| 1. |
- Yang, Wen-Yi, et al.
(författare)
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Association of Office and Ambulatory Blood Pressure With Mortality and Cardiovascular Outcomes
- 2019
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Ingår i: Journal of the American Medical Association (JAMA). - : AMER MEDICAL ASSOC. - 0098-7484 .- 1538-3598. ; 322:5, s. 409-420
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Tidskriftsartikel (refereegranskat)abstract
- ImportanceBlood pressure (BP) is a known risk factor for overall mortality and cardiovascular (CV)-specific fatal and nonfatal outcomes. It is uncertain which BP index is most strongly associated with these outcomes. ObjectiveTo evaluate the association of BP indexes with death and a composite CV event. Design, Setting, and ParticipantsLongitudinal population-based cohort study of 11135 adults from Europe, Asia, and South America with baseline observations collected from May 1988 to May 2010 (last follow-ups, August 2006-October 2016). ExposuresBlood pressure measured by an observer or an automated office machine; measured for 24 hours, during the day or the night; and the dipping ratio (nighttime divided by daytime readings). Main Outcomes and MeasuresMultivariable-adjusted hazard ratios (HRs) expressed the risk of death or a CV event associated with BP increments of 20/10 mm Hg. Cardiovascular events included CV mortality combined with nonfatal coronary events, heart failure, and stroke. Improvement in model performance was assessed by the change in the area under the curve (AUC). ResultsAmong 11135 participants (median age, 54.7 years, 49.3% women), 2836 participants died (18.5 per 1000 person-years) and 2049 (13.4 per 1000 person-years) experienced a CV event over a median of 13.8 years of follow-up. Both end points were significantly associated with all single systolic BP indexes (P<.001). For nighttime systolic BP level, the HR for total mortality was 1.23 (95% CI, 1.17-1.28) and for CV events, 1.36 (95% CI, 1.30-1.43). For the 24-hour systolic BP level, the HR for total mortality was 1.22 (95% CI, 1.16-1.28) and for CV events, 1.45 (95% CI, 1.37-1.54). With adjustment for any of the other systolic BP indexes, the associations of nighttime and 24-hour systolic BP with the primary outcomes remained statistically significant (HRs ranging from 1.17 [95% CI, 1.10-1.25] to 1.87 [95% CI, 1.62-2.16]). Base models that included single systolic BP indexes yielded an AUC of 0.83 for mortality and 0.84 for the CV outcomes. Adding 24-hour or nighttime systolic BP to base models that included other BP indexes resulted in incremental improvements in the AUC of 0.0013 to 0.0027 for mortality and 0.0031 to 0.0075 for the composite CV outcome. Adding any systolic BP index to models already including nighttime or 24-hour systolic BP did not significantly improve model performance. These findings were consistent for diastolic BP. Conclusions and RelevanceIn this population-based cohort study, higher 24-hour and nighttime blood pressure measurements were significantly associated with greater risks of death and a composite CV outcome, even after adjusting for other office-based or ambulatory blood pressure measurements. Thus, 24-hour and nighttime blood pressure may be considered optimal measurements for estimating CV risk, although statistically, model improvement compared with other blood pressure indexes was small.
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| 2. |
- Munch, Marie W., et al.
