Understanding the structure of changes in the Southern Ocean eddy field

The Southern Ocean is riddled with mesoscale eddies. Although just a few km in size, these loops and vortices are key parts of the climate system, and are important in controlling how ocean circulation responds to changes in forcing. Observations reveal that changes in the intensity of these eddies vary significantly around the Southern Ocean. This contrasts with the nature of the atmospheric forcing, which is more zonally symmetric. Recent progress using high-resolution modeling has pinpointed where intrinsic variability dominates over wind-driven variability, and hence the areas where future responses to climatic changes in forcing are likely to be clearest

Defining and characterizing team resilience in elite sport

Objectives: The objectives of this study were to develop a definition of team resilience and to identify the resilient characteristics of elite sport teams. Design and Method: Focus groups consisting of a total of 31 participants were conducted with five elite teams from a range of sports. An interpretive thematic analysis using inductive and deductive reasoning was employed to analyze the data. Results and Conclusions: Team resilience was defined as a dynamic, psychosocial process which protects a group of individuals from the potential negative effect of the stressors they collectively encounter. It comprises of processes whereby team members use their individual and combined resources to positively adapt when experiencing adversity. Findings revealed four main resilient characteristics of elite sport teams: group structure, mastery approaches, social capital, and collective efficacy. This study extends resilience research in sport psychology by providing greater conceptual clarity of resilience at a team level. The implications of the findings for those conducting research in this area and for those consulting with elite sport teams are discussed

The seasonal cycle of ocean-atmosphere CO2 Flux in Ryder Bay, West Antarctic Peninsula

Approximately 15 million km2 of the Southern Ocean is seasonally ice covered, yet the processes affecting carbon cycling and gas exchange in this climatically important region remain inadequately understood. Here, 3 years of dissolved inorganic carbon (DIC) measurements and carbon dioxide (CO2) fluxes from Ryder Bay on the west Antarctic Peninsula (WAP) are presented. During spring and summer, primary production in the surface ocean promotes atmospheric CO2 uptake. In winter, higher DIC, caused by net heterotrophy and vertical mixing with Circumpolar Deep Water, results in outgassing of CO2 from the ocean. Ryder Bay is found to be a net sink of atmospheric CO2 of 0.59–0.94 mol C m−2 yr−1 (average of 3 years). Seasonal sea ice cover increases the net annual CO2 uptake, but its effect on gas exchange remains poorly constrained. A reduction in sea ice on the WAP shelf may reduce the strength of the oceanic CO2 sink in this region

“You Come Back to the Same Ole Shit:” A Qualitative Study of Smoking Cessation Barriers among Women Living with HIV: Implications for Intervention Development

Although tobacco use among women living with HIV (WLWH) is decreasing, the prevalence is more than double that of women in the general population and remains an important health behavior to target among WLWH. Few smoking cessation interventions specifically focus on the unique social and medical needs of women living with HIV (WLWH). Thus, the investigative team engaged WLWH (N=18) in qualitative focus groups to: 1) understand barriers and facilitators to smoking cessation; and 2) inform intervention structure and content priorities. Participants identified salient reasons for smoking and barriers to smoking cessation, which included coping mechanisms for life stressors, HIV-related stress, HIV-related stigma, and social isolation. Further, WLWH highlighted the importance of long-term smoking cessation support, peer support, mental health content, religion/spirituality, and targeted risk messaging in smoking cessation intervention development. Study findings provide concrete, operational strategies for future use in a theory-based smoking cessation intervention, and underscore the importance of formative research to inform smoking cessation interventions for WLWH

