The effects of mesoscale ocean–atmosphere coupling on the large-scale ocean circulation

Author Posting. © American Meteorological Society, 2009. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Climate 22 (2009): 4066–4082, doi:10.1175/2009JCLI2629.1.Small-scale variation in wind stress due to ocean–atmosphere interaction within the atmospheric boundary layer alters the temporal and spatial scale of Ekman pumping driving the double-gyre circulation of the ocean. A high-resolution quasigeostrophic (QG) ocean model, coupled to a dynamic atmospheric mixed layer, is used to demonstrate that, despite the small spatial scale of the Ekman-pumping anomalies, this phenomenon significantly modifies the large-scale ocean circulation. The primary effect is to decrease the strength of the nonlinear component of the gyre circulation by approximately 30%–40%. This result is due to the highest transient Ekman-pumping anomalies destabilizing the flow in a dynamically sensitive region close to the western boundary current separation. The instability of the jet produces a flux of potential vorticity between the two gyres that acts to weaken both gyres.AH and WD were supported by an ARC Linkage International Grant (LX0668781). WD was also supported by NSF Grants OCE 0424227 and OCE 0550139. Funding for PB was provided by NSF Grants OCE 0344094 and OCE 0725796 and by the research grant from the Newton Trust of the University of Cambridge. SK was supported by U.S. DOE Grant DE-FG02–02ER63413 and NASA Grant NNG-06- AG66G-1

The wineglass effect shapes particle export to the deep ocean in mesoscale eddies

Mesoscale eddies in the ocean strongly impact the distribution of planktonic particles, mediating carbon fluxes over ~1/3 of the world ocean. However, mechanisms controlling particle transport through eddies are complex and challenging to measure in situ. Here we show the subsurface distribution of eddy particles funneled into a wineglass shape down to 1000 m, leading to a sevenfold increase of vertical carbon flux in the eddy center versus the eddy flanks, the “wineglass effect”. We show that the slope of the wineglass (R) is the ratio of particle sinking velocity to the radially inward velocity, such that R represents a tool to predict radial particle movement (here 0.05ms�1). A simple model of eddy spindown predicts such an ageostrophic flow concentrating particles in the eddy center. We explore how size-specific particle flux toward the eddy center impacts eddies' biogeochemistry and export fluxes

Early Mortality and AIDS Progression Despite High Initial Antiretroviral Therapy Adherence and Virologic Suppression in Botswana

Background Adverse outcomes occurring early after antiretroviral therapy (ART) initiation are common in sub-Saharan Africa, despite reports of high levels of ART adherence in this setting. We sought to determine the relationship between very early ART adherence and early adverse outcomes in HIV-infected adults in Botswana. Methods This prospective cohort study of 402 ART-naïve, HIV-infected adults initiating ART at a public HIV clinic in Gaborone, Botswana evaluated the relationship between suboptimal early ART adherence and HIV treatment outcomes in the initial months after ART initiation. Early adherence during the interval between initial ART dispensation and first ART refill was calculated using pill counts. In the primary analysis patients not returning to refill and those with adherence \u3c0.95 were considered to have suboptimal early adherence. The primary outcome was death or loss to follow-up during the first 6 months of ART; a secondary composite outcome included the primary outcome plus incident opportunistic illness (OIs) and virologic failure. We also calculated the percent of early adverse outcomes theoretically attributable to suboptimal early adherence using the population attributable risk percent (PAR%). Results Suboptimal early adherence was independently associated with loss to follow-up and death (adjusted OR 2.3, 95% CI 1.1–4.8) and with the secondary composite outcome including incident OIs and virologic failure (adjusted OR 2.6, 95% CI 1.4–4.7). However, of those with early adverse outcomes, less than one-third had suboptimal adherence and approximately two-thirds achieved virologic suppression. The PAR% relating suboptimal early adherence and primary and secondary outcomes were 14.7% and 17.7%, respectively. Conclusions Suboptimal early adherence was associated with poor outcomes, but most early adverse outcomes occurred in patients with optimal early adherence. Clinical care and research efforts should focus on understanding early adverse outcomes that occur despite optimal adherence

Models of care for musculoskeletal health: A cross-sectional qualitative study of Australian stakeholders' perspectives on relevance and standardised evaluation

Background: The prevalence and impact of musculoskeletal conditions are predicted to rapidly escalate in the coming decades. Effective strategies are required to minimise 'evidence-practice', 'burden-policy' and 'burden-service' gaps and optimise health system responsiveness for sustainable, best-practice healthcare. One mechanism by which evidence can be translated into practice and policy is through Models of Care (MoCs), which provide a blueprint for health services planning and delivery. While evidence supports the effectiveness of musculoskeletal MoCs for improving health outcomes and system efficiencies, no standardised national approach to evaluation in terms of their 'readiness' for implementation and 'success' after implementation, is yet available. Further, the value assigned to MoCs by end users is uncertain. This qualitative study aimed to explore end users' views on the relevance of musculoskeletal MoCs to their work and value of a standardised evaluation approach. Methods: A cross-sectional qualitative study was undertaken. Subject matter experts (SMEs) with health, policy and administration and consumer backgrounds were drawn from three Australian states. A semi-structured interview schedule was developed and piloted to explore perceptions about musculoskeletal MoCs including: i) aspects important to their work (or life, for consumers) ii) usefulness of standardised evaluation frameworks to judge 'readiness' and 'success' and iii) challenges associated with standardised evaluation. Verbatim transcripts were analysed by two researchers using a grounded theory approach to derive key themes. Results: Twenty-seven SMEs (n = 19; 70.4 % female) including five (18.5 %) consumers participated in the study. MoCs were perceived as critical for influencing and initiating changes to best-practice healthcare planning and delivery and providing practical guidance on how to implement and evaluate services. A 'readiness' evaluation framework assessing whether critical components across the health system had been considered prior to implementation was strongly supported, while 'success' was perceived as an already familiar evaluation concept. Perceived challenges associated with standardised evaluation included identifying, defining and measuring key 'readiness' and 'success' indicators; impacts of systems and context changes; cost; meaningful stakeholder consultation and developing a widely applicable framework. Conclusions: A standardised evaluation framework that includes a strong focus on 'readiness' is important to ensure successful and sustainable implementation of musculoskeletal MoCs

