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The handaxe is an iconic stone tool form used to define and symbolise both the Acheulean and the wider Palaeolithic. There has long been debate around the extent of its morphological variability between sites, and the role that extrinsic factors (especially raw material, blank type, and the extent of resharpening) have played in driving this variability, but there has been a lack of high-resolution examinations of these factors in the same study. In this paper, we present a 2D geometric morphometric analysis of 1097 handaxes from across Africa, the Levant, and western Europe to examine the patterning of this variability and what it can tell us about hominin behaviour. We replicate the findings of previous studies, that handaxe shape varies significantly between sites and entire continental regions, but we find no evidence for raw material, blank type, or resharpening in determining this pattern. What we do find, however, is that markers of reduction trajectory vary substantially between sites, suggesting that handaxes were deployed differently according to hominin need at a given site. We argue this is reflective of a continuum of reduction strategies, from those focused on the maintenance of a sharp cutting edge (i.e. direct use in cutting activities), to those focused on maintaining tip shapes, and perhaps a corresponding production of flakes. Implications for hominin behavioural flexibility are discussed., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Clark et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Archaeological evidence attests multiple early dispersals of Homo sapiens out of Africa, but genetic evidence points to the primacy of a single dispersal 70-40 ka. Laili in Timor-Leste is on the southern dispersal route between Eurasia and Australasia and has the earliest record of human occupation in the eastern Wallacean archipelago. New evidence from the site shows that, unusually in the region, sediment accumulated in the shelter without human occupation, in the window 59-54 ka. This was followed by an abrupt onset of intensive human habitation beginning ~44 ka. The initial occupation is distinctive from overlying layers in the aquatic focus of faunal exploitation, while it has similarities in material culture to other early Homo sapiens sites in Wallacea. We suggest that the intensive early occupation at Laili represents a colonisation phase, which may have overwhelmed previous human dispersals in this part of the world., (© 2024. The Author(s).)

Purpose: This feasibility study investigated the practicability of collecting and analyzing tear proteins from preterm infants at risk of retinopathy of prematurity (ROP). We sought to identify any tear proteins which might be implicated in the pathophysiology of ROP as well as prognostic markers., Methods: Schirmer's test was used to obtain tear samples from premature babies, scheduled for ROP screening, after parental informed consent. Mass spectrometry was used for proteomic analysis., Results: Samples were collected from 12 infants, which were all adequate for protein analysis. Gestational age ranged from 25 + 6 to 31 + 1 weeks. Postnatal age at sampling ranged from 19 to 66 days. One infant developed self-limiting ROP. Seven hundred one proteins were identified; 261 proteins identified in the majority of tear samples, including several common tear proteins, were used for analyses. Increased risk of ROP as determined by the postnatal growth ROP (G-ROP) criteria was associated with an increase in lactate dehydrogenase B chain in tears. Older infants demonstrated increased concentration of immunoglobulin complexes within their tear samples and two sets of twins in the cohort showed exceptionally similar proteomes, supporting validity of the analysis., Conclusions: Tear sampling by Schirmer test strips and subsequent proteomic analysis by mass spectrometry in preterm infants is feasible. A larger study is required to investigate the potential use of tear proteomics in identification of ROP., Translational Relevance: Tear sampling and subsequent mass spectrometry in preterm infants is feasible. Investigation of the premature tear proteome may increase our understanding of retinal development and provide noninvasive biomarkers for identification of treatment-warranted ROP.

Archaeological sites with surface hearths are a ubiquitous feature across the arid zones of the Arabian interior. At Jebel Oraf, in the Jubbah basin of the Nefud Desert of northern Arabia, numerous grinding stone fragments were found in association with hearths, though the original purpose of these stones was unclear owing to the poor preservation of faunal and botanic remains. Here we describe results from use-wear analysis on five grinding tools at Jebel Oraf, demonstrating that such artefacts were used during the Neolithic for plant processing, bone processing, and pigment production. Grinding stones were often broken up after initial use and fragments were subsequently re-used for alternative purposes, before finally being placed on hearths or discarded. More specifically, plants were ground or prepared and possibly cooked in the hearths, and bones were processed as well. The analyses also highlight the importance of pigment processing at Neolithic sites and provide a link to painted rock art. The frequent use of pigment in the archaeological record suggests that pigment was widely used, and that Neolithic painted art may have been more common than the surviving images suggest., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Lucarini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

We report a man in his 80s who described sudden unilateral loss of vision, resulting in extensive urgent investigations by the accident and emergency department team. Subsequent evaluation of visual acuity with pinhole demonstrated significant improvement, triggering further questioning. It transpired that he was mistakenly wearing his wife's glasses, which accounted for his visual symptoms. This case illustrates the importance of a stepwise approach to visual assessment, and avoiding assumptions, as using the simple pinhole test could have avoided extensive investigations and their subsequent costs., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Burial elaborations are a human behaviour that, in recent contexts can inform on social diversification, belief systems, and the introduction of new practices resulting from migration or cultural transmission. The study of mortuary practices in Mainland and Island Southeast Asia has revealed complex and diverse treatments of the deceased. This paper contributes to this topic with the description of three new burials excavated in Tron Bon Lei (Alor Island, Indonesia) dated to 7.5, 10, and 12 kya cal BP. In addition to the bioskeletal profiles and palaeohealth observations, we propose the adoption of archaeothanatological methods to characterise burial types in the region. Through the analysis of skeletal element representation, body position, articulation, and grave associations, we provide an example of a holistic approach to mortuary treatments in the Lesser Sunda Islands. Our results provide significant new data for understanding the evolution and diversification of burial practices in Southeast Asia, contributing to a growing body of literature describing prehistoric socio-cultural behaviour in this region., Competing Interests: The authors have declared that no competing interests exist.

Stone tools are a manifestation of the complex cognitive and dexterous skills of our hominin ancestors. As such, much research has been devoted to understanding the skill requirements of individual lithic technologies. Yet, comparing skill across different technologies, and thus across the vast timespan of the Palaeolithic, is an elusive goal. We seek to quantify a series of commensurable metrics of knapping skill across four different lithic technologies (discoids, handaxes, Levallois, and prismatic blades). To compare the requisite dexterity, coordination, and care involved in each technology, we analysed video footage and lithic material from a series of replicative knapping experiments to quantify deliberation (strike time), precision (platform area), intricacy (flake size relative to core size), and success (relative blank length). According to these four metrics, discoidal knapping appears to be easiest among the sample. Levallois knapping involved an intricate reduction sequence, but did not require as much motor control as handaxes and especially prismatic blades. Compared with the other Palaeolithic technologies, we conclude that prismatic blade knapping is set apart by being a skill intensive means of producing numerous standardised elongate end-products., (© 2022. The Author(s).)

Pleistocene hominin dispersals out of, and back into, Africa necessarily involved traversing the diverse and often challenging environments of Southwest Asia 1-4 . Archaeological and palaeontological records from the Levantine woodland zone document major biological and cultural shifts, such as alternating occupations by Homo sapiens and Neanderthals. However, Late Quaternary cultural, biological and environmental records from the vast arid zone that constitutes most of Southwest Asia remain scarce, limiting regional-scale insights into changes in hominin demography and behaviour 1,2,5 . Here we report a series of dated palaeolake sequences, associated with stone tool assemblages and vertebrate fossils, from the Khall Amayshan 4 and Jubbah basins in the Nefud Desert. These findings, including the oldest dated hominin occupations in Arabia, reveal at least five hominin expansions into the Arabian interior, coinciding with brief 'green' windows of reduced aridity approximately 400, 300, 200, 130-75 and 55 thousand years ago. Each occupation phase is characterized by a distinct form of material culture, indicating colonization by diverse hominin groups, and a lack of long-term Southwest Asian population continuity. Within a general pattern of African and Eurasian hominin groups being separated by Pleistocene Saharo-Arabian aridity, our findings reveal the tempo and character of climatically modulated windows for dispersal and admixture., (© 2021. The Author(s).)

The antiquity and nature of coastal resource procurement is central to understanding human evolution and adaptations to complex environments. It has become increasingly apparent in global archaeological studies that the timing, characteristics, and trajectories of coastal resource use are highly variable. Within Africa, discussions of these issues have largely been based on the archaeological record from the south and northeast of the continent, with little evidence from eastern coastal areas leaving significant spatial and temporal gaps in our knowledge. Here, we present data from Panga ya Saidi, a limestone cave complex located 15 km from the modern Kenyan coast, which represents the first long-term sequence of coastal engagement from eastern Africa. Rather than attempting to distinguish between coastal resource use and coastal adaptations, we focus on coastal engagement as a means of characterising human relationships with marine environments and resources from this inland location. We use aquatic mollusc data spanning the past 67,000 years to document shifts in the acquisition, transportation, and discard of these materials, to better understand long-term trends in coastal engagement. Our results show pulses of coastal engagement beginning with low-intensity symbolism, and culminating in the consistent low-level transport of marine and freshwater food resources, emphasising a diverse relationship through time. Panga ya Saidi has the oldest stratified evidence of marine engagement in eastern Africa, and is the only site in Africa which documents coastal resources from the Late Pleistocene through the Holocene, highlighting the potential archaeological importance of peri-coastal sites to debates about marine resource relationships., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Michael D. Petraglia currently serves as an Academic Editor for PLOS ONE. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

The human colonization of eastern Africa's near- and offshore islands was accompanied by the translocation of several domestic, wild and commensal fauna, many of which had long-term impacts on local environments. To better understand the timing and nature of the introduction of domesticated caprines (sheep and goat) to these islands, this study applied collagen peptide fingerprinting (Zooarchaeology by Mass Spectrometry or ZooMS) to archaeological remains from eight Iron Age sites, dating between ca 300 and 1000 CE, in the Zanzibar, Mafia and Comoros archipelagos. Where previous zooarchaeological analyses had identified caprine remains at four of these sites, this study identified goat at seven sites and sheep at three, demonstrating that caprines were more widespread than previously known. The ZooMS results support an introduction of goats to island eastern Africa from at least the seventh century CE, while sheep in our sample arrived one-two centuries later. Goats may have been preferred because, as browsers, they were better adapted to the islands' environments. The results allow for a more accurate understanding of early caprine husbandry in the study region and provide a critical archaeological baseline for examining the potential long-term impacts of translocated fauna on island ecologies., (© 2021 The Authors.)

The origin and evolution of hominin mortuary practices are topics of intense interest and debate 1-3 . Human burials dated to the Middle Stone Age (MSA) are exceedingly rare in Africa and unknown in East Africa 1-6 . Here we describe the partial skeleton of a roughly 2.5- to 3.0-year-old child dating to 78.3 ± 4.1 thousand years ago, which was recovered in the MSA layers of Panga ya Saidi (PYS), a cave site in the tropical upland coast of Kenya 7,8 . Recent excavations have revealed a pit feature containing a child in a flexed position. Geochemical, granulometric and micromorphological analyses of the burial pit content and encasing archaeological layers indicate that the pit was deliberately excavated. Taphonomical evidence, such as the strict articulation or good anatomical association of the skeletal elements and histological evidence of putrefaction, support the in-place decomposition of the fresh body. The presence of little or no displacement of the unstable joints during decomposition points to an interment in a filled space (grave earth), making the PYS finding the oldest known human burial in Africa. The morphological assessment of the partial skeleton is consistent with its assignment to Homo sapiens, although the preservation of some primitive features in the dentition supports increasing evidence for non-gradual assembly of modern traits during the emergence of our species. The PYS burial sheds light on how MSA populations interacted with the dead.

