The evolution of the Patagonian Ice Sheet from 35 ka to the present day (PATICE)

\ua9 2020 The AuthorsWe present PATICE, a GIS database of Patagonian glacial geomorphology and recalibrated chronological data. PATICE includes 58,823 landforms and 1,669 geochronological ages, and extends from 38\ub0S to 55\ub0S in southern South America. We use these data to generate new empirical reconstructions of the Patagonian Ice Sheet (PIS) and subsequent ice masses and ice-dammed palaeolakes at 35 ka, 30 ka, 25 ka, 20 ka, 15 ka, 13 ka (synchronous with the Antarctic Cold Reversal), 10 ka, 5 ka, 0.2 ka and 2011 AD. At 35 ka, the PIS covered of 492.6 x103 km2, had a sea level equivalent of ~1,496 mm, was 350 km wide and 2090 km long, and was grounded on the Pacific continental shelf edge. Outlet glacier lobes remained topographically confined and the largest generated the suites of subglacial streamlined bedforms characteristic of ice streams. The PIS reached its maximum extent by 33 – 28 ka from 38\ub0S to 48\ub0S, and earlier, around 47 ka from 48\ub0S southwards. Net retreat from maximum positions began by 25 ka, with ice-marginal stabilisation then at 21 – 18 ka, which was then followed by rapid, irreversible deglaciation. By 15 ka, the PIS had separated into disparate ice masses, draining into large ice-dammed lakes along the eastern margin, which strongly influenced rates of recession. Glacial readvances or stabilisations occurred at least at 14 – 13 ka, 11 ka, 6 – 5 ka, 2 – 1 ka, and 0.5 – 0.2 ka. We suggest that 20th century glacial recession (% a-1) is occurring faster than at any time documented during the Holocene

Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic.

BACKGROUND: Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery. METHODS: This international cohort study included adult patients undergoing elective surgery for cancer in areas affected by SARS-CoV-2 up to 19 April 2020. Patients suspected of SARS-CoV-2 infection before operation were excluded. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery. Preoperative testing strategies were adjusted for confounding using mixed-effects models. RESULTS: Of 8784 patients (432 hospitals, 53 countries), 2303 patients (26.2 per cent) underwent preoperative testing: 1458 (16.6 per cent) had a swab test, 521 (5.9 per cent) CT only, and 324 (3.7 per cent) swab and CT. Pulmonary complications occurred in 3.9 per cent, whereas SARS-CoV-2 infection was confirmed in 2.6 per cent. After risk adjustment, having at least one negative preoperative nasopharyngeal swab test (adjusted odds ratio 0.68, 95 per cent confidence interval 0.68 to 0.98; P = 0.040) was associated with a lower rate of pulmonary complications. Swab testing was beneficial before major surgery and in areas with a high 14-day SARS-CoV-2 case notification rate, but not before minor surgery or in low-risk areas. To prevent one pulmonary complication, the number needed to swab test before major or minor surgery was 18 and 48 respectively in high-risk areas, and 73 and 387 in low-risk areas. CONCLUSION: Preoperative nasopharyngeal swab testing was beneficial before major surgery and in high SARS-CoV-2 risk areas. There was no proven benefit of swab testing before minor surgery in low-risk areas