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A dust with climate The EPICA ice core, drilled at Dome C in East Antarctica, provides an undisturbed record of the past eight climatic cycles. Dust particles in the atmosphere can affect temperature by absorbing or reflecting solar radiation, and previous work suggested that production, transport and deposition of dust is influenced by climatic changes on glacial-interglacial timescales. A new analysis of the record of dust deposits in the EPICA core shows that the flux in atmospheric dust content increasingly correlates with Antarctic temperature during glacial periods as the climate gets colder, indicative of a progressive coupling of the climates of Antarctica and lower latitudes. An observed 25-fold increase in glacial dust flux over all eight glacial periods may reflect a strengthening of South American dust sources, and longer dust-particle lifetimes in the upper troposphere due to a reduced hydrological cycle during ice ages. It has been suggested that production, transport, and deposition of dust is influenced by climatic changes on glacial-interglacial timescales. This paper presents a high-resolution record of aeolian dust from the EPICA Dome C ice core in East Antarctica, which suggests that dust is increasingly correlated with Antarctic temperature as the climate becomes colder, indicative of a progressive coupling of the climates of Antarctica and lower latitudes. Dust can affect the radiative balance of the atmosphere by absorbing or reflecting incoming solar radiation 1 ; it can also be a source of micronutrients, such as iron, to the ocean 2 . It has been suggested that production, transport and deposition of dust is influenced by climatic changes on glacial-interglacial timescales 3 , 4 , 5 , 6 . Here we present a high-resolution record of aeolian dust from the EPICA Dome C ice core in East Antarctica, which provides an undisturbed climate sequence over the past eight climatic cycles 7 , 8 . We find that there is a significant correlation between dust flux and temperature records during glacial periods that is absent during interglacial periods. Our data suggest that dust flux is increasingly correlated with Antarctic temperature as the climate becomes colder. We interpret this as progressive coupling of the climates of Antarctic and lower latitudes. Limited changes in glacial-interglacial atmospheric transport time 4 , 9 , 10 suggest that the sources and lifetime of dust are the main factors controlling the high glacial dust input. We propose that the observed ∼25-fold increase in glacial dust flux over all eight glacial periods can be attributed to a strengthening of South American dust sources, together with a longer lifetime for atmospheric dust particles in the upper troposphere resulting from a reduced hydrological cycle during the ice ages.

Agricultural land use is a primary driver of environmental impacts on streams. However, the causal processes that shape these impacts operate through multiple pathways and at several spatial scales. This complexity undermines the development of more effective management approaches, and illustrates the need for more in-depth studies to assess the mechanisms that determine changes in stream biodiversity. Here we present results of the most comprehensive multi-scale assessment of the biological condition of streams in the Amazon to date, examining functional responses of fish assemblages to land use. We sampled fish assemblages from two large human-modified regions, and characterized stream conditions by physical habitat attributes and key landscape-change variables, including density of road crossings (i.e. riverscape fragmentation), deforestation, and agricultural intensification. Fish species were functionally characterized using ecomorphological traits describing feeding, locomotion, and habitat preferences, and these traits were used to derive indices that quantitatively describe the functional structure of the assemblages. Using structural equation modeling, we disentangled multiple drivers operating at different spatial scales, identifying causal pathways that significantly affect stream condition and the structure of the fish assemblages. Deforestation at catchment and riparian network scales altered the channel morphology and the stream bottom structure, changing the functional identity of assemblages. Local deforestation reduced the functional evenness of assemblages (i.e. increased dominance of specific trait combinations) mediated by expansion of aquatic vegetation cover. Riverscape fragmentation reduced functional richness, evenness and divergence, suggesting a trend toward functional homogenization and a reduced range of ecological niches within assemblages following the loss of regional connectivity. These results underscore the often-unrecognized importance of different land use changes, each of which can have marked effects on stream biodiversity. We draw on the relationships observed herein to suggest priorities for the improved management of stream systems in the multiple-use landscapes that predominate in human-modified tropical forests.

