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Abstract Objectives To develop a prediction model of mortality in pediatric trauma-based injuries. Our secondary objective was to transform this model into a translational tool for clinical use. Study design A retrospective cohort study of children ≤ 18 years was derived from the National Trauma Data Bank between the years of 2007 to 2015. The goal was to identify clinical or physiologic variables that would serve as predictors for pediatric death. Data was split into a development cohort (80%) to build the model and then tested in an internal validation cohort (20%) and a temporal cohort. The area under the receiver operating characteristic curve (AUC) was assessed for the new model. Results In 693,192 children, the mortality rate was 1.4% (n = 9,785). Most subjects were male (67%), White (65%), and incurred an unintentional injury (92%). The proposed model had an AUC of 96.4% (95% CI: 95.9%-96.9%). In contrast, the Injury Severity Score yielded an AUC of 92.9% (95% CI: 92.2%-93.6%), while the Revised Trauma Score resulted in an AUC of 95.0% (95% CI: 94.4%-95.6%). Conclusion The TRAGIC + Model (Temperature, Race, Age, GCS, Injury Type, Cardiac-systolic blood pressure + Mechanism of Injury and Sex) is a new pediatric mortality prediction model that leverages variables easily obtained upon trauma admission.

We report radiocarbon dates obtained from on-shore marine and near-shore terrestrial deposits near Yzerfontein, on the West Coast of South Africa. These deposits include Late Pleistocene shell concretions from the southern end of 16 Mile Beach and a marine shell deposit inland of the coastal Rooipan (Red Pan); mid-Holocene coastal pan deposits exposed by modern storm erosion of the sandy 16 Mile Beach; and four Holocene storm beach deposits on a rocky shore to the south. We interpret the results in terms of local geomorphology constraints on sea-level fluctuations. The eastern margin of Rooipan is a >40 ka elevated beach deposit in a dune cordon that separates it from the adjacent Yzerfonteinpan. Both pans have gypsum deposits up to 2 m thick formed by repeated marine overwash. Saline pan deposits that are exposed intermittently on the beach are mid-Holocene and indicate a former westward extension of Rooipan. This is in contrast to storm beaches dating 8000–2600 cal BP at higher elevations on a rocky platform further south. This suggests that a dune barrier existed seaward of the present shoreline near Rooipan at this time. The coastal changes described here show that deposition and erosion can be affected significantly by the local palaeogeomorphology and cannot be ascribed solely to sea-level change. Significance: Mollusc shells from Yzerfontein, Western Cape Province, South Africa, show radiocarbon ages ranging from >40 000 years to a few decades before present. There is evidence for elevated sea levels between 8000 and 2600 years ago, and sea levels similar to the present in the last 2000 years. Neither the elevation of the deposits nor their ages conform to published sea-level change curves for the Western Cape coast. Inundation by rising sea levels in the Holocene was not spatially uniform. Former and present geomorphology have had a significant effect on deposition and preservation of indicators of sea-level change.

Several models which remain equivocal and controversial cite migration and/or diffusion for the emergence and spread of pastoralism and farming in southern Africa during the first millennium AD. A synthesis of archaeobotanical proxies (e.g., palynology, phytoliths, anthracology) consistent with existing archaeobotanical and archaeological data leads to new insights into anthropogenic impacts in palaeorecords. Harnessing such archaeobotanical evidence is viable for tracing the spread of pastoralism and farming in the first millennium AD because the impact of anthropogenic practices is likely to result in distinct patterns of vegetation change. We assess this impact through the synthesis of published archaeobotanical evidence of pastoralism and farming, as well as vegetation changes in southern Africa during the first millennium AD. It has been argued that the decline of forests during the first millennium AD in southern Africa predominantly relates to climate change. This argument often precludes anthropogenic effects on vegetation. Our reassessment of the relationship between vegetation, climate, and human activities in southern Africa reveals evidence of human impact during the same period. We also highlight gaps in the current knowledge of early pastoralism and farming and potential future research directions. We hypothesize that the pattern exhibited by the decline of forest tree pollen, coupled with the increase of open-land indicators, the occurrence of pioneer trees, as well as the spores of coprophilous fungi, and possible changes in the fire regime are reflective of, and consistent with, anthropogenic activities of pre-European pastoralists and farmers.

The Makgadikgadi Basin in Botswana hosts a system of salt lakes, which developed from the Upper Pleistocene onward due to the gradual shrinking of the giant Lake Palaeo-Makgadikgadi. Stratigraphic and palaeoclimatic studies of this area are difficult due to the influence of several factors, such as a complex history of regional tectonic activities, as well as climatic changes coupled with dryland diagenetic processes. This lake, in the central Kalahari, is the key to understanding the climatic variability in the southern part of Africa in the Quaternary and has played an important role in the evolution of numerous taxa, including our own. In this study, detailed sedimentological analyses (grain size and major elements distribution) of shallow sediments from the Makgadikgadi Pans were combined with the first comprehensive study of the encountered ostracod fauna to establish trends in the environmental changes in the area from the late Quaternary. Ostracod fossil assemblages from the cores of the Makgadikgadi Pans are dominated by the Limnocythere ssp., an opportunistic taxa commonly colonizing the littoral areas of shallow evaporative, ephemeral lakes, together with the subordinate occurrences of Sarcypridopsis ochracea, Sclerocypris cf. bicornis, Candonopsis spp., and Ilyocypris spp. The sediments from the pans show fluctuations in the Cl/K and Ca/Cl ratios, often in phase with the relative abundance of Limnocythere suggesting a cyclicity induced by changes of salinity and alkalinity in the water. This multi-proxy study of the cores collected from the pans suggests a Late Pleistocene shallow, playa lake environment with strongly alkaline water, interrupted by a prolonged drought with sustained aeolian conditions between ∼16 and 2 ka BP. Increasing diversity of ostracod fauna in the top 20–30 cm of the cores indicates that a temporary shift toward higher humidity occurred around 2–1.5 ka BP and lasted through the Medieval Warm Period. This humid period was followed by an overall desiccation trend that started with the Little Ice Age and continues until the present day.

No abstract available.

Abstract Background Lung disease is a leading cause of morbidity and mortality. A breach in the lung alveolar-epithelial barrier and impairment in lung function are hallmarks of acute and chronic pulmonary illness. This review is part two of our previous work. In part 1, we demonstrated that CdM is as effective as MSCs in modulating inflammation. Herein, we investigated the effects of mesenchymal stromal cell (MSC)-conditioned media (CdM) on (i) lung architecture/function in animal models mimicking human lung disease, and (ii) performed a head-to-head comparison of CdM to MSCs. Methods Adhering to the animal Systematic Review Centre for Laboratory animal Experimentation protocol, we conducted a search of English articles in five medical databases. Two independent investigators collected information regarding lung: alveolarization, vasculogenesis, permeability, histologic injury, compliance, and measures of right ventricular hypertrophy and right pulmonary pressure. Meta-analysis was performed to generate random effect size using standardized mean difference with 95% confidence interval. Results A total of 29 studies met inclusion. Lung diseases included bronchopulmonary dysplasia, asthma, pulmonary hypertension, acute respiratory distress syndrome, chronic obstructive pulmonary disease, and pulmonary fibrosis. CdM improved all measures of lung structure and function. Moreover, no statistical difference was observed in any of the lung measures between MSCs and CdM. Conclusions In this meta-analysis of animal models recapitulating human lung disease, CdM improved lung structure and function and had an effect size comparable to MSCs.

