The South Atlantic meridional overturning circulation and mesoscale eddies in the first GO-SHIP section at 34.5°S

This is the final version. Available from Wiley via the DOI in this record. The data from the MSM60 cruise are available at: https://doi.org/10.2312/cr_msm60. ADT data were downloaded from http://marine.copernicus.eu/, SST from https://podaac.jpl.nasa.gov/, eddy tracking from https://vesg.ipsl.upmc.fr/thredds/catalog/IPSLFS/rlaxe/catalog.html?data set=DatasetScanIPSLFS/rlaxe/ Database_ South_Atl.zip. GO-SHIP datasets were downloaded from http://cchdo.ucsd.edu.The variability of the Atlantic meridional overturning circulation (AMOC) has considerable impacts on the global climate system. Past studies have shown that changes in the South Atlantic control the stability of the AMOC and drive an important part of its variability. That is why significant resources have been invested in a South (S)AMOC observing system. In January 2017, the RV Maria S. Merian conducted the first GO-SHIP hydrographic transect along the SAMOC-Basin Wide Array (SAMBA) line at 34.5°S in the South Atlantic. This paper presents estimates of meridional volume, freshwater (MFT), and heat (MHT) transports through the line using the slow varying geostrophic density field and direct velocity observations. An upper and an abyssal overturning cell are identified with a strength of 15.64 ± 1.39 Sv and 2.4 ± 1.6 Sv, respectively. The net northward MHT is 0.27 ± 0.10 PW, increasing by 0.12 PW when we remove the observed mesoscale eddies with a climatology derived from the Argo floats data set. We attribute this change to an anomalous predominance of cold core eddies during the cruise period. The highest velocities are observed in the western boundary, within the Brazil and the Deep Western Boundary currents. These currents appear as a continuous deep jet located 150 km off the slope squeezed between two cyclonic eddies. The zonal changes in water masses properties and velocity denote the imprint of exchange pathways with both the Southern and the Indian oceans.TOEddies CNES-TOSCASouth African NRFANII-Campus FranceCooperative Institute for Marine and Atmospheric Studies (CIMAS)NOAA Atlantic Oceanographic and Meteorological LaboratorySao Paulo State Research FoundationSouth African National Research FoundationGerman Federal Ministry of Education and Research (BMBF)Department of Environment, Forestry and Fisherie

Moored observations of mesoscale features in the Cape Basin: characteristics and local impacts on water mass distributions

The eastern side of the South Atlantic Meridional overturning circulation Basin-wide Array (SAMBA) along 34.5°&thinsp;S is used to assess the nonlinear, mesoscale dynamics of the Cape Basin. This array presently consists of current meter moorings and bottom mounted Current and Pressure recording Inverted Echo Sounders (CPIES) deployed across the continental slope. These data, available from September 2014 to December 2015, combined with satellite altimetry allow us to investigate the characteristics and the impact of mesoscale dynamics on local water mass distribution and cross-validate the different data sets. We demonstrate that the moorings are affected by the complex dynamics of the Cape Basin involving Agulhas rings, cyclonic eddies and anticyclonic eddies from the Agulhas Bank and the South Benguela upwelling front and filaments. Our analyses show that exchange of water masses happens through the advection of water by mesoscale eddies but also via wide water mass intrusions engendered by the existence of intense dipoles. These complex dynamics induce strong intra-seasonal upper-ocean velocity variations and water mass exchanges between the shelf and the open ocean but also across the subantarctic and subtropical waters. This work presents the first independent observations comparison between full-depth moorings and CPIES data sets within the eastern South Atlantic region that gives some evidence of eastern boundary buoyancy anomalies associated with migrating eddies. It also highlights the need to continuously sample the full water depth as inter-basin exchanges occur intermittently and affect the whole water column.</p

Perspectives on Anaphylaxis Epidemiology in the United States with New Data and Analyses

Anaphylaxis incidence rates and time trends in the United States have been reported using different data sources and selection methods. Larger studies using diagnostic coding have inherent limitations in sensitivity and specificity. In contrast, smaller studies using chart reviews, including reports from single institutions, have better case characterization but suffer from reduced external validity due to their restricted nature. Increasing anaphylaxis hospitalization rates since the 1990s have been reported abroad. However, we report no significant overall increase in the United States. There have been several reports of increasing anaphylaxis rates in northern populations in the United States, especially in younger people, lending support to the suggestion that higher anaphylaxis rates occur at higher latitudes. We analyzed anaphylaxis hospitalization rates in comparably sized northern (New York) and southern (Florida) states and found significant time trend differences based on age. This suggests that the relationship of latitude to anaphylaxis incidence is complex

Anesthesia advanced circulatory life support

The constellation of advanced cardiac life support (ACLS) events, such as gas embolism, local anesthetic overdose, and spinal bradycardia, in the perioperative setting differs from events in the pre-hospital arena. As a result, modification of traditional ACLS protocols allows for more specific etiology-based resuscitation. Perioperative arrests are both uncommon and heterogeneous and have not been described or studied to the same extent as cardiac arrest in the community. These crises are usually witnessed