Unraveling North-African riverine and eolian contributions to central Mediterranean sediments during Holocene sapropel S1 formation

Hydroclimate variability has exerted a fundamental control on the alternating deposition of organic-lean marl and organic-rich sapropel sediments in the eastern Mediterranean Sea (EMS). However, the exact mechanisms regarding the freshwater sources and related changes are still debated. Here, Sr and Nd isotopes and high-resolution elemental data are used to constrain different riverine and eolian supplies to the central Mediterranean over the past 9.8 ka. The detrital sediments in core CP10BC, taken at the margin of the Libyan shelf in the southwestern Ionian Sea, can be described by a three-endmember mixing system based on Sr and Nd isotopic compositions. The same systematics can also be deduced from Ti and K compositional variability. The endmembers comprise: Saharan Dust, Aegean/Nile, and Libyan Soil, representing the eolian supply from North Africa, the riverine inputs from the Aegean/Nile areas, as well as the riverine and shelf-derived fluxes from the Libyan-Tunisian margin, respectively. For the sapropel S1 period in particular, we find important detrital supplies from fossil river/wadi systems along the Libyan-Tunisian margin, activated by intensified African monsoon precipitation. Combining the temporal profiles with the consistent variability observed in the 87Sr/86Sr–1000/Sr diagram, such Libyan contribution has been most prominent during the uppermost period of sapropel S1 in core CP10BC. This observation is in agreement with hydroclimate reconstructions of northwestern Libya. Comparison of the Sr-Nd isotope data between core CP10BC and four cores taken along a west–east transect throughout the EMS shows that this detrital supply originated mainly from western Libya/Tunisia, and was transported as far eastward as ∼25°E while being diluted by an increasing Nile contribution

Feedback of mesoscale ocean currents on atmospheric winds in high-resolution coupled models and implications for the forcing of ocean-only models

The repercussions of surface ocean currents for the near-surface wind and the air-sea momentum flux are investigated in two versions of a global climate model with eddying ocean. The focus is on the effect of mesoscale ocean current features at scales of less than 150 km, by considering high-pass filtered, monthly-mean model output fields. We find a clear signature of a mesoscale oceanic imprint in the wind fields over the energetic areas of the oceans, particularly along the extensions of the western boundary currents and the Antarctic Circumpolar Current. These areas are characterized by a positive correlation between mesoscale perturbations in the curl of the surface currents and the wind curl. The coupling coefficients are spatially non-uniform and show a pronounced seasonal cycle. The positive feedback of mesoscale current features on the near-surface wind acts in opposition to their damping effect on the wind stress. A tentative incorporation of this feedback in the surface stress formulation of an eddy-permitting global ocean-only model leads to a gain in the kinetic energy of up to 10 %, suggesting a fundamental shortcoming of present ocean model configurations

25 years of experience with transjugular intrahepatic portosystemic shunt (TIPS): changes in patient selection and procedural aspects

Background: TIPS is an established treatment for portal hypertension. The aim was to analyze how patient selection for TIPS implantation and procedural aspects have changed over 25 years. Routinely collected demographic, clinical, laboratory, and procedural data of 835 patients treated with TIPS in a single center were used. Time trends over the observational period from 1993 to 2018 were retrospectively analyzed. Descriptive statistical analysis was performed. Results: The most common indication for TIPS implantation has changed significantly from secondary prevention of variceal hemorrhage in the early years to treatment of recurrent ascites. During the observation period, increasingly more severely ill patients became TIPS candidates. There was little change in MELD scores over this period (in total median 13.00; IQR 10.00-18.00). The proportion of patients with Child-Pugh C cirrhosis increased. The most frequent underlying diseases in total were alcohol-related liver disease (66.5%) and viral hepatitis (11.9%). However, shares of cryptogenic liver cirrhosis, autoimmune hepatitis, and NASH increased over time. The proportion of patients post liver transplant also increased. While bare metal stents were standard in the past, use of covered stents increased. The success rate of TIPS (defined by successful implantation and a decrease in the portosystemic pressure gradient <= 12 mmHg) increased significantly over time. The total success rate according to this definition was 84.9%. Conclusion: The results of our analysis reflect technical developments in TIPS, especially in terms of stent material and gains in clinical experience, particularly regarding indications and patient selection for TIPS implantation

