| 1. |
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| 2. |
- Bravo, L, et al.
(author)
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- 2021
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swepub:Mat__t
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| 3. |
- Tabiri, S, et al.
(author)
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- 2021
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swepub:Mat__t
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| 4. |
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| 5. |
- Glasbey, JC, et al.
(author)
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- 2021
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swepub:Mat__t
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| 6. |
- Thomas, HS, et al.
(author)
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- 2019
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swepub:Mat__t
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| 7. |
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| 8. |
- Khatri, C, et al.
(author)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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In: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Journal article (peer-reviewed)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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| 9. |
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| 10. |
- Meech, K. J., et al.
(author)
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EPOXI: Comet 103P/Hartley 2 Observations from a Worldwide Campaign
- 2011
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In: Astrophysical Journal Letters. - London : IOP. - 2041-8213 .- 2041-8205. ; 734:L1, s. 1-9
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Journal article (peer-reviewed)abstract
- Earth- and space-based observations provide synergistic information for space mission encounters by providing data over longer timescales, at different wavelengths and using techniques that are impossible with an in situ flyby. We report here such observations in support of the EPOXI spacecraft flyby of comet 103P/Hartley 2. The nucleus is small and dark, and exhibited a very rapidly changing rotation period. Prior to the onset of activity, the period was ~16.4?hr. Starting in 2010 August the period changed from 16.6?hr to near 19?hr in December. With respect to dust composition, most volatiles and carbon and nitrogen isotope ratios, the comet is similar to other Jupiter-family comets. What is unusual is the dominance of CO 2 -driven activity near perihelion, which likely persists out to aphelion. Near perihelion the comet nucleus was surrounded by a large halo of water-ice grains that contributed significantly to the total water production.
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| 11. |
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| 12. |
- Jin, S. C., et al.
(author)
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Mutations disrupting neuritogenesis genes confer risk for cerebral palsy
- 2020
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In: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 52:10
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Journal article (peer-reviewed)abstract
- Whole-exome sequencing of 250 parent-offspring trios identifies an enrichment of rare damaging de novo mutations in individuals with cerebral palsy and implicates genetically mediated dysregulation of early neuronal connectivity in the etiology of this disorder. In addition to commonly associated environmental factors, genomic factors may cause cerebral palsy. We performed whole-exome sequencing of 250 parent-offspring trios, and observed enrichment of damaging de novo mutations in cerebral palsy cases. Eight genes had multiple damaging de novo mutations; of these, two (TUBA1AandCTNNB1) met genome-wide significance. We identified two novel monogenic etiologies,FBXO31andRHOB, and showed that theRHOBmutation enhances active-state Rho effector binding while theFBXO31mutation diminishes cyclin D levels. Candidate cerebral palsy risk genes overlapped with neurodevelopmental disorder genes. Network analyses identified enrichment of Rho GTPase, extracellular matrix, focal adhesion and cytoskeleton pathways. Cerebral palsy risk genes in enriched pathways were shown to regulate neuromotor function in aDrosophilareverse genetics screen. We estimate that 14% of cases could be attributed to an excess of damaging de novo or recessive variants. These findings provide evidence for genetically mediated dysregulation of early neuronal connectivity in cerebral palsy.
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| 13. |
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| 14. |
- Schiller, D, et al.
(author)
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The Human Affectome
- 2024
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In: Neuroscience and biobehavioral reviews. - 1873-7528. ; 158, s. 105450-
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Journal article (peer-reviewed)
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| 15. |
- Smartt, S. J., et al.
(author)
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A kilonova as the electromagnetic counterpart to a gravitational-wave source
- 2017
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In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 551:7678, s. 75-
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Journal article (peer-reviewed)abstract
- Gravitational waves were discovered with the detection of binary black-hole mergers(1) and they should also be detectable from lower-mass neutron-star mergers. These are predicted to eject material rich in heavy radioactive isotopes that can power an electromagnetic signal. This signal is luminous at optical and infrared wavelengths and is called a kilonova(2-5). The gravitational-wave source GW170817 arose from a binary neutron-star merger in the nearby Universe with a relatively well confined sky position and distance estimate(6). Here we report observations and physical modelling of a rapidly fading electromagnetic transient in the galaxy NGC 4993, which is spatially coincident with GW170817 and with a weak, short.-ray burst(7,8). The transient has physical parameters that broadly match the theoretical predictions of blue kilonovae from neutron-star mergers. The emitted electromagnetic radiation can be explained with an ejected mass of 0.04 +/- 0.01 solar masses, with an opacity of less than 0.5 square centimetres per gram, at a velocity of 0.2 +/- 0.1 times light speed. The power source is constrained to have a power-law slope of -1.2 +/- 0.3, consistent with radioactive powering from r-process nuclides. (The r-process is a series of neutron capture reactions that synthesise many of the elements heavier than iron.) We identify line features in the spectra that are consistent with light r-process elements (atomic masses of 90-140). As it fades, the transient rapidly becomes red, and a higher-opacity, lanthanide-rich ejecta component may contribute to the emission. This indicates that neutron-star mergers produce gravitational waves and radioactively powered kilonovae, and are a nucleosynthetic source of the r-process elements.
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| 16. |
- McKnight, J. A., et al.
(author)
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Glycaemic control of Type1 diabetes in clinical practice early in the 21st century: an international comparison
- 2015
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In: Diabetic Medicine. - : Wiley. - 0742-3071. ; 32:8, s. 1036-1050
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Journal article (peer-reviewed)abstract
- AimsImproving glycaemic control in people with Type1 diabetes is known to reduce complications. Our aim was to compare glycaemic control among people with Type1 diabetes using data gathered in regional or national registries. MethodsData were obtained for children and/or adults with Type1 diabetes from the following countries (or regions): Western Australia, Austria, Denmark, England, Champagne-Ardenne (France), Germany, Epirus, Thessaly and Thessaloniki (Greece), Galway (Ireland), several Italian regions, Latvia, Rotterdam (The Netherlands), Otago (New Zealand), Norway, Northern Ireland, Scotland, Sweden, Volyn (Ukraine), USA and Wales) from population or clinic-based registries. The sample size with available data varied from 355 to 173880. Proportions with HbA(1c) <58mmol/mol (<7.5%) and 75mmol/mol (9.0%) were compared by age and sex. ResultsData were available for 324501 people. The proportions with HbA(1c) 58mmol/mol (<7.5%) varied from 15.7% to 46.4% among 44058 people aged <15years, from 8.9% to 49.5% among 50766 people aged 15-24years and from 20.5% to 53.6% among 229677 people aged 25years. Sex differences in glycaemic control were small. Proportions of people using insulin pumps varied between the 12 sources with data available. ConclusionThese results suggest that there are substantial variations in glycaemic control among people with Type1 diabetes between the data sources and that there is room for improvement in all populations, especially in young adults. We present HbA(1c) data from registries in 19 different countries describing control in 324501 people with Type1 diabetes, across all age groups. These data are the best representation of diabetes care available and therefore describe the state of the art'. We show clearly that Type1 diabetes control is not as good as suggested in guidelines, but that some healthcare systems appear to result in better control than others. These data present a challenge to diabetes services. Leaders in diabetes units/service can compare their local data to our data and encourage improvement.
