Earth's Energy Imbalance and Implications

Improving observations of ocean heat content show that Earth is absorbing more energy from the sun than it is radiating to space as heat, even during the recent solar minimum. The inferred planetary energy imbalance, 0.59 \pm 0.15 W/m2 during the 6-year period 2005-2010, confirms the dominant role of the human-made greenhouse effect in driving global climate change. Observed surface temperature change and ocean heat gain together constrain the net climate forcing and ocean mixing rates. We conclude that most climate models mix heat too efficiently into the deep ocean and as a result underestimate the negative forcing by human-made aerosols. Aerosol climate forcing today is inferred to be 1.6 \pm 0.3 W/m2, implying substantial aerosol indirect climate forcing via cloud changes. Continued failure to quantify the specific origins of this large forcing is untenable, as knowledge of changing aerosol effects is needed to understand future climate change. We conclude that recent slowdown of ocean heat uptake was caused by a delayed rebound effect from Mount Pinatubo aerosols and a deep prolonged solar minimum. Observed sea level rise during the Argo float era is readily accounted for by ice melt and ocean thermal expansion, but the ascendency of ice melt leads us to anticipate acceleration of the rate of sea level rise this decade.Comment: 39 pages, 18 figures; revised version submitted to Atmos. Chem. Phy

Interprofessional training for nursing and medical students in Norway : exploring different professional perspectives.

This article presents an explorative case study focusing on interprofessional training for medical and nursing students in Norway. Based on interviews with, and observations of, multiple stakeholder groups-students, university faculty, and hospital staff-content analysis was applied to investigate their perspectives regarding the design of such educational training. The findings revealed a positive perspective amongst stakeholders while voicing some concerns related to how communication issues, collaboration, workflow, and professional role patterns should be reflected in such training. Based on our data analysis we derive three themes that must be considered for successful interprofessional training of nursing and medical students: clinical professionalism, team performance, and patient-centered perspective. These themes must be balanced contingent on the students' background and the learning objectives of future interprofessional training efforts

Ultra-broadband photon pair preparation by spontaneous four wave mixing in dispersion-engineered optical fiber

We present a study of the spectral properties of photon pairs generated through the process of spontaneous four wave mixing (SFWM) in single mode fiber. Our analysis assumes narrowband pumps, which are allowed to be frequency-degenerate or non-degenerate. Based on this analysis, we derive conditions on the pump frequencies and on the fiber dispersion parameters which guarantee the generation of ultra-broadband photon pairs. Such photon pairs are characterized by: i) a very large degree of entanglement, and ii) a very high degree of temporal synchronization between the signal and idler photons. Through a numerical exercise, we find that the use of photonic crystal fiber (PCF) facilitates the fulfilment of the conditions for ultra-broadband photon pair generation; in particular, the spectral region in which emission occurs can be adjusted to particular needs through an appropriate choice of the PCF parameters. In addition, we present a novel quantum interference effect, resulting from indistinguishable pathways to the same outcome, which can occur when pumping a SFWM source with multiple spectral lines.Comment: 15 pages, 10 figures. To be published in Phys. Rev.

Temporal and regional differences in the incidence of hospital-diagnosed endometriosis:a Danish population-based study

INTRODUCTION: Due to diagnostic challenges, normalization of symptoms and an overall lack of awareness among both patients and physicians, endometriosis is an underdiagnosed disease. This can result in delayed treatment and potentially worsening of the disease. Despite initiatives, such as patients' support organizations and specialized endometriosis referral centers, differences in awareness, socioeconomic factors and lifestyle, combined with varying distances to specialized referral centers, could result in regional differences in the degree of underdiagnosing. This study aims to explore temporal and regional variations in the incidence of endometriosis based on the Danish hospital discharge register, and shed light on the degree of underdiagnosing of endometriosis in Denmark. MATERIAL AND METHODS: This registry‐based cohort study included all women aged 15–55 living in Denmark from 1990–2017. Participants were identified through the Danish Civil Registration system and endometriosis diagnoses received at a hospital were obtained from the Danish National Patient Registry. Incidence rates of diagnosed endometriosis were calculated for each year of the study period and for each municipality in Denmark. A Cox regression analysis, stratified by calendar time and adjusted for ethnic origin, household composition, highest educational level and family socioeconomic status, was performed to estimate the association between residence and likelihood of receiving a hospital‐based diagnosis of endometriosis. RESULTS: The nationwide incidence rate of hospital‐diagnosed endometriosis was 7.89 (95% confidence interval [CI] 7.80–7.99) per 10 000 person‐years and the prevalence in 2017 was 1.63%. The results showed an overall increase in the incidence of diagnosed endometriosis of 46.8% (95% CI 32.9–62.2) during the study period and also displayed significant regional differences. After adjustments, women living in northern Jutland had the highest probability of receiving a hospital‐based diagnosis of endometriosis (hazard ratio 1.13, 95% CI 1.09–1.18), whereas women living in northern Zealand had the lowest probability (hazard ratio 0.63, 95% CI 0.60–0.67) compared with eastern Jutland. These regional differences have become more evident over time. CONCLUSIONS: Our results reveal significant regional differences in the incidence of hospital‐diagnosed endometriosis, suggesting that a significant number of women may be left behind without a diagnosis. Further studies are needed to assess the underlying reasons for the significant regional differences