166 research outputs found

    Dominant patterns of boreal summer interactions between tropics and mid-latitude: causal relationships and the role of timescales

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    Tropical convective activity represents a source of predictability for mid-latitude weather in the Northern Hemisphere. In winter, the El Niño–Southern Oscillation (ENSO) is the dominant source of predictability in the tropics and extra-tropics, but its role in summer is much less pronounced and the exact teleconnection pathways are not well understood. Here, we assess how tropical convection interacts with mid-latitude summer circulation at different intraseasonal time-scales and how ENSO affects these interactions. First, we apply maximum covariance analysis (MCA) between tropical convective activity and mid-latitude geopotential height fields to identify the dominant modes of interaction. The first MCA mode connects the South Asian monsoon with the mid-latitude circumglobal teleconnection pattern. The second MCA mode connects the western North Pacific summer monsoon in the tropics with a wave-5 pattern centred over the North Pacific High in the mid-latitudes. We show that the MCA patterns are fairly insensitive to the selected intraseasonal time-scale from weekly to 4-weekly data. To study the potential causal interdependencies between these modes and with other atmospheric fields, we apply causal effect networks (CEN) at different time-scales. CENs extend standard correlation analysis by removing the confounding effects of autocorrelation, indirect links and common drivers. In general, there is a two-way causal interaction between the tropics and mid-latitudes but the strength and sometimes sign of the causal link are time-scale dependent. We introduce causal maps that plot the regionally specific causal effect from each MCA mode. Those maps confirm the dominant patterns of interaction and in addition, highlight specific mid-latitude regions that are most strongly connected to tropical convection. In general, the identified causal teleconnection patterns are only mildly affected by ENSO and the tropical-mid-latitude linkages remain similar. Still, La Niña strengthens the South Asian monsoon generating a stronger response in the mid-latitudes, while during El Niño years, the Pacific pattern is reinforced. This study paves the way for process-based validation of boreal summer teleconnections in (sub)seasonal forecast models and climate models and therefore helps to improve sub-seasonal and climate projections

    Information seeking behavioural paths of physicians for diabetes mellitus care: a qualitative comparative analysis of information needs, sources, and barriers

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    This study addresses diabetes physicians’ information seeking behavioural paths (digital, conventional, interpersonal) which lead to information needs satisfaction and the barriers encountered in this process. The study was based on empirical evidence from a survey of 159 physicians. Theoretical analysis was informed by Wilson’s model of information seeking behaviour. The data were analysed using fuzzy set qualitative comparative analysis method. The method was successful in identifying five behavioural paths leading to physicians’ information needs satisfaction (professional/health coaching) which demonstrate different relationships between information sources (conventional/interpersonal/digital) and information barriers (personal/digital illiteracy) and five behavioural paths that are not leading to satisfaction

    Agreement between reconstructed and modeled boreal precipitation of the Last Interglacial

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    The last extended time period when climate may have been warmer than today was during the Last Interglacial (LIG; ca. 129 to 120 thousand years ago). However, a global view of LIG precipitation is lacking. Here, seven new LIG climate models are compared to the first global database of proxies for LIG precipitation. In this way, models are assessed in their ability to capture important hydroclimatic processes during a different climate. The models can reproduce the proxy-based positive precipitation anomalies from the preindustrial period over much of the boreal continents. Over the Southern Hemisphere, proxy-model agreement is partial. In models, LIG boreal monsoons have 42% wider area than in the preindustrial and produce 55% more precipitation and 50% more extreme precipitation. Austral monsoons are weaker. The mechanisms behind these changes are consistent with stronger summer radiative forcing over boreal high latitudes and with the associated higher temperatures during the LIG