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| 17. |
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| 18. |
- Calvert, Clara, et al.
(author)
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Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries
- 2023
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In: Nature Human Behaviour. - : Springer Nature. - 2397-3374. ; 7:4, s. 529-544
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Journal article (peer-reviewed)abstract
- Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from -90% to +30%, were reported in many countries following early COVID-19 pandemic response measures ('lockdowns'). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95-0.98, P value <0.0001), second (0.96, 0.92-0.99, 0.03) and third (0.97, 0.94-1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96-1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88-1.14, 0.98), third (0.99, 0.88-1.12, 0.89) and fourth (1.01, 0.87-1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02-1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03-1.15, 0.002), third (1.10, 1.03-1.17, 0.003) and fourth (1.12, 1.05-1.19, <0.001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways.
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| 19. |
- Janko, Matthew, et al.
(author)
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Contemporary Outcomes After Partial Resection of Infected Aortic Grafts
- 2021
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In: Annals of Vascular Surgery. - : Elsevier. - 0890-5096 .- 1615-5947. ; 76, s. 202-210
-
Journal article (peer-reviewed)abstract
- INTRODUCTION: Aortic graft infection remains a considerable clinical challenge, and it is unclear which variables are associated with adverse outcomes among patients undergoing partial resection.METHODS: A retrospective, multi-institutional study of patients who underwent partial resection of infected aortic grafts from 2002 to 2014 was performed using a standard database. Baseline demographics, comorbidities, operative, and postoperative variables were recorded. The primary outcome was mortality. Descriptive statistics, Kaplan-Meier (KM) survival analysis, and Cox regression analysis were performed.RESULTS: One hundred fourteen patients at 22 medical centers in 6 countries underwent partial resection of an infected aortic graft. Seventy percent were men with median age 70 years. Ninety-seven percent had a history of open aortic bypass graft: 88 (77%) patients had infected aortobifemoral bypass, 18 (16%) had infected aortobiiliac bypass, and 1 (0.8%) had an infected thoracic graft. Infection was diagnosed at a median 4.3 years post-implant. All patients underwent partial resection followed by either extra-anatomic (47%) or in situ (53%) vascular reconstruction. Median follow-up period was 17 months (IQR 1, 50 months). Thirty-day mortality was 17.5%. The KM-estimated median survival from time of partial resection was 3.6 years. There was no significant survival difference between those undergoing in situ reconstruction or extra-anatomic bypass (P = 0.6). During follow up, 72% of repairs remained patent and 11% of patients underwent major amputation. On univariate Cox regression analysis, Candida infection was associated with increased risk of mortality (HR 2.4; P = 0.01) as well as aortoenteric fistula (HR 1.9, P = 0.03). Resection of a single graft limb only to resection of abdominal (graft main body) infection was associated with decreased risk of mortality (HR 0.57, P = 0.04), as well as those with American Society of Anesthesiologists classification less than 3 (HR 0.35, P = 0.04). Multivariate analysis did not reveal any factors significantly associated with mortality. Persistent early infection was noted in 26% of patients within 30 days postoperatively, and 39% of patients were found to have any post-repair infection during the follow-up period. Two patients (1.8%) were found to have a late reinfection without early persistent postoperative infection. Patients with any post-repair infection were older (67 vs. 60 years, P = 0.01) and less likely to have patent repairs during follow up (59% vs. 32%, P = 0.01). Patients with aortoenteric fistula had a higher rate of any post-repair infection (63% vs. 29%, P < 0.01)CONCLUSION: This large multi-center study suggests that patients who have undergone partial resection of infected aortic grafts may be at high risk of death or post-repair infection, especially older patients with abdominal infection not isolated to a single graft limb, or with Candida infection or aortoenteric fistula. Late reinfection correlated strongly with early persistent postoperative infection, raising concern for occult retained infected graft material.
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| 20. |
- Janko, Matthew R., et al.
(author)
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In-situ bypass is associated with superior infection-free survival compared with extra-anatomic bypass for the management of secondary aortic graft infections without enteric involvement
- 2022
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In: Journal of Vascular Surgery. - : Elsevier. - 0741-5214 .- 1097-6809. ; 76:2, s. 546-
-
Journal article (peer-reviewed)abstract
- Objective: The optimal revascularization modality following complete resection of aortic graft infection (AGI) without enteric involvement remains unclear. The purpose of this investigation is to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients undergoing complete excision of AGI. Methods: A retrospective, multi-institutional study of AGI from 2002 to 2014 was performed using a standardized database. Baseline demographics, comorbidities, and perioperative variables were recorded. The primary outcome was infection-free survival. Descriptive statistics, Kaplan-Meier survival analysis, and univariate and multivariable analyses were performed. Results: A total of 241 patients at 34 institutions from seven countries presented with AGI during the study period (median age, 68 years; 75% male). The initial aortic procedures that resulted in AGI were 172 surgical grafts (71%), 66 endografts (27%), and three unknown (2%). Of the patients, 172 (71%) underwent complete excision of infected aortic graft material followed by in situ (in-line) bypass (ISB), including antibiotic-treated prosthetic graft (35%), autogenous femoral vein (neo-aortoiliac surgery) (24%), and cryopreserved allograft (41%). Sixty-nine patients (29%) underwent extra-anatomic bypass (EAB). Overall median Kaplan-Meier estimated survival was 5.8 years. Perioperative mortality was 16%. When stratified by ISB vs EAB, there was a significant difference in Kaplan-Meier estimated infection-free survival (2910 days; interquartile range, 391-3771 days vs 180 days; interquartile range, 27-3750 days; P <.001). There were otherwise no significant differences in presentation, comorbidities, or perioperative variables. Multivariable Cox regression showed lower infection-free survival among patients with EAB (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.6-3.6; P <.001), polymicrobial infection (HR, 2.2; 95% CI, 1.4-3.5; P = .001), methicillin-resistant Staphylococcus aureus infection (HR, 1.7; 95% CI, 1.1-2.7; P = .02), as well as the protective effect of omental/muscle flap coverage (HR, 0.59; 95% CI, 0.37-0.92; P = .02). Conclusions: After complete resection of AGI, perioperative mortality is 16% and median overall survival is 5.8 years. EAB is associated with nearly a two and one-half-fold higher reinfection/mortality compared with ISB. Omental and/or muscle flap coverage of the repair appear protective.
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| 21. |
- Kankare, E., et al.
