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BACKGROUND: Recently, fatigue has received more attention as a workplace hazard. This scoping review focuses on fatigue in anaesthesia providers. We explore the prevalence of fatigue in anaesthesia providers, and we examine how fatigue impacts their performance. METHODS: A literature search was independently conducted from December 2019 through March 2020. The following four databases were consulted: MEDLINE, CINAHL, EMBASE, and PubPsych. Only studies discussing fatigue in anaesthesia providers were eligible. RESULTS: The initial database search identified a total of 118 studies, of which 30 studies were included in the review. Eight articles concerned the prevalence of fatigue in anaesthesia providers, whereas 22 explored the impact of fatigue on the performance of anaesthesia providers. Up to 60.8% of anaesthesia providers suffered from severe excessive daytime sleepiness, and fatigue was denoted as a common workplace problem in up to 73.1% of anaesthesia providers. Fatigue had a negative influence on medication errors and vigilance, and it decreased the performance of anaesthesia providers during laboratory psychomotor testing. There was a decrease in non-technical skills (notably communication and teamwork) and worsening mood when fatigued. CONCLUSIONS: Based on this scoping review, fatigue is a prevalent a phenomenon that anaesthesia providers cannot ignore. A combination of deterioration in non technical skills, increased medication errors, loss of sustained attention, and psychomotor decline can lead to poorer performance and cause patient harm. Concrete strategies to mitigate fatigue should be developed.

Background: The literature considers sclerotherapy to be a safe and effective treatment for benign thyroid cysts. No subsequent diagnostic problems have been reported as a complication. We report the occurrence of focal inflammation after said therapy, mimicking a thyroid malignancy.Case presentation: We report a case of a young male with a solitary strongly suspicious lesion in the thyroid. The patient had undergone prior sclerotherapy of a thyroid cyst with Doxycycline. The lesion appeared to be a focal area of inflammation and thus iatrogenic in nature. Systemic use of doxycycline is known to sometimes cause a non-immune chemical thyroiditis, dubbed as black thyroid due to the intense black discoloration of the thyroid. It might be that the instillation of doxycycline was responsible for a similar, more localized, process of affliction.Conclusions: For the work-out of a solitary suspicious thyroid lesion, the medical history of the patient should always be considered. In case of antecedents of ipsilateral sclerotherapy, a reactive inflammatory response may mimic thyroid malignancy. A fine needle aspiration should be performed to exclude thyroid cancer. Treatment is not necessary; the affliction appears self-limiting as evidenced in the follow-up of this case.

4-Dimensional computed tomography (4DCT) for the detection of (an) enlarged parathyroid(s) is a commonly performed examination in the management of primary hyperparathyroidism. In our center, we introduced a high-frequency multiphase 4DCT protocol obtaining 16 phases, including 11 different arterial phases. Exposure to this multiphase 4DCT technique is similar to that for classic helical 4DCT. In this pictorial essay we reconstructed our multiphase 4DCT series in the manner of a classic helical 4DCT and compare both techniques. We illustrate how multiphase 4DCT may aid in the detection of parathyroid adenomas. We found 17 out of 19 lesions demonstrating a type A pattern of enhancement, therefore suggesting this pattern could be more prevalent than previously thought. Some parathyroid adenomas may be mistaken for enlarged lymph nodes using classic 4DCT whereas high-frequency multiphase 4DCT can detect a temporary rise in enhancement, thus suggesting the lesions in question to be of parathyroid origin. Smaller lesions may prove more obvious as the difference in enhancement between parathyroid and thyroid can become more prominent. Key Point Using high-frequency multiphase 4DCT an arterial phase with maximum enhancement of parathyroid tissue can be defined. This phase may aid in the detection of parathyroid adenomas.

