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Changes in temperature, precipitation, sea level, and coastal storms will likely increase the vulnerability of infrastructure across the United States. Using four models that analyze vulnerability, impacts, and adaptation, this paper estimates impacts to roads, bridges, coastal properties, and urban drainage infrastructure and investigates sensitivity to varying greenhouse gas emission scenarios, climate sensitivities, and global climate models. The results suggest that the impacts of climate change in this sector could be large, especially in the second half of the 21st century as sea-level rises, temperature increases, and precipitation patterns become more extreme and affect the sustainability of long-lived infrastructure. Further, when considering sea-level rise, scenarios which incorporate dynamic ice sheet melting yield impact model results in coastal areas that are roughly 70 to 80 % higher than results that do not incorporate dynamic ice sheet melting. The potential for substantial economic impacts across all infrastructure sectors modeled, however, can be reduced by cost-effective adaptation measures. Mitigation policies also show potential to reduce impacts in the infrastructure sector – a more aggressive mitigation policy reduces impacts by 25 to 35 %, and a somewhat less aggressive policy reduces impacts by 19 to 30 %. The existing suite of models suitable for estimating these damages nonetheless covers only a small portion of expected infrastructure sector effects from climate change, so much work remains to better understand impacts on electric and telecommunications networks, rail, and air transportation systems. In addition, the effects of climate-induced extreme events are likely to be important, but are incompletely understood and remain an emerging area for research.

Rock domes, with their onion-skin layers of exfoliation sheets, are among the most captivating landforms on Earth. Long recognized as integral in shaping domes, the exact mechanism(s) by which exfoliation occurs remains enigmatic, mainly due to the lack of direct observations of natural events. In August 2014, during the hottest days of summer, a granitic dome in California, USA, spontaneously exfoliated; witnesses observed extensive cracking, including a ~8000 kg sheet popping into the air. Subsequent exfoliation episodes during the following two summers were recorded by instrumentation that captured—for the first time—exfoliation deformation and stress conditions. Here we show that thermal cycling and cumulative dome surface heating can induce subcritical cracking that culminates in seemingly spontaneous exfoliation. Our results indicate that thermal stresses—largely discounted in dome formation literature—can play a key role in triggering exfoliation and therefore may be an important control for shaping domes worldwide. Thermal triggering of rock exfoliation has long been discounted as relevant to the evolution of rock domes. Here, the authors documented and measured recent fracturing events in California, USA to show that hot summer periods can lead to thermal stresses and cause seemingly spontaneous rock exfoliation.

Consistent relations between shallow landslide initiation and associated rainfall characteristics remain difficult to identify, due largely to the complex hydrological and geological processes causing slopes to be predisposed to failure and those processes that subsequently trigger failures. Considering the importance of hillslope hydrology for rainfall-induced landsliding, we develop and test a method for identifying hybrid hydro-meteorological thresholds to assess landslide initiation potential. We outline a series of steps for using a landslide inventory in combination with triggering rainfall and antecedent wetness to identify empirical thresholds that can inform landslide early warning systems. The method is semi-automated but remains flexible enough to allow threshold developers to consider data inputs and various performance metrics with different priorities for balancing failed versus false alarms. We demonstrate the utility of our approach for two monitoring sites near Seattle, Washington and in Portland, Oregon, USA, to develop daily bilinear thresholds within a two-dimensional parameter space, which rely on accurate 24 h forecasts, measured recent rainfall and in situ soil saturation. Although there were no prior landslide thresholds for Portland, our new hybrid threshold for the Seattle area outperforms established rainfall-only thresholds for the same region. Introducing subsurface hydrologic monitoring into landslide initiation thresholds has the potential to greatly improve early warning capabilities and help reduce losses.

