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The incidence of traumatic brain injury (TBI) in the United States was 3.5 million cases in 2009, according to the Centers for Disease Control and Prevention. It is a contributing factor in 30.5% of injury-related deaths among civilians. Additionally, since 2000, more than 260,000 service members were diagnosed with TBI, with the vast majority classified as mild or concussive (76%). The objective assessment of TBI via imaging is a critical research gap, both in the military and civilian communities. In 2011, the Department of Defense (DoD) prepared a congressional report summarizing the effectiveness of seven neuroimaging modalities (computed tomography [CT], magnetic resonance imaging [MRI], transcranial Doppler [TCD], positron emission tomography, single photon emission computed tomography, electrophysiologic techniques [magnetoencephalography and electroencephalography], and functional near-infrared spectroscopy) to assess the spectrum of TBI from concussion to coma. For this report, neuroimaging experts identified the most relevant peer-reviewed publications and assessed the quality of the literature for each of these imaging technique in the clinical and research settings. Although CT, MRI, and TCD were determined to be the most useful modalities in the clinical setting, no single imaging modality proved sufficient for all patients due to the heterogeneity of TBI. All imaging modalities reviewed demonstrated the potential to emerge as part of future clinical care. This paper describes and updates the results of the DoD report and also expands on the use of angiography in patients with TBI.

Discussions on a long-term global goal to limit climate change, in the form of an upper limit to warming, were only partially resolved at the United Nations Framework Convention on Climate Change negotiations in Paris, 2015. Such a political agreement must be informed by scientific knowledge. One way to communicate the costs and benefits of policies is through a mapping that systematically explores the consequences of different choices. Such a multi-disciplinary effort based on the analysis of a set of scenarios helped structure the IPCC AR5 Synthesis Report. This Perspective summarizes this approach, reviews its strengths and limitations, and discusses how decision-makers can use its results in practice. It also identifies research needs that can facilitate integrated analysis of climate change and help better inform policy-makers and the public.

Discussions on a long-term global goal to limit climate change, in the form of an upper limit to warming, were only partially resolved at the United Nations Framework Convention on Climate Change negotiations in Paris, 2015. Such a political agreement must be informed by scientific knowledge. One way to communicate the costs and benefits of policies is through a mapping that systematically explores the consequences of different choices. Such a multi-disciplinary effort based on the analysis of a set of scenarios helped structure the IPCC AR5 Synthesis Report. This Perspective summarizes this approach, reviews its strengths and limitations, and discusses how decision-makers can use its results in practice. It also identifies research needs that can facilitate integrated analysis of climate change and help better inform policy-makers and the public.

The global nitrogen (N) cycle at the beginning of the 21st century has been shown to be strongly influenced by the inputs of reactive nitrogen (Nr) from human activities, including combustion-related NOx, industrial and agricultural N fixation, estimated to be 220 Tg N yr−1 in 2010, which is approximately equal to the sum of biological N fixation in unmanaged terrestrial and marine ecosystems. According to current projections, changes in climate and land use during the 21st century will increase both biological and anthropogenic fixation, bringing the total to approximately 600 Tg N yr−1 by around 2100. The fraction contributed directly by human activities is unlikely to increase substantially if increases in nitrogen use efficiency in agriculture are achieved and control measures on combustion-related emissions implemented. Some N-cycling processes emerge as particularly sensitive to climate change. One of the largest responses to climate in the processing of Nr is the emission to the atmosphere of NH3, which is estimated to increase from 65 Tg N yr−1 in 2008 to 93 Tg N yr−1 in 2100 assuming a change in global surface temperature of 5 °C in the absence of increased anthropogenic activity. With changes in emissions in response to increased demand for animal products the combined effect would be to increase NH3 emissions to 135 Tg N yr−1. Another major change is the effect of climate changes on aerosol composition and specifically the increased sublimation of NH4NO3 close to the ground to form HNO3 and NH3 in a warmer climate, which deposit more rapidly to terrestrial surfaces than aerosols. Inorganic aerosols over the polluted regions especially in Europe and North America were dominated by (NH4)2SO4 in the 1970s to 1980s, and large reductions in emissions of SO2 have removed most of the SO42− from the atmosphere in these regions. Inorganic aerosols from anthropogenic emissions are now dominated by NH4NO3, a volatile aerosol which contributes substantially to PM10 and human health effects globally as well as eutrophication and climate effects. The volatility of NH4NO3 and rapid dry deposition of the vapour phase dissociation products, HNO3 and NH3, is estimated to be reducing the transport distances, deposition footprints and inter-country exchange of Nr in these regions. There have been important policy initiatives on components of the global N cycle. These have been regional or country-based and have delivered substantial reductions of inputs of Nr to sensitive soils, waters and the atmosphere. To date there have been no attempts to develop a global strategy to regulate human inputs to the nitrogen cycle. However, considering the magnitude of global Nr use, potential future increases, and the very large leakage of Nr in many forms to soils, waters and the atmosphere, international action is required. Current legislation will not deliver the scale of reductions globally for recovery from the effects of Nr deposition on sensitive ecosystems, or a decline in N2O emissions to the global atmosphere. Such changes would require substantial improvements in nitrogen use efficiency across the global economy combined with optimization of transport and food consumption patterns. This would allow reductions in Nr use, inputs to the atmosphere and deposition to sensitive ecosystems. Such changes would offer substantial economic and environmental co-benefits which could help motivate the necessary actions.

