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To manage Earth in the Anthropocene, new tools, new institutions, and new forms of international cooperation will be required. Earth Virtualization Engines is proposed as an international federation of centers of excellence to empower all people to respond to the immense and urgent challenges posed by climate change.

A new global high-resolution coupled climate model, EC-Earth3P-HR has been developed by the EC-Earth consortium, with a resolution of approximately 40 km for the atmosphere and 0.25∘ for the ocean, alongside with a standard-resolution version of the model, EC-Earth3P (80 km atmosphere, 1.0∘ ocean). The model forcing and simulations follow the High Resolution Model Intercomparison Project (HighResMIP) protocol. According to this protocol, all simulations are made with both high and standard resolutions. The model has been optimized with respect to scalability, performance, data storage and post-processing. In accordance with the HighResMIP protocol, no specific tuning for the high-resolution version has been applied. Increasing horizontal resolution does not result in a general reduction of biases and overall improvement of the variability, and deteriorating impacts can be detected for specific regions and phenomena such as some Euro-Atlantic weather regimes, whereas others such as the El Niño–Southern Oscillation show a clear improvement in their spatial structure. The omission of specific tuning might be responsible for this. The shortness of the spin-up, as prescribed by the HighResMIP protocol, prevented the model from reaching equilibrium. The trend in the control and historical simulations, however, appeared to be similar, resulting in a warming trend, obtained by subtracting the control from the historical simulation, close to the observational one.

We present a new framework for global ocean–sea-ice model simulations based on phase 2 of the Ocean Model Intercomparison Project (OMIP-2), making use of the surface dataset based on the Japanese 55-year atmospheric reanalysis for driving ocean–sea-ice models (JRA55-do). We motivate the use of OMIP-2 over the framework for the first phase of OMIP (OMIP-1), previously referred to as the Coordinated Ocean–ice Reference Experiments (COREs), via the evaluation of OMIP-1 and OMIP-2 simulations from 11 state-of-the-science global ocean–sea-ice models. In the present evaluation, multi-model ensemble means and spreads are calculated separately for the OMIP-1 and OMIP-2 simulations and overall performance is assessed considering metrics commonly used by ocean modelers. Both OMIP-1 and OMIP-2 multi-model ensemble ranges capture observations in more than 80 % of the time and region for most metrics, with the multi-model ensemble spread greatly exceeding the difference between the means of the two datasets. Many features, including some climatologically relevant ocean circulation indices, are very similar between OMIP-1 and OMIP-2 simulations, and yet we could also identify key qualitative improvements in transitioning from OMIP-1 to OMIP-2. For example, the sea surface temperatures of the OMIP-2 simulations reproduce the observed global warming during the 1980s and 1990s, as well as the warming slowdown in the 2000s and the more recent accelerated warming, which were absent in OMIP-1, noting that the last feature is part of the design of OMIP-2 because OMIP-1 forcing stopped in 2009. A negative bias in the sea-ice concentration in summer of both hemispheres in OMIP-1 is significantly reduced in OMIP-2. The overall reproducibility of both seasonal and interannual variations in sea surface temperature and sea surface height (dynamic sea level) is improved in OMIP-2. These improvements represent a new capability of the OMIP-2 framework for evaluating process-level responses using simulation results. Regarding the sensitivity of individual models to the change in forcing, the models show well-ordered responses for the metrics that are directly forced, while they show less organized responses for those that require complex model adjustments. Many of the remaining common model biases may be attributed either to errors in representing important processes in ocean–sea-ice models, some of which are expected to be reduced by using finer horizontal and/or vertical resolutions, or to shared biases and limitations in the atmospheric forcing. In particular, further efforts are warranted to resolve remaining issues in OMIP-2 such as the warm bias in the upper layer, the mismatch between the observed and simulated variability of heat content and thermosteric sea level before 1990s, and the erroneous representation of deep and bottom water formations and circulations. We suggest that such problems can be resolved through collaboration between those developing models (including parameterizations) and forcing datasets. Overall, the present assessment justifies our recommendation that future model development and analysis studies use the OMIP-2 framework.