We reviewed existing and planned adaptation activities of federal, tribal, state, and local governments and the private sector in the United States (U.S.) to understand what types of adaptation activities are underway across different sectors and scales throughout the country. Primary sources of review included material officially submitted for consideration in the upcoming 2013 U.S. National Climate Assessment and supplemental peer-reviewed and grey literature. Although substantial adaptation planning is occurring in various sectors, levels of government, and the private sector, few measures have been implemented and even fewer have been evaluated. Most adaptation actions to date appear to be incremental changes, not the transformational changes that may be needed in certain cases to adapt to significant changes in climate. While there appear to be no one-size-fits-all adaptations, there are similarities in approaches across scales and sectors, including mainstreaming climate considerations into existing policies and plans, and pursuing no- and low-regrets strategies. Despite the positive momentum in recent years, barriers to implementation still impede action in all sectors and across scales. The most significant barriers include lack of funding, policy and institutional constraints, and difficulty in anticipating climate change given the current state of information on change. However, the practice of adaptation can advance through learning by doing, stakeholder engagements (including “listening sessions”), and sharing of best practices. Efforts to advance adaptation across the U.S. and globally will necessitate the reduction or elimination of barriers, the enhancement of information and best practice sharing mechanisms, and the creation of comprehensive adaptation evaluation metrics.

Preterm-labour-associated preterm birth is a common cause of perinatal mortality and morbidity in twin pregnancy. We aimed to test the hypothesis that the Arabin pessary would reduce preterm-labour-associated preterm birth by 40% or greater in women with a twin pregnancy and a short cervix. We conducted an open-label randomised controlled trial in 57 hospital antenatal clinics in the UK and Europe. From 1 April 2015 to 14 February 2019, 2,228 women with a twin pregnancy underwent cervical length screening between 18 weeks 0 days and 20 weeks 6 days of gestation. In total, 503 women with cervical length ≤ 35 mm were randomly assigned to pessary in addition to standard care (n = 250, mean age 32.4 years, mean cervical length 29 mm, with pessary inserted in 230 women [92.0%]) or standard care alone (n = 253, mean age 32.7 years, mean cervical length 30 mm). The pessary was inserted before 21 completed weeks of gestation and removed at between 35 and 36 weeks or before birth if earlier. The primary obstetric outcome, spontaneous onset of labour and birth before 34 weeks 0 days of gestation, was present in 46/250 (18.4%) in the pessary group compared to 52/253 (20.6%) following standard care alone (adjusted odds ratio [aOR] 0.87 [95% CI 0.55-1.38], p = 0.54). The primary neonatal outcome-a composite of any of stillbirth, neonatal death, periventricular leukomalacia, early respiratory morbidity, intraventricular haemorrhage, necrotising enterocolitis, or proven sepsis, from birth to 28 days after the expected date of delivery-was present in 67/500 infants (13.4%) in the pessary group compared to 76/506 (15.0%) following standard care alone (aOR 0.86 [95% CI 0.54-1.36], p = 0.50). The positive and negative likelihood ratios of a short cervix (≤35 mm) to predict preterm birth before 34 weeks were 2.14 and 0.83, respectively. A meta-analysis of data from existing publications (4 studies, 313 women) and from STOPPIT-2 indicated that a cervical pessary does not reduce preterm birth before 34 weeks in women with a short cervix (risk ratio 0.74 [95% CI 0.50-1.11], p = 0.15). No women died in either arm of the study; 4.4% of babies in the Arabin pessary group and 5.5% of babies in the standard treatment group died in utero or in the neonatal period (p = 0.53). Study limitations include lack of power to exclude a smaller than 40% reduction in preterm labour associated preterm birth, and to be conclusive about subgroup analyses. These results led us to reject our hypothesis that the Arabin pessary would reduce the risk of the primary outcome by 40%. Smaller treatment effects cannot be ruled out. ISRCTN Registry ISRCTN 02235181. ClinicalTrials.gov NCT02235181.

Article 2 of the United Nations Framework Convention on Climate Change [United Nations (1992) http://unfccc.int/resource/docs/convkp/conveng.pdf. Accessed February 9, 2009] commits signatory nations to stabilizing greenhouse gas concentrations in the atmosphere at a level that \"would prevent dangerous anthropogenic interference (DAI) with the climate system.\" In an effort to provide some insight into impacts of climate change that might be considered DAI, authors of the Third Assessment Report (TAR) of the Intergovernmental Panel on Climate Change (IPCC) identified 5 \"reasons for concern\" (RFCs). Relationships between various impacts reflected in each RFC and increases in global mean temperature (GMT) were portrayed in what has come to be called the \"burning embers diagram.\" In presenting the \"embers\" in the TAR, IPCC authors did not assess whether any single RFC was more important than any other; nor did they conclude what level of impacts or what atmospheric concentrations of greenhouse gases would constitute DAI, a value judgment that would be policy prescriptive. Here, we describe revisions of the sensitivities of the RFCs to increases in GMT and a more thorough understanding of the concept of vulnerability that has evolved over the past 8 years. This is based on our expert judgment about new findings in the growing literature since the publication of the TAR in 2001, including literature that was assessed in the IPCC Fourth Assessment Report (AR4), as well as additional research published since AR4. Compared with results reported in the TAR, smaller increases in GMT are now estimated to lead to significant or substantial consequences in the framework of the 5 \"reasons for concern.\"

