Multi-isotopic and morphometric evidence for the migration of farmers leading up to the Inka conquest of the southern Andes

We present isotopic and morphometric evidence suggesting the migration of farmers in the southern Andes in the period AD 1270–1420, leading up to the Inka conquest occurring ~ AD 1400. This is based on the interdisciplinary study of human remains from archaeological cemeteries in the Andean Uspallata Valley (Argentina), located in the southern frontier of the Inka Empire. The studied samples span AD 800–1500, encompassing the highly dynamic Late Intermediate Period and culminating with the imperial expansion. Our research combines a macro-regional study of human paleomobility and migration based on a new strontium isoscape across the Andes that allows identifying locals and migrants, a geometric morphometric analysis of cranio-facial morphology suggesting separate ancestral lineages, and a paleodietary reconstruction based on stable isotopes showing that the migrants had diets exceptionally high in C4 plants and largely based on maize agriculture. Significantly, this migration influx occurred during a period of regional demographic increase and would have been part of a widespread period of change in settlement patterns and population movements that preceded the Inka expansion. These processes increased local social diversity and may have been subsequently utilized by the Inka to channel interaction with the local societies.Fil: Barberena, Ramiro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Interdisciplinario de Ciencias Básicas. - Universidad Nacional de Cuyo. Instituto Interdisciplinario de Ciencias Básicas; Argentina. Universidad Nacional de Cuyo. Facultad de Filosofía y Letras; ArgentinaFil: Menéndez, Lumila. Universitat Bonn; AlemaniaFil: le Roux, Petrus J.. University of Cape Town; SudáfricaFil: Marsh, Erik Johnson. Universidad Nacional de Cuyo. Facultad de Filosofía y Letras; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Interdisciplinario de Ciencias Básicas. - Universidad Nacional de Cuyo. Instituto Interdisciplinario de Ciencias Básicas; ArgentinaFil: Tessone, Augusto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Geocronología y Geología Isotópica. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Geocronología y Geología Isotópica; ArgentinaFil: Novellino, Paula Silvana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Mendoza. Museo de Ciencias Naturales y Antropológicas J. Cornelio Moyano; ArgentinaFil: Lucero, Gustavo. Universidad Católica de Temuco; ChileFil: Luyt, Julie. University of Cape Town; SudáfricaFil: Sealy, Judith. University of Cape Town; SudáfricaFil: Cardillo, Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Multidisciplinario de Historia y Ciencias Humanas; ArgentinaFil: Gasco, Alejandra Valeria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Interdisciplinario de Ciencias Básicas. - Universidad Nacional de Cuyo. Instituto Interdisciplinario de Ciencias Básicas; Argentina. Universidad Nacional de Cuyo. Facultad de Filosofía y Letras; ArgentinaFil: Llano, Carina Lourdes. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Interdisciplinario de Ciencias Básicas. - Universidad Nacional de Cuyo. Instituto Interdisciplinario de Ciencias Básicas; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Aplicadas a la Industria; ArgentinaFil: Frigolé, Cecilia Andrea. Universidad Nacional de Cuyo. Facultad de Filosofía y Letras; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Interdisciplinario de Ciencias Básicas. - Universidad Nacional de Cuyo. Instituto Interdisciplinario de Ciencias Básicas; ArgentinaFil: Guevara, Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Mendoza. Museo de Ciencias Naturales y Antropológicas J. Cornelio Moyano; ArgentinaFil: Da Peña, Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Mendoza. Museo de Ciencias Naturales y Antropológicas J. Cornelio Moyano; ArgentinaFil: Winocur, Diego Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; ArgentinaFil: Benítez, Anahí. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; ArgentinaFil: Cornejo, Luis. Universidad Alberto Hurtado; ChileFil: Falabella, Fernanda. Universidad de Chile; ChileFil: Méndez, César. Centro de Investigación en Ecosistemas de la Patagonia; ChileFil: Nuevo Delaunay, Amalia. Centro de Investigación en Ecosistemas de la Patagonia; ChileFil: Sanhueza, Lorena. Universidad de Chile; ChileFil: Santana Sagredo, Francisca. Pontificia Universidad Católica de Chile; ChileFil: Troncoso, Andrés. Universidad de Chile; ChileFil: Zárate, Sol. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Interdisciplinario de Ciencias Básicas. - Universidad Nacional de Cuyo. Instituto Interdisciplinario de Ciencias Básicas; ArgentinaFil: Duran, Victor Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Interdisciplinario de Ciencias Básicas. - Universidad Nacional de Cuyo. Instituto Interdisciplinario de Ciencias Básicas; Argentina. Universidad Nacional de Cuyo. Facultad de Filosofía y Letras; ArgentinaFil: Cortegoso, Valeria. Universidad Nacional de Cuyo. Facultad de Filosofía y Letras; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Interdisciplinario de Ciencias Básicas. - Universidad Nacional de Cuyo. Instituto Interdisciplinario de Ciencias Básicas; Argentin

