Representation of climate extreme indices in the ACCESS1.3b coupled atmosphere–land surface model

Climate extremes, such as heat waves and heavy precipitation events, have large impacts on ecosystems and societies. Climate models provide useful tools for studying underlying processes and amplifying effects associated with extremes. The Australian Community Climate and Earth System Simulator (ACCESS) has recently been coupled to the Community Atmosphere Biosphere Land Exchange (CABLE) model. We examine how this model represents climate extremes derived by the Expert Team on Climate Change Detection and Indices (ETCCDI) and compare them to observational data sets using the AMIP framework. We find that the patterns of extreme indices are generally well represented. Indices based on percentiles are particularly well represented and capture the trends over the last 60 years shown by the observations remarkably well. The diurnal temperature range is underestimated, minimum temperatures (TMIN) during nights are generally too warm and daily maximum temperatures (TMAX) too low in the model. The number of consecutive wet days is overestimated, while consecutive dry days are underestimated. The maximum consecutive 1-day precipitation amount is underestimated on the global scale. Biases in TMIN correlate well with biases in incoming longwave radiation, suggesting a relationship with biases in cloud cover. Biases in TMAX depend on biases in net shortwave radiation as well as evapotranspiration. The regions and season where the bias in evapotranspiration plays a role for the TMAX bias correspond to regions and seasons where soil moisture availability is limited. Our analysis provides the foundation for future experiments that will examine how land-surface processes contribute to these systematic biases in the ACCESS modelling system

Modulation of land-use change impacts on temperature extremes via land–atmosphere coupling over Australia

The role of land–atmosphere coupling in modulating the impact of land-use change (LUC) on regional climate extremes remains uncertain. Using the Weather and Research Forecasting Model, this study combines the Global Land–Atmosphere Coupling Experiment with regional LUC to assess the combined impact of land–atmosphere coupling and LUC on simulated temperature extremes. The experiment is applied to an ensemble of planetary boundary layer (PBL) and cumulus parameterizations to determine the sensitivity of the results to model physics. Results show a consistent weakening in the soil moisture–maximum temperature coupling strength with LUC irrespective of the model physics. In contrast, temperature extremes show an asymmetric response to LUC dependent on the choice of PBL scheme, which is linked to differences in the parameterization of vertical transport. This influences convective precipitation, contributing a positive feedback on soil moisture and consequently on the partitioning of the surface turbulent fluxes. The results suggest that the impact of LUC on temperature extremes depends on the land–atmosphere coupling that in turn depends on the choice of PBL. Indeed, the sign of the temperature change in hot extremes resulting from LUC can be changed simply by altering the choice of PBL. The authors also note concerns over the metrics used to measure coupling strength that reflect changes in variance but may not respond to LUC-type perturbations

Determining the Anthropogenic Greenhouse Gas Contribution to the Observed Intensification of Extreme Precipitation

This study conducts a detection and attribution analysis of the observed changes in extreme precipitation during 1951-2015. Observed and CMIP6 multimodel simulated changes in annual maximum daily and consecutive 5-day precipitation are compared using an optimal fingerprinting technique for different spatial scales from global land, Northern Hemisphere extratropics, tropics, three continental regions (North America and western and eastern Eurasia), and global "dry" and "wet" land areas (as defined by their average extreme precipitation intensities). Results indicate that anthropogenic greenhouse gas influence is robustly detected in the observed intensification of extreme precipitation over the global land and most of the subregions considered, all with clear separation from natural and anthropogenic aerosol forcings. Also, the human-induced greenhouse gas increases are found to be a dominant contributor to the observed increase in extreme precipitation intensity, which largely follows the increased moisture availability under global warming. Plain Language Summary Human influences have been identified in the observed intensification of extreme precipitation at global and continental scales, but quantifying the contribution of greenhouse gas increases remains challenging. Here, we isolate anthropogenic greenhouse gas impacts on the observed intensification of extreme precipitation during 1951-2015 by comparing observations with CMIP6 individual forcing experiments. Results show that greenhouse gas influences are detected over the global land, Northern Hemisphere extratropics, western and eastern Eurasia, and global "dry" and "wet" regions, which are separable from other external forcings such as solar and volcanic activities and anthropogenic aerosols. The human-induced greenhouse gas increases are also found to explain most of the observed changes in extreme precipitation intensity, which are consistent with the increased moisture availability with warming. Our results provide the first quantitative evidence for the dominant influence of human-made greenhouse gases on extreme precipitation increase.11Nsciescopu

The Use of Fecal Calprotectin Testing in Paediatric Disorders: A Position Paper of the European Society for Paediatric Gastroenterology and Nutrition Gastroenterology Committee

OBJECTIVES: The aim of the study was to review the evidence regarding the clinical use and value of fecal calprotectin (FC) measurements in different gastrointestinal disorders in children. METHODS: A literature search was conducted in the PubMed, MEDLINE, EMBASE, and Cochrane databases until October 31, 2019. Subtopics were identified and each assigned to individual authors. RESULTS: A total of 28 recommendations were voted on using the nominal voting technique. Recommendations are given related to sampling, measurement methods, and results interpretation. The 14 authors anonymously voted on each recommendation using a 9-point scale (1 strongly disagree to 9 fully agree). Consensus was considered achieved if at least 75% of the authors voted 6, 7, 8, or 9. CONCLUSIONS: Consensus was reached for all recommendations. Limitations for the use of FC in clinical practice include variability in extraction methodology, performance of test kits as well as the need to establish local reference ranges because of the influence of individual factors, such as age, diet, microbiota, and drugs. The main utility of FC measurement at present is in the diagnosis and monitoring of inflammatory bowel disease (IBD) as well as to differentiate it from functional gastrointestinal disorders (FAPDs). FC, however, has neither utility in the diagnosis of infantile colic nor to differentiate between functional and organic constipation. A rise in FC concentration, may alert to the risk of developing necrotizing enterocolitis and help identifying gastrointestinal involvement in children with Henoch-Schönlein purpura. FC measurement is of little value in Cow's Milk Protein Allergy, coeliac disease (CD), and cystic fibrosis. FC does neither help to distinguish bacterial from viral acute gastroenteritis (AGE), nor to diagnose Helicobacter Pylori infection, small intestinal bacterial overgrowth (SIBO), acute appendicitis (AA), or intestinal polyps. Copyright © 2021 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

Sexualized drug injection among men who have sex with men in Madrid and Barcelona as the first episode of drug injecting

Background: We estimate the prevalence of drug injection, the variables associated with having ever injected and the proportion of ever injectors whose first drug injection was for having sex; we describe the first drug injection episode, analyze the drugs most frequently injected and estimate the prevalence of risky injecting behaviors. Methods: The participants were 3387 MSM without a previous HIV diagnosis attending four HIV/STI diagnosis services in Madrid and Barcelona. Lifetime prevalence and prevalence ratios (PRs) by different factors were calculated using Poisson regression models with robust variance. We compared the characteristics of first drug injection episode, lifetime injection and risky injecting behaviors of those whose first injection was for sex (FIS) with those whose was not (non-FIS). Results: Lifetime prevalence of injection was 2.1% (CI 1.7-2.7). In the multivariate analysis, it was strongly associated with having been penetrated by more than five men in the last 12 months (aPR = 10.4; CI 2.5-43.4) and having met most of their partners at private parties (aPR = 7.5; CI 4.5-12.3), and less strongly with other factors. Of those who had ever injected drugs, 81.9% injected for sex the first time they injected drugs (FIS). At first injection, FIS participants had a mean age of 31 years, 62.7% used mephedrone and 32.2% methamphetamine on that occasion. Of this FIS group 39.0% had ever shared drugs or equipment and 82.6% had always shared for sex. Some 30.8% of non-FIS reported having also injected drugs for sex later on. Conclusions: Only two out of a hundred had ever injected, most to have sex and with frequent drug or injecting equipment sharing. Injecting for sex is the most common first episode of drug injection and is the most efficient risky behavior for the transmission of HIV, hepatitis B or C and other blood-borne infections. MSM participating in private parties should be considered a priority group for prevention policies