accurately dated record of human occupation in Europe, to our knowledge. The study of the human mandible suggests that the first settlement of Western Europe could be related to an early demographic expansion out of Africa. The new evidence, with previous findings in other Atapuerca sites (level TD6 from Gran Dolina), also suggests that a speciation event occurred in this extreme area of the Eurasian continent during the Early Pleistocene, initiating the hominin lineage represented by the TE9 and TD6 hominins.

Matuyama-age lithic tools from the Sima del Elefante site, Atapuerca (northern Spain).

Paleomagnetic results obtained from the sedimentary fill at the Sima del Elefante site in Atapuerca, Spain, reveal a geomagnetic reversal, interpreted as the Matuyama-Brunhes boundary (0.78 Ma). The uppermost lithostratigraphic units (E17 through E19), which contain Mode II and III archaeological assemblages, display normal polarity magnetization, whereas the six lowermost units (E9 through E16) yield negative latitudinal virtual geomagnetic pole positions. Units E9 through E13, all of which display reverse magnetic polarity, contain Mode I (Oldowan) lithic tools, testifying to the presence of humans in the early Pleistocene (0.78-1.77 Ma).