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Despite faster-than-expected progress in clean energy technology deployment, global annual CO2 emissions have increased from 2020 to 2023. The feasibility of limiting warming to 1.5 °C is therefore questioned. Here we present a model intercomparison study that accounts for emissions trends until 2023 and compares cost-effective scenarios to alternative scenarios with institutional, geophysical and technological feasibility constraints and enablers informed by previous literature. Our results show that the most ambitious mitigation trajectories with updated climate information still manage to limit peak warming to below 1.6 °C (‘low overshoot’) with around 50% likelihood. However, feasibility constraints, especially in the institutional dimension, decrease this maximum likelihood considerably to 5–45%. Accelerated energy demand transformation can reduce costs for staying below 2 °C but have only a limited impact on further increasing the likelihood of limiting warming to 1.6 °C. Our study helps to establish a new benchmark of mitigation scenarios that goes beyond the dominant cost-effective scenario design.

How are rain forest photosynthesis and turbulent fluxes influenced by clouds? To what extent are clouds affected by local processes driven by rain forest energy, water, and carbon fluxes? These interrelated questions were the main drivers of the intensive field experiment CloudRoots-Amazon22 which took place at the Amazon Tall Tower Observatory (ATTO)/Campina supersites in the Amazon rain forest during the dry season, in August 2022. CloudRoots-Amazon22 collected observational data to derive cause–effect relationships between processes occurring at the leaf level up to canopy scales in relation to the diurnal evolution of the clear-to-cloudy transition. First, we studied the impact of cloud and canopy radiation perturbations on the subdiurnal variability of stomatal conductance. Stoma opening is larger in the morning, modulated by the cloud optical thickness. Second, we combined 1-Hz frequency measurements of the stable isotopologues of carbon dioxide and water vapor with measurements of turbulence to determine carbon dioxide and water vapor sources and sinks within the canopy. Using scintillometer observations, we inferred 1-min sensible heat flux that responded within minutes to the cloud passages. Third, collocated profiles of state variables and greenhouse gases enabled us to determine the role of clouds in vertical transport. We then inferred, using canopy and upper-atmospheric observations and a parameterization, the cloud cover and cloud mass flux to establish causality between canopy and cloud processes. This shows the need for a comprehensive observational set to improve weather and climate model representations. Our findings contribute to advance our knowledge of the coupling between cloudy boundary layers and primary carbon productivity of the Amazon rain forest.

Het project Klimaatadaptatie Open Teelten is in het leven geroepen om de landbouw te leren omgaan met de veranderingen in het klimaat. Dit project heeft als doel om in de akkerbouw de risico’s op opbrengstderving door extreme weersomstandigheden te verkleinen. Ook wordt er gewerkt aan een efficiënter gebruik van nutriënten en water, een verminderde afspoeling van nutriënten en pesticiden naar het oppervlaktewater en een verhoging van het rendement in de teelt van met name rooivruchten. Dit doel wordt bereikt door combinaties van maatregelen: verbetering van de bodemkwaliteit, teeltmaatregelen, een slimmere omgang met water en beter beregenen. Het project bestaat uit vier werkpakketten, die zich elk focussen op een bepaald aspect. Voor dit rapport wordt uitsluitend gefocust op werkpakket 4, dat zich richt op zuinig beregenen en waterkwaliteit in de teelt van zetmeelaardappelen. Binnen dit werkpakket wordt er gebruik gemaakt van verschillende waterkwaliteiten en wordt er gekeken naar het effect van die waterkwaliteit op de afsterving van bladeren en de opbrengst van het gewas. Daarnaast wordt er gebruikt gemaakt van verschillende beregeningsmethodes om zo zuinig mogelijk om te gaan met water: in dit project wordt er gebruikt gemaakt van druppelirrigatie, sproeiers en watersensoren.

