A new perspective on Copper Age technology, economy and settlement: grinding tools at the Valencina mega‑site

Activity patterns at large prehistoric sites are often difficult to interpret, as they frequently combine productive, domestic and funerary components. Valencina, the largest of the Copper Age mega-sites in Iberia, has proved particularly challenging in this regard. Macrolithic tool assemblages have been generally neglected in these debates but can provide specific insight into the nature and patterning of activities. In this study, 185 grinding tools from seven separate excavations across this 450 ha mega-site were subjected to multiple lines of analysis including quantification, morphology, raw material, use-wear and depositional context. A surprising feature of this assemblage is the high degree of fragmentation, with more than half of the items representing less than 25% of the original artefact and only a small minority of them (< 10%) complete. The absence of intact quernstones is particularly striking. The results indicate a ritualization of deposition at Valencina, and throw new light on the interpretation of this complex site. Furthermore, they emphasize the central role that grinding technology should play in future discussion of European prehistoric mega-sites

Importancia del roedor Mus musculus en enfermedades infecciosas relevantes en salud pública

El Mus musculus, es una especie de roedor miomorfo de la familia Muridae, comúnmente utilizado en experimentos de laboratorio, subdividiéndose en 4 subespecies; Mus musculus domesticus, Mus musculus musculus, Mus musculus castaneus y Mus musculus bactrianus (1). Es un múrido de tamaño pequeño y aspecto grácil, su peso aproximado es de 12,5 a 29 gr, su cola está recubierta de escamas presentando escaso pelo fino, su hocico es ligeramente puntiagudo, sus ojos son normalmente negros y pequeños, orejas redondeadas, presenta un pelaje de color gris en su etapa de juventud y en etapa adulta su coloración puede variar de clara a oscura (2), posee un numero estándar de cromosomas de 40 n con 19 pares de cromosomas autosómicos

Physical activity and risk of Metabolic Syndrome in an urban Mexican cohort

Abstract Background In the Mexican population metabolic syndrome (MS) is highly prevalent. It is well documented that regular physical activity (PA) prevents coronary diseases, type 2 diabetes and MS. Most studies of PA have focused on moderate-vigorous leisure-time activity, because it involves higher energy expenditures, increase physical fitness, and decrease the risk of MS. However, for most people it is difficult to get a significant amount of PA from only moderately-vigorous leisure activity, so workplace activity may be an option for working populations, because, although may not be as vigorous in terms of cardio-respiratory efforts, it comprises a considerable proportion of the total daily activity with important energy expenditure. Since studies have also documented that different types and intensity of daily PA, including low-intensity, seem to confer important health benefits such as prevent MS, we sought to assess the impact of different amounts of leisure-time and workplace activities, including low-intensity level on MS prevention, in a sample of urban Mexican adults. Methods The study population consisted of 5118 employees and their relatives, aged 20 to 70 years, who were enrolled in the baseline evaluation of a cohort study. MS was assessed according to the criteria of the National Cholesterol Education Program, ATP III and physical activity with a validated self-administered questionnaire. Associations between physical activity and MS risk were assessed with multivariate logistic regression models. Results The prevalence of the components of MS in the study population were: high glucose levels 14.2%, high triglycerides 40.9%, high blood pressure 20.4%, greater than healthful waist circumference 43.2% and low-high density lipoprotein 76.9%. The prevalence of MS was 24.4%; 25.3% in men and 21.8% in women. MS risk was reduced among men (OR 0.72; 95%CI 0.57–0.95) and women (OR 0.78; 95%CI 0.64–0.94) who reported an amount of ≥30 minutes/day of leisure-time activity, and among women who reported an amount of ≥3 hours/day of workplace activity (OR 0.75; 95%CI 0.59–0.96). Conclusion Our results indicate that both leisure-time and workplace activity at different intensity levels, including low-intensity significantly reduce the risk of MS. This finding highlights the need for more recommendations regarding the specific amount and intensity of leisure-time and workplace activity needed to prevent MS

EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

Memorias de Hacienda y del Tesoro y de la Nueva Granada y Colombia, siglo XIX

Descripción de los tipos de gastos públicos que tiene el gobierno, los pagos y la relación contable de la hacienda pública en Colombia en 1847.*El libro conserva la ortografía de la época

Integración de impactos ecológicos causados por plantas exóticas invasoras: propuesta metodológica

Tanto en España como en Europa existen demasiadas plantas exóticas invasoras para poder afrontar la gestión de todas ellas, por lo que es necesario priorizar las más nocivas. Sin embargo, ello requiere disponer de medidas cuantitativas, sistemáticas y comparables de su impacto. La información disponible es desigual en cuanto a los criterios y variables para medir impactos y por tanto difícil de integrar. Proponemos el siguiente método para integrar medidas de impactos procedentes de distintos estudios: 1) Búsqueda de casos de estudio, 2) cálculo de tamaños del efecto; 3) clasificación de los casos por nivel de organización, 4) integración de los tamaños del efecto para cada especie y nivel de impacto con técnicas de meta-análisis, y 5) estima de un índice de fiabilidad (basado en el número de casos) y otro de consistencia (basado en la heterogeneidad entre casos). Aplicamos este método para estimar los impactos en España de tres árboles invasores (Ailanthus altissima, Robinia pseudoacacia y Ulmus pumila). Encontramos 50 casos para A. altissima, 39 para R. pseudoacacia y 15 para U. pumila. Los impactos en el nivel de ecosistema (fertilidad) fueron los más estudiados, mientras que los de comunidad e individuo están menos documentados. Robinia pseudoacacia tiende a incrementar la fertilidad, mientras que A. altissima no altera esta propiedad. La metodología propuesta tiene la ventaja de permitir estimar el impacto con datos de estudios diversos, pero su aplicación está limitada por la disponibilidad de casos de estudio