| 1. |
- Marto, João Pedro, et al.
(författare)
-
Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19: The Global COVID-19 Stroke Registry.
- 2023
-
Ingår i: Neurology. - 1526-632X. ; 100:7
-
Tidskriftsartikel (refereegranskat)abstract
- COVID-19-related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19.This was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection. With a doubly robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT).Of a total of 15,128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19; of those, 5,848 (38.7%) patients received IVT-only and 9,280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted OR 1.53; 95% CI 1.16-2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20-2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23-1.99), 24-hour mortality (OR 2.47; 95% CI 1.58-3.86), and 3-month mortality (OR 1.88; 95% CI 1.52-2.33). Patients with COVID-19 also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26-1.60).Patients with AIS and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non-COVID-19 patients receiving treatment. Current available data do not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in patients with COVID-19 or to establish different treatment recommendations in this subgroup of patients with ischemic stroke. Our findings can be taken into consideration for treatment decisions, patient monitoring, and establishing prognosis.The study was registered under ClinicalTrials.gov identifier NCT04895462.
|
|
| 2. |
- Nguyen, Thanh N, et al.
(författare)
-
Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: A 1-Year Follow-up.
- 2023
-
Ingår i: Neurology. - 1526-632X. ; 100:4
-
Tidskriftsartikel (refereegranskat)abstract
- Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020).We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases.There were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1-6.9]; p < 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1-4.6]; p < 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4-5.8]; p < 0.0001). Larger declines were observed at high-volume compared with low-volume centers (all p < 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6-0.9]; p = 0.49). Stroke was diagnosed in 1.3% [1.31-1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82-2.97], 5,656/195,539) of all stroke hospitalizations.There was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year.This study is registered under NCT04934020.
|
|
| 3. |
- Canova, Moara Almeida, et al.
(författare)
-
Different ecosystem services, same (dis)satisfaction with compensation : A critical comparison between farmers' perception in Scotland and Brazil
- 2019
-
Ingår i: Ecosystem Services. - : Elsevier BV. - 2212-0416. ; 35, s. 164-172
-
Tidskriftsartikel (refereegranskat)abstract
- Payments for Ecosystem Services (PES) schemes have increasingly expanded to consider ecosystem services (ESS). In Brazil, the Forest Code permits PES but does not specify the scheme operationalization. The way ESS should be quantified and valued has not yet been implemented country-wide, nor has the funding source for PES. Through interviews with farmers in Rio Claro-SP, Brazil, and in Cairngorms National Park in the highlands and lowlands of Scotland, UK, we compared farmers' perspectives concerning ESS and PES, focusing on the PES implementation in sugarcane landscape in Sao Paulo state. While Scottish farmers perceived more cultural services, Brazilian farmers focused on regulating services, which we attribute to socio-political and landscape differences. Despite these differences, farmers in both areas preferred opportunity cost approach for ESS valuation because this method captures efforts to maintain ESS. Thereby, the opportunity cost should be considered for valuation in PES schemes, but conversely, budgetary constraints make it impossible to satisfy farmers with PES in regions of high productivity in the southeast of Brazil. Lessons learned concerning the PES subsidies in Scotland indicates the importance of co-designing schemes with stakeholders, minimizing trade-offs between the environment. Therefore, the participants as ESS providers, beneficiaries and intermediaries in the public policies arena was recognized for co-optimize the trade-offs between costs and effectiveness in PES.
|
|
| 4. |
|
|
| 5. |
- Lapola, David M., et al.
