The settlement of the Guadalete river basin during the upper Palaeolithic. Re-evaluation within the context of the southern Iberia.

Este artículo pretende realizar una revaloración de los yacimientos del Paleolítico superior de la cuenca del Guadalete. En su mayoría fueron dados a conocer en la década de los 90 del siglo pasado, pero desde esas fechas se han añadido nuevas localizaciones, así como nuevos estudios. Dada la oportunidad de este Homenaje, creemos conveniente realizar una contextualización dentro del panorama actual de las investigaciones.This article aims to carry out a re-evaluation of the Upper Palaeolithic sites of the Guadalete River basin. Most of these were made known in the 1990s, but new locations and studies have come to light since then. We have taken the opportunity, in this special edition tribute, to contextualise these within the current research panorama

Saline springs and ophites outcrops: geoarchaeological evidences in the Prehistory of the inland of Cadiz

Gran parte de la provincia de Cádiz posee importantes afloramientos de aguas salobres relacionadas con las formaciones geológicas del Triásico en su facies Keuper. Las explotaciones salineras aparecen asociadas a asentamientos de poblaciones prehistóricas e históricas. En varios de sus entornos se documentan ofitas que fueron la base para la fabricación de útiles pulimentados de épocas prehistóricasMuch of the province of Cadiz has important brackish water springs related to the geological formations of the Triassic Keuper phase. The salt pands and settlements are associated with prehistoric and historical villages. In several of these environments there are recorded ophites that were the basis for manufacturing of prehistoric polished items

Arte paleolítico en Gorham's Cave (Gibraltar)

En este trabajo presentamos las novedades sobre el arte paleolítico de la cueva de Gorham. En el apartado mobiliar, abordamos una aproximación multidisciplinar en la que se analizan los datos petrográficos, deposicionales, diagenéticos, tafonómicos y antrópicos (técnicos o iconográficos) identificados en dos plaquetas de arte mueble. El arte parietal de Gorham se amplía con las manifestaciones localizadas en una Galería ubicada al final del cavernamiento. En ambos casos, la procedencia estratigráfica o los rasgos estilísticos permiten su atribución al Magdaleniense.We present the news on Palaeolithic art of Gorham’s cave. In paragraph of mobiliary art, we discuss a multidisciplinary approach in analyzing the petrographic, depositional, diagenetic, taphonomic and anthropic (technical or iconographic) data identified of two plaquettes of portable art. The Gorham’s cave art expands with the paintings located in the gallery located at the end of the cave. In both cases, the stratigraphic provenance or stylistic features allow its attribution to the Magdalenian

Manos en la oscuridad: arte paleolítico en Gorham's Cave (Gibraltar)

The work in the inner area of Gorham’s Cave, Gibraltar, has added to the Palaeolithic art located in the cave. Although work continues on the surveying and the study of the evidence found up to now, we present here a preview consisting of a representation of a red deer, and also a hand stencil, alongside numerous marks which have been found scattered throughout the inner cave. In this paper we present new data on the Upper Palaeolithic rock art in Gorham’s Cave (Gibraltar) including direct dating of a hand stencil. Situating this dating in the archaeological context of the stencil, we conclude that it is associated with the Solutrean technocomplexe. This is particularly significant in the light of recent reviews which put European hand stencils in the context of the Early or Initial Upper Palaeolithic. In this context, the Gorham data opens the discussion on the systematic chronological correlation of all hands in negatives of European Palaeolithic rock art.Los trabajos en la zona más interior de la cueva de Gorham (Gibraltar) han ampliado la zona con arte rupestre paleolítico en la cavidad. Aunque los trabajos continúan, presentamos en este trabajo un avance de los nuevos hallazgos, un ciervo y una mano en negativo, así como numerosos trazos. Así mismo, damos a conocer la datación directa mediante 14C-AMS de una mano en negativo y situamos el resultado obtenido en el contexto del registro arqueológico de Gorham, que nos lleva a proponer una ejecución durante el Solutrense evolucionado. El resultado es particularmente significativo a la luz del encuadre convencional a este tipo de de motivos, atribuidos normalmente a momentos antiguos del Paleolítico Superior. En este contexto, el dato de Gorham abre la discusión sobre esta correlación sistemática de todas las manos en negativos del arte paleolítico europeo.Spanish Ministerio de Economía y Competitividad HAR2013-44269-P HAR2016-77789-

Bray, una cueva sepulcral de la Edad del Bronce en el Peñón de Gibraltar

Las excavaciones en la Cueva de Bray en Gibraltar han documentado una serie de enterramientos de la Edad de Bronce, esto supone una nueva aportación al conocimiento de la ocupación prehistórica del Peñón de Gibraltar y se convierte en una referencia regional para el estudio de los rituales funerarios de este período

Culto y culturas en la cueva de Gorham (Gibraltar): La historia del santuario y sus materiales inscritos

This paper presents an updated overview of the ongoing archaeological research carried out in the Protohistoric sanctuary of Gorham’s Cave (Gibraltar). It is based on the results of recent excavations, focusing on incised pottery with inscriptions or other marks. The catalogue of inscriptions includes both Phoenician and Graeco-Iberian examples, which could be related with the deposition of votive offerings from Archaic to Hellenistic periods.El artículo presenta un nuevo estado de la cuestión arqueológico sobre el santuario protohistórico de la Cueva de Gorham (Gibraltar) a la luz de los resultados de las recientes campañas de excavación y estudia los materiales cerámicos con inscripciones u otro tipo de marcas hallados en la cueva. El catálogo incluye un nuevo grafito fenicio y una inscripción greco-ibérica que se relacionan con las ofrendas depositadas en el lugar desde época arcaica hasta el periodo helenístico

Where myth and archaeology meet: Discovering the Gorgon Medusa's Lair.

Here we report the discovery of ceramic fragments that form part of a Gorgoneion, a ceramic image representation of the Gorgon Medusa. The fragments were found in a deep part of Gorham's Cave, well known to ancient mariners as a natural shrine, between the 8th and 2nd century BCE. We discuss the context of this discovery, both within the inner topography of the cave itself, and also the broader geographical context. The discovery is situated at the extreme western end of the Mediterranean Sea, where it meets the Atlantic Ocean. The location was known to ancient mariners as the northern Pillar of Herakles, which marked the end of the known world. We relate the discovery, and its geographical and chronological context, to Greek legends that situated the lair of the Gorgon sisters at a location which coincides with the physical attributes and geographical position of Gorham's Cave. We thus provide, uniquely, a geographical and archaeological context to the myth of Perseus and the slaying of the Gorgon Medusa

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe