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The status of risk factors and disease remains a disputed question in the theory and practice of medicine and healthcare, and so does the related question of delineating disease boundaries. I present a framework based on Bernard Lonergan’s account of emergent probability for differentiating (1) generically distinct levels of systematic function within organisms and between organisms and their environments and (2) the methods of functional, genetic, and statistical investigation. I then argue on this basis that it is possible to understand disease in terms of biological or higher intra-level dysfunction, risk factors—including genetic risk factors—in terms of statistical inter-level conditioning of a given stage or developmental sequence of systematic functioning, and the empirical boundaries of disease in terms of the limits of both functional categorization (from an epistemic standpoint) and upper-level integration of lower-level processes and events (from an ontological standpoint).

The safe and effective management of pain is a critical healthcare and societal need. The potential for misuse and addiction associated with opioids, nephrotoxicity, and gastrointestinal damage from chronic non-steroidal anti-inflammatory drug (NSAID) use, as well as acute liver injury from paracetamol (ApAP) overdose, are unresolved challenges. To address them, we developed a non-opioid and non-hepatotoxic small molecule, SRP-001. Compared to ApAP, SRP-001 is not hepatotoxic as it does not produce N-acetyl-p-benzoquinone-imine (NAPQI) and maintains hepatic tight junction integrity at high doses. SRP-001 has comparable analgesia in pain models, including the complete Freund’s adjuvant (CFA) inflammatory von Frey. Both induce analgesia via N-arachidonoylphenolamine (AM404) formation in the midbrain periaqueductal grey (PAG) nociception area, with SRP-001 generating higher amounts of AM404 than ApAP. Single-cell transcriptomics of PAG uncovered that SRP-001 and ApAP also share modulation of pain-related gene expression and cell signaling pathways, including the endocannabinoid, mechanical nociception, and fatty acid amide hydrolase (FAAH) pathways. Both regulate the expression of key genes encoding FAAH, 2-AG, CNR1, CNR2, TRPV4, and voltage-gated Ca2+ channel. Interim Phase 1 trial results demonstrate SRP-001’s safety, tolerability, and favorable pharmacokinetics (NCT05484414). Given its non-hepatotoxicity and clinically validated analgesic mechanisms, SRP-001 offers a promising alternative to ApAP, NSAIDs, and opioids for safer pain treatment.

Lockdowns were widely used to reduce transmission of COVID-19 and prevent health care services from being overwhelmed. While these mitigation measures helped to reduce loss of life, they also disrupted the everyday lives of billions of people. We use data from a survey of Singaporean citizens and permanent residents during the peak of the lockdown period between April and July 2020 to evaluate the social and economic impacts of Singapore’s COVID-19 mitigation measures. Over 60% of the population experienced negative impacts on their social lives and 40% on household economics. Regression models show the negative economic impacts were influenced by socio-economic and demographic factors that align with underlying societal vulnerabilities. When dealing with large-scale crisis’ like COVID-19, slow-onset disasters, and climate change, some of the burdens of mitigation measures can constitute a crisis in their own right – and this could be experienced unevenly by vulnerable segments of the population.

The 2015 Nepal earthquakes devastated the Kathmandu Valley and exposed the challenges of conserving andrestoring architectural heritage in historic urban neighborhoods damaged by disasters, while also trying to rapidly rebuild houses, revitalize livelihoods, and reduce vulnerabilities to future hazards. In this paper we use quantitative and qualitative data to investigate how traditional housing was transformed during the post-earthquake reconstruction of four historic neighborhoods in the Kathmandu Valley. We assess how traditional housing stock in these neighborhoods was transformed by a combination of the direct impact of the earthquake; the enforcement of seismic-resistant modern building technology; the costs and logistics of rebuilding; and the priorities of local residents. Our findings indicate that the enforcement of seismic safety building codes and the expense of incorporating traditional architectural elements led to notable changes to the tangible cultural heritage of Kathmandu's historic urban neighborhoods, but likely also improved seismic safety., International Journal of Disaster Risk Reduction, 86, ISSN:2212-4209

