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The Greenland ice sheet is considered as one of the main causes of sea level rise (SLR) at the end of the 21st century. But what if it is already too late to reverse the loss of ice from the Greenland ice sheet? The mass balance (MB) resulting from the coupling between the Regional Atmospheric Model (MAR, ULiège) and the Parallel Ice Sheet Model (PISM, PIK) over Greenland following the CESM2 ssp585 climate indicates that even if we stop the CESM2 warming in 2100 and continue with a +7°C climate until 2200 with respect to the reference period (1961-1990), the GrIS continues to lose mass up to a contribution equivalent to 60 cm of SLR in 2200. From this coupling experiment, we ran several coupled simulations by stabilizing the warming at different thresholds (+ 1, 2, 3, ... °C) with respect to our reference period in order to highlight a kind of tipping point of the ice sheet with respect to atmospheric warming. Other experiments have been launched by reversing the climate imposed by CESM2 from 2100 to 2000, for example, with the aim of identifying whether the GrIS could gain ice mass again with a climate as warm as the present one.

The Greenland Ice Sheet is a key contributor to sea level rise. By melting, the ice sheet thins, inducing higher surface melt due to lower surface elevations, accelerating the melt coming from global warming. This process is called the melt-elevation feedback that can be considered by using two types of models: atmospheric models, which can represent the surface mass balance, usually using a fixed surface elevation, and the ice sheet models, which represent the surface elevation evolution but do not represent the surface mass balance as well as atmospheric models. A new coupling between the regional climate model MAR (Modèle Atmosphérique Régional) and the ice sheet model PISM (Parallel Ice Sheet Model) is presented here following the CESM2 (SSP5-8.5) scenario until 2100 at the MAR lateral boundaries. The coupling is extended to 2200 with a stabilised climate (+ 7 °C compared to 1961–1990) by randomly sampling the last 10 years of CESM2 to force MAR and reaches a sea level rise contribution of 64 cm. The fully coupled simulation is compared to a 1-way experiment where surface topography remains fixed in MAR. However, the surface mass balance is corrected to the melt-elevation feedback when extrapolated on the PISM grid by using surface mass balance vertical gradients as a function of local elevation variations (offline correction). This method is often used to represent the melt-elevation feedback and avoid a coupling expensive in computation time. In the fully-coupled MAR simulation, the ice sheet morphology evolution (changing slope and reducing the orographic barrier) induces changes in local atmospheric circulation. More specifically, wind regimes are modified which influences the melt rate at the ice sheet margins. We highlighted a mitigation of the melt lapse rate on the margins by modifying the surface morphology. The lapse rates considered by the offline correction are no longer valid at the ice sheet margins. If used (1-way simulation), this correction implies an overestimation of the sea level rise contribution of 2.5 %. The mitigation of the melt lapse rate on the margins can only be corrected by using a full coupling between an ice-sheet model and an atmospheric model.

ObjectiveSchool-aged children in low- and middle-income countries carry the highest burden of intestinal helminth infections, such as soil-transmitted helminths (STH). STH infections have been associated with negative consequences for child physical and cognitive development and wellbeing. Thus, the aim of this study was to determine the association of STH infections in schoolchildren from Gqeberha, focusing on physical activity, physical fitness, and clustered cardiovascular disease (CVD) risk score.MethodsThis cross-sectional study involved 680 schoolchildren (356 girls and 324 boys; mean age 8.19 years, SD±1.4) from disadvantaged communities in Gqeberha (formerly, Port Elizabeth), South Africa. Stool samples were collected and examined for STH infections using the Kato-Katz method. Physical activity (accelerometer) and physical fitness (grip strength, 20 m shuttle run) were measured using standard procedures. Furthermore, anthropometry, blood pressure, as well as glycated haemoglobin and lipid profile from capillary blood samples were assessed. We employed one-way ANOVAs to identify the associations of STH infections in terms of species and infection intensity with physical activity, physical fitness, and clustered CVD risk score.ResultsWe found a low STH infection prevalence (7.2%) in our study, with participants infected with at least one intestinal helminth species. In comparison to their non-infected peers, children infected with STH had lower mean grip strength scores, but higher mean VO2max estimation and higher levels of MVPA (pA. lumbricoidesinfection and MVPA was found. In contrast, lightT. trichiura-infected children had significantly lower grip strength scores compared to non-infected children. VO2max and MVPA were positively associated with lightT. trichiurainfection. No significant association between the clustered CVD risk score and infection with any STH species was evident.ConclusionsSTH-infected children had lower grip strength scores than their non-infected peers, yet, achieved higher VO2max and MVPA scores. Our study highlights that the type and intensity of STH infection is relevant in understanding the disease burden of STH infections on children’s health. The findings of our study must be interpreted cautiously due to the low infection rate, and more research is needed in samples with higher prevalence rates or case-control designs.

