Intraspinal and Intracranial Neurotuberculosis, Clinical and Imaging Characteristics and Outcomes in Hospitalized Patients: A Cohort Study (2000-2022).

Neurotuberculosis (neuroTB) is a devastating disease, and is difficult to diagnose. The aim of this study was to analyze the clinical and imaging characteristics, and outcomes of a retrospective cohort (2000-2022) of hospitalized patients diagnosed with intraspinal and intracranial neuroTB. This work was designed through clinical, laboratory and imaging findings. Variables included: demographic data, history of tuberculosis, neurological complications, comorbidities and outcomes. Morbi-mortality risk factors were identified by univariate analysis. The cohort included: 103 patients with intraspinal and 82 with intracranial neuroTB. During the study period, in-hospital mortality of 3% for intraspinal and 29.6% for intracranial neuroTB was estimated. Motor deficit was found in all patients with intraspinal neuroTB. Risk factors for the unfavorable outcome of patients with intraspinal neuroTB were: age ≥ 40 years, diabetes mellitus (DM), diagnostic delay, kyphosis and spondylodiscitis ≥ 3 levels of involvement. Among the patients with intracranial neuroTB, 79/82 (96.3%) had meningitis and 22 patients had HIV infection (10 of them died). Risk factors for mortality from intracranial neuroTB were: HIV infection, hydrocephalus, stroke, lymphopenia and disseminated and gastrointestinal TB. Patients with intraspinal neuroTB had a significant number of destroyed vertebrae that determined their neurological deficit status. The mortality burden in intracranial neuroTB was conditioned by HIV infection and renal transplantation patients.

Rehabilitation After Gluteus Medius and Minimus Treatment.

We reviewed the current literature regarding rehabilitation after gluteus medius and minimus tears as part of a conservative management or postoperative protocol. The greater trochanteric pain syndrome includes a constellation of pathologies that generate pain in the greater trochanteric region and may be accompanied by varying degrees of hip abductor disfunction. It may be related to tendinitis of the gluteus medius and minimus, greater trochanteric bursitis, or even formal tears of the hip abductor tendons. The initial management strategy of the hip abductor tears is conservative, including different anti-inflammatory therapies such as physical therapy and cortisone and platelet-rich plasma injections. The clearest indication for surgical management is failure of conservative management and loss of abductor muscle power. Surgical management has been performed both open and endoscopic with good reported clinical results. More severe tears typically require a more rigid and complex type of fixation. Exorcise intervention seem to improve symptoms after 4 months to a year of therapy therefore a very close supervision of the rehabilitation protocol is mandatory. Gluteus medius and minimus tears are frequent and may be not diagnosed timely. Treatment of these of lesions is based on the knowledge of pathomechanics involved and the extent of injury to the tendon and muscle tissue. Conservative management is based on protecting the hip abductor tendons from excessive tensile and compression stresses while applying progressive load in conjunction with physical and medical anti-inflammatory measures. Surgical treatment is indicated when conservative management fails or an abductor power deficit is associated with pain. Similar physical therapy protocols to those used in conservative management are used postoperatively. LEVEL OF EVIDENCE: Level V, expert opinion.

Proposal for the Inclusion of Tobacco Use in Suicide Risk Scales: Results of a Meta-Analysis.

There is an association between smoking and suicide, even though the direction and nature of this relationship remains controversial. This meta-analysis aimed to evaluate the association between smoking and suicidal behaviours (ideation, planning, suicide attempts, and death by suicide). On 24 August 2020, we searched the PubMed, Cochrane library, Scopus, Web of Science, TRIP, and SCIENCE DIRECT databases for relevant articles on this topic. Twenty prospective cohort studies involving 2,457,864 participants were included in this meta-analysis. Compared with never smokers, former and current smokers had an increased risk of death by suicide (relative risk [RR] = 1.31; 95% CI [1.13, 1.52] and RR = 2.41; 95% CI [2.08, 2.80], respectively), ideation (RR = 1.35; 95% CI [1.31, 1.39] and RR = 1.84; 95% CI [1.21, 2.78]), and attempted suicide (RR = 1.27; 95% CI [0.56, 2.87] and RR = 1.71; 95% CI [0.73, 3.97]). Moreover, compared to never smokers, current smoker women (RR = 2.51; 95% CI [2.06-3.04] had an increased risk of taking their own life (Q = 13,591.53; p < 0.001) than current smoker men (RR = 2.06; 95% CI [1.62-2.62]. Furthermore, smoking exposure (former and current smokers) was associated with a 1.74-fold increased risk (95% CI [1.54, 1.96]) of suicidal behaviour (death by suicide, ideation, planning, or attempts). Thus, because of the prospective relationship between smoking and suicidal behaviours, smoking should be included in suicide risk scales as a useful and easy item to evaluate suicide risk.

