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Numerical methods and simulation codes are essential for the advancement of our understanding of complex atmospheric processes. As technology and computer hardware continue to evolve, the development of sophisticated code is vital for accurate and efficient simulations. In this paper, we present the recent advancements made in the FLEXible PARTicle dispersion model (FLEXPART), a Lagrangian particle dispersion model, which has been used in a wide range of atmospheric transport studies over the past 3 decades, extending from tracing radionuclides from the Fukushima nuclear disaster, to inverse modelling of greenhouse gases, and to the study of atmospheric moisture cycles. This version of FLEXPART includes notable improvements in accuracy and computational efficiency. (1) By leveraging the native vertical coordinates of European Centre for Medium Range Weather Forecasts (ECMWF) Integrated Forecasting System (IFS) instead of interpolating to terrain-following coordinates, we achieved an improvement in trajectory accuracy, leading to a ∼8 %–10 % reduction in conservation errors for quasi-conservative quantities like potential vorticity. (2) The shape of aerosol particles is now accounted for in the gravitational settling and dry-deposition calculation, increasing the simulation accuracy for non-spherical aerosol particles such as microplastic fibres. (3) Wet deposition has been improved by the introduction of a new below-cloud scheme, by a new cloud identification scheme, and by improving the interpolation of precipitation. (4) Functionality from a separate version of FLEXPART, the FLEXPART CTM (chemical transport model), is implemented, which includes linear chemical reactions. Additionally, the incorporation of Open Multi-Processing parallelisation makes the model better suited for handling large input data. Furthermore, we introduced novel methods for the input and output of particle properties and distributions. Users now have the option to run FLEXPART with more flexible particle input data, providing greater adaptability for specific research scenarios (e.g. effective backward simulations corresponding to satellite retrievals). Finally, a new user manual (https://flexpart.img.univie.ac.at/docs/, last access: 11 September 2024) and restructuring of the source code into modules will serve as a basis for further development.

We analyzed long-term measurements of organic carbon, elemental carbon, and source-specific organic tracers from 2017 to 2020 to constrain carbonaceous aerosol sources in the rapidly changing Arctic. Additionally, we used absorption photometer (Aethalometer) measurements to constrain equivalent black carbon (eBC) from biomass burning and fossil fuel combustion, using positive matrix factorization (PMF). Our analysis shows that organic tracers are essential for understanding Arctic carbonaceous aerosol sources. Throughout 2017 to 2020, levoglucosan exhibited bimodal seasonality, reflecting emissions from residential wood combustion (RWC) in the heating season (November to May) and from wildfires (WFs) in the non-heating season (June to October), demonstrating a pronounced interannual variability in the influence of WF. Biogenic secondary organic aerosol (BSOA) species (2-methyltetrols) from isoprene oxidation was only present in the non-heating season, peaking in July to August. Warm air masses from Siberia led to a substantial increase in 2-methyltetrols in 2019 and 2020 compared to 2017 to 2018. This highlights the need to investigate the contribution of local sources vs. long-range atmospheric transport (LRT), considering the temperature sensitivity of biogenic volatile organic compound emissions from Arctic vegetation. Tracers of primary biological aerosol particles (PBAPs), including various sugars and sugar alcohols, showed elevated levels in the non-heating season, although with different seasonal trends, whereas cellulose had no apparent seasonality. Most PBAP tracers and 2-methyltetrols peaked during influence of WF emissions, highlighting the importance of measuring a range of source-specific tracers to understand sources and dynamics of carbonaceous aerosol. The seasonality of carbonaceous aerosol was strongly influenced by LRT episodes, as background levels are extremely low. In the non-heating season, the organic aerosol peak was as influenced by LRT, as was elemental carbon during the Arctic haze period. Source apportionment of carbonaceous aerosol by Latin hypercube sampling showed mixed contributions from RWC (46 %), fossil fuel (FF) sources (27 %), and BSOA (25 %) in the heating season. In contrast, the non-heating season was dominated by BSOA (56 %), with lower contributions from WF (26 %) and FF sources (15 %). Source apportionment of eBC by PMF showed that FF combustion dominated eBC (70±2.7 %), whereas RWC (22±2.7 %) was more abundant than WF (8.0±2.9 %). Modeled BC concentrations from FLEXPART (FLEXible PARTicle dispersion model) attributed an almost equal share to FF sources (51±3.1 %) and to biomass burning. Both FLEXPART and the PMF analysis concluded that RWC is a more important source of (e)BC than WF. However, with a modeled RWC contribution of 30±4.1 % and WF of 19±2.8 %, FLEXPART suggests relatively higher contributions to eBC from these sources. Notably, the BB fraction of EC was twice as high as that of eBC, reflecting methodological differences between source apportionment by LHS and PMF. However, important conclusions drawn are unaffected, as both methods indicate the presence of RWC- and WF-sourced BC at Zeppelin, with a higher relative BB contribution during the non-heating season. In summary, organic aerosol (281±106 ng m−3) constitutes a significant fraction of Arctic PM10, although surpassed by sea salt aerosol (682±46.9 ng m−3), mineral dust (613±368 ng m−3), and typically non-sea-salt sulfate SO42- (314±62.6 ng m−3), originating mainly from anthropogenic sources in winter and from natural sources in summer.

Ammonia (NH3), a significant precursor of particulate matter, affects not only biodiversity, ecosystems, and soil acidification but also climate and human health. In addition, its concentrations are constantly rising due to increasing feeding needs and the large use of fertilization and animal farming. Despite the significance of ammonia, its emissions are associated with large uncertainties, while its atmospheric abundance is difficult to measure. Nowadays, satellite products can effectively measure ammonia with low uncertainty and a global coverage. Here, we use satellite observations of column ammonia in combination with an inversion algorithm to derive ammonia emissions with a high resolution over Europe for the period 2013–2020. Ammonia emissions peak in northern Europe due to agricultural application and livestock management, in western Europe (industrial activity), and over Spain (pig farming). Emissions have decreased by −26 % since 2013 (from 5431 Gg in 2013 to 3994 Gg in 2020), showing that the abatement strategies adopted by the European Union have been very efficient. The slight increase (+4.4 %) in 2015 is also reproduced here and is attributed to some European countries exceeding annual emission targets. Ammonia emissions are low in winter (286 Gg) and peak in summer (563 Gg) and are dominated by the temperature-dependent volatilization of ammonia from the soil. The largest emission decreases were observed in central and eastern Europe (−38 %) and in western Europe (−37 %), while smaller decreases were recorded in northern (−17 %) and southern Europe (−7.6 %). When complemented with ground observations, modelled concentrations using the posterior emissions showed improved statistics, also following the observed seasonal trends. The posterior emissions presented here also agree well with respective estimates reported in the literature and inferred from bottom-up and top-down methodologies. These results indicate that satellite measurements combined with inverse algorithms constitute a robust tool for emission estimates and can infer the evolution of ammonia emissions over large timescales.

Brominated flame retardants (BFRs) that are gradually being phased out are being replaced by emerging BFRs. Here, we report the concentration of the α- and β-isomers of 1,2-dibromo-4-(1,2-dibromoethyl)cyclohexane (TBECH; also known as DBE-DBCH) in over 300 air, water, and precipitation samples collected between 2019 and 2022 using active air and deposition sampling as well as networks of passive air and water samplers. The sampling region includes Canada's most populated cities and areas along the St. Lawrence River and Estuary, Quebec, as well as around the Salish Sea, British Columbia. TBECH was detected in over 60 % of air samples at levels comparable to those of 2,2′,4,4′-tetrabromodiphenyl ether (BDE-47). Concentrations of TBECH and BDE-47 were typically higher in urban areas, with stronger correlations with population density during warmer deployments. Uniform α- / β-TBECH ratios across space, time, and environmental media indicate the highly similar atmospheric fate of the two isomers. Although TBECH air concentrations were strongly related to temperature in urban Toronto and a remote site on the east coast, the lack of such dependence at a remote site on the west coast can be explained by the small seasonal temperature range and summertime air mass transport from the Pacific Ocean. Despite there being no evidence that TBECH has been produced, or imported for use, in Canada, it is now one of the most abundant gaseous BFRs in the Canadian atmosphere. The recorded spatial and temporal variability of TBECH suggest that its emissions are not constrained to specific locations but are generally tied to the presence of humans. The most likely explanation for its environmental occurrence in Canada is the release from imported consumer products containing TBECH. Chiral analysis suggests that despite its urban origin, at least some fraction of TBECH has experienced enantioselective processing, i.e., has volatilized from reservoirs where it has undergone microbial transformations. Microbial processes in urban soils and in marine waters may have divergent enantioselectivity.