(författare)
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Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia The COVID STEROID 2 Randomized Trial
- 2021
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Ingår i: Journal of the American Medical Association (JAMA). - : AMER MEDICAL ASSOC. - 0098-7484 .- 1538-3598. ; 326:18, s. 1807-1817
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Tidskriftsartikel (refereegranskat)abstract
- Question What is the effect of 12 mg vs 6 mg of dexamethasone on the number of days alive without life support at 28 days in patients with COVID-19 and severe hypoxemia? Findings In this randomized trial that included 1000 patients with COVID-19 and severe hypoxemia, treatment with 12 mg/d of dexamethasone resulted in 22.0 days alive without life support at 28 days compared with 20.5 days in those receiving 6 mg/d of dexamethasone. This difference was not statistically significant. Meaning Compared with 6 mg of dexamethasone, 12 mg of dexamethasone did not statistically significantly reduce the number of days alive without life support at 28 days. This multicenter randomized clinical trial compares the effects of 12 mg/d vs 6 mg/d of dexamethasone in patients with COVID-19 and severe hypoxemia. IMPORTANCE A daily dose with 6 mg of dexamethasone is recommended for up to 10 days in patients with severe and critical COVID-19, but a higher dose may benefit those with more severe disease. OBJECTIVE To assess the effects of 12 mg/d vs 6 mg/d of dexamethasone in patients with COVID-19 and severe hypoxemia. DESIGN, SETTING, AND PARTICIPANTS A multicenter, randomized clinical trial was conducted between August 2020 and May 2021 at 26 hospitals in Europe and India and included 1000 adults with confirmed COVID-19 requiring at least 10 L/min of oxygen or mechanical ventilation. End of 90-day follow-up was on August 19, 2021. INTERVENTIONS Patients were randomized 1:1 to 12 mg/d of intravenous dexamethasone (n = 503) or 6 mg/d of intravenous dexamethasone (n = 497) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was the number of days alive without life support (invasive mechanical ventilation, circulatory support, or kidney replacement therapy) at 28 days and was adjusted for stratification variables. Of the 8 prespecified secondary outcomes, 5 are included in this analysis (the number of days alive without life support at 90 days, the number of days alive out of the hospital at 90 days, mortality at 28 days and at 90 days, and >= 1 serious adverse reactions at 28 days). RESULTS Of the 1000 randomized patients, 982 were included (median age, 65 [IQR, 55-73] years; 305 [31%] women) and primary outcome data were available for 971 (491 in the 12 mg of dexamethasone group and 480 in the 6 mg of dexamethasone group). The median number of days alive without life support was 22.0 days (IQR, 6.0-28.0 days) in the 12 mg of dexamethasone group and 20.5 days (IQR, 4.0-28.0 days) in the 6 mg of dexamethasone group (adjusted mean difference, 1.3 days [95% CI, 0-2.6 days]; P = .07). Mortality at 28 days was 27.1% in the 12 mg of dexamethasone group vs 32.3% in the 6 mg of dexamethasone group (adjusted relative risk, 0.86 [99% CI, 0.68-1.08]). Mortality at 90 days was 32.0% in the 12 mg of dexamethasone group vs 37.7% in the 6 mg of dexamethasone group (adjusted relative risk, 0.87 [99% CI, 0.70-1.07]). Serious adverse reactions, including septic shock and invasive fungal infections, occurred in 11.3% in the 12 mg of dexamethasone group vs 13.4% in the 6 mg of dexamethasone group (adjusted relative risk, 0.83 [99% CI, 0.54-1.29]). CONCLUSIONS AND RELEVANCE Among patients with COVID-19 and severe hypoxemia, 12 mg/d of dexamethasone compared with 6 mg/d of dexamethasone did not result in statistically significantly more days alive without life support at 28 days. However, the trial may have been underpowered to identify a significant difference.
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| 3. |
- Davies, Siwan M, et al.
(författare)
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Identification of the Fugloyarbanki tephra in the NGRIP ice-core: a key tie-point for marine and ice-core sequences during the last glacial period
- 2008
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Ingår i: Journal of Quaternary Science. - : Wiley. - 0267-8179 .- 1099-1417. ; 23:5, s. 409-414
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Tidskriftsartikel (refereegranskat)abstract
- A visible tephra horizon in the NGRIP ice core has been identified by geochemical analysis as the Fugloyarbanki Tephra, a widespread marker horizon in marine cores from the Faroe Islands area and the northern North Atlantic. An age of 26 740 ± 390 yr b2k (1σ uncertainty) is derived for this tephra according to the new Greenland Ice Core Chronology (GICC05) based on multi-parameter counting of annual layers. Detection of this tephra for the first time within the NGRIP ice core provides a key tie-point between marine and ice-core records during the transition between MIS 3 and 2. Identification of this volcanic event within the Greenland records demonstrates the future potential of using tephrochronology to precisely correlate palaeoarchives in widely separated localities that span the last glacial period, as well as providing a potential method for examining the extent of the radiocarbon marine reservoir effect at this time.
