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The XWS (eXtreme WindStorms) catalogue consists of storm tracks and model-generated maximum 3 s wind-gust footprints for 50 of the most extreme winter windstorms to hit Europe in the period 1979–2012. The catalogue is intended to be a valuable resource for both academia and industries such as (re)insurance, for example allowing users to characterise extreme European storms, and validate climate and catastrophe models. Several storm severity indices were investigated to find which could best represent a list of known high-loss (severe) storms. The best-performing index was Sft, which is a combination of storm area calculated from the storm footprint and maximum 925 hPa wind speed from the storm track. All the listed severe storms are included in the catalogue, and the remaining ones were selected using Sft. A comparison of the model footprint to station observations revealed that storms were generally well represented, although for some storms the highest gusts were underestimated. Possible reasons for this underestimation include the model failing to simulate strong enough pressure gradients and not representing convective gusts. A new recalibration method was developed to estimate the true distribution of gusts at each grid point and correct for this underestimation. The recalibration model allows for storm-to-storm variation which is essential given that different storms have different degrees of model bias. The catalogue is available at http://www.europeanwindstorms.org .

Natural hazards, such as European windstorms, have widespread effects that result in insured losses at multiple locations throughout a continent. Multivariate extreme-value statistical models for such environmental phenomena must therefore accommodate very high dimensional spatial data, as well as correctly representing dependence in the extremes to ensure accurate estimation of these losses. Ideally one would employ a flexible model, able to characterise all forms of extremal dependence. However, such models are restricted to a few dozen dimensions, hence an a priori diagnostic approach must be used to identify the dominant form of extremal dependence. Here, we present various approaches for exploring the dominant extremal dependence class in very high dimensional spatial hazard fields: tail dependency measures, copula fits, and conceptual loss distributions. These approaches are illustrated by application to a data set of high-dimensional historical European windstorm footprints (6103 spatial maps of 3-day maximum gust speeds at 14 872 locations). We find there is little evidence of asymptotic extremal dependency in windstorm footprints. Furthermore, empirical extremal properties and conceptual losses are shown to be well reproduced using Gaussian copulas but not by extremally dependent models such as Gumbel copulas. It is conjectured that the lack of asymptotic dependence is a generic property of turbulent flows. These results open up the possibility of using geostatistical Gaussian process models for fast simulation of windstorm hazard fields.

A decline in damaging European windstorms has led to a reduction in insured losses in the 21st century. This decline is explored by identifying a damaging windstorm characteristic and investigating how and why this characteristic has changed in recent years. This novel exploration is based on 6103 high-resolution model-generated historical footprints (1979–2014), representing the whole European domain. The footprint of a windstorm is defined as the maximum wind gust speed to occur at a set of spatial locations over the duration of the storm. The area of the footprint exceeding 20 ms−1 over land, A20, is shown to be a good predictor of windstorm damage. This damaging characteristic has decreased in the 21st century, due to a statistically significant decrease in the relative frequency of windstorms exceeding 20 ms−1 in north-western Europe, although an increase is observed in southern Europe. This is explained by a decrease in the quantiles of the footprint wind gust speed distribution above approximately 18 ms−1 at locations in this region. In addition, an increased variability in the number of windstorm events is observed in the 21st century. Much of the change in A20 is explained by the North Atlantic Oscillation (NAO). The correlation between winter total A20 and winter-averaged mean sea-level pressure resembles the NAO pattern, shifted eastwards over Europe, and a strong positive relationship (correlation of 0.715) exists between winter total A20 and winter-averaged NAO. The shifted correlation pattern, however, suggests that other modes of variability may also play a role in the variation in windstorm losses.

Clearer understanding is needed of the premises underlying SI and how it relates to food-system priorities. Food security is high on the global policy agenda. Demand for food is increasing as populations grow and gain wealth to purchase more varied and resource-intensive diets. There is increased competition for land, water, energy, and other inputs into food production. Climate change poses challenges to agriculture, particularly in developing countries ( 1 ), and many current farming practices damage the environment and are a major source of greenhouse gases (GHG). In an increasingly globalized world, food insecurity in one region can have widespread political and economic ramifications ( 2 ).

