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Arctic warming under increased CO2 peaks in winter, but is influenced by summer forcing via seasonal ocean heat storage. Yet changes in atmospheric heat transport into the Arctic have mainly been investigated in the annual mean or winter, with limited focus on other seasons. We investigate the full seasonal cycle of poleward heat transport modeled with increased CO2 or with individually applied Arctic sea‐ice loss and global sea‐surface warming. We find that a winter reduction in dry heat transport is driven by Arctic sea‐ice loss and warming, while a summer increase in moist heat transport is driven by sub‐Arctic warming and moistening. Intermodel spread in Arctic warming controls spread in seasonal poleward heat transport. These seasonal changes and their intermodel spread are well‐captured by down‐gradient diffusive heat transport. While changes in moist and dry heat transport compensate in the annual‐mean, their opposite seasonality may support non‐compensating effects on Arctic warming. Plain Language Summary: The Arctic is warming much faster than the rest of the planet in response to rising greenhouse gas concentrations. Because Arctic warming peaks in winter, many studies have focused on the wintertime processes amplifying Arctic warming. However, others have found that summer atmospheric heating also contributes to winter warming by melting sea ice and storing heat in the ocean until it is released to the atmosphere in winter. Here we study changes in all seasons for one source of atmospheric heating in the Arctic—atmospheric heat transport from lower latitudes. Using climate model simulations, we find that heat and moisture are transported away from the regions that warm and moisten the most in response to rising greenhouse gas concentrations. The Arctic warms more than lower latitudes in winter, which reduces heat transport to the Arctic in winter. Atmospheric moisture increases most in late summer at lower latitudes, driving increased moisture transport in late summer from lower latitudes to the Arctic. We suggest that changes in heat and moisture transport may impact Arctic warming differently due to their opposite seasonality: by producing a larger change in surface solar absorption, summer changes in moisture transport may outweigh winter changes in heat transport. Key Points: Sea‐ice loss reduces dry heat transport to the Arctic in winter; sub‐Arctic warming increases latent heat transport to the Arctic in summerIntermodel spread in Arctic warming controls intermodel spread in seasonal heat transport changesThe seasonal pattern of poleward heat transport change is well‐captured by down‐gradient diffusion of temperature and moisture anomalies [ABSTRACT FROM AUTHOR]

Arctic warming under increased CO2 peaks in winter, but is influenced by summer forcing via seasonal ocean heat storage. Yet changes in atmospheric heat transport into the Arctic have mainly been investigated in the annual mean or winter, with limited focus on other seasons. We investigate the full seasonal cycle of poleward heat transport modeled with increased CO2 or with individually applied Arctic sea‐ice loss and global sea‐surface warming. We find that a winter reduction in dry heat transport is driven by Arctic sea‐ice loss and warming, while a summer increase in moist heat transport is driven by sub‐Arctic warming and moistening. Intermodel spread in Arctic warming controls spread in seasonal poleward heat transport. These seasonal changes and their intermodel spread are well‐captured by down‐gradient diffusive heat transport. While changes in moist and dry heat transport compensate in the annual‐mean, their opposite seasonality may support non‐compensating effects on Arctic warming. Plain Language Summary: The Arctic is warming much faster than the rest of the planet in response to rising greenhouse gas concentrations. Because Arctic warming peaks in winter, many studies have focused on the wintertime processes amplifying Arctic warming. However, others have found that summer atmospheric heating also contributes to winter warming by melting sea ice and storing heat in the ocean until it is released to the atmosphere in winter. Here we study changes in all seasons for one source of atmospheric heating in the Arctic—atmospheric heat transport from lower latitudes. Using climate model simulations, we find that heat and moisture are transported away from the regions that warm and moisten the most in response to rising greenhouse gas concentrations. The Arctic warms more than lower latitudes in winter, which reduces heat transport to the Arctic in winter. Atmospheric moisture increases most in late summer at lower latitudes, driving increased moisture transport in late summer from lower latitudes to the Arctic. We suggest that changes in heat and moisture transport may impact Arctic warming differently due to their opposite seasonality: by producing a larger change in surface solar absorption, summer changes in moisture transport may outweigh winter changes in heat transport. Key Points: Sea‐ice loss reduces dry heat transport to the Arctic in winter; sub‐Arctic warming increases latent heat transport to the Arctic in summerIntermodel spread in Arctic warming controls intermodel spread in seasonal heat transport changesThe seasonal pattern of poleward heat transport change is well‐captured by down‐gradient diffusion of temperature and moisture anomalies [ABSTRACT FROM AUTHOR]

