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Hydrogen (H2) is considered a promising fuel to contribute to net-zero carbon emission goals. While hydrogen itself is not a greenhouse gas, leakage of hydrogen fuels causes indirect warming due to hydrogen’s influence on methane, tropospheric ozone, and stratospheric water vapor, with the methane term dominating the impact. Some studies consider a simple four-equation box model to explore the climate consequences of leakage from hydrogen fuel use relative to methane, while others have employed much more detailed global photochemical models. Here we use a comprehensive photochemical box model including 66 reactions to show and quantify how the analogous four-equation system is missing a critical OH feedback, leading it to overestimate the time-integrated methane response to a pulse of hydrogen by over 100%. We estimate a hydrogen global warming potential (GWP) relative to carbon dioxide of 28−11+18 on the 20-year time horizon and 10−4+7 on the 100-year time horizon based on the 66-reaction model and information from the literature. GWPs provide a measure of the relative global warming impact of emission of one gas compared to a selected reference gas per unit mass emitted. While CO2 is generally chosen for the reference, any gas can be used. We present the GWP of H2 using CH4 as the reference, as this choice cancels out some uncertainties that are common to both H2 and CH4. The GWP for H2 relative to CH4 from fossil fuel sources is 0.35−0.06+0.13 on time horizons beyond 15 years; put differently, we find that relative to an equivalent mass of emission of fossil CH4, hydrogen emission has a climate impact about three times smaller. These global warming potentials underscore that hydrogen leakage does contribute to climate change, emphasizing the importance of limiting both hydrogen and methane leakage if global net-zero greenhouse gas emissions are to be achieved by 2050.

Abstract Following the Hunga Tonga–Hunga Ha'apai (HTHH) eruption in January 2022, significant reductions in stratospheric hydrochloric acid (HCl) were observed in the Southern Hemisphere mid‐latitudes during the latter half of 2022, suggesting potential chlorine activation. The objective of this study is to comprehensively understand the loss of HCl in the aftermath of HTHH. Satellite measurements and a global chemistry‐climate model are employed for the analysis. We find strong agreement of 2022 anomalies between the modeled and the measured data. The observed tracer‐tracer relations between nitrous oxide (N2O) and HCl indicate a significant role of chemical processing in the observed HCl reduction, especially during the austral winter of 2022. Further examining the roles of chlorine gas‐phase and heterogeneous chemistry, we find that heterogeneous chemistry emerges as the primary driver for the chemical loss of HCl, and the reaction between hypobromous acid (HOBr) and HCl on sulfate aerosols is the dominant loss process.

Abstract Background The World Health Organisation declared the novel Coronavirus disease (COVID-19) a global pandemic on 11th March 2020. Since then, the world has been firmly in its grip. At the time of writing, there were more than 767,972,961 million confirmed cases and over 6,950,655 million deaths. While the main policy focus has been on controlling the virus and ensuring vaccine roll-out and uptake, the population mental health impacts of the pandemic are expected to be long-term, with certain population groups affected more than others. Methods The overall objectives of our ‘Coronavirus: Mental Health and the Pandemic’ study were to explore UK adults’ experiences of the Coronavirus pandemic and to gain insights into the mental health impacts, population-level changes over time, current and future mental health needs, and how these can best be addressed. The wider mixed-methods study consisted of repeated cross-sectional surveys and embedded qualitative sub-studies including in-depth interviews and focus group discussions with the wider UK adult population. For this particular inequalities and mental health sub-study, we used mixed methods data from our cross-sectional surveys and we carried out three Focus Group Discussions with a maximum variation sample from across the UK adult population. The discussions covered the broader topic of 'Inequalities and mental health during the Coronavirus pandemic in the UK’ and took place online between April and August 2020. Focus Groups transcripts were analysed using thematic analysis in NVIVO. Cross-sectional survey data were analysed using STATA for descriptive statistics. Results Three broad main themes emerged, each supporting a number of sub-themes: (1) Impacts of the pandemic; (2) Moving forward: needs and recommendations; (3) Coping mechanisms and resilience. Findings showed that participants described their experiences of the pandemic in relation to its impact on themselves and on different groups of people. Their experiences illustrated how the pandemic and subsequent measures had exacerbated existing inequalities and created new ones, and triggered various emotional responses. Participants also described their coping strategies and what worked and did not work for them, as well as support needs and recommendations for moving forward through, and out of, the pandemic; all of which are valuable learnings to be considered in policy making for improving mental health and for ensuring future preparedness. Conclusions The pandemic is taking a long-term toll on the nations’ mental health which will continue to have impacts for years to come. It is therefore crucial to learn the vital lessons learned from this pandemic. Specific as well as whole-government policies need to respond to this, address inequalities and the different needs across the life-course and across society, and take a holistic approach to mental health improvement across the UK.

