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- Loisel, J., et al.
(författare)
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Expert assessment of future vulnerability of the global peatland carbon sink
- 2021
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Ingår i: Nature Climate Change. - : Springer Science and Business Media LLC. - 1758-678X .- 1758-6798. ; 11:1, s. 70-77
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Tidskriftsartikel (refereegranskat)abstract
- Peatlands are impacted by climate and land-use changes, with feedback to warming by acting as either sources or sinks of carbon. Expert elicitation combined with literature review reveals key drivers of change that alter peatland carbon dynamics, with implications for improving models. The carbon balance of peatlands is predicted to shift from a sink to a source this century. However, peatland ecosystems are still omitted from the main Earth system models that are used for future climate change projections, and they are not considered in integrated assessment models that are used in impact and mitigation studies. By using evidence synthesized from the literature and an expert elicitation, we define and quantify the leading drivers of change that have impacted peatland carbon stocks during the Holocene and predict their effect during this century and in the far future. We also identify uncertainties and knowledge gaps in the scientific community and provide insight towards better integration of peatlands into modelling frameworks. Given the importance of the contribution by peatlands to the global carbon cycle, this study shows that peatland science is a critical research area and that we still have a long way to go to fully understand the peatland-carbon-climate nexus.
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| 3. |
- Khorram-Manesh, Amir, 1958, et al.
(författare)
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The implication of a translational triage tool in mass casualty incidents: part three: a multinational study, using validated patient cards.
- 2023
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Ingår i: Scandinavian journal of trauma, resuscitation and emergency medicine. - 1757-7241. ; 31:1
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Tidskriftsartikel (refereegranskat)abstract
- Mass casualty incidents (MCI) pose significant challenges to existing resources, entailing multiagency collaboration. Triage is a critical component in the management of MCIs, but the lack of a universally accepted triage system can hinder collaboration and lead to preventable loss of life. This multinational study uses validated patient cards (cases) based on real MCIs to evaluate the feasibility and effectiveness of a novel Translational Triage Tool (TTT) in primary triage assessment of mass casualty victims.Using established triage systems versus TTT, 163 participants (1575 times) triaged five patient cases. The outcomes were statistically compared.TTT demonstrated similar sensitivity to the Sieve primary triage method and higher sensitivity than the START primary triage system. However, the TTT algorithm had a lower specificity compared to Sieve and higher over-triage rates. Nevertheless, the TTT algorithm demonstrated several advantages due to its straightforward design, such as rapid assessment, without the need for additional instrumental interventions, enabling the engagement of non-medical personnel.The TTT algorithm is a promising and feasible primary triage tool for MCIs. The high number of over-triages potentially impacts resource allocation, but the absence of under-triages eliminates preventable deaths and enables the use of other personal resources. Further research involving larger participant samples, time efficiency assessments, and real-world scenarios is needed to fully assess the TTT algorithm's practicality and effectiveness in diverse multiagency and multinational contexts.
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| 4. |
- Ratnayake, C. B. B., et al.
(författare)
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Sarcopenic obesity and post-operative morbidity after pancreatic surgery: a cohort study
- 2019
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Ingår i: ANZ Journal of Surgery. - : Wiley. - 1445-1433 .- 1445-2197. ; 89:12, s. 1587-1592
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several indices of sarcopenia (SARC) exist in the literature, however, there is no consensus as to the best SARC index to predict post-operative morbidity following pancreatic surgery. Methods: A prospectively collected database was reviewed in a single institution including a total of 89 consecutive patients who had undergone pancreatic resection between 2015 and 2018. Results: A total of 89 patients comprised the cohort. Seventy-one percent (63/89) underwent pancreaticoduodenectomy. SARC was identified in 49 patients (55%) using psoas muscle index, 44 patients (49%) using the skeletal muscle index and 25 patients (28%) using the skeletal muscle attenuation. Post-operative morbidity did not differ between SARC and non-SARC (NSARC) patients using all three preoperative computed tomography measures (skeletal muscle index SARC 64%, 28/44, NSARC 64%, 29/45, P = 1.000; psoas muscle index SARC 63%, 31/49, NSARC 65%, 26/40, P = 0.810; skeletal muscle attenuation SARC 17/25, NSARC 40/64, P = 0.247). However, sarcopenic obesity was a significant independent risk factor for overall post-operative morbidity on multivariate analysis (odds ratio 1.241 (SE 0.608), P = 0.041) with the highest specificity (81%). Conclusion: Preoperative sarcopenic obesity can be an important independent predictor of post-operative morbidity following pancreatic resection. There remains a need for standardization of SARC indices. © 2019 Royal Australasian College of Surgeons
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