Individual high-Alpine ice cores have been proven to contain a well-preserved history of past anthropogenic air pollution in western Europe. The question of how representative one ice core is with respect to the reconstruction of atmospheric composition in the source region has not been addressed so far. Here, we present the first study systematically comparing longer-term ice-core records (1750–2015 CE) of various anthropogenic compounds, such as major inorganic aerosol constituents (NH4+, NO3-, SO42-), black carbon (BC), and trace species (Cd, F−, Pb). Depending on the data availability for the different air pollutants, up to five ice cores from four high-Alpine sites located in the European Alps analysed by different laboratories were considered. Whereas absolute concentration levels can partly differ depending on the prevailing seasonal distribution of accumulated precipitation, all seven investigated anthropogenic compounds are in excellent agreement between the various sites for their respective, species-dependent longer-term concentration trends. This is related to common source regions of air pollution impacting the four sites less than 100 km away including western European countries surrounding the Alps. For individual compounds, the Alpine ice-core composites developed in this study allowed us to precisely time the onset of pollution caused by industrialization in western Europe. Extensive emissions from coal combustion and agriculture lead to an exceeding of pre-industrial (1750–1850) concentration levels already at the end of the 19th century for BC, Pb, exSO42- (non-dust, non-sea salt SO42-), and NH4+, respectively. However, Cd, F−, and NO3- concentrations started surpassing pre-industrial values only in the 20th century, predominantly due to pollution from zinc and aluminium smelters and traffic. The observed maxima of BC, Cd, F−, Pb, and exSO42- concentrations in the 20th century and a significant decline afterwards clearly reveal the efficiency of air pollution control measures such as the desulfurization of coal, the introduction of filters and scrubbers in power plants and metal smelters, and the ban of leaded gasoline improving the air quality in western Europe. In contrast, NO3- and NH4+ concentration records show levels in the beginning of the 21th century which are unprecedented in the context of the past 250 years, indicating that the introduced abatement measures to reduce these pollutants were insufficient to have a major effect at high altitudes in western Europe. Only four ice-core composite records (BC, F−, Pb, exSO42-) of the seven investigated pollutants correspond well with modelled trends, suggesting inaccuracies of the emission estimates or an incomplete representation of chemical reaction mechanisms in the models for the other pollutants. Our results demonstrate that individual ice-core records from different sites in the European Alps generally provide a spatially representative signal of anthropogenic air pollution trends in western European countries.

While carbon dioxide is the main cause for global warming, modeling short-lived climate forcers (SLCFs) such as methane, ozone, and particles in the Arctic allows us to simulate near-term climate and health impacts for a sensitive, pristine region that is warming at 3 times the global rate. Atmospheric modeling is critical for understanding the long-range transport of pollutants to the Arctic, as well as the abundance and distribution of SLCFs throughout the Arctic atmosphere. Modeling is also used as a tool to determine SLCF impacts on climate and health in the present and in future emissions scenarios. In this study, we evaluate 18 state-of-the-art atmospheric and Earth system models by assessing their representation of Arctic and Northern Hemisphere atmospheric SLCF distributions, considering a wide range of different chemical species (methane, tropospheric ozone and its precursors, black carbon, sulfate, organic aerosol, and particulate matter) and multiple observational datasets. Model simulations over 4 years (2008–2009 and 2014–2015) conducted for the 2022 Arctic Monitoring and Assessment Programme (AMAP) SLCF assessment report are thoroughly evaluated against satellite, ground, ship, and aircraft-based observations. The annual means, seasonal cycles, and 3-D distributions of SLCFs were evaluated using several metrics, such as absolute and percent model biases and correlation coefficients. The results show a large range in model performance, with no one particular model or model type performing well for all regions and all SLCF species. The multi-model mean (mmm) was able to represent the general features of SLCFs in the Arctic and had the best overall performance. For the SLCFs with the greatest radiative impact (CH4, O3, BC, and SO42-), the mmm was within ±25 % of the measurements across the Northern Hemisphere. Therefore, we recommend a multi-model ensemble be used for simulating climate and health impacts of SLCFs. Of the SLCFs in our study, model biases were smallest for CH4 and greatest for OA. For most SLCFs, model biases skewed from positive to negative with increasing latitude. Our analysis suggests that vertical mixing, long-range transport, deposition, and wildfires remain highly uncertain processes. These processes need better representation within atmospheric models to improve their simulation of SLCFs in the Arctic environment. As model development proceeds in these areas, we highly recommend that the vertical and 3-D distribution of SLCFs be evaluated, as that information is critical to improving the uncertain processes in models.

The Zeppelin Observatory (78.90∘ N, 11.88∘ E) is located on Zeppelin Mountain at 472 m a.s.l. on Spitsbergen, the largest island of the Svalbard archipelago. Established in 1989, the observatory is part of Ny-Ålesund Research Station and an important atmospheric measurement site, one of only a few in the high Arctic, and a part of several European and global monitoring programmes and research infrastructures, notably the European Monitoring and Evaluation Programme (EMEP); the Arctic Monitoring and Assessment Programme (AMAP); the Global Atmosphere Watch (GAW); the Aerosol, Clouds and Trace Gases Research Infrastructure (ACTRIS); the Advanced Global Atmospheric Gases Experiment (AGAGE) network; and the Integrated Carbon Observation System (ICOS). The observatory is jointly operated by the Norwegian Polar Institute (NPI), Stockholm University, and the Norwegian Institute for Air Research (NILU). Here we detail the establishment of the Zeppelin Observatory including historical measurements of atmospheric composition in the European Arctic leading to its construction. We present a history of the measurements at the observatory and review the current state of the European Arctic atmosphere, including results from trends in greenhouse gases, chlorofluorocarbons (CFCs) and hydrochlorofluorocarbons (HCFCs), other traces gases, persistent organic pollutants (POPs) and heavy metals, aerosols and Arctic haze, and atmospheric transport phenomena, and provide an outline of future research directions.

In early October 2020, northern Europe experienced an episode with poor air quality due to high concentrations of particulate matter (PM). At several sites in Norway, recorded weekly values exceeded historical maximum PM10 concentrations from the past 4 to 10 years. Daily mean PM10 values at Norwegian sites were up to 97 µg m−3 and had a median value of 59 µg m−3. We analysed this severe pollution episode caused by long-range atmospheric transport based on surface and remote sensing observations and transport model simulations to understand its causes. Samples from three sites in mainland Norway and the Arctic remote station Zeppelin (Svalbard) showed strong contributions from mineral dust to PM10 (23 %–36 % as a minimum and 31 %–45 % as a maximum) and biomass burning (8 %–16 % to 19 %–21 %). Atmospheric transport simulations indicate that Central Asia was the main source region for mineral dust observed in this episode. The biomass burning fraction can be attributed to forest fires in Ukraine and southern Russia, but we cannot exclude other sources contributing, like fires elsewhere, because the model underestimates observed concentrations. The combined use of remote sensing, surface measurements, and transport modelling proved effective in describing the episode and distinguishing its causes.

Although the interest in root traits has increased in recent years, we still have limited knowledge of (i) whether functionally different fine roots-absorptive versus transport roots-have similar trait coordination and (ii) how they help to explain plant performance, such as growth. We measured traits of 25 European broadleaved tree species growing in a research arboretum to study (i) the coordination of root traits within absorptive and transport fine roots and (ii) the degree of trait-tree growth relationships. To do so, we combined a suite of morphological and anatomical traits for each of the absorptive and transport roots. Despite remarkable differences in average trait values between absorptive and transport roots, our study shows that trait coordination within absorptive and transport roots is relatively similar. Our results also show that, for the selected traits, tree growth is better explained by absorptive root traits than by transport root traits and is higher in species with thinner roots. The stronger relationship between absorptive roots and tree growth highlights that roots mostly involved with resource absorption are more important in explaining tree growth than transport roots, which are mainly responsible for resource transportation., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Reef building corals are important in subtropical marine ecoregions, shaping ecosystems and providing habitats for fish and benthic species. Algal communities contribute substantially to the benthic population structure across subtropical coral reefs, however increasing algal cover on subtropical reefs is also linked to degraded ecosystems as has been shown on tropical systems. As such, the dynamics of coral-algal interactions on subtropical reefs are also likely to be an indicator of ecosystem health on subtropical ecosystems. The subtropical lagoonal coral reef of Norfolk Island within the Norfolk Marine Park has been impacted by a regime of disturbance since 2020 including flooding, sedimentation, and heat stress events. Assessing the type and extent of algal interactions with the dominant coral Pocillopora damiconis within the reef sites of Emily Bay, Slaughter Bay, and Cemetery Bay has the potential to provide insight into drivers of ecosystem decline within the reef. Similarly, photochemical efficiency, as measured by yield (Fv/Fm) using pulse amplitude modulated fluorometry, can be used to provide a measure of the health of corals on reefs during degradation events. Here we assess the extent of coral-algal interactions and health of colonies of P. damicornis prior to the onset of summertime conditions (April 2023) and during summertime conditions (December 2023). Seasonal and within site dynamics of coral-algal interactions were evident by a significant bloom of red cyanobacteria ( P  < 0.0001, April 2023) and Lyngbya { P  < 0.01 [Slaughter Bay West (SBW)], P  < 0.01 [Slaughter Bay East (SBE)], December 2023}. Within reef, variability of coral-algal interactions was most evident for Lyngbya , and on the Norfolk reef, interactions of Lyngbya with P. damincornis were found to be significantly higher at slaughter bay west (SBW 30.2% of interactions) and east (SBE 24.6% of interactions) in December 2023 than at neighboring Emily (11.6% of interactions) and Cemetery Bay (0.6% of interactions). Pulse Amplitude Modulated (PAM) fluorometry also highlighted the potential for algal interactions to influence the photochemical efficiency of Pocillopora damicornis . Benthic structure, as measured by coral-algal interactions, and coral health within the Norfolk lagoonal, both highlight the potential for anthropogenic drivers of reef decline to influence the health of the ecosystem. Further investigation is therefore necessary to elucidate the specific causes and consequences of algae linked to poor water quality, such as red cyanobacteria and Lyngbya , interacting with corals., Competing Interests: The authors declare that there is no conflict of interest in this study., (© The Author(s) 2025. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology.)

Nanoplastics are suspected to pollute every environment on Earth, including very remote areas reached via atmospheric transport. We approached the challenge of measuring environmental nanoplastics by combining high-sensitivity TD-PTR-MS (thermal desorption-proton transfer reaction-mass spectrometry) with trained mountaineers sampling high-altitude glaciers ("citizen science"). Particles < 1 μm were analysed for common polymers (polyethylene, polyethylene terephthalate, polypropylene, polyvinyl chloride, polystyrene and tire wear particles), revealing nanoplastic concentrations ranging 2-80 ng mL - 1 at five of 14 sites. The dominant polymer types found in this study were tire wear, polystyrene and polyethylene particles (41%, 28% and 12%, respectively). Lagrangian dispersion modelling was used to reconstruct possible sources of micro- and nanoplastic emissions for those observations, which appear to lie largely to the west of the Alps. France, Spain and Switzerland have the highest contributions to the modelled emissions. The citizen science approach was found to be feasible providing strict quality control measures are in place, and is an effective way to be able to collect data from remote and inaccessible regions across the world., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

The amount of methane released to the atmosphere from the Nord Stream subsea pipeline leaks remains uncertain, as reflected in a wide range of estimates 1-18 . A lack of information regarding the temporal variation in atmospheric emissions has made it challenging to reconcile pipeline volumetric (bottom-up) estimates 1-8 with measurement-based (top-down) estimates 8-18 . Here we simulate pipeline rupture emission rates and integrate these with methane dissolution and sea-surface outgassing estimates 9,10 to model the evolution of atmospheric emissions from the leaks. We verify our modelled atmospheric emissions by comparing them with top-down point-in-time emission-rate estimates and cumulative emission estimates derived from airborne 11 , satellite 8,12-14 and tall tower data. We obtain consistency between our modelled atmospheric emissions and top-down estimates and find that 465 ± 20 thousand metric tons of methane were emitted to the atmosphere. Although, to our knowledge, this represents the largest recorded amount of methane released from a single transient event, it is equivalent to 0.1% of anthropogenic methane emissions for 2022. The impact of the leaks on the global atmospheric methane budget brings into focus the numerous other anthropogenic methane sources that require mitigation globally. Our analysis demonstrates that diverse, complementary measurement approaches are needed to quantify methane emissions in support of the Global Methane Pledge 19 ., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. United Nations Environment Programme and the Authors.)

Objective: Family-based treatment (FBT) is the leading evidence-based treatment for adolescent eating disorders, but research exploring access and engagement in FBT is sparse. This paper focuses on findings from a broader study, specifically addressing the social determinants of health (SDH) impeding access and engagement in FBT for diverse families (i.e., families belonging to identity groups subject to systemic barriers and prejudices)., Methods: Forty-one FBT clinicians were recruited globally using purposive and snowball sampling. Clinicians participated in individual interviews or focus groups, discussing their experiences engaging diverse families in FBT. Qualitative data were transcribed verbatim and analyzed using reflexive thematic analysis., Results: The findings underscore the pervasive impact of SDH on equitable access to FBT, specifically, the critical need for tailored approaches by clinicians to enhance access and engagement in FBT for diverse families experiencing practical, resource, and systemic barriers. Recommendations include broader dissemination of FBT knowledge, telehealth options to mitigate geographical barriers, community resource collaborations, and sensitivity to cultural and systemic factors impacting treatment engagement., Discussion: Results of this study may inform future FBT planning (tailoring treatment approaches to address barriers), clinician training, clinical decision-making tools, and opportunities for supporting under-resourced families within the model, leading to more equitable FBT treatment access and engagement for diverse families., (© 2024 The Author(s). International Journal of Eating Disorders published by Wiley Periodicals LLC.)

Per- and polyfluoroalkyl substances (PFAS) are persistent anthropogenic contaminants, some of which are toxic and bioaccumulative. Perfluoroalkyl carboxylic acids (PFCAs) and perfluoroalkyl sulfonic acids (PFSAs) can form during the atmospheric degradation of precursors such as fluorotelomer alcohols (FTOHs), N -alkylated perfluoroalkane sulfonamides (FASAs), and hydrofluorocarbons (HFCs). Since PFCAs and PFSAs will readily undergo wet deposition, snow and ice cores are useful for studying PFAS in the Arctic atmosphere. In this study, 36 PFAS were detected in surface snow around the Arctic island of Spitsbergen during January-August 2019 (i.e., 24 h darkness to 24 h daylight), indicating widespread and chemically diverse contamination, including at remote high elevation sites. Local sources meant some PFAS had concentrations in snow up to 54 times higher in Longyearbyen, compared to remote locations. At a remote high elevation ice cap, where PFAS input was from long-range atmospheric processes, the median deposition fluxes of C 2 -C 11 PFCAs, PFOS and HFPO-DA (GenX) were 7.6-71 times higher during 24 h daylight. These PFAS all positively correlated with solar flux. Together this suggests seasonal light is important to enable photochemistry for their atmospheric formation and subsequent deposition in the Arctic. This study provides the first evidence for the possible atmospheric formation of PFOS and GenX from precursors.

