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Fluting is a technological and morphological hallmark of some of the most iconic North American Paleoindian stone points. Through decades of detailed artifact analyses and replication experiments, archaeologists have spent considerable effort reconstructing how flute removals were achieved, and they have explored possible explanations of why fluting was such an important aspect of early point technologies. However, the end of fluting has been less thoroughly researched. In southern North America, fluting is recognized as a diagnostic characteristic of Clovis points dating to approximately 13,000 cal yr BP, the earliest widespread use of fluting. One thousand years later, fluting occurs more variably in Dalton and is no longer useful as a diagnostic indicator. How did fluting change, and why did point makers eventually abandon fluting? In this article, we use traditional 2D measurements, geometric morphometric (GM) analysis of 3D models, and 2D GM of flute cross sections to compare Clovis and Dalton point flute and basal morphologies. The significant differences observed show that fluting in Clovis was highly standardized, suggesting that fluting may have functioned to improve projectile durability. Because Dalton points were used increasingly as knives and other types of tools, maximizing projectile functionality became less important. We propose that fluting in Dalton is a vestigial technological trait retained beyond its original functional usefulness.

The Tennessee Division of Archaeology documented an extensive Paleoindian lithic quarry and workshop at the Sinclair site in Tennessee in 2008. We present the first detailed description of the lithic assemblage here, which focuses on aspects of its prismatic blade technology. Quantitative and qualitative attributes of 117 blades are assessed to characterize the assemblage and investigate human behaviors related to its formation. We then compare the blades from Sinclair to other blade assemblages. Blades at Clovis workshop sites are large and generally unstandardized. Mobile Clovis bands selected long, highly standardized blades from workshop sites, cached them as resource insurance, and crafted and used them as tools at campsites. The prismatic blade assemblage at Sinclair and other sites throughout the Midsouth suggests that this region played an important role in the development of prismatic blade technology at the end of the Pleistocene.

Experimental archaeology is a key component of research for reconstructing past human behaviors, and this approach has been a cornerstone for interpreting the earliest archaeological record in the ...

Dermatofibrosarcoma protuberans (DFSP) is an uncommon, locally aggressive malignancy with wide local excision (WLE) or Mohs micrographic surgery (MMS) representing the treatment of choice. This article illustrates the experience of a single academic institution in treating DFSP with MMS and adds two particularly large, difficult closures of the glabella/central forehead and sternum to the body of literature.To report the results of 15 patients with DFSP treated with MMS over a five-year period by a single Mohs surgeon at the University of Arkansas for Medical Sciences (UAMS).A total of 15 patients between the ages of 16 and 80 years were diagnosed with DFSP and treated with MMS and were contacted in October 2021 to assess for recurrence.None of the 15 patients had a recurrence of DFSP following MMS, with a mean follow-up interval of 22.4 months and an average of 1.93 Mohs layers required for tumor clearance.This experience reaffirms that MMS is an effective treatment for DFSP and adds additional examples of closure techniques of large, ovoid surgical defects on the glabella/central forehead and sternum to the literature.

Paleoindian projectile points occur in high numbers in the American Southeast, and when compared to other regions of the East, the Southeast has the greatest projectile-point diversity. In ...

Biphasic lesions comprised of melanocytic and epithelial components are rare entities believed to arise either as a collision of 2 histologically distinct lesions in the same anatomic location or as a singular progenitor tumor differentiating along 2 differing lineages. Regardless of mechanism of origin, these tumors present unique challenges in pathologic interpretation and in determining appropriate measurements, which assigns subsequent prognosis to the patient. We present 4 tumors of melanoma co-existing with basal cell carcinoma (BCC) and discuss relevant literature regarding these biphasic entities. Patients consisted of 3 males and 1 female, ranging in age from 62 to 93, with lesions located on the shoulder, frontal scalp, forearm and nose. Three of 4 lesions showed melanoma cells limited to BCC tumor lobules, without evidence of direct dermal invasion by melanoma cells, raising the question of whether or not these tumors should be classified as in situ or invasive melanoma. These cases highlight the complexity that such lesions pose to dermatopathologists, in terms of their uncertain origin and variable microscopic appearance. In the absence of data regarding outcomes for these tumors (given their rarity), it is important to utilize a case-by-case approach, with careful clinical correlation and appropriate use of ancillary techniques.

