Architecture, sedentism, and social complexity at Pre-Pottery Neolithic A WF16, Southern Jordan

Recent excavations at Pre-Pottery Neolithic A (PPNA) WF16 in southern Jordan have revealed remarkable evidence of architectural developments in the early Neolithic. This sheds light on both special purpose structures and "domestic" settlement, allowing fresh insights into the development of increasingly sedentary communities and the social systems they supported. The development of sedentary communities is a central part of the Neolithic process in Southwest Asia. Architecture and ideas of homes and households have been important to the debate, although there has also been considerable discussion on the role of communal buildings and the organization of early sedentarizing communities since the discovery of the tower at Jericho. Recently, the focus has been on either northern Levantine PPNA sites, such as Jerf el Ahmar, or the emergence of ritual buildings in the Pre-Pottery Neolithic B of the southern Levant. Much of the debate revolves around a division between what is interpreted as domestic space, contrasted with "special purpose" buildings. Our recent evidence allows a fresh examination of the nature of early Neolithic communities.     

Evidence for food storage and predomestication granaries 11,000 years ago in the Jordan Valley

Food storage is a vital component in the economic and social package that comprises the Neolithic, contributing to plant domestication, increasingly sedentary lifestyles, and new social organizations. Recent excavations at Dhra′ near the Dead Sea in Jordan provide strong evidence for sophisticated, purpose-built granaries in a predomestication context ≈11,300–11,175 cal B.P., which support recent arguments for the deliberate cultivation of wild cereals at this time. Designed with suspended floors for air circulation and protection from rodents, they are located between residential structures that contain plant-processing instillations. The granaries represent a critical evolutionary shift in the relationship between people and plant foods, which precedes the emergence of domestication and large-scale sedentary communities by at least 1,000 years.     

New chronology for Ksar ‘Akil (Lebanon) supports Levantine route of modern human dispersal into Europe

Modern human dispersal into Europe is thought to have occurred with the start of the Upper Paleolithic around 50,000–40,000 y ago. The Levantine corridor hypothesis suggests that modern humans from Africa spread into Europe via the Levant. Ksâr ‘Akil (Lebanon), with its deeply stratified Initial (IUP) and Early (EUP) Upper Paleolithic sequence containing modern human remains, has played an important part in the debate. The latest chronology for the site, based on AMS radiocarbon dates of shell ornaments, suggests that the appearance of the Levantine IUP is later than the start of the first Upper Paleolithic in Europe, thus questioning the Levantine corridor hypothesis. Here we report a series of AMS radiocarbon dates on the marine gastropod Phorcus turbinatus associated with modern human remains and IUP and EUP stone tools from Ksâr ‘Akil. Our results, supported by an evaluation of individual sample integrity, place the EUP layer containing the skeleton known as “Egbert” between 43,200 and 42,900 cal B.P. and the IUP-associated modern human maxilla known as “Ethelruda” before ∼45,900 cal B.P. This chronology is in line with those of other Levantine IUP and EUP sites and demonstrates that the presence of modern humans associated with Upper Paleolithic toolkits in the Levant predates all modern human fossils from Europe. The age of the IUP-associated Ethelruda fossil is significant for the spread of modern humans carrying the IUP into Europe and suggests a rapid initial colonization of Europe by our species.Fossil and genetic evidence suggest that anatomically modern humans (AMH) originated in Africa and colonized Europe between at least 50,000–40,000 calendar years ago (cal B.P.; i.e., calendar years relative to AD 1950) (1–6). The modern human fossil record for this time period is limited to only a few remains, including those found at Ksâr ''Akil (7) and Manot Cave (8) in the eastern Mediterranean region of southwestern Asia and Peştera cu Oase in Romania (2) (SI Appendix, Section 3). The interpretation of this scant record is affected by imprecise chronologies, and in some cases, by problematic stratigraphies or lack of contextual data (2, 8–10). The recently discovered fossil at Manot (Israel) places AMH in the Levant as early as 60,200–49,200 y ago (8). However, because the fossil was found on a natural shelf unconnected with the otherwise rich archeological deposits elsewhere in the cave, its affiliation to an archeological technocomplex is unclear. Based on the uranium–thorium dates, the authors suggest an attribution of the fossil to either a late Middle Paleolithic (MP) or Initial Upper Paleolithic (IUP) technocomplex. The lack of archeological association and contextual behavioral data limits our understanding of the fossil’s relation to both the Levantine and the European record. Hence, there is very little information to study the dispersal trajectory of modern humans into Europe. However, bones of modern humans from the Levant (e.g., Üçağızlı I and Ksâr ''Akil) and Europe (e.g., Kostenki 1, 14, and 17) are found in archeological contexts and in association with Early UP (EUP) lithic technologies (7, 9, 11, 12). These lithic assemblages, therefore, can be used as a proxy for modern human dispersal (13) and links between several such Levantine and European technocomplexes have been documented (11, 12, 14–16). The archeological record suggests that modern human dispersal from Africa likely took place in several episodes rather than one large exodus (3, 6, 14, 17–19). This hypothesis is supported by genetic and fossil data (20).AMH dispersal into Europe is broadly contemporaneous with the disappearance of Neanderthals and the beginning of the UP, as witnessed by changes in the archeological record including frequent use of red ochre, modified marine shells and perforated animal teeth as body ornaments, elaborate bone and antler technology, as well as changes in lithic technology (19). Most scholars (3, 6, 14, 19, 21, 22) advocate the importance of southwestern Asia, including the Levant, as a “gateway” to Eurasia for modern humans coming from Africa. This Levantine corridor hypothesis has recently been questioned, as it has been argued that the UP and modern behavior, evidenced by the presence of shell beads in the material culture, first appeared in Europe before their first occurrence in the Levant (23). This interpretation is based on a combination of relatively old ages (around 39,900 cal B.P.) for Uluzzian ornamental shell in southern Italy (10) and strikingly young ages (around 36,300–37,400 cal B.P.) for shell ornaments from Üçağızlı I and Ksâr ''Akil in the Levant (23, 24). If the UP in Europe truly predates the Levantine evidence, as Douka et al. (24) suggest, it should be considered unlikely that its makers traveled from Africa through the Levant before arriving in Europe. Here, we provide a new chronology for Ksâr ''Akil and show that the earliest UP and its associated AMH remains predate any European evidence.     

