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European legislation requires monitoring of toxic algae in marine areas where shellfish are harvested for consumption. Monitoring assumes the existence of homogeneous water bodies, the definition of which have important implications for stakeholders and consumers. Yet, the definition of homogeneous water bodies remains unclear. Here we present a methodology to divide coastal and estuarine waters into homogeneous water bodies to monitor toxic algae. The proposed method is mainly based on water transport, and secondarily on oceanographic characteristics; salinity and sea surface height. We apply the methodology to the Limfjord in Denmark and demonstrate its usefulness in areas with a complicated coastal morphology. The oceanographic descriptors applied in the method are standard outputs from coastal hydrodynamical models. Provided that validated and high resolution model output is available for a given area, the technique is thus adaptable to other morphologically and oceanographically complicated estuarine and coastal areas where toxic algae monitoring is necessary.

Litter cleanup and disposal management in the marine environment are increasingly subject to public scrutiny, government regulation and stakeholder initiatives. In practice, ongoing efforts and new investment decisions, for example in new cleanup technologies, are constrained by financial and economic resources. Given budgetary restrictions, it is important to optimize decision-making using a scientific framework that takes into account the various effects of investments by combining multiple scientific perspectives and integrating these in a consistent and coherent way. Identifying optimal levels of marine litter cleanup is a challenge, because of its cross-disciplinary nature, involving physics, environmental engineering, science, and economics. In this paper, we propose a bridge-building, spatial cost-benefit optimization framework that allows prioritizing where to apply limited cleanup efforts within a regional spatial network of marine litter sources, using input from the maturing field of marine litter transport modeling. The framework also includes ecosystem functioning in relation to variable litter concentrations, as well as the potentially non-linear cost-efficiency of cleanup technologies. From these three components (transport modeling, ecosystem functioning, cleanup-effectiveness), along with litter source mapping, we outline the optimal cleanup solution at any given ecological target or economic constraint, as well as determine the cleanup feasibility. We illustrate our framework in a Baltic and Mediterranean Sea case study, using real data for litter transport and cleanup technology. Our study shows that including pollution Green's functions is essential to assess the feasibility of cleanup and determine optimal deployment of cleanup investments, where the presented framework combines physical, economical, technological and biological data consistently to compare and rank alternatives.

Litter cleanup and disposal management in the marine environment are increasingly subject to public scrutiny, government regulation and stakeholder initiatives. In practice, ongoing efforts and new investment decisions, for example in new cleanup technologies, are constrained by financial and economic resources. Given budgetary restrictions, it is important to optimize decision-making using a scientific framework that takes into account the various effects of investments by combining multiple scientific perspectives and integrating these in a consistent and coherent way. Identifying optimal levels of marine litter cleanup is a challenge, because of its cross-disciplinary nature, involving physics, environmental engineering, science, and economics. In this paper, we propose a bridge-building, spatial cost-benefit optimization framework that allows prioritizing where to apply limited cleanup efforts within a regional spatial network of marine litter sources, using input from the maturing field of marine litter transport modeling. The framework also includes ecosystem functioning in relation to variable litter concentrations, as well as the potentially non-linear cost-efficiency of cleanup technologies. From these three components (transport modeling, ecosystem functioning, cleanup-effectiveness), along with litter source mapping, we outline the optimal cleanup solution at any given ecological target or economic constraint, as well as determine the cleanup feasibility. We illustrate our framework in a Baltic and Mediterranean Sea case study, using real data for litter transport and cleanup technology. Our study shows that including pollution Green's functions is essential to assess the feasibility of cleanup and determine optimal deployment of cleanup investments, where the presented framework combines physical, economical, technological and biological data consistently to compare and rank alternatives.

Si listano le singole sezioni in cui S.Simoncelli ha contribuito. Ogni sezione puo' essere citata separatamente dal report 1.1 Ocean temperature and salinity S. Mulet, B. Buongiorno Nardelli, S. Good, A. Pisano, E. Greiner, M. Monier E. Autret, L. Axell, F. Boberg, S. Ciliberti, M. Drévillon, R. Droghei, O. Embury, J. Gourrion, J. Høyer, M. Juza, J. Kennedy, B. Lemieux-Dudon, E. Peneva, R. Reid, S. Simoncelli, A. Storto, J. Tinker, K. von Schuckmann, S. L. Wakelin. 2.1. Ocean heat content .K. von Schuckmann, A. Storto, S. Simoncelli, R. P. Raj, A.Samuelsen, A. de Pascual Collar, M. Garcia Sotillo, T Szerkely, M. Mayer, K. A. Peterson, H. Zuo, G. Garric, M. Monier. 3.4 Water mass formation processes in the Mediterranean Sea over the past 30 years S. Simoncelli, Nadia Pinardi, C. Fratianni, C. Dubois, G. Notarstefano. 3.5 Ventilation of the Western Mediterranean Deep Water through the Strait of Gibraltar S. Sammartino, J. García Lafuente, C. Naranjo, S. Simoncelli. 4.4 Unusual salinity pattern in the South Adriatic Sea in 2016 Z. Kokkini, G. Notarstefano P-M Poulain, E. Mauri, R. Gerin, S. Simoncelli ; The oceans regulate our weather and climate from global to regional scales. They absorb over 90% of accumulated heat in the climate system (IPCC 2013 IPCC. 2013. Climate change 2013: The physical science basis. Contribution of working group I to the fifth assessment report of the intergovernmental panel on climate change [Stocker TF, Qin D, Plattner G-K, Tignor M, Allen SK, Boschung J, Nauels A, Xia Y, Bex V, Midgley PM, editors]. Cambridge: Cambridge University Press, 1535. doi:10.1017/CBO9781107415324. [Crossref], , [Google Scholar]) and over a quarter of the anthropogenic carbon dioxide (Le Quéré et al. 2016 Le Quéré C, Andrew RM, Canadell JG, Sitch S, Korsbakken JI, Peters GP, Manning AC, Boden TA, Tans PP, Houghton RA, et al. 2016. Global carbon budget 2016. Earth Syst Sci Data. 8( 2): 605– 649. doi:10.5194/essd-8-605-2016 [Crossref], [Web of Science ®], , [Google Scholar]). They provide nearly half of the world's oxygen. Most of our rain and drinking water is ultimately regulated by the sea. The oceans provide food and energy and are an important source of the planet's biodiversity and ecosystem services. They are vital conduits for trade and transportation and many economic activities depend on them (OECD 2016 OECD . 2016. The ocean economy in 2030. Paris : OECD Publishing. doi:10.1787/9789264251724-en. [Crossref], , [Google Scholar]). Our oceans are, however, under threat due to climate change and other human induced activities and it is vital to develop much better, sustainable and science-based reporting and management approaches (UN 2017 UN . 2017. Report of the United Nations conference to support the implementation of sustainable development goal 14: Conserve and sustainably use the oceans, seas and marine resources for sustainable development (Advance unedited version). https://sustainabledevelopment.un.org/content/documents/15662FINAL_15_June_2017_RepoRe_Goal_14.pdf . [Google Scholar]). Better management of our oceans requires long-term, continuous and state-of-the art monitoring of the oceans from physics to ecosystems and global to local scales. The Copernicus Marine Environment Monitoring Service (CMEMS) has been set up to address these challenges at European level. Mercator Ocean was tasked in 2014 by the European Union under a delegation agreement to implement the operational phase of the service from 2015 to 2021 (CMEMS 2014 CMEMS . 2014. Technical annex to the delegation agreement with Mercator Ocean for the implementation of the Copernicus Marine Environment Monitoring Service (CMEMS). www.copernicus.eu/sites/default/files/library/CMEM_TechnicalAnnex_PUBLIC.docx.pdf . [Google Scholar]). The CMEMS now provides regular and systematic reference information on the physical state, variability and dynamics of the ocean, ice and marine ecosystems for the global ocean and the European regional seas (Figure 0.1; CMEMS 2016 CMEMS . 2016. High level service evolution strategy, a document prepared by Mercator Ocean with the support of the CMEMS STAC. [Google Scholar]). This capacity encompasses the description of the current situation (analysis), the prediction of the situation 10 days ahead (forecast), and the provision of consistent retrospective data records for recent years (reprocessing and reanalysis). CMEMS provides a sustainable response to European user needs in four areas of benefits: (i) maritime safety, (ii) marine resources, (iii) coastal and marine environment and (iv) weather, seasonal forecast and climate. ; Copernicus Marine Environment Monitoring Service ; Published ; S1-S142 ; 4A. Oceanografia e clima ; JCR Journal

Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040.We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country's UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios.

