Uncovering archaeological landscapes at Angkor using lidar.

Previous archaeological mapping work on the successive medieval capitals of the Khmer Empire located at Angkor, in northwest Cambodia (∼9th to 15th centuries in the Common Era, C.E.), has identified it as the largest settlement complex of the preindustrial world, and yet crucial areas have remained unmapped, in particular the ceremonial centers and their surroundings, where dense forest obscures the traces of the civilization that typically remain in evidence in surface topography. Here we describe the use of airborne laser scanning (lidar) technology to create high-precision digital elevation models of the ground surface beneath the vegetation cover. We identify an entire, previously undocumented, formally planned urban landscape into which the major temples such as Angkor Wat were integrated. Beyond these newly identified urban landscapes, the lidar data reveal anthropogenic changes to the landscape on a vast scale and lend further weight to an emerging consensus that infrastructural complexity, unsustainable modes of subsistence, and climate variation were crucial factors in the decline of the classical Khmer civilization.

Negative Space: An Alternative Framework for Archaeoacoustics.

Hearing the remote past seems impossible. Archaeoacoustics is a contemporary field intent on reconstructing the evolution of early communication systems, offering the possibility of developing methodologies relating to past sound signaling and music. Through a contribution of the emerging sensory field of archaeoacoustics and an example of acoustic assessments conducted at the site of Coves del Toll, can we understand signals of the past in order to investigate human behaviour and trace its cognitive evolution? This paper explores alternative methodological and theoretical approaches to understanding prehistoric sonic behaviours in early hominids and aims to set out a framework to theoretically and philosophically approach the "sound record" of the past. The theoretical proposition of this paper integrates the musical and sound art disciplines of spectralism and sound ecology to challenge the current limitations of listening to sound.

Climate as a contributing factor in the demise of Angkor, Cambodia.

The "hydraulic city" of Angkor, the capitol of the Khmer Empire in Cambodia, experienced decades-long drought interspersed with intense monsoons in the fourteenth and fifteenth centuries that, in combination with other factors, contributed to its eventual demise. The climatic evidence comes from a seven-and-a-half century robust hydroclimate reconstruction from tropical southern Vietnamese tree rings. The Angkor droughts were of a duration and severity that would have impacted the sprawling city's water supply and agricultural productivity, while high-magnitude monsoon years damaged its water control infrastructure. Hydroclimate variability for this region is strongly and inversely correlated with tropical Pacific sea surface temperature, indicating that a warm Pacific and El Niño events induce drought at interannual and interdecadal time scales, and that low-frequency variations of tropical Pacific climate can exert significant influence over Southeast Asian climate and society.

Vestibular rehabilitation potential of commercially available virtual reality video games.

BACKGROUND: Peripheral vestibular disorders affect 2.8-6.5% of people. Standard treatment is vestibular rehabilitation therapy, and virtual reality (VR) could improve outcomes. The objective of this study was to identify the commercially available VR video game that is most congruent to vestibular rehabilitation therapy. METHODS: A term search "virtual reality racing" was performed on the App Store in March 2022. Results were screened for free point-of-view racing games compatible with Android and iOS devices. An investigator was filmed playing each game and videos were distributed to 237 physiotherapists. Physiotherapists completed a survey of 5-point Likert scale questions that assessed the video games vestibular rehabilitation potential. Survey responses were analyzed using Friedman Two-Way ANOVA (alpha = 0.05) and paired samples sign test with Bonferroni correction. RESULTS: The search yielded 58 games, 4 were included. Forty physiotherapists participated. VR Tunnel Race (VRTR) and VR Real World Bike Racing (VRWBR) had the greatest vestibular rehabilitation potential (median global scores = 18.00). VRTR replicated habituation exercises significantly (p < 0.001) better than Derby VR, and VRWBR replicated physiotherapist-prescribed exercises significantly (p < 0.001) better than VR X-Racer. There were no discernable significant differences between VRWBR and VRTR. CONCLUSIONS: VRTR and VRWBR are the most congruent VR games to standard vestibular rehabilitation. VRWBR is preferable to VRTR with respect to ease of use and the ability to alter the amount of optokinetic stimulation. Prospective studies are needed to confirm the efficacy of these videos games and to determine if they could be used as solitary treatments. TRIAL REGISTRATION: Not applicable.

Development of a national pain management competency profile to guide entry-level physiotherapy education in Canada.

BACKGROUND: National strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across Canada. AIMS: This study aimed to create a consensus-based competency profile for pain management, specific to the Canadian PT context. METHODS: A modified Delphi design was used to achieve consensus across Canadian university-based and clinical pain educators. RESULTS: Representatives from 14 entry-level PT programs (93% of Canadian programs) and six clinical educators were recruited. After two rounds, a total of 15 competencies reached the predetermined endorsement threshold (75%). Most participants (85%) reported being "very satisfied" with the process. CONCLUSIONS: This process achieved consensus on a novel pain management competency profile specific to the Canadian PT context. The resulting profile delineates the necessary abilities required by physiotherapists to manage pain upon entry to practice. Participants were very satisfied with the process. This study also contributes to the emerging literature on integrated research in pain management by profiling research methodology that can be used to inform related work in other health professions and regions.

