Worldwide comparison of survival from childhood leukaemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries

Background Global inequalities in access to health care are reflected in differences in cancer survival. The CONCORD programme was designed to assess worldwide differences and trends in population-based cancer survival. In this population-based study, we aimed to estimate survival inequalities globally for several subtypes of childhood leukaemia. Methods Cancer registries participating in CONCORD were asked to submit tumour registrations for all children aged 0-14 years who were diagnosed with leukaemia between Jan 1, 1995, and Dec 31, 2009, and followed up until Dec 31, 2009. Haematological malignancies were defined by morphology codes in the International Classification of Diseases for Oncology, third revision. We excluded data from registries from which the data were judged to be less reliable, or included only lymphomas, and data from countries in which data for fewer than ten children were available for analysis. We also excluded records because of a missing date of birth, diagnosis, or last known vital status. We estimated 5-year net survival (ie, the probability of surviving at least 5 years after diagnosis, after controlling for deaths from other causes [background mortality]) for children by calendar period of diagnosis (1995-99, 2000-04, and 2005-09), sex, and age at diagnosis (< 1, 1-4, 5-9, and 10-14 years, inclusive) using appropriate life tables. We estimated age-standardised net survival for international comparison of survival trends for precursor-cell acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML). Findings We analysed data from 89 828 children from 198 registries in 53 countries. During 1995-99, 5-year agestandardised net survival for all lymphoid leukaemias combined ranged from 10.6% (95% CI 3.1-18.2) in the Chinese registries to 86.8% (81.6-92.0) in Austria. International differences in 5-year survival for childhood leukaemia were still large as recently as 2005-09, when age-standardised survival for lymphoid leukaemias ranged from 52.4% (95% CI 42.8-61.9) in Cali, Colombia, to 91.6% (89.5-93.6) in the German registries, and for AML ranged from 33.3% (18.9-47.7) in Bulgaria to 78.2% (72.0-84.3) in German registries. Survival from precursor-cell ALL was very close to that of all lymphoid leukaemias combined, with similar variation. In most countries, survival from AML improved more than survival from ALL between 2000-04 and 2005-09. Survival for each type of leukaemia varied markedly with age: survival was highest for children aged 1-4 and 5-9 years, and lowest for infants (younger than 1 year). There was no systematic difference in survival between boys and girls. Interpretation Global inequalities in survival from childhood leukaemia have narrowed with time but remain very wide for both ALL and AML. These results provide useful information for health policy makers on the effectiveness of health-care systems and for cancer policy makers to reduce inequalities in childhood survival

Modelling mixing and circulation in subglacial Lake Vostok, Antarctica

Lake Vostok, isolated from direct exchange with the atmosphere by about 4 km of ice for millions of years, provides a unique environment. This inaccessibility raises the importance of numerical models to investigate the physical conditions within the lake. Using a three-dimensional numerical model and the best available geometry, we test different parameter settings to define a standard model configuration suitable for studying flow in this subglacial lake. From our model runs we find a baroclinic circulation within the lake that splits into three different parts: Along a topographic ridge in the northern part of Lake Vostok, bottom water masses are transported eastward, diverging away from the ridge. In the lakes surface layer, the flow in these two vertical overturning cells has opposite directions. In the southern part of the lake, where freezing occurs across about 3,500 km^2, two opposing gyres split the water column vertically. The general flow isstronger in the southern basin with horizontal velocities in the order of 1 mm/s. The strongest upwelling, found in the eastern part of this basin, is about 25 &#956;m/s. We estimate the lower limit of the overturning timescale to be about 2.5 years vertically and 8.6 years horizontally. The basal mass loss of ice from the ice sheet floating on the lake is 5.6 mm/year (equivalent to a fresh water flux of 2.78 m^3/s, or a basal ice loss of 0.09 km^3/year). This imbalance indicates either a constant growth of the lake or its continuous (or periodical) discharge into a subglacial drainage system

The effects of 1.5 and 2 degrees of global warming on Africa in the CORDEX ensemble