Mixed-species forests are promoted as a forest management strategy for climate change adaptation, but whether they are more resistant to drought than monospecific forests remains contested. In particular, the trait-based mechanisms driving the role of tree diversity under drought remain elusive. Using tree cores from a large-scale biodiversity experiment, we investigated tree growth and physiological stress responses (i.e. increase in wood carbon isotopic ratio; δ 13 C) to changes in climate-induced water availability (wet to dry years) along gradients in neighbourhood tree species richness and drought-tolerance traits. We hypothesized that neighbourhood species richness increases growth and decreases δ 13 C and that these relationships are modulated by the abiotic (i.e. climatic conditions) and the biotic context. We characterised the biotic context using drought-tolerance traits of focal trees and their neighbours. These traits are related to cavitation resistance versus resource acquisition and stomatal control. Tree growth increased with neighbourhood species richness. However, we did not observe a universal relief of water stress in species-rich neighbourhoods. The effects of neighbourhood species richness and climate on growth and δ 13 C were modulated by the traits of focal trees and the traits of their neighbours. At either end of each drought-tolerance gradient, species responded in opposing directions during dry and wet years. We show that species' drought-tolerance traits can explain the strength and nature of biodiversity-ecosystem functioning relationships in experimental tree communities experiencing drought. Mixing tree species can increase growth but may not universally relieve drought stress., (© 2024 The Authors. Plant Biology published by John Wiley & Sons Ltd on behalf of German Society for Plant Sciences, Royal Botanical Society of the Netherlands.)

Objective: Family-Based Treatment (FBT) is the leading manualized treatment for adolescent eating disorders; however, there is limited research on the adaptation of FBT for diverse families (i.e., families belonging to identity groups subject to systemic barriers and prejudices). The purpose of this qualitative study was to address: (1) adaptations made to the FBT model (if any) by clinicians working with diverse youth and families; (2) the barriers/facilitators of maintaining adherence (fidelity) to the model for these families; and, (3) the barriers/facilitators to access and engagement in FBT for diverse families., Method: Forty-one FBT clinicians were recruited globally using purposive and snowball sampling, and listservs from eating disorder networks. Clinicians participated in individual interviews or focus groups, discussing their experiences delivering and adapting FBT for diverse families. Qualitative data was transcribed verbatim and analyzed using directed content analysis., Results: Some participants reported making adaptations to every phase of the FBT model, while others did not, when working with diverse families. In Phase 1, participants cited adapting the family meal, length/number of sessions provided, and addressed systemic barriers. In Phase 2, participants adapted the length of the phase and rate/level of independence given back to the adolescent. In Phase 3, participants increased or decreased the number of sessions, or eliminated this phase to address barriers to engagement in FBT., Discussion: This is the first study to qualitatively examine clinicians' experiences of implementing FBT with diverse families. Results may inform future FBT planning, clinician training, clinical decision-making tools, and opportunities for modifications to the foundational model., Public Significance: This qualitative study examined clinicians' perceptions and experiences implementing FBT with diverse families, specifically what adaptations (if any) were made to the foundational model, and the barriers and facilitators to adhering to and engaging in the model. Results show that some participants reported making adaptations to every phase of FBT, while others did not, with diverse families. Findings may inform future treatment planning, clinician training, clinical decision-making tools, and potential modifications to FBT., (© 2024 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.)

Records from polar and alpine ice reflect past changes in background and industrial toxic heavy metal emissions. While Northern Hemisphere records have been used to evaluate environmental effects and linkages to historical events such as foreign conquests, plagues, economic downturns, and technological developments during the past three millennia, little is known about the magnitude and environmental effects of such emissions in the Southern Hemisphere or their historical linkages, especially prior to late 19th century industrialization. Here we used detailed measurements of the toxic heavy metals lead, cadmium, and thallium, as well as non-toxic bismuth, cerium, and sulfur in an array of five East Antarctic ice cores to investigate hemispheric-scale pollution during the Common Era. While thallium showed no anthropogenic increases, the other three metals increased by orders of magnitude in recent centuries after accounting for crustal and volcanic components. These first detailed records indicate that East Antarctic lead pollution started in the 13th century coincident with Late Intermediate Period metallurgy in the Andes and was pervasive during the Spanish Colonial period in parallel with large-scale exploitation of Andean silver and other ore deposits. Lead isotopic variations suggest that 19th-century increases in lead, cadmium, and bismuth resulted from Australian lead and Bolivian tin mining emissions, with 20th century pollution largely the result of the latter. As in the Northern Hemisphere, variations in heavy metal pollution coincided with plagues, cultural and technological developments, as well as global economic and political events including the Great Depression and the World Wars. Estimated atmospheric heavy metal emissions from Spanish Colonial-era mining and smelting during the late 16th and early 17th century were comparable to estimated European emissions during the 1st-century apex of the Roman Empire, with atmospheric model simulations suggesting hemispheric-scale toxic heavy metal pollution during the past five centuries as a result., 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. Published by Elsevier B.V.)

Risk assessment of pesticide impacts on remote ecosystems makes use of model-estimated degradation in air. Recent studies suggest these degradation rates to be overestimated, questioning current pesticide regulation. Here, we investigated the concentrations of 76 pesticides in Europe at 29 rural, coastal, mountain, and polar sites during the agricultural application season. Overall, 58 pesticides were observed in the European atmosphere. Low spatial variation of 7 pesticides suggests continental-scale atmospheric dispersal. Based on concentrations in free tropospheric air and at Arctic sites, 22 pesticides were identified to be prone to long-range atmospheric transport, which included 15 substances approved for agricultural use in Europe and 7 banned ones. Comparison between concentrations at remote sites and those found at pesticide source areas suggests long atmospheric lifetimes of atrazine, cyprodinil, spiroxamine, tebuconazole, terbuthylazine, and thiacloprid. In general, our findings suggest that atmospheric transport and persistence of pesticides have been underestimated and that their risk assessment needs to be improved.

There is concern over possible effects on ecosystems and humans from exposure to persistent organic pollutants (POPs) and chemicals with similar properties. The main objective of this study was to develop, evaluate, and apply the Nested Exposure Model (NEM) designed to simulate the link between global emissions and resulting ecosystem exposure while accounting for variation in time and space. NEM, using environmental and biological data, global emissions, and physicochemical properties as input, was used to estimate PCB-153 concentrations in seawater and biota of the Norwegian marine environment from 1930 to 2020. These concentrations were compared to measured concentrations in (i) seawater, (ii) an Arctic marine food web comprising zooplankton, fish and marine mammals, and (iii) Atlantic herring ( Clupea harengus ) and Atlantic cod ( Gadus morhua ) from large baseline studies and monitoring programs. NEM reproduced PCB-153 concentrations in seawater, the Arctic food web, and Norwegian fish within a factor of 0.1-31, 0.14-3.1, and 0.09-21, respectively. The model also successfully reproduced measured trophic magnification factors for PCB-153 at Svalbard as well as geographical variations in PCB-153 burden in Atlantic cod between the Skagerrak, North Sea, Norwegian Sea, and Barents Sea, but estimated a steeper decline in PCB-153 concentration in herring and cod during the last decades than observed. Using the evaluated model with various emission scenarios showed the important contribution of European and global primary emissions for the PCB-153 load in fish from Norwegian marine offshore areas.

Background: Merkel cell carcinoma (MCC) is an immunogenic but aggressive skin cancer. Even after complete resection and radiation, relapse rates are high. PD-1 and PD-L1 checkpoint inhibitors showed clinical benefit in advanced MCC. We aimed to assess efficacy and safety of adjuvant immune checkpoint inhibition in completely resected MCC (ie, a setting without an established systemic standard-of-care treatment)., Methods: In this multicentre phase 2 trial, patients (any stage, Eastern Cooperative Oncology Group performance status 0-1) at 20 academic medical centres in Germany and the Netherlands with completely resected MCC lesions were randomly assigned 2:1 to receive nivolumab 480 mg every 4 weeks for 1 year, or observation, stratified by stage (American Joint Committee on Cancer stages 1-2 vs stages 3-4), age (<65 vs ≥65 years), and sex. Landmark disease-free survival (DFS) at 12 and 24 months was the primary endpoint, assessed in the intention-to-treat populations. Overall survival and safety were secondary endpoints. This planned interim analysis was triggered when the last-patient-in was followed up for more than 1 year. This study is registered with ClinicalTrials.gov (NCT02196961) and with the EU Clinical Trials Register (2013-000043-78)., Findings: Between Oct 1, 2014, and Aug 31, 2020, 179 patients were enrolled (116 [65%] stage 3-4, 122 [68%] ≥65 years, 111 [62%] male). Stratification factors (stage, age, sex) were balanced across the nivolumab (n=118) and internal control group (observation, n=61); adjuvant radiotherapy was more common in the control group. At a median follow-up of 24·3 months (IQR 19·2-33·4), median DFS was not reached (between-groups hazard ratio 0·58, 95% CI 0·30-1·12); DFS rates in the nivolumab group were 85% at 12 months and 84% at 24 months, and in the observation group were 77% at 12 months and 73% at 24 months. Overall survival results were not yet mature. Grade 3-4 adverse events occurred in 48 [42%] of 115 patients who received at least one dose of nivolumab and seven [11%] of 61 patients in the observation group. No treatment-related deaths were reported., Interpretation: Adjuvant therapy with nivolumab resulted in an absolute risk reduction of 9% (1-year DFS) and 10% (2-year DFS). The present interim analysis of ADMEC-O might suggest clinical use of nivolumab in this area of unmet medical need. However, overall survival events rates, with ten events in the active treatment group and six events in the half-the-size observation group, are not mature enough to draw conclusions. The explorative data of our trial support the continuation of ongoing, randomised trials in this area. ADMEC-O suggests that adjuvant immunotherapy is clinically feasible in this area of unmet medical need., Funding: Bristol Myers Squibb., Competing Interests: Declaration of interests JCB reports grants from Alcedis, Bristol Myers Squibb, HTC Molecular Diagnostics, IQVIA, Merck Serono, and Alcedis; consulting fees from Almirall Hermal, Boehringer Ingelheim, InProTher, Merck Serono, Pfizer, and Sanofi–Regeneron; and honoraria from Amgen, Pfizer, Recordati, and Sanofi. JCB participated on a data safety monitoring or advisory board from ICON Clinical Research and 4SC. SU reports grants or contracts from Bristol Myers Squibb and Merck Serono and support for attending meetings and travel from Bristol Myers Squibb, MSD, and Pierre Fabre. SU participated on a data safety monitoring or advisory board from Bristol Myers Squibb, MSD, Merck Serono Novartis, and has a leadership role in the German dermato-oncology working group also known as the German dermatologic cooperative group (ADO/DeCOG). UL reports research support from MSD and honoraria and participation on a data safety monitoring or advisory board from Almirall Hermal, MSD, Novartis, Roche, Sanofi, and Sun Pharma. FM reports consulting fees and honoraria and participation on a drug safety monitoring or advisory board for Bristol Myers Squibb, MSD, Novartis, Pierre Fabre, Roche, and Sanofi, and support for attending meetings or travel grants from Bristol Myers Squibb, MSD, Pierre Fabre, and Sanofi. RG reports consulting fees, personal fees, and support for attending meetings or travel grants from Bristol Myers Squibb, Merck Serono, Pierre Fabre, Roche, and Sun Pharma; consulting and personal fees from Almirall Hermal, Amgen, Immunocore, MSD, Novartis, and Sanofi; and institutional research funding from Almirall Hermal, Amgen, Johnson & Johnson, Kyowa-Kirin, Merck Serono, Novartis, Pfizer, and Sanofi, in addition to an unpaid leadership role (ADO/DeCOG). SH reports personal fees and honoraria and participation on a drug safety monitoring or advisory board for Bristol Myers Squibb and MSD. LZ reports institutional payments from Novartis and Bristol Myers Squibb; personal fees and support for attending meetings or travel grants from Bristol Meyers-Squibb, MSD, Pierre Fabre, Novartis, Sanofi, and Sun Pharma; and participation on drug safety monitoring or advisory boards for the same companies. EL reports personal fees, honoraria, and support for attending meetings or travel grants from Bristol Myers Squibb, Medac, Novartis, Pierre Fabre, and Sun Pharma, and honoraria from MSD, Recordati, and Sanofi. EL participated on a drug safety monitoring or advisory board for Bristol Myers Squibb, Novartis, Sanofi, and Sun Pharma. TKE reports consulting fees from Almirall Hermal, Bristol Myers Squibb, Immunocore, Novartis, Pierre Fabre, and Sanofi outside the submitted work, and an unpaid leadership or fiduciary role for ADO/DeCOG. AH reports grants and personal fees for Amgen, Bristol Myers Squibb, Eisai, Immunocore, Merck Pfizer, MSD, Novartis, Pierre Fabre, Philogen, Regeneron, Replimune, Roche, Seagen, and Sanofi-Genzyme. JCH reports honoraria and personal consulting fees from GSK, MSD, Pierre Fabre, and Sun Pharma; further honoraria from Amgen, Bristol Myers Squibb, Immunocore, Novartis, and Sanofi; travel support from Bristol Myers Squibb and Sun Pharma; institutional fees for consultancy from Bristol Myers Squibb, Immunocore, Nektar Therapeutics, Novartis, Philogen, and Sanofi; participation on drug safety monitoring or advisory boards for NEC OncoImmunity and several pharmaceutical companies (GSK, MSD, Pierre Fabre, Sunpharma, Bristol Myers Squibb, Immunocore, Nektar, Novartis, Philogen, and Sanofi); and an unpaid leadership or fiduciary role for ADO/DeCOG. PM reports institutional grants from Bristol Myers Squibb, MSD, and Novartis; personal fees and honoraria from Amgen, Bristol Myers Squibb, GSK, MSD, Merck Serono, Novartis, Pierre Fabre, Roche, Sanofi, and Sun Pharma; and travel support from Bristol Myers Squibb. PM participated on a data safety monitoring or advisory board from Almirall Hermal, Amgen, Beiersdorf, Bristol Myers Squibb, MSD, Merck Serono, Novartis, Pierre Fabre, Roche, Sanofi, and Sun Pharma, and received travel support from Bristol Myers Squibb and Sun Pharma. MF reports payment or honoraria (for presentations and participation on advisory boards) from Bristol Myers Squibb, Pierre Fabre, Roche, and Sanofi. IT reports institutional grants or contracts from Kartos Therapeutics, 4SC, and Incyte; consulting fees and honoraria from Bristol Myers Squibb outside the submitted work; and honoraria and travel support from Pierre Fabre. MG reports honoraria and travel support from Amgen, Bristol Myers Squibb, MSD, Novartis, Pierre Fabre, Roche, and Sanofi. IG reports payment or honoraria from Bristol Myers Squibb, Kyowa Kirin, MSD, Novartis, Pierre Fabre, Sanofi-Genzyme, and Sun Pharma; travel support from Bristol Myers Squibb and Kyowa Kirin; and participation on drug safety monitoring or advisory boards for Almirall Hermal, Bristol Myers Squibb, MSD, Novartis, Roche, and Sanofi. ANS and SE are employees of Alcedis. All other authors declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Aim: ImmunoCobiVem investigated whether a planned switch to atezolizumab after achieving tumour control during run-in with vemurafenib + cobimetinib improves progression-free survival (PFS) and overall survival (OS) compared to continuous targeted therapy (TT) in patients with previously untreated advanced BRAF V600 -mutated melanoma., Methods: In this multicenter phase 2 study, patients received vemurafenib plus cobimetinib. After 3months, patients without progressive disease (PD) were randomly assigned (1:1) to continue vemurafenib + cobimetinib (Arm A) or switch to atezolizumab (Arm B) until first documented PD (PD1). Primary outcome was PFS1 (time from start of run-in until PD1 or death). OS and safety were also assessed., Results: Of 185 patients enroled between November 2016 and December 2019, 135 were randomly assigned after the run-in period (Arm A, n = 69; Arm B, n = 66). Median PFS1 was significantly longer in Arm A versus Arm B (13.9 versus 5.9months; hazard ratio [HR] 0.55; 95% confidence interval [CI], 0.37-0.84; P Stratified =0.001). Median OS was not reached in either arm (HR 1.22; 95%CI, 0.69-2.16; P Stratified =0.389); 2-year OS was higher in Arm B versus Arm A (67%; 95%CI, 53-78 versus 58%; 95%CI, 45-70). Grade 3/4 AEs occurred in 55% of patients in Arm A and 64% in Arm B; treatment-related AEs led to discontinuation of any drug in 7% and 9% of patients, respectively., Conclusion: In patients with BRAF V600 -mutated advanced melanoma who achieve tumour control with TT, early switch at 3months to atezolizumab led to rapid loss of tumour control but provided a numerical OS benefit at 2years compared with continued TT., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: EL received honoraria from Novartis, Medac, Bristol Myers Squibb, Sanofi, Sun Pharma, and Pierre Fabre, reports consulting/advisory roles with Bristol Myers Squibb, Pierre Fabre, MSD, Sanofi, and Novartis; and received travel/accommodations/expenses from Pierre Fabre, Bristol Myers Squibb, Medac, and Sun Pharma. HG received honoraria from Bristol Myers Squibb, MSD Oncology, Pierre Fabre, and Sanofi/Regeneron; reports consulting/advisory roles with Bristol Myers Squibb, MSD Oncology, Amgen, Pierre Fabre, and Sanofi/Regeneron; received research funding from Bristol Myers Squibb, Roche, MSD Oncology, Amgen, Novartis, and Iovance Biotherapeutics; and received travel/accommodations/expenses from Bristol Myers Squibb, MSD, Amgen, and Pfizer. LK-S reports consulting/advisory roles with MSD Oncology, Novartis, Roche, and Bristol Myers Squibb/Medarex; was on speaker’s bureaus for MSD Oncology, Novartis, Roche, Bristol Myers Squibb, Janssen, and AbbVie; and received travel/accommodations expenses from MSD Oncology and Roche. FM reports travel support and/or speaker’s fees and/or advisor’s honoraria from Novartis, Roche, Bristol Myers Squibb, MSD, Pierre Fabre, and Sanofi and research funding from Novartis and Roche. TKE reports consulting/advisory roles with Bristol Myers Squibb/Medarex, Sanofi/Regeneron, Novartis, and Pierre Fabre, and speakers' bureaus for Almirall Hermal GmbH. MZ reports a consultant/advisory role with Bristol Myers Squibb; speakers bureaus for Bristol Myers Squibb, Novartis, MSD, and Pierre Fabre; research funding from Novartis; and travel/accommodations/expenses from Philogen. PAMT received honoraria from Almirall, Bristol Myers Squibb, Kyowa Kirin, Novartis, Pierre Fabre, Roche, Sanofi, and 4SC; reports consulting/advisory roles with Almirall, Bristol Myers Squibb, Novartis, Pierre-Fabre, Merck, Serono, Sanofi, Roche, and Kyowa Kirin; and travel/accommodations/expenses from Pierre Fabre and Bristol Myers Squibb. AHG received honoraria from Novartis, Almirall Hermal GmbH, MSD Sharp & Dohme GmbH, and Pierre Fabre Pharma GmbH; reports consulting/advisory roles with Novartis, Bristol Myers Squibb, and Pierre Fabre Pharma GmbH; and received travel/accommodations/expenses from Novartis and Pierre Fabre. RAH is an employee of Helios Kliniken. KCK reports honoraria from Bristol Myers Squibb, MSD, Novartis, and Sanofi-Aventis; reports consulting/advisory roles with Bristol Myers Squibb and MSD; received research funding from Novartis; and received travel/accommodations/expenses from Bristol Myers Squibb, MSD, Novartis, and Roche. DCZ declares no conflicts of interest. ZM received honoraria from Novartis, Janssen, La Roche-Posay, Bristol Myers Squibb/Medarex, Roche, MSD Oncology, AbbVie, Lilly, and Boehringer Ingelheim, and reports consulting/advisory roles with Lilly and Janssen. MG was on a speaker’s bureau for and received travel/accommodations/expenses from Bristol Myers Squibb. CG reports consulting/advisory roles with Bristol Myers Squibb, MSD Oncology, NeraCare GmBH, Novartis, Roche/Genentech, Sanofi, and CeCaVa; received honoraria from Bristol Myers Squibb, MSD Oncology, NeraCare GmBH, Novartis, Philogen, Roche/Genentech, Sanofi, and CeCaVa; and received research funding from Bristol Myers Squibb, NeraCare GmBH, Novartis, and Roche/Genentech. AR reports consulting/advisory roles with and received honoraria from Novartis and Bristol Myers Squibb; received research funding from Novartis, Bristol Myers Squibb, and Adtec; and received travel/accommodations/expenses from Novartis, Bristol Myers Squibb, Roche, and MSD. SU reports research support from Bristol Myers Squibb and Merck Serono; speakers and advisory board honoraria from Bristol Myers Squibb, Merck Sharp & Dohme, Merck Serono, Novartis, and Roche; and travel support from Bristol Myers Squibb, Merck Sharp & Dohme, and Pierre Fabre, outside the submitted work. RG reports honoraria from Bristol Myers Squibb, Merck Sharp & Dohme, Roche/Genentech, Novartis, Merck Serono, Almirall Hermal GmbH, Amgen, Sun Pharma, Pierre Fabre, Sanofi/Regeneron, and Immunocore; consulting/advisory roles with Bristol Myers Squibb, Merck Sharp & Dohme, Roche/Genentech, Novartis, Almirall Hermal GmbH, 4SC, Amgen, Pierre Fabre, Merck Serono, Sun Pharma, Sanofi, and Immunocore; research funding from Pfizer, Novartis, Johnson & Johnson, Amgen, Merck Serono, Sun Pharma, and Sanofi; and travel/accommodations/expenses from Bristol Myers Squibb, Roche, Merck Serono, Pierre Fabre, and Sun Pharma. JJG reports consulting/advisory roles with Bristol Myers Squibb, MSD, Novartis, Roche, Amgen, Pierre Fabre, Philogen, Pfizer, Merck, and Sanofi; participates in a speaker’s bureau for Novartis and Bristol Myers Squibb; received research funding from Pierre Fabre and Bristol Myers Squibb; and received travel/accommodations/expenses from Novartis, Bristol Myers Squibb, and Pierre Fabre. FK reports consulting/advisory roles with Bristol Myers Squibb, MSD, Novartis, Pierre Fabre, and Sanofi. JU is an advisory board member for and has received honoraria and travel support from Amgen, Bristol Myers Squibb, GlaxoSmithKline, Immunocore, LEO Pharma, Merck Sharp & Dohme, Novartis, Pierre Fabre, Roche, and Sanofi outside the submitted work. CW-K declares no conflicts of interest. SE declares no conflicts of interest. LZ; received honoraria from Merck Sharp & Dohme, Bristol Myers Squibb, Novartis, Roche, and Pierre Fabre; reports consulting/advisory roles with Merck Sharp & Dohme, Roche, Bristol Myers Squibb, Novartis, Sanofi, Pierre Fabre, and Sun Pharma; received research funding from Novartis, and received travel/accommodations/expenses from Amgen, Bristol Myers Squibb, Merck Sharp & Dohme, Novartis, Pierre Fabre, Sanofi, and Sun Pharma. DS received honoraria from Roche/Genentech, Novartis, Bristol Myers Squibb, Merck Sharp & Dohme, Immunocore, Merck Serono, Array BioPharma, Pfizer, Pierre Fabre, Philogen, Regeneron, 4SC, Sanofi/Regeneron, Neracare, Sun Pharma, Inflarx GmbH, Ultimovacs, Sandoz, Amgen, Daiichi Sankyo Japan, LabCorp, Nektar, and Replimune; reports consulting/advisory roles with Roche/Genentech, Novartis, Bristol Myers Squibb, Merck Sharp & Dohme, Merck Serono, 4SC, Pierre Fabre, Sanofi/Regeneron, and Nektar; participates in speaker’s bureaus for Bristol Myers Squibb, Merck Sharp & Dohme, Novartis, Pierre Fabre, Sanofi/Regeneron, and Merck KGaA; received research funding from Bristol Myers Squibb, Novartis, Roche, MSD Oncology, Array/Pfizer, and Amgen; and received travel/accommodations/expenses from Roche/Genentech, Bristol Myers Squibb, Merck Serono, Novartis, Merck Sharp & Dohme, Pierre Fabre, and Sanofi/Regeneron., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Introduction and Hypothesis: Data examining the effect of diabetes mellitus (DM) on prolapse recurrence after sacrocolpopexy (SCP) is limited. The primary objective of this study was to determine if DM affects prolapse recurrence after robotic SCP., Methods: This was a retrospective cohort study of women who underwent robotic SCP between 2012 and 2019 at Kaiser Permanente Southern California. The cohort was divided into women with and without DM at the time of SCP. The primary outcome was composite failure. Secondary outcomes included recurrent compartment-specific prolapse, reoperation rates, and surgical complications., Results: Of 547 patients included, 100 had DM. Women with DM were older, had higher BMI, higher parity, and were more likely to be nonwhite. Women with DM had more advanced prolapse at baseline but were not more likely to undergo concomitant procedures at the time of SCP. Over a median follow-up of 2.1 years (IQR 1.3, 3.4), women with DM had significantly increased risk of anterior vaginal prolapse (AVP) recurrence (13% vs 3%, p<0.01), but not composite failure (21% vs 14%, p=0.14). On multivariate regression, women with DM were almost 4 times as likely to experience AVP recurrence over time (AVP hazard ratio (HR) 3.93, 95% CI 1.29-12.03, p=0.02)., Conclusion: In our cohort, DM was a risk factor for AVP recurrence but not composite failure after robotic SCP., (© 2023. The International Urogynecological Association.)

The Fenwei Plain is one of China's most polluted regions, with poor atmospheric dispersion conditions and an outdated energy structure. After implementing multiple policies in recent years, significant reductions in air pollutant concentrations were observed. In this study, based on the Lagrangian-Bayesian inversion framework FLEXINVERT, we constructed a variable resolution inversion system focusing on the Fenwei Plain and inferred the carbon monoxide (CO) emissions using in-situ atmospheric CO observations from April 2014 to March 2020. We analyzed the spatiotemporal variations of the CO emissions and discussed their causes, especially the effect of the "Three-year Action Plan on Defending the Blue Sky" (TAPDBS). Before the policy, CO emissions temporarily increased, and the overall decrease in CO emissions per unit of Gross Domestic Product (GDP) slowed down. When the policy was implemented, CO emission fluxes declined sharply, with an average drop of 28%, accompanied by an even higher 37% decrease of CO emission per GDP. The reasons for the decline in CO emissions in Shanxi, Shaanxi and Henan are diverse. The decrease in energy intensity is the reason for CO emission reduction in Shannxi and Henan province but not in Shanxi province. This research fills the gap in emission information in recent years and confirms that TAPDBS has brought a breakthrough in both economic development and air quality protection in the Fenwei Plain., 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 Ltd. All rights reserved.)