Surface melting of the Greenland Ice Sheet contributes a large amount to current and future sea-level rise. Increased surface melt, algae growth, debris, and dust deposition lower the reflectivity of the ice surface and thereby increase melt rates: the so-called melt-albedo feedback describes this potentially self-sustaining increase in surface melting. Here we present a simplified version of the diurnal Energy Balance Model (dEBM-simple) which is implemented as a surface melt module in the Parallel Ice Sheet Model (PISM). dEBM-simple is a modification of diurnal Energy Balance Model (dEBM), a surface melt scheme of intermediate complexity useful for simulations over centennial to multi-millennial timescales. dEBM-simple is computationally efficient, suitable for standalone ice-sheet modeling and includes a simple representation of the melt-albedo feedback. Using dEBM-simple and PISM, we find that this feedback increases ice loss until 2300 through surface warming by 60 % for the high-emission scenario RCP8.5. With an increase of 90 %, the effect is more pronounced for lower surface warming under RCP2.6. Furthermore, assuming an immediate darkening of the ice surface over all summer months, we estimate an upper bound for this effect to be +70 % in the RCP8.5 scenario and a more than fourfold increase under RCP2.6. With dEBM-simple implemented in PISM, we find that the melt-albedo feedback is an essential contributor to mass loss in dynamic simulations of the Greenland Ice Sheet under future warming.

Background: Little is known whether physical activity (PA)-promoting environments are equally accessible to children with divergent socioeconomic status (SES) in low-/middle-income countries. The authors, therefore, examined whether South African children from poorer versus wealthier families living in marginalized communities differed in moderate to vigorous PA and cardiorespiratory fitness. We also tested associations between family car ownership and PA/cardiorespiratory fitness. Methods: Parents/guardians of 908 children (49% girls, mean age = 8.3 [1.4] y) completed a survey on household SES. PA was assessed via 7-day accelerometry, parental and child self-reports, and cardiorespiratory fitness with the 20-m shuttle run test. Results: Based on accelerometry, most children met current moderate to vigorous PA recommendations (≥60 min/d). About 73% of the children did not engage in structured physical education lessons. Whereas children of the lowest SES quintile accumulated higher levels of device-based moderate to vigorous PA, peers from the highest SES quintile engaged in more sedentary behaviors, but self-reported higher engagement in sports, dance, and moving games after school. Families’ car ownership was associated with higher parent/self-reported leisure-time PA. Conclusions: A deeper understanding is needed about why wealthier children are more sedentary, but simultaneously engage in more leisure-time PA. The fact that access to structural physical education is denied to most children is critical and needs to be addressed.

Background: Over the past decades, childhood overweight has increased in many African countries. We examined the relationship between sedentary behaviour, moderate-to-vigorous physical activity (MVPA), and body composition in South African primary schoolchildren living in peri-urban settings. Methods: MVPA was measured via 7-day accelerometry and body composition via bioelectrical impedance analysis in 1090 learners (49.2% girls, Mage = 8.3 ± 1.4 years). The relationships between MVPA and sedentary behaviour with the various body composition indicators (body fat and fat-free mass [total, truncal, arms, and legs], bone mass, muscle mass, and body water) were tested with mixed linear regressions. Results: The prevalence of overweight and obesity was 9.8% and 6.6%, respectively; 77.1% of the children engaged in ≥60 min of MVPA/day. Girls were more likely to be overweight/obese, to accumulate less than 60 min of MVPA/day, and had significantly higher relative body fat than boys (ps < 0.001). Lower MVPA was associated with a higher likelihood of being overweight/obese, higher relative body fat, and lower relative fat-free mass, bone mass, muscle mass, and body water (ps < 0.001). For lower sedentary behaviour, the associations with body composition pointed in the opposite direction. Conclusions: In this South African setting, girls are a particularly relevant target group for future physical activity interventions to prevent overweight/obesity-related non-communicable diseases in later life.

