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Cities are vital for achieving the Sustainable Development Goals (SDG), but different local strategies to advance on the same SDG may cause different ‘spillovers’ elsewhere. Research efforts that support governance of such spillovers are urgently needed to empower ambitious cities to ‘account globally’ when acting locally on SDG implementation strategies.

The fashion and textiles industry, and policymakers at all levels, are showing an increased interest in the concept of circular economy as a way to decrease business risks and negative environmental impacts. However, focus is placed mainly on the material ‘stuff’ of textile fashion and its biophysical harms. The current material focus has several shortcomings, because fashion is a social-ecological system and cannot be understood merely by addressing its environmental dimensions. In this paper, we rethink the fashion system from a critical social-ecological perspective. The driver-state-response framework shows social drivers and ecological impacts as an adaptive social-ecological system, exposing how these interacting aspects need to be addressed for sustainable and resilient implementation of circular economy. We show how current responses to global sustainability challenges have so far fallen short. Our overall aim is to expand possibilities for reframing responses that better reflect the complex links between the global fashion system, culture and creativity and the dynamics of the living planet. We argue that reducing planetary pressure from the global fashion and textiles industry requires greater recognition of the system’s social drivers with more emphasis on the many cross-scale links between social and ecological dimensions. Resilient decisions aiming for sustainable circularity of the fashion industry must therefore pay attention to social activities beyond the industry value chain, not just material flows within it. Funding: Open access funding provided by Stockholm University. The work presented here was part of a consortium research project between Stockholm Resilience Centre and the Ellen MacArthur Foundation, initiated and funded by H&M Group, the Swedish public limited company. Celinda Palm, Sarah Cornell and Tiina Häyhä’s employment was part-funded through this project.

Linking knowledge with action for effective societal responses to persistent problems of unsustainability requires transformed, more open knowledge systems. Drawing on a broad range of academic and practitioner experience, we outline a vision for the coordination and organization of knowledge systems that are better suited to the complex challenges of sustainability than the ones currently in place. This transformation includes inter alia: societal agenda setting, collective problem framing, a plurality of perspectives, integrative research processes, new norms for handling dissent and controversy, better treatment of uncertainty and of diversity of values, extended peer review, broader and more transparent metrics for evaluation, effective dialog processes, and stakeholder participation. We set out institutional and individual roadmaps for achieving this vision, calling for well-designed, properly resourced, longitudinal, international learning programs., Environmental Science & Policy, 28, ISSN:1462-9011, ISSN:1873-6416

Direct electrical stimulation of the brain is the gold standard technique used to define functional-anatomical relationships during neurosurgical procedures. Areas that respond to stimulation are considered “critical nodes” of circuits that must remain intact for the subject to maintain the ability to perform certain functions, like moving and speaking. Despite its routine use, the neurophysiology underlying downstream motor responses to electrical stimulation of the brain, such as muscle contraction or movement arrest, is poorly understood. Furthermore, varying and sometimes counterintuitive responses can be seen depending on how and where the stimulation is applied, even within the human primary motor cortex. Therefore, here we review relevant neuroanatomy of the human motor system, provide a brief historical perspective on electrical brain stimulation, explore mechanistic variations in stimulation applications, examine neurophysiological properties of different parts of the motor system, and suggest areas of future research that can promote a better understanding of the interaction between electrical stimulation of the brain and its function.