Abstract Hydrochlorofluorocarbons (HCFCs) and hydrofluorocarbons (HFCs) are potent greenhouse gases regulated under the Montreal Protocol and its amendments. Emission estimates generally use constant atmospheric lifetimes accounting for loss via hydroxyl radical (OH) reactions. However, chemistry‐climate models suggest OH increases after 1980, implying underestimated emissions. Further, HCFCs and HFCs are soluble in seawater and could be destroyed through in situ oceanic microbial activity. These ocean sinks are largely overlooked. Using a coupled atmosphere‐ocean model, we show that increases in modeled OH imply underestimated HCFC and HFC emissions by ∼10% near their respective peak emissions. Our model results also suggest that oceanic processes could lead to up to an additional 10% underestimation in these halocarbon emissions in the 2020s. Ensuring global compliance to the Protocol and accurate knowledge of contributions to global warming from these gases therefore requires understanding of these processes.

Hot extremes, such as heatwaves, have been associated with health, economic, and ecosystem-wide impacts. The timing of emergence of changes in extremes due to anthropogenic climate change is a topic of broad scientific and societal importance. While various studies have estimated the timing and impacts of heatwaves, the definitional aspect of a heatwave in determining the relative time of emergence has not been addressed. We adopt two commonly used definitions of heatwave employed in different reports of the Intergovernmental Panel on Climate Change (IPCC) to evaluate the time at which the frequency of heatwaves becomes detectably different from the historical baseline using an ensemble of 10 GCMS from the CMIP6 archives forced by the SSP2–4.5 concentration pathway. For a heatwave definition of sustained temperatures exceeding 5 °C warmer above the historical climatology, time of emergence is earliest in high latitudes over land and displays correlation with the signal (amount of warming) and noise (variability). In contrast, for a heatwave definition of sustained temperatures exceeding the 90th percentile of historical climatology, time of emergence is earliest in low latitude regions and is correlated with the signal to noise ratio. This work underscores the importance of metric choice in estimating the timing of new climate regimes and that metric selection for informing adaptation timing should thus be tailored to the regional context.

BackgroundWorldwide, the Coronavirus pandemic has had a major impact on people's health, lives, and livelihoods. However, this impact has not been felt equally across various population groups. People from ethnic minority backgrounds in the UK have been more adversely affected by the pandemic, especially in terms of their physical health. Their mental health, on the other hand, has received less attention. This study aimed to explore the mental health experiences of UK adults from ethnic minorities during the Coronavirus pandemic. This work forms part of our wider long-term UK population study “Mental Health in the Pandemic.”MethodsWe conducted an exploratory qualitative study with people from ethnic minority communities across the UK. A series of in-depth interviews were conducted with 15 women, 14 men and 1 non-binary person from ethnic minority backgrounds, aged between 18 and 65 years old (mean age = 40). We utilized purposefully selected maximum variation sampling in order to capture as wide a variety of views, perceptions and experiences as possible. Inclusion criteria: adults (18+) from ethnic minorities across the UK; able to provide full consent to participate; able to participate in a video- or phone-call interview. All interviews took place via MS Teams or Zoom. The gathered data were transcribed verbatim and underwent thematic analysis following Braun and Clarke carried out using NVivo 12 software.ResultsThe qualitative data analysis yielded seven overarching themes: (1) pandemic-specific mental health and wellbeing experiences; (2) issues relating to the media; (3) coping mechanisms; (4) worries around and attitudes toward vaccination; (5) suggestions for support in moving forward; (6) best and worst experiences during pandemic and lockdowns; (7) biggest areas of change in personal life. Generally, participants' mental health experiences varied with some not being affected by the pandemic in a way related to their ethnicity, some sharing positive experiences and coping strategies (exercising more, spending more time with family, community cohesion), and some expressing negative experiences (eating or drinking more, feeling more isolated, or even racism and abuse, especially toward Asian communities). Concerns were raised around trust issues in relation to the media, the inadequate representation of ethnic minorities, and the spread of fake news especially on social media. Attitudes toward vaccinations varied too, with some people more willing to have the vaccine than others.ConclusionThis study's findings highlight the diversity in the pandemic mental health experiences of ethnic minorities in the UK and has implications for policy, practice and further research. To enable moving forward beyond the pandemic, our study surfaced the need for culturally appropriate mental health support, financial support (as a key mental health determinant), accurate media representation, and clear communication messaging from the Governments of the UK.

