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  • 1
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    Online Resource
    Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy
    American Medical Association (AMA) ; 2022
    In:  JAMA Network Open Vol. 5, No. 11 ( 2022-11-21), p. e2243119-
    Details
    In: JAMA Network Open, American Medical Association (AMA), Vol. 5, No. 11 ( 2022-11-21), p. e2243119-
    Abstract: Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. Objective To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. Design, Setting, and Participants This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. Exposures Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. Main Outcomes and Measures The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. Results A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR] , 1.07; 95% CI, 1.01-1.13; P  = .03), aggressive biology (OR, 1.32; 95% CI, 1.15-1.53; P   & amp;lt; .001), and stenotic lesions (OR, 1.15; 95% CI, 1.01-1.31; P  = .03). Conclusions and Relevance This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients.
    Type of Medium: Online Resource
    ISSN: 2574-3805
    URL: Article
    DOI: 10.1001/jamanetworkopen.2022.43119
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2022
    detail.hit.zdb_id: 2931249-8
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  • 2
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    Effect of centre volume on pathological outcomes and postoperative complications after surgery for colorectal cancer: results of a multicentre national study
    Oxford University Press (OUP) ; 2023
    In:  British Journal of Surgery ( 2023-11-14)
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), ( 2023-11-14)
    Abstract: The association between volume, complications and pathological outcomes is still under debate regarding colorectal cancer surgery. The aim of the study was to assess the association between centre volume and severe complications, mortality, less-than-radical oncologic surgery, and indications for neoadjuvant therapy. Methods Retrospective analysis of 16,883 colorectal cancer cases from 80 centres (2018–2021). Outcomes: 30-day mortality; Clavien-Dindo grade & gt;2 complications; removal of ≥ 12 lymph nodes; non-radical resection; neoadjuvant therapy. Quartiles of hospital volumes were classified as LOW, MEDIUM, HIGH, and VERY HIGH. Independent predictors, both overall and for rectal cancer, were evaluated using logistic regression including age, gender, AJCC stage and cancer site. Results LOW-volume centres reported a higher rate of severe postoperative complications (OR 1.50, 95% c.i. 1.15–1.096, P = 0.003). The rate of ≥ 12 lymph nodes removed in LOW-volume (OR 0.68, 95% c.i. 0.56–0.85, P & lt; 0.001) and MEDIUM-volume (OR 0.72, 95% c.i. 0.62–0.83, P & lt; 0.001) centres was lower than in VERY HIGH-volume centres. Of the 4676 rectal cancer patients, the rate of ≥ 12 lymph nodes removed was lower in LOW-volume than in VERY HIGH-volume centres (OR 0.57, 95% c.i. 0.41–0.80, P = 0.001). A lower rate of neoadjuvant chemoradiation was associated with HIGH (OR 0.66, 95% c.i. 0.56–0.77, P & lt; 0.001), MEDIUM (OR 0.75, 95% c.i. 0.60–0.92, P = 0.006), and LOW (OR 0.70, 95% c.i. 0.52–0.94, P = 0.019) volume centres (vs. VERY HIGH). Conclusion Colorectal cancer surgery in low-volume centres is at higher risk of suboptimal management, poor postoperative outcomes, and less-than-adequate oncologic resections. Centralisation of rectal cancer cases should be taken into consideration to optimise the outcomes.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znad373
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2006309-X
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  • 3
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    Fennoscandian freshwater control on Greenland hydroclimate shifts at the onset of the Younger Dryas
    Springer Science and Business Media LLC ; 2015
    In:  Nature Communications Vol. 6, No. 1 ( 2015-11-17)
    Details
    In: Nature Communications, Springer Science and Business Media LLC, Vol. 6, No. 1 ( 2015-11-17)
    Abstract: Sources and timing of freshwater forcing relative to hydroclimate shifts recorded in Greenland ice cores at the onset of Younger Dryas, ∼12,800 years ago, remain speculative. Here we show that progressive Fennoscandian Ice Sheet (FIS) melting 13,100–12,880 years ago generates a hydroclimate dipole with drier–colder conditions in Northern Europe and wetter–warmer conditions in Greenland. FIS melting culminates 12,880 years ago synchronously with the start of Greenland Stadial 1 and a large-scale hydroclimate transition lasting ∼180 years. Transient climate model simulations forced with FIS freshwater reproduce the initial hydroclimate dipole through sea-ice feedbacks in the Nordic Seas. The transition is attributed to the export of excess sea ice to the subpolar North Atlantic and a subsequent southward shift of the westerly winds. We suggest that North Atlantic hydroclimate sensitivity to FIS freshwater can explain the pace and sign of shifts recorded in Greenland at the climate transition into the Younger Dryas.