Skin and wound blotting are non-invasive techniques used to sample the skin and wound surface chemistry, whereby a nitrocellulose membrane is applied to an intact or broken cutaneous surface to detect biomarkers. However, there has been no comprehensive review of the evidence for the techniques used and data obtained to date. The primary aim of this study was to review the utilities of surface blotting for the diagnosis and prognosis of physiological, pre-disease, and pathological states. The secondary aim was to summarise the procedural steps. A systematic literature search was conducted on 9 July 2021 using Medline, Embase, and Google Scholar databases. Investigators used McMaster's Critical Review Form for Quantitative Studies to assess quality, then performed a narrative synthesis reporting according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-five studies were reviewed. Eighteen studies were of good quality, and seven were of moderate quality. These studies conducted skin and wound blotting on 176 animals and 1546 humans. Studies reported physiological and pathological states for diagnosis and prediction of conditions, including skin tears, wound healing, biofilm detection, and skin barrier function. The four steps for blotting are surface preparation, blot preparation, application and removal of blot, and analysis. This review demonstrates that blotting can determine the skin and wound surface chemistry using a versatile and reproducible technique. However, future research is needed to validate the technique and skin biomarkers identified.

This study presents a distinctive type of Muslim gravestone found on the northern coast of Sumatra, Indonesia, that dates to the 15th century. These grave markers, locally known as plang-pleng, pro...

On 12 November 1970, the Bhola Cyclone swept across the southern districts of East Pakistan, killing over 300,000 people. Small islands were swept away and dead bodies of humans and cattle lay strewn across the devastated landscape. Following the news of the destruction, journalists, students, artists, and political workers rushed to the affected area with basic relief supplies, without waiting for the Military Law Administration (MLA) to intervene. The cyclone's occurrence just three weeks prior to the first general elections in Pakistan added a new dimension to the already simmering political crisis. The extensive media coverage of the disaster brought the pitiful state of infrastructural development and lack of governance in East Pakistan under local and global scrutiny. The cyclone and the corresponding issues soon became embroiled within the larger political demand for regional autonomy. The MLA came under attack from sections of East Pakistan's politicians, press, and public, as well as international political actors, for its poor disaster governance. This article uses the Bhola Cyclone of 1970 as the lens to explore the complex interconnections between environmental disasters and a key issue of governance. While the Bhola Cyclone has been a subject of recent discussions, this article uses a disaster-politics analytical framework to understand the disaster's role in the subsequent political turbulence and the emergence of Bangladesh. Ministry of Education (MOE) National Research Foundation (NRF) Published version

Significance We demonstrate that a tsunami in the late 14th century CE destroyed coastal sites along a critical part of the maritime Silk Road and set in motion profound changes in the political economy of Southeast Asia. Our results provide a precise chronology of settlement and trade along a historically strategic section of the Sumatran coast and are robust physical evidence for the rise of the Aceh Sultanate. Tragically, coastal areas impacted by the late 14th century tsunami were devastated by the 2004 Indian Ocean tsunami. This makes our findings relevant to debates about hazard mitigation and risk reduction. This example shows that archaeological, historical, and geological data are relevant in discussions about the long-term sustainability of communities exposed to geological hazards., Archaeological evidence shows that a predecessor of the 2004 Indian Ocean tsunami devastated nine distinct communities along a 40-km section of the northern coast of Sumatra in about 1394 CE. Our evidence is the spatial and temporal distribution of tens of thousands of medieval ceramic sherds and over 5,000 carved gravestones, collected and recorded during a systematic landscape archaeology survey near the modern city of Banda Aceh. Only the trading settlement of Lamri, perched on a headland above the reach of the tsunami, survived into and through the subsequent 15th century. It is of historical and political interest that by the 16th century, however, Lamri was abandoned, while low-lying coastal sites destroyed by the 1394 tsunami were resettled as the population center of the new economically and politically ascendant Aceh Sultanate. Our evidence implies that the 1394 tsunami was large enough to impact severely many of the areas inundated by the 2004 tsunami and to provoke a significant reconfiguration of the region’s political and economic landscape that shaped the history of the region in subsequent centuries.

Background:Outpatient clinics play a vital role in assessing and treating patients. They traditionally involve face-to-face consultation with a clinician to diagnose and treat many medical and surgical conditions. During the COVID-19 pandemic many of these traditional methods were replaced with telemedicine to minimise patient interaction and therefore potential exposure. This study utilises data from patient questionnaires with the aim of determining patient satisfaction in regard to telemedicine.Method:A list of patients who attended the Rockingham General hospital outpatient Orthopaedic phone clinic was obtained between 23rd of March and 30th of May, this list was then filtered into a randomised generator to provide a call list of patients. Patients were contacted and verbal consent was obtained to participate in satisfaction questionnaire that was completed via phone.Results: A total of 100 patients completed the questionnaire - 50 from elective surgery clinics and 50 from fracture clinics. The mean time for participants’ one-way commute to the hospital was 21 minutes (2 to 60 minutes). Only 4% of telehealth consultations resulted in patients being forced to miss work or school. 13% of patients were required to attend the hospital on the day of their consultation for either radiological imaging or for application or removal of casts or splint. We observed consistently high satisfaction scores across all parameters, in both elective and fracture clinics, culminating in a mean score of 9.08/10 on the Likert scale. In the qualitative component of the questionnaire, patients frequently acknowledged a high quality of care despite adverse circumstances.Conclusion:Telemedicine continues to develop and become a more widely accessible tool in the provision of outpatient orthopaedic care. With its ever-increasing availability and acceptance, it should play a more central role in delivering effective and efficient healthcare to all patients.

We present archaeological evidence for a trading settlement dating from the 13th to the mid-16th century ce on an elevated headland in Lamreh village about 30 km east of Banda Aceh, on the northern coast of Sumatra, Indonesia. We propose this site was part of historic Lamri, known from documentary sources as an important node in the maritime “silk road” between the 9th to 16th centuries CE. Our landscape archaeological survey revealed large concentrations of ceramics on the headland that span from the early 13th through the mid-16th century, some of them of imperial quality. Several of the Muslim grave markers at this site are of a distinctive type and date across nearly the entire range of the 15th century. Geological evidence suggests low-lying parts of Lamri were destroyed by a major tsunami at the end of the 14th century. However, our data show that activity on the elevated headland continued until the site was abandoned in the mid-16th century. The lack of material culture dating from the 9th to 13th centuries suggests that earlier textual references to Lamri referred more generally to a broad stretch of the north Sumatran coast, with the headland in Lamreh village emerging as the geographic centre of historic Lamri after the turn of the 13th century., Nous présentons les preuves archéologiques d’un établissement commercial datant du XIIIe au milieu du XVIe siècle EC sur un promontoire élevé du village de Lamreh, à environ 30 km à l’est de Banda Aceh, sur la côte nord de Sumatra, en Indonésie. Nous l’identifions au site historique de Lamri, décrit par les sources textuelles comme un noeud important de la « route de la soie » maritime entre le IXe et le XVIe siècle EC. Notre prospection a révélé de grandes concentrations de céramiques sur le promontoire, qui datent du début du XIIIe siècle jusqu’au milieu du XVIe siècle, certaines de qualité impériale. Plusieurs des stèles funéraires musulmanes de ce site sont d’un type particulier et datent de la quasi-totalité du XVe siècle. Les données géologiques suggèrent que les parties basses de Lamri ont été détruites par un fort tsunami à la fin du XIVe siècle. Cependant, nos données montrent que l’activité sur le promontoire s’est poursuivie jusqu’à ce que le site soit abandonné au milieu du XVIe siècle. L’absence de culture matérielle datant du IXe au XIIIe siècle suggère que les références textuelles antérieures à Lamri se référaient plus généralement à une grande partie de la côte nord de Sumatra, le village de Lamreh ne devenant le centre géographique du Lamri historique qu’après le tournant du XIIIe siècle., Daly Patrick t., McKinnon E.E., Feener R.Michael, Yew Seng Tai, Ardiansyah , Parnell Andrew, Nizamuddin , Ismail Nazli, Sieh Kerry, Majewski Jedrzej. The Historic Trading Port of Lamri on the North Sumatran Coast. In: Bulletin de l'Ecole française d'Extrême-Orient. Tome 105, 2019. pp. 115-144.

