| 1. |
- Drake, Thomas M., et al.
(author)
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Outcomes following small bowel obstruction due to malignancy in the national audit of small bowel obstruction
- 2019
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In: European Journal of Surgical Oncology. - : Elsevier BV. - 0748-7983 .- 1532-2157. ; 45:12, s. 2319-2324
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Journal article (peer-reviewed)abstract
- © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology Introduction: Patients with cancer who develop small bowel obstruction are at high risk of malnutrition and morbidity following compromise of gastrointestinal tract continuity. This study aimed to characterise current management and outcomes following malignant small bowel obstruction. Methods: A prospective, multicentre cohort study of patients with small bowel obstruction who presented to UK hospitals between 16th January and 13th March 2017. Patients who presented with small bowel obstruction due to primary tumours of the intestine (excluding left-sided colonic tumours) or disseminated intra-abdominal malignancy were included. Outcomes included 30-day mortality and in-hospital complications. Cox-proportional hazards models were used to generate adjusted effects estimates, which are presented as hazard ratios (HR) alongside the corresponding 95% confidence interval (95% CI). The threshold for statistical significance was set at the level of P ≤ 0.05 a-priori. Results: 205 patients with malignant small bowel obstruction presented to emergency surgery services during the study period. Of these patients, 50 had obstruction due to right sided colon cancer, 143 due to disseminated intraabdominal malignancy, 10 had primary tumours of the small bowel and 2 patients had gastrointestinal stromal tumours. In total 100 out of 205 patients underwent a surgical intervention for obstruction. 30-day in-hospital mortality rate was 11.3% for those with primary tumours and 19.6% for those with disseminated malignancy. Severe risk of malnutrition was an independent predictor for poor mortality in this cohort (adjusted HR 16.18, 95% CI 1.86 to 140.84, p = 0.012). Patients with right-sided colon cancer had high rates of morbidity. Conclusions: Mortality rates were high in patients with disseminated malignancy and in those with right sided colon cancer. Further research should identify optimal management strategy to reduce morbidity for these patient groups.
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| 2. |
- Tjernström, Michael, et al.
(author)
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The Arctic Summer Cloud Ocean Study (ASCOS) : overview and experimental design
- 2014
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In: Atmospheric Chemistry And Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 14:6, s. 2823-2869
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Journal article (peer-reviewed)abstract
- The climate in the Arctic is changing faster than anywhere else on earth. Poorly understood feedback processes relating to Arctic clouds and aerosol-cloud interactions contribute to a poor understanding of the present changes in the Arctic climate system, and also to a large spread in projections of future climate in the Arctic. The problem is exacerbated by the paucity of research-quality observations in the central Arctic. Improved formulations in climate models require such observations, which can only come from measurements in situ in this difficult-to-reach region with logistically demanding environmental conditions. The Arctic Summer Cloud Ocean Study (ASCOS) was the most extensive central Arctic Ocean expedition with an atmospheric focus during the International Polar Year (IPY) 2007-2008. ASCOS focused on the study of the formation and life cycle of low-level Arctic clouds. ASCOS departed from Longyearbyen on Svalbard on 2 August and returned on 9 September 2008. In transit into and out of the pack ice, four short research stations were undertaken in the Fram Strait: two in open water and two in the marginal ice zone. After traversing the pack ice northward, an ice camp was set up on 12 August at 87 degrees 21' N, 01 degrees 29' W and remained in operation through 1 September, drifting with the ice. During this time, extensive measurements were taken of atmospheric gas and particle chemistry and physics, mesoscale and boundary-layer meteorology, marine biology and chemistry, and upper ocean physics. ASCOS provides a unique interdisciplinary data set for development and testing of new hypotheses on cloud processes, their interactions with the sea ice and ocean and associated physical, chemical, and biological processes and interactions. For example, the first-ever quantitative observation of bubbles in Arctic leads, combined with the unique discovery of marine organic material, polymer gels with an origin in the ocean, inside cloud droplets suggests the possibility of primary marine organically derived cloud condensation nuclei in Arctic stratocumulus clouds. Direct observations of surface fluxes of aerosols could, however, not explain observed variability in aerosol concentrations, and the balance between local and remote aerosols sources remains open. Lack of cloud condensation nuclei (CCN) was at times a controlling factor in low-level cloud formation, and hence for the impact of clouds on the surface energy budget. ASCOS provided detailed measurements of the surface energy balance from late summer melt into the initial autumn freeze-up, and documented the effects of clouds and storms on the surface energy balance during this transition. In addition to such process-level studies, the unique, independent ASCOS data set can and is being used for validation of satellite retrievals, operational models, and reanalysis data sets.