Carbon dynamics of the Weddell Gyre, Southern Ocean

The accumulation of carbon within the Weddell Gyre and its exchanges across the gyre boundaries are investigated with three recent full-depth oceanographic sections enclosing this climatically important region. The combination of carbonmeasurements with ocean circulation transport estimates from a box inverse analysis reveals that deepwater transports associated with Warm Deep Water (WDW) and Weddell Sea Deep Water dominate the gyre’s carbon budget, while a dual-cell vertical overturning circulation leads to both upwelling and the delivery of large quantities of carbon to the deep ocean. Historical sea surface pCO2 observations, interpolated using a neural network technique, confirm the net summertime sink of 0.044 to 0.058 ± 0.010 Pg C / yr derived from the inversion. However, a wintertime outgassing signal similar in size results in a statistically insignificant annual air-to-sea CO2 flux of 0.002± 0.007 Pg C / yr (mean 1998–2011) to 0.012 ± 0.024 Pg C/ yr (mean 2008–2010) to be diagnosed for the Weddell Gyre. A surface layer carbon balance, independently derived fromin situ biogeochemical measurements, reveals that freshwater inputs and biological drawdown decrease surface ocean inorganic carbon levels more than they are increased by WDW entrainment, resulting in an estimated annual carbon sink of 0.033 ± 0.021 Pg C / yr. Although relatively less efficient for carbon uptake than the global oceans, the summertime Weddell Gyre suppresses the winter outgassing signal, while its biological pump and deepwater formation act as key conduits for transporting natural and anthropogenic carbon to the deep ocean where they can reside for long time scales

Implementing telephone triage in general practice: a process evaluation of a cluster randomised controlled trial

Background: Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. However, limited evidence exists of the challenges GP practices face in implementing telephone triage. We conducted a qualitative process evaluation alongside a UK-based cluster randomised trial (ESTEEM) which compared the impact of GP-led and nurse-led telephone triage with usual care on primary care workload, cost, patient experience, and safety for patients requesting a same-day GP consultation. The aim of the process study was to provide insights into the observed effects of the ESTEEM trial from the perspectives of staff and patients, and to specify the circumstances under which triage is likely to be successfully implemented. Here we report perspectives of staff. Methods: The intervention comprised implementation of either GP-led or nurse-led telephone triage for a period of 2-3 months. A qualitative evaluation was conducted using staff interviews recruited from eight general practices (4 GP triage, 4 Nurse triage) in the UK, implementing triage as part of the ESTEEM trial. Qualitative interviews were undertaken with 44 staff members in GP triage and nurse triage practices (16 GPs, 8 nurses, 7 practice managers, 13 administrative staff). Results: Staff reported diverse experiences and perceptions regarding the implementation of telephone triage, its effects on workload, and on the benefits of triage. Such diversity were explained by the different ways triage was organised, the staffing models used to support triage, how the introduction of triage was communicated across practice staff, and by how staff roles were reconfigured as a result of implementing triage. Conclusion: The findings from the process evaluation offer insight into the range of ways GP practices participating in ESTEEM implemented telephone triage, and the circumstances under which telephone triage can be successfully implemented beyond the context of a clinical trial. Staff experiences and perceptions of telephone triage are shaped by the way practices communicate with staff, prepare for and sustain the changes required to implement triage effectively, as well as by existing practice culture, and staff and patient behaviour arising in response to the changes made. Trial registration: Current Controlled Trials ISRCTN20687662. Registered 28 May 2009

Proactive prevention: Act now to disrupt the impending non-communicable disease crisis in low-burden populations

Non-communicable disease (NCD) prevention efforts have traditionally targeted high-risk and high-burden populations. We propose an alteration in prevention efforts to also include emphasis and focus on low-risk populations, predominantly younger individuals and low-prevalence populations. We refer to this approach as “proactive prevention.” This emphasis is based on the priority to put in place policies, programs, and infrastructure that can disrupt the epidemiological transition to develop NCDs among these groups, thereby averting future NCD crises. Proactive prevention strategies can be classified, and their implementation prioritized, based on a 2-dimensional assessment: impact and feasibility. Thus, potential interventions can be categorized into a 2-by-2 matrix: high impact/high feasibility, high impact/ low feasibility, low impact/high feasibility, and low impact/low feasibility. We propose that high impact/high feasibility interventions are ready to be implemented (act), while high impact/low feasibility interventions require efforts to foster buy-in first. Low impact/high feasibility interventions need to be changed to improve their impact while low impact/low feasibility might be best re-designed in the context of limited resources. Using this framework, policy makers, public health experts, and other stakeholders can more effectively prioritize and leverage limited resources in an effort to slow or prevent the evolving global NCD crisis.Fil: Njuguna, Benson. Moi Teaching & Referral Hospital; KeniaFil: Fletcher, Sara L.. State University of Oregon; Estados UnidosFil: Akwanalo, Constantine. Moi Teaching & Referral Hospital; KeniaFil: Asante, Kwaku Poku. Kintampo Health Research Centre; GhanaFil: Baumann, Ana. Washington University in St. Louis; Estados UnidosFil: Brown, Angela. Washington University in St. Louis; Estados UnidosFil: Davila Roman, Victor G.. Washington University in St. Louis; Estados UnidosFil: Dickhaus, Julia. New York University Grossman School of Medicine; Estados UnidosFil: Fort, Meredith. Colorado School Of Public Health; Estados UnidosFil: Iwelunmor, Juliet. Saint Louis University; Estados UnidosFil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Mohan, Sailesh. Centre For Chronic Disease Control; India. Public Health Foundation Of India; IndiaFil: Mutabazi, Vincent. Regional Alliance For Sustainable Development; RuandaFil: Newsome, Brad. Center for Translation Research and Implementation Science; Estados UnidosFil: Ogedegbe, Olugbenga. New York University Grossman School of Medicine; Estados UnidosFil: Pastakia, Sonak D.. Purdue University College Of Pharmacy; Estados UnidosFil: Peprah, Emmanuel K.. University of New York; Estados UnidosFil: Plange Rhule, Jacob. Ghana College Of Physicians And Surgeons; GhanaFil: Roth, Gregory. University of Washington; Estados UnidosFil: Shrestha, Archana. Kathmandu University School Of Medical Sciences; NepalFil: Watkins, David A.. University of Washington; Estados UnidosFil: Vedanthan, Rajesh. New York University Grossman School of Medicine; Estados Unido

