| 1. |
- Dyson, Kylie, et al.
(author)
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International variation in survival after out-of-hospital cardiac arrest : A validation study of the Utstein template.
- 2019
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In: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 138, s. 168-181
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) survival varies greatly between communities. The Utstein template was developed and promulgated to improve the comparability of OHCA outcome reports, but it has undergone limited empiric validation. We sought to assess how much of the variation in OHCA survival between emergency medical services (EMS) across the globe is explained by differences in the Utstein factors. We also assessed how accurately the Utstein factors predict OHCA survival.METHODS: We performed a retrospective analysis of patient-level prospectively collected data from 12 OHCA registries from 12 countries for the period 1 Jan 2006 through 31 Dec 2011. We used generalized linear mixed models to examine the variation in survival between EMS agencies (n=232).RESULTS: Twelve registries contributed 86,759 cases. Patient arrest characteristics, EMS treatment and patient outcomes varied across registries. Overall survival to hospital discharge was 10% (range, 6% to 22%). Overall survival with Cerebral Performance Category of 1 or 2 (available for 8/12 registries) was 8% (range, 2% to 20%). The area-under-the-curve for the Utstein model was 0.85 (Wald CI: 0.85-0.85). The Utstein factors explained 51% of the EMS agency variation in OHCA survival.CONCLUSIONS: The Utstein factors explained 51% of the variation in survival to hospital discharge among multiple large geographically separate EMS agencies. This suggests that quality improvement and public health efforts should continue to target modifiable Utstein factors to improve OHCA survival. Further study is required to identify the reasons for the variation that is incompletely understood.
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| 2. |
- Gorsich, Erin E., et al.
(author)
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Model-guided suggestions for targeted surveillance based on cattle shipments in the US
- 2018
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In: Preventive Veterinary Medicine. - : ELSEVIER SCIENCE BV. - 0167-5877 .- 1873-1716. ; 150, s. 52-59
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Journal article (peer-reviewed)abstract
- Risk-based sampling is an essential component of livestock health surveillance because it targets resources towards sub-populations with a higher risk of infection. Risk-based surveillance in U.S. livestock is limited because the locations of high-risk herds are often unknown and data to identify high-risk herds based on shipments are often unavailable. In this study, we use a novel, data-driven network model for the shipments of cattle in the U.S. (the U.S. Animal Movement Model, USAMM) to provide surveillance suggestions for cattle imported into the U.S. from Mexico. We describe the volume and locations where cattle are imported and analyze their predicted shipment patterns to identify counties that are most likely to receive shipments of imported cattle. Our results suggest that most imported cattle are sent to relatively few counties. Surveillance at 10 counties is predicted to sample 22-34% of imported cattle while surveillance at 50 counties is predicted to sample 43%-61% of imported cattle. These findings are based on the assumption that USAMM accurately describes the shipments of imported cattle because their shipments are not tracked separately from the remainder of the U.S. herd. However, we analyze two additional datasets - Interstate Certificates of Veterinary Inspection and brand inspection data - to ensure that the characteristics of potential post-import shipments do not change on an annual scale and are not dependent on the dataset informing our analyses. Overall, these results highlight the utility of USAMM to inform targeted surveillance strategies when complete shipment information is unavailable.
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| 3. |
- Gribenski, Natacha, 1986-, et al.
(author)
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Complex patterns of glacier advances during the late glacial in the Chagan Uzun Valley, Russian Altai
- 2016
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In: Quaternary Science Reviews. - : Elsevier BV. - 0277-3791 .- 1873-457X. ; 149, s. 288-305
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Journal article (peer-reviewed)abstract
- The Southern part of the Russian Altai Mountains is recognized for its evidence for catastrophic glacial lake outbursts. However, little is known about the late Pleistocene paleoglacial history, despite the interest in such reconstructions for constraining paleoclimate. In this study, we present a detailed paleoglaciological reconstruction of the Chagan Uzun Valley, in the Russian Altai Mountains, combining for the first time detailed geomorphological mapping, sedimentological logging, and in situ cosmogenic 10Be and 26Al surface exposure dating of glacially-transported boulders. The Chagan Uzun Valley exhibits the most impressive glacial landforms of this sector of the Altai, with extensive lobate moraine belts deposited in the intramontane Chuja Basin, reflecting a series of pronounced former glacial advances. Observations of “hillside-scale” folding and extensive faulting of pre-existing soft sediments within the outer moraine belts, together with the geomorphology, strongly indicate that these moraine belts were formed during surge-like events. Identification of surge-related features is essential for paleoclimate inference because these features correspond to a glacier system that is not in equilibrium with the contemporary climate, but instead largely influenced by various internal and external factors. Therefore, no strict relationship can be established between climatic variables and the pronounced distal glacial extent observed in the Chagan Uzun Valley/Chuja basin. In contrast, the inner (up-valley) glacial landforms of the Chagan Uzun valley were likely deposited during retreat of temperate valley glaciers, close to equilibrium with climate, and so most probably triggered by a general warming. Cosmogenic ages associated with the outermost, innermost, and intermediate stages all indicate deposition times clustered around 19 ka. However, the actual deposition time of the outermost moraine may slightly predate the 10Be ages due to shielding caused by subsequent lake water coverage. This chronology indicates a Marine Isotope Stage (MIS) 2 last maximum extent of the Chagan Uzun Glacier, and an onset of the deglaciation around 19 ka. This is consistent with other regional paleoclimate proxy records and with the Northern Hemisphere glaciation chronology. Finally, this study also highlights the highly dynamic environment in this area, with complex interactions between glacial events and the formation and drainage of lakes.
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| 5. |
- Matuozzo, Daniela, et al.
(author)
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Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19.
- 2023
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In: Genome medicine. - 1756-994X. ; 15:1
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Journal article (peer-reviewed)abstract
- We previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in~80% of cases.We report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.No gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P=1.1×10-4) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR=3.70[95%CI 1.3-8.2], P=2.1×10-4). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR=19.65[95%CI 2.1-2635.4], P=3.4×10-3), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR=4.40[9%CI 2.3-8.4], P=7.7×10-8). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD]=43.3 [20.3] years) than the other patients (56.0 [17.3] years; P=1.68×10-5).Rare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60years old.
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| 6. |
- Nolan, Jerry P, et al.
(author)
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Intensive care medicine research agenda on cardiac arrest
- 2017
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In: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 43:9, s. 1282-1293
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Journal article (peer-reviewed)abstract
- Over the last 15 years, treatment of comatose post-cardiac arrest patients has evolved to include therapeutic strategies such as urgent coronary angiography with percutaneous coronary intervention (PCI), targeted temperature management (TTM)—requiring mechanical ventilation and sedation—and more sophisticated and cautious prognostication. In 2015, collaboration between the European Resuscitation Council (ERC) and the European Society for Intensive Care Medicine (ESICM) resulted in the first European guidelines on post-resuscitation care. This review addresses the major recent advances in the treatment of cardiac arrest, recent trials that have challenged current practice and the remaining areas of uncertainty.
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