The coastline of Sub-Saharan Africa hosts highly diverse fish communities of great conservation value, which are also key resources for local livelihoods. However, many costal ecosystems are threatened by overexploitation and their conservation state is frequently unknown due to their vast spatial extent and limited monitoring budgets. Here, we evaluated the potential of citizen science-based eDNA surveys to alleviate such chronic data deficiencies and assessed fish communities in Mozambique using two 12S metabarcoding primer sets. Samples were either collected by scientific personnel or trained community members and results from the two metabarcoding primers were combined using a new data merging approach. Irrespective of the background of sampling personnel, a high average fish species richness was recorded (38 ± 20 OTUs per sample). Individual sections of the coastline largely differed in the occurrence of threatened and commercially important species, highlighting the need for regionally differentiated management strategies. A detailed comparison of the two applied primer sets revealed an important trade-off in primer choice with MiFish primers amplifying a higher number of species but Riaz primers performing better in the detection of threatened fish species. This trade-off could be partly resolved by applying our new data-merging approach, which was especially designed to increase the robustness of multiprimer assessments in regions with poor reference libraries. Overall, our study provides encouraging results but also highlights that eDNA-based monitoring will require further improvements of, for example, reference databases and local analytical infrastructure to facilitate routine applications in Sub-Saharan Africa.

01 augustus 2023, Contains fulltext : 294962.pdf (Publisher’s version ) (Closed access), BACKGROUND AND PURPOSE: The hypo-FLAME trial showed that once-weekly (QW) focal boosted prostate stereotactic body radiotherapy (SBRT) is associated with acceptable acute genitourinary (GU) and gastrointestinal (GI) toxicity. Currently, we investigated the safety of reducing the overall treatment time (OTT) of focal boosted prostate SBRT from 29 to 15 days. MATERIAL AND METHODS: Patients with intermediate- and high-risk prostate cancer were treated with SBRT delivering 35 Gy in 5 fractions to the whole prostate gland with an iso-toxic boost up to 50 Gy to the intraprostatic lesion(s) in a semi-weekly (BIW) schedule. The primary endpoint was radiation-induced acute toxicity (CTCAE v5.0). Changes in quality of life (QoL) were examined in terms of proportions achieving a minimal clinically important change (MCIC). Finally, acute toxicity and QoL scores of the BIW schedule were compared with the results of the prior QW hypo-FLAME schedule (n = 100). RESULTS: Between August 2020 and February 2022, 124 patients were enrolled and treated BIW. No grade ≥3 GU or GI toxicity was observed. The 90-days cumulative incidence of grade 2 GU and GI toxicity rates were 47.5% and 7.4%, respectively. Patients treated QW scored significant less grade 2 GU toxicity (34.0%, p = 0.01). No significant differences in acute GI toxicity were observed. Furthermore, patients treated QW had a superior acute bowel and urinary QoL. CONCLUSION: Semi-weekly prostate SBRT with iso-toxic focal boosting is associated with acceptable acute GU and GI toxicity. Based on the comparison between the QW and BIW schedule, patients should be counselled regarding the short-term advantages of a more protracted schedule. Registration number ClinicalTrials.gov: NCT04045717.

