The importance of interacting climate modes on Australia’s contribution to global carbon cycle extremes

The global carbon cycle is highly sensitive to climate-driven fluctuations of precipitation, especially in the Southern Hemisphere. This was clearly manifested by a 20% increase of the global terrestrial C sink in 2011 during the strongest sustained La Niña since 1917. However, inconsistencies exist between El Niño/La Niña (ENSO) cycles and precipitation in the historical record; for example, significant ENSO-precipitation correlations were present in only 31% of the last 100 years, and often absent in wet years. To resolve these inconsistencies, we used an advanced temporal scaling method for identifying interactions amongst three key climate modes (El Niño, the Indian Ocean dipole, and the southern annular mode). When these climate modes synchronised (1999-2012), drought and extreme precipitation were observed across Australia. The interaction amongst these climate modes, more than the effect of any single mode, was associated with large fluctuations in precipitation and productivity. The long-term exposure of vegetation to this arid environment has favoured a resilient flora capable of large fluctuations in photosynthetic productivity and explains why Australia was a major contributor not only to the 2011 global C sink anomaly but also to global reductions in photosynthetic C uptake during the previous decade of drought

Adaptive independent sticky MCMC algorithms

Monte Carlo methods have become essential tools to solve complex Bayesian inference problems in different fields, such as computational statistics, machine learning, and statistical signal processing. In this work, we introduce a novel class of adaptive Monte Carlo methods, called adaptive independent sticky Markov Chain Monte Carlo (MCMC) algorithms, to sample efficiently from any bounded target probability density function (pdf). The new class of algorithms employs adaptive non-parametric proposal densities, which become closer and closer to the target as the number of iterations increases. The proposal pdf is built using interpolation procedures based on a set of support points which is constructed iteratively from previously drawn samples. The algorithm’s efficiency is ensured by a test that supervises the evolution of the set of support points. This extra stage controls the computational cost and the convergence of the proposal density to the target. Each part of the novel family of algorithms is discussed and several examples of specific methods are provided. Although the novel algorithms are presented for univariate target densities, we show how they can be easily extended to the multivariate context by embedding them within a Gibbs-type sampler or the hit and run algorithm. The ergodicity is ensured and discussed. An overview of the related works in the literature is also provided, emphasizing that several well-known existing methods (like the adaptive rejection Metropolis sampling (ARMS) scheme) are encompassed by the new class of algorithms proposed here. Eight numerical examples (including the inference of the hyper-parameters of Gaussian processes, widely used in machine learning for signal processing applications) illustrate the efficiency of sticky schemes, both as stand-alone methods to sample from complicated one-dimensional pdfs and within Gibbs samplers in order to draw from multi-dimensional target distributions

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Lakeside View: Sociocultural Responses to Changing Water Levels of Lake Turkana, Kenya

Throughout the Holocene, Lake Turkana has been subject to drastic changes in lake levels and the subsistence strategies people employ to survive in this hot and arid region. In this paper, we reconstruct the position of the lake during the Holocene within a paleoclimatic context. Atmospheric forcing mechanisms are discussed in order to contextualize the broader landscape changes occurring in eastern Africa over the last 12,000 years. The Holocene is divided into five primary phases according to changes in the strand-plain evolution, paleoclimate, and human subsistence strategies practiced within the basin. Early Holocene fishing settlements occurred adjacent to high and relatively stable lake levels. A period of high-magnitude oscillations in lake levels ensued after 9,000 years BP and human settlements appear to have been located close to the margins of the lake. Aridification and a final regression in lake levels ensued after 5,000 years BP and human communities were generalized pastoralists-fishers-foragers. During the Late Holocene, lake levels may have dropped below their present position and subsistence strategies appear to have been flexible and occasionally specialized on animal pastoralism. Modern missionary and government outposts have encouraged the construction of permanent settlements in the region, which are heavily dependent on outside resources for their survival. Changes in the physical and cultural environments of the Lake Turkana region have been closely correlated, and understanding the relationship between the two variables remains a vital component of archaeological research

Cold spells in the Nordic Seas during the early Eocene Greenhouse

Abstract The early Eocene (c. 56 - 48 million years ago) experienced some of the highest global temperatures in Earth’s history since the Mesozoic, with no polar ice. Reports of contradictory ice-rafted erratics and cold water glendonites in the higher latitudes have been largely dismissed due to ambiguity of the significance of these purported cold-climate indicators. Here we apply clumped isotope paleothermometry to a traditionally qualitative abiotic proxy, glendonite calcite, to generate quantitative temperature estimates for northern mid-latitude bottom waters. Our data show that the glendonites of the Danish Basin formed in waters below 5 °C, at water depths of &lt;300 m. Such near-freezing temperatures have not previously been reconstructed from proxy data for anywhere on the early Eocene Earth, and these data therefore suggest that regionalised cool episodes punctuated the background warmth of the early Eocene, likely linked to eruptive phases of the North Atlantic Igneous Province.</jats:p