Automated detection of basal icequakes and discrimination from surface crevassing

Icequakes at or near the bed of a glacier have the potential to allow us to investigate the interaction of ice with the underlying till or bedrock. Understanding this interaction is important for studying basal sliding of glaciers and ice streams, a critical process in ice dynamics models used to constrain future sea level rise projections. However, seismic observations on glaciers can be dominated by seismic energy from surface crevassing. We present a method of automatically detecting basal icequakes and discriminating them from surface crevassing, comparing this method to a commonly used spectrum-based method of detecting icequakes. We use data from Skeidararjo ̈kull, an outlet glacier of the Vatnaj ̈okull Ice Cap, South-East Iceland, to demonstrate that our method outperforms the commonly used spectrum-based method. Our method detects a higher number of basal icequakes, has a lower rate of incorrectly identifying crevassing as basal icequakes and detects an additional, spatially independent basal icequake cluster. We also show independently that the icequakes do not originate from near the glacier surface. We conclude that the method described here is more effective than currently implemented methods for detecting and discriminating basal icequakes from surface crevassing

Downhole distributed acoustic seismic profiling at Skytrain Ice Rise, West Antarctica

Antarctic ice sheet history is imprinted in the structure and fabric of the ice column. At ice rises, the signature of ice flow history is preserved due to the low strain rates inherent at these independent ice flow centres. We present results from a distributed acoustic sensing (DAS) experiment at Skytrain Ice Rise in the Weddell Sea sector of West Antarctica, aimed at delineating the englacial fabric to improve our understanding of ice sheet history in the region. This pilot experiment demonstrates the feasibility of an innovative technique to delineate ice rise structure. Both direct and reflected P- and S-wave energy, as well as surface wave energy, are observed using a range of source offsets, i.e. a walkaway vertical seismic profile, recorded using fibre optic cable. Significant noise, which results from the cable hanging untethered in the borehole, is modelled and suppressed at the processing stage. At greater depth where the cable is suspended in drilling fluid, seismic interval velocities and attenuation are measured. Vertical P-wave velocities are high (VINT=3984±218 m s−1) and consistent with a strong vertical cluster fabric. Seismic attenuation is high (QINT=75±12) and inconsistent with previous observations in ice sheets over this temperature range. The signal level is too low, and the noise level too high, to undertake analysis of englacial fabric variability. However, modelling of P- and S-wave travel times and amplitudes with a range of fabric geometries, combined with these measurements, demonstrates the capacity of the DAS method to discriminate englacial fabric distribution. From this pilot study we make a number of recommendations for future experiments aimed at quantifying englacial fabric to improve our understanding of recent ice sheet history

Potential Cost-effectiveness of Early Identification of Hospital-acquired Infection in Critically Ill Patients

Limitations in methods for the rapid diagnosis of hospital-acquired infections often delay initiation of effective antimicrobial therapy. New diagnostic approaches offer potential clinical and cost-related improvements in the management of these infections. We developed a decision modeling framework to assess the potential cost-effectiveness of a rapid biomarker assay to identify hospital-acquired infection in high-risk patients earlier than standard diagnostic testing. The framework includes parameters representing rates of infection, rates of delayed appropriate therapy, and impact of delayed therapy on mortality, along with assumptions about diagnostic test characteristics and their impact on delayed therapy and length of stay. Parameter estimates were based on contemporary, published studies and supplemented with data from a four-site, observational, clinical study. Extensive sensitivity analyses were performed. The base-case analysis assumed 17.6% of ventilated patients and 11.2% of nonventilated patients develop hospital-acquired infection and that 28.7% of patients with hospital-acquired infection experience delays in appropriate antibiotic therapy with standard care. We assumed this percentage decreased by 50% (to 14.4%) among patients with true-positive results and increased by 50% (to 43.1%) among patients with false-negative results using a hypothetical biomarker assay. Cost of testing was set at $110/d. In the base-case analysis, among ventilated patients, daily diagnostic testing starting on admission reduced inpatient mortality from 12.3 to 11.9$1,640 per patient, resulting in an incremental cost-effectiveness ratio of $21,389 per life-year saved. Among nonventilated patients, inpatient mortality decreased from 7.3 to 7.1$1,381 with diagnostic testing. The resulting incremental cost-effectiveness ratio was $42,325 per life-year saved. Threshold analyses revealed the probabilities of developing hospital-acquired infection in ventilated and nonventilated patients could be as low as 8.4 and 9.8$50,000 per life-year saved. Development and use of serial diagnostic testing that reduces the proportion of patients with delays in appropriate antibiotic therapy for hospital-acquired infections could reduce inpatient mortality. The model presented here offers a cost-effectiveness framework for future test development

Not all icequakes are created equal: basal icequakes suggest diverse bed deformation mechanisms at Rutford Ice Stream, West Antarctica

Microseismicity, induced by the sliding of a glacier over its bed, can be used to characterize frictional properties of the ice‐bed interface, which are a key parameter controlling ice stream flow. We use naturally occurring seismicity to monitor spatiotemporally varying bed properties at Rutford Ice Stream, West Antarctica. We locate 230000 micro‐earthquakes with local magnitudes from –2.0 to –0.3 using 90 days of recordings from a 35‐station seismic network located ∼40 km upstream of the grounding line. Events exclusively occur near the ice‐bed interface and indicate predominantly flow‐parallel stick‐slip. They mostly lie within a region of interpreted stiff till and along the likely stiffer part of mega‐scale glacial landforms. Within these regions, micro‐earthquakes occur in spatially (<100 m radius) and temporally (mostly 1‐5 days activity) restricted event‐clusters (up to 4000 events), which exhibit an increase, followed by a decrease, in event magnitude with time. This may indicate event triggering once activity is initiated. Although ocean tides modulate the surface ice flow velocity, we observe little periodic variation in overall event frequency over time and conclude that water content, bed topography and stiffness are the major factors controlling microseismicity. Based on variable rupture mechanisms and spatiotemporal characteristics, we suggest the event‐clusters relate to three end‐member types of bed deformation: (1) continuous creation and seismogenic destruction of small‐scale bed‐roughness, (2) ploughed clasts and (3) flow‐oblique deformation during landform‐formation or along bedrock outcrops. This indicates that multiple processes, simultaneously active during glacial sliding, can accommodate stick‐slip behaviour and that the bed continuously reorganizes

Telomerecat: A ploidy-agnostic method for estimating telomere length from whole genome sequencing data.

Telomere length is a risk factor in disease and the dynamics of telomere length are crucial to our understanding of cell replication and vitality. The proliferation of whole genome sequencing represents an unprecedented opportunity to glean new insights into telomere biology on a previously unimaginable scale. To this end, a number of approaches for estimating telomere length from whole-genome sequencing data have been proposed. Here we present Telomerecat, a novel approach to the estimation of telomere length. Previous methods have been dependent on the number of telomeres present in a cell being known, which may be problematic when analysing aneuploid cancer data and non-human samples. Telomerecat is designed to be agnostic to the number of telomeres present, making it suited for the purpose of estimating telomere length in cancer studies. Telomerecat also accounts for interstitial telomeric reads and presents a novel approach to dealing with sequencing errors. We show that Telomerecat performs well at telomere length estimation when compared to leading experimental and computational methods. Furthermore, we show that it detects expected patterns in longitudinal data, repeated measurements, and cross-species comparisons. We also apply the method to a cancer cell data, uncovering an interesting relationship with the underlying telomerase genotype

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research