(author)
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On the triple peaks of SNHunt248 in NGC 5806
- 2015
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In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 581
-
Journal article (peer-reviewed)abstract
- We present our findings on a supernova (SN) impostor, SNHunt248, based on optical and near-IR data spanning similar to 15 yr before discovery, to similar to 1 yr post-discovery. The light curve displays three distinct peaks, the brightest of which is at MR similar to -15.0 mag. The post-discovery evolution is consistent with the ejecta from the outburst interacting with two distinct regions of circumstellar material. The 0.5-2.2 mu m spectral energy distribution at -740 d is well-matched by a single 6700 K blackbody with log(L/L-circle dot) similar to 6.1. This temperature and luminosity support previous suggestions of a yellow hypergiant progenitor; however, we find it to be brighter than the brightest and most massive Galactic late-F to early-G spectral type hypergiants. Overall the historical light curve displays variability of up to similar to +/- 1 mag. At current epochs (similar to 1 yr post-outburst), the absolute magnitude (MR similar to -9 mag) is just below the faintest observed historical absolute magnitude similar to 10 yr before discovery.
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| 22. |
- KC, Ashish, 1982-, et al.
(author)
-
Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries.
- 2023
-
In: Nature human behaviour. - : Springer Science and Business Media LLC. - 2397-3374. ; 7:4, s. 529-544
-
Journal article (peer-reviewed)abstract
- Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from -90% to +30%, were reported in many countries following early COVID-19 pandemic response measures ('lockdowns'). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95-0.98, P value <0.0001), second (0.96, 0.92-0.99, 0.03) and third (0.97, 0.94-1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96-1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88-1.14, 0.98), third (0.99, 0.88-1.12, 0.89) and fourth (1.01, 0.87-1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02-1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03-1.15, 0.002), third (1.10, 1.03-1.17, 0.003) and fourth (1.12, 1.05-1.19, <0.001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways.
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| 23. |
- Leloudas, G., et al.
(author)
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The superluminous transient ASASSN-15lh as a tidal disruption event from a Kerr black hole
- 2016
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In: Nature Astronomy. - : Springer Science and Business Media LLC. - 2397-3366. ; 1:1
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Journal article (peer-reviewed)abstract
- When a star passes within the tidal radius of a supermassive black hole, it will be torn apart1. For a star with the mass of the Sun (M-circle dot) and a non-spinning black hole with a mass <10(8)M(circle dot), the tidal radius lies outside the black hole event horizon2 and the disruption results in a luminous flare(3-6). Here we report observations over a period of ten months of a transient, hitherto interpreted(7) as a superluminous supernova(8). Our data show that the transient rebrightened substantially in the ultraviolet and that the spectrum went through three different spectroscopic phases without ever becoming nebular. Our observations are more consistent with a tidal disruption event than a superluminous supernova because of the temperature evolution(6), the presence of highly ionized CNO gas in the line of sight(9) and our improved localization of the transient in the nucleus of a passive galaxy, where the presence of massive stars is highly unlikely(10,11). While the supermassive black hole has a mass >10(8)M(circle dot)(12,13), a star with the same mass as the Sun could be disrupted outside the event horizon if the black hole were spinning rapidly(14). The rapid spin and high black hole mass can explain the high luminosity of this event.
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| 24. |
- Luhmann, J. G., et al.
(author)
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Investigating magnetospheric interaction effects on Titan's ionosphere with the Cassini orbiter Ion Neutral Mass Spectrometer, Langmuir Probe and magnetometer observations during targeted flybys
- 2012
-
In: Icarus. - : Elsevier BV. - 0019-1035 .- 1090-2643. ; 219:2, s. 534-555
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Journal article (peer-reviewed)abstract
- In the similar to 6 years since the Cassini spacecraft went into orbit around Saturn in 2004, roughly a dozen Titan flybys have occurred for which the Ion Neutral Mass Spectrometer (INMS) measured that moon's ionospheric density and composition. For these, and for the majority of the similar to 60 close flybys probing to altitudes down to similar to 950 km, Langmuir Probe electron densities were also obtained. These were all complemented by Cassini magnetometer observations of the magnetic fields affected by the Titan plasma interaction. Titan's ionosphere was expected to differ from those of other unmagnetized planetary bodies because of significant contributions from particle impact due to its magnetospheric environment. However, previous analyses of these data clearly showed the dominance of the solar photon source, with the possible exception of the nightside. This paper describes the collected ionospheric data obtained in the period between Cassini's Saturn Orbit Insertion in 2004 and 2009, and examines some of their basic characteristics with the goal of searching for magnetospheric influences. These influences might include effects on the altitude profiles of impact ionization by magnetospheric particles at the Titan orbit location, or by locally produced pickup ions freshly created in Titan's upper atmosphere. The effects of forces on the ionosphere associated with both the draped and penetrating external magnetic fields might also be discernable. A number of challenges arise in such investigations given both the observed order of magnitude variations in the magnetospheric particle sources and the unsteadiness of the magnetospheric magnetic field and plasma flows at Titan's (similar to 20Rs (Saturn Radius)) orbit. Transterminator flow of ionospheric plasma from the dayside may also supply some of the nightside ionosphere, complicating determination of the magnetospheric contribution. Moreover, we are limited by the sparse sampling of the ionosphere during the mission as the Titan interaction also depends on Saturn Local Time as well as possible intrinsic asymmetries and variations of Titan's neutral atmosphere. We use organizations of the data by key coordinate systems of the plasma interaction with Titan's ionosphere to help interpret the observations. The present analysis does not find clear characteristics of the magnetosphere's role in defining Titan's ionosphere. The observations confirm the presence of an ionosphere produced mainly by sunlight, and an absence of expected ionospheric field signatures in the data. Further investigation of the latter, in particular, may benefit from numerical experiments on the inner boundary conditions of 3D models including the plasma interaction and features such as neutral winds.
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| 25. |
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| 26. |
- Smith, ER, et al.
(author)
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Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: an individual participant data meta-analysis
- 2023
-
In: BMJ global health. - : BMJ. - 2059-7908. ; 8:1
-
Journal article (peer-reviewed)abstract
- Despite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies.MethodsWe screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale.ResultsWe screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women.Pregnant women with SARS-CoV-2 infection—as compared with uninfected pregnant women—were at significantly increased risk of maternal mortality (10 studies; n=1490; RR 7.68, 95% CI 1.70 to 34.61); admission to intensive care unit (8 studies; n=6660; RR 3.81, 95% CI 2.03 to 7.17); receiving mechanical ventilation (7 studies; n=4887; RR 15.23, 95% CI 4.32 to 53.71); receiving any critical care (7 studies; n=4735; RR 5.48, 95% CI 2.57 to 11.72); and being diagnosed with pneumonia (6 studies; n=4573; RR 23.46, 95% CI 3.03 to 181.39) and thromboembolic disease (8 studies; n=5146; RR 5.50, 95% CI 1.12 to 27.12).Neonates born to women with SARS-CoV-2 infection were more likely to be admitted to a neonatal care unit after birth (7 studies; n=7637; RR 1.86, 95% CI 1.12 to 3.08); be born preterm (7 studies; n=6233; RR 1.71, 95% CI 1.28 to 2.29) or moderately preterm (7 studies; n=6071; RR 2.92, 95% CI 1.88 to 4.54); and to be born low birth weight (12 studies; n=11 930; RR 1.19, 95% CI 1.02 to 1.40). Infection was not linked to stillbirth. Studies were generally at low or moderate risk of bias.ConclusionsThis analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity, but not stillbirth or intrauterine growth restriction. As more data become available, we will update these findings per the published protocol.
