On the linearity of the stratospheric and Euro-Atlantic sector response to ENSO

The dependence of the winter stratospheric and Euro-Atlantic climate response on ENSO amplitude is investigated using the HadGEM3 model. Experiments are performed with imposed east Pacific sea surface temperature perturbations corresponding to Niño-3.4 anomalies of 60.75, 1.5, 2.25, and 3.0 K. In the North Pacific, El Niño (EN) deepens and shifts the Aleutian low eastward, while the equivalent magnitude La Niña (LN) perturbations drive anomalies of opposite sign that are around 4 times weaker. The muted North Pacific response to LN can be traced back to the weaker response of tropical convection and the associated anomalous Rossby wave source. The EN perturbations weaken the Arctic polar vortex, with the winter mean zonal mean zonal wind at 608N and 10 hPa decreasing approximately linearly with Niño-3.4 anomaly by around 23.6 m s21 K21 . For the strongest EN case (13 K), the frequency of sudden stratospheric warmings (SSWs) increases by ;60% compared to the control experiment. Hence the results do not support a saturation of the stratospheric pathway for strong EN as suggested in previous literature. The equivalent amplitude LN perturbations cause a weak strengthening of the polar vortex and no substantial change in SSW frequency, in contrast to some reanalysis-based studies. EN induces a negative North Atlantic Oscillation (NAO) index throughout boreal winter, which increases approximately linearly with the Niño-3.4 anomaly by around 20.6 standard deviations K21 . Only the response to the strongest LN perturbations projects onto a weak positive NAO in November, suggesting that the mechanism for the Euro-Atlantic response to LN may be distinct from EN

Is there a role for patients and their relatives in escalating clinical deterioration in hospital? A systematic review

Background: Measures exist to improve early recognition of, and response to, deteriorating patients in hospital. However, deteriorating patients continue to go unrecognized. To address this, interventions have been developed that invite patients and relatives to escalate patient deterioration to a rapid response team (RRT). Objective: To systematically review articles that describe these interventions and investigate their effectiveness at reducing preventable deterioration. Search strategy: Following PRISMA guidelines, four electronic databases and two web search engines were searched to identify literature investigating patient and relative led escalation. Inclusion criteria: Articles investigating the implementation or use of systems involving patients and relatives in the detection of clinical patient deterioration and escalation of patient care to address any clinical or non-clinical outcomes were included. Articles' eligibility was validated by a second reviewer (20%). Data extraction: Data were extracted according to pre-defined criteria. Data synthesis: Narrative synthesis was applied to included studies. Main results: Nine empirical studies and 36 grey literature articles were included in the review. Limited studies were conducted to establish the clinical effectiveness of patient and relative led escalation. Instead, studies investigated the impact of this intervention on health-care staff and available resources. Although appropriate, this reflects the infancy of research in this area. Patients and relatives did not overwhelm resources by activating the RRT. However, they did activate it to address concerns unrelated to patient deterioration. Conclusions: Activating a RRT may not be the most appropriate or cost-effective method of resolving non-life-threatening concerns

Biases in Indian summer monsoon precipitation forecasts in the Unified Model and their relationship with BSISO index.

Abstract This study shows that the Boreal Summer Intraseasonal Oscillation (BSISO) dominates the Indian summer monsoon low‐precipitation bias in the Met Office Unified model. Analyzing a recent 9‐year period (June, July, August only), it is found that the precipitation bias is dominated by break and break‐to‐active transition BSISO phases, while some of the other phases have no bias at all over a 7‐day forecast. Evidence of a link to upstream effects is found, in that there is a delayed reduction in the moisture flux entering India from the west. It is also shown that an increase in the net flow of moisture out of India to the east is strongly linked to the low‐precipitation bias, and there is some evidence that this is related to a lack of low‐pressure systems over India. Most atmospheric models have substantial rainfall biases over India, and these results may indicate the circulation patterns responsible. Plain Language Summary The Met Office Unified Model (UM) is widely used worldwide for weather forecasting, climate prediction and environmental research. An important deficiency of the UM, in common with many other weather and climate models, is that it simulates significantly too little rainfall over India, when averaged over the summer monsoon season. Indian monsoon rainfall is important to the livelihoods of hundreds of millions of people, and these errors in the models have knock‐on consequences for weather and climate prediction around the world. This study shows that the UM's rainfall bias is dominated by periods when the general monsoon behavior is in transition from low‐activity to high‐activity, while in other periods, the rainfall forecasts perform much better. These results will help us to better understand the causes of the model bias. A systematic evaluation of the UM moisture flow has also been carried out; this suggests that a key problem in these low to high‐activity transition periods is a replacement of monsoon cyclonic systems with too much purely westerly flow out of India. The results should also be of value in weather forecasting, in identifying weather regimes where we have relatively high, and relatively low, confidence in the forecasts