At the height of the Covid pandemic, there was much discussion in the literature about using human challenge trials (HCTs) to expedite the development of effective Covid-19 vaccines. Historically, reluctance to fully accept HCTs has largely been due to potential conflicts with the principle of nonmaleficence in bioethics. Only a few commentators have explored this topic in depth. In this paper, we claim that to address ethical concerns regarding HCTs, two types of ethical reasons should be identified and investigated: first-order reasons that can be given to claim that a practice in itself is in direct conflict with the principles of bioethics; and second-order reasons that take into consideration how a practice is carried out and its consequences. We argue that understanding these ethical reasons is crucial for guiding the implementation of HCTs. We investigate a first-order reason against HCTs when the practice is in conflict with the principle of nonmaleficence, and when it is not. Following this argument and assuming there is no first-order reason based on nonmaleficence that hinders using HCTs, we argue there may be second-order reasons to guide implementation of this practice, such as difficulty in obtaining informed consent; protection of the weaker party; and trust in the scientific enterprise., (© 2024 The Authors. Ethics & Human Research, published by Wiley Periodicals LLC on behalf of The Hastings Center.)

Background: The COVID-19 pandemic has not only tested the resilience of public health systems but also underscored the criticality of allocative choices on health resources. These choices, however, are not confined to health emergencies but are integral to public health decisions, which inherently grapple with limited resources. In this context, physicians play a pivotal role as the architects of clinical actions in various scenarios. Therefore, doctors are called upon to make their decisions by considering not only the criteria of clinical appropriateness but also the ethical aspects linked, in particular, to the principle of justice. Indeed, the assessment of the effectiveness of a treatment for a particular patient must be balanced against criteria of equity and justice for the whole. To be fully applied, the principle of justice presupposes the use of economic evaluation techniques designed to drive the organisation decisions by effectiveness and efficiency., Methods: The present paper aims to empirically analyse whether and to what extent economic evaluation is known and used by doctors in healthcare decision-making and, therefore, what the most widespread approaches are used in such processes. In particular, this paper intends to present the results of an empirical study on a sample of doctors registered with the Order of Physicians in Lombardy (Italy), one of the areas most affected by the COVID-19 pandemic., Results: The research reveals a particular awareness of the criticality of allocation issues accompanied by a lack of knowledge of the economic evaluation techniques or, more broadly, by an almost total disuse of financial criteria. The main reasons are doctors' need for more knowledge of these tools and insufficient availability of economic information at the country system level., Conclusion: In the conclusion, we propose some suggestions to facilitate the transition to more current decision-making models consistent with the characteristics of more advanced national healthcare contexts., (© 2024 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)

Coastal saltmarshes provide globally important ecosystem services including 'blue carbon' sequestration, flood protection, pollutant remediation, habitat provision and cultural value. Large portions of marshes have been lost or fragmented as a result of land reclamation, embankment construction, and pollution. Sea level rise threatens marsh survival by blocking landward migration where coastlines have been developed. Research-informed saltmarsh conservation and restoration efforts are helping to prevent further loss, yet significant knowledge gaps remain. Using a mixed methods approach, this paper identifies ten research priorities through an online questionnaire and a residential workshop attended by an international, multi-disciplinary network of 35 saltmarsh experts spanning natural, physical and social sciences across research, policy, and practitioner sectors. Priorities have been grouped under four thematic areas of research: Saltmarsh Area Extent, Change and Restoration Potential (including past, present, global variation), Spatio-social contexts of Ecosystem Service delivery (e.g. influences of environmental context, climate change, and stakeholder groups on service provisioning), Patterns and Processes in saltmarsh functioning (global drivers of saltmarsh ecosystem structure/function) and Management and Policy Needs (how management varies contextually; challenges/opportunities for management). Although not intended to be exhaustive, the challenges, opportunities, and strategies for addressing each research priority examined here, providing a blueprint of the work that needs to be done to protect saltmarshes for future generations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

This paper puts forward a wish list of requirements for formal fairness in the specific context of triage in emergency departments (EDs) and maps the empirical and conceptual research questions that need to be addressed in this context in the near future. The pandemic has brought to the fore the necessity for public debate about how to allocate resources fairly in a situation of great shortage. However, issues of fairness arise also outside of pandemics: decisions about how to allocate resources are structurally unavoidable in healthcare systems, as value judgements underlie every allocative decision, although they are not always easily identifiable. In this paper, we set out to bridge this gap in the context of EDs. In the first part, we propose five formal requirements specifically applied for ED triage to be considered fair and legitimate: publicity, accessibility, relevance, standardisability and accountability. In the second part of the paper, we map the conceptual and empirical ethics questions that will need to be investigated to assess whether healthcare systems guarantee a formally just ED triage. In conclusion, we argue that there is a vast research landscape in need of an in-depth conceptual and empirical investigation in the context of ED triage in ordinary times. Addressing both types of questions in this context is vital for promoting a fair and legitimate ED triage and for fostering reflection on formal fairness allocative issues beyond triage., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Procreative obligations are often discussed by evaluating only the consequences of reproductive actions or omissions; less attention is paid to the moral role of intentions and attitudes. In this paper, I assess whether intentions and attitudes can contribute to defining our moral obligations with regard to assisted reproductive technologies already available, such as preimplantation genetic diagnosis (PGD), and those that may be available in future, such as reproductive genome editing and ectogenesis, in a way compatible with person-affecting constraints. I propose the parent-child relationship argument, which is based on the moral distinction between creating and parenting a child. Hence, I first argue that intentions and attitudes can play a role in defining our moral obligations in reproductive decisions involving PGD. Second, I maintain that if we accept this and recognize reproductive genome editing and ectogenesis as person-affecting procedures, we should be committed to arguing that prospective parents may have moral reasons to prefer reproduction via such techniques than via sexual intercourse. In both cases, I observe an extension of our procreative responsibility beyond what is proposed by the consequentialist person-affecting morality., (© 2023 The Authors. Bioethics published by John Wiley & Sons Ltd.)

