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Boreal forest fires emit large amounts of carbon into the atmosphere primarily through the combustion of soil organic matter 1 – 3 . During each fire, a portion of this soil beneath the burned layer can escape combustion, leading to a net accumulation of carbon in forests over multiple fire events 4 . Climate warming and drying has led to more severe and frequent forest fires 5 – 7 , which threaten to shift the carbon balance of the boreal ecosystem from net accumulation to net loss 1 , resulting in a positive climate feedback 8 . This feedback will occur if organic-soil carbon that escaped burning in previous fires, termed ‘legacy carbon’, combusts. Here we use soil radiocarbon dating to quantitatively assess legacy carbon loss in the 2014 wildfires in the Northwest Territories of Canada 2 . We found no evidence for the combustion of legacy carbon in forests that were older than the historic fire-return interval of northwestern boreal forests 9 . In forests that were in dry landscapes and less than 60 years old at the time of the fire, legacy carbon that had escaped burning in the previous fire cycle was combusted. We estimate that 0.34 million hectares of young forests (<60 years) that burned in the 2014 fires could have experienced legacy carbon combustion. This implies a shift to a domain of carbon cycling in which these forests become a net source—instead of a sink—of carbon to the atmosphere over consecutive fires. As boreal wildfires continue to increase in size, frequency and intensity 7 , the area of young forests that experience legacy carbon combustion will probably increase and have a key role in shifting the boreal carbon balance. Soil radiocarbon dating reveals that combusted ‘legacy carbon’—soil carbon that escaped burning during previous fires—could shift the carbon balance of boreal ecosystems, resulting in a positive climate feedback.

We present a timeseries of 14CO2 for the period 1910–2021 recorded by annual plants collected in the southwestern United States, centered near Flagstaff, Arizona. This timeseries is dominated by five commonly occurring annual plant species in the region, which is considered broadly representative of the southern Colorado Plateau. Most samples (1910–2015) were previously archived herbarium specimens, with additional samples harvested from field experiments in 2015–2021. We used this novel timeseries to develop a smoothed local record with uncertainties for “bomb spike” 14C dating of recent terrestrial organic matter. Our results highlight the potential importance of local records, as we document a delayed arrival of the 1963–1964 bomb spike peak, lower values in the 1980s, and elevated values in the last decade in comparison to the most current Northern Hemisphere Zone 2 record. It is impossible to retroactively collect atmospheric samples, but archived annual plants serve as faithful scribes: samples from herbaria around the Earth may be an under-utilized resource to improve understanding of the modern carbon cycle.

Boreal forests harbor as much carbon (C) as the atmosphere and significant amounts of organic nitrogen (N), the nutrient most likely to limit plant productivity in high‐latitude ecosystems. In the boreal biome, the primary disturbance is wildfire, which consumes plant biomass and soil material, emits greenhouse gasses, and influences long‐term C and N cycling. Climate warming and drying is increasing wildfire severity and frequency and is combusting more soil organic matter (SOM). Combustion of surface SOM exposes deeper older layers of accumulated soil material that previously escaped combustion during past fires, here termed legacy SOM. Postfire SOM decomposition and nutrient availability are determined by these layers, but the drivers of legacy SOM decomposition are unknown. We collected soils from plots after the largest fire year on record in the Northwest Territories, Canada, in 2014. We used radiocarbon dating to measure Δ14C (soil age index), soil extractions to quantify N pools and microbial biomass, and a 90‐day laboratory incubation to measure the potential rate of element mineralization and understand patterns and drivers of legacy SOM C decomposition and N availability. We discovered that bulk soil C age predicted C decomposition, where cumulatively, older soil (approximately −450.0‰) produced 230% less C during the incubation than younger soil (~0.0‰). Soil age also predicted C turnover times, with old soil turnover 10 times slower than young soil. We found respired C was younger than bulk soil C, indicating most C enters and leaves relatively quickly, while the older portion remains a stable C sink. Soil age and other indices were unrelated to N availability, but microbial biomass influenced N availability, with more microbial biomass immobilizing soil N pools. Our results stress the importance of legacy SOM as a stable C sink and highlight that soil age drives the pace and magnitude of soil C contributions to the atmosphere between wildfires.

