| 1. |
- Axfors, Cathrine, et al.
(author)
-
Association between convalescent plasma treatment and mortality in COVID-19 : a collaborative systematic review and meta-analysis of randomized clinical trials
- 2021
-
In: BMC Infectious Diseases. - : BioMed Central (BMC). - 1471-2334. ; 21:1
-
Research review (peer-reviewed)abstract
- Background: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, ). Methods: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I-2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. Conclusions: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care.
|
|
| 2. |
- Ademuyiwa, Adesoji O., et al.
(author)
-
Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
-
In: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
-
Journal article (peer-reviewed)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
|
|
| 3. |
- Hudson, Thomas J., et al.
(author)
-
International network of cancer genome projects
- 2010
-
In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 464:7291, s. 993-998
-
Journal article (peer-reviewed)abstract
- The International Cancer Genome Consortium (ICGC) was launched to coordinate large-scale cancer genome studies in tumours from 50 different cancer types and/or subtypes that are of clinical and societal importance across the globe. Systematic studies of more than 25,000 cancer genomes at the genomic, epigenomic and transcriptomic levels will reveal the repertoire of oncogenic mutations, uncover traces of the mutagenic influences, define clinically relevant subtypes for prognosis and therapeutic management, and enable the development of new cancer therapies.
|
|
| 4. |
- Birney, Ewan, et al.
(author)
-
Prepublication data sharing
- 2009
-
In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 461:7261, s. 168-170
-
Journal article (peer-reviewed)abstract
- Rapid release of prepublication data has served the field of genomics well. Attendees at a workshop in Toronto recommend extending the practice to other biological data sets.
|
|
| 5. |
- Hogan, Kelly A., et al.
(author)
-
Glacial sedimentation, fluxes and erosion rates associated with ice retreat in Petermann Fjord and Nares Strait, north-west Greenland
- 2020
-
In: The Cryosphere. - : Copernicus GmbH. - 1994-0416 .- 1994-0424. ; 14:1, s. 261-286
-
Journal article (peer-reviewed)abstract
- Petermann Fjord is a deep ( > 1000 m) fjord that incises the coastline of north-west Greenland and was carved by an expanded Petermann Glacier, one of the six largest outlet glaciers draining the modern Greenland Ice Sheet (GrIS). Between 5 and 70 m of unconsolidated glacigenic material infills in the fjord and adjacent Nares Strait, deposited as the Petermann and Nares Strait ice streams retreated through the area after the Last Glacial Maximum. We have investigated the deglacial deposits using seismic stratigraphic techniques and have correlated our results with high-resolution bathymetric data and core lithofacies. We identify six seismoacoustic facies in more than 3500 line kilometres of subbottom and seismic-reflection profiles throughout the fjord, Hall Basin and Kennedy Channel. Seismo-acoustic facies relate to bedrock or till surfaces (Facies I), subglacial deposition (Facies II), deposition from meltwater plumes and icebergs in quiescent glacimarine conditions (Facies III, IV), deposition at grounded ice margins during stillstands in retreat (grounding-zone wedges; Facies V) and the redeposition of material downslope (Facies IV). These sediment units represent the total volume of glacial sediment delivered to the mapped marine environment during retreat. We calculate a glacial sediment flux for the former Petermann ice stream as 1080-1420 m(3) a(-1) per metre of ice stream width and an average deglacial erosion rate for the basin of 0.29-0.34 mm a(-1). Our deglacial erosion rates are consistent with results from Antarctic Peninsula fjord systems but are several times lower than values for other modern GrIS catchments. This difference is attributed to fact that large volumes of surface water do not access the bed in the Petermann system, and we conclude that glacial erosion is limited to areas overridden by streaming ice in this large outlet glacier setting. Erosion rates are also presented for two phases of ice retreat and confirm that there is significant variation in rates over a glacial-deglacial transition. Our new glacial sediment fluxes and erosion rates show that the Petermann ice stream was approximately as efficient as the palaeo-Jakobshavn Isbra at eroding, transporting and delivering sediment to its margin during early deglaciation.
|
|
| 6. |
- Jennings, Anne E., et al.
