Persistent warm Mediterranean surface waters during the Roman period

Reconstruction of last millennia Sea Surface Temperature (SST) evolution is challenging due to the difficulty retrieving good resolution marine records and to the several uncertainties in the available proxy tools. In this regard, the Roman Period (1 CE to 500 CE) was particularly relevant in the socio-cultural development of the Mediterranean region while its climatic characteristics remain uncertain. Here we present a new SST reconstruction from the Sicily Channel based in Mg/Ca ratios measured on the planktonic foraminifer Globigerinoides ruber. This new record is framed in the context of other previously published Mediterranean SST records from the Alboran Sea, Minorca Basin and Aegean Sea and also compared to a north Hemisphere temperature reconstruction. The most solid image that emerges of this trans-Mediterranean comparison is the persistent regional occurrence of a distinct warm phase during the Roman Period. This record comparison consistently shows the Roman as the warmest period of the last 2 kyr, about 2 °C warmer than average values for the late centuries for the Sicily and Western Mediterranean regions. After the Roman Period a general cooling trend developed in the region with several minor oscillations. We hypothesis the potential link between this Roman Climatic Optimum and the expansion and subsequent decline of the Roman Empire

Holocene hydrography evolution in the Alboran Sea: a multi-record and multi-proxy comparison

A new high-resolution deglacial and Holocene sea surface temperature (SST) reconstruction is presented for the Alboran Sea (western Mediterranean), based on Mg∕Ca ratios measured in the planktonic foraminifera Globigerina bulloides. This new record is evaluated by comparison with other Mg∕Ca SST records and previously published alkenone SST reconstructions from the same region for both the Holocene and glacial periods. In all cases there is a high degree of coherence between the different Mg∕Ca SST records but strong discrepancies when compared to the alkenone SST records. We argue that these discrepancies are due to differences in the proxy response during deglaciation which we hypothesize to reflect a resilience strategy of G. bulloides, changing its main growth season, and consequently Mg∕Ca records a shorter deglacial warming than alkenones. In contrast, short-term Holocene SST variability is larger in the Mg∕Ca SST than in the alkenone SST records. We propose that the larger Mg∕Ca SST variability is a result of spring temperatures variability, while the smoothed alkenone SST variability represents averaged annual temperatures. The Mg∕Ca SST record differentiates the Holocene into three periods: (1) the warmest SST values occurred during the Early Holocene (11.7–9&thinsp;cal.&thinsp;kyr&thinsp;BP), (2) a continuous cooling trend occurred during the Middle Holocene that culminated in the coldest Holocene SST having a double cold peak structure centred at around 4.2&thinsp;cal.&thinsp;kyr&thinsp;BP, and (3) the Late Holocene (4.2&thinsp;cal.&thinsp;kyr&thinsp;BP to present) did not follow any clear cooling/warming trend although millennial-scale oscillations were enhanced. This SST evolution is discussed in the context of the changing properties in the Atlantic inflow water associated with North Atlantic circulation conditions and also with local hydrographical and atmospheric changes. We propose that a tight link between North Atlantic circulation patterns and the inflow of surface waters into the Mediterranean played a major role in controlling Holocene climatic variability of this region.</p

Collateral effects of the COVID-19 pandemic on endocrine treatments for breast and prostate cancer in the UK: a cohort study

Background:: The COVID-19 pandemic affected cancer screening, diagnosis and treatments. Many surgeries were substituted with bridging therapies during the initial lockdown, yet consideration of treatment side effects and their management was not a priority. Objectives:: To examine how the changing social restrictions imposed by the pandemic affected incidence and trends of endocrine treatment prescriptions in newly diagnosed (incident) breast and prostate cancer patients and, secondarily, endocrine treatment-related outcomes (including bisphosphonate prescriptions, osteopenia and osteoporosis), in UK clinical practice from March 2020 to June 2022. Design:: Population-based cohort study using UK primary care Clinical Practice Research Datalink GOLD database. Methods:: There were 13,701 newly diagnosed breast cancer patients and 12,221 prostate cancer patients with ⩾1-year data availability since diagnosis between January 2017 and June 2022. Incidence rates (IR) and incidence rate ratios (IRR) were calculated across multiple time periods before and after lockdown to examine the impact of changing social restrictions on endocrine treatments and treatment-related outcomes, including osteopenia, osteoporosis and bisphosphonate prescriptions. Results:: In breast cancer patients, aromatase inhibitor (AI) prescriptions increased during lockdown versus pre-pandemic [IRR: 1.22 (95% confidence interval (CI): 1.11–1.34)], followed by a decrease post-first lockdown [IRR: 0.79 (95% CI: 0.69–0.89)]. In prostate cancer patients, first-generation antiandrogen prescriptions increased versus pre-pandemic [IRR: 1.23 (95% CI: 1.08–1.4)]. For breast cancer patients on AIs, diagnoses of osteopenia, osteoporosis and bisphosphonate prescriptions were reduced across all lockdown periods versus pre-pandemic (IRR range: 0.31–0.62). Conclusion:: During the first 2 years of the pandemic, newly diagnosed breast and prostate cancer patients were prescribed more endocrine treatments compared to pre-pandemic due to restrictions on hospital procedures replacing surgeries with bridging therapies. But breast cancer patients had fewer diagnoses of osteopenia and osteoporosis and bisphosphonate prescriptions. These patients should be followed up in the coming years for signs of bone thinning. Evidence of poorer management of treatment-related side effects will help assess resource allocation for patients at high risk for bone-related complications