Over the past decade, Greenland has experienced several extreme melt events, the most pronounced ones in the years 2010, 2012 and 2019. With progressing climate change, such extreme melt events can be expected to occur more frequently and potentially become more severe and persistent. So far, however, projections of ice loss and sea-level change from Greenland typically rely on scenarios which only take gradual changes in the climate into account. Using the Parallel Ice Sheet Model (PISM), we investigate the effect of extreme melt events on the overall mass balance of the Greenland Ice Sheet and the changes in ice flow, invoked by the altered surface topography. As a first constraint, this study estimates to the overall effect of extreme melt events on the cumulative mass loss of the Greenland Ice Sheet. We find that the sea-level contribution from Greenland might increase by 2 to 45 cm by the year 2300 if extreme events occur more frequently in the future, and the ice-sheet area might be reduced by an additional 1500 to 18000 km2 by 2300 in comparison to future warming scenarios without extremes. We conclude that both changes in the frequency and intensity of extreme events need to be taken into account when projecting the future sea-level contribution from the Greenland Ice Sheet.

Changes in the Greenland Blocking Index (GBI) present a threat to both the mass loss of the Greenland ice sheet, potentially leading to increased sea level rise, and downstream regions, such as the European continent and Mediterranean Basin that may be affected by associated changes in the frequency and characteristics of weather patterns. While a consistent increase in the summer GBI has been detected in (several) observational and reanalysis datasets, global climate models and seasonal prediction systems so far have failed in capturing this historical trend. The question whether the observed trend is real and not reproduced by models or an artifact of multidecadal variability (and, hence, a transient phenomenon) has so far not been answered. Here we apply the Peter and Clark momentary conditional independence (PCMCI) causal discovery tool to (i) unravel essential causal drivers of the GBI in a set of selected atmospheric fields at intraseasonal (weekly and 3-day averages) time scales in observations and (ii) compare the latter with those found in the ECMWF SEAS5 seasonal forecasts. Observed causal links well reproduced by the dynamical model would be considered indicative of the trend in GBI found in observations more likely emerging because of the selected time frame. By contrast, any differences between the two sets of causal drivers in observations and models would support the hypothesis that some key mechanisms are not appropriately represented in the forecast model, preventing it from correctly reproducing the observed trend.

Over the past decade, Greenland has experienced several extreme melt events, the most pronounced ones in the years 2010, 2012 and 2019. With progressing climate change, such extreme melt events can be expected to occur more frequently and potentially become more severe. So far, however, projections of ice loss and sea-level change from Greenland typically rely on scenarios that only take gradual changes in the climate into account. Here we investigate the effect of extreme melt events on the ice dynamics and overall mass balance of the Greenland Ice Sheet in simulations using the Parallel Ice Sheet Model (PISM). While the extremes generally lead to thinning of the ice sheet by enhanced melting, they partly also decrease the overall ice surface velocities due to a reduced driving gradient. In our simulations, we find that taking extreme events into account leads to additional ice loss compared to the baseline scenario without extremes. We find that the sea-level contribution from Greenland could increase by up to 45 cm by the year 2300 if severe extreme events are considered in future projections. We conclude that both changes in the frequency and intensity of extreme events need to be taken into account when projecting the future sea-level contribution from the Greenland Ice Sheet.

ObjectivesMuscular strength represents a specific component of health-related fitness. Hand grip strength (HGS) is used as an indicator for musculoskeletal fitness in children. HGS can also be used as a marker of cardiometabolic risk, but most available HGS data are derived from Western high-income countries. Therefore, this study examines whether HGS is associated with body composition and markers of cardiovascular risk in children from three sub-Saharan African countries.DesignCross-sectional study.SettingPublic primary schools (grade 1–4) in Taabo (Côte d’Ivoire), Gqeberha (South Africa) and Ifakara (Tanzania).ParticipantsData from 467 children from Côte d’Ivoire (210 boys, 257 girls), 864 children from South Africa (429 boys, 435 girls) and 695 children from Tanzania (334 boys, 361 girls) were analysed.Primary and secondary outcome measuresBody composition (assessed via bioelectrical impedance analysis) was the primary outcome. Cardiovascular risk markers were considered as secondary outcome. Blood pressure was measured with an oscillometric monitor, and blood markers (cholesterol, triglycerides, glycated haemoglobin) via Afinion point-of-care testing. HGS (independent variable) was assessed with a hydraulic hand dynamometer. Inferential statistics are based on mixed linear regressions and analyses of covariance.ResultsAcross all study sites, higher HGS was associated with lower body fat, higher muscle mass and higher fat-free mass (pConclusionsHGS assessment is popular due to its simplicity, feasibility, practical utility and high reliability of measurements. This is one of the first HGS studies with children from sub-Saharan Africa. There is a great need for further studies to examine whether our findings can be replicated, to develop reference values for African children, to establish links to other health outcomes, and to explore whether HGS is associated with later development of cardiovascular risk markers.Trial registration numberISRCTN29534081.

