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- Axfors, Cathrine, et al.
(author)
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Association between convalescent plasma treatment and mortality in COVID-19 : a collaborative systematic review and meta-analysis of randomized clinical trials
- 2021
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In: BMC Infectious Diseases. - : BioMed Central (BMC). - 1471-2334. ; 21:1
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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and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, ).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 Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients).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 The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis.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.
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| 2. |
- Agosti, Francina, et al.
(author)
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Melanocortin 4 receptor activation inhibits presynaptic N-type calcium channels in amygdaloid complex neurons
- 2014
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In: European Journal of Neuroscience. - : Wiley. - 0953-816X .- 1460-9568. ; 40:5, s. 2755-2765
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Journal article (peer-reviewed)abstract
- The melanocortin 4 receptor (MC4R) is a G protein-coupled receptor involved in food intake and energy expenditure regulation. MC4R activation modifies neuronal activity but the molecular mechanisms by which this regulation occurs remain unclear. Here, we tested the hypothesis that MC4R activation regulates the activity of voltage-gated calcium channels and, as a consequence, synaptic activity. We also tested whether the proposed effect occurs in the amygdala, a brain area known to mediate the anorexigenic actions of MC4R signaling. Using the patch-clamp technique, we found that the activation of MC4R with its agonist melanotan II specifically inhibited 34.5 +/- 1.5% of N-type calcium currents in transiently transfected HEK293 cells. This inhibition was concentration-dependent, voltage-independent and occluded by the G(s) pathway inhibitor cholera toxin. Moreover, we found that melanotan II specifically inhibited 25.9 +/- 2.0% of native N-type calcium currents and 55.4 +/- 14.4% of evoked inhibitory postsynaptic currents in mouse cultured amygdala neurons. Invivo, we found that the MC4R agonist RO27-3225 increased the marker of cellular activity c-Fos in several components of the amygdala, whereas the N-type channel blocker conotoxin GVIA increased c-Fos expression exclusively in the central subdivision of the amygdala. Thus, MC4R specifically inhibited the presynaptic N-type channel subtype, and this inhibition may be important for the effects of melanocortin in the central subdivision of the amygdala.
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| 3. |
- Callesen, Gustav, et al.
(author)
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Recycling Nutrients and Reducing Carbon Emissions in the Baltic Sea Region—Sustainable or Economically Infeasible?
- 2022
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In: Environmental Management. - : Springer. - 0364-152X .- 1432-1009. ; 69:1, s. 213-225
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Journal article (peer-reviewed)abstract
- Ecotechnologies have the potential to reduce the use of finite resources while providing a variety of co-benefits to society, though they often lack in market competitiveness. In this study, we investigate the sustainability of ecotechnologies for recovering carbon and nutrients, and demonstrate how a so-called “bottom-up” approach can serve as a decision-making instrument. Based on three case study catchments with a focus on domestic wastewater in Sweden and Poland, and on manure, grass and blackwater substrates in Finland, we apply a cost–benefit analysis (CBA) on system alternatives derived from a participatory process. After drawing on an initial systematic mapping of relevant ecotechnologies, the scope of the CBA is determined by stakeholder suggestions, namely in terms of the considered assessment criteria, the physical impacts and the utilised data. Thus, this CBA is rooted in a localised consideration of ecotechnologies rather than a centralised governmental approach to systems boundaries. The key advantage of applying such a bottom-up approach is that it has gone through a robust participatory selection process by local stakeholders, which provides more legitimacy to the decisions reached compared with traditional feasibility studies. Despite considering the revenues of the recovered products as well as the provision of the non-market goods CO2 mitigation and reduced eutrophication, findings from this study indicate that the benefits of the considered ecotechnologies are often outweighed by their costs. Only anaerobic digestion of agricultural wastes appears to be economically feasible under the current conditions, highlighting that further efforts and incentives may be required to mainstream ecotechnologies. © 2021, The Author(s),
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| 4. |
- Krause, Torsten, et al.
(author)
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A new war on nature and people: taking stock of the Colombian peace agreement
- 2022
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In: Global Sustainability. - : Cambridge University Press (CUP). - 2059-4798. ; 5
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Journal article (peer-reviewed)abstract
- Non-technical summary Almost 6 years have passed since the Colombian peace agreement was signed. However, the promise of a 'Stable and lasting peace' is slipping away as the transition towards peace is increasingly tainted and overshadowed with violence. The future of Colombia is at a crossroad and without international support and action taken to monitor global supply chains, these particular drivers of conflict, violence and environmental degradation will persist. We summarize the current situation and shed light on the complexities of building peace in Colombia, with a particular focus on the environmental changes that took place since the peace agreement was signed. Technical summary The Colombian peace agreement officially ended one of the world's longest internal armed conflicts. But the transformation of land use that takes place in the wake of the peace agreement has made the historic inequalities of access to land more visible and revealed inherent and violent struggles over resources that persist across the country. In this briefing we analyse the current status of peacebuilding in Colombia and highlight the major barriers and challenges in the current peacebuilding efforts. We show how the last few years brought severe and negative repercussions for people, communities and the natural environment in Colombia as cattle ranching, 'productive agriculture' and extractive industries are increasingly encroaching into indigenous territories, protected areas and forest ecosystems, replacing diverse natural forests that support biodiversity and contribute to human well-being locally and globally. The resurging presence of numerous armed groups seeking to control the profitable drug trade and mineral deposits are a major problem and obstacle for building lasting and sustainable peace among people and with the natural environment in Colombia. We conclude this briefing with points that we see as crucial to support the implementation of the peace agreement. Social media summary Colombia's peacebuilding effort must foster environmental stewardship and respect its biological and cultural diversity.
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| 5. |
- López, Jesica, et al.
(author)
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Landscape connectivity loss after the de-escalation of armed conflict in the Colombian Amazon (2011–2021)
- 2024
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In: Global Ecology and Conservation. - 2351-9894. ; 54
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Journal article (peer-reviewed)abstract
- Rapid deforestation has been well-documented in Colombia after the 2016 peace agreement with FARC. While many analysis using remote sensing identify land cover change, structural connectivity variables are less studied for understanding landscape transformation. In this work, we used data from the Landsat archive from 2011 to 2021, the Continuous Change Detection and Classification algorithm (CCDC), and Morphological Spatial Pattern Analysis (MSPA) to analyze deforestation, land cover change, and landscape connectivity in northwestern Colombia’s Amazon. We examined the spatial patterns in three specific subsets in the Colombian arc of deforestation, with a special focus on the surroundings of the National Natural Park Serranía de Chiribiquete. Our results confirm changes in structural connectivity linked to pasture expansion from the conversion forest to pasture during the analyzed period showing changes in the borders of Serranía de Chiribiquete National Park along rivers and roads, where cattle is transported. Before 2016, the average annual deforested area in the three study areas was 27.93 km²; after 2016, this number increased to 73.36 km². The outcomes of our study contribute to an improved understanding of pasture dynamics. They can aid decision-making in areas that play a key role in ecological networks necessary for long-term conservation efforts. Our quantitative assessments have revealed a temporal shrinking of the core area, indicative of a decline in forest cover. Concurrently, we observed an expansion of the edge and background areas, which is consistent with the proliferation of pastures. This study presents methodology and data in support of policy-making for sustainable land use and ecological connectivity to mitigate further environmental degradation in the area.
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