THE INCA ADMINISTRATIVE CENTER OF TAMBO VIEJO

En este artículo presentamos los resultados de los trabajos de investigación efectuados en el centro administrativo Inca de Tambo Viejo, el único de su carácter establecido en el valle de Acarí, en la costa sur del Perú. Este estudio revela, entre otros, la complejidad arquitectónica del sitio, así como su inmensa dimensión. A su vez, el presente estudio enseña que el sitio presenta una larga secuencia de ocupación humana iniciada a comienzos del periodo Intermedio Temprano y que continuó hasta el periodo colonial. Este estudio tiene como foco de análisis la ocupación Inca, la misma que es evaluada teniendo en consideración la arquitectura de Tambo Viejo. Dicho análisis revela que Tambo Viejo fue construido siguiendo un diseño Inca; sin embargo, la arquitectura es local y sugiere que éste fue edificado por constructores locales. Esta observación permite sostener que la administración Inca se adaptó a los patrones constructivos locales.In this article we present the results of the archaeological studies carried out at the Inca administrative center of Tambo Viejo, the only facility of its character built by the Inca in the Acari Valley of the Peruvian south coast region. This study reveals, among others, the architectural complexity of the site and its enormous size. Likewise, this study demonstrates that Tambo Viejo has a long sequence of human occupation that began early in the Early Intermediate period and continued to colonial times. In this paper we evaluate the Inca ocupation of the site, taking into consideration the architecture. This analysis demonstrates that Tambo Viejo was established following an Inca plan; however, the architecture is local, suggesting that the builders of the site were from Acari. This observation allows us to argue that the Inca administration adapted to local construction patterns

THE CERAMICS OF THE INCA ADMINISTRATIVE CENTER OF TAMBO VIEJO

En este artículo presentamos los resultados del análisis de la cerámica proveniente del sitio Inca de Tambo Viejo, del valle de Acarí. Entre otros, este estudio revela que a la llegada Inca hacia Acarí había un estilo de cerámica local que ya recibía influencia de los estilos de los valles adyacentes del norte. Dicho acercamiento estilístico denota que las varias poblaciones de la región mantenían contacto. Con la presencia Inca, el estilo local de Acarí continuó recibiendo influencias de los valles norteños, pero a su vez empezó a incorporar nue-vos elementos decorativos, esta vez de origen Inca. Motivos selectos Inca, una vez modificados, fueron incor-porados al estilo local. Esta evidencia permite observar que la conquista Inca del valle de Acarí no representó la paralización total del estilo local y la sustitución por el estilo Inca; por el contrario, el estilo local sobrevivió a tal extremo que los elementos propiamente Inca son raros en Tambo Viejo. Esto posiblemente refleja la incorporación pacífica del valle al dominio Inca. El hecho que la ocupación Inca duró corto tiempo fue otro factor que no permitió la asimilación completa de las formas culturales locales con raíces más profundas.In this article we present the results of the analysis of the ceramic assemblage coming from Tambo Viejo, the single most important Inca establishment in the Acari Valley. Among others, this study reveals that at the time of the Inca conquest of Acari, there was a local ceramic style that already received some influence from the valleys found immediately to the north. With the Inca presence, the local style continued recei-ving northern influences, but also began incorporating new decorative elements, this time of Inca origins. Selected and previously modified Inca designs were incorporated. This evidence indicates that the Inca conquest of Acari did not represent the end of the local style; on the contrary, the local style survived to the point that Inca ceramics are rare in Tambo Viejo. This is more likely the result of the pacific incorpora-tion of Acari to Inca dominium. At the same time, the Inca occupation lasted only for a short period of time and thus did not result in a successful assimilation of the local cultural traits with deeper roots

Intra-dance variation among waggle runs and the design of efficient protocols for honey bee dance decoding

Noise is universal in information transfer. In animal communication, this presents a challenge not only for intended signal receivers, but also to biologists studying the system. In honey bees, a forager communicates to nestmates the location of an important resource via the waggle dance. This vibrational signal is composed of repeating units (waggle runs) that are then averaged by nestmates to derive a single vector. Manual dance decoding is a powerful tool for studying bee foraging ecology, although the process is time-consuming: a forager may repeat the waggle run 1- >100 times within a dance. It is impractical to decode all of these to obtain the vector; however, intra-dance waggle runs vary, so it is important to decode enough to obtain a good average. Here we examine the variation among waggle runs made by foraging bees to devise a method of dance decoding. The first and last waggle runs within a dance are significantly more variable than the middle run. There was no trend in variation for the middle waggle runs. We recommend that any four consecutive waggle runs, not including the first and last runs, may be decoded, and we show that this methodology is suitable by demonstrating the goodness-of-fit between the decoded vectors from our subsamples with the vectors from the entire dances

Honey bee foraging distance depends on month and forage type

To investigate the distances at which honey bee foragers collect nectar and pollen, we analysed 5,484 decoded waggle dances made to natural forage sites to determine monthly foraging distance for each forage type. Firstly, we found significantly fewer overall dances made for pollen (16.8 %) than for non-pollen, presumably nectar (83.2 %; P < 2.2 × 10−23). When we analysed distance against month and forage type, there was a significant interaction between the two factors, which demonstrates that in some months, one forage type is collected at farther distances, but this would reverse in other months. Overall, these data suggest that distance, as a proxy for forage availability, is not significantly and consistently driven by need for one type of forage over the other

Consensus Recommendations for the Use of Automated Insulin Delivery (AID) Technologies in Clinical Practice

International audienceThe significant and growing global prevalence of diabetes continues to challenge people with diabetes (PwD), healthcare providers and payers. While maintaining near-normal glucose levels has been shown to prevent or delay the progression of the long-term complications of diabetes, a significant proportion of PwD are not attaining their glycemic goals. During the past six years, we have seen tremendous advances in automated insulin delivery (AID) technologies. Numerous randomized controlled trials and real-world studies have shown that the use of AID systems is safe and effective in helping PwD achieve their long-term glycemic goals while reducing hypoglycemia risk. Thus, AID systems have recently become an integral part of diabetes management. However, recommendations for using AID systems in clinical settings have been lacking. Such guided recommendations are critical for AID success and acceptance. All clinicians working with PwD need to become familiar with the available systems in order to eliminate disparities in diabetes quality of care. This report provides much-needed guidance for clinicians who are interested in utilizing AIDs and presents a comprehensive listing of the evidence payers should consider when determining eligibility criteria for AID insurance coverage

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570