Drought-induced biomass burning as a source of black carbon to the central Himalaya since 1781 CE as reconstructed from the Dasuopu ice core

Himalayan glaciers are melting due to atmospheric warming, with the potential to limit access to water for more than 25 % of the global population that resides in these glacier meltwater catchments. Black carbon has been implicated as a factor that is contributing to Himalayan glacier melt, but its sources and mechanisms of delivery to the Himalayas remain controversial. Here, we provide a 211-year ice core record spanning 1781–1992 CE for refractory black carbon (rBC) deposition from the Dasuopu glacier ice core that has to date provided the highest-elevation ice core record (7200 m). We report an average rBC concentration of 1.5 µg L−1 (SD=5.0, n=1628) over the 211-year period. An increase in the frequency and magnitude of rBC deposition occurs after 1877 CE, accompanied by decreased snow accumulation associated with a shift in the North Atlantic Oscillation Index to a positive phase. Typically, rBC is deposited onto Dasuopu glacier during the non-monsoon season, and short-lived increases in rBC concentration are associated with periods of drought within neighboring regions in northwestern India, Afghanistan, and Pakistan. Using a combination of spectral and back-trajectory analyses, as well as a comparison with a concurrent analysis of trace metals at equivalent depths in the same ice core, we show that biomass burning resulting from dry conditions is a source of rBC to the central Himalaya and is responsible for deposition that is up to 60 times higher than the average rBC concentration over the time period analyzed. We suggest that biomass burning is a significant source of rBC to the central Himalaya and that the rBC record can be used to identify periods of drought in nearby regions that are upwind of Dasuopu glacier

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Aeolian Dust Preserved in the Guliya Ice Cap (Northwestern Tibet): A Promising Paleo-Environmental Messenger

Asian aeolian dust is a primary factor in Northern Hemisphere atmospheric dynamics. Predicting past and future changes in atmospheric circulation patterns relies in part on sound knowledge of Central Asian dust properties and the dust cycle. Unfortunately for that region, data are too sparse to constrain the variation in dust composition over time. Here, we evaluate the potential of a Tibetan ice core to provide a comprehensive paleo-atmospheric dust record and thereby reduce uncertainties regarding mineral aerosols’ feedback on the climate system. We present the first datasets of the mineralogical, geochemical, and Sr-Nd isotope composition of aeolian dust preserved in pre-Holocene layers of two ice cores from the Guliya ice cap (Kunlun Mountains). The composition of samples from the Summit (GS; 6710 m a.s.l.) and Plateau (GP; 6200 m a.s.l.) cores reveals that the characteristics of the dust in the cores’ deepest ice layers are significantly different. The deepest GS layers reveal isotopic values that correspond to aeolian particles from the Taklimakan desert, contain a mix of fine and coarse grains, and include weathering-sensitive material suggestive of a dry climate at the source. The deep GP layers primarily consist of unusual nodules of well size-sorted grey clay enriched in weathering-resistant minerals and elements typically found in geothermal waters, suggesting that the dust preserved in the oldest GP layers originates from a wet and possibly anoxic source. The variability of the dust composition highlighted here attests to its relevance as a paleo-environmental messenger and warrants further exploration of the particularly heterogenous Guliya glacial dust archive

Aeolian Dust Preserved in the Guliya Ice Cap (Northwestern Tibet): A Promising Paleo-Environmental Messenger

Asian aeolian dust is a primary factor in Northern Hemisphere atmospheric dynamics. Predicting past and future changes in atmospheric circulation patterns relies in part on sound knowledge of Central Asian dust properties and the dust cycle. Unfortunately for that region, data are too sparse to constrain the variation in dust composition over time. Here, we evaluate the potential of a Tibetan ice core to provide a comprehensive paleo-atmospheric dust record and thereby reduce uncertainties regarding mineral aerosols&rsquo; feedback on the climate system. We present the first datasets of the mineralogical, geochemical, and Sr-Nd isotope composition of aeolian dust preserved in pre-Holocene layers of two ice cores from the Guliya ice cap (Kunlun Mountains). The composition of samples from the Summit (GS; 6710 m a.s.l.) and Plateau (GP; 6200 m a.s.l.) cores reveals that the characteristics of the dust in the cores&rsquo; deepest ice layers are significantly different. The deepest GS layers reveal isotopic values that correspond to aeolian particles from the Taklimakan desert, contain a mix of fine and coarse grains, and include weathering-sensitive material suggestive of a dry climate at the source. The deep GP layers primarily consist of unusual nodules of well size-sorted grey clay enriched in weathering-resistant minerals and elements typically found in geothermal waters, suggesting that the dust preserved in the oldest GP layers originates from a wet and possibly anoxic source. The variability of the dust composition highlighted here attests to its relevance as a paleo-environmental messenger and warrants further exploration of the particularly heterogenous Guliya glacial dust archive

Use of δ18Oatm in dating a Tibetan ice core record of Holocene/Late Glacial climate