"Healthcare Kamikazes" during the COVID-19 Pandemic: Purpose in Life and Moral Courage as Mediators of Psychopathology.

Although the required personal protective equipment was not available during the first wave of the COVID-19 pandemic, Spanish healthcare workers continued to work, being dubbed as 'healthcare kamikazes'. Two possible reasons are moral courage and purpose in life that, in turn, would modulate the appearance of psychopathology. Cross-sectional study was carried out in 90 Spanish and 59 Mexican healthcare professionals, and 56 medical and nursing students. Spanish professionals had suffered more work and overall exposure (M = 8.30; SD = 2.57 and M = 9.03; SD = 2.66) than Mexican (M = 5.10; SD = 1.87 and M = 5.55; SD = 2.35). Mexican professionals had fewer anxiety disorders (30.5%; n = 18) and a lower depression score (M = 4.45; SD = 5.63) than the Spanish (43.7%; n = 38; and M = 8.69; SD = 8.07). Spanish professionals more often experienced acute stress disorder (32.6%; n = 29). Purpose in life, in addition to having a direct protective effect on psychopathology, also modulated the relationship between personal and family exposure and psychopathology. In conclusion, purpose in life protects against the appearance of psychopathology in healthcare workers with personal and family exposure to SARS-CoV-2.

Bone mineral density and low bone mass in severely burned patients: A retrospective cohort study.

INTRODUCTION: Severe burns can alter bone metabolism through different mechanisms. Despite prior published studies describing the association between burns and a decrease in bone mineral density (BMD), no clinical guidelines currently exist recommending the systematic evaluation of bone health in patients after severe burns. This study aims to describe the BMD of individuals with severe burn injuries and healthy controls and determine the frequency of low-to-normal bone mass (LNBM) and BMD below the expected range for age (BEA). MATERIALS AND METHODS: We conducted a retrospective cohort of patients with either severe thermal or electrical burns and healthy controls paired by gender and age. We performed a dual-energy X-ray absorptiometry at least 90 days after the burn and collected data from each patient's clinical evaluation and clinical file. RESULTS: A total of 77 patients (64 men and 13 women) and their paired controls were included in the study (age [mean ± standard deviation, SD]: 30.37 ± 8.66 years). Patients participated in the study an average of 315 ± 438 days after their burn. The BMD (grs/cm2) in total hip burned vs controls was: 0.998 ± 0.135 vs 1.059 ± 0.12 (p = 0.004); femoral neck 0.876 ± 0.121 vs 0.915 ± 0.097 (p = 0.031), spine 0.977 ± 0.127 vs 1.003 ± 0.076 (p = 0.132).The Z-scores for total hip were - 0.06 ± 1.05 vs 0.41 ± 0.80 (p = 0.002); for neck -0.39 ± 0.89 vs -0.01 ± 0.77 (p = 0.005); and for spine -0.75 ± 1.11 vs -0.32 ± 0.73 (p = 0.005). The proportion of subjects with BMD BEA in burns vs controls was 5.2 vs 1.2% (p = 0.05) in total hip, 3.9 vs 0% (p = 0.045) in the neck, and 18.2 vs 1.2% (p = 0.001) in the spine. The logistic regression model found-in burn patients vs controls-an OR of 9.83 for BMD BEA (CI 95%: 2.17-44.45, p = 003), OR = 4.05 for electrical burns (CI 95%: 1.72-20.89, p = 004) and OR = 15.16 for thermal burns (CI 95%: 2.91-79.00, p = 001). The model also found an OR = 2.48 for LNBM (CI 95%: 1.25-4.93, p = 0.009). The burn variables associated with BMD BEA at any site in the patients were BMI >25 Kg/m2 with an OR = 0.180 (CI 95%: 0.046-0.710, p = 0.014); and the lower limb amputation with an OR = 7.33 (CI 95%; 1.12-48.33, p = 0.038). Five burn patients had a fragility fracture. CONCLUSION: BMD was significantly lower in severely burned patients than in controls, and the proportion BMD BEA cases was significantly higher in the burn patient sample. Severe burns are a strong independent predictor of bone loss, and this risk is maintained for an extended period after the burn.

