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- Ekanem, Emmanuel, et al.
(författare)
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Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study
- 2024
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Ingår i: Nature Medicine. - : NATURE PORTFOLIO. - 1078-8956 .- 1546-170X.
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Tidskriftsartikel (refereegranskat)abstract
- Pulsed field ablation (PFA) is an emerging technology for the treatment of atrial fibrillation (AF), for which pre-clinical and early-stage clinical data are suggestive of some degree of preferentiality to myocardial tissue ablation without damage to adjacent structures. Here in the MANIFEST-17K study we assessed the safety of PFA by studying the post-approval use of this treatment modality. Of the 116 centers performing post-approval PFA with a pentaspline catheter, data were received from 106 centers (91.4% participation) regarding 17,642 patients undergoing PFA (mean age 64, 34.7% female, 57.8% paroxysmal AF and 35.2% persistent AF). No esophageal complications, pulmonary vein stenosis or persistent phrenic palsy was reported (transient palsy was reported in 0.06% of patients; 11 of 17,642). Major complications, reported for similar to 1% of patients (173 of 17,642), were pericardial tamponade (0.36%; 63 of 17,642) and vascular events (0.30%; 53 of 17,642). Stroke was rare (0.12%; 22 of 17,642) and death was even rarer (0.03%; 5 of 17,642). Unexpected complications of PFA were coronary arterial spasm in 0.14% of patients (25 of 17,642) and hemolysis-related acute renal failure necessitating hemodialysis in 0.03% of patients (5 of 17,642). Taken together, these data indicate that PFA demonstrates a favorable safety profile by avoiding much of the collateral damage seen with conventional thermal ablation. PFA has the potential to be transformative for the management of patients with AF.
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2. |
- Alpizar, F., et al.
(författare)
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A framework for selecting and designing policies to reduce marine plastic pollution in developing countries
- 2020
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Ingår i: Environmental Science and Policy. - : Elsevier BV. - 1462-9011 .- 1873-6416. ; 109:July 2020, s. 25-35
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Tidskriftsartikel (refereegranskat)abstract
- © 2020 The Authors The polluting of marine ecosystems with plastics is both a global and a local problem with potentially severe consequences for wildlife, economic activity, and human health. It is a problem that originates in countries’ inability to adequately manage the growing flow of waste. We use an impact pathway framework to trace the flow of plastics through the socio-ecological system and identify the role of specific policy instruments in achieving behavioral changes to reduce marine plastic waste. We produce a toolbox for finding a policy that is suitable for different countries. We use the impact pathway and toolbox to make country-specific recommendations that reflect the reality in each of the selected countries.
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3. |
- Athey, S. N., et al.
(författare)
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Unraveling Physical and Chemical Effects of Textile Microfibers
- 2022
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Ingår i: Water (Switzerland). - : MDPI AG. - 2073-4441. ; 14:23
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Forskningsöversikt (refereegranskat)abstract
- Microfibers are the most prevalent microplastics in most terrestrial, freshwater, and marine biota as well as in human tissues and have been collected from environmental compartments across most ecosystems and species sampled worldwide. These materials, made of diverse compound types, range from semi-synthetic and treated natural fibers to synthetic microfibers. Microfibers expose organisms across diverse taxa to an array of chemicals, both from the manufacturing process and from environmental adsorption, with effects on organisms at subcellular to population levels. Untangling the physical versus chemical effects of these compounds on organisms is challenging and requires further investigations that tease apart these mechanisms. Understanding how physical and chemical exposures affect organisms is essential to improving strategies to minimize harm.
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4. |
- Carstensen, Jacob, et al.
(författare)
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Factors regulating the coastal nutrient filter in the Baltic Sea
- 2020
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Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 49:6, s. 1194-1210
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Tidskriftsartikel (refereegranskat)abstract
- The coastal zone of the Baltic Sea is diverse with strong regional differences in the physico-chemical setting. This diversity is also reflected in the importance of different biogeochemical processes altering nutrient and organic matter fluxes on the passage from land to sea. This review investigates the most important processes for removal of nutrients and organic matter, and the factors that regulate the efficiency of the coastal filter. Nitrogen removal through denitrification is high in lagoons receiving large inputs of nitrate and organic matter. Phosphorus burial is high in archipelagos with substantial sedimentation, but the stability of different burial forms varies across the Baltic Sea. Organic matter processes are tightly linked to the nitrogen and phosphorus cycles. Moreover, these processes are strongly modulated depending on composition of vegetation and fauna. Managing coastal ecosystems to improve the effectiveness of the coastal filter can reduce eutrophication in the open Baltic Sea.
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5. |
- Schäffer, Andreas, et al.
(författare)
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Conflicts of Interest in the Assessment of Chemicals, Waste, and Pollution
- 2023
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Ingår i: Environmental Science and Technology. - 0013-936X .- 1520-5851. ; 57:48, s. 19066-19077
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Tidskriftsartikel (refereegranskat)abstract
- Pollution by chemicals and waste impacts human and ecosystem health on regional, national, and global scales, resulting, together with climate change and biodiversity loss, in a triple planetary crisis. Consequently, in 2022, countries agreed to establish an intergovernmental science-policy panel (SPP) on chemicals, waste, and pollution prevention, complementary to the existing intergovernmental science-policy bodies on climate change and biodiversity. To ensure the SPP’s success, it is imperative to protect it from conflicts of interest (COI). Here, we (i) define and review the implications of COI, and its relevance for the management of chemicals, waste, and pollution; (ii) summarize established tactics to manufacture doubt in favor of vested interests, i.e., to counter scientific evidence and/or to promote misleading narratives favorable to financial interests; and (iii) illustrate these with selected examples. This analysis leads to a review of arguments for and against chemical industry representation in the SPP’s work. We further (iv) rebut an assertion voiced by some that the chemical industry should be directly involved in the panel’s work because it possesses data on chemicals essential for the panel’s activities. Finally, (v) we present steps that should be taken to prevent the detrimental impacts of COI in the work of the SPP. In particular, we propose to include an independent auditor’s role in the SPP to ensure that participation and processes follow clear COI rules. Among others, the auditor should evaluate the content of the assessments produced to ensure unbiased representation of information that underpins the SPP’s activities.
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7. |
- Wahlstrom, I., et al.
(författare)
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Projected climate change impact on a coastal sea-As significant as all current pressures combined
- 2022
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 28:17, s. 5310-5319
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Tidskriftsartikel (refereegranskat)abstract
- Climate change influences the ocean's physical and biogeochemical conditions, causing additional pressures on marine environments and ecosystems, now and in the future. Such changes occur in environments that already today suffer under pressures from, for example, eutrophication, pollution, shipping, and more. We demonstrate how to implement climate change into regional marine spatial planning by introducing data of future temperature, salinity, and sea ice cover from regional ocean climate model projections to an existing cumulative impact model. This makes it possible to assess climate change impact in relation to pre-existing cumulative impact from current human activities. Results indicate that end-of-century projected climate change alone is a threat of the same magnitude as the combination of all current pressures to the marine environment. These findings give marine planners and policymakers forewarning on how future climate change may impact marine ecosystems, across space, emission scenarios, and in relation to other pressures.
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