The impacts avoided with a 1.5 °C climate target: a global and regional assessment

The 2015 Paris Agreement commits countries to pursue efforts to limit the increase in global mean temperature to 1.5 °C above pre-industrial levels. We assess the consequences of achieving this target in 2100 for the impacts that are avoided, using several indicators of impact (exposure to drought, river flooding, heat waves and demands for heating and cooling energy). The proportion of impacts that are avoided is not simply equal to the proportional reduction in temperature. At the global scale, the median proportion of projected impacts avoided by the 1.5 °C target relative to a rise of 4 °C ranges between 62 and 95% across sectors: the greatest reduction is for heat wave impacts. The 1.5 °C target results in impacts that would be between 27 and 62% lower than with the 2 °C target. For each indicator, there are differences in the proportions of impacts avoided between regions depending on exposure and the regional changes in climate (particularly precipitation). Uncertainty in the proportion of impacts that are avoided for a specific sector depends on the range in the shape of the relationship between global temperature change and impact, and this varies between sectors

Subthalamic nucleus deep brain stimulation in elderly patients – analysis of outcome and complications

BACKGROUND: There is an ongoing discussion about age limits for deep brain stimulation (DBS). Current indications for DBS are tremor-dominant disorders, Parkinson's disease, and dystonia. Electrode implantation for DBS with analgesia and sedation makes surgery more comfortable, especially for elderly patients. However, the value of DBS in terms of benefit-risk ratio in this patient population is still uncertain. METHODS: Bilateral electrode implantation into the subthalamic nucleus (STN) was performed in a total of 73 patients suffering from Parkinson's disease. Patients were analyzed retrospectively. For this study they were divided into two age groups: group I (age <65 years, n = 37) and group II (age ≥ 65 years, n = 36). Examinations were performed preoperatively and at 6-month follow-up intervals for 24 months postoperatively. Age, UPDRS motor score (part III) on/off, Hoehn & Yahr score, Activity of Daily Living (ADL), L-dopa medication, and complications were determined. RESULTS: Significant differences were found in overall performance determined as ADL scores (group I: 48/71 points, group II: 41/62 points [preoperatively/6-month postoperatively]) and in the rate of complications (group I: 4 transient psychosis, 4 infections in a total of 8 patients, group II: 2 deaths [unrelated to surgery], 1 intracerebral hemorrhage, 7 transient psychosis, 3 infections, 2 pneumonia in a total of 13 patients), (p < 0.05). Interestingly, changes in UPDRS scores, Hoehn & Yahr scores, and L-dopa medication were not statistically different between the two groups. CONCLUSION: DBS of the STN is clinically as effective in elderly patients as it is in younger ones. However, a more careful selection and follow-up of the elderly patients are required because elderly patients have a higher risk of surgery-related complications and a higher morbidity rate

The neurogenic potential of astrocytes is regulated by inflammatory signals

Although the adult brain contains neural stem cells (NSCs) that generate new neurons throughout life, these astrocyte-like populations are restricted to two discrete niches. Despite their terminally differentiated phenotype, adult parenchymal astrocytes can re-acquire NSC-like characteristics following injury, and as such, these 'reactive' astrocytes offer an alternative source of cells for central nervous system (CNS) repair following injury or disease. At present, the mechanisms that regulate the potential of different types of astrocytes are poorly understood. We used in vitro and ex vivo astrocytes to identify candidate pathways important for regulation of astrocyte potential. Using in vitro neural progenitor cell (NPC)-derived astrocytes, we found that exposure of more lineage-restricted astrocytes to either tumor necrosis factor alpha (TNF-α) (via nuclear factor-κB (NFκB)) or the bone morphogenetic protein (BMP) inhibitor, noggin, led to re-acquisition of NPC properties accompanied by transcriptomic and epigenetic changes consistent with a more neurogenic, NPC-like state. Comparative analyses of microarray data from in vitro-derived and ex vivo postnatal parenchymal astrocytes identified several common pathways and upstream regulators associated with inflammation (including transforming growth factor (TGF)-β1 and peroxisome proliferator-activated receptor gamma (PPARγ)) and cell cycle control (including TP53) as candidate regulators of astrocyte phenotype and potential. We propose that inflammatory signalling may control the normal, progressive restriction in potential of differentiating astrocytes as well as under reactive conditions and represent future targets for therapies to harness the latent neurogenic capacity of parenchymal astrocytes

Self-Healing Collagen-Based Hydrogel for Brain Injury Therapy

Hydrogels derived from biopolymers, also called biohydrogels, have shown potential for brain injury therapy due to their tunable physical, chemical, and biological properties. Among different biohydrogels, those made from collagen type I are very promising candidates for the reparation of nervous tissues due to its biocompatibility, noncytotoxic properties, injectability, and self-healing ability. Moreover, although collagen does not naturally occur in the brain, it has been demonstrated that collagen type I, which resides in the basal lamina of the subventricular zone in adults, supports neural cell attachment, axonal growth, and cell proliferation due to its intrinsic content of specific cell-signaling domains. This chapter summarizes the most relevant results obtained from both in vitro and in vivo studies using self-healing biohydrogels based on collagen type I as key component in the field of neuroregeneration.University of RegensburgUniversidad de La LagunaMinisterio de Ciencia, Innovación y Universidade

Climate Impacts, Political Institutions, and Leader Survival: Effects of Drought and Flooding Precipitation.

We explore how the political survival of leaders in different political regimes is affected by drought and flooding precipitation, which are the two major anticipated impacts of anthropogenic climate change. Using georeferenced climate data for the entire world and the Archigos dataset for the period of 1950-2010, we find that irregular political exits, such as coups or revolutions, are not significantly affected by climate impacts. Similarly, drought has a positive but insignificant effect on all types of political exits. On the other hand, we find that floods increase political turnover through the regular means such as elections or term limits. Democracies are better able to withstand the pressures arising from the economic and social disruptions associated with high precipitation than other institutional arrangements. Our results further suggest that, in the context of floods, political institutions play a more important role than economic development for the leaders’ political survival

Anthropogenic intensification of short-duration rainfall extremes

Short- duration (1-3 h) rainfall extremes can cause serious damage to societies through rapidly developing (flash) flooding and are determined by complex, multifaceted processes that are altering as Earth's climate warms. In this Review, we examine evidence from observational, theoretical and modelling studies for the intensification of these rainfall extremes, the drivers and the impact on flash flooding. Both short- duration and long- duration (\textgreater1 day) rainfall extremes are intensifying with warming at a rate consistent with the increase in atmospheric moisture (~7% K-1), while in some regions, increases in short- duration extreme rainfall intensities are stronger than expected from moisture increases alone. These stronger local increases are related to feedbacks in convective clouds, but their exact role is uncertain because of the very small scales involved. Future extreme rainfall intensification is also modulated by changes to temperature stratification and large- scale atmospheric circulation. The latter remains a major source of uncertainty. Intensification of short- duration extremes has likely increased the incidence of flash flooding at local scales and this can further compound with an increase in storm spatial footprint to considerably increase total event rainfall. These findings call for urgent climate change adaptation measures to manage increasing flood risks

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS