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.

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.

Physician documentation of sepsis syndrome is associated with more aggressive treatment.

INTRODUCTION: Timely recognition and treatment of sepsis improves survival. The objective is to examine the association between recognition of sepsis and timeliness of treatments. METHODS: We identified a retrospective cohort of emergency department (ED) patients with positive blood cultures from May 2007 to January 2009, and reviewed vital signs, imaging, laboratory data, and physician/nursing charts. Patients who met systemic inflammatory response syndrome (SIRS) criteria and had evidence of infection available to the treating clinician at the time of the encounter were classified as having sepsis. Patients were dichotomized as RECOGNIZED if sepsis was explicitly articulated in the patient record or if a sepsis order set was launched, or as UNRECOGNIZED if neither of these two criteria were met. We used median regression to compare time to antibiotic administration and total volume of fluid resuscitation between groups, controlling for age, sex, and sepsis severity. RESULTS: SIRS criteria were present in 228/315 (72.4%) cases. Our record review identified sepsis syndromes in 214 (67.9%) cases of which 118 (55.1%) had sepsis, 64 (29.9%) had severe sepsis, and 32 (15.0%) had septic shock. The treating team contemplated sepsis (RECOGNIZED) in 123 (57.6%) patients. Compared to the UNRECOGNIZED group, the RECOGNIZED group had a higher use of antibiotics in the ED (91.9 vs.75.8%, p=0.002), more patients aged 60 years or older (56.9 vs. 33.0%, p=0.001), and more severe cases (septic shock: 18.7 vs. 9.9%, severe sepsis: 39.0 vs.17.6%, sepsis: 42.3 vs.72.5%; p<0.001). The median time to antibiotic (minutes) was lower in the RECOGNIZED (142) versus UNRECOGNIZED (229) group, with an adjusted median difference of -74 minutes (95% CI [-128 to -19]). The median total volume of fluid resuscitation (mL) was higher in the RECOGNIZED (1,600 mL) compared to the UNRECOGNIZED (1,000 mL) group. However, the adjusted median difference was not statistically significant: 262 mL (95% CI [ -171 to 694 mL]). CONCLUSION: Patients whose emergency physicians articulated sepsis syndrome in their documentation or who launched the sepsis order set received antibiotics sooner and received more total volume of fluid. Age <60 and absence of fever are factors associated with lack of recognition of sepsis cases.

Modeling the pre-industrial roots of modern super-exponential population growth.

To Malthus, rapid human population growth-so evident in 18th Century Europe-was obviously unsustainable. In his Essay on the Principle of Population, Malthus cogently argued that environmental and socioeconomic constraints on population rise were inevitable. Yet, he penned his essay on the eve of the global census size reaching one billion, as nearly two centuries of super-exponential increase were taking off. Introducing a novel extension of J. E. Cohen's hallmark coupled difference equation model of human population dynamics and carrying capacity, this article examines just how elastic population growth limits may be in response to demographic change. The revised model involves a simple formalization of how consumption costs influence carrying capacity elasticity over time. Recognizing that complex social resource-extraction networks support ongoing consumption-based investment in family formation and intergenerational resource transfers, it is important to consider how consumption has impacted the human environment and demography--especially as global population has become very large. Sensitivity analysis of the consumption-cost model's fit to historical population estimates, modern census data, and 21st Century demographic projections supports a critical conclusion. The recent population explosion was systemically determined by long-term, distinctly pre-industrial cultural evolution. It is suggested that modern globalizing transitions in technology, susceptibility to infectious disease, information flows and accumulation, and economic complexity were endogenous products of much earlier biocultural evolution of family formation's embeddedness in larger, hierarchically self-organizing cultural systems, which could potentially support high population elasticity of carrying capacity. Modern super-exponential population growth cannot be considered separately from long-term change in the multi-scalar political economy that connects family formation and intergenerational resource transfers to wider institutions and social networks.

Embodied niche construction in the hominin lineage: semiotic structure and sustained attention in human embodied cognition.

Human evolution unfolded through a rather distinctive, dynamically constructed ecological niche. The human niche is not only generally terrestrial in habitat, while being flexibly and extensively heterotrophic in food-web connections. It is also defined by semiotically structured and structuring embodied cognitive interfaces, connecting the individual organism with the wider environment. The embodied dimensions of niche-population co-evolution have long involved semiotic system construction, which I hypothesize to be an evolutionarily primitive aspect of learning and higher-level cognitive integration and attention in the great apes and humans alike. A clearly pre-linguistic form of semiotic cognitive structuration is suggested to involve recursively learned and constructed object icons. Higher-level cognitive iconic representation of visually, auditorily, or haptically perceived extrasomatic objects would be learned and evoked through indexical connections to proprioceptive and affective somatic states. Thus, private cognitive signs would be defined, not only by their learned and perceived extrasomatic referents, but also by their associations to iconically represented somatic states. This evolutionary modification of animal associative learning is suggested to be adaptive in ecological niches occupied by long-lived, large-bodied ape species, facilitating memory construction and recall in highly varied foraging and social contexts, while sustaining selective attention during goal-directed behavioral sequences. The embodied niche construction (ENC) hypothesis of human evolution posits that in the early hominin lineage, natural selection further modified the ancestral ape semiotic adaptations, favoring the recursive structuration of concise iconic narratives of embodied interaction with the environment.

Altitude Sickness in Climbers and Efficacy of NSAIDs Trial (ASCENT): randomized, controlled trial of ibuprofen versus placebo for prevention of altitude illness.

OBJECTIVE: To study the effectiveness of ibuprofen versus placebo in preventing acute mountain sickness (AMS) and high altitude headache (HAH). METHODS: Double-blind, randomized, placebo-controlled trial. RESULTS: Two hundred ninety-four healthy Western trekkers were recruited on the Everest approach at 4280 m or 4358 m and randomly assigned to receive either 600 mg of ibuprofen or placebo 3 times daily before and during ascent to 4928 m. One hundred eighty-three of 294 participants completed the trial. Of the participants who did not complete the trial, 62 were lost to follow-up and another 49 broke trial protocol. In an intent-to-treat analysis (232 participants), ibuprofen was found to be more effective than placebo in reducing the incidence of AMS (24.4% vs 40.4%; P = .01) and the incidence of HAH (42.3% vs 60.5%; P < .01). Ibuprofen was also superior to placebo in reducing the severity of HAH (4.9% vs 14.7%; P = .01). The end point of oxygen saturation was also higher in the ibuprofen group (80.8 % vs 82.4%; P = .035). For the 183 participants who completed the trial and conformed to the protocol, the incidence of AMS between placebo and treatment groups was not significant (32.9% vs 22.7%; P = .129 for AMS incidence, 9.6% vs 8.2%; P = .74 for AMS severity, 54.8% vs 42.7%; P = .11 for HAH incidence, and 8.2% vs 3.6%; P = .18 for HAH severity). CONCLUSIONS: Ibuprofen was found to be effective in preventing AMS in the intent-to-treat analysis group but not in those who completed the trial. This loss of significance in the subjects who completed the trial may be explained by persons in the placebo group having a higher burden of illness and associated decreased compliance with the protocol. An important limitation of this study may be the possibility that ibuprofen can mask headache, which is a compulsory criterion for the diagnosis of AMS.

Increasing the resolution of the Broad Spectrum Revolution in the Southern Levantine Epipaleolithic (19-12 ka).

We analyze terminal Pleistocene archaeofaunal diversity trends in the Southern Levant by examining eight Epipaleolithic (ca. 19-12ka) assemblages from the Western Galilee/Mt. Carmel, Israel subregion. We test predictions from a Broad Spectrum Revolution model of the population dynamics of human foragers and their prey. The study emphasizes control over geographic variability and archaeological recovery and recording methods, as we analyze a time series that samples the Epipaleolithic more fully than have previous studies. This provides a new opportunity to examine human population and economic change in the long-term transition to sedentism and agriculture. We use the Mantel test to evaluate the significance of temporal trends in body-size-based big game diversity, as well as in diversity of small game prey types. Results demonstrate a highly significant decline through time in the relative abundance of medium and large big game, measured relative to small big game. This suggests that the apparent "gazelle specialization" by Late Epipaleolithic (Natufian) hunters reflects longer-term anthropogenic overexploitation of the largest prey types in the spectrum. While large and medium big game abundance declined, our results show small game increased in economic importance over time. Considered with associated climate change data, the results provide substantial support for the hypothesis that local human populations expanded rapidly in size after the Last Glacial Maximum (LGM). We suggest that following the post-LGM population pulse, human foragers adopted a shifting series of intensification strategies mediated by changes in residential mobility.