Considerable uncertainty surrounds the extent and timing of the advance and retreat of the Greenland Ice Sheet (GIS) on the continental shelf bordering Baffi n Bay during the last glacial cycle. Here we use marine geophysical and geological data to show that fast-fl owing ice sheet outlets, including the ancestral Jakobshavn Isbrae, expanded several hundred kilometers to the shelf edge during the last glaciation ca. 20 ka. Retreat of these outlets was asynchronous. Initial retreat from the shelf edge was underway by 14,880 calibrated (cal) yr B.P. in Uummannaq trough. Radiocarbon dates from the adjacent Disko trough and adjoining trough-mouth fan imply later deglaciation of Jakobshavn Isbrae, and, signifi cantly, an extensive readvance and rapid retreat of this outlet during the Younger Dryas stadial (YD). This is notable because it is the fi rst evidence of a major advance of the GIS during the YD on the West Greenland shelf, although the short duration suggests that it may have been out of phase with YD temperatures.

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An understanding of the interaction between ice sheet dynamics and forcing mechanisms, such as oceanic and atmospheric circulation, is important because of the potential contribution of these processes to constraining models that seek to predict future rates of sea-level change. Here we report new benthic foraminiferal data from Disko Bugt, West Greenland, showing a close correlation between subsurface ocean temperature changes and the ice margin position of the glacier Jakobshavn Isbrae over the past 100 yr. In particular, our faunal data show that warm ocean currents entered a bay, Disko Bugt, during the retreat phases of Jakobshavn Isbrae from A.D. 1920 to 1950 and since 1998. We also show a link between West Greenland ocean temperature and the Atlantic Multidecadal Oscillation, a key climate indicator in the North Atlantic Ocean. The close coupling between the oceans and the cryosphere identifi ed here should be assessed in future projections of sea-level change.

BackgroundThe efficacy of endovascular thrombectomy (ET) for acute ischemic stroke (AIS) in octogenarians is still controversial.ObjectiveTo evaluate, using a large multicenter cohort of patients, outcomes after ET in octogenarians compared with younger patients.MethodsData from prospectively maintained databases of patients undergoing ET for AIS at seven US-based comprehensive stroke centers between January 2013 and January 2018 were reviewed. Demographic, procedural, and outcome variables were collected. Outcomes included 90-day modified Rankin Scale (mRS) score, postprocedural National Institutes of Health Stroke Scale score, postprocedural hemorrhage, and mortality. Univariate and multivariate analyses were performed to assess the independent effect of age ≥80 on outcome measures. Subgroup analyses were also performed based on location of stroke, success of recanalization, or ET technique used.ResultsRates of functional independence (mRS score 0–2) after ET in elderly patients were significantly lower than for younger counterparts. Age ≥80 was independently associated with increased mortality and poor outcome. Age ≥80 showed an independent negative prognostic effect on outcome even when patients were divided according to thrombectomy technique, location of stroke, or success of recanalization. Age ≥80 independently predicted higher rate of postprocedural hemorrhage, but not success of recanalization. Baseline deficit and number of reperfusion attempts, but not Thrombolysis in Cerebral Infarction score were associated with lower odds of good outcome.ConclusionThe large effect size of ET on AIS outcomes is significantly diminished in the elderly population when using comparable selection criteria to those used in younger counterparts. This raises concerns about the risk–benefit ratio and the cost-effectiveness of performing this procedure in the elderly before optimizing patient selection.