Increased efforts are required to prevent further losses to terrestrial biodiversity and the ecosystem services that it provides1,2. Ambitious targets have been proposed, such as reversing the declining trends in biodiversity3; however, just feeding the growing human population will make this a challenge4. Here we use an ensemble of land-use and biodiversity models to assess whether—and how—humanity can reverse the declines in terrestrial biodiversity caused by habitat conversion, which is a major threat to biodiversity5. We show that immediate efforts, consistent with the broader sustainability agenda but of unprecedented ambition and coordination, could enable the provision of food for the growing human population while reversing the global terrestrial biodiversity trends caused by habitat conversion. If we decide to increase the extent of land under conservation management, restore degraded land and generalize landscape-level conservation planning, biodiversity trends from habitat conversion could become positive by the mid-twenty-first century on average across models (confidence interval, 2042–2061), but this was not the case for all models. Food prices could increase and, on average across models, almost half (confidence interval, 34–50%) of the future biodiversity losses could not be avoided. However, additionally tackling the drivers of land-use change could avoid conflict with affordable food provision and reduces the environmental effects of the food-provision system. Through further sustainable intensification and trade, reduced food waste and more plant-based human diets, more than two thirds of future biodiversity losses are avoided and the biodiversity trends from habitat conversion are reversed by 2050 for almost all of the models. Although limiting further loss will remain challenging in several biodiversity-rich regions, and other threats—such as climate change—must be addressed to truly reverse the declines in biodiversity, our results show that ambitious conservation efforts and food system transformation are central to an effective post-2020 biodiversity strategy. To promote the recovery of the currently declining global trends in terrestrial biodiversity, increases in both the extent of land under conservation management and the sustainability of the global food system from farm to fork are required.

Earth system science (ESS) has identified worrying trends in the human impact on fundamental planetary systems. In this conceptual article, we discuss the implications of this research for business schools and management education (ME). We argue that ESS findings raise significant concerns about the relationship between business and nature and, consequently, a radical reframing is required to embed economic and social activity within the global sustainability of natural systems. This has transformative implications for ME. To illustrate this reframing, we apply the ESS lenses of social-ecological interdependence, multiscalar relations, environmental governance, and environmental values to the ME functional domains of institutional purpose, social context and engagement, pedagogical practice, curricular design, and research focus. Our work contributes to the literature on business education for sustainability and the business-society-nature nexus. We explore and apply key ESS findings and concepts, discuss normative implications of these ideas, and offer guidance on transformational pathways for business schools and ME.

Science is increasingly able to identify precautionary boundaries for critical Earth system processes, and the business world provides societies with important means for adaptive responses to global environmental risks. In turn, investors provide vital leverage on companies. Here, we report on our transdisciplinary science/business experience in applying the planetary boundaries framework (sensu Rockström et al., Ecol Soc 14, 2009) to define a boundary-compatible investment universe and analyse the environmental compatibility of companies. We translate the planetary boundaries into limits for resource use and emissions per unit of economic value creation, using indicators from the Carnegie Mellon University EIO‑LCA database. The resulting precautionary 'economic intensities' can be compared with the current levels of companies' environmental impact. This necessarily involves simplifying assumptions, for which dialogue between biophysical science, corporate sustainability and investment perspectives is needed. The simplifications mean that our translation is transparent from both biophysical and financial viewpoints, and allow our approach to be responsive to future developments in scientific insights about planetary boundaries. Our approach enables both sub‑industries and individual companies to be screened against the planetary boundaries. Our preliminary application of this screening to the entire background universe of all investable stock‑listed companies gives a selectivity of two orders of magnitude for an investment universe of environmentally attractive stocks. We discuss implications for an expanded role of environmental change science in the development of thematic equity funds.

Global change and governance scholars frequently highlight polycentricity as a feature of resilient governance, but both theoretical and empirical knowledge about features and outcomes of the concept are lacking at the global scale. Here we investigate the structural properties of governance of global nitrogen (N) and phosphorus (P) cycles, two processes in the ‘planetary boundaries’ framework. We have used a mixed-methods approach to institutional analysis, integrating polycentric theory with social network theory in environmental policy and legal studies. We include an actor collaboration case study, the Global Partnership on Nutrient Management (GPNM), to explore governance challenges associated with global N and P cycles. We set the scope for selection of relevant legal instruments using an overview of global N and P flows between Earth system ‘components’ (land, water, atmosphere, oceans, biosphere) and the major anthropogenic N and P perturbations. Our network analysis of citations of global N and P governance exposes the structural patterns of a loose network among the principal institutions and actors, in which legal instruments of the European Union serve as key cross-scale and cross-sectoral ‘gateways’. We show that the current international regimes in place for regulating N- and P-related issues represent a gap in governance at the global level. In addition, we are able to show that the emergence of GPNM provides synergies in this context of insufficient governance. The GPNM can be viewed as a structure of polycentric governance as it involves deliberate attempts for mutual adjustments and self-organised action.

