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- Danielsen, Stein Ove, et al.
(författare)
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Thirty-day readmissions in surgical and transcatheter aortic valve replacement: A systematic review and meta-analysis.
- 2018
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Ingår i: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 268, s. 85-91
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Tidskriftsartikel (refereegranskat)abstract
- The 30-day all-cause readmission rate after surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) vary substantially. We conducted a systematic review and meta-analysis to examine the overall incidence, causes, and risk factors of 30-day all-cause readmission rate after SAVR and TAVR.Eight medical research databases were searched; Cochrane, Medline, Embase, UpToDate, PROSPERO, National Guideline Clearinghouse, SweMed and Oria. We followed The Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) for this study.Thirty-three articles were included in the systematic review, 32 of which were appropriate for the meta-analysis. Overall, 17% (95% CI: 16-18%) of patients in the SAVR group, and 16% (95% CI: 15-18%) in the TAVR groups were readmitted within 30days. Heart failure, arrhythmia, infection, and respiratory problems were the most frequent causes of all-cause readmission after SAVR and TAVR. Most frequent reported prior risk factors for all-cause readmission following TAVR were diabetes, chronic lung disease/chronic obstructive pulmonary disease, atrial fibrillation, kidney problems, and transapical approach/nonfemoral access. For SAVR, no risk factors for 30-day all-cause readmission were reported in the literature to date.In conclusion, the overall proportion of 30-day all-cause readmission after SAVR and TAVR are high. Interventions to prevent avoidable readmissions ought to be developed and implemented.
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| 2. |
- Lee, Craig M., et al.
(författare)
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A Framework for the Development, Design and Implementation of a Sustained Arctic Ocean Observing System
- 2019
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Ingår i: Frontiers in Marine Science. - : Frontiers Media SA. - 2296-7745. ; 6
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Forskningsöversikt (refereegranskat)abstract
- Rapid Arctic warming drives profound change in the marine environment that have significant socio-economic impacts within the Arctic and beyond, including climate and weather hazards, food security, transportation, infrastructure planning and resource extraction. These concerns drive efforts to understand and predict Arctic environmental change and motivate development of an Arctic Region Component of the Global Ocean Observing System (ARCGOOS) capable of collecting the broad, sustained observations needed to support these endeavors. This paper provides a roadmap for establishing the ARCGOOS. ARCGOOS development must be underpinned by a broadly endorsed framework grounded in high-level policy drivers and the scientific and operational objectives that stem from them. This should be guided by a transparent, internationally accepted governance structure with recognized authority and organizational relationships with the national agencies that ultimately execute network plans. A governance model for ARCGOOS must guide selection of objectives, assess performance and fitness-to-purpose, and advocate for resources. A requirements-based framework for an ARCGOOS begins with the Societal Benefit Areas (SBAs) that underpin the system. SBAs motivate investments and define the system's science and operational objectives. Objectives can then be used to identify key observables and their scope. The domains of planning/policy, strategy, and tactics define scope ranging from decades and basins to focused observing with near real time data delivery. Patterns emerge when this analysis is integrated across an appropriate set of SBAs and science/operational objectives, identifying impactful variables and the scope of the measurements. When weighted for technological readiness and logistical feasibility, this can be used to select Essential ARCGOOS Variables, analogous to Essential Ocean Variables of the Global Ocean Observing System. The Arctic presents distinct needs and challenges, demanding novel observing strategies. Cost, traceability and ability to integrate region-specific knowledge have to be balanced, in an approach that builds on existing and new observing infrastructure. ARCGOOS should benefit from established data infrastructures following the Findable, Accessible, Interoperable, Reuseable Principles to ensure preservation and sharing of data and derived products. Linking to the Sustaining Arctic Observing Networks (SAON) process and involving Arctic stakeholders, for example through liaison with the International Arctic Science Committee (IASC), can help ensure success.
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| 3. |
- Smith, Gregory C., et al.
(författare)
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Polar ocean observations: A critical gap in the observing system and its effect on environmental predictions from hours to a season
- 2019
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Ingår i: Frontiers in Marine Science. - : Frontiers Media SA. - 2296-7745. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- There is a growing need for operational oceanographic predictions in both the Arctic and Antarctic polar regions. In the former, this is driven by a declining ice cover accompanied by an increase in maritime traffic and exploitation of marine resources. Oceanographic predictions in the Antarctic are also important, both to support Antarctic operations and also to help elucidate processes governing sea ice and ice shelf stability. However, a significant gap exists in the ocean observing system in polar regions, compared to most areas of the global ocean, hindering the reliability of ocean and sea ice forecasts. This gap can also be seen from the spread in ocean and sea ice reanalyses for polar regions which provide an estimate of their uncertainty. The reduced reliability of polar predictions may affect the quality of various applications including search and rescue, coupling with numerical weather and seasonal predictions, historical reconstructions (reanalysis), aquaculture and environmental management including environmental emergency response. Here, we outline the status of existing near-real time ocean observational efforts in polar regions, discuss gaps, and explore perspectives for the future. Specific recommendations include a renewed call for open access to data, especially real-time data, as a critical capability for improved sea ice and weather forecasting and other environmental prediction needs. Dedicated efforts are also needed to make use of additional observations made as part of the Year of Polar Prediction (YOPP; 2017-19) to inform optimal observing system design. To provide a polar extension to the Argo network, it is recommended that a network of ice-borne sea ice and upper-ocean observing buoys be deployed and supported operationally in ice-covered areas together with autonomous profiling floats and gliders (potentially with ice detection capability) in seasonally-ice covered seas. Finally, additional efforts to better measure and parameterize surface exchanges in polar regions are much needed to improve coupled environmental prediction.
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| 4. |
- Starkweather, Sandy, et al.
(författare)
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Sustaining Arctic Observing Networks’ (SAON) Roadmap for Arctic Observing and Data Systems (ROADS)
- 2021
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Ingår i: Arctic. - : The Arctic Institute of North America. - 0004-0843 .- 1923-1245. ; 74:Suppl. 1, s. 56-68
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Tidskriftsartikel (refereegranskat)abstract
- Arctic observing and data systems have been widely recognized as critical infrastructures to support decision making and understanding across sectors in the Arctic and globally. Yet due to broad and persistent issues related to coordination, deployment infrastructure and technology gaps, the Arctic remains among the most poorly observed regions on the planet from the standpoint of conventional observing systems. Sustaining Arctic Observing Networks (SAON) was initiated in 2011 to address the persistent shortcomings in the coordination of Arctic observations that are maintained by its many national and organizational partners. SAON set forth a bold vision in its 2018 – 28 strategic plan to develop a roadmap for Arctic observing and data systems (ROADS) to specifically address a key gap in coordination efforts—the current lack of a systematic planning mechanism to develop and link observing and data system requirements and implementation strategies in the Arctic region. This coordination gap has hampered partnership development and investments toward improved observing and data systems. ROADS seeks to address this shortcoming through generating a systems-level view of observing requirements and implementation strategies across SAON’s many partners through its roadmap. A critical success factor for ROADS is equitable participation of Arctic Indigenous Peoples in the design and development process, starting at the process design stage to build needed equity. ROADS is both a comprehensive concept, building from a societal benefit assessment approach, and one that can proceed step-wise so that the most imperative Arctic observations—here described as shared Arctic variables (SAVs)—can be rapidly improved. SAVs will be identified through rigorous assessment at the beginning of the ROADS process, with an emphasis in that assessment on increasing shared benefit of proposed system improvements across a range of partnerships from local to global scales. The success of the ROADS process will ultimately be measured by the realization of concrete investments in and well-structured partnerships for the improved sustainment of Arctic observing and data systems in support of societal benefit.
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