Long-term Changes Research Articles

Climate resilience of urban water systems: A case study of sponge cities in China

Resilience is an important aim of climate adaptation in urban development planning. Since 2015, sponge city (SC) pilot construction in China has highlighted the importance of urban water systems, but has paid insufficient attention to extreme and long-term climate change risks. This paper aims to provide a new method for evaluating the urban water system climate resilience (UWSCR), classify China cities in combination with climate hazards, conduct case studies on SC pilots, and propose ways to improve the UWSCR in SCs. Firstly, Taking heavy rain and drought as hazards, an evaluation index system of UWSCR is established, including engineering resilience (ENR), ecological resilience (ECR) and evolutionary resilience (EVR). A combination model based on the analytic hierarchy process and entropy weight method is used to measure the UWSCR of 27 SC pilot cities and 253 non-pilot cities at or above the prefecture level in China. Secondly, coordinating hazard index and UWSCR index, cities are divided into four types. The results show that the ENR and EVR of SC pilots exhibited an increasing trend from 2010 to 2020 and were greater than those of non-pilots. Among the four types, Resilient Cities and Low Risk Cities with high climate resilience (CR) were mainly distributed in the eastern and central regions of China. High Risk Cities and Vulnerable Cities with low CR were mostly distributed in the central and western regions. Among the cities of high CR, SC pilots accounted for 63.0% of the pilot samples, while non-pilots only accounted for 26.5% of the non-pilot samples. Finally, this paper analyzes the typical cases of SC pilots, and puts forward some suggestions, such as considering the UWSCR systematically and holistically, improving the ECR of UWSCR, making medium-term to long-term adaptation planning and providing differentiated policy support. The originality of this work is to identify four types of cities from the perspective of UWSCR and provide reference for improving the CR of SCs.

Trained innate immunity modulates osteoblast and osteoclast differentiation

Macrophages are key regulators in bone repair and regeneration. Recent studies have shown that long-term epigenetic changes and metabolic shifts occur during specific immune training of macrophages that affect their functional state, resulting in heightened (trained) or reduced (tolerant) responses upon exposure to a second stimulus. This is known as innate immune memory. Here, we study the impact of macrophages’ memory trait on osteoblast differentiation of human mesenchymal stromal cells (hMSCs) and osteoclast differentiation. An in vitro trained immunity protocol of monocyte-derived macrophages was employed using inactivated Candida albicans and Bacillus Calmette–Guérin (BCG) to induce a ‘trained’ state and Pam3CSK4 (PAM) and Lipopolysaccharides (LPS) to induce a ‘tolerance’ state. Macrophages were subsequently cocultured with hMSCs undergoing osteogenic differentiation during either resting (unstimulated) or inflammatory conditions (restimulated with LPS). Alkaline phosphatase activity, mineralization, and cytokine levels (TNF, IL-6, oncostatin M and SDF-1α) were measured. In addition, macrophages underwent osteoclast differentiation. Our findings show that trained and tolerized macrophages induced opposing results. Under resting conditions, BCG-trained macrophages enhanced ALP levels (threefold), while under inflammatory conditions this was found in the LPS-tolerized macrophages (fourfold). Coculture of hMSCs with trained macrophages showed mineralization while tolerized macrophages inhibited the process under both resting and inflammatory conditions. While osteoclast differentiation was not affected in trained-macrophages, this ability was significantly loss in tolerized ones. This study further confirms the intricate cross talk between immune cells and bone cells, highlighting the need to consider this interaction in the development of personalized approaches for bone regenerative medicine.Graphical

Changes in Sea Level along the South China Sea Coast Based on the Homogenized Tide Gauge Data