Machine learning methods tend to outperform traditional statistical models at prediction. In the prediction of academic achievement, ML models have not shown substantial improvement over logistic regression. So far, these results have almost entirely focused on college achievement, due to the availability of administrative datasets, and have contained relatively small sample sizes by ML standards. In this article we apply popular machine learning models to a large dataset ($n=1.2$ million) containing primary and middle school performance on a standardized test given annually to Australian students. We show that machine learning models do not outperform logistic regression for detecting students who will perform in the `below standard' band of achievement upon sitting their next test, even in a large-$n$ setting., 15 pages, 2 tables, 6 figures. Note that previous versions of this paper contained an error in our codes. The error has been rectified and the paper substantially rewritten

Coherently addressing the 17 Sustainable Development Goals requires planning tools that guide policy makers. Given the integrative nature of the SDGs, we believe that integrative modelling techniques are especially useful for this purpose. In this paper, we present and demonstrate the use of the new System Dynamics based iSDG family of models. We use a national model for Tanzania to analyse impacts of substantial investments in photovoltaic capacity. Our focus is on the impacts on three SDGs: SDG 3 on healthy lives and well-being, SDG 4 on education, and SDG 7 on energy. In our simulations, the investments in photovoltaics positively affect life expectancy, years of schooling and access to electricity. More importantly, the progress on these dimensions synergizes and leads to broader system-wide impacts. While this one national example illustrates the anticipated impact of an intervention in one specific area on several SDGs, the iSDG model can be used to support similar analyses for policies related to all the 17 SDGs, both individually and concurrently. We believe that integrated models such as the iSDG model can bring interlinks to the forefront and facilitate a shift to a discussion on development grounded in systems thinking.

Life cycle assessment (LCA) can be used to translate the planetary boundaries (PBs) concept to the scale of decisions related to products. Existing PB-LCA methods convert quantified resource use and emissions to changes in the values of PB control variables. However, the control variable for the Land-system change PB, “area of forested land remaining”, is not suitable for use in LCA, since it is expressed at the beginning of an impact pathway and only covers forest biomes. At the same time, LCA approaches for modelling the biogeophysical impacts of land use and land-use change are immature and any interactions with other types of environmental impacts are lagging. Here, we propose how the assessment of Land-system change in PB-LCA can be improved. First, we introduce two control variables for application in LCA; surface air temperature and precipitation, and we identify corresponding provisional threshold values associated with state shifts in four comprehensive biome categories. Second, we propose simplified approaches suitable for modelling the impact of land use and land-use change in product life cycles on the values of these two control variables. Third, we propose how to quantify interactions between the PBs for Land-system change, Climate change and Freshwater use for a PB-LCA method. Finally, we identify several research needs to facilitate full implementation of our proposed approach.

Extreme weather events, such as the UK floods of 2007 and cold snap of 2010–2011, stress the importance of infrastructure systems' resilience for business continuity. The interconnected nature of critical national infrastructure and its component parts places demands on the approach used to deal with its subsequent complexity. Recognition of infrastructure as a complex adaptive system has led to the development of an innovative, systems-based methodology for sustainability assessment in the built environment. The methodology consists of a database of causal interactions which, when combined with a process, allows users to produce causal loop diagrams that identify unanticipated systemic behaviour, communicate risks, share knowledge, and identify systemic intervention points that minimise negative consequences and add value in a project context. The approach is applied to highlight the key characteristics of complex adaptive systems that critical national infrastructure exhibits and show how the technique can be used to increase infrastructure resilience and sustainability.

