The emergence of the Acheulean from the earlier Oldowan constitutes a major transition in human evolution, the theme of this special issue. This paper discusses the evidence for the origins of the ...Acheulean, a cornerstone in the history of human technology, from two perspectives; firstly, a review of the history of investigations on Acheulean research is presented. This approach introduces the evolution of theories throughout the development of the discipline, and reviews the way in which cumulative knowledge led to the prevalent explanatory framework for the emergence of the Acheulean. The second part presents the current state of the art in Acheulean origins research, and reviews the hard evidence for the appearance of this technology in Africa around 1.7 Ma, and its significance for the evolutionary history of Homo erectus.
This article is part of the themed issue ‘Major transitions in human evolution’.
Objective
To develop and validate new classification criteria for adult and juvenile idiopathic inflammatory myopathies (IIM) and their major subgroups.
Methods
Candidate variables were assembled ...from published criteria and expert opinion using consensus methodology. Data were collected from 47 rheumatology, dermatology, neurology, and pediatric clinics worldwide. Several statistical methods were utilized to derive the classification criteria.
Results
Based on data from 976 IIM patients (74% adults; 26% children) and 624 non‐IIM patients with mimicking conditions (82% adults; 18% children), new criteria were derived. Each item is assigned a weighted score. The total score corresponds to a probability of having IIM. Subclassification is performed using a classification tree. A probability cutoff of 55%, corresponding to a score of 5.5 (6.7 with muscle biopsy) “probable IIM,” had best sensitivity/specificity (87%/82% without biopsies, 93%/88% with biopsies) and is recommended as a minimum to classify a patient as having IIM. A probability of ≥90%, corresponding to a score of ≥7.5 (≥8.7 with muscle biopsy), corresponds to “definite IIM.” A probability of <50%, corresponding to a score of <5.3 (<6.5 with muscle biopsy), rules out IIM, leaving a probability of ≥50–<55% as “possible IIM.”
Conclusion
The European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for IIM have been endorsed by international rheumatology, dermatology, neurology, and pediatric groups. They employ easily accessible and operationally defined elements, and have been partially validated. They allow classification of “definite,” “probable,” and “possible” IIM, in addition to the major subgroups of IIM, including juvenile IIM. They generally perform better than existing criteria.
Background
Since May 2022, a new outbreak of monkeypox has been reported in several countries, including Spain. The clinical and epidemiological characteristics of the cases in this outbreak may ...differ from those in earlier reports.
Objectives
To document the clinical and epidemiological characteristics of cases of monkeypox in the current outbreak.
Methods
We conducted a prospective cross‐sectional study in multiple medical facilities in Spain to describe the cases of monkeypox in the 2022 outbreak.
Results
In total, 185 patients were included. Most cases started with primarily localized homogeneous papules, not pustules, in the probable area of inoculation, which could be cutaneous or mucous, including single lesions. Generalized small pustules appeared later in some of them. Heterogeneous lesions occurred during this generalized phase. All patients had systemic symptoms. Less common lesions included mucosal ulcers (including pharyngeal ulcers and proctitis) and monkeypox whitlows. Four patients were hospitalized, none died. Smallpox vaccination and well‐controlled HIV disease were not associated with markers of severity. Contact during sex is the most likely mechanism of transmission. In this outbreak, cases have been described in men who have sex with men and are strongly associated with high‐risk sexual behaviours. Seventy‐six per cent of the patients had other sexually transmitted diseases upon screening.
Conclusions
The clinical findings in this outbreak differ from previous findings and highly suggest contact transmission and initiation at the entry site. The characterization of the epidemiology of this outbreak has implications for control.
What is already known about this topic?
Monkeypox eruption is described as consisting of pustules.
The roles of HIV and previous smallpox vaccination in the prognosis are unknown.
The transmission route was initially described as respiratory droplets and was later suggested to be via sexual contact.
What does this study add?
Initial lesions at the probable inoculation area were homogeneous and papular (pseudopustules). Generalized small pustules appeared later in some of them. Heterogeneous lesions occurred during this generalized phase. All patients had systemic symptoms.
Less common signs included mucosal ulcers (including pharyngeal ulcers and proctitis) and monkeypox whitlows. Well‐controlled HIV and previous smallpox vaccination were not associated with severity. No patient died.
The data support the hypothesis of transmission via contact during sex. Although this might change, the outbreak is currently limited mostly to men who have sex with men, with high‐risk factors for sexually transmitted diseases.
Monkeypox eruption starts as pseudopustules at the inoculation site and can be followed by distant pustular lesions. It is transmitted by contact and, although it can be very uncomfortable, no patient in our series died.
Linked Comment: R.E. Watchorn and C.B. Bunker. Br J Dermatol 2022; 187:636–637.