Portal enlargement in hip arthroscopy preserving the iliofemoral ligament: a novel access technique protecting soft tissue restraints.

Capsulotomy in different modalities has been used to provide adequate exposure to access both the central and peripheral compartment in hip arthroscopy. Even though the hip joint has inherent bony stability, soft tissue restraints may be important in patients with ligaments hyperlaxity or in some cases with diminished bony stability. Biomechanical studies and clinical outcomes have shown the relevant role of the capsule in hip stability, mainly the role of the iliofemoral ligament. Although is not very common, iatrogenic post-arthroscopy subluxation and dislocation have been reported and many surgeons are concerned about the role aggressive capsulotomy or capsulectomy in this situation, thus capsule repair has become very popular. We present a novel technique to access the hip without cutting the iliofemoral ligament. With this technique we can obtain adequate arthroscopic access to the hip joint in order to treat adequately the central compartment pathologies reducing the risk of iatrogenic post-operative hip instability.

Isthmin 2 is decreased in preeclampsia and highly expressed in choriocarcinoma.

INTRODUCTION: Isthmin 2 (ISM2) is a protein which expression in humans is almost specific to the placenta. There is no previous report in the literature that investigated this protein in preeclampsia or choriocarcinoma. METHODS: We conducted a prospective, cross-sectional study that included women with preeclampsia, gestational hypertension and normotensive pregnancy. We measured serum concentrations of ISM2 protein and performed immunohistochemistry in placenta tissues. We also performed immunohistochemistry of ISM2 in samples from choriocarcinoma and compare with lung, prostate, colon, gastric and breast cancers. RESULTS: A total of 81 patients were included, 30 with preeclampsia, 21 with gestational hypertension and 30 controls. The ISM2 protein was found to be decreased in patients with preeclampsia compared to the control group (P = 0.036). These results were confirmed by immunohistochemistry. We also found that ISM2 protein was overexpressed in choriocarcinoma. DISCUSSION: Taken together, our results suggest an angiogenic function for ISM2. Its serum level decreased in our patients with preeclampsia could be reflecting that it is involved in the pathogenesis of the disease; on the other hand its high expression in choriocarcinoma, indicates that ISM2 may play an active role in the angiogenesis of this and other cancers.

Disease-related factors associated with exercise adherence in postmenopausal women with osteoporosis.

OBJECTIVES: Exercise is the most widely-used intervention for reducing bone loss and the incidence of falls and fractures in osteoporosis patients. However, disease-related changes can alter these patients' adherence to exercise programs. This study attempted to describe the factors influencing exercise adherence in a group of postmenopausal women with osteoporosis. METHODS: We conducted a retrospective cohort of postmenopausal women with osteoporosis. We collected data from each patient's last clinical evaluation, as well as from their clinical file of the previous year. RESULTS: A total of 288 women were included in the study, with an average age of 69.45 (Standard deviation ± 9.2 years). Around a quarter, 76 (26.3%), of the patients did not adhere to exercise, 91 (31.5%) did partially, and 121 (41.9%) did completely. In univariate analysis, the variables significantly associated with exercise adherence were age, height, spine pain intensity, joint pain, and prevalent fracture. In a logistic regression model, pharmacological treatment for osteoporosis and polypharmacy were associated with exercise adherence, while poor balance and hyperkyphosis were associated with non-adherence. CONCLUSION: Pharmacological treatment, polypharmacy, poor balance, and hyperkyphosis all appear to be associated with exercise adherence. As these findings are the significant predictors of exercise engagement, it is necessary to explore balance and postural changes and emphasize the importance of postural and balance training prescription in this group of patients.

Survival of Late Pleistocene Hunter-Gatherer Ancestry in the Iberian Peninsula.