Research has demonstrated that variation in assemblages of prehistoric bifacial stone point blades results from episodes of breakage and resharpening that occur throughout the artifact’s use-life. Is it commonly accepted that point bases were less affected by trauma resulting from use and more likely to retain culturally diagnostic characteristics of shape. Archaeologists using variation in bifacial points, such as projectiles, knives, and drills, as a proxy to study prehistoric cultures’ identity, mobility, and evolutionary trajectories have, therefore, focused most attention on the proximal portions of these artifacts. This approach to the study of stone tools has proven effective, but recently the question has been raised as to whether some cultures, specifically Clovis, the earliest widespread technological tradition in the Americas, included normative resharpening strategies in their technological repertoire. In addressing this question, we use geometric morphometrics to compare the shape of a collection of Clovis points resampled into three datasets: bases, blades, and complete points. We find that the complement of base and blade shape, i.e., the complete point, provides the most parsimonious representation of Clovis-point shape and is most successful in discriminating among regional differences.

BACKGROUND When an excision is performed by a method other than elliptical excision, direct primary wound closure can result in standing cones or "dog-ears." In 2008, Lee and colleagues noted that dog-ears of

An experiment was performed to determine the effects of bismuth subsalicylate (BSS) and calcium-ammonium nitrate (CAN) on in vitro fermentation of a high-concentrate (87% concentrate, DM basis) substrate. Serum bottles containing 20 mL of a 2:1 buffer:ruminal fluid inoculum and 0.2 g of substrate were incubated for 24 h. Four ruminally cannulated steers (BW = 520 ± 30 kg) were used as ruminal fluid donors and each donor was considered a block. Treatments were arranged in a 2 × 2 factorial with the following factors: BSS (0 or 0.33%, DM basis) and CAN (0 or 2.22%, DM basis). Treatments were made isonitrogenous with urea. In vitro organic matter digestibility (IVOMD) was determined in separate 100-mL centrifuge tubes. Data were analyzed using the MIXED procedure of SAS with the fixed effect of BSS, CAN, BSS × CAN, and the random effect of donor. An interaction (P < 0.01) was observed for total gas production (TGP). When CAN was included, without BSS, TGP was increased (P < 0.01); however, the combination of CAN with BSS did not affect (P = 0.85) TGP when compared to the combination of urea and BSS. Ammonia-N tended (P = 0.10) to increase when CAN was used as N source rather than urea. In vitro OM digestibility (P > 0.23) and final pH (P > 0.66) of in vitro ruminal fermentation were not affected by treatments. A tendency (P = 0.06) for an interaction regarding the production of H2S was observed; however, there were no treatment mean differences (P > 0.28). The combination of CAN and BSS did not negatively affect in vitro fermentation parameters such as OM digestion and gas production; however, a reduction in H2S with the combination of BSS and CAN may indicate potential benefits of such feeding strategies for feedlot cattle

An experiment was performed to determine the effects of bismuth subsalicylate (BSS) and calcium-ammonium nitrate (CAN) on in vitro fermentation of a high-concentrate (87% concentrate, DM basis) substrate. Serum bottles containing 20 mL of a 2:1 buffer:ruminal fluid inoculum and 0.2 g of substrate were incubated for 24 h. Four ruminally cannulated steers (BW = 520 ± 30 kg) were used as ruminal fluid donors and each donor was considered a block. Treatments were arranged in a 2 × 2 factorial with the following factors: BSS (0 or 0.33%, DM basis) and CAN (0 or 2.22%, DM basis). Treatments were made isonitrogenous with urea. In vitro organic matter digestibility (IVOMD) was determined in separate 100-mL centrifuge tubes. Data were analyzed using the MIXED procedure of SAS with the fixed effect of BSS, CAN, BSS × CAN, and the random effect of donor. An interaction (P < 0.01) was observed for total gas production (TGP). When CAN was included, without BSS, TGP was increased (P < 0.01); however, the combination of CAN with BSS did not affect (P = 0.85) TGP when compared to the combination of urea and BSS. Ammonia-N tended (P = 0.10) to increase when CAN was used as N source rather than urea. In vitro OM digestibility (P > 0.23) and final pH (P > 0.66) of in vitro ruminal fermentation were not affected by treatments. A tendency (P = 0.06) for an interaction regarding the production of H2S was observed; however, there were no treatment mean differences (P > 0.28). The combination of CAN and BSS did not negatively affect in vitro fermentation parameters such as OM digestion and gas production; however, a reduction in H2S with the combination of BSS and CAN may indicate potential benefits of such feeding strategies for feedlot cattle.

