Indian Ocean glacial deoxygenation and respired carbon accumulation during mid-late Quaternary ice ages

Reconstructions of ocean oxygenation are critical for understanding the role of respired carbon storage in regulating atmospheric CO2. Independent sediment redox proxies are essential to assess such reconstructions. Here, we present a long magnetofossil record from the eastern Indian Ocean in which we observe coeval magnetic hardening and enrichment of larger, more elongated, and less oxidized magnetofossils during glacials compared to interglacials over the last ~900 ka. Our multi-proxy records of redox-sensitive magnetofossils, trace element concentrations, and benthic foraminiferal Δδ13C consistently suggest a recurrence of lower O2 in the glacial Indian Ocean over the last 21 marine isotope stages, as has been reported for the Atlantic and Pacific across the last glaciation. Consistent multi-proxy documentation of this repeated oxygen decline strongly supports the hypothesis that increased Indian Ocean glacial carbon storage played a significant role in atmospheric CO2 cycling and climate change over recent glacial/interglacial timescales.

Open-Source Intelligence for Detection of Radiological Events and Syndromes Following the Invasion of Ukraine in 2022: Observational Study

BACKGROUND

On February 25, 2022, Russian forces took control of the Chernobyl power plant after continuous fighting within the Chernobyl exclusion zone. Continual events occurred in the month of March, which raised the risk of potential contamination of previously uncontaminated areas and the potential for impacts on human and environmental health. The disruption of war has caused interruptions to normal preventive activities, and radiation monitoring sensors have been nonfunctional. Open-source intelligence can be informative when formal reporting and data are unavailable.

OBJECTIVE

This paper aimed to demonstrate the value of open-source intelligence in Ukraine to identify signals of potential radiological events of health significance during the Ukrainian conflict.

METHODS

Data were collected from search terminology for radiobiological events and acute radiation syndrome detection between February 1 and March 20, 2022, using 2 open-source intelligence (OSINT) systems, EPIWATCH and Epitweetr.

RESULTS

Both EPIWATCH and Epitweetr identified signals of potential radiobiological events throughout Ukraine, particularly on March 4 in Kyiv, Bucha, and Chernobyl.

CONCLUSIONS

Open-source data can provide valuable intelligence and early warning about potential radiation hazards in conditions of war, where formal reporting and mitigation may be lacking, to enable timely emergency and public health responses.

Angular Correlations in the β Decay of ^{8}B: First Tensor-Current Limits from a Mirror-Nucleus Pair

We present the first measurement of the α-β-ν angular correlation in the Gamow-Teller β^{+} decay of ^{8}B. This was accomplished using the Beta-decay Paul Trap, expanding on our previous work on the β^{-} decay of ^{8}Li. The ^{8}B result is consistent with the V-A electroweak interaction of the standard model and, on its own, provides a limit on the exotic right-handed tensor current relative to the axial-vector current of |C_{T}/C_{A}|^{2}<0.013 at the 95.5% confidence level. This represents the first high-precision angular correlation measurements in mirror decays and was made possible through the use of an ion trap. By combining this ^{8}B result with our previous ^{8}Li results, we demonstrate a new pathway for increased precision in searches for exotic currents.

Artificial intelligence in public health: the potential of epidemic early warning systems

The use of artificial intelligence (AI) to generate automated early warnings in epidemic surveillance by harnessing vast open-source data with minimal human intervention has the potential to be both revolutionary and highly sustainable. AI can overcome the challenges faced by weak health systems by detecting epidemic signals much earlier than traditional surveillance. AI-based digital surveillance is an adjunct to-not a replacement of-traditional surveillance and can trigger early investigation, diagnostics and responses at the regional level. This narrative review focuses on the role of AI in epidemic surveillance and summarises several current epidemic intelligence systems including ProMED-mail, HealthMap, Epidemic Intelligence from Open Sources, BlueDot, Metabiota, the Global Biosurveillance Portal, Epitweetr and EPIWATCH. Not all of these systems are AI-based, and some are only accessible to paid users. Most systems have large volumes of unfiltered data; only a few can sort and filter data to provide users with curated intelligence. However, uptake of these systems by public health authorities, who have been slower to embrace AI than their clinical counterparts, is low. The widespread adoption of digital open-source surveillance and AI technology is needed for the prevention of serious epidemics.

