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Introduction: Burn injuries pose a significant public health challenge, especially in low- and middle-income countries (LMICs). In Bangladesh, burn injuries are prevalent and often result in severe disability or death. However, knowledge regarding the causes of burn injuries, acute burn management, and barriers to seeking burn care in the riverine areas of northern Bangladesh is limited., Methods: We conducted a questionnaire-based study in eight subunits and five selected districts in northern Bangladesh to determine the prevalence, causes, and management of burn injuries in these areas. A total of 210 individuals from different households were interviewed, which represented a population of 1020 persons., Results: Among the respondents, 55% reported that at least one member of their household suffered from a burn injury in the past. The most common causes of burn injuries were open fire (41%) and hot fluids (30%). More than 40% of burns were not rinsed with water directly after sustaining the injury. Additionally, almost 30% of respondents did not seek medical care immediately after the injury, with financial constraints being the most commonly cited reason., Discussion: We found a low rate of adequate cooling and seeking medical care. The need for basic knowledge on prevention and treatment of burn injuries and improved access to affordable health care services in the region is high., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

The isolation of specific grain size classes of lithogenic samples and biogenic carbonate from the <63 µm fraction (i.e. clay and silt) of marine sediment is often a prerequisite to further pre-treatments and/or analytical measurements for palaeoceanographic studies. Established techniques employed have included sieving, settling and micro-filtration (and/or a combination of these). However, these methods often use significant amounts of bulk sediment (often up to ∼3 g) and/or require considerable amounts of time during sediment processing (ranging from 48 h to 3 weeks) to isolate a size specific class for further analyses. Here, we build on previous approaches to isolate three grain size classes (e.g. <2 µm, clay; 2-10 µm, fine silt; and 10-63 µm, coarse silt) from the <63 µm fraction of marine sediment with the aid of a centrifuge at varying revolutions per minute using Stokes' Law. We show the utility of our approach using two common sediment types dominated by (i) lithogenic and (ii) biogenic carbonate (specifically coccoliths) components of marine sediment cores. Our method reduces the amount of sample material required to 1-2 g to provide an isolated clay fraction (or other targeted size fraction) and decreases the sample processing time (to ∼1 hour) to enable high throughput of analysis, when compared to previous techniques for palaeoceanographic proxy measurements.•We recommend a more straightforward grain size isolation method for lithogenic sediment and biogenic carbonate sediment types•Isolating commonly targeted grain size fractions for palaeoceanographic studies using a centrifuge., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier B.V.)

Species assemblage composition of marine microfossils offers the possibility to investigate ecological and climatological change on time scales inaccessible using conventional observations. Planktonic foraminifera - calcareous zooplankton - have an excellent fossil record and are used extensively in palaeoecology and palaeoceanography. During the Last Glacial Maximum (LGM; 19,000 - 23,000 years ago), the climate was in a radically different state. This period is therefore a key target to investigate climate and biodiversity under different conditions than today. Studying LGM climate and ecosystems indeed has a long history, yet the most recent global synthesis of planktonic foraminifera assemblage composition is now nearly two decades old. Here we present the ForCenS-LGM dataset with 2,365 species assemblage samples collected using standardised methods and with harmonised taxonomy. The data originate from marine sediments from 664 sites and present a more than 50% increase in coverage compared to previous work. The taxonomy is compatible with the most recent global core top dataset, enabling direct investigation of temporal changes in foraminifera biogeography and facilitating seawater temperature reconstructions., (© 2024. The Author(s).)

Introduction: Burns are a frequent injury in children and can cause great physical and psychological impairment. Studies have identified positive effects of prevention measures based on increase in knowledge or reduction in hazards. The main goal of burn prevention campaigns, however, is to prevent burns. Therefore, this review is focused on the effectiveness of prevention programmes on the rates of burns in children., Methods: A literature search was performed on PubMed, Embase, CINAHL, Web of Science, Google Scholar and Scopus, including a reference-check. Included were studies which evaluated burn prevention programmes in terms of burn injury rate in children up to 19 years old. Studies specifically focused on non-accidental burns were excluded as well as studies with only outcomes such as safety knowledge or number of hazards., Results: The search led to 1783 articles that were screened on title and abstract. 85 articles were screened in full text, which led to 14 relevant studies. Nine of them reported a significant reduction in burn injury rate. Five others showed no effect on the number of burn injuries. In particular, studies that focused on high-risk populations and combined active with passive preventive strategies were successful., Conclusion: Some prevention programmes appear to be an effective manner to reduce the number of burn injuries in children. However, it is essential to interpret the results of the included studies cautiously, as several forms of biases may have influenced the observed outcomes. The research and evidence on this subject is still very limited. Therefore, it is of great importance that future studies will be evaluated on a decrease in burns and bias will be prevented. Especially in low-income countries, where most of the burns in children occur and the need for effective prevention campaigns is vital., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Prior to ~1 million years ago (Ma), variations in global ice volume were dominated by changes in obliquity; however, the role of precession remains unresolved. Using a record of North Atlantic ice rafting spanning the past 1.7 million years, we find that the onset of ice rafting within a given glacial cycle (reflecting ice sheet expansion) consistently occurred during times of decreasing obliquity whereas mass ice wasting (ablation) events were consistently tied to minima in precession. Furthermore, our results suggest that the ubiquitous association between precession-driven mass wasting events and glacial termination is a distinct feature of the mid to late Pleistocene. Before then (increasing), obliquity alone was sufficient to end a glacial cycle, before losing its dominant grip on deglaciation with the southward extension of Northern Hemisphere ice sheets since ~1 Ma.

