bluuebunny/crossref_metadata_2025 huggingface dataset:
Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy
Authors: Griffiths Ewen A. , Hodson James , Vohra Ravi S. , Marriott Paul ,   the CholeS Study Group, Katbeh Tarek , Zino Samer , Nassar Ahmad H. M. ,   West Midlands Research Collaborative
Published: June 2018

Background

A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets.

Methods

Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis.

Results

A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001).

Conclusion

We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty.
Weighing in on Body Mass Index and Infection After Total Joint Arthroplasty: Is There Evidence for a Body Mass Index Threshold?
Authors: Shohat Noam , Fleischman Andrew , Tarabichi Majd , Tan Timothy L. , Parvizi Javad
Published: June 2018

Background

Although morbid obesity is considered a modifiable risk factor for periprosthetic joint infection (PJI), there is no consensus regarding an appropriate threshold for body mass index (BMI) above which a high risk for infection may outweigh the benefits of surgery.

Questions/purposes

(1) Is there a BMI cutoff threshold that is associated with increased risk for PJI? (2) Is the risk of PJI increased in higher obesity classes?

Methods

A retrospective study was conducted of all primary THAs and TKAs performed at one institution between 2006 and 2015. Overall 19,226 patients were eligible to be included in the study; 1053 patients were excluded as a result of incomplete data, resulting in a final cohort of 18,173 patients (8757 TKAs and 9416 THAs). PJI was defined using the International Consensus Meeting criteria. To ensure accurate followup, and because there is evidence to support the association between obesity and early infection, we identified PJI within 90 days of the index surgery. This relationship was examined separately for BMI as a continuous variable and for each BMI category as defined by the Centers for Disease Control and Prevention (underweight ≤ 18.49 kg/m2; normal 18.5-24.9 kg/m2; overweight 25-29.9 kg/m2; obese class I 30-34.9 kg/m2; obese class II 35-39.9 kg/m2; obese class III ≥ 40 kg/m2). Analyses were performed with logistic regression, accounting for both patient and surgical risk factors. A BMI threshold was evaluated with a receiver operating characteristic (ROC) curve and the Youden index.

Results

The area under the ROC curve for BMI and risk of PJI within 90 days was only 0.58 (confidence interval [CI], 0.52-0.63) suggesting such a cutoff was not much better than random chance. Among the BMI classes, patients with class III obesity (≥ 40 kg/m2) were the only ones showing a higher risk for PJI within 90 days (odds ratio [OR], 3.09 [1.46-6.54]; p = 0.003). The risk of developing PJI was not greater for overweight (OR, 0.72; 95% CI, 0.38-1.4), class I obese (OR, 1.06; 95% CI, 0.57-2.0), or class II obese (OR, 1.08; 95% CI, 0.52-2.2) patients. Underweight patients also demonstrated no increased risk for PJI (OR, 1.80; 95% CI, 0.23-13.9).

Conclusions

The risk for infection increases gradually throughout the full range of BMI, but no threshold exists. Weight reduction before surgery may mitigate risk for infection for all patients with a BMI above normal. Of note, patients with a BMI > 40 kg/m2 carried a threefold higher risk for PJI and for these patients, the risks of surgery must be carefully weighed against its benefits.

Level of Evidence

Level III, therapeutic study.
Hypoxia and myelination deficits in the developing brain
Authors: Singh Dhiraj Kumar , Ling Eng‐Ang , Kaur Charanjit
Published: June 2018

Myelination is a complex and orderly process during brain development that is essential for normal motor, cognitive and sensory functions. Cellular and molecular interactions between myelin‐forming oligodendrocytes and axons are required for normal myelination in the developing brain. Oligodendrocyte progenitor cells (OPCs) proliferate and differentiate into mature myelin‐forming oligodendrocytes. In this connection, astrocytes and microglia are also involved in survival and proliferation of OPCs. Hypoxic insults during the perinatal period affect the normal development, differentiation and maturation of the OPCs or cause their death resulting in impaired myelination. Several factors such as augmented release of proinflammatory cytokines by activated microglia and astrocytes, extracellular accumulation of excess glutamate and increased levels of nitric oxide are some of the underlying factors for hypoxia induced damage to the OPCs. Additionally, hypoxia also leads to down‐regulation of several genes involved in oligodendrocyte differentiation encoding proteolipid protein, platelet‐derived growth factor receptor and myelin‐associated glycoprotein in the developing brain. Furthermore, oligodendrocytes may also accumulate increased amounts of iron in hypoxic conditions that triggers endoplasmic reticulum stress, misfolding of proteins and generation of reactive oxygen species that ultimately would lead to myelination deficits. More in‐depth studies to elucidate the pathophysiological mechanisms underlying the inability of oligodendrocytes to myelinate the developing brain in hypoxic insults are desirable to develop new therapeutic options or strategies for myelination deficits.
Ejaculatory Disorders in Men With Urethral Stricture and Impact of Urethroplasty on the Ejaculatory Function: A Systematic Review
Authors: Kaluzny Adam , Gibas Artur , Matuszewski Marcin
Published: June 2018

Background

Urethral stricture may disturb both micturition and semen emission. Urethroplasty, despite the restoration of a proper urethral patency, may not eliminate the accompanying ejaculatory dysfunction (EjD).