Executive functions (EFs) are essential for optimal academic development. Appropriate nutrition and physical activity (PA) have been shown to facilitate optimal cognitive development. Therefore, this study examined whether a 12-week school-based PA and multi-micronutrient supplementation (MMNS) intervention would improve cognitive and academic performance. A cluster-randomized controlled trial (RCT) was conducted. Children from four schools located in a peri-urban area of South Africa were randomly assigned to (i) PA + MMNS, (ii) PA + placebo, (iii) MMNS or (iv) placebo. Information processing and inhibitory control were measured with a computerized Flanker task. End-of-year results provided insight into academic achievement. Anthropometric measures were used to determine nutritional status. Data were analyzed with linear mixed-models, adjusting for baseline scores, school classes and age; 932 children (458 girls (49.1%), Mage (mean age) = 8.42 ± 1.94 years) completed baseline and post-intervention assessments. Cognitive performance improved among all four groups, with no significant group × time effects. For academic achievement, there was no significant interaction effect between the combined intervention group and placebo. We encourage future studies in this neglected area in order to determine the most optimal design of school-based nutrition and PA programs to enhance overall cognitive performance.

Background The prevalence of overweight and obesity is increasing among African children potentially predisposing them to greater obesity and non-communicable diseases (NCDs) in adulthood. This risk may be higher among growth-impaired children who may have greater fat mass. Therefore, we examined the effects of school-based physical activity (PA) promotion and multi-micronutrient supplementation (MMNS) on body composition among South African children enrolled in a longitudinal school-based randomized controlled trial. Methods Children were cluster-randomized by class to one of four groups: (a) a physical activity group (PA), (b) a multi-micronutrient supplementation group (MMNS), (c) a physical activity + multi-micronutrient supplementation group (PA + MMNS), and (d) control group, and were being followed for 3 years. Linear random effects regression models with random intercepts for school classes tested the associations of each intervention arm with overall fat mass (FM), fat-free mass (FFM), truncal fat mass (TrFM), and truncal fat-free mass (TrFFM) at 9 months (T2) for boys and girls. These differences were then explored among children who differed in height velocity (HV). Results A total of 1304 children (614 girls, 667 boys) in twelve clusters were assessed at baseline and after 9 months follow-up (T2). At baseline, approximately 15% of children were classified as overweight or obese while approximately 38% of children were classified as mildly stunted or moderately/severely stunted. Among girls, promotion of PA was associated with reduced FM and TrFM at T2 while MMNS was associated with increased FFM. Children with reduced HV in the PA arm had reduced FM while children in the MMNS arm with lower HV had increased FFM compared to children in the control arm. Similarly, children with lower HV in the MM and PA groups had reduced TrFM compared to children in the control arm. Conclusions Our study suggests that the promotion of school-based physical activity programs and micronutrient supplementation can reduce childhood adiposity and so reduce the risk of obesity and chronic diseases later in adulthood. Trial registration ISRCTN, ISRCTN29534081. Registered on August 9, 2018. The trial was designed, analyzed, and interpreted based on the CONSORT protocol (Additional file 1: CONSORT checklist for randomized trial)

Childhood stunting can have negative long-term consequences on cognitive development, academic achievement, and economic productivity later in life. We determined the prevalence of stunting and examined whether stunting and associated risk factors (low dietary diversity, insufficient hemoglobin, food insecurity, and soil-transmitted helminth (STH) infections) are associated with academic achievement and cognitive function among South African children living in marginalized communities. A cross-sectional sample of 1277 children (aged 5–12 years) was analyzed. Stunting was defined according to 2007 WHO growth references. Cognitive functioning was measured with the computerized Flanker task and academic performance via school grades. Blood and stool samples were collected to obtain hemoglobin level and STH infection. Dietary diversity was assessed by a food frequency questionnaire. Associations were examined via mixed linear regression (with school class as a random intercept). Nine percent of the children were stunted (95% CI: 7.6–10.8%). Low dietary diversity (β = 0.13, p = 0.004), food insecurity (β = −0.12, p = 0.034), and stunting (β = −0.13, p = 0.031) were associated with poorer end of the year results among girls. No such associations were found among boys. No significant associations were found for socioeconomic status and hemoglobin levels. The prevalence of stunting and STH infections were low in the present sample. Risk factors seem differently associated with girls’ and boys’ academic achievement. Promoting nutrition may help to promote academic achievement among girls living in low- and middle-income countries.

