Modelización de territorios ganaderos en la alta montaña al final del Neolítico: una integración de análisis espacial e información etnográfica

Recent archaeological research in the mountains of Ibe­ria is beginning to document extensive sequences of occu­pation during de Holocene. In the Pyrenees stands out the location of a considerable number of sites date to 3350 and 2350 cal BC (Late Neolithic / Chalcolithic). This phenome­non seems to link with the consolidation of the livestock exploitation in the alpine and subalpine zones. This work undertakes a the dispersion pattern analysis of archaeolog­ical sites of this period in the National Park of Aigüestortes i Estany de Sant Maurici, in the Central Pyrenees. Using GIS it defines influence areas around the sites and the opti­mal paths between them so as to evaluate two important variables in any livestock practice: the accessibility to the settlements and grazing areas. For comparative purposes the dispersion pattern of modern and contemporary sites is analysed as well. This study allows to conclude significant differences in the distribution of the sites both ancient and recent in relation to pastures and roads.En los últimos años la investigación arqueológica en áreas de montaña de la península ibérica está empezando a llenar el vacío de información con extensas secuencias de ocupación durante el Holoceno. En el Pirineo se localiza una cantidad considerable de yacimientos del final del Neolítico/ Calcolítico con cronologías entre el 3350 y 2350 cal ANE. Este fenómeno parece vincularse con la consolidación de la explotación ganadera de las zonas alpinas y subalpinas. En este trabajo se analiza el patrón de dispersión de los yaci­mientos de esta época en el Parque Nacional de Aigüestortes i Estany de Sant Maurici, en el Pirineo central. Se definen mediante SIG áreas de influencia alrededor de los asenta­mientos y caminos óptimos para evaluar dos variables clave en cualquier práctica ganadera: la accesibilidad a los asen­tamientos y a los pastos. Con fines comparativos se analiza también el patrón de los yacimientos de época moderna y contemporánea. El estudio permite concluir diferencias sig­nificativas en la dispersión de los yacimientos de cada épo­ca con relación a los pastos y a los caminos

Comparer et modéliser les sites, les territoires et les systèmes pastoraux pyrénéens dans la diachronie: présentation et premiers résultats du projet collaboratif DEPART

Le développement récent des recherches archéologiques sur les dynamiques des systèmes pastoraux d'altitude a engendré, tout au long du massif pyrénéen, la constitution d'une dizaine de zones ateliers interdisciplinaires, conçues comme autant de laboratoires d'étude des interactions entre les sociétés, leur espace et leur environnement, dans la longue durée. La quantité de données amassées permet aujourd'hui de dépasser le cadre des monographies, pour se lancer dans une véritable approche comparée des trajectoires de ces territoires d'altitude sous l’angle du pastoralisme. Ce projet, qui se fonde sur la modélisation et la création d'un Système d’Information Géographique (SIG), nécessite un important travail d'élaboration, technique et théorique, tant en termes de construction de la base de données spatialisée, que de formalisation des processus à étudier. Le réseau DEPART, créé dans cette perspective, s’est fixé comme premiers objectifs de construire et tester un SIG partagé sur un échantillon du corpus, et d'élaborer les outils et les questions structurant la comparaison. Après une présentation synthétique des différentes zones ateliers, cet article expose les résultats des discussions actuelles, sur les choix de structuration de la base et les questions appelées à sous-tendre l’analyse comparative.Peer reviewe

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Modelling Surface Archaeological Data: A Spatial Database for High Mountain Surveys

Ponencia expuesta online en la Landscape Archaeology Conference (2021)

Modeling Land Use of High Mountain Environments: Understanding the Late Neolithic Herding

Trabajo presentado en la Landscape Archaeology Conference LAC 2020+1, celebrada en Madrid del 8 al 11 de junio de 2021

Territorios ganaderos en la alta montaña al final del Neolítico/Calcolítico, 3300 cal ANE – 2200 cal ANE

Peer reviewe