Aim

To investigate the relationship among urethral stricture, urethroplasty, and ejaculatory function.

Methods

For the systematic review, the authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Internet-based bibliographic databases (PubMed and Scopus) were searched to access studies that examined the influence of urethral stricture and urethroplasty on ejaculatory function.

Outcomes

EjD accompanying urethral stricture, before and after urethroplasty, was evaluated.

Results

20 Studies were included in the final analysis. In total, these studies comprised a population of 1,913 patients, aged between 11–86 years, 1,823 with an anterior urethral stricture and 90 with a posterior one. No randomized trials regarding the topic were found. Patients with urethral stricture typically report poor force of ejaculation, reduced ejaculatory volume, reduced pleasure, or complete failure to ejaculate. The prevalence of pre-operative disorders depends on patients’ age and is more severe in the older population. The pre-operative stricture length, location, and type of surgery have no statistically significant influence on post-operative EjD. In some patients, despite a successful urethral reconstruction, problems with ejaculation persist. The improvement in ejaculation after urethroplasty is observed only in younger men. The available data are inconclusive whether the separation of the bulbospongiosus muscle during urethroplasty impairs its later functionality.

Clinical Implications

Analyzing the available literature on the subject, this review provides knowledge about the possible influence of urethroplasty on ejaculatory function, which may be useful both in the pre-operative patient consultation and in the choice of treatment method.

Strengths & Limitations

The evidence is sufficient to determine effects on health outcomes. However, the strength of evidence is limited by the lack of randomized trials and differences in terms of methodology and analyzed populations, preclusive of conducting the meta-analysis.

Conclusion

It has not been unequivocally determined which factors related to the stricture or surgery are decisive for post-operative ejaculatory function. The improvement in ejaculation after urethroplasty is observed only in younger men.
High Prevalence of Erectile Dysfunction in Diabetic Men With Depressive Symptoms: A Meta-Analysis
Authors: Wang Xu , Yang Xiaohua , Cai Yihong , Wang Shengmei , Weng Weiqun
Published: June 2018

Background

Erectile dysfunction (ED) may be common among diabetic men with depressive symptoms (DS), but its prevalence is still debated.

Aim

To conduct a meta-analysis of the prevalence of ED in diabetic men with DS compared to those without DS, calculating the relative odds ratios (ORs) and 95% CIs.

Methods

PubMed, MEDLINE, Embase, and Web of Science were searched up to January 2018. All the studies assessing the risk of ED among diabetic men having DS were reviewed. 2 Authors independently assessed literature and extracted information eligibility. Any disagreement was resolved by a third reviewer. Newcastle-Ottawa quality assessment scale was used to evaluate study quality in meta-analyses. We calculated the ORs with 95% CIs using software Stata, Version 12.0; StataCorp, College Station, TX). Data were pooled using a fixed or random effects model according to heterogeneity. Sensitivity analyses were conducted to assess potential bias. This study was conducted according to the guidelines for Meta-Analyses and Systematic Reviews of Observational Studies.

Outcomes

The strength of the association between DS and the prevalence of ED was evaluated using ORs and 95% CIs.

Results

5 Studies were eligible for the present analysis, reporting on a total of 2525 diabetic men. Mean age of patients ranged from 42.37–61.65 years in the included studies. The overall prevalence of ED in diabetic men with DS was 74.2% (95% CI 59.0–89.4). The overall prevalence of ED in diabetic men without DS was 37.4% (95% CI 16.2–58.6). The pooled crude OR for these 5 studies was 6.40 (95% CI 2.11–19.38, P < .05, I2 = 94.6%). The pooled OR of 4 multi-variate analyses was 3.08 (95% CI 1.32–4.85, P < .001, I2 = 83.5%).

Clinical Implications

Diabetic men with DS had a significantly increased prevalence of ED, suggesting that ED should be of concern to clinicians when managing diabetic men with DS.

Strengths & Limitations

A strength of this study is that it is the first meta-analysis to assess the prevalence of ED in diabetic men with DS and quantitatively analyze the association between DS and ED risk among diabetic men. A limitation is that all included studies were cross-sectional studies, which may generate bias.

Conclusion

The present meta-analysis of 5 cross-sectional studies suggests that diabetic men showing DS, compared to the diabetic men without DS, have more risk of ED. Further larger prospective cohorts with more power or meta-analysis based on individual patient data need to be conducted to confirm this association.
The Hemodynamic Effects of Intracavernosal Phenylephrine for the Treatment of Ischemic Priapism
Authors: Sidhu Ajaydeep S. , Wayne George F. , Kim Bu J. , Anderson Alexander G.S. , Cordon Billy H. , Caso Jorge R. , Polackwich A. Scott
Published: June 2018

Aim

We sought to evaluate whether the administration of phenylephrine (PE) at concentrations higher than those described in guidelines resulted in any significant changes in vital signs or impacted outcomes.