To estimate the changes in the annual mean sea level (MSL) and extreme sea levels (ESLs), the largest collection of tide gauge records from 10 tidal stations along the northern coast of the South China Sea (SCS) were analyzed in this study. Here, all the tide gauge records had been homogenized by a two-step process involving the detection of inhomogeneities, that is, breakpoints caused by non-climatic changes and the application of the adjustment. The study’s conclusions, based on the homogenized tide gauge records, can be summarized as follows: The instrument change and station relocation are the main causes for the identified inhomogeneities. From 1989 to 2018, the sea level along the SCS was at an average rate of 4.0 mm per year, as measured by the homogenized tide gauges. The ESLs from the nine tidal stations rose notably with interannual fluctuations, except for the XSA station. Additionally, the ESLs exhibited substantial decadal variations. The ESLs rose along the northern coast of the SCS and were accelerated at most stations throughout the whole study period, especially after the 1980s. There were significant positive correlations between the ESL and the annual MSL at most tide gauges. The MSL’s changes, especially long-term changes, play an important role in the change in ESLs.

Changes in bryophyte functional composition during post-fire succession

Climate and land-use changes are altering fire regimes in many regions around the world. To date, most studies have focused on the effects of altered fire regimes on woody and herbaceous communities, while the mechanisms driving post-fire bryophyte succession remain poorly understood, particularly in Mediterranean-type ecosystems. Here, we examined changes in bryophyte functional composition along a post-fire chronosequence (ranging from 1 to 20+ years) in Pyrenean oak woodlands (northeastern Portugal). To do so, we defined bryophyte functional groups based on seven morphological, reproductive, and life history traits. Then, we fitted linear and structural equation models to disentangle the direct and indirect effects of fire (time since fire and fire intensity), vegetation structure, climate, topography, and edaphic conditions on the abundance of each group. We identified two main functional groups: early colonizers (species with traits associated with strong colonization ability and desiccation tolerance) and perennial stayers (species with high competitive ability, i.e., large perennial mosses). Overall, the abundance of early colonizer species decreased with time since fire and increased with fire intensity, while the opposite was observed for perennial stayers. Thus, successional dynamics reflected a trade-off between species' competitive and colonization abilities, highlighting the role of biotic interactions later in succession. Patterns of functional composition were also consistent with changes in environmental conditions during succession, suggesting that species may experience stressful conditions (i.e., high radiation and low water availability) in early stages of post-fire succession. Our results also indicate that increased fire intensity may alter successional trajectories, leading to long-term changes in bryophyte communities. By understanding the response of bryophyte communities to fire, we were able to identify species with potential use as soil restoration materials.

A clinical study on the risk and safety profiles of NSAIDs used for osteoporotic fractures in Chinese patients with rheumatoid arthritis

Purpose: To investigate the risk and safety profile of non-steroidal anti-inflammatory drugs (NSAIDs) for osteoporotic fractures in patients with rheumatoid arthritis (RA). 
 Methods: 298 RA patients admitted to The First People's Hospital of Huzhou, Huzhou, China from August 2020 to September 2022, were investigated. Patients were assigned to groups based on drugs used viz: control group received anti-rheumatic drugs other than NSAIDs; corticosteroid group received dexamethasone, disease-modifying anti-rheumatic drugs (DMARDs) groups received sulfasalazine, NSAID group received either diclofenac or ibuprofen etc. Each group of patients received the respective treatment frequently for at least 3 years. The primary outcome in this study was the incidence of osteoporotic fracture resulting from fragile bone and deterioration of bone mass. 
 Results: The incidence of osteoporotic fracture was highest in NSAID group (11.58 %) when compared to 5.44, 4.96, and 2.36 % in the corticosteroid, DMARD and control groups, respectively (p < 0.05). This shows that users of NSAIDs had a 5-fold higher risk of osteoporotic fracture than patients in control group (OR = 1.26 (95 % CI: 1.22 - 1.81)) and 2-fold possibility of osteoporotic fracture when compared to corticosteroid users ((OR = 1.46 (95 % CI: 1.57 - 2.32)) and DMARD users (1.83 (95 % CI: 1.26 - 1.67)). 
 Conclusion: Rheumatoid arthritis patients on NSAIDs such as celecoxib, diclofenac, ibuprofen, indomethacin, and oxaprozin are at risk of developing osteoporotic fracture. Therefore, NSAIDs must be used with proper counseling in RA patients to minimize the risk of osteoporotic fracture. In future, the study duration will need to be extended to determine the long-term effects and potential changes in bone properties.

