Ocean acidification exacerbates the effect of UV radiation on the calcifying phytoplankter Emiliania huxleyi

Increasing atmospheric CO2 concentration affects calcification in most planktonic calcifiers. Both reduced or stimulated calcification under high CO2 have been reported in the widespread coccolithophore Emiliania huxleyi. This might affect the response of cells to photosynthetically active radiation ( PAR; 400-700 nm) and ultraviolet radiation (UVR; 280-400 nm) by altering the thickness of the coccolith layer. Here we show that in the absence of UVR, the calcification rates in E. huxleyi decrease under lowered pH levels (pH(NBS) of 7.9 and 7.6; pCO(2) of 81 and 178 Pa or 804 and 1759 ppmv, respectively) leading to thinned coccolith layers, whereas photosynthetic carbon fixation was slightly enhanced at pH 7.9 but remained unaffected at pH 7.6. Exposure to UVR (UV-A 19.5 W m(-2), UV-B 0.67 W m(-2)) in addition to PAR (88.5 W m(-2)), however, results in significant inhibition of both photosynthesis and calcification, and these rates are further inhibited with increasing acidification. The combined effects of UVR and seawater acidification resulted in the inhibition of calcification rates by 96% and 99% and that of photosynthesis by 6% and 15%, at pH 7.9 and 7.6, respectively. This differential inhibition of calcification and photosynthesis leads to significant reduction of the ratio of calcification to photosynthesis. Seawater acidification enhanced the transmission of harmful UVR by about 26% through a reduction of the coccolith layer of 31%. Our data indicate that the effect of a high-CO2 and low-pH ocean on E. huxleyi ( because of reduced calcification associated with changes in the carbonate system) enhances the detrimental effects of UVR on the main pelagic calcifier.National Basic Research Program of China [2009CB421207]; National Natural Science Foundation of China [40676063, 40876058]; Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET, Argentina) ; Shantou University and by the European Project on Ocean Acidification (EPOCA), through the European Community's 7th Framework Programme [211384

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH

Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached$8. 8 trillion (95% uncertainty interval UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this,$13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and$1.4 billion was repurposed from existing health projects. $3.1 billion (22.4$2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7$1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd

Ocean acidification exacerbates the effect of UV radiation on the calcifying phytoplankter Emiliania huxleyi

Increasing atmospheric CO2 concentration affects calcification in most planktonic calcifiers. Both reduced or stimulated calcification under high CO2 have been reported in the widespread coccolithophore Emiliania huxleyi. This might affect the response of cells to photosynthetically active radiation ( PAR; 400-700 nm) and ultraviolet radiation (UVR; 280-400 nm) by altering the thickness of the coccolith layer. Here we show that in the absence of UVR, the calcification rates in E. huxleyi decrease under lowered pH levels (pH(NBS) of 7.9 and 7.6; pCO(2) of 81 and 178 Pa or 804 and 1759 ppmv, respectively) leading to thinned coccolith layers, whereas photosynthetic carbon fixation was slightly enhanced at pH 7.9 but remained unaffected at pH 7.6. Exposure to UVR (UV-A 19.5 W m(-2), UV-B 0.67 W m(-2)) in addition to PAR (88.5 W m(-2)), however, results in significant inhibition of both photosynthesis and calcification, and these rates are further inhibited with increasing acidification. The combined effects of UVR and seawater acidification resulted in the inhibition of calcification rates by 96% and 99% and that of photosynthesis by 6% and 15%, at pH 7.9 and 7.6, respectively. This differential inhibition of calcification and photosynthesis leads to significant reduction of the ratio of calcification to photosynthesis. Seawater acidification enhanced the transmission of harmful UVR by about 26% through a reduction of the coccolith layer of 31%. Our data indicate that the effect of a high-CO2 and low-pH ocean on E. huxleyi ( because of reduced calcification associated with changes in the carbonate system) enhances the detrimental effects of UVR on the main pelagic calcifier

