Spectral Decomposition of Regulatory Thresholds for Climate-Driven Fluctuations in Hydro- and Wind Power Availability

Abstract Climate-driven fluctuations in the runoff and potential energy of surface water are generally large in comparison to the capacity of hydropower regulation, particularly when hydropower is used to balance the electricity production from covarying renewable energy sources such as wind power. To define the bounds of reservoir storage capacity, we introduce a dedicated reservoir volume that aggregates the storage capacity of several reservoirs to handle runoff from specific watersheds. We show how the storage bounds can be related to a spectrum of the climate-driven modes of variability in water availability and to the covariation between water and wind availability. A regional case study of the entire hydropower system in Sweden indicates that the longest regulation period possible to consider spans from a few days of individual subwatersheds up to several years, with an average limit of a couple of months. Watershed damping of the runoff substantially increases the longest considered regulation period and capacity. The high covariance found between the potential energy of the surface water and wind energy significantly reduces the longest considered regulation period when hydropower is used to balance the fluctuating wind power

The person-centred approach to an ageing society

Modern care is often based on investigations such as laboratory markers and imaging - for example, X-ray or ultrasound. The results contribute to a diagnosis and, if judged necessary, treatment is initiated. This diseased-oriented approach is the prevailing mode of management in modern medicine. In contrast, person-centered care (PCC) takes the point of departure from each person\ub4s subjective experience of illness and its impact on daily life. A patient is considered as a person with emotions and feelings. PCC is considered present within clinical care according to a definition articulated by the Centre for Person Centred Care at the University of Gothenburg (GPCC) when three core components are present: elicitation of a detailed patient narrative; formulated partnership between caregiver and patient and documentation of the partnership in the patient record. Accordingly, when there is an illness requiring care and the person is attended using these components, PCC is being applied. In most situations today, PCC is not applied in terms of the narrative and is not fully elicited or the partnership and/or the documentation are not included. It is proposed that the challenge to Society arising from changing demographics can be addressed by implementing PCC and creating an alternative to existing healthcare. The importance and benefits of such an approach on a wider scale is not yet clear as research has been limited to date. Studies in selected patient populations (heart failure and hip fractures), however, have shown promising results. As the population ages, there will be a dramatic increase in healthcare consumption. Even with technological developments, there will be a need for tremendous resources to be dedicated to care. A new organization and attitude from healthcare policymakers and providers above and beyond the present model appears required in order to respond to this demand. As part of such change, person-centred care, with the interaction between healthcare providers and the person of the patient, can facilitate, compensate and develop more effective healthcare services for the future

Bone Biomarkers Help Grading Severity of Coronary Calcifications in Non Dialysis Chronic Kidney Disease Patients

BACKGROUND: Osteoprotegerin (OPG) and fibroblast growth factor-23 (FGF23) are recognized as strong risk factors of vascular calcifications in non dialysis chronic kidney disease (ND-CKD) patients. The aim of this study was to investigate the relationships between FGF23, OPG, and coronary artery calcifications (CAC) in this population and to attempt identification of the most powerful biomarker of CAC: FGF23? OPG? METHODOLOGY/PRINCIPAL FINDINGS: 195 ND-CKD patients (112 males/83 females, 70.8 [27.4-94.6] years) were enrolled in this cross-sectional study. All underwent chest multidetector computed tomography for CAC scoring. Vascular risk markers including FGF23 and OPG were measured. Logistic regression analyses were used to study the potential relationships between CAC and these markers. The fully adjusted-univariate analysis clearly showed high OPG (≥10.71 pmol/L) as the only variable significantly associated with moderate CAC ([100-400[) (OR = 2.73 [1.03;7.26]; p = 0.04). Such association failed to persist for CAC scoring higher than 400. Indeed, severe CAC was only associated with high phosphate fractional excretion (FEPO(4)) (≥38.71%) (OR = 5.47 [1.76;17.0]; p = 0.003) and high FGF23 (≥173.30 RU/mL) (OR = 5.40 [1.91;15.3]; p = 0.002). In addition, the risk to present severe CAC when FGF23 level was high was not significantly different when OPG was normal or high. Conversely, the risk to present moderate CAC when OPG level was high was not significantly different when FGF23 was normal or high. CONCLUSIONS: Our results strongly suggest that OPG is associated to moderate CAC while FGF23 rather represents a biomarker of severe CAC in ND-CKD patients

