Background The gallstone prevalence in the western world is 10-20%. Most gallstones are silent, but symptoms and complications appear in 20-40%. The incidence of symptom development in patients with silent gallstones is 2-4% per year. The indication for surgical (including endoscopic) treatment of gallstones is symptoms of certain magnitude, and no contraindications. During the past three decades an intense technical development in imaging (ultrasound, computerised tomography and magnetic resonance imaging), endoscopic therapy, and surgery has taken place. The aim of this thesis is to scrutinize changes in management of complicated gallstone disease on a population-based level, using national register data. Have the new methods improved the treatment of acute pancreatitis, common bile duct stones and acute gallbladder disease? Methods Data is collected from National Patient Register (NPR) run by The Swedish National Board of Health and Welfare. NPR collects discharge data from every admission from every Swedish hospital. Mortality is calculated as standardised mortality ratio (SMR) using age-, gender-, and calendar year specific survival estimates. We have studied both general trends in admissions and treatment alternatives and outcomes in defined patient cohorts. Length of hospital stay, readmission, and mortality has been used as proxy indicators of the effectiveness of treatment strategies used. Results During the study period mortality in acute pancreatitis (SMR within 90 days of admission) improved and hospital stay for all patients with acute pancreatitis decreased. Cholecystectomy rate at or shortly after index stay for mild acute biliary pancreatitis increased from 14.5 % to 22.7 %. Of all patients with acute pancreatitis 68.4 % of the patients had no aetiological diagnosis in the register. The incidence of bile duct interventions increased 27.8% from 1988 through 2006. The favoured treatment of bile duct stones changed from open choledocholithectomy to endoscopic sphincterotomy with stone extraction during the same period. However, in 2006, still 19.6% of bile duct interventions for stones were performed as choledochotomy and in the great majority of these cases as open surgery. This indicates a continuing need of education in open bile duct surgery. Mean hospital stay for treatment of common bile duct stones decreased significantly (4.5 days) during the period studied. The mortality (SMR) diminished although without statistical significance during the time period, and there was no significant difference in SMR between choledochotomy and endoscopic sphincterotomy. For acute gallbladder disease a moderate increase of admissions occurred from 1988 through 2006. The relation between acute cholecystectomies versus all cholecystectomies did not change during this period. Of all patients admitted with acute gallbladder disease 32.3 % were cholecystectomised during their first hospital stay, whereas 20.3 % underwent elective cholecystectomy and 6.1 % emergency cholecystectomy within two years of first admission. 41.4 % of patients were not operated on for gallbladder disease within two years of first admission with this diagnosis. Mortality from first admission and 90 days onwards was elevated three-fold during the entire period without time trend, without statistical difference between age groups, and between patients who had cholecystectomy at first admission or later. Conclusion During the audit period treatment of acute pancreatitis improved. However, etiological classification and timing of cholecystectomy in mild acute biliary pancreatitis fell below accepted guidelines. Interventions on the common bile duct for gallstone disease increased significantly. Common bile duct clearance has been separated from cholecystectomy, and cholecystectomy often not done. Only one third of all patients with acute gallbladder disease underwent cholecystectomy at first admission. There is room for improvement in treatment of complicatedgallstone disease, and, gallstone surgeons still need good knowledge in open biliary surgery.

This thesis deals with issues relating to the cosmological dimensions of landscapes, the cultural construction of age and the long-term changes in passage rituals and mortuary practices in the Bronze Age societies of Södermanland in East Central Sweden. A gender perspective forms the underlying theoretical framework, while the study as a whole is particularly interested in power relations between generations as an impetus for societal change. Burials from cairns and cemeteries, as well as heaps of fire-cracked stones, rock-carvings and ritual hoards from two Bronze Age Landscapes in Södermanland are used as examples and to illustrate the interpretations presented in this study. It is proposed that perceptions of landscapes and cosmology were created by placing cairns and stone settings at liminal places or boundaries in the landscape, while heaps of fire-cracked stones were situated at focal points. Places where rock-carvings are found, nearby rapids or on islands along river courses, are interpreted as birth-places, and stem from origin myths about the birth of the first humans at these sites. It is proposed that birth, life and death as cosmological principles may be perceived in the landscape and are related to different kinds of waters. In addition, it is suggested that the cultural construction of age is expressed in spatial terms where adults - both men and women - with special abilities and esoteric knowledge related to passage rituals, were buried in cairns. Infants, whose relationship with these adults was special, were instead buried in the heaps of fire-cracked stones. It is also considered that, among other things, the absence of swords in burials implies that the societies of East Central Sweden probably had a social organization that was distinct from the societies of southern Scandinavia. Regarding long-term changes in ritual practices it is suggested that ritual tools used in mortuary practices change from flint daggers in the Late Neolithic, to razors and tweezers during the Bronze Age. Further changes occurred in the Late Bronze Age, when pins were introduced into the ritual practices. Regarding age and gender, osteological estimates show that both adult men and women participated in passage rituals. With the transition to pins we also see changes in who dealt with passage rituals and it is rather young women who were responsible for this sphere in the later period. As children also become visible - both in burials and at rock-carving sites – during the Late Bronze Age, this is interpreted as signalling shifts in power relations between genders and generations in favour of women and younger people.

