An integrated approach based on archaeometry, use-wear analysis and experimental archaeology to investigate the function of a specific type of basin diffused in the Predynastic sites of lower Egypt (4th mill. BC)

This paper focuses on the functional analysis of a specific oval shaped basin diffused in Lower Egyptian Predynastic sites during the first half of the 4th millennium BC. These oval shallow ceramic basins are characterised by a flat and wide inner surface that is covered by a layer of small rock fragments pressed into the clay matrix. Several archeologists have interpreted them as grinding tools, but the limited number of samples unearthed thus far and their poor state of preservation made this interpretation uncertain. Here we present the results of a preliminary integrated study based on the combination of experimental archaeology and petrographic, use-wear and residue analyses carried out on two samples from the Predynastic site of Maadi. The use-wear analysis of the archaeological fragments highlighted traces of an intentional grinding and light pounding of oily substances, which is also partially supported by the organic residue investigation. These results were tested through experimental tests that confirmed these basins are most likely mortars. Establishing the actual functional activities performed in such a unique type of vessel is important not only for understanding the social behaviors of the Lower Egyptian Predynastic communities and the dynamics related to the diffusion of such basins, but it also provides a new methodological framework for Egyptian Predynastic studies

Il Delta orientale del Nilo, un territorio di frontiera tra il II e il I millennio a.C.

L’area geografica oggetto di questo contributo è quella del Delta orientale e del Sinai settentrionale. Il Delta orientale ospitò invariabilmente nel tempo il confine dell’Egitto1, aldilà delle conquiste effettuate dai faraoni e delle invasioni subite; il Sinai settentrionale, percepito dagli Egiziani come “terra straniera”2, ebbe la funzione di regione cuscinetto fra due paesi urbanizzati quali l’Egitto e la Palestina. La frontiera nord-orientale dell’Egitto sfruttava una serie di barriere naturali che, in mancanza di rilievi, erano costituite dalle lagune, dai laghi e dal ramo pelusico del Nilo che, a partire dalle immediate vicinanze della costa, si estendevano su tutto il margine orientale del Delta, fra le terre fertili e il deserto. Questa regione subì notevoli variazioni nel tempo, tra cui le più rilevanti furono lo spostamento della linea di costa e la migrazione del distributario più orientale del grande fiume. All’analisi critica dell’edito si vuole qui affiancare una base cartografica omogenea costruita mediante digitalizzazione e rielaborazione in ambiente CAD di carte geomorfologiche3 e delle planimetrie archeologiche contenute negli articoli e rapporti di scavo e ricognizione di superficie effettuate nella regione. La digitalizzazione di tutta questa documentazione ha permesso di realizzare elaborazioni a seconda delle esigenze di resa grafica oltre a nuove immagini esplicative di ipotesi ricostruttive (ad esempio i modelli tridimensionali del terreno). Nell’analisi topografica parziale qui proposta ci si è soffermati in particolare sull’area della paleolaguna, nel margine nord-orientale del Delta, dove era situata la frontiera del paese, sulla sua conformazione geografica e sullo stretto rapporto fra questa e le strutture costruite a difesa della zona

RESEARCHES OF THE SAPIENZA UNIVERSITY OF ROME IN THE SITE OF MAADI (LOWER EGYPT): TOPOGRAPHY AND ARTEFACTS IN A CHRONOLOGICAL PERSPECTIVE

Between 1977 and 1986 an Italian expedition from the Sapienza University of Rome carried out six diggings campaigns in the well-known predynastic site of Maadi (IV mill. B.C.). The investigation, conducted by the Italian Expedition for the Researches in Egypt and Sudan under the direction of S. M. Puglisi and A. Palmieri, covered an area of around 450sqm. The excavation was located in the eastern part of the ancient settlement, diametrically opposite to the more recent diggings executed by the German Archaeological Institute. The study of the documentation, still unpublished except for some preliminary papers, has been resumed by the authors. This material represents the occasion to complete the information contained in the past monographs about the first excavations done at Maadi, deepening the stratigraphic aspect which is fundamental for the understanding of the dynamics of formation and development of the site and in general of the Lower Egypt Predynastic culture, and to reconsider this site in the light of the latest researches made in the Nile Delta. The present paper delivers preliminary results from the ongoing study and it is especially focused on the characteristics of the archaeological stratigraphy and on pottery and lithic assemblages

