Controls on the spatial distribution of oceanic <i>δ</i>¹³C_DIC

We describe the design and evaluation of a large ensemble of coupled climate–carbon cycle simulations with the Earth system model of intermediate complexity GENIE. This ensemble has been designed for application to a range of carbon cycle questions, including the causes of late- Quaternary fluctuations in atmospheric CO2. Here we evaluate the ensemble by applying it to a transient experiment over the recent industrial era (1858 to 2008 AD). We employ singular vector decomposition and principal component emulation to investigate the spatial modes of ensemble variability of oceanic dissolved inorganic carbon (DIC) δ13C, considering both the spun-up pre-industrial state and the transient change. These analyses allow us to separate the natural (preindustrial) and anthropogenic controls on the δ13CDIC distribution. We apply the same dimensionally reduced emulation techniques to consider the drivers of the spatial uncertainty in anthropogenic DIC. We show that the sources of uncertainty related to the uptake of anthropogenic δ13CDIC and DIC are quite distinct. Uncertainty in anthropogenic δ13C uptake is controlled by air–sea gas exchange, which explains 63% of modelled variance. This mode of variability is largely absent from the ensemble variability in CO2 uptake, which is rather driven by uncertainties in thermocline ventilation rates. Although the need to account for air–sea gas exchange is well known, these results suggest that, to leading order, uncertainties in the ocean uptake of anthropogenic 13C and CO2 are governed by very different processes. This illustrates the difficulties in reconstructing one from the other, and furthermore highlights the need for careful targeting of both δ13CDIC and DIC observations to better constrain the ocean sink of anthropogenic CO2

Doing Biopolitics Differently? Radical Potential in the Post-2015 MDG and SDG Debates

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Antarctic ice sheet fertilises the Southern Ocean

Southern Ocean (SO) marine primary productivity (PP) is strongly influenced by the availability of iron in surface waters, which is thought to exert a significant control upon atmospheric CO2 concentrations on glacial/interglacial timescales. The zone bordering the Antarctic Ice Sheet exhibits high PP and seasonal plankton blooms in response to light and variations in iron availability. The sources of iron stimulating elevated SO PP are in debate. Established contributors include dust, coastal sediments/upwelling, icebergs and sea ice. Subglacial meltwater exported at the ice margin is a more recent suggestion, arising from intense iron cycling beneath the ice sheet. Icebergs and subglacial meltwater may supply a large amount of bioavailable iron to the SO, estimated in this study at 0.07–0.2 Tg yr−1. Here we apply the MIT global ocean model (Follows et al., 2007) to determine the potential impact of this level of iron export from the ice sheet upon SO PP. The export of iron from the ice sheet raises modelled SO PP by up to 40%, and provides one plausible explanation for seasonally very high in situ measurements of PP in the near-coastal zone. The impact on SO PP is greatest in coastal regions, which are also areas of high measured marine PP. These results suggest that the export of Antarctic runoff and icebergs may have an important impact on SO PP and should be included in future biogeochemical modelling.Leverhulme Trust (Philip Leverhulme Prize)Leverhulme Trust (Leverhulme Research Fellowship)Leverhulme Trust (PDRA grant F/00182/BY)Royal Society (Great Britain) (Fellowship)European Commission (Marie-Curie Intra-European Fellowship)Natural Environment Research Council (Great Britain) (NERC Fellowship NE/J019062/1

