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- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 4. |
- Hesselstrand, Roger, et al.
(författare)
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An open-label study to evaluate biomarkers and safety in systemic sclerosis patients treated with paquinimod
- 2021
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Ingår i: Arthritis Research and Therapy. - : Springer Science and Business Media LLC. - 1478-6354 .- 1478-6362. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate the changes in disease-related biomarkers and safety of paquinimod, an oral immunomodulatory compound, in patients with systemic sclerosis (SSc). Methods: In this open-label, single-arm, multicenter study, SSc patients with a rapidly progressive disease received paquinimod for 8 weeks. Blood and skin biopsies were collected at baseline, during treatment, and at follow-up for the analyses of type I interferon (IFN) activity, chemokine (C-C motif) ligand 2 (CCL2), and the number of myofibroblasts. The safety of paquinimod was evaluated throughout the study. Results: Nine SSc patients were enrolled and completed the study treatment with paquinimod at 3 mg/day for 8 weeks. After the treatment, a reduction of type I IFN activity in the plasma from one patient with elevated baseline IFN activity was recorded. A trend towards reduced IFN activity in the skin after treatment was also observed in patients. The serum level of CCL2 was reduced in 7 of 9 patients after paquinimod treatment. There was a median reduction of 10% of the number of myofibroblasts in skin biopsies at week 8 compared to baseline. No change in modified Rodnan skin score and quality of life was detected in the study. Reported adverse events (AEs) were mild to moderate and expected with the most common being arthralgia (n = 3) and headache (n = 3), and C-reactive protein (CRP) increase. Conclusions: Analysis of biomarkers before and after treatment suggest reduced type I IFN activity and reduced number of myofibroblasts in lesional skin. Paquinimod was overall well tolerated with mild to moderate and expected AEs. Trial registration: ClinicalTrials.gov, NCT01487551. Registered on 7 September 2011.
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| 5. |
- Hillier, Ladeana W, et al.
(författare)
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Sequence and comparative analysis of the chicken genome provide unique perspectives on vertebrate evolution
- 2004
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Ingår i: Nature. - 0028-0836 .- 1476-4687. ; 432:7018, s. 695-716
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Tidskriftsartikel (refereegranskat)abstract
- We present here a draft genome sequence of the red jungle fowl, Gallus gallus. Because the chicken is a modern descendant of the dinosaurs and the first non-mammalian amniote to have its genome sequenced, the draft sequence of its genome--composed of approximately one billion base pairs of sequence and an estimated 20,000-23,000 genes--provides a new perspective on vertebrate genome evolution, while also improving the annotation of mammalian genomes. For example, the evolutionary distance between chicken and human provides high specificity in detecting functional elements, both non-coding and coding. Notably, many conserved non-coding sequences are far from genes and cannot be assigned to defined functional classes. In coding regions the evolutionary dynamics of protein domains and orthologous groups illustrate processes that distinguish the lineages leading to birds and mammals. The distinctive properties of avian microchromosomes, together with the inferred patterns of conserved synteny, provide additional insights into vertebrate chromosome architecture.
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| 6. |
- Andersson, Helén C., 1968, et al.
(författare)
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Regulation of the Indonesian throughflow by baroclinic draining of the North Australian Basin
- 2005
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Ingår i: Deep-Sea Research Part I-Oceanographic Research Papers. - : Elsevier BV. - 0967-0637. ; 52:12, s. 2214-2233
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Tidskriftsartikel (refereegranskat)abstract
- The Indonesian throughflow (ITF) is studied using historic hydrographical data with purpose of obtaining a description of the characteristics of the large-scale flow and an understanding of both the forcing and control of the flow. The investigation makes use of the steric sea level and the contents of freshwater and heat in the water Column integrated down to the depth of the deepest connection (effective sill depth) between the Pacific and Indian Oceans within the Indonesian seas. It is shown that it is mainly low-saline water of North Pacific origin that fills the upper part of both the Indonesian seas and a downstream buoyant (surface) pool (DBP) that stretches horizontally over a large part of the North Australian Basin. The long-term mean steric sea level in the Indonesian seas is approximately horizontal and equal to the sea level in the neighboring part of the Pacific Ocean. This indicates small frictional losses against the mean throughflow, which is verified using a coupled multiple basin model of the Indonesian seas. The chan e of the steric sea level, from the Pacific Ocean level to the Indian Ocean level, Occurs essentially at the border between the DBP and the adjacent Indian Ocean. It is found that Darwin is situated inside the DBP, indicating that the sea level recorded in this place is a poor representative of mean and low frequency parts of the sea level variability of the Indian Ocean. It is argued that the control of ITF is set by the baroclinic transport capacity of the DBP relative to the adjacent (Indian Ocean) water. The mean ITF, estimated as the Outflow from the DBP to the South Equatorial Current, is about 10 Sv. The integrated ITF imprint is fresh and cold and the net heat transport is estimated to be 0.3 PW. The buffering capacity of the DBP is about 5 years, so variations in the circulation should be modest on shorter time-scales. It is suggested that the atmospheric transfer of freshwater to the North Pacific and vertical mixing in the North Pacific provide the driving of the mean ITF and that ITF is a major branch of the estuarine-type vertical circulation of the North Pacific. (c) 2005 Elsevier Ltd. All rights reserved.
