| 1. |
- Axfors, Cathrine, et al.
(författare)
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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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Ingår i: BMC Infectious Diseases. - : BioMed Central (BMC). - 1471-2334. ; 21:1
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Forskningsöversikt (refereegranskat)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and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, ).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 Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients).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 The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis.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. |
- Hudson, Thomas J., et al.
(författare)
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International network of cancer genome projects
- 2010
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 464:7291, s. 993-998
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Tidskriftsartikel (refereegranskat)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.
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| 3. |
- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Tidskriftsartikel (refereegranskat)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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| 4. |
- Birney, Ewan, et al.
(författare)
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Prepublication data sharing
- 2009
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 461:7261, s. 168-170
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Tidskriftsartikel (refereegranskat)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.
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| 5. |
- Detlef, Henrieka, et al.
(författare)
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Holocene sea-ice dynamics in Petermann Fjord in relation to ice tongue stability and Nares Strait ice arch formation
- 2021
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Ingår i: The Cryosphere. - : Copernicus GmbH. - 1994-0416 .- 1994-0424. ; 15:9, s. 4357-4380
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Tidskriftsartikel (refereegranskat)abstract
- The Petermann 2015 expedition to Petermann Fjord and adjacent Hall Basin recovered a transect of cores, extending from Nares Strait to underneath the 48 km long ice tongue of Petermann glacier, offering a unique opportunity to study ice-ocean-sea ice interactions at the interface of these realms. First results suggest that no ice tongue existed in Petermann Fjord for large parts of the Holocene, raising the question of the role of the ocean and the marine cryosphere in the collapse and re-establishment of the ice tongue. Here we use a multi-proxy approach (sea-ice-related biomarkers, total organic carbon and its carbon isotopic composition, and benthic and planktonic foraminiferal abundances) to explore Holocene sea ice dynamics at OD1507-03TC-41GC-03PC in outer Petermann Fjord. Our results are in line with a tight coupling of the marine and terrestrial cryosphere in this region and, in connection with other regional sea ice reconstructions, give insights into the Holocene evolution of ice arches and associated landfast ice in Nares Strait. The late stages of the regional Holocene Thermal Maximum (6900-5500 cal yr BP) were marked by reduced seasonal sea ice concentrations in Nares Strait and the lack of ice arch formation. This was followed by a transitional period towards Neoglacial cooling from 5500-3500 cal yr BP, where a southern ice arch might have formed, but an early seasonal breakup and late formation likely caused a prolonged open water season and enhanced pelagic productivity in Nares Strait. Between 3500 and 1400 cal yr BP, regional records suggest the formation of a stable northern ice arch only, with a short period from 2500-2100 cal yr BP where a southern ice arch might have formed intermittently in response to atmospheric cooling spikes. A stable southern ice arch, or even double arching, is also inferred for the period after 1400 cal yr BP. Thus, both the inception of a small Petermann ice tongue at similar to 2200 cal yr BP and its rapid expansion at similar to 600 cal yr BP are preceded by a transition towards a southern ice arch regime with landfast ice formation in Nares Strait, suggesting a stabilizing effect of landfast sea ice on Petermann Glacier.
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| 6. |
- Hogan, Kelly A., et al.
(författare)
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Glacial sedimentation, fluxes and erosion rates associated with ice retreat in Petermann Fjord and Nares Strait, north-west Greenland
- 2020
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Ingår i: The Cryosphere. - : Copernicus GmbH. - 1994-0416 .- 1994-0424. ; 14:1, s. 261-286
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Tidskriftsartikel (refereegranskat)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.
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| 7. |
- Jakobsson, Martin, et al.
(författare)
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Arctic Ocean glacial history
- 2014
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Ingår i: Quaternary Science Reviews. - : Elsevier BV. - 0277-3791 .- 1873-457X. ; 92, s. 40-67
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Forskningsöversikt (refereegranskat)abstract
- While there are numerous hypotheses concerning glacial interglacial environmental and climatic regime shifts in the Arctic Ocean, a holistic view on the Northern Hemisphere's late Quaternary ice-sheet extent and their impact on ocean and sea-ice dynamics remains to be established. Here we aim to provide a step in this direction by presenting an overview of Arctic Ocean glacial history, based on the present state-of-the-art knowledge gained from field work and chronological studies, and with a specific focus on ice-sheet extent and environmental conditions during the Last Glacial Maximum (LGM). The maximum Quaternary extension of ice sheets is discussed and compared to LGM. We bring together recent results from the circum-Arctic continental margins and the deep central basin; extent of ice sheets and ice streams bordering the Arctic Ocean as well as evidence for ice shelves extending into the central deep basin. Discrepancies between new results and published LGM ice-sheet reconstructions in the high Arctic are highlighted and outstanding questions are identified. Finally, we address the ability to simulate the Arctic Ocean ice sheet complexes and their dynamics, including ice streams and ice shelves, using presently available ice-sheet models. Our review shows that while we are able to firmly reject some of the earlier hypotheses formulated to describe Arctic Ocean glacial conditions, we still lack information from key areas to compile the holistic Arctic Ocean glacial history.
