Midlatitude Oceanic Cloud and Precipitation Properties as Sampled by the ARM Eastern North Atlantic Observatory

An edited version of this paper was published by AGU. Copyright 2019 American Geophysical Union.Marine low clouds are critical to the climate system because of their extensive coverage and associated controls on boundary layer dynamics and radiative energy balance. The primary foci for this study are marine low cloud observations over a heavily instrumented site on the Azores archipelago in the Eastern North Atlantic and their associated raindrop size distribution (DSD) properties, relative low cloud contributions to the precipitation, and additional sampling (instrument, environmental) considerations. The contribution from low clouds (e.g., cloud top < 4 km) to the overall precipitation over midlatitude oceans is poorly understood, in part because of the lack of coupled, high‐quality measurements of precipitation and low cloud properties. Cloud regime and precipitation breakdowns performed for a multiyear (2014–2017) record emphasize diurnal precipitation and raindrop size distribution characteristics for both low and deeper clouds, as well as differences between the two disdrometer types used. Results demonstrate that marine low clouds over this Eastern North Atlantic location account for a significant (45%) contribution to the total rainfall and exhibit a diurnal cycle in cloud (thickness, top, and base) and precipitation characteristics similar to satellite records. Additional controls on observed surface rainfall characteristics of low clouds allowed by the extended ground‐based facility data sets are also explored. From those analyses, it is suggested that the synoptic state exerts a significant control on low cloud and surface precipitation properties

A temperate former West Antarctic ice sheet suggested by an extensive zone of bed channels

Several recent studies predict that the West Antarctic Ice Sheet will become increasingly unstable under warmer conditions. Insights on such change can be assisted through investigations of the subglacial landscape, which contains imprints of former ice-sheet behavior. Here, we present radio-echo sounding data and satellite imagery revealing a series of ancient large sub-parallel subglacial bed channels preserved in the region between the Möller and Foundation Ice Streams, West Antarctica. We suggest that these newly recognized channels were formed by significant meltwater routed along the icesheet bed. The volume of water required is likely substantial and can most easily be explained by water generated at the ice surface. The Greenland Ice Sheet today exemplifies how significant seasonal surface melt can be transferred to the bed via englacial routing. For West Antarctica, the Pliocene (2.6–5.3 Ma) represents the most recent sustained period when temperatures could have been high enough to generate surface melt comparable to that of present-day Greenland. We propose, therefore, that a temperate ice sheet covered this location during Pliocene warm periods

Clinical Public Health Integration in Medical School Curriculum: Transitioning Medical Student Training from Medical Problems to Health Solutions

The current chronic disease burden, growing health disparities, and evolution of our healthcare system require that medical students be equipped with basic public health education to effectively manage patients, navigate the healthcare system, and advocate for health(1,2,3,4,5,6). The Institute of Medicine and the AAMC emphasize the need for physicians to be trained in public health(1,8). The inaugural year of the revised curriculum at The George Washington University School of Medicine and Health Sciences (GW SMHS) represented a first step at the institution to integrate clinical public health into medical education. As part of this process, the Clinical Public Health (CLiPH) Working Group, a student formed curriculum advisory board, was created to give real time feedback and assess the Public Health & Health Policy theme curriculum in the first year at GW SMHS. The project objectives were: 1.) To review and evaluate the effectiveness of the public health theme curriculum in the first year of the revised curriculum, including first year medical students’ perceptions and knowledge of the public health theme. 2.) To develop a proposal to maximize opportunities and achieve better integration of the public health theme into the curriculum. The group aims toward clinical public health integration across the four year medical degree curriculum and better collaboration with the GW Milken School of Public Health (SPH) to create an expanded scope of practice within public health for practicing physicians. Over the summer, the working group engaged with multiple stakeholders to forward the clinical public health agenda at GW SMHS. To conduct the curriculum assessment, the students developed a template and the group reviewed over fifty sessions, in the Public Health & Health Policy Theme, Clinical Skills and Reasoning Course (CSR), and intersession activities. Outside research was done to supplement resources to recommend and improve integration of the clinical public health material into the revised preclinical curriculum. Recommended revisions and developments were sent to faculty stakeholders as resources for the revision process of the curriculum. Future work to revise the curriculum should include study of the evolution of students’ knowledge, attitudes, and beliefs surrounding clinical public health and the impact it has on their development as a physician. To better inform the development of the curriculum and how best to engage students with clinical public health, major stakeholders, such as health departments, community stakeholders, public health experts, and most importantly students should continue to be a part of the dialogue

Connecting Research and Practice: An Experience Report on Research Infusion with SAVE

