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AbstractThe time scales of the Paris Climate Agreement indicate urgent action is required on climate policies over the next few decades, in order to avoid the worst risks posed by climate change. On these relatively short time scales the combined effect of climate variability and change are both key drivers of extreme events, with decadal time scales also important for infrastructure planning. Hence, in order to assess climate risk on such time scales, we require climate models to be able to represent key aspects of both internally driven climate variability and the response to changing forcings. In this paper we argue that we now have the modeling capability to address these requirements—specifically with global models having horizontal resolutions considerably enhanced from those typically used in previous Intergovernmental Panel on Climate Change (IPCC) and Coupled Model Intercomparison Project (CMIP) exercises. The improved representation of weather and climate processes in such models underpins our enhanced confidence in predictions and projections, as well as providing improved forcing to regional models, which are better able to represent local-scale extremes (such as convective precipitation). We choose the global water cycle as an illustrative example because it is governed by a chain of processes for which there is growing evidence of the benefits of higher resolution. At the same time it comprises key processes involved in many of the expected future climate extremes (e.g., flooding, drought, tropical and midlatitude storms).

Secondary exposure of predators to anticoagulant rodenticides, and in particular second generation anticoagulant rodenticides (SGARs), is a global phenomenon. The widespread and large-scale nature of this exposure has attracted considerable concern, although the consequences in terms of likelihood of poisoning of individuals and resultant impacts on populations are not well characterised. Secondary exposure of predators may as rise from once or more of: (i) eating contaminated commensal rodents subject to control (target species are typically rats and house mice); (ii) consumption of contaminated non-target small mammals (such as Peromyscus, Microtus, and Apodemus species) that encounter and feed on what are rodent-attractive baits; (iii) consumption of non-rodent vertebrate and invertebrate prey that may also incidentally encounter and eat baits. We hypothesised that predators feeding primarily on target species may be most at risk of exposure to SGARs while those predominantly taking non-mammalian prey may be at least risk. We tested this hypothesis by comparing exposure, determined from the presence and magnitude of SGAR liver residues, in red kites (Milvus milvus), which feeds extensively on rats, in barn owls (Tyto alba), kestrels (Falco tinnunculus), and tawny owls (Strix aluco) that feed widely on non-target small mammals, and in sparrowhawks (Accipiter nisus) that feed predominantly on small birds. We found that the scale and magnitude of exposure was broadly consistent with our hypothesis, and that controlling for age in the analysis could be important as older birds can accumulate residues with age. However, exposure in kestrels was typically greater than that in barn owls and tawny owls, despite what is thought to be a general similarity among the species in their diets. We discuss the relative importance of trophic pathways relative to other factors that may drive secondary exposure in predators, and confirm that species that feed on rats or other target species may be at most risk of exposure and poisoning.

Background Chronic subdural haematoma (cSDH) is a common neurosurgical pathology affecting older patients with other health conditions. A significant proportion (up-to 90%) of referrals for surgery in neurosciences units (NSU) come from secondary care. However, the organisation of this care and the experience of patients repatriated to non-specialist centres are currently unclear. Objectives This study aimed to clarify patient outcome in non-specialist centres following NSU discharge for cSDH surgery and to understand key system challenges. The study was set within a representative neurosurgical care system in the east of England. Design and methods We performed a retrospective cohort analysis of patients referred for cSDH surgery. Alongside case record review, patient and staff experience were explored using surveys as well as an interactive c-design workshop. Challenges were identified from thematic analysis of survey responses and triangulated by focussed workshop discussions. Results Data on 381 patients referred for cSDH surgery from six centres was reviewed. One hundred and fifty-six (41%) patients were repatriated following surgery. Sixty-one (39%) of those repatriated suffered an inpatient complication (new infection, troponin rise or renal injury) following NSU discharge, with 58 requiring institutional discharge or new care. Surveys for staff (n = 42) and patients (n = 209) identified that resourcing, communication, and inter-hospital distance posed care challenges. This was corroborated through workshop discussions with stakeholders from two institutions. Conclusions A significant amount of perioperative care for cSDH is delivered outside of specialist centres. Future improvement initiatives must recognise the system-wide nature of delivery and the challenges such an arrangement presents. [ABSTRACT FROM AUTHOR]

Pictures showing strong and mild expressions of disgust have been found to activate anterior insular cortex but not the amygdala. Structures connected to a limbic cortico-striatal-thalamic circuit were also activated by pictures showing strong disgust. This research has shown for the first time that there are differences between the neural responses to facial expressions showing fear and disgust. It seems that perception of others' disgust and that of taste have a similar neural substrate.