Interprofessional collaboration skills and motivation one year after an interprofessional educational intervention for undergraduate medical and nursing students

BackgroundThe increasingly complex patient care in the twenty-first century is delivered by interprofessional health care teams. Interprofessional collaboration can be taught during interprofessional education. However, whether a long-term change in collaborative competencies can be achieved by interprofessional education has not been studied sufficiently. Our research questions were: How does motivation for interprofessional collaboration and interprofessional collaborative skills change up to one year after an interprofessional educational intervention? How are they related to each other?MethodsDuring a one-year period, undergraduate medical and nursing students attended four interprofessional (intervention) or uniprofessional (control group) education sessions. Self-determination Theory was used as the theoretical framework. Autonomous and controlled motivation scores for interprofessional collaboration were calculated using the Academic Self-Regulation Questionnaire, before (T1), directly after (T2) and one year post-intervention (T3). At T3, the students also filled out the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), which measured the perceived attainment of collaborative competencies by a retrospective pre-test/post-test design. We used linear mixed effects models to analyse the motivation scores and linear regression for the relation between motivation and competence.ResultsIn the interprofessional group, autonomous motivation scores of the participants were significantly lower at T2 vs. T1. Controlled motivation scores were significantly higher at T3 vs. T1. Controlled motivation scores for T2 were significantly higher in the uniprofessional group than in the interprofessional group. Perceived competence was related to higher autonomous motivation scores. At T3 the interprofessional collaborative competencies seemed to have grown more among students in the interprofessional group.ConclusionsThe perceived growth in interprofessional collaboration competence lasted at least up to one year after the intervention, and was measurable with the ICCAS. The growth was significantly more in the IPE students than in the UPE students. The few differences found in motivation scores for interprofessional collaboration were probably caused by an imbalance of nursing versus medical students over the different time points. This finding indicates that classroom based IPE can contribute to interprofessional collaboration skills of nursing and medical students at least up to one year after an intervention.

Understanding climate change dynamics in the Godavari middle sub-basin using parametric and non-parametric models

Climate change is considered a long-term change in precipitation, temperature and other meteorological variables. The pattern of meteorological variables is changing due to anthropogenic activities globally. Climate change has posed threat to natural and human systems. Thus, assessing and forecasting climate variability have become imperative for making resources sustainable and society resilient. This study examined trend and forecasted climate change using parametric and non-parametric methods in the Godavari Middle Sub-basin, India. Mann-Kendall and Sen's slope methods were utilized to analyze trend and magnitude of meteorological variables such as rainfall, maximum and minimum temperature, mean wind speed, mean evaporation and relative humidity. Forecasting of meteorological variables was carried out using the autoregressive integrated moving average (ARIMA) and seasonal autoregressive integrated moving average (SARIMA) models. Increasing trend in maximum and minimum temperature was observed at various level of significance. Decreasing trend was observed in mean evaporation at 0.05 level of significance. Decreasing trend in wind speed was also recorded in the sub-basin. February, March, April, June, October and December have shown increasing trend in relative humidity. Total monthly rainfall has shown decreasing trend in the south-eastern part of the sub-basin. Forecast of meteorological variables have also shown decrease in rainfall, increase in maximum and minimum temperature during 2017–2027 creating the sub-basin more prone to dry climate condition. Thus, a policy intervention-oriented climate action plan for lessening the impact of climate change is required in the sub-basin.