Modeling on the Effects of Deliberate Release of Aerosolized Inhalational Bacillus anthracis (Anthrax) on an Australian Population

This study aimed to determine optimal mitigation strategies in the event of an aerosolized attack with Bacillus anthracis, a category A bioterrorism agent with a case fatality rate of nearly 100% if inhaled and untreated. To simulate the effect of an anthrax attack, we used a plume dispersion model for Sydney, Australia, accounting for weather conditions. We determined the radius of exposure in different sizes of attack scenarios by spore quantity released per second. Estimations of different spore concentrations were then used to calculate the exposed population to inform a Susceptible-Exposed-Infected-Recovered (SEIR) deterministic mathematical model. Results are shown as estimates of the total number of exposed and infected people, along with the burden of disease, to quantify the amount of vaccination and antibiotics doses needed for stockpiles. For the worst-case scenario, over 500,000 people could be exposed and over 300,000 infected. The number of deaths depends closely on timing to start postexposure prophylaxis. Vaccination used as a postexposure prophylaxis in conjunction with antibiotics is the most effective mitigation strategy to reduce deaths after an aerosolized attack and is more effective when the response starts early (2 days after release) and has high adherence, while it makes only a small difference when started late (after 10 days).

Early pandemic use of face masks in Papua New Guinea under a mask mandate

Objective

During the coronavirus disease (COVID-19) pandemic, face mask wearing was mandated in Port Moresby, Papua New Guinea in July 2020, but compliance was observed to be low. We aimed to determine the frequency of face mask wearing by the general public in Papua New Guinea under the mask mandate.

Methods

To estimate compliance with the mandate, we analysed photographs of people gathering in Port Moresby published between 29 September and 29 October 2020. Photo-epidemiology was performed on the 40 photographs that met pre-defined selection criteria for inclusion in our study.

Results

Among the total of 445 fully visible photographed faces, 53 (11.9%) were observed wearing a face mask over mouth and nose. Complete non-compliance (no faces wearing masks) was observed in 19 (4.3%) photographs. Physical distancing was observed in 10% of the 40 photographs. Mask compliance in indoor settings (16.4%) was higher than that observed in outdoor settings (9.8%), and this difference was statistically significant (P < 0.05). Mask compliance was observed in 8.9% of large-sized gatherings (> 30 people), 12.7% of medium-sized gatherings (11-30 people) and 25.0% of small-sized gatherings (4-10 people; photographs with < 4 people were excluded from analysis).

Discussion

We found very low population compliance with face mask mandates in Papua New Guinea during the pre-vaccine pandemic period. Individuals without face coverings and non-compliant with physical distancing guidelines are considered to be in a high-risk category for COVID-19 transmission particularly in medium- and large-sized gatherings. A new strategy to enforce public health mandates is required and should be clearly promoted to the public.

Graphene- and Nanoparticle-Embedded Antimicrobial and Biocompatible Cotton/Silk Fabrics for Protective Clothing

Protection against pathogens using personal protective equipment is essential yet challenging in healthcare settings. Concerns over emerging biothreats and outbreaks of infectious diseases underscore the need for antimicrobial and biocompatible protective clothing to protect patients and staff. Herein, we report the antimicrobial efficacy and cytotoxicity of cotton/silk fabrics containing embedded reduced graphene oxide (RGO) and Ag/Cu nanoparticles (NPs), prepared using a 3-glycidyloxypropyl trimethoxy silane coupling agent followed by chemical reduction and vacuum heat treatment. Embedding NPs on top of the RGO layer substantially increased the antimicrobial activity. All RGO-Ag NPs or RGO-Cu NPs embedded in cotton or silk fabrics reduced the viability of approximately 99% of the Gram-negative bacteria Escherichia coli and Pseudomonas aeruginosa. RGO-Ag NPs embedded into cotton or silk fabrics reduced the viability of the Gram-positive bacterium Staphylococcus aureus by 78-99%, which was higher than the growth inhibition by RGO-Cu NPs samples against S. aureus. Both silk and cotton containing RGO-Cu NPs produced a greater reduction in the viability of the yeast Candida albicans compared to RGO-Ag NPs fabrics. All RGO-Ag NPs or RGO-Cu NPs embedded in cotton or silk fabrics showed good washing durability by sustaining good bactericidal activity, even on washing up to 10 times. Moreover, none of the RGO-Ag or RGO-Cu fabrics reduced mammalian cells' (HEK293) viability by >30%, suggesting low cytotoxicity and good biocompatibility. These findings show that RGO-NPs embedded in cotton or silk fabrics have great potential for use in protective clothing and medical textiles.

