Detection of an endangered mammalian species using environmental DNA analysis

Poster presented at The Mammal Society 63rd Spring Conference & AGM, 31st March-2nd April, 2017, Cambridge, UK

Environmental DNA analysis – non-invasive detection of endangered species in aquatic and terrestrial environments

Poster presented at Human Identification Solutions (HIDS) 2017, 16th-17th May, 2017, Vienna, Austria

Holocene glacial and climate history of Prince Gustav Channel, northeastern Antarctic Peninsula

The Antarctic Peninsula is one of the most rapidly warming regions on Earth, as evidenced by a recent increase in the intensity and duration of summer melting, the recession of glaciers and the retreat and collapse of ice shelves. Despite this, only a limited number of well-dated near shore marine and lake sediment based palaeoenvironmental records exist from this region; so our understanding of the longer-term context of this rapid climate change is limited. Here we provide new well-dated constraints on the deglaciation history, and changes in sea ice and climate based on analyses of sedimentological proxies, diatoms and fossil pigments in a sediment core collected from an isolation basin on Beak Island in Prince Gustav Channel, NE Antarctic Peninsula (63°36′S, 57°20′W). Twenty two radiocarbon dates provided a chronology for the core including a minimum modelled age for deglaciation of 10,602 cal yr BP, following the onset of marine sedimentation. Conditions remained cold and perennial sea ice persisted in this part of Prince Gustav Channel until c. 9372 cal yr BP. This was followed by a seasonally open marine environment until at least 6988 cal yr BP, corresponding with the early retreat and disintegration of the ice shelf in southern Prince Gustav Channel. Following isolation of the basin from 6988 cal yr BP a relatively cold climate persisted until 3169 cal yr BP. A Mid-late Holocene climate optimum occurred between 3169 and 2120 cal yr BP, inferred from multiple indicators of increased biological production. This postdates the onset of the Mid-late Holocene climate optimum in the South Shetland Islands (4380 cal yr BP) and the South Orkney Islands (3800 cal yr BP) suggesting that cooler climate systems of the Weddell Sea Gyre to the east of the Peninsula may have buffered the onset of warming. Climate deterioration is inferred from c. 2120 cal yr BP until 543 cal yr BP. This was followed by warming. Superimposed on this warming trend, the instrumental record of recent warming at nearby Hope Bay is mirrored by a recent increase in the lake’s primary production and a shift in the diatom communities in the uppermost 3 cm of sediments, suggesting that this is amongst the first records to show an ecological response to recent rapid temperature increase. These new constraints on glaciological and climate events in Prince Gustav Channel are reviewed in the context of wider changes in the Antarctic region

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London