A transition to a decentralised, decarbonised energy system for the domestic sector is constrained by the difficulty of obtaining energy balance between fluctuating demand and the intermittent, non-dispatchable power supply delivered by most renewables. A microgrid system including a mix of renewable generation technologies, energy storage and demand response (DR) systems has been modelled using a linear programming approach, based on real world data of residential energy consumption and weather variables. This model allows the exploration of the effects of fluctuations in demand and supply, microgrid scale and configuration, energy management options and alternative optimisation criteria. The model demonstrates quantitatively that a mixed-renewables microgrid system can reduce demand fluctuations and improve energy balance. Peak demand hour fluctuations were reduced by up to 19% for a simulated microgrid containing 144 households with one renewable unit and four batteries per household, with a renewables mix of 83% photovoltaic (PV) panels and 17% wind turbines. With this system, the demand on macrogrid energy supply was reduced by 16%, CO2 emissions associated with energy use were reduced by 10% for all hours of operation, and by 74% during the hours of renewable supply. These findings suggest that microgrids using contemporary technologies can contribute significantly to CO2 mitigation targets.

The Integrated History and future of People on Earth (IHOPE) initiative is a global network of researchers and research projects with its International Program Office (IPO) now based at the Stockho ...

Complex Earth system models, and their various sub-components, are not yet subject to rigorous evaluation against observations as much as they should be, despite the existence of hundreds of proposed diagnostics. A concerted process is urgently needed to make this the norm, not the exception. Earth Observation, field observations and palaeo data can be applied to contexts as diverse as wildfire, marine ecosystems, the land carbon cycle, and greenhouse gases. Model evaluation (by comparing models and benchmark data) and model weighting (defining the ‘quality’ of models on the basis of such a comparison) should be considered as separate issues. Systematic approaches to parameter optimization, such as the adjoint technique, allow structural differences between models to be identified and limitations to be addressed. Such methods are established in atmospheric tracer transport and carbon cycling; research carried out in the QUEST programme has demonstrated their applicability for climate modelling. Although it is impossible to devise a foolproof metric for the ability of models to predict the future, relevant metrics could be based on their ability to simulate the past. Furthermore, it should be possible to extend parameter optimization techniques to assimilate data from the past. There are limits to what can be achieved by benchmarking against a mean state, when it is a change in state that is of greatest interest. It is useful to benchmark individual processes rather than aggregate properties. Coupling good components does not automatically result in a good Earth System model, so for complex models, a two-stage process is needed: first, benchmarking the components in stand-alone mode, and second, using the same benchmarks in coupled mode.

Contemporary increases in atmospheric carbon dioxide concentration are in large part the result of anthropogenic carbon dioxide emissions from fossil fuel combustion. Scenario analysis is commonly used to generate projections of future carbon dioxide emissions, the resulting atmospheric concentrations and climate impact. In most scenario modelling published to date, carbon dioxide emission scenarios are based on demand-side (socioeconomic and technology) factors. The fossil fuel resource is assumed ample enough that supply-side factors do not drive future emission scenarios. This review of the literature on non-renewable resource extraction rate modelling and empirical studies of the global fossil fuel resource base suggests this assumption is unsafe. Supply-side factors can be expected to drive extraction rates and therefore carbon dioxide emissions as fossil fuel resources become significantly depleted. It is likely that the future carbon dioxide emission trajectory will become dominated by supply-side factors during the 21st century. By omitting this possibility, most scenario analysis is too narrow. An implication of such narrow scenario analysis is that policy driven by the UNFCCC‟s agreement to “avoid dangerous climate change” targets only demand-side factors to the exclusion of supply-side factors. As supply-side factors come to drive the carbon dioxide emission trajectory, policy focus should switch from demand-side factors to supply-side factors.

The concept of ecosystem services is proliferating rapidly in research and policy world- wide and holds strong appeal as a bridging concept between the natural world and society. In apply- ing the concept, we should remain alert to some 'health warnings' from previous experience in envi- ronmental economics. (1) The ecosystem services concept involves a narrowing of focus onto the money value of ecosystems. Researchers and practitioners should reflect on past efforts in integrative benefits analysis. (2) There can be a conceptual disconnection of value from function, particularly when there is a reliance on benefits transfer, yet the value of ecosystem services is conditional on a well-functioning whole ecosystem. (3) The problem of data paucity is stark. While inadequate data and the resulting uncertainty are ubiquitous problems in environmental decision-making, the pow- erful simplicity of one number—the estimated monetary value of a given ecosystem service—may mean that more nuanced precautionary considerations that normally apply in uncertain contexts are bypassed. New challenges arise because values (determined in the past) are applied to a changing and already resource-depleted world. Here I highlight the non-stationary nature of trends, the extent to which models are trusted and its role in uncertainty and risk, and the need for in-depth interdisci- plinary study. Some organisations have already entered into these meta-debates; examples are the joint Environment Agency/Quantifying and Understanding the Earth System (EA/QUEST) project on uplands and the Economic and Social Research Council-Natural Environment Research Council (ESRC-NERC) interdisciplinary workshop series in the UK, and, internationally, the Ecosystem Services Partnership. It is important that this debate is maintained and extended.