Experimental Evidence for the Optimal Design of a High-Performing Cloth Mask

Cloth masks can be an alternative to medical masks during pandemics. Recent studies have examined the performance of fabrics under various conditions; however, the performance against violent respiratory events such as human sneezes is yet to be explored. Accordingly, we present a comprehensive experimental study using sneezes by a healthy adult and a tailored image-based flow measurement diagnostic system evaluating all dimensions of protection of commonly available fabrics and their layered combinations: the respiratory droplet blocking efficiency, water resistance, and breathing resistance. Our results reveal that a well-designed cloth mask can outperform a three-layered surgical mask for such violent respiratory events. Specifically, increasing the number of layers significantly increases the droplet blocking efficiency, on average by ∼20 times per additional fabric layer. A minimum of three layers is necessary to resemble the droplet blocking performance of surgical masks, and a combination of cotton/linen (hydrophilic inner layer)-blends (middle layer)-polyester/nylon (hydrophobic outer layer) exhibited the best performance among overall indicators tested. In an optimum three-layered design, the average thread count should be greater than 200, and the porosity should be less than 2%. Furthermore, machine washing at 60 °C did not significantly impact the performance of cloth masks. These findings inform the design of high-performing homemade cloth masks.

Sea level and deep-sea temperature reconstructions suggest quasi-stable states and critical transitions over the past 40 million years

Sea level and deep-sea temperature variations are key indicators of global climate changes. For continuous records over millions of years, deep-sea carbonate microfossil-based δ¹⁸O (δ_c) records are indispensable because they reflect changes in both deep-sea temperature and seawater δ¹⁸O (δ_w); the latter are related to ice volume and, thus, to sea level changes. Deep-sea temperature is usually resolved using elemental ratios in the same benthic microfossil shells used for δ_c, with linear scaling of residual δ_w to sea level changes. Uncertainties are large and the linear-scaling assumption remains untested. Here, we present a new process-based approach to assess relationships between changes in sea level, mean ice sheet δ¹⁸O, and both deep-sea δ_w and temperature and find distinct nonlinearity between sea level and δ_w changes. Application to δ_c records over the past 40 million years suggests that Earth's climate system has complex dynamical behavior, with threshold-like adjustments (critical transitions) that separate quasi-stable deep-sea temperature and ice-volume states.

Seldom heard voices: a meta-narrative systematic review of Aboriginal and Torres Strait Islander peoples healthcare experiences

Background

It is well established that Aboriginal and Torres Strait Islander populations face considerable health inequities, exacerbated by poorer healthcare quality. Patient experience is recognised as a major contributing factor to healthcare quality and outcomes, therefore, enriched knowledge of the patient experiences of Aboriginal and Torres Strait Islander populations is critical to redress health inequities. This review synthesises evidence of the healthcare experiences amongst Aboriginal and Torres Strait Islander patients through a metanarrative synthesis of qualitative literature.

Methods

A systematic search strategy was developed and applied to six electronic databases between January 2000 and July 2019. Titles and abstracts were screened before applying the inclusion criteria to full text articles. A meta-narrative synthesis was undertaken.

Results

Fifty-four publications were identified from four research traditions; each with a unique conceptualisation of patient experience. Three themes emerged that demonstrate Aboriginal and Torres Strait Islander patient experiences are informed by 1) beliefs about wellbeing and healthcare provision, 2) their level of trust in the healthcare system, and 3) individual and community health system interactions. The findings highlight a range of aspects of patient experience that were important to participating Aboriginal and Torres Strait Islanders in the included studies but not captured currently in health system surveys.