To assess the exposure of beachgoers to viruses, a study on seawater, sand, and beach-stranded material was carried out, searching for human viruses, fecal indicator organisms, and total fungi. Moreover, for the first time, the genome persistence and infectivity of two model viruses was studied in laboratory-spiked sand and seawater samples during a one-week experiment. Viral genome was detected in 13.6 % of the environmental samples, but it was not infectious (Human Adenovirus - HAdV, and enterovirus). Norovirus and SARS-CoV-2 were not detected. The most contaminated samples were from sand and close to riverine discharges. In lab-scale experiments, the infectivity of HAdV5 decreased by ~1.5-Log 10 in a week, the one of Human Coronavirus-229E disappeared in <3 h in sand. The genome of both viruses persisted throughout the experiment. Our results confirm viral contamination of the beach and suggest HAdV as an index pathogen for beach monitoring and quantitative risk assessment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Coastal ecosystems such as sand dunes, mangrove forests, and salt marshes provide natural storm protection for vulnerable shorelines. At the same time, storms erode and redistribute biological materials among coastal systems via wrack. Yet how such cross-ecosystem subsidies affect post-storm recovery is not well understood. Here, we report an experimental investigation into the effect of storm wrack on eco-geomorphological recovery of a coastal embryo dune in north-eastern Florida, USA, following hurricane Irma. We contrasted replicated 100-m2 wrack-removal and unmanipulated (control) plots, measuring vegetation and geomorphological responses over 21 months. Relative to controls, grass cover was reduced 4-fold where diverse storm wrack, including seagrass rhizomes, seaweed, and wood, was removed. Wrack removal was also associated with a reduction in mean elevation, which persisted until the end of the experiment when removal plots had a 14% lower mean elevation than control plots. These results suggest that subsides of wrack re-distributed from other ecosystem types (e.g. seagrasses, macroalgae, uplands): i) enhances the growth of certain dune-building grasses; and ii) boosts the geomorphological recovery of coastal dunes. Our study also indicates that the practice of post-storm beach cleaning to remove wrack-a practice widespread outside of protected areas-may undermine the resilience of coastal dunes and their services., Competing Interests: The authors have declared that no competing interests exist.

Beach litter can affect public health and economic activities worldwide forcing local authorities to expensive beach cleaning. Understanding the key mechanisms affecting the accumulation of this waste on beaches, such as sea state and proximity to entry points, is critical to plan effective management strategies. In this one-year study, we estimated the impact of storm events and waterways runoff on litter abundance and local economy using as a model a managed, peri-urban beach facing a north-western sector of the Mediterranean Sea. We also investigated the relationship between litter composition/density and beach proximity to major/closest harbors/rivers at regional scale by combining our data with those on litter density available in literature. Autumn/winter storms caused larger litter depositions than spring/summer ones in the peri-urban beach. No preferential accumulation occurred near to waterway mouths. Litter mainly consisted of plastic, and its composition in terms of micro-categories varied over seasons. In total, 367,070 items were deposited along 4.7 km of beach over one year, and the cost for the removal of this waste amounted to approximately 27,600 euros per km/year. At regional scale, beach litter density was positively correlated to the proximity of major harbors while its composition was related to the proximity to both major harbors and rivers. Results indicate that autumn/winter storms are important drivers of marine litter deposition. They also suggest that beaches in front of the convergence zone of littoral currents and close to major harbors can be particularly subjected to this kind of pollutant. To increase their effectiveness, litter mitigation/cleaning activities should be planned based on predictions of major storm events and performed at spatial scales encompassing at least coastal regional sectors., Competing Interests: Declaration of competing interest The authors declare no known competing financial interests or personal relationships that could have influenced the present work., (Copyright © 2022 Elsevier B.V. All rights reserved.)