The Randomized Shortened Dental Arch Study: Tooth Loss

The evidence concerning the management of shortened dental arch (SDA) cases is sparse. This multi-center study was aimed at generating data on outcomes and survival rates for two common treatments, removable dental prostheses (RDP) for molar replacement or no replacement (SDA). The hypothesis was that the treatments lead to different incidences of tooth loss. We included 215 patients with complete molar loss in one jaw. Molars were either replaced by RDP or not replaced, according to the SDA concept. First tooth loss after treatment was the primary outcome measure. This event occurred in 13 patients in the RDP group and nine patients in the SDA group. The respective Kaplan-Meier survival rates at 38 months were 0.83 (95% CI: 0.74-0.91) in the RDP group and 0.86 (95% CI: 0.78-0.95) in the SDA group, the difference being non-significant

Image-based dosimetry for 225Ac-PSMA-I&T therapy using quantitative SPECT

Purpose!#!After a decade of PET/MR, the case of attenuation correction (AC) remains open. The initial four-compartment (air, water, fat, soft tissue) Dixon-based AC scheme has since been expanded with several features, the latest being MR field-of-view extension and a bone atlas. As this potentially changes quantification, we evaluated the impact of these features in PET AC in prostate cancer patients.!##!Methods!#!Two hundred prostate cancer patients were examined with either !##!Results!#!High correlation and no visually perceivable differences between all evaluated methods (r &amp;gt; 0.996) were found. The mean relative difference in lesion uptake of !##!Conclusions!#!Based on these results and the encountered bone atlas registration inaccuracy, we deduce that including bones and extending the MR field-of-view did not introduce clinically significant differences in PSMA diagnostic accuracy and tracer uptake quantification in prostate cancer pelvic lesions, facilitating the analysis of serial studies respectively. However, in the absence of ground truth data, we advise against atlas-based methods when comparing serial scans for bone lesions

A comparison of sea surface temperatures from microwave remote sensing of the Labrador Sea with in situ measurements and model simulations

As one of the few places in the ocean where winter cooling and mixing creates conditions where water from the surface can penetrate into the deep ocean the Labrador Sea is an area of interest to people studying climate change in the ocean. Persistent cloud cover over this area makes it impossible to use infrared satellite imagery to relate space/time changes in sea surface temperature (SST) to changes in surface currents and air-sea interaction. Using passive microwave SSTs from the Advanced Microwave Scanning Radiometer (AMSR-E), we plot space/time changes in SST in the Labrador Sea and relate these changes to both simultaneous in situ measurements of temperature and numerical model SSTs. A direct comparison between the microwave SSTs, infrared SSTs, and in situ temperatures measured from profiling floats reveals that the microwave SSTs are a good representation of space/time changes in infrared SST and in ocean temperatures down to 10 m below the sea surface. Comparisons between the microwave SSTs and time series of temperatures at depths below 50 m reveal that winter/spring surface cooling makes the SST similar to temperatures at these deeper depths in the convection region of the central Labrador Sea. Detailed comparison of the annual cycle between the microwave SSTs and the model SST and 10 m currents reveals overall good agreement and some interesting differences

Signal propagation related to the North Atlantic Overturning

Changes of the meridional overturning circulation (MOC) due to surface heat flux variability related to the North Atlantic Oscillation (NAO) are analyzed in various ocean models, i.e., eddying and non‐eddying cases. A prime signature of the forcing is variability of the winter‐time convection in the Labrador Sea. The associated changes in the strength of the MOC near the subpolar front (45°N) are closely related to the NAO‐index, leading MOC anomalies by about 2–3 years in both the eddying and non‐eddying simulation. Further south the speed of the meridional signal propagation depends on model resolution. With lower resolution (non‐eddying case, 4/3° resolution) the MOC signal propagates equatorward with a mean speed of about 0.6 cm/s, similar as spreading rates of passive tracer anomalies. Eddy‐permitting experiments (1/3°) show a significantly faster propagation, with speeds corresponding to boundary waves, thus leading to an almost in‐phase variation of the MOC transport over the subtropical to subpolar North Atlantic