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Human campylobacteriosis exhibits a distinctive seasonality in temperate regions. This paper aims to identify the origins of this seasonality. Clinical isolates [typed by multi-locus sequence typing (MLST)] and epidemiological data were collected from Scotland. Young rural children were found to have an increased burden of disease in the late spring due to strains of non-chicken origin (e.g. ruminant and wild bird strains from environmental sources). In contrast the adult population had an extended summer peak associated with chicken strains. Travel abroad and UK mainland travel were associated with up to 17% and 18% of cases, respectively. International strains were associated with chicken, had a higher diversity than indigenous strains and a different spectrum of MLST types representative of these countries. Integrating empirical epidemiology and molecular subtyping can successfully elucidate the seasonal components of human campylobacteriosis. The findings will enable public health officials to focus strategies to reduce the disease burden.
This Summary for Policymakers presents key findings from the Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation (SREX). The SREX approaches the topic by assessing the scientific literature on issues that range from the relationship between climate change and extreme weather and climate events (‘climate extremes’) to the implications of these events for society and sustainable development. The assessment concerns the interaction of climatic, environmental, and human factors that can lead to impacts and disasters, options for managing the risks posed by impacts and disasters, and the important role that non-climatic factors play in determining impacts. Box SPM.1 defines concepts central to the SREX.
The character and severity of impacts from climate extremes depend not only on the extremes themselves but also on exposure and vulnerability. In this report, adverse impacts are considered disasters when they produce widespread damage and cause severe alterations in the normal functioning of communities or societies. Climate extremes, exposure, and vulnerability are influenced by a wide range of factors, including anthropogenic climate change, natural climate variability, and socioeconomic development (Figure SPM.1). Disaster risk management and adaptation to climate change focus on reducing exposure and vulnerability and increasing resilience to the potential adverse impacts of climate extremes, even though risks cannot fully be eliminated (Figure SPM.2). Although mitigation of climate change is not the focus of this report, adaptation and mitigation can complement each other and together can significantly reduce the risks of climate change. [SYR AR4, 5.3]
A major challenge for scanned probe microscopy is to identify structures and chemical species on a surface, which have not already been inferred from other analytical techniques. Progress is impeded by the fact that in general the structure and composition of the tip atom is not known. To illustrate some of the issues involved, we report simultaneous scanning tunneling microscopy/atomic force microscopy (STM/AFM) of the TiO2 (110) surface. The use of small amplitudes enabled the simultaneous acquisition of force gradient and barrier height images during standard STM imaging. Surprisingly, we find most STM images exhibit a corrugation contrast inverse to that usually reported in the literature. However, regardless of the contrast in STM, force gradient images always showed greater attraction over O rows. Barrier height images also show this consistency, always being greater over O rows. This supports the theoretical model of the electronic structure of the surface, but shows that the tip structure and interaction cannot be ignored in modeling STM images. We conclude that there is a fine balance between topography and local density of states (LDOS) in STM imaging of this surface; which of them dominates the STM image is determined by the tip. Simultaneous multi-parameter imaging is useful in interpreting images reliably, particularly on multi-component surfaces.
Karen W. L. Yee, Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, ON, Canada,
Susan M. O'Brien, Hematopathology and Oncology Department, Quest Diagnostics Nichols Institute, San Juan Capistrano, CA, USA
Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in adults in the Western world, accounting for nearly 25% of all leukemias with an estimated annual age-adjusted incidence of 3 per 100,000 persons in the United States. The median age at diagnosis is approximately 70 years, with 81% of the patients diagnosed when aged ≥ 60 years. Under the World Health Organization (WHO) classification, CLL is a B-cell neoplasm and the entity T-cell CLL has been reclassified as T-cell prolymphocytic leukemia (PLL). Recent data from the Surveillance, Epidemiology, and End Results (SEER) cancer statistics indicate that 5-year survival of patients with CLL is 73%.
Significant changes in the understanding and management of CLL have occurred in the last two decades. With the advent of newer treatment modalities, such as purine analogs and monoclonal antibodies, substantial improvements have been made in achieving complete responses (CR), with a proportion achieving molecular remissions and durable responses. Despite the advances in the treatment of patients with CLL, the majority of patients will relapse after primary therapy.
The current diagnosis of CLL is based on minor modifications of the criteria originally proposed by the National Cancer Institute (NCI) (Table 5.1). A bone marrow evaluation is no longer required for diagnosis but is useful to determine the extent and pattern of involvement and to clarify the etiology of cytopenias.
The morphology and immunophenotype are adequate for diagnosis and to distinguish CLL from other disorders (Table 5.2).
Almost every day new scientific evidence suggests that the climate is changing due to human action and will continue to change over our lifetimes and those of the next generations. It would be inconceivable that humans, as the most adaptable of species, would not adapt to this challenge. But the state of science about how and whether we adapt and the cost and consequences of such adaptations is nowhere near that of science of atmospheric change. Of course, societies adapt all the time to diverse risks and challenges. So, drawing on theoretical and empirical research, we should be able to discern how adaptation to a changing climate will proceed. Herein lies the impetus for this book.
Until recently, adaptation has been somewhat sidelined, or some would say, actually tabooed, in the climate change discourse. Many argue that investing in adapting to the impacts distracts from the major task of mitigating the causes of anthropogenic climate change by reducing greenhouse gas emissions. Others are convinced that adaptation will automatically happen, once environmental changes become visible. But the time for adaptation action has arrived and the demand for information and rigorous science in this area is increasing exponentially. The funding for adaptation research is growing, and so are the questions that need to be addressed. Many of these questions are directly related to the process of adaptation, and to one overarching question: can we live with climate change?
Adapting to climate change is a critical problem facing humanity. This involves reconsidering our lifestyles, and is linked to our actions as individuals, societies and governments. This book presents top science and social science research on whether the world can adapt to climate change. Written by experts, both academics and practitioners, it examines the risks to ecosystems, demonstrating how values, culture and the constraining forces of governance act as barriers to action. As a review of science and a holistic assessment of adaptation options, it is essential reading for those concerned with responses to climate change, especially researchers, policymakers, practitioners, and graduate students. Significant features include historical, contemporary, and future insights into adaptation to climate change; coverage of adaptation issues from different perspectives: climate science, hydrology, engineering, ecology, economics, human geography, anthropology and political science; and contributions from leading researchers and practitioners from around the world.
Look out the window and assess the weather. If it is hot, change into a lighter shirt. If it is raining, take an umbrella. This is adaptation to changing weather.
Adaptation to changing climate is a different matter. The climate may change either slowly or rapidly, and the changes may be irreversible and impossible to predict with any accuracy. The simple principles of adapting to changing weather begin to break down when the climate changes. In the context of climate change the options for adaptation may involve relocating homes, moving cities, changing the foods we grow and consume, seeking compensation for economic damages, and mourning the loss of our favourite place or iconic species. The difference between adapting to changing weather and adapting to a changing climate lies both in the time-frame and in the significance of the changes required. Moreover, the consequences of not adapting to climate change may be far more serious than not adapting to changing weather.
There are two aspects of climate change that have profound significance for adaptation. First is the growing recognition that the weather is no longer ‘natural’. While the weather varies and changes seasonally as part of the natural rhythm of our lives, climate change, as it is presently observed, is now beyond all reasonable doubt driven by human activities. This induces a feeling, for some, that the world is sullied, and nature itself is at an end (McKibben, 1999).