The hidden threat of heavy metal leaching in urban runoff: Investigating the long-term consequences of land use changes on human health risk exposure

This study evaluated the potential effects of long-term land use and climate change on the quality of surface runoff and the health risks associated with it. The land use change projection 2030 was derived from the main changes in land use from 2009 to 2019, and rainfall data was obtained from the Long Ashton Research Station Weather Generator (LARS-WG) model. The Long-Term Hydrological Impact Assessment (L-THIA) model was then utilized to calculate the rate of runoff heavy metal (HM) pollutant loading from the urban catchment. It was found that areas with heavy development posed a significantly greater public health risk associated with runoff, with higher risks observed in high-development and traffic areas compared to industrial, residential, and commercial areas. Additionally, exposure to Lead (Pb), Mercury (Hg), and Arsenic (As) was found to contribute significantly to overall non-carcinogenic health risks for possible consumers of runoff. Carcinogenic risk values of As, Cadmium (Cd), and Pb were also observed to increase, particularly in high-development and traffic areas, by 2030. This investigation offers important insight into the health risks posed by metals present in surface runoff in urban catchment areas under different land use and climate change scenarios.

Transition to a weaker Sun: Changes in the solar atmosphere during the decay of the Modern Maximum

The Sun experienced a period of unprecedented activity during the 20th century, now called the Modern Maximum (MM). The decay of the MM after its maximum in cycle 19 has changed the Sun, the heliosphere, and the planetary environments in many ways. However, studies disagree on whether this decay has proceeded synchronously in different solar parameters or not. One of the related key issues is if the relation between two long parameters of solar activity, the sunspot number and the solar 10.7\,cm radio flux, has remained the same during this decay. A recent study argues that there is an inhomogeneity in the 10.7\,cm radio flux in 1980, which leads to a step-like jump ("1980 jump") in this relation. If true, this result would reduce the versatility of possible long-term studies of the Sun during the MM. Here we aim to show that the relation between sunspot number and 10.7\,cm radio flux does indeed vary in time, not due to an inhomogeneous radio flux but due to physical changes in the solar atmosphere. We used radio flux measurements made in Japan at four different wavelengths, and studied their long-term relation with the sunspot number and the 10.7\,cm radio flux during the decay of MM. We also used two other solar parameters, the MgII index and the number of solar active regions, in order to study the nature of the observed long-term changes in more detail. We find that the 1980 jump is only the first of a series of 1-2-year "humps" that mainly occur during solar maxima. All five radio fluxes depict an increasing trend with respect to the sunspot number from the 1970s to 2010s. These results exclude the interpretation of the 1980 jump as an inhomogeneity in the 10.7\,cm flux, and reestablish the 10.7\,cm flux as a homogeneous measure of solar activity. The fluxes of the longer radio waves are found to increase with respect to the shorter waves, which suggests a long-term change in the solar radio spectrum. We also find that the MgII index of solar UV irradiance and the number of active regions also increased with respect to the sunspot number, further verifying the difference in the long-term evolution in chromospheric and photospheric parameters. Our results provide evidence for important structural changes in solar magnetic fields and the solar atmosphere during the decay of the MM, which have not been reliably documented so far. We also emphasize that the changing relation between the different (e.g., photospheric and chromospheric) solar parameters should be taken into account when using the sunspot number or any single parameter in long-term studies of solar activity.

A multi-residency elective to address well-being as a systems issue

What was the educational challenge? Burnout is a well-established issue in medical training, but optimal systems approaches for well-being and ways to engage residents in well-being work are unknown. What was the solution? The authors developed a multi-residency well-being elective with participants from internal medicine, anesthesiology, and urology residency programs. The elective included an asynchronous learning curriculum, a mentored independent project on system drivers of well-being, and participation in a cross-residency group that set elective priorities. How was the solution implemented? The authors worked with each residency’s leadership to protect time for participation. Concepts from Quality Improvement were used to structure the elective. Project work and resident participation were assessed continually to monitor engagement. What lessons were learned that are relevant to a wider global audience? Projects led to short- and long-term changes to support well-being in residency programs. Creating opportunities for residents from different specialties to discuss well-being work allowed ideas to spread across residencies. Protecting time to work on well-being issues may enhance a culture of well-being by demonstrating commitment to well-being as a priority equivalent to other educational endeavors. What are next steps? Further research is needed to assess the impact on resident participants and to understand how to optimally incorporate resident interventions into broader organizational strategies for well-being.