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| 3. |
- Weinstock, Joshua S, et al.
(author)
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Aberrant activation of TCL1A promotes stem cell expansion in clonal haematopoiesis.
- 2023
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In: Nature. - 1476-4687. ; 616:7958, s. 755-763
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Journal article (peer-reviewed)abstract
- Mutations in a diverse set of driver genes increase the fitness of haematopoietic stem cells (HSCs), leading to clonal haematopoiesis1. These lesions are precursors for blood cancers2-6, but the basis of their fitness advantage remains largely unknown, partly owing to a paucity of large cohorts in which the clonal expansion rate has been assessed by longitudinal sampling. Here, to circumvent this limitation, we developed a method to infer the expansion rate from data from a single time point. We applied this method to 5,071 people with clonal haematopoiesis. A genome-wide association study revealed that a common inherited polymorphism in the TCL1A promoter was associated with a slower expansion rate in clonal haematopoiesis overall, but the effect varied by driver gene. Those carrying this protective allele exhibited markedly reduced growth rates or prevalence of clones with driver mutations in TET2, ASXL1, SF3B1 and SRSF2, butthis effect was not seen inclones withdriver mutations in DNMT3A. TCL1A was not expressed in normal or DNMT3A-mutated HSCs, but the introduction of mutations in TET2 or ASXL1 led to the expression of TCL1A protein and the expansion of HSCs in vitro. The protective allele restricted TCL1A expression and expansion of mutant HSCs, as did experimentalknockdown of TCL1A expression. Forced expression of TCL1A promoted the expansion of human HSCs in vitro and mouse HSCs in vivo. Our results indicate that the fitness advantage of several commonly mutated driver genes in clonal haematopoiesis may be mediated by TCL1A activation.
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| 4. |
- Cristina Baglio, Maria, et al.
(author)
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A Wildly Flickering Jet in the Black Hole X-Ray Binary MAXI J1535-571
- 2018
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In: Astrophysical Journal. - : American Astronomical Society. - 1538-4357 .- 0004-637X. ; 867:2
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Journal article (peer-reviewed)abstract
- We report on the results of optical, near-infrared (NIR), and mid-infrared observations of the black hole X-ray binary candidate (BHB) MAXI J1535-571 during its 2017/2018 outburst. During the first part of the outburst (MJD 58004-58012), the source shows an optical-NIR spectrum that is consistent with an optically thin synchrotron power law from a jet. After MJD 58015, however, the source faded considerably, the drop in flux being much more evident at lower frequencies. Before the fading, we measure a dereddened flux density of 100 mJy in the mid-infrared, making MAXI J1535-571 one of the brightest mid-infrared BHBs known so far. A significant softening of the X-ray spectrum is evident contemporaneous with the infrared fade. We interpret it as being due to the suppression of the jet emission, similar to the accretion-ejection coupling seen in other BHBs. However, MAXI J1535-571 did not transition smoothly to the soft state, instead showing X-ray hardness deviations associated with infrared flaring. We also present the first mid-IR variability study of a BHB on minute timescales, with a fractional rms variability of the light curves of ∼15%-22%, which is similar to that expected from the internal shock jet model, and much higher than the optical fractional rms (≲7%). These results represent an excellent case of multiwavelength jet spectral timing and demonstrate how rich, multiwavelength time-resolved data of X-ray binaries over accretion state transitions can help in refining models of the disk-jet connection and jet launching in these systems.
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| 5. |
- Lezo, A., et al.
