11 research outputs found
La grotte Bouyssonie, Brive la Gaillarde, CorrÚze : bilan de deux années de fouilles (2020-2021)
International audienceLe Bassin de Brive est un haut lieu de la PrĂ©histoire française comme en tĂ©moignent les fouilles des grottes et abris dans la vallĂ©e de la Planchetorte au XIXĂšme et au dĂ©but du XXĂšme siĂšcle. Ces gisements, fouillĂ©s avec les techniques de lâĂ©poque, ont participĂ© Ă la construction des subdivisions chronologiques de la PrĂ©histoire que les chercheurs utilisent encore aujourdâhui. Pour autant, dans la seconde moitiĂ© du XXĂšme siĂšcle et plus encore depuis les annĂ©es 1980, les fouilles de sites prĂ©historiques en CorrĂšze se sont rarĂ©fiĂ©es, alors mĂȘme que lâarchĂ©ologie Ă©tait en pleine mutation et que les techniques se dĂ©veloppaient. La fouille de la grotte Bouyssonie est ainsi lâun des rares chantiers dâarchĂ©ologie programmĂ©e en activitĂ© en Limousin, pour les pĂ©riodes prĂ©historiques. DĂ©couverte en 2005 Ă lâoccasion de travaux de terrassement et Ă©valuĂ©e par lâInrap (lâInstitut national de recherche dâarchĂ©ologie prĂ©ventive), la grotte sâouvre en plein cĆur de Brive-la-Gaillarde dans les grĂšs qui barrent le flanc nord du plateau de Bassaler. La forme quâelle prĂ©sente aujourdâhui nâest toutefois pas celle quâelle avait Ă lâĂ©poque prĂ©historique, puisquâune carriĂšre a exploitĂ© son flanc ouest Ă lâĂ©poque moderne et quâune partie du plafond sâest effondrĂ© au cours et Ă la fin du PalĂ©olithique. Ainsi, nous ne connaissons ni sa forme, ni son extension maximale, puisque les premiĂšres estimations montrent quâelle sâĂ©tend encore en profondeur sur plusieurs mĂštres. La surface de fouille ne concerne donc quâune petite partie du gisement et il est probable que celui-ci soit plus Ă©tendu le long de lâescarpement rocheux
« Y a plus de saison ma bonne dame ! »Entre contrainte météorologique et gestion des ressources sur une fouille : exemple du protocole de prélÚvement des restes macrobotaniques de la grotte Bouyssonie, Brive-La-Gaillarde, CorrÚze
International audienceLa grotte Bouyssonie est un site prĂ©historique ayant livrĂ© des occupations datĂ©es entre environ 40 et 5ka BP. Une des particularitĂ©s du site est la prĂ©servation exceptionnelle des restes anthracologiques, abondants mais fragiles, laquelle permet de suivre l'Ă©volution de la vĂ©gĂ©tation ligneuse du Bassin de Brive depuis les dĂ©buts du PalĂ©olithique supĂ©rieur. Ces conditions sont potentiellement favorables Ă la prĂ©sence d'autres macrorestes botaniques tels que des graines, pour lesquels un protocole de prĂ©lĂšvement ad hoc a Ă©tĂ© mis en place depuis 2020.Bien que les fouilles se dĂ©roulent en saison estivale, une mĂ©tĂ©o parfois capricieuse alternant entre pĂ©riodes caniculaires et fortes prĂ©cipitations affecte le bon dĂ©roulement de la post-fouille, et notamment le traitement des vestiges d'origine organique. En effet, des variations trop importantes du taux d'humiditĂ© et de la tempĂ©rature peuvent entraĂźner une surfragmentation pouvant biaiser la reprĂ©sentativitĂ© des restes ou, d'un point de vue logistique, se traduire par une augmentation significative du temps de sĂ©chage, accumulant des retards qui se rĂ©percutent sur l'ensemble des tĂąches.Ainsi, le protocole de rĂ©cupĂ©ration des restes macrobotaniques - prĂ©lĂšvement, tamisage, sĂ©chage et conditionnement - est progressivement affinĂ© afin de prĂ©server au maximum les diffĂ©rents macrorestes, tout en intĂ©grant les moyens mobilisĂ©s pour leur traitement au sein d'une rĂ©flexion incluant (i) la variabilitĂ© mĂ©tĂ©orologique, (ii) les coĂ»ts humains (temps et effort) et (iii) les dĂ©penses Ă©nergĂ©tiques (eau et Ă©lectricitĂ©). Sur la base d'un traitement systĂ©matique des sĂ©diments fouillĂ©s Ă des ouvertures de tamis variant entre 2mm et 250”m, diffĂ©rents protocoles ont Ă©tĂ© appliquĂ©s lors de la saison 2022 en faisant varier les modes de tamisage (sec vs eau vs flottation) et de sĂ©chage (air ambiant, 40°C, 70°C). Pour