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- de Lavergne, C., et al.
(författare)
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A Parameterization of Local and Remote Tidal Mixing
- 2020
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Ingår i: Journal of Advances in Modeling Earth Systems. - 1942-2466. ; 12:5
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Tidskriftsartikel (refereegranskat)abstract
- Vertical mixing is often regarded as the Achilles' heel of ocean models. In particular, few models include a comprehensive and energy-constrained parameterization of mixing by internal ocean tides. Here, we present an energy-conserving mixing scheme which accounts for the local breaking of high-mode internal tides and the distant dissipation of low-mode internal tides. The scheme relies on four static two-dimensional maps of internal tide dissipation, constructed using mode-by-mode Lagrangian tracking of energy beams from sources to sinks. Each map is associated with a distinct dissipative process and a corresponding vertical structure. Applied to an observational climatology of stratification, the scheme produces a global three-dimensional map of dissipation which compares well with available microstructure observations and with upper-ocean finestructure mixing estimates. This relative agreement, both in magnitude and spatial structure across ocean basins, suggests that internal tides underpin most of observed dissipation in the ocean interior at the global scale. The proposed parameterization is therefore expected to improve understanding, mapping, and modeling of ocean mixing. ©2020. The Authors.
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| 2. |
- van de Vlasakker, Vincent C. J., et al.
(författare)
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The impact of PRODIGE 7 on the current worldwide practice of CRS-HIPEC for colorectal peritoneal metastases : A web-based survey and 2021 statement by Peritoneal Surface Oncology Group International (PSOGI)
- 2021
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Ingår i: European Journal of Surgical Oncology. - : Elsevier. - 0748-7983 .- 1532-2157. ; 47:11, s. 2888-2892
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionThe PRODIGE 7-trial investigated the additional value of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) to cytoreductive surgery (CRS) for patients with colorectal peritoneal metastases (CPM). The results of PRODIGE 7 were presented at the 2018 ASCO meeting showing that 30 min oxaliplatin-based HIPEC did not improve overall survival. The current study investigated the impact of PRODIGE 7 on the worldwide practice of CRS and HIPEC.Materials and methodsCRS-HIPEC experts from 19 countries were invited through the Peritoneal Surface Oncology Group International (PSOGI) to complete an online survey concerning the current CRS-HIPEC practice in their hospital and country, and were asked to appraise the effect of PRODIGE 7.ResultsThe survey was completed by 18/19 experts. Although their personal opinions of CRS-HIPEC were barely influenced by PRODIGE 7, they reported a substantial impact on daily practice. This included a switch towards Mitomycin-C based HIPEC-regimens and prolongation of HIPEC perfusion time, a reduction in the number of referrals from non-HIPEC centers, a reduction in national consensus, the removal of HIPEC from national guidelines, and a reduced reimbursement rate.ConclusionThe PRODIGE 7 has had a major impact on the practice of CRS-HIPEC for CPM worldwide. HIPEC remains an attractive option with potential for control and eradication of disease and further studies into the optimal HIPEC-regimen are urgently needed. Meanwhile, given the complexity of the treatment of patients with CPM, and the proven benefits of optimal CRS, referral of patients with potentially resectable CPM to expert centers is recommended whilst the precise role of HIPEC is further evaluated.
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| 3. |
- de Lavergne, C., et al.
(författare)
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Toward global maps of internal tide energy sinks
- 2019
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Ingår i: Ocean Modelling. - : Elsevier BV. - 1463-5003 .- 1463-5011. ; 137, s. 52-75
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Tidskriftsartikel (refereegranskat)abstract
- Internal tides power much of the observed small-scale turbulence in the ocean interior. To represent mixing induced by this turbulence in ocean climate models, the cascade of internal tide energy to dissipation scales must be understood and mapped. Here, we present a framework for estimating the geography of internal tide energy sinks. The mapping relies on the following ingredients: (i) a global observational climatology of stratification; (ii) maps of the generation of M-2, S-2 and K-1 internal tides decomposed into vertical normal modes; (iii) simplified representations of the dissipation of low-mode internal tides due to wave-wave interactions, scattering by small-scale topography, interaction with critical slopes and shoaling; (iv) Lagrangian tracking of low-mode energy beams through observed stratification, including refraction and reflection. We thus obtain a global map of the column-integrated energy dissipation for each of the four considered dissipative processes, each of the three tidal constituents and each of the first five modes. Modes >= 6 are inferred to dissipate within the local water column at the employed half-degree horizontal resolution. Combining all processes, modes and constituents, we construct a map of the total internal tide energy dissipation, which compares well with observational inferences of internal wave energy dissipation. This result suggests that tides largely shape observed spatial contrasts of dissipation, and that the framework has potential in improving understanding and modelling of ocean mixing. However, sensitivity to poorly constrained parameters and simplifying assumptions entering the parameterized energy sinks calls for additional investigation. The attenuation of low-mode internal tides by wave-wave interactions needs particular attention.
