A Bayesian network approach to modelling rip-current drownings and shore-break wave injuries

A Bayesian network (BN) approach is used to model and predict shore-break-related injuries and rip-current drowning incidents based on detailed environmental conditions (wave, tide, weather, beach morphology) on the high-energy Gironde coast, southwest France. Six years (2011–2017) of boreal summer (15 June–15 September) surf zone injuries (SZIs) were analysed, comprising 442 (fatal and non-fatal) drownings caused by rip currents and 715 injuries caused by shore-break waves. Environmental conditions at the time of the SZIs were used to train two separate Bayesian networks (BNs), one for rip-current drownings and the other one for shore-break wave injuries. Each BN included two so-called “hidden” exposure and hazard variables, which are not observed yet interact with several of the observed (environmental) variables, which in turn limit the number of BN edges. Both BNs were tested for varying complexity using K-fold cross-validation based on multiple performance metrics. Results show a poor to fair predictive ability of the models according to the different metrics. Shore-break-related injuries appear more predictable than rip-current drowning incidents using the selected predictors within a BN, as the shore-break BN systematically performed better than the rip-current BN. Sensitivity and scenario analyses were performed to address the influence of environmental data variables and their interactions on exposure, hazard and resulting life risk. Most of our findings are in line with earlier SZI and physical hazard-based work; that is, more SZIs are observed for warm sunny days with light winds; long-period waves, with specifically more shore-break-related injuries at high tide and for steep beach profiles; and more rip-current drownings near low tide with near-shore-normal wave incidence and strongly alongshore non-uniform surf zone morphology. The BNs also provided fresh insight, showing that rip-current drowning risk is approximately equally distributed between exposure (variance reduction Vr=14.4 %) and hazard (Vr=17.4 %), while exposure of water user to shore-break waves is much more important (Vr=23.5 %) than the hazard (Vr=10.9 %). Large surf is found to decrease beachgoer exposure to shore-break hazard, while this is not observed for rip currents. Rapid change in tide elevation during days with large tidal range was also found to result in more drowning incidents. We advocate that such BNs, providing a better understanding of hazard, exposure and life risk, can be developed to improve public safety awareness campaigns, in parallel with the development of more skilful risk predictors to anticipate high-life-risk days.Marier les objectifs de défense côtière avec ceux de la protection du milieu naturel grâce aux dunes sableuse

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Life-threatening infections in children in Europe (the EUCLIDS Project): a prospective cohort study

Background: Sepsis and severe focal infections represent a substantial disease burden in children admitted to hospital. We aimed to understand the burden of disease and outcomes in children with life-threatening bacterial infections in Europe. Methods: The European Union Childhood Life-threatening Infectious Disease Study (EUCLIDS) was a prospective, multicentre, cohort study done in six countries in Europe. Patients aged 1 month to 18 years with sepsis (or suspected sepsis) or severe focal infections, admitted to 98 participating hospitals in the UK, Austria, Germany, Lithuania, Spain, and the Netherlands were prospectively recruited between July 1, 2012, and Dec 31, 2015. To assess disease burden and outcomes, we collected demographic and clinical data using a secured web-based platform and obtained microbiological data using locally available clinical diagnostic procedures. Findings: 2844 patients were recruited and included in the analysis. 1512 (53·2%) of 2841 patients were male and median age was 39·1 months (IQR 12·4–93·9). 1229 (43·2%) patients had sepsis and 1615 (56·8%) had severe focal infections. Patients diagnosed with sepsis had a median age of 27·6 months (IQR 9·0–80·2), whereas those diagnosed with severe focal infections had a median age of 46·5 months (15·8–100·4; p<0·0001). Of 2844 patients in the entire cohort, the main clinical syndromes were pneumonia (511 [18·0%] patients), CNS infection (469 [16·5%]), and skin and soft tissue infection (247 [8·7%]). The causal microorganism was identified in 1359 (47·8%) children, with the most prevalent ones being Neisseria meningitidis (in 259 [9·1%] patients), followed by Staphylococcus aureus (in 222 [7·8%]), Streptococcus pneumoniae (in 219 [7·7%]), and group A streptococcus (in 162 [5·7%]). 1070 (37·6%) patients required admission to a paediatric intensive care unit. Of 2469 patients with outcome data, 57 (2·2%) deaths occurred: seven were in patients with severe focal infections and 50 in those with sepsis. Interpretation: Mortality in children admitted to hospital for sepsis or severe focal infections is low in Europe. The disease burden is mainly in children younger than 5 years and is largely due to vaccine-preventable meningococcal and pneumococcal infections. Despite the availability and application of clinical procedures for microbiological diagnosis, the causative organism remained unidentified in approximately 50% of patients

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Forging connections: anthologies, arts collectives, and the politics of inclusion