Background Rare locations of hernias, as well as primary ventral hernias under certain circumstances (cirrhosis, dialysis, rectus diastasis, subsequent pregnancy), might be technically challenging. The aim was to identify situations where the treatment strategy might deviate from routine management. Methods The guideline group consisted of surgeons from the European and Americas Hernia Societies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used in formulating the recommendations. The Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklists were used to evaluate the quality of full‐text papers. A systematic literature search was performed on 1 May 2018 and updated 1 February 2019. The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was followed. Results Literature was limited in quantity and quality. A majority of the recommendations were graded as weak, based on low quality of evidence. In patients with cirrhosis or on dialysis, a preperitoneal mesh repair is suggested. Subsequent pregnancy is a risk factor for recurrence. Repair should be postponed until after the last pregnancy. For patients with a concomitant rectus diastasis or those with a Spigelian or lumbar hernia, no recommendation could be made for treatment strategy owing to lack of evidence. Conclusion This is the first European and American guideline on the treatment of umbilical and epigastric hernias in patients with special conditions, including Spigelian and lumbar hernias. All recommendations were weak owing to a lack of evidence. Further studies are needed on patients with rectus diastasis, Spigelian and lumbar hernias. Antecedentes Las hernias de localización rara, así como las hernias ventrales primarias en determinadas circunstancias (cirrosis, diálisis, diástasis de recto, tras un embarazo) pueden ser complejas desde el punto de vista técnico. El objetivo fue identificar situaciones en las que la estrategia de tratamiento pudiera ser diferente del tratamiento habitual. Métodos Esta guía fue elaborada por cirujanos de las sociedades europeas y americana de hernia (European Hernia Society, EHS y American Hernia Society, AHS). La búsqueda sistemática de la literatura se efectuó el 1 de mayo de 2018 y se actualizó el 1 de febrero de 2019. Para evaluar la calidad de los artículos completos seleccionados se utilizó la normativa SIGN (Scottish Intercollegiate Guidelines Network). Las recomendaciones formuladas siguieron la metodología GRADE (Grading of Recommendations Assessment, Development and Evaluation) y la redacción de la guía siguió las normas AGREE (Appraisal of Guidelines for Research & Evaluation). Resultados La literatura es limitada en cantidad y calidad. La mayoría de las recomendaciones se calificaron como débiles en función de la baja calidad de la evidencia. En pacientes con cirrosis o en diálisis, se sugiere una reparación con malla preperitoneal. Un embarazo tras la reparación de una hernia es un factor de riesgo de recidiva. La reparación debería posponerse hasta después del último embarazo. Debido a la falta de evidencia no se pudo hacer ninguna recomendación para la reparación de hernias en pacientes con diástasis de recto concomitante o con hernias de Spigel o lumbares. Conclusión Esta es la primera guía europea y americana del tratamiento de hernias umbilicales y epigástricas en pacientes con patologías especiales, incluyendo las hernias de Spigel y lumbares. Todas las recomendaciones fueron débiles debido a la falta de evidencia. Se necesitan más estudios en pacientes con diástasis de recto, hernias de Spigel y lumbares. This guideline addresses the treatment of umbilical and epigastric hernias in clinically challenging situations (cirrhosis, dialysis, subsequent pregnancy, rectus diastasis), as well as the treatment of Spigelian and primary lumbar hernias. Emphasises the need for better evidence

AimThe prevalence and definition of diastasis recti abdominis (DRA) is under debate. This retrospective cross-sectional study evaluated the interrectal distance and the prevalence of DRA in computed tomography (CT) in an asymptomatic population.Materials and methodsPatients undergoing CT scans for suspected appendicitis or kidney stones from 01/2016 to 12/2018 were screened retrospectively to participate. A study population with equal distribution according to gender and age (18–90 years) was generated (n = 329 patients) and the interrectal distance was measured at six reference points.ResultsDRA (defined as > 2 cm at 3 cm above the umbilicus) was present in 57% of the population. The 80th percentile of the interrectal distance was 10 mm at the xiphoid (median 3 mm, 95% confidence interval (CI) 0–19 mm), 27 mm halfway from xiphoid to umbilicus (median 17 mm, 95% CI 0–39 mm), 34 mm at 3 cm above the umbilicus (median 22 mm, 95% CI 0–50 mm), 32 mm at the umbilicus (median 25 mm, 95% CI 0–45 mm), 25 mm at 2 cm below the umbilicus (median 14 mm, 95% CI 0–39 mm), and 4 mm halfway from umbilicus to pubic symphysis (median 0 mm, 95% CI 0–19 mm). In the multivariate analysis, higher age (p = 0.001), increased body mass index (p < 0.001), and parity (p < 0.037) were independent risk factors for DRA, while split xiphoid, tobacco abuse, and umbilical hernia were not.ConclusionThe prevalence of DRA is much higher than commonly estimated (57%). The IRD 3 cm above the umbilicus may be considered normal up to 34 mm. To avoid over-treatment, the definition of DRA should be revised.

Instream wood plays important chemical, physical and ecological functions in aquatic systems, benefiting biota directly and indirectly. However, human activities along river corridors have disrupted wood recruitment and retention, usually leading to reductions in the amount of instream wood. In the tropics, where wood is believed to be more transient, the expansion of agriculture and infrastructure might be reducing instream wood stock even more than in the better studied temperate streams. However, research is needed to augment the small amount of information about wood in different biomes and ecosystems of neotropical streams. Here we present the first extensive assessment of instream wood loads and size distributions in streams of the wet-tropical Amazon and semi-humid-tropical Cerrado (the Brazilian savanna). We also compare neotropical wood stocks with those in temperate streams, first comparing against data from the literature, and then from a comparable dataset from temperate biomes in the USA. Contrary to our expectations, Amazon and Cerrado streams carried similar wood loads, which were lower than the world literature average, but similar to those found in comparable temperate forest and savanna streams in the USA. Our results indicate that the field survey methods and the wood metric adopted are highly important when comparing different datasets. But when properly compared, we found that most of the wood in temperate streams is made-up of a small number of large pieces, whereas wood in neotropical streams is made up of a larger number of small pieces that produce similar total volumes. The character of wood volumes among biomes is linked more to the delivery, transport and decomposition mechanisms than to the total number of pieces. Future studies should further investigate the potential instream wood drivers in neotropical catchments in order to better understand the differences and similarities here detected between biomes and climatic regions.