Andersson, J. 2008. Bildstenarna och den muntliga traditionen på Gotland under yngre järnålder. The Picture Stones and the Oral Tradition of Gotland During the Late Iron Age. Högskolan i Kalmar ht 2008. This is a study of the picture stones of Gotland and the oral tradition connected to them. This study consists of two main parts; in the main part the discussion focus on the oral tradition and the continuity of the same, where the memory plays a significant role. It also contains a discussion of the physical environment and its influences of the oral tradition. The second part concentrates around the picture stones, the variation of the scenes and the numerous of them.  Keywords: oral traditions, picture stones, late iron age, Gotland, Nordic mythology.

Mounds of fire-cracked stones is a typical Bronze Age monument for the region around lake Mälaren. They are usually, because of their content, interpreted as piles of rubbish. But as they often have kerbs, are situated on cemeteries and sometimes contain human bones, the traditional interpretation is not fully satisfactory. The main focus of this essay is on the mounds of fire-cracked stones which contain human bones in the region north of lake Mälaren. With a detailed study of these, and a comparison with those without human bones, my aim is to get closer to an explanation why the human bones were deposited. The essay consist of a comp­ilation  of 98 excavated mounds and a database with various information gathered from excavation reports and archive documents. With different kinds of osteological aspects taken in consideration, the study shows that human bones have been found in about a third of the mounds. The mounds with human bones more often have kerbs. The same types of artefacts are found both in mounds with and without human bones. A significant difference is that the mounds with human bones contain more categories of artefacts and sometimes even bronze. The study also shows that there is nothing that indicates that the bones were deposited after the primary use of the mound. The human bones could therefore had been deposited contemporary to the “rubbish”. To understand this phenomenon I strongly believe that the mounds no longer only can be interpreted as heaps of garbage.

The following work presents a hypothesis which identifies the origins and meaning of an ancient Mesoamerican concept known as the three stones of creation. Previous interpretations have tended to apply astronomical, spatial, or geographical models, while many conclusions have been made on the basis of one Classic Maya monument, Stela C of Quirigua. This thesis builds an argument for the temporal nature of these “stones,” used to metaphorically represent a sequence of separate units of time, referred to as eras, ages, or creations. A primary goal is to demonstrate that Quirigua Stela C provides in brief, summary form a chronology which is better defined through inscriptions in the Cross Group at Palenque, and in a sequence of panels at Yaxchilan containing beliefs about the origins of the ballgame. In constructing an argument for the temporal nature of the three stones of creation, every available context from a set of hieroglyphs mentioned in the Quirigua Stela C “creation” text—including Na Ho Chan (“First 5-Sky”) and “6-Sky”—is discussed in Chapter 2. In Chapter 3, these glyphs are shown to aid in the organization of the deeper past within the Palenque and Yaxchilan mythologies. When compared chronologically and thematically, these sites seem to point to the 24th century B.C.E. as the important termination of a time period (i.e., the planting of a creation stone) related to a mythic complex involving the death and underworld journey of the Maize Lord, followed by his resurrection, emergence, and/or accession to power. Key questions addressed include the antiquity of these beliefs and where the metaphors used to arrange time observed among the Classic Maya originate. In Chapter 4, earlier expressions of this time ideology are interpreted through iconographic conventions, ritual deposits, and monumental architecture at the Olmec site of La Venta. Similarly, Chapter 5 proposes that the Humboldt Celt, the earliest known example of the three stones of creation, arranges units of time into a sequence. These and other interpretations suggest the existence of an ancestral, Mesoamerican era-based time model to which later Postclassic, colonial, and contemporary beliefs, such as those expressed in the K’iche’-Mayan Popol Vuh, are fundamentally related. / text

The Viking Age rune-carvers and their readers used runes as a semiotic resource to convey and structure the messages on rune-stones. An analysis of the ways in which this resource is used together with other resources gives us a deeper insight into the relationship between writers and readers and into the written culture in which the rune-stones were produced. The present study treats runic carvings as multimodal texts in which different semiotic modes produce meaning by visual and verbal means. The roles played by runes in such texts are studied from three different perspectives. The empirical study in chapter 3 investigates how the verbal messages of the inscriptions interrelate with ornamental compositions. The most important convention found is that runic inscriptions usually start in the lower left part of the ornamental band in which they are inscribed. A second result is that there is a certain correlation between the visual and syntactic structure of runic texts. In chapter 4, Södermanlandic inscriptions employing more than one writing system are investigated. These carvings can be tied to a context of high social ambition in which at least two different, socially stratified discourses are expressed by means of the runes as a visual semiotic mode. Chapter 5 is devoted to non-lexical inscriptions, showing that such carvings are indeed runic texts despite their lack of verbal message. Different types of readers can use runic resources in different ways. Firstly, runes carry meaning independent of any verbal message, giving them significance even to illiterate readers. Secondly, literate readers can appreciate certain conventions of runic composition and, thirdly, one and the same runic text can be part of different discourses and hence be aimed at different kinds of readers. / <p>Disputationen sker på norska och svenska</p>

This essay focuses upon the Kivik monument and its conservation difficulties, since its discovery at 1748 until modern time. The Kivik monument is found in southeast of Scania, and dated within the Bronze Age period. The perspective of the conservation on the monument has merely been on the monuments inner cist of stone and the rock carvings on the cist-slabs. When the monument was first archaeological examined at 1931, its sizeable cairn (75 m in diameter) had almost vanished and the cist was sheltered by a casing of concrete and metal roof. Between 1932 and 1933 the monument has undergone a large-scale restoration, and this criticized restoration resulted in a low antiquarian value with the responsible authority. With a low antiquarian value, the protection of ancient monuments by national laws is nearly none and the interest by responsible authority is insignificantly. This has lead to substandard preservation of the monument and its surrounding area. By comparing the Kivik monument with the monument Ales stones, who undergone equal restorations, I discovered that Ales stones is still considered an intact ancient monument with a high antiquarian value with the responsible authority and therefore in a good state of preservation. This is probably a result of that the restorations of the Kivik monument contain none authentic material as concrete and its museological construction, which Ales stones is not and therefore perceived as a genuine ancient monument.

Thesis (Ph. D.)--Dept. of Art and Art History and Dept. of History. University of Missouri--Kansas City, 2005. / "A dissertation in art history and history." Advisors: Donald Matthews and Burton Dunbar. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed June 26, 2006. Includes bibliographical references (leaves 263-283). Online version of the print edition.