Discussions on a long-term global goal to limit climate change, in the form of an upper limit to warming, were only partially resolved at the United Nations Framework Convention on Climate Change negotiations in Paris, 2015. Such a political agreement must be informed by scientific knowledge. One way to communicate the costs and benefits of policies is through a mapping that systematically explores the consequences of different choices. Such a multi-disciplinary effort based on the analysis of a set of scenarios helped structure the IPCC AR5 Synthesis Report. This Perspective summarizes this approach, reviews its strengths and limitations, and discusses how decision-makers can use its results in practice. It also identifies research needs that can facilitate integrated analysis of climate change and help better inform policy-makers and the public.

The global nitrogen (N) cycle at the beginning of the 21st century has been shown to be strongly influenced by the inputs of reactive nitrogen (N-r) from human activities, including combustion-related NOx, industrial and agricultural N fixation, estimated to be 220 TgNyr(-1) in 2010, which is approximately equal to the sum of biological N fixation in unmanaged terrestrial and marine ecosystems. According to current projections, changes in climate and land use during the 21st century will increase both biological and anthropogenic fixation, bringing the total to approximately 600 TgNyr(-1) by around 2100. The fraction contributed directly by human activities is unlikely to increase substantially if increases in nitrogen use efficiency in agriculture are achieved and control measures on combustion-related emissions implemented. Some N-cycling processes emerge as particularly sensitive to climate change. One of the largest responses to climate in the processing of Nr is the emission to the atmosphere of NH3, which is estimated to increase from 65 TgNyr(-1) in 2008 to 93 TgNyr(-1) in 2100 assuming a change in global surface temperature of 5 degrees C in the absence of increased anthropogenic activity. With changes in emissions in response to increased demand for animal products the combined effect would be to increase NH3 emissions to 135 TgNyr(-1). Another major change is the effect of climate changes on aerosol composition and specifically the increased sublimation of NH4NO3 close to the ground to form HNO3 and NH3 in a warmer climate, which deposit more rapidly to terrestrial surfaces than aerosols. Inorganic aerosols over the polluted regions especially in Europe and North America were dominated by (NH4)(2)SO4 in the 1970s to 1980s, and large reductions in emissions of SO2 have removed most of the SO42- from the atmosphere in these regions. Inorganic aerosols from anthropogenic emissions are now dominated by NH4NO3, a volatile aerosol which contributes substantially to PM10 and human health effects globally as well as eutrophication and climate effects. The volatility of NH4NO3 and rapid dry deposition of the vapour phase dissociation products, HNO3 and NH3, is estimated to be reducing the transport distances, deposition footprints and inter-country exchange of N-r in these regions. There have been important policy initiatives on components of the global N cycle. These have been regional or country-based and have delivered substantial reductions of inputs of Nr to sensitive soils, waters and the atmosphere. To date there have been no attempts to develop a global strategy to regulate human inputs to the nitrogen cycle. However, considering the magnitude of global Nr use, potential future increases, and the very large leakage of Nr in many forms to soils, waters and the atmosphere, international action is required. Current legislation will not deliver the scale of reductions globally for recovery from the effects of Nr deposition on sensitive ecosystems, or a decline in N2O emissions to the global atmosphere. Such changes would require substantial improvements in nitrogen use efficiency across the global economy combined with optimization of transport and food consumption patterns. This would allow reductions in Nr use, inputs to the atmosphere and deposition to sensitive ecosystems. Such changes would offer substantial economic and environmental co-benefits which could help motivate the necessary actions.

Conventional systems of government have not been very successful in resolving coastal management problems. This lack of progress is partially attributable to inadequate representation in governance processes of the variety of knowledges present on the coast. In particular there has been a struggle to engage effectively with climate science and its implications. There has also been a broader failure to capture the complexity of voices, interests, values, and discourses of coastal users. We argue here that coastal governance challenges are not likely to be resolved by singular solutions; rather, interaction and collaboration will generate improvements. We suggest that a co-requisite for progress in coastal management is the development of institutions and processes that enable different knowledges to have a bearing on governance processes. This paper examines a selection of the many opportunities available to broaden and enhance the use of knowledge in decision-making for the coast. A description is provided of emerging elements of coastal governance from an Australian perspective, together with new types of institutions, processes, tools and techniques that may help to achieve an improved coastal knowledge-governance interaction.

Wasserstoff ist ein Schlüsselelement, um Klimaneutralität zu erreichen. Besonders für die Dekarbonisierung der Industrie und bestimmter Verkehrssektoren stellt er eine wichtige Ergänzung zur direkten Elektrifizierung dar. Um die künftig hohen Bedarfe zu decken, werden Importe nötig sein. Es gilt, aus der Vergangenheit zu lernen und Abhängigkeiten zu minimieren. Die ESYS-Fachleute zeigen in einer Analyse Transportoptionen und ihre Vor- und Nachteile auf und beschreiben Hemmnisse und Herausforderungen für den Aufbau von Transportketten und Wasserstoffkooperationen.

In 2020 the world was hit by the COVID-19 pandemic putting entire governments and civil societies in crisis mode. Around the globe unprecedented shortages of equipment and qualified personnel were reported in hospitals and diagnostic laboratories. When a crisis is global, supply chains are strained worldwide and external help may not be readily available. In Switzerland, as part of the efforts of the Swiss National COVID-19 Science Task Force, we developed a tailor-made web-based tool where needs and offers for critical laboratory equipment and expertise can be brought together, coordinated, prioritized, and validated. This Academic Resources for COVID-19 (ARC) Platform presents the specialized needs of diagnostic laboratories to academic research groups at universities, allowing the sourcing of said needs from unconventional supply channels, while keeping the entities tasked with coordination of the crisis response in control of each part of the process. An instance of the ARC Platform is operated in Switzerland (arc.epfl.ch) catering to the diagnostic efforts in Switzerland and sourcing from the Swiss academic sector. The underlying technology has been released as open source so that others can adopt the customizable web-platform for need/supply match-making in their own relief efforts, during the COVID-19 pandemic or any future disaster.

Context: Place-based transdisciplinary research involves multiple academic disciplines and non-academic actors. Long-Term Socio-Ecological Research (LTSER) platform is one concept with ~ 80 initiatives globally. Objectives: As an exercise in learning through evaluation we audited (1) the siting, construction and maintenance of individual LTSER platforms, and (2) them as a distributed infrastructure for place-based transdisciplinary research with focus on the European continent. Methods: First, we defined a normative model for ideal performance at both platform and network levels. Second, four surveys were sent out to the 67 self-reported LTSER platforms officially listed at the end of 2016. Third, with a focus on the network level, we analyzed the spatial distribution of both long-term ecological monitoring sites within LTSER platforms, and LTSER platforms across the European continent. Fourth, narrative biographies of 18 platforms in different stages of development were analyzed. Results: While the siting ofLTSER platforms represented biogeographical regions well, variations in land use history and democratic governance were not well represented. Platform construction was based on 2.1 ecological monitoring sites, with 72% ecosystem and 28% social system research. Maintenance of a platform required three to five staff members, focused mostly on ecosystem research, was based mainly on national funding, and had 1–2 years of future funding secured. Networking with other landscape approach concepts was common. Conclusions: Individually, and as a network, LTSER platforms have good potential for transdisciplinary knowledge production and learning about sustainability challenges. To improve the range of variation of Pan-European social–ecological systems we encourage interfacing with other landscape approach concepts. ; Peer reviewed

Context Place-based transdisciplinary research involves multiple academic disciplines and non-academic actors. Long-Term Socio-Ecological Research (LTSER) platform is one concept with similar to 80 initiatives globally.Objectives As an exercise in learning through evaluation we audited (1) the siting, construction and maintenance of individual LTSER platforms, and (2) them as a distributed infrastructure for place-based transdisciplinary research with focus on the European continent.MethodsFirst, we defined a normative model for ideal performance at both platform and network levels. Second, four surveys were sent out to the 67 self-reported LTSER platforms officially listed at the end of 2016. Third, with a focus on the network level, we analyzed the spatial distribution of both long-term ecological monitoring sites within LTSER platforms, and LTSER platforms across the European continent. Fourth, narrative biographies of 18 platforms in different stages of development were analyzed.ResultsWhile the siting of LTSER platforms represented biogeographical regions well, variations in land use history and democratic governance were not well represented. Platform construction was based on 2.1 ecological monitoring sites, with 72% ecosystem and 28% social system research. Maintenance of a platform required three to five staff members, focused mostly on ecosystem research, was based mainly on national funding, and had 1-2years of future funding secured. Networking with other landscape approach concepts was common.ConclusionsIndividually, and as a network, LTSER platforms have good potential for transdisciplinary knowledge production and learning about sustainability challenges. To improve the range of variation of Pan-European social-ecological systems we encourage interfacing with other landscape approach concepts. ; Peer reviewed