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Apport des données moléculaires dans la prise en charge médicale des patients souffrant de tumeur cérébrale primitive

International audiencePrimary brain tumors comprise a large group of malignant and non-malignant tumors including heterogeneous entities with various biological and clinical behaviors. Up till recently, diagnosis of brain cancers, that drives treatment decision-making, was based on integration of clinical, radiological and pathological features of patients and tumors. Over the last years, practical neuro-oncology has entered an era of molecular-based personalized medicine. Indeed, molecular features of tumors provide critical information to physicians for daily clinical management of patients and for design of relevant clinical research. Sporadic gliomas or glial tumors are the most common primary brain tumors in adults. Recently, their medical management has been revolutionized by molecular data. Indeed, optimal therapeutic management of grade III glioma patients now requires assessment of chromosome arms 1p/19q copy number and IDH mutational statuses as predictive and prognostic biomarkers. Indeed, two large phase III clinical trials have demonstrated that early chemotherapy plus radiotherapy, versus radiotherapy alone, doubles median overall survival of patients suffering from 1p/19q co-deleted and/or IDH mutated anaplastic oligodendroglial tumor. Interestingly, both biomarkers have been identified in a large proportion of WHO grade II gliomas. Their clinical value, in this population, is under investigation through multiple phase III clinical trials. In sporadic WHO grade I gliomas, and specifically in pilocytic astrocytomas, MAPK signaling pathway activation is a frequent event, mainly due to genetic alterations involving BRAF gene. This characteristic opens new therapeutic perspectives using MAPK signaling pathway inhibitors. Finally, in the most aggressive gliomas, WHO grade IV gliomas, two critical biomarkers have been identified: (i) MGMT promoter methylation associated with longer survival and better response to chemotherapy and (ii) IDH mutations predicting better prognosis. Although, further studies are needed, MGMT promoter methylation will undoubtedly be transferred soon to clinical practice. Molecular characteristics are beginning to be valuable and indispensable in neuro-oncology for better management of brain tumors patients. The near future will be marked by identification of novel molecular biomarkers and their validation for clinical practice.Jusqu’à tout récemment, le diagnostic des tumeurs cérébrales, pivot de la prise en charge thérapeutique, était basé sur les caractéristiques clinico-radiologiques et neuropathologiques du patient et de sa tumeur. Ces dernières années, la neuro-oncologie clinique est entrée dans l’ère de la médecine personnalisée moléculaire. En effet, les caractéristiques moléculaires de la tumeur apportent des informations majeures au clinicien pour le traitement du patient. Les gliomes sont les tumeurs cérébrales primitives les plus fréquentes chez l’adulte. Leur prise en charge médicale a été transformée, depuis peu, par les données moléculaires. À titre d’exemple, le traitement optimal des patients souffrant d’un gliome de grade III nécessite désormais la détermination des statuts des chromosomes 1p et 19q et des gènes IDH. En effet, deux essais cliniques de phase III ont démontré que la chimiothérapie précoce plus la radiothérapie, versus la radiothérapie seule, double la survie globale médiane des patients souffrant d’un gliome grade III 1p/19q co-délété et/ou IDH muté. Les données moléculaires sont dorénavant indispensables en neuro-oncologie pour une prise en charge médicale optimale des patients. Les prochaines années seront incontestablement marquées, dans tous les sous-types de tumeurs cérébrales, par l’identification et la validation de nouveaux biomarqueurs moléculaires pertinents pour la pratique clinique

Geoarchaeological reconstruction of Caverna de Las Brujas (Mendoza, Argentina) for the archaeological intervention