A team‐taught interdisciplinary undergraduate unit in Sustainable Development has been developed and run over the past two years at the University of Bristol. This has been a unique initiative for this university to take. As in most other research‐intensive higher education institutions, teaching generally follows rather traditional disciplinary conventions, operating within departmental bounds. The initiative was unusual – and indeed ambitious – enough to gain the Higher Education Environmental Performance Improvement (HEEPI) Green Gown Award in teaching for 2007 (HEEPI is a project supported by the Higher Education Founding Council for England; http://www.heepi.org.uk/green_gown_awards.htm). There are both challenges and pleasures in designing and delivering a team‐taught unit in a traditional university setting. This experience is outlined and evaluated here, giving consideration to both the practical and the more fundamentally philosophical issues encountered in the process.

Managed realignment—the deliberate process of realigning river, estuary or coastal defences—is increasingly seen as a key element to sustainable long term flood and coastal management in the UK and other parts of the world, given current trends of sea level rise, and increasing costs of flood and coastal defence. This paper presents results of an extensive consultation of key stakeholders in England and Wales on what they consider to be the main drivers, of and obstacles to, managed realignment. It reveals why managed realignment has not taken place on a larger scale so far, and suggests new directions for a long-term strategic approach to river and coastal flood management.

International audience; Ecosystem services are defined as the ecological and socio-economic value of goods and services provided by natural and semi-natural ecosystems. Ecosystem services are being impacted by many human induced stresses, one of them being nitrogen (N) deposition and its interactions with other pollutants and climate change. It is concluded that N directly or indirectly affects a wide range of provisioning, regulating, supporting and cultural ecosystem services, many of which are interrelated. When considering the effects of N on ecosystem services, it is important to distinguish between different types of ecosystems/species and the protection against N impacts should include other aspects related to N, in addition to biodiversity. The Working Group considered the following priorities of ecosystem services in relation to N: biodiversity; air quality/atmosphere; ecosystem changes; NO3 leaching; climate regulation and cultural issues. These are the services for which the best evidence is available in the literature. There is a conflicting interest between greenhouse gas ecosystem services and biodiversity protection; up to some point of increasing N inputs, net greenhouse gas uptake is improved, while biodiversity is already adversely affected.

Sarah E. Cornell - Stockholm Resilience Centre. I lead a transdisciplinary global sustainability research group at SRC, researching the “safe and just operating space for humanity”. We use models and observational evidence of global change to explore options, informing responses by policy, business and communities.

Preface 1. The Lund Meeting and the Production of this Book 2. Developing a Vision for the Planet 3. The Starting Point - Planet 2010 4. The Vision of 2050 5. Pathways between 2010 and 2050 6. Back to the Reality of 2010 and the Challenges Ahead

This thesis investigates community adaptation in two municipalities in Northern Norway. The two municipalities, Berg and Oksnes, were selected in order to understand how northern coastal communitie...