Motility and photosynthetic responses of the green microalga Tetraselmis subcordiformis to visible and UV light levels

To test the effects of photosynthetic active radiation (PAR, 400-700 nm) and ultraviolet radiation (UVR, 280-400 nm) on phototaxis and photosynthesis of free swimming microalgae, experiments were performed with Tetraselmis subcordiformis (Wille) Butcher under a solar simulator. In particular, we evaluated the effects of different PAR levels and radiation regimes (i.e., PAR only and PAR+UVR) on those two processes. We found that the cells preferred to move to a particular area (e.g., receiving 100 W m(-2) PAR) with little photochemical suppression or inhibition of carbon fixation. Adding UV-A to high PAR decreased its swimming capacity and photosynthetic capability, and further adding UV-B led to more inhibition. The suppression of the moving capability of T. subcordiformis was reversible but the cells exposed to PAR combined with UVR needed longer time intervals to recover their motility as compared with those irradiated only with PAR. Based on the above results, we postulate that in nature, the motile capability and photosynthesis of free swimming the green microalga might be impaired by enhanced solar UVR. On the other hand, the cells can reduce the damage caused by high irradiances (and even get the optimum light level for photosynthesis) by a behavioral swimming response.National Natural Science Foundation [40930846, 41120164007]; Program for Changjiang Scholars and Innovative Research Team [IRT0941]; China-Japan collaboration project from MOST [S2012GR0290]; Shanghai Municipal Natural Science Foundation [11ZR1449900]; visiting professor program for State Key Laboratory of Marine Environmental Science, Xiamen University [MELRS0919]; Ministry of Educatio

Ocean Acidification Alters the Photosynthetic Responses of a Coccolithophorid to Fluctuating Ultraviolet and Visible Radiation

National Basic Research Program of China [2009CB421207, 2011CB200902]; National Natural Science Foundation [40930846, 41120164007]; Program for Changjiang Scholars and Innovative Research Team [IRT0941]; China-Japan Collaboration Project from the Ministry of Science and Technology [S2012GR0290]; Chinese Ministry of Education [111]; State Key Laboratory of Marine Environmental Science Visiting Scientist ProgramMixing of seawater subjects phytoplankton to fluctuations in photosynthetically active radiation (400-700 nm) and ultraviolet radiation (UVR; 280-400 nm). These irradiance fluctuations are now superimposed upon ocean acidification and thinning of the upper mixing layer through stratification, which alters mixing regimes. Therefore, we examined the photosynthetic carbon fixation and photochemical performance of a coccolithophore, Gephyrocapsa oceanica, grown under high, future (1,000 mu atm) and low, current (390 mu atm) CO2 levels, under regimes of fluctuating irradiances with or without UVR. Under both CO2 levels, fluctuating irradiances, as compared with constant irradiance, led to lower nonphotochemical quenching and less UVR-induced inhibition of carbon fixation and photosystem II electron transport. The cells grown under high CO2 showed a lower photosynthetic carbon fixation rate but lower nonphotochemical quenching and less ultraviolet B (280-315 nm)-induced inhibition. Ultraviolet A (315-400 nm) led to less enhancement of the photosynthetic carbon fixation in the high-CO2-grown cells under fluctuating irradiance. Our data suggest that ocean acidification and fast mixing or fluctuation of solar radiation will act synergistically to lower carbon fixation by G. oceanica, although ocean acidification may decrease ultraviolet B-related photochemical inhibition

Vertical mixing within the epilimnion modulates UVR-induced photoinhibition in tropical freshwater phytoplankton from southern China