With coastal populations growing and sea levels rising, reconstruction decisions after coastal disasters are increasingly consequential determinants of future societal vulnerability and thus the sustainability of development. The humanitarian sector tends to favour rebuilding in-place to avoid the social disruptions of mass relocation, yet evidence on what affected people want is mixed. Using the case of post-tsunami Banda Aceh, Indonesia, we investigate whether a policy to rebuild in-place in the disaster-affected area suits an urban population that was previously unaware of the hazard. We show that following the tsunami, a substantial proportion of the population prefers to live farther from the coast. This has caused a new price premium for inland properties and socio-economic sorting of poorer households into coastal areas. These findings show that offering reconstruction aid predominantly within a hazard-exposed area can inadvertently transfer disaster risk to the poor. Post-disaster reconstruction in hazard-exposed areas can increase social vulnerability if a disaster changes where people wish to live. In a post-tsunami zone in Indonesia, the authors find that many people wish to move to safer areas, causing housing prices to go up inland and the poor to live near the coast.

This paper, based on a participatory methodological framework involving expert stakeholders and researchers from six European countries (Germany, Ireland, Poland, Spain, Sweden and UK), analyses the priority issues for the development of short-rotation plantations (SRP), and proposes a series of policy strategies to strengthen this development. The results indicate that there is a lack of awareness of the multifaceted benefits of SRP at the level of farmers, policy makers and public authorities. More research is required to put a value on the multifunctionality of SRP and justify its public support. Small-scale projects using established technologies are also required with energy crops introduced in a phased manner. The simultaneous dissemination of this knowledge upwards to policy makers and downwards to producers and farmers is critical in the success of SRP. Also, greater financial support on both the supply and demand side is highlighted as being necessary: on the supply side linking multifunctional benefits of SRP and targeted payments, along with increased long-term contractual arrangements between farmers and energy plant operators; demand side incentives should overcome any difference in price between fossil fuels and energy crops. Groups to lobby for the uptake and support of SRP and bioenergy are also of necessary.

In this introduction to a special subsection of Theoretical Medicine and Bioethics comprising separate reviews of the Springer Handbook of the Philosophy of Medicine, The Routledge Companion to Philosophy of Medicine, and The Bloomsbury Companion to Contemporary Philosophy of Medicine, I compare the three texts with respect to their overall organization and their approach to the relation between the science and the art of medicine. I then indicate two areas that merit more explicit attention in developing a comprehensive philosophy of medicine going forward: health economics and systematic relations within the field as a whole. The reviews that follow speak for themselves.