The Greenland ice sheet (GrIS) is a key contributor to see level rise. By melting in surface, ice sheet is thinning and reaches higher temperature which accelerate the melting processes coming from Global Warming. The main goal of our research is to improve the representation of melt-elevation feedback, which is crucial to determine how and when GrIS will melt and will involve in a near future, by coupling two kind of numerical models. The difficulty to model this feedback relies on the fact that ice-sheet models (ISMs) can reproduce the dynamic of the ice sheet and thus provide an evolution of the surface elevation, whereas (regional) climate models (RCMs) can represent the ice/snow and atmosphere interactions trough the surface mass balance (SMB). A coupling between these models appears as a solution and has already been accomplished. However, ISMs responses to a same forcing field may be quite different, while SMB from different RCMs are relatively more similar with the same forcing. Coupling could therefore be dependent of which ISMs are used. To avoid a coupling, costly in computing time, SMB vertical gradient as a function of local elevation variations could be used by ISMs to correct SMB. Nonetheless, these SMB gradients are computed with a RCM using a fixed topography, which could introduce biases if the surface elevation vary significantly. Here we decide to full couple the RCM MAR, specifically developed for polar climate and forced at his lateral boundaries by CESM2 (a CMIP6 model, scenario ssp585), with the ISM PISM. The coupling means that, each year, we exchange ice thickness from PISM to update the topography and ice mask of MAR, and SMB from MAR to update forcing fields of PISM. First of all the aim is to analyze what became the GrIS in 2100 with this extreme scenario. Then we want to define a coupling time threshold to determine after how much years an update of the topography in MAR is needed by varying the time step (from 1 to 5, 10, 20, 30 and 50 years) of the coupling. The final aim is to determine until when the MAR based SMB gradients are valid for a same topography in MAR.

The coexistence of multiple cardiovascular risk factors has been reported in school-aged children from the age of nine years, but most evidence stems from high-income countries. This cross-sectional study aimed at describing the cardiovascular health risk, physical activity (PA) behavior and cardiorespiratory fitness (CRF) levels of South African primary schoolchildren, and at examining the associations between PA/CRF and a composite measure of cardiovascular risk. Cross-sectional data from 832 primary schoolchildren (grade 1–4) were analyzed. Total cholesterol/HDL ratio, triglycerides, systolic/diastolic blood pressure, body fat, and glycated hemoglobin were assessed as cardiovascular risk markers. Data were analyzed via mixed linear regressions and analyses of covariance. Overall, 24.2% of the participants did not meet current PA standards. Higher CRF/PA were associated with lower body fat and lower clustered cardiovascular risk (p &lt, 0.05). When categorizing children into CRF/PA quartiles, a lower clustered cardiovascular risk gradient was found in children with higher CRF (p &lt, 0.05) or PA (p &lt, 0.05). Our data shows that higher CRF/PA is associated with lower clustered cardiovascular risk already from a young age. Given that clustered cardiovascular risk present during childhood can track into adulthood, we advocate for PA participation and a healthy weight from a young age onwards.

(1) Background: Early childhood malnutrition may result in increased fat mass (FM) among school-aged children in low- and middle-income countries (LMICs). We explored whether South African children with shorter stature have greater overall and abdominal FM compared to normal stature children. (2) Methods: Baseline assessments of body composition and weight were determined among school-aged children enrolled in a randomized controlled trial in Port Elizabeth, South Africa, using bioelectrical impedance analysis. Multiple linear regression models tested associations of children’s height and degree of stunting with FM, fat free mass (FFM), truncal fat mass (TrFM), and truncal fat free mass (TrFFM) overall and by sex. (3) Results: A total of 1287 children (619 girls, 668 boys) were assessed at baseline. Reduced child height was associated with higher FM and lower FFM and TrFFM, but these associations were reversed with increases in height. Girls classified as mildly or moderately/severely stunted had higher FM and TrFM but lower FFM and TrFFM, while no association was found for boys. (4) Conclusions: Our study suggests that efforts to reduce the non-communicable disease burden in LMICs should target growth-impaired children who may have greater overall FM and greater abdominal FM.