Advocates of growth management and smart growth often propose policies that raise housing prices, thereby making housing less affordable to many households trying to buy or rent homes. Such policies include urban growth boundaries, zoning restrictions on multi-family housing, utility district lines, building permit caps, and even construction moratoria. Does this mean there is an inherent conflict between growth management and smart growth on the one hand, and creating more affordable housing on the other? Or can growth management and smart growth promote policies that help increase the supply of affordable housing? These issues are critical to the future of affordable housing because so many local communities are adopting various forms of growth management or smart growth in response to growth-related problems. Those problems include rising traffic congestion, the absorption of open space by new subdivisions, and higher taxes to pay for new infrastructures. This book explores the relationship between growth management and smart growth and affordable housing in depth. It draws from material presented at a symposium on these subjects held at the Brookings Institution in May 2003, sponsored by the U.S. Department of Housing and Urban Development, the National Association of Realtors, and the Fannie Mae Foundation. Contributors seek to inform the debate and provide some useful answers to help the nation accommodate the curtailment of growth in urban and suburban domains while still ensuring a supply of affordable housing. Contributors include Karen Destorel Brown (Brookings), Robert Burchell, (Rutgers University), Daniel Carlson (University of Washington), David L. Crawford (Econsult Corporation), Anthony Downs (Brookings), Ingrid Gould Ellen (New York University), William Fischel (Dartmouth College), George C. Galster (Wayne State University), Jill Khadduri (Abt Associates), Gerrit J. Knaap (University of Maryland), Robert Lang (Virginia Polytechnic Institute and State University), Shishir Mathur (University of Washington), Arthur C. Nelson (Virginia Polytechnic Institute and State University), Rolf Pendall (Cornell University), Douglas R. Porter, (Growth Management Institute), Michael Pyatok (University of Washington), Michael Schill (New York University School of Law), Samuel R. Staley (Reason Public Policy Institute), Richard P. Voith (Econsult Corporation).

Seawater temperatures are increasing, with many unquantified impacts on marine diseases. While prolonged temperature stress can accelerate host–pathogen interactions, the outcomes in nature are poorly quantified. We monitored eelgrass wasting disease (EWD) from 2013–2017 and correlated mid-summer prevalence of EWD with remotely sensed seawater temperature metrics before, during, and after the 2015–2016 marine heatwave in the northeast Pacific, the longest marine heatwave in recent history. Eelgrass shoot density declined by 60% between 2013 and 2015 and did not recover. EWD prevalence ranged from 5–70% in 2013 and increased to 60–90% by 2017. EWD severity approximately doubled each year between 2015 and 2017. EWD prevalence was positively correlated with warmer temperature for the month prior to sampling while EWD severity was negatively correlated with warming prior to sampling. This complex result may be mediated by leaf growth; bigger leaves may be more likely to be diseased, but may also grow faster than lesions, resulting in lower severity. Regional stressors leading to population declines prior to or early in the heatwave may have exacerbated the effects of warming on eelgrass disease susceptibility and reduced the resilience of this critical species.

Cerebral angiography is an invasive procedure associated with a small, but definite risk of neurological morbidity. In this study we sought to establish the nature and rate of complications at our institution among a large prospective cohort of consecutive patients. Also, the data were analysed in an attempt to identify risk factors for complications associated with catheter angiography. Data were prospectively collected for a consecutive cohort of patients undergoing diagnostic cerebral angiography between January 2001 and May 2006. A total of 2,924 diagnostic cerebral angiography procedures were performed during this period. The following data were recorded for each procedure: date of procedure, patient age and sex, clinical indication, referring specialty, referral status (routine/emergency), operator, angiographic findings, and the nature of any clinical complication or asymptomatic adverse event (arterial dissection). Clinical complications occurred in 23 (0.79%) of the angiographic procedures: 12 (0.41%) significant puncture-site haematomas, 10 (0.34%) transient neurological events, and 1 nonfatal reaction to contrast agent. There were no permanent neurological complications. Asymptomatic technical complications occurred in 13 (0.44%) of the angiographic procedures: 3 groin dissections and 10 dissections of the cervical vessels. No patient with a neck dissection suffered an immediate or delayed stroke. Emergency procedures (P = 0.0004) and angiography procedures performed for intracerebral haemorrhage (P = 0.02) and subarachnoid haemorrhage (P = 0.04) were associated with an increased risk of complications. Neurological complications following cerebral angiography are rare (0.34%), but must be minimized by careful case selection and the prudent use of alternative noninvasive angiographic techniques, particularly in the acute setting. The low complication rate in this series was largely due to the favourable case mix.

