Lithium isotope behavior in Hawaiian regoliths: Soil-atmosphere-biosphere exchanges

Understanding the influence of terrestrial soil-atmosphere-biosphere exchanges on Li geochemical behaviors is vital before using Li isotopes as a weathering tracer. We investigated Li geochemistry of the humid and arid regolith profiles formed on the Pololu lavas, the Kohala Mountain, Hawaii. The shallow regolith (0–1 m depth) retains Li (τLi,Nb > 0) and displays peak Li accumulation in biologically-active, near-surface soil layers (humid, τLi,Nb = 10.9; arid, τLi,Nb = 2.8), with heavy Li isotopic compositions (humid, 4.7–9.9‰; arid, 4.0–13.9‰) with respect to the basalt signal (2.2‰). The deep regolith (>1 m) demonstrates δ7Li (ave. 3.3‰) comparable to the composition of the underlying parent basalt (2.2‰). Decoupling of Li abundance and isotopic composition in the shallow regolith from those of the deep regolith implies different regolith controls on Li chemistry at vertical locations. The Li geochemistry in the shallow regolith has been substantially influenced by: (i) atmospheric deposition, (ii) plant cycling, and (iii) secondary mineral formation. In addition to weathering alteration, our data show that dust addition mainly influences δ7Li in the humid regolith, and marine aerosol largely affects δ7Li in the arid regolith. In the humid regolith, downward seepage migration allows for deeper and more advanced weathering, whereas occasional wetting events followed by rapid drying likely dominate in the arid regolith. Thus, biological cycling and the deposition of Asian dust and volcanic ash from the more recent Hawi eruptions are responsible for upward Li enrichment in soils and increases of soil δ7Li composition in the shallow regolith. This is particularly important in the humid site with dense plant coverage and heavy rainfall. By contrast, the deep regolith of the humid and arid sites is mostly affected by pore fluid percolation and accumulation, thus inheriting heavy Li isotope signals from pore fluids. Our study emphasizes climate-regulated and long-neglected biological controls on terrestrial Li cycling during chemical weathering

Vegetation control on soil organic matter dynamics

Soil organic matter (SOM) formation is one of the least understood steps of the global carbon cycle. An example is uncertainty around the role of plant communities in regulating SOM formation and turnover. Here we took advantage of the highly controlled conditions at the San Dimas lysimeter installation to quantify the influence of oak and pine vegetation on SOM dynamics. SOM turnover rates, estimated using total C and C-14 content of litter and physically separable soil fractions, were faster under oak than under pine. In contrast to the rapid turnover for the oak litter (<2 years), the delay in litter incorporation into the mineral soil under pine was a controlling factor of SOM fluxes. (C) 2001 Published by Elsevier Science Ltd

Soil-landscape and climatic relationships in the middle Miocene of the Madrid Basin

The Miocene alluvial-lacustrine sequences of the Madrid Basin, Spain, formed in highly varied landscapes. The presence of various types of palaeosols allows assessment of the effects of local and external factors onsedimentation, pedogenesis and geomorphological development. In the northern, more arid, tectonicallyactive arca, soils were weakly developed in aggrading alluvial fans, dominated by mass flows. reflecting high sedimentation rates. In more distal parts of the fans and in playa lakes calcretes and dolocretes developed: the former were associated with Mg-poor fan sediments whitc: the latter formed on Mg-rich lake clays exposed during minar lake lowstands. The nonh-east part of the basin had a less arid climate. Alluvial fans in this area were dominated by stream Aood deposits, sourced by carbonate terrains. Floodplain and freshwater lakc deposits formed in distal areas. The high local supply of calcium carbonate may have contributed to the preferential developmenl on calcretes on the fans. Both the fan and floodplain palaeosols exhibit pedofacies relationships and more mature soils developed in settings more distant from the sediment sources. Palaeosols also developed on pond and lake margin carbonates, and led to the formation of palustrine limestones. The spatial distributions and stratigraphies of palaeosols in the Madrid Basin alluvial fans suggest that soil formation was controlled by local factors. These palaeosols differ from those seen in Quatemary fans. Which are characterized by climatically induced periods of stability and instability

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation &lt;92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p&lt;0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p&lt;0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation

Mechanisms of carbon storage in grassland soils

On a sequence of soils developed under similar vegetation, temperature, and precipitation conditions, but with variations in mineralogical properties, we use organic carbon and 14C inventories to examine mineral protection of soil organic carbon. In these soils, 14C data indicate that the creation of slow-cycling carbon can be modeled as occurring through reaction of organic ligands with Al3+ and Fe3+ cations in the upper horizons, followed by sorption to amorphous inorganic Al compounds at depth. Only one of these processes, the chelation of Al3+ and Fe3+ by organic ligands, is linked to large carbon stocks. Organic ligands stabilized by this process traverse the soil column as dissolved organic carbon (both from surface horizons and root exudates). At our moist grassland site, this chelation and transport process is very strongly correlated with the storage and long-term stabilization of soil organic carbon. Our 14C results show that the mechanisms of organic carbon transport and storage at this site follow a classic model previously believed to only be significant in a single soil order (Spodosols), and closely related to the presence of forests. The presence of this process in the grassland Alfisol, Inceptisol, and Mollisol soils of this chronosequence suggests that this process is a more significant control on organic carbon storage than previously thought

Success of endodontic management of compromised first permanent molars in children: A systematic review

Background: Endodontic therapies may be required in the management of compromised first permanent molar teeth; their success in children, however, is unknown. Aim: To determine the success of endodontic therapies used on first permanent molar teeth in children aged sixteen and under. Design: MEDLINE, Embase, Cochrane library, CENTRAL, Clinicaltrials.gov, and the ISRCTN registry as well as relevant paediatric, endodontic, and traumatology journal were searched using a detailed search strategy. References of included studies were hand-searched. A PICOS question was formulated: (P): children aged sixteen and under; (I): endodontic therapies (not pulp capping) on a first permanent molar tooth; (C): no treatment; (O): clinical success of endodontic therapy; and (S): all study types included. Bias was assessed using the Cochrane and Robins-I risk tools. Quality of evidence was assessed using the GRADE approach. Significant heterogeneity precluded meta-analysis. Results: 4172 studies were retrieved and eleven were included in the narrative review. Partial and coronal pulpotomies have high success rates in the short term and long term. Limited evidence is available for conventional pulpectomy or regenerative techniques. Conclusions: Partial and coronal pulpotomies are successful endodontic therapies for use in a compromised child's first permanent molar.</p