The production of chlorofluorocarbons (CFC) was phased-out under the Montreal, but renewed emissions of CFC-11 have been reported recently. Here, the authors present a joint analysis of multiple factors and find that emissions of CFC-11, but also CFC-12 and CFC-113 are higher than expected, indicating renewed emissions.

Background: Drug utilization research on psychotropic drug use facilitates rational prescriptions in psychiatric patients. Low follow-up rates and nonadherence to psychotropic medications are key challenges in psychiatry. The objective of this study was to determine the prescription pattern of psychotropic medications, the follow-up pattern, and medication adherence in psychiatric outpatients. Materials and Methods: In this retrospective observational study, the prescription pattern and number of follow-ups were abstracted for each new psychiatric outpatient for a period of 6 months from the time of the first assessment. In addition, medication adherence was assessed using a secondary database analysis. A continuous measure of medication acquisition (CMA) was calculated and those patients with CMA of 0.8 or more were considered adherent. Results: A total of 317 patients were included in the study. At the first visit, 198 patients (62.46%) were prescribed two psychotropic medications. Out of the total sample, 157 (49.53%) were prescribed once-daily medication and 151 (47.63%) received twice-daily medication. During the follow-up visits, the primary medication was changed in 40 (12.62%) patients and polypharmacy was used in 23 (7.26%) patients. After the initial visit, 138 (43.53%) patients did not come for even a single follow-up visit. Only 50 (15.77%) patients had a medication prescription for at least 80% of the study period. Conclusion: Olanzapine, escitalopram, sertraline, and clonazepam were the most commonly prescribed psychotropic medications. Most patients were prescribed two psychotropic medications which included one benzodiazepine. However, polypharmacy was an uncommon practice. Follow-up rate and medication adherence were poor across different diagnostic categories.

The Montreal Protocol has begun to heal the Antarctic ozone hole and avoided more global warming than any other treaty. Still, recent research shows that new unexpected emissions of several chlorofluorocarbons, carbon tetrachloride, and hydrofluorocarbons, are undermining the Protocol’s success. It is time for policymakers to plug the holes in the ozone hole treaty.

Following international agreements, the use of chlorofluorocarbons in production is supposed to be phased out. Here, the authors present a new estimate of these products already in use and their emissions and show that they are larger than expected and that not recovering these banks leads to a substantial delay in the polar ozone hole recovery.

The long atmospheric residence time of CO2 creates an urgent need to add atmospheric carbon drawdown to CO2 regulatory strategies. Synthetic and systems biology (SSB), which enables manipulation of cellular phenotypes, offers a powerful approach to amplifying and adding new possibilities to current land management practices aimed at reducing atmospheric carbon. The participants (in attendance: Christina Agapakis, George Annas, Adam Arkin, George Church, Robert Cook-Deegan, Charles DeLisi, Dan Drell, Sheldon Glashow, Steve Hamburg, Henry Jacoby, Henry Kelly, Mark Kon, Todd Kuiken, Mary Lidstrom, Mike MacCracken, June Medford, Jerry Melillo, Ron Milo, Pilar Ossorio, Ari Patrinos, Keith Paustian, Kristala Jones Prather, Kent Redford, David Resnik, John Reilly, Richard J. Roberts, Daniel Segre, Susan Solomon, Elizabeth Strychalski, Chris Voigt, Dominic Woolf, Stan Wullschleger, and Xiaohan Yang) identified a range of possibilities by which SSB might help reduce greenhouse gas concentrations and which might also contribute to environmental sustainability and adaptation. These include, among other possibilities, engineering plants to convert CO2 produced by respiration into a stable carbonate, designing plants with an increased root-to-shoot ratio, and creating plants with the ability to self-fertilize. A number of serious ecological and societal challenges must, however, be confronted and resolved before any such application can be fully assessed, realized, and deployed.

Abstract Satellite temperature measurements do not support the recent claim of a “leveling off of warming” over the past two decades. Tropospheric warming trends over recent 20-year periods are always significantly larger (at the 10% level or better) than model estimates of 20-year trends arising from natural internal variability. Over the full 38-year period of the satellite record, the separation between observed warming and internal variability estimates is even clearer. In two out of three recent satellite datasets, the tropospheric warming from 1979 to 2016 is unprecedented relative to internally generated temperature trends on the 38-year timescale.

Clozapine is superior to all other antipsychotics in treatment-resistant schizophrenia. However, metabolic side effects are common while treating patients with clozapine. Administering clozapine in a patient who already is diabetic involves careful weighing of risks and benefits. Here, we report our experience of starting clozapine in a known diabetic patient. Clozapine was started in a patient with treatment-resistant psychosis in view of suicidal risk. Her diabetes mellitus was under good control with oral medications. After initiation of clozapine, blood sugars increased several fold within few days. Blood glucose continued to increase even with high doses of insulin and insulin infusion. Finally, blood sugars came under control only after discontinuation of clozapine. Precautionary measures while initiating clozapine in a diabetic patient are suggested – close monitoring of blood sugar during the initial few days and intensive intervention if blood sugar levels increase. Discontinuation of clozapine should also be kept in mind as a last resort.

Previous work has examined the Brewer–Dobson circulation (BDC) changes for 1980–2009 based on satellite Microwave Sounding Unit (MSU/AMSU) lower-stratospheric temperature ( T _LS ) observations and ERA-Interim reanalysis data. Here we examine the BDC changes for the longer period now available (1980–2018), which also allows analysis of both the ozone depletion (1980–1999) and ozone healing (2000–2018) periods. We provide observational evidence that the annual mean BDC accelerated for 1980–1999 but decelerated for 2000–2018, with the changes largely driven by the Southern Hemisphere (SH), which might be partly contributed by the effects of ozone depletion and healing. We also show that the annual mean BDC has accelerated in the last 40 years (at the 90% confidence level) with a relative strengthening of ∼1.7% per decade. This overall acceleration was driven by both Northern Hemisphere (40%) and SH (60%) cells. Significant SH radiative warming is also identified in September for 2000–2018 after excluding the year 2002 when a very rare SH stratospheric sudden warming occurred, supporting the view that healing of the Antarctic ozone layer has now begun to occur during the month of September.

Bereavement reactions are associated with numerous physical and mental complications. Atypical bereavement reactions have been described but their place in the classificatory system has not been established. We present the case of an eighty-year-old woman who came with the belief that her deceased son was alive. We discuss the diagnostic dilemma she posed and conclude that it may be difficult to differentiate atypical bereavement from other psychiatric illnesses.