(author)
-
Baffin Bay paleoenvironments in the LGM and HS1 : Resolving the ice-shelf question
- 2018
-
In: Marine Geology. - : Elsevier BV. - 0025-3227 .- 1872-6151. ; 402, s. 5-16
-
Journal article (peer-reviewed)abstract
- Core HU2008029-12PC from the Disko trough mouth fan on the central West Greenland continental slope is used to test whether an ice shelf covered Baffin Bay during the Last Glacial Maximum (LGM) and at the onset of the deglaciation. We use benthic and planktic foraminiferal assemblages, stable isotope analysis of planktic forams, algal biomarkers, ice-rafted detritus (IRD), lithofacies characteristics defined from CT scans, and quantitative mineralogy to reconstruct paleoceanographic conditions, sediment processes and sediment provenance. The chronology is based on radiocarbon dates on planktic foraminifers using a Delta R of 140 +/- 30 C-14 years, supplemented by the varying reservoir estimates of Stern and Lisiecki (2013) that provide an envelope of potential ages. HU2008029-12PC is bioturbated throughout. Sediments between the core base at 11.3 m and 4.6 m (LGM through HS1) comprise thin turbidites, plumites and hemipelagic sediments with Greenlandic provenance consistent with processes active at the Greenland Ice Sheet margin grounded at or near the shelf edge. Abundance spikes of planktic forams coincide with elevated abundance of benthic forams in assemblages indicative of chilled Atlantic Water, meltwater and intermittent marine productivity. IRD and IP25 are rare in this interval, but brassicasterol, an indicator of marine productivity reaches and sustains low levels during the LGM. These biological characteristics are consistent with a sea-ice covered ocean experiencing periods of more open water such as leads or polynyas in the sea ice cover, with chilled Atlantic Water at depth, rather than full iceshelf cover. They do not support the existence of a full Baffin Bay ice shelf cover extending from grounded ice on the Davis Strait. Initial ice retreat from the West Greenland margin is manifested by a pronounced lithofacies shift to bioturbated, diatomaceous mud with rare IRD of Greenlandic origin at 467 cm (16.2 cal ka BP; Delta R = 140 yrs) within HS1. A spike in foraminiferal abundance and ocean warmth indicator benthic forams precedes the initial ice retreat from the shelf edge. At the end of HS1, IP 25 , brassicasterol and benthic forams indicative of sea-ice edge productivity increase, indicating warming interstadial conditions. Within the Bolling/Allerod interstadial a strong rise in IP 25 content and IRD spikes rich in detrital carbonate from northern Baffin Bay indicate that northern Baffin Bay ice streams were retreating and provides evidence for increased open water, advection of Atlantic Water in the West Greenland Current, and formation of an IRD belt along the W. Greenland margin.
|
|
| 7. |
- Polyak, Leonid, et al.
(author)
-
History of sea ice in the Arctic
- 2010
-
In: Quaternary Science Reviews. - : Elsevier BV. - 0277-3791 .- 1873-457X. ; 29:15-16, s. 1757-1778
-
Journal article (peer-reviewed)abstract
- Arctic sea-ice extent and volume are declining rapidly. Several studies project that the Arctic Ocean may become seasonally ice-free by the year 2040 or even earlier. Putting this into perspective requires information on the history of Arctic sea-ice conditions through the geologic past. This information can be provided by proxy records from the Arctic Ocean floor and from the surrounding coasts. Although existing records are far from complete, they indicate that sea ice became a feature of the Arctic by 47 Ma, following a pronounced decline in atmospheric pCO(2) after the Paleocene-Eocene Thermal Optimum, and consistently covered at least part of the Arctic Ocean for no less than the last 13-14 million years. Ice was apparently most widespread during the last 2-3 million years, in accordance with Earth's overall cooler climate. Nevertheless, episodes of considerably reduced sea ice or even seasonally ice-free conditions occurred during warmer periods linked to orbital variations. The last low-ice event related to orbital forcing (high insolation) was in the early Holocene, after which the northern high latitudes cooled overall, with some superimposed shorterterm (multidecadal to millennial-scale) and lower-magnitude variability. The current reduction in Arctic ice cover started in the late 19th century, consistent with the rapidly warming climate, and became very pronounced over the last three decades. This ice loss appears to be unmatched over at least the last few thousand years and unexplainable by any of the known natural variabilities.
|
|
| 8. |
- Slieker, Roderick C, et al.
(author)
-
Identification of biomarkers for glycaemic deterioration in type 2 diabetes
- 2023
-
In: Nature Communications. - 2041-1723. ; 14, s. 1-18
-
Journal article (peer-reviewed)abstract
- We identify biomarkers for disease progression in three type 2 diabetes cohorts encompassing 2,973 individuals across three molecular classes, metabolites, lipids and proteins. Homocitrulline, isoleucine and 2-aminoadipic acid, eight triacylglycerol species, and lowered sphingomyelin 42:2;2 levels are predictive of faster progression towards insulin requirement. Of ~1,300 proteins examined in two cohorts, levels of GDF15/MIC-1, IL-18Ra, CRELD1, NogoR, FAS, and ENPP7 are associated with faster progression, whilst SMAC/DIABLO, SPOCK1 and HEMK2 predict lower progression rates. In an external replication, proteins and lipids are associated with diabetes incidence and prevalence. NogoR/RTN4R injection improved glucose tolerance in high fat-fed male mice but impaired it in male db/db mice. High NogoR levels led to islet cell apoptosis, and IL-18R antagonised inflammatory IL-18 signalling towards nuclear factor kappa-B in vitro. This comprehensive, multi-disciplinary approach thus identifies biomarkers with potential prognostic utility, provides evidence for possible disease mechanisms, and identifies potential therapeutic avenues to slow diabetes progression.
|
|