Prefrontal control of superior colliculus modulates innate escape behavior following adversity

Innate defensive responses, though primarily instinctive, must also be highly adaptive to changes in risk assessment. However, adaptive changes can become maladaptive, following severe stress, as seen in posttraumatic stress disorder (PTSD). In a series of experiments, we observed long-term changes in innate escape behavior of male mice towards a previously non-threatening stimulus following an adverse shock experience manifested as a shift in the threshold of threat response. By recording neural activity in the superior colliculus (SC) while phototagging specific responses to afferents, we established the crucial influence of input arriving at the SC from the medial prefrontal cortex (mPFC), both directly and indirectly, on escape-related activity after adverse shock experience. Inactivating these specific projections during the shock effectively abolished the observed changes. Conversely, optogenetically activating them during encounters controlled escape responses. This establishes the necessity and sufficiency of those specific mPFC inputs into the SC for adverse experience related changes in innate escape behavior.

Interannual Monitoring of Cropland in South China from 1991 to 2020 Based on the Combination of Deep Learning and the LandTrendr Algorithm

Timely and accurate acquisition of spatial distribution and changes in cropland is of significant importance for food security and ecological preservation. Most studies that monitor long-term changes in cropland tend to overlook the rationality in the process of cropland evolution, and there are conflicts between the interannual cropland data, so they cannot be used to analyze land use change. This study focuses on the rationality of annual identification results for cropland, considering the long-term evolution and short-term variations influenced by natural environmental changes and human activities. An approach for annual monitoring of cropland based on long time series and deep learning is also proposed. We acquired imagery related to cropland’s vegetation lush period (VLP) and vegetation differential period (VDP) from Landsat images on the Google Earth Engine (GEE) platform and used the ResUNet-a structural model for training. Finally, a long-time-series cropland correction algorithm based on LandTrendr is introduced, and interannual cropland maps of Guangdong Province from 1991 to 2020 were generated. Evaluating the cropland monitoring results in Guangdong Province every five years, we found an overall accuracy of 0.91–0.93 and a kappa coefficient of 0.80–0.83. Our results demonstrate good consistency with agricultural statistical data. Over the past 30 years, the total cropland area in Guangdong Province has undergone three phases: a decrease, significant decrease, and stabilization. Significant regional variations have also been observed. Our approach can be applied to long-time-series interannual cropland monitoring in the southern regions of China, providing valuable data support for the further implementation of cropland protection.

“Why am I still suffering?”: Experience of long-term fatigue and neurocognitive changes in oropharyngeal cancer survivors following (chemo)radiotherapy

