Different atmospheric moisture divergence responses to extreme and moderate El Niños

On seasonal and inter-annual time scales, vertically integrated moisture divergence provides a useful measure of the tropical atmospheric hydrological cycle. It reflects the combined dynamical and thermodynamical effects, and is not subject to the limitations that afflict observations of evaporation minus precipitation. An empirical orthogonal function (EOF) analysis of the tropical Pacific moisture divergence fields calculated from the ERA-Interim reanalysis reveals the dominant effects of the El Niño-Southern Oscillation (ENSO) on inter-annual time scales. Two EOFs are necessary to capture the ENSO signature, and regression relationships between their Principal Components and indices of equatorial Pacific sea surface temperature (SST) demonstrate that the transition from strong La Niña through to extreme El Niño events is not a linear one. The largest deviation from linearity is for the strongest El Niños, and we interpret that this arises at least partly because the EOF analysis cannot easily separate different patterns of responses that are not orthogonal to each other. To overcome the orthogonality constraints, a self-organizing map (SOM) analysis of the same moisture divergence fields was performed. The SOM analysis captures the range of responses to ENSO, including the distinction between the moderate and strong El Niños identified by the EOF analysis. The work demonstrates the potential for the application of SOM to large scale climatic analysis, by virtue of its easier interpretation, relaxation of orthogonality constraints and its versatility for serving as an alternative classification method. Both the EOF and SOM analyses suggest a classification of “moderate” and “extreme” El Niños by their differences in the magnitudes of the hydrological cycle responses, spatial patterns and evolutionary paths. Classification from the moisture divergence point of view shows consistency with results based on other physical variables such as SST

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Influence of ocean–atmospheric oscillations on lake ice phenology in eastern North America

Our results reveal long-term trends in ice out dates (1836–2013) for twelve lakes in Maine, New Brunswick and New Hampshire, in eastern North America. The trends are remarkably coherent between lakes (rs = 0.462–0.933, p < 0.01) and correlate closely with the March–April (MA) instrumental temperature records from the region (rs = 0.488–0.816, p < 0.01). This correlation permits use of ice out dates as a proxy to extend the shorter MA instrumental record (1876–2013). Mean ice out dates trended progressively earlier during the recovery from the Little Ice Age through to the 1940s, and gradually became later again through to the late 1970s, when ice out dates had returned to values more typical of the late nineteenth century. Post-1970’s ice out dates resumed trending toward earlier dates, with the twenty-first century being characterized by the earliest ice out dates on record. Spectral and wavelet time series analysis indicate that ice out is influenced by several teleconnections including the Quasi-biennial Oscillation, El Niño-Southern Oscillation, North Atlantic Oscillation, as well as a significant correlation between inland lake records and the Atlantic Multidecadal Oscillation. The relative influence of these teleconnections is variable with notable shifts occurring after ~1870, ~1925, and ~1980–2000. The intermittent expression of these cycles in the ice out and MA instrumental record is not only influenced by absolute changes in the intensity of the various teleconnections and other climate drivers, but through phase interference between teleconnections, which periodically damps the various signals

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Wandtemperaturmodell. Literaturstudie zum Thema Wandtemperaturmodell

Available from TIB Hannover: RA 1581(684) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Estresse e síndrome de burnout entre trabalhadores da equipe de Saúde da Família Estrés y síndrome de burnout entre trabajadores del equipo de Salud de la Familia Stress and burnout syndrome among workers of the Family Health team

