Towards a new osteometric method for sexing ancient cremated human remains. Analysis of Late Bronze Age and Iron Age samples from Italy with gendered grave goods

Sex estimation of human remains is one of the most important research steps for physical anthropologists and archaeologists dealing with funerary contexts and trying to reconstruct the demographic structure of ancient societies. However, it is well known that in the case of cremations sex assessment might be complicated by the destructive/transformative effect of the fire on bones. Osteometric standards built on unburned human remains and contemporary cremated series are often inadequate for the analysis of ancient cremations, and frequently result in a significant number of misclassifications. This work is an attempt to overcome the scarcity of methods that could be applied to pre-proto-historic Italy and serve as methodological comparison for other European contexts. A set of 24 anatomical traits were measured on 124 Bronze Age and Iron Age cremated individuals with clearly engendered grave goods. Assuming gender largely correlated to sex, male and female distributions of each individual trait measured were compared to evaluate sexual dimorphism through inferential statistics and Chaktaborty and Majumder\u2019s index. The discriminatory power of each variable was evaluated by cross-validation tests. Eight variables yielded an accuracy equal to or greater than 80%. Four of these variables also show a similar degree of precision for both sexes. The most diagnostic measurements are from radius, patella, mandible, talus, femur, first metatarsal, lunate and humerus. Overall, the degree of sexual dimorphism and the reliability of estimates obtained from our series are similar to those of a modern cremated sample recorded by Gon\ue7alves and collaborators. Nevertheless, mean values of the male and female distributions in our case study are lower, and the application of the cut-off point calculated from the modern sample to our ancient individuals produces a considerable number of misclassifications. This result confirms the need to build population-specific methods for sexing the cremated remains of ancient individuals

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Carborane reductive-elimination reaction from a six-coordinate hydridocarboranyliridium(III) complex: Kinetic and mechanistic study

A kinetic and mechanistic study of the reductive-elimination reaction of the carborane 1-H-T-C6H5-1,7-C2B10H10 (H-carb) from the six-coordinate iridium(III) complex Ir(H)(Cl)(\u3c3-carb)(CO)(PPh3)2 has been carried out in 1,2-dichloroethane by IR spectroscopy between 20 and 50\ub0C. The mechanism of the carborane-elimination reaction implies a preliminary PPh3 dissociation to give the five-coordinate Ir(H)(Cl)(\u3c3-carb)(CO)(PPh3) complex. This intermediate then undergoes a reductive elimination of the carborane molecule through two pathways: (i) direct elimination to give the three-coordinate iridium(I) complex, IrCl(CO)(PPh3); (ii) a phosphine-induced elimination via trans \u2192 cis isomerization of the H and carb ligands. The kinetic and thermodynamic parameters are also reported and discussed. \ua9 1984 American Chemical Society

Kinetic and mechanistic study of the succinic anhydride reductive-elimination reaction from the six-coordinate Ir(H)[\u3c3-CHCH2C(O)OC(O)](\u3c3-carb)(CO)(PhCN)(PPh 3) complex

The hydridoalkyliridium(III) complex Ir(H)[\u3c3-CHCH2C(O)OC(O)](\u3c3-carb)(CO)(PhCN)(PPh 3), where carb = 7-C6H5-1,7-C2B10H10, undergoes reductive-elimination reaction of succinic anhydride under mild conditions. This reaction, which represents a crucial step in the homogeneous hydrogenation of maleic anhydride catalyzed by the four-coordinate iridium(I) complex Ir(\u3c3-carb)(CO)(PhCN)(PPh3) at T = 50\ub0C (PH2 = 1 atm), has been kinetically investigated in 1,2-dichloroethane solution by IR spectroscopy between 35 and 45\ub0C. The elimination reaction implies preliminary PhCN dissociation to give a five-coordinate intermediate that then undergoes intramolecular reductive elimination of succinic anhydride. The obtained activation parameters indicate that the reductive elimination of succinic anhydride from the five-coordinate hydridoalkyliridium(III) intermediate is a highly concerted process whose drawing force is the incipient formation of the strong C-H bond of the product. \ua9 1984 American Chemical Society

Use of NT-proBNP in weaning from mechanical ventilation

Our objective is to evaluate the role of the levels of B-type natriuretic peptide (BNP), released in response to increased wall tension, as a predictor of weaning failure. Methods We enrolled 98 patients, admitted to the ICU for acute respiratory failure, who underwent mechanical ventilation and were considered ready for a weaning trial. Patients were divided by means of echocardiographic criteria into four groups according to the severity of heart dysfunction: Group 1: normal left and right ventricular function and absence of relevant valvulopathy; Group 2: mild left systolic ventricular dysfunction, ejection fraction >40%, mild valvulopathy, diastolic dysfunction >II; Group 3: moderate to severe left systolic ventricular dysfunction, ejection fraction 0.6, arterial pulmonary pressure >30 mmHg. Plasma NT-proBNP was measured just before (BNP 1) and at the end (BNP 2) of the weaning trial in all patients. Patients who passed the weaning test were finally extubated. Extubation was considered failed if the patient required reintubation within 48 hours. We compared plasma BNP concentrations in the different groups with Mann-Whitney or chi-square tests and we considered also \u394BNP (BNP 2 - BNP1) and %Variation (\u394/BNP1). Results In the whole sample NT-proBNP levels were not significantly different in patients who had a positive weaning and in those who failed it. \u394BNP and %Variation were higher (P < 0.001) in patients who failed the test than in patients who passed the test. In Group 1 a higher \u394BNP, and in Group 2 a higher \u394BNP and %Variation, were correlated with weaning failure. In Group 4, instead, the plasma BNP concentration decreased during the weaning test. ROC curve analysis was performed to assess \u394BNP and %Variation's ability to discriminate between patients who had a positive weaning and those who failed. In Group 1 the area under the ROC curve values were 0.88 for \u394BNP and 0.94 for %Variation. In Group 2 the area under the ROC curve values were 0.64 for \u394BNP and 0.86 for %Variation. Conclusions Recent papers evaluated the role of BNP in patients who had undergone mechanical ventilation. In our population \u394BNP and %Variation before and after the weaning test are more reliable than NT-proBNP levels to detect extubation failure in patients with mild cardiopathy or without relevant cardiopathy. In patients with severe cardiopathy because of the complexity of clinical pattern, NT-pro-BNP cannot be used as a predictive marker of extubation failure