The Iberian Peninsula in southwestern Europe represents an important test case for the study of human population movements during prehistoric periods. During the Last Glacial Maximum (LGM), the peninsula formed a periglacial refugium [1] for hunter-gatherers (HGs) and thus served as a potential source for the re-peopling of northern latitudes [2]. The post-LGM genetic signature was previously described as a cline from Western HG (WHG) to Eastern HG (EHG), further shaped by later Holocene expansions from the Near East and the North Pontic steppes [3-9]. Western and central Europe were dominated by ancestry associated with the ∼14,000-year-old individual from Villabruna, Italy, which had largely replaced earlier genetic ancestry, represented by 19,000-15,000-year-old individuals associated with the Magdalenian culture [2]. However, little is known about the genetic diversity in southern European refugia, the presence of distinct genetic clusters, and correspondence with geography. Here, we report new genome-wide data from 11 HGs and Neolithic individuals that highlight the late survival of Paleolithic ancestry in Iberia, reported previously in Magdalenian-associated individuals. We show that all Iberian HGs, including the oldest, a ∼19,000-year-old individual from El Mirón in Spain, carry dual ancestry from both Villabruna and the Magdalenian-related individuals. Thus, our results suggest an early connection between two potential refugia, resulting in a genetic ancestry that survived in later Iberian HGs. Our new genomic data from Iberian Early and Middle Neolithic individuals show that the dual Iberian HG genomic legacy pertains in the peninsula, suggesting that expanding farmers mixed with local HGs. VIDEO ABSTRACT.

Oldowan technological behaviour at HWK EE (Olduvai Gorge, Tanzania).

HWK EE (Olduvai Gorge, Tanzania) is a late Oldowan site dated to ∼1.7 Ma that contains a large fossil and lithic assemblage. This paper reports on the technology of the recently excavated stone tool collection, over 18,000 pieces. Our results indicate that reduction sequences were generally short, flaking productivity was low, and knapping methods were largely simple and expedient, lacking the technical skills observed in other Oldowan assemblages. Conspicuous differences are observed in the chaînes opératoires of the three main raw materials used at HWK EE: the quartzite reduction sequence can be reconstructed in full at the site, most of the lava detached pieces are missing, and there is a preferential use of chert for retouched tools. This portrays a composite picture, where knapping expediency and low productivity are accompanied by raw material selectivity and consistent presence of retouched artefacts. Coexistence of these features in the same assemblage leads us to question the monolithic structure of the Oldowan techno-complex, and highlights the kaleidoscopic nature of technological strategies at Olduvai immediately before the earliest Acheulean handaxes appear in the sequence.

Technological behaviour in the early Acheulean of EF-HR (Olduvai Gorge, Tanzania).

Technological strategies of early humans are discussed in the light of a recently excavated stone tool assemblage from EF-HR, an archaeological site older than 1.33 Ma at Olduvai Gorge, Tanzania. Renewed fieldwork at EF-HR has unearthed a lithic collection containing over 2300 artefacts (including a hundred handaxes in stratigraphic position), which represents one of the largest assemblages for the early Acheulean in eastern Africa. Our technological study shows co-occurrence of two distinctive reduction sequences in the same assemblage, one aimed at obtaining small flakes and the other focused on the production of large, thick, heavy flakes that were then used as blanks for handaxe shaping. Flaking of small cores is expedient and low intensity, and knapping methods are similar to those observed in earlier Oldowan assemblages. Large Cutting Tools (LCTs) show no evidence of planform and biconvex symmetry, and shaping sequences are brief and discontinuous, indicating short use-lives for handaxes. Bifaces are rare and atypical. Recurrent morphotypes are knives, which are poorly-shaped, scraper-like, large-sized handaxes. Despite the apparent expediency of EF-HR handaxe production, a closer inspection of the interplay between debitage and façonnage stages reveals remarkably standardized procedural patterns. Large Cutting Tool blanks were produced following fixed knapping rules resulting in flakes with a specific morphology and mass distribution. Adapted to the idiosyncrasies of each blank, shaping was almost invariably imposed over the same areas in all LCTs and sought to produce morphotypes that, technologically, are remarkably identical to each other. This strongly supports the existence of mental templates and technical rules that were systematically practiced in LCT production at EF-HR, and underscore the structured nature of technological behaviour at the onset of the Acheulean in eastern Africa.

New excavations at the HWK EE site: Archaeology, paleoenvironment and site formation processes during late Oldowan times at Olduvai Gorge, Tanzania.