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| 27. |
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| 28. |
- Westlake, J. H., et al.
(author)
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Titan's ionospheric composition and structure : Photochemical modeling of Cassini INMS data
- 2012
-
In: Journal of Geophysical Research. - 0148-0227 .- 2156-2202. ; 117, s. E01003-
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Journal article (peer-reviewed)abstract
- Titan's upper atmosphere produces an ionosphere at high altitudes from photoionization and electron impact that exhibits complex chemical processes in which hydrocarbons and nitrogen-containing molecules are produced through ion-molecule reactions. The structure and composition of Titan's ionosphere has been extensively investigated by the Ion and Neutral Mass Spectrometer (INMS) onboard the Cassini spacecraft. We present a detailed study using linear correlation analysis, 1-D photochemical modeling, and empirical modeling of Titan's dayside ionosphere constrained by Cassini measurements. The 1-D photochemical model is found to reproduce the primary photoionization products of N(2) and CH(4). The major ions, CH(5)(+), C(2)H(5)(+), and HCNH(+) are studied extensively to determine the primary processes controlling their production and loss. To further investigate the chemistry of Titan's ionosphere we present an empirical model of the ion densities that calculates the ion densities using the production and loss rates derived from the INMS data. We find that the chemistry included in our model sufficiently reproduces the hydrocarbon species as observed by the INMS. However, we find that the chemistry from previous models appears insufficient to accurately reproduce the nitrogen-containing organic compound abundances observed by the INMS. The major ion, HCNH(+), is found to be overproduced in both the empirical and 1-D photochemical models. We analyze the processes producing and consuming HCNH(+) in order to determine the cause of this discrepancy. We find that a significant chemical loss process is needed. We suggest that the loss process must be with one of the major components, namely C(2)H(2), C(2)H(4), or H(2).
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| 29. |
- Zoback, Mary Lou, et al.
(author)
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Global patterns of tectonic stress
- 1989
-
In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 341:6240, s. 291-298
-
Research review (peer-reviewed)abstract
- Regional patterns of present-day tectonic stress can be used to evaluate the forces acting on the lithosphere and to investigate intraplate seismicity. Most intraplate regions are characterized by a compressional stress regime; extension is limited almost entirely to thermally uplifted regions. In several plates the maximum horizontal stress is subparallel to the direction of absolute plate motion, suggesting that the forces driving the plates also dominate the stress distribution in the plate interior.
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| 30. |
- 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.
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| 31. |
- Allori, AC, et al.
(author)
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A Standard Set of Outcome Measures for the Comprehensive Appraisal of Cleft Care
- 2017
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In: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1545-1569. ; 54:5, s. 540-554
-
Journal article (peer-reviewed)abstract
- Care of the patient with cleft lip and/or palate remains complex. Prior attempts at aggregating data to study the effectiveness of specific interventions or overall treatment protocols have been hindered by a lack of data standards. There exists a critical need to better define the outcomes- particularly those that matter most to patients and their families-and to standardize the methods by which these outcomes will be measured. This report summarizes the recommendations of an international, multidisciplinary working group with regard to which outcomes a typical cleft team could track, how those outcomes could be measured and recorded, and what strategies may be employed to sustainably implement a system for prospective data collection. It is only by agreeing on a common, standard set of outcome measures for the comprehensive appraisal of cleft care that intercenter comparisons can become possible. This is important for quality-improvement endeavors, comparative effectiveness research, and value-based health-care reform.
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| 32. |
- Arechvo, A., et al.
(author)
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Incidence of pre-eclampsia : effect of deprivation
- 2023
-
In: Ultrasound in Obstetrics and Gynecology. - : Wiley. - 0960-7692 .- 1469-0705. ; 61:1, s. 26-32
-
Journal article (peer-reviewed)abstract
- Objectives: To examine the relationship between the English index of multiple deprivation (IMD) and the incidence of pre-eclampsia (PE), evaluate the distribution of IMD in a cohort of ethnically diverse pregnant women in South East England and assess whether IMD improves the prediction of PE compared with that provided by the ‘history-only’ competing-risks model (based on maternal characteristics and medical history). Methods: This was a prospective, observational study of 159 125 women with a singleton pregnancy who attended their first routine hospital visit at 11 + 0 to 13 + 6 weeks' gestation in two maternity hospitals in the UK. The inclusion criteria were delivery at ≥ 24 weeks' gestation of babies without major abnormality. Participants completed a questionnaire on demographic characteristics and obstetric and medical history, which was then reviewed by a doctor together with the woman. Patients were asked to self-identify as white, black, South Asian, East Asian or mixed race. IMD was used as a measure of socioeconomic status, which takes into account income, employment, education, skills and training, health and disability, crime, barriers to housing and services, and living environment. Each neighborhood is ranked according to their level of deprivation relative to that of other areas into one of five equal groups, with Quintile 1 containing the 20% most deprived areas and Quintile 5 containing the 20% least deprived areas. IMD was assigned based on a woman's postcode. Risk factors for PE and its incidence were assessed across IMD using chi-square test or t-test, as appropriate. The relationship between IMD and gestational age at delivery with PE was evaluated by fitting parametric survival models for IMD alone, IMD combined with race and IMD combined with the Fetal Medicine Foundation history-only competing-risks model. Results: The incidence of PE (n = 4088, 2.6%) increased progressively across IMD quintiles, from 2.0% in Quintile 5 (least deprived) to 3.0% in Quintile 1 (most deprived). Compared with white women and those in other racial groups, black women had a higher incidence of PE (4.8%), were less often in IMD Quintiles 4 and 5, and were more often in IMD Quintiles 1 and 2. None of the IMD quintiles improved the prediction of PE compared with that provided by the history-only competing-risks model (which includes race). The history-only competing-risks model with vs without IMD had a similar detection rate for delivery with PE at < 37 weeks' gestation (44.1% (95% CI, 41.1–47.2%) vs 43.9% (95% CI, 40.1–47.0%)) and at any gestational age (35.2% (95% CI, 33.8–36.7%) vs 35.1% (95% CI, 33.7–36.6%)), at a 10% screen-positive rate. Conclusions: The incidence of PE is higher in women living in the most deprived areas in South East England and in black women (vs those of other racial groups), who also live in areas of higher deprivation. However, in screening for PE, inclusion of IMD does not improve the prediction of PE provided by race and other maternal characteristics and elements of medical history.
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| 33. |
- Bath, Jonathan, et al.