There is a general lack of information about the potential effects of 1.5, 2 or more degrees of global warming on the regional climates within Africa, and most studies that address this use data from coarse resolution global models. Using a large ensemble of CORDEX Africa simulations, we present a pan-African overview of the effects of 1.5 and 2 °C global warming levels (GWLs) on the African climate. The CORDEX simulations, consistent with their driving global models, show a robust regional warming exceeding the mean global one over most of Africa. The highest increase in annual mean temperature is found over the subtropics and the smallest one over many coastal regions. Projected changes in annual mean precipitation have a tendency to wetter conditions in some parts of Africa (e.g. central/eastern Sahel and eastern Africa) at both GWLs, but models' agreement on the sign of change is low. In contrast to mean precipitation, there is a consistent increase in daily precipitation intensity of wet days over a large fraction of tropical Africa emerging already at 1.5 °C GWL and strengthening at 2 °C. A consistent difference between 2 °C and 1.5 °C warmings is also found for projected changes in annual mean temperature and daily precipitation intensity. Our study indicates that a 0.5 °C further warming (from 1.5 °C–2 °C) can indeed produce a robust change in some aspects of the African climate and its extremes

Inland thinning of West Antarctic Ice Sheet steered along subglacial rifts

Current ice loss from the West Antarctic Ice Sheet (WAIS) accounts for about ten per cent of observed global sea-level rise1. Losses are dominated by dynamic thinning, in which forcings by oceanic or atmospheric perturbations to the ice margin lead to an accelerated thinning of ice along the coastline2, 3, 4, 5. Although central to improving projections of future ice-sheet contributions to global sea-level rise, the incorporation of dynamic thinning into models has been restricted by lack of knowledge of basal topography and subglacial geology so that the rate and ultimate extent of potential WAIS retreat remains difficult to quantify. Here we report the discovery of a subglacial basin under Ferrigno Ice Stream up to 1.5 kilometres deep that connects the ice-sheet interior to the Bellingshausen Sea margin, and whose existence profoundly affects ice loss. We use a suite of ice-penetrating radar, magnetic and gravity measurements to propose a rift origin for the basin in association with the wider development of the West Antarctic rift system. The Ferrigno rift, overdeepened by glacial erosion, is a conduit which fed a major palaeo-ice stream on the adjacent continental shelf during glacial maxima6. The palaeo-ice stream, in turn, eroded the ‘Belgica’ trough, which today routes warm open-ocean water back to the ice front7 to reinforce dynamic thinning. We show that dynamic thinning from both the Bellingshausen and Amundsen Sea region is being steered back to the ice-sheet interior along rift basins. We conclude that rift basins that cut across the WAIS margin can rapidly transmit coastally perturbed change inland, thereby promoting ice-sheet instability

Potential methane reservoirs beneath Antarctica

Once thought to be devoid of life, the ice-covered parts of Antarctica are now known to be a reservoir of metabolically active microbial cells and organic carbon. The potential for methanogenic archaea to support the degradation of organic carbon to methane beneath the ice, however, has not yet been evaluated. Large sedimentary basins containing marine sequences up to 14 kilometres thick and an estimated 21,000 petagrams (1Pg equals 10 15 g) of organic carbon are buried beneath the Antarctic Ice Sheet. No data exist for rates of methanogenesis in sub-Antarctic marine sediments. Here we present experimental data from other subglacial environments that demonstrate the potential for overridden organic matter beneath glacial systems to produce methane. We also numerically simulate the accumulation of methane in Antarctic sedimentary basins using an established one-dimensional hydrate model and show that pressure/temperature conditions favour methane hydrate formation down to sediment depths of about 300metres in West Antarctica and 700metres in East Antarctica. Our results demonstrate the potential for methane hydrate accumulation in Antarctic sedimentary basins, where the total inventory depends on rates of organic carbon degradation and conditions at the ice-sheet bed. We calculate that the sub-Antarctic hydrate inventory could be of the same order of magnitude as that of recent estimates made for Arctic permafrost. Our findings suggest that the Antarctic Ice Sheet may be a neglected but important component of the global methane budget, with the potential to act as a positive feedback on climate warming during ice-sheet wastage