Global impacts of energy demand on the freshwater resources of nations

The growing geographic disconnect between consumption of goods, the extraction and processing of resources, and the environmental impacts associated with production activities makes it crucial to factor global trade into sustainability assessments. Using an empirically validated environmentally extended global trade model, we examine the relationship between two key resources underpinning economies and human well-being—energy and freshwater. A comparison of three energy sectors (petroleum, gas, and electricity) reveals that freshwater consumption associated with gas and electricity production is largely confined within the territorial boundaries where demand originates. This finding contrasts with petroleum, which exhibits a varying ratio of territorial to international freshwater consumption, depending on the origin of demand. For example, although the United States and China have similar demand associated with the petroleum sector, international freshwater consumption is three times higher for the former than the latter. Based on mapping patterns of freshwater consumption associated with energy sectors at subnational scales, our analysis also reveals concordance between pressure on freshwater resources associated with energy production and freshwater scarcity in a number of river basins globally. These energy-driven pressures on freshwater resources in areas distant from the origin of energy demand complicate the design of policy to ensure security of fresh water and energy supply. Although much of the debate around energy is focused on greenhouse gas emissions, our findings highlight the need to consider the full range of consequences of energy production when designing policy

Blood pressure self-monitoring in pregnancy: examining feasibility in a prospective cohort study

Background: Raised blood pressure (BP) affects approximately 10% of pregnancies worldwide, and a high proportion of affected women develop pre-eclampsia. This study aimed to evaluate the feasibility of self-monitoring of BP in pregnancy in women at higher risk of pre-eclampsia. Methods: This prospective cohort study of self-monitoring BP in pregnancy was carried out in two hospital trusts in Birmingham and Oxford and thirteen primary care practices in Oxfordshire. Eligible women were those defined by the UK National Institute for Health and Care Excellence (NICE) guidelines as at higher risk of pre-eclampsia. A total of 201 participants were recruited between 12 and 16 weeks of pregnancy and were asked to take two BP readings twice daily three times a week through their pregnancy. Primary outcomes were recruitment, retention and persistence of self-monitoring. Study recruitment and retention were analysed with descriptive statistics. Survival analysis was used to evaluate the persistence of self-monitoring and the performance of self-monitoring in the early detection of gestational hypertension, compared to clinic BP monitoring. Secondary outcomes were the mean clinic and self-monitored BP readings and the performance of self-monitoring in the detection of gestational hypertension and pre-eclampsia compared to clinic BP. Results: Of 201 women recruited, 161 (80%) remained in the study at 36 weeks or to the end of their pregnancy, 162 (81%) provided any home readings suitable for analysis, 148 (74%) continued to self-monitor at 20 weeks and 107 (66%) at 36 weeks. Self-monitored readings were similar in value to contemporaneous matched clinic readings for both systolic and diastolic BP. Of the 23 who developed gestational hypertension or pre-eclampsia and self-monitored, 9(39%) had a raised home BP prior to a raised clinic BP. Conclusions: Self-monitoring of BP in pregnancy is feasible and has potential to be useful in the early detection of gestational hypertensive disorders but maintaining self-monitoring throughout pregnancy requires support and probably enhanced training

Historical dataset details the distribution, extent and form of lost Ostrea edulis reef ecosystems