Methods

After receiving institutional review board approval, we retrospectively reviewed the charts of patients presenting to our emergency department between May 1, 2014, and August 15, 2016, using International Classification of Diseases, Ninth Edition and Internation Classification of Disease, Tenth Edition diagnosis codes for priapism. Treatment was reviewed, including corporal aspiration/irrigation, injection of PE, and shunt procedures. Vital signs were compared before and after treatment with PE. Baseline variables were explored with categorical data analysis (chi-squared tests, t-tests, and Mann-Whitney nonparametric tests). Where feasible, linear regression was used to evaluate outcomes.

Main Outcome Measure

Detumescence and changes in blood pressure and heart rate.

Results

We identified 74 different patient encounters of acute priapism. The median age was 36.5 years (interquartile range [IQR] = 27–47), and the median time to presentation was 5.4 hours (IQR = 4.0–9.6). 62 percent of cases were due to drug-induced priapism. In 58 (74%) encounters, patients received PE. The median dose of PE given was 1000 μg (IQR 500–2,000). Univariate regression found no association between PE dose and change in patient heart rate or blood pressure. A statistically significant decrease in heart rate (HR) (−4.2 BPM), systolic blood pressure (BP) (−1.8 mm Hg), and diastolic BP (−5.4 mm Hg) was noted. Fifty-three of 58 (91%) patients receiving PE experienced detumescence at the bedside, 2 required shunting in operating room, and 3 refused treatment and left against medical advice. No adverse events occurred.

Conclusion

We frequently treat patients with high doses of PE and seldom notice adverse effects, typically resulting in resolution of priapism without any additional procedures. Careful administration of high doses of intracavernosal PE in patients presenting with priapism does not appear to significantly affect heart rate or blood pressure and may help prevent further ischemic damage and achieve detumescence effectively and efficiently.
The Significance of the Female Orgasm: A Nationally Representative, Dyadic Study of Newlyweds' Orgasm Experience
Authors: Leonhardt Nathan D. , Willoughby Brian J. , Busby Dean M. , Yorgason Jeremy B. , Holmes Erin K.
Published: June 2018

Background

Self-reported orgasm, perception of partner's orgasm, and misperception of partner's orgasm have each been correlated with individual sexual and relationship satisfaction, but these associations have rarely included dyadic data, have not fully accounted for potentially confounding variables such as sexual communication, and have never been simultaneously studied with a nationally representative sample.

Aim

To provide a more complete picture of how the orgasmic experience within the heterosexual couple influences individual and partner sexual and relationship satisfaction.

Methods

Using a nationally representative dyadic sample of 1,683 newlywed heterosexual couples, a structural equation model was estimated to test associations between husband and wife self-reported orgasm frequency, husband and wife report of the other partner's orgasm frequency, and husband and wife misperception of their partner's orgasm frequency, as correlates of relationship and sexual satisfaction.

Outcomes

Both husband and wife completed the Couples Satisfaction Index to assess their own relationship satisfaction, and completed a sexual satisfaction instrument designed for the CREATE study.

Results

87% of husbands and 49% of wives reported consistently experiencing orgasm. 43% of husbands misperceived how often their wives experienced orgasm. The final structural equation model, including sexual communication, explained moderate amounts of variance in wives' and husbands' relationship satisfaction, and a high level of variance for wives' and husbands' sexual satisfaction. Wives' relationship satisfaction was positively associated with wives' and husbands' sexual communication. Wives' sexual satisfaction was positively associated with self-reported orgasm frequency, and both wives' and husbands' sexual communication. Husbands' relationship satisfaction was positively associated with husbands' and wives' sexual communication. Husbands' sexual satisfaction was positively associated with husbands' perception of wives' orgasm frequency, and both husbands' and wives' sexual communication.

Clinical Translation

When counseling couples, clinicians should give particular attention to the wife's orgasm experiences, to potentially help both husbands and wives have higher sexual satisfaction.

Strengths & Limitations

Strengths of this study include the use of a nationally representative sample and dyadic data. Limitations include cross-sectional data, and the assessment of sexual experiences only in newlywed couples.

Conclusion

Wives' orgasm (wives' self-report of frequency and husbands' perception of frequency) has a unique positive association with sexual satisfaction, even after taking into account other aspects of the orgasm experience and sexual communication.
Ex vivo ovine model for teaching open laryngotracheal surgery
Authors: Soliman Ahmed M.S. , Ianacone David C. , Isaacson Glenn C.
Published: June 2018

Objective

To develop an animal model for teaching open laryngotracheal surgical procedures.