Green stone beads at the dawn of agriculture

The use of beads and other personal ornaments is a trait of modern human behavior. During the Middle and Upper Paleolithic periods, beads were made out of shell, bone, ivory, egg shell, and occasionally of minerals. During the transition to agriculture in the Near East, stone, in particular green stone, was used for the first time to make beads and pendants. We observed that a large variety of minerals of green colors were sought, including apatite, several copper-bearing minerals, amazonite and serpentinite. There seems to be an increase with time of distance from which the green minerals were sought. Because beads in white, red, yellow, brown, and black colors had been used previously, we suggest that the occurrence of green beads is directly related to the onset of agriculture. Green beads and bead blanks were used as amulets to ward off the evil eye and as fertility charms.     

Pre-Neolithic wild boar management and introduction to Cyprus more than 11,400 years ago

The beginnings of pig domestication in Southwest Asia are controversial. In some areas, it seems to have occurred abruptly ca. 10,500 years ago, whereas in nearby locations, it appears to have resulted from a long period of management of wild boar starting at the end of the Late Pleistocene. Here, we present analyses of suid bones from Akrotiri Aetokremnos, Cyprus. This site has provided the earliest evidence for human occupation of the Mediterranean islands. Morphological analysis and direct radiocarbon dating of both degraded collagen and apatite of these bones reveal that small-sized suids were living on Cyprus 11,400–11,700 years ago. We demonstrate that these suids were introduced by humans and that, at this early date, their small size must result from island isolation. This sheds light on the early Holocene colonization of Cyprus and on pre-Neolithic Mediterranean seafaring. We further argue that wild boar were managed on the mainland before their introduction to Cyprus (i.e., before the beginning of the Neolithic and at least 1 millennium before the earliest known morphological modifications attributable to domestication). This adds weight to the theory that pig domestication involved a long period of wild boar management that started about the time of the Pleistocene/Holocene transition.     

The Development of Novel Near-Infrared (NIR) Tetraarylazadipyrromethene Fluorescent Dyes

Novel structures of an near-infrared (NIR) tetraarylazadipyrromethene (aza-BODIPY) series have been prepared. We designed the core structure containing two amido groups at the para-position of the aromatic rings. The amido group was incorporated to secure insensitivity to pH and to ensure a bathochromic shift to the NIR region. Forty members of aza-BODIPY compounds were synthesized by substitution of the acetyl group with commercial amines on the alpha bromide. The physicochemical properties and photostability were investigated and the fluorescence emission maxima (745~755 nm) were found to be in the near infrared (NIR) range of fluorescence.     

