Background Outpatient monoclonal antibodies are no longer effective and antiviral treatments for coronavirus disease 2019 (COVID-19) disease remain largely unavailable in many countries worldwide.... Show moreBackground Outpatient monoclonal antibodies are no longer effective and antiviral treatments for coronavirus disease 2019 (COVID-19) disease remain largely unavailable in many countries worldwide. Although treatment with COVID-19 convalescent plasma (CCP) is promising, clinical trials among outpatients have shown mixed results. Methods We conducted an individual participant data meta-analysis from outpatient trials to assess the overall risk reduction for all-cause hospitalizations by day 28 in transfused participants. Relevant trials were identified by searching Medline, Embase, medRxiv, World Health Organization COVID-19 Research Database, Cochrane Library, and Web of Science from January 2020 to September 2022. Results Five included studies from 4 countries enrolled and transfused 2620 adult patients. Comorbidities were present in 1795 (69%). The virus neutralizing antibody dilutional titer levels ranged from 8 to 14 580 in diverse assays. One hundred sixty of 1315 (12.2%) control patients were hospitalized, versus 111 of 1305 (8.5%) CCP-treated patients, yielding a 3.7% (95% confidence interval [CI], 1.3%-6.0%; P = .001) absolute risk reduction and 30.1% relative risk reduction for all-cause hospitalization. The hospitalization reduction was greatest in those with both early transfusion and high titer with a 7.6% absolute risk reduction (95% CI, 4.0%-11.1%; P = .0001) accompanied by at 51.4% relative risk reduction. No significant reduction in hospitalization was seen with treatment >5 days after symptom onset or in those receiving CCP with antibody titers below the median titer. Conclusions Among outpatients with COVID-19, treatment with CCP reduced the rate of all-cause hospitalization and may be most effective when given within 5 days of symptom onset and when antibody titer is higher.While this outpatient COVID-19 convalescent plasma meta-analysis indicated heterogeneity in participant risk factors and convalescent plasma titer, the combined efficacy for reducing hospitalization was significant, improving with transfusion within 5 days of symptom onset and high antibody neutralization levels. Show less
Murungi, M.; Esteban, I.; Sifogeorgakis, E.; Dusseldorp, G.L. 2021
The period between ~40 and 20 ka BP encompassing the Middle Stone Age (MSA) and Later Stone Age (LSA) transition has long been of interest because of the associated technological change.... Show moreThe period between ~40 and 20 ka BP encompassing the Middle Stone Age (MSA) and Later Stone Age (LSA) transition has long been of interest because of the associated technological change. Understanding this transition in southern Africa is complicated by the paucity of archaeological sites that span this period. With its occupation sequence spanning the last ~70,000 years, Umhlatuzana Rock Shelter is one of the few sites that record this transition. Umhlatuzana thus offers a great opportunity to study past environmental dynamics from the Late Pleistocene (MIS 4) to the Late Holocene, and past human subsistence strategies, their social organisation, technological and symbolic innovations. Although organic preservation is poor (bones, seeds, and charcoal) at the site, silica phytoliths preserve generally well throughout the sequence. These microscopic silica particles can identify different plant types that are no longer visible at the site because of decomposition or burning to a reliable taxonomical level. Thus, to trace site occupation, plant resource use, and in turn reconstruct past vegetation, we applied phytolith analyses to sediment samples of the newly excavated Umhlatuzana sequence. We present results of the phytolith assemblage variability to determine change in plant use from the Pleistocene to the Holocene and discuss them in relation to taphonomical processes and human plant gathering strategies and activities. This study ultimately seeks to provide a palaeoenvironmental context for modes of occupation and will shed light on past human-environmental interactions in eastern South Africa. Show less
Sifogeorgakis, E.; Klinkenberg, M.V.; Esteban, I.; Murungi, M.; Carr, A.S.; Brink, V.B. van den; Dusseldorp, G.L. 2020
Umhlatuzana rockshelter has an occupation sequence spanning the last 70,000 years. It is one of the few sites with deposits covering the Middle to Later Stone Age transition (~40,000–30,000 years... Show moreUmhlatuzana rockshelter has an occupation sequence spanning the last 70,000 years. It is one of the few sites with deposits covering the Middle to Later Stone Age transition (~40,000–30,000 years BP) in southern Africa. Comprehending the site’s depositional history and occupation sequence is thus important for the broader understanding of the development of Homo sapiens’ behavior. The rockshelter was first excavated in the 1980s by Jonathan Kaplan. He suggested that the integrity of the late Middle Stone Age and Later Stone Age sediments was compromised by large-scale sediment movement. In 2018, we initiated a high-resolution geoarchaeological study of the site to clarify the site formation processes. Here, we present the results of the excavation and propose a revised stratigraphic division of the Pleistocene sequence based on field observations, sedimentological (particle size) analyses, and cluster analysis. The taphonomy of the site is assessed through phytolith and geochemical (pH, loss on ignition, stable carbon isotope) analyses. The results indicate a consistent sedimentological environment characterized by in situ weathering. The analysis of the piece-plotted finds demonstrates semihorizontal layering of archaeologically dense zones and more sterile ones. There was no indication of large-scale postdepositional sediment movement. We show that the low-density archaeological horizons in the upper part of the Pleistocene sequence are best explained by the changing patterns of sedimentation rate Show less