Background General practitioners play an important role in the first-line care of individuals with mental health conditions. However, factors such as time constraints, limited experience in managing mental health conditions and high rates of comorbidity may hinder adequate treatment. To improve psychological care, adopting a transdiagnostic approach shows potential. Research on transdiagnostic interventions delivered by general practitioners is scarce. Thus, a transdiagnostic intervention adapted from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders was developed specifically for primary care. In a parallel-group, two-arm, cluster randomised controlled pilot study, the transdiagnostic intervention will be evaluated for feasibility, acceptability and potential effectiveness in German primary care. Methods A total of 100 adult patients with a mental health condition will be recruited by general practitioners. In the intervention group, general practitioners will administer the transdiagnostic intervention, introducing patients to psychological concepts based on transdiagnostic factors (i.e., understanding emotions, cognitive flexibility, countering emotion-based avoidance). In the control group, general practitioners will provide improved treatment as usual oriented on official German treatment guidelines for depression, anxiety and somatoform disorders. In both study groups, treatment will be carried out in four 20-min sessions over 12-weeks. Self-report questionnaires will be completed before treatment initiation (only patients) and after treatment completion (patients and general practitioners) to assess feasibility and acceptability (i.e., treatment recruitment, delivery, response, effectiveness, unintended consequences and maintenance) as well as potential effectiveness (i.e., change in transdiagnostic factors). Discussion The pilot study will address the research gap concerning general practitioner-led psychological interventions in primary care and will give insights into whether the adoption of a transdiagnostic approach is of benefit to general practitioners and patients. Findings may inform the design of a main trial by identifying barriers to the transdiagnostic intervention’s feasibility and acceptability, whilst advancing treatment delivery protocols to support effectiveness. Trial registration The protocol for this study has been registered with the German Clinical Trials Register: DRKS00033386, Date of registration: 18 th of March 2024, https://drks.de/search/en/trial/DRKS00033386 .

Ebert argues that colonial trade tended to lead to accelerated state involvement in the activities of the merchants involved, and consequently spawned an evolving institutional framework. He suggests that the shift in the use of insurance was a noticeable and accelerating trend in the period up to 1630, which was the formative phase of Atlantic trade since it fell chronologically before the widespread creation of chartered joint-stock companies in a variety of European states. Individualist forms of merchant organization did not entirely supplant collectivist methodology, neither in the early modern period nor in people own time. But the maritime insurance practices described here were precursors of modern financial mechanisms. State-sponsored institutions for managing risk are also dominant features of modern capitalism. They are indispensable supports for the proliferation of individualist merchant practices that are characteristic in developed countries today.

This study of the wholesale trade in Brazilian sugar challenges previous imperial and mercantilist perspectives and presents the Atlantic economy in its earliest phases as an integrated, inter-imperial system not subject to monopolies and effective imperial regulation.

Depressive disorders are common in the primary care setting. Despite its high prevalence, depression treatment in primary care is less guideline-oriented compared to specialized settings, which often makes it less efficient. Current research has focused on explanations on the practitioner's side but has neglected the patient's perspective and its effect on treatment largely. We conducted a scoping review on the electronic databases Medline and Psycinfo. Eligible publications contained information of the patients' perspective on depression treatment in primary care in OECD member states. Publications until August 2nd 2023 were considered. After the removal of duplicates, the search yielded 14.059 articles, of which 232 were included. Current literature focuses on behavioral and obvious measures like satisfaction, and on patient-sided barriers and facilitators to adherence. Other treatment-related behaviors are less researched. Patients with undiagnosed depression often report exclusively or mainly physical symptoms in general practice. This review provides a comprehensive framework for the concept. Research on barriers and facilitators to depression treatment in primary care is still inconclusive. Educating patients and addressing stigmatizing beliefs are promising targets to promote the seeking out, initiation of, and adherence to treatment. Being aware of a hidden depression when somatic symptoms are present, can help to detect more cases. This review is registered via OSF (https://osf.io/p9rnc).

