Presurgical language fMRI: Clinical practices and patient outcomes in epilepsy surgical planning

The goal of this study was to document current clinical practice and report patient outcomes in presurgical language functional MRI (fMRI) for epilepsy surgery. Epilepsy surgical programs worldwide were surveyed as to the utility, implementation, and efficacy of language fMRI in the clinic; 82 programs responded. Respondents were predominantly US (61%) academic programs (85%), and evaluated adults (44%), adults and children (40%), or children only (16%). Nearly all (96%) reported using language fMRI. Surprisingly, fMRI is used to guide surgical margins (44% of programs) as well as lateralize language (100%). Sites using fMRI for localization most often use a distance margin around activation of 10mm. While considered useful, 56% of programs reported at least one instance of disagreement with other measures. Direct brain stimulation typically confirmed fMRI findings (74%) when guiding margins, but instances of unpredicted decline were reported by 17% of programs and 54% reported unexpected preservation of function. Programs reporting unexpected decline did not clearly differ from those which did not. Clinicians using fMRI to guide surgical margins do not typically map known language-critical areas beyond Broca's and Wernicke's. This initial data shows many clinical teams are confident using fMRI not only for language lateralization but also to guide surgical margins. Reported cases of unexpected language preservation when fMRI activation is resected, and cases of language decline when it is not, emphasize a critical need for further validation. Comprehensive studies comparing commonly-used fMRI paradigms to predict stimulation mapping and post-surgical language decline remain of high importance

Loss and Damage in the Rapidly Changing Arctic

Arctic climate change is happening much faster than the global average. Arctic change also has global consequences, in addition to local ones. Scientific evidence shows that meltwater of Arctic sources contributes to sea-level rise significantly while accounting for 35% of current global sea-level rise. Arctic communities have to find ways to deal with rapidly changing environmental conditions that are leading to social impacts such as outmigration, similarly to the global South. International debates on Loss and Damage have not addressed the Arctic so far. We review literature to show what impacts of climate change are already visible in the Arctic, and present local cases in order to provide empirical evidence of losses and damages in the Arctic region. This evidence is particularly well presented in the context of outmigration and relocation of which we highlight examples. The review reveals a need for new governance mechanisms and institutional frameworks to tackle Loss and Damage. Finally, we discuss what implications Arctic losses and damages have for the international debate

A discursive review of the textual use of ‘trapped’ in environmental migration studies: The conceptual birth and troubled teenage years of trapped populations

First mooted in 2011, the concept of Trapped Populations referring to people unable to move from environmentally high-risk areas broadened the study of human responses to environmental change. While a seemingly straightforward concept, the underlying discourses around the reasons for being ‘trapped’, and the language describing the concept have profound influences on the way in which policy and practice approaches the needs of populations at risk from environmental stresses and shocks. In this article, we apply a Critical Discourse Analysis to the academic literature on the subject to reveal some of the assumptions implicit within discussing ‘trapped’ populations. The analysis reveals a dominant school of thought that assisted migration, relocation, and resettlement in the face of climate change are potentially effective adaptation strategies along a gradient of migrant agency and governance

A 5 ̊C Arctic in a 2 ̊C World

The Columbia Climate Center, in partnership with World Wildlife Fund, Woods Hole Research Center, and Arctic 21, held a workshop titled A 5 C Arctic in a 2 C World on July 20 and 21, 2016. The workshop was co-sponsored by the International Arctic Research Center (University of Alaska Fairbanks), the Arctic Institute of North America (Canada), the MEOPAR Network (Marine Environmental Observation, Prediction, and Response), and the Future Ocean Excellence Cluster. The goal of the workshop was to advance thinking on the science and policy implications of the temperature change in the context of the 1.5 to 2 C warming expected for the globe, as dis- cussed during the 21st session of the Conference of the Parties of the United Nations Framework Convention on Climate Change at Paris in 2015. For the Arctic, such an increase means an antic- ipated increase of roughly 3.5 to 5 C. An international group of 41 experts shared perspectives on the regional and global impacts of an up to +5 C Arctic, examined the feasibility of actively lowering Arctic temperatures, and considered realistic timescales associated with such interventions. The group also discussed the science and the political and governance actions required for alternative Arctic futures

Climigration? Population and climate change in Arctic Alaska

Residents of towns and villages in Arctic Alaska live on “the front line of climate change.” Some communities face immediate threats from erosion and flooding associated with thawing permafrost, increasing river flows, and reduced sea ice protection of shorelines. The term climigration, referring to migration caused by climate change, originally was coined for these places. Although initial applications emphasized the need for government relocation policies, it has elsewhere been applied more broadly to encompass unplanned migration as well. Some historical movements have been attributed to climate change, but closer study tends to find multiple causes, making it difficult to quantify the climate contribution. Clearer attribution might come from comparisons of migration rates among places that are similar in most respects, apart from known climatic impacts. We apply this approach using annual 1990–2014 time series on 43 Arctic Alaska towns and villages. Within-community time plots show no indication of enhanced out-migration from the most at-risk communities. More formally, there is no significant difference between net migration rates of at-risk and other places, testing several alternative classifications. Although climigration is not detectable to date, growing risks make either planned or unplanned movements unavoidable in the near future

Displacement and Resettlement: Understanding the Role of Climate Change in Contemporary Migration

How do we understand displacement and resettlement in the context of climate change? This chapter outlines challenges and debates in the literature connecting climate change to the growing global flow of people. We begin with an outline of the literature on environmental migration, specifically the definitions, measurements, and forms of environmental migration. The discussion then moves to challenges in the reception of migrants, treating the current scholarship on migrant resettlement. We detail a selection of cases in which the environment plays a role in the displacement of a population, including sea level rise in Pacific Island States, cyclonic storms in Bangladesh, and desertification in West Africa, as well as the role of deforestation in South America’s Southern Cone as a driver of both climate change and migration. We outline examples of each, highlighting the complex set of losses and damages incurred by populations in each case