The Early Paleolithic Go Da Site and the Bifacial Lithic Industries of Southeast Asia

The lithic industry of the stratified site Go Da in Central Vietnam is described, and its place among the contemporaneous Early Paleolithic sites of East and Southeast Asia is determined. Results of a morphological technotypological analysis of the Go Da assemblage are provided. Go Da is attributed to the An Khe-type sites situated in the eponymous area of Vietnam. Cores and tools were made from pebbles, less often from fl akes. Primary reduction focused on simple pebble cores with natural striking-platforms, whereas radial cores were less common. Predom inant among the tools are picks, scrapers of various modifi cations, choppers, and chopping tools, as well as denticulate and notched tools; also, bifaces occur. These tools belong to a single homogeneous industry, showing common features in primary reduction, preparation, and design of key artifacts. On the basis of analysis of the stratigraphic sequence of Go Da and the absolute date of 806 ± 22 ka BP, generated by the potassium-argon analysis of tektites, it is proposed that the site is older than other dated locations with the An Khe industry. Apparently, it resulted from a convergent evolution of the pebble-fl ake industry introduced by the fi rst wave of Homo erectus from Africa. Go Da and other An Khe sites likely belong to a vast habitation zone of Southeast Asian hominins with technologically and typologically similar industries dating to the boundary between the Lower and the Middle Pleistocene.

How to Approach Secondary Breast Reduction: International Trends and a Systematic Review of the Literature

Background Secondary breast reduction is complex and poses significant challenges to surgeons. Complication rates exceed those of primary reduction, commonly caused by impaired vascular supply of the nipple-areolar complex (NAC). Literature on the topic is scare and provides contradicting recommendations, especially with regard to pedicle choice in cases with unknown primary reduction technique. Aim of this study was to investigate international trends and to compare findings with literature. Methods A large-scale web-based questionnaire on international trends in mammaplasty (mastopexy and breast reduction) was designed and distributed to over five thousand surgeons in eight geographic regions. The presented manuscript evaluated information regarding pedicle choice in secondary breast reduction and compared data to literature identified in a systematic review. Results The survey was completed by 1431 participants. Overall, secondary procedures were performed in less than 5% or in 5 to 10% of cases. The preferred pedicle for secondary reductions differed significantly between geographic regions (p<0.001). The majority of respondents reported to use a superior or supero-medial pedicle (34.8% and 32.2%, respectively). Residual analysis revealed a strong association between the use of an inferior pedicle and procedures performed in North America. Conclusions Secondary breast reduction is challenging and there remains international disparity with regard to pedicle choice for secondary procedures. Studies investigating outcome when the primary pedicle is unknown are scarce and provide incoherent recommendations. High-quality data is needed to provide evidence-based practice guidelines. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

PERBANDINGAN METODE PRELOADING DENGAN VAKUM KONSOLIDASI TANAH PADA PEMODELAN DI LABORATORIUM

ABSTRACT This study aims to determine the parameter comparison of the magnitude of the primary reduction and consolidation time in the preloading method using PVD and vacuum method using PVD with modeling in the laboratory. The benefit of this research is that it can provide a comparison of the preloading method and the vacuum method in terms of accelerating the consolidation time as well as contributing to science in the field of soil improvement. Primary consolidation theory is used in this research. Quantitative descriptive research method with testing data collection techniques by means of modeling in the laboratory. The modeling of the vacuum method used a test tub measuring (1.2 × 0.6 × 0.9) m, the vacuum pump suction capacity of 5 Pa, the air hose as PHD and geomembrane cloth as PVD material. The preloading method with PVD uses a test tub measuring (0.8 × 0.6 × 0.9) m, preloading load in the form of bangka sand (ɣ = 1.532 t / m³) with a thickness of 10 cm and a geomembrane cloth as PVD material. In each test basin filled with soil and water with a soil volume weight of 1.3 t / m³, a ground surface height of 0.5 m and a groundwater level of 0.42 m. The results showed that with the same amount of reduction, namely 7.26 mm preloading method using PVD took 81 hours while in the vacuum method the time needed was 41 hours. Thus it can be concluded that the reduction in the vacuum method is faster than the preloading method with PVD. Keywords: Primer settelment, PVD, Vacum, consolidation time

Primary reduction technology in the Sukhaya Mechetka site assemblage

The Sukhaya Mechetka site in the Lower Volga region being widely known due to the unique preservation of cultural remains, their clear geological position and a rich set of tools has long become a kind of icon of the Middle Paleolithic of Eastern Europe. Improtantly the site was excavated over a wide area (about 650 square meters). During the excavation an assemblage of stone items including more than 350 tools, cores and about 10,000 flint and quartzite flakes of various types was collected. The neogene flint and the paleogene quartzite were used as raw materials approximately equally. According to our observations almost all available and suitable for processing stone rocks that were carried to the site as nodules, blocks, fragments and flakes were intensively used. Raw materials were collected in the immediate vicinity of the site. The signals of raw materials shortage and significant depth of its processing were detected. The distribution of the products of flint and quartzite raw materials on the site is irregular. Primary knapping was carried out according to typical Middle Paleolithic technologies. A small series of stone hammers display specific patterns of their use-wear. The cores and the flakes produced with these hammers were found. The complete sequence of preparation and flaking from the pre-cores to the residual forms has been documented. The shortage of high-quality raw material resulted in extremely complete usage of the most cores. Additionally many residual forms have been used for making tools. The cores can be divided into radial, cuboid and Levallois samples.