Background Opioid overprescribing is a major contributor to the opioid crisis. The lack of procedure-specific guidelines contributes to the vast differences in prescribing practices. Objective Create opioid-prescribing consensus guidelines for common dermatologic procedures. Methods We utilized a four-step modified Delphi method to conduct a systematic discussion among a panel of providers in the fields of general dermatology, dermatologic surgery, and cosmetics/phlebology to develop opioid-prescribing guidelines for some of the most common dermatologic procedural scenarios. Guidelines were developed for opioid-naive patients undergoing routine procedures. Opioid tablets were defined as oxycodone 5-mg oral equivalents. Results Postoperative pain after most uncomplicated procedures (76%) can be adequately managed with acetaminophen and/or ibuprofen. Group consensus identified no specific dermatological scenario that routinely requires more than 15 oxycodone 5-mg oral equivalents to manage postoperative pain. Group consensus found that 23 percent of the procedural scenarios routinely require 1-10 opioid tablets, while only one routinely requires 1-15 opioid tablets. Limitations These recommendations are based on expert consensus in lieu of quality evidence-based outcomes research. These recommendations must be individualized to accommodate patients’ comorbidities. Conclusions Procedure-specific opioid-prescribing guidelines may serve as a foundation to produce effective and responsible postoperative pain management strategies after dermatologic interventions.

Golondrina is a lanceolate point type linked to the Southeastern Dalton tradition that emerged during the Paleoindian to Archaic transition in southern Texas and northeastern Mexico. The type remains imprecisely dated because only a handful of sites have yielded Golondrina points in buried, dateable contexts, and the few radiocarbon dates from these sites often have relatively large standard deviations. In this paper, we present new radiocarbon dates from Greer's 1968 Texas Archeological Research Laboratory excavations at the Baker Cave site, Texas and present an analysis of artifacts from late Paleoindian/early Archaic contexts. A radiocarbon date from an excavation level that yielded a Golondrina point returned an age of 8910 ± 40 radiocarbon years before present, reducing prior imprecision and refining the age of the Golondrina occupation at Baker Cave. These results provide additional evidence that Golondrina, hypothesized to be culturally evolutionarily related to Dalton, represents a late regional e...

Multiple hypotheses have been proposed to explain the relationship between fully fluted Folsom points and unfluted Midland points. One hypothesis, proposed by Hofman (1992, “Recognition and interpretation of Folsom technological variability on the southern plains.” In Ice Age Hunters of the Rockies, edited by D. J. Stanford, and J. S. Day, 193–229. Boulder: University Press of Colorado), is that mobile Folsom bands shifted from making Folsom points, which often fatally broke during the production process, to less risky Midland points as stone supplies dwindled. In cultural evolutionary terms, this hypothesis proposes that an increase in local, site-scale functional controls, specifically stone supply stress, resulted in the modification of the existing Folsom point production recipe and led to the adoption of a new cultural variant, the Midland point. After testing archaeological implications of Hofman's hypothesis, I conclude that it is empirically supported and does explain the innovation of the Midland...

At the end of the Pleistocene, Dalton hunter-gatherers substantially altered their technology by crafting points with serrated, beveled, and tapered blade margins. The functions of these attributes have been the focus of a long-held debate. Some archaeologists argue that the variation was the result of resharpening and use in varied tasks, like cutting—showing an adaptive shift to processing smaller game like deer. Other researchers suggest these new attributes were designed from the outset for the single functional use as projectiles. In this study, we use actualistic experiments to build analogues for interpreting microscopic usewear traces on an archaeological Dalton point assemblage from the Brand site, Arkansas. We then consider changes in point functionality within the broader context of the organization of Dalton lithic technology and how these changes reflect adaptations to the emerging Holocene environment.