Introduction: The Global Initiative for Chronic Obstructive Lung Disease (GOLD 2023) no longer recommends a long-acting β 2 -agonist (LABA) plus inhaled corticosteroid (ICS) combination for the treatment of chronic obstructive pulmonary disease (COPD). In patients treated with LABA/ICS, who continue to experience symptoms without frequent or severe exacerbations, GOLD now recommends switching to long-acting muscarinic antagonist (LAMA)/LABA instead of escalating to triple therapy (TT; LAMA/LABA/ICS), which previously was also a recommended option. EVELUT ® , a real-life, observational study, compared these two treatment strategies in terms of symptom relief and health status improvement., Methods: Patients with symptomatic COPD at low exacerbation risk (GOLD B) were switched, at their physicians' discretion, from LABA/ICS to either fixed-dose LAMA/LABA (tiotropium/olodaterol, Respimat ® [Tio/Olo]) or fixed or free TT. Primary endpoints were change in modified Medical Research Council (mMRC) and COPD Assessment Test™ (CAT™) scores after 12 weeks., Results: The safety set contained 463 patients (Tio/Olo, n = 329; TT, n = 134). In a propensity score-matched set (Tio/Olo, n = 121; TT, n = 121), improvement in mMRC score was similar in patients on Tio/Olo (-0.23; 95% confidence interval [CI] -0.11, -0.36) and TT (-0.25; 95% CI -0.13, -0.38). Improvement in total CAT score was slightly larger in patients on Tio/Olo (-3.45; 95% CI -2.45, -4.45) versus TT (-2.51; 95% CI -1.62, -3.40). In both groups, Physician's Global Evaluation scores increased, with 69-89% of patients satisfied with their treatment overall. Marginally more patients on Tio/Olo responded to treatment versus TT (Δ mMRC score ≥ 1; 25% vs. 22%; Δ CAT score ≥ 2, 68% vs. 56%)., Conclusion: In patients with symptomatic COPD at low exacerbation risk, treatment can be switched from LABA/ICS to LAMA/LABA without compromising clinical benefit, compared with escalating to LAMA/LABA/ICS. Switching from LABA/ICS to LAMA/LABA can provide symptom relief and improve health status without exposure to the risks associated with ICS., Clinical Trial Registration: ClinicalTrials.gov: NCT03954132., (© 2023. The Author(s).)

Few studies report the occurrence of microplastics (MP), including tire wear particles (TWP) in the marine atmosphere, and little data is available regarding their size or sources. Here we present active air sampling devices (low- and high-volume samplers) for the evaluation of composition and MP mass loads in the marine atmosphere. Air was sampled during a research cruise along the Norwegian coast up to Bear Island. Samples were analyzed with pyrolysis-gas chromatography-mass spectrometry, generating a mass-based data set for MP in the marine atmosphere. Here we show the ubiquity of MP, even in remote Arctic areas with concentrations up to 37.5 ng m -3 . Cluster of polyethylene terephthalate (max. 1.5 ng m -3 ) were universally present. TWP (max. 35 ng m -3 ) and cluster of polystyrene, polypropylene, and polyurethane (max. 1.1 ng m -3 ) were also detected. Atmospheric transport and dispersion models, suggested the introduction of MP into the marine atmosphere equally from sea- and land-based emissions, transforming the ocean from a sink into a source for MP., (© 2023. The Author(s).)

Importance and Objectives: The objective was to determine whether patients with diabetes mellitus (DM) treated with intravesical onabotulinumtoxinA (BoNT) injection for overactive bladder (OAB) had increased urinary retention requiring clean intermittent catheterization (CIC), as well as the impact of disease duration and severity. We hypothesize that patients with DM will have higher rates of retention after BoNT injection., Study Design: We performed a retrospective cohort analysis of women in the Kaiser Permanente Southern California Health System who underwent BoNT injection for OAB, excluding women with a history of urinary retention or neurogenic bladder., Results: We identified 565 patients, 410 in the control group and 155 in the DM group. No significant difference was found in the rate of CIC (9% in the control group versus 5.8% in the DM group, P = 0.2), voiding dysfunction, and peak postprocedure postvoid residual volume (PVR). Patients with diabetes had a significantly increased rate of postprocedure urinary tract infection (UTI; 27.6% versus 38.1%, P = 0.02). Urinary tract infection was significantly associated with urinary retention (adjusted odds ratio [OR], 2.26; 95% confidence interval [CI], 1.02-4.99; P = 0.045) and peak PVR ≥200 mL (adjusted OR, 2.42; 95% CI, 1.15-5.06; P = 0.019). Diabetic disease duration and severity were not a predictor of urinary retention, elevated PVR, or voiding dysfunction; however, the presence of ≥1 disease-related complication was a predictor of UTI (adjusted OR, 2.81; 95% CI, 1.34-5.91; P = 0.006)., Conclusions: Diabetic patients had a similar rate of urinary retention requiring CIC after BoNT injection for OAB compared with nondiabetic patients. Diabetic patients had an increased risk of UTI based on disease severity., Competing Interests: The authors have declared they have no conflict of interest., (Copyright © 2022 American Urogynecologic Society. All rights reserved.)

Importance: The proportion of female physicians in the workforce has been steadily increasing, but the proportion of women in department leadership roles across the United States remains low. Urogynecology has the highest representation of women in leadership roles across obstetrics and gynecology and urology subspecialties; however, the proportion of women in leadership roles within urogynecology fellowship programs has not been described previously., Objectives: Our objective was to investigate gender representation within urogynecology fellowship program leadership positions., Study Design: This was a cross-sectional observational study where urogynecology fellowship program websites were queried for the geographic state as well as the gender expression of the program director and division chair., Results: A total of 68 American Council for Graduate Medical Education-accredited urogynecology fellowship programs were queried. Of these, 53 are obstetrics and gynecology-based programs and 15 are urology-based programs. Overall, women represent 67.6% of fellowship directors and 59.2% of division directors. One in 4 female fellowship directors concurrently hold the role of division chair. Women are significantly more likely to be fellowship directors in obstetrics and gynecology-based programs compared with urology-based urogynecology programs (75.4% versus 40.0%; odds ratio, 4.1; 95% confidence interval, 1.20-14.0). Women are also more likely to be division chairs in obstetrics and gynecology-based compared with urology-based urogynecology programs, although this did not reach statistical significance (63.4% versus 37.5%; odds ratio, 2.9, 95% confidence interval, 0.60-13.8)., Conclusions: Across urogynecology fellowship programs, women are the majority of division chairs and fellowship directors. However, female representation in leadership roles is lagging at urology-based urogynecology programs., Competing Interests: The authors have declared they have no conflicts of interest., (Copyright © 2023 American Urogynecologic Society. All rights reserved.)

Black carbon emitted by incomplete combustion of fossil fuels and biomass has a net warming effect in the atmosphere and reduces the albedo when deposited on ice and snow; accurate knowledge of past emissions is essential to quantify and model associated global climate forcing. Although bottom-up inventories provide historical Black Carbon emission estimates that are widely used in Earth System Models, they are poorly constrained by observations prior to the late 20th century. Here we use an objective inversion technique based on detailed atmospheric transport and deposition modeling to reconstruct 1850 to 2000 emissions from thirteen Northern Hemisphere ice-core records. We find substantial discrepancies between reconstructed Black Carbon emissions and existing bottom-up inventories which do not fully capture the complex spatial-temporal emission patterns. Our findings imply changes to existing historical Black Carbon radiative forcing estimates are necessary, with potential implications for observation-constrained climate sensitivity., (© 2023. The Author(s).)

Coffee bean harvesting incurs various by-products known for their long traditional use. However, they often still end up being a waste instead of being used to their full potential. On the European market, coffee cherry (cascara) products are not yet common, and a novel food approval for beverages made from coffee cherry pulp was issued only recently. In this article, exposure and risk assessment of various products such as juice, jam, jelly, puree, and flour made from coffee cherry pulp and husk are reviewed. Since caffeine in particular, as a bioactive ingredient, is considered a limiting factor, safe intake will be derived for different age groups, showing that even adolescents could consume limited quantities without adverse health effects. Moreover, the composition can be influenced by harvesting methods and processing steps. Most interestingly, dried and powdered coffee cherry can substitute the flour in bakery products by up to 15% without losing baking properties and sensory qualities. In particular, this use as a partial flour substitute is a possible approach to counteract rising grain prices, transport costs, and disrupted supply chains, which are caused by the Russia-Ukraine war and changing climatic conditions. Thus, the supply of affordable staple foods could be partially ensured for the inhabitants of countries that depend on imported wheat and cultivate coffee locally by harvesting both beans and by-products.

Importance: Understanding postoperative opioid consumption is key to reducing opioid misuse., Objective: The aim of the study was to quantify the amount of outpatient opioids consumed after urogynecologic surgery., Study Design: This is a prospective multicenter cohort study sponsored by the American Urogynecologic Society Fellow's Pelvic Research Network. Women undergoing pelvic organ prolapse or urinary incontinence surgery between May 2019 and January 2021 were included. Patients used text messaging to report daily opioid consumption, pain levels, and nonopioid analgesic consumption 2 weeks postoperatively. Demographic and perioperative factors associated with high opioid use (>75th percentile) were identified., Results: Two hundred sixty-one patients were included from 9 academic centers. The median (interquartile range) morphine milligram equivalents (MME) consumed were 28 (0-65) and prescribed were 75 (50-113). The median ibuprofen and acetaminophen tablets consumed were 19 (10-34) and 12 (4-26). The median pain level was 2.7 of 10 (1.7-4.4). Factors associated with high MME use (>65 MME) included body mass index greater than 30 ( P < 0.01), chronic pain ( P < 0.01), elevated baseline pain score ( P < 0.01), elevated blood loss ( P < 0.01), longer operating time ( P < 0.01), and southern region ( P < 0.01). High MME consumers more frequently underwent perineorrhaphy ( P = 0.03), although this was not significant on multivariate analysis., Conclusions: Urogynecology patients consume a median of 28 MME (3-4 oxycodone 5-mg tablets) after surgery, and surgeons prescribe 3 times this amount (75 MME, 10 oxycodone tablets). In addition, there are several factors that can be used to identify patients who will require greater numbers of opioids. These data may be used to enhance existing prescribing guidelines., Competing Interests: The authors have declared they have no conflicts of interest., (Copyright © 2022 American Urogynecologic Society. All rights reserved.)

Introduction and Hypothesis: The objective of this study was to evaluate the impact of patient- and physician-directed education in the primary care setting on screening, diagnosis, treatment, and referral patterns to Urogynecology for urinary incontinence (UI)., Methods: This was a prospective, multi-phase, before-and-after study conducted over a 3-year period. New female patients, 40 years and older, seen in the Internal Medicine (IM) clinic of our institution, were included. Phase 1 intervention consisted of UI lectures for IM residents. Phase 2 intervention involved placement of patient-directed posters throughout the IM clinic. Prior to phase 1, charts of new patients were reviewed as the control group to establish a baseline rate of screening, diagnosis, treatment initiation, and referrals. The same data were collected for 4 months after both phase 1 and phase 2. A washout period of 1 year occurred between phase 1 and phase 2., Results: A total of 410 charts were reviewed and included 200 control, 92 phase 1, and 118 phase 2 patients. In the control group, 13% of patients were screened for UI. There was no significant increase in screening after phase 1 (15% vs 13%, p = 0.6); however, there was a significant increase after phase 2 (32.2% vs 13%, p < 0.001). There was no difference in treatment initiation for patients with a positive screen after either phase., Conclusion: In our study, providing an informative lecture to an IM referral base did not improve UI screening. Alternatively, directly targeting patients through posters significantly improved screening rates in the primary care setting, demonstrating that simple interventions can improve screening for conditions that are difficult to discuss such as UI., (© 2022. The International Urogynecological Association.)

We combine observations from Western USA and inverse modelling to constrain global atmospheric emissions of microplastics (MPs) and microfibers (MFs). The latter are used further to model their global atmospheric dynamics. Global annual MP emissions were calculated as 9.6 ± 3.6 Tg and MF emissions as 6.5 ± 2.9 Tg. Global average monthly MP concentrations were 47 ng m -3 and 33 ng m -3 for MFs, at maximum. The largest deposition of agricultural MPs occurred close to the world's largest agricultural regions. Road MPs mostly deposited in the East Coast of USA, Central Europe, and Southeastern Asia; MPs resuspended with mineral dust near Sahara and Middle East. Only 1.8% of the emitted mass of oceanic MPs was transferred to land, and 1.4% of land MPs to ocean; the rest were deposited in the same environment. Previous studies reported that 0.74-1.9 Tg y -1 of land-based atmospheric MPs/MFs (< 5 mm) are transported to the ocean, while riverine transport is between 3.3 and 14 Tg y -1 . We calculate that 0.418 ± 0.201 Tg y -1 MPs/MFs (size up to 250 and 2500 µm) were transported from the land to ocean (large particles were ignored). Model validation against observations showed that particle removal must be urgently updated in global models., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)