The modeled robustness of the aridity response to climate change has already been well established: global drylands are expanding as increases in potential evapotranspiration outpace precipitation increases. This work considers three questions not previously addressed: (1) in which aridity zones are aridity trends expected to first emerge? (2) To what extent are future populations expected to experience changes in aridity? (3) For which locations and populations is aridity change determined by changes in precipitation versus temperature? Using a multi-model ensemble of general circulation models (GCMs) from the CMIP5 archives, together with population statistics from United Nations databases we find the following: (1) drier regions are projected to dry earlier, more severely and to a greater extent than humid regions. (2) By the end of the century, up to 700 million more people are projected to live in arid regions, with half of humankind living in regions experiencing drying of at least 5% and 3 billion experiencing 25% drying under a high emissions scenario. The largest populations to experience extreme drying are in Africa and Asia. According to GCMs, aridity increases have already begun to emerge in Northern Africa. Populations in sub-Saharan Africa appear to be the most vulnerable considering current water scarcity levels there. And (3) precipitation change is projected to drive the most severe drying in arid regions, contributing to the earliest emerging signals of aridity change and driving the differential drying across aridity zones. A comparison of aridity data derived from observations with model ensemble data suggests that increased aridity is already emerging in the driest regions. In sum, widespread aridity trends across a warming state imply that most of humanity will live in a more arid world.

Recurrent hair pulling resulting in hair loss, in the absence of a medical or another mental disorder is a diagnostic feature of trichotillomania. It is commonly seen in depression and many other psychiatric disorders. Trichotillomania rarely occurs as a co morbid condition in patients with schizophrenia. Even rarer is recurrent hair pulling in response to psychotic symptoms in schizophrenia. We present the case of a young adult male who presented with recurrent hair pulling due to command auditory hallucinations and discuss the salient differentiating features of hair pulling seen in our patient and hair pulling in patients with trichotillomania.

We present observational evidence for linkages between extreme Arctic stratospheric ozone anomalies in March and Northern Hemisphere tropospheric climate in spring (March–April). Springs characterized by low Arctic ozone anomalies in March are associated with a stronger, colder polar vortex and circulation anomalies consistent with the positive polarity of the Northern Annular Mode/North Atlantic Oscillation in March and April. The associated spring tropospheric circulation anomalies indicate a poleward shift of zonal winds at 500 hPa over the North Atlantic. Furthermore, correlations between March Arctic ozone and March–April surface temperatures reveal certain regions where a surprisingly large fraction of the interannual variability in spring surface temperatures is associated with interannual variability in ozone. We also find that years with low March Arctic ozone in the stratosphere display surface maximum daily temperatures in March–April that are colder than normal over southeastern Europe and southern Asia, but warmer than normal over northern Asia, adding to the warming from increasing well-mixed greenhouse gases in those locations. The results shown here do not establish causality, but nevertheless suggest that March stratospheric ozone is a useful indicator of spring averaged (March–April) tropospheric climate in certain Northern Hemispheric regions.

Policy makers have called for a ‘fair and ambitious’ global climate agreement. Scientific constraints, such as the allowable carbon emissions to avoid exceeding a 2 °C global warming limit with 66% probability, can help define ambitious approaches to climate targets. However, fairly sharing the mitigation challenge to meet a global target involves human values rather than just scientific facts. We develop a framework based on cumulative emissions of carbon dioxide to compare the consistency of countries’ current emission pledges to the ambition of keeping global temperatures below 2 °C, and, further, compare two alternative methods of sharing the remaining emission allowance. We focus on the recent pledges and other official statements of the EU, USA, and China. The EU and US pledges are close to a 2 °C level of ambition only if the remaining emission allowance is distributed based on current emission shares, which is unlikely to be viewed as ‘fair and ambitious’ by others who presently emit less. China’s stated emissions target also differs from measures of global fairness, owing to emissions that continue to grow into the 2020s. We find that, combined, the EU, US, and Chinese pledges leave little room for other countries to emit CO _2 if a 2 °C limit is the objective, essentially requiring all other countries to move towards per capita emissions 7 to 14 times lower than the EU, USA, or China by 2030. We argue that a fair and ambitious agreement for a 2 °C limit that would be globally inclusive and effective in the long term will require stronger mitigation than the goals currently proposed. Given such necessary and unprecedented mitigation and the current lack of availability of some key technologies, we suggest a new diplomatic effort directed at ensuring that the necessary technologies become available in the near future.