The impact of the UK COVID-19 lockdown on the screening, diagnostics and incidence of breast, colorectal, lung and prostate cancer in the UK: a population-based cohort study

Introduction: The COVID-19 pandemic had collateral effects on many health systems. Cancer screening and diagnostic tests were postponed, resulting in delays in diagnosis and treatment. This study assessed the impact of the pandemic on screening, diagnostics and incidence of breast, colorectal, lung, and prostate cancer; and whether rates returned to pre-pandemic levels by December, 2021. Methods: This is a cohort study of electronic health records from the United Kingdom (UK) primary care Clinical Practice Research Datalink (CPRD) GOLD database. The study included individuals registered with CPRD GOLD between January, 2017 and December, 2021, with at least 365 days of clinical history. The study focused on screening, diagnostic tests, referrals and diagnoses of first-ever breast, colorectal, lung, and prostate cancer. Incidence rates (IR) were stratified by age, sex, and region, and incidence rate ratios (IRR) were calculated to compare rates during and after lockdown with rates before lockdown. Forecasted rates were estimated using negative binomial regression models. Results: Among 5,191,650 eligible participants, the first lockdown resulted in reduced screening and diagnostic tests for all cancers, which remained dramatically reduced across the whole observation period for almost all tests investigated. There were significant IRR reductions in breast (0.69 [95% CI: 0.63-0.74]), colorectal (0.74 [95% CI: 0.67-0.81]), and prostate (0.71 [95% CI: 0.66-0.78]) cancer diagnoses. IRR reductions for lung cancer were non-significant (0.92 [95% CI: 0.84-1.01]). Extrapolating to the entire UK population, an estimated 18,000 breast, 13,000 colorectal, 10,000 lung, and 21,000 prostate cancer diagnoses were missed from March, 2020 to December, 2021. Discussion: The UK COVID-19 lockdown had a substantial impact on cancer screening, diagnostic tests, referrals, and diagnoses. Incidence rates remained significantly lower than pre-pandemic levels for breast and prostate cancers and associated tests by December, 2021. Delays in diagnosis are likely to have adverse consequences on cancer stage, treatment initiation, mortality rates, and years of life lost. Urgent strategies are needed to identify undiagnosed cases and address the long-term implications of delayed diagnoses

Country-report pattern corrections of new cases allow accurate 2-week predictions of COVID-19 evolution with the Gompertz model

Accurate short-term predictions of COVID-19 cases with empirical models allow Health Officials to prepare for hospital contingencies in a two–three week window given the delay between case reporting and the admission of patients in a hospital. We investigate the ability of Gompertz-type empiric models to provide accurate prediction up to two and three weeks to give a large window of preparation in case of a surge in virus transmission. We investigate the stability of the prediction and its accuracy using bi-weekly predictions during the last trimester of 2020 and 2021. Using data from 2020, we show that understanding and correcting for the daily reporting structure of cases in the different countries is key to accomplish accurate predictions. Furthermore, we found that filtering out predictions that are highly unstable to changes in the parameters of the model, which are roughly 20%, reduces strongly the number of predictions that are way-off. The method is then tested for robustness with data from 2021. We found that, for this data, only 1–2% of the one-week predictions were off by more than 50%. This increased to 3% for two-week predictions, and only for three-week predictions it reached 10%

Physiological Basis and Transcriptional Profiling of Three Salt-Tolerant Mutant Lines of Rice