Shoreline analysis in response to the rapid erosion of sandy beaches has evolved along with geospatial and computer technology; it remains an essential task for sustainable coastal management. This severe and rapid erosion has been reported at several sandy beaches worldwide, including Yzerfontein beaches, on the southwest coast of South Africa. We determined this vulnerability from 1937 to 2020 and predicted its change by 2040 by manually delineating shoreline positions from 1937, 1960, and 1977 from aerial photographs and Landsat products between 1985 and 2020 in an automated fashion using the CoastSat toolkit and Google Earth Engine. We then integrated these datasets to calculate the extent of shoreline dynamics over the past eight decades using the Digital Shoreline Analysis System (DSAS). Our results show that the coastline changed dynamically between 1937 and 2020, culminating in an average net erosion of 38 m, with the most extensive erosion occurring between 2015 and 2020. However, coastal projections indicate a slight change in shoreline position over the next two decades. Further studies should integrate additional high resolution remote sensing data and non-remote sensing data (e.g., field surveys) to improve our results and provide a more thorough understanding of the coastal environment and overcome some of remotely-sensed data underlying uncertainties.

Background: Multisystem inflammatory syndrome in children (MIS-C), also known as pediatric inflammatory multisystem syndrome, is a new dangerous childhood disease that is temporally associated with coronavirus disease 2019 (COVID-19). We aimed to describe the typical presentation and outcomes of children diagnosed with this hyperinflammatory condition. Methods: We conducted a systematic review to communicate the clinical signs and symptoms, laboratory findings, imaging results, and outcomes of individuals with MIS-C. We searched four medical databases to encompass studies characterizing MIS-C from January 1st, 2020 to July 25th, 2020. Two independent authors screened articles, extracted data, and assessed risk of bias. This review was registered with PROSPERO CRD42020191515. Findings: Our search yielded 39 observational studies (n = 662 patients). While 71·0% of children (n = 470) were admitted to the intensive care unit, only 11 deaths (1·7%) were reported. Average length of hospital stay was 7·9 ± 0·6 days. Fever (100%, n = 662), abdominal pain or diarrhea (73·7%, n = 488), and vomiting (68·3%, n = 452) were the most common clinical presentation. Serum inflammatory, coagulative, and cardiac markers were considerably abnormal. Mechanical ventilation and extracorporeal membrane oxygenation were necessary in 22·2% (n = 147) and 4·4% (n = 29) of patients, respectively. An abnormal echocardiograph was observed in 314 of 581 individuals (54·0%) with depressed ejection fraction (45·1%, n = 262 of 581) comprising the most common aberrancy. Interpretation: Multisystem inflammatory syndrome is a new pediatric disease associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is dangerous and potentially lethal. With prompt recognition and medical attention, most children will survive but the long-term outcomes from this condition are presently unknown. Funding: Parker B. Francis and pilot grant from 2R25-HL126140. Funding agencies had no involvement in the study

Background: Studies summarizing the clinical picture of COVID-19 in children are lacking. This review characterizes clinical symptoms, laboratory, and imaging findings, as well as therapies provided to confirmed pediatric cases of COVID-19. Methods: Adhering to PRISMA guidelines, we searched four medical databases (PubMed, LitCovid, Scopus, WHO COVID-19 database) between December 1, 2019 to May 14, 2020 using the keywords “novel coronavirus”, “COVID-19” or “SARS-CoV-2”. We included published or in press peer-reviewed cross-sectional, case series, and case reports providing clinical signs, imaging findings, and/or laboratory results of pediatric patients who were positive for COVID-19. Risk of bias was appraised through the quality assessment tool published by the National Institutes of Health. PROSPERO registration # CRD42020182261. Findings: We identified 131 studies across 26 countries comprising 7780 pediatric patients. Although fever (59·1%) and cough (55·9%) were the most frequent symptoms 19·3% of children were asymptomatic. Patchy lesions (21·0%) and ground-glass opacities (32·9%) depicted lung radiograph and computed tomography findings, respectively. Immunocompromised children or those with respiratory/cardiac disease comprised the largest subset of COVID-19 children with underlying medical conditions (152 of 233 individuals). Coinfections were observed in 5.6% of children and abnormal laboratory markers included serum D-dimer, procalcitonin, creatine kinase, and interleukin-6. Seven deaths were reported (0·09%) and 11 children (0·14%) met inclusion for multisystem inflammatory syndrome in children. Interpretation: This review provides evidence that children diagnosed with COVID-19 have an overall excellent prognosis. Future longitudinal studies are needed to confirm our findings and better understand which patients are at increased risk for developing severe inflammation and multiorgan failure. Funding: Parker B. Francis and pilot grant from 2R25-HL126140. Funding agencies had no involvement in the study.