Anisotropic Structure of the Order Parameter in FeSe0.45Te0.55 Revealed by Angle Resolved Specific Heat

The symmetry and structure of the superconducting gap in the Fe-based superconductors are the central issue for understanding these novel materials. So far the experimental data and theoretical models have been highly controversial. Some experiments favor two or more constant or nearly-constant gaps, others indicate strong anisotropy and yet others suggest gap zeros ("nodes"). Theoretical models also vary, suggesting that the absence or presence of the nodes depends quantitatively on the model parameters. An opinion that has gained substantial currency is that the gap structure, unlike all other known superconductors, including cuprates, may be different in different compounds within the same family. A unique method for addressing this issue, one of the very few methods that are bulk and angle-resolved, calls for measuring the electronic specific heat in a rotating magnetic field, as a function of field orientation with respect to the crystallographic axes. In this Communication we present the first such measurement for an Fe-based high-Tc superconductor (FeBSC). We observed a fourfold oscillation of the specific heat as a function of the in-plane magnetic field direction, which allowed us to identify the locations of the gap minima (or nodes) on the Fermi surface. Our results are consistent with the expectations of an extended s-wave model with a significant gap anisotropy on the electron pockets and the gap minima along the \Gamma M (or Fe-Fe bond) direction.Comment: 32 pages, 7 figure

GCRF African SWIFT Testbed 1 Report

This document describes the activities and outcomes of the GCRF African Science for Weather Information and Forecasting Techniques (SWIFT) Weather Forecasting Testbed 1. Testbed 1 was conducted in the first part of 2019, from an operational forecasting office at IMTR Nairobi, at the Kenya Meteorological Department (KMD). Other centres connected to the Testbed by video-conference. The Testbed was designed to support SWIFT’s programme of research capability-building in the science of weather prediction. New forecasting and evaluation products were tested. The outcomes of the Testbed will be used to steer the research and development of these tools, as well as to provide meteorological case studies and to stimulate new hypotheses. Successes of Testbed 1 include the real-time use of satellite-based Nowcasting products (NWC SAF products), convection-permitting model ensembles from the UK Met Office and systematic forecast evaluation. Testbed 1 also devised and refined an effective programme of work for operational synoptic forecasting, nowcasting and evaluation, which could form the basis for new Standard Operating Procedures

Emergent dynamic chirality in a thermally driven artificial spin ratchet

Modern nanofabrication techniques have opened the possibility to create novel functional materials, whose properties transcend those of their constituent elements. In particular, tuning the magnetostatic interactions in geometrically frustrated arrangements of nanoelements called artificial spin ice1, 2 can lead to specific collective behaviour3, including emergent magnetic monopoles4, 5, charge screening6, 7 and transport8, 9, as well as magnonic response10, 11, 12. Here, we demonstrate a spin-ice-based active material in which energy is converted into unidirectional dynamics. Using X-ray photoemission electron microscopy we show that the collective rotation of the average magnetization proceeds in a unique sense during thermal relaxation. Our simulations demonstrate that this emergent chiral behaviour is driven by the topology of the magnetostatic field at the edges of the nanomagnet array, resulting in an asymmetric energy landscape. In addition, a bias field can be used to modify the sense of rotation of the average magnetization. This opens the possibility of implementing a magnetic Brownian ratchet13, 14, which may find applications in novel nanoscale devices, such as magnetic nanomotors, actuators, sensors or memory cells

The elusive archaeology of Kongo urbanism: the case of Kindoki, Mbanza Nsundi (Lower Congo, DRC)

We present here results, analyses and an in-depth historical contextualisation of the fieldwork undertaken in 2012 and 2013 at the Kindoki site in the Lower Congo (DRC). This site is linked with Mbanza Nsundi, one of the Kongo Kingdom's provincial capitals, which turns out to be archaeologically 'elusive'. Pinpointing its location proved to be particularly challenging. To this end, a historically-informed excavation methodology was developed that was never implemented in Central Africa before. We combined a strategy of systematic test pits with a large-scale 50 m grid approach. A cemetery was identified on Kindoki Hill with distinct but contemporaneous quarters of a 16th-17thcenturies settlement on both sides. The cemetery itself contains mainly 18th-century burials, in all likelihood of successive Nsundi rulers. The foreign, especially Portuguese, ceramics excavated on the hilltop and the hundreds of Venetian and likely Bavarian beads found in the graves are indicative of Mbanza Nsundi's connection to trade routes linking the Atlantic coast with the Pool region. The most striking discovery is that of a previously unknown type of comb-impressed pottery, from a pit with a calibrated radiocarbon date AD 1294-1393 (2 sigma). This suggests that a settlement had been developing at Kindoki since at least the 14th century, which allows us, for the very first time, to spatially bridge Kongo history and 'prehistory'. For the entire Lower Congo region only three 14C dates posterior to AD 1000 were available before the start of the KongoKing project, twelve have been added for just Kindoki

