Appetite for destruction. Current interpretations of accidental or deliberate destructions in Bronze Age Cyprus

Destruction processes are considered 'time capsules of material culture' (Driessen 2013) as they freeze a site at one moment of its history providing key evidence for interpreting the archaeological record and reconstructing social, political, cultural and ideological circumstances. By focusing on selected case-studies, this paper aims at briefly discussing existing evidence of destruction events in Bronze Age contexts in Cyprus, and at a preliminary presentation of new research data resulting from ongoing interdisciplinary analyses at Middle Bronze Age Erimi

An Improved Model for Relativistic Solar Proton Acceleration applied to the 2005 January 20 and Earlier Events

This paper presents results on modelling the ground level response of the higher energy protons for the 2005 January 20 ground level enhancement (GLE). This event, known as GLE 69, produced the highest intensity of relativistic solar particles since the famous event on 1956 February 23. The location of recent X-ray and gamma-ray emission (N14 W61) was near to Sun-Earth connecting magnetic field lines, thus providing the opportunity to directly observe the acceleration source from Earth. We restrict our analysis to protons of energy greater than 450 MeV to avoid complications arising from transport processes that can affect the propagation of low energy protons. In light of this revised approach we have reinvestigated two previous GLEs: those of 2000 July 14 (GLE 59) and 2001 April 15 (GLE 60). Within the limitations of the spectral forms employed, we find that from the peak (06:55 UT) to the decline (07:30 UT) phases of GLE 69, neutron monitor observations from 450 MeV to 10 GeV are best fitted by the Gallegos-Cruz & Perez-Peraza stochastic acceleration model. In contrast, the Ellison & Ramaty spectra did not fit the neutron monitor observations as well. This result suggests that for GLE 69, a stochastic process cannot be discounted as a mechanism for relativistic particle acceleration, particularly during the initial stages of this solar event. For GLE 59 we find evidence that more than one acceleration mechanism was present, consistent with both shock and stochastic acceleration processes dominating at different times of the event. For GLE 60 we find that Ellison & Ramaty spectra better represent the neutron monitor observations compared to stochastic acceleration spectra. The results for GLEs 59 and 60 are in agreement with our previous work.Comment: 42 pages, 10 figures, 10 tables, published in ApJ, August 200

Historical micronutrient psychiatry: descriptive analysis of patients with pellagra admitted to the “San Lazzaro” asylum in Reggio Emilia (Italy) in the decade 1901-1910

This study aims at describing the socio-demographic and clinical characteristics of the patients affected by pellagra and admitted to the “San Lazzaro” psychiatric asylum (Reggio Emilia, Italy) from 1901 to 1910 besides exploring possible gender differences for the collected information. Data were collected from the admission register and clinical records of those patients who were admitted to the San Lazzaro Psychiatric Hospital receiving a diagnosis of pellagra at their first admission. The pellagrous patient population was characterised by a higher rate of hospitalisation for women (64.3%) and the number of hospitalised patients suffering from pellagra gradually decreased from 1901 (78; 8.3%) to 1910 (8;0.7%). The most common profession for men admitted with pellagra was farmer/agricultural labourer, while most of the women were housewives. A characteristic shared by both the male and female population of inpatients was very high rate of illiteracy: only one patient was recorded as being able to read and write. The generic diagnosis of “mental illness from pellagra” was predominant (70%), while “dementia from pellagra” accounts for 17.85% of the admission diagnoses: no statistically significant differences between men and women were found in the frequency of diagnosis. Half of the patients, both men and women, died while being inpatients. This study confirms previous findings about the case mix of pellagra patients admitted to psychiatric hospital at the beginning of the last century in northern Italy and highlights the significance of the relationship of psychiatry with other medical disciplines and the sociocultural milieu

Neuropsychiatric Questionnaires in Systemic Lupus Erythematosus

Patients with systemic lupus erythematosus (SLE) can be affected by a multitude of neurologic and psychiatric symptoms with a wide range of prevalence and severity. Irrespectively from attribution to SLE or other causes, neuropsychiatric (NP) symptoms strongly impact short-term and long-term outcomes,thus NP evaluation during routine clinical practice in SLE should be undertaken regularly. The assessment of NP involvement in SLE patients is challenging and the available diagnostic tools fail to guarantee optimal diagnostic accuracy, sensitivity to changes as well as feasibility in routine clinical care. Standardised questionnaires (both physician-administered and self-reported) can offer valuable help to the treating physician to capture all possible NP syndromes; few SLE-specific NP questionnaire have been developed but validation in large cohort or cross-cultural adaptations are still pending. On the other hand, general instruments have been largely applied to SLE patients. Both kinds of questionnaires can address all possible NP manifestations either globally or, more frequently, focus on specific NP symptoms. These latter have been mainly used in SLE to detect and classify mild and subtle symptoms, more likely to be overlooked during routine clinical assessment such as headache, cognitive impairment and psychiatric manifestations. In conclusion, this literature review highlights a clear case for validation studies in this area and the wider implementation of questionnaires to assess NP involvement is still warranted. The broader use of such instruments could have important consequences; first of all, by standardising symptom assessment, a better definition of the prevalence of NP manifestation across different centres could be achieved. Secondly, prospective studies could allow for the evaluation of clinical significance of mild symptoms and their impact on the patient’s function and quality of life

Development and performance of the Clinical Trials ESSDAI (ClinTrialsESSDAI), consisting of frequently active clinical domains, in two randomised controlled trials in primary Sjogren's syndrome

Objective. To develop and evaluate the Clinical Trials EULAR Sjogren's Syndrome Disease Activity Index (ClinTrialsESSDAI), consisting of frequently active clinical domains of the ESSDAI, using two randomised controlled trials in primary Sjogren's syndrome (pSS). Methods. The ASAP-III trial in abatacept (80 pSS patients) and TRACTISS trial in rituximab (133 pSS patients) were analysed. The most frequently active clinical domains were selected, and ClinTrialsESSDAI total score was calculated using existing weightings of the ClinESSDAI (which also excludes the biological domain). Performance of the ClinTrialsESSDAI was compared to ClinESSDAI and ESSDAI. Responsiveness was assessed using standardised response mean (SRM), and discrimination was assessed using adjusted mean difference. Results. Besides the biological domain, the most frequently active domains were glandular, articular, haematological, constitutional, lymphadenopathy and cutaneous. These domains were selected for the ClinTrialsESSDAI. At primary endpoint visits, SRM values of ClinTrialsESSDAI, ClinESSDAI and ESSDAI were respectively -0.65/-0.59, -0.63/-0.59 and - 0.64/-0.61 for abatacept/placebo and -0.33/-0.13, -0.34/0.12 and -0.41/-0.16 for rituximab/placebo. Adjusted mean differences between active treatment and placebo groups were respectively -1.7, -1.4 and -1.1 for ASAP-III and -1.1, -1.1 and -1.2 for TRACTISS. Conclusion. The ClinTrialsESSDAI, consisting of six frequently active clinical domains of the ESSDAI, shows closely similar responsiveness and discrimination between treatment groups compared to the ClinESSDAI and ESSDAI. Therefore, this ClinTrialsESSDAI is not preferable to ClinESSDAI and ESSDAI for use as primary endpoint. A composite endpoint combining response at multiple clinically relevant items seems more suitable as primary study endpoint in pSS