cela, la fouille s'est Ă©quipĂ©e d'une station mĂ©tĂ©o pour relever quotidiennement la tempĂ©rature et l'humiditĂ©, d'un compteur pour estimer la consommation d'eau Ă la station de tamisage et d'un dĂ©shydrateur pour contrĂŽler la tempĂ©rature. Les durĂ©es pour chaque Ă©tape ont Ă©tĂ© relevĂ©es et comparĂ©es.Les rĂ©sultats montrent que l'uniformisation de la mĂ©thode de prĂ©lĂšvement tend Ă minimiser les biais de reprĂ©sentativitĂ©. Etant donnĂ©e la nature compacte de la matrice argilo-sableuse, les tests rĂ©vĂšlent que la flottation est la mĂ©thode la plus efficace permettant la rĂ©cupĂ©ration exhaustive des macrorestes botaniques. Si la manĆuvre est longue, sa consommation en eau est acceptable (infĂ©rieure au tamisage Ă l'eau) et le tri qui suit est plus rapide. Comme attendu, la tempĂ©rature est inversement corrĂ©lĂ©e Ă la durĂ©e de sĂ©chage. NĂ©anmoins, elle ne semble pas introduire de fragmentation supplĂ©mentaire. La tempĂ©rature minimale de l'appareil (30°C) est cependant suffisante pour un sĂ©chage optimal quand les conditions le nĂ©cessitent. Abordable et consommant peu d'Ă©lectricitĂ©, le dĂ©shydrateur remplace avantageusement l'Ă©tuve de laboratoire. Enfin, l'installation pĂ©renne d'un rĂ©cupĂ©rateur d'eau est un projet qui permettrait de tendre vers une autonomie de la consommation en eau sur le site. Cette rĂ©flexion globale autour de la mĂ©thodologie de terrain a permis de proposer un protocole rĂ©alisable, reproductible, sobre Ă©nergĂ©tiquement et adaptable aux variations de tempĂ©rature et d'humiditĂ© pour la prĂ©servation et le traitement des restes botaniques in situ
Does the clinical frailty score improve the accuracy of the SOFA score in predicting hospital mortality in elderly critically ill patients? A prospective observational study
International audiencePurpose To determine whether the addition of the frailty status assessed by the clinical frailty scale (CFS) to the SOFA score (SOFA-CFS) improves the performance of the SOFA score alone in predicting the hospitalmortality of elderly critically ill patients. Methods A prospective observational study performed between February 2015 and February 2016 including 189 patients aged >= 65 years and hospitalized >= 24 h in the intensive care unit (ICU). Results The SOFA-CFS score did not improve the performance of the SOFA score alone in predicting hospitalmortality (AUC=0.66, 95% CI 0.58-0.74 vs AUC=0.63, 95% CI 0.55-0.72, respectively, p = 0.082). The AUC of the CFS score was 0.62 (95% CI 0.53-0.71). In the multivariable analysis, age (OR 1.09, 95% CI 1.03-1.16, p = 0.006), McCabe score C vs A (reference) and B vs A (reference) (OR 8.28, 95% CI 2.83-24.27and OR 2.29, 95% CI 1.02-5.12, p = 0.006, respectively), Glasgow coma score at admission (OR 0.31, 95% CI 0.14-0.48, p = 0.003), and SOFA score (OR 1.11, 95% CI 1.01-1.23, p = 0.037) were risk factors for hospital mortality. Conclusions The performance of the SOFA score in predicting hospital mortality was low, although it was an independent risk factor for mortality. The combination of frailty status with the SOFA score did not improve the performance of the SOFA score alone. (C) 2018 Elsevier Inc. All rights reserved
Follow up of pain reported by children undergoing outpatient surgery using a smartphone application: AlgoDARPEF multicenter descriptive prospective study
International audienceIn pediatric patients, pain remains the most common complaint after surgery. This French multicenter epidemiological study (AlgoDARPEF) aimed to evaluate the use of a smartphone application (App) to assess the duration and severity of pain experienced by children undergoing outpatient surgery. Children below 18 years of age scheduled for an elective outpatient procedure in one of the participating centers were eligible. Parents were invited to provide daily information for 10 days regarding their childâs pain and comfort via a smartphone App using the Parentsâ Postoperative Pain Measure - Short Form (PPPM-SF). Children over 6 years old could also provide self-assessments of pain using a Numerical Rating Scale (NRS-11). Data regarding pain medication, preoperative anxiety, postoperative nausea and vomiting, and parent satisfaction were also analyzed. Repeated-measures analyses of variance (ANOVAs) were used to compare the self- and hetero-assessments of pain. Eleven centers participated in the study, and 1,573 patients were recruited. Forty-nine percent of parents (n = 772) actually used the App at least once. In all surgeries, the average pain rating on the PPPM-SF scale did not exceed 3/10 throughout the follow-up period, as well as for the four main surgical specialties. Age, visceral surgery, and preoperative anxiety â„ 4/10 were identified as independent risk factors for experiencing at least one episode of pain â„ 4/10 during the first 48 postoperative hours. While these findings indicated that postoperative pain management appears to be satisfactory in the families who used the App, some improvements in anxiety management are suggested. This study shows that inviting parents to use a smartphone App to assess and report the quality of postoperative management in pediatric patients, provides useful information. A continuous report is possible, regarding pain and adverse events, over a postoperative ten days period, by a self-reporting or a parentâs contribution. Future studies should investigate the ability of live data collection using an App to ensure fast, efficient interactions between patients and physicians
The DeerPal project: humans and deer during the Palaeolithic, integrating the variability of prey ecology and ethology in the investigation of past human â environment interactions
International audienc
The DeerPal project: humans and deer during the Palaeolithic, integrating the variability of prey ecology and ethology in the investigation of past human â environment interactions
International audienc
The DeerPal project: humans and deer during the Palaeolithic, integrating the variability of prey ecology and ethology in the investigation of past human â environment interactions
International audienc
The Clinical Frailty Scale for mortality prediction of old acutely admitted intensive care patients: a meta-analysis of individual patient-level data
Abstract Background This large-scale analysis pools individual data about the Clinical Frailty Scale (CFS) to predict outcome in the intensive care unit (ICU). Methods A systematic search identified all clinical trials that used the CFS in the ICU (PubMed searched until 24th June 2020). All patients who were electively admitted were excluded. The primary outcome was ICU mortality. Regression models were estimated on the complete data set, and for missing data, multiple imputations were utilised. Cox models were adjusted for age, sex, and illness acuity score (SOFA, SAPS II or APACHE II). Results 12 studies from 30 countries with anonymised individualised patient data were included (nâ=â23,989 patients). In the univariate analysis for all patients, being frail (CFSââ„â5) was associated with an increased risk of ICU mortality, but not after adjustment. In older patients (â„â65Â years) there was an independent association with ICU mortality both in the complete case analysis (HR 1.34 (95% CI 1.25â1.44), pâ<â0.0001) and in the multiple imputation analysis (HR 1.35 (95% CI 1.26â1.45), pâ<â0.0001, adjusted for SOFA). In older patients, being vulnerable (CFS 4) alone did not significantly differ from being frail. After adjustment, a CFS of 4â5, 6, andââ„â7 was associated with a significantly worse outcome compared to CFS of 1â3. Conclusions Being frail is associated with a significantly increased risk for ICU mortality in older patients, while being vulnerable alone did not significantly differ. New Frailty categories might reflect its âcontinuumâ better and predict ICU outcome more accurately. Trial registration: Open Science Framework (OSF: https://osf.io/8buwk/ ). Graphical Abstrac