Methods

The heads and necks from 5 pre‐pubescent sheep were harvested after humane anesthesia. After 2–5 days to allow for rigor mortis to resolve, a specimen was supported with sandbags on an operating table. Operative procedures including tracheotomy, medialization laryngoplasty, anterior cartilage grafting, tracheal resection with primary anastomosis, and laryngectomy with closure of the pharynx were attempted.

Results

The ovine head and neck provided an accurate model for simulation of all attempted procedures. Ovine tissue resembled that of humans in mechanical properties and handling. Postsurgical endoscopy confirmed graft alignment.

Conclusions

The sheep head and neck provides an inexpensive, realistic, and safe model for surgical training for a variety of open laryngotracheal procedures. This is particularly relevant given the recent emphasis on surgical simulation and the relative rarity of some of these procedures in residency training.
Poro on Trial: The 1913 Special Commission Court case ofRex v. Fino, Bofio and Kalfalla
Authors: Keefer Katrina H.B.
Published: June 2018

In 1913, a Special Commission Court in Sierra Leone saw a series of trials concerning members of the Human Leopard Society, and conflated this society with the regional Poro Society. This article examines one of those trials and unearths motivations for murder and questions of bias. With the reinvention of identity in the shadow of slavery, a nuanced and complicated picture emerges of the situation. Though more questions than answers are offered by the details of the case, this article problematizes Sierra Leone under British authority, and shows a nuanced snapshot of power struggles playing out in a murder trial.
Bougie-assisted cricothyroidotomy: Delphi-derived essential steps for the novice learner
Authors: Dharamsi Alia , Gray Sara , Hicks Christopher , Sherbino Jonathan , McGowan Melissa , Petrosoniak Andrew
Published: June 2018

Objective

A cricothyroidotomy is a life-saving procedure, performed as a final option to emergency airway algorithms, and is essential for all clinicians who perform emergency airway management. The bougie-assisted cricothyroidotomy (BAC) is a novel technique that may be performed faster and with fewer complications than other traditional approaches. There is no established standard set of steps to guide the instruction of BAC performance. This study sought to systematically develop a BAC checklist for novice instruction using a modified Delphi methodology and international airway experts.

Methods

A literature review informed the creation of a preliminary BAC checklist. A three round, modified Delphi method was used to establish a BAC checklist intended for novice-level instruction. The consensus level for each step and the final checklist were predefined at 80%. Participants were international airway experts identified by study personnel and snowball sampling.

Results

Fourteen international airway experts across six acute care specialities participated in the study. The checklist was refined using a seven-point rating scale for each item and participant comments. A 17-item checklist was developed with expert consensus achieved after three rounds. Internal consistency, measured with Cronbach’s α, was 0.855 (95% confidence interval 0.73-0.94).

Conclusion

This modified Delphi-derived checklist is the first systematically developed list of essential steps for guiding BAC instruction for novice learners. This tool serves to standardize BAC skill instruction and provide learners with a structured and consistent set of steps for deliberate practice.
Improved rates of antimicrobial stewardship interventions following implementation of the Epic antimicrobial stewardship module
Authors: Pettit Natasha N. , Han Zhe , Choksi Anish R. , Charnot-Katsikas Angella , Beavis Kathleen G. , Tesic Vera , Bhagat Palak , Nguyen Cynthia T. , Bartlett Allison H. , Pisano Jennifer
Published: June 2018

We evaluated the impact of the Epic antimicrobial stewardship module (EAM) on the number of interventions, antimicrobial usage, and clinical outcomes. Use of the EAM allowed us to significantly increase the number of ASP antimicrobial reviews and interventions while maintaining a sustained impact on antimicrobial utilization.
Successful and unsuccessful weight-loss maintainers: strategies to counteract metabolic compensation following weight loss
Authors: Clamp Louise D. , Hume David J. , Lambert Estelle V. , Kroff Jacolene
Published: June 2018

Adaptive thermogenesis and reduced fat oxidative capacity may accompany weight loss, continuing in weight maintenance. The present study aimed (1) to determine whether weight-reduced and weight-loss relapsed women are at greater metabolic risk for weight gain compared with BMI-matched controls with no weight-loss history, and (2) to identify protective strategies that might attenuate weight loss-associated adaptive thermogenesis and support successful weight-loss maintenance. Four groups of women were recruited: reduced-overweight/obese (RED,n15), controls (low-weight stable weight; LSW,n19) BMI <27 kg/m2; relapsed-overweight/obese (REL,n11), controls (overweight/obese stable weight; OSW,n11) BMI >27 kg/m2. Body composition (bioelectrical impedance), 75 g oral glucose tolerance test, fasting and postprandial metabolic rate (MR) and substrate utilisation (RER) and physical activity (accelerometer (7 d)) were measured. Sociobehavioural questionnaires and 3 × 24 h diet recalls were completed. Fasting and postprandial MR, RER and total daily energy intake (TDEI) were not different between RED and RELv.controls (P> 0·05). RED consumed less carbohydrate (44·8 (sd10·3)v.53·4 (sd10·0) % TDEI,P= 0·020), more protein (19·2 (sd6·0)v.15·6 (sd4·2) % TDEI,P= 0·049) and increased physical activity, but behaviourally reported greater dietary restraint (P= 0·002) compared with controls. TDEI, macronutrient intake and physical activity were similar between OSW and REL. REL reported higher subjective fasting and lower postprandial ratings of prospective food consumption compared with OSW. Weight-reduced women had similar RMR (adjusted for fat-free mass) compared with controls with no weight-loss history. Increased physical activity, higher protein intake and greater lean muscle mass may have counteracted weight loss-associated metabolic compensation and highlights their importance in weight-maintenance programmes.
Sex in the laboratory: the Family Planning Association and contraceptive science in Britain, 1929–1959
Authors: SZUHAN NATASHA
Published: June 2018