Conclusion

This review highlights the influence of beliefs about health and wellbeing on the patient experience amongst Aboriginal and Torres Strait Islander populations in the Australian health system. Patient experiences were informed by past experience and their trust in the health system. The different factors influencing patient experience and the gravity of their influence must be considered in current approaches to capturing patient experience data collection methods.

Trial registration

PROSPERO (ID: CRD42019134765).

Coupling of Indo-Pacific climate variability over the last millennium

The Indian Ocean Dipole (IOD) affects climate and rainfall across the world, and most severely in nations surrounding the Indian Ocean^1-4. The frequency and intensity of positive IOD events increased during the twentieth century⁵ and may continue to intensify in a warming world⁶. However, confidence in predictions of future IOD change is limited by known biases in IOD models⁷ and the lack of information on natural IOD variability before anthropogenic climate change. Here we use precisely dated and highly resolved coral records from the eastern equatorial Indian Ocean, where the signature of IOD variability is strong and unambiguous, to produce a semi-continuous reconstruction of IOD variability that covers five centuries of the last millennium. Our reconstruction demonstrates that extreme positive IOD events were rare before 1960. However, the most extreme event on record (1997) is not unprecedented, because at least one event that was approximately 27 to 42 per cent larger occurred naturally during the seventeenth century. We further show that a persistent, tight coupling existed between the variability of the IOD and the El Niño/Southern Oscillation during the last millennium. Indo-Pacific coupling was characterized by weak interannual variability before approximately 1590, which probably altered teleconnection patterns, and by anomalously strong variability during the seventeenth century, which was associated with societal upheaval in tropical Asia. A tendency towards clustering of positive IOD events is evident in our reconstruction, which-together with the identification of extreme IOD variability and persistent tropical Indo-Pacific climate coupling-may have implications for improving seasonal and decadal predictions and managing the climate risks of future IOD variability.

Can feedback approaches reduce unwarranted clinical variation? A systematic rapid evidence synthesis

Background

Assessment of clinical variation has attracted increasing interest in health systems internationally due to growing awareness about better value and appropriate health care as a mechanism for enhancing efficient, effective and timely care. Feedback using administrative databases to provide benchmarking data has been utilised in several countries to explore clinical care variation and to enhance guideline adherent care. Whilst methods for detecting variation are well-established, methods for determining variation that is unwarranted and addressing this are strongly debated. This study aimed to synthesize published evidence of the use of feedback approaches to address unwarranted clinical variation (UCV).

Methods

A rapid review and narrative evidence synthesis was undertaken as a policy-focused review to understand how feedback approaches have been applied to address UCV specifically. Key words, synonyms and subject headings were used to search the major electronic databases Medline and PubMed between 2000 and 2018. Titles and abstracts of publications were screened by two reviewers and independently checked by a third reviewer. Full text articles were screened against the eligibility criteria. Key findings were extracted and integrated in a narrative synthesis.

Results

Feedback approaches that occurred over a duration of 1 month to 9 years to address clinical variation emerged from 27 publications with quantitative (20), theoretical/conceptual/descriptive work (4) and mixed or multi-method studies (3). Approaches ranged from presenting evidence to individuals, teams and organisations, to providing facilitated tailored feedback supported by a process of ongoing dialogue to enable change. Feedback approaches identified primarily focused on changing clinician decision-making and behaviour. Providing feedback to clinicians was identified, in a range of a settings, as associated with changes in variation such as reducing overuse of tests and treatments, reducing variations in optimal patient clinical outcomes and increasing guideline or protocol adherence.

Conclusions

The review findings suggest value in the use of feedback approaches to respond to clinical variation and understand when action is warranted. Evaluation of the effectiveness of particular feedback approaches is now required to determine if there is an optimal approach to create change where needed.

Addressing unwarranted clinical variation: A rapid review of current evidence

INTRODUCTION

Unwarranted clinical variation (UCV) can be described as variation that can only be explained by differences in health system performance. There is a lack of clarity regarding how to define and identify UCV and, once identified, to determine whether it is sufficiently problematic to warrant action. As such, the implementation of systemic approaches to reducing UCV is challenging. A review of approaches to understand, identify, and address UCV was undertaken to determine how conceptual and theoretical frameworks currently attempt to define UCV, the approaches used to identify UCV, and the evidence of their effectiveness.

