22 research outputs found
The future of algal blooms in lakes globally is in our hands
Get PDFLakes are fundamental to society and nature, yet they are currently exposed to excessive nutrients and climate change, resulting in algal blooms. In the future, this may change, but how and where still needs more scientific attention. Here, we explore future trends in algal blooms in lakes globally for >3,500 ârepresentative lakesâ for the year 2050, considering the attribution of both nutrient and climate factors. We soft-coupled a process-based lake ecosystem model (PCLake+) with a watershed nutrient model (MARINA-Multi) to assess trends in algal blooms in terms of the Trophic State Index for chlorophyll-a (TSI-Chla). Globally between 2010 and 2050, we show a rising trend in algal blooms under fossil-fuelled development (TSI-Chla increase in 91% of lakes) and a declining trend under sustainable development (TSI-Chla decrease in 63% of lakes). These changes are significantly attributed to nutrients. While not always significant, climate change attributions point to being unfavourable for lakes in 2050, exacerbating lake water quality. Our study stresses prioritising responsible nutrient and climate management on policy agendas. This implies that the future of algal blooms in lakes is in our hands
A triple increase in global river basins with water scarcity due to future pollution
Get PDFWater security is at stake today. While climate changes influence water availability, urbanization and agricultural activities have led to increasing water demand as well as pollution, limiting safe water use. We conducted a global assessment of future clean-water scarcity for 2050s by adding the water pollution aspect to the classical water quantity-induced scarcity assessments. This was done for >10,000 sub-basins focusing on nitrogen pollution in rivers by integrating land-system, hydrological and water quality models. We found that water pollution aggravates water scarcity in >2000 sub-basins worldwide. The number of sub-basins with water scarcity triples due to future nitrogen pollution worldwide. In 2010, 984 sub-basins are classified as water scarce when considering only quantity-induced scarcity, while 2517 sub-basins are affected by quantity & quality-induced scarcity. This number even increases to 3061 sub-basins in the worst case scenario in 2050. This aggravation means an extra 40 million km2 of basin area and 3 billion more people that may potentially face water scarcity in 2050. Our results stress the urgent need to address water quality in future water management policies for the Sustainable Development Goals
Future Scenarios for River Exports of Multiple Pollutants by Sources and SubâBasins Worldwide: Rising Pollution for the Indian Ocean
Get PDFAbstract In the future, rivers may export more pollutants to coastal waters, driven by socioâeconomic development, increased material consumption, and climate change. However, existing scenarios often ignore multiâpollutant problems. Here, we aim to explore future trends in annual river exports of nutrients (nitrogen and phosphorus), plastics (macro and micro), and emerging contaminants (triclosan and diclofenac) at the subâbasin scale worldwide. For this, we implement into the processâbased MARINAâMulti model (Model to Assess River Inputs of pollutaNts to the seAs) two new multiâpollutant scenarios: âSustainabilityâdriven Futureâ (SD) and âEconomyâdriven Futureâ (ED). In ED, river exports of nutrients and microplastics will double by 2100, globally. In SD, a decrease of up to 83% is projected for river export of all studied pollutants by 2100, globally. Diffuse sources such as fertilizers are largely responsible for increasing nutrient pollution in the two scenarios. Point sources, namely sewage systems, are largely responsible for increasing microplastic pollution in the ED scenario. In both scenarios, the coastal waters of the Indian Ocean will receive up to 400% more pollutants from rivers by 2100 because of growing population, urbanization, and poor waste management in the African and Asian subâbasins. The situation differs for subâbasins draining into the Mediterranean Sea and the Pacific Ocean (mainly less future pollution) and the Atlantic Ocean and Arctic Ocean (more or less future pollution depending on subâbasins and scenarios). From 56% to 78% of the global population are expected to live in more polluted river basins in the future, challenging sustainable development goals for clean waters
Future microplastics in the Black Sea: River exports and reduction options for zero pollution
No full textFuture microplastics in the Black Sea : River exports and reduction options for zero pollution
No full textThe Black Sea receives increasing amounts of microplastics from rivers. In this study, we explore options to reduce future river export of microplastics to the Black Sea. We develop five scenarios with different reduction options and implement them to a Model to Assess River Inputs of pollutaNts to seA (MARINA-Global) for 107 sub-basins. Today, European rivers draining into the Black Sea export over half of the total microplastics. In 2050, Asian rivers draining into the sea will be responsible for 34â46% of microplastic pollution. Implemented advanced treatment will reduce point-source pollution. Reduced consumption or more collection of plastics will reduce 40% of microplastics in the sea by 2050. In the optimistic future, sea pollution is 84% lower than today when the abovementioned reduction options are combined. Reduction options affect the share of pollution sources. Our insights could support environmental policies for a zero pollution future of the Black Sea
WATER POLLUTION AND AGRICULTURE: MULTI-POLLUTANT PERSPECTIVES
No full textâ Four highlights are identified for agriculture and water from the multi-pollutant perspective.â Large variations in time and space for multiple pollutants in waters and their sources.â Scientific agenda should account for multiple pollutants in agricultural strategies. Agriculture is an important cause of multiple pollutants in water. With population growth and increasing food demand, more nutrients, plastics, pesticides, pathogens and antibiotics are expected to enter water systems in the 21st century. As a result, water science has been shifting from single-pollutant to multi-pollutant perspectives for large-scale water quality assessments. This perspective paper summarizes and discusses four main highlights related to water pollution and agriculture from the multi-pollutant perspective. These highlights reveal the spatial and temporal distribution and main sources of multiple pollutants in waters. Based on the highlights, a scientific agenda is proposed to prioritize solutions for sustainable agriculture (UN Sustainable Development Goal 2) and clean water (UN Sustainable Development Goals 6 and 14). This agenda points out that when formulating solutions for water pollution, it is essential to take into account multiple pollutants and their interactions beyond biogeochemistry
A triple increase in global river basins with water scarcity due to future pollution
No full textAbstract Water security is at stake today. While climate changes influence water availability, urbanization and agricultural activities have led to increasing water demand as well as pollution, limiting safe water use. We conducted a global assessment of future clean-water scarcity for 2050s by adding the water pollution aspect to the classical water quantity-induced scarcity assessments. This was done for >10,000 sub-basins focusing on nitrogen pollution in rivers by integrating land-system, hydrological and water quality models. We found that water pollution aggravates water scarcity in >2000 sub-basins worldwide. The number of sub-basins with water scarcity triples due to future nitrogen pollution worldwide. In 2010, 984 sub-basins are classified as water scarce when considering only quantity-induced scarcity, while 2517 sub-basins are affected by quantity & quality-induced scarcity. This number even increases to 3061 sub-basins in the worst case scenario in 2050. This aggravation means an extra 40 million km2 of basin area and 3 billion more people that may potentially face water scarcity in 2050. Our results stress the urgent need to address water quality in future water management policies for the Sustainable Development Goals
COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study
No full textAbstract
Background
The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms.
Methods
International, prospective observational study of 60â109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms.
Results
âTypicalâ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (â€â18 years: 69, 48, 23; 85%), older adults (â„â70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each Pâ<â0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country.
Interpretation
This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30Â years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60Â years. Women are less likely to experience typical symptoms than men.
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Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study
No full textBackground: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs).
Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support.
Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83-7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97-2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14-1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25-1.30]).
Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable
Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study
No full textBackground: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24Â h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24Â h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83â7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97â2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14â1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25â1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable
