Shortwave spectral radiative signatures and their physical controls

The spectrum of reflected solar radiation emerging at the top of the atmosphere is rich with Earth system information. To identify spectral signatures in the reflected solar radiation and directly relate them to the underlying physical properties controlling their structure, over 90,000 solar reflectance spectra are computed over West Africa in 2010 using a fast radiation code employing the spectral characteristics of the SCanning Imaging Absorption spectroMeter for Atmospheric CHartographY (SCIAMACHY). Cluster analysis applied to the computed spectra reveals spectral signatures related to distinct surface properties, and cloud regimes distinguished by their spectral short-wave cloud radiative effect (SWCRE). The cloud regimes exhibit a diverse variety of mean broadband SWCREs, and offer an alternative approach to define cloud type for SWCRE applications that does not require any prior assumptions. The direct link between spectral signatures and distinct physical properties extracted from clustering remains robust between spatial scales of 1, 20 and 240 km, and presents an excellent opportunity to understand the underlying properties controlling real spectral reflectance observations. Observed SCIAMACHY spectra are assigned to the calculated spectral clusters, showing that cloud regimes are most frequent during the active West African monsoon season of June–October in 2010, and all cloud regimes have a higher frequency of occurrence during the active monsoon season of 2003 compared with the inactive monsoon season of 2004. Overall, the distinct underlying physical properties controlling spectral signatures show great promise for monitoring evolution of the Earth system directly from solar spectral reflectance observations

Chemical probing of thiotetronate bio-assembly

Chemical ‘chain termination’ probes were utilised for the investigation of thiotetronate antibiotic biosynthesis in the filamentous bacteria Lentzea sp. and Streptomyces thiolactonus NRRL 15439. The use of these tools led to the capture of biosynthetic intermediates involved in the thiotetronate polyketide backbone assembly, providing first insights into substrate specificity and in vivo intermediate processing by unusual iterative synthases

Openness in Education as a Praxis: From Individual Testimonials to Collective Voices

Why is Openness in Education important, and why is it critically needed at this moment? As manifested in our guiding question, the significance of Openness in Education and its immediate necessity form the heart of this collaborative editorial piece. This rather straightforward, yet nuanced query has sparked this collective endeavour by using individual testimonies, which may also be taken as living narratives, to reveal the value of Openness in Education as a praxis. Such testimonies serve as rich, personal narratives, critical introspections, and experience-based accounts that function as sources of data. The data gleaned from these narratives points to the understanding of Openness in Education as a complex, multilayered concept intricately woven into an array of values. These range from aspects such as sharing, access, flexibility, affordability, enlightenment, barrier-removal, empowerment, care, individual agency, trust, innovation, sustainability, collaboration, co-creation, social justice, equity, transparency, inclusivity, decolonization, democratisation, participation, liberty, and respect for diversity. This editorial, as a product of collective endeavour, invites its readers to independently engage with individual narratives, fostering the creation of unique interpretations. This call stems from the distinctive character of each narrative as they voice individual researchers’ perspectives from around the globe, articulating their insights within their unique situational contexts

Openness in Education as a Praxis: From Individual Testimonials to Collective Voices

Why is Openness in Education important, and why is it critically needed at this moment? As manifested in our guiding question, the significance of Openness in Education and its immediate necessity form the heart of this collaborative editorial piece. This rather straightforward, yet nuanced query has sparked this collective endeavour by using individual testimonies, which may also be taken as living narratives, to reveal the value of Openness in Education as a praxis. Such testimonies serve as rich, personal narratives, critical introspections, and experience-based accounts that function as sources of data. The data gleaned from these narratives points to the understanding of Openness in Education as a complex, multilayered concept intricately woven into an array of values. These range from aspects such as sharing, access, flexibility, affordability, enlightenment, barrier-removal, empowerment, care, individual agency, trust, innovation, sustainability, collaboration, co-creation, social justice, equity, transparency, inclusivity, decolonization, democratisation, participation, liberty, and respect for diversity. This editorial, as a product of collective endeavour, invites its readers to independently engage with individual narratives, fostering the creation of unique interpretations. This call stems from the distinctive character of each narrative as they voice individual researchers’ perspectives from around the globe, articulating their insights within their unique situational contexts

Openness in Education as a Praxis: From Individual Testimonials to Collective Voices

Why is Openness in Education important, and why is it critically needed at this moment? As manifested in our guiding question, the significance of Openness in Education and its immediate necessity form the heart of this collaborative editorial piece. This rather straightforward, yet nuanced query has sparked this collective endeavour by using individual testimonies, which may also be taken as living narratives, to reveal the value of Openness in Education as a praxis. Such testimonies serve as rich, personal narratives, critical introspections, and experience-based accounts that function as sources of data. The data gleaned from these narratives points to the understanding of Openness in Education as a complex, multilayered concept intricately woven into an array of values. These range from aspects such as sharing, access, flexibility, affordability, enlightenment, barrier-removal, empowerment, care, individual agency, trust, innovation, sustainability, collaboration, co-creation, social justice, equity, transparency, inclusivity, decolonization, democratisation, participation, liberty, and respect for diversity. This editorial, as a product of collective endeavour, invites its readers to independently engage with individual narratives, fostering the creation of unique interpretations. This call stems from the distinctive character of each narrative as they voice individual researchers’ perspectives from around the globe, articulating their insights within their unique situational contexts

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone