A mathematical framework for analysis of water tracers: Part 1: Development of theory and application to the preindustrial mean state

A new matrix operator framework is developed to analyze results from climate modeling studies that employ numerical water tracers (WTs), which track the movement of water in the aerial hydrological cycle from evaporation to precipitation. Model WT output is related to the fundamental equation of hydrology, and the moisture flux divergence is subdivided into the divergence of locally evaporated moisture and the convergence of remotely evaporated moisture. The formulation also separates locally and remotely sourced precipitation. The remote contribution (also the remote moisture convergence) may be further subdivided into zonal, meridional, intrabasin, and interbasin parts. This framework is applied to the preindustrial climate as simulated by a global climate model in which water has been tagged in 10° latitude bands in each of the major ocean basins, and in which each major land mass has been tagged separately. New insights from the method reveal fundamental differences between the major ocean basins in locally sourced precipitation, remotely sourced precipitation, and their relative partitioning. Per unit area, the subtropical Atlantic is the largest global moisture source, providing precipitable water to adjacent land areas and to the eastern Pacific tropics while retaining the least for in situ precipitation. Subtropical moisture is least divergent over the Pacific, which is the smallest moisture source (per unit area) for global land areas. Basins also differ in how subtropical moisture is partitioned between tropical, midlatitude, and land regions. Part II will apply this framework to hydrological cycle perturbations due to CO₂ doubling.Keywords: linear algebra, numerical water tracers, hydrologic cycle, big data analysis, matrix operatorKeywords: linear algebra, numerical water tracers, hydrologic cycle, big data analysis, matrix operato

A cobalt complex redox shuttle for dye-sensitized solar cells with high open-circuit potentials

Dye-sensitized solar cells are a promising alternative to traditional inorganic semiconductor-based solar cells. Here we report an open-circuit voltage of over 1,000 mV in mesoscopic dye-sensitized solar cells incorporating a molecularly engineered cobalt complex as redox mediator. Cobalt complexes have negligible absorption in the visible region of the solar spectrum, and their redox properties can be tuned in a controlled fashion by selecting suitable donor/acceptor substituents on the ligand. This approach offers an attractive alternate to the traditional I3−/I− redox shuttle used in dye-sensitized solar cells. A cobalt complex using tridendate ligands [Co(bpy-pz)2]3+/2+(PF6)3/2 as redox mediator in combination with a cyclopentadithiophene-bridged donor-acceptor dye (Y123), adsorbed on TiO2, yielded a power conversion efficiency of over 10% at 100 mW cm−2. This result indicates that the molecularly engineered cobalt redox shuttle is a legitimate alternative to the commonly used I3−/I− redox shuttle

Hydroclimate footprint of pan-Asian monsoon water isotope during the last deglaciation

Oxygen isotope speleothem records exhibit coherent variability over the pan-Asian summer monsoon (AM) region. The hydroclimatic representation of these oxygen isotope records for the AM, however, has remained poorly understood. Here, combining an isotope-enabled Earth system model in transient experiments with proxy records, we show that the widespread AM delta O-18(c) signal during the last deglaciation (20 to 11 thousand years ago) is accompanied by a continental-scale, coherent hydroclimate footprint, with spatially opposite signs in rainfall. This footprint is generated as a dynamically coherent response of the AM system primarily to meltwater forcing and secondarily to insolation forcing and is further reinforced by atmospheric teleconnection. Hence, widespread delta O-18(p) depletion in the AM region is accompanied by a northward migration of the westerly jet and enhanced southwesterly monsoon wind, as well as increased rainfall from South Asia (India) to northern China but decreased rainfall in southeast China

Tracking the Strength of the Walker Circulation With Stable Isotopes in Water Vapor

General circulation models (GCMs) predict that the global hydrological cycle will change in response to anthropogenic warming. However, these predictions remain uncertain, in particular, for precipitation (Intergovernmental Panel on Climate Change, 2013, https://doi .org/10.1017/CB09781107415324.004). Held and Soden (2006, https://doi.org/10.1175/JCLI3990.1) suggest that as lower tropospheric water vapor concentration increases in a warming climate, the atmospheric circulation and convective mass fluxes will weaken. Unfortunately, this process is difficult to constrain, as convective mass fluxes are poorly observed and incompletely simulated in GCMs. Here we demonstrate that stable hydrogen isotope ratios in tropical atmospheric water vapor can trace changes in temperature, atmospheric circulation, and convective mass flux in a warming world. We evaluate changes in temperature, the distribution of water vapor, vertical velocity (omega), advection, and water isotopes in vapor (delta D-v). Using water isotope-enabled GCM experiments for modern versus high-CO2 atmospheres, we identify spatial patterns of circulation change over the tropical Pacific. We find that slowing circulation in the tropical Pacific moistens the lower troposphere and weakens convective mass flux, both of which impact the delta D of water vapor in the midtroposphere. Our findings constitute a critical demonstration of how water isotope ratios in the tropical Pacific respond to changes in radiative forcing and atmospheric warming. Moreover, as changes in delta D-v can be observed by satellites, our results develop new metrics for the detection of global warming impacts to the hydrological cycle and, specifically, the strength of the Walker circulation

Efficacy and safety of acoziborole in patients with human African trypanosomiasis caused by Trypanosoma brucei gambiense: a multicentre, open-label, single-arm, phase 2/3 trial

Summary Background Human African trypanosomiasis caused by Trypanosoma brucei gambiense (gambiense HAT) in patients with late-stage disease requires hospital admission to receive nifurtimox-eflornithine combination therapy (NECT). Fexinidazole, the latest treatment that has been recommended by WHO, also requires systematic admission to hospital, which is problematic in areas with few health-care resources. We aim to assess the safety and efficacy of acoziborole in adult and adolescent patients with gambiense HAT. Methods This multicentre, prospective, open-label, single-arm, phase 2/3 study recruited patients aged 15 years or older with confirmed gambiense HAT infection from ten hospitals in the Democratic Republic of the Congo and Guinea. Inclusion criteria included a Karnofsky score less than 50, ability to swallow tablets, a permanent address or traceability, ability to comply with follow-up visits and study requirements, and agreement to hospital admission during treatment. Oral acoziborole was administered as a single 960 mg dose (3 × 320 mg tablets) to fasted patients. Patients were observed in hospital until day 15 after treatment administration then for 18 months as outpatients with visits at 3, 6, 12, and 18 months. The primary efficacy endpoint was the success rate of acoziborole treatment at 18 months in patients with late-stage gambiense HAT (modified intention-to-treat [mITT] population), based on modified WHO criteria. A complementary post-hoc analysis comparing the 18-month success rates for acoziborole and NECT (using historical data) was performed. This study is registered at ClinicalTrials.gov, NCT03087955. Findings Between Oct 11, 2016, and March 25, 2019, 260 patients were screened, of whom 52 were ineligible and 208 were enrolled (167 with late-stage and 41 with early-stage or intermediate-stage gambiense HAT; primary efficacy analysis set). All 41 (100%) patients with early-stage or intermediate-stage and 160 (96%) of 167 with late-stage disease completed the last 18-month follow-up visit. The mean age of participants was 34·0 years (SD 12·4), including 117 (56%) men and 91 (44%) women. Treatment success rate at 18 months was 95·2% (95% CI 91·2-97·7) reached in 159 of 167 patients with late-stage gambiense HAT (mITT population) and 98·1% (95·1-99·5) reached in 159 of 162 patients (evaluable population). Overall, 155 (75%) of 208 patients had 600 treatment-emergent adverse events. A total of 38 drug-related treatment-emergent adverse events occurred in 29 (14%) patients; all were mild or moderate and most common were pyrexia and asthenia. Four deaths occurred during the study; none were considered treatment related. The post-hoc analysis showed similar results to the estimated historical success rate for NECT of 94%. Interpretation Given the high efficacy and favourable safety profile, acoziborole holds promise in the efforts to reach the WHO goal of interrupting HAT transmission by 2030. Funding Bill & Melinda Gates Foundation, UK Aid, Federal Ministry of Education and Research, Swiss Agency for Development and Cooperation, Médecins Sans Frontières, Dutch Ministry of Foreign Affairs, Norwegian Agency for Development Cooperation, Norwegian Ministry of Foreign Affairs, the Stavros Niarchos Foundation, Spanish Agency for International Development Cooperation, and the Banco Bilbao Vizcaya Argentaria Foundation. Translation For the French translation of the abstract see Supplementary Materials section

Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia

BACKGROUND: Community-acquired pneumonia (CAP) is the most frequent infection-related cause of death. The reference standard to diagnose CAP is a new infiltrate on chest radiograph in the presence of recently acquired respiratory signs and symptoms. This study aims to evaluate the diagnostic and prognostic accuracy of clinical signs and symptoms and laboratory biomarkers for CAP. METHODS: 545 patients with suspected lower respiratory tract infection, admitted to the emergency department of a university hospital were included in a pre-planned post-hoc analysis of two controlled intervention trials. Baseline assessment included history, clinical examination, radiography and measurements of procalcitonin (PCT), highly sensitive C-reactive protein (hsCRP) and leukocyte count. RESULTS: Of the 545 patients, 373 had CAP, 132 other respiratory tract infections, and 40 other final diagnoses. The AUC of a clinical model including standard clinical signs and symptoms (i.e. fever, cough, sputum production, abnormal chest auscultation and dyspnea) to diagnose CAP was 0.79 [95% CI, 0.75–0.83]. This AUC was significantly improved by including PCT and hsCRP (0.92 [0.89–0.94]; p < 0.001). PCT had a higher diagnostic accuracy (AUC, 0.88 [0.84–0.93]) in differentiating CAP from other diagnoses, as compared to hsCRP (AUC, 0.76 [0.69–0.83]; p < 0.001) and total leukocyte count (AUC, 0.69 [0.62–0.77]; p < 0.001). To predict bacteremia, PCT had a higher AUC (0.85 [0.80–0.91]) as compared to hsCRP (p = 0.01), leukocyte count (p = 0.002) and elevated body temperature (p < 0.001). PCT, in contrast to hsCRP and leukocyte count, increased with increasing severity of CAP, as assessed by the pneumonia severity index (p < 0.001). CONCLUSION: PCT, and to a lesser degree hsCRP, improve the accuracy of currently recommended approaches for the diagnosis of CAP, thereby complementing clinical signs and symptoms. PCT is useful in the severity assessment of CAP