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| 4. |
- Davies, Siwan M., et al.
(författare)
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Tracing volcanic events in the NGRIP ice-core and synchronising North Atlantic marine records during the last glacial period
- 2010
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Ingår i: Earth and Planetary Science Letters. - : Elsevier BV. - 0012-821X .- 1385-013X. ; 294, s. 69-79
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Five basaltic tephra horizons have been identified in the NGRIP ice-core during the last glacial period. Geochemical analyses indicate that these tephras are of Icelandic origin with one horizon identified as the Faroe Marine Ash Zone III (FMAZ III) — an important marker horizon in several marine records within the Faroe Islands margin. The FMAZ III is a few millimetres thick and is constrained to 38,122 ± 723 yr b2k (before year AD 2000) according to the Greenland Ice Core Chronology (GICC05). This event falls directly at the thermal peak of Greenland Interstadial 8 (GI-8) and a marine-ice correlation, based on the position of this tephra, suggests a close coupling of the marine and atmospheric systems at this time. The remaining tephras originate from the Eastern Volcanic Zone with the Katla volcanic system pinpointed as the dominant source. These are thought to represent previously unknown volcanic events which add considerably to our knowledge of Icelandic volcanism during this period. Independent ages are assigned to these events and together with major element characterisation, form the backbone of the tephrochronology framework presented here. Despite the identification of these tephras, this study also demonstrates that the sulphate record may not always act as a suitable proxy for the identification of tephra horizons in ice-core records.
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| 5. |
- Haahr, Thor, et al.
(författare)
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Vaginal dysbiosis in pregnancy associates with risk of emergency caesarean section: a prospective cohort study
- 2022
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Ingår i: Clinical Microbiology and Infection. - Oxford, United Kingdom : Elsevier. - 1198-743X .- 1469-0691. ; 28:4, s. 588-595
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate changes in vaginal microbiota during pregnancy, and the association between vaginal dysbiosis and reproductive outcomes.Methods: A total of 730 (week 24) and 666 (week 36) vaginal samples from 738 unselected pregnant women were studied by microscopy (Nugent score) and characterized by 16S rRNA gene sequencing. A novel continuous vaginal dysbiosis score was developed based on these methods using a supervised partial least squares model.Results: Among women with bacterial vaginosis in week 24 (n = 53), 47% (n = 25) also had bacterial vaginosis in week 36. In contrast, among women without bacterial vaginosis in week 24, only 3% (n = 18) developed bacterial vaginosis in week 36. Vaginal samples dominated by Lactobacillus crispatus (OR 0.35, 95% CI 0.20–0.60) and Lactobacillus iners (OR 0.40, 95% CI 0.23–0.68) in week 24 were significantly more stable by week 36 when compared with other vaginal community state types. Vaginal dysbiosis score at week 24 was associated with a significant increased risk of emergency, but not elective, caesarean section (OR 1.37, 955 CI 1.15–1.64, p < 0.001), suggesting a 37% increased risk per standard deviation increase in vaginal dysbiosis score.Conclusions: Changes in vaginal microbiota from week 24 to week 36 of pregnancy correlated with bacterial vaginosis status and vaginal community state type. A novel vaginal dysbiosis score was associated with a significantly increased risk of emergency, but not elective, caesarean section. This was not found for bacterial vaginosis or any vaginal community state type and could point to the importance of investigating vaginal dysbiosis as a nuanced continuum instead of crude clusters.
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| 6. |
- Jørgensen, Tine, et al.
