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Streambed biogeochemical processes strongly influence riverine water quality and gaseous emissions. These processes depend largely on flow paths through the hyporheic zone (HZ), the streambed volume saturated with stream water. Boulders and other macroroughness elements are known to induce hyporheic flows in gravel‐bed streams. However, data quantifying the impact of these elements on hyporheic chemistry are lacking. We demonstrate that, in gravel‐bed rivers, the amount of dissolved oxygen (DO) in the bed depends chiefly on changes in bed shape, or morphology, such as the formation of scour and depositional areas, caused by the boulders, among other factors. The study was conducted by comparing DO distributions across different bed states and hydraulic conditions. Our experimental facility replicates conditions observed in natural gravel‐bed streams. We instrumented a section in the bed with DO sensors. Results generally indicate that boulder placement on planar beds has some effects, which are significant at high base flows, on increasing hyporheic oxygen amount compared to the planar case without boulders. Conversely, boulder‐induced morphological changes noticeably and significantly increase the amount of oxygen in the HZ, with the increase depending on sediment inputs during flood flows able to mobilize the sediment. Therefore, streambeds of natural, plane‐bed streams may have deeper oxic zones than previously thought because the presence of boulders and the occurrence of flood flows with varying sediment inputs induce streambed variations among these elements.

We present Multi-Source Weighted-Ensemble Precipitation, version 2 (MSWEP V2), a gridded precipitation P dataset spanning 1979–2017. MSWEP V2 is unique in several aspects: i) full global coverage (all land and oceans); ii) high spatial (0.1°) and temporal (3 hourly) resolution; iii) optimal merging of P estimates based on gauges [WorldClim, Global Historical Climatology Network-Daily (GHCN-D), Global Summary of the Day (GSOD), Global Precipitation Climatology Centre (GPCC), and others], satellites [Climate Prediction Center morphing technique (CMORPH), Gridded Satellite (GridSat), Global Satellite Mapping of Precipitation (GSMaP), and Tropical Rainfall Measuring Mission (TRMM) Multisatellite Precipitation Analysis (TMPA) 3B42RT)], and reanalyses [European Centre for Medium-Range Weather Forecasts (ECMWF) interim reanalysis (ERA-Interim) and Japanese 55-year Reanalysis (JRA-55)]; iv) distributional bias corrections, mainly to improve the P frequency; v) correction of systematic terrestrial P biases using river discharge Q observations from 13,762 stations across the globe; vi) incorporation of daily observations from 76,747 gauges worldwide; and vii) correction for regional differences in gauge reporting times. MSWEP V2 compares substantially better with Stage IV gauge–radar P data than other state-of-the-art P datasets for the United States, demonstrating the effectiveness of the MSWEP V2 methodology. Global comparisons suggest that MSWEP V2 exhibits more realistic spatial patterns in mean, magnitude, and frequency. Long-term mean P estimates for the global, land, and ocean domains based on MSWEP V2 are 955, 781, and 1,025 mm yr−1, respectively. Other P datasets consistently underestimate P amounts in mountainous regions. Using MSWEP V2, P was estimated to occur 15.5%, 12.3%, and 16.9% of the time on average for the global, land, and ocean domains, respectively. MSWEP V2 provides unique opportunities to explore spatiotemporal variations in P, improve our understanding of hydrological processes and their parameterization, and enhance hydrological model performance.

SummaryAn analysis of United States (US) Medicare claims data from 2002 to 2015 for women aged ≥ 65 years found that age-adjusted hip fracture rates for 2013, 2014, and 2015 were higher than projected, resulting in an estimated increase of more than 11,000 hip fractures.IntroductionHip fractures are a major public health concern due to high morbidity, mortality, and healthcare expenses. Previous studies have reported a decrease in the annual incidence of hip fractures in the US beginning in 1995, coincident with the introduction of modern diagnostic tools and therapeutic agents for osteoporosis. In recent years, there has been less bone density testing and fewer prescriptions for osteoporosis treatments. The large osteoporosis treatment gap raises concern of possible adverse effects on hip fracture rates.MethodsWe assessed hip fracture incidence in the US to determine if the previous decline in hip fracture incidence continued. Using 2002 to 2015 Medicare Part A and Part B claims for women ≥ 65 years old, we calculated age-adjusted hip fracture rates, weighting to the 2014 population.ResultsWe found that hip fracture rates declined each year from 2002 to 2012 and then plateaued at levels higher than projected for years 2013, 2014, and 2015.ConclusionsThe plateau in age-adjusted hip fracture incidence rate resulted in more than 11,000 additional estimated hip fractures over the time periods 2013, 2014, and 2015. We recommend further study to assess all factors contributing to this remarkable change in hip fracture rate and to develop strategies to reduce the osteoporosis treatment gap.