Background Cardiovascular fitness has been associated with both executive function and academic achievement in multiple cohort studies including children and adolescents. However, research is scarce among children from low- and middle-income countries. Hence, this paper focuses on South African primary schoolchildren living in marginalized areas and examines if academic achievement and inhibitory control can be explained by children’s age, socioeconomic status, soil-transmitted helminth infections, food insecurity, stunting, grip strength, and cardiorespiratory fitness. Methods The sample of this cross-sectional study consisted of 1277 children (48% girls, mean age: 8.3 years). Data were assessed via questionnaires, stool samples, anthropometric measurements, 20 m shuttle run test, grip strength test, Flanker task, and school grades. Data were analysed with mixed linear regression models with random intercepts for school classes, separately for boys and girls. Results Higher socioeconomic status was most closely associated with academic achievement among boys (p p p p p Conclusions Academic performance has been shown to be compromised in schoolchildren living in marginalised areas, compared to schoolchildren in less disadvantaged parts of South Africa. The present study suggests that cardiorespiratory fitness and grip strength are two potentially modifiable factors that are associated with children’s academic achievement and cognitive performance, and that should be targeted in future school-based interventions.

Background:\ud Adequate nutrition is essential for good health and active life. However, diets in most low and middle-income households lack diversity, especially in settings where people eat predominantly starchy foods. In this study, we assessed the associations between socio-economic status and household dietary diversity in families living in South-eastern Tanzania.\ud \ud Method:\ud A cross-sectional questionnaire was administered to 925 parents of school children in four wards in South-eastern Tanzania, as part of a trial; assessing the effects of physical activity and micronutrient supplementation on overall growth, health and well-being of school children. The dietary intake was assessed by 24-h dietary recall and dietary diversity score (DDS) was calculated. Socio-economic status was derived from a weighted score using principal component analysis (PCA). Multinomial logistic regression was used to investigate the association between dietary diversity and socio-economic status. This baseline data assessment was completed in July and August 2019.\ud \ud Results:\ud Cereals, oils and fats were the most consumed food groups, legumes were the most common source of protein and fish was the most common animal protein. More than three quarters of the households had medium dietary diversity (MDD). Higher household education and large farm size were the only factors significantly associated with having high dietary diversity.\ud \ud Conclusion:\ud A majority of the households in South-eastern Tanzania have medium dietary diversity, comprised of cereal, fats and oils and proteins. Having high dietary diversity was associated with higher education and large farm sizes. Improving community members’ knowledge and awareness of nutritional benefits could improve the dietary diversity at household level.

In the past years, Greenland has been affected by several extreme melt events, particularly in the years 2010, 2012 and most recently, during this year's spring/summer. With progressing climate change, extreme melt events can be expected to occur more frequently and become more severe/persistent. So far, however, longer-term projections of ice loss from Greenland typically rely on scenarios that only take account of gradual changes in the climate, for instance, based on the Representative Concentration Pathways. Extreme melt events have generally been underestimated and their potential effect on future surface mass balance shows already serve impacts for sea-level rise. Here we investigate the total impact of future extreme melt events on the Greenland Ice Sheet. We force the thermodynamically coupled parallel ice sheet model PISM with idealized surface-mass-balance scenarios that include extreme melt events. Thereby, we investigate the dynamical response of the ice sheet model to changes in frequency and intensity of extreme melt events and quantify their impacts with respect to sea-level rise.