La carbonisation hydrothermale transforme les déchets municipaux (copeaux de bois, boues d'épuration, bagasse, feuilles…) en un produit solide appelé bio-charbon. Le produit hydrothermal connu sous le nom hydrochar est fréquemment utilisé comme carburant ou engrais, mais aussi il pourrait être converti en un produit à haute valeur ajoutée, à savoir le charbon actif. L‘objectif principal de cette thèse est d‘étudier la transformation de grignon d‘olive, précurseur lignocellulosique largement disponible en Tunisie et en pays méditerranéen, en hydrochar et en charbon actif. Dans cette étude, un réacteur discontinu de laboratoire a été conçu et construit. Les grignons d‘olive transformés en hydrochar ont été préparés à différentes sévérités et avec addition de sels, acide et ammoniac. Les hydrochars ont été caractérisés par plusieurs méthodes d‘analyse. L‘eau de traitement de la carbonisation hydrothermale a été analysée et les résultats montrent qu‘elle contient des composants à haute valeur ajoutée comme le furfural et le 5-HMF. Les charbons actifs ont été préparés à partir du hydrochar suivant des voies d‘activation physique (à l‘aide de l‘agent d‘activation CO2) et voies d‘activation chimique (par l‘agent d‘activation KOH). Les matériaux obtenus ont une surface spécifique élevée (1400 m2g-1) et aussi une chimie de surface riche en groupe fonctionnel. Les performances de ces charbons actifs dans l‘adsorption de molécules pharmaceutiques en phase liquide et de l‘hydrogène en phase gazeuse ont été examinées. Des capacités intéressantes ont été relevées pour les deux applications / Hydrothermal carbonization process uses green waste from municipalities (Wood chips, sewage sludge, bagasse, leaves …) to produce solid bio-coal. The solid HTC product known as hydrochar commonly used as a fuel or fertilizer but it could be converted also into high- value products like activated carbon. The principal purpose of this thesis is to study the conversion of olive stones, widely available lignocellulosic biomass in Tunisia and Mediterranean country, into hydrochar and then activated carbon. In this study, a laboratory scale batch reactor has been designed and built. The hydrothermally carbonized olive stones were prepared at different reaction severity and with addition of salts, acid or ammonia. All prepared hydrochar are characterized by different analysis methods. The HTC water was also analyzed and the results show that HTC-liquid contains high added value components such as furfural and 5-HMF. The hydrothermally carbonized olive stones were activated by both physical activation, using CO2 and chemical activation, using KOH. The materials had high surface area (as high as 1400 m2 g-1) and rich surface chemistry. The potential for pharmaceuticals (Ibuprofen and Metronidazole) and hydrogen adsorption were assessed for HTC-activated carbon and they showed good performance in both application

Made available in DSpace on 2014-06-11T19:32:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-05-19Bitstream added on 2014-06-13T19:21:56Z : No. of bitstreams: 1 cabanasnavarro_f_dr_rcla.pdf: 4430700 bytes, checksum: a93015794da4e288862dea20ef0e01d3 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Considerando um conjunto de 21 tipos de rochas utilizadas como revestimento e subdivididas em quatro conjuntos por afinidade da composição mineral (rochas carbonáticas, quartzosas, feldspáticas e quartzo-feldspáticas) foram realizados ensaios tecnológicos para a determinação do coeficiente de dilatação térmica linear e da resistência à compressão uniaxial, bem como a anisotropia dessas propriedades. Os dados tecnológicos obtidos foram correlacionados com informações petrográficas qualitativas e quantitativas referentes à composição mineral, variações texturais e estruturais determinadas em seções ortogonais entre si a partir de um sistema de referência (xyz) baseado na foliação e lineação macroscopicamente visíveis. A análise integrada dos dados utilizando estatística convencional e multivariada procurou apontar as variáveis petrográficas mais relevantes para as duas propriedades tecnológicas enfocadas e suas respectivas anisotropias. A dilatação térmica e sua anisotropia são influenciadas principalmente pela composição mineral e pela orientação preferencial dos minerais embora as microfissuras desempenhem papel importante em alguns casos. A tensão de compressão mostra sua variabilidade e anisotropia influenciadas pela granulação média, tipos de contatos minerais predominantes e padrões de microfissuras mais ou menos definidos por influência da foliação presente. Constatou-se que no conjunto analisado a presença da foliação não implica necessariamente em anisotropia das duas propriedades estudadas. / The anisotropy of thermal expansion coefficient and compressive tensile strength were determined for 21 commercially used stones gathered in four set according the main mineral composition named carbonatic, quartz-rich, feldspar-rich and quartz-feldspar-rich rocks. Using a coordinate reference system (xyz) based on the macroscopic visible foliation and lineation the samples were submitted to normalized laboratorial analyses for determination of the both technological properties and the petrographical features such as mineral composition, texture and fabric. Additionally was carried out measurements of weathered area and microcrack quantification by image analysis and texture quantification by U-stage methods. In order to understand the relationship between the anisotropy measured and petrographical data it was applied traditional and multivariate statistical analysis. The results pointed to the great significance of mineral composition and the crystallographic preferred orientation for thermal expansion and respective anisotropy, especially to monomineralic and/or foliated rocks, in spite of some cases microcracks play this role. The compressive strength is mainly controlled by a complex interaction between grain size distribution, grain boundary and microcrack patterns related or not to foliation.