    A charter to improve patient care in severe asthma

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    Severe asthma is a subtype of asthma that is difficult to treat and control. By conservative estimates, severe asthma affects approximately 5-10% of patients with asthma worldwide. Severe asthma impairs patients' health-related quality of life, and patients are at risk of life-threatening asthma attacks. Severe asthma also accounts for the majority of health care expenditures associated with asthma. Guidelines recommend that patients with severe asthma be referred to a specialist respiratory team for correct diagnosis and expert management. This is particularly important to ensure that they have access to newly available biologic treatments. However, many patients with severe asthma can suffer multiple asthma attacks and wait several years before they are referred for specialist care. As global patient advocates, we believe it is essential to raise awareness and understanding for patients, caregivers, health care professionals, and the public about the substantial impact of severe asthma and to create opportunities for improving patient care. Patients should be empowered to live a life free of symptoms and the adverse effects of traditional medications (e.g., oral corticosteroids), reducing hospital visits and emergency care, the loss of school and work days, and the constraints placed on their daily lives. Here we provide a Patient Charter for severe asthma, consisting of six core principles, to mobilize national governments, health care providers, payer policymakers, lung health industry partners, and patients/caregivers to address the unmet need and burden in severe asthma and ultimately work together to deliver meaningful improvements in care.Funding for this study, the article processing charges, and the open access charge was provided by AstraZeneca

    Climatic risks and impacts in South Asia: extremes of water scarcity and excess

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    This paper reviews the current knowledge of climatic risks and impacts in South Asia associated with anthropogenic warming levels of 1.5°C to 4°C above pre-industrial values in the 21st century. It is based on the World Bank Report “Turn Down the Heat, Climate Extremes, Regional Impacts and the Case for Resilience” (2013). Many of the climate change impacts in the region, which appear quite severe even with relatively modest warming of 1.5–2°C, pose significant hazards to development. For example, increased monsoon variability and loss or glacial meltwater will likely confront populations with ongoing and multiple challenges. The result is a significant risk to stable and reliable water resources for the region, with increases in peak flows potentially causing floods and dry season flow reductions threatening agriculture. Irrespective of the anticipated economic development and growth, climate projections indicate that large parts of South Asia’s growing population and especially the poor are likely to remain highly vulnerable to climate change

    Projected changes of rainfall seasonality and dry spells in a high greenhouse gas emissions scenario

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    In this diagnostic study we analyze changes of rainfall seasonality and dry spells by the end of the twenty-first century under the most extreme IPCC5 emission scenario (RCP8.5) as projected by twenty-four coupled climate models contributing to Coupled Model Intercomparison Project 5 (CMIP5). We use estimates of the centroid of the monthly rainfall distribution as an index of the rainfall timing and a threshold-independent, information theory-based quantity such as relative entropy (RE) to quantify the concentration of annual rainfall and the number of dry months and to build a monsoon dimensionless seasonality index (DSI). The RE is projected to increase, with high inter-model agreement over Mediterranean-type regions---southern Europe, northern Africa and southern Australia---and areas of South and Central America, implying an increase in the number of dry days up to 1Â month by the end of the twenty-first century. Positive RE changes are also projected over the monsoon regions of southern Africa and North America, South America. These trends are consistent with a shortening of the wet season associated with a more prolonged pre-monsoonal dry period. The extent of the global monsoon region, characterized by large DSI, is projected to remain substantially unaltered. Centroid analysis shows that most of CMIP5 projections suggest that the monsoonal annual rainfall distribution is expected to change from early to late in the course of the hydrological year by the end of the twenty-first century and particularly after year 2050. This trend is particularly evident over northern Africa, southern Africa and western Mexico, where more than 90% of the models project a delay of the rainfall centroid from a few days up to 2Â weeks. Over the remaining monsoonal regions, there is little inter-model agreement in terms of centroid changes

    Natural hazards in Australia: heatwaves

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    As part of a special issue on natural hazards, this paper reviews the current state of scientific knowledge of Australian heatwaves. Over recent years, progress has been made in understanding both the causes of and changes to heatwaves. Relationships between atmospheric heatwaves and large-scale and synoptic variability have been identified, with increasing trends in heatwave intensity, frequency and duration projected to continue throughout the 21st century. However, more research is required to further our understanding of the dynamical interactions of atmospheric heatwaves, particularly with the land surface. Research into marine heatwaves is still in its infancy, with little known about driving mechanisms, and observed and future changes. In order to address these knowledge gaps, recommendations include: focusing on a comprehensive assessment of atmospheric heatwave dynamics; understanding links with droughts; working towards a unified measurement framework; and investigating observed and future trends in marine heatwaves. Such work requires comprehensive and long-term collaboration activities. However, benefits will extend to the international community, thus addressing global grand challenges surrounding these extreme events

    Deprescribing benzodiazepines and Z-drugs in community-dwelling adults: a scoping review

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