Understanding CMIP6 biased in the representation of the Greater Horn of Africa long and short rains

The societies of the Greater Horn of Africa (GHA) are vulnerable to variability in two distinct rainy seasons, the March–May ‘long’ rains and the October–December ‘short’ rains. Recent trends in both rainy seasons, possibly related to patterns of low-frequency variability, have increased interest in future climate projections from General Circulation Models (GCMs). However, previous generations of GCMs historically have poorly simulated the regional hydroclimate. This study conducts a process-based evaluation of simulations of the long and short rains in CMIP6, the latest generation of GCMs. Key biases in CMIP5 remain or are worsened, including long rains that are too short and weak and short rains that are too long and strong. Model biases are driven by a complex set of related oceanic and atmospheric factors, including simulations of the Walker Circulation. Biased wet short rains in models are connected with Indian Ocean zonal sea surface temperature (SST) gradients that are too warm in the west and convection that is too deep. Models connect equatorial African winds with the strength of the short rains, though in observations a robust connection is primarily found in the long rains. Model mean state biases in the timing of the western Indian Ocean SST seasonal cycle are associated with certain rainfall timing biases, though both biases may be due to a common source. Simulations driven by historical SSTs (AMIP runs) often have larger biases than fully coupled runs. A path towards using biases to better understand uncertainty in projections of GHA rainfall is suggested

Projected Changes to Hydroclimate Seasonality in the Continental United States

Future changes to the hydrological cycle are projected in a warming world, and any shifts in drought risk may prove extremely consequential for natural and human systems. In addition to long-term moistening, drying, or warming trends, perturbations to the annual cycle of regional hydroclimate variables may also have substantial impacts. We analyze projected changes in several hydroclimate variables across the continental United States, along with shifts in the amplitude and phase of their annual cycles. We find that even in regions where no robust change in the annual mean is expected, coherent changes to the annual cycle are projected. In particular, we identify robust regional phase shifts toward earlier arrival of peak evaporation in the northern regions, and peak runoff and total soil moisture in the western regions. Changes in the amplitude of the annual cycle of total and surface soil moisture are also projected, and reflect changes to the annual cycle in surface water supply and demand. Whether changes become detectable above the background noise of internal variability depends strongly on the future scenario considered, and significant changes to the annual cycle are largely avoided in the lowest-forcing scenario

Uncertainties, Limits, and Benefits of Climate Change Mitigation for Soil Moisture Drought in Southwestern North America

Over the last two decades, southwestern North America (SWNA) has been in the grip of one of the most severe droughts of the last 1,200 years, with one third to nearly one half of its severity attributable to climate change. We analyze how the risk of extreme soil moisture droughts in SWNA, analogous to the most severe 21-year (≥ in magnitude to 2000–2020) and single-year (≥ in magnitude to 2002) events of the last several decades, changes in projections from Phase 6 of the Coupled Model Intercomparison Project. By the end of the 21st century, SWNA experiences robust (R ≥ 0.80) soil moisture drying and substantial increases in extreme single-year drought risk that scale strongly with warming, spanning an 8%–26% probability of occurrence across +2–4 K. Notably, our results show that 21-year droughts analogous to 2000–2020 are up to 5 times more likely than extreme single-year droughts under all levels of warming (≈50%). These high levels of 21-year drought risk are largely invariant across scenarios because of large spring precipitation declines in half the models, shifting SWNA into a drier mean state. Despite projections of this sweeping and ostensibly inevitable increase in 21-year drought risk, climate mitigation reduces their severity by reducing the magnitude of extreme single-year droughts during these events. Our results emphasize both the importance of preparing SWNA for imminent increases in persistent drought events and constraining projected precipitation uncertainty to better resolve future long-term drought risk