Constraining the past sea ice variability in the Nordic Seas is critical for a comprehensive understanding of the abrupt Dansgaard-Oeschger (D-O) climate changes during the last glacial. Here we present unprecedentedly detailed sea ice proxy evidence from two Norwegian Sea sediment cores and an East Greenland ice core to resolve and constrain sea ice variations during four D-O events between 32 and 41 ka. Our independent sea ice records consistently reveal a millennial-scale variability and threshold response between an extensive seasonal sea ice cover in the Nordic Seas during cold stadials and reduced seasonal sea ice conditions during warmer interstadials. They document substantial and rapid sea ice reductions that may have happened within 250 y or less, concomitant with reinvigoration of deep convection in the Nordic Seas and the abrupt warming transitions in Greenland. Our empirical evidence thus underpins the cardinal role of rapid sea ice decline and related feedbacks to trigger abrupt and large-amplitude climate change of the glacial D-O events., Competing Interests: The authors declare no competing interest.

The interocean transfer of thermocline water between the Indian and the Atlantic Oceans known as 'Agulhas leakage' is of global significance as it influences the Atlantic Meridional Overturning Circulation (AMOC) on different time scales. Variability in the Agulhas Current regime is key in shaping hydroclimate on the adjacent coastal areas of the African continent today as well as during past climates. However, the lack of long, continuous records from the proximal Agulhas Current region dating beyond the last glacial cycle prevents elucidation of its role in regional and wider global climate changes. This is the first continuous record of hydrographic variability (SST; δ 18 O sw ) from the Agulhas Current core region spanning the past 270,000 years. The data set is analytical sound and provides a solid age model. As such, it can be used by paleoclimate scientists, archaeologists, and climate modelers to evaluate, for example, linkages between the Agulhas Current system and AMOC dynamics, as well as connections between ocean heat transport and Southern African climate change in the past and its impact on human evolution.

Extending oceanographic data beyond the instrumental period is highly needed to better characterize and understand multi-decadal to centennial natural ocean variability. Here, a stable isotope record at unprecedented temporal resolution (1 to 2 years) from a new marine core retrieved off western North Iceland is presented. We aim to better constrain the variability of subsurface, Atlantic-derived Subpolar Mode Water (SPMW), using near surface-dwelling planktic foraminifera and Arctic Intermediate Water (AIW) mass changes using benthic foraminifera over the last ~165 years. The reconstruction overlaps in time with instrumental observations and a direct comparison reveals that the δ18O record of Neogloboquadrina pachyderma is reliably representing temperature fluctuations in the SPMWs. Trends in the N. pachyderma δ13C record match the measured phosphate concentration in the upper 200 m on the North Icelandic Shelf well. Near surface-dwelling foraminifera trace anthropogenic CO2 in the Iceland Sea by ~ 1950 ± 8, however, a reduced amplitude shift in the Marine Suess effect is identified. We argue that this is caused by a contemporary ongoing increase in marine primary productivity in the upper ocean due to enhanced Greenland's freshwater discharge that has contributed to a nutrient-driven fertilization since the 1940s/50s (Perner et al., 2019). Multi-decadal variability is detected. We find that the 16-year periodicity evident in SPMW and AIWs based on the δ18O of N. pachyderma and M. barleeanum is a signal of SST anomalies propagated into the Nordic Seas via the Atlantic inflow branches around Iceland. Spectral analyses of the planktic foraminiferal δ13C signal indicate intermittent 30-year cycles that are likely reflecting the ocean response to atmospheric variability, presumably the East Atlantic Pattern. A long-term trend in benthic δ18O suggests that Atlantic-derived waters are expanding their core within the water column from the subsurface into deeper intermediate depths towards the present day. This is a result of increased transport by the North Icelandic Irminger Current to the North Iceland Shelf over the historical era., Competing Interests: The authors have declared that no competing interests exist.

