486 research outputs found

    Stone, procurement and use

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    Multidisciplinary approaches to the Amazonian past: Introduction to the theme issue

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    This theme issue presents collaborative research by anthropologists, linguists, archaeologists, geneticists, historians and biogeographers, who work across disciplinary boundaries to investigate the Amazonian past. Amazonia is a fertile ground in which to develop such multidisciplinary approaches because its relative paucity of documentary records makes other sources of evidence regarding the past more important; because multidisciplinary approaches are well suited to address important unanswered questions in Amazonian history; and because a recent and dramatic reappraisal of the region's past make this an exciting time to conduct this sort of research. The papers in this theme issue feature different combinations of academic disciplines, and they address different geographical regions and historical periods, but all of them show how combining insights from different fields can help illuminate aspects of the Amazonian past that would otherwise remain obscure to them all

    Understanding preservation and identification biases of ancient adhesives through experimentation

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    Abstract: Adhesive production is one of the earliest forms of transformative technology, predating ceramics and metallurgy by over 150,000 years. The study of adhesive use by Neandertals and early modern humans currently plays a significant role in debates about human technological and cognitive evolution. Depending on the type of adhesive used, different production sequences were required. These can vary in complexity, and would have needed different knowledge, expertise, and resources to manufacture. However, our knowledge of this important technological development is severely hampered by poorly understood taphonomic processes, which affect the preservation and identification of adhesive materials, and leads to a research bias. Here we present the results from a three year field preservation experiment. Flint flakes hafted and non-hafted with replica adhesives were left to weather naturally on and below the surface at two locations with different soils and climatic conditions. Differential preservation was recorded on a variety of natural adhesives by digitally measuring the surface area of each residue before and after the elapsed time. Residues were further assessed and photographed using metallographic optical microscopy. Results show that certain adhesives preserve to a significantly higher degree than others, while some materials may be more easily overlooked or visually misdiagnosed. We must therefore be aware of both taphonomic and identification biases when discussing ancient adhesive technology. This research provides a first look that will help us understand the disparities between which adhesives were used in the past, and what we find in the archaeological record today

    2010 SSO John Wayne Clinical Research Lecture: Rectal Cancer Outcome Improvements in Europe: Population-Based Outcome Registrations will Conquer the World

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    During the past two decades, rectal cancer treatment has improved considerably in Europe. Clinical trials played a crucial role in improving surgical techniques, (neo)adjuvant treatment schedules, imaging, and pathology. However, there is still a wide variation in outcome after rectal cancer. In most western health care systems, efforts are made to reduce hospital variation by focusing on selective referral and encouraging patients to seek care in high-volume hospitals. On the other hand, the expertise for diagnosis and treatment of common types of cancer should be preferably widespread and easily accessible for all patients. As an alternative to volume-based referral, hospitals and surgeons can improve their results by learning from their own outcome statistics and those from colleagues treating a similar patient group. Several European surgical (colo)rectal audits have led to improvements with a greater impact than any of the adjuvant therapies currently under study. However, differences remain between European countries, which cannot be easily explained. To generate the best care for colorectal cancer in the whole of Europe and to meet political and public demands for transparency, the European CanCer Organisation (ECCO) initiated an international, multidisciplinary, outcome-based quality improvement program: European Registration of Cancer Care (EURECCA). The goal is to create a multidisciplinary European registration structure for patient, tumor, and treatment characteristics linked to outcome registration. Clinical trials will always play a major role in improving rectal cancer treatment. To further improve outcomes and diminish variation, EURECCA will establish the basis for a strong, multidisciplinary, international audit structure that can be used as a template for similar projects worldwide

    Prediction of 60 day case-fatality after aneurysmal subarachnoid haemorrhage: results from the International Subarachnoid Aneurysm Trial (ISAT)

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    Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating event with substantial case-fatality. Our purpose was to examine which clinical and neuro-imaging characteristics, available on admission, predict 60 day case-fatality in aSAH and to evaluate performance of our prediction model. We performed a secondary analysis of patients enrolled in the International Subarachnoid Aneurysm Trial (ISAT), a randomised multicentre trial to compare coiling with clipping in aSAH patients. Multivariable logistic regression analysis was used to develop a prognostic model to estimate the risk of dying within 60 days from aSAH based on clinical and neuro-imaging characteristics. The model was internally validated with bootstrapping techniques. The study population comprised of 2,128 patients who had been randomised to either endovascular coiling or neurosurgical clipping. In this population 153 patients (7.2%) died within 60 days. World Federation of Neurosurgical Societies (WFNS) grade was the most important predictor of case-fatality, followed by age, lumen size of the aneurysm and Fisher grade. The model discriminated reasonably between those who died within 60 days and those who survived (c statistic = 0.73), with minor optimism according to bootstrap re-sampling (optimism corrected c statistic = 0.70). Several strong predictors are available to predict 60 day case-fatality in aSAH patients who survived the early stage up till a treatment decision; after external validation these predictors could eventually be used in clinical decision making
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