Response and adaptation to the impacts of climate change is a vital and increasing requirement for protected area management. On the ground managers of cultural and natural values in protected places ...have requested practical guidance on how to undertake climate change impact analysis, vulnerability assessment, and adaptation planning together with enhanced capacity for planning with partners, rightsholders and stakeholders. In this paper we explore how co-development and subsequent testing among World Heritage site managers, Indigenous experts and researchers, produced guidance for assessing, responding to and planning for the impacts of climate change on the diverse values of World Heritage sites in Australia. We draw on the diversity of cultural and natural heritage values associated with the terrestrial, coastal and marine environments in Australian World Heritage sites, and the broad range of institutional contexts in these sites, to highlight considerations of relevance to other protected areas (including other World Heritage sites around the world, Ramsar wetlands and marine protected areas). Our paper highlights that, for climate adaptation planning to become a normal part of management, there is a need for ongoing capacity building, including around the use of climate information to inform adaptation planning and implementation, as well as integrating Indigenous perspectives. Building capacity may involve trial and error, negotiation, sharing, sourcing and interpreting new information, and changes in expectations. It will require novel and more dynamic relationships between partners and stakeholders. Managers should include capacity building for climate adaptation planning and implementation as a specific climate adaptation task in their planning.
•We present co-developed and tested climate change guidance for World Heritage.•This guidance is co-authored with Indigenous experts.•There is an ongoing need for capacity building in adaptation planning.•Co-development processes can build capacity and bring together diverse knowledge.•World Heritage is a useful context for understanding climate adaptation planning needs.
The suprapatellar approach for medullary nailing of the tibia is increasing. This requires intra-articular passage of instruments, which theoretically places the knee at risk of postoperative sepsis ...in the setting of open fracture. We hypothesized that the risk of knee sepsis is similar after suprapatellar or infrapatellar nailing of open tibia fractures.
Retrospective, multicenter.
Three urban level 1 trauma centers.
All patients treated with medullary nailing for open diaphyseal tibia fractures (OTA 42) from 2009 to 2015. Patients younger than 18 years of age and with less than 12 weeks of follow-up were excluded. We identified 289 fractures in 282 patients.
Suprapatellar (SP) or infrapatellar (IP) medullary nailing of open tibia fractures.
Occurrence of ipsilateral knee sepsis, defined as presence of a positive culture from knee aspiration or arthrotomy. Deep infection requiring operative debridement, superficial infection requiring antibiotic therapy alone, and all-cause reoperation were also recorded.
IP nailing was used for 142 fractures. There were 20 infections (14.1%), of which 14 (9.8%) were deep. Fourteen tibias (9.8%) required reoperation for noninfectious reasons for 28 total reoperations (19.7%). SP nailing was used in 147 fractures. There were 24 infections (16.2%), of which 16 (10.8%) were deep. Fourteen additional tibias (9.5%) required reoperation for noninfectious reasons for a total of 30 reoperations (20.4%). There were no differences in the rates of infection, deep infection, or reoperation between groups. There were 2 cases of knee sepsis after SP nailing (1.4%) but zero cases after IP nailing (P = 0.5).
There was no significant difference in the rate of knee sepsis with SP or IP approaches. The risk of knee sepsis after SP nailing of open fractures is low, but present.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
INTRODUCTION
The effect of spinal versus general anesthesia on the risk of postoperative delirium or other outcomes for patients with or without cognitive impairment (including dementia) is unknown.
...METHODS
Post hoc secondary analysis of a multicenter pragmatic trial comparing spinal versus general anesthesia for adults aged 50 years or older undergoing hip fracture surgery.
RESULTS
Among patients randomized to spinal versus general anesthesia, new or worsened delirium occurred in 100/295 (33.9%) versus 107/283 (37.8%; odds ratio OR 0.85; 95% confidence interval CI 0.60 to 1.19) among persons with cognitive impairment and 70/432 (16.2%) versus 71/445 (16.0%) among persons without cognitive impairment (OR 1.02; 95% CI 0.71 to 1.47, p = 0.46 for interaction). Delirium severity, in‐hospital complications, and 60‐day functional recovery did not differ by anesthesia type in patients with or without cognitive impairment.
DISCUSSION
Anesthesia type is not associated with differences in delirium and functional outcomes among persons with or without cognitive impairment.
Statistical models of the variability of plasma in the topside ionosphere based on the Swarm data have been developed in the “Swarm Variability of Ionospheric Plasma” (Swarm-VIP) project within the ...European Space Agency’s Swarm+4D-Ionosphere framework. The models can predict the electron density, its gradients for three horizontal spatial scales – 20, 50 and 100 km – along the North-South direction and the level of the density fluctuations. Despite being developed by leveraging on Swarm data, the models provide predictions that are independent of these data, having a global coverage, fed by various parameters and proxies of the helio-geophysical conditions. Those features make the Swarm-VIP models useful for various purposes, which include the possible support for already available ionospheric models and proxy of the effect of ionospheric irregularities of the medium scales that affect the signals emitted by Global Navigation Satellite Systems (GNSS). The formulation, optimisation and validation of the Swarm-VIP models are reported in Paper 1 (Wood et al. 2024.
J Space Weather Space Clim
. in press). This paper describes the performance assessment of the models, by addressing their capability to reproduce the known climatological variability of the modelled quantities, and the ionospheric weather as depicted by ground-based GNSS, as a proxy for the ionospheric effect on GNSS signals. Additionally, we demonstrate that, under certain conditions, the model can better reproduce the ionospheric variability than a physics-based model, namely the Thermosphere-Ionosphere-Electrodynamics General Circulation Model (TIE-GCM).
This work presents statistical models of the variability of plasma in the topside ionosphere based on observations made by the European Space Agency’s (ESA) Swarm satellites. The models were ...developed in the “Swarm Variability of Ionospheric Plasma” (Swarm-VIP) project within the European Space Agency’s Swarm+4D-Ionosphere framework. The configuration of the Swarm satellites, their near-polar orbits and the data products developed, enable studies of the spatial variability of the ionosphere at multiple scale sizes. The statistical modelling technique of Generalised Linear Modelling (GLM) was used to create models of both the electron density and measures of the variability of the plasma structures at horizontal spatial scales between 20 km and 100 km. Despite being developed using the Swarm data, the models provide predictions that are independent of these data. Separate models were created for low, middle, auroral and polar latitudes. The models make predictions based on heliogeophysical variables, which act as proxies for the solar and geomagnetic processes. The first and most significant term in the majority of the models was a proxy for solar activity. The most common second term varied with the latitudinal region. This was the Solar Zenith Angle (SZA) in the polar region, a measure of latitude in the auroral region, solar time in the mid-latitude region and a measure of latitude in the equatorial region. Other, less significant terms in the models covered a range of proxies for the solar wind, geomagnetic activity and location. In this paper, the formulation, optimisation and evaluation of these models are discussed. The models show very little bias, with a mean error of zero to two decimal places in 14 out of 20 cases. The models capture some, but not all, of the trends present in the data, with Pearson correlation coefficients of up to 0.75 between the observations and the model predictions. The models also capture some, but not all, of the variability of the ionospheric plasma, as indicated by the precision, which ranged between 0.20 and 0.83. The addition of the thermospheric density as an explanatory variable in the models improved the precision in the polar and auroral regions. It is suggested that, if the thermosphere could be observed at a higher spatial resolution, then even more of the variability of the plasma structures could be captured by statistical models. The formulation and optimisation of the models are presented in this paper. The capability of the model in reproducing the expected climatological features of the topside ionosphere, in supporting GNSS-based ionospheric observations and the performance of the model against the Thermosphere-Ionosphere-Electrodynamics General Circulation Model (TIE-GCM), are provided in a companion paper (Spogli L et al. 2024. J Space Weather Space Clim
https://doi.org/10.1051/swsc/2024003
).
Using near simultaneously acquired Landsat 7 Enhanced Thematic Mapper Plus (ETM+) and Earth Observing-1 Advanced Land Imager (ALI) data we assess the relative radiant responses over active lava flows ...from the Mt. Etna July/August 2001 flank eruption. By assessing the extent of saturation between the two instruments and using the dual-band method of extracting sub pixel thermal information, we show that the ALI represents an improvement over the ETM+ in the present ability to assess temperatures of hot active lava flows for a number of reasons. (1) The extra spectral channels provided by ALI compliment the current SWIR channels on ETM+ by providing a greater number of paired channel combinations for input into the dual-band method. Thus, dual-band temperature solutions can be determined for a greater range of lava flow types than previously possible using the two paired channel combinations available with the ETM+. (2) The ALI instrument is less susceptible than ETM+ to saturation within the SWIR, especially when using channels 5, 5p and 4p at wavelengths of 1.65, 1.25 and 0.87 μm respectively. (3) The greater radiometric sensitivity of the ALI 12 bit electronics coupled with a significantly higher signal to noise ratio aid in obtaining successful dual-band solutions.
A study measured the prevalence of HIV and described the established risk factors in female prostitutes in London. There was a significant risk of other sexually transmitted infections in prostitutes.
OBJECTIVE--To measure the prevalence of HIV and to describe established risk factors in female prostitutes. DESIGN--A cross sectional survey. SETTING--A genitourinary medicine clinic, streets, and ...magistrates' courts in London. SUBJECTS--280 female prostitutes recruited between April 1989 and August 1991. MAIN OUTCOME MEASURES--Infection with HIV-1, reported risk behaviours, and prevalence of sexually transmitted infections. RESULTS--228 of the women had HIV tests, and two (0.9% (95% confidence interval 0% to 2.1%)) were infected with HIV-1. Reported use of condoms was high for commercial clients and low for non-paying partners: 98% (251/255) of women used condoms with all clients and 12% (25/207) with non-paying partners for vaginal intercourse. Twenty two women were current or past injecting drug users. Of the 193 women examined for sexually transmitted infections, 27 had an acute infection (gonorrhoea, chlamydia, trichomonas, or primary genital herpes) at the time of interview. Infection was associated with younger age and increasing numbers of non-paying sexual partners, but not with duration of prostitution, numbers of clients, or reports of condom failures. When age and numbers of non-paying partners were analysed by logistic regression they remained significantly associated with sexually transmitted infections. CONCLUSIONS--A large and diverse sample of prostitutes had a low prevalence of infection with HIV and high levels of use of condoms in commercial sex. There was a significant risk of other sexually transmitted infections associated with prostitutes' non-commercial sexual relationships, in which unprotected sex is common. Interventions to reduce the risk of sexually transmitted infections in prostitutes should address both commercial and non-commercial sexual partnerships.
Thermal monitoring of active volcanoes has long been the domain of satellite and airborne remote sensing (for reviews of current capabilities, see Harris et al. 2002). However, ground‐based thermal ...sensors offer considerable benefits in that (1) they can be located beneath cloud decks that prohibit aerial views; (2) they allow small thermal targets to be resolved; (3) they observe targets with a constant viewing geometry for long periods of time; and (4) they provide data at high sample rates (tens to hundreds of Hz). This latter capability is extremely attractive when tracking transient or rapidly evolving events, such as volcanic explosions. In addition, when used in conjunction with other geophysical data sets, thermal time series reveal clues as to the manner in which a volcanic system is erupting.
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