The geochemical and isotopic composition of terrigenous clays from marine sediments can provide important information on the sources and pathways of sediments. In order to extract the detrital signal from bulk marine sediments, standard sediment leaching methods are commonly applied to remove carbonate and ferromanganese oxides. In comparison to most previous studies that aimed to extract the terrestrial signal from marine sediments we additionally applied a CsCl wash throughout the sample preparation Simon et al. [1]. The motivation behind that extra step, not frequently applied, is to remove ions that are gained on the clay surface due to re-adsorption of authigenic trace metals in the ocean or during the leaching procedure and thus could alter the original composition of the detrital fraction if no cation exchange was applied. Here we present an improved and detailed step-by-step leaching protocol for the extraction of the detrital fraction of bulk deep-sea sediments including commonly used buffered acetic acid and acid-reductive mix solutions including a final cation exchange wash.•standard method to remove carbonate and ferromanganese oxides and Stokes settling to isolate the clay fractions•additional application of cation cation exchange wash (CsCl)•removal of ions that are gained on the clay surface due to adsorption of authigenic trace metals in the ocean or during the leaching procedure., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 The Author(s). Published by Elsevier B.V.)

Introduction: Corrective osteotomies of the lower limb are standard procedures in orthopedic surgery. Still, there is only limited research on factors affecting bone healing after osteotomies. We hypothesize that especially the location of the osteotomy, smoking status and BMI affect bone healing., Material and Methods: The healing process of 547 patients who underwent osteotomies of the lower limb (259 female, 288 male; average 40.6 years, range 14-77) was evaluated. To assess bone healing, participants were divided into three groups by bone healing duration ( < 5/5-8/ > 8 months). Differences in healing duration related to the anatomic level of the osteotomy (diaphysis vs. metaphysis), age, gender, smoking status, BMI, and modus of the osteotomy (open vs. closed wedge) were tested for significance using an ordinal regression analysis., Results: A significant correlation between bone healing and the anatomical level of the osteotomy on femur and tibia and the patients' smoking status was found. The odds of the diaphysis considering bone healing was 0.187 (95% CI, 0.08-0.44) times that of the metaphysis (Wald χ 2 (1) = 14.597, p < 0.000). The odds ratio of smokers considering bone healing was 0.192 (95% CI, 0.11-0.33) times that of non-smokers (Wald χ 2 (1) = 35.420, p < 0.000). All other analyzed factors did not show a significant correlation with bone healing., Conclusions: Smoking status and the localization of the osteotomy on femur and tibia (diaphysis vs. metaphysis) are significantly correlated with bone healing duration. In line with current literature emphasizing the detrimental effect of smoking on bone healing, our findings should encourage surgeons to think twice about the indication to perform osteotomies on smokers. Furthermore, if applicable, osteotomies should be performed in the metaphyseal areas of femur and tibia.

Constraining the response time of the climate system to changes in North Atlantic Deep Water (NADW) formation is fundamental to improving climate and Atlantic Meridional Overturning Circulation predictability. Here we report a new synchronization of terrestrial, marine, and ice-core records, which allows the first quantitative determination of the response time of North Atlantic climate to changes in high-latitude NADW formation rate during the last deglaciation. Using a continuous record of deep water ventilation from the Nordic Seas, we identify a ∼400-year lead of changes in high-latitude NADW formation ahead of abrupt climate changes recorded in Greenland ice cores at the onset and end of the Younger Dryas stadial, which likely occurred in response to gradual changes in temperature- and wind-driven freshwater transport. We suggest that variations in Nordic Seas deep-water circulation are precursors to abrupt climate changes and that future model studies should address this phasing.

Processes that control the hydrological balance in eastern South Africa on orbital to millennial timescales remain poorly understood because proxy records documenting its variability at high resolution are scarce. In this work, we present a detailed 270,000 year-long record of terrestrial climate variability in the KwaZulu-Natal province based on elemental ratios of Fe/K from the southwest Indian Ocean, derived from X-ray fluorescence core scanning. Eastern South African climate variability on these time scales reflects both the long-term effect of regional insolation changes driven by orbital precession and the effects associated with high-latitude abrupt climate forcing over the past two glacial-interglacial cycles, including millennial-scale events not previously identified. Rapid changes towards more humid conditions in eastern South Africa as the Northern Hemisphere entered phases of extreme cooling were potentially driven by a combination of warming in the Agulhas Current and shifts of the subtropical anticyclones. These climate oscillations appear coherent with other Southern Hemisphere records but are anti-phased with respect to the East Asian Monsoon. Numerical modelling results reveal that higher precipitation in the KwaZulu-Natal province during precession maxima is driven by a combination of increased local evaporation and elevated moisture transport into eastern South Africa from the coast of Mozambique.

The development of modernity in early human populations has been linked to pulsed phases of technological and behavioural innovation within the Middle Stone Age of South Africa. However, the trigger for these intermittent pulses of technological innovation is an enigma. Here we show that, contrary to some previous studies, the occurrence of innovation was tightly linked to abrupt climate change. Major innovational pulses occurred at times when South African climate changed rapidly towards more humid conditions, while northern sub-Saharan Africa experienced widespread droughts, as the Northern Hemisphere entered phases of extreme cooling. These millennial-scale teleconnections resulted from the bipolar seesaw behaviour of the Atlantic Ocean related to changes in the ocean circulation. These conditions led to humid pulses in South Africa and potentially to the creation of favourable environmental conditions. This strongly implies that innovational pulses of early modern human behaviour were climatically influenced and linked to the adoption of refugia.