Why artificial light at night should be a focus for global change research in the 21st century

The environmental impacts of artificial light at night have been a rapidly growing field of global change science in recent years. Yet, light pollution has not achieved parity with other global change phenomena in the level of concern and interest it receives from the scientific community, government and nongovernmental organizations. This is despite the globally widespread, expanding and changing nature of night-time lighting and the immediacy, severity and phylogenetic breath of its impacts. In this opinion piece, we evidence 10 reasons why artificial light at night should be a focus for global change research in the 21st century. Our reasons extend beyond those concerned principally with the environment, to also include impacts on human health, culture and biodiversity conservation more generally. We conclude that the growing use of night-time lighting will continue to raise numerous ecological, human health and cultural issues, but that opportunities exist to mitigate its impacts by combining novel technologies with sound scientific evidence. The potential gains from appropriate management extend far beyond those for the environment, indeed it may play a key role in transitioning towards a more sustainable society

Cannulation of the subclavian vein using real-time ultrasound guidance

Cannulation of the subclavian vein has many advantages when compared to other anatomical sites for central venous access. Difficulty in its ultrasonic visualisation, and the perceived consequent ‘higher’ complication rate, mean that this approach has fallen out of favour. This barrier, however, may now have disappeared. In this article, we discuss the indications, contraindications and complications associated with subclavian vein cannulation, and present an ultrasound-guided approach to infraclavicular subclavian cannulation

Reducing the ecological consequences of night-time light pollution: options and developments.

1. Much concern has been expressed about the ecological consequences of night-time light pollution. This concern is most often focused on the encroachment of artificial light into previously unlit areas of the night-time environment, but changes in the spectral composition, duration and spatial pattern of light are also recognized as having ecological effects.2. Here, we examine the potential consequences for organisms of five management options to reduce night-time light pollution. These are to (i) prevent areas from being artificially lit; (ii) limit the duration of lighting; (iii) reduce the 'trespass' of lighting into areas that are not intended to be lit (including the night sky); (iv) change the intensity of lighting; and (v) change the spectral composition of lighting.3. Maintaining and increasing natural unlit areas is likely to be the most effective option for reducing the ecological effects of lighting. However, this will often conflict with other social and economic objectives. Decreasing the duration of lighting will reduce energy costs and carbon emissions, but is unlikely to alleviate many impacts on nocturnal and crepuscular animals, as peak times of demand for lighting frequently coincide with those in the activities of these species. Reducing the trespass of lighting will maintain heterogeneity even in otherwise well-lit areas, providing dark refuges that mobile animals can exploit. Decreasing the intensity of lighting will reduce energy consumption and limit both skyglow and the area impacted by high-intensity direct light. Shifts towards 'whiter' light are likely to increase the potential range of environmental impacts as light is emitted across a broader range of wavelengths.4.Synthesis and applications. The artificial lightscape will change considerably over coming decades with the drive for more cost-effective low-carbon street lighting solutions and growth in the artificially lit area. Developing lighting strategies that minimize adverse ecological impacts while balancing the often conflicting requirements of light for human utility, comfort and safety, aesthetic concerns, energy consumption and carbon emission reduction constitute significant future challenges. However, as both lighting technology and understanding of its ecological effects develop, there is potential to identify adaptive solutions that resolve these conflicts.The research leading to this article has received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007-2013)/ERC grant agreement no. 268504

The nature, extent, and ecological implications of marine light pollution

This is the final version of the article. Available from Ecological Society of America via the DOI in this record.Despite centuries of use, artificial light at night has only recently been recognized as a cause for environmental concern. Its global extent and ongoing encroachment into naturally lit ecosystems has sparked scientific interest into the many ways in which it may negatively affect human health, societal attitudes, scientific endeavors, and biological processes. Yet, perhaps because sources of artificial light are largely land based, the potential for artificial light pollution to interfere with the biology of the ocean has not been explored in any detail. There is little information on how light pollution affects those species, behaviors, and interactions that are informed by the intensity, spectra, and periodicity of natural nighttime light in marine ecosystems. Here, we provide an overview of the extent of marine light pollution, discuss how it changes the physical environment, and explore its potential role in shaping marine ecosystems. © The Ecological Society of America.The research leading to this paper has received funding from the European Research Council (ERC) under the EU's Seventh Framework Program (FP7/2007–2013)/ ERC grant agreement No 268504 to KJG