Use of low-dose oral theophylline as an adjunct to inhaled corticosteroids in preventing exacerbations of chronic obstructive pulmonary disease: study protocol for a randomised controlled trial.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with high morbidity, mortality, and health-care costs. An incomplete response to the anti-inflammatory effects of inhaled corticosteroids is present in COPD. Preclinical work indicates that 'low dose' theophylline improves steroid responsiveness. The Theophylline With Inhaled Corticosteroids (TWICS) trial investigates whether the addition of 'low dose' theophylline to inhaled corticosteroids has clinical and cost-effective benefits in COPD. METHOD/DESIGN: TWICS is a randomised double-blind placebo-controlled trial conducted in primary and secondary care sites in the UK. The inclusion criteria are the following: an established predominant respiratory diagnosis of COPD (post-bronchodilator forced expiratory volume in first second/forced vital capacity [FEV1/FVC] of less than 0.7), age of at least 40 years, smoking history of at least 10 pack-years, current inhaled corticosteroid use, and history of at least two exacerbations requiring treatment with antibiotics or oral corticosteroids in the previous year. A computerised randomisation system will stratify 1424 participants by region and recruitment setting (primary and secondary) and then randomly assign with equal probability to intervention or control arms. Participants will receive either 'low dose' theophylline (Uniphyllin MR 200 mg tablets) or placebo for 52 weeks. Dosing is based on pharmacokinetic modelling to achieve a steady-state serum theophylline of 1-5 mg/l. A dose of theophylline MR 200 mg once daily (or placebo once daily) will be taken by participants who do not smoke or participants who smoke but have an ideal body weight (IBW) of not more than 60 kg. A dose of theophylline MR 200 mg twice daily (or placebo twice daily) will be taken by participants who smoke and have an IBW of more than 60 kg. Participants will be reviewed at recruitment and after 6 and 12 months. The primary outcome is the total number of participant-reported COPD exacerbations requiring oral corticosteroids or antibiotics during the 52-week treatment period. DISCUSSION: The demonstration that 'low dose' theophylline increases the efficacy of inhaled corticosteroids in COPD by reducing the incidence of exacerbations is relevant not only to patients and clinicians but also to health-care providers, both in the UK and globally. TRIAL REGISTRATION: Current Controlled Trials ISRCTN27066620 was registered on Sept. 19, 2013, and the first subject was randomly assigned on Feb. 6, 2014

Time spent with cats is never wasted: Lessons learned from feline acromegalic cardiomyopathy, a naturally occurring animal model of the human disease

<div><p>Background</p><p>In humans, acromegaly due to a pituitary somatotrophic adenoma is a recognized cause of increased left ventricular (LV) mass. Acromegalic cardiomyopathy is incompletely understood, and represents a major cause of morbidity and mortality. We describe the clinical, echocardiographic and histopathologic features of naturally occurring feline acromegalic cardiomyopathy, an emerging disease among domestic cats.</p><p>Methods</p><p>Cats with confirmed hypersomatotropism (IGF-1>1000ng/ml and pituitary mass; n = 67) were prospectively recruited, as were two control groups: diabetics (IGF-1<800ng/ml; n = 24) and healthy cats without known endocrinopathy or cardiovascular disease (n = 16). Echocardiography was performed in all cases, including after hypersomatotropism treatment where applicable. Additionally, tissue samples from deceased cats with hypersomatotropism, hypertrophic cardiomyopathy and age-matched controls (n = 21 each) were collected and systematically histopathologically reviewed and compared.</p><p>Results</p><p>By echocardiography, cats with hypersomatotropism had a greater maximum LV wall thickness (6.5mm, 4.1–10.1mm) than diabetic (5.9mm, 4.2–9.1mm; Mann Whitney, p<0.001) or control cats (5.2mm, 4.1–6.5mm; Mann Whitney, p<0.001). Left atrial diameter was also greater in cats with hypersomatotropism (16.6mm, 13.0–29.5mm) than in diabetic (15.4mm, 11.2–20.3mm; Mann Whitney, p<0.001) and control cats (14.0mm, 12.6–17.4mm; Mann Whitney, p<0.001). After hypophysectomy and normalization of IGF-1 concentration (n = 20), echocardiographic changes proved mostly reversible. As in humans, histopathology of the feline acromegalic heart was dominated by myocyte hypertrophy with interstitial fibrosis and minimal myofiber disarray.</p><p>Conclusions</p><p>These results demonstrate cats could be considered a naturally occurring model of acromegalic cardiomyopathy, and as such help elucidate mechanisms driving cardiovascular remodeling in this disease.</p></div