Objective. 4DCT for the detection of (an) enlarged parathyroid(s) is a commonly performed examination in the management of primary hyperparathyroidism. Protocols are often institution-specific; this review aims to summarize the different protocols and explore the reported sensitivity and specificity of different 4DCT protocols as well as the associated dose. Materials and Methods. A literature study was independently conducted by two radiologists from April 2020 until May 2020 using the Medical Literature Analysis and Retrieval System Online (MEDLINE) database. Articles were screened and assessed for eligibility. From eligible studies, data were extracted to summarize different parameters of the scanning protocol and observed diagnostic attributes. Results. A total of 51 articles were included and 56 scanning protocols were identified. Most protocols use three (n = 25) or four different phases (n = 23). Almost all authors include noncontrast enhanced imaging and an arterial phase. Arterial images are usually obtained 25–30 s after administration of contrast, and less agreement exists concerning the timing of the venous phase(s). A mean contrast bolus of 100 mL is administered at 3-4 mL/s. Bolus tracking is not often used (n = 3). A wide range of effective doses are reported, up to 28 mSv. A mean sensitivity of 81.5% and a mean specificity of 86% are reported. Conclusion. Many different 4DCT scanning protocols for the detection of parathyroid adenomas exist in the literature. The number of phases does not appear to affect sensitivity or specificity. A triphasic approach, however, seems preferable, as three patterns of enhancement of parathyroid adenomas are described. Bolus tracking could help to reduce the variability of enhancement. Sensitivity and specificity also do not appear to be affected by other scan parameters like tube voltage or tube current. To keep the effective dose within limits, scanning at a lower fixed tube current seems preferable. Lowering tube voltage from 120 kV to 100 kV may yield similar image contrast but would also help lower the dose.

Small, irregular isolated bones identified as remains of leatherback turtles (Dermochelys coriacea) were recovered from Mid to Late Holocene sites at Ra’s al-Hamra and Ra’s al-Hadd, coastal Oman. These provide the third instance of this animal being documented from any prehistoric site anywhere, and the records provide one of the oldest, if not the oldest, dates for this distinctive chelonian—even though they do not refer to fossils. Decades of research in this region has yielded vast amounts of archeological information, including abundant evidence of intense exploitation and utilization of marine turtles from about 6,500 to 4,000 BP. During part of this period, turtle remains in human burials have been extraordinary; the turtle involved, Chelonia mydas, has been abundant in the region during modern times. Yet despite intense and varied forms of prehistoric marine resource exploitation, and major, long-term archeological work, no other turtle species has been previously authenticated from these, or other coastal sites. The documentation of remains of the largest and most distinctive of living marine turtles, D. coriacea, at Ra’s al-Hamra and Ra’s al-Hadd, presented herein, provide detailed information that serves as the basis for future interpretations and discussions regarding incomplete, disarticulated remains from the Mid to Late Holocene, particularly in reference to taphonomic questions and diverse environmental conditions.

This article investigates the production and distribution of a high quality ceramic typical of the Indo-Iranian Borderlands ca 3000 BC, a ceramic we term here Late Shahi-Tump ware, often included under the generic label Emir Grey ware. Recorded at sites located hundreds of kilometers distant on the Southeastern Iranian Plateau, including Shahr-i Sokhta, Tepe Yahya, and Shahi-Tump, this ceramic is one of the few data points we have to approach the various communities settled in this area during the Early Bronze Age and to clarify the nature of their relationships. Through chemical composition analysis of the most relevant assemblages, using Instrumental Neutron Activation, we hoped to gain insights as to whether and how these ceramics circulated across the Southeastern Iranian Plateau. In the end, this analysis reveals patterns of distribution at the intraregional level in Southwestern Pakistan and a vast sphere of ceramic exchange at the interregional level. These results reinforce the picture of the Indo-Iranian Borderlands as a dynamic place for production and trade of high quality ceramics, a characteristic that continued and intensified during the 3rd millennium BC., Cet article traite de la production et de la distribution d’une céramique de haute qualité caractéristique des confins indoiraniens autour de 3000 av. J.-C. Cette céramique que nous nommons Late Shahi-Tump ware est souvent incluse sous l’appellation plus générale de Emir Grey ware. Elle a été collectée sur des sites du sud-est du Plateau iranien distants de plusieurs centaines de kilomètres, en particulier Shahr-i Sokhta, Tepe Yahya et Shahi-Tump. La céramique Late Shahi-Tump ware est l’une des rares sources de données permettant d’étudier les communautés vivant dans ce secteur et leurs relations au tout début de l’âge du Bronze. À travers des analyses par activation neutronique des assemblages les plus représentatifs, nous avons tenté de savoir si et comment cette céramique était distribuée. Ces analyses ont permis de fournir une première étude de sa distribution à l’échelle régionale dans le Kech-Makran (sud-ouest du Pakistan) et de mettre en évidence une vaste sphère de distribution interrégionale dans le sud-est du Plateau iranien. Ces résultats confirment l’image que l’on a des confins indo-iraniens autour de 3000 av. J.-C., à savoir une région particulièrement dynamique en ce qui concerne la production et l’échange de céramiques de haute qualité, une caractéristique qui continuera et ira en s’intensifiant au cours du 3e millénaire av. J.-C., Mutin Benjamin, Minc Leah D., Lamberg Karlovsky Carl C., Tosi Maurizio. Regional and long-distance exchange of an emblematic ‘prestige’ ceramic in the Indo-Iranian Borderlands. Results of Neutron Activation Analysis. In: Paléorient, 2017, vol. 43, n°1. pp. 141-162.

In case of a ruptured bladder with urine leakage into the peritoneal cavity 'reversed autodialysis' can occur, in which urea and creatinine diffuse back into the bloodstream via the peritoneum. This causes clinical signs of pseudorenal failure, with raised concentrations of creatinine and urea. The urea/creatinine ratio does not change.A 34-year-old female patient experienced increasing abdominal pain 3 days after laparoscopic myomectomy. Acute renal failure was suspected because of increased serum concentrations of creatinine and urea, but no cause could be found. There was a build-up of fluid in the abdominal cavity, which proved to be urine originating from an iatrogenic rupture of the bladder. Serum levels normalised following repair of the rupture.If serum creatinine levels rise rapidly following abdominal surgery or blunt abdominal trauma the bladder should be examined for possible perforation, particularly if the abdominal dimension increases. A ruptured bladder leading to pseudorenal failure is an indication for rapid surgical intervention.

Bone remains of camel (Camelus dromedarius) have been found in several sites of south-eastern Arabia, dating from the Late Holocene period to the Bronze Age, and generally attributed to wild animals. The new camel finds from the Early Bronze Age site of Ra's al-Hadd (HD-6) - dated with radiocarbon technique between 2890-2580 BC - are the oldest camel evidence in the Sultanate of Oman. This discovery represents an opportunity for a critical review of all available data in the Arabian Peninsula. These remains are important because widen our knowledge about camel spreading trajectory and raise an obvious question about its domestication or wild status. This study contributes to the debate about camel status and the relationship between late prehistoric communities and this animal.

L'articolo presenta i risultati delle indagini preliminari condotte dalla missione archeologica a Samarcanda (Uzbekistan), trattando nello specifico: carta archeologica e censimento dei siti; lo scavo del sito altomedievale di Kafir Kala; lo studio del Dargom e del sistema d'irrigazione

The oasis of Samarkand in the Middle Zeravshan Valley (modern Uzbekistan) was a major political and economic center in ancient western Central Asia. The chronology of its irrigation system was, until now, only constrained by the quality and quantity of archaeological findings and several different hypotheses have been proposed for it. We use a new approach combining archaeological surveying, radiocarbon dating, sedimentary analysis, and the numerical modeling of a flood event to offer new evidence for, and quantitative dating of, the development of irrigation system on the southern flank of the Middle Zeravshan Valley. We analyzed 13 bones and charcoals from 3 archaeological sites and obtained new 14C ages from Afrasiab (ancient Samarkand), a dwelling damaged by flooding in the 2nd century AD (site code: SAM-174) and the fortress of Kafir Kala. We established the origin of sedimentary deposits at the sites to infer the presence of the 2 most important canals of the southern flank: the Dargom and the Yanghiaryk. Finally, we show with a numerical model of overland flow that a natural flood was unlikely to have produced the damage observed at SAM-174. The combined results of the study indicate that the canals south of Samarkand existed, and were mainly developed, in the 2nd century AD and were not connected to the main feeding canal of Afrasiab at that time.