Background In low- and middle-income countries, infectious diseases remain a key public health issue. Additionally, non-communicable diseases are a rapidly growing public health problem that impose a considerable burden on population health. One way to address this dual disease burden, is to incorporate (lifestyle) health promotion measures within the education sector. In the planned study, we will (i) assess and compare physical activity, physical fitness, micronutrient status, body composition, infections with soil-transmitted helminths, Schistosoma mansoni, malaria, inflammatory and cardiovascular health risk markers, cognitive function, health-related quality of life, and sleep in schoolchildren in Côte d’Ivoire, South Africa and Tanzania. We will (ii) determine the bi- and multivariate associations between these variables and (iii) examine the effects of a school-based health intervention that consists of physical activity, multi-micronutrient supplementation, or both. Methods Assuming that no interaction occurs between the two interventions (physical activity and multi-micronutrient supplementation), the study is designed as a cluster-randomised, placebo-controlled trial with a 2 × 2 factorial design. Data will be obtained at three time points: at baseline and at 9 months and 21 months after the baseline assessment. In each country, 1320 primary schoolchildren from grades 1–4 will be recruited. In each school, classes will be randomly assigned to one of four interventions: (i) physical activity; (ii) multi-micronutrient supplementation; (iii) physical activity plus multi-micronutrient supplementation; and (iv) no intervention, which will serve as the control. A placebo product will be given to all children who do not receive multi-micronutrient supplementation. After obtaining written informed consent from the parents/guardians, the children will be subjected to anthropometric, clinical, parasitological and physiological assessments. Additionally, fitness tests will be performed, and children will be invited to wear an accelerometer device for 7 days to objectively assess their physical activity. Children infected with S. mansoni and soil-transmitted helminths will receive deworming drugs according to national policies. Health and nutrition education will be provided to the whole study population independently of the study arm allocation. Discussion The study builds on the experience and lessons of a previous study conducted in South Africa. It involves three African countries with different social-ecological contexts to investigate whether results are generalisable across the continent. Trial registration The study was registered on August 9, 2018, with ISRCTN. 10.1186/ISRCTN29534081.

Obesity as a multifactorial disorder involves low-grade inflammation, increased reactive oxygen species incidence, gut microbiota aberrations, and epigenetic consequences. Thus, prevention and therapies with epigenetic active antioxidants, (-)-Epigallocatechin-3-gallate (EGCG), are of increasing interest. DNA damage, DNA methylation and gene expression ofDNA methyltransferase 1,interleukin 6, andMutL homologue 1were analyzed in C57BL/6J male mice fed a high-fat diet (HFD) or a control diet (CD) with and without EGCG supplementation. Gut microbiota was analyzed with quantitative real-time polymerase chain reaction. An induction of DNA damage was observed, as a consequence of HFD-feeding, whereas EGCG supplementation decreased DNA damage. HFD-feeding induced a higher inflammatory status. Supplementation reversed these effects, resulting in tissue specific gene expression and methylation patterns ofDNA methyltransferase 1andMutL homologue 1. HFD feeding caused a significant lower bacterial abundance. TheFirmicutes/Bacteroidetesratio is significantly lower in HFD + EGCG but higher in CD + EGCG compared to control groups. The results demonstrate the impact of EGCG on the one hand on gut microbiota which together with dietary components affects host health. On the other hand effects may derive from antioxidative activities as well as epigenetic modifications observed on CpG methylation but also likely to include other epigenetic elements.

In recent decades, the Greenland Ice Sheet has experienced an accelerated mass loss, contributing to approximately 25 % of contemporary sea level rise. This mass loss is caused by increased surface melt over a large area of the ice sheet and by the thinning, retreat and acceleration of numerous Greenland outlet glaciers. The latter is likely connected to enhanced submarine melting that, in turn, can be explained by ocean warming and enhanced subglacial discharge. The mechanisms involved in submarine melting are not yet fully understood and are only crudely incorporated in some models of the Greenland Ice Sheet. Here, we investigate the response of twelve representative Greenland outlet glaciers to atmospheric and oceanic warming using a coupled 1D line-plume glacier-flowline model. The model parameters have been tuned for individual outlet glaciers using present-day observational constraints. We then run the model from present to the year 2100, forcing the model with changes in surface mass balance and surface runoff from simulations with a regional climate model for the RCP 8.5 scenario, and applying a linear ocean temperature warming with different rates of changes representing uncertainties in the CMIP 5 model experiments for the same climate change scenario. We also used different initial temperature-salinity profiles obtained from direct measurements and from ocean reanalysis data. Using different combinations of submarine melting and calving parameters that reproduce the present-day state of the glaciers, we estimated uncertainties in the contribution to global sea level rise for individual glaciers. We also performed a factor analysis, which shows that the role of different forcing (change in surface mass balance, ocean temperature and subglacial discharge) are diverse for individual glaciers. We found that changes in, ocean temperature and subglacial discharge are of comparable importance for the cumulative contribution of all twelve glaciers to global sea level rise in the 21st century. The median range of the cumulative contribution to the global sea level rise for all twelve glaciers is about 14 mm from which roughly 85 % are associated with the response to increased submarine melting and the remaining part to surface mass loss. We also found a weak correlation (correlation coefficient 0.35) between present-day grounding line discharge and their future contribution to sea level rise in 2100. If the contribution of the twelve glaciers is scaled up to the total present-day discharge of Greenland, we estimate the contribution of all Greenland glaciers to 21st-century sea level rise to be approximately 50 mm. This result confirms earlier studies that the response of the outlet glaciers to global warming has to be taken into account to correctly assess the total contribution of Greenland to sea level change.