Contexte: Contexte: Les stratégies nationales nord-américaines préconisent des améliorations sensibles à la formation de base en matiére de prise en charge de la douleur afin de contribuer à la réduction du fardeau de la douleur chronique. Des travaux antérieurs ont généré un ensemble de compétences interprofessionnelles utile en matiére de prise en charge de la douleur afin de guider la formation des futurs professionnels de la santé. Cependant, trés peu de travaux ont porté sur l'acquisition de telles compétences pour des professions individuelles dans différentes régions. L'uisition de compétences spécifiques à une profession adaptées au contexte local est une première étape nécessaire pour leur intégration dans les systèmes réglementaires locaux. Notre groupe travaille à cet objectif dans le cadre de programmes de formation de base en physiothèrapie partout au Canada.Objectifs: Cette étude visait à créer un profil de compétences consensuel pour la prise en charge de la douleur, propre au contexte canadien de la physiothérapie.Méthodes: Un devis Delphi modifié a étè utilisé pour parvenir à un consensus parmi des formateurs en milieu universitaire et clinique en matière de douleur en milieu universitaire et clinique.Résultats: Des représentants de 14 programmes de formation de base en physiothérapie (93 % des programmes canadiens) et de six formateurs en milieu clinique ont été recrutés. Après deux tours, 15 compétences ont atteint le seuil d'approbation prédéterminé (75 %). La plupart des participants (85 %) ont déclaré être « très satisfaits ¼du processus.Conclusions: Ce processus a permis de dégager un consensus sur un nouveau profil de compétences en matiére de prise en charge de la douleur propre au contexte canadien de la physiothérapie. Ce profil délimite les habiletés requises des physiothérapeutes pour prendre en charge la douleur en début de pratique. Les participants ont été très satisfaits du processus. Cette étude contribue également à la littérature émergente sur la recherche intégrée en matière de prise en charge de la douleur en définissant une méthodologie de recherche qui peut être utilisée pour éclairer des travaux similaires dans d'autres professions de la santé et dans d'autres régions.

Does readiness to change influence pain-related outcomes after an educational intervention for people with chronic pain? A pragmatic, preliminary study.

Background: There is a strong association between chronic pain and unhelpful pain cognitions. Educating patients on pain neuroscience has been shown to reduce pain catastrophization, kinesiophobia, and self-perceived disability. This study investigated whether a group-based pain neuroscience education (PNE) session influenced pain-related outcomes, and whether readiness to change moderated these outcomes.Method: In a pragmatic pre-post-intervention study using a convenience sample, adults with chronic pain participated in one, 90-120 minute PNE session. Pain-related outcomes (i.e. pain catastrophization, kinesiophobia, disability, and pain neuroscience knowledge) and the Pain Stage of Change Questionnaire (PSOCQ) were assessed at baseline and immediately post-intervention. Paired t-tests evaluated pre-post changes in outcomes, and linear regression examined the impact of PSOCQ score changes on PNE-induced changes in clinical outcomes.Results: Sixty-five participants were recruited. All outcomes showed positive intervention effects (p < .01). Relationships between changes in PSOCQ subscale scores and change in post-intervention pain-related outcomes were found; 'Pre-Contemplation' was positively associated with pain catastrophization (p = .01), and 'Action' was negatively associated with kinesiophobia (p = .03).Conclusion: Consistent with previous research, there were improvements in outcomes associated with chronic pain after PNE. Some of these improvements were predicted by changes in PSOCQ scores, however, these findings are preliminary and require further investigation using controlled research designs.

Diachronic modeling of the population within the medieval Greater Angkor Region settlement complex.

Angkor is one of the world's largest premodern settlement complexes (9th to 15th centuries CE), but to date, no comprehensive demographic study has been completed, and key aspects of its population and demographic history remain unknown. Here, we combine lidar, archaeological excavation data, radiocarbon dates, and machine learning algorithms to create maps that model the development of the city and its population growth through time. We conclude that the Greater Angkor Region was home to approximately 700,000 to 900,000 inhabitants at its apogee in the 13th century CE. This granular, diachronic, paleodemographic model of the Angkor complex can be applied to any ancient civilization.

The demise of Angkor: Systemic vulnerability of urban infrastructure to climatic variations.

Complex infrastructural networks provide critical services to cities but can be vulnerable to external stresses, including climatic variability. This vulnerability has also challenged past urban settlements, but its role in cases of historic urban demise has not been precisely documented. We transform archeological data from the medieval Cambodian city of Angkor into a numerical model that allows us to quantify topological damage to critical urban infrastructure resulting from climatic variability. Our model reveals unstable behavior in which extensive and cascading damage to infrastructure occurs in response to flooding within Angkor's urban water management system. The likelihood and extent of the cascading failure abruptly grow with the magnitude of flooding relative to normal flows in the system. Our results support the hypothesis that systemic infrastructural vulnerability, coupled with abrupt climatic variation, contributed to the demise of the city. The factors behind Angkor's demise are analogous to challenges faced by modern urban communities struggling with complex critical infrastructure.

A comprehensive archaeological map of the world's largest preindustrial settlement complex at Angkor, Cambodia.

The great medieval settlement of Angkor in Cambodia [9th-16th centuries Common Era (CE)] has for many years been understood as a "hydraulic city," an urban complex defined, sustained, and ultimately overwhelmed by a complex water management network. Since the 1980s that view has been disputed, but the debate has remained unresolved because of insufficient data on the landscape beyond the great temples: the broader context of the monumental remains was only partially understood and had not been adequately mapped. Since the 1990s, French, Australian, and Cambodian teams have sought to address this empirical deficit through archaeological mapping projects by using traditional methods such as ground survey in conjunction with advanced radar remote-sensing applications in partnership with the National Aeronautics and Space Administration (NASA)/Jet Propulsion Laboratory (JPL). Here we present a major outcome of that research: a comprehensive archaeological map of greater Angkor, covering nearly 3,000 km2, prepared by the Greater Angkor Project (GAP). The map reveals a vast, low-density settlement landscape integrated by an elaborate water management network covering>1,000 km2, the most extensive urban complex of the preindustrial world. It is now clear that anthropogenic changes to the landscape were both extensive and substantial enough to have created grave challenges to the long-term viability of the settlement.