This paper presents a systematic review of the archaeological evidence for cultural interaction between the Helmand and the Indus during the 3rd millennium BCE. A series of artefacts found at Shahr-i Sokhta and nearby sites (Iranian Seistan) that were presumably imported from Baluchistan and the Indus domain are discussed, together with finds from the French excavations at Mundigak (Kandahar, Afghanistan) that might have the same origin. Other artefacts and the involved technologies bear witness to the local adaptation of south-eastern manufactures and practices in the protohistoric Sistan culture. While the objects datable to the first centuries of the 3rd millennium BCE fall in the so called “domestic universe” and reflect common household activities, in the centuries that follow we see a shift to the sharing of luxury objects and activities concerning the display of a superior social status ; but this might be fruit of a general transformation of the archaeological record of Shahr-i Sokhta and its formation processes., Cet article propose un ré-examen systématique des documents archéologiques qui témoignent d’interactions culturelles entre le Helmand et le bassin de l’Indus au cours du IIIe millénaire avant J.-C. Une série d’objets, selon toute vraisemblance, importés du Baluchistan et de la vallée de l’Indus, trouvés aussi bien à Shahr-i Sokhta que sur les sites avoisinants du Séistan iranien, sont discutés ici, en parallèle avec d’autres, recueillis par la mission française à Mundigak (Kandahar, Afghanistan). D’autres artefacts ainsi que leurs technologies montrent clairement dans la culture protohistorique du Séistan l’adaptation de coutumes et de pratiques en provenance du Sud-Est. Alors que les objets qui peuvent être datés des premiers siècles du IIIe millénaire avant J.-C. appartiennent à la «sphère domestique» et reflètent des activités quotidiennes, dans les siècles qui suivent on observe un glissement vers des objets de luxe et vers des activités permettant d’afficher un statut social supérieur ; on pourrait y voir le résultat d’une transformation générale des assemblages de Shahr-I Sokhta et des processus qui y ont présidé., Cortesi Elisa, Tosi Maurizio, Lazzari Alessandra, Vidale Massimo. Cultural Relationships beyond the Iranian Plateau: The Helmand Civilization, Baluchistan and the Indus Valley in the 3rd Millennium BCE. In: Paléorient, 2008, vol. 34, n°2. pp. 5-35.

Cet article offre une description de l'industrie du lapis lazuli mise au jour par la mission archeologique francaise de Mehrgarh, en surface du site MR2 (4e millenaire av. J.-C). Cette decouverte represente l'un des plus anciens assemblages de perles en lapis lazuli d'Asie du sud et temoigne du role de la region de la plaine de Kachi dans la production ďornements de luxe depuis des periodes relativement anciennes. Il sera tente ici de dresser un tableau general des sequences de fabrication des perles et de donner une premiere evaluation des taux relatifs de perte - en termes de dechets de matiere premiere - rencontres tout au long des differentes etapes de la production.