(author)
-
Contemporary outcomes after treatment of aberrant subclavian artery and Kommerell's diverticulum
- 2023
-
In: Journal of Vascular Surgery. - : Elsevier BV. - 0741-5214 .- 1097-6809. ; 77:5, s. 1339-1348.e6
-
Journal article (peer-reviewed)abstract
- Objective: Aberrant subclavian artery (ASA) and Kommerell's diverticulum (KD) are rare vascular anomalies that may be associated with lifestyle-limiting and life-threatening complications. The aim of this study is to report contemporary outcomes after invasive treatment of ASA/KD using a large international dataset.Methods: Patients who underwent treatment for ASA/KD (2000-2020) were identified through the Vascular Low Frequency Disease Consortium, a multi-institutional collaboration to investigate uncommon vascular disorders. We report the early and mid-term clinical outcomes including stroke and mortality, technical success, and other operative outcomes including reintervention rates, patency, and endoleak.Results: Overall, 285 patients were identified during the study period. The mean patient age was 57 years; 47% were female and 68% presented with symptoms. A right-sided arch was present in 23%. The mean KD diameter was 47.4 mm (range, 13.0-108.0 mm). The most common indication for treatment was symptoms (59%), followed by aneurysm size (38%). The most common symptom reported was dysphagia (44%). A ruptured KD was treated in 4.2% of cases, with a mean diameter of 43.9 mm (range, 18.0-100.0 mm). An open procedure was performed in 101 cases (36%); the most common approach was ASA ligation with subclavian transposition. An endovascular or hybrid approach was performed in 184 patients (64%); the most common approach was thoracic endograft and carotid-subclavian bypass. A staged operative strategy was employed more often than single setting repair (55% vs 45%). Compared with endovascular or hybrid approach, those in the open procedure group were more likely to be younger (49 years vs 61 years; P < .0001), female (64% vs 36%; P < .0001), and symptomatic (85% vs 59%; P < .0001). Complete or partial symptomatic relief at 1 year after intervention was 82.6%. There was no association between modality of treatment and symptom relief (open 87.2% vs endovascular or hybrid approach 78.9%; P = .13). After the intervention, 11 subclavian occlusions (4.5%) occurred; 3 were successfully thrombectomized resulting in a primary and secondary patency of 95% and 96%, respectively, at a median follow-up of 39 months. Among the 33 reinterventions (12%), the majority were performed for endoleak (36%), and more reinterventions occurred in the endovascular or hybrid approach than open procedure group (15% vs 6%; P = .02). The overall survival rate was 87.3% at a median follow-up of 41 months. The 30-day stroke and death rates were 4.2% and 4.9%, respectively. Urgent or emergent presentation was independently associated with increased risk of 30-day mortality (odds ratio [OR], 19.8; 95% confidence interval [CI], 3.3-116.6), overall mortality (OR, 3.6; 95% CI, 1.2-11.2) and intraoperative complications (OR, 8.3; 95% CI, 2.8-25.1). Females had a higher risk of reintervention (OR, 2.6; 95% CI, 1.0-6.5). At an aneurysm size of 44.4 mm, receiver operator characteristic curve analysis suggested that 60% of patients would have symptoms.Conclusions: Treatment of ASA/KD can be performed safely with low rates of mortality, stroke and reintervention and high rates of symptomatic relief, regardless of the repair strategy. Symptomatic and urgent operations were associated with worse outcomes in general, and female gender was associated with a higher likelihood of reintervention. Given the worse overall outcomes when symptomatic and the inherent risk of rupture, consideration of repair at 40 mm is reasonable in most patients. ASA/KD can be repaired in asymptomatic patients with excellent outcomes and young healthy patients may be considered better candidates for open approaches versus endovascular or hybrid modalities, given the lower likelihood of reintervention and lower early mortality rate.
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| 34. |
- Clementson, Joel, et al.
(author)
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Tungsten spectroscopy relevant to the diagnostics of ITER divertor plasmas
- 2010
-
In: Journal of Physics B: Atomic, Molecular and Optical Physics. - : IOP Publishing. - 0953-4075 .- 1361-6455. ; 43:14
-
Journal article (peer-reviewed)abstract
- The possibility of using extreme ultraviolet emission from low charge states of tungsten ions to diagnose the divertor plasmas of the ITER tokamak has been investigated. Spectral modelling of Lu-like W3+ to Gd-like W10+ has been performed by using the Flexible Atomic Code, and spectroscopic measurements have been conducted at the Sustained Spheromak Physics Experiment (SSPX) in Livermore. To simulate ITER divertor plasmas, tungsten was introduced into the SSPX spheromak by prefilling it with tungsten hexacarbonyl prior to the usual hydrogen gas injection and initiation of the plasma discharge. The tungsten emission was studied using a grazing-incidence spectrometer.
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| 35. |
- Gutierrez, C. P., et al.
(author)
-
DES16C3cje : A low-luminosity, long-lived supernova
- 2020
-
In: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 496:1, s. 95-110
-
Journal article (peer-reviewed)abstract
- We present DES16C3cje, a low-luminosity, long-lived type II supernova (SN II) at redshift 0.0618, detected by the Dark Energy Survey (DES). DES16C3cje is a unique SN. The spectra are characterized by extremely narrow photospheric lines corresponding to very low expansion velocities of less than or similar to 1500 km s(-1), and the light curve shows an initial peak that fades after 50 d before slowly rebrightening over a further 100 d to reach an absolute brightness of M-r similar to 15.5 mag. The decline rate of the late-time light curve is then slower than that expected from the powering by radioactive decay of Co-56, but is comparable to that expected from accretion power. Comparing the bolometric light curve with hydrodynamical models, we find that DES16C3cje can be explained by either (i) a low explosion energy (0.11 foe) and relatively large Ni-56 production of 0.075 M-circle dot from an similar to 15 M-circle dot red supergiant progenitor typical of other SNe II, or (ii) a relatively compact similar to 40 M-circle dot star, explosion energy of 1 foe, and 0.08 M-circle dot of Ni-56. Both scenarios require additional energy input to explain the late-time light curve, which is consistent with fallback accretion at a rate of similar to 0.5 x 10(-)(8) M-circle dot s(-1).
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| 36. |
- Janko, Matthew R., et al.