This study quantifies mean annual and monthly fluxes of Earth’s water cycle over continents and ocean basins during the first decade of the millennium. To the extent possible, the flux estimates are based on satellite measurements first and data-integrating models second. A careful accounting of uncertainty in the estimates is included. It is applied within a routine that enforces multiple water and energy budget constraints simultaneously in a variational framework in order to produce objectively determined optimized flux estimates. In the majority of cases, the observed annual surface and atmospheric water budgets over the continents and oceans close with much less than 10% residual. Observed residuals and optimized uncertainty estimates are considerably larger for monthly surface and atmospheric water budget closure, often nearing or exceeding 20% in North America, Eurasia, Australia and neighboring islands, and the Arctic and South Atlantic Oceans. The residuals in South America and Africa tend to be smaller, possibly because cold land processes are negligible. Fluxes were poorly observed over the Arctic Ocean, certain seas, Antarctica, and the Australasian and Indonesian islands, leading to reliance on atmospheric analysis estimates. Many of the satellite systems that contributed data have been or will soon be lost or replaced. Models that integrate ground-based and remote observations will be critical for ameliorating gaps and discontinuities in the data records caused by these transitions. Continued development of such models is essential for maximizing the value of the observations. Next-generation observing systems are the best hope for significantly improving global water budget accounting.

Summary Osteoporosis causes an elevated fracture risk. We propose the continued use of T-scores as one means for diagnosis but recommend that, alternatively, hip fracture; osteopenia-associated vertebral, proximal humerus, pelvis, or some wrist fractures; or FRAX scores with ≥3 % (hip) or 20 % (major) 10-year fracture risk also confer an osteoporosis diagnosis. Introduction Osteoporosis is a common disorder of reduced bone strength that predisposes to an increased risk for fractures in older individuals. In the USA, the standard criterion for the diagnosis of osteoporosis in postmenopausal women and older men is a T-score of ≤ −2.5 at the lumbar spine, femur neck, or total hip by bone mineral density testing. Methods Under the direction of the National Bone Health Alliance, 17 clinicians and clinical scientists were appointed to a working group charged to determine the appropriate expansion of the criteria by which osteoporosis can be diagnosed. Results The group recommends that postmenopausal women and men aged 50 years should be diagnosed with osteoporosis if they have a demonstrable elevated risk for future fractures. This includes having a T-score of less than or equal to −2.5 at the spine or hip as one method for diagnosis but also permits a diagnosis for individuals in this population who have experienced a hip fracture with or without bone mineral density (BMD) testing and for those who have osteopenia by BMD who sustain a vertebral, proximal humeral, pelvic, or, in some cases, distal forearm fracture. Finally, the term osteoporosis should be used to diagnose individuals with an elevated fracture risk based on the World Health Organization Fracture Risk Algorithm, FRAX. Conclusions As new ICD-10 codes become available, it is our hope that this new understanding of what osteoporosis represents will allow for an appropriate diagnosis when older individuals are recognized as being at an elevated risk for fracture.

New objectively balanced observation-based reconstructions of global and continental energy budgets and their seasonal variability are presented that span the golden decade of Earth-observing satellites at the start of the twenty-first century. In the absence of balance constraints, various combinations of modern flux datasets reveal that current estimates of net radiation into Earth’s surface exceed corresponding turbulent heat fluxes by 13–24 W m−2. The largest imbalances occur over oceanic regions where the component algorithms operate independent of closure constraints. Recent uncertainty assessments suggest that these imbalances fall within anticipated error bounds for each dataset, but the systematic nature of required adjustments across different regions confirm the existence of biases in the component fluxes. To reintroduce energy and water cycle closure information lost in the development of independent flux datasets, a variational method is introduced that explicitly accounts for the relative accuracies in all component fluxes. Applying the technique to a 10-yr record of satellite observations yields new energy budget estimates that simultaneously satisfy all energy and water cycle balance constraints. Globally, 180 W m−2of atmospheric longwave cooling is balanced by 74 W m−2of shortwave absorption and 106 W m−2of latent and sensible heat release. At the surface, 106 W m−2of downwelling radiation is balanced by turbulent heat transfer to within a residual heat flux into the oceans of 0.45 W m−2, consistent with recent observations of changes in ocean heat content. Annual mean energy budgets and their seasonal cycles for each of seven continents and nine ocean basins are also presented.

Objective Since the publication of the first Asia Pacific Consensus on Colorectal Cancer (CRC) in 2008, there are substantial advancements in the science and experience of implementing CRC screening. The Asia Pacific Working Group aimed to provide an updated set of consensus recommendations. Design Members from 14 Asian regions gathered to seek consensus using other national and international guidelines, and recent relevant literature published from 2008 to 2013. A modified Delphi process was adopted to develop the statements. Results Age range for CRC screening is defined as 50–75 years. Advancing age, male, family history of CRC, smoking and obesity are confirmed risk factors for CRC and advanced neoplasia. A risk-stratified scoring system is recommended for selecting high-risk patients for colonoscopy. Quantitative faecal immunochemical test (FIT) instead of guaiac-based faecal occult blood test (gFOBT) is preferred for average-risk subjects. Ancillary methods in colonoscopy, with the exception of chromoendoscopy, have not proven to be superior to high-definition white light endoscopy in identifying adenoma. Quality of colonoscopy should be upheld and quality assurance programme should be in place to audit every aspects of CRC screening. Serrated adenoma is recognised as a risk for interval cancer. There is no consensus on the recruitment of trained endoscopy nurses for CRC screening. Conclusions Based on recent data on CRC screening, an updated list of recommendations on CRC screening is prepared. These consensus statements will further enhance the implementation of CRC screening in the Asia Pacific region.

Soil nitrogen mineralisation (N-min), the conversion of organic into inorganic N, is important for productivity and nutrient cycling. The balance between mineralisation and immobilisation (net N-min) varies with soil properties and climate. However, because most global-scale assessments of net N-min are laboratory-based, its regulation under field-conditions and implications for real-world soil functioning remain uncertain. Here, we explore the drivers of realised (field) and potential (laboratory) soil net N-min across 30 grasslands worldwide. We find that realised N-min is largely explained by temperature of the wettest quarter, microbial biomass, clay content and bulk density. Potential N-min only weakly correlates with realised N-min, but contributes to explain realised net N-min when combined with soil and climatic variables. We provide novel insights of global realised soil net N-min and show that potential soil net N-min data available in the literature could be parameterised with soil and climate data to better predict realised N-min.

A large array of species distribution model (SDM) approaches has been developed for explaining and predicting the occurrences of individual species or species assemblages. Given the wealth of existing models, it is unclear which models perform best for interpolation or extrapolation of existing data sets, particularly when one is concerned with species assemblages. We compared the predictive performance of 33 variants of 15 widely applied and recently emerged SDMs in the context of multispecies data, including both joint SDMs that model multiple species together, and stacked SDMs that model each species individually combining the predictions afterward. We offer a comprehensive evaluation of these SDM approaches by examining their performance in predicting withheld empirical validation data of different sizes representing five different taxonomic groups, and for prediction tasks related to both interpolation and extrapolation. We measure predictive performance by 12 measures of accuracy, discrimination power, calibration, and precision of predictions, for the biological levels of species occurrence, species richness, and community composition. Our results show large variation among the models in their predictive performance, especially for communities comprising many species that are rare. The results do not reveal any major trade‐offs among measures of model performance; the same models performed generally well in terms of accuracy, discrimination, and calibration, and for the biological levels of individual species, species richness, and community composition. In contrast, the models that gave the most precise predictions were not well calibrated, suggesting that poorly performing models can make overconfident predictions. However, none of the models performed well for all prediction tasks. As a general strategy, we therefore propose that researchers fit a small set of models showing complementary performance, and then apply a cross‐validation procedure involving separate data to establish which of these models performs best for the goal of the study.