Environmental changes and the rise and fall of civilizations in the northern Horn of Africa: an approach combining δD analyses of land-plant derived fatty acids with multiple proxies in soil

International audienceThe domains of the ancient polities D'MT and Aksum in the Horn of Africa's highlands are a superior natural system for evaluating roles of environmental change on the rise and fall of civilizations. To compare environmental changes of the times of the two polities, we analyzed stable hydrogen isotopic ratios (δD) of land-plant derived fatty acids (n-C26-30) and other proxies from soil sequences spanning the Holocene from the region. Three results suggest that trends in δD values unambiguously reflect changes in rainfall. First, increases in δD coincide with dry periods inferred from studies of eastern African lakes. Second, changes in δD values were parallel among sections during overlapping time intervals. Third, consideration of vegetation history did not alter directions of trends in δD values over time. By unambiguously recording precipitation, the δD values also enhanced interpretations of proxies that are affected by both climate and land clearing. Both D'MT (ca 2750-2350 cal y BP) and the Aksumite (ca 2100-1250 cal y BP) rose during wetter intervals of the drier part of the Holocene (after ca 6000 cal y BP). Analyses of charred matter indicated that fire had been a common agent of land clearing in all sites. The influence of climate on fire varied, however. Prior to the emergence of D'MT, δD values were correlated with C4:C3 plant ratios estimated from δ13C values. There are no C4 trees and precipitation may have been the main influence on canopy openness. After ca 4300 cal y BP, there was no significant relationship between δD and C4:C3 plant ratios suggesting that factors such as fire influenced canopy openness regardless of climate. Furthermore, the impact of land clearance differed between sites and between D'MT and the Aksumite's times. In one site, the interval from 3550 cal y BP to the decline of D'MT had several anomalies that suggested dramatic increases in thermal severity of fire and human impact. Among these were a large contribution of charred matter to a high% total organic carbon that low hydrogen and oxygen indices suggest was severely altered by other factors than humification. These results support hypotheses about the rise of civilizations being favored by specific climatic conditions but suggest that patterns of land clearing differed during the declines of D'MT and the Aksumite

Pediatric home mechanical ventilation: A Canadian Thoracic Society clinical practice guideline executive summary

Over the last 30 to 40 years, improvements in technology, as well as changing clinical practice regarding the appropriateness of long-term ventilation in patients with “non-curable” disorders, have resulted in increasing numbers of children surviving what were previously considered fatal conditions. This has come but at the expense of requiring ongoing, long-term prolonged mechanical ventilation (both invasive and noninvasive). Although there are many publications pertaining to specific aspects of home mechanical ventilation (HMV) in children, there are few comprehensive guidelines that bring together all of the current literature. In 2011 the Canadian Thoracic Society HMV Guideline Committee published a review of the available English literature on topics related to HMV in adults, and completed a detailed guideline that will help standardize and improve the assessment and management of individuals requiring noninvasive or invasive HMV. This current document is intended to be a companion to the 2011 guidelines, concentrating on the issues that are either unique to children on HMV (individuals under 18 years of age), or where common pediatric practice diverges significantly from that employed in adults on long-term home ventilation. As with the adult guidelines,1 this document provides a disease-specific review of illnesses associated with the necessity for long-term ventilation in children, including children with chronic lung disease, spinal muscle atrophy, muscular dystrophies, kyphoscoliosis, obesity hypoventilation syndrome, and central hypoventilation syndromes. It also covers important common themes such as airway clearance, the ethics of initiation of long-term ventilation in individuals unable to give consent, the process of transition to home and to adult centers, and the impact, both financial, as well as social, that this may have on the child\u27s families and caregivers. The guidelines have been extensively reviewed by international experts, allied health professionals and target audiences. They will be updated on a regular basis to incorporate any new information

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