This paper presents GIS time-series land-use analysis of satellite images to quantify the recovery of rice cultivation and aquaculture following the 2004 Indian Ocean tsunami in coastal communities in Aceh, Indonesia. We supplement this with qualitative data to illustrate the post-disaster challenges faced by residents, and the extent to which coastal communities have adapted to post-tsunami realities. Our analysis shows that the rehabilitation of rice cultivation and aquaculture in areas inundated by the tsunami has been limited by extensive degradation of land, diversion of labor by tsunami mortality and transition to alternative livelihoods, and re-purposing of rice fields for residential use during the reconstruction phase. This is especially prominent in areas where subsistence activities are not the primary source of livelihood. The Aceh case study shows that social, economic, and environmental factors can be stronger determinants of how coastal livelihoods rebound and change following destructive inundation events than livelihood rehabilitation aid. Additionally, our case study suggests the human impact of coastal hazards can be felt outside the physical extent of inundation. Ministry of Education (MOE) National Research Foundation (NRF) Published version The results in this paper are part of the Aftermath of Aid project, a collaboration between the Earth Observatory of Singapore, the International Centre for Aceh and Indian Ocean Studies, and Syiah Kuala University. This research is supported by the National Research Foundation Singapore, and the Singapore Ministry of Education under the Research Centres of Excellence initiative. This work comprises Earth Observatory of Singapore contribution no. 147.

This paper presents a field study on the long-term effectiveness and sustainability of livelihood interventions following the 2004 Indian Ocean tsunami in Aceh, Indonesia. We assess the extent to which post-tsunami aid in Aceh helped beneficiaries to stabilize and restore their pre-disaster livelihoods, and/or develop new livelihoods. We draw upon qualitative data captured in 183 in-depth interviews and 38 focus group discussions involving village leaders, livelihood aid participants, and NGO workers. Our results show that livelihood assistance helped people stabilize their household finances and partially restore their pre-disaster livelihoods. Furthermore, we found that aid programs were able to help some people without pre-disaster livelihood experience to participate in part-time, ad hoc work. However, aid packages were generally not able to support the development of full-time, sustainable new livelihoods for people lacking pre-disaster training and experience. Our data suggests that it is difficult to conduct efficient and sustainable livelihood development initiatives within the time pressures and current institutional approaches to large-scale post-disaster reconstruction., International Journal of Disaster Risk Reduction, 49, ISSN:2212-4209

We review published literature and historical texts to propose that three periods of official Chinese maritime bans impacted the composition and circulation of trade ceramics along Asian trade routes: Ming Ban 1 (1371 – 1509), Ming Ban 2 (1521 – 1529), and Qing Ban (1654 – 1684). We use ceramics collected during a landscape archaeology survey along 40km of coast in Aceh, Indonesia to show how the three ban periods manifest in the ceramic record of settlements along an important stretch of the maritime silkroad. All three ban periods overlap with reductions in the quantity of Chinese ceramics. Within several decades of the start of Ming Ban 1, people in Aceh began importing ceramics from production centers in Burma and Thailand as a substitute for Chinese ceramics. Following Ming Ban 2, there is an increase in imports from Chinese production centers, albeit from new kilns sites. While brief, the Qing ban resulted in an almost immediate influx of ceramics from Japan and Vietnam, which maintained some market share until the mid-17th century, after which Chinese ceramics dominate the record until the end of the Qing dynasty. Our data show both the importance of Chinese ceramics within regional trade networks and how those networks and local patterns of consumption adapted to disruptions of supply. Ministry of Education (MOE) National Research Foundation (NRF)

Background Transient receptor potential vanilloid 2 is a calcium channel activated by probenecid. Probenecid is a Food and Drug Administration–approved uricosuric drug that has recently been shown to induce positive lusitropic and inotropic effects in animal models through cardiomyocyte transient receptor potential vanilloid 2 activation. The aim of this study was to test the hypothesis that oral probenecid can improve cardiac function and symptomatology in patients with heart failure with reduced ejection fraction and to further elucidate its calcium‐dependent effects on myocyte contractility. Methods and Results The clinical trial recruited stable outpatients with heart failure with reduced ejection fraction randomized in a single‐center, double‐blind, crossover design. Clinical data were collected including a dyspnea assessment, physical examination, ECG, echocardiogram to assess systolic and diastolic function, a 6‐minute walk test, and laboratory studies. In vitro force generation studies were performed on cardiomyocytes isolated from murine tissue exposed to probenecid or control treatments. The clinical trial recruited 20 subjects (mean age 57 years, mean baseline fractional shortening of 13.6±1.0%). Probenecid therapy increased fractional shortening by 2.1±1.0% compared with placebo −1.7±1.0% ( P =0.007). Additionally, probenecid improved diastolic function compared with placebo by decreasing the E/E′ by −2.95±1.21 versus 1.32±1.21 in comparison to placebo ( P =0.03). In vitro probenecid increased myofilament force generation (92.36 versus 80.82 mN/mm 2 , P P Conclusions Probenecid improves cardiac function with minimal effects on symptomatology and no significant adverse effects after 1 week in patients with heart failure with reduced ejection fraction and increases force development and calcium sensitivity at the cardiomyocyte level. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique identifier: NCT 01814319.