1. The importance of vertical mixing in modulating the impact of UVR on phytoplankton photosynthesis was assessed in a tropical, shallow lake in southern China from late winter to mid-spring of 2005. 2. Daily cycles of fluorescence measurements (i.e. photosynthetic quantum yield, Y) were performed on both 'static' and in situ samples. Static samples were of surface water incubated at the surface of the lake under three radiation treatments - PAB (PAR + UVR, 280-700 nm), PA (PAR + UV-A, 320-700 nm) and P (PAR, 400-700 nm). In situ samples were collected every hour at three different depths - 0, 0.5 and 1 m. 3. The general daily pattern was of a significant decrease in Y from early morning towards noon, with partial recovery in the afternoon. Samples incubated under static conditions always had lower Y than those under in situ conditions at the same time of the day. 4. Under stratified conditions, no overall impact of UVR impact could be detected in situ when compared with the static samples. Further rapid vertical mixing not only counteracted the impact of UVR but also stimulated photosynthetic efficiency. 5. Based on these measurements of fluorescence, the mixing speed of cells moving within the epilimnion was estimated to range between 0.53 and 6.5 cm min(-1). 6. These data show that mixing is very important in modulating the photosynthetic response of phytoplankton exposed to natural radiation and, hence, strongly conditions the overall impact of UVR on aquatic ecosystems.1. The importance of vertical mixing in modulating the impact of UVR on phytoplankton photosynthesis was assessed in a tropical, shallow lake in southern China from late winter to mid-spring of 2005

Variability of UVR effects on photosynthesis of summer phytoplankton assemblages from a tropical coastal area of the South China Sea

From June to September 2005, we carried out experiments to determine the ultraviolet radiation (UVR) -induced photoinhibition of summer phytoplankton assemblages from a coastal site of the South China Sea. Variability in taxonomic composition was determined throughout the summer, with a peak chlorophyll a (chl a similar to 20 mu g chl a L-1) dominated by the diatom Skeletonema costatum that was detected early in the study period; the rest of the time samples were characterized by monads and flagellates, with low chi a values (1-5 chl a mu g L-1). Surface water samples were placed in quartz tubes, inoculated with radiocarbon and exposed to solar radiation for 2-3 h to determine photosynthetic rates under three quality radiation treatments (i.e. PAB, 280-700 nm; PA, 320-700 nm and P, 400-700 nm) using different filters and under seven levels of ambient irradiance using neutral density screens (P vs E curves). UVR inhibition of samples exposed to maximum irradiance (i.e. at the surface) varied from -12.2% to 50%, while the daytime-integrated UVR-related photoinhibition in surface seawater varied from -62% to 7%. The effects of UVR on the photosynthetic parameters p(max)(B) and E-k were also variable, but UV-B accounted for most of the observed variability. During sunny days, photosynthesis of microplankton ( > 20 mu m) and piconanoplankton ( < 20 mu m) were significantly inhibited by UVR (mostly by UV-B). However, during cloudy days, while piconanoplankton cells were still inhibited by UVR, microplankton cells used UVR (mostly UV-A) as the source of energy for photosynthesis, resulting in higher carbon fixation in samples exposed to UVR than the ones exposed only to photosynthetically active radiation (PAR). Our results indicate that size structure and cloudiness clearly condition the overall impact of UVR on phytoplankton photosynthesis in this tropical site of South China. In addition, model predictions for this area considering only PAR for primary production might have underestimated carbon fixation due to UVR contribution

Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

BackgroundThe rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020.MethodsWe estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050.FindingsIn 2019, health spending globally reached$8·8 trillion (95% uncertainty interval [UI] 8·7–8·8) or $1132 (1119–1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40·4 billion (0·5%, 95% UI 0·5–0·5) was development assistance for health provided to low-income and middle-income countries, which made up 24·6% (UI 24·0–25·1) of total spending in low-income countries. We estimate that $54·8 billion in development assistance for health was disbursed in 2020. Of this,$13·7 billion was targeted toward the COVID-19 health response. $12·3 billion was newly committed and$1·4 billion was repurposed from existing health projects. $3·1 billion (22·4$2·4 billion (17·9%) was for supply chain and logistics. Only $714·4 million (7·7$1519 (1448–1591) per person in 2050, although spending across countries is expected to remain varied.InterpretationGlobal health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all.</h4

Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000–2018

Background: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA