What if none of the building stones at Stonehenge came from Wiltshire?

The sarsen and bluestone stones at Stonehenge (Wiltshire, UK) have played a significant role in the development of twentieth-century ideas about Neolithic and early Bronze Age social structure. Sarsen and bluestone are not, however, the only rock types used at Stonehenge. The varied stones present at the monument include previously under-studied material, such as the normally unseen, and largely forgotten, packing stones for Stonehenge’s famous settings. By reflecting on more recently developed theoretical frameworks to interpret this variety, this paper exposes the possibility that an alternative to the dominant discourse, in which Stonehenge represents the culmination of Neolithic social evolution, is possible

‘Connoisseurs of stone’: everyday sarsen stone in neolithic Britain

Sarsen stone boulders are familiar components of numerous British Neolithic megalithic monuments. Non-monumental uses of sarsen stone are, however, less well understood. This paper focuses on non-megalithic sarsen and its roles for communities, using case studies from three sites spanning the Neolithic in Wiltshire. Published data from Windmill Hill causewayed enclosure and analysis, using a new methodology, of recently excavated material from the West Kennet Avenue occupation site, and Marden henge enclosure are used to explore the varied ways in which sarsen was used. Rather than being an expedient ‘mundane’ stone this analysis demonstrates that non-megalithic sarsen could be just as meaning-laden as other more ‘attractive’ (larger, exotic) material. Daily encounters with sarsen stone for different purposes and in varied quotidian contexts afforded it with values which likely contributed to its use in monumental contexts. The importance of attending to sarsen in its multiple forms and contexts is thus made clear

Sarsen Stones in Wessex

This dataset comprises the manually-digitised analogue records created by the Sarsen Stones in Wessex survey. The survey was led by Fellows of the Society of Antiquaries of London during the 1970s, under the aegis of the Society's Evolution of the Landscape Project. The data describe the presence of sarsen stones and sarsen-built structures (of all periods) in the three UK counties of Hampshire, Dorset and Wiltshire. The data were created by survey volunteers primarily during fieldwork and from literature review. Data fields describe the location and nature of each observation. The data are accompanied by documents that describe the analogue archive collection, and the methods and protocols used to complete the manual transcription

'Sarsen stones in Wessex': a society of antiquaries project contextualised and renewed

This paper reviews the Society of Antiquaries’ Evolution of the Landscape project, which started in 1974, and the project’s Sarsen Stones in Wessex survey. The survey was an ambitious public archaeology project, involving c 100 volunteers led by Fellows of the Society during the 1970s. Its aims, objectives and outcomes are described. The survey’s unique dataset, produced for the counties of Wiltshire, Hampshire and Dorset, has now been digitised. Drawing on the dataset, the paper situates the Evolution of the Landscape project in the context of later-twentieth century British archaeology. It demonstrates the importance not only of individual Fellows, but also contemporary movements in academic and development-led archaeology, to the direction of the Society’s activities in this formative period for the discipline today, and shows how the Society’s research was engaged with some of archaeology’s most pressing cultural resource management issue

An Exploratory Study into Objective and Reported Characteristics of Neuropathic Pain in Women with Chronic Pelvic Pain

Chronic pelvic pain (CPP) affects 5.7-26.6% women worldwide. 55% have no obvious pathology and 40% have associated endometriosis. Neuropathic pain (NeP) is pain arising as a consequence of a lesion/disease affecting the somatosensory system. The prevalence of NeP in women with CPP is not known. The diagnosis of NeP is challenging because there is no gold-standard assessment. Questionnaires have been used in the clinical setting to diagnose NeP in other chronic pain conditions and quantitative sensory testing (QST) has been used in a research setting to identify abnormal sensory function. We aimed to determine if women with chronic pelvic pain (CPP) have a neuropathic pain (NeP) component to their painful symptoms and how this is best assessed. We performed an exploratory prospective cohort study of 72 pre-menopausal women with a diagnosis of CPP. They underwent a clinician completed questionnaire (DN4) and completed the S-LANSS and PainDETECT™ questionnaires. Additionally QST testing was performed by a clinician. They also completed a patient acceptability questionnaire. Clinical features of NeP were identified by both questionnaires and QST. Of the women who were NeP positive, 56%, 35% and 26% were identified by the S-LANSS, DN4 and PainDETECT™ respectively. When NeP was identified by questionnaire, the associated laparoscopy findings were similar irrespective of which questionnaire was used. No subject had entirely unchanged QST parameters. There were distinct loss and gain subgroups, as well as mixed alteration in function, but this was not necessarily clinically significant in all patients. 80% of patients were confident that questionnaires could diagnose NeP, and 90% found them easy to complete. Early identification of NeP in women with CPP with a simple questionnaire could facilitate targeted therapy with neuromodulators, which are cheap, readily available, and have good safety profiles. This approach could prevent unnecessary or fertility-compromising surgery and prolonged treatment with hormones

Assessing the impact of preventive mass vaccination campaigns on yellow fever outbreaks in Africa: A population-level self-controlled case series study.