Context Place-based transdisciplinary research involves multiple academic disciplines and non-academic actors. Long-Term Socio-Ecological Research (LTSER) platform is one concept with similar to 80 initiatives globally.Objectives As an exercise in learning through evaluation we audited (1) the siting, construction and maintenance of individual LTSER platforms, and (2) them as a distributed infrastructure for place-based transdisciplinary research with focus on the European continent.MethodsFirst, we defined a normative model for ideal performance at both platform and network levels. Second, four surveys were sent out to the 67 self-reported LTSER platforms officially listed at the end of 2016. Third, with a focus on the network level, we analyzed the spatial distribution of both long-term ecological monitoring sites within LTSER platforms, and LTSER platforms across the European continent. Fourth, narrative biographies of 18 platforms in different stages of development were analyzed.ResultsWhile the siting of LTSER platforms represented biogeographical regions well, variations in land use history and democratic governance were not well represented. Platform construction was based on 2.1 ecological monitoring sites, with 72% ecosystem and 28% social system research. Maintenance of a platform required three to five staff members, focused mostly on ecosystem research, was based mainly on national funding, and had 1-2years of future funding secured. Networking with other landscape approach concepts was common.ConclusionsIndividually, and as a network, LTSER platforms have good potential for transdisciplinary knowledge production and learning about sustainability challenges. To improve the range of variation of Pan-European social-ecological systems we encourage interfacing with other landscape approach concepts.

Open access journal ; This is the final version of the article. Available from Copernicus Publications via the DOI in this record. ; Accurate assessments of anthropogenic carbon dioxide (CO2) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere is important to better understand the global carbon cycle, support the climate policy process, and project future climate change. Present-day analysis requires the combination of a range of data, algorithms, statistics and model estimates and their interpretation by a broad scientific community. Here we describe datasets and a methodology developed by the global carbon cycle science community to quantify all major components of the global carbon budget, including their uncertainties. We discuss changes compared to previous estimates, consistency within and among components, and methodology and data limitations. CO2 emissions from fossil fuel combustion and cement production (EFF) are based on energy statistics, while emissions from Land-Use Change (ELUC), including deforestation, are based on combined evidence from land cover change data, fire activity in regions undergoing deforestation, and models. The global atmospheric CO2 concentration is measured directly and its rate of growth (GATM) is computed from the concentration. The mean ocean CO2 sink (SOCEAN) is based on observations from the 1990s, while the annual anomalies and trends are estimated with ocean models. Finally, the global residual terrestrial CO2 sink (SLAND) is estimated by the difference of the other terms. For the last decade available (2002-2011), EFF was 8.3 ± 0.4 PgC yr-1, ELUC 1.0 ± 0.5 PgC yr-1, GATM 4.3 ± 0.1PgC yr-1, SOCEAN 2.5 ± 0.5 PgC yr-1, and SLAND 2.6 ± 0.8 PgC yr-1. For year 2011 alone, EFF was 9.5 ± 0.5 PgC yr -1, 3.0 percent above 2010, reflecting a continued trend in these emissions; ELUC was 0.9 ± 0.5 PgC yr-1, approximately constant throughout the decade; GATM was 3.6 ± 0.2 PgC yr-1, SOCEAN was 2.7 ± 0.5 PgC yr-1, and SLAND was 4.1 ± 0.9 PgC yr-1. GATM was low in 2011 compared to the 2002-2011 average because of a high uptake by the land probably in response to natural climate variability associated to La Niña conditions in the Pacific Ocean. The global atmospheric CO2 concentration reached 391.31 ± 0.13 ppm at the end of year 2011. We estimate that EFF will have increased by 2.6% (1.9-3.5%) in 2012 based on projections of gross world product and recent changes in the carbon intensity of the economy. All uncertainties are reported as ±1 sigma (68% confidence assuming Gaussian error distributions that the real value lies within the given interval), reflecting the current capacity to characterise the annual estimates of each component of the global carbon budget. This paper is intended to provide a baseline to keep track of annual carbon budgets in the future. © 2013 Author(s). ; We thank all people and institutions who provided data used in this carbon budget, in particular, G. Hurt, L. Chini, and I. Harris. The observations and modelling analysis were possible thanks to funding from multiple agencies around the world. The UK Natural Environment Research Council provided funding to CLQ and the GCP though their International Opportunities Fund specifically to support this publication (project NE/103002X/1). CLQ, PC, SZ, and JS thank the EU FP7 for funding through projects GEOCarbon (283080), COMBINE (226520) and CARBOCHANGE (264879). GPP and RMA acknowledge support from the Norwegian Research Council (221355/E10). SCD acknowledges support from the US National Science Foundation (NSF AGS-1048827). JH was supported by a Leverhulme Research Fellowship and the Cabot Institute, University of Bristol. RJA and TAB were sponsored by US Department of Energy, Office of Science, Biological and Environmental Research (BER) programs and performed at Oak Ridge National Laboratory (ORNL) under US Department of Energy contract DE-AC05-00OR22725. CH was supported by the Centre for Ecology and Hydrology "Science Budget". EK was supported by the Global Environment Research Fund (S-10) of the Ministry of Environment of Japan. GrvdW was supported by the European Research Council. BDS was supported by the Swiss National Science Foundation. AA acknowledges the Mistra-SWECIA programme and the strategic research areas MERGE, BECC and LUCCI. AKJ is funded by the NASA LCLUC Program (No. NNX08AK75G) and the Office of Science (BER), US Department of Energy (DOE-DE-SC0006706).