(författare)
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A comparative study of ancient sedimentary DNA, pollen and macrofossils from permafrost sediments of Northern Siberia reveals long-term vegetational stability
- 2012
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Ingår i: Molecular Ecology. - 0962-1083. ; 21:8, s. 1989-2003
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in Undetermined Although ancient DNA from sediments (sedaDNA) has been used to investigate past ecosystems, the approach has never been directly compared with the traditional methods of pollen and macrofossil analysis. We conducted a comparative survey of 18 ancient permafrost samples spanning the Late Pleistocene (4612.5 thousand years ago), from the Taymyr Peninsula in northern Siberia. The results show that pollen, macrofossils and sedaDNA are complementary rather than overlapping and, in combination, reveal more detailed information on plant palaeocommunities than can be achieved by each individual approach. SedaDNA and macrofossils share greater overlap in plant identifications than with pollen, suggesting that sedaDNA is local in origin. These two proxies also permit identification to lower taxonomic levels than pollen, enabling investigation into temporal changes in species composition and the determination of indicator species to describe environmental changes. Combining data from all three proxies reveals an area continually dominated by a mosaic vegetation of tundra-steppe, pioneer and wet-indicator plants. Such vegetational stability is unexpected, given the severe climate changes taking place in the Northern Hemisphere during this time, with changes in average annual temperatures of >22 degrees C. This may explain the abundance of ice-age mammals such as horse and bison in Taymyr Peninsula during the Pleistocene and why it acted as a refugium for the last mainland woolly mammoth. Our finding reveals the benefits of combining sedaDNA, pollen and macrofossil for palaeovegetational reconstruction and adds to the increasing evidence suggesting large areas of the Northern Hemisphere remained ecologically stable during the Late Pleistocene.
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| 7. |
- Rasmussen, Tine L., et al.
(författare)
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Atlantic surface water inflow to the Nordic seas during the Pleistocene-Holocene transition (mid-late Younger Dryas and Pre-Boreal periods, 12 450-10 000 a BP)
- 2011
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Ingår i: Journal of Quaternary Science. - : Wiley. - 0267-8179 .- 1099-1417. ; 26:7, s. 723-733
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Tidskriftsartikel (refereegranskat)abstract
- The inflow of Atlantic Water to the Nordic seas from mid-late Younger Dryas to earliest Holocene (12 450-10 000 a BP) is reconstructed on the basis of a high-resolution core (LINK14) from 346 m water depth on the east Faroe shelf. We have analysed the distribution of planktic and benthic foraminifera, stable isotopes and ice-rafted debris (IRD), and calculated absolute temperatures and salinities by transfer functions. During the investigated time period there was almost continuous inflow of Atlantic Water to the Nordic seas. Deposition of IRD during the mid-late Younger Dryas and Pre-Boreal coolings indicates the presence of melting icebergs and that summer sea surface temperatures were low. The east-west temperature gradient across the Faroe-Shetland Channel was much steeper than today. The cold conditions around the Faroe Islands are attributed to stronger East Greenland and East Icelandic currents than at present. The near-continuous inflow of Atlantic Water is consistent with published evidence suggesting that deep convection took place in the Nordic seas, although the convection sites probably had shifted to a more easterly position than at present. Around the time of deposition of the Saksunarvatn Tephra c. 10 350 a BP, sea surface temperatures increased to the present level.
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| 8. |
- Sen, Arunima, et al.
(författare)
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The phylogeography and ecology of Oligobrachia frenulate species suggest a generalist chemosynthesis-based fauna in the arctic
- 2023
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Ingår i: Heliyon. - : Elsevier BV. - 2405-8440. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- We used ancient DNA (aDNA) extraction methods to sequence museum voucher samples of Oligobrachia webbi, a frenulate siboglinid polychaete described from a northern Norwegian fjord over fifty years ago. Our sequencing results indicate a genetic match with the cryptic seep species, Oligobrachia haakonmosbiensis (99% pairwise identity for 574 bp mtCOI fragments). Due to its similarity with O. webbi, the identity of O. haakonmosbiensis has been a matter of debate since its description, which we have now resolved. Furthermore, our results demonstrate that chemosynthesis-based siboglinids, that constitute the bulk of the biomass at Arctic seeps are not seep specialists. Our data on sediment geochemistry and carbon and nitrogen content reveal reduced conditions in fjords/sounds, similar to those at seep systems. Accumulation and decomposition of both terrestrial and marine organic matter results in the buildup of methane and sulfide that apparently can sustain chemosymbiotic fauna. The occurrence of fjords and by extension, highly reducing habitats, could have led to Arctic chemosymbiotic species being relatively generalist with their habitat, as opposed to being seep or vent specialists. Our stable isotope analyses indicate the incorporation of photosynthetically derived carbon in some individuals, which aligns with experiments conducted on frenulates before the discovery of chemosynthesis that demonstrated their ability to take up organic molecules from the surrounding sediment. Since reduced gases in non-seep environments are ultimately sourced from photosynthetic processes, we suggest that the extreme seasonality of the Arctic has resulted in Arctic chemosymbiotic animals seasonally changing their degree of reliance on chemosynthetic partners. Overall, the role of chemosynthesis in Arctic benthos and marine ecosystems and links to photosynthesis may be complex, and more extensive than currently known.
