A baroclinic western boundary current over a continental slope

Baroclinic flow over a western continental slope is investigated using a simple model in which inertia is completely neglected and the temperature of the ocean depends only on horizontal position. Solutions of this model are also solutions of the three-dimensional equations without inertia. This model is arguably the simplest model in which the Joint Effect of Baroclinicity and Relief (JEBAR) can affect the mass transport on the slope. Offshore, we suppose that a classical double-gyre circulation exists, in which the subpolar gyre is colder than the subtropical gyre. Using asymptotic expansions based on small viscosity and small thermal diffusivity, we show analytically that a thin baroclinic current, or front, forms on the slope. The baroclinic current flows across the slope from south to north and shallow to deep. Recirculating gyres are formed on both flanks of the current, and the extent to which both the baroclinic current and the gyres resemble the observed flow in the Western North Atlantic is discussed

A simple model of the ‘joint effect of baroclinicity and relief’ on ocean circulation

We offer a simple model for studying the joint effect of baroclinicity and relief (jebar) on large-scale ocean circulation, based upon the planetary geostrophic equations. Applying a Galerkin approximation to the buoyancy equation, and asssuming that the temperature diffusion and vertical stratification are weak, we obtain a simple relation between the ocean temperature and the streamfunction ψ for the vertically-averaged horizontal transport. Substituting this relation back into the vertically-averaged vorticity equation yields a single, generally nonlinear equation for ψ, in which jebar corresponds to a clockwise ‘advection’ of ψ along the continental slope (for the realistic case of temperature increasing with ψ). Numerical solutions resemble those obtained by Salmon (1994) using a more accurate model, and provide a physically transparent explanation for the northward excursion of the Gulf Stream along the western continental slope observed in the previous study

Weed Control in Rice.

4 p

Weed Control in Rice.

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Three-dimensional acoustic scattering by vortical flows. II. Axisymmetric scattering by Hill’s spherical vortex

The general theory of Part I is applied to the the specific case of scattering of a wave incident along the axis of Hill’s spherical vortex. The full asymptotic solution to the initial-value problem is calculated. Results agree with the general approach, showing that the conditions required for the latter to hold apply in the case of Hill’s spherical vortex

Effect of antihypertensive deprescribing on hospitalisation and mortality: long-term follow-up of the OPTiMISE randomised controlled trial

Background: Deprescribing of antihypertensive medications is recommended for some older patients with low blood pressure and frailty. The OPTiMISE trial showed that this deprescribing can be achieved with no differences in blood pressure control at 3 months compared with usual care. We aimed to examine effects of deprescribing on longer-term hospitalisation and mortality. Methods: This randomised controlled trial enrolled participants from 69 general practices across central and southern England. Participants aged 80 years or older, with systolic blood pressure less than 150 mm Hg and who were receiving two or more antihypertensive medications, were randomly assigned (1:1) to antihypertensive medication reduction (removal of one antihypertensive) or usual care. General practitioners and participants were aware of the treatment allocation following randomisation but individuals responsible for analysing the data were masked to the treatment allocation throughout the study. Participants were followed up via their primary and secondary care electronic health records at least 3 years after randomisation. The primary outcome was time to all-cause hospitalisation or mortality. Intention-to-treat analyses were done using Cox regression modelling. A per-protocol analysis of the primary outcome was also done, excluding participants from the intervention group who did not reduce treatment or who had medication reinstated during the initial trial 12-week follow-up period. This study is registered with the European Union Drug Regulating Authorities Clinical Trials Database (EudraCT2016-004236-38) and the ISRCTN Registry (ISRCTN97503221). Findings: Between March 20, 2017, and Sept 30, 2018, a total of 569 participants were randomly assigned. Of these, 564 (99%; intervention=280; control=284) were followed up for a median of 4·0 years (IQR 3·7–4·3). Participants had a mean age of 84·8 years (SD 3·4) at baseline and 273 (48%) were women. Medication reduction was sustained in 109 participants at follow-up (51% of the 213 participants alive in the intervention group). Participants in the intervention group had a larger reduction in antihypertensives than the control group (adjusted mean difference –0·35 drugs [95% CI –0·52 to –0·18]). Overall, 202 (72%) participants in the intervention group and 218 (77%) participants in the control group experienced hospitalisation or mortality during follow-up (adjusted hazard ratio [aHR] 0·93 [95% CI 0·76 to 1·12]). There was some evidence that the proportion of participants experiencing the primary outcome in the per-protocol population was lower in the intervention group (aHR 0·80 [0·64 to 1·00]). Interpretation: Half of participants sustained medication reduction with no evidence of an increase in all-cause hospitalisation or mortality. These findings suggest that an antihypertensive deprescribing intervention might be safe for people aged 80 years or older with controlled blood pressure taking two or more antihypertensives

Health Care Inflation and It\u27s Implications for Monetary Policy

Motivated by recent findings on the cyclical movement of both health and health spending, we construct a general equilibrium model that distinguishes health care demand from the demand for other goods. Using this model, we are able to generate inflation dynamics and cyclicality of health that match the US data. When the model is subjected to an expansionary monetary policy shock, it yields different output and inflation responses compared with a two-sector model with homogeneous demand. We show that the trade-off between leisure and health spending plays an important role in model dynamics. The model further predicts different degrees of inflation stabilization across sectors when a shift in the monetary policy occurs