Special issue Contributions from Advances in Marine Ecosystem Modelling Research II 23-26 June 2008, Plymouth, UK.-- 15 pages, 7 figures, 1 table, The MarQUEST (Marine Biogeochemistry and Ecosystem Modelling Initiative in QUEST) project was established to develop improved descriptions of marine biogeochemistry, suited for the next generation of Earth system models. We review progress in these areas providing insight on the advances that have been made as well as identifying remaining key outstanding gaps for the development of the marine component of next generation Earth system models. The following issues are discussed and where appropriate results are presented; the choice of model structure, scaling processes from physiology to functional types, the ecosystem model sensitivity to changes in the physical environment, the role of the coastal ocean and new methods for the evaluation and comparison of ecosystem and biogeochemistry models. We make recommendations as to where future investment in marine ecosystem modelling should be focused, highlighting a generic software framework for model development, improved hydrodynamic models, and better parameterisation of new and existing models, reanalysis tools and ensemble simulations. The final challenge is to ensure that experimental/observational scientists are stakeholders in the models and vice versa, MarQUEST was funded by the Natural Environment Research Council (NERC) as a part of the Quantifying and Understanding the Earth System (QUEST) program

Jaramillo and Destouni claim that freshwater consumption is beyond the planetary boundary, based on high estimates of water cycle components, different definitions of water consumption, and extrapolation from a single case study. The difference from our analysis, based on mainstream assessments of global water consumption, highlights the need for clearer definitions of water cycle components and improved models and databases.

ESS2010 was the first Open Science Conference of the international collaborative initiative AIMES, and was convened and organized by QUEST, the UK's directed research programme for Earth System science. The conference showcased advances in Earth system modelling, deploying observations and process understanding to develop more quantitative and predictive understanding of the interactions of the climate system, the biosphere and the anthroposphere. These tools extend understanding of the system dynamics of biogeochemical cycles, and give perspectives on the relationships between climate, ecosystems and human needs. As Earth system science is a global research endeavour, and its remit has important societal and policy implications, a recurrent theme in the conference was the responsibility of scientists working on knowledge integration in the global environmental change context.

The development of the post-2020 strategic plan for the Convention on Biological Diversity provides a vital window of opportunity to set out an ambitious plan of action to restore global biodiversity. The components of such a plan, including its goal, targets and some metrics, already exist and provide a roadmap to 2050.

This article is a contribution to the PAGES Focus 4 ‘Regional Integration’ theme. ABSTRACT: Humanity faces a major global challenge in achieving wellbeing for all while simultaneously ensuring that the biophysical processes and ecosystem services that underpin wellbeing are exploited within scientifically informed boundaries of sustainability. We propose a framework for defining the safe and just operating space for humanity that integrates social wellbeing into the original planetary boundaries concept (Rockström et al. 2009ab) for application at regional scales. We argue that such a framework can: (1) increase the policy impact of the boundaries concept as most governance takes place at the regional rather than planetary scale; (2) contribute to the understanding and dissemination of complexity thinking throughout governance and policy making; (3) act as a powerful metaphor and communication tool for regional equity and sustainability. We demonstrate the approach in two rural Chinese localities where we define the safe and just operating space that lies between an environmental ceiling and a social foundation from analysis of time series drawn from monitored and palaeoecological data and from social survey statistics respectively. Agricultural intensification has led to poverty reduction though not eradicated it but at the expense of environmental degradation. Currently the environmental ceiling is exceeded for degraded water quality at both localities even though the least well met social standards are for available piped water and sanitation. The conjunction of these social needs and environmental constraints around the issue of water access and quality illustrates the broader value of the safe and just operating space approach for sustainable development.