Scientific and medical contraceptive standards are commonly believed to have begun with the advent of the oral contraceptive pill in the late 1950s. This article explains that in Britain contraceptive standards were imagined and implemented at least two decades earlier by the Family Planning Association, which sought to legitimize contraceptive methods, practice and provision through the foundation of the field of contraceptive science. This article charts the origins of the field, investigating the three methods the association devised and employed to achieve its goal of effecting contraceptive regulation. This was through the development of standardized methods to assess spermicidal efficacy; the establishment of quality, strength and manufacturing standards for rubber prophylactics; and the institution of animal trials to ensure the safety of specific contraceptives. The association publicized the results of its scientific testing on proprietary contraceptives in its annual Approved List of contraceptives. This provided doctors and chemists with a definitive register of safe and effective methods to prescribe.
A Functional Analysis of “Horizon Styles” in Peruvian Archaeology
Authors: Willey Gordon R.
Published: June 2018

Since the beginnings of scientific archaeology in Peru investigators have employed the concept of the “horizon” or “horizon style” in attempting to reconstruct the major outlines of Central Andean prehistory. This formulation of the horizon is an abstraction based upon the recurrence of specific features of style or manufacture in prehistoric artifacts, ‘mainly pottery, from one region to another so that the phenomena become pan-Peruvian in scope and coordinate our knowledge of the past in a broad temporal and spatial scheme. This integration is made possible when the same stylistic or technical complex of traits is found in the respective culture sequences of geographically widely separated regions, and by this means the two or more sequences are brought together and equated in time. The constructs of horizons have been useful synthesizing elements in the understanding of Peruvian archaeology on the level of time-space systematics. As yet, however, there has been little consideration of their functional significance in the prehistoric native societies of which they were a part. This present exploratory analysis ventures to define and characterize as cultural forces on the level of social interaction what heretofore have been viewed chiefly as historical phenomena.
A Summary of the Racial History of the Peruvian Area
Authors: Newman Marshall T.
Published: June 2018

Studies of physical remains in aboriginal Peru have lagged behind those concerned with archaeology, and barely enough is known of Peruvian racial history to permit a synthesis at this time. Difficulties are three-fold: first, few physical anthropologists with a proper sense of problem have worked there; second, archaeologically documented skeletal series from Peru are not plentiful; and third, cranial deformation, while culturally of vital interest, tends to mask racial characters. Furthermore, sweeping generalizations from meager evidence by Imbelloni and others have persuaded the uncritical that the racial problems of the aboriginal Peru-Bolivian area have been largely solved. Actually, physical anthropology in Peru as compared to the archaeology is just entering the Uhle stage of rigorous scientific method. Now is the time, therefore, to reappraise our knowledge and to outline future research.
Towards Absolute Time: Guano Archaeology
Authors: Kubler George
Published: June 2018

The Peruvian records indicate that the guano islands (Fig. 14) yielded, between 1826 and 1875, several thousand artifacts of pre-Conquest origin. These are probably only a fraction of the archaeological material actually discovered during the commercial destruction of guano caps. Most of it has been lost; several hundred specimens in the museums of Europe and America still retain some record of their origin; and a small group of pieces, with which this paper is principally concerned, are known to have been discovered under stratified and depth-recorded conditions.
Stone Sculpture in the Callejón de Huaylas
Authors: Schaedel Richard
Published: June 2018

One of the most archaeologically significant characteristics of highland Andean cultures is the stone-sculpturing tradition. Most of the reports that have been published to date deal with the more spectacular sites of Tiahuanaco in the south highlands and Chavín de Huántar in the north highlands, but little has appeared to indicate the widespread existence of stone sculpture throughout the Peruvian highlands and the centers where the tradition is particularly strong. It is the purpose of this paper to summarize the stone sculpture in the Callejón de Huaylas area and to indicate its relationship to the accepted archaeological horizons in the north highlands.
Cultural Epochs and Refuse Stratigraphy in Peruvian Archaeology
Authors: Duncan Strong WM.
Published: June 2018

