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The Pliensbachian–Toarcian succession of North Yorkshire provides a global reference for the interval incorporating the Toarcian Oceanic Anoxic Event (T-OAE, ∼183 Ma). Major and trace element, carbon stable-isotope (δ13Corg) and total organic carbon (TOC) data for the Dove’s Nest core, drilled close to the classic outcrop sections of the Yorkshire coast, demonstrate geochemical, mineralogical and grain-size trends linked to sea level and climate change in the Cleveland Basin. High-resolution correlation between the core and outcrop enables the integration of data to generate a comprehensive chemostratigraphic record. Palaeoredox proxies (Mo, U, V, TOC/P, DOP and Fe speciation) show a progressive shift from oxic bottom waters in the late Pliensbachian through dysoxic–anoxic conditions in the earliest Toarcian to euxinia during the T-OAE. Anoxia–dysoxia persisted into the middle Toarcian. Elemental and isotope data (Re, Re/Mo, δ34SCAS, δ98Mo and ε205Tl) from the coastal sections evidence global expansion of anoxic and euxinic seafloor area driving drawdown of redox-sensitive metals and sulfate from seawater leading to severe depletion in early Toarcian ocean water. The record of anoxia–euxinia in the Cleveland Basin largely reflects global-scale changes in ocean oxygenation, although metal depletion was temporarily enhanced by periods of local basin restriction. Osmium and Sr isotopes demonstrate a pulse of accelerated weathering accompanying the early Toarcian hyperthermal, coincident with the T-OAE. The combined core and outcrop records evidence local and global environmental change accompanying one of the largest perturbations in the global carbon cycle during the last 200 Ma and a period of major biotic turnover.

Fine-grained sedimentary successions contain the most detailed record of past environmental conditions. High-resolution analyses of these successions yield important insights into sedimentary composition and depositional processes and are, therefore, required to contextualise and interpret geochemical data which are commonly used as palaeoclimate proxies. The Kimmeridge Clay Formation (KCF) is a 500 m-thick mudstone succession deposited throughout the North Sea in the Late Jurassic and records environmental conditions through this time. Here, we present petrographic analyses (on 36 thin sections) on a 50 m section of a KCF core from the Cleveland Basin (Yorkshire, UK) to investigate controls on sedimentation in this region during the Tithonian, Late Jurassic. Facies descriptions demonstrate that deposition took place in a hydrodynamically variable environment in which the sediment origins, sediment dispersal mechanisms, and redox conditions fluctuated on the scale of thousands of years. Petrographic analyses show that the sediment comprises marine (algal macerals, calcareous fossils), detrital (quartz, clay, feldspar), and diagenetic (dolomite and authigenic kaolinite) components and that several sediment dispersal mechanisms influenced deposition and facilitated both the supply and preservation of terrestrial and marine organic material. This work provides a framework for the interpretation of geochemical palaeoclimate proxies and reinforces the importance of looking at the rock when interpreting whole-rock geochemical data.

The Kimmeridge Clay Formation (KCF) is a laterally extensive, total-organic-carbon-rich succession deposited throughout northwest Europe during the Kimmeridgian–Tithonian (Late Jurassic). It has recently been postulated that an expanded Hadley cell, with an intensified but alternating hydrological cycle, heavily influenced sedimentation and total organic carbon (TOC) enrichment by promoting primary productivity and organic matter burial in the UK sectors of the Boreal Seaway. Consistent with such climate boundary conditions, petrographic observations, total organic carbon and carbonate contents, and major and trace element data presented here indicate that the KCF of the Cleveland Basin was deposited in the Laurasian Seaway under the influence of these conditions. Depositional conditions alternated between three states that produced a distinct cyclicity in the lithological and geochemical records: lower-variability mudstone intervals (LVMIs) which comprise clay-rich mudstone and higher-variability mudstone intervals (HVMIs) which comprise TOC-rich sedimentation and carbonate-rich sedimentation. The lower-variability mudstone intervals dominate the studied interval but are punctuated by three ∼ 2–4 m thick intervals of alternating TOC-rich and carbonate-rich sedimentation (HVMIs). During the lower-variability mudstone intervals, conditions were quiescent with oxic to suboxic bottom water conditions. During the higher-variability mudstone intervals, highly dynamic conditions resulted in repeated switching of the redox system in a way similar to the modern deep basins of the Baltic Sea. During carbonate-rich sedimentation, oxic conditions prevailed, most likely due to elevated depositional energies at the seafloor by current–wave action. During TOC-rich sedimentation, intermittent anoxic–euxinic conditions led to an enrichment of redox-sensitive and sulfide-forming trace metals at the seafloor and a preservation of organic matter, and an active Mn–Fe particulate shuttle delivered redox-sensitive and sulfide-forming trace metals to the seafloor. In addition, based on TOC–S–Fe relationships, organic matter sulfurization appears to have increased organic material preservation in about half of the analysed samples throughout the core, while the remaining samples were either dominated by excess Fe input into the system or experienced pyrite oxidation and sulfur loss during oxygenation events. New Hg∕TOC data do not provide evidence of increased volcanism during this time, consistent with previous work. Set in the context of recent climate modelling, our study provides a comprehensive example of the dynamic climate-driven depositional and redox conditions that can control TOC and metal accumulations in a shallow epicontinental sea, and it is therefore key to understanding the formation of similar deposits throughout Earth's history.