The state of South Carolina is examined by the physiographic provinces of Mountains, Piedmont, and Coastal Plain using established Paleoindian projectile point types and their geographic distributions by raw materials. Foraging ranges are reconstructed. There is a substantial drop in post-Clovis point frequencies, as seen elsewhere in the Southeast, with a great increase by Dalton times. Younger Dryas age environmental changes are reviewed, with late Pleistocene flora and fauna changes noted. Starting in Dalton times, sea level rise appears to have affected settlement strategies due to the inundation of the primary resource habitats of the Coastal Plain. The Piedmont Transhumance hypothesis is offered as an explanation of these changes.

During the late Paleoindian and early Archaic periods, the Southern Plains witnessed a diversification in unfluted lanceolate point styles. The classification of these points into distinct and meaningful typological groups continues to play a fundamental role in building an understanding of cultural changes at the end of the last Ice Age. In this study, we analyze a sample of points from the Hogeye site, Texas to explore unfluted lanceolate point classifications. The results suggest the presence of at least three late Paleoindian/early Archaic point hafting traditions in the Southern Plains, an Angostura/Thrall Tradition, a Dalton/Golondrina Tradition, and a Plainview/St. Mary's Hall Tradition.

For the Southeast, it has been proposed that climate changes during the Younger Dryas period triggered a human population decline and/or substantial reorganization. We use the Georgia point record in the Paleoindian Database of the Americas to test for evidence of changes in landscape use through the Paleoindian period and consider these changes in the context of the Georgia paleoenvironmental record spanning the Younger Dryas. Based on differences in point frequencies, distributions, raw material types, and transport distances and directions, we conclude that significant changes in landscape use occurred during the Paleoindian period, and these correspond to destabilization of the immediate coastal zone due to fluctuations in sea level.

The purpose of this paper is to discuss the recent geochemical analysis of three bifaces from the Hogeye Clovis period cache recovered in Bastrop, Texas with the geochemistry of 302 geologic samples. These samples are derived from seven primary sources spread through the Edwards Plateau region and adjacent areas. The results of this analysis and comparison suggest that the three bifaces may be derived from chert resources geochemically similar to those found at the Gault Site in Central Texas. The results also hint that the Hogeye Cache may have served as either an insurance cache or a communal contribution from multiple groups living near the Gault Site and Buttermilk Creek.

The objective was to evaluate treatments designed to increase passage rate on forage intake and digestion. Eight ruminally-cannulated steers were assigned to a replicated 4 × 4 Latin square design. All steers were fed an ad libitum diet of prairie grass hay (10.4% CP) with the following treatments designed to increase passage rate: no treatment (control; CON), pelleted (PEL), 7% Ca(OH)2 treated (CAOH), and six 2 kg weights inserted into the rumen (WTS). Molasses (3% of diet DM) was added to all treatments. Feed, orts, and total feces was collected on d 12–17 to determine total tract digestibility. On d 17–20, ruminal pH was recorded every 8 hr. Data were analyzed using the MIXED procedure of SAS 9.4 with treatment and period as fixed effects and steer as a random effect. A treatment effect (P < 0.01) was observed for ruminal pH; steers fed CAOH had the highest pH (6.97) with WTS and CON intermediate and PEL being the lowest (6.34). Organic matter intake (OMI) was affected (P < 0.01) by treatment with PEL steers consuming the most (7.86 kg). While steers consuming CON had greater OMI than CAOH (P = 0.04), WTS was not different from CON (P = 0.50). Organic matter digestibility (OMD) was also affected (P < 0.01) by treatment as WTS and CON were the greatest (62.8% and 61.7%, respectively) and CAOH (58.7%) tended (P = 0.08) to be greater than PEL (55.9%). Total digestible organic matter intake (TDOMI) was affected (P < 0.01) by treatment; PEL had the greatest TDOMI with CON being intermediate, and CAOH and WTS being the least. Treatments designed to increase passage rate did affect forage intake and digestion with the greatest effect resulting from pelleting grass hay due to the severe reduction in particle size.