It is the purpose of the present paper to discuss, as briefly as possible, the manner in which major Peruvian cultural periods or epochs have been determined to the present and to suggest certain modifications as the result of recent objective, refuse-heap, stratigraphic studies, particularly those in the Virú Valley of Peru. It must be obvious to all students in the Peruvian field that our present terminology for major cultural epochs in prehistoric Peru is inconsistent and unsatisfactory. That this is due in considerable part to the recent great increases in stratigraphic knowledge makes such a re-evaluation even more necessary. Assuming, with Kroeber, “That the foundations of scientific archaeology in Peru were laid by Max Uhle,” and that, “the only general scheme of interpretation … not founded essentially on Uhle's” is that of Julio Tello, we will, very briefly, discuss these two major theoretical approaches.
The Columbia-Fraser Region and the Northwest Coast
Authors: Smith Marian W.
Published: June 2018

The archaeology of the Columbia-Fraser region in the southern Northwest Coast is more complicated than early generalizations woilld have led one to suspect. Although there has been a constant adaptation to a river and marine economy, variations within that economy are marked and may be tentatively identified by the presence of bone and stone carving, and by the proportion.of stone to bone tools. Using these criteria, four cultural phases may be recognized: (1) Late Bone, which ties with historically known Indian groups and occurs throughout the region. It has wood sculpture but no carving in bone or stone; there are a few ground stone artifacts but chipped stone is rare. (2) Early Bone, which has the greatest antiquity and is apparently the richest culture of the region, having elaborate carving in bone and stone, beaten copper, a large variety of bone artifacts, and a number of stone pieces both ground and chipped.
Implements
Authors: King Arden R.
Published: June 2018

Perhaps the most successful manner of presenting a description of artifacts without undue misinterpretation of original purposes of the objects is first to give a purely physical and processual description. This will be the plan followed here. The artifacts will first be classified as to technique of manufacture and secondly as to form. A comparative archaeological and ethnological section will follow the discussion of each artifact category in an endeavour to place it in time and space and to discover, as well, the uses to which it was put through a comparison with ethnological materials.
Paleoeskimo Occupations of Central and High Arctic Canada
Authors: McGhee Robert
Published: June 2018

Most of our knowledge regarding the Paleoeskimos of Arctic Canada is derived from the “core area” of Paleoeskimo occupation, a rough circle of some 1,000 km diameter including the coasts of Fury and Hecla Strait, Hudson Bay, and Hudson Strait. This is the area in which Dorset culture was first recognized, the source of most of our larger collections, and the area where continuity of development throughout the Paleoeskimo sequence has been demonstrated (Meldgaard 1962; Taylor 1968a; Maxwell 1973). The number and size of archaeological collections from this area suggest that it supported a larger Paleoeskimo population than did other regions of Arctic Canada, while the temporal distribution of components and continuities of style suggests that the region was occupied continuously throughout the Paleoeskimo period.

In the fringe areas surrounding this central core, continuous occupation has not yet been demonstrated through any major segment of the Paleoeskimo sequence. Work in these fringe areas has rapidly progressed during the past decade, and it now seems certain that most of the temporal gaps and cultural discontinuities are not the result of poor archaeological sampling but reflect a situation of sporadic occupation occurring at different times in different regions. One of the striking features of the Paleoeskimo population was its propensity for expanding and retracting its geographical range, and this is the phenomenon which this paper will attempt to document. The primary aim of the paper is to sort out who lived where and when; a secondary aim is to suggest how they may have got there and what happened to them.
Radiocarbon Dates on Samples from New York State
Authors: Ritchie William A.
Published: June 2018

Radiocarbon dates on charcoal samples from New York State have added significant new data to our knowledge of previously little known factors of chronology and continuity in the area. The dates have provided the lower portions of an apparently valid time scale upon which may be reared a more realistic three-dimensional picture of the prehistoric events of this portion of the United States.

Sample 191 was excavated by the writer from a hearth situated in the deepest refuse level in trench 4, section 4, of the Frontenac Island site, Cayuga County (Ritchie, 1945, pp. 6, 115, Plate 115). At Frontenac Island, an occupational component referable to the Lamoka focus appeared to precede the coming of Laurentian brachycephals with their specific cultural complex. The subsequent interaction of the two discrete peoples and cultures was evident in the physical remains, burial modes, and character of grave goods. The hearth, found on the lower level of the site, is presumed to pertain to the initial Lamoka- Laurentian contact. The radiocarbon dating yielded an antiquity of 4930 ± 260 years of elapsed time.
South American Radiocarbon Dates
Authors: Bird Junius
Published: June 2018