Quantifying the value of investment in medical research can inform decision-making on the prioritisation of research programmes. Existing methodologies to estimate the rate of return of medical research are inappropriate for early-phase translational research due to censoring of health benefits and time lags. A strategy to improve the process of translational research for patient benefit has been initiated as part of the UK National Institute for Health Research (NIHR) investment in Biomedical Research Centres (BRCs) in England. By providing a platform for partnership between universities, NHS trusts and industry, successful BRCs should reduce time lags within translational research whilst also providing an impetus for local economic growth through industry collaboration. We present a novel contribution in the assessment of early-phase biomedical research by estimating the impact of the Oxford Biomedical Research Centre (OxBRC) on income and job creation following the initial NIHR investment. We adopt a macroeconomic assessment approach using Input-Output Analysis to estimate the value of medical research in terms of income and job creation during the early pathway towards translational biomedical research. Inter-industry linkages are assessed by building a model economy for the South East England region to estimate the return on investment of the OxBRC. The results from the input-output model estimate that the return on investment in biomedical research within the OxBRC is 46%. Each £1 invested in the OxBRC generates an additional £0.46 through income and job creation alone. Multiplicative employment effects following a marginal investment in the OxBRC of £98m during the period 2007-2017 result in an estimated additional 196 full time equivalent positions being created within the local economy on top of direct employment within OxBRC. Results from input-output analyses can be used to inform the prioritisation of biomedical research programmes when compared against national minimum thresholds of investment.

[This corrects the article DOI: 10.1371/journal.pone.0214361.].

Early warning for rainfall-induced shallow landsliding can help reduce fatalities and economic losses. Although these commonly occurring landslides are typically triggered by subsurface hydrological processes, most early warning criteria rely exclusively on empirical rainfall thresholds and other indirect proxies for subsurface wetness. We explore the utility of explicitly accounting for antecedent wetness by integrating real-time subsurface hydrologic measurements into landslide early warning criteria. Our efforts build on previous progress with rainfall thresholds, monitoring, and numerical modeling along the landslide-prone railway corridor between Everett and Seattle, Washington, USA. We propose a modification to a previously established recent versus antecedent (RA) cumulative rainfall thresholds by replacing the antecedent 15-day rainfall component with an average saturation observed over the same timeframe. We calculate this antecedent saturation with real-time telemetered measurements from five volumetric water content probes installed in the shallow subsurface within a steep vegetated hillslope. Our hybrid rainfall versus saturation (RS) threshold still relies on the same recent 3-day rainfall component as the existing RA thresholds, to facilitate ready integration with quantitative precipitation forecasts. During the 2015–2017 monitoring period, this RS hybrid approach has an increase of true positives and a decrease of false positives and false negatives relative to the previous RA rainfall-only thresholds. We also demonstrate that alternative hybrid threshold formats could be even more accurate, which suggests that further development and testing during future landslide seasons is needed. The positive results confirm that accounting for antecedent wetness conditions with direct subsurface hydrologic measurements can improve thresholds for alert systems and early warning of rainfall-induced shallow landsliding.

Within a few decades, tens of billions, and possibly over a hundred billion, dollars will be needed for climate change adaptation in developing countries. In recent international climate negotiations, US$100 billion per year by 2020 was pledged by developed countries for mitigation and adaptation. Even if this pledge is realized, it is not clear that it will generate sufficient funds to address the adaptation needs of developing countries. A majority of what has been identified as climate change adaptation needs could be considered as funding for basic development. In addition, a large share of current development assistance is spent on climate-sensitive projects. With the potential for funding of climate change adaptation to fall short of what is needed and for development funding to continue funding many climate-sensitive activities, coordination of the two funding streams may enable more effective support for both sustainable development and climate change adaptation. Preliminary steps to facilitate such coordination are part of the Cancun Agreements and initiatives by other organizations.