(author)
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Chronic Intestinal Failure in Children: An International Multicenter Cross-Sectional Survey
- 2022
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In: Nutrients. - : MDPI AG. - 2072-6643. ; 14:9
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Journal article (peer-reviewed)abstract
- Background: The European Society for Clinical Nutrition and Metabolism database for chronic intestinal failure (CIF) was analyzed to investigate factors associated with nutritional status and the intravenous supplementation (IVS) dependency in children. Methods: Data collected: demographics, CIF mechanism, home parenteral nutrition program, z-scores of weight-for-age (WFA), length or height-for-age (LFA/HFA), and body mass index-for-age (BMI-FA). IVS dependency was calculated as the ratio of daily total IVS energy over estimated resting energy expenditure (%IVSE/REE). Results: Five hundred and fifty-eight patients were included, 57.2% of whom were male. CIF mechanisms at age 1-4 and 14-18 years, respectively: SBS 63.3%, 37.9%; dysmotility or mucosal disease: 36.7%, 62.1%. One-third had WFA and/or LFA/HFA z-scores < -2. One-third had %IVSE/REE > 125%. Multivariate analysis showed that mechanism of CIF was associated with WFA and/or LFA/HFA z-scores (negatively with mucosal disease) and %IVSE/REE (higher for dysmotility and lower in SBS with colon in continuity), while z-scores were negatively associated with %IVSE/REE. Conclusions: The main mechanism of CIF at young age was short bowel syndrome (SBS), whereas most patients facing adulthood had intestinal dysmotility or mucosal disease. One-third were underweight or stunted and had high IVS dependency. Considering that IVS dependency was associated with both CIF mechanisms and nutritional status, IVS dependency is suggested as a potential marker for CIF severity in children.
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| 6. |
- Ghanem, Hind, et al.
(author)
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40Ar/39Ar and U-Pb SIMS zircon ages of Ediacaran dikes from the Arabian-Nubian Shield of south Jordan
- 2020
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In: Precambrian Research. - : Elsevier BV. - 0301-9268 .- 1872-7433. ; 343
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Journal article (peer-reviewed)abstract
- A spectacular feature of the Arabian-Nubian Shield (ANS) is the abundance of well-exposed and extensive Neoproterozoic dike swarms of variable compositions. Most of these dikes are late to post-orogenic with respect to the East African Orogen (EAO) and are unmetamorphosed. We dated a composite dike with latite margins and a rhyolite core (607 ± 6 Ma, U-Pb), a biotite rhyolite dike (600 ± 4 Ma, 40Ar/39Ar age of biotite), an andesite dike (594 ± 3, 40Ar/39Ar age of amphibole) and a dolerite dike (~579 Ma, 40Ar/39Ar whole rock total gas age). We propose that the first three dikes represent one generation that was emplaced at different episodes extending between 607 and 590 Ma. Time and composition equivalent dikes are common in the northern ANS. The dikes crosscut late collisional granitoids and geochemically display a subduction-related character as evidenced by a negative Nb-Ta anomaly. These dikes are absent in the alkali feldspar A-type Humrat Syenogranite dated at 586 ± 5 Ma in Jordan and equivalent rocks in the northern ANS, which are crosscut only by the (~579 Ma) dolerite dikes. The within-plate character of the dolerite dikes is supported by the absence of the Nb-Ta anomaly and high field strength element geochemistry. We propose that the dolerite dikes are a generation, distinct from the ~607–590 Ma dikes, that reflects a change in tectonic regime and represents the last magmatic activity of the Neoproterozoic in the northern ANS. The ages of the dikes dated in this study agree with the published age range of the transitional stage from late orogenic calc-alkaline to extensional alkaline tectono-magmatic setting for the ANS. We propose that the magmatic activity was terminated ~50 m.y. before the age of the Cambrian unconformity at ~530 Ma. Correlation with ages of dikes and magmatic rocks in the northern ANS favors this supposition. The dike geochemistry and geochronology are compatible with a tectonic model that involves mantle lithosphere delamination from below the northern ANS after a significant crust-mantle thickening caused by the EAO, followed by thermal relaxation, subsidence and gradual denudation until the age of the unconformity at ~530 Ma.
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| 7. |
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| 8. |
- Rockabrand, David M, et al.
(author)
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Enterotoxigenic Escherichia coli colonization factor types collected from 1997 to 2001 in US military personnel during operation Bright Star in northern Egypt.