Antarctic ice sheet fertilises the Southern Ocean

Open access journalSouthern Ocean (SO) marine primary productivity (PP) is strongly influenced by the availability of iron in surface waters, which is thought to exert a significant control upon atmospheric CO2 concentrations on glacial/interglacial timescales. The zone bordering the Antarctic Ice Sheet exhibits high PP and seasonal plankton blooms in response to light and variations in iron availability. The sources of iron stimulating elevated SO PP are in debate. Established contributors include dust, coastal sediments/upwelling, icebergs and sea ice. Subglacial meltwater exported at the ice margin is a more recent suggestion, arising from intense iron cycling beneath the ice sheet. Icebergs and subglacial meltwater may supply a large amount of bioavailable iron to the SO, estimated in this study at 0.07-0.2 Tg yr-1. Here we apply the MIT global ocean model (Follows et al., 2007) to determine the potential impact of this level of iron export from the ice sheet upon SO PP. The export of iron from the ice sheet raises modelled SO PP by up to 40%, and provides one plausible explanation for seasonally very high in situ measurements of PP in the near-coastal zone. The impact on SO PP is greatest in coastal regions, which are also areas of high measured marine PP. These results suggest that the export of Antarctic runoff and icebergs may have an important impact on SO PP and should be included in future biogeochemical modelling.Philip Leverhulme PrizeLeverhulme Research FellowshipLeverhulme TrustRoyal Society Fellowship7th European Community Framework Programme - Marie Curie Intra European FellowshipNatural Environment Research Council (NERC

To identify the factors that influence the recognizing and responding to adult patient deterioration in acute hospitals

Aims. To identify factors that influence recognition and response to adult patient deterioration in acute hospitals. Design. A Mixed-Studies Systematic Review. Data sources. CINAHL, Medline and Web of Science were searched for relevant literature published between; 2007-2018. Review Methods. Studies were critically appraised, data extracted and thematically analyzed. Results. Thirteen papers met the inclusion criteria. Three main themes were identified: (1) Knowledge and understanding of clinical deterioration; (2) Organizational factors; managing deterioration and staffing levels; and (3) Communication; inter-professional relationships and professional-patient communication. Conclusion. Despite national guidelines, the review findings suggest that the recognition and response to adult patient deterioration in acute hospital settings is sub-optimal. A multitude of factors influencing the recognition and response to adult patient deterioration emerged from the findings. Impact. Patients are receiving sub-optimal care due to failure in recognizing and responding to patient deterioration in an appropriate and timely manner. Nurses lack knowledge and understanding of deterioration. Organizational factors contribute to inadequate care and communication among professionals was highlighted as challenging. The factors that influence the recognizing and responding to patient deterioration in acute hospitals are multi-faceted, however this review highlights immediate recommendations for professionals in the acute care setting

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade

Freshwater invertebrate responses to fine sediment stress A multi-continent perspective

Excessive fine sediment (particles <2 mm) deposition in freshwater systems is a pervasive stressor worldwide. However, understanding of ecological response to excess fine sediment in river systems at the global scale is limited. Here, we aim to address whether there is a consistent response to increasing levels of deposited fine sediment by freshwater invertebrates across multiple geographic regions (Australia, Brazil, New Zealand and the UK). Results indicate ecological responses are not globally consistent and are instead dependent on both the region and the facet of invertebrate diversity considered, that is, taxonomic or functional trait structure. Invertebrate communities of Australia were most sensitive to deposited fine sediment, with the greatest rate of change in communities occurring when fine sediment cover was low (below 25% of the reach). Communities in the UK displayed a greater tolerance with most compositional change occurring between 30% and 60% cover. In both New Zealand and Brazil, which included the most heavily sedimented sampled streams, the communities were more tolerant or demonstrated ambiguous responses, likely due to historic environmental filtering of invertebrate communities. We conclude that ecological responses to fine sediment are not generalisable globally and are dependent on landscape filters with regional context and historic land management playing important roles

Colliding AdS gravitational shock waves in various dimensions and holography

The formation of marginally trapped surfaces in the off-center collision of two shock waves on AdS_D (with D=4,5,6,7 and 8) is studied numerically. We focus on the case when the two waves collide with nonvanishing impact parameter while the sources are located at the same value of the holographic coordinate. In all cases a critical value of the impact parameter is found above which no trapped surface is formed. The numerical results show the existence of a simple scaling relation between the critical impact parameter and the energy of the colliding waves. Using the isometries of AdS_D we relate the solutions obtained to the ones describing the collision of two waves with a purely holographic impact parameter. This provides a gravitational dual for the head-on collision of two lumps of energy of unequal size.Comment: 25 pages, 11 figures. v2: minor changes, typos corrected. To appear in JHE

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017 : a systematic analysis for the global burden of disease study 2017

Background: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods: The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings: At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation: Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Funding: Bill & Melinda Gates Foundation