Ocean ecosystems have been subjected to anthropogenic influences for centuries, but the scale of past ecosystem changes is often unknown. For centuries, the European flat oyster (Ostrea edulis), an ecosystem engineer providing biogenic reef habitats, was a culturally and economically significant source of food and trade. These reef habitats are now functionally extinct, and almost no memory of where or at what scales this ecosystem once existed, or its past form, remains. The described datasets present qualitative and quantitative extracts from written records published between 1524 and 2022. These show: (1) locations of past flat oyster fisheries and/or oyster reef habitat described across its biogeographical range, with associated levels of confidence; (2) reported extent of past oyster reef habitats, and; (3) species associated with these habitats. These datasets will be of use to inform accelerating flat oyster restoration activities, to establish reference models for anchoring adaptive management of restoration action, and in contributing to global efforts to recover records on the hidden history of anthropogenic-driven ocean ecosystem degradation.RHT received funding from the Convex Seascape Survey, the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No 856488 – ERC Synergy project “SEACHANGE: Quantifying the impact of major cultural transitions on marine ecosystem functioning and biodiversity”), and the Environment Agency. PzE and HM were supported by the Flotilla Foundation. RHT, PzE and FdC were part supported by the COST Action MAF-WORLD CA20102, supported by COST (European Cooperation in Science and Technology), www.cost.eu. FdC and EG acknowledge the support of RemediOS Project, developed with the collaboration of the Biodiversity Foundation (Spanish Ministry for Ecological Transition and the Demographic Challenge), through the Pleamar Program, co-financed by the European Maritime and Fisheries Fund (EMFF). BoP was supported by the Independent Research Fund Denmark-project, “Living on the Edge – Risk, Resources, Resilience and Relocations in the Western Limfjord, c. 1750–1900”. SP received funding from a pluri-annual agreement between two French National Institutes, Ifremer and OFB, French Office for Biodiversity (Grant agreement No OFB.22.0034, “REEFOREST: REstoring the European Flat Oyster Reefs & their Ecosystem Services on the french coasT”). BP and CP work within the projects RESTORE (FKZ 3516892001, FKZ 3519892016, FKZ 3520892013) and PROCEED (FKZ 3517685013) funded by the German Federal Agency for Nature Conservation (BfN) with funds from the German Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV). TCC has been funded by UKRI, CEFAS and Natural England. CS received funding from the Irish Research Council (IRC) under their COALESCE call for the “Food Smart Dublin project” (grant no. COALESCE/2019/97). DG was supported by the PO-FEAMP (Programma Operativo - Fondo Europeo per gli Affari Marittimi e la Pesca) 2014–2020 project ECOGESTOCK “Approccio ECOsistemico per la tutela e la GEStione delle risorse biologiche e STOCK ittici nelle acque interne”, and thanks Mauro Doneddu and Egidio Trainito for their shared experience. The works developed by JAJ and BO were funded by the Program LIFE-Climate Change Adaptation (LIFE18 CCA/ES/001160): Adaptation to climate change through management and restoration of European estuarine ecosystems (LIFE ADAPTA BLUES). We thank members of the NORA historical ecology working group and the following collaborators for data and discussion during working group meetings and conferences: Alison Debney, Celine Gamble, Liam Darcy, Iain Dummet, Fay Sandford, Zoe Laurence, Christopher Ranger, Alexei Kraidovskiy, Andrea Fischel, Anamarija Frankic, Cristina Joanaz de Melo, Stein Mortensen, Paula Chainho, Marina Albentosa, Lucas Bosseboeuf, Cass Bromley, José Costa, Sara Cabral, Juana Cano, Molly Cornwell, Thomas Day, Sara Hornborg, Camilla Bertolini, Gianni Brundu, Jose M. Fariñas-Franco, Hein Sas, Lucia de Nicolò, Luigi Divari, Francis Kerckhof; Thomas Kerkhove, M. Jose Rosique, Uxia Tenreiro, Filip Volckaert, Robert Whiteley. The NORA Secretariat was funded by the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU) and the German Federal Agency for Nature Conservation (Bundesamt für Naturschutz, BfN) through the Federal Program for Biodiversity and the Alfred Wegener Institute Helmholtz Centre for Polar and Marine Research within the project PROCEED (FKZ 3517685013)