    Type of Medium: Online Resource
    ISSN: 2041-1723
    URL: Article
    DOI: 10.1038/ncomms9939
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2015
    detail.hit.zdb_id: 2553671-0
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  • 4
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    Enhanced ice sheet melting driven by volcanic eruptions during the last deglaciation
    Springer Science and Business Media LLC ; 2017
    In:  Nature Communications Vol. 8, No. 1 ( 2017-10-24)
    Details
    In: Nature Communications, Springer Science and Business Media LLC, Vol. 8, No. 1 ( 2017-10-24)
    Abstract: Volcanic eruptions can impact the mass balance of ice sheets through changes in climate and the radiative properties of the ice. Yet, empirical evidence highlighting the sensitivity of ancient ice sheets to volcanism is scarce. Here we present an exceptionally well-dated annual glacial varve chronology recording the melting history of the Fennoscandian Ice Sheet at the end of the last deglaciation (∼13,200–12,000 years ago). Our data indicate that abrupt ice melting events coincide with volcanogenic aerosol emissions recorded in Greenland ice cores. We suggest that enhanced ice sheet runoff is primarily associated with albedo effects due to deposition of ash sourced from high-latitude volcanic eruptions. Climate and snowpack mass-balance simulations show evidence for enhanced ice sheet runoff under volcanically forced conditions despite atmospheric cooling. The sensitivity of past ice sheets to volcanic ashfall highlights the need for an accurate coupling between atmosphere and ice sheet components in climate models.
    Type of Medium: Online Resource
    ISSN: 2041-1723
    URL: Article
    DOI: 10.1038/s41467-017-01273-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
    detail.hit.zdb_id: 2553671-0
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  • 5
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    Greening of the Sahara suppressed ENSO activity during the mid-Holocene
    Springer Science and Business Media LLC ; 2017
    In:  Nature Communications Vol. 8, No. 1 ( 2017-07-07)
    Details
    In: Nature Communications, Springer Science and Business Media LLC, Vol. 8, No. 1 ( 2017-07-07)
    Abstract: The evolution of the El Niño-Southern Oscillation (ENSO) during the Holocene remains uncertain. In particular, a host of new paleoclimate records suggest that ENSO internal variability or other external forcings may have dwarfed the fairly modest ENSO response to precessional insolation changes simulated in climate models. Here, using fully coupled ocean-atmosphere model simulations, we show that accounting for a vegetated and less dusty Sahara during the mid-Holocene relative to preindustrial climate can reduce ENSO variability by 25%, more than twice the decrease obtained using orbital forcing alone. We identify changes in tropical Atlantic mean state and variability caused by the momentous strengthening of the West Africa Monsoon (WAM) as critical factors in amplifying ENSO’s response to insolation forcing through changes in the Walker circulation. Our results thus suggest that potential changes in the WAM due to anthropogenic warming may influence ENSO variability in the future as well.
    Type of Medium: Online Resource
    ISSN: 2041-1723
    URL: Article
    DOI: 10.1038/ncomms16020
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
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  • 6
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    Breakout Group A: What should the research questions and priorities in paleoscience be for the next 10 years?