A study has been carried out on the mineralogical composition of stone beads found in the course of archaeological excavations carried out at the site of Ra's al-Hadd in Southern Oman. The data provide information about the raw material and technology used for beads production. Several beads and micro-beads made of white paste of different shapes and sizes have been analysed. They range, in size, from two to four millimetres in diameter, two to fifteen millimetres in height, and the diameter of the hole is approximately one millimetre. The shape is tubular for the biggest bead, cylindrical for slender beads and ring-shaped for micro-beads. The beads were analysed using X-ray diffraction (XRD); the method was optimised to minimise the amount of the sample necessary for analysis (15 milligrams were necessary using special sample holders while in traditional holders 300 milligrams are needed). XRD analysis revealed that the beads arc made of “synthetic enstatite”, a magnesium silicate belonging to pyroxene group (orthopy-roxene Mg2Si2O6). The relative intensity of the main peaks confirms that the material is “synthetic enstatite”. Natural enstatite is a hard mineral (its hardness is five or six on the Mohs scale), therefore we propose that a softer magnesium-bearing mineral was used: steatite (Mg5Si4O10 (OH)2 commonly known as massive talc - hardness one on the Mohs scale). The beads might have been worked from soft steatite bulk material and then hardened by transformation of the steatite to synthetic enstatite during firing at about 1000 °C so that the formerly soft beads became hard and durable. Some preliminary heating experiments on talc bulk fired at about 1000 °C was carried out to compare powder diffractograms of the beads and the fired massive talc; a good overall resemblance of the two patterns is evident. The raw material of the examined beads might have came from the ultramafic rocks of Oman and it is very likely that these beads were produced from locally available raw materials. Nous avons étudié la composition minéralogique des petites perles trouvées lors des fouilles archéologiques effectuées sur le site de Ra's al-Hadd situé au sud de l'Oman. Nous avons analysé beaucoup de petites perles et micro-perles fabriquées avec un matériel blanc et de différentes formes et dimensions. Les résultats de l'analyse ont livré des informations sur le matériel et la technologie utilisés pour la production des petites perles. Les dimensions sont de deux à quatre millimètres de diamètre et de deux à quinze millimètres de haut, le diamètre du trou perforé est approximativement de un millimètre. La forme est tubulaire pour la perle la plus grande et cylindrique pour les plus petites perles, de forme circulaire pour les micro-perles. Les petites perles ont été analysées par diffraction de rayons X. Nous avons optimisé la méthode pour minimiser la quantité de matériel utilisé pour l'analyse (15 mg de poudre sont nécessaires avec un porte échantillon spécial contre 500 mg de poudre nécessaires avec un porte échantillon traditionnel). L'analyse par diffraction de rayons X indique que les petites perles sont en enstatite synthétique, un silicate de magnésium appartenant au groupe des pyroxènes (ortopyroxène Mg2Si2O6). L'intensité relative des pics principaux confirme que le matériel utilisé est l'enstatite synthétique. L'enstatite naturelle est un minéral très dur (il a une dureté de cinq à six sur l'échelle Mohs) et c'est pourquoi nous proposons que la stéatite (Mg2Si4O10(OH)2 normalement connue comme talc massif de dureté un sur l'échelle de Mohs) est le matériel utilisé pour la réalisation des petites perles. Les petites perles pourraient avoir été réalisées avec de la stéatite et être ensuite transformées en enstatite synthétique par cuisson au four à une température d'environ 1000 degrés centigrades. Cette méthode permettrait la production de petites perles très dures, réalisées à partir d'un matériel tendre. Nous avons fait des expériences avec du talc italien chauffé à 1000 degrés centigrades pour comparer les diagrammes de diffraction des petites perles avec les diagrammes de diffraction du talc chauffé.

The evolution of Holocene human communities in the Arabian Peninsula appears very different from that of neighbouring areas. Until the 4th millennium ВС, it seems characterized by an almost exclusively hunting-gathering economy. This synthesis makes use of an admitedly still insufficient set of data to analyze the relations between the evolution of these populations and various factors of climatic and environmental changes during the Holocene. These include the existence of a mid-Holocene more humid episode that is still to be accurately dated, changes in groundwater availability and, for the coastal areas, variations in sea levels. We argue the evolution of human communities is not the result of a direct response to these transformations, nor is it an attenuated echo to the adoption of the neolithic economy in the Fertile Crescent or, later, the products of direct influences from the urban societies of the Ancient Orient. Taking into account these factors, we emphasize the elements of a local evolution of the Holocene hunter-gatherers societies of Arabia, grounded on their own adaptative strategies to the highly constraining environments on which live., L'évolution du peuplement des régions arides de la Péninsule arabique à l'Holocène présente des caractéristiques très différentes de celle des régions avoisinantes, avec notamment l'apparente persistance, jusqu'au cours du quatrième millénaire, d'une économie exclusivement fondée sur la chasse et la cueillette. La présente synthèse, fondée sur des données encore partielles, tente d'analyser l'évolution de ce peuplement en le situant par rapport aux facteurs climatiques et environnementaux de l'Holocène, à savoir l'existence d'une période plus humide à l'Holocène moyen dont les dates restent discutées, l'évolution des nappes phréatiques et, pour les zones côtières, les fluctuations des niveaux marins. Elle vise à montrer que l'évolution du peuplement n'est pas le résultat de réponses directes à ces transformations, pas davantage qu'elle n'est un écho tardif de l'adaptation d'une économie néolithique dans les régions du Croissant fertile ou plus tard le produit direct des influences venues des sociétés urbaines de l'Orient ancien. Sans négliger ces facteurs, nous proposons les éléments de l'analyse d'une évolution propre aux chasseurs-cueilleurs de l'Arabie Holocène, en fonction de leurs stratégies d'adaptation aux milieux particulièrement contraignants qu'elles exploitent., Cleuziou S., Tosi Maurizio. Hommes, climats et environnements de la Péninsule arabique à l'Holocène.. In: Paléorient, 1997, vol. 23, n°2. Paléoenvironnement et sociétés humaines au moyen-orient de 20 000 BP à 6 000 BP. pp. 121-135.

Les cachets en chlorite (2 inscrits et 1 non inscrit) presentes dans cet article ont ete decouverts dans une maison de briques crues attribuee au debut de la phase II (2500-2200 av. J.-C.) d'occupation du site RJ-2 du cap de Ra's al-Junayz. Apres une description des cachets et des signes inscrits, l'auteur s'interroge sur la nature de ces signes (ecriture ?), puis sur la diffusion des systeme d'ecritures alors existant en Egypte, en Mesopotamie, en Elam et dans l'Indus, vers la peninsule d'Oman et le Golfe persique a la fin du 3e millenaire (vers 2200 av. J.-C.)

A reappraisal of Marx's thinking on certain aspects of state formation, in the light of recent archaeological discoveries, yields signifi? cant results. Marx wrote the Grundrisse der Kritik der Politischen ?konomie, the most pertinent work in this context, in 1857?1858 as a collection of preparatory texts and notes for Das Kapital, and not, it seems, for publica? tion. Although it was the fruit of mature Marxian thought, the Grundrisse has been the last work by Marx to be studied by scholars, partly because it was not available until 1939? 1941, when the Marx-Engels-Lenin Institute in Moscow published it, using the original manu? scripts which had been brought to the USSR by N.I. Bucharin some years earlier,1 and partly because it only began to be known widely in 1953, when it was published in the German Democratic Republic.2 The Grundrisse is critical for the study of the formative process of capitalist society as it is set out in the sec? tion entitled "Pre-capitalist economic forma? tions." The studies by Hobsbawn and Godelier, among others,3 which followed German publica? tion, have further reflected the Marxian models of the development of human society. (The most remarkable Soviet contribution is by L.V. Danilova.4) In the scheme referring to the Orient, Marx anticipates the conclusion of archaeologists in concisely dividing the dynamics of the Asiatic mode of production into three successive stages:5 1. The nomadic community of gatherers, characterized by complex kinship structures and dependent on limited resources. The exploitation of these resources took place in temporary settlements and through collective use of the land. 2. The tribal community, in which territory was permanently appropriated by continually expanding farming settlements. Holding property in common persists, despite the loosening of ties of kinship. This tribal property "contains in Itself all the conditions of repro? duction and surplus production." Artisanship and agriculture are combined inside this small self-supporting community. 3. Despotic centralized government attaining ideal unity, which is later personified in the figure of the king. The king dominates the small communities that gradually coalesce into towns. Towns are coordinating centers, organiz? ing collective labor and commanding the surplus; both the products of external trade and local surpluses must flow toward it. As Marx conceived it, social evolution is dependent on a quantitative increase in the surplus, which is capitalized and reinvested in the name of collective property; this is the consistent and peculiar aspect of Asiatic society. For Marx, Asiatic society thus paves the way for the most complete despotism, where both the products and the means of production ? human beings included among the latter ? belong to the king (the transformation of the Maurizio Tosi is Professor of Archaeology, Istituto del Mezzo e d'Estremo Oriente, Rome.

Once screening and floatation systems have been adopted in an excavation, most ancient sites in the Near East and Iran have been providing us with well-preserved remains of insects and other arthropods to an extent as large as in turf deposits of western Europe. The present paper is based on results from floatation works carried out at Shahr-i Sokhta (Sistan, Iran), Tepe Hasanlu (Azerbaijan) and Tel Baroda in Ctesiphon. Among others is here discussed the better feasibility of hand-operated floatation techniques for the specific recovery of insect remains. Primarily on the basis of the Shahr-i Sokhta finds the authors enlist the genera or species mostly frequent in a protohistorical assemblage and their utility to the reconstruction of early environment and economy., Depuis l'utilisation du tamisage et de la flottation en archéologie, la plupart des sites anciens au Proche-Orient et en Iran ont livré autant de restes bien conservés d'insectes et autres arthropodes que les dépots de tourbe d'Europe Occidentale. Cet article utilise les résultats des travaux de flottation effectués à Shahr-i Sokhta (Sistan, Iran), Tepe Hasanlu (Azerbaijan) et Tel Baroda à Ctesiphon. Entre autres techniques, celles mettant en œuvre la flottation semblent les plus appropriées pour recueillir les restes d'insectes. Les auteurs, se fondant surtout sur les résultats de Shahr-i Sokhta, font une liste des genres et des espèces les plus fréquents dans un assemblage protohistorique et leur utilité dans la reconstruction de l'environnement et de l'économie de ces périodes., Costantini Lorenzo, Tosi Maurizio, Vigna Taglianti Augusto. Typology and Socioeconomical Implications of Entomological Finds from some Ancient Near Eastern Sites. In: Paléorient, 1975, vol. 3. pp. 247-258.