The biological assessment of rivers i.e., their assessment through use of aquatic assemblages, integrates the effects of multiple-stressors on these systems over time and is essential to evaluate ecosystem condition and establish recovery measures. It has been undertaken in many countries since the 1990s, but not globally. And where national or multi-national monitoring networks have gathered large amounts of data, the poor water body classifications have not necessarily resulted in the rehabilitation of rivers. Thus, here we aimed to identify major gaps in the biological assessment and rehabilitation of rivers worldwide by focusing on the best examples in Asia, Europe, Oceania, and North, Central, and South America. Our study showed that it is not possible so far to draw a world map of the ecological quality of rivers. Biological assessment of rivers and streams is only implemented officially nation-wide and regularly in the European Union, Japan, Republic of Korea, South Africa, and the USA. In Australia, Canada, China, New Zealand, and Singapore it has been implemented officially at the state/province level (in some cases using common protocols) or in major catchments or even only once at the national level to define reference conditions (Australia). In other cases, biological monitoring is driven by a specific problem, impact assessments, water licenses, or the need to rehabilitate a river or a river section (as in Brazil, South Korea, China, Canada, Japan, Australia). In some countries monitoring programs have only been explored by research teams mostly at the catchment or local level (e.g., Brazil, Mexico, Chile, China, India, Malaysia, Thailand, Vietnam) or implemented by citizen science groups (e.g., Southern Africa, Gambia, East Africa, Australia, Brazil, Canada). The existing large-extent assessments show a striking loss of biodiversity in the last 2–3 decades in Japanese and New Zealand rivers (e.g., 42% and 70% of fish species threatened or endangered, respectively). A poor condition (below Good condition) exists in 25% of South Korean rivers, half of the European water bodies, and 44% of USA rivers, while in Australia 30% of the reaches sampled were significantly impaired in 2006. Regarding river rehabilitation, the greatest implementation has occurred in North America, Australia, Northern Europe, Japan, Singapore, and the Republic of Korea. Most rehabilitation measures have been related to improving water quality and river connectivity for fish or the improvement of riparian vegetation. The limited extent of most rehabilitation measures (i.e., not considering the entire catchment) often constrains the improvement of biological condition. Yet, many rehabilitation projects also lack pre-and/or post-monitoring of ecological condition, which prevents assessing the success and shortcomings of the recovery measures. Economic constraints are the most cited limitation for implementing monitoring programs and rehabilitation actions, followed by technical limitations, limited knowledge of the fauna and flora and their life-history traits (especially in Africa, South America and Mexico), and poor awareness by decision-makers. On the other hand, citizen involvement is recognized as key to the success and sustainability of rehabilitation projects. Thus, establishing rehabilitation needs, defining clear goals, tracking progress towards achieving them, and involving local populations and stakeholders are key recommendations for rehabilitation projects (Table 1). Large-extent and long-term monitoring programs are also essential to provide a realistic overview of the condition of rivers worldwide. Soon, the use of DNA biological samples and eDNA to investigate aquatic diversity could contribute to reducing costs and thus increase monitoring efforts and a more complete assessment of biodiversity. Finally, we propose developing transcontinental teams to elaborate and improve technical guidelines for implementing biological monitoring programs and river rehabilitation and establishing common Water 2021, 13, 371 3 of 45 financial and technical frameworks for managing international catchments. We also recommend providing such expert teams through the United Nations Environment Program to aid the extension of biomonitoring, bioassessment, and river rehabilitation knowledge globally.

1. Agricultural expansion and intensification are major threats to tropical biodiversity. In addition to the direct removal of native vegetation, agricultural expansion often elicits other human-induced disturbances, many of which are poorly addressed by existing environmental legislation and conservation programmes. This is particularly true for tropical freshwater systems, where there is considerable uncertainty about whether a legislative focus on protecting riparian vegetation is sufficient to conserve stream fauna. 2. To assess the extent to which stream fish are being effectively conserved in agricultural landscapes, we examined the spatial distribution of assemblages in river basins to identify the relative importance of human impacts at instream, riparian and catchment scales, in shaping observed patterns. We used an extensive dataset on the ecological condition of 83 low-order streams distributed in three river basins in the eastern Brazilian Amazon. 3. We collected and identified 24,420 individual fish from 134 species. Multiplicative diversity partitioning revealed high levels of compositional dissimilarity (DS) among stream sites (DS = 0.74 to 0.83) and river basins (DS = 0.82), due mainly to turnover (77.8% to 81.8%) rather than nestedness. The highly heterogeneous fish faunas in small Amazonian streams underscore the vital importance of enacting measures to protect forests on private lands outside of public protected areas. 4. Instream habitat features explained more variability in fish assemblages (15%-19%) than riparian (2%-12%), catchment (4%-13%) or natural covariates (4%-11%). Although grouping species into functional guilds allowed us to explain up to 31% of their abundance (i.e. for nektonic herbivores), individual riparian - and catchment - scale predictor variables that are commonly a focus of environmental legislation explained very little of the observed variation (partial R² values mostly <5%). 5. Policy implications. Current rates of agricultural intensification and mechanization tropical landscapes are unprecedented, yet the existing legislative frameworks focusing on protecting riparian vegetation seem insufficient to conserve stream environments and their fish assemblages. To safeguard the species-rich freshwater biota of small Amazonian streams, conservation actions must shift towards managing whole basins and drainage networks, as well as agricultural practices in already-cleared land.