A starting point in the evaluation of the outcome of care: an example using cancer registry information

Many health services worldwide are paying increasing attention to the evaluation of care. However, most studies in the past have concentrated on structure and process instead of outcome. The objective of this paper is to show how a fairly simple technique can provide a possible feedback loop to a health service system. A study on patients with lung cancer in East Anglia, UK is used as an example. Using information which was more or less routinely collected in cancer registration, the study showed that there was no significant difference between the survival of patients seen in the eight districts in East Anglia. Adjustment by the use proportional hazard modelling for prognostic factors including age, sex, histological type, stage and whether active treatment was given did not alter the outcome. This finding was slightly unexpected in view of the presumed (yet not documented) variation in enthusiasm and expertise among the districts. Such a result should be seen as a starting point for studies designed to examine the effects of the level of care provided and resource use on the length and quality of survival. While the methodology requires refinement and substantial local difficulties may arise, development of similar researches on the outcome of care should be encouraged in Hong Kong.published_or_final_versio

Potential biological and ecological effects of flickering artificial light.

Organisms have evolved under stable natural lighting regimes, employing cues from these to govern key ecological processes. However, the extent and density of artificial lighting within the environment has increased recently, causing widespread alteration of these regimes. Indeed, night-time electric lighting is known significantly to disrupt phenology, behaviour, and reproductive success, and thence community composition and ecosystem functioning. Until now, most attention has focussed on effects of the occurrence, timing, and spectral composition of artificial lighting. Little considered is that many types of lamp do not produce a constant stream of light but a series of pulses. This flickering light has been shown to have detrimental effects in humans and other species. Whether a species is likely to be affected will largely be determined by its visual temporal resolution, measured as the critical fusion frequency. That is the frequency at which a series of light pulses are perceived as a constant stream. Here we use the largest collation to date of critical fusion frequencies, across a broad range of taxa, to demonstrate that a significant proportion of species can detect such flicker in widely used lamps. Flickering artificial light thus has marked potential to produce ecological effects that have not previously been considered.The research leading to this paper received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007–2013)/ERC grant agreement no. 268504 to K.J.G. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Risk factors, biomarkers, and mechanisms for persistent inflammation, immunosuppression, and catabolism syndrome (PICS): a systematic review and meta-analysis.

INTRODUCTION: Persistent inflammation, immunosuppression, and catabolism syndrome (PICS) has been proposed as an endotype of chronic critical illness (CCI). The aim of this systematic review is to synthesise the available evidence of risk factors, biomarkers, and biological mechanisms underlying PICS. METHODS: MEDLINE, CENTRAL, and EMBASE were searched on June 2, 2023. Our population of interest was adult intensive care unit survivors. The exposure group was patients with PICS and the comparator group was patients with no PICS, CCI, or rapid recovery. Mean differences were pooled for each biomarker using a random effects DerSimonian-Laird method. Risk of bias assessment was done using the Newcastle-Ottawa Scale. RESULTS: Six papers were included. Five were single-centre retrospective cohort studies, and one was a prospective cohort study, with sample sizes ranging from 22 to 391 patients. Two studies showed an increased incidence of PICS with age, and two studies showed an association between PICS and Charlson Comorbidity Index scores. PICS was associated with requiring mechanical ventilation in four studies. Meta-analysis showed a 34.4 mg L-1 higher C-reactive protein (95% confidence interval [CI] 12.7-56.2 mg L-1; P<0.01), a 4.4 g L-1 lower albumin (95% CI 0.5-8.3 g L-1; P<0.01), and a 0.36×109 L-1 lower lymphocyte count (95% CI 0.25-0.47×109 L-1; P=0.01) in the PICS compared with the non-PICS group. There are a large variety of other potential biomarkers but limited validation studies. The overall quality of evidence is limited, and these results should be interpreted accordingly. CONCLUSIONS: While older patients and those with co-morbidities could be at greater risk for PICS, acquired risk factors, such as injury severity, are potentially more predictive of PICS than intrinsic patient characteristics. There are many potential biomarkers for PICS, but limited validation studies have been conducted. Persistent myeloid-derived suppressor cell expansion, the continual release of danger-associated molecular patterns and pathogen-associated molecular patterns propagating inflammation, and bioenergetic failure are all mechanisms underlying PICS that could offer potential for novel biomarkers and therapeutic interventions. CLINICAL TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO; CRD42023427749)

Ecological effects of artificial light at night on wild plants

PublishedSummary 1.Plants use light as a source of both energy and information. Plant physiological responses to light, and interactions between plants and animals (such as herbivory and pollination), have evolved under a more or less stable regime of 24-h cycles of light and darkness, and, outside of the tropics, seasonal variation in day length. 2.The rapid spread of outdoor electric lighting across the globe over the past century has caused an unprecedented disruption to these natural light cycles. Artificial light is widespread in the environment, varying in intensity by several orders of magnitude from faint skyglow reflected from distant cities to direct illumination of urban and suburban vegetation. 3.In many cases, artificial light in the night-time environment is sufficiently bright to induce a physiological response in plants, affecting their phenology, growth form and resource allocation. The physiology, behaviour and ecology of herbivores and pollinators are also likely to be impacted by artificial light. Thus, understanding the ecological consequences of artificial light at night is critical to determine the full impact of human activity on ecosystems. 4.Synthesis. Understanding the impacts of artificial night-time light on wild plants and natural vegetation requires linking the knowledge gained from over a century of experimental research on the impacts of light on plants in the laboratory and glasshouse with knowledge of the intensity, spatial distribution, spectral composition and timing of light in the night-time environment. To understand fully the extent of these impacts requires conceptual models that can (i) characterize the highly heterogeneous nature of the night-time light environment at a scale relevant to plant physiology; and (ii) scale physiological responses to predict impacts at the level of the whole plant, population, community and ecosystem.ERC under the European Union's Seventh Framework programm

Human alteration of natural light cycles: causes and ecological consequences.

Artificial light at night is profoundly altering natural light cycles, particularly as perceived by many organisms, over extensive areas of the globe. This alteration comprises the introduction of light at night at places and times at which it has not previously occurred, and with different spectral signatures. Given the long geological periods for which light cycles have previously been consistent, this constitutes a novel environmental pressure, and one for which there is evidence for biological effects that span from molecular to community level. Here we provide a synthesis of understanding of the form and extent of this alteration, some of the key consequences for terrestrial and aquatic ecosystems, interactions and synergies with other anthropogenic pressures on the environment, major uncertainties, and future prospects and management options. This constitutes a compelling example of the need for a thoroughly interdisciplinary approach to understanding and managing the impact of one particular anthropogenic pressure. The former requires insights that span molecular biology to ecosystem ecology, and the latter contributions of biologists, policy makers and engineers.The research leading to this paper has received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007–2013)/ERC grant agreement no. 268504 to K. J. G

Contrasting trends in light pollution across Europe based on satellite observed night time lights.

Since the 1970s nighttime satellite images of the Earth from space have provided a striking illustration of the extent of artificial light. Meanwhile, growing awareness of adverse impacts of artificial light at night on scientific astronomy, human health, ecological processes and aesthetic enjoyment of the night sky has led to recognition of light pollution as a significant global environmental issue. Links between economic activity, population growth and artificial light are well documented in rapidly developing regions. Applying a novel method to analysis of satellite images of European nighttime lights over 15 years, we show that while the continental trend is towards increasing brightness, some economically developed regions show more complex patterns with large areas decreasing in observed brightness over this period. This highlights that opportunities exist to constrain and even reduce the environmental impact of artificial light pollution while delivering cost and energy-saving benefits.The research leading to this paper has received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007–2013)/ ERC grant agreement no. 268504 to K.J.G