Two hundreds of marine-terminating Greenland outlet glaciers deliver more than half of the annually accumulated ice into the ocean and play an important role in the Greenland ice sheet mass loss observed since the mid 1990s. Submarine melt plays a crucial role in the mass balance and position of the grounding line of these outlet glaciers. As the ocean warms, it is expected that submarine melt will increase and outlet glaciers will retreat, contributing to sea level rise. Projections of the future contribution of outlet glaciers to sea level rise is hampered by the necessity to use extremely high resolution of the order of a few hundred meters both for modelling of the outlet glaciers and as well as coupling them with high resolution 3D ocean models. In addition fjord bathymetry data are mostly missing or are inaccurate (errors of several 100s of meters), which questions the benefit of using computational expensive 3D models for future predictions. Here we propose an alternative approach based on using of computationally efficient parameterization of submarine melt based on turbulent plume theory. We show that such parameterization is in a reasonable agreement with several available modeling studies. We performed a suit of experiments to analyse sensitivity of these parameterizations to model parameters and climate characteristics. We found that the computationally cheap plume model demonstrates qualitatively similar behaviour as 3D gerneral circulation models. To match results of the 3D models in a quantitative manner, a scaling factor in the order of one is needed for the plume models. We applied this approach to model submarine melt for six representative Greenland glaciers and found that the parameterization of a line plume can produce submarine melt compatible with observational data. Our results show that the line plume model is more appropriate than the cone plume model for simulating the submarine melting of real glaciers in Greenland.

Obesity as a multifactorial disorder involves low-grade inflammation, increased reactive oxygen species incidence, gut microbiota aberrations, and epigenetic consequences. Thus, prevention and therapies with epigenetic active antioxidants, (−)-Epigallocatechin-3-gallate (EGCG), are of increasing interest. DNA damage, DNA methylation and gene expression of DNA methyltransferase 1, interleukin 6, and MutL homologue 1 were analyzed in C57BL/6J male mice fed a high-fat diet (HFD) or a control diet (CD) with and without EGCG supplementation. Gut microbiota was analyzed with quantitative real-time polymerase chain reaction. An induction of DNA damage was observed, as a consequence of HFD-feeding, whereas EGCG supplementation decreased DNA damage. HFD-feeding induced a higher inflammatory status. Supplementation reversed these effects, resulting in tissue specific gene expression and methylation patterns of DNA methyltransferase 1 and MutL homologue 1. HFD feeding caused a significant lower bacterial abundance. The Firmicutes/Bacteroidetes ratio is significantly lower in HFD + EGCG but higher in CD + EGCG compared to control groups. The results demonstrate the impact of EGCG on the one hand on gut microbiota which together with dietary components affects host health. On the other hand effects may derive from antioxidative activities as well as epigenetic modifications observed on CpG methylation but also likely to include other epigenetic elements.

Smaller differences and greater extremes Has recent rapid warming in the Arctic affected weather elsewhere in the world? Coumou et al. find that some key measures of atmospheric circulation in the Northern Hemisphere have weakened during the summer. This change has been caused by the reduction of the temperature difference between mid-latitudes and the North Pole. As summertime circulation has decreased in intensity, episodes of hot weather have become more persistent because there are fewer storms to bring cooler conditions. Science , this issue p. 324

Rapid warming in the Arctic could influence mid-latitude circulation by reducing the poleward temperature gradient. The largest changes are generally expected in autumn or winter, but whether significant changes have occurred is debated. Here we report significant weakening of summer circulation detected in three key dynamical quantities: (i) the zonal-mean zonal wind, (ii) the eddy kinetic energy (EKE), and (iii) the amplitude of fast-moving Rossby waves. Weakening of the zonal wind is explained by a reduction in the poleward temperature gradient. Changes in Rossby waves and EKE are consistent with regression analyses of climate model projections and changes over the seasonal cycle. Monthly heat extremes are associated with low EKE, and thus the observed weakening might have contributed to more persistent heat waves in recent summers.