Climate exerts a strong influence on sedimentation. Understanding the processes behind the spatial and temporal heterogeneities in sedimentary successions can, therefore, be used to reconstruct climate processes in the geological past. Deposited across >1000 km in northwest Europe in the shallow (< 200 m), epicontinental Laurasian Seaway, the Kimmeridge Clay Formation provides an exceptional opportunity to study climate processes and their effect on sedimentation at different latitudes through the Late Jurassic (Kimmeridgian-Tithonian). This thesis presents independent climate modelling, sedimentological, and geochemical datasets from three time-equivalent sections, spanning 1 million years, in the northern and southern extents of the Laurasian Seaway (30-60°N palaeo-latitude) in order to investigate climate dynamics and controls on sedimentation at different northern hemisphere latitudes in the Late Jurassic. The climate modelling results yield two different hypotheses: 1) HadCM3L indicates that an expanded Hadley Cell and migrated intertropical convergence zone resulted in tropical conditions over the Laurasian Seaway, whereby organic carbon-enrichment in sediments was promoted through enhanced nutrient supply resulting from continental weathering and erosion, and 2) FOAM suggests subtropical-temperate conditions prevailed and that organic carbon enrichment was driven by wind-driven upwelling of nutrient-rich water. Sedimentological and geochemical analyses for the Ebberston 87 Core, drilled in the Cleveland Basin (Yorkshire, UK), indicates depositional conditions fluctuated between three distinct states and that alternations of organic carbon-rich, carbonate-rich, and clay-rich mudstone and redox conditions were driven by the expansion/migration of the intertropical convergence zone. Analysis of the Swanworth Quarry 1 Core, drilled in the Wessex Basin (Dorset, UK), reveals that although depositional energy differed between the Cleveland and Wessex Basins, sedimentation in both basins was driven by the same, over-arching tropical climate control. Analysis of a third core, drilled in Adventdalen (Svalbard), demonstrates that organic carbon-rich sedimentation occurred in a deltaic setting, which had a markedly higher depositional energy. While the depositional environments in the northern and southern sectors of the Laurasian Seaway differed substantially, similarities between the three studied sections, namely cyclical deposition of terrestrial organic carbon-rich and detrital-rich sedimentation, integrated with published data from throughout the seaway, suggest a low-latitude, tropical influence on sedimentation and organic carbon enrichment across the entire Laurasian Seaway. Furthermore, the palaeogeographic setting of the Laurasian Seaway made the sedimentary system sensitive to subtle changes in weathering and water depths, resulting in distinct modes of sedimentation and biogeochemical cycling.

Contemporary consumers, societies, and ecologies face many challenges to well-being. Consumer researchers have responded with new attention to what engenders happiness and flourishing, particularly as a function of wiser consumption. Consumer wisdom has been conceptualized as the pursuit of well-being through the application of six interrelated dimensions: responsibility, purpose, flexibility, perspective, reasoning, and sustainability.However, up to now, the roles ofmarketingmanagement and government policies with respect to enabling and supporting consumer wisdom have not been thoroughly and systematically considered. To do this, the authors adopt an integrative approach based on a range of theoretical and empirical insights from both consumer research and wisdom research in the social sciences. They weave these insights into the stages of an expanded version of the circular economy model of the value cycle, within which they also include the traditional four Ps of the marketing mix. This approach allows the authors to identify how marketing practices and public policies can enable and support consumer wisdom, resulting in advancements to well-being and the common good, as well as restorations to the missions and reputations of business and government.

Background Risk prediction for patients with suspected coronary artery disease is complex due to the common occurrence of prior cardiovascular disease and extensive risk modification in primary care. Numerous markers have the potential to predict prognosis and guide management, but we currently lack robust ‘real-world’ evidence for their use. Methods Prospective, multicentre observational study of consecutive patients referred for elective coronary angiography. Clinicians were blinded to all risk assessments, consisting of conventional factors, radial artery pulse wave analysis, 5-minute heart rate variability, high-sensitivity C-reactive protein and B-type natriuretic peptide (BNP). Blinded, independent adjudication was performed for all-cause mortality and the composite of death, myocardial infarction or stroke, analysed with Cox proportional hazards regression. Results Five hundred twenty-two patients were assessed with median age 66 years and 21% prior revascularization. Median baseline left ventricular ejection fraction was 64%, and 62% had ≥ 50% stenosis on angiography. During 5.0 years median follow-up, 30% underwent percutaneous and 16% surgical revascularization. In multivariate analysis, only age and BNP were independently associated with outcomes. The adjusted hazard ratio per log unit increase in BNP was 2.15 for mortality (95% CI 1.45–3.19; p  = 0.0001) and 1.27 for composite events (1.04–1.54; p  = 0.018). Patients with baseline BNP > 100 pg/mL had substantially higher mortality and composite events (20.9% and 32.2%) than those with BNP ≤ 100 pg/mL (5.6% and 15.5%). BNP improved both classification and discrimination of outcomes ( p  ≤ 0.003), regardless of left ventricular systolic function. Conversely, high-sensitivity C-reactive protein, pulse wave analysis and heart rate variability were unrelated to prognosis at 5 years after risk modification and treatment of coronary disease. Conclusions Conventional risk factors and other markers of arterial compliance, inflammation and autonomic function have limited value for prediction of outcomes in risk-modified patients assessed for coronary disease. BNP can independently identify patients with subtle impairment of cardiac function that might benefit from more intensive management. Trial registration Clinicaltrials.gov, NCT00403351 Registered on 22 November 2006

Introduction: With the goal of eliminating hepatitis C virus (HCV) as a public health problem in Washington State, Public Health–Seattle & King County (PHSKC) designed a Hepatitis C Virus Test and Cure (HCV-TAC) data system to integrate surveillance, clinical, and laboratory data into a comprehensive database. The intent of the system was to promote identification, treatment, and cure of HCV-infected persons (ie, HCV care cascade) using a population health approach. Materials and Methods: The data system automatically integrated case reports received via telephone and fax from health care providers and laboratories, hepatitis test results reported via electronic laboratory reporting, and data on laboratory and clinic visits reported by 6 regional health care systems. PHSKC examined patient-level laboratory test results and established HCV case classification using Council of State and Territorial Epidemiologists criteria, classifying patients as confirmed if they had detectable HCV RNA. Results: The data enabled PHSKC to report the number of patients at various stages along the HCV care cascade. Of 7747 HCV RNA-positive patients seen by a partner site, 5377 (69%) were assessed for severity of liver fibrosis, 3932 (51%) were treated, and 2592 (33%) were cured. Practice Implications: Data supported local public heath surveillance and HCV program activities. The data system could serve as a foundation for monitoring future HCV prevention and control programs.

Hepatitis C virus (HCV) infection is common in the United States and leads to significant morbidity, mortality, and economic costs. Simplified screening recommendations and highly effective direct‐acting antivirals for HCV present an opportunity to eliminate HCV. The objective of this study was to increase testing, linkage to care, treatment, and cure of HCV. This was an observational, prospective, population‐based intervention program carried out between September 2014 and September 2018 and performed in three community health centers, three large multiclinic health care systems, and an HCV patient education and advocacy group in King County, WA. There were 232,214 patients included based on criteria of documented HCV‐related diagnosis code, positive HCV laboratory test or prescription of HCV medication, and seen at least once at a participating clinical site in the prior year. Electronic health record (EHR) prompts and reports were created. Case management linked patients to care. Primary care providers received training through classroom didactics, an online curriculum, specialty clinic shadowing, and a telemedicine program. The proportion of baby boomer patients with documentation of HCV testing increased from 18% to 54% during the project period. Of 77,577 baby boomer patients screened at 87 partner clinics, 2,401 (3%) were newly identified HCV antibody positive. The number of patients staged for treatment increased by 391%, and those treated increased by 1,263%. Among the 79% of patients tested after treatment, 95% achieved sustained virologic response. Conclusion: A combination of EHR‐based health care system interventions, active linkage to care, and clinician training contributed to a tripling in the number of patients screened and a more than 10‐fold increase of those treated. The interventions are scalable and foundational to the goal of HCV elimination.

Contemporary consumers, societies, and ecologies face many challenges to well-being. Consumer researchers have responded with new attention to what engenders happiness and flourishing, particularly as a function of consuming more wisely. Consumer wisdom has been conceptualized as the pursuit of well-being through the application of six interrelated dimensions: Responsibility, Purpose, Flexibility, Perspective, Reasoning, and Sustainability (Luchs, Mick, and Haws 2020). However, up to now, the roles of marketing management and government policies with respect to enabling and supporting consumer wisdom have not been thoroughly and systematically considered. To do so, we adopt an integrative approach based on a range of theoretical and empirical insights from both wisdom research in the social sciences and in consumer research. We weave those insights into the stages of an expanded version of the circular economy model of the value cycle, within which we also include the traditional four Ps of the marketing mix. This approach allows us to identify how marketing practices and public policies can enable and support consumer wisdom, resulting in advancements to well-being and the common good as well as restorations to the missions and reputations of business and government.