BackgroundLate effects of cancer treatment, such as neurocognitive deficits and fatigue, can be debilitating. Other than head and neck–specific functional deficits such as impairments in swallowing and speech, little is known about survivorship after oropharyngeal cancer. This study examines the lived experience of fatigue and neurocognitive deficits in survivors of oropharyngeal squamous cell cancer and impact on their daily lives. MethodsThis work is part of the multicentre mixed method ROC-oN study (Radiotherapy for Oropharyngeal Cancer and impact on Neurocognition), evaluating fatigue and neurocognitive function in patients following radiotherapy +/- chemotherapy for oropharyngeal cancer and impact on quality of life. Semi-structured interviews were conducted in adults treated with radiotherapy (+/-chemotherapy) for oropharyngeal squamous cell carcinoma >/=24 months from completing treatment. Reflexive thematic analysis performed. Results21 interviews (11 men and 10 women; median age 58 years and median time post-treatment 5 years) were conducted and analysed, yielding six themes: (1) unexpected burden of fatigue, (2) noticing changes in neurocognitive function, (3) the new normal, (4) navigating changes, (5)insufficient awareness and (6)required support. Participants described fatigue that persisted beyond the acute post-treatment period and changes in neurocognitive abilities across several domains. Paid and unpaid work, emotions and mood were impacted. Participants described navigating the new normal by adopting self-management strategies and accepting external support. They reported lack of recognition of these late effects, being poorly informed and being unprepared. Follow-up services were thought to be inadequate. ConclusionsFatigue and neurocognitive impairment were frequently experienced by survivors of oropharyngeal cancer, at least two years after treatment. Patients felt ill-prepared for these late sequelae, highlighting opportunities for improvement of patient information and support services.

Long-term changes in water quality downstream of three abandoned metal mines

Abandoned metal mines pollute rivers with both acidic and circumneutral metal-rich waters, sometimes from well-mapped mines, but often from long-abandoned adits with limited historical records. Changes in water quality over the monitored timescales were calculated for three mines across Wales (Nantymwyn, Parys Mountain and Frongoch), each abandoned since the early 20th century. Using all available spot sampling data provided by the environmental regulator, it was found that there was a sustained input of metals to the receiving watercourses with no or limited reduction in the concentrations from the mines without remediation, despite the passage of time and impacts of weathering. At Nantymwyn, comparison with five months’ sampling in 2019 showed no significant change (p > 0.05) in metal concentrations compared to the same months in 1985. Parys Mountain showed an increase in filtered zinc concentrations of 2 % between 2004 and 2020. At Frongoch, however, a substantial reduction in its environmental impact was observed after remediation, including a 90 % reduction in total lead concentrations. Realisation that the pollution from these sites does not reduce over the decades since abandonment should galvanize the resolve to understand the highest priority sites, and where possible remediate them.

Relationship between long-term visual function and the ratio of foveal avascular zone area in eyes with macular hole and healthy fellow eyes.

This study is to investigate the relationship between long-term changes in the foveal avascular zone (FAZ) and visual function of eyes with macular hole (MH) and compare the relationship between the FAZ of MH eyes and fellow eyes. This study included 31 patients with unilateral MH who underwent vitrectomy and their fellow eyes. Best-corrected visual acuity (BCVA) and metamorphopsia were measured preoperatively and at 1, 3, 6, and 12months postoperatively. We evaluated retinal parameters using optical coherence tomography (OCT) and the superficial FAZ using OCT angiography. The FAZ ratio was defined as follows: (preoperative FAZ area of the MH eye)/(FAZ area of the fellow eye). The preoperative FAZ area of MH eyes was 0.42 ± 0.08 mm2, which decreased to 0.24 ± 0.07 mm2 1month postoperatively (p < 0.001) and slightly increased to 0.25 ± 0.06 mm2 12months postoperatively (p = 1.000). The FAZ area did not differ significantly from that of fellow eyes (0.39 ± 0.06 mm2, p = 0.281). The FAZ area of MH eyes was not associated with visual function at any time point. The FAZ ratio showed a correlation with the preoperative, 6-month, and 12-month BCVA (r = 0.604, p < 0.001; r = 0.510, p = 0.003; and r = 0.475, p = 0.007, respectively). A larger FAZ in the MH eye than that in the fellow eye is associated with poorer long-term visual acuity. The preoperative comparison of the FAZ of the MH eye with that of the fellow eye may be a biomarker for predicting long-term visual acuity.