Humans first left Siberia and colonized the Americas perhaps around 16,000 years ago, and the Clovis archaeological com plex in North America has traditionally been linked to this migratory pulse. Archaeologists searching for evidence of Clo vis technological antecedents have focused their attention on the Beringian and Siberian archaeological records. Growing evidence for the pre-Clovis occupation of North America provides a possible alternative source for the origins of Clovis. In this paper, we present new data on the pre-Clovis lithic assemblage from the Debra L. Friedkin site, Texas, and compare Clovis and pre-Clovis lithic technological signatures. We show that while Clovis and pre-Clovis share some important tech nological traits, they also differ in important ways. We conclude that the pre-Clovis assemblage from Debra L. Friedkin cannot be called “Clovis,” but it could represent a technological antecedent of Clovis. Los seres humanos primero dejaron de Siberia y colonizaron America quizas alrededor de 16,000 anos, y el complejo arque ologico de Clovis en America del norte, tradicionalmente se ha relacionado con este pulso migratoria. Arqueologos buscando evidencia de Clovis antecedentes tecnologicos han centrado su atencion en los registros arqueologicos Beringian y Siberia nos. Creciente evidencia de la ocupacion de pre-Clovis de America del norte proporciona una fuente alternativa posible para los origenes de Clovis. En este trabajo presentamos nuevos datos sobre el conjunto litico de pre-Clovis del sitio de Debra L. Friedkin, Texas y compara Clovis y firmas tecnologicas liticas de pre-Clovis. Nos muestran que mientras que Clovis y preClovis comparten algunas caracteristicas tecnologicas importantes, tambien difieren en aspectos importantes. Concluimos que el conjunto de pre-Clovis de Debra L. Friedkin no puede llamarse “Clovis,” pero podria representar un antecedente tec nologico de Clovis.

The Hogeye Clovis cache is comprised of 52 late-stage bifaces, finished points, and knife/cores cached in central Texas. Because these artifacts were all likely made and cached approximately 13,000 years ago by one or a handful of knappers belonging to a single band with a shared Clovis cultural template, Hogeye provides a rare opportunity to investigate Clovis lithic reduction signatures. This paper builds on previous analyses and presents new methods for quantifying Clovis biface production signatures, including serial flaking and the timing of last overshot flaking. The results show that the Hogeye cache bifaces technologically and morphologically differ from other regional Clovis biface reduction signatures. Additional data is needed to determine whether these differences reflect individual knapping preferences or regional cultural signatures. The methods used and developed here are not Clovis-specific and could be modified and combined with other analytical techniques to identify reduction signatures in biface assemblages from other times and places.

The archaeological transition from Clovis to Folsom and Midland in the North American Great Plains coincides with the end of the Pleistocene and onset of the Younger Dryas. Comparisons exploring the adaptive changes that took place during this period frequently employ regional-scale approaches. The focus on regional-scale analyses largely results from the dearth of sites repeatedly visited by multiple early Paleoindian groups. However, regional-scale comparisons have the potential to overlook smaller-scale differences. The Debra L. Friedkin site, Texas offers an opportunity to study Midland, Folsom, and Clovis technology and site-use at a single site. This paper presents the context and chronology of the Midland, Folsom, and Clovis assemblages and a site-scale analysis of lithics from the Friedkin site. It is argued that point production and late-stage reduction were primary activities, and the use of bifacial cores for flake tools was important throughout these occupation periods. Site use at Friedkin differs from early Paleoindian occupation at the nearby Gault site and expands our understanding of settlement and technological organization in the region.

Bend and radially broken flake tools have been identified in Paleolithic and Paleoindian assemblages, and their presence raises important questions. Were these breaks intentionally produced to serve as tool edges or were broken flakes simply scavenged? More importantly, can we distinguish between intentionally produced breaks and those produced incidentally? Experimental archaeology can help answer these questions. In this paper, three sets of experimentally produced bend and radial flake breaks were compared. Flakes were intentionally broken by percussion, and these breaks were compared to those produced during bifacial core reduction and by flake trampling. The presence of point of impact markers, near ninety degree break angles, and an assemblage with high percentages of bend and radial breaks distinguish intentional fracture from incidental fractures produced during bifacial reduction. High percentages of radial breaks distinguish intentional fracture from trampling. Finally, it may not be possible to identify intentional breaks in a bifacial reduction assemblage severely affected by flake-on-flake trampling.

Early Paleoindians often are described as highly mobile hunter–gatherers who employed lithic technologies designed to minimize stone transport costs. We experimentally reduced blade and bifacial cores and found both reduction strategies to be equally efficient for the production of useable flake blanks. Further, when compared to similar core reduction experiments, the results of this study showed no significant differences in core efficiency between bifacial, prismatic blade, and wedge-shaped blade core reduction. Biface and blade cores with initial weights greater than 1000 g produced useable flakes as efficiently as informal cores. However, bifacial and blade core efficiency decreased with initial core weight. When considered in terms of Early Paleoindian technological organization, differences in core efficiencies suggest that Folsom groups employed core reduction strategies designed to minimize stone transport costs, but Clovis groups did not.