Zusammenfassung
Hintergrund Über die qualitative Bedeutung der testenden Zentren
im Gesundheitswesen ist wenig bekannt, gleichzeitig stellen die Late-Presenter
eine immer noch große Gruppe bei den HIV-Erstdiagnosen.
Ziel der Arbeit Analyse des Einflusses von Testzentren und -grund auf die
Prävalenz von HIV-Erstdiagnosen und Late-Presentation, exemplarisch
für das Jahr 2014.
Material und Methoden In einer Querschnittsstudie wurden zu allen im
Netzwerk HIV-Regional Behandelten mit Erstdiagnose HIV im Jahr 2014
retrospektiv, pseudonymisiert und dezentral klinische und demographische
Patienten-Charakteristika inklusive Angaben HIV-Test gesammelt und zentral
statistisch ausgewertet.
Ergebnisse 971 Individuen mit Erstdiagnose HIV aus 31 spezialisierten
Versorgungszentren in ganz Deutschland (15 Kliniken, 16 Praxen)
repräsentieren einen Anteil von 27,5% aller
HIV-Erstdiagnosemeldungen des Robert-Koch-Instituts für 2014, mit
ähnlichen Ergebnissen für CD4-Zellzahl und
HIV-Übertragungsrisiko. Häufigster Testort war das Krankenhaus
(34,8%), gefolgt vom Hausarzt (19,6%) und Facharzt
(16,1%). Wurde die Erstdiagnose in der Klinik gestellt, dann waren die
Betroffenen im Mittel älter als ambulant getestete (42 vs. 37 Jahre,
p=0,001), außerdem fand sich eine höhere HI-Viruslast
(585 vs. 270 Tsd. Kopien/mL, p<0,001) und niedrigere
CD4-Zellzahl (265 vs. 414/µL, p<0,001). Bei
208/971 HIV-positiv getesteten fand sich mindestens eine
AIDS-definierende Erkrankung, am häufigsten die Pneumocystis-Pneumonie
(43,8%), Candidiasis (36,5%) und Kaposi-Sarkom (10,6%).
Im regionalen Vergleich fand sich bei ostdeutschen Erstdiagnostizierten ein
jüngeres Lebensalter, eine höhere HIV-RNA und häufiger
das Vollbild AIDS.
Schlussfolgerung Die HIV-Regional-Analyse zum Jahr 2014 erlaubt
exemplarisch einen tieferen Einblick in die HIV-Erstdiagnosen am Vorabend der
Einführung wichtiger Präventionsmaßnahmen in
Deutschland, z. B. HIV-Heimtests und die
Prä-Expositionsprophylaxe. Diese repräsentative Stichprobe
unterstreicht die Bedeutung spezialisierter Kliniken für die
HIV-Versorgungsstruktur, besonders für Ostdeutschland und allgemein
für die Einbindung sogenannter Late-Presenter ins Gesundheitswesen.