1. Unhealthy and unsustainably produced food poses a global risk to people and the planet. More than 820 million people have insufficient food and many more consume an unhealthy diet that contributes to premature death and morbidity. Moreover, global food production is the largest pressure caused by humans on Earth, threatening local ecosystems and the stability of the Earth system. 2. Current dietary trends, combined with projected population growth to about 10 billion by 2050, will exacerbate risks to people and planet. The global burden of non-communicable diseases is predicted to worsen and the effects of food production on greenhouse-gas emissions, nitrogen and phosphorus pollution, biodiversity loss, and water and land use will reduce the stability of the Earth system. 3. Transformation to healthy diets from sustainable food systems is necessary to achieve the UN Sustainable Development Goals and the Paris Agreement, and scientific targets for healthy diets and sustainable food production are needed to guide a Great Food Transformation. 4. Healthy diets have an appropriate caloric intake and consist of a diversity of plant-based foods, low amounts of animal source foods, unsaturated rather than saturated fats, and small amounts of refined grains, highly processed foods, and added sugars. 5. Transformation to healthy diets by 2050 will require substantial dietary shifts, including a greater than 50% reduction in global consumption of unhealthy foods, such as red meat and sugar, and a greater than 100% increase in consumption of healthy foods, such as nuts, fruits, vegetables, and legumes. However, the changes needed differ greatly by region. 6. Dietary changes from current diets to healthy diets are likely to substantially benefit human health, averting about 10·8–11·6 million deaths per year, a reduction of 19·0–23·6%. 7. With food production causing major global environmental risks, sustainable food production needs to operate within the safe operating space for food systems at all scales on Earth. Therefore, sustainable food production for about 10 billion people should use no additional land, safeguard existing biodiversity, reduce consumptive water use and manage water responsibly, substantially reduce nitrogen and phosphorus pollution, produce zero carbon dioxide emissions, and cause no further increase in methane and nitrous oxide emissions. 8. Transformation to sustainable food production by 2050 will require at least a 75% reduction of yield gaps, global redistribution of nitrogen and phosphorus fertiliser use, recycling of phosphorus, radical improvements in efficiency of fertiliser and water use, rapid implementation of agricultural mitigation options to reduce greenhouse-gas emissions, adoption of land management practices that shift agriculture from a carbon source to sink, and a fundamental shift in production priorities. 9. The scientific targets for healthy diets from sustainable food systems are intertwined with all UN Sustainable Development Goals. For example, achieving these targets will depend on providing high-quality primary health care that integrates family planning and education on healthy diets. These targets and the Sustainable Development Goals on freshwater, climate, land, oceans, and biodiversity will be achieved through strong commitment to global partnerships and actions. 10. Achieving healthy diets from sustainable food systems for everyone will require substantial shifts towards healthy dietary patterns, large reductions in food losses and waste, and major improvements in food production practices. This universal goal for all humans is within reach but will require adoption of scientific targets by all sectors to stimulate a range of actions from individuals and organisations working in all sectors and at all scales.

BackgroundRespiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity.MethodsPRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of pneumonia, endotracheal re-intubation, or death within 30 days after randomisation, assessed in the intention-to-treat population. Safety was assessed in all patients who received CPAP. The trial is registered with the ISRCTN registry, ISRCTN56012545.FindingsBetween Feb 8, 2016, and Nov 11, 2019, 4806 patients were randomly assigned (2405 to the CPAP group and 2401 to the usual care group), of whom 4793 were included in the primary analysis (2396 in the CPAP group and 2397 in the usual care group). 195 (8·1%) of 2396 patients in the CPAP group and 197 (8·2%) of 2397 patients in the usual care group met the composite primary outcome (adjusted odds ratio 1·01 [95% CI 0·81-1·24]; p=0·95). 200 (8·9%) of 2241 patients in the CPAP group had adverse events. The most common adverse events were claustrophobia (78 [3·5%] of 2241 patients), oronasal dryness (43 [1·9%]), excessive air leak (36 [1·6%]), vomiting (26 [1·2%]), and pain (24 [1·1%]). There were two serious adverse events: one patient had significant hearing loss and one patient had obstruction of their venous catheter caused by a CPAP hood, which resulted in transient haemodynamic instability.InterpretationIn this large clinical effectiveness trial, CPAP did not reduce the incidence of pneumonia, endotracheal re-intubation, or death after major abdominal surgery. Although CPAP has an important role in the treatment of respiratory failure after surgery, routine use of prophylactic post-operative CPAP is not recommended.FundingNational Institute for Health Research, Barts Charity, Intersurgical, Association of Anaesthetists, and Sapienza Università di Roma.

The story is about a family's Sunday outings. The family used to go to the port where the father stared at the oily waters in such a way that if he "were still alive he would perhaps still have before his eyes the oily water(. . .)." His look disquieted the daughters. At nightfall, the youngest daughter who enjoys the father's special favors, climbs on a high swivelling stool in one of the city's numerous bars. This, the father found amusing