Salinity is a complex trait that affects growth and productivity in many crops, including rice. Mutation induction, a useful tool to generate salt tolerant plants, enables the analysis of plants with similar genetic background, facilitating the understanding of the salt tolerance mechanisms. In this work, we generated three salt tolerant mutant lines by irradiation of a salt-sensitive cultivar plants and screened M2 plants at seedling stage in the presence of high salinity. These three lines, SaT20, SaS62, and SaT58, showed different responses to salinity, but exhibited similar phenotype to wild type plants, except SaT20 that displayed shorter height when grown in the absence of salt. Under salt conditions, all three mutants and the parental line showed similar reduction in yield, although relevant differences in other physiological parameters, such as Na+ accumulation in healthy leaves of SaT20, were registered. Microarray analyses of gene expression profiles in roots revealed the occurrence of common and specific responses in the mutants. The three mutants showed up-regulation of responsive genes, the activation of oxido-reduction process and the inhibition of ion transport. The participation of jasmonate in the plant response to salt was evident by down-regulation of a gene coding for a jasmonate O-methyltransferase. Genes dealing with lipid transport and metabolism were, in general, up-regulated except in SaS62, that also exhibited down-regulation of genes involved in ion transport and Ca2+ signal transduction. The two most tolerant varieties, SaS62 and SaT20, displayed lower levels of transcripts involved in K+ uptake. The physiological study and the description of the expression analysis evidenced that the three lines showed different responses to salt: SaT20 showed a high Na+ content in leaves, SaS62 presented an inhibition of lipid metabolism and ion transport and SaT58 differs in both features in the response to salinity. The analysis of these salt tolerant mutants illustrates the complexity of this trait evidencing the breadth of the plant responses to salinity including simultaneous cooperation of alternative or complementary mechanisms

Deglacial-Holocene Pulses of Old Carbon-Enriched Mediterranean Water Masses: Implications for Aragonite Mounds Growth and Global Carbon Cycle

Major changes in the Mediterranean Thermohaline Circulation (MedTHC) related to deglaciation and monsoon dynamics have been documented, while in turn, Mediterranean waters have been proposed to play a role back in global climate variability, ocean circulation and carbon cycle budgets, for instance via changes in water mass residence times. The 14C offset between coeval planktonic and benthic foraminifera over time is a very useful tool to infer variations in the water column ventilation (with no biological interference) that becomes more accurate when combined with local paired 14C-U/Th analyses in cold-water corals (CWC). Here, we present a multi-proxy-archive study (i.e., estimates of reservoir ages, εNd, [CO3 2-], O2 and current speed) carried out on the on-mound sediment core MD13-3452 (305 m, West Melilla, Alboran Sea, Western Mediterranean), which investigates potential deglacial changes and triggers in deep reservoir ages, as well as possible impacts on CWC aragonite mound growth and on global carbon cycle.Our combined foraminifera-CWC radioactive isotopes results show: 1) the arrival of two pulses of aged waters at intermediate depth corresponding to the Younger Dryas (YD) and to the end of the last sapropel (S1), when low CWC mound growth rates dominated, and 2) a very well-ventilated water mass between those two events, parallel to a CWC mound flourishing stage. In combination with the other proxies, poorer ventilated water pulses seem to have had a different origin, but common higher content in respired carbon. Our results allow, for the first time, changes in ventilation rates to be shown, quantified, and timed in association with a periodical MedTHC weakening, as well as suggesting significant aragonite dissolution as a cause of decreased mound growth rate when higher CO2 episodes. Our findings may have implications for past hydrographic interconnexions between Mediterranean basins and for global marine carbon storage and alkalinity budget in particular

Calculating daily dose in the Observational Medical Outcomes Partnership Common Data Model

Purpose: We aimed to develop a standardized method to calculate daily dose (i.e., the amount of drug a patient was exposed to per day) of any drug on a global scale using only drug information of typical observational data in the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM) and a single reference table from Observational Health Data Sciences And Informatics (OHDSI). Materials and Methods: The OMOP DRUG_STRENGTH reference table contains information on the strength or concentration of drugs, whereas the OMOP DRUG_EXPOSURE table contains information on patients' drug prescriptions or dispensations/claims. Based on DRUG_EXPOSURE data from the primary care databases Clinical Practice Research Datalink GOLD (United Kingdom) and Integrated Primary Care Information (IPCI, The Netherlands) and healthcare claims from PharMetrics® Plus for Academics (USA), we developed four formulas to calculate daily dose given different DRUG_STRENGTH reference table information. We tested the dose formulas by comparing the calculated median daily dose to the World Health Organization (WHO) Defined Daily Dose (DDD) for six different ingredients in those three databases and additional four international databases representing a variety of healthcare settings: MAITT (Estonia, healthcare claims and discharge summaries), IQVIA Disease Analyzer Germany (outpatient data), IQVIA Longitudinal Patient Database Belgium (outpatient data), and IMASIS Parc Salut (Spain, hospital data). Finally, in each database, we assessed the proportion of drug records for which daily dose calculations were possible using the suggested formulas. Results: Applying the dose formulas, we obtained median daily doses that generally matched the WHO DDD definitions. Our dose formulas were applicable to >85% of drug records in all but one of the assessed databases. Conclusion: We have established and implemented a standardized daily dose calculation in OMOP CDM providing reliable and reproducible results