The Middle to Later Stone Age transition is a critical period of human behavioral change that has been variously argued to pertain to the emergence of modern cognition, substantial population growth, and major dispersals of Homo sapiens within and beyond Africa. However, there is little consensus about when the transition occurred, the geographic patterning of its emergence, or even how it is manifested in the stone tool technology that is used to define it. Here, we examine a long sequence of lithic technological change at the cave site of Panga ya Saidi, Kenya, that spans the Middle and Later Stone Age and includes human occupations in each of the last five Marine Isotope Stages. In addition to the stone artifact technology, Panga ya Saidi preserves osseous and shell artifacts, enabling broader considerations of the covariation between different spheres of material culture. Several environmental proxies contextualize the artifactual record of human behavior at Panga ya Saidi. We compare technological change between the Middle and Later Stone Age with on-site paleoenvironmental manifestations of wider climatic fluctuations in the Late Pleistocene. The principal distinguishing feature of Middle from Later Stone Age technology at Panga ya Saidi is the preference for fine-grained stone, coupled with the creation of small flakes (miniaturization). Our review of the Middle to Later Stone Age transition elsewhere in eastern Africa and across the continent suggests that this broader distinction between the two periods is in fact widespread. We suggest that the Later Stone Age represents new short use-life and multicomponent ways of using stone tools, in which edge sharpness was prioritized over durability., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Between 10 and six thousand years ago the Arabian Peninsula saw the most recent of the 'Green Arabia' periods, when increased rainfall transformed this generally arid region. The transition to the Neolithic in Arabia occurred during this period of climatic amelioration. Various forms of stone structures are abundant in northern Arabia, and it has been speculated that some of these dated to the Neolithic, but there has been little research on their character and chronology. Here we report a study of 104 'mustatil' stone structures from the southern margins of the Nefud Desert in northern Arabia. We provide the first chronometric age estimate for this type of structure - a radiocarbon date of ca. 5000 BC - and describe their landscape positions, architecture and associated material culture and faunal remains. The structure we have dated is the oldest large-scale stone structure known from the Arabian Peninsula. The mustatil phenomenon represents a remarkable development of monumental architecture, as hundreds of these structures were built in northwest Arabia. This 'monumental landscape' represents one of the earliest large-scale forms of monumental stone structure construction anywhere in the world. Further research is needed to understand the function of these structures, but we hypothesise that they were related to rituals in the context of the adoption of pastoralism and resulting territoriality in the challenging environments of northern Arabia., (© The Author(s) 2020.)

Background/objectives: Anterior segment optical coherence tomography (AS-OCT) can be used to visualise keratic precipitates (KPs) on the corneal endothelium. However, there has been no correlation between characteristic clinical appearances of KPs and AS-OCT morphology. We wished to assess the potential diagnostic role of AS-OCT in patients presenting with inflammatory eye disease and KPs., Subjects/methods: Six patients with inflammatory KPs were compared to one patient with infective interface keratitis following Descemet Membrane Endothelial Keratoplasty (DMEK) and one patient with endothelial pigment. AS-OCT was performed in each case and morphological features of the KPs were compared. Reflectivity of KPs was also compared numerically by measuring their relative lightness., Results: AS-OCT images in acute and active inflammation generally demonstrated hyperreflective KP variants in comparison to conditions with moderate or longstanding inflammation. In the patient with infective interface keratitis, KPs were evident on the endothelial surface but no changes could be identified at the graft-host interface. There were no significant differences between infective and inflammatory KPs to help distinguish between the two. Endothelial pigment deposits were clearly differentiated from keratic precipitates with smaller, poorly defined deposits on the endothelium surface which were isoreflective to the cornea., Conclusion: Hyperreflective KPs could be suggestive of newly deposited KPs and active inflammation; they may also be increased in KPs of herpetic origin. AS-OCT should not be used to differentiate infective infiltrate from inflammatory KPs if a patient were to present with post-operative inflammation and interface infection should still be suspected even if only endothelial deposits are identified on AS-OCT. AS-OCT may be used as a diagnostic and monitoring tool to assess response to treatment in cases where anterior segment inflammation of uncertain aetiology is present., (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)

The first excavations on Obi Island, north-east Wallacea, reveal three phases of occupation beginning in the terminal Pleistocene. Ground shell artefacts appear at the end of the terminal Pleistocene, the earliest examples in Wallacea. In the subsequent early Holocene occupation phase, ground stone axe flakes appear, which are again the earliest examples in Wallacea. Ground axes were likely instrumental to subsistence in Obi's dense tropical forest. From ~8000 BP there was a hiatus lasting several millennia, perhaps because increased precipitation and forest density made the sites inhospitable. The site was reoccupied in the Metal Age, with this third phase including quadrangular ground stone artefacts, as well as pottery and pigs; reflecting Austronesian influences. Greater connectivity at this time is also indicated by an Oliva shell bead tradition that occurs in southern Wallacea and an exotic obsidian artefact. The emergence of ground axes on Obi is an independent example of a broader pattern of intensification at the Pleistocene-Holocene transition in Wallacea and New Guinea, evincing human innovation in response to rapid environmental change., Competing Interests: The authors have declared that no competing interests exist.