Smoking rates in the UK are at an all-time low but this masks considerable inequalities; prevalence amongst adults who are homeless remains four times higher than the national average. The objective of this trial was to assess the feasibility of supplying free e-cigarette starter kits to smokers accessing homeless centres and to estimate parameters to inform a possible future larger trial. In this feasibility cluster trial, four homeless centres in Great Britain were non-randomly allocated to either a Usual Care (UC) or E-Cigarette (EC) arm. Smokers attending the centres were recruited by staff. UC arm participants (N = 32) received advice to quit and signposting to the local Stop Smoking Service. EC arm participants (N = 48) received an EC starter kit and 4-weeks supply of e-liquid. Outcome measures were recruitment and retention rates, use of ECs, smoking cessation/reduction and completion of measures required for economic evaluation. Eighty (mean age 43 years; 65% male) of the 153 eligible participants who were invited to participate, were successfully recruited (52%) within a five-month period, and 47 (59%) of these were retained at 24 weeks. The EC intervention was well received with minimal negative effects and very few unintended consequences (e.g. lost, theft, adding illicit substances). In both study arm, depression and anxiety scores declined over the duration of the study. Substance dependence scores remained constant. Assuming those with missing follow up data were smoking, CO validated sustained abstinence at 24 weeks was 3/48 (6.25%) and 0/32 (0%) respectively for the EC and UC arms. Almost all participants present at follow-up visits completed data collection for healthcare service and health-related quality of life measures. Providing an e-cigarette starter kit to smokers experiencing homelessness was associated with reasonable recruitment and retention rates and promising evidence of effectiveness and cost-effectiveness.

This study uses a randomized controlled trial (RCT) to test the health benefits of expressive writing that is culturally adapted for Chinese immigrant breast cancer survivors (BCSs) and to characterize how acculturation moderates the effects of expressive writing interventions. We will recruit Chinese immigrant BCSs (N = 240) diagnosed with stage 0-III breast cancer and within 5 years of completion of primary treatment. Recruitment will occur primarily through community-based organizations and cancer registries. Participants will be randomly assigned either to a control condition to write about neutral topics or to one of two intervention conditions, self-regulation or self-cultivation, both of which aim to promote adaptive cognitive processes but differ in how they achieve this goal. The self-regulation intervention culturally adapts a Western expressive writing paradigm and incorporates emotional disclosure, whereas the self-cultivation intervention originates from Asian cultural values without disclosing emotions. Participants in all three conditions will be asked to write in their preferred language for three 30-minute sessions. The primary outcome will be quality of life (QOL) at the 6- and 12-month follow-ups, and the secondary outcomes will be perceived stress, stress biomarkers, and medical appointments for cancer-related morbidities. This project will be the first large RCT to test culturally based brief interventions to improve QOL and reduce stress among Chinese immigrant BCSs. This project is expected to address two important needs of Chinese immigrant BCSs: their unmet psychological needs and the lack of culturally competent mental health care for Chinese immigrant BCSs. The immediate product of this line of research will be empirically evaluated, culturally responsive interventions ready for dissemination to Chinese immigrant BCSs across the United States. NCT04754412.

Purpose We evaluated the impact of personal melanoma genomic risk information on sun-related behaviors and psychological outcomes. Methods In this parallel group, open, randomized controlled trial, 1,025 Australians of European ancestry without melanoma and aged 18–69 years were recruited via the Medicare database (3% consent). Participants were randomized to the intervention ( n  = 513; saliva sample for genetic testing, personalized melanoma risk booklet based on a 40-variant polygenic risk score, telephone-based genetic counseling, educational booklet) or control ( n  = 512; educational booklet). Wrist-worn ultraviolet (UV) radiation dosimeters (10-day wear) and questionnaires were administered at baseline, 1 month postintervention, and 12 months postbaseline. Results At 12 months, 948 (92%) participants completed dosimetry and 973 (95%) the questionnaire. For the primary outcome, there was no effect of the genomic risk intervention on objectively measured UV exposure at 12 months, irrespective of traditional risk factors. For secondary outcomes at 12 months, the intervention reduced sunburns (risk ratio: 0.72, 95% confidence interval: 0.54–0.96), and increased skin examinations among women. Melanoma-related worry was reduced. There was no overall impact on general psychological distress. Conclusion Personalized genomic risk information did not influence sun exposure patterns but did improve some skin cancer prevention and early detection behaviors, suggesting it may be useful for precision prevention. There was no evidence of psychological harm.