Ice cores from the northwestern Tibetan Plateau (NWTP) contain long records of regional climate variability, but refrozen meltwater and dust in these cores has hampered development of robust timescales. Here, we introduce an approach to dating the ice via the isotopic composition of atmospheric O2 in air bubbles (δ18Oatm), along with annual layer counting and radiocarbon dating. We provide a robust chronology for water isotope records (δ18Oice and d-excess) from three ice cores from the Guliya ice cap in the NWTP. The measurement of δ18Oatm, although common in polar ice core timescales, has rarely been used on ice cores from low-latitude, high-altitude glaciers due to (1) low air pressure, (2) the common presence of refrozen melt that adds dissolved gases and reduces the amount of air available for analysis, and (3) the respiratory consumption of molecular oxygen (O2) by micro-organisms in the ice, which fractionates the δ18O of O2 from the atmospheric value. Here, we make corrections for melt and respiration to address these complications. The resulting records of water isotopes from the Guliya ice cores reveal climatic variations over the last 15,000 y, the timings of which correspond to those observed in independently dated lake and speleothem records and confirm that the Guliya ice cap existed before the Holocene. The millennial-scale drivers of δ18Oice are complex and temporally variable; however, Guliya δ18Oice values since the mid-20th century are the highest since the beginning of the Holocene and have increased with regional air temperature

Dust composition changes from Taylor Glacier (East Antarctica) during the last glacial-interglacial transition: A multi-proxy approach

Mineral dust is transported in the atmosphere and deposited in oceans, ice sheets and the terrestrial biosphere. Temporal changes in locations of dust source areas and transport pathways have implications for global climate and biogeochemical cycles. The chemical and physical characterization of the dust record preserved in ice cores is useful for identifying of dust source regions, dust transport, dominant wind direction and storm trajectories. Here, we present a 50,000-year geochemical characterization of mineral dust entrapped in a horizontal ice core from the Taylor Glacier in East Antarctica. Strontium (Sr) and neodymium (Nd) isotopes, grain size distribution, trace and rare earth element (REE) concentrations, and inorganic ion (Cl− and Na+) concentrations were measured in 38 samples, corresponding to a time interval from 46 kyr before present (BP) to present. The Sr and Nd isotope compositions of insoluble dust in the Taylor Glacier ice shows distinct changes between the Last Glacial Period (LGP in this study ranging from ∼46.7–15.3 kyr BP) the early Holocene (in this study ranging from ∼14.5–8.7 kyr BP), and zero-age samples. The 87Sr/86Sr isotopic composition of dust in the Taylor Glacier ice ranged from 0.708 to 0.711 during the LGP, while the variability during the early Holocene is higher ranging from 0.707 to 0.714. The εNd composition ranges from 0.1 to −3.9 during the LGP, and is more variable from 1.9 to −8.2 during the early Holocene. The increased isotopic variability during the early Holocene suggests a shift in dust provenance coinciding with the major climate transition from the LGP to the Holocene. The isotopic composition and multiple physical and chemical constraints support previous work attributing Southern South America (SSA) as the main dust source to East Antarctica during the LGP, and a combination of both local Ross Sea Sector dust sources and SSA after the transition into the Holocene. This study provides the first high time resolution data showing variations in dust provenance to East Antarctic ice during a major climate regime shift, and we provide evidence of changes in the atmospheric transport pathways of dust following the last deglaciation

A Latin American survey on demographic aspects of hospitalized, decompensated cirrhotic patients and the resources for their management

Introduction &amp; objectives: Liver cirrhosis is a major cause of mortality worldwide. Adequate diagnosis and treatment of decompensating events requires of both medical skills and updated technical resources. The objectives of this study were to search the demographic profile of hospitalized cirrhotic patients in a group of Latin American hospitals and the availability of expertise/facilities for the diagnosis and therapy of decompensation episodes. Methods: A cross sectional, multicenter survey of hospitalized cirrhotic patients. Results: 377 patients, (62% males; 58 ± 11 years) (BMI > 25, 57%; diabetes 32%) were hospitalized at 65 centers (63 urbans; 57 academically affiliated) in 13 countries on the survey date. Main admission causes were ascites, gastrointestinal bleeding, hepatic encephalopathy and spontaneous bacterial peritonitis/other infections. Most prevalent etiologies were alcohol-related (AR) (40%); non-alcoholic-steatohepatitis (NASH) (23%), hepatitis C virus infection (HCV) (7%) and autoimmune hepatitis (AIH) (6%). The most frequent concurrent etiologies were AR + NASH. Expertise and resources in every analyzed issue were highly available among participating centers, mostly accomplishing valid guidelines. However, availability of these facilities was significantly higher at institutions located in areas with population > 500,000 (n = 45) and in those having a higher complexity level (Gastrointestinal, Liver and Internal Medicine Departments at the same hospital (n = 22). Conclusions: The epidemiological etiologic profile in hospitalized, decompensated cirrhotic patients in Latin America is similar to main contemporary emergent agents worldwide. Medical and technical resources are highly available, mostly at great population urban areas and high complexity medical centers. Main diagnostic and therapeutic approaches accomplish current guidelines recommendations

Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures