Gestion de la chaine opératoire de traitement des peaux et implication socioéconomique de la femme dorsétienne (Detroit d'Hudson, Nunavik). Ethnoarchéologie, tracéologie et analyse de genre

Le fait dorsétien reste à ce jour, en préhistoire de l’Arctique, sujet à de nombreux débats quant à sa définition exacte, les modalités entourant son implantation, son expansion et sa disparition de la portion Est de l’Arctique canadien, ainsi que l’organisation socioéconomique qui le caractérise. La compréhension des chaînes opératoires reliées à la production de la culture matérielle constitue un moyen privilégié d’accéder à l’univers des choix techniques et socioéconomiques. Suivant la documentation ethnographique, nous considérons que l’analyse de la séquence de traitement des peaux, dans le but de produire les vêtements et l’équipement nécessaires à la survie en milieu arctique, peut donner accès aux modes de gestions des différentes phases de cette activité technique dans le temps et dans l’espace, ainsi qu’à la nature de la contribution féminine au cours du cycle saisonnier d’exploitation des ressources. Cette étude démontre que, suivant les similarités et les contrastes extraits d’une confrontation entre les modes de gestion des chaînes opératoires de traitement des peaux Inuit et Dorsétien, il est possible de proposer un modèle révélant le mode d’organisation socioéconomique de ces derniers, ainsi que d’aborder la nature des relations sociales (relations de genre) sous-jacentes. Étant soumis à un cycle saisonnier de disponibilité et d’accessibilité aux ressources, ainsi qu’à des besoins matériels équivalent à celui ceux des Inuits, les peuples dorsétiens ont pu élaborer un mode de gestion de leurs activités techniques et de leurs relations sociales particulier, en accord avec une réalité culturelle et sociale qui se distingue de celle de leurs successeurs. La combinaison des analyses tracéologiques (identification de la fonction de l’outillage en chert et en quartz) et spatiales, complétée par une analyse des relations de genre, permet de générer les données nécessaire à ce type d’étude. Les trois sites archéologiques sélectionnés sont situés le long du littoral sud du détroit d’Hudson au Nunavik. La période culturelle couverte par ces derniers comprend la phase de transition du paléoesquimau ancien au paléoesquimau récent (Pita KcFr-5 / 2800-2600 AA), ainsi que la phase dite Dorsétienne (Tivi KcFr-8A / 2600-1000 AA et Tayara KbFk-7 / 2125 – 1186 AA). Mots clés : Paléoesquimau, Dorsétien, chaîne opératoire de traitement des peaux, analyse lithique, tracéologie, expérimentations archéologiques, ethnoarchéologie, analyse de genre, archéologie de l’espace domestique, cycle saisonnier, fonction des outils, microlame.To this day, Dorset culture continues to be the subject of numerous debates in the field of Arctic prehistory, regarding its exact définition, the methods it used to establish itself, its expansion, and its disappearance from the eastern portion of the Canadian Arctic, as well as its characteristic socioeconomic organization. An understanding of the chaînes opératoires related to their material culture represents a privileged path to access a universe of technical and socioeconomic choices. By following the ethnographical documentation, we consider that the analysis of the skins working process, for the purpose of producing the garments and equipment necessary to survive in an Arctic environment, could provide access to methods to manage the different phases of this technical activity in time and space, in addition to showing the nature of female contributions throughout seasonal cycles of resources availability. This study demonstrates that, by looking at the différences and similarities gathered through a comparison between the management methods of production processes to treat animal skins used by the Inuit and Dorset cultures, it is possible to suggest a relevant model of the socioeconomic organization of the latter, as well as to approach the nature of their underlying social and gender relations. Being subject to a seansonal cyle of availability and access to resources, while experiencing material needs équivalent to those of the Inuit, the Dorset peoples were able to create a particular method for managing their technical activities and their social relationships, consistent with a cultural and social reality that differs from the one experienced by their successors. A combination of use-wear analyses (identification of the use of tools in chert and quartz) and spatial analyses, completed by an analysis of gender relationships, allows the data necessary in this type of study to be generated. The three archaeological sites chosen are located along the southern coastline of the Hudson Strait in Nunavik. The cultural period covered by these sites covers the transitional phase from ancient to récent Paleo-Eskimo (Pita KcFr-5/2800-2600 B.P.), as well as the one knows as the Dorset phase (Tivi KcFr-8A/2600-1000 B.P. and Tayara KbFk-7/2125-1186 B.P.). Keywords: Paleo-Eskimo, Dorset, skin process chaîne opératoire, lithic analysis, use-wear analysis, archaeological experiments, ethno-archaeology, gender analysis, household analysis, seasonal cycle, tools function, microblades

Examination of the Aggregate Scoring Method in a Judgment Concordance Test

The use of the aggregate scoring method for scoring concordance tests requires the weighting of test items to be derived from the performance of a group of experts who take the test under the same conditions as the examinees. However, the average score of experts constituting the reference panel remains a critical issue in the use of these tests. This study aims to examine the distribution of panelists’ scores on the judgment concordance test (JCT) using the aggregate scoring method. A test composed of 32 items was developed and completed by 14 experts. The mean scores of the experts were calculated based on whether their choices of response categories for the 32 JCT items were included or excluded. Descriptive statistics were conducted. The mean scores of the experts showed a difference of 5.76%, depending on the approach used. The approach that excludes the experts’ response category choices was found to be more penalizing (76.16%±8.9) than the method including their own choices (81.92%±8.1). It is recommended that researchers make their computational approaches explicit in addition to outlining the distribution of expert results retained for the purpose of determining scores in the concordance tests. Further research is required to refine our understanding of the quality of score-setting in this type of test

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

BACKGROUND: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. METHODS: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). FINDINGS: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29-146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0- 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25-1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39-1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65-1·60]; p=0·92). INTERPRETATION: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention. FUNDING: British Heart Foundation

Note de recherche. Au coeur d’un chantier forestier : le campement du Dauphinais, parc national de la Mauricie

Les interventions archéologiques menées par l’équipe d’archéologie terrestre de Parcs Canada en 2022 dans le cadre du projet de réhabilitation des lacs et des cours d’eau du parc national de la Mauricie ont permis de documenter différents types de vestiges liés aux activités d’exploitations forestières des xixe et xxe siècles. Parmi ceux-ci se trouvait un ancien campement forestier, localisé non loin d’un ancien barrage dans le secteur de la décharge du lac Dauphinais. Le relevé de localisation des structures observées sur le site a permis d’évaluer la composition et l’organisation du campement. Les caractéristiques observées suggèrent des pistes d’interprétation quant à son contexte d’occupation et sa place dans l’histoire de l’exploitation forestière en Mauricie.Archaeological work by Parks Canada’s terrestrial archaeology team in 2022, as part of a lake and stream rehabilitation project in La Mauricie National Park, has led to the discovery of various types of remains from logging operations in the 19th and 20th centuries. These remains include an old logging camp located not far from what is left of the Lake Dauphinais outlet dam. A survey of the structures found on the site revealed the composition and organization of the camp. Several of the characteristics observed suggest avenues for interpreting the context of the occupation and its position in the history of logging in La Mauricie