Socialising the Landscape in the Early Neolithic of Thessaly, Greece

This article attempts to draw attention to the social choices of the earliest farming societies, evaluating new and old settlement data from the Early Neolithic of Thessaly in Greece. We examine the inhabitation of landscapes, the organisation of the inhabited spaces and the human-landscape interaction as a framework for the creation of a socialised environment. Taking into account aspects such as settlement location, duration, architecture and intra- and intersite arrangements, this study shows that the observed diversity in space and time reflects alternative modes of settlement and land use, variations in notions of permanence and continuity and different modalities of the adoption and meaning of new socioeconomic practices. This evidence challenges traditional interpretations of simplicity, homogeneity and change as being induced from outside and calls for a new reading of the Early Neolithic. We argue that the model of a single and uniform development, deriving from concepts of diffusionism and evolutionism, does not hold in Neolithic Thessaly (or in Greece). Instead, Neolithisation was a contextual process that involved human awareness and different choices, and that the social landscape created by the pioneering farming societies set the stage for all kinds of different developments that occurred in later phases. © 2021 Stella Souvatzi et al., published by De Gruyter

Perioperative anticoagulation for colorectal cancer patients

Population ageing has substantially contributed to the rising number of new cancer cases worldwide. Fifty percent of new diagnoses of colorectal cancer are made in patients aged over 70 years, and 25% are aged 80 years or over. Older patients present with more co-morbidities and frailty than younger patients. Here we describe the case of a 78-year-old lady with atrial fibrillation (AF) and previous stroke who had a right hemicolectomy for a caecal adenocarcinoma. Unfortunately, whilst off anticoagulation at day 5 post operatively she suffered a catastrophic stroke. For patients requiring surgical management of colorectal carcinoma who are on anticoagulation for AF, bespoke peri-operative planning is required to assess risks and benefits of bridging anticoagulation

An observational analysis of a novel digital rectoscope.

BACKGROUND: This is an analysis of the first 50 in-human uses of a novel digital rigid sigmoidoscope. The technology provides digital image capture, telemedicine capabilities, improved ergonomics, and the ability to biopsy under pneumorectum while maintaining the low cost of conventional rigid sigmoidoscopy. The primary outcome was adverse events, and the secondary outcome was diagnostic view. PRELIMINARY RESULTS: Fifty patients underwent outpatient (n = 25) and surgical rectal assessment (n = 25), with a mean age of 60 years. This included 31 men and 19 women with 12 different clinical use indications. No adverse events were reported, and no defects were reported with the instrumentation. Satisfactory diagnoses were obtained in 48 (96%) of 50 uses, images were captured in 48 (96%) of 50 uses, and biopsies were successfully taken in 13 uses (26%). No adverse events were recorded. Independent reviewers of recorded videos agreed on the quality and diagnostic value of the images with a κ of 0.225 (95% CI, 0.144-0.305) when assessing whether the target pathology was adequately visualized. IMPACT OF INNOVATION: The improved views afforded by digital rectoscopy facilitated a satisfactory clinical diagnosis in 96% of uses. The device was successfully deployed in the operating room and outpatients irrespective of bowel preparation method, where it has the potential to replace flexible sigmoidoscopy for specific use cases. The technology provides a high-quality image and video that can be securely recorded for documentation and medicolegal purposes with agreement between blinded users despite a lack of standardized training and heterogenous pathology. We perceive significant impact of this technology for the assessment of colorectal anastomoses, the office management of colitis, "watch and wait," and for diagnostic support in rectal cancer diagnosis. The technology has significant potential to facilitate proctoring and training, and it now requires prospective trials to validate its diagnostic accuracy against more costly flexible sigmoidoscopy systems