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| 9. |
- Wastegård, Stefan, 1961-, et al.
(författare)
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Faroe Marine Ash Zone IV : a new MIS 3 ash zone on the Faroe Islands margin
- 2014
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Ingår i: Gas Generation and Migration in Deep Geological Radioactive Waste Repositories. - London : The Geological Society Publishing House. - 9781862397132 ; , s. 81-93
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Bokkapitel (refereegranskat)abstract
- A basaltic tephra layer from MIS 3 has been discovered by analysis of cores from the Faroe Islands margin. The tephra layer appears up to 20 cm thick in some records. After the first main fall-out event the tephra is believed to be mainly deposited and redistributed by bottom currents. Geochemical analyses suggest that the tephra is relatively undisturbed by allochtonous tephra grains and unmixed. The peak occurrences are in the lower part of GIS (Greenland Interstadial) 12 and we suggest naming this new tephra Faroe Marine Ash Zone IV (FMAZ IV), following the nomenclature adopted for previous ash zones found on the Faroe Islands margin. Geochemical analyses of the tephra show affinities with the Grimsvotn volcanic system in the Eastern Volcanic Zone in south Iceland. The average age of FMAZ IV from four independent age models is 46 800 +/- 1000 years BP. We suggest that the V5 ash zone, found on the Reykjanes Ridge is a correlative to the FMAZ IV.
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| 10. |
- Wastegård, Stefan, et al.
(författare)
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Tephrochronology of the North Atlantic region: linking marine and ice-core records spanning the last glacial cycle
- 2007
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Ingår i: XVII INQUA Congress, July 28-August 3 2007, Cairns, Australia. Programs with Abstracts.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Tephrochronology has recently become a key technique for the precise correlation of Late Quaternary records in the North Atlantic region. Recent developments have extended the geographical distribution of significant tephra strata and, as a result, have established important tie-points between diverse palaeoarchives during the last glacial cycle. We will report on the work being undertaken to identify, date and geochemically characterise tephra horizons in marine cores from the Faroe Islands region and the Greenland ice-cores. Four ash zones including the widespread North Atlantic Ash Zone II (NAAZ II; 52-53 ka BP) and three mainly basaltic ash zones here referred to as the Faroe Marine Ash Zones (FMAZ) I (ca 15.4 14C ka BP), II/Fugloyarbanki Tephra (ca 23-24 14C ka BP) and III (ca 33 14C ka BP) occur in several cores from the Faroe Islands margin. Detailed investigations of NAAZ II in high-resolution cores show that two separate layers can be distinguished; a lower mixed alkalic basalt and rhyolitic layer and an upper predominantly tholeiitic basalt tephra, separated by as much as 1500 years. FMAZ III is a thick and relatively scattered basaltic ash zone found in three cores from the Faroe area. It has not been directly dated, but extrapolation of AMS radiocarbon dates from all cores suggest an age of c. 33,000 14C years BP, slightly above Heinrich layer 4, and close to the onset of GIS8. An equivalent tephra was recently identified in NGRIP where it is situated right at the peak of GIS8. The FMAZ II/Fugloyarbanki tephra occurs in all analysed marine cores in the Faroe Islands region and in NGRIP. It is dated to 26,740 ± 390 b2k according to the Greenland Ice Core Chronology (GICC05). This tephra falls right after the warmest peak of GIS3 in both the NGRIP and marine records and provides another important tie-point. Other tephras identified within the ice-core material have revealed the presence of previously unreported tephra horizons of Icelandic origin, thus, adding considerably to our knowledge of Icelandic volcanism during the last glacial cycle.
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