(author)
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In situ bypass and extra-anatomic bypass procedures result in similar survival in patients with secondary aortoenteric fistulas
- 2021
-
In: Journal of Vascular Surgery. - : Elsevier. - 0741-5214 .- 1097-6809. ; 73:1, s. 210-221.e1
-
Journal article (peer-reviewed)abstract
- Objective: The optimal revascularization modality in secondary aortoenteric fistula (SAEF) remains unclear in the literature. The purpose of this investigation was to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients with SAEF. Methods: A retrospective, multi-institutional study of SAEF from 2002 to 2014 was performed using a standardized database. Baseline demographics, comorbidities, and operative and postoperative variables were recorded. The primary outcome was long-term mortality. Descriptive statistics, Kaplan-Meier survival analysis, and univariate and multivariate analyses were performed. Results: During the study period, 182 patients at 34 institutions from 11 countries presented with SAEF (median age, 72 years; 79% male). The initial aortic procedures that resulted in SAEF were 138 surgical grafts (76%) and 42 endografts (23%), with 2 unknown; 102 of the SAEFs (56%) underwent complete excision of infected aortic graft material, followed by in situ (in-line) bypass (ISB), including antibiotic-soaked prosthetic graft (53), autogenous femoral vein (neoaortoiliac surgery; 17), cryopreserved allograft (28), and untreated prosthetic grafts (4). There were 80 patients (44%) who underwent extra-anatomic bypass (EAB) with infected graft excision. Overall median Kaplan-Meier estimated survival was 319 days (interquartile range, 20-2410 days). Stratified by EAB vs ISB, there was no significant difference in Kaplan-Meier estimated survival (P = .82). In comparing EAB vs ISB, EAB patients were older (74 vs 70 years; P = .01), had less operative hemorrhage (1200 mL vs 2000 mL; P = .04), were more likely to initiate dialysis within 30 days postoperatively (15% vs 5%; P = .02), and were less likely to experience aorta-related hemorrhage within 30 days postoperatively (3% aortic stump dehiscence vs 11% anastomotic rupture; P = .03). There were otherwise no significant differences in presentation, comorbidities, and intraoperative or postoperative variables. Multivariable Cox regression showed that the duration of antibiotic use (hazard ratio, 0.92; 95% confidence interval, 0.86-0.98; P = .01) and rifampin use at time of discharge (hazard ratio, 0.20; 95% confidence interval, 0.05-0.86; P = .03) independently decreased mortality. Conclusions: These data suggest that ISB does not offer a survival advantage compared with EAB and does not decrease the risk of postoperative aorta-related hemorrhage. After repair, <50% of SAEF patients survive 10-months. Each week of antibiotic use decreases mortality by 8%. Further study with risk modeling is imperative for this population. (J Vasc Surg 2021;73:210-21.)
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| 37. |
- Kovacevic, A., et al.
(author)
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Fetal aortic valvuloplasty : investigating institutional bias in surgical decision-making
- 2014
-
In: Ultrasound in Obstetrics and Gynecology. - : Wiley. - 0960-7692 .- 1469-0705. ; 44:5, s. 538-544
-
Journal article (peer-reviewed)abstract
- Objectives Fetal aortic valvuloplasty may prevent the progression of aortic stenosis to hypoplastic left heart syndrome and allow biventricular rather than univentricular postnatal treatment. This study aimed to investigate whether blinded simulation of a multidisciplinary team approach aids interpretation of multicenter data to uncover institutional bias in postnatal decision-making following fetal cardiac intervention for aortic stenosis. Methods The study included 109 cases of prenatally diagnosed aortic stenosis from 13 European countries, of which 32 had undergone fetal cardiac intervention. The multidisciplinary team, blinded to fetal cardiac intervention, institutional location and postnatal treatment, retrospectively assigned a surgical pathway (biventricular or univentricular) based on a review of recorded postnatal imaging and clinical characteristics. The team's decisions were the numerical consensus of silent voting, with case review when a decision was split. Funnel plots showing concordance between the multidisciplinary team and the local team's surgical choice (first pathway) and with outcome (final pathway) were created. Results In 105 cases the multidisciplinary team reached a consensus decision regarding the surgical pathway, with no decision in four cases because the available imaging records were inadequate. Blinded multidisciplinary team consensus for the first pathway matched the decision of the surgical center in 93/105 (89%) cases, with no difference in agreement between those that had undergone successful fetal cardiac intervention (n= 32) and no (n= 74) or unsuccessful (n= 3) valvuloplasty (no fetal cardiac intervention) (kappa = 0.73 (95% CI, 0.38-1.00) vs 0.74 (95% CI, 0.51-0.96)). However, funnel plots comparing multidisciplinary team individual decisions with those of the local teams displayed more discordance (meaning biventricular-univentricular conversion) for the final surgical pathway following fetal cardiac intervention than they did for cases without such intervention (36/74 vs 34/130; P = 0.002), and identified one outlying center. Conclusions The use of a blinded multidisciplinary team to simulate decision-making and presentation of data in funnel plots may assist in the interpretation of data submitted to multicenter studies and permit the identification of outliers for further investigation. In the case of aortic stenosis, a high level of agreement was observed between the multidisciplinary team and the surgical centers, but one outlying center was identified.
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| 38. |
- Magee, M. R., et al.
(author)
-
The type Iax supernova, SN 2015H A white dwarf deflagration candidate
- 2016
-
In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 589
-
Journal article (peer-reviewed)abstract
- We present results based on observations of SN 2015H which belongs to the small group of objects similar to SN 2002cx, otherwise known as type Iax supernovae. The availability of deep pre-explosion imaging allowed us to place tight constraints on the explosion epoch. Our observational campaign began approximately one day post-explosion, and extended over a period of about 150 days post maximum light, making it one of the best observed objects of this class to date. We find a peak magnitude of M-r = 17.27 +/- 0.07, and a (Delta m(15))(r) = 0.69 +/- 0.04. Comparing our observations to synthetic spectra generated from simulations of deflagrations of Chandrasekhar mass carbon-oxygen white dwarfs, we find reasonable agreement with models of weak deflagrations that result in the ejection of similar to 0.2 M-circle dot of material containing similar to 0.07 M-circle dot of Ni-56. The model light curve however, evolves more rapidly than observations, suggesting that a higher ejecta mass is to be favoured. Nevertheless, empirical modelling of the pseudo-bolometric light curve suggests that less than or similar to 0.6 M-circle dot of material was ejected, implying that the white dwarf is not completely disrupted, and that a bound remnant is a likely outcome.
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| 39. |
- Mandt, Kathleen E., et al.
(author)
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Ion densities and composition of Titan's upper atmosphere derived from the Cassini Ion Neutral Mass Spectrometer : Analysis methods and comparison of measured ion densities to photochemical model simulations
- 2012
-
In: Journal of Geophysical Research. - 0148-0227 .- 2156-2202. ; 117, s. E10006-
-
Journal article (peer-reviewed)abstract
- The Cassini Ion Neutral Mass Spectrometer (INMS) has measured both neutral and ion species in Titan's upper atmosphere and ionosphere and the Enceladus plumes. Ion densities derived from INMS measurements are essential data for constraining photochemical models of Titan's ionosphere. The objective of this paper is to present an optimized method for converting raw data measured by INMS to ion densities. To do this, we conduct a detailed analysis of ground and in-flight calibration to constrain the instrument response to ion energy, the critical parameter on which the calibration is based. Data taken by the Cassini Radio Plasma Wave Science Langmuir Probe and the Cassini Plasma Spectrometer Ion Beam Spectrometer are used as independent measurement constraints in this analysis. Total ion densities derived with this method show good agreement with these data sets in the altitude region (similar to 1100-1400 km) where ion drift velocities are low and the mass of the ions is within the measurement range of the INMS (1-99 Daltons). Although ion densities calculated by the method presented here differ slightly from those presented in previous INMS publications, we find that the implications for the science presented in previous publications is mostly negligible. We demonstrate the role of the INMS ion densities in constraining photochemical models and find that (1) cross sections having high resolution as a function of wavelength are necessary for calculating the initial photoionization products and (2) there are disagreements between the measured ion densities representative of the initial steps in Titan photochemistry that require further investigation.
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| 40. |
- Moffatt, Clare, et al.