Megadroughts in the Common Era and the Anthropocene

Exceptional drought events, known as megadroughts, have occurred on every continent outside Antarctica over the past ~2,000 years, causing major ecological and societal disturbances. In this Review, we discuss shared causes and features of Common Era (Year 1–present) and future megadroughts. Decadal variations in sea surface temperatures are the primary driver of megadroughts, with secondary contributions from radiative forcing and land–atmosphere interactions. Anthropogenic climate change has intensified ongoing megadroughts in south-western North America and across Chile and Argentina. Future megadroughts will be substantially warmer than past events, with this warming driving projected increases in megadrought risk and severity across many regions, including western North America, Central America, Europe and the Mediterranean, extratropical South America, and Australia. However, several knowledge gaps currently undermine confidence in understanding past and future megadroughts. These gaps include a paucity of high-resolution palaeoclimate information over Africa, tropical South America and other regions; incomplete representations of internal variability and land surface processes in climate models; and the undetermined capacity of water-resource management systems to mitigate megadrought impacts. Addressing these deficiencies will be crucial for increasing confidence in projections of future megadrought risk and for resiliency planning

Correction to: Cluster identification, selection, and description in Cluster randomized crossover trials: the PREP-IT trials

An amendment to this paper has been published and can be accessed via the original article

Twenty-First Century Drought Projections in the CMIP6 Forcing Scenarios

There is strong evidence that climate change will increase drought risk and severity, but these conclusions depend on the regions, seasons, and drought metrics being considered. We analyze changes in drought across the hydrologic cycle (precipitation, soil moisture, and runoff) in projections from Phase Six of the Coupled Model Intercomparison Project (CMIP6). The multimodel ensemble shows robust drying in the mean state across many regions and metrics by the end of the 21st century, even following the more aggressive mitigation pathways (SSP1-2.6 and SSP2-4.5). Regional hotspots with strong drying include western North America, Central America, Europe and the Mediterranean, the Amazon, southern Africa, China, Southeast Asia, and Australia. Compared to SSP3-7.0 and SSP5-8.5, however, the severity of drying in the lower warming scenarios is substantially reduced and further precipitation declines in many regions are avoided. Along with drying in the mean state, the risk of the historically most extreme drought events also increases with warming, by 200–300% in some regions. Soil moisture and runoff drying in CMIP6 is more robust, spatially extensive, and severe than precipitation, indicating an important role for other temperature-sensitive drought processes, including evapotranspiration and snow. Given the similarity in drought responses between CMIP5 and CMIP6, we speculate that both generations of models are subject to similar uncertainties, including vegetation processes, model representations of precipitation, and the degree to which model responses to warming are consistent with observations. These topics should be further explored to evaluate whether CMIP6 models offer reasons to have increased confidence in drought projections

PREVENTion of CLots in Orthopaedic Trauma (PREVENT CLOT): a randomised pragmatic trial protocol comparing aspirin versus low-molecular-weight heparin for blood clot prevention in orthopaedic trauma patients

Introduction Patients who sustain orthopaedic trauma are at an increased risk of venous thromboembolism (VTE), including fatal pulmonary embolism (PE). Current guidelines recommend low-molecular-weight heparin (LMWH) for VTE prophylaxis in orthopaedic trauma patients. However, emerging literature in total joint arthroplasty patients suggests the potential clinical benefits of VTE prophylaxis with aspirin. The primary aim of this trial is to compare aspirin with LMWH as a thromboprophylaxis in fracture patients.Methods and analysis PREVENT CLOT is a multicentre, randomised, pragmatic trial that aims to enrol 12 200 adult patients admitted to 1 of 21 participating centres with an operative extremity fracture, or any pelvis or acetabular fracture. The primary outcome is all-cause mortality. We will evaluate non-inferiority by testing whether the intention-to-treat difference in the probability of dying within 90 days of randomisation between aspirin and LMWH is less than our non-inferiority margin of 0.75%. Secondary efficacy outcomes include cause-specific mortality, non-fatal PE and deep vein thrombosis. Safety outcomes include bleeding complications, wound complications and deep surgical site infections.Ethics and dissemination The PREVENT CLOT trial has been approved by the ethics board at the coordinating centre (Johns Hopkins Bloomberg School of Public Health) and all participating sites. Recruitment began in April 2017 and will continue through 2021. As both study medications are currently in clinical use for VTE prophylaxis for orthopaedic trauma patients, the findings of this trial can be easily adopted into clinical practice. The results of this large, patient-centred pragmatic trial will help guide treatment choices to prevent VTE in fracture patients.Trial registration number NCT02984384