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Existing Infection Facilitates Establishment and Density of Malaria Parasites in Their Mosquito Vector

Very little is known about how vector-borne pathogens interact within their vector and how this impacts transmission. Here we show that mosquitoes can accumulate mixed strain malaria infections after feeding on multiple hosts. We found that parasites have a greater chance of establishing and reach higher densities if another strain is already present in a mosquito. Mixed infections contained more parasites but these larger populations did not have a detectable impact on vector survival. Together these results suggest that mosquitoes taking multiple infective bites may disproportionally contribute to malaria transmission. This will increase rates of mixed infections in vertebrate hosts, with implications for the evolution of parasite virulence and the spread of drug-resistant strains. Moreover, control measures that reduce parasite prevalence in vertebrate hosts will reduce the likelihood of mosquitoes taking multiple infective feeds, and thus disproportionally reduce transmission. More generally, our study shows that the types of strain interactions detected in vertebrate hosts cannot necessarily be extrapolated to vectors

Southern Ocean response to relative velocity wind stress forcing

An eddy-resolving quasigeostrophic model of the Southern Ocean coupled to a dynamic atmospheric mixed layer is used to compare the performance of two different wind stress parameterization schemes. The first is the standard quadratic drag law, based on atmospheric velocity alone, whereas the second (more exact) formulation is based on the difference between ocean and atmosphere velocities. The two different schemes give very similar magnitudes of mean stress; however, the relative velocity scheme has substantially lower power input, resulting in a weaker eddy field, and consequently, greater circumpolar transport. These results are explored in terms of the existing theories of the Antarctic Circumpolar Current (including eddy saturation and eddy damping) and the implications for modeling the Southern Ocean are discussed

Multidecadal variability in the climate system: phenomena and mechanisms

An open and fundamental issue in climate dynamics is the origin of multidecadal variability in the climate system. Resolving this issue is essential for adequate attribution of human-induced climate change. The purpose of this paper is to provide a perspective on multidecadal variability from the analysis of observations and results from model simulations. Data from the instrumental record indicate the existence of large-scale coherent patterns of multidecadal variability in sea surface temperature. Combined with long time series of proxy data, these results provide ample evidence for the existence of multidecadal sea surface temperature variations. Results of a hierarchy of climate models have provided several mechanisms of this variability, ranging from pure atmospheric forcing, via internal ocean processes to coupled ocean-atmosphere interactions. An important problem is that current state-of-the-art climate models underestimate multidecadal variability. We argue that these models miss important processes in their representation of ocean eddies and focus on a robust mechanism of multidecadal variability which is found in multi-century simulations with climate models having a strongly eddying ocean component

Multidecadal variability in the climate system: phenomena and mechanisms

An open and fundamental issue in climate dynamics is the origin of multidecadal variability in the climate system. Resolving this issue is essential for adequate attribution of human-induced climate change. The purpose of this paper is to provide a perspective on multidecadal variability from the analysis of observations and results from model simulations. Data from the instrumental record indicate the existence of large-scale coherent patterns of multidecadal variability in sea surface temperature. Combined with long time series of proxy data, these results provide ample evidence for the existence of multidecadal sea surface temperature variations. Results of a hierarchy of climate models have provided several mechanisms of this variability, ranging from pure atmospheric forcing, via internal ocean processes to coupled ocean-atmosphere interactions. An important problem is that current state-of-the-art climate models underestimate multidecadal variability. We argue that these models miss important processes in their representation of ocean eddies and focus on a robust mechanism of multidecadal variability which is found in multi-century simulations with climate models having a strongly eddying ocean component

The wineglass effect shapes particle export to the deep ocean in mesoscale eddies

International audienceMesoscale eddies in the ocean strongly impact the distribution of planktonic particles, mediating carbon fluxes over similar to 1/3 of the world ocean. However, mechanisms controlling particle transport through eddies are complex and challenging to measure in situ. Here we show the subsurface distribution of eddy particles funneled into a wineglass shape down to 1000 m, leading to a sevenfold increase of vertical carbon flux in the eddy center versus the eddy flanks, the ``wineglass effect''. We show that the slope of the wineglass (R) is the ratio of particle sinking velocity to the radially inward velocity, such that R represents a tool to predict radial particle movement (here 0.05 m s(-1)). A simple model of eddy spindown predicts such an ageostrophic flow concentrating particles in the eddy center. We explore how size-specific particle flux toward the eddy center impacts eddies' biogeochemistry and export fluxes