Archaeological prospection and excavation in the Caverna de las Brujas (southern part of the province of Mendoza, Argentina) has offered the first known data on human presence in this cave. This is of great interest for understanding the evolution of peopling in the southern Mendoza province during the Holocene. Four archaeological pits were excavated, two in the gallery known as the Sala de la Virgen and another two near the cave entrance. Three volcanic ash levels were dated by TL techniques (7780±600, 4700±500; 765 ±200 years) and a level with enough organic material was dated by 14C analysis (3695±65 years BP). The available data is sufficient to establish the origin and make a geomorphological reconstruction of the Holocene levels. At the same time, a hypothetical model is proposed that uses geomorphological criteria to predict the stratigraphy of the unexcavated lower levels at the cave entrance. The aim of thismodel is to help direct future archaeological excavations of the cave's oldest deposits.Fil: Peña Monné, José Luis. Universidad de Zaragoza. Departamento de Geografía y Ordenación del Territorio; EspañaFil: Sancho Marcén, Carlos. Universidad de Zaragoza. Departamento de Ciencias de la Tierra; EspañaFil: Duran, Victor Alberto. Universidad Nacional de Cuyo. Facultad de Filosofia y Letras. Centro Interdisciplinario de Estudios Regionales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Mendoza; ArgentinaFil: Mikkan, Raul. Universidad Nacional de Cuyo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Mendoza; Argentin

Perampanel in Drug-Resistant Epilepsy with Gliomas Seizure Response to Perampanel in Drug-resistant Epilepsy with Gliomas: Early Observations

International audienceDrug-resistant epilepsy (DRE) occurs commonly in gliomas, possibly due to a shared mechanism of AMPA-activation involving both seizure activity and tumor growth. We tested the AMPA-receptor blocker perampanel (PER) in patients with DRE in low- and high-grade gliomas. Seizure response was defined as 50% drop in seizure frequency or as seizure-freedom. Cognitive function was examined by computerized test on cognitive speed (CTCS), which is sensitive to the type of cognitive dysfunction associated with epilepsy and use of anticonvulsants. Treatment policy included reduction of dose or discontinuation of one or more concurrent AEDs, once a seizure-free response was observed. Twelve patients were included patients, median age 41 years, 9 men versus 3 women and 6 months median duration of follow-up. An objective seizure response (75%) was observed in 9 (75%) out of 12 patients: 50%-seizure response in 3, seizure-freedom in 6, which is plainly more than seen with other types of DRE. Side-effects occurred in six patients. Cognitive function as examined by CTCS improved in six out of eight associated withlowering of concurrent AEDs. The final median dose of PER was 8 mg (varying between 2 and 12 mg). These results of an objective seizure response in 9 (75%) out of 12 patients treated by PER in DRE may be interpreted as a surrogate-marker of tumor response secondary to AMPA blockade, advancing confirmation by MR imaging. These results warrant further study of PER on tumor activity in gliomas

Emerging circulating biomarkers in glioblastoma: promises and challenges

International audienceGlioblastoma (GBM) is the most common and devastating primary malignant brain tumor in adults. The past few years have seen major progress in our understanding of the molecular basis of GBM. These advances, which have contributed to the development of novel targeted therapies, will change the paradigms in GBM therapy from disease-based to individually tailored molecular target-based treatment. No validated circulating biomarkers have yet been integrated into clinical practice for GBM. There is thus a critical need to implement minimally invasive clinical tests enabling molecular stratification and prognosis assessment, as well as the prediction and monitoring of treatment response. After examination of data from recent studies exploring several categories of tumor-associated biomarkers (circulating tumor cells, extracellular vesicles, nucleic acids and oncometabolites) identified in the blood, cerebrospinal fluid and urine, this article discusses the challenges and prospects for the development of circulating biomarkers in GBM

Primary Central Nervous System Lymphoma in Elderly Patients: Management and Perspectives

International audienceThe management of elderly patients suffering from primary central nervous system (CNS) lymphoma, who represent a rapidly growing population, is challenging. Despite the advances made in PCNSL treatment, the prognosis in older patients remains unsatisfactory. The high risk of systemic and CNS toxicity induced by a high-dose chemotherapy regimen and radiation therapy, respectively, limits the use of consolidation phase treatments in elderly patients and contributes to the poor outcome of these patients. Here, we review the current treatment strategies and ongoing trials proposed for elderly PCNSL patients