Follow-up survey of oral health status of children enrolled in UNRWA schools: a cross-sectional study

Background

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) School Health Programme provides preventive oral health services to school students through regular dental screening of new entrants and fourth and seventh grade students, in addition to the health education activities and treatment of decayed teeth provided by dental surgeons in health centres and by mobile dental teams. The main focus of UNRWA oral health services continues to be prevention rather than treatment. The objective of this follow-up survey was to calculate decayed, missing, and filled teeth (DMFT), and decayed, missing, and filled surfaces (DMFS) indices among seventh grade UNRWA schoolchildren in all five areas in which UNRWA operates (Gaza, Jordan, Lebanon, Syria, and West Bank), and to compare the results of this survey globally, locally and with a previous survey conducted in 2010 and 2011.

近焦窄带光成像鉴别诊断增生性息肉及无蒂型锯齿状腺瘤/息肉的价值

目的 评估近焦窄带光成像（near focus narrow-band imaging, NF-NBI）鉴别增生性息肉（hyperplastic polyp, HP）及无蒂型锯齿状腺瘤/息肉（sessile serrated adenoma/polyp,SSA/P）的价值。方法 回顾性分析2017年10月至2018年9月于复旦大学附属华东医院消化内镜中心内镜下切除后病理结果为HP或SSA/P,且数据库内有清晰NF-NBI图像的65例病变资料。由3名高年资医生分别观察NF-NBI图像,包括扩张的隐窝开口(expanded crypt opening, ECO)及增粗的树枝样血管(thick and branched vessel, TBV),将结果与病理结果进行对比,分析ECO与TBV对于HP及SSA/P鉴别诊断价值。结果 65例病变中,病理结果显示SSA/P44例,HP21例。ECO对于SSA/P诊断的灵敏度、特异度和准确率分别为80.3%(106/132)、85.7%(54/63)和82.1%(160/195);TBV对于SSA/P诊断的灵敏度、特异度和准确率分别为38.6%(51/132)和82.5%(52/63)、52.8%(103/195)。ECO联合TBV对于SSA/P诊断的灵敏度、特异度和准确率分别为84.8%(112/132)、73.0%(46/63)和81.0%(158/195)。结论 NF-NBI下ECO对于诊断SSA/P具有较高灵敏度。ECO与TBV联合诊断,有助于SSA/P与HP的鉴别诊断。     

Sociocultural factors in access to contraception by Palestine refugees in Jordan: a qualitative study

Background

Maternal mortality rates in Palestine refugees in Jordan increased by 16% between 2013 and 2016. Action is needed to prevent future maternal deaths. Risk factors for maternal mortality are a young mother (below 20 years of age) and pregnancies that are close together (interval of less than 18 months), which can be prevented through the use of contraception. Contraceptive discontinuation rates increased among Palestine refugees in Jordan by 3% between 2015 and 2016. Sociocultural factors are important in access to contraception. This study assesses sociocultural barriers and opportunities to accessing contraception among Palestine refugees in Jordan.

Breastfeeding and infant health outcomes at 9 months of age in the Gaza Strip: a cross-sectional randomised trial

Background

There are limited studies about optimal duration and benefits of breastfeeding—and in particular, exclusive breastfeeding—on infant health and growth in the occupied Palestinian territory. This study aimed to evaluate the effect of exclusive breastfeeding on the health of infants in the Gaza Strip (at age 9 months), in terms of anthropometric measurements, growth, and morbidity.

The burden of influenza in East and South‐East Asia: a review of the English language literature

Abstract While human infections with avian influenza A (H5NI) viruses in Asia have prompted concerns about an influenza pandemic, the burden of human influenza in East and Southeast Asia has received far less attention. We conducted a review of English language articles on influenza in 18 countries in East and Southeast Asia published from 1980 to 2006 that were indexed on PubMed. Articles that described human influenza‐associated illnesses among outpatients or hospitalized patients, influenza‐associated deaths, or influenza‐associated socioeconomic costs were reviewed. We found 35 articles from 9 countries that met criteria for inclusion in the review. The quality of articles varied substantially. Significant heterogeneity was noted in case definitions, sampling schemes and laboratory methods. Early studies relied on cell culture, had difficulties with specimen collection and handling, and reported a low burden of disease. The recent addition of PCR testing has greatly improved the proportion of respiratory illnesses diagnosed with influenza. These more recent studies reported that 11–26% of outpatient febrile illness and 6‐14% of hospitalized pneumonia cases had laboratory‐confirmed influenza infection. The influenza disease burden literature from East and Southeast Asia is limited but expanding. Recent studies using improved laboratory testing methods and indirect statistical approaches report a substantial burden of disease, similar to that of Europe and North America. Current increased international focus on influenza, coupled with unprecedented funding for surveillance and research, provide a unique opportunity to more comprehensively describe the burden of human influenza in the region.     