Defining the Morbidity of Robot-Assisted Radical Cystectomy with Intracorporeal Urinary Diversion: Adoption of the Comprehensive Complication Index

Background and Objective: The Clavien-Dindo Classification (CDC) only reports the postoperative complication of highest grade. It is thus of limited value for radical cystectomy, after which patients usually experience multiple complications. The Comprehensive Complication Index (CCI) is a novel scoring system, which incorporates all postoperative events in one single value. The study aimed to adopt the CCI for the evaluation of complications in patients undergoing robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) and explore its advantages in the analysis of the morbidity of RARC with ICUD.Patients and Methods: A multicentric cohort of 959 patients undergoing RARC+ICUD between 2015 and 2020, whose complications are encoded in local prospective registries. Postoperative complications at 30 days were assessed using both the CDC and CCI. The CCI was calculated using an online tool (assessurgery.com). Risk factors for overall, major complications (CDC >= III), and CCI were evaluated using uni- and multivariable logistic and linear regressions. To analyze the potential advantage of using the CCI in clinical trials, a sample size calculation of a hypothetic clinical trial was performed using as endpoint reduction of morbidity with either the CDC or CCI.Results: Overall, 885 postoperative complications were reported in 507 patients (53%). The CCI improved the definition of postoperative morbidity in 22.6% of patients. Male sex and neobladder were associated with major complications and to a significant increase in CCI on adjusted regressions. In a hypothetical clinical trial, 80 patients would be needed to demonstrate a ten-point reduction in CCI, compared with 186 needed to demonstrate an absolute risk reduction of 20% in overall morbidity using the CDC.Conclusion: CCI improves the evaluation of postoperative morbidity by considering the cumulative aspect of complications compared with the CDC. Implementing the CCI for radical cystectomy would help reducing sample sizes in clinical trials.Clinical Trial Registration number: NCT03049410

Continuing acetylsalicylic acid during Robotic-Assisted Radical Cystectomy with intracorporeal urinary diversion does not increase hemorrhagic complications: results from a large multicentric cohort

Objectives: To evaluate whether continuing the antiplatelet drug acetylsalicylic acid <= 100mg (ASA) during Robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) increases the risk of peri-and postoperative hemorrhagic complications and overall morbidity. Indeed, guidelines recommend interrupting antiplatelet therapy before radical cystectomy; however, RARC with ICUD is associated to reduced estimated blood loss and blood transfusions compared to its open counterpart.Methods: Data from a multicentric European database were analyzed. All participating centers maintained a prospective database of patients undergoing RARC with ICUD. We identified patients receiving antiplatelet therapy by acetylsalicylic acid <= 100mg. Patients were divided into three groups: those not taking acetylsalicylic acid (no-ASA), those where ASA was continued perioperatively (c-ASA) and those where ASA was interrupted perioperatively (i-ASA). Estimated blood loss and peri-and post-operative transfusions were recorded. Hemorrhagic complications, ischemic, thrombotic and cardiac morbidity was recorded and classified using the Clavien-Dindo score by a senior urologist.Results: 640 patients were analyzed. Patients on acetylsalicylic acid were significantly older and had more comorbidities. No significant difference was found for estimated blood loss between no-ASA, c-ASA and i-ASA (280 vs. 300 vs. 200ml respectively; P = 0.09). Similarly, no significant difference was found for intraoperative (5% vs. 9% vs. 11%; P = 0.07) and postoperative transfusion rate (11% vs. 13% vs. 18%; P = 0.17). Higher ischemic complications were noted in the i-ASA group compared to no-ASA and c-ASA (4% vs. 0.6% vs. 1.4%; P = 0.03). On uni and multivariate logistic regression, continuing acetylsalicylic acid was not significantly associated to either major complications or post-operative transfusions.Conclusions: Peri-operative acetylsalicylic acid continuation in RARC with ICUD does not increase hemorrhagic complications. Interrupting acetylsalicylic acid peri-operatively may expose patients to a higher risk of ischemic events. (C) 2021 Elsevier Inc. All rights reserved