    Past Global Changes (PAGES) ; 2013
    In:  PAGES news Vol. 21, No. 2 ( 2013-8), p. 94-94
    Details
    In: PAGES news, Past Global Changes (PAGES), Vol. 21, No. 2 ( 2013-8), p. 94-94
    Type of Medium: Online Resource
    ISSN: 1811-1602
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.22498/pages.21.2
    DOI: 10.22498/pages
    DOI: 10.22498/pages.22.2.94a
    Language: Unknown
    Publisher: Past Global Changes (PAGES)
    Publication Date: 2013
    detail.hit.zdb_id: 2779253-5
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  • 7
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    Pore water geochemistry along continental slopes north of the East Siberian Sea: inference of low methane concentrations
    Copernicus GmbH ; 2017
    In:  Biogeosciences Vol. 14, No. 12 ( 2017-06-20), p. 2929-2953
    Details
    In: Biogeosciences, Copernicus GmbH, Vol. 14, No. 12 ( 2017-06-20), p. 2929-2953
    Abstract: Abstract. Continental slopes north of the East Siberian Sea potentially hold large amounts of methane (CH4) in sediments as gas hydrate and free gas. Although release of this CH4 to the ocean and atmosphere has become a topic of discussion, the region remains sparingly explored. Here we present pore water chemistry results from 32 sediment cores taken during Leg 2 of the 2014 joint Swedish–Russian–US Arctic Ocean Investigation of Climate–Cryosphere–Carbon Interactions (SWERUS-C3) expedition. The cores come from depth transects across the slope and rise extending between the Mendeleev and the Lomonosov ridges, north of Wrangel Island and the New Siberian Islands, respectively. Upward CH4 flux towards the seafloor, as inferred from profiles of dissolved sulfate (SO42−), alkalinity, and the δ13C of dissolved inorganic carbon (DIC), is negligible at all stations east of 143° E longitude. In the upper 8 m of these cores, downward SO42− flux never exceeds 6.2 mol m−2 kyr−1, the upward alkalinity flux never exceeds 6.8 mol m−2 kyr−1, and δ13C composition of DIC (δ13C-DIC) only moderately decreases with depth (−3.6 ‰ m−1 on average). Moreover, upon addition of Zn acetate to pore water samples, ZnS did not precipitate, indicating a lack of dissolved H2S. Phosphate, ammonium, and metal profiles reveal that metal oxide reduction by organic carbon dominates the geochemical environment and supports very low organic carbon turnover rates. A single core on the Lomonosov Ridge differs, as diffusive fluxes for SO42− and alkalinity were 13.9 and 11.3 mol m−2 kyr−1, respectively, the δ13C-DIC gradient was 5.6 ‰ m−1, and Mn2+ reduction terminated within 1.3 m of the seafloor. These are among the first pore water results generated from this vast climatically sensitive region, and they imply that abundant CH4, including gas hydrates, do not characterize the East Siberian Sea slope or rise along the investigated depth transects. This contradicts previous modeling and discussions, which due to the lack of data are almost entirely based on assumption.
    Type of Medium: Online Resource
    ISSN: 1726-4189
    URL: Article
    URL: Article
    DOI: 10.5194/bg-14-2929-2017
    DOI: 10.5194/bg-14-2929-2017-supplement
    Language: English
    Publisher: Copernicus GmbH
    Publication Date: 2017
    detail.hit.zdb_id: 2158181-2
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  • 8
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    Warm summers during the Younger Dryas cold reversal
    Springer Science and Business Media LLC ; 2018
    In:  Nature Communications Vol. 9, No. 1 ( 2018-04-24)
    Details
    In: Nature Communications, Springer Science and Business Media LLC, Vol. 9, No. 1 ( 2018-04-24)
    Abstract: The Younger Dryas (YD) cold reversal interrupts the warming climate of the deglaciation with global climatic impacts. The sudden cooling is typically linked to an abrupt slowdown of the Atlantic Meridional Overturning Circulation (AMOC) in response to meltwater discharges from ice sheets. However, inconsistencies regarding the YD-response of European summer temperatures have cast doubt whether the concept provides a sufficient explanation. Here we present results from a high-resolution global climate simulation together with a new July temperature compilation based on plant indicator species and show that European summers remain warm during the YD. Our climate simulation provides robust physical evidence that atmospheric blocking of cold westerly winds over Fennoscandia is a key mechanism counteracting the cooling impact of an AMOC-slowdown during summer. Despite the persistence of short warm summers, the YD is dominated by a shift to a continental climate with extreme winter to spring cooling and short growing seasons.