Most Earth system models (ESMs) are running under different high-performance computing (HPC) environments. This has several advantages, from allowing different groups to work with the same tool in parallel to leveraging the burden of ensemble climate simulations, but it also offers alternative solutions in the case of shutdown (expected or not) of any of the environments. However, for obvious scientific reasons, it is critical to ensure that ESMs provide identical results under changes in computing environment. While strict bit-for-bit reproducibility is not always guaranteed with ESMs, it is desirable that results obtained under one computing environment are at least statistically indistinguishable from those obtained under another environment, which we term a “replicability” condition following the metrology nomenclature. Here, we develop a protocol to assess the replicability of the EC-Earth ESM. Using two versions of EC-Earth, we present one case of non-replicability and one case of replicability. The non-replicable case occurs with the older version of the model and likely finds its origin in the treatment of river runoff along Antarctic coasts. By contrast, the more recent version of the model provides replicable results. The methodology presented here has been adopted as a standard test by the EC-Earth consortium (27 institutions in Europe) to evaluate the replicability of any new model version across platforms, including for CMIP6 experiments. To a larger extent, it can be used to assess whether other ESMs can safely be ported from one HPC environment to another for studying climate-related questions. Our results and experience with this work suggest that the default assumption should be that ESMs are not replicable under changes in the HPC environment, until proven otherwise.

We formulate a new conceptual model, named " MT 2", to describe global ocean heat uptake, as simulated by atmosphere-ocean general circulation models (AOGCMs) forced by increasing atmospheric CO 2 , as a function of global-mean surface temperature change T and the strength of the Atlantic meridional overturning circulation (AMOC, M ). MT 2 has two routes whereby heat reaches the deep ocean. On the basis of circumstantial evidence, we hypothetically identify these routes as low- and high-latitude. In low latitudes, which dominate the global-mean energy balance, heat uptake is temperature-driven and described by the two-layer model, with global-mean T as the temperature change of the upper layer. In high latitudes, a proportion p (about 14%) of the forcing is taken up along isopycnals, mostly in the Southern Ocean, nearly like a passive tracer, and unrelated to T . Because the proportion p depends linearly on the AMOC strength in the unperturbed climate, we hypothesise that high-latitude heat uptake and the AMOC are both affected by some characteristic of the unperturbed global ocean state, possibly related to stratification. MT 2 can explain several relationships among AOGCM projections, some found in this work, others previously reported: ∙  Ocean heat uptake efficiency correlates strongly with the AMOC. ∙  Global ocean heat uptake is not correlated with the AMOC. ∙  Transient climate response (TCR) is anticorrelated with the AMOC. ∙   T projected for the late twenty-first century under high-forcing scenarios correlates more strongly with the effective climate sensitivity than with the TCR., Competing Interests: Conflict of interestNone., (© The Author(s) 2023.)

El Niño-Southern Oscillation (ENSO) is a key mode of climate variability with worldwide climate impacts. Recent studies have highlighted the impact of other tropical oceans on its variability. In particular, observations have demonstrated that summer Atlantic Niños (Niñas) favor the development of Pacific Niñas (Niños) the following winter, but it is unclear how well climate models capture this teleconnection and its role in defining the seasonal predictive skill of ENSO. Here we use an ensemble of seasonal forecast systems to demonstrate that a better representation of equatorial Atlantic variability in summer and its lagged teleconnection mechanism with the Pacific relates to enhanced predictive capacity of autumn/winter ENSO. An additional sensitivity study further shows that correcting SST variability in equatorial Atlantic improves different aspects of forecast skill in the Tropical Pacific, boosting ENSO skill. This study thus emphasizes that new efforts to improve the representation of equatorial Atlantic variability, a region with long standing systematic model biases, can foster predictive skill in the region, the Tropical Pacific and beyond, through the global impacts of ENSO.