11 juli 2023, Contains fulltext : 295281.pdf (Publisher’s version ) (Open Access), An Elimination Diet (ED) may be effective in reducing symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), but has never been compared to an active control condition [i.e., Healthy Diet (HD)]. In a two-armed RCT, a total of N = 165 children (5-12 years) with ADHD were randomized by means of minimization (1:1) to either an ED (N = 84) or HD (N = 81) within two Dutch child and adolescent psychiatry centers. The design included a non-randomized comparator arm including N = 58 children being treated with Care as Usual (CAU). Treatment allocation was unblinded. The primary outcome was a 5-point ordinal measure of respondership based on a combination of parent and teacher ratings on ADHD and emotion regulation, determined after 5 weeks of treatment. Ordinal regression analyses were done on an intention-to-treat basis. Fewer ED (35%) than HD (51%) participants showed a partial to full response, despite overall good-to-excellent treatment adherence (> 88%) and comparable high parental prior believes. A younger age and higher problem severity predicted a better respondership. CAU-preferring participants responded more often favorably (56%) compared to ED-but not HD-participants. Small-to-medium improvements in physical health (blood pressure, heart rate, and somatic complaints) were found in response to ED/HD versus decrements in response to CAU (74% received psychostimulants). The lack of superiority of the ED versus HD suggests that for the majority of children, dietary treatment response is not rooted in food-allergies/-sensitivities. The comparable results for treatment with HD and CAU are remarkable given that CAU participants were probably 'easier to treat' than HD (and ED) participants with proportionally fewer with a (suboptimal/non-response to) prior treatment with medication (4% versus 20%). Further assessment of long-term effects is needed to evaluate the potential place of dietary treatment within clinical guidelines. The trial is closed and registered in

Energy models are used to study emissions mitigation pathways, such as those compatible with the Paris Agreement goals. These models vary in structure, objectives, parameterization and level of detail, yielding differences in the computed energy and climate policy scenarios. To study model differences, diagnostic indicators are common practice in many academic fields, for example, in the physical climate sciences. However, they have not yet been applied systematically in mitigation literature, beyond addressing individual model dimensions. Here we address this gap by quantifying energy model typology along five dimensions: responsiveness, mitigation strategies, energy supply, energy demand and mitigation costs and effort, each expressed through several diagnostic indicators. The framework is applied to a diagnostic experiment with eight energy models in which we explore ten scenarios focusing on Europe. Comparing indicators to the ensemble yields comprehensive ‘energy model fingerprints’, which describe systematic model behaviour and contextualize model differences for future multi-model comparison studies.

The 4th Maastricht Consensus Conference on Thrombosis (MCCT), included the following themes: Theme 1: The coagulome as a critical driver of cardiovascular disease Blood coagulation proteins also play divergent roles in biology and pathophysiology, related to specific organs, including brain, heart, bone marrow and kidney. Four investigators shared their views on these organ-specific topics. Theme 2: Novel mechanisms of thrombosis Mechanisms linking factor XII to fibrin, including their structural and physical properties, contribute to thrombosis, which is also affected by variation in microbiome status. Virus infections associated-coagulopathies perturb the hemostatic balance resulting in thrombosis and/or bleeding. Theme 3: How to limit bleeding risks: insights from translational studies This theme included state of the art methodology for exploring the contribution of genetic determinants of a bleeding diathesis; determination of polymorphisms in genes that control the rate of metabolism by the liver of P2Y12 inhibitors, to improve safety of antithrombotic therapy. Novel reversal agents for direct oral anticoagulants are discussed. Theme 4: Hemostasis in extracorporeal systems: how to utilize ex vivo models? Perfusion flow chamber and nanotechnology developments are developed for studying bleeding and thrombosis tendencies. Vascularised organoids are utilized for disease modeling and drug development studies. Strategies for tackling extracorporeal membrane oxygenation (ECMO) associated coagulopathy are discussed. Theme 5: Clinical dilemmas in thrombosis and antithrombotic management Plenary presentations addressed controversial areas, ie thrombophilia testing, thrombosis risk assessment in hemophilia, novel antiplatelet strategies and clinically tested factor XI(a) inhibitors,both possibly with reduced bleeding risk. Finally, Covid-19 associated coagulopathy is revisited.

The Society for Vascular Surgery and the Enhanced Recovery After Surgery (ERAS®) Society formally collaborated and elected an international, multi-disciplinary panel of experts to review the literature and provide evidence-based suggestions for coordinated peri-operative care for patients undergoing infrainguinal bypass surgery for peripheral artery disease. Structured around the ERAS® core elements, 26 suggestions were made and organized into preadmission, preoperative, intraoperative, and postoperative sections.