    Type of Medium: Online Resource
    ISSN: 2041-1723
    URL: Article
    DOI: 10.1038/s41467-018-04071-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2553671-0
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  • 9
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    Amino acid racemization in Quaternary foraminifera from the Yermak Plateau, Arctic Ocean
    Copernicus GmbH ; 2019
    In:  Geochronology Vol. 1, No. 1 ( 2019-11-18), p. 53-67
    Details
    In: Geochronology, Copernicus GmbH, Vol. 1, No. 1 ( 2019-11-18), p. 53-67
    Abstract: Abstract. Amino acid racemization (AAR) geochronology is a powerful tool for dating Quaternary marine sediments across the globe, yet its application to Arctic Ocean sediments has been limited. Anomalous rates of AAR in foraminifera from the central Arctic were reported in previously published studies, indicating that either the rate of racemization is higher in this area, or inaccurate age models were used to constrain the sediment ages. This study investigates racemization rates in foraminifera from three well-dated sediment cores taken from the Yermak Plateau during the 2015 TRANSSIZ (TRansitions in the Arctic Seasonal Sea Ice Zone) expedition on RV Polarstern. D and L isomers of the amino acids aspartic acid (Asp) and glutamic acid (Glu) were separated in samples of the planktic foraminifer Neogloboquadrina pachyderma and the benthic species Cassidulina neoteretis to quantify the extent of racemization. In total, 241 subsamples were analysed, extending back to marine oxygen isotope stage (MIS) 7. Two previously published power functions, which relate the extent of racemization of Asp and Glu in foraminifera to sample age are revisited, and a comparison is made between the ages predicted by these calibrated age equations and independent geochronological constraints available for the cores. Our analyses reveal an excellent match between ages predicted by a global compilation of racemization rates for N. pachyderma and confirm that a proposed Arctic-specific calibration curve is not applicable at the Yermak Plateau. These results generally support the rates of AAR determined for other cold bottom water sites and further highlight the anomalous nature of the purportedly high rate of racemization indicated by previous analyses of central Arctic sediments.
    Type of Medium: Online Resource
    ISSN: 2628-3719
    URL: Article
    URL: Article
    DOI: 10.5194/gchron-1-53-2019
    DOI: 10.5194/gchron-1-53-2019-supplement
    Language: English
    Publisher: Copernicus GmbH
    Publication Date: 2019
    detail.hit.zdb_id: 2966593-0
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  • 10
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    A new 30 000-year chronology for rapidly deposited sediments on the Lomonosov Ridge using bulk radiocarbon dating and probabilistic stratigraphic alignment
    Copernicus GmbH ; 2020
    In:  Geochronology Vol. 2, No. 1 ( 2020-04-22), p. 81-91
    Details
    In: Geochronology, Copernicus GmbH, Vol. 2, No. 1 ( 2020-04-22), p. 81-91
    Abstract: Abstract. We present a new marine chronostratigraphy from a high-accumulation rate Arctic Ocean core at the intersection of the Lomonosov Ridge and the Siberian margin, spanning the last ∼ 30 kyr. The chronology was derived using a combination of bulk 14C dating and stratigraphic correlation to Greenland ice-core records. This was achieved by applying an appositely developed Markov chain Monte Carlo algorithm for Bayesian probabilistic alignment of proxy records. The algorithm simulates depositionally realistic alignments that are consistent with the available radiocarbon age estimates and allows deriving uncertainty bands associated with the inferred alignment. Current composite chronologies from this region are reasonably consistent with our age model during the Holocene and the later part of deglaciation. However, prior to ∼ 14 kyr BP they yield too old age estimates with offsets that linearly increase up to ∼ 40 kyr near the onset of Marine Isotope Stage (MIS) 2. Our results challenge the robustness of previous regional chronostratigraphies and provide a new stratotype for correlation of sediment cores from this sector of the Lomonosov Ridge and East Siberian slope. In particular, they call for a re-interpretation of events in recent sea-ice proxy reconstructions (Xiao et al., 2015) inaccurately attributed to MIS 3 and the Last Glacial Maximum.
    Type of Medium: Online Resource
    ISSN: 2628-3719
    URL: Article
    URL: Article
    DOI: 10.5194/gchron-2-81-2020
    DOI: 10.5194/gchron-2-81-2020-supplement
    Language: English
    Publisher: Copernicus GmbH
    Publication Date: 2020
    detail.hit.zdb_id: 2966593-0
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