The Stratigraphic data on some of the Peruvian samples provide a fairly good basis for evaluating the radiocarbon date measurements in relation to each other. The accompanying chart (Fig. 1) was prepared to clarify what is bound to be tedious reading. On it the plotting of the radiocarbon dates is obvious. The insertion with them of sectional profiles of midden excavations may be confusing, but does show where the tested material was found. In one instance (382), although the tested sample did not come from this midden, it belongs chronologically at the level indicated. Knowledge of the nature of the structure between the various layers gives us further means of assessing the results. Thus it is possible to compare the date blocks, as we might call the total plus and minus time span, and to point out which portions cannot be reconciled and are therefore impossible and which portions are improbable. The remaining segments mark the periods within which the actual dates are most likely to fall.
Radiocarbon Dates and Their Implications in the Near and Middle Eastern Area, a Brief
Authors: Braidwood Robert J. , Jacobsen Thorkild , Parker Richard A. , Weinberg Saul
Published: June 2018

It is an unfortunate fact that the Near-Middle Eastern area, which has produced its share of the world's more spectacular antiquities, and which has been the focus of archaeological activity for so many years, has supplied but little material for the radiocarbon dating project. The dearth of specimens would seem to be due to two main factors. First, the general lack of attention hitherto given by excavators to non-artifactual materials (i.e., unworked wood, grain, etc.). Second, the understandable reluctance of museum curators to submit actual specimens of artifacts as samples, since they are destroyed in the process.
Radiocarbon Dating: A Summary
Authors: Johnson Frederick , Rainey Froelich , Collier Donald , Flint Richard F.
Published: June 2018

The Preceding discussions have considered the radiocarbon dates in relation to a number of archaeological, geological, and palynological problems. It remains to consider the endeavor as a whole, and to reach some conclusions concerning its present and future value and usefulness. Of primary importance is a consideration of what the dates mean. Basic to this is an understanding of the statistics involved. At the request of the Committee, Arnold, who has been intimately associated with the project, has kindly contributed the following explanatory paragraphs:

It seems worth while to review briefly the physical scientist's notions about the errors inherent in such measurements, as they apply to radiocarbon dates.
Hypotheses on Inner Asian Pastoral Nomadism and its Culture Area
Authors: Beardsley Richard K.
Published: June 2018

Considering the amount of attention that has been given to pastoral nomadism in studies of Asiatic cultures and their histories, one would expect that students of this subject would have reached agreement on the fundamentals. But on the contrary, expert views show a surprising amount of difference on important points. Discussions of pastoral nomadism often fail to coincide as to the nature of pastoral nomadism (i.e., what features are basic and essential), as-to its relationship with other types of culture, and as to its antiquity. These problems are increasingly acute when dealing with the question of whether or not a pastoral nomad culture area exists or has ever existed. Recent considerations of the subject include Bacon (1946, p. 123), Kroeber (1947, pp. 323-4), and Naroll (1950, p. 184). Kroeber raises the question of the validity of pastoral nomadism as a complete culture; Naroll side-steps the problem by referring to a “Steppe Area.”
The Significance of Recent Archaeological Discoveries in Inland Alaska
Authors: Rainey Froelich
Published: June 2018

Inland Alaska is undoubtedly one of the most discouraging areas for archaeological research in North America. But the fascinating theory of human migrations via Bering Strait has led several of us to search this critical territory of boreal forest and tundra for material evidence of the theory. Sites and collections of implements discovered so far are ridiculously small and scattered considering the size of the territory, yet as a while they may be significant.” I shall present here my own conclusions on the present significance of these materials—conclusions which reflect discussions with Giddings and Larsen but which do not convict them.

Reviewing what has been done in this field during the post-war years I cannot escape the conclusion that there is as yet no evidence whatever for the hypothetic migrations of men from Asia via the Bering Strait region during the Neolithic period, that is in the European sense of the term.
1. Cultural and Historical Background
Authors: Strong William Duncan
Published: June 2018

The present title suggests the emphasis of this paper, not its total content. Essentially, this is an advance report on the 1952-53 Columbia University archaeological expedition in the river valleys of the lea and Rio Grande de Nazca in south coastal Peru. The scope of this work was both intensive and extensive and the materials to be studied so numerous and varied that final publication will take time. For this reason it seems well to first present a brief, but carefully considered, outline of our major findings. Even this has had to wait until painstaking analyses had been made in the laboratory.
4 Description of the Farming Sites
Authors: Woodbury Richard B.
Published: June 2018

Although there are many farming sites in the Point of Pines area, only ten are described here in detail. These ten sites are representative of the variety of topographic situations and types of farms, and provide an adequate sample for studying the prehistoric agricultural practices of the area. Summary data on the ten sites are presented at the end of this chapter (Table 4).

About 8 miles west-northwest of the Point of Pines field school and about a mile south of Clover Well, on a small promontory overlooking Clover Basin, are the remains of a small village partly surrounded by farms or garden plots. The location today is in grass, with scattered juniper and ponderosa pine, and the surface is littered with basalt boulders (Fig. 4). At many places the boulders appear concentrated in lines and a little study reveals the pattern shown in the map (Fig. 3).
2 The Cemetery and Other Features
Authors: Greenwood Roberta S.
Published: June 2018

A Well Defined cemetery was located at a distance approximately 75 feet west and 20 feet south of the geographical center of the site. It covers an area about 20 feet square, containing 14 burials and the fragments of undoubtedly many others, and 12 lithic features. Six other rock features were discovered elsewhere and will be described separately.