This paper describes an alternative means for determining the free moisture in elastomer closures used to seal lyophilized products that is rapid (in seconds) and nondestructive in nature. The advantages and disadvantages of the Karl Fischer method will be briefly discussed, especially in light of current efforts to implement Process Analytical Technology into the lyophilization process. A general description of the dielectric properties of the elastomer materials and the impact that moisture will have on the quality factor (Q) will be described. The analytical equipment and method used for correlating the Q of the elastomer closure to its average free moisture content will also be described. Examples of the histogram and frequency distributions for the average moisture content and individual moisture content in both 13- and 20-mm closures will be shown and discussed.

Hepatitis C virus NS3 helicase can unwind double-stranded DNA and RNA and has been proposed to form oligomeric structures. Here we examine the DNA unwinding activity of monomeric NS3. Oligomerization was measured by preparing a fluorescently labeled form of NS3, which was titrated with unlabeled NS3, resulting in a hyperbolic increase in fluorescence anisotropy and providing an apparent equilibrium dissociation constant of 236 nm. To evaluate the DNA binding activity of individual subunits within NS3 oligomers, two oligonucleotides were labeled with fluorescent donor or acceptor molecules and then titrated with NS3. Upon the addition of increasing concentrations of NS3, fluorescence energy transfer was observed, which reached a plateau at a 1:1 ratio of NS3 to oligonucleotides, indicating that each subunit within the oligomeric form of NS3 binds to DNA. DNA unwinding was measured under multiple turnover conditions with increasing concentrations of NS3; however, no increase in specific activity was observed, even at enzyme concentrations greater than the apparent dissociation constant for oligomerization. An ATPase-deficient form of NS3, NS3(D290A), was prepared to explore the functional consequences of oligomerization. Under single turnover conditions in the presence of excess concentration of NS3 relative to DNA, NS3(D290A) exhibited a dominant negative effect. However, under multiple turnover conditions in which DNA concentration was in excess to enzyme concentration, NS3(D290A) did not exhibit a dominant negative effect. Taken together, these data support a model in which monomeric forms of NS3 are active. Oligomerization of NS3 occurs, but subunits can function independently or cooperatively, dependent upon the relative concentration of the DNA.

Coincident with the climatic changes occurring during the Pleistocene-Holocene transition, a number of regionally distinct Paleoindian projectile-point styles emerged throughout North America. This paper examines one understudied and poorly understood Late Paleoindian style, the San Patrice point. Although traditionally considered woodland-adapted hunter-gatherers, projectile-point distributions indicate that San Patrice groups, utilizing the same hafting and resharpening technologies, also made significant use of plains resources. Raw material sourcing reveals that while all San Patrice populations focused on local toolstone sources, plains bands were more mobile than those in the woodlands. These findings have implications for our greater understanding of Paleoindian adaptations. While some hunter-gatherers developed specialized, environmentally specific strategies, San Patrice groups adopted more generalized strategies enabling them to succeed in diverse settings.

Hepatitis C virus (HCV) infects over 170 million persons worldwide. It is the leading cause of liver disease in the U.S. and is responsible for most liver transplants. Current treatments for this infectious disease are inadequate; therefore, new therapies must be developed. Several labs have obtained evidence for a protein complex that involves many of the nonstructural (NS) proteins encoded by the virus. NS3, NS4A, NS4B, NS5A, and NS5B appear to interact structurally and functionally. In this study, we investigated the interaction between the helicase, NS3, and the RNA polymerase, NS5B. Pull-down experiments and surface plasmon resonance data indicate a direct interaction between NS3 and NS5B that is primarily mediated through the protease domain of NS3. This interaction reduces the basal ATPase activity of NS3. However, NS5B stimulates product formation in RNA unwinding experiments under conditions of excess nucleic acid substrate. When the concentrations of NS3 and NS5B are in excess of nucleic acid substrate, NS5B reduces the rate of NS3-catalyzed unwinding. Under pre-steady-state conditions, in which NS3 and substrate concentrations are similar, product formation increased in the presence of NS5B. The increase was consistent with 1:1 complex formed between the two proteins. A fluorescently labeled form of NS3 was used to investigate this interaction through fluorescence polarization binding assays. Results from this assay support interactions that include a 1:1 complex formed between NS3 and NS5B. The modulation of NS3 by NS5B suggests that these proteins may function together during replication of the HCV genome.

Importance Skin cancer is the most common malignancy occurring after organ transplantation. Although previous research has reported an increased risk of skin cancer in solid organ transplant recipients (OTRs), no study has estimated the posttransplant population–based incidence in the United States. Objective To determine the incidence and evaluate the risk factors for posttransplant skin cancer, including squamous cell carcinoma (SCC), melanoma (MM), and Merkel cell carcinoma (MCC) in a cohort of US OTRs receiving a primary organ transplant in 2003 or 2008. Design, Setting, and Participants This multicenter retrospective cohort study examined 10 649 adult recipients of a primary transplant performed at 26 centers across the United States in the Transplant Skin Cancer Network during 1 of 2 calendar years (either 2003 or 2008) identified through the Organ Procurement and Transplantation Network (OPTN) database. Recipients of all organs except intestine were included, and the follow-up periods were 5 and 10 years. Main Outcomes and Measures Incident skin cancer was determined through detailed medical record review. Data on predictors were obtained from the OPTN database. The incidence rates for posttransplant skin cancer overall and for SCC, MM, and MCC were calculated per 100 000 person-years. Potential risk factors for posttransplant skin cancer were tested using multivariate Cox regression analysis to yield adjusted hazard ratios (HR). Results Overall, 10 649 organ transplant recipients (mean [SD] age, 51 [12] years; 3873 women [36%] and 6776 men [64%]) contributed 59 923 years of follow-up. The incidence rates for posttransplant skin cancer was 1437 per 100 000 person-years. Specific subtype rates for SCC, MM, and MCC were 812, 75, and 2 per 100 000 person-years, respectively. Statistically significant risk factors for posttransplant skin cancer included pretransplant skin cancer (HR, 4.69; 95% CI, 3.26-6.73), male sex (HR, 1.56; 95% CI, 1.34-1.81), white race (HR, 9.04; 95% CI, 6.20-13.18), age at transplant 50 years or older (HR, 2.77; 95% CI, 2.20-3.48), and being transplanted in 2008 vs 2003 (HR, 1.53; 95% CI, 1.22-1.94). Conclusions and Relevance Posttransplant skin cancer is common, with elevated risk imparted by increased age, white race, male sex, and thoracic organ transplantation. A temporal cohort effect was present. Understanding the risk factors and trends in posttransplant skin cancer is fundamental to targeted screening and prevention in this population.

THE BRITISH PALEOLITHIC: HUMAN SOCIETIES AT THE EDGE OF THE PLEISTOCENE WORLD, edited by Paul Pettitt and Mark White. Routledge, 2012. 616 pp. (Hardback) $160, (Paperback) $50. ISBN-10: 0415674557....

This thesis re-examines the physical layer of a communication link in order to increase the energy efficiency of a remote device or sensor. Backscatter modulation allows a remote device to wirelessly telemeter information without operating a traditional transceiver. Instead, a backscatter device leverages a carrier transmitted by an access point or base station.A low-power multi-state vector backscatter modulation technique is presented where quadrature amplitude modulation (QAM) signalling is generated without running a traditional transceiver. Backscatter QAM allows for significant power savings compared to traditional wireless communication schemes. For example, a device presented in this thesis that implements 16-QAM backscatter modulation is capable of streaming data at 96 Mbps with a radio communication efficiency of 15.5 pJ/bit. This is over 100x lower energy per bit than WiFi (IEEE 802.11).This work could lead to a new class of high-bandwidth sensors or implantables with power consumption far lower than traditional radios.