DESIGN

Rapid evidence assessment (REA) methodology was used.

DATA SOURCES

A range of text words, synonyms, and subject headings were developed for the major concepts of unwarranted clinical variation, standards (and deviation from these standards), and health care environment. Two electronic databases (Medline and Pubmed) were searched from January 2006 to April 2017, in addition to hand searching of relevant journals, reference lists, and grey literature.

DATA SYNTHESIS

Results were merged using reference-management software (Endnote) and duplicates removed. Inclusion criteria were independently applied to potentially relevant articles by 3 reviewers. Findings were presented in a narrative synthesis to highlight key concepts addressed in the published literature.

RESULTS

A total of 48 relevant publications were included in the review; 21 articles were identified as eligible from the database search, 4 from hand searching published work and 23 from the grey literature. The search process highlighted the voluminous literature reporting clinical variation internationally; yet, there is a dearth of evidence regarding systematic approaches to identifying or addressing UCV.

CONCLUSION

Wennberg's classification framework is commonly cited in relation to classifying variation, but no single approach is agreed upon to systematically explore and address UCV. The instances of UCV that warrant investigation and action are largely determined at a systems level currently, and stakeholder engagement in this process is limited. Lack of consensus on an evidence-based definition for UCV remains a substantial barrier to progress in this field.

Coupled microbial bloom and oxygenation decline recorded by magnetofossils during the Palaeocene-Eocene Thermal Maximum

Understanding marine environmental change and associated biological turnover across the Palaeocene–Eocene Thermal Maximum (PETM; ~56 Ma)—the most pronounced Cenozoic short-term global warming event—is important because of the potential role of the ocean in atmospheric CO₂ drawdown, yet proxies for tracing marine productivity and oxygenation across the PETM are limited and results remain controversial. Here we show that a high-resolution record of South Atlantic Ocean bottom water oxygenation can be extracted from exceptionally preserved magnetofossils—the bioinorganic magnetite nanocrystals produced by magnetotactic bacteria (MTB) using a new multiscale environmental magnetic approach. Our results suggest that a transient MTB bloom occurred due to increased nutrient supply. Bottom water oxygenation decreased gradually from the onset to the peak PETM. These observations provide a record of microbial response to the PETM and establish the value of magnetofossils as palaeoenvironmental indicators.

Understanding the response of marine productivity and CO₂ drawdown to past warming events can provide important insights into the future. Here, the authors use bacterial magnetite nanoparticle fossils to reconstruct nutrient supply and marine deoxygenation during the Palaeocene–Eocene Thermal Maximum.

Penultimate deglacial warming across the Mediterranean Sea revealed by clumped isotopes in foraminifera

The variability of seawater temperature through time is a critical measure of climate change, yet its reconstruction remains problematic in many regions. Mg/Ca and oxygen isotope (δ¹⁸O_C) measurements in foraminiferal carbonate shells can be combined to reconstruct seawater temperature and δ¹⁸O (δ¹⁸O_SW). The latter is a measure of changes in local hydrology (e.g., precipitation/evaporation, freshwater inputs) and global ice volume. But diagenetic processes may affect foraminiferal Mg/Ca. This restricts its potential in many places, including the Mediterranean Sea, a strategic region for deciphering global climate and sea-level changes. High alkalinity/salinity conditions especially bias Mg/Ca temperatures in the eastern Mediterranean (eMed). Here we advance the understanding of both western Mediterranean (wMed) and eMed hydrographic variability through the penultimate glacial termination (TII) and last interglacial, by applying the clumped isotope (Δ₄₇) paleothermometer to planktic foraminifera with a novel data-processing approach. Results suggest that North Atlantic cooling during Heinrich stadial 11 (HS11) affected surface-water temperatures much more in the wMed (during winter/spring) than in the eMed (during summer). The method’s paired Δ₄₇ and δ¹⁸O_C data also portray δ¹⁸O_SW. These records reveal a clear HS11 freshwater signal, which attenuated toward the eMed, and also that last interglacial surface warming in the eMed was strongly amplified by water-column stratification during the deposition of the organic-rich (sapropel) interval known as S5.