Treatment of Primary Central Nervous System Lymphoma in Immunocompetent Patients

International audiencePURPOSE OF REVIEW: This review focuses on the findings of recent randomized prospective trials evaluating new therapeutic options for primary central nervous system lymphoma (PCNSL) in first-line treatment and on the most promising novel agents.RECENT FINDINGS: The current standard treatment of newly diagnosed PCNSL has long been depending on high-dose methotrexate (HD-MTX)-based polychemotherapy followed by whole-brain radiotherapy (WBRT). Recent randomized trials have provided evidence that high-dose chemotherapy with autologous stem cell transplantation (ASCT) is a valuable alternative option to WBRT as consolidation after induction HD-MTX-based chemotherapy. For the elderly, cumulative studies confirm that chemotherapy alone as initial treatment is the best approach in this frail population in order to reduce chemoradiation neurotoxicity. If the role of rituximab needs to be further investigated, novel agents such as imids and ibrutinib have shown to be promising drugs to be incorporated in innovative combination treatment. The role of WBRT, at least at conventional dose, is declining in first-line treatment in favor of intensive consolidation chemotherapy with or without ASCT and possibly maintenance chemotherapy in the elderly. Despite their rarity, it has been shown that ambitious randomized trials in PCNSL are feasible thanks to collaborative networks.Summary: The role of WBRT, at least at conventional dose, is declining in first-line treatment in favor of intensive consolidation chemotherapy with or without ASCT and possibly maintenance chemotherapy in the elderly. Despite their rarity, it has been shown that ambitious randomized trials in PCNSL are feasible thanks to collaborative networks

Simulación de la difusión del cl- hasta la despasivación del acero de refuerzo en concreto con microsílice y expuesto a carbonatación

RESUMEN: En este trabajo se simuló la difusión de cloruros y la corrosión de acero de refuerzo embebido en un pilote de concreto afectadopor carbonatación en un ambiente marino de la costa pacífica colombiana, teniendo en cuenta, el tiempo de exposición, la carbonatación yla concentración de agregados finos en la preparación de las mezclas de las estructuras de hormigón. La simulación se realizó con la ayudadel software MATLAB Y FEMLAB, mediante ecuaciones diferenciales parciales de transporte de masa, para evaluar el servicio de vidaútil de la estructura con acero de refuerzo. Se simularon tres diferentes mezclas 0.4, 0.5 y 0.6 de agua/cemento, con un 10% de microsílicecomo aditivo, en un ambiente sumergido en agua de mar. Los resultados mostraron la penetración del cloruro en el concreto y del dióxidode carbono y la predicción del tiempo de despasivación de las varillas de refuerzo

Holocenic impact of volcanism and glacial advances in the human peopling of the southern Andes of Mendoza (Argentina): a geoarchaeological approach

Para el sur de Mendoza, se ha propuesto la existencia de un período prolongado de baja ocupación humana provocado por un aumento de la aridez durante el Holoceno medio. También se ha planteado que el poblamiento sistemático de la cordillera recién se inició a partir de 2000-1500 años AP como consecuencia de un proceso de intensificación generado por presión demográfica en áreas con mayor oferta de recursos. Aquí se presentan los resultados de una investigación diseñada para definir si el volcanismo y el glaciarismo holocénicos pudieron provocar las discontinuidades observadas en los registros arqueológicos de ambientes de altura. El estudio se desarrolló en una franja latitudinal comprendida entre 35º-37º S. Se presentan datos geoquímicos y fechados de tefras localizadas en sitios arqueológicos y depósitos geológicos para definir las fuentes de emisión y el impacto de esos eventos. En escala local, se hace un análisis geoarqueológico de la cuenca del río Valenzuela, donde se percibe la magnitud de la actividad del complejo volcánico Planchón-Peteroa y del glaciarismo holocénico. La información obtenida permite proponer alternativas a los modelos de poblamiento vigentes y destacar la importancia de los estudios geoarqueológicos.A prolonged period of decreased human occupation has been proposed for Mendoza Province, provoked by conditions of increasing aridity during the mid-Holocene. It has also been suggested that the systematic human peopling of the high-altitude Andean environments started ca. 2000-1500 years BP, because of a process of economic intensification in lowland areas with higher availability of resources. In this paper, we present the results of a project designed to assess the role of volcanic activity and glacial advances as the main cause for archaeological discontinuities recorded in the archaeological record of the high Andes. This study covers a latitudinal range between 35º-37ºS. We present geochemical and chronological results for tephras recorded in archaeological and geological sites, attempting to define the volcanic sources and their impact on the landscape. The analysis includes a geoarchaeological study of the Valenzuela River, which shows the magnitude of the volcanic activity in the Planchón-Peteroa complex, as well as the extent of Holocene glacial processes. The results presented allow suggesting alternative explanation for the temporal sequences of the archaeological record, inasmuch as highlighting the contribution of geoarchaeology.Fil: Duran, Victor Alberto. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales. Laboratorio de Paleoecología Humana; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Winocur, Diego Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; ArgentinaFil: Stern, Charles. University of Colorado; Estados UnidosFil: Garvey, Raven. University of Michigan; Estados UnidosFil: Barberena, Ramiro. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales. Laboratorio de Paleoecología Humana; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Peña Monné, José Luis. Universidad de Zaragoza; EspañaFil: Benitez, Angélica Anahí. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; Argentin