Climate Information for Improved Planning and Management of Mega Cities (Needs Perspective)

The majority of the population of the planet (6.6 billion) now live in urban areas, which have distinct impacts upon climate at scales from the local to the global. This urban effect is due to the physical form of the city (its three-dimensional geometry and material composition) and its functions (the day-to-day activity patterns that generate emissions of waste heat and materials into the overlying air). While a substantial body of knowledge on the science of urban climates has been developed over the past fifty years, there is little evidence that this knowledge is incorporated into urban planning and design practice. This paper focuses on this gap by examining the nature of urban climate expertise and the needs of those that make decisions about urban areas. In conclusion it makes recommendations to maintain and enhance urban observations and data; to improve understanding of local, regional and global climate linkages; to develop tools for practical planning; and to disseminate urban climate knowledge and its relevance to urban planning to both practicing meteorologists and urban decision makers

The impact of mental health recovery narratives on recipients experiencing mental health problems: Qualitative analysis and change model.

BACKGROUND: Mental health recovery narratives are stories of recovery from mental health problems. Narratives may impact in helpful and harmful ways on those who receive them. The objective of this paper is to develop a change model identifying the range of possible impacts and how they occur. METHOD: Semi-structured interviews were conducted with adults with experience of mental health problems and recovery (n = 77). Participants were asked to share a mental health recovery narrative and to describe the impact of other people's recovery narratives on their own recovery. A change model was generated through iterative thematic analysis of transcripts. RESULTS: Change is initiated when a recipient develops a connection to a narrator or to the events descripted in their narrative. Change is mediated by the recipient recognising experiences shared with the narrator, noticing the achievements or difficulties of the narrator, learning how recovery happens, or experiencing emotional release. Helpful outcomes of receiving recovery narratives are connectedness, validation, hope, empowerment, appreciation, reference shift and stigma reduction. Harmful outcomes are a sense of inadequacy, disconnection, pessimism and burden. Impact is positively moderated by the perceived authenticity of the narrative, and can be reduced if the recipient is experiencing a crisis. CONCLUSIONS: Interventions that incorporate the use of recovery narratives, such as peer support, anti-stigma campaigns and bibliotherapy, can use the change model to maximise benefit and minimise harms from narratives. Interventions should incorporate a diverse range of narratives available through different mediums to enable a range of recipients to connect with and benefit from this material. Service providers using recovery narratives should preserve authenticity so as to maximise impact, for example by avoiding excessive editing

Intratumor genetic heterogeneity in squamous cell carcinoma of the oral cavity

BackgroundWe sought to evaluate intratumor heterogeneity in squamous cell carcinoma of the oral cavity (OCC) and specifically determine the effect of physical separation and histologic differentiation within the same tumor.MethodsWe performed whole exome sequencing on five biopsy sites—two from well‐differentiated, two from poorly differentiated regions, and one from normal parenchyma—from five primary OCC specimens.ResultsWe found high levels of intratumor heterogeneity and, in four primary tumors, identified only 0 to 2 identical mutations in all subsites. We found that the heterogeneity inversely correlated with physical separation and that pairs of well‐differentiated samples were more similar to each other than analogous poorly differentiated specimens. Only TP53 mutations, but not other purported “driver mutations” in head and neck squamous cell carcinoma, were found in multiple biopsy sites.ConclusionThese data highlight the challenges to characterization of the mutational landscape of OCC with single site biopsy and have implications for personalized medicine.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/150549/1/hed25719.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/150549/2/hed25719_am.pd

A Meta-Analysis of Global Urban Land Expansion

The conversion of Earth's land surface to urban uses is one of the most irreversible human impacts on the global biosphere. It drives the loss of farmland, affects local climate, fragments habitats, and threatens biodiversity. Here we present a meta-analysis of 326 studies that have used remotely sensed images to map urban land conversion. We report a worldwide observed increase in urban land area of 58,000 km2 from 1970 to 2000. India, China, and Africa have experienced the highest rates of urban land expansion, and the largest change in total urban extent has occurred in North America. Across all regions and for all three decades, urban land expansion rates are higher than or equal to urban population growth rates, suggesting that urban growth is becoming more expansive than compact. Annual growth in GDP per capita drives approximately half of the observed urban land expansion in China but only moderately affects urban expansion in India and Africa, where urban land expansion is driven more by urban population growth. In high income countries, rates of urban land expansion are slower and increasingly related to GDP growth. However, in North America, population growth contributes more to urban expansion than it does in Europe. Much of the observed variation in urban expansion was not captured by either population, GDP, or other variables in the model. This suggests that contemporary urban expansion is related to a variety of factors difficult to observe comprehensively at the global level, including international capital flows, the informal economy, land use policy, and generalized transport costs. Using the results from the global model, we develop forecasts for new urban land cover using SRES Scenarios. Our results show that by 2030, global urban land cover will increase between 430,000 km2 and 12,568,000 km2, with an estimate of 1,527,000 km2 more likely

Intratumoural evolutionary landscape of high-risk prostate cancer: the PROGENY study of genomic and immune parameters