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| 8. |
- Jakobsson, Martin, et al.
(författare)
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The Holocene retreat dynamics and stability of Petermann Glacier in northwest Greenland
- 2018
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Submarine glacial landforms in fjords are imprints of the dynamic behaviour of marine-terminating glaciers and are informative about their most recent retreat phase. Here we use detailed multibeam bathymetry to map glacial landforms in Petermann Fjord and Nares Strait, northwestern Greenland. A large grounding-zone wedge (GZW) demonstrates that Petermann Glacier stabilised at the fjord mouth for a considerable time, likely buttressed by an ice shelf. This stability was followed by successive backstepping of the ice margin down the GZW's retrograde backslope forming small retreat ridges to 680 m current depth (similar to 730-800 m palaeodepth). Iceberg ploughmarks occurring somewhat deeper show that thick, grounded ice persisted to these water depths before final breakup occurred. The palaeodepth limit of the recessional moraines is consistent with final collapse driven by marine ice cliff instability (MICI) with retreat to the next stable position located underneath the present Petermann ice tongue, where the seafloor is unmapped.
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| 9. |
- Jennings, Anne E., et al.
(författare)
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Baffin Bay paleoenvironments in the LGM and HS1 : Resolving the ice-shelf question
- 2018
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Ingår i: Marine Geology. - : Elsevier BV. - 0025-3227 .- 1872-6151. ; 402, s. 5-16
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Tidskriftsartikel (refereegranskat)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.
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| 10. |
- Jennings, Anne, et al.
(författare)
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Modern and early Holocene ice shelf sediment facies from Petermann Fjord and northern Nares Strait, northwest Greenland
- 2022
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Ingår i: Quaternary Science Reviews. - : Elsevier BV. - 0277-3791 .- 1873-457X. ; 283
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Tidskriftsartikel (refereegranskat)abstract
- Based on sediment cores and geophysical data collected from Petermann Fjord and northern Nares Strait, NW Greenland, an Arctic ice shelf sediment facies is presented that distinguishes sub and pro ice shelf environments. Sediment cores were collected from sites beneath the present day Petermann Ice Tongue (PIT) and in deglacial sediments of northern Nares Strait with a focus on understanding the glacial and oceanographic history over the last 11,000 cal yr BP. The modern sub ice shelf sediment facies in Petermann Fjord is laminated and devoid of coarse clasts (IRD) due to strong basal melting that releases debris (debris filtering) from the basal ice at the grounding zone driven by buoyant subglacial meltwater and entrained Atlantic Water. Laminated sediments in the deep basin proximal to the gounding zone comprise layers of fine mud formed by suspension settling from turbid meltwater plumes (plumites) interrupted by normally graded very fine sand to medium silt layers with sharp basal contacts and rip-up clasts of mud, interpreted as turbidites. An inner fjord sill limits distribution of sediment gravity flows from the grounding zone to the deep inner fjord basin, such that sites on the inner sill and beyond the ice tongue largely only comprise plumites. Bioturbation and foraminiferal abundances increase with distance from the grounding zone. The benthic foraminiferal species, Elphidium clavatum is absent beneath the ice tongue, but dominant in the turbid meltwater influenced environment beyond the ice tongue. The very sparse IRD in sediments beneath the PIT and in the fjord beyond the PIT derives mainly from englacial debris in the ice tongue, side valley glaciers, rock falls from the steep fjord walls and sea ice.We use the modern ice shelf sediment facies characteristics to infer the past presence of ice shelves in northern Nares Strait using analyses of sediment cores from several cruises (OD1507, HLY03, 2001LSSL, RYDER19). On bathymetric highs, bioturbated mud with dispersed IRD overlies a 10–15 m thick, distinctly laminated silt and clay unit with rare coarse clasts and sparse foraminifera which forms a sediment drape of nearly uniform thickness. We interpret these laminated sediments to represent glaciomarine deposition by meltwater plumes emanating from ice streams that terminated in floating ice shelves. IRD layers, shifts in sediment composition (qXRD, MS and XRF) and faunal assemblage changes in the laminated unit document periods of ice-shelf instability sometimes, but not always, coupled with grounding zone retreat. Our deglacial reconstruction, including ice shelves, begins ∼10.7 cal ka BP, with confluent ice streams grounded in Hall Basin fronted by the Robeson Channel ice shelf. Ice shelf breakup and grounding zone retreat to relatively stable grounding zones at Kennedy Channel and the mouth of Petermann Fjord was accomplished by 9.4 cal ka BP when the Hall Basin ice shelf was established. This ice shelf broke up and reformed once prior to the final break up at 8.5 to 8.4 cal ka BP marking ice stream collapse, separation of Greenland and Innuitian ice sheets, and the opening of Nares Strait for Arctic-Atlantic throughflow. The Petermann ice shelf remained in Hall Basin until the Petermann Glacier retreated from the fjord mouth ∼7.1 cal ka BP. The resilience of these northern ice streams to strong early Holocene insolation and subsurface Atlantic Water advection is attributed to their northern aspect, buttressing by narrow passages, and high ice flux from the Greenland Ice Sheet (GIS).
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