(author)
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International Multi-Institutional Experience with Presentation and Management of Aortic Arch Laterality in Aberrant Subclavian Artery and Kommerell's Diverticulum
- 2023
-
In: Annals of Vascular Surgery. - : Elsevier. - 0890-5096 .- 1615-5947. ; 95, s. 23-31
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Aberrant subclavian artery (ASA) with or without Kommerell's diverticulum (KD) is a rare anatomic aortic arch anomaly that can cause dysphagia and/or life-threatening rupture. The objective of this study is to compare outcomes of ASA/KD repair in patients with a left versus right aortic arch.METHODS: Using the Vascular Low Frequency Disease Consortium methodology, a retrospective review was performed of patients ≥18 years old with surgical treatment of ASA/KD from 2000 to 2020 at 20 institutions.RESULTS: 288 patients with ASA with or without KD were identified; 222 left-sided aortic arch (LAA), and 66 right-sided aortic arch (RAA). Mean age at repair was younger in LAA 54 vs. 58 years (P = 0.06). Patients in RAA were more likely to undergo repair due to symptoms (72.7% vs. 55.9%, P = 0.01), and more likely to present with dysphagia (57.6% vs. 39.1%, P < 0.01). The hybrid open/endovascular approach was the most common repair type in both groups. Rates of intraoperative complications, death within 30 days, return to the operating room, symptom relief and endoleaks were not significantly different. For patients with symptom status follow-up data, in LAA, 61.7% had complete relief, 34.0% had partial relief and 4.3% had no change. In RAA, 60.7% had complete relief, 34.4% had partial relief and 4.9% had no change.CONCLUSIONS: In patients with ASA/KD, RAA patients were less common than LAA, presented more frequently with dysphagia, had symptoms as an indication for intervention, and underwent treatment at a younger age. Open, endovascular and hybrid repair approaches appear equally effective, regardless of arch laterality.
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| 41. |
- Molteni, Erika, et al.
(author)
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Symptoms and syndromes associated with SARS-CoV-2 infection and severity in pregnant women from two community cohorts
- 2021
-
In: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 11:1
-
Journal article (peer-reviewed)abstract
- We tested whether pregnant and non-pregnant women differ in COVID-19 symptom profile and severity, and we extended previous investigations on hospitalized pregnant women to those who did not require hospitalization. Two female community-based cohorts (18–44 years) provided longitudinal (smartphone application, N = 1,170,315, n = 79 pregnant tested positive) and cross-sectional (web-based survey, N = 1,344,966, n = 134 pregnant tested positive) data, prospectively collected through self-participatory citizen surveillance in UK, Sweden and USA. Pregnant and non-pregnant were compared for frequencies of events, including SARS-CoV-2 testing, symptoms and hospitalization rates. Multivariable regression was used to investigate symptoms severity and comorbidity effects. Pregnant and non-pregnant women positive for SARS-CoV-2 infection were not different in syndromic severity, except for gastrointestinal symptoms. Pregnant were more likely to have received testing, despite reporting fewer symptoms. Pre-existing lung disease was most closely associated with syndromic severity in pregnant hospitalized. Heart and kidney diseases and diabetes increased risk. The most frequent symptoms among non-hospitalized women were anosmia [63% pregnant, 92% non-pregnant] and headache [72%, 62%]. Cardiopulmonary symptoms, including persistent cough [80%] and chest pain [73%], were more frequent among pregnant who were hospitalized. Consistent with observations in non-pregnant populations, lung disease and diabetes were associated with increased risk of more severe SARS-CoV-2 infection during pregnancy.
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| 42. |
- Plaza-Menacho, Iván, et al.
(author)
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Ras/ERK1/2-mediated STAT3 Ser727 phosphorylation by familial medullary thyroid carcinoma-associated RET mutants induces full activation of STAT3 and is required for c-fos promoter activation, cell mitogenicity, and transformation.
- 2007
-
In: Journal of Biological Chemistry. - 0021-9258 .- 1083-351X. ; 282:9, s. 6415-24
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Journal article (peer-reviewed)abstract
- The precise role of STAT3 Ser(727) phosphorylation in RET-mediated cell transformation and oncogenesis is not well understood. In this study, we have shown that familial medullary thyroid carcinoma (FMTC) mutants RET(Y791F) and RET(S891A) induced, in addition to Tyr(705) phosphorylation, constitutive STAT3 Ser(727) phosphorylation. Using inhibitors and dominant negative constructs, we have demonstrated that RET(Y791F) and RET(S891A) induce STAT3 Ser(727) phosphorylation via a canonical Ras/ERK1/2 pathway and that integration of the Ras/ERK1/2/ELK-1 and STAT3 pathways was required for up-regulation of the c-fos promoter by FMTC-RET. Moreover, inhibition of ERK1/2 had a more severe effect on cell proliferation and cell phenotype in HEK293 cells expressing RET(S891A) compared with control and RET(WT)-transfected cells. The transforming activity of RET(Y791F) and RET(S891A) in NIH-3T3 cells was also inhibited by U0126, indicating a role of the ERK1/2 pathway in RET-mediated transformation. To investigate the biological significance of Ras/ERK1/2-induced STAT3 Ser(727) phosphorylation for cell proliferation and transformation, N-Ras-transformed NIH-3T3 cells were employed. These cells displayed elevated levels of activated ERK1/2 and Ser(727)-phosphorylated STAT3, which were inhibited by treatment with U0126. Importantly, overexpression of STAT3, in which the Ser(727) was mutated into Ala (STAT3(S727A)), rescued the transformed phenotype of N-Ras-transformed cells. Immunohistochemistry in tumor samples from FMTC patients showed strong nuclear staining of phosphorylated ERK1/2 and Ser(727) STAT3. These data show that FMTC-RET mutants activate a Ras/ERK1/2/STAT3 Ser(727) pathway, which plays an important role in cell mitogenicity and transformation.
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| 43. |
- Prentice, S. J., et al.
(author)
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Transitional events in the spectrophotometric regime between stripped envelope and superluminous supernovae
- 2021
-
In: Monthly notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 508:3, s. 4342-4358
-
Journal article (peer-reviewed)abstract
- The division between stripped-envelope supernovae (SE-SNe) and superluminous supernovae (SLSNe) is not well-defined in either photometric or spectroscopic space. While a sharp luminosity threshold has been suggested, there remains an increasing number of transitional objects that reach this threshold without the spectroscopic signatures common to SLSNe. In this work, we present data and analysis on four SNe transitional between SE-SNe and SLSNe; the He-poor SNe 2019dwa and 2019cri, and the He-rich SNe 2019hge and 2019unb. Each object displays long-lived and variable photometric evolution with luminosities around the SLSN threshold of Mr < −19.8 mag. Spectroscopically however, these objects are similar to SE-SNe, with line velocities lower than either SE-SNe and SLSNe, and thus represent an interesting case of rare transitional events.
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| 44. |
- Richard, M. S., et al.