Records reveal the vast historical extent of european oyster reef ecosystems

Anthropogenic activities have impacted marine ecosystems at extraordinary scales. Biogenic reef ecosystems built by the European flat oyster (Ostrea edulis) typically declined before scientific monitoring. The past form and extent of these habitats thus remains unknown, with such information potentially providing valuable perspectives for current management and policy. Collating >1,600 records published over 350 years, we created a map of historical oyster reef presence at the resolution of 10 km2 across its biogeographic range, including documenting abundant reef habitats along the coasts of France, Denmark, Ireland and the United Kingdom. Spatial extent data were available from just 26% of locations yet totalled >1.7 million hectares (median reef size=29.9 ha, range 0.01-1,536,000 ha), with 190 associated macrofauna species from 13 phyla described. Our analysis demonstrates that oyster reefs were once a dominant three-dimensional feature of European coastlines, with their loss pointing to a fundamental restructuring and "flattening" of coastal and shallow-shelf seafloors. This unique empirical record demonstrates the highly degraded nature of European seas and provides key baseline context for international restoration commitments.We acknowledge the support of the following agencies: European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (Grant Agreement No. 856488 – ERC Synergy project ‘SEACHANGE: Quantifying the impact of major cultural transitions on marine ecosystem functioning and biodiversity’) to R.H.T.; Convex Seascape Survey to R.H.T. and C.M.R.; Environment Agency to R.H.T.; Flotilla Foundation to P.S.E.z.E. and H.M.; COST Action MAF-WORLD CA20102, supported by COST (European Cooperation in Science and Technology; www.cost.eu) to R.H.T., P.S.E.z.E. and F.d.C.; the International Council for Exploitation of the Sea (ICES) Working Group on the History of Fish and Fisheries provided feedback on the work to R.H.T.; The RemediOS Project, developed with the collaboration of the Biodiversity Foundation (Spanish Ministry for Ecological Transition and Demographic Challenge), through the Pleamar Program, co-financed by the European Maritime and Fisheries Fund (EMFF) to F.d.C. and E.G.; Independent Research Fund Denmark, project ‘Living on the Edge – Risk, Resources, Resilience and Relocations in the Western Limfjord, c. 1750-1900’ to B. Poulsen; a pluri-annual agreement between two French National Institutes, Ifremer and OFB, French Office for Biodiversity (Grant Agreement No. OFB.22.0034, ‘REEFOREST: REstoring the European Flat Oyster Reefs & their Ecosystem Services on the french coasT’) to S.P.; RESTORE (FKZ 3516892001, FKZ 3519892016, FKZ 3520892013) and PROCEED (FKZ 3517685013), funded by the German Federal Agency for Nature Conservation (BfN) with funds from the German Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV) to B.P. and C.P.; UKRI, Cefas and Natural England to T.C.C.; the Irish Research Council (IRC) under their COALESCE call for the ‘Food Smart Dublin project’ (Grant No. COALESCE/2019/97) to C.S.; Project PO-FEAMP (Programma Operativo - Fondo Europeo per gli Affari Marittimi e la Pesca) 2014-2020 ECOGESTOCK ‘Approccio ECOsistemico per la tutela e la GEStione delle risorse biologiche e STOCK ittici nelle acque interne’ and Project funded under the National Recovery and Resilience Plan (NRRP), Mission 4 Component 2 Investment 1.4 - Call for tender No. 3138 of 16 December 2021, rectified by Decree n.3175 of 18 December 2021 of Italian Ministry of University and Research funded by the European Union – NextGenerationEU; Project code CN_00000033, Concession Decree No. 1034 of 17 June 2022 adopted by the Italian Ministry of University and Research, CUP D33C22000960007, Project title National Biodiversity Future Center (NBFC) to D.G.; the Program LIFE-Climate Change Adaptation (LIFE18 CCA/ES/001160): Adaptation to climate change through management and restoration of European estuarine ecosystems (LIFE ADAPTA BLUES) to J.A.J. and B.O. D.G. thanks M. Doneddu and E. Trainito for shared experience. We thank members of the NORA historical ecology working group and the following collaborators for data and discussion during working group meetings and conferences: A. Debney, C. Gamble, L. Darcy, I. Dummet, F. Sandford, Z. Laurence, C. Ranger, A. Kraidovskiy, A. Fischel, A. Frankic, C. Joanaz de Melo, S. Mortensen, P. Chainho, M. Albentosa, L. Bosseboeuf, C. Bromley, J. Costa, S. Cabral, J. Cano, M. Cornwell, T. Day, S. Hornborg, C. Bertolini, G. Brundu, J. M. Fariñas-Franco, H. Sas, L. de Nicolò, L. Divari, F. Kerckhof, T. Kerkhove, M. J. Rosique, U. Tenreiro, F. Volckaert, R. Whiteley. The NORA Secretariat was funded by the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU) and the German Federal Agency for Nature Conservation (Bundesamt für Naturschutz, BfN) through the Federal Program for Biodiversity and the Alfred Wegener Institute Helmholtz Centre for Polar and Marine Research within the project PROCEED (FKZ 3517685013)

Thresholds for adding degraded tropical forest to the conservation estate

Logged and disturbed forests are often viewed as degraded and depauperate environments compared with primary forest. However, they are dynamic ecosystems1 that provide refugia for large amounts of biodiversity2, 3, so we cannot afford to underestimate their conservation value4. Here we present empirically defined thresholds for categorizing the conservation value of logged forests, using one of the most comprehensive assessments of taxon responses to habitat degradation in any tropical forest environment. We analysed the impact of logging intensity on the individual occurrence patterns of 1,681 taxa belonging to 86 taxonomic orders and 126 functional groups in Sabah, Malaysia. Our results demonstrate the existence of two conservation-relevant thresholds. First, lightly logged forests (68%) of their biomass removed, and these are likely to require more expensive measures to recover their biodiversity value. Overall, our data confirm that primary forests are irreplaceable5, but they also reinforce the message that logged forests retain considerable conservation value that should not be overlooked

The support of early-career researchers in health professions education? An expert position statement

Introduction: The development of health professions education (HPE) as an academic discipline requires well-qualified educational researchers, equipped with the competence to advance the field. There is, therefore, a need to establish and support pathways in which early-career researchers (ECRs) can develop the necessary competence to pursue a career in this field. Approach: A group of 19 international experts in HPE from various professions, conducted a 2.5-day Scoping Workshop in Hannover, Germany, in November 2024. The main output of the workshop is a joint position statement on the support of ECRs in HPE, using appreciative inquiry and collaborative writing. Position: The Scoping Workshop led to a dynamic and productive exchange of ideas and experiences resulting in a common vision and five positions: (1) identify, establish, and recognize distinct career paths, (2) develop and implement a robust funding strategy, (3) create a nurturing and diverse intellectual culture, (4) connect research to practice and address real-world problems, (5) invest in leadership, advocacy, and coaching. There was strong agreement that these areas were not well developed and required urgent attention. Outlook: There is a need to foster interprofessional and interdisciplinary collaboration and provision of sustainable support structures so that ECRs can advance HPE. Only when these areas are addressed can these educational researchers contribute to the development of effective learning which prepares the healthcare workforce to meet today’s challenges. Researchers, educators, decision-makers and stakeholders in academia, education, and health and social care contexts share a responsibility for shaping the way forward

Different inflammatory signatures based on CSF biomarkers relate to preserved or diminished brain structure and cognition

Neuroinflammation is a hallmark of Alzheimer's disease (AD) and both positive and negative associations of individual inflammation-related markers with brain structure and cognitive function have been described. We aimed to identify inflammatory signatures of CSF immune-related markers that relate to changes of brain structure and cognition across the clinical spectrum ranging from normal aging to AD. A panel of 16 inflammatory markers, A beta 42/40 and p-tau181 were measured in CSF at baseline in the DZNE DELCODE cohort (n = 295);a longitudinal observational study focusing on at-risk stages of AD. Volumetric maps of gray and white matter (GM/WM;n = 261) and white matter hyperintensities (WMHs, n = 249) were derived from baseline MRIs. Cognitive decline (n = 204) and the rate of change in GM volume was measured in subjects with at least 3 visits (n = 175). A principal component analysis on the CSF markers revealed four inflammatory components (PCs). Of these, the first component PC1 (highly loading on sTyro3, sAXL, sTREM2, YKL-40, and C1q) was associated with older age and higher p-tau levels, but with less pathological A beta when controlling for p-tau. PC2 (highly loading on CRP, IL-18, complement factor F/H and C4) was related to male gender, higher body mass index and greater vascular risk. PC1 levels, adjusted for AD markers, were related to higher GM and WM volumes, less WMHs, better baseline memory, and to slower atrophy rates in AD-related areas and less cognitive decline. In contrast, PC2 related to less GM and WM volumes and worse memory at baseline. Similar inflammatory signatures and associations were identified in the independent F.ACE cohort. Our data suggest that there are beneficial and detrimental signatures of inflammatory CSF biomarkers. While higher levels of TAM receptors (sTyro/sAXL) or sTREM2 might reflect a protective glia response to degeneration related to phagocytic clearance, other markers might rather reflect proinflammatory states that have detrimental impact on brain integrity

Blood Pressure Self-Monitoring in Pregnancy: Examining Feasibility in a Prospective Cohort Study

BACKGROUND: Raised blood pressure (BP) affects approximately 10% of pregnancies worldwide, and a high proportion of affected women develop pre-eclampsia. This study aimed to evaluate the feasibility of self-monitoring of BP in pregnancy in women at higher risk of pre-eclampsia. METHODS: This prospective cohort study of self-monitoring BP in pregnancy was carried out in two hospital trusts in Birmingham and Oxford and thirteen primary care practices in Oxfordshire. Eligible women were those defined by the UK National Institute for Health and Care Excellence (NICE) guidelines as at higher risk of pre-eclampsia. A total of 201 participants were recruited between 12 and 16 weeks of pregnancy and were asked to take two BP readings twice daily three times a week through their pregnancy. Primary outcomes were recruitment, retention and persistence of self-monitoring. Study recruitment and retention were analysed with descriptive statistics. Survival analysis was used to evaluate the persistence of self-monitoring and the performance of self-monitoring in the early detection of gestational hypertension, compared to clinic BP monitoring. Secondary outcomes were the mean clinic and self-monitored BP readings and the performance of self-monitoring in the detection of gestational hypertension and pre-eclampsia compared to clinic BP. RESULTS: Of 201 women recruited, 161 (80%) remained in the study at 36 weeks or to the end of their pregnancy, 162 (81%) provided any home readings suitable for analysis, 148 (74%) continued to self-monitor at 20 weeks and 107 (66%) at 36 weeks. Self-monitored readings were similar in value to contemporaneous matched clinic readings for both systolic and diastolic BP. Of the 23 who developed gestational hypertension or pre-eclampsia and self-monitored, 9 (39%) had a raised home BP prior to a raised clinic BP. CONCLUSIONS: Self-monitoring of BP in pregnancy is feasible and has potential to be useful in the early detection of gestational hypertensive disorders but maintaining self-monitoring throughout pregnancy requires support and probably enhanced training

Amyloid and SCD jointly predict cognitive decline across Chinese and German cohorts.

INTRODUCTION Subjective cognitive decline (SCD) in amyloid-positive (Aβ+) individuals was proposed as a clinical indicator of Stage 2 in the Alzheimer's disease (AD) continuum, but this requires further validation across cultures, measures, and recruitment strategies. METHODS Eight hundred twenty-one participants from SILCODE and DELCODE cohorts, including normal controls (NC) and individuals with SCD recruited from the community or from memory clinics, underwent neuropsychological assessments over up to 6 years. Amyloid positivity was derived from positron emission tomography or plasma biomarkers. Global cognitive change was analyzed using linear mixed-effects models. RESULTS In the combined and stratified cohorts, Aβ+ participants with SCD showed steeper cognitive decline or diminished practice effects compared with NC or Aβ- participants with SCD. These findings were confirmed using different operationalizations of SCD and amyloid positivity, and across different SCD recruitment settings. DISCUSSION Aβ+ individuals with SCD in German and Chinese populations showed greater global cognitive decline and could be targeted for interventional trials. HIGHLIGHTS SCD in amyloid-positive (Aβ+) participants predicts a steeper cognitive decline. This finding does not rely on specific SCD or amyloid operationalization. This finding is not specific to SCD patients recruited from memory clinics. This finding is valid in both German and Chinese populations. Aβ+ older adults with SCD could be a target population for interventional trials