Climate variation affects surface ocean processes and the production of organic carbon, which ultimately comprises the primary food supply to the deep-sea ecosystems that occupy ≈60% of the Earth's surface. Warming trends in atmospheric and upper ocean temperatures, attributed to anthropogenic influence, have occurred over the past four decades. Changes in upper ocean temperature influence stratification and can affect the availability of nutrients for phytoplankton production. Global warming has been predicted to intensify stratification and reduce vertical mixing. Research also suggests that such reduced mixing will enhance variability in primary production and carbon export flux to the deep sea. The dependence of deep-sea communities on surface water production has raised important questions about how climate change will affect carbon cycling and deep-ocean ecosystem function. Recently, unprecedented time-series studies conducted over the past two decades in the North Pacific and the North Atlantic at >4,000-m depth have revealed unexpectedly large changes in deep-ocean ecosystems significantly correlated to climate-driven changes in the surface ocean that can impact the global carbon cycle. Climate-driven variation affects oceanic communities from surface waters to the much-overlooked deep sea and will have impacts on the global carbon cycle. Data from these two widely separated areas of the deep ocean provide compelling evidence that changes in climate can readily influence deep-sea processes. However, the limited geographic coverage of these existing time-series studies stresses the importance of developing a more global effort to monitor deep-sea ecosystems under modern conditions of rapidly changing climate.

Blackwater rivers and streams have stained or tea‐colored water from tannins released by decaying plant matter. Natural conditions in these waters often differ from non‐blackwater systems. For example, the pH and oxygen levels in waters can be very low, but completely natural. We examined an existing USEPA data set and found that blackwaters existed across the contiguous United States but were most common in the east. Water chemistry showed differences between blackwater and non‐blackwater sites, but differences were not consistent across ecoregions making national scale generalizations difficult. Physical habitat data analysis did not show dramatic differences between blackwater and non‐blackwater sites. Blackwater typically arises from streams that drain tannin‐rich bogs/muskeg and wetlands, so as expected blackwater sites had a shorter Euclidean distance to wetlands than non‐blackwater sites and existed in watersheds with a higher percentage of wetland habitat. Blackwaters in Northern and Temperate Plains tended to have higher acid neutralizing capacity, conductivity, and lower True Color; a visual color scale used for water purity. We posit that differences were because Color and Dissolved Organic Carbon at these sites were from buried wetland deposits rather than contemporary wetland habitats. Research needs that may increase our understanding and management of blackwaters include development of an operational definition that includes a classification framework and reference conditions for different blackwater types, identification of stressors and their associated dynamics that negatively impact blackwater systems, and development of data‐driven, consistent, and repeatable assessment methods, including development of targets, protective of unique conditions in blackwater rivers and streams. Plain Language Summary Blackwater rivers and stream systems have stained or tea‐colored water due to tannins released by decaying plant matter. Although blackwaters exist across the contiguous United States, they are most common in the eastern United States. Beyond their distinct appearance, the chemistry of blackwater systems can be very different from other stream types. For example, the pH and amount of oxygen in the water can be very low, but completely natural. As a result of these and other characteristics, the fish, plants, and animals that live in blackwaters can also be unique. Because of these considerations, management of these systems can be challenging. To address these challenges, U.S. Environmental Protection Agency scientists are studying these systems. One of their early findings is that different types of blackwaters exist across the country. The team has highlighted the need for a classification system to distinguish among these types. Once this system exists, scientists can begin to identify what is required to protect blackwater systems and the services they supply. Key Points There are a substantial number of blackwater rivers in multiple ecoregions of the United States The water chemistry of blackwater rivers and streams is often very different than that of non‐blackwater rivers and streams We explore these differences and identify research needs that would contribute to their management and protection

The boycott of polio vaccination in three Northern Nigerian states in 2003 created a global health crisis that was political in origin. This paper traces the diplomatic actions that were taken by the Global Polio Eradication Initiative, the United Nations, and the U.S. government, to restart polio vaccination and resolve the crisis. The polio vaccination boycott in Northern Nigeria provides a useful case study of the practice of global health diplomacy. [PUBLICATION ABSTRACT]