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| 7. |
- Andersson, Helén C., 1968, et al.
(författare)
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Thermohaline circulation in a two-layer model with sloping boundaries and a mid-ocean ridge
- 2004
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Ingår i: DEEP-SEA RESEARCH PART I-OCEANOGRAPHIC RESEARCH. - : Elsevier BV. - 0967-0637. ; 51:1, s. 93-106
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Tidskriftsartikel (refereegranskat)abstract
- A model ocean basin has continental slopes at the west and north and a mid-ocean ridge running north-south. The first problem treated here is Stommel's (Deep-Sea Res. 5 (1958) 80) abyssal flow of a homogeneous fluid in the presence of topography with a source of fluid at the northwest corner. The flow is driven by uniform upwelling everywhere except over the non-flat topography where the fluid is not driven and inviscid. The solution over the topography is determined by conservation of potential vorticity with the flow being driven by matching to the known solution over the flat bottom. A second problem is the two-layer case for which we use an analysis by Salmon (J. Mar. Res. 50 (1992) 341) in which he obtained expressions for the potential vorticity distribution for inviscid, non-forced flow over topography. We produce analytical solutions for the two-layer case. Conservation of potential vorticity over the slopes leads to flows that make large north-south excursions as the fluid crosses the topographic regions over the western slope and the mid-ocean ridge. We justify our procedure by showing a similarity between a wind-driven double gyre solution of Salmon's that shows a cyclonic circulation on the onshore (Gulf Stream) side of the anticyclonic wind gyre and an observed cyclonic gyre in the Slope Sea inshore of the Gulf Stream. For the two-layer case we obtain flow over the midocean ridge in the lower layer that compares favorably with the excursion of particles over the mid-Atlantic Ridge as reported by Defant (Deutsche Atlantische Expedition 'Meteor' 1925-1927, 6, 1941, pp. 191-260; Physical Oceanography, Vol. 1, Pergamon Press, New York, Oxford, London, Paris, 1961). Our inviscid solutions contain sharp discontinuities which will have to be smoothed by friction when viscosity is added, but it is possible that friction will take the flow far from the one that we have derived. A numerical solution of the problem is planned to test this possibility.
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| 8. |
- Fazey, Ioan, et al.
(författare)
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Transforming knowledge systems for life on Earth : Visions of future systems and how to get there
- 2020
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Ingår i: Energy Research & Social Science. - : Elsevier. - 2214-6296 .- 2214-6326. ; 70
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Tidskriftsartikel (refereegranskat)abstract
- Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent.
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| 9. |
- Furukawa, Toshi A., et al.
(författare)
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Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression : a systematic review and component network meta-analysis using individual data
- 2021
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Ingår i: Lancet psychiatry. - London, United Kingdom : Elsevier. - 2215-0374 .- 2215-0366. ; 8:6, s. 500-511
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Forskningsöversikt (refereegranskat)abstract
- Findings We identified 76 RCTs, including 48 trials contributing individual participant data (11 704 participants) and 28 trials with aggregate data (6474 participants). The participants' weighted mean age was 42.0 years and 12 406 (71%) of 17 521 reported were women. There was suggestive evidence that behavioural activation might be beneficial (iMD -1.83 [95% credible interval (CrI) -2.90 to -0.80]) and that relaxation might be harmful (1.20 [95% CrI 0.17 to 2.27]). Baseline severity emerged as the strongest prognostic factor for endpoint depression. Combining human and automated encouragement reduced dropouts from treatment (incremental odds ratio, 0.32 [95% CrI 0.13 to 0.93]). The risk of bias was low for the randomisation process, missing outcome data, or selection of reported results in most of the included studies, uncertain for deviation from intended interventions, and high for measurement of outcomes. There was moderate to high heterogeneity among the studies and their components. 511
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| 10. |
- Jutterström, Sara, 1975, et al.
(författare)
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Multiple stressors threatening the future of the Baltic Sea-Kattegat marine ecosystem: Implications for policy and management actions
- 2014
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Ingår i: Marine Pollution Bulletin. - : Elsevier BV. - 0025-326X. ; 86:1-2, s. 468-480
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Tidskriftsartikel (refereegranskat)abstract
- The paper discusses the combined effects of ocean acidification, eutrophication and climate change on the Baltic Sea and the implications for current management strategies. The scientific basis is built on results gathered in the BONUS+ projects Baltic-C and ECOSUPPORT. Model results indicate that the Baltic Sea is likely to be warmer, more hypoxic and more acidic in the future. At present management strategies are not taking into account temporal trends and potential ecosystem change due to warming and/or acidification, and therefore fulfilling the obligations specified within the Marine Strategy Framework Directive, OSPAR and HELCOM conventions and national environmental objectives may become significantly more difficult. The paper aims to provide a basis for a discussion on the effectiveness of current policy instruments and possible strategies for setting practical environmental objectives in a changing climate and with multiple stressors.
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