The Eliminate Yellow fever Epidemics (EYE) strategy was launched in 2017 in response to the resurgence of yellow fever in Africa and the Americas. The strategy relies on several vaccination activities, including preventive mass vaccination campaigns (PMVCs). However, to what extent PMVCs are associated with a decreased risk of outbreak has not yet been quantified. We used the self-controlled case series (SCCS) method to assess the association between the occurrence of yellow fever outbreaks and the implementation of PMVCs at the province level in the African endemic region. As all time-invariant confounders are implicitly controlled for in the SCCS method, this method is an alternative to classical cohort or case-control study designs when the risk of residual confounding is high, in particular confounding by indication. The locations and dates of outbreaks were identified from international epidemiological records, and information on PMVCs was provided by coordinators of vaccination activities and international funders. The study sample consisted of provinces that were both affected by an outbreak and targeted for a PMVC between 2005 and 2018. We compared the incidence of outbreaks before and after the implementation of a PMVC. The sensitivity of our estimates to a range of assumptions was explored, and the results of the SCCS method were compared to those obtained through a retrospective cohort study design. We further derived the number of yellow fever outbreaks that have been prevented by PMVCs. The study sample consisted of 33 provinces from 11 African countries. Among these, the first outbreak occurred during the pre-PMVC period in 26 (79%) provinces, and during the post-PMVC period in 7 (21%) provinces. At the province level, the post-PMVC period was associated with an 86% reduction (95% CI 66% to 94%, p < 0.001) in the risk of outbreak as compared to the pre-PMVC period. This negative association between exposure to PMVCs and outbreak was robustly observed across a range of sensitivity analyses, especially when using quantitative estimates of vaccination coverage as an alternative exposure measure, or when varying the observation period. In contrast, the results of the cohort-style analyses were highly sensitive to the choice of covariates included in the model. Based on the SCCS results, we estimated that PMVCs were associated with a 34% (95% CI 22% to 45%) reduction in the number of outbreaks in Africa from 2005 to 2018. A limitation of our study is the fact that it does not account for potential time-varying confounders, such as changing environmental drivers of yellow fever and possibly improved disease surveillance. In this study, we provide new empirical evidence of the high preventive impact of PMVCs on yellow fever outbreaks. This study illustrates that the SCCS method can be advantageously applied at the population level in order to evaluate a public health intervention

Interpretable surface-based detection of focal cortical dysplasias:a Multi-centre Epilepsy Lesion Detection study

One outstanding challenge for machine learning in diagnostic biomedical imaging is algorithm interpretability. A key application is the identification of subtle epileptogenic focal cortical dysplasias (FCDs) from structural MRI. FCDs are difficult to visualize on structural MRI but are often amenable to surgical resection. We aimed to develop an open-source, interpretable, surface-based machine-learning algorithm to automatically identify FCDs on heterogeneous structural MRI data from epilepsy surgery centres worldwide. The Multi-centre Epilepsy Lesion Detection (MELD) Project collated and harmonized a retrospective MRI cohort of 1015 participants, 618 patients with focal FCD-related epilepsy and 397 controls, from 22 epilepsy centres worldwide. We created a neural network for FCD detection based on 33 surface-based features. The network was trained and cross-validated on 50% of the total cohort and tested on the remaining 50% as well as on 2 independent test sites. Multidimensional feature analysis and integrated gradient saliencies were used to interrogate network performance. Our pipeline outputs individual patient reports, which identify the location of predicted lesions, alongside their imaging features and relative saliency to the classifier. On a restricted 'gold-standard' subcohort of seizure-free patients with FCD type IIB who had T1 and fluid-attenuated inversion recovery MRI data, the MELD FCD surface-based algorithm had a sensitivity of 85%. Across the entire withheld test cohort the sensitivity was 59% and specificity was 54%. After including a border zone around lesions, to account for uncertainty around the borders of manually delineated lesion masks, the sensitivity was 67%. This multicentre, multinational study with open access protocols and code has developed a robust and interpretable machine-learning algorithm for automated detection of focal cortical dysplasias, giving physicians greater confidence in the identification of subtle MRI lesions in individuals with epilepsy

Sarsen stone in southern Britain: an archaeological and ethno-historical approach to an ancient industry

This thesis is an inter-disciplinary study of human engagement with the silcrete called sarsen stone, found dispersed across parts of south-central and south-eastern England and used prolifically since prehistory. Prehistoric sarsen megaliths (for example, Stonehenge) have dominated discussion of the cultural contexts of its use, but it enjoys a far longer relationship with people and, in those places where it is most abundant, more recent architectural sarsen fabric is an integral component informing sense-of-place. This thesis reveals the variety of Neolithic sarsen engagement, drawing that together with postmedieval sarsen industries to foreground some of the many ways that it has been exploited. By focussing on different chaînes opératoires studied through archaeological and ethnohistorical sources, I propose that sarsen stone behaves as a different material depending on the technical action applied to it and thus has the potential for varied ontological status dependent on context. A collection of six published papers, this thesis first contextualises archaeological perceptions of sarsen stone that have dominated scholarly study thus far. Newly-digitised datasets from the archived collections of twentieth century sarsen surveys are considered. Secondly, different modes of sarsen exploitation are explored through multi-scalar methodologies. A landscape approach is applied to quarries in Buckinghamshire and Wiltshire study areas, combining aerial investigation and analytical earthworks surveys with an eclectic range of archival sources to cast light on traditional sarsen-working practices. A new methodology, developed to habilitate excavated sarsen assemblages into archaeological analysis, is applied to material from Neolithic sites in Wiltshire including Marden henge and West Kennet Avenue, which with data from the Windmill Hill enclosure shows how common non-megalithic uses of sarsen were. Value in attending to this previously under-studied material in its own right is demonstrated, encouraging more detailed analysis in future research