This paper reports the results of renewed fieldwork at the HWK EE site (Olduvai Gorge, Tanzania). HWK EE is positioned across the boundary between Lower and Middle Bed II, a crucial interval for studying the emergence of the Acheulean at Olduvai Gorge. Our excavations at HWK EE have produced one of the largest collections of fossils and artefacts from any Oldowan site, distributed across several archaeological units and a large excavation surface in four separate trenches that can be stratigraphically correlated. Here we present the main stratigraphic and archaeological units and discuss site formation processes. Results show a great density of fossils and stone tools vertically through two stratigraphic intervals (Lemuta and Lower Augitic Sandstone) and laterally across an area of around 300 m2, and highlight the confluence of biotic and abiotic agents in the formation of the assemblage. The large size and diversity of the assemblage, as well as its good preservation, qualify HWK EE as a reference site for the study of the late Oldowan at Olduvai Gorge and elsewhere in Africa. In addition, the description of the stratigraphic and archaeological sequence of HWK EE presented in this paper constitutes the foundation for further studies on hominin behavior and paleoecology in Lower and Middle Bed II.

Identifying bipolar knapping in the Mesolithic site of Font del Ros (northeast Iberia).

Despite recent advances in the identification of bipolar knapping, its role in many sites is not well known. We propose to assess the significance of this technique in the context of changes that occur in the Mesolithic. A lithic assemblage was recovered from unit SG at Font del Ros (Catalunya, Spain) in which pitted stones, cores and products arising from bipolar reduction (flakes, fragments and splintered pieces) were identified. This study indicates that the bipolar technique is fundamental in the settlement. These results are key to defining the organization of Holocene hunter-gatherer subsistence in northeast Iberia.

Spinal tuberculosis in western mexico, 2008-2013 / Tuberculose da coluna vertebral no oeste do méxico, 2008-2013 / Tuberculosis espinal en el occidente de méxico, 2008-2013

Objective: To identify the prevalence, clinical features and postoperative outcome of patients with spinal tuberculosis at the Instituto Mexicano del Seguro Social, in Jalisco, Mexico from 2008 to 2013. Methods: Prevalence study of patients undergoing spine surgery due to tuberculosis. Clinical, surgical pre- and postoperative parameters were evaluated by analysis of 41 medical records. Results: Seventeen (41.4%) were women and 24 (58.6%) were men with a mean age of 47.7 years. The main diagnoses were tuberculous spondylitis in 14 (34.1%) patients; discitis in 13 (31.7%); infectious spondylitis in 9 (21.9%); chronic spondylitis in four (9.7%); abscess in one patient (2.4%). Only 22% of patients were positive for epidemiological study of tuberculosis contacts. The most affected region was the lumbar spine followed by the thoracic spine and the most affected vertebrae were L3-L4. The most used surgical instrumentation was by posterior approach with drainage on 29 occasions, anterior approach with drainage in nine, and the mixed approach in three. Twenty-nine patients were independent to perform daily activities after discharge. Conclusion: The discitis or infectious spondylodiscitis should be considered in any patient with localized pain at any level of the spine. Once solved the problem of infection and stability, patients respond favorably to the surgical procedure. .

Objetivo: Identificar a prevalência, as características clínicas e a evolução pós-cirúrgica de pacientes com tuberculose vertebral do Instituto Mexicano del Seguro Social, em Jalisco, México, no período de 2008 a 2013. Métodos: Estudo de prevalência de pacientes submetidos a cirurgia de coluna vertebral devido à tuberculose. Foram avaliados os parâmetros clínicos, cirúrgicos, pré e pós-operatórios pela análise de 41 prontuários médicos. Resultados: Dezessete (41,4%) eram mulheres e 24 (58,6%) homens, com média de idade de 47,7 anos. Os principais diagnósticos foram: espondilite tuberculosa em 14 (34,1%) pacientes; discite em 13 (31,7%); espondilite infecciosa em 9 (21,9%); espondilite crônica em 4 (9,7%); abcesso em 1 paciente (2,4%). Somente 22% dos pacientes eram positivos para estudo epidemiológico de contatos tuberculosos. A região vertebral mais afetada foi a lombar, seguida pela torácica e as vértebras mais acometidas foram L3-L4. A instrumentação cirúrgica mais utilizada foi por via posterior com drenagem em 29 ocasiões, pela via anterior com drenagem em nove e pela via mista em três ocasiões. Vinte e nove pacientes apresentaram independência nas atividades diárias depois da alta hospitalar. C...

Objetivo: Identificar la prevalencia, las características clínicas y la evolución post quirúrgica de los pacientes con tuberculosis espinal del Instituto Mexicano del Seguro Social en Jalisco, México de 2008 a 2013. Métodos: Estudio de prevalencia con pacientes sometidos a cirugía de columna por tuberculosis. Se evaluaron aspectos clínicos, quirúrgicos, pre y post operatorios, mediante la revisión de 41 registros médicos. Resultados: Diecisiete pacientes (41,4%) fueron mujeres y 24 (58,6%) hombres, con una edad promedio de 47,7 años. Los diagnósticos principales fueron: espondilitis tuberculosa en 14 (34,1%) pacientes; discitis en 13 (31,7%); espondilitis infecciosa en 9 (21,9%); espondilitis crónica en 4 (9,7%) y absceso en 1 paciente (2,4%). Únicamente el 22% de los pacientes fueron positivos para la prueba epidemiólogica de Combe. La región vertebral más afectada fue la lumbar seguida por la torácica y las vértebras más frecuentemente afectadas fueron L3-L4. La instrumentación quirúrgica más utilizada fue la vía posterior con drenaje en 29 ocasiones, la vía anterior más drenaje en nueve y vía mixta en tres. Veintinueve pacientes presentaron independencia en sus actividades diarias después de su alta. Conclusión: ...

Acheulean technological behaviour in the Middle Pleistocene landscape of Mieso (East-Central Ethiopia).

The Mieso valley is a new paleoanthropological sequence located in East-Central Ethiopia. It contains Middle and Upper Pleistocene deposits with fossil and lithic assemblages in stratified deposits. This paper introduces the Middle Pleistocene archaeological sequence, attributed to the late Acheulean. Low density clusters of artefacts suggest short-term use of the landscape by Acheulean hominins. In Mieso 31, one of the excavated assemblages, refit sets indicate fragmentation of the reduction sequences and enable study of the initial stages of biface manufacture. Mieso 7, also a stratified site, is primarily characterized by a small concentration of standardized cleavers, and portrays another dimension of Acheulean technology, that related to final stages of use and discard of large cutting tools. Available radiometric dates place the Mieso Acheulean around 212 ka (thousands of years) ago, which would make this sequence among the latest evidence of the Acheulean in East Africa, in a time span when the Middle Stone Age is already documented in the region.

Experimental investigation of the flow on a simple frigate shape (SFS).

Helicopters operations on board ships require special procedures introducing additional limitations known as ship helicopter operational limitations (SHOLs) which are a priority for all navies. This paper presents the main results obtained from the experimental investigation of a simple frigate shape (SFS) which is a typical case of study in experimental and computational aerodynamics. The results obtained in this investigation are used to make an assessment of the flow predicted by the SFS geometry in comparison with experimental data obtained testing a ship model (reduced scale) in the wind tunnel and on board (full scale) measurements performed on a real frigate type ship geometry.

The Middle-to-Upper Palaeolithic transition in Cova Gran (Catalunya, Spain) and the extinction of Neanderthals in the Iberian Peninsula.

The excavations carried out in Cova Gran de Santa Linya (Southeastern PrePyrenees, Catalunya, Spain) have unearthed a new archaeological sequence attributable to the Middle Palaeoloithic/Upper Palaeolithic (MP/UP) transition. This article presents data on the stratigraphy, archaeology, and (14)C AMS dates of three Early Upper Palaeolithic and four Late Middle Palaeolithic levels excavated in Cova Gran. All these archaeological levels fall within the 34-32 ka time span, the temporal frame in which major events of Neanderthal extinction took place. The earliest Early Upper Palaeolithic (497D) and the latest Middle Palaeolithic (S1B) levels in Cova Gran are separated by a sterile gap and permit pinpointing the time period in which the Mousterian disappeared from Northeastern Spain. Technological differences between the Early Upper Palaeolithic and Late Middle Palaeolithic industries in Cova Gran support a cultural rupture between the two periods. A series of 12 (14)C AMS dates prompts reflections on the validity of reconstructions based on radiocarbon data. Thus, results from excavations in Cova Gran lead us to discuss the scenarios relating the MP/UP transition in the Iberian Peninsula, a region considered a refuge of late Neanderthal populations.

Primate archaeology.

All modern humans use tools to overcome limitations of our anatomy and to make difficult tasks easier. However, if tool use is such an advantage, we may ask why it is not evolved to the same degree in other species. To answer this question, we need to bring a long-term perspective to the material record of other members of our own order, the Primates.