The changing social and political landscape of twentieth-century Britain catalysed a remarkable rise in collaborative activity by artists and activists of black and Asian heritage. Creative communities began to gather in both local and regional contexts, with the aim of sharing resources and securing an audience. This chapter records some of these many activities, tracing the groups’ genesis, manifest objectives, and key contributions. It argues that anthologising should be understood as a specifically motivated activity. Literary anthologies of poetry and fiction served to showcase the diversity of contemporary writing, while also suggesting its coherence. Drawing on the concept of “strategic essentialism” elucidated by Gayatri Chakravorty Spivak, I show that the anthology acts to ensure the visibility of a group, bannered as a unified and singly-titled selection of texts, while also insisting on the differences within: the heterogeneous multiplicity of black and Asian British experiences and creative practices

'Vernacular Voices: Black British Poetry'

ABSTRACT Black British poetry is the province of experimenting with voice and recording rhythms beyond the iambic pentameter. Not only in performance poetry and through the spoken word, but also on the page, black British poetry constitutes and preserves a sound archive of distinct linguistic varieties. In Slave Song (1984) and Coolie Odyssey (1988), David Dabydeen employs a form of Guyanese Creole in order to linguistically render and thus commemorate the experience of slaves and indentured labourers, respectively, with the earlier collection providing annotated translations into Standard English. James Berry, Louise Bennett, and Valerie Bloom adapt Jamaican Patois to celebrate Jamaican folk culture and at times to represent and record experiences and linguistic interactions in the postcolonial metropolis. Grace Nichols and John Agard use modified forms of Guyanese Creole, with Nichols frequently constructing gendered voices whilst Agard often celebrates linguistic playfulness. The borders between linguistic varieties are by no means absolute or static, as the emergence and marked growth of ‘London Jamaican’ (Mark Sebba) indicates. Asian British writer Daljit Nagra takes liberties with English for different reasons. Rather than having recourse to established Creole languages, and blending them with Standard English, his heteroglot poems frequently emulate ‘Punglish’, the English of migrants whose first language is Punjabi. Whilst it is the language prestige of London Jamaican that has been significantly enhanced since the 1990s, a fact not only confirmed by linguistic research but also by its transethnic uses both in the streets and on the page, Nagra’s substantial success and the mainstream attention he receives also indicate the clout of vernacular voices in poetry. They have the potential to connect with oral traditions and cultural memories, to record linguistic varieties, and to endow ‘street cred’ to authors and texts. In this chapter, these double-voiced poetic languages are also read as signs of resistance against residual monologic ideologies of Englishness. © Book proposal (02/2016): The Cambridge History of Black and Asian British Writing p. 27 of 4

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection ar

A Bayesian network approach to modelling rip-current drownings and shore-break wave injuries

International audienceAbstract. A Bayesian network (BN) approach is used to model and predict shore-break-related injuries and rip-current drowning incidents based on detailed environmental conditions (wave, tide, weather, beach morphology) on the high-energy Gironde coast, southwest France. Six years (2011–2017) of boreal summer (15 June–15 September) surf zone injuries (SZIs) were analysed, comprising 442 (fatal and non-fatal) drownings caused by rip currents and 715 injuries caused by shore-break waves. Environmental conditions at the time of the SZIs were used to train two separate Bayesian networks (BNs), one for rip-current drownings and the other one for shore-break wave injuries. Each BN included two so-called “hidden” exposure and hazard variables, which are not observed yet interact with several of the observed (environmental) variables, which in turn limit the number of BN edges. Both BNs were tested for varying complexity using K-fold cross-validation based on multiple performance metrics. Results show a poor to fair predictive ability of the models according to the different metrics. Shore-break-related injuries appear more predictable than rip-current drowning incidents using the selected predictors within a BN, as the shore-break BN systematically performed better than the rip-current BN. Sensitivity and scenario analyses were performed to address the influence of environmental data variables and their interactions on exposure, hazard and resulting life risk. Most of our findings are in line with earlier SZI and physical hazard-based work; that is, more SZIs are observed for warm sunny days with light winds; long-period waves, with specifically more shore-break-related injuries at high tide and for steep beach profiles; and more rip-current drownings near low tide with near-shore-normal wave incidence and strongly alongshore non-uniform surf zone morphology. The BNs also provided fresh insight, showing that rip-current drowning risk is approximately equally distributed between exposure (variance reduction Vr=14.4 %) and hazard (Vr=17.4 %), while exposure of water user to shore-break waves is much more important (Vr=23.5 %) than the hazard (Vr=10.9 %). Large surf is found to decrease beachgoer exposure to shore-break hazard, while this is not observed for rip currents. Rapid change in tide elevation during days with large tidal range was also found to result in more drowning incidents. We advocate that such BNs, providing a better understanding of hazard, exposure and life risk, can be developed to improve public safety awareness campaigns, in parallel with the development of more skilful risk predictors to anticipate high-life-risk days