Chronic inflammatory disorders have been associated with accelerated atherosclerosis and increased cardiovascular (CV) risk. Recent evidence suggests that erosive hand osteoarthritis (EOA) has considerable inflammation; therefore, we examined the presence of subclinical atherosclerosis and endothelial dysfunction in EOA. Twenty-four patients with EOA and 24 age- and sex-matched healthy individuals without clinical OA were included in the study. No subject had a history of CV disease. Intima-media thickness (IMT) and atheromatous plaques in the common carotid and common femoral arteries were measured by Doppler ultrasonography. The endothelium-dependent, flow-mediated dilatation (FMD) and endothelium-independent, sublingual glyceryl trinitrate (NTG)-induced dilatation (NMD) of the brachial artery were assessed. The EOA patients had significantly elevated systolic and diastolic blood pressure (p<0.001 for both). The 10-year risk of general CV disease, as predicted with the Framingham Risk Score, was similar in patients and controls (p=0.18). IMT of both common carotid and common femoral artery were increased in EOA (p=0.01 and p<0.01, respectively), but the frequency of atherosclerotic plaques was not increased. There was no difference in FMD and NMD between the two groups, but the difference between FMD and NMD was increased in EOA. In conclusion, this small controlled study showed an association between EOA and subclinical atherosclerosis that cannot be fully attributed to traditional CV risk factors, as assessed by the Framingham score. These results suggest that chronic, low-grade inflammation is implicated in atherosclerosis in EOA.

During a 5 year period, 1417 patients with various types of hip fractures were surgically treated. Three cases of iatrogenic arterial injuries occurred during the correction procedures, giving an incidence of 0.21%. In 2 patients the profunda femoral and in one the common femoral artery were involved. The mechanisms of injury were: a protruding screw, beyond the medial border of the femur in the first patient, arterial tear, due to bone speculae in the second and external pressure to the artery from an avulsed lesser trochanter in the third. The clinical findings were false aneurysms in two and distal ischaemia in the third patient. All patients were surgically treated. Early diagnosis of this type of injuries is the cornerstone for a good outcome.

One hundred eight femoral shaft fractures in one hundred six adults were treated by closed intramedullary interlocked nailing. Ninety-two fractures were severely comminuted and 16 fractures were segmental. The procedures were done with the patients in the supine position. A modification of the cylinder guide for fixation of the distal screws is described. All the fractures healed in an average of 18 weeks (range, 12-24 weeks). Dynamization was performed in 15 fractures. There were two postoperative complications, which did not ultimately affect the clinical results. No infections or delayed unions were observed. Closed intramedullary interlocked nailing seems to be the treatment of choice for comminuted and segmental fractures of the femoral shaft provided that all the technical details are followed by the surgeon.

From October 1987 to September 1990, 32 patients with ipsilateral fractures of the femur and the tibia were treated. There were 20 men and 12 women with a mean age of 27 years (range 18-75 years). All were caused by road accidents. There were 7 femoral and 22 tibial open fractures. The management of the fractures was partially the same. The tibial fractures were reduced and stabilized by a unilateral external fixator, while in 29 out of 32 femoral fractures, a closed intramedullary nailing was performed. The remaining three patients with an open grade III fracture were initially treated by external fixation, with two of them converted into nailing. The time of hospitalization ranged from 12 to 105 days (mean 30 days). The femoral fractures healed in an average of 15.5 weeks, while the tibial fractures healed in 18.5 weeks. The evaluation of our results was made according to Karlstrom and Olerud's criteria. We achieved 81 per cent excellent or good results and 19 per cent acceptable or poor, in a follow-up time of 19.5 months.

Two cases of the rare injury of avulsion of the triceps tendon are presented. The difficulties in clinical diagnosis and proper evaluation of the roentgenographic findings whenever present are discussed and the treatment is outlined.

Sixty-two patients with beta-thalassemia (36 men and 26 women) were investigated in a survey of the incidence and distribution of fractures. Patient ages ranged from 10 to 32 years (mean, 16.7). The examination consisted of a detailed orthopedic and roentgenographic skeletal survey. Fractures are a frequent occurrence in beta-thalassemia (Cooley's anemia). One in three patients had sustained fractures. In one of five, fractures were multiple or recurrent. The fractures, however, were not entirely responsible for the high incidence of deformities. Only one patient had a malunited limb-deforming fracture. The high incidence of deformities was caused by the premature fusion of the epiphyses of the long bones; the pathogenesis of beta-thalassemia-induced epiphyseal fusion is obscure. Thirty patients of the 62 patients developed epiphyseal abnormalities, generally in the lower tibial and fibular, upper humeral, and lower femoral epiphyses. The ensuring deformities are severe and frequently occur in patients older than 12.

We report a case of osteoclastoma of the distal radius originally treated by curettage, then by resection and bone replacement. There was a soft tissue recurrence of the tumor 13 years later.