Dominant 100,000-year precipitation cyclicity in a late Miocene lake from northeast Tibet

East Asian summer monsoon (EASM) precipitation received by northern China over the past 800 thousand years (ky) is characterized by dominant 100-ky periodicity, mainly attributed to CO₂ and Northern Hemisphere insolation-driven ice sheet forcing. We established an EASM record in the Late Miocene from lacustrine sediments in the Qaidam Basin, northern China, which appears to exhibit a dominant 100-ky periodicity similar to the EASM records during the Late Quaternary. Because evidence suggests that partial or ephemeral ice existed in the Northern Hemisphere during the Late Miocene, we attribute the 100-ky cycles to CO₂ and Southern Hemisphere insolation-driven Antarctic ice sheet forcing. This indicates a >6-million year earlier onset of the dominant 100-ky Asian monsoon and, likely, glacial and CO₂ cycles and may indicate dominant forcing of Northern Hemisphere climate by CO₂ and Southern Hemisphere ice sheets in a warm world.

Bipolar seesaw control on last interglacial sea level

Our current understanding of ocean-atmosphere-cryosphere interactions at ice-age terminations relies largely on assessments of the most recent (last) glacial-interglacial transition, Termination I (T-I). But the extent to which T-I is representative of previous terminations remains unclear. Testing the consistency of termination processes requires comparison of time series of critical climate parameters with detailed absolute and relative age control. However, such age control has been lacking for even the penultimate glacial termination (T-II), which culminated in a sea-level highstand during the last interglacial period that was several metres above present. Here we show that Heinrich Stadial 11 (HS11), a prominent North Atlantic cold episode, occurred between 135 ± 1 and 130 ± 2 thousand years ago and was linked with rapid sea-level rise during T-II. Our conclusions are based on new and existing data for T-II and the last interglacial that we collate onto a single, radiometrically constrained chronology. The HS11 cold episode punctuated T-II and coincided directly with a major deglacial meltwater pulse, which predominantly entered the North Atlantic Ocean and accounted for about 70 per cent of the glacial-interglacial sea-level rise. We conclude that, possibly in response to stronger insolation and CO2 forcing earlier in T-II, the relationship between climate and ice-volume changes differed fundamentally from that of T-I. In T-I, the major sea-level rise clearly post-dates Heinrich Stadial 1. We also find that HS11 coincided with sustained Antarctic warming, probably through a bipolar seesaw temperature response, and propose that this heat gain at high southern latitudes promoted Antarctic ice-sheet melting that fuelled the last interglacial sea-level peak.

Anthropogenic forcings on the surficial osmium cycle

Osmium is among the least abundant elements in the Earth's continental crust. Recent anthropogenic Os contamination of the environment from mining and smelting activities, automotive catalytic converter use, and hospital discharges has been documented. Here we present evidence for anthropogenic overprinting of the natural Os cycle using a ca. 7000-year record of atmospheric Os deposition and isotopic composition from an ombrotrophic peat bog in NW Spain. Preanthropogenic Os accumulation in this area is 0.10 +/- 0.04 ng m(-2) y(-1). The oldest strata showing human influence correspond to early metal mining and processing on the Iberian Peninsula (ca. 4700-2500 cal. BP). Elevated Os accumulation rates are found thereafter with a local maximum of 1.1 ng m(-2) y(-1) during the Roman occupation of the Iberian Peninsula (ca. 1930 cal. BP) and a further increase starting in 1750 AD with Os accumulation reaching 30 ng m(-2) y(-1) in the most recent samples. Osmium isotopic composition ((187)Os/(188)Os) indicates that recent elevated Os accumulation results from increased input of unradiogenic Os from industrial and automotive sources as well as from enhanced deposition of radiogenic Os through increased fossil fuel combustion and soil erosion. We posit that the rapid increase in catalyst-equipped vehicles, increased fossil fuel combustion, and changes in land-use make the changes observed in NW Spain globally relevant.