We present stratigraphic, archeological and historical evidence for two closely timed predecessors of the giant 2004 tsunami on the northern coast of Aceh, northern Sumatra. This is the first direct evidence that a tsunami played a role in a fifteenth century cultural hiatus along the northern Sumatran portion of the maritime silk route. One seacliff exposure on the eastern side of the Lambaro headlands reveals two beds of tsunamigenic coral rubble within a small alluvial fan. Radiocarbon and Uranium-Thorium disequilibrium dates indicate emplacement of the coral rubble after 1344 ± 3 C.E. Another seacliff exposure, on the western side of the peninsula, contains evidence of nearly continuous settlement from ~1240 C.E. to soon after 1366 ± 3 C.E., terminated by tsunami destruction. At both sites, the tsunamis are likely coincident with sudden uplift of coral reefs above the Sunda megathrust 1394 ± 2 C.E., evidence for which has been published previously. The tsunami (or tsunami pair) appears to have destroyed a vibrant port community and led to the temporary recentering of marine trade dominance to more protected locations farther east. The reestablishment of vibrant communities along the devastated coast by about 1500 CE set the stage for the 2004 disaster.

The devastating 2004 Indian Ocean tsunami caught millions of coastal residents and the scientific community off-guard. Subsequent research in the Indian Ocean basin has identified prehistoric tsunamis, but the timing and recurrence intervals of such events are uncertain. Here we present an extraordinary 7,400 year stratigraphic sequence of prehistoric tsunami deposits from a coastal cave in Aceh, Indonesia. This record demonstrates that at least 11 prehistoric tsunamis struck the Aceh coast between 7,400 and 2,900 years ago. The average time period between tsunamis is about 450 years with intervals ranging from a long, dormant period of over 2,000 years, to multiple tsunamis within the span of a century. Although there is evidence that the likelihood of another tsunamigenic earthquake in Aceh province is high, these variable recurrence intervals suggest that long dormant periods may follow Sunda megathrust ruptures as large as that of the 2004 Indian Ocean tsunami., Tsunamis can be an extremely hazardous event, but understanding their occurrence through past records remains challenging. Here, the authors document tsunami occurrence from a 7,400 year old record of tsunami deposits in a cave in Indonesia, helping us to reconstruct the frequency of earthquakes in the region.

The originally published review of this book did not include the information that an electronic version is available.

Tsunami vertical evacuation (TVE) buildings have the potential to save many lives. Yet whether TVE buildings actually save lives depends critically on whether people trust and evacuate to them, a question that has not previously been researched. We examine the case of the city of Banda Aceh, Indonesia, where a M8.6 earthquake on 11-April-2012 caused a spontaneous mass evacuation but no tsunami. Our survey of residents living near TVE buildings (n = 202) shows that they clearly prefer horizontal evacuation: in the 2012 earthquake, only 26% evacuated to a TVE building, while 74% evacuated horizontally; if a similar earthquake happened in the future, only 32% intend to evacuate to a TVE building, while 68% intend to evacuate horizontally. To investigate the reasons for this, we extend protection motivation theory to examine people's choices among protective actions under social influence. Those who prefer to evacuate horizontally do not trust the safety of the TVE building and think they can reach a safe inland destination in time, while those who prefer to evacuate to a TVE building think they cannot reach a safe inland destination in time. Encouragement from friends and family influences people's evacuation destinations but official information and training do not. These findings suggest that more attention to the social context is crucial for the effectiveness of TVE buildings. Our extension of protection motivation theory to include choices among protective actions under social influence can be broadly useful in research on self-protective behavior in natural hazards, public health, and other contexts., International Journal of Disaster Risk Reduction, 24, ISSN:2212-4209