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| 4. |
- Fanaroff, Alexander C., et al.
(författare)
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Antithrombotic agents for secondary prevention after acute coronary syndromes : A systematic review and network meta-analysis
- 2017
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Ingår i: International Journal of Cardiology. - : ELSEVIER IRELAND LTD. - 0167-5273 .- 1874-1754. ; 241, s. 87-96
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nine oral antithrombotic medications currently available in the United States and Europe have been studied in clinical trials for secondary prevention of cardiac events following acute coronary syndrome (ACS). Few combinations of these medications have been directly compared, and studies have used multiple different comparator regimens.Methods: We performed a systematic review and network meta-analysis of randomized controlled trials evaluating one or more available oral antithrombotic therapies in patients with ACS or prior myocardial infarction (MI). Co-primary outcomes were all-cause and cardiovascular mortality compared with imputed placebo and aspirin monotherapy.Results: Forty-seven studies (196,057 subjects) met inclusion criteria and were included in the systematic review. Almost all studies tested either aspirin monotherapy compared with placebo or a combination of antithrombotic agents that included aspirin. Nearly all regimens reduced all-cause and cardiovascular mortality compared with imputed placebo. However, compared with imputed aspirin monotherapy, only combination therapy with aspirin plus ticagrelor was associated with lower cardiovascular mortality (OR 0.80, 95% CI 0.68-0.93), and triple therapy with aspirin, clopidogrel, and very low dose rivaroxaban was associated with lower all-cause mortality (OR 0.67, 95% CI 0.49-0.90). Major bleeding was increased 45-95% with dual antithrombotic therapy, and 2-6-fold with triple therapy.Conclusion: Few combinations of antithrombotic therapy were associated with a reduction inmortality compared with aspirin monotherapy, highlighting the difficulty in clinical interpretation of composite ischemic endpoints. Future studies may need to focus on limiting the number of antithrombotic therapies tested in combination to best balance ischemic event reduction and bleeding.
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| 7. |
- Mendez, Martin, et al.
(författare)
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Integrating multiple lines of evidence to better understand the evolutionary divergence of humpback dolphins along their entire distribution range : a new dolphin species in Australian waters?
- 2013
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Ingår i: Molecular Ecology. - : Wiley. - 0962-1083 .- 1365-294X. ; 22:23, s. 5936-5948
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Tidskriftsartikel (refereegranskat)abstract
- The conservation of humpback dolphins, distributed in coastal waters of the Indo-West Pacific and eastern Atlantic Oceans, has been hindered by a lack of understanding about the number of species in the genus (Sousa) and their population structure. To address this issue, we present a combined analysis of genetic and morphologic data collected from beach-cast, remote-biopsied and museum specimens from throughout the known Sousa range. We extracted genetic sequence data from 235 samples from extant populations and explored the mitochondrial control region and four nuclear introns through phylogenetic, population-level and population aggregation frameworks. In addition, 180 cranial specimens from the same geographical regions allowed comparisons of 24 morphological characters through multivariate analyses. The genetic and morphological data showed significant and concordant patterns of geographical segregation, which are typical for the kind of demographic isolation displayed by species units, across the Sousa genus distribution range. Based on our combined genetic and morphological analyses, there is convincing evidence for at least four species within the genus (S.teuszii in the Atlantic off West Africa, S.plumbea in the central and western Indian Ocean, S.chinensis in the eastern Indian and West Pacific Oceans, and a new as-yet-unnamed species off northern Australia).
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