Wind Power Persistence Characterized by Superstatistics

Mitigating climate change demands a transition towards renewable electricity generation, with wind power being a particularly promising technology. Long periods either of high or of low wind therefore essentially define the necessary amount of storage to balance the power system. While the general statistics of wind velocities have been studied extensively, persistence (waiting) time statistics of wind is far from well understood. Here, we investigate the statistics of both high- and low-wind persistence. We find heavy tails and explain them as a superposition of different wind conditions, requiring q-exponential distributions instead of exponential distributions. Persistent wind conditions are not necessarily caused by stationary atmospheric circulation patterns nor by recurring individual weather types but may emerge as a combination of multiple weather types and circulation patterns. This also leads to Fréchet instead of Gumbel extreme value statistics. Understanding wind persistence statistically and synoptically may help to ensure a reliable and economically feasible future energy system, which uses a high share of wind generation

Fibroblast growth factor 23 is independently associated with renal magnesium handling in patients with chronic kidney disease.

BACKGROUND: Disturbances in magnesium homeostasis are common in patients with chronic kidney disease (CKD) and are associated with increased mortality. The kidney is a key organ in maintaining normal serum magnesium concentrations. To this end, fractional excretion of magnesium (FEMg) increases as renal function declines. Despite recent progress, the hormonal regulation of renal magnesium handling is incompletely understood. Fibroblast Growth Factor 23 (FGF23) is a phosphaturic hormone that has been linked to renal magnesium handling. However, it has not yet been reported whether FGF23 is associated with renal magnesium handling in CKD patients. METHODS: The associations between plasma FGF23 levels, plasma and urine magnesium concentrations and FEMg was investigated in a cross-sectional cohort of 198 non-dialysis CKD patients undergoing renal biopsy. RESULTS: FGF23 was significantly correlated with FEMg (Pearson's correlation coefficient = 0.37, p<0.001) and urinary magnesium (-0.14, p=0.04), but not with plasma magnesium. The association between FGF23 and FEMg remained significant after adjusting for potential confounders, including estimated glomerular filtration rate (eGFR), parathyroid hormone and 25-hydroxyvitamin D. CONCLUSIONS: We report that plasma FGF23 is independently associated with measures of renal magnesium handling in a cohort of non-dialysis CKD patients. A potential causal relationship should be investigated in future studies

Eastern Mediterranean Deep Water Formation During Sapropel S1: A Reconstruction Using Geochemical Records Along a Bathymetric Transect in the Adriatic Outflow Region

Eastern Mediterranean thermohaline circulation is directly influenced by middle- and low-latitude climate systems. The dramatic paleoclimate changes during the last African Humid Period (~10–6 ka BP) were captured in Mediterranean sediments as the distinctly organic-rich unit sapropel S1. Here, deepwater formation variability during S1 deposition is reconstructed. We use geochemical records of three cores along a bathymetric transect (775-, 1,359-, and 1,908-m water depths), at the transition between the Adriatic DW- formation area and the Eastern Mediterranean. In all three cores, sedimentation rates are distinctly higher during S1, corresponding with enhanced runoff emanating from the Adriatic hinterland. Hence, major runoff did not only come from southern but also from northern borderlands in this period. During sapropel formation, enhanced levels of primary productivity occurred in the surface waters and oxygen-depleted conditions in the bottom waters for all sites. Conditions for sediment and bottom-water below ~1.4 km water depth were sulfidic throughout S1, but for intermediate depth (775 m) were anoxic only during the first part (S1a). Bottom-water oxygenation interrupted S1 formation at water depths down to ~1.4 km, during two brief episodes, at 8.2 and 7.4 cal. ka BP. From the 7.4 cal. ka BP ventilation onward, the transition to more oxygenated bottom-water conditions was more progressive for the intermediate water depth site (775 m) than for the deeper sites. Conditions remained fully oxic for all water depths following the S1-MarkerBed ventilation event. Possibly, the onset of continuously oxic conditions started slightly earlier at intermediate depth (775 m; 6.6 ± 0.3 cal. ka BP) than at greater depths (1,359 m, 1,908 m; 6.0 ± 0.3 cal. ka BP)