Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or ≥ 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

Mid-Holocene pulse of thinning in the Weddell Sea sector of the West Antarctic ice sheet

Establishing the trajectory of thinning of the West Antarctic ice sheet (WAIS) since the last glacial maximum (LGM) is important for addressing questions concerning ice sheet (in)stability and changes in global sea level. Here we present detailed geomorphological and cosmogenic nuclide data from the southern Ellsworth Mountains in the heart of the Weddell Sea embayment that suggest the ice sheet, nourished by increased snowfall until the early Holocene, was close to its LGM thickness at 10 ka. A pulse of rapid thinning caused the ice elevation to fall ~400 m to the present level at 6.5–3.5 ka, and could have contributed 1.4–2 m to global sea-level rise. These results imply that the Weddell Sea sector of the WAIS contributed little to late-glacial pulses in sea-level rise but was involved in mid-Holocene rises. The stepped decline is argued to reflect marine downdraw triggered by grounding line retreat into Hercules Inlet

Improved Constraints on Models of Glacial Isostatic Adjustment: A Review of the Contribution of Ground-based Geodetic Observations

The provision of accurate models of Glacial Isostatic Adjustment (GIA) is presently a priority need in climate studies, largely due to the potential of the Gravity Recovery and Climate Experiment (GRACE) data to be used to determine accurate and continent-wide assessments of ice mass change and hydrology. However, modelled GIA isuncertain due to insufficient constraints on our knowledge of past glacial changes and to large simplifications in the underlying Earth models. Consequently, we show differences between models that exceed several mm/year in terms of surface displacement for the two major ice sheets: Greenland and Antarctica. Geodetic measurements of surface displacement offer the potential for new constraints to be made on GIA models, especially when they are used to improve structural features of the Earth’s interior as to allow for a more realistic reconstruction of the glaciation history. We present the distribution of presently available campaign and continuous geodetic measurements in Greenland and Antarctica and summarise surface velocities published to date, showing substantial disagreement between techniques and GIA models alike. We review the current state-of-the-art in ground-based geodesy (GPS, VLBI, DORIS, SLR) in determining accurate and precise surface velocities. In particular, we focus on known areas of need in GPS observation level models and the terrestrial reference frame in order to advance geodetic observation precision/ accuracy toward 0.1 mm/year and therefore further constrain models of GIA and subsequent present-day ice mass change estimates