The directional occurrence of the Levantine geomagnetic field anomaly: New data from Cyprus and abrupt directional changes

We present new insights on the directional occurrence of the Levantine Iron Age Anomaly (LIAA) through the analysis of new and previously published directional archaeomagnetic data from Cyprus and nearby countries. The new directions, obtained from in situ baked clay structures such as small hearths and ovens from five Cypriot archaeological sites, dated from 2000 BCE to 1400 CE, are very well defined and are added to the scant reference dataset for Cyprus. The new records together with literature data from nearby countries are used to investigate the directional variations of the geomagnetic field in the Eastern Mediterranean and Middle East. The first directional palaeosecular variation curve for Middle East is calculated using a critical selection of reference data from Cyprus, Israel, Turkey and Syria. The curve covers the last four millennia and shows several periods characterized by abrupt directional changes. A maximum change in curvature is clearly observed around 900 BCE, characterized by a change rate as high as 13.2° per century. The new curve confirms that during the Levantine Iron Age Anomaly notable for extreme intensity values, the geomagnetic field was characterized by steep inclinations and important directional change too. The maximum curvature is shifted by around one century from the two distinct intensity spikes previously observed in Levant around the 10th and 8th centuries BCE. Other periods of important curvature change are also identified and deserve further investigation

Do salivary bypass tubes lower the incidence of pharyngocutaneous fistula following total laryngectomy? A retrospective analysis of predictive factors using multivariate analysis

Salivary bypass tubes (SBT) are increasingly used to prevent pharyngocutaneous fistula (PCF) following laryngectomy and pharyngolaryngectomy. There is minimal evidence as to their efficacy and literature is limited. The aim of the study was to determine if SBT prevent PCF. The study was a multicentre retrospective case control series (level of evidence 3b). Patients who underwent laryngectomy or pharyngolaryngectomy for cancer or following cancer treatment between 2011 and 2014 were included in the study. The primary outcome was development of a PCF. Other variables recorded were age, sex, prior radiotherapy or chemoradiotherapy, prior tracheostomy, type of procedure, concurrent neck dissection, use of flap reconstruction, use of prophylactic antibiotics, the suture material used for the anastomosis, tumour T stage, histological margins, day one post-operative haemoglobin and whether a salivary bypass tube was used. Univariate and multivariate analysis were performed. A total of 199 patients were included and 24 received salivary bypass tubes. Fistula rates were 8.3% in the SBT group (2/24) and 24.6% in the control group (43/175). This was not statistically significant on univariate (p value 0.115) or multivariate analysis (p value 0.076). In addition, no other co-variables were found to be significant. No group has proven a benefit of salivary bypass tubes on multivariate analysis. The study was limited by a small case group, variations in tube duration and subjects given a tube may have been identified as high risk of fistula. Further prospective studies are warranted prior to recommendation of salivary bypass tubes following laryngectomy