Background : Pain management after posterior thoracolumbar interbody fusion surgery remains a challenging problem. Epidural analgesia with local anesthetics as an adjuvant treatment might prove beneficial. Objective : To evaluate the effects of continuous epidural analgesia with a ropivacaine solution as an adjuvant treatment after posterior thoracolumbar interbody fusion. Study design : A prospective double-blind, randomized, placebo-controlled clinical trial. Setting : University Hospital Brussels, a tertiary academic health science centre. Methods : Thirty-three patients undergoing spinal fusion surgery were randomized into two groups. One group was administered a continuous epidural infusion of a 0.9% saline solution. The other group was administered a continuous epidural infusion of a 0.2% ropivacaine solution. The primary outcome measure was the level of pain experienced by the patients, which was assessed using the visual analogue scale (VAS). Secondary outcomes were time to mobilisation, total length of stay and opioid consumption on patient demand. Results : The mean VAS score postoperatively the day of surgery was scored as 3,5 for the patients receiving the ropivacaine infusion. The placebo group scored 5 on the VAS scale, thus suggesting a beneficial effect of ropivacaine infusion (p-value 0.02). The mean VAS score at post-op day 1 of surgery differed between 2 for the ropivacaine group and 2,8 for the placebo group (p-value 0.05). Length of stay was shorter for patients who had received ropivacaine infusion (mean difference 1,8 days ; p-value 0,02). No other significant differences were withheld. Conclusion : The use of a continuous epidural ropivacaine infusion after posterior thoracolumbar spinal fusion surgery could improve postoperative VAS scores and may also result in faster hospital discharge rate. Trial registration : registered and approved in the EudraCT registry (2014-004713-91).

First evidence of prehistoric coastal adaptations along the Arabian shores of the Indian Ocean is being recovered at Qurum in the Sultanate of Oman. The cluster of shell‐middens currently excavated relates to a small population of fishermen of the 5th and 4th millennia B.C. having a strongly maritime‐oriented culture. The economy was based on local resource intensification, but stock‐breeding of goats and cattle was practised as well, suggesting early contacts with farming groups and the spreading of domesticates through coastal interchanges.

International audience

The development and elaboration of softstone and marine shell bead production is one of the major questions that need to be addressed in the ongoing research of early human coastal adaptations in the Oman Peninsula. This research aimed first at testing the archaeological significance of beads as an indicator of cultural variability among the Late Neolithic coastal communities of Oman based on a series of specific stylistic, technological and morphometric features. Around 600 softstone and marine shell beads were documented from eight Late Neolithic sites located along the coast of the Sultanate of Oman, including both settlements and necropolises. From North to South the sites are, Ras Al-Hamra RH- 5, RH-6 and RH-10 in Muscat; Wadi Shab GAS-1 near Tiwi; Ras Al-Hadd HD-5, Ras Al-Khabbah KHB-1 and Suwayh SWY-1 and SWY-2 along the Ja’alan coast

International audience

HD-6 is the earliest Early Bronze Age settlement excavated in the area of Ras Al-Hadd and reflects the results of the ‘great transformation’ that affected the Oman Peninsula and the whole of Eastern Arabia towards the end of the 4th millennium BC. Among the mammal remains of the site some camel remains were identificated, Up to date the new dromedary remains from the Early Bronze Age site of HD-6 represent the oldest camel evidence from present-day Oman.

International audience