Aeolus wind lidar observations of the 2019/2020 Quasi-Biennial Oscillation disruption with comparison to radiosondes and reanalysis

The quasi-biennial oscillation (QBO) was unexpectedly disrupted for only the second time in the historical record during the 2019/20 boreal winter. As the dominant mode of atmospheric variability in the tropical stratosphere, and a significant source of seasonal predictability globally, understanding the drivers behind this unusual behaviour is very important. Here, novel data from Aeolus, the first Doppler wind lidar in space, is used to observe the 2019/20 QBO disruption. Aeolus is the first satellite able to observe winds at high resolution on a global scale, and is therefore a uniquely capable platform for studying the evolution of the disruption and the broader circulation changes triggered by it. This study therefore contains the first direct wind observations of the QBO from space, and exploits measurements from a special Aeolus scanning mode, implemented to observe this disruption as it happened. Aeolus observes easterly winds of up to 20 ms&minus;1 in the core of the disruption jet during July 2020. By co-locating with radiosonde measurements from Singapore and ERA5 reanalysis, like-for-like comparisons of the observed wind structures in the tropical stratosphere are produced, showing equatorial Kelvin wave activity and key parts of the Walker Circulation during the disruption period. The onset of the disruption easterly jet occurs 5 days earlier in Aeolus observations compared with the reanalysis. This analysis highlights how Aeolus and future Doppler wind lidar satellites can deepen our understanding of the QBO, its disruptions, and the tropical upper-troposphere lower-stratosphere region more generally.</p

Atmospheric Gravity Waves in Aeolus Wind Lidar Observations

Abstract Aeolus is the first Doppler wind lidar in space. It provides unique high-resolution measurements of horizontal wind in the sparsely-observed upper-troposphere/lower-stratosphere (UTLS), with global coverage. In this study, Aeolus’ ability to resolve atmospheric gravity waves (GWs) is demonstrated. The accurate representation of these small-scale waves is vital to properly simulate dynamics in global weather and climate models. In a case study over the Andes, Aeolus GW measurements show coherent phase structure from the surface to the lower stratosphere, with wind perturbations > 10 ms−1, a vertical wavelength ∼8 km and an along-track horizontal wavelength ∼900 km. Good agreement is found between Aeolus and colocated satellite, ground-based lidar and reanalysis data sets for this example. Our results show that data from satellites of this type can provide unique information on GW sources and propagation in the UTLS, filling a key knowledge gap that underlies known major deficiencies in weather and climate modelling

Impact of general practice endorsement on the social gradient in uptake in bowel cancer screening

This is a summary of independent research funded by the National Institute for Health. Research (NIHR)’s Programme Grants for Applied Research Programme (RP-PG-0609–10106

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Operational use of spaceborne lidar datasets

The Met Office plans to use space lidar datasets from CALIPSO, CATS, Aeolus and EarthCARE operationally in near real time (NRT), for the detection of aerosols. The first step is the development of NRT imagery for nowcasting of volcanic events, air quality, and mineral dust episodes. Model verification and possibly assimilation will be explored. Assimilation trials of Aeolus winds are also planned. Here we will present our first in-house imagery and our operational requirements

Atmospheric Gravity Waves in Aeolus Wind Lidar Observations

Abstract Aeolus is the first Doppler wind lidar in space. It provides unique high-resolution measurements of horizontal wind in the sparsely-observed upper-troposphere/lower-stratosphere (UTLS), with global coverage. In this study, Aeolus’ ability to resolve atmospheric gravity waves (GWs) is demonstrated. The accurate representation of these small-scale waves is vital to properly simulate dynamics in global weather and climate models. In a case study over the Andes, Aeolus GW measurements show coherent phase structure from the surface to the lower stratosphere, with wind perturbations > 10 ms−1, a vertical wavelength ∼8 km and an along-track horizontal wavelength ∼900 km. Good agreement is found between Aeolus and colocated satellite, ground-based lidar and reanalysis data sets for this example. Our results show that data from satellites of this type can provide unique information on GW sources and propagation in the UTLS, filling a key knowledge gap that underlies known major deficiencies in weather and climate modelling

Physiotherapy at high amputations as a complication of diabetes mellitus

A topic of this bachelor thesis is "Physiotherapy at high amputations as a complication of diabetes mellitus." Diabetes mellitus is a chronic, etiopathogenically heterogeneous disease. It arises from the lack of an insulin action at its absolute or relative absence and it is accompanied by a complex metabolic disorder of sugars, fats and proteins. Long-term vascular complications, which can lead to an amputation, gradually develop on the basis of this disease. An introductory part of the current state is focused on the characteristic of diabetes mellitus, its classification, risk factors, pathogenesis, course and its complications. The other part is focused on the problem of amputations and the last part of the current state is focused on used examination methods and physiotherapeutic procedures. A goal of the research part was to evaluate a usage of physiotherapeutic methods at patients with the high amputation as a complication of diabetes mellitus and a possibility to integrate these patients into a life in the highest possible quality. I used, for the practical part of the bachelor thesis, methods of the qualitative research, the case study and an analysis of personal documents. The tested sample consisted of two patients with the high amputation, which was indicated because of complications of diabetes mellitus. The patients were monitored during their hospitalization in the rehabilitation ward or in the successive care ward of the hospital in České Budějovice. The results have been worked up in the form of case reports. The health status of all patients was at least partially improved and it came about their better integration into the society. It is therefore possible to say that rehabilitation goals were met. The bachelor thesis can be used in the actual work of physiotherapists or as a basis for their further scientific research. Then it can be used by patients themselves or by their close people in dealing with this handicap