Japanese honey bees (Apis cerana japonica) have swarmed more often over the last two decades

The impacts of temperature increase are a concern for honey bees, which are major pollinators of crops and wild plants. Swarming is the reproductive behavior of honey bees that increases colony numbers. Honey bee colonies sometimes swarm multiple times, with each swarming termed a “swarming event” and a series of these events called a “swarming cycle.” The number of swarming events per swarming cycle varies widely depending on climatic conditions and subspecies, and the recent temperature increase due to global warming might be affecting the number of swarming events per swarming cycle of native honey bees. We clarified long-term changes in the number of swarming events per swarming cycle of Japanese honey bees (Apis cerana japonica) by collecting beekeepers’ swarming logbooks. The survey showed that between 2000 and 2022, Japanese honey bees swarmed 1 to 8 times per swarming cycle. Generalized linear model analysis indicated that year had a significant positive effect (coefficient, 0.03; 95% CI, 0.01–0.04); that is, the number of swarming events per swarming cycle showed a moderate increase over time. In addition, we found that colonies swarmed more often in a cycle when the swarming process began in early spring, especially in March. Considering the notably strong trend in Japan of warmer temperatures in March, the number of swarming events per swarming cycle may be increasing because reproduction is beginning earlier in the year. Further analyses are needed to verify the causal relationship of temperature increase on the number of swarming events per swarming cycle.

Changes in glacier surface temperature across the Third Pole from 2000 to 2021

Glacier surface temperature is not only an important indicator of climate change, but is also directly related to glacier physical processes and mass balance. Glaciers over the Third Pole have shown heterogeneous but accelerated mass loss over the past two decades. However, few studies have focused on changes of glacier surface temperature in this region. In this study, we investigate this change from 2000 to 2021 using an altitudinal area-weighting method based on Landsat surface temperature products. The results show that this method can robustly derive inter-annual variability and long-term trends of subregional glacier surface temperature. Over the entire Third Pole, glacier surfaces exhibited warming at the rate of +0.17 ± 0.35 °C dec−1 (p = 0.32). The warming had a distinct seasonal pattern: warming in autumn (+0.50 ± 0.53 °C dec−1, p = 0.06) but cooling in spring (−0.22 ± 0.36 °C dec−1, p = 0.23). Correspondingly, the ablation season 0 °C isotherm altitude has risen >100 m and the glacier area with GST ≥0 °C has expanded by 10%. Moreover, the GST changes displayed large spatial heterogeneity. In the westerlies-dominated regions (e.g., Karakoram and Kun Lun), glacier surfaces showed slight warming or even cooling on average (from −0.10 to +0.06 °C dec−1), while in the monsoon-dominated regions (e.g., East Himalaya, Southeast Tibetan Plateau and Hengduan Mountains), strong warming was observed (> +0.50 °C dec−1, p < 0.05). Glacier surfaces generally showed a faster warming at north slopes than south slopes, especially in the ablation season. These results emphasize that different magnitudes of glacier surface warming are important indicators for the contrasting glacier changes over the Third Pole. The method presented here opens the way to investigate long-term surface temperature change of global mountain glaciers, which can help us further understand the mechanisms of glacier response to global climate change.

Environmental DNA identifies coastal plant community shift 1,000 years ago in Torrens Island, South Australia

Anthropogenic activities are causing detrimental changes to coastal plants– namely seagrass, mangrove, and tidal marshes. Looking beyond recent times to past vegetation dynamics is critical to assess the response and resilience of an environment to change. Here, we develop a high-resolution multi-proxy approach, providing a new evidence base to decipher long-term change in coastal plant communities. Combining targeted environmental DNA analysis with chemical analysis of soils, we reconstructed 4,000 years of change at a temperate wetland on Torrens Island South Australia and identified an ecosystem shift that occurred ~ 1000 years ago. What was once a subtidal seagrass system shifted to an intertidal mangrove environment that persists at this site today. We demonstrate that high-resolution historical changes in coastal vegetation can be attained using these proxies. This approach could be applied to other ecosystems to improve the way we protect, conserve, and restore vegetated ecosystems.