Background: Intratumoural heterogeneity (ITH) is well recognised in prostate cancer (PC), but its role in high-risk disease is uncertain. A prospective, single-arm, translational study using targeted multiregion prostate biopsies was carried out to study genomic and T-cell ITH in clinically high-risk PC aiming to identify drivers and potential therapeutic strategies. Patients and methods: Forty-nine men with elevated prostate-specific antigen and multiparametric-magnetic resonance imaging detected PC underwent image-guided multiregion transperineal biopsy. Seventy-nine tumour regions from 25 patients with PC underwent sequencing, analysis of mutations, copy number and neoepitopes combined with tumour infiltrating T-cell subset quantification. Results: We demonstrated extensive somatic nucleotide variation and somatic copy number alteration heterogeneity in high-risk PC. Overall, the mutational burden was low (0.93/Megabase), but two patients had hypermutation, with loss of mismatch repair (MMR) proteins, MSH2 and MSH6. Somatic copy number alteration burden was higher in patients with metastatic hormone-naive PC (mHNPC) than in those with high-risk localised PC (hrlPC), independent of Gleason grade. Mutations were rarely ubiquitous and mutational frequencies were similar for mHNPC and hrlPC patients. Enrichment of focal 3q26.2 and 3q21.3, regions containing putative metastasis drivers, was seen in mHNPC patients. We found evidence of parallel evolution with three separate clones containing activating mutations of beta-catenin in a single patient. We demonstrated extensive intratumoural and intertumoural T-cell heterogeneity and high inflammatory infiltrate in the MMR-deficient (MMRD) patients and the patient with parallel evolution of beta-catenin. Analysis of all patients with activating Wnt/beta-catenin mutations demonstrated a low CD8+/FOXP3+ ratio, a potential surrogate marker of immune evasion. Conclusions: The PROGENY (PROstate cancer GENomic heterogeneitY) study provides a diagnostic platform suitable for studying tumour ITH. Genetic aberrations in clinically high-risk PC are associated with altered patterns of immune infiltrate in tumours. Activating mutations of Wnt/beta-catenin signalling pathway or MMRD could be considered as potential biomarkers for immunomodulation therapies. Clinical Trials.gov Identifier: NCT02022371

Global Cooling: Increasing World-Wide Urban Albedos to Offset CO2

Modification of urban albedos reduces summertime urban temperatures, resulting in a better urban air quality and building air-conditioning savings. Furthermore, increasing urban albedos has the added benefit of reflecting some of the incoming global solar radiation and countering to some extent the effects of global warming. In many urban areas, pavements and roofs constitute over 60% of urban surfaces (roof 20-25%, pavements about 40%). Using reflective materials, both roof and the pavement albedos can be increased by about 0.25 and 0.10, respectively, resulting in a net albedo increase for urban areas of about 0.1. Many studies have demonstrated building cooling-energy savings in excess of 20% upon raising roof reflectivity from an existing 10-20% to about 60% (a U.S. potential savings in excess of $1 billion (B) per year in net annual energy bills). On a global basis, our preliminary estimate is that increasing the world-wide albedos of urban roofs and paved surfaces will induce a negative radiative forcing on the earth equivalent to removing {approx} 22-40 Gt of CO{sub 2} from the atmosphere. Since, 55$25/tonne of CO{sub 2}, a 40-73 Gt CO{sub 2} emission reduction from changing the albedo of roofs and paved surfaces is worth about $1,000B to 1800B. These estimated savings are dependent on assumptions used in this study, but nevertheless demonstrate considerable benefits that may be obtained from cooler roofs and pavements

Predictors of moving on from mental health supported accommodation in England: national cohort study

National Institute of Health Research (RP-PG-0610-10097

Effects of climate change on exposure to coastal flooding in Latin America and the Caribbean

This study considers and compares several of the most important factors contributing to coastal flooding in Latin American and the Caribbean (LAC) while accounting for the variations of these factors with location and time. The study assesses the populations, the land areas and the built capital exposed at present and at the middle and end of the 21st century for a set of scenarios that include both climatic and non-climatic drivers. Climatic drivers include global mean sea level, natural modes of climate variability such as El Niño, natural subsidence, and extreme sea levels resulting from the combination of projected local sea-level rise, storm surges and wave setup. Population is the only human-related driver accounted for in the future. Without adaptation, more than 4 million inhabitants will be exposed to flooding from relative sea-level rise by the end of the century, assuming the 8.5 W m−2 trajectory of the Representative Concentration Pathways (RCPs), or RCP8.5. However, the contributions from El Niño events substantially raise the threat in several Pacific-coast countries of the region and sooner than previously anticipated. At the tropical Pacific coastlines, the exposure by the mid-century for an event similar to El Niño 1998 would be comparable to that of the RCP4.5 relative sea-level rise by the end of the century. Furthermore, more than 7.5 million inhabitants, 42,600 km2 and built capital valued at 334 billion USD are currently situated at elevations below the 100-year extreme sea level. With sea levels rising and the population increasing, it is estimated that more than 9 million inhabitants will be exposed by the end of the century for either of the RCPs considered. The spatial distribution of exposure and the comparison of scenarios and timeframes can serve as a guide in future adaptation and risk reduction policies in the region