Plain language summary available online
The Early Stone Age sites of Gadeb (Ethiopian South-East Plateau) were excavated under the direction of Desmond Clark in the 1970s. Dated to between 1.45 and 0.7 Ma, Gadeb proved that humans had ...already occupied high altitude areas in the Lower Pleistocene. Despite the importance of the Gadeb sites, their lithic assemblages were never published in detail, and no review of the stone tools has ever been reported since the original 1970s study. This paper updates the information available on Gadeb by presenting a systematic review of the lithic technology of several assemblages. The objectives are to evaluate the technological skills of Gadeb knappers and to contextualize them into the current discussion of the origins of the Acheulean and its possible coexistence with the so-called Developed Oldowan in East Africa.
Thermal dissipation at the active region of electronic devices is a fundamental process of considerable importance. Inadequate heat dissipation can lead to prohibitively large temperature rises that ...degrade performance, and intensive efforts are under way to mitigate this self-heating. At room temperature, thermal resistance is due to scattering, often by defects and interfaces in the active region, that impedes the transport of phonons. Here, we demonstrate that heat dissipation in widely used cryogenic electronic devices instead occurs by phonon black-body radiation with the complete absence of scattering, leading to large self-heating at cryogenic temperatures and setting a key limit on the noise floor. Our result has important implications for the many fields that require ultralow-noise electronic devices.
The European Genome-phenome Archive (EGA) is a permanent archive that promotes the distribution and sharing of genetic and phenotypic data consented for specific approved uses but not fully open, ...public distribution. The EGA follows strict protocols for information management, data storage, security and dissemination. Authorized access to the data is managed in partnership with the data-providing organizations. The EGA includes major reference data collections for human genetics research.
To develop response criteria for adult dermatomyositis (DM) and polymyositis (PM). Expert surveys, logistic regression, and conjoint analysis were used to develop 287 definitions using core set ...measures. Myositis experts rated greater improvement among multiple pairwise scenarios in conjoint analysis surveys, where different levels of improvement in 2 core set measures were presented. The PAPRIKA (Potentially All Pairwise Rankings of All Possible Alternatives) method determined the relative weights of core set measures and conjoint analysis definitions. The performance characteristics of the definitions were evaluated on patient profiles using expert consensus (gold standard) and were validated using data from a clinical trial. The nominal group technique was used to reach consensus. Consensus was reached for a conjoint analysis-based continuous model using absolute per cent change in core set measures (physician, patient, and extramuscular global activity, muscle strength, Health Assessment Questionnaire, and muscle enzyme levels). A total improvement score (range 0-100), determined by summing scores for each core set measure, was based on improvement in and relative weight of each core set measure. Thresholds for minimal, moderate, and major improvement were ≥20, ≥40, and ≥60 points in the total improvement score. The same criteria were chosen for juvenile DM, with different improvement thresholds. Sensitivity and specificity in DM/PM patient cohorts were 85% and 92%, 90% and 96%, and 92% and 98% for minimal, moderate, and major improvement, respectively. Definitions were validated in the clinical trial analysis for differentiating the physician rating of improvement (p<0.001). The response criteria for adult DM/PM consisted of the conjoint analysis model based on absolute per cent change in 6 core set measures, with thresholds for minimal, moderate, and major improvement.
Polynorbornenes prepared by vinyl addition polymerization and bearing pendant alkenyl groups serve as skeletons to support trispyrazolylborate ligands (Tpx) built at those alkenyl sites. Reaction ...with CuI in acetonitrile led to VA‐PNB–TpxCu(NCMe) (VA‐PBN=vinyl addition polynorbornene) with a 0.8–1.4 mmol incorporation of Cu per gram of polymer. The presence of tetracoordinated copper(I) ions was been assessed by FTIR studies on the corresponding VA‐PNB‐TpxCu(CO) adducts, in agreement with those on discrete TpxCu(CO). The new materials were employed as heterogeneous catalysts in several carbene‐ and nitrene‐transfer reactions, showing a behavior similar to that of the homogeneous counterparts but also being recycled several times maintaining a high degree of activity and selectivity. This is the first example of supported Tpx ligands onto polymeric supports with catalytic applications.
Recyclable catalysts: Trispyrazolylborate ligands covalently bound to vinyl addition polynorbornenes form copper(I) complexes with catalytic properties toward carbene‐ and nitrene‐transfer reactions identical to those of the homogeneous counterparts, but allowing for easy catalyst separation and recycling.
During the 12th International Workshop on Autoantibodies and Autoimmunity held in Sao Paulo, Brazil, on August 28, 2014, a full day session was devoted to establishing a consensus on the nomenclature ...of staining patterns observed in the antinuclear antibody (ANA) indirect immunofluorescence test on HEp-2 cells. The current report summarizes the collective agreements with input from the host Brazilian and international communities that represented research, clinical, and diagnostic service laboratories. Patterns are categorized in three major groups (nuclear, cytoplasmic, and mitotic patterns) and each pattern has been defined and described in detail. The consensus nomenclature and representative patterns are made available online at the international consensus on antinuclear antibody pattern (ICAP) website (www.ANApatterns.org). To facilitate continuous improvement and input, specific comments on ICAP are encouraged and these will be discussed in subsequent ICAP meetings. The ultimate goal with the establishment of the ICAP is to promote harmonization and understanding of autoantibody test nomenclature, as well as interpretation guidelines for ANA testing, thereby optimizing usage in patient care.
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