New ages for flowstone, sediments and fossil bones from the Dinaledi Chamber are presented. We combined optically stimulated luminescence dating of sediments with U-Th and palaeomagnetic analyses of flowstones to establish that all sediments containing Homo naledi fossils can be allocated to a single stratigraphic entity (sub-unit 3b), interpreted to be deposited between 236 ka and 414 ka. This result has been confirmed independently by dating three H. naledi teeth with combined U-series and electron spin resonance (US-ESR) dating. Two dating scenarios for the fossils were tested by varying the assumed levels of 222Rn loss in the encasing sediments: a maximum age scenario provides an average age for the two least altered fossil teeth of 253 +82/–70 ka, whilst a minimum age scenario yields an average age of 200 +70/–61 ka. We consider the maximum age scenario to more closely reflect conditions in the cave, and therefore, the true age of the fossils. By combining the US-ESR maximum age estimate obtained from the teeth, with the U-Th age for the oldest flowstone overlying Homo naledi fossils, we have constrained the depositional age of Homo naledi to a period between 236 ka and 335 ka. These age results demonstrate that a morphologically primitive hominin, Homo naledi, survived into the later parts of the Pleistocene in Africa, and indicate a much younger age for the Homo naledi fossils than have previously been hypothesized based on their morphology.

The distinctions between the public and the private have long been a way of organising the material world, and those distinctions are shifting. This article traces a brief history of the increasingly insecure privacy – both deliberate and not – that is a defining characteristic of our age.

Young women are increasingly diagnosed with sexually transmitted infections (STIs), including HIV. The aim of this study was to test various types of mass media and their associations with interpersonal communication about sex and HIV or AIDS among female college students, stratified by race. The study used a nonexperimental cross-sectional design and an electronic survey. The sample consisted of female college students ( N = 776) at a 4-year public university in the southeast. We found that the race of college women influenced their preferred media source for reception of information about sex and HIV/AIDS, which subsequently either motivated or was insignificant to communication with parents and/or partners.

The effects of temperature, precipitation, relative humidity and hours of sunlight on Campylobacter incidence in humans and broiler flocks is examine by using lag dependence functions, locally fitted linear models and cross validation methods. The combined effects of temperature and sunlight or the combined effects of temperature and relative humidity predicted the incidence in human equally well.

The article provides public awareness on the benefits of a balanced and varied diet in attaining a healthy weight in Great Britain. Several approaches and activities were implemented focusing more on ending food poverty in the region including health walks, healthy eating sessions, classes on cooking for diabetics, reading food labels, tai chi, dancing and seated exercise.

A central component of the public's conception of the mentally ill is that they are dangerous. This belief receives support from recent studies of the arrest rates of ex-mental patients which suggest that arrests for violent crimes have increased. In order for investigate this issue, samples were taken at two points in lime. Analysis of arrest rates revealed that very few ex-mental patients were subsequently arrested for violent crimes, although these rates were higher and increasing faster than those of the general population. Most significant were the findings that subsequent arrests were best explained by the number of prior arrests and that the percentage of patients with a history of criminal behavior has increased dramatically over lime. The implications of these trends in violent crime among ex-mental patients for the perceived link between mental illness and violence and for the social control functions of society are discussed. [ABSTRACT FROM AUTHOR]

Provides information on the activities at the Oxford Verse Speaking Contest and Festival in England in 1931. Background on previous celebrations of the festival; Participants in the festival; Details of the speeches and lectures given at the festival.