A clinicopathologic study of intussusception in Nepalese adults

Introduction: Intussusception is rate in adults and is usually secondary to a definable pathology. This study was designed to review adult intussusception, including presentation, diagnosis, and pathology. Methods: A retrospective study of 18 cases of intussusception in individuals older than 18 years of age visiting the department of surgery of Civil Service Hospital from 2010 to 2018 was done. Results: There were 18 cases of adult intussusception. The mean age was 49.2 years (range 19-84 years). Abdominal pain and vomiting were the commonest symptoms. The median duration of presentation was 5 days (range 20 hours to 10 months). Three patients (16.6%) presented with generalized peritonitis. There were eight ileocolic, seven ileoileal, and three colocolic intussusceptions. Two patients (11.1%) settled spontaneously. Twelve out of the 18 patients (66.6%) had leading lesions. Benign pathologies were seen in seven cases (38.8%) and malignant in five patients (27.7%). All malignancies were in the large bowl Conclusions: Adult intussusception is a rare entity, nearly one-third of their causes are malignant. Surgery is the best recommended treatment, with or without a primary reduction of the intussusception; the latter can result in more limited bowel resection.

Association of secondary displacement of distal radius fractures with cortical bone quality at the distal radius

Introduction The aim of this study was to investigate the associations of patient characteristics, bone mineral density (BMD), bone microarchitecture and calculated bone strength with secondary displacement of a DRF based on radiographic alignment parameters. Materials and methods Dorsal angulation, radial inclination and ulnar variance were assessed on conventional radiographs of a cohort of 251 patients, 38 men and 213 women, to determine the anatomic position of the DRF at presentation (primary position) and during follow-up. Secondary fracture displacement was assessed in the non-operatively treated patients (N = 154) with an acceptable position, preceded (N = 97) or not preceded (N = 57) by primary reduction (baseline position). Additionally, bone microarchitecture and calculated bone strength at the contralateral distal radius and tibia were assessed by HR-pQCT in a subset of, respectively, 63 and 71 patients. Outcome Characteristics of patients with and without secondary fracture displacement did not differ. In the model with adjustment for primary reduction [OR 22.00 (2.27–212.86), p = 0.008], total [OR 0.16 (95% CI 0.04–0.68), p = 0.013] and cortical [OR 0.19 (95% CI 0.05–0.80], p = 0.024] volumetric BMD (vBMD) and cortical thickness [OR 0.13 (95% CI 0.02–0.74), p = 0.021] at the distal radius were associated with secondary DRF displacement. No associations were found for other patient characteristics, such as age gender, BMD or prevalent vertebral fractures. Conclusions In conclusion, our study indicates that besides primary reduction, cortical bone quality may be important for the risk of secondary displacement of DRFs.

Effect of Sample Preparation Pressure on Transformation Law of Low-Valent Titanium Oxide in a Multi-Stage Reduction Process

A novel method for preparing titanium powder by multi-stage reduction of TiO2 was proposed. Its core is the preparation of high-quality low-valent titanium oxide. In this paper, the effect mechanism of different sample preparation pressures on the preparation of low-valent titanium oxide by the primary reduction (self-propagating high-temperature synthesis mode, SHS) of the Mg-TiO2 system was studied. The results show that the generation of Mg thermal fluid is the key link of the self-sustaining chemical reaction of the Mg-TiO2 system. Titanium exists inα-Ti and TiO at the end of combustion, and constitutes a non-stoichiometric low-valent titanium oxide. The sample preparation pressure determines the proportion of pores reserved for Mg diffusion in the compacts and the contact area of the reactants, thereby determining the partitioning behavior and heat transfer effect of Mg thermal fluid during the combustion process. When the sample preparation pressure is 75 MPa (relative density is 0.66 ± 0.01), the combustion effect is optimal, and the low-valent titanium oxide with oxygen content of 15.1% can be obtained. It was subjected to deep reduction to obtain a titanium powder product with an oxygen content of 0.27%.

A Technological and Typological Analysis of Lithic Material from Skovmosen I, Denmark

During road construction work, material attributed to the Final Palaeolithic was discovered at Skovmosen I, near Kongens Lyngby on Zealand, eastern Denmark. Although it is regularly mentioned in reviews of the southern Scandinavian Final Palaeolithic, the Skovmosen I assemblage has hitherto remained poorly described. We here review the site’s discovery history and its context. Aided by a three-dimensional digital recording protocol, this article details the assemblage composition and its technology. The assemblage is comprised of tanged points, scrapers and burins, alongside blades and cores as primary reduction products. Although evidently disturbed by the road construction that led to the site’s discovery, the material likely reflects the remains of a small Final Palaeolithic locale, where diverse activities were carried out.

Nasal Fractures: The Role of Primary Reduction and Secondary Revision

The nasal bones are among the most commonly fractured bones in the facial skeleton. Proper management of nasal trauma acutely is important in minimizing secondary deformities and impaired function with nasal airway obstruction. Septal hematoma, if present, should be drained right away. Acutely closed nasal reduction and limited septoplasty can be performed. Unrecognized septal fracture may play a role in the failure of closed nasal reduction of fractured nasal bones. Complex nasoorbitoethmoid fractures are approached openly and treated with rigid fixation. Primary use of open rhinoplasty in an acute setting is debated, and there are no clearly accepted indications for timing, patient selection, and surgical technique. However, open septorhinoplasty is more commonly used in a delayed fashion to provide definitive correction of any residual cosmetic or functional problems. Recent algorithms provide a systematic approach to nasal trauma and may improve secondary deformity rates following closed reduction.