- 2006
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In: Diagnostic microbiology and infectious disease. - : Elsevier BV. - 0732-8893. ; 55:1, s. 9-12
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Journal article (peer-reviewed)abstract
- Operation Bright Star (OBS) is a biennial, multinational exercise in Egypt involving 15000 US troops. Consistent with past observations in deployed troops, diarrhea is the most significant cause of morbidity. Focused efforts are ongoing to develop vaccines against the most common pathogens affecting our troops. As part of these efforts, diarrhea surveillance was conducted during OBS to monitor pathogens associated with illness and to identify new vaccine targets. A retrospective review was conducted of prior studies with similar methods. Soldiers with diarrhea presenting to the OBS clinic provided a stool sample that was inoculated into Carey-Blair transport media. Within 3 days, the Cary-Blair tubes were transported to the Naval Medical Research Unit no. 3 in Cairo where bacterial culture was performed. As part of the evaluation, 5 Escherichia coli-like colonies were collected and tested for toxin production using the GM1-ELISA. Toxin-positive isolates were further tested for colonization factors (CF) by a dot-blot assay using a standardized panel of monoclonal antibodies against CFA/I, CS1-CS7, CS17, CS8 (CFA/III), CS12 (PCFO159), and CS14 (PCFO166). Enterotoxigenic E. coli (ETEC) was the most frequently isolated pathogen during each OBS from which data were collected. The rate of ETEC-associated diarrhea ranged from 22% to 58%. Over time, there were dramatic shifts in the frequency and distribution of CFs. Over the 5 years of study, an increasing number of ETEC isolates had no known CF identified, and in 2001, only 40% of ETEC was associated with known CFs. The most commonly identified CF was CS6. Diarrheal disease, particularly ETEC, continues to be a common malady among US military personnel deployed to Egypt. We have identified ETEC CF types, especially CS6, which should be considered potential vaccine candidates. However, despite intensive testing, CFs could not be identified in most of the ETEC isolated, highlighting the need for further studies to identify novel CFs and alternative vaccine targets.
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| 9. |
- Schutte, Aletta E., et al.
(author)
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Addressing global disparities in blood pressure control : perspectives of the International Society of Hypertension
- 2023
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In: Cardiovascular Research. - : Oxford University Press (OUP). - 0008-6363 .- 1755-3245. ; 119:2, s. 381-409
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Research review (peer-reviewed)abstract
- Raised blood pressure (BP) is the leading cause of preventable death in the world. Yet, its global prevalence is increasing, and it remains poorly detected, treated, and controlled in both high- and low-resource settings. From the perspective of members of the International Society of Hypertension based in all regions, we reflect on the past, present, and future of hypertension care, highlighting key challenges and opportunities, which are often region-specific. We report that most countries failed to show sufficient improvements in BP control rates over the past three decades, with greater improvements mainly seen in some high-income countries, also reflected in substantial reductions in the burden of cardiovascular disease and deaths. Globally, there are significant inequities and disparities based on resources, sociodemographic environment, and race with subsequent disproportionate hypertension-related outcomes. Additional unique challenges in specific regions include conflict, wars, migration, unemployment, rapid urbanization, extremely limited funding, pollution, COVID-19-related restrictions and inequalities, obesity, and excessive salt and alcohol intake. Immediate action is needed to address suboptimal hypertension care and related disparities on a global scale. We propose a Global Hypertension Care Taskforce including multiple stakeholders and societies to identify and implement actions in reducing inequities, addressing social, commercial, and environmental determinants, and strengthening health systems implement a well-designed customized quality-of-care improvement framework.
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| 10. |
- Takaro, Tim K., et al.
