Should Swedish sea level planners worry more about mean sea level rise or sea level extremes?

Current coastal spatial planning in Sweden uses simple methods to account for how flood risks increase owing to sea level rise. Those methods, however, fail to account for several important aspects of sea level rise, such as: projection uncertainty, emission scenario uncertainty and time dependence. Here, enhanced methods that account for these uncertainties are applied at several locations along the coast. The relative importance of mean sea level rise and extreme events for flood risk is explored for different timeframes. A general conclusion for all locations is that, extreme events dominate the flood risk for planning periods lasting a few decades. For longer planning periods, lasting toward the end of the century, the flood risk is instead dominated by the risk of high sea level rise. It is argued that these findings are important for assessments of future flood risk, and that they should be reflected in coastal spatial planning.

A yearly maximum sea level simulator and its applications: A Stockholm case study.

A yearly maximum sea level simulator for Stockholm is presented. The simulator combines extreme sea level estimates and mean sea level rise projections into a joint probabilistic framework. The framework can be used, for example, to assess the risk that new structures placed at the current minimum allowed height above the sea level can become flooded in the future. Such assessments can be used to underpin future building free levels, which would be a great improvement over the much more arbitrary criteria in use today. Another strong point of the framework is that it can be used to quantify the influence of uncertainties in mean sea level projections, estimates of sea level extremes and future emission scenarios on the risk of flooding. For Stockholm mean sea level uncertainty is found to be much more important than extreme sea level uncertainty. The framework is also set-up to test adaptation measures. It is found that protections that are built once the mean sea level has risen above some given threshold can be very efficient. Lastly, the framework is embedded into a simple decision problem that can be used to calculate risk/reward ratios for land development as a function of height above today's mean sea level.

Determining maximal achievable effect sizes of antidepressant therapies in placebo-controlled trials.

OBJECTIVE: Antidepressants outperform placebo with an effect size of around 0.30. It has been suggested that effect sizes as high as 0.875 are necessary for a minimal clinically important difference. Whether such effect sizes are achievable in placebo-controlled trials is unknown. Therefore, we aimed to assess what effect sizes are theoretically achievable in placebo-controlled trials of antidepressants. METHODS: Patient-level analyses comparing Hamilton Depression Rating Scale (HDRS-17) outcomes for simulated antidepressant therapies to placebo-treated participants (n = 2201) from clinical trials of selective serotonin reuptake inhibitors. RESULTS: An optimally effective antidepressant, where all treated participants achieve HDRS-17 scores comparable to those displayed by healthy volunteers (remission-type model), had a maximum effect size of 1.75, with a mean difference of 11.6 points on the HDRS-17. In simulations where patients received an additional 50% symptom reduction over that obtained with placebo (improvement-type model), the maximum effect size was 1.08 with a mean HDRS-17 difference of 7.2. When adjusting for normal rates of treatment discontinuation, maximum effect sizes were 1.10 (remission-type model) and 0.76 (improvement-type model) with HDRS-17 mean differences of 8.8 and 5.6, respectively. CONCLUSIONS: Three methodological issues (i) a large and variable placebo response, (ii) a high rate of dropout and (iii) HDRS-17-ratings significantly larger than zero in healthy volunteers, reduce the degree of treatment-placebo separation achievable in depression trials. Assuming that those who discontinue treatment have only partial response, even a highly effective antidepressant would have difficulties surpassing such effect size cut-offs as have been suggested to signify a minimal clinically important difference.

Sea-level rise projections for Sweden based on the new IPCC special report: The ocean and cryosphere in a changing climate.

New sea-level rise projections for Sweden are presented. Compared to earlier projections, we have here, more carefully, taken regional variations in sea-level rise into consideration. The better treatment of regional variations leads to lower sea-level rise projections for Sweden. However, recent research has also shown that Antarctic ice loss, in high emission scenarios, could be greater than what was believed earlier. Taking also this into account, we find a near cancellation between the increased Antarctic contribution and the decrease owing to the better treatment of spatial inhomogeneities. Sweden's sensitivity to melt from Antarctica and Greenland is also estimated using a new set of sea-level fingerprint kernels, and the sensitivity to melt from Greenland is found to be weak. To illustrate the influence mean sea-level rise has on extreme sea levels, it is also shown how the return period of sea-level extremes changes as a function of time owing to mean sea-level rise in the different projections.