(author)
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An empirical approach to modeling ion production rates in Titan's ionosphere I : Ion production rates on the dayside and globally
- 2015
-
In: Journal of Geophysical Research - Space Physics. - 2169-9380 .- 2169-9402. ; 120:2, s. 1264-1280
-
Journal article (peer-reviewed)abstract
- Titan's ionosphere is created when solar photons, energetic magnetospheric electrons or ions, and cosmic rays ionize the neutral atmosphere. Electron densities generated by current theoretical models are much larger than densities measured by instruments on board the Cassini orbiter. This model density overabundance must result either from overproduction or from insufficient loss of ions. This is the first of two papers that examines ion production rates in Titan's ionosphere, for the dayside and nightside ionosphere, respectively. The first (current) paper focuses on dayside ion production rates which are computed using solar ionization sources (photoionization and electron impact ionization by photoelectrons) between 1000 and 1400km. In addition to theoretical ion production rates, empirical ion production rates are derived from CH4, CH3+, and CH4+ densities measured by the INMS (Ion Neutral Mass Spectrometer) for many Titan passes. The modeled and empirical production rate profiles from measured densities of N-2(+) and CH4+ are found to be in good agreement (to within 20%) for solar zenith angles between 15 and 90 degrees. This suggests that the overabundance of electrons in theoretical models of Titan's dayside ionosphere is not due to overproduction but to insufficient ion losses.
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| 45. |
- Robertson, I. P., et al.
(author)
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Structure of Titan's ionosphere : Model comparisons with Cassini data
- 2009
-
In: Planetary and Space Science. - : Elsevier BV. - 0032-0633 .- 1873-5088. ; 57:14-15, s. 1834-1846
-
Journal article (peer-reviewed)abstract
- Solar extreme ultraviolet and X-ray radiation and energetic plasma from Saturn's magnetosphere interact with the upper atmosphere producing an ionosphere at Titan. The highly coupled ionosphere and upper atmosphere system mediates the interaction between Titan and the external environment. New insights into Titan's ionosphere are being facilitated by data from several instruments onboard the Cassini Orbiter, although the Ion and Neutral Mass Spectrometer (INMS) measurements will be emphasized here. We present dayside ionosphere models and compare the results with both Radio and Plasma Wave-Langmuir Probe (RPWS/LP) and INMS data, exploring the sensitivity of models to ionospheric chemistry schemes and solar flux variations. Modeled electron densities for the dayside leg of T18 and all of T17 (dayside) had reasonable agreement with the measured RPWS electron densities and INMS total ion densities. Magnetospheric inputs make at best minor contributions to the ionosphere for these flybys, at least for altitudes above about 1000 km. At lower (< 1100 km) altitudes, the total ion densities measured by the INMS are less than the electron densities measured by the RPWS/LP which could be due to heavy (> 100 daltons) ions, which the INMS is not able to detect. Qualitatively, INMS spectra exhibit the same ion species and 12 amu family separations for the dayside ionospheres of T17 and T18 as were seen in the mass spectra measured during T5 (nightside). However, the relative abundance of high-mass (m > 50) ion species is about 10 times less for the dayside T17 and T18 passes than it was for the polar nightside T5 flyby, which can perhaps be explained in several ways including differences in neutral composition, less dissociative recombination on the nightside than on the dayside (due to lower electron densities and affecting heavier ion species more than lighter ones), and transport of longer-lived high-mass species from day-to-night.
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| 46. |
- Wahlund, Jan Erik, et al.
(author)
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On the amount of heavy molecular ions in Titan's ionosphere
- 2009
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In: Planetary and Space Science. - : Elsevier BV. - 0032-0633 .- 1873-5088. ; 57:14-15, s. 1857-1865
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Journal article (peer-reviewed)abstract
- We present observational evidence that the ionosphere of Titan below an altitude of 1150 km is a significant source of heavy (> 100 amu) molecular organic species. This study is based on measurements by five instruments (RPWS/LP, RPWS/E, INMS, CAPS/ELS, CAPS/IBS) onboard the Cassini spacecraft during three flybys (T17, T18, T32) of Titan. The ionospheric peaks encountered at altitudes of 950-1300 km had densities in the range 900-3000 cm(-3). Below these peaks the number densities of heavy positively charged ions reached 100-2000 cm(-3) and approached 50-70% of the total ionospheric density with an increasing trend toward lowest measured altitudes. Simultaneously measured negatively charged ion densities were in the range 50-150 cm(-3). These results imply that similar to 10(5)similar to 10(6) heavy positively charged ions/m(3)/s are continuously recombining into heavy neutrals and supply the atmosphere of Titan. The ionosphere may in this way produce 0.1-1 Mt/yr of heavy organic compounds and is therefore a sizable source for aerosol formation. We also predict that Titan's ionosphere is dominated by heavy (> 100 amu) molecular ions below 950 km.
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| 47. |
- Wevers, T., et al.
(author)
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An elliptical accretion disk following the tidal disruption event AT 2020zso
- 2022
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In: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 666
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Journal article (peer-reviewed)abstract
- Aims. The modelling of spectroscopic observations of tidal disruption events (TDEs) to date suggests that the newly formed accretion disks are mostly quasi-circular. In this work we study the transient event AT 2020zso, hosted by an active galactic nucleus (AGN; as inferred from narrow emission line diagnostics), with the aim of characterising the properties of its newly formed accretion flow.Methods. We classify AT 2020zso as a TDE based on the blackbody evolution inferred from UV/optical photometric observations and spectral line content and evolution. We identify transient, double-peaked Bowen (N III), He I, He II, and Hα emission lines. We model medium-resolution optical spectroscopy of the He II (after careful de-blending of the N III contribution) and Hα lines during the rise, peak, and early decline of the light curve using relativistic, elliptical accretion disk models.Results. We find that the spectral evolution before the peak can be explained by optical depth effects consistent with an outflowing, optically thick Eddington envelope. Around the peak, the envelope reaches its maximum extent (approximately 1015 cm, or ∼3000–6000 gravitational radii for an inferred black hole mass of 5−10 × 105 M⊙) and becomes optically thin. The Hα and He II emission lines at and after the peak can be reproduced with a highly inclined (i = 85 ± 5 degrees), highly elliptical (e = 0.97 ± 0.01), and relatively compact (Rin = several 100 Rg and Rout = several 1000 Rg) accretion disk.Conclusions. Overall, the line profiles suggest a highly elliptical geometry for the new accretion flow, consistent with theoretical expectations of newly formed TDE disks. We quantitatively confirm, for the first time, the high inclination nature of a Bowen (and X-ray dim) TDE, consistent with the unification picture of TDEs, where the inclination largely determines the observational appearance. Rapid line profile variations rule out the binary supermassive black hole hypothesis as the origin of the eccentricity; these results thus provide a direct link between a TDE in an AGN and the eccentric accretion disk. We illustrate for the first time how optical spectroscopy can be used to constrain the black hole spin, through (the lack of) disk precession signatures (changes in inferred inclination). We constrain the disk alignment timescale to > 15 days in AT2020zso, which rules out high black hole spin values (a < 0.8) for MBH ∼ 106 M⊙ and disk viscosity α ≳ 0.1.
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