(author)
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The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study : assessment of environmental exposures
- 2015
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In: Journal of Exposure Science and Environmental Epidemiology. - New York : Nature Publishing Group. - 1559-0631 .- 1559-064X. ; 25:6, s. 580-592
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Journal article (peer-reviewed)abstract
- The Canadian Healthy Infant Longitudinal Development birth cohort was designed to elucidate interactions between environment and genetics underlying development of asthma and allergy. Over 3600 pregnant mothers were recruited from the general population in four provinces with diverse environments. The child is followed to age 5 years, with prospective characterization of diverse exposures during this critical period. Key exposure domains include indoor and outdoor air pollutants, inhalation, ingestion and dermal uptake of chemicals, mold, dampness, biological allergens, pets and pests, housing structure, and living behavior, together with infections, nutrition, psychosocial environment, and medications. Assessments of early life exposures are focused on those linked to inflammatory responses driven by the acquired and innate immune systems. Mothers complete extensive environmental questionnaires including time-activity behavior at recruitment and when the child is 3, 6, 12, 24, 30, 36, 48, and 60 months old. House dust collected during a thorough home assessment at 3-4 months, and biological specimens obtained for multiple exposure-related measurements, are archived for analyses. Geo-locations of homes and daycares and land-use regression for estimating traffic-related air pollution complement time-activity-behavior data to provide comprehensive individual exposure profiles. Several analytical frameworks are proposed to address the many interacting exposure variables and potential issues of co-linearity in this complex data set.
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| 11. |
- Abdelmagid, Nada, et al.
(author)
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The Governance of Childhood Vaccination Services in Crisis Settings : A Scoping Review
- 2023
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In: Vaccines. - : MDPI. - 2076-393X. ; 11:12
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Journal article (peer-reviewed)abstract
- The persistence of inadequate vaccination in crisis-affected settings raises concerns about decision making regarding vaccine selection, timing, location, and recipients. This review aims to describe the key features of childhood vaccination intervention design and planning in crisis-affected settings and investigate how the governance of childhood vaccination is defined, understood, and practised. We performed a scoping review of 193 peer-reviewed articles and grey literature on vaccination governance and service design and planning. We focused on 41 crises between 2010 and 2021. Following screening and data extraction, our analysis involved descriptive statistics and applying the governance analysis framework to code text excerpts, employing deductive and inductive approaches. Most documents related to active outbreaks in conflict-affected settings and to the mass delivery of polio, cholera, and measles vaccines. Information on vaccination modalities, target populations, vaccine sources, and funding was limited. We found various interpretations of governance, often implying hierarchical authority and regulation. Analysis of governance arrangements suggests a multi-actor yet fragmented governance structure, with inequitable actor participation, ineffective actor collaboration, and a lack of a shared strategic vision due to competing priorities and accountabilities. Better documentation of vaccination efforts during emergencies, including vaccination decision making, governance, and planning, is needed. We recommend empirical research within decision-making spaces.
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| 12. |
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| 13. |
- Saikia, Payaswini, et al.
(author)
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A Multiwavelength Study of GRS 1716-249 in Outburst: Constraints on Its System Parameters
- 2022
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In: Astrophysical Journal. - : American Astronomical Society. - 1538-4357 .- 0004-637X. ; 932:1
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Journal article (peer-reviewed)abstract
- We present a detailed study of the evolution of the Galactic black hole transient GRS 1716-249 during its 2016-2017 outburst at optical (Las Cumbres Observatory), mid-infrared (Very Large Telescope), near-infrared (Rapid Eye Mount telescope), and ultraviolet (the Neil Gehrels Swift Observatory Ultraviolet/Optical Telescope) wavelengths, along with archival radio and X-ray data. We show that the optical/near-infrared and UV emission of the source mainly originates from a multi-temperature accretion disk, while the mid-infrared and radio emission are dominated by synchrotron emission from a compact jet. The optical/UV flux density is correlated with the X-ray emission when the source is in the hard state, consistent with an X-ray irradiated accretion disk with an additional contribution from the viscous disk during the outburst fade. We find evidence for a weak, but highly variable jet component at mid-infrared wavelengths. We also report the long-term optical light curve of the source and find that the quiescent i'-band magnitude is 21.39 +/- 0.15 mag. Furthermore, we discuss how previous estimates of the system parameters of the source are based on various incorrect assumptions, and so are likely to be inaccurate. By comparing our GRS 1716-249 data set to those of other outbursting black hole X-ray binaries, we find that while GRS 1716-249 shows similar X-ray behavior, it is noticeably optically fainter, if the literature distance of 2.4 kpc is adopted. Using several lines of reasoning, we argue that the source distance is further than previously assumed in the literature, likely within 4-17 kpc, with a most likely range of similar to 4-8 kpc.
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