OBJETIVO: Compreender o estresse laboral vivenciado pelos trabalhadores das equipes de Saúde da Família (ESF), do município de Santa Maria, Rio Grande do Sul e as implicações para sua saúde. MÉTODOS: Estudo descritivo, com integração de métodos quantitativos e qualitativos, desenvolvido com 86 trabalhadores de todas as ESF do município. Na primeira etapa, foi aplicado o Maslach Burnout Inventory (MBI) e na segunda, foi aplicada entrevista semiestruturada com os 12 trabalhadores que apresentaram os maiores (seis) e os menores (seis) escores no MBI. RESULTADOS: A idade jovem teve associação estatisticamente significativa com os níveis de estresse apresentados pelos trabalhadores (p= 0,034). Os trabalhadores esgotados utilizavam formas de enfrentamento direcionadas às emoções, ou seja, recursos pessoais, enquanto os não esgotados resolviam os problemas do cotidiano laboral com apoio do grupo de trabalho. CONCLUSÃO: Os principais motivos para o desenvolvimento da Síndrome de Burnout estavam vinculados a problemas relacionais e organizacionais.<br>OBJETIVO: Comprender el estrés laboral experimentado por los trabajadores de los Equipos de Salud de la Familia (ESF), del municipio de Santa Maria, Rio Grande del Sur y las implicaciones para su salud. MÉTODOS: Se trata de un estudio descriptivo con integración de métodos cuantitativos y cualitativos, desarrollados con 86 trabajadores de todas los ESF del municipio. En la primera etapa, fue aplicado el Maslach Burnout Inventory (MBI) y en la segunda etapa, fue aplicada la entrevista semiestructurada con los 12 trabajadores que presentaron los mayores (seis) y los menores (seis) puntajes en el MBI. RESULTADOS: la edad joven presentó una asociación estadísticamente significativa con los niveles de estrés presentados por los trabajadores (p= 0,034). Los trabajadores agotados utilizaban formas de enfrentar los problemas utilizando las emociones, o sea, usando recursos personales, en cuanto que los no agotados resolvían los problemas del cotidiano laboral con apoyo del equipo de trabajo. CONCLUSIÓN: Los principales motivos para el desarrollo del Síndrome de Burnout estuvieron asociados a problemas de relaciones y de organización.<br>OBJECTIVE: To understand the stress experienced by workers in the Family Health Teams (FHT) - in the municipality of Santa Maria, Rio Grande do Sul - and the implications for their health. METHODS: This is a descriptive study to integrate quantitative and qualitative methods, developed with 86 workers of all teams, in the municipality of Santa Maria. In the first stage, was applied the Maslach Burnout Inventory (MBI) and in the second stage was applied semi-structured interviews with 12 workers who had the highest (6) and lowest (6) scores on the MBI. RESULTS: Younger age showed a statistically significant association with levels of stress presented by the workers (p = 0.034). The exhausted workers used ways of coping problems using emotions which are personal resources; the not exhausted, solved the everyday work problems using the team support. CONCLUSION: The main reasons for development of the burnout syndrome were associated with relationship problems and organization

Mathematical and Statistical Methods for Actuarial Sciences and Finance

The interaction between mathematicians, statisticians and econometricians working in actuarial sciences and finance is producing numerous meaningful scientific results. This volume introduces new ideas, in the form of four-page papers, presented at the international conference Mathematical and Statistical Methods for Actuarial Sciences and Finance (MAF), held at Universidad Carlos III de Madrid (Spain), 4th-6th April 2018. The book covers a wide variety of subjects in actuarial science and financial fields, all discussed in the context of the cooperation between the three quantitative approaches. The topics include: actuarial models; analysis of high frequency financial data; behavioural finance; carbon and green finance; credit risk methods and models; dynamic optimization in finance; financial econometrics; forecasting of dynamical actuarial and financial phenomena; fund performance evaluation; insurance portfolio risk analysis; interest rate models; longevity risk; machine learning and soft-computing in finance; management in insurance business; models and methods for financial time series analysis, models for financial derivatives; multivariate techniques for financial markets analysis; optimization in insurance; pricing; probability in actuarial sciences, insurance and finance; real world finance; risk management; solvency analysis; sovereign risk; static and dynamic portfolio selection and management; trading systems. This book is a valuable resource for academics, PhD students, practitioners, professionals and researchers, and is also of interest to other readers with quantitative background knowledge