Importance The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. Objective To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus. Evidence Review Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition. Findings In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, −1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535 000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined. Between 2006 and 2016, the average annual age-standardized incidence rates for all cancers combined increased in 130 of 195 countries or territories, and the average annual age-standardized death rates decreased within that timeframe in 143 of 195 countries or territories. Conclusions and Relevance Large disparities exist between countries in cancer incidence, deaths, and associated disability. Scaling up cancer prevention and ensuring universal access to cancer care are required for health equity and to fulfill the global commitments for noncommunicable disease and cancer control.

Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders. Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach. Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their agestandardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable). Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies. ; publishedVersion ; © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Importance: The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. Objective: To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus. Evidence Review: Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition. Findings: In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, -1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535 000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined. Between 2006 and 2016, the average annual age-standardized incidence rates for all cancers combined increased in 130 of 195 countries or territories, and the average annual age-standardized death rates decreased within that timeframe in 143 of 195 countries or territories. Conclusions and Relevance: Large disparities exist between countries in cancer incidence, deaths, and associated disability. Scaling up cancer prevention and ensuring universal access to cancer care are required for health equity and to fulfill the global commitments for noncommunicable disease and cancer control.

Background - The scale-up of tobacco control, especially after the adoption of the Framework Convention for Tobacco Control, is a major public health success story. Nonetheless, smoking remains a leading risk for early death and disability worldwide, and therefore continues to require sustained political commitment. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) offers a robust platform through which global, regional, and national progress toward achieving smoking-related targets can be assessed. Methods - We synthesised 2818 data sources with spatiotemporal Gaussian process regression and produced estimates of daily smoking prevalence by sex, age group, and year for 195 countries and territories from 1990 to 2015. We analysed 38 risk-outcome pairs to generate estimates of smoking-attributable mortality and disease burden, as measured by disability-adjusted life-years (DALYs). We then performed a cohort analysis of smoking prevalence by birth-year cohort to better understand temporal age patterns in smoking. We also did a decomposition analysis, in which we parsed out changes in all-cause smoking-attributable DALYs due to changes in population growth, population ageing, smoking prevalence, and risk-deleted DALY rates. Finally, we explored results by level of development using the Socio-demographic Index (SDI). Findings - Worldwide, the age-standardised prevalence of daily smoking was 25·0% (95% uncertainty interval [UI] 24·2–25·7) for men and 5·4% (5·1–5·7) for women, representing 28·4% (25·8–31·1) and 34·4% (29·4–38·6) reductions, respectively, since 1990. A greater percentage of countries and territories achieved significant annualised rates of decline in smoking prevalence from 1990 to 2005 than in between 2005 and 2015; however, only four countries had significant annualised increases in smoking prevalence between 2005 and 2015 (Congo [Brazzaville] and Azerbaijan for men and Kuwait and Timor-Leste for women). In 2015, 11·5% of global deaths (6·4 million [95% UI 5·7–7·0 million]) were attributable to smoking worldwide, of which 52·2% took place in four countries (China, India, the USA, and Russia). Smoking was ranked among the five leading risk factors by DALYs in 109 countries and territories in 2015, rising from 88 geographies in 1990. In terms of birth cohorts, male smoking prevalence followed similar age patterns across levels of SDI, whereas much more heterogeneity was found in age patterns for female smokers by level of development. While smoking prevalence and risk-deleted DALY rates mostly decreased by sex and SDI quintile, population growth, population ageing, or a combination of both, drove rises in overall smoking-attributable DALYs in low-SDI to middle-SDI geographies between 2005 and 2015. Interpretation - The pace of progress in reducing smoking prevalence has been heterogeneous across geographies, development status, and sex, and as highlighted by more recent trends, maintaining past rates of decline should not be taken for granted, especially in women and in low-SDI to middle-SDI countries. Beyond the effect of the tobacco industry and societal mores, a crucial challenge facing tobacco control initiatives is that demographic forces are poised to heighten smoking's global toll, unless progress in preventing initiation and promoting cessation can be substantially accelerated. Greater success in tobacco control is possible but requires effective, comprehensive, and adequately implemented and enforced policies, which might in turn require global and national levels of political commitment beyond what has been achieved during the past 25 years.