(författare)
-
Limiting the high impacts of Amazon forest dieback with no-regrets science and policy action
- 2018
-
Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 115:46, s. 11671-11679
-
Tidskriftsartikel (refereegranskat)abstract
- Large uncertainties still dominate the hypothesis of an abrupt large-scale shift of the Amazon forest caused by climate change [Amazonian forest dieback (AFD)] even though observational evidence shows the forest and regional climate changing. Here, we assess whether mitigation or adaptation action should be taken now, later, or not at all in light of such uncertainties. No action/later action would result in major social impacts that may influence migration to large Amazonian cities through a causal chain of climate change and forest degradation leading to lower river-water levels that affect transportation, food security, and health. Net-present value socioeconomic damage over a 30-year period after AFD is estimated between US dollar (USD) $957 billion (x10(9)) and $3,589 billion (compared with Gross Brazilian Amazon Product of USD $150 billion per year), arising primarily from changes in the provision of ecosystem services. Costs of acting now would be one to two orders of magnitude lower than economic damages. However, while AFD mitigation alternatives-e.g., curbing deforestation-are attainable (USD $64 billion), their efficacy in achieving a forest resilience that prevents AFD is uncertain. Concurrently, a proposed set of 20 adaptation measures is also attainable (USD $122 billion) and could bring benefits even if AFD never occurs. An interdisciplinary research agenda to fill lingering knowledge gaps and constrain the risk of AFD should focus on developing sound experimental and modeling evidence regarding its likelihood, integrated with socioeconomic assessments to anticipate its impacts and evaluate the feasibility and efficacy of mitigation/adaptation options.
|
|
| 6. |
- Mechler, R., et al.
(författare)
-
Loss and Damage and limits to adaptation : recent IPCC insights and implications for climate science and policy
- 2020
-
Ingår i: Sustainability Science. - : Springer Science and Business Media LLC. - 1862-4065 .- 1862-4057. ; 15:4, s. 1245-1251
-
Tidskriftsartikel (refereegranskat)abstract
- Recent evidence shows that climate change is leading to irreversible and existential impacts on vulnerable communities and countries across the globe. Among other effects, this has given rise to public debate and engagement around notions of climate crisis and emergency. The Loss and Damage (L&D) policy debate has emphasized these aspects over the last three decades. Yet, despite institutionalization through an article on L&D by the United Nations Framework Convention on Climate Change (UNFCCC) in the Paris Agreement, the debate has remained vague, particularly with reference to its remit and relationship to adaptation policy and practice. Research has recently made important strides forward in terms of developing a science perspective on L&D. This article reviews insights derived from recent publications by the Intergovernmental Panel on Climate Change (IPCC) and others, and presents the implications for science and policy. Emerging evidence on hard and soft adaptation limits in certain systems, sectors and regions holds the potential to further build momentum for climate policy to live up to the Paris ambition of stringent emission reductions and to increase efforts to support the most vulnerable. L&D policy may want to consider actions to extend soft adaptation limits and spur transformational, that is, non-standard risk management and adaptation, so that limits are not breached. Financial, technical, and legal support would be appropriate for instances where hard limits are transgressed. Research is well positioned to further develop robust evidence on critical and relevant risks at scale in the most vulnerable countries and communities, as well as options to reduce barriers and limits to adaptation.
|
|
| 7. |
- Pereira, Laura M., 1985-, et al.
(författare)
-
Equity and justice should underpin the discourse on tipping points
- 2024
-
Ingår i: Earth System Dynamics. - 2190-4979 .- 2190-4987. ; 15:2, s. 341-366
-
Forskningsöversikt (refereegranskat)abstract
- Radical and quick transformations towards sustainability will be fundamental to achieving a more sustainable future. However, deliberate interventions to reconfigure systems will result in winners and losers, with the potential for greater or lesser equity and justice outcomes. Positive tipping points (PTPs) have been proposed as interventions in complex systems with the aim to (a) reduce the likelihood of negative Earth system tipping points and/or (b) increase the likelihood of achieving just social foundations. However, many narratives around PTPs often do not take into account the entire spectrum of impacts the proposed alternatives could have or still rely on narratives that maintain current unsustainable behaviours and marginalize many people (i.e. do not take “b” into account). One such example is the move from petrol-based to electric vehicles. An energy transition that remains based on natural resource inputs from the Global South must be unpacked with an equity and justice lens to understand the true cost of this transition. There are two arguments why a critical engagement with these and other similar proposals needs to be made. First, the idea of transitioning through a substitution (e.g. of fuel) while maintaining the system structure (e.g. of private vehicles) may not necessarily be conceived as the kind of radical transformation being called for by global scientific bodies like the Intergovernmental Panel on Climate Change (IPCC) and Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES). Second, and probably more importantly, the question of positive for whom, positive where, and positive how must be considered. In this paper, we unpack these narratives using a critical decolonial view from the south and outline their implications for the concept of tipping points.
|
|
| 8. |
- Seitzinger, Sybil P., et al.