Activated macrophages promote hepatitis C virus entry in a tumor necrosis factor-dependent manner

10.1002/hep.26911Hepatology5941320-133

Mesoscale modulation of air-sea CO2 flux in Drake Passage

Author Posting. © American Geophysical Union, 2016. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research: Oceans 121 (2016): 6635–6649, doi:10.1002/2016JC011714.We investigate the role of mesoscale eddies in modulating air-sea CO2 flux and associated biogeochemical fields in Drake Passage using in situ observations and an eddy-resolving numerical model. Both observations and model show a negative correlation between temperature and partial pressure of CO2 (pCO2) anomalies at the sea surface in austral summer, indicating that warm/cold anticyclonic/cyclonic eddies take up more/less CO2. In austral winter, in contrast, relationships are reversed: warm/cold anticyclonic/cyclonic eddies are characterized by a positive/negative pCO2 anomaly and more/less CO2 outgassing. It is argued that DIC-driven effects on pCO2 are greater than temperature effects in austral summer, leading to a negative correlation. In austral winter, however, the reverse is true. An eddy-centric analysis of the model solution reveals that nitrate and iron respond differently to the same vertical mixing: vertical mixing has a greater impact on iron because its normalized vertical gradient at the base of the surface mixed layer is an order of magnitude greater than that of nitrate.NASA High-End Computing (HEC) Program through the NASA Advanced Supercomputing (NAS) Division at Ames Research Center Grant Number: SMD-15-5752; NSF MOBY project Grant Numbers: (OCE-1048926), OCE-1259388, PLR-1341647, AOAS-0944761, and AOAS-066975; NOAA Climate Program Office Grant Number: (NA12OAR4310058)2017-03-1

A multi-stage genome-wide association study of bladder cancer identifies multiple susceptibility loci.

We conducted a multi-stage, genome-wide association study of bladder cancer with a primary scan of 591,637 SNPs in 3,532 affected individuals (cases) and 5,120 controls of European descent from five studies followed by a replication strategy, which included 8,382 cases and 48,275 controls from 16 studies. In a combined analysis, we identified three new regions associated with bladder cancer on chromosomes 22q13.1, 19q12 and 2q37.1: rs1014971, (P = 8 × 10⁻¹²) maps to a non-genic region of chromosome 22q13.1, rs8102137 (P = 2 × 10⁻¹¹) on 19q12 maps to CCNE1 and rs11892031 (P = 1 × 10⁻⁷) maps to the UGT1A cluster on 2q37.1. We confirmed four previously identified genome-wide associations on chromosomes 3q28, 4p16.3, 8q24.21 and 8q24.3, validated previous candidate associations for the GSTM1 deletion (P = 4 × 10⁻¹¹) and a tag SNP for NAT2 acetylation status (P = 4 × 10⁻¹¹), and found interactions with smoking in both regions. Our findings on common variants associated with bladder cancer risk should provide new insights into the mechanisms of carcinogenesis