Survival Among Patients With High-Risk Gastrointestinal Cancers During the COVID-19 Pandemic

Prior reports demonstrated that patients with cancer experienced worse outcomes from pandemic-related stressors and COVID-19 infection. Patients with certain malignant neoplasms, such as high-risk gastrointestinal (HRGI) cancers, may have been particularly affected. To evaluate disruptions in care and outcomes among patients with HRGI cancers during the COVID-19 pandemic, assessing for signs of long-term changes in populations and survival. This retrospective cohort study used data from the National Cancer Database to identify patients with HRGI cancer (esophageal, gastric, primary liver, or pancreatic) diagnosed between January 1, 2018, and December 31, 2020. Data were analyzed between August 23 and September 4, 2023. Trends in monthly new cases and proportions by stage in 2020 were compared with the prior 2 years. Kaplan-Meier curves and Cox regression were used to assess 1-year mortality in 2020 compared with 2018 to 2019. Proportional monthly trends and multivariable logistic regression were used to evaluate 30-day and 90-day mortality in 2020 compared with prior years. Of the 156 937 patients included in this study, 54 994 (35.0%) were aged 60 to 69 years and 100 050 (63.8%) were men. There was a substantial decrease in newly diagnosed HRGI cancers in March to May 2020, which returned to prepandemic levels by July 2020. For stage, there was a proportional decrease in the diagnosis of stage I (-3.9%) and stage II (-2.3%) disease, with an increase in stage IV disease (7.1%) during the early months of the pandemic. Despite a slight decrease in 1-year survival rates in 2020 (50.7% in 2018 and 2019 vs 47.4% in 2020), survival curves remained unchanged between years (all P > .05). After adjusting for confounders, diagnosis in 2020 was not associated with increased 1-year mortality compared with 2018 to 2019 (hazard ratio, 0.99; 95% CI, 0.97-1.01). The rates of 30-day (2.1% in 2018, 2.0% in 2019, and 2.1% in 2020) and 90-day (4.3% in 2018, 4.4% in 2019, and 4.6% in 2020) operative mortality also remained similar. In this retrospective cohort study, a period of underdiagnosis and increase in stage IV disease was observed for HRGI cancers during the pandemic; however, there was no change in 1-year survival or operative mortality. These results demonstrate the risks associated with gaps in care and the tremendous efforts of the cancer community to ensure quality care delivery during the pandemic. Future research should investigate long-term survival changes among all cancer types as additional follow-up data are accrued.

Association between sun exposure habits and disease progression in multiple sclerosis.

Higher latitude has been associated with increased occurrence of multiple sclerosis (MS) and with more severe disease. The aim was to study the impact of sun exposure habits on MS disease progression and health-related quality of life. Patients from a population-based case-control study were categorized based on sun exposure habits at diagnosis and were followed up to 15 years post-diagnosis through the Swedish MS registry (n = 3314) with regard to changes in Expanded Disability Status Scale (EDSS). Linear mixed models were used to analyse long-term changes, while Cox regression models, with 95% confidence intervals, were used to investigate outcomes, including 24-week confirmed diasability worsening, EDSS3, EDSS4, and physical worsening as measured by the physical component of the Multiple Sclerosis Impact Scale 29. Compared to average sun exposure (median value), low exposure to sunlight was associated with faster EDSS progression, increased risk of confirmed disability worsening (hazard ratio [HR] 1.48, 95% CI 1.21-1.81), increased risk of reaching EDSS 3 (HR 1.35, 95% CI 1.02-1.79), EDSS 4 (HR 1.47, 95% CI 1.01-2.20) and self-reported physical worsening (HR 1.27, 95% CI 1.00-1.62). Significant trends revealed a lower risk of unfavourable outcomes with increasing sun exposure. Very low levels of sun exposure are associated with worse disease progression and health-related quality of life in patients with MS.