NASA systems need to be highly dependable to avoid catastrophic mission failures. This calls for rigorous engineering processes including meticulous validation and verification. However, NASA systems are often highly distributed and overwhelmingly complex, making the software portion of these systems challenging to understand, maintain, change, reuse, and test. NASA's systems are long-lived and the software maintenance process typically constitutes 60-80% of the total cost of the entire lifecycle. Thus, in addition to the technical challenges of ensuring high life-time quality of NASA's systems, the post-development phase also presents a significant financial burden. Some of NASA's software-related challenges could potentially be addressed by some of the many powerful technologies that are being developed in software research laboratories. Many of these research technologies seek to facilitate maintenance and evolution by for example architecting, designing and modeling for quality, flexibility, and reuse. Other technologies attempt to detect and remove defects and other quality issues by various forms of automated defect detection, architecture analysis, and various forms of sophisticated simulation and testing. However promising, most such research technologies nevertheless do not make the transition from the research lab to the software lab. One reason the transition from research to practice seldom occurs is that research infusion and technology transfer is difficult. For example, factors related to the technology are sometimes overshadowed by other types of factors such as reluctance to change and therefore prohibits the technology from sticking. Successful infusion might also take very long time. One famous study showed that the discrepancy between the conception of the idea and its practical use was 18 years plus or minus three. Nevertheless, infusing new technology is possible. We have found that it takes special circumstances for such research infusion to succeed: 1) there must be evidence that the technology works in the practitioner's particular domain, 2) there must be a potential for great improvements and enhanced competitive edge for the practitioner, 3) the practitioner has to have strong individual curiosity and continuous interest in trying out new technologies, 4) the practitioner has to have support on multiple levels (i.e. from the researchers, from management, from sponsors etc), and 5) to remain infused, the new technology has to be integrated into the practitioner's processes so that it becomes a natural part of the daily work. NASA IV&V's Research Infusion initiative sponsored by NASA's Office of Safety & Mission Assurance (OSMA) through the Software Assurance Research Program (SARP), strives to overcome some of the problems related to research infusion

Development of an occupational advice intervention for patients undergoing lower limb arthroplasty (the OPAL study)

Background: There are an increasing number of patients of working age undergoing hip and knee replacements. Currently there is variation in the advice and support given about sickness absence, recovery to usual activities and return to work after these procedures. Earlier, sustainable, return to work improves the health of patients and benefits their employers and society. An intervention that encourages and supports early recovery to usual activities, including work, has the potential to reduce the health and socioeconomic burden of hip and knee replacements. Methods/design: A two-phase research programme delivered over 27 months will be used to develop and subsequently test the feasibility of an occupational advice intervention to facilitate return to work and usual activities in patients undergoing lower limb arthroplasty. The 2 phases will incorporate a six-stage intervention mapping process: Phase 1: Intervention mapping stages 1–3: 1 Needs assessment (including rapid evidence synthesis, prospective cohort analysis and structured stakeholder interviews) 2 Identification of intended outcomes and performance objectives 3 Selection of theory-based methods and practical strategies Phase 2: Intervention mapping stages 4–6: 4 Development of components and materials for the occupational advice intervention using a modified Delphi process 5 Adoption and implementation of the intervention 6 Evaluation and feasibility testing The study will be undertaken in four National Health Service (NHS) hospitals in the United Kingdom and two Higher Education Institution. Discussion: OPAL (Occupational advice for Patients undergoing Arthroplasty of the Lower limb) aims to develop an occupational advice intervention to support early recovery to usual activities including work, which is tailored to the requirements of patients undergoing hip and knee replacements. The developed intervention will then be assessed with a specific focus on evaluating its feasibility as a potential trial intervention to improve speed of recovery to usual activities including work

Ethane steam reforming over a platinum/alumina catalyst: effect of sulphur poisoning

In this study we have examined the adsorption of hydrogen sulfide and methanethiol over platinum catalysts and examined the effect of these poisons on the steam reforming of ethane. Adsorption of hydrogen sulfide was measured at 293 and 873 K. At 873 K the adsorbed state of hydrogen sulfide in the presence of hydrogen was SH rather than S, even though the Pt:S ratio was unity. The effect of 11.2 ppm hydrogen sulfide or methanethiol on the steam reforming of ethane was studied at 873 K and 20 barg. Both poisons deactivated the catalyst over a number of hours, but methanethiol was found to be more deleterious, reducing the conversion by almost an order of magnitude, possibly due to the co-deposition of sulfur and carbon. Changes in the selectivity revealed that the effect of sulfur was not uniform on the reactions occurring, with the production of methane reduced proportionally more than the other products, due to the surface sensitivity of the hydrogenolysis and methanation reactions. The water-gas shift reaction was affected to a lesser extent. No regeneration was observed when hydrogen sulfide was removed from the feedstream in agreement with adsorption studies. A slight regeneration was observed when methanethiol was removed from the feed, but this was believed to be due to the removal of carbon rather than sulfur. The overall effect of sulfur poisoning was to reduce activity and enhance hydrogen selectivity

Same-visit HIV testing in Trinidad and Tobago

Abstract Background The Ministry of Health (hereafter, Ministry) of Trinidad and Tobago is responsible for delivery of all health services in the country. The Ministry takes responsibility for direct delivery of care in the public sector and has initiated a process whereby those seeking HIV test results could obtain confidential reports during a single-visit to a testing location. The Ministry requested technical assistance with this process from the Caribbean Epidemiology Centre (CAREC). The United States Centers for Disease Control and Prevention (CDC) played an important role in this process through its partnership with CAREC. Methods Under the technical guidance of CAREC and CDC, the Ministry organized a technical working group which included representatives from key national HIV program services and technical assistance partners. This working group reviewed internationally-recognized best practices for HIV rapid testing and proposed a program that could be integrated into the national HIV programs of Trinidad and Tobago. The working group wrote a consensus protocol, defined certification criteria, prepared training materials and oversaw implementation of "same-visit" HIV testing at two pilot sites. Results A Ministry-of-Health-supported program of "same-visit" HIV testing has been established in Trinidad and Tobago. This program provides confidential testing that is independent of laboratory confirmation. The program allows clients who want to know their HIV status to obtain this information during a single-visit to a testing location. Testers who are certified to provide testing on behalf of the Ministry are also counselors. Non-laboratory personnel have been trained to provide HIV testing in non-laboratory locations. The program includes procedures to assure uniform quality of testing across multiple testing sites. Several procedural and training documents were developed during implementation of this program. This report contains links to those documents. Conclusions The Ministry of Health has implemented a program of "same-visit" HIV testing in Trinidad and Tobago. This program provides clients confidential HIV test reports during a single visit to a testing location. The program is staffed by non-laboratory personnel who are trained to provide both testing and counseling in decentralized (non-laboratory) settings. This approach may serve as a model for other small countries.</p

Differential nutrient limitation and tree height control leaf physiology, supporting niche partitioning in tropical dipterocarp forests

1. Revealing the mechanisms of environmental niche partitioning within lowland tropical forests is important for understanding the drivers of current species distributions and potential vulnerability to environmental change. Tropical forest structure and species composition change across edaphic gradients in Borneo over short distances. However, our understanding of how edaphic conditions affect tree physiology and whether these relationships drive niche partitioning within Bornean forests remains incomplete. 2. This study evaluated how leaf physiological function changes with nutrient availability across a fine-scale edaphic gradient and whether these relationships vary according to tree height. Furthermore, we tested whether intraspecific leaf trait variation allows generalist species to populate a wider range of environments. 3. We measured leaf traits of 218 trees ranging in height from 4 to 66 m from 13 dipterocarp species within four tropical forest types (alluvial, mudstone, sandstone and kerangas) occurring along an <5 km edaphic gradient in North Borneo. The traits measured included saturating photosynthesis (Asat), maximum photosynthetic capacity (Vcmax), leaf dark respiration (Rleaf), leaf mass per area (LMA), leaf thickness, minimum stomatal conductance (gdark) and leaf nutrient concentrations (N, P, Ca, K and Mg). 4. Across all species, leaf traits varied consistently in response to soil nutrient availability across forest types except Rleaf_mass, [Mg]leaf and [Ca]leaf. Changes in photosynthesis and respiration rates were related to different leaf nutrients across forest types, with greater nutrient-use efficiency in more nutrient-poor environments. Generalist species partially or fully compensated reductions in mass-based photosynthesis through increasing LMA in more nutrient-poor environments. 5. Leaf traits also varied with tree height, except Vcmax_mass, but only in response to height-related modifications of leaf morphology (LMA and leaf thickness). These height–trait relationships did not vary across the edaphic gradient, except for Asat, [N]leaf, [P]leaf and [K]leaf. 6. Our results highlight that modification of leaf physiological function and morphology act as important adaptations for Bornean dipterocarps in response to edaphic and vertical environmental gradients. Meanwhile, multiple nutrients appear to contribute to niche partitioning and could drive species distributions and high biodiversity within Bornean forest landscapes