Chemical evidence for milk, meat, and marine resource processing in Later Stone Age pots from Namaqualand, South Africa

The subsistence practices of Later Stone Age (LSA) foragers and herders living in Namaqualand South Africa are often difficult to differentiate based on their archaeological signatures but characterizing their dietary choices is vital to understand the economic importance of domesticates. However, ethnohistoric accounts have provided information on the cooking/boiling of marine mammal fat, mutton, plants, and milk by early herders and foragers across the Western Cape. To further investigate these reports, we use lipid residue analysis to characterize 106 potsherds from four open-air LSA sites, spanning in time from the early first millennium to the late second millennium AD. Two sites (SK2005/057A, SK2006/026) are located on the Atlantic coast whereas sites Jakkalsberg K and Jakkalsberg M are located further inland on the southern bank of the Orange River. Notably, at the coastal sites, the presence of marine biomarkers suggests the intensive and/or specialized processing of marine products in many vessels. The dominance of ruminant carcass products at inland sites and probable sheep remains confirms the importance of stockkeeping. Furthermore, and in good agreement with ethnohistoric accounts for its use, our results provide the first direct chemical evidence for the use of dairy products in LSA western South Africa.

278 The Paediatric Major Trauma Tertiary Survey: Are We Missing the Mark on Missed Injuries?

The tertiary survey is an integral part of assessment in major trauma. This has been shown to reduce missed injuries resulting in better patient care and favourable medico-legal outcomes. A formal tertiary survey should be carried out for all paediatric major trauma patients.

The primary aim of this audit was to assess completion rates of the tertiary survey proforma for major trauma admissions under the paediatric surgery team at the Bristol Royal Hospital for Children. The secondary aim was to evaluate the adequacy of the current proforma and detect areas for improvement.

Paediatric surgery major trauma admissions were audited over a 7-month period and data was collected retrospectively from patient notes on Evolve (n = 20).

A formal tertiary survey was completed for 6 patients which equated to a completion rate of 30%. A total of 1 missed injury was identified (lip laceration) which required no further treatment. Head-to-toe examination was documented in all of the completed surveys but lacked detail. Documentation of gait was absent in 85% and a body map was not filled in for any of the patients.

The audit was presented at a departmental meeting to increase awareness about the tertiary survey and requirements for completion. An MDT of doctors, nurses and trauma co-ordinators was consulted to design a more thorough proforma which included specific sections for review of bloods and imaging.

Re-audit of the new proforma is ongoing and it is hoped that, in combination with educational initiatives, this will lead to increased identification of missed injuries.

An Ancient Baboon Genome Demonstrates Long-Term Population Continuity in Southern Africa

Baboons are one of the most abundant large nonhuman primates and are widely studied in biomedical, behavioral, and anthropological research. Despite this, our knowledge of their evolutionary and demographic history remains incomplete. Here, we report a 0.9-fold coverage genome sequence from a 5800-year-old baboon from the site of Ha Makotoko in Lesotho. The ancient baboon is closely related to present-day Papio ursinus individuals from southern Africa-indicating a high degree of continuity in the southern African baboon population. This level of population continuity is rare in recent human populations but may provide a good model for the evolution of Homo and other large primates over similar timespans in structured populations throughout Africa.

Ancient human parallel lineages within North America contributed to a coastal expansion

Little is known regarding the first people to enter the Americas and their genetic legacy. Genomic analysis of the oldest human remains from the Americas showed a direct relationship between a Clovis-related ancestral population and all modern Central and South Americans as well as a deep split separating them from North Americans in Canada. We present 91 ancient human genomes from California and Southwestern Ontario and demonstrate the existence of two distinct ancestries in North America, which possibly split south of the ice sheets. A contribution from both of these ancestral populations is found in all modern Central and South Americans. The proportions of these two ancestries in ancient and modern populations are consistent with a coastal dispersal and multiple admixture events.

Massive, solitary, intrahepatic, extramedullary hematopoietic tumor in thalassemia

Diffuse compensatory extramedullary hematopoiesis is well known to involve the spleen and liver in certain hematologic disorders. Hematopoietic tumor masses occasionally form and usually occur paraspinally in the posterior mediastinum. A 31-year-old patient with thalassemia is described with a massive, solitary, intrahepatic hematopoietic tumor and a smaller one in the posterior mediastinum. Review of the literature indicates that presentation as a large, focal liver lesion is unique. The implications and differential diagnosis are discussed.

Retroperitoneal dermoid presenting as an infected pancreatic cyst

Bacteroides fragilis infection of a juxtapancreatic benign cystic retroperitoneal teratoma in a 28 year old Chinese male is reported. Preliminary drainage was followed by excision. The radiological and pathological findings of this rare tumour are reported with emphasis on the differential diagnosis which includes inflammatory and neoplastic pancreatic cysts.

Hepatocellular carcinoma in Hong Kong: clinical study on 340 cases

Three hundred and forty cases of hepatocellular carcinoma in Hong Kong were studied for their clinical features, and various factors were analysed for their prognostic values. The clinical presentation was often vague and rather non-specific and a majority of patients were presented late and often unresectable. The overall median survival was 8 weeks. The Karnofsky performance scale and bilirubin level were the most important prognostic factors. The treated group survived longer than the untreated group.