The « race ¼ correction in estimating glomerular filtration rate: an European point of view.

PURPOSE OF REVIEW: There is currently a heated debate ongoing whether or not to use the race coefficient for black people in the Modification of Diet in Renal Diseases and Chronic Kidney Disease Epidemiology-equation. The use of the race coefficient is thought by several American authors as a source of discrimination. RECENT FINDINGS: It has recently been shown that the race coefficient is inaccurate in European and African black people. Therefore, it seems that the race correction is more a correction for black Americans, rather than for black in general. This 'correction' at the glomerular filtration rate (GFR)-level has been criticized, as it is misleading, and should be abandoned, as it has not been shown that GFR is different between black and white people. However, as differences in creatinine generation between black and white people might exist, a correction or adjustment, different for black and white people, at the creatinine level might be required, very similar to the different scaling of creatinine for males and females. SUMMARY: The current debate on the race coefficient is particularly difficult because of the absence of good scientific data in black subjects and there lies the real discrimination in our opinion. We therefore call for future dedicated studies, both in Europe and USA.

Consequences of rapid ice sheet melting on the Sahelian population vulnerability.

The acceleration of ice sheet melting has been observed over the last few decades. Recent observations and modeling studies have suggested that the ice sheet contribution to future sea level rise could have been underestimated in the latest Intergovernmental Panel on Climate Change report. The ensuing freshwater discharge coming from ice sheets could have significant impacts on global climate, and especially on the vulnerable tropical areas. During the last glacial/deglacial period, megadrought episodes were observed in the Sahel region at the time of massive iceberg surges, leading to large freshwater discharges. In the future, such episodes have the potential to induce a drastic destabilization of the Sahelian agroecosystem. Using a climate modeling approach, we investigate this issue by superimposing on the Representative Concentration Pathways 8.5 (RCP8.5) baseline experiment a Greenland flash melting scenario corresponding to an additional sea level rise ranging from 0.5 m to 3 m. Our model response to freshwater discharge coming from Greenland melting reveals a significant decrease of the West African monsoon rainfall, leading to changes in agricultural practices. Combined with a strong population increase, described by different demography projections, important human migration flows could be potentially induced. We estimate that, without any adaptation measures, tens to hundreds million people could be forced to leave the Sahel by the end of this century. On top of this quantification, the sea level rise impact over coastal areas has to be superimposed, implying that the Sahel population could be strongly at threat in case of rapid Greenland melting.

COVID-19 responses restricted abilities and aspirations for mobility and migration: insights from diverse cities in four continents.

Research on the impacts of COVID-19 on mobility has focused primarily on the increased health vulnerabilities of involuntary migrant and displaced populations. But virtually all migration flows have been truncated and altered because of reduced economic and mobility opportunities of migrants. Here we use a well-established framework of migration decision-making, whereby individual decisions combine the aspiration and ability to migrate, to explain how public responses to the COVID-19 pandemic alter migration patterns among urban populations across the world. The principal responses to COVID-19 pandemic that affected migration are: 1) through travel restrictions and border closures, 2) by affecting abilities to move through economic and other means, and 3) by affecting aspirations to move. Using in-depth qualitative data collected in six cities in four continents (Accra, Amsterdam, Brussels, Dhaka, Maputo, and Worcester), we explore how populations with diverse levels of education and occupations were affected in their current and future mobility decisions. We use data from interviews with sample of internal and international migrants and non-migrants during the 2020 COVID-19 pandemic outbreak to identify the mechanisms through which the pandemic affected their mobility decisions. The results show common processes across the different geographical contexts: individuals perceived increased risks associated with further migration, which affected their migration aspirations, and had reduced abilities to migrate, all of which affected their migration decision-making processes. The results also reveal stark differences in perceived and experienced migration decision-making across precarious migrant groups compared to high-skilled and formally employed international migrants in all settings. This precarity of place is particularly evident in low-income marginalised populations.

Climate-induced population displacements in a 4°C+ world.

Massive population displacements are now regularly presented as one of the most dramatic possible consequences of climate change. Current forecasts and projections show that regions that would be affected by such population movements are low-lying islands, coastal and deltaic regions, as well as sub-Saharan Africa. Such estimates, however, are usually based on a 2°C temperature rise. In the event of a 4°C+ warming, not only is it likely that climate-induced population movements will be more considerable, but also their patterns could be significantly different, as people might react differently to temperature changes that would represent a threat to their very survival. This paper puts forward the hypothesis that a greater temperature change would affect not only the magnitude of the associated population movements, but also--and above all--the characteristics of these movements, and therefore the policy responses that can address them. The paper outlines the policy evolutions that climate-induced displacements in a 4°C+ world would require.