Compositional data supports decentralized model of production and circulation of artifacts in the pre-Columbian south-central Andes

ArticleThis is the author accepted manuscript. The final version is available from National Academy of Sciences via the DOI in this record.The circulation and exchange of goods and resources at various scales have long been considered central to the understanding of complex societies, and the Andes have provided a fertile ground for investigating this process. However, long-standing archaeological emphasis on typological analysis, although helpful to hypothesize the direction of contacts, has left important aspects of ancient exchange open to speculation. To improve understanding of ancient exchange practices and their potential role in structuring alliances, we examine material exchanges in northwest Argentina (part of the south-central Andes) during 400 BC to AD 1000 (part of the regional Formative Period), with a multianalytical approach (petrography, instrumental neutron activation analysis, laser ablation inductively coupled plasma mass spectrometry) to artifacts previously studied separately. We assess the standard centralized model of interaction vs. a decentralized model through the largest provenance database available to date in the region. The results show: (i) intervalley heterogeneity of clays and fabrics for ordinary wares; (ii) intervalley homogeneity of clays and fabrics for a wide range of decorated wares (e.g., painted Ciénaga); (iii) selective circulation of two distinct polychrome wares (Vaquerías and Condorhuasi); (iv) generalized access to obsidian from one major source and various minor sources; and (v) selective circulation of volcanic rock tools from a single source. These trends reflect the multiple and conflicting demands experienced by people in small-scale societies, which may be difficult to capitalize by aspiring elites. The study undermines centralized narratives of exchange for this period, offering a new platform for understanding ancient exchange based on actual material transfers, both in the Andes and beyond.We thank the former directors of Museo Etnográfico (University of Buenos Aires), M. N. Tarragó (2005–2015) and the late J. A. Pérez Gollán (1987–2005), who provided access to key samples and enthusiastic support for this project since its earliest stages. We also thank M. Berón (current Director of Museo Etnográfico, University of Buenos Aires), R. Cattáneo (Director of Museo de Antropología, University of Córdoba, 2011–2013), J. P. Carbonelli, M. E. De Feo, V. Puente, G. Míguez, and R. Spano for providing access to additional samples; A. Brechbuhler and E. Gillispie for assisting with lithic sample preparation and measurements; and C. Roush for preparing the samples for irradiation and for general laboratory management responsibilities. This research was primarily funded by Arts and Humanities Research Council Early Career Grant SX–5317 (2011–2013) and preliminary research was funded by British Academy Small Grant 51798 (2009) (both to M.L.). Fieldwork and petrography analyses have been supported by successive grants from Argentinean National Agency for Science and Technology (ANCyT) Raíces Program PICT 2007-00116 (to M.C.S.) and ANCyT PICT 2010-1048 (to M.A.K.). Funding was also provided by the National Council for Science and Technical Research PIP 112-2008 01-00256 (to M.C.S.) and PIP 11/042 (to M.A.K.). The Archaeometry Laboratory at the University of Missouri Research Reactor is supported in part by the National Science Foundation (BCS-1415403 and BCS-0922374)

Social interaction and communities of practice in Formative period NW Argentina: a multi-analytical study of ceramics

We present clear production areas for two distinct polychrome wares in the earlier part of the period. Both networks appear to be geographically selective. The connection between Quebrada del Toro and the southern sector of Calchaquí has been now clearly demonstrated and should be considered in future modeling. There existed shared technological style in the core study area throughout the first millennium AD: ordinary wares varied across valleys but minimally, decorated wares were technologically homogenous (intercommunity circulation of clays, pots, knowledge & skills). Results call for a revision of the purported central role of some areas: Ambato clays not found, Condohuasi likely to have been manufactured at Campo del Pucará but other areas cannot be discarded yet. We need to acknowledge the relevance of connections between ?marginal? areas to model social interaction and emergent complexity. A complex and ever-widening network of associations and mutual dependencies demonstrated beyond typological analysis. The diversity of connections revealed in this study shows that communities often avoided the artifacts and iconographies related to so-called centers.Fil: Lazzari, Marisa. University of Exeter; Reino UnidoFil: Pereyra Domingorena, Lucas. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Museo Etnográfico "Juan B. Ambrosetti"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Scattolin, Maria Cristina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Museo Etnográfico "Juan B. Ambrosetti"; ArgentinaFil: Stoner, Wesley D.. University of Arkansas; Estados UnidosFil: Glascock, Michael D. University of Missouri; Estados Unidos81st Meeting Society for American ArchaeologyOrlandoEstados UnidosSociety for American Archaeolog