Background Antidepressants are first-line medications for many psychiatric disorders. However, their widespread long-term use in some indications (e.g., mild depression and insomnia) is concerning. Particularly in older adults with comorbidities and polypharmacy, who are more susceptible to adverse drug reactions, the risks and benefits of treatment should be regularly reviewed. The aim of this consensus process was to identify explicit criteria of potentially inappropriate antidepressant use (indicators) in order to support primary care clinicians in identifying situations, where deprescribing of antidepressants should be considered. Methods We used the RAND/UCLA Appropriateness Method to identify the indicators of high-risk and overprescribing of antidepressants. We combined a structured literature review with a 3-round expert panel, with results discussed in moderated meetings in between rounds. Each of the 282 candidate indicators was scored on a 9-point Likert scale representing the necessity of a critical review of antidepressant continuation (1–3 = not necessary; 4–6 = uncertain; 7–9 = clearly necessary). Experts rated the indicators for the necessity of review, since decisions to deprescribe require considerations of patient risk/benefit balance and preferences. Indicators with a median necessity rating of ≥ 7 without disagreement after 3 rating rounds were accepted. Results The expert panel comprised 2 general practitioners, 2 clinical pharmacologists, 1 gerontopsychiatrist, 2 psychiatrists, and 3 internists/geriatricians (total N  = 10). After 3 assessment rounds, there was consensus for 37 indicators of high-risk and 25 indicators of overprescribing, where critical reviews were felt to be necessary. High-risk prescribing indicators included settings posing risks of drug-drug, drug-disease, and drug-age interactions or the occurrence of adverse drug reactions. Indicators with the highest ratings included those suggesting the possibility of cardiovascular risks (QTc prolongation), delirium, gastrointestinal bleeding, and liver injury in specific patient subgroups with additional risk factors. Overprescribing indicators target patients with long treatment durations for depression, anxiety, and insomnia as well as high doses for pain and insomnia. Conclusions Explicit indicators of antidepressant high-risk and overprescribing may be used directly by patients and health care providers, and integrated within clinical decision support tools, in order to improve the overall risk/benefit balance of this commonly prescribed class of prescription drugs.

Unipolar depression is a prevalent and disabling condition, often left untreated. In the outpatient setting, general practitioners fail to recognize depression in about 50% of cases mainly due to somatic comorbidities. Given the significant economic, social, and interpersonal impact of depression and its increasing prevalence, there is a need to improve its diagnosis and treatment in outpatient care. Various efforts have been made to isolate individual biological markers for depression to streamline diagnostic and therapeutic approaches. However, the intricate and dynamic interplay between neuroinflammation, metabolic abnormalities, and relevant neurobiological correlates of depression is not yet fully understood. To address this issue, we propose a naturalistic prospective study involving outpatients with unipolar depression, individuals without depression or comorbidities, and healthy controls. In addition to clinical assessments, cardiovascular parameters, metabolic factors, and inflammatory parameters are collected. For analysis we will use conventional statistics as well as machine learning algorithms. We aim to detect relevant participant subgroups by data-driven cluster algorithms and their impact on the subjects’ long-term prognosis. The POKAL-PSY study is a subproject of the research network POKAL (Predictors and Clinical Outcomes in Depressive Disorders; GRK 2621).

Background Antidepressants have a pivotal role in the treatment of many psychiatric disorders, but there are concerns about long-term use and adverse effects. The objectives of this study were (1) to examine time trends in antidepressant use, (2) to estimate the prevalence of long-term and potential high-risk antidepressant use, and (3) to examine patient characteristics associated with potential deprescribing indications (PDIs) (i.e., simultaneous long-term and potential high-risk antidepressant use). Methods Repeated population-based cross-sectional study for all 609,299 people aged ≥ 18 years resident in the Tayside or Fife regions of Scotland. The prevalence of antidepressant use was examined on June 30th (index date) of each year from 2012 to 2019, while the prevalence of long-term and potential high-risk use as well as PDIs was assessed and compared on the same dates in 2012 and 2019. Binary logistic regression modeling was used to examine patient characteristics associated with PDIs. Results Antidepressant use increased by 27% from 12.0 to 15.3% among adult residents between 2012 and 2019. While the proportion of antidepressants users dispensed ≥ 1 antidepressant for > 2 years increased from 54.3 to 61.9% between 2012 and 2019, the proportion of antidepressant users triggering ≥ 1 indicator of potential high-risk use decreased slightly from 37.9 to 34.7%. In 2019, potential high-risk use most commonly related to indicators targeting fall risk (16.0%), cardiovascular risks (14.1%), insomnia (10.6%), and risk of orthostatic hypotension (8.6%). More than 1 in 4 (25.8%) antidepressant users had PDIs. The main risk factors associated with PDIs included increasing age (65–79, adjusted OR 14.12; 95% CI, 13.15–15.17), increasing number of drugs taken concomitantly (≥ 15 drugs, adjusted OR 7.37; 95% CI, 6.71–8.10), use of tricyclic antidepressants (≥ 50 mg) (adjusted OR 5.49; 95% CI, 5.02–6.01), and concomitant use of ≥ 2 antidepressants (adjusted OR 5.52; 95% CI, 5.20–5.85). Conclusions Long-term and potential high-risk use of antidepressants is widespread, and potential deprescribing indications (PDIs) are increasing, suggesting the need for a critical review of their ongoing use by clinicians. If deemed necessary, future deprescribing interventions may use the criteria applied here for identification of patients with PDIs and for evaluating intervention effectiveness.