Paleoindian unifacial stone tools frequently exhibit distinct, sharp projections, known as “spurs”. During the last two decades, a theoretically and empirically informed interpretation–based on individual artifact analysis, use-wear, tool-production techniques, and studies of resharpening–suggested that spurs were sometimes created intentionally via retouch, and other times created incidentally via resharpening or knapping accidents. However, more recently Weedman strongly criticized the inference that Paleoindian spurs were ever intentionally produced or served a functional purpose, and asserted that ethnographic research “demonstrates that the presence of so called ‘graver’ spurs does not have a functional significance.” While ethnographic data cannot serve as a direct test of the archaeological record, we used Weedman’s ethnographic observations to create two quantitative predictions of the Paleoindian archaeological record in order to directly examine the hypothesis that Paleoindian spurs were predominantly accidents occurring incidentally via resharpening and reshaping. The first prediction is that the frequency of spurs should increase as tool reduction proceeds. The second prediction is that the frequency of spurs should increase as tool breakage increases. An examination of 563 unbroken tools and 629 tool fragments from the Clovis archaeological record of the North American Lower Great Lakes region showed that neither prediction was consistent with the notion that spurs were predominately accidents. Instead, our results support the prevailing viewpoint that spurs were sometimes created intentionally via retouch, and other times, created incidentally via resharpening or knapping accidents. Behaviorally, this result is consistent with the notion that unifacial stone tools were multifunctional implements that enhanced the mobile lifestyle of Pleistocene hunter-gatherers.

Compelling archaeological evidence of an occupation older than Clovis (~12.8 to 13.1 thousand years ago) in North America is present at only a few sites, and the stone tool assemblages from these sites are small and varied. The Debra L. Friedkin site, Texas, contains an assemblage of 15,528 artifacts that define the Buttermilk Creek Complex, which stratigraphically underlies a Clovis assemblage and dates between ~13.2 and 15.5 thousand years ago. The Buttermilk Creek Complex confirms the emerging view that people occupied the Americas before Clovis and provides a large artifact assemblage to explore Clovis origins.

HCV NS3 helicase exhibits activity toward DNA and RNA substrates. The DNA helicase activity of NS3 has been proposed to be optimal when multiple NS3 molecules are bound to the same substrate molecule. NS3 catalyzes little or no measurable DNA unwinding under single cycle conditions in which the concentration of substrate exceeds the concentration of enzyme by 5-fold. However, when NS3 (100 nm) is equimolar with the substrate, a small burst amplitude of approximately 8 nm is observed. The burst amplitude increases as the enzyme concentration increases, consistent with the idea that multiple molecules are needed for optimal unwinding. Protein-protein interactions may facilitate optimal activity, so the oligomeric properties of the enzyme were investigated. Chemical cross-linking indicates that full-length NS3 forms higher order oligomers much more readily than the NS3 helicase domain. Dynamic light scattering indicates that full-length NS3 exists as an oligomer, whereas NS3 helicase domain exists in a monomeric form in solution. Size exclusion chromatography also indicates that full-length NS3 behaves as an oligomer in solution, whereas the NS3 helicase domain behaves as a monomer. When NS3 was passed through a small pore filter capable of removing protein aggregates, greater than 95% of the protein and the DNA unwinding activity was removed from solution. In contrast, only approximately 10% of NS3 helicase domain and approximately 20% of the associated DNA unwinding activity was removed from solution after passage through the small pore filter. The results indicate that the optimally active form of full-length NS3 is part of an oligomeric species in vitro.

The concept of a stakeholder is commonplace in a business context. Participative- democratic communication refers to those organization-wide principles and practices that "represent" many relevant stakeholders in the decision making of work-related activities. One case in point is as follows: In May 2000, the Spartanburg Regional Healthcare System board of directors forced its CEO to resign, ending his 6-year tenure and the heated controversy of the previous 2 months. The former CEO focused primarily on strategic growth to the detriment of operations. Through participative-democratic practices, the interim CEO mended the damaged relations between the hospital administration, the community, and employee stakeholders in surfacing conflict to bolster operational efficiency. The current CEO attended to building stakeholder relationships and trust as a way to wed strategic growth and the organization's capacity to maintain it. Top executive managers and directly involved community political leaders helped in developing the participative-democratic communication principles set forth in this article. These core principles are (a) creating the space for new communicative interaction, (b) safeguarding a credible and open process, and (c) reclaiming suppressed views.

A 7-year-old boy presented with an annular verrucous plaque on the chin of 5 weeks duration. The lesion occurred after a bicycle accident and was unresponsive to antibiotics. Fungal culture grew Sporothrix schenckii. Sporotrichosis should be considered and fungal culture obtained whenever a nodule or plaque fails to respond to initial treatment. Language: en