Temperature,Hematocrit, pH,and Glucose 4-Way ANOVA of Cytochrome C Oxidase Redox Status During Systemic Cold Circulatory Arrest in Swine

Various investigators using near infrared spectroscopy (NIRS) have reported differing patterns of cytochrome C oxidase (cytochrome a,a₃) redox status in similar brain oxygenation studies. We investigated whether distinctive differences could be due to combinations of variations in temperature, hematocrit, pH, and glucose. Methods: Thirty-six healthy 10 kg commercial juvenile swine on cardiopulmonary bypass underwent 2–8 sequential periods of circulatory arrest. Prior to each arrest, key physiological variables were adjusted to match a random selection of one of 81 combinations of high, normal, or low levels of hypothermia, hematocrit, pH, and serum glucose. In the course of the study, the combinations were repeated twice to yield 162 NIRS data sets. Results: The mean rate of change in net oxidized minus reduced cytochrome a,a₃ redox status in the brain following 7.5 min of ischemia was 0.49 ± 0.26 mol L^–1 min^–1, and, the corresponding mean magnitude of change was –1.23 ± 0.57 mol L^–1. The rate of change was influenced by temperature but not by hematocrit, pH, or glucose, either singly or in combination. Conclusion: The respiratory response in mitochondria during systemic circulatory arrest is significantly influenced by temperature.     

Hospitalisation coverage by UNRWA in Jordan,Lebanon, Syria,Gaza, and the West Bank: a comparative snapshot analysis

Background

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) supports the hospitalisation of Palestine refugees with country-specific policies in five fields of operation; Jordan, Lebanon, Syria, Gaza, and the West Bank. The objective of this study was to compare caseloads and percentage vulnerability generated by the different policies.

The relationship between leader–member exchange,organisational citizenship behaviour,and organisational commitment among UNRWA health staff in the Gaza governorates

Background

Leader–member exchange (the relationship between the manager and his or her employees) is important for the sustained growth of any organisation, and contributes to the organisation's goals and achievements. This study explores the relationship between leader–member exchange and two managerial domains—organisational citizenship behaviour and organisational commitment—among UNRWA health staff in Gaza governorates.

Errors and near misses in digestive endoscopy units

Background

Not much is known about errors and near misses in digestive endoscopy.

Aims

To verify whether an incident report, with certain facilitating features, gives useful information about unintended events, only excluding errors in medical diagnosis.

Method

Nine endoscopy units took part in this cross sectional, prospective, multicentre study which lasted for two weeks. Members of the staff were required to report any unintended, potentially dangerous event observed during the daily work. A form was provided with a list of “reminders” and facilitators were appointed to help.The main outcome measurements were type of event, causes, corrective interventions, stage of occurrence in the workflow and qualification of the reporters.

Results

A total of 232 errors were reported (two were not related to endoscopy). The remaining 230 amount to 10.3% of 2239 procedures; 66 (29%) were considered errors with consequences, 164 (71%) “near misses”. There were 150 pre-operative errors (65%), 22 operative (10%) and 58 post-operative (25%). Corrective interventions were provided for 60 cases of errors and 119 near misses. Most of the events were reported by the nurses (106 out of 232, 46%).

Conclusions

Short-term incident reporting focusing on near misses, using forms with lists of “reminders”, and the help of a facilitator, can give useful information on errors and near misses in digestive endoscopy.     

Intravascular ultrasound,optical coherence tomography and near infrared spectroscopy

Intravascular ultrasound (IVUS), optical coherence tomography (OCT) and near infrared spectroscopy (NIRS) allows for a thorough analysis of the atheroma's morphology in vivo. Moreover, it helps to guide coronary intervention and assess the results of stenting. IVUS, OCT and NIRS provide unique data about the analyzed tissue and thus all of them complement each other. Their application in daily clinical practice helps to understand the underlying pathology of disease and may contribute to the improvement of outcomes in coronary interventions.     

Prevalence of exclusive breastfeeding and associated factors among refugees from Palestine in Jordan: a cross-sectional study

Background

WHO and UNICEF recommend early initiation of breastfeeding, within the first hour after delivery, and exclusive breastfeeding (EBF) in the first 6 months of infant life. The most recent data available (from 2001) show that the EBF prevalence among Palestinian refugee infants under 4 months in Jordan was 24%. The study objectives were to estimate the current prevalence of EBF and early initiation, and to examine factors associated with EBF among refugees from Palestine in Jordan registered with UNRWA.