Within the burial area, the features were dispersed rather more widely than the bone itself. Four discrete burials were found within one five-foot pit, and two each within four tangential squares. Almost all of the bone lay at a depth of 18 to 24 inches with the interments resting on large sandstone boulders on the occupation base of tan-colored sand with streaks of clay. At this depth the earth no longer shows the darker brown color typical of the deposit, but does exhibit small flecks of charcoal and bits of burned sandstone.
5 All Other Remains
Authors: Greenwood Roberta S.
Published: June 2018

Perhaps the most remarkable discoveries at the Browne site are the two effigy-like sculptures in-the-round. The larger of these was found in situ in undisturbed soil at a depth of one foot. It lay dorsal aspect uppermost in a portion of the site which yielded many of the grinding tools, and was within 10 inches of a mano. It measures 16.5 cm. in length, 11.8 cm. in diameter at the mid-point, and 7.5 cm. in height. It weighs 2,834 gr.

The figure is a thoroughly sophisticated work of art with masterly handling of the plane surfaces and a delicate balance from both front to back and side to side. Although at first glance it resembles a fish, the absence of fishing equipment and skeletal remains makes it improbable that fish were either economically or ritually important at the site and therefore would be unlikely subjects for the artist. It is more likely the representation of a toad or frog. The protuberant eyes, pointed jaw, and V-shaped mouth all suggest an amphibian or some intermediate evolutionary form.
V. The Conclusions from the Experiment
Authors: Mueller James W.
Published: June 2018

In this experiment, the frequencies of occurrence of prehistoric cultural traits have been used to evaluate various alternatives of the process of sampling a hypo the tic ally unknown region. The sampling process is manifestly useful in archaeological survey.

The experimental results are only as valid as the methods, data, and theory on which the results are based. The sampling theory has been presented in Chapter III. Therefore, a synopsis of the research methods of the Paria Plateau survey is presented in this section so that the reader can continue to evaluate the data and the results of the experiment.

As frequently happens in contract archaeology, the topic of this experiment was formulated after the completion of the fieldwork. Therefore, the experiment depends on data that were collected to solve non-sampling problems. If the problem of this study had been conceived prior to fieldwork, it would have been possible to collect interval level data (such as the area of the site, of surface refuse, and of dwelling units) and to perform controlled, probabilistic surface collections. This would have added 2 interval variables—artifact and debris densities—and allowed for the employment of more powerful statistical tests.
Chapter 1: Theoretical Foundations
Authors: Weiss Kenneth M.
Published: June 2018

The approach to population structure followed in this work is that of stable population theory as developed by A. J. Lotka and others. An early exposition of this theory is found in Lotka (1956); more recently it has been summarized by Coale (1972), Keyfitz (1968), and Shryock and Siegel(1971).

The theory of stable populations requires that a population is infinite in size, has no net immigration or outmigration, and has fixed rates of fertility and mortality at each age. These assumptions are often approximated closely enough by real populations for the theory to be useful. Given the stated conditions, a population is described by its age distribution, or the number of individuals at each age. Since the theoretical population is infinite, the age distribution is defined in terms of relative numbers or percentages rather than finite numbers of individuals at each age.

The age structure is determined by the rates of mortality and fertility. It has been proved by Lotka that, no matter what the initial age distribution, a population under these assumptions approaches a certain age distribution which is determined by those rates. The result is the so-called stable age distribution since it will no longer change if mortality and fertility remain fixed. In fact, a temporary perturbation in these rates will only temporarily disturb the age distribution, which will quickly return to the stable form. Human populations approach the stable age distribution in well under 100 yr after the rates become fixed.
Chapter 9: The History of Human Life Expectancy
Authors: Weiss Kenneth M.
Published: June 2018

Many authors have written comparative articles on the history of human mortality and life expectancy; for example, see Acsádi and Nemeskéri (1970), Angel (1969), Brothwell (1971), Gejvall (1960), Genovés (1969), Goldstein (1953), Howells (1960), Kobayashi (1967), Russell (1958), Şenyürek (1951), Todd (1927), Vallois (1937, 1960). These studies are based on skeletal or historical material. Many of these studies have been used as data sources earlier in this work, and in fact several of the same data series are used by many of these authors.

Drawing on many of these sources, Deevey (1960) has recently analyzed the history of human life expectancies. This article has been reprinted and cited more than the others combined, and the life expectancies given by Deevey are used in many textbooks of ecology and anthropology. Deevey acknowledges the poorness of his source data, in particular the lack of juvenile skeletons. He also stresses that his life expectancies are only the adult mean ages at death. Yet, since Deevey's values are frequently taken as representative of total life expectancy, it seems appropriate to reexamine them in the light of this work and of material published since his paper. The life expectancies given by Deevey are shown in Table 22.