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Reevaluating human colonization of the Caribbean using chronometric hygiene and Bayesian modeling.

ABSTRACT: Human settlement of the Caribbean represents the only example in the Americas of peoples colonizing islands that were not visible from surrounding mainland areas or other islands. Unfortunately, many interpretive models have relied on radiocarbon determinations that do not meet standard criteria for reporting because they lack critical information or sufficient provenience, often leading to specious interpretations. We have collated 2484 radiocarbon determinations, assigned them to classes based on chronometric hygiene criteria, and constructed Bayesian colonization models of the acceptable determinations to examine patterns of initial settlement. Colonization estimates for 26 islands indicate that (i) the region was settled in two major population dispersals that likely originated from South America; (ii) colonists reached islands in the northern Antilles before the southern islands; and (iii) the results support the southward route hypothesis and refute the "stepping-stone model."

SUBMITTER: Napolitano MF

PROVIDER: S-EPMC6957329 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Reevaluating human colonization of the Caribbean using chronometric hygiene and Bayesian modeling.

Napolitano Matthew F MF DiNapoli Robert J RJ Stone Jessica H JH Levin Maureece J MJ Jew Nicholas P NP Lane Brian G BG O'Connor John T JT Fitzpatrick Scott M SM

Science advances 20191218 12

Human settlement of the Caribbean represents the only example in the Americas of peoples colonizing islands that were not visible from surrounding mainland areas or other islands. Unfortunately, many interpretive models have relied on radiocarbon determinations that do not meet standard criteria for reporting because they lack critical information or sufficient provenience, often leading to specious interpretations. We have collated 2484 radiocarbon determinations, assigned them to classes based ...[more]

PMID: 31976370

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Project description:ObjectivePrevious studies on diagnostic accuracy of dipstick testing for leukocyte esterase (LE) and nitrite to diagnose urinary tract infection (UTI) had used urine culture, which is an imperfect gold standard. Estimates of diagnostic accuracy obtained using the classical gold standard framework might not reflect the true diagnostic accuracy of dipstick tests.MethodsWe used the dataset from a prospective, observational study conducted in the emergency department of a teaching hospital in southern India. Patients with a clinical suspicion of UTI underwent dipstick testing for LE and nitrite, urine microscopy, and urine culture. Based on the results of urine microscopy and culture, UTI was classified into definite, probable, and possible. Patients with microscopic pyuria and a positive urine culture were adjudicated as definite UTI. Unequivocal imaging evidence of emphysematous pyelonephritis or perinephric collections was also considered definite UTI. We estimated the diagnostic accuracy of LE and nitrite tests using the classical analysis (assuming definite UTI as gold standard) and two different Bayesian latent class models (LCMs; 3-tests in 1-population and 2-tests in 2-populations models).ResultsWe studied 149 patients. Overall, 64 (43%) patients had definite, 76 (51%) had probable, and 2 (1.3%) had possible UTI; 7 (4.6%) had alternate diagnoses. In classical analysis, LE was more sensitive than nitrite (87.5% versus 70.5%), while nitrite was more specific (24% versus 58%). The 3-tests in 1-population Bayesian LCM indicated a substantially better sensitivity and specificity for LE (98.1% and 47.6%) and nitrite (88.2% and 97.7%). True sensitivity and specificity of urine culture as estimated by the model was 48.7% and 73.0%. Estimates of the 2-tests in 2-populations model were in agreement with the 3-tests in 1-population model.ConclusionsBayesian LCMs indicate a clinically important improvement in the true diagnostic accuracy of urine dipstick testing for LE and nitrite. Given this, a negative dipstick LE would rule-out UTI, while a positive dipstick nitrite would rule-in UTI in our study setting. True diagnostic accuracy of urine dipstick testing for UTI in various practice settings needs reevaluation using Bayesian LCMs.

Dataset Information

Reevaluating human colonization of the Caribbean using chronometric hygiene and Bayesian modeling.

Publications

Reevaluating human colonization of the Caribbean using chronometric hygiene and Bayesian modeling.

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