A 7.8-magnitude earthquake struck Nepal on 25 April 2015, killing nearly 9,000 people and destroying half a million homes. This paper analyses the effectiveness of Nepali government institutions managing the reconstruction. Using institutional ethnography, we analyse how the post-earthquake governance framework has incorporated the flexibility and decentralization outlined in pre-earthquake plans. We balance this with observations from five case study urban settlements in the Kathmandu Valley to provide a “bottom-up” perspective on how local stakeholders are engaged in rebuilding their communities. The creation of ad hoc national-level disaster management agencies can weaken already under-resourced local governance structures. The Nepal case study reveals that national disaster management plans drafted after the Hyogo and Sendai frameworks, which promote the decentralization of disaster governance, are not necessarily followed up with practical steps to empower local stakeholders and facilitate decentralization – and are readily dismissed in the face of a real emergency., Environment and Urbanization, 29 (2), ISSN:0956-2478, ISSN:1746-0301

Whether they are one-off, or part of cycles, disasters have exerted profound long-term cultural impacts on societies around the world. The verses quoted above, excerpted from a Malay poem written just after the cataclysmic eruption of Krakatau in 1883, comprise part of one cultural artifact produced in response to natural disaster. More specifically, these lines open a window onto the roles that religion, and debates about religious interpretation, can play in post-disaster contexts. In this particular case, the poet first describes an almost stereotypically “fatalist” response on the part of some believers in his Muslim community. Immediately thereafter, however, he turns to make a critical intervention—arguing that in his understanding of Islam, the situation demanded not a retreat into theodicy discourse, but rather a renewed sense of communal solidarity and social action.

On the early morning of 26 December 2004, a 9.4 rupture of the Sunda megath-rust off of the west coast of Sumatra caused a tsunami that impacted countries all around the Indian Ocean, causing catastrophic damage and loss of life (Sieh 2012 ). In the decade since the event, billions of dollars have been spent on relief, rehabili-tation and reconstruction projects in Indonesia, Malaysia, Thailand, Sri Lanka, India and the Maldives. These projects have met with varying degrees of success and failure, but to the credit of local communities, governments, NGOs, corpora-tions and private donors, tremendous progress has been made, and the scars of the event on the built environment have been replaced with new infrastructure and housing. Indeed, in heavily affected areas like Aceh, Indonesia, it would be diffi -cult for a recent visitor to identify the areas that were destroyed in 2004. Accepted version

Recent research in Europe, Africa, and Southeast Asia suggests that we can no longer assume a direct and exclusive link between anatomically modern humans and behavioral modernity (the 'human revolution'), and assume that the presence of either one implies the presence of the other: discussions of the emergence of cultural complexity have to proceed with greater scrutiny of the evidence on a site-by-site basis to establish secure associations between the archaeology present there and the hominins who created it. This paper presents one such case study: Niah Cave in Sarawak on the island of Borneo, famous for the discovery in 1958 in the West Mouth of the Great Cave of a modern human skull, the 'Deep Skull,' controversially associated with radiocarbon dates of ca. 40,000 years before the present. A new chronostratigraphy has been developed through a re-investigation of the lithostratigraphy left by the earlier excavations, AMS-dating using three different comparative pre-treatments including ABOX of charcoal, and U-series using the Diffusion-Absorption model applied to fragments of bones from the Deep Skull itself. Stratigraphic reasons for earlier uncertainties about the antiquity of the skull are examined, and it is shown not to be an 'intrusive' artifact. It was probably excavated from fluvial-pond-desiccation deposits that accumulated episodically in a shallow basin immediately behind the cave entrance lip, in a climate that ranged from times of comparative aridity with complete desiccation, to episodes of greater surface wetness, changes attributed to regional climatic fluctuations. Vegetation outside the cave varied significantly over time, including wet lowland forest, montane forest, savannah, and grassland. The new dates and the lithostratigraphy relate the Deep Skull to evidence of episodes of human activity that range in date from ca. 46,000 to ca. 34,000 years ago. Initial investigations of sediment scorching, pollen, palynomorphs, phytoliths, plant macrofossils, and starch grains recovered from existing exposures, and of vertebrates from the current and the earlier excavations, suggest that human foraging during these times was marked by habitat-tailored hunting technologies, the collection and processing of toxic plants for consumption, and, perhaps, the use of fire at some forest-edges. The Niah evidence demonstrates the sophisticated nature of the subsistence behavior developed by modern humans to exploit the tropical environments that they encountered in Southeast Asia, including rainforest.

Coating of yam seed tubers with liquid ethoprophos and cadusafos controlled a root population of Scutellonema bradys but did not produce a significant increase in yield. During storage, the yield loss was 10% with healthy tubers but reached 40% with infested tubers; the volume of necrotic tissues being proportional to the rate of infestation. When nematodes were controlled with cadusafos, only 23% of tuber yield was lost compared to 68% in untreated and nematode infested tubers. Seventy per cent of the tubers harvested from the plot treated with cadusafos were free of nematode. When these were cut into 200–230 g pieces, corresponding to seed tubers, 80% of them were healthy whereas only 30% were nematode-free, when pieces of tubers harvested in the non-treated plot were used.

A quarter of all patients presenting to emergency departments are children. Although there are several large, well-conducted studies on adults enabling accurate selection of patients with head injury at high risk for computed tomography scanning, no such study has derived a rule for children.To conduct a prospective multicentre diagnostic cohort study to provide a rule for selection of high-risk children with head injury for computed tomography scanning.All children presenting to the emergency departments of 10 hospitals in the northwest of England with any severity of head injury were recruited. A tailor-made proforma was used to collect data on around 40 clinical variables for each child. These variables were defined from a literature review, and a pilot study was conducted before the children's head injury algorithm for the prediction of important clinical events (CHALICE) study. All children who had a clinically significant head injury (death, need for neurosurgical intervention or abnormality on a computed tomography scan) were identified. Recursive partitioning was used to create a highly sensitive rule for the prediction of significant intracranial pathology.22,772 children were recruited over 2 1/2 years. 65% of these were boys and 56% were5 years old. 281 children showed an abnormality on the computed tomography scan, 137 had a neurosurgical operation and 15 died. The CHALICE rule was derived with a sensitivity of 98% (95% confidence interval (CI) 96% to 100%) and a specificity of 87% (95% CI 86% to 87%) for the prediction of clinically significant head injury, and requires a computed tomography scan rate of 14%.A highly sensitive clinical decision rule is derived for the identification of children who should undergo computed tomography scanning after head injury. This rule has the potential to improve and standardise the care of children presenting with head injuries. Validation of this rule in new cohorts of patients should now be undertaken.

A study with soda-lime glass rods showed that modulus of rupture values can be increased from approximately 124 × 106 Pa (18 ksi) to 276 × 106 Pa (40 ksi) by heat treatment. Dipping the rods into diethyldichlorosilane prior to heating at 593°C (1100°F) or exposing hot glass to the silane vapor following heat treatment increased strength an additional 30% over the average strength obtained by heating only at this temperature. Similar treatment with phenyltrichlorosilane or diethyldichlorosilane did not give strengths statistically higher than those obtained by heating alone.