Compositional data supports decentralized model of production and circulation of artifacts in the pre-Columbian south-central Andes

The circulation and exchange of goods and resources at various scales have long been considered central to the understanding of complex societies, and the Andes have provided a fertile ground for investigating this process. However, long-standing archaeological emphasis on typological analysis, although helpful to hypothesize the direction of contacts, has left important aspects of ancient exchange open to speculation. To improve understanding of ancient exchange practices and their potential role in structuring alliances, we examine material exchanges in northwest Argentina (part of the south-central Andes) during 400 BC to AD 1000 (part of the regional Formative Period), with a multianalytical approach (petrography, instrumental neutron activation analysis, laser ablation inductively coupled plasma mass spectrometry) to artifacts previously studied separately. We assess the standard centralized model of interaction vs. a decentralized model through the largest provenance database available to date in the region. The results show: (i) intervalley heterogeneity of clays and fabrics for ordinary wares; (ii) intervalley homogeneity of clays and fabrics for a wide range of decoratedwares (e.g., painted Ciénaga); (iii) selective circulation of two distinct polychrome wares (Vaquerías and Condorhuasi); (iv) generalized access to obsidian from one major source and various minor sources; and (v) selective circulation of volcanic rock tools from a single source. These trends reflect the multiple and conflicting demands experienced by people in small-scale societies, which may be difficult to capitalize by aspiring elites. The study undermines centralized narratives of exchange for this period, offering a new platform for understanding ancient exchange based on actual material transfers, both in the Andes and beyond.Facultad de Ciencias Naturales y Muse

Real-world data on treatment outcomes in EGFR-mutant non-small-cell lung cancer patients receiving osimertinib in second or further lines

Aims: This study describes real-world outcomes of pretreated EGFR T790M-positive (T790M+) advanced non-small-cell lung cancer patients progressing after first- or second-generation tyrosine kinase inhibitors and receiving osimertinib, compared with T790M-negative (T790M-) patients. We have also described progression patterns and treatment sequences. Patients & methods: This is a retrospective multicenter Italian observational study including consecutive Caucasian patients referred between 2014 and 2018. Results: 167 patients were included. Median progression-free survival was 9.8 months (95% CI: 8.3-13.3) for T790M+ and 6.0 months (95% CI: 4.9-7.2) for T790M- patients, respectively. Median overall survival was 20.7 months (95% CI: 18.9-28.4) for T790M+ and 10.6 months (95% CI: 8.6-23.6) for T790M- patients, respectively. The T790M mutation correlated with absence of new sites of disease. After progression, most T790M+ patients continued osimertinib, whereas most T790M- patients received a different treatment line. Conclusion: Better outcomes were shown in patients receiving osimertinib. A more limited progression pattern for T790M+ was suggested

Achieving a Molecular Remission before Allogeneic Stem Cell Transplantation in Adult Patients with Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia: Impact on Relapse and Long Term Outcome

Allogeneic stem cell transplantation (alloHSCT) in first complete remission (CR1) remains the consolidation therapy of choice in Philadelphia-positive (Ph+) acute lymphoblastic leukemia (ALL). The prognostic value of measurable levels of minimal residual disease (MRD) at time of conditioning is a matter of debate. We analyzed the predictive relevance of MRD levels before transplantation on the clinical outcome of Ph+ ALL patients treated with chemotherapy and imatinib in 2 consecutive prospective clinical trials. MRD evaluation before transplantation was available for 65 of the 73 patients who underwent an alloHSCT in CR1. A complete or major molecular response at time of conditioning was achieved in 24 patients (37%), whereas 41 (63%) remained carriers of any other positive MRD level in the bone marrow. MRD negativity at time of conditioning was associated with a significant benefit in terms of risk of relapse at 5 years, with a relapse incidence of 8% compared with 39% for patients with MRD positivity (P\u2009=\u2009.007). However, thanks to the post-transplantation use of tyrosine kinase inhibitors (TKIs), disease-free survival was 58% versus 41% (P\u2009=\u2009.17) and overall survival was 58% versus 49% (P\u2009=\u2009.55) in MRD-negative compared with MRD-positive patients, respectively. The cumulative incidence of nonrelapse mortality was similar in the 2 groups. Achieving a complete molecular remission before transplantation reduces the risk of leukemia relapse even though TKIs may still rescue some patients relapsing after transplantation

Incidence, treatment and outcome of central nervous system relapse in adult acute lymphoblastic leukaemia patients treated front-line with paediatric-inspired regimens: A retrospective multicentre Campus ALL study

Within the Campus ALL network we analyzed the incidence, characteristics, treatment and outcome of a central nervous system (CNS) relapse in 1035 consecutive adult acute lymphoblastic leukemia (ALL) patients treated frontline with pediatric-inspired protocols between 2009 and 2020. Seventy-one patients (6.8%) experienced a CNS recurrence, more frequently in T- (28/278; 10%) than in B-ALL (43/757; 5.7%) (p = 0.017). An early CNS relapse—< 12 months from diagnosis—was observed in 41 patients. In multivariate analysis, risk factors for early CNS relapse included T-cell phenotype (p = <0.001), hyperleucocytosis >100 × 109/L (p<0.001) and male gender (p = 0.015). Treatment was heterogeneous, including chemotherapy, radiotherapy, intrathecal therapy and novel agents. A complete remission (CR) was obtained in 39 patients (55%) with no differences among strategies. After CR, 26 patients underwent an allogenic transplant, with a significant overall survival benefit compared to non-transplanted patients (p = 0.012). After a median observation of 8 months from CNS relapse, 23 patients (32%) were alive. In multivariate analysis, the time to CNS relapse was the strongest predictor of a lower 2-year post-relapse survival (p<0.001). In conclusion, in adult ALL the outcome after a CNS relapse remains very poor. Effective CNS prophylaxis remains the best approach and allogenic transplant should be pursued when possible

A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study

Lymphoma represents a heterogeneous hematological malignancy (HM), which is characterized by severe immunosuppression. Patients diagnosed of coronavirus disease 2019 (COVID-19) during the course of HM have been described to have poor outcome, with only few reports specifically addressing lymphoma patients. Here, we investigated the clinical behavior and clinical parameters of a large multicenter cohort of adult patients with different lymphoma subtypes, with the aim of identifying predictors of death. The study included 856 patients, of whom 619 were enrolled prospectively in a 1-year frame and were followed-up for a median of 66 days (range 1-395). Patients were managed as outpatient (not-admitted cohort, n = 388) or required hospitalization (n = 468), and median age was 63 years (range 19-94). Overall, the 30-and 100-days mortality was 13% (95% confi-dence interval (CI), 11% to 15%) and 23% (95% CI, 20% to 27%), respectively. Antilymphoma treatment, including anti-CD20 containing regimens, did not impact survival. Patients with Hodgkin's lymphoma had the more favorable survival, but this was partly related to signifi-cantly younger age. The time interval between lymphoma diagnosis and COVID-19 was inversely related to mortality. Multivariable analysis recognized 4 easy-to-use factors (age, gender, lymphocyte, and platelet count) that were associated with risk of death, both in the admitted and in the not-admitted cohort (HR 3.79 and 8.85 for the intermediate-and high risk group, respectively). Overall, our study shows that patients should not be deprived of the best available treatment of their underlying disease and indicates which patients are at higher risk of death. This study was registered with ClinicalTrials.gov, NCT04352556

Health promotion in school environment in Brazil

ABSTRACT OBJECTIVE Evaluate the school environments to which ninth-year students are exposed in Brazil and in the five regions of the country according to health promotion guidelines. METHODS Cross-sectional study from 2012, with a representative sample of Brazil and its macroregions. We interviewed ninth-year schoolchildren and managers of public and private schools. We proposed a score of health promotion in the school environment (EPSAE) and estimated the distribution of school members according to this score. Crude and adjusted odds ratios (OR) were used, by ordinal regression, to determine the schoolchildren and schools with higher scores, according to the independent variables. RESULTS A student is more likely to attend a school with a higher EPSAE in the South (OR = 2.80; 95%CI 2.67–2.93) if the school is private (OR = 4.52; 95%CI 4.25–4.81) and located in a state capital, as well as if the student is 15 years of age or older, has a paid job, or has parents with higher education. CONCLUSIONS The inequalities among the country’s regions and schools are significant, demonstrating the need for resources and actions that promote greater equity