(författare)
-
Planetary Stewardship in an Urbanizing World : Beyond City Limits
- 2012
-
Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 41:8, s. 787-794
-
Tidskriftsartikel (refereegranskat)abstract
- Cities are rapidly increasing in importance as a major factor shaping the Earth system, and therefore, must take corresponding responsibility. With currently over half the world's population, cities are supported by resources originating from primarily rural regions often located around the world far distant from the urban loci of use. The sustainability of a city can no longer be considered in isolation from the sustainability of human and natural resources it uses from proximal or distant regions, or the combined resource use and impacts of cities globally. The world's multiple and complex environmental and social challenges require interconnected solutions and coordinated governance approaches to planetary stewardship. We suggest that a key component of planetary stewardship is a global system of cities that develop sustainable processes and policies in concert with its non-urban areas. The potential for cities to cooperate as a system and with rural connectivity could increase their capacity to effect change and foster stewardship at the planetary scale and also increase their resource security.
|
|
| 9. |
- Spaiser, Viktoria, et al.
(författare)
-
Negative social tipping dynamics resulting from and reinforcing Earth system destabilization
- 2024
-
Ingår i: Earth System Dynamics. - 2190-4979 .- 2190-4987. ; 15:5, s. 1179-1206
-
Tidskriftsartikel (refereegranskat)abstract
- In recent years, research on normatively positive social tipping dynamics in response to the climate crisis has produced invaluable insights. In contrast, relatively little attention has been given to the potentially negative social tipping processes that might unfold due to an increasingly destabilized Earth system and to how they might in turn reinforce social and ecological destabilization dynamics and/or impede positive social change. In this paper, we discuss selected potential negative social tipping processes (anomie, radicalization and polarization, displacement, conflict, and financial destabilization) linked to Earth system destabilization. We draw on related research to understand the drivers and likelihood of these negative tipping dynamics, their potential effects on human societies and the Earth system, and the potential for cascading interactions (e.g. food insecurity and displacement) contributing to systemic risks. This first attempt to provide an explorative conceptualization and empirical account of potential negative social tipping dynamics linked to Earth system destabilization is intended to motivate further research into an under-studied area that is nonetheless crucial for our ability to respond to the climate crisis and for ensuring that positive social tipping dynamics are not averted by negative ones.
|
|
| 10. |
- Szegő, Éva M., et al.
(författare)
-
Cytosolic Trapping of a Mitochondrial Heat Shock Protein Is an Early Pathological Event in Synucleinopathies
- 2019
-
Ingår i: Cell Reports. - : Elsevier BV. - 2211-1247. ; 28:1, s. 6-77
-
Tidskriftsartikel (refereegranskat)abstract
- Alpha-synuclein (aSyn) accumulates in intracellular inclusions in synucleinopathies, but the molecular mechanisms leading to disease are unclear. We identify the 10 kDa heat shock protein (HSP10) as a mediator of aSyn-induced mitochondrial impairments in striatal synaptosomes. We find an age-associated increase in the cytosolic levels of HSP10, and a concomitant decrease in the mitochondrial levels, in aSyn transgenic mice. The levels of superoxide dismutase 2, a client of the HSP10/HSP60 folding complex, and synaptosomal spare respiratory capacity are also reduced. Overexpression of HSP10 ameliorates aSyn-associated mitochondrial dysfunction and delays aSyn pathology in vitro and in vivo. Altogether, our data indicate that increased levels of aSyn induce mitochondrial deficits, at least partially, by sequestering HSP10 in the cytosol and preventing it from acting in mitochondria. Importantly, these alterations manifest first at presynaptic terminals. Our study not only provides mechanistic insight into synucleinopathies but opens new avenues for targeting underlying cellular pathologies. Szegő et al. identify HSP10 as a modulator of alpha-synuclein-induced mitochondrial impairment in striatal synaptosomes. Age-associated increase in the cytosolic and decrease in mitochondrial levels of HSP10 results in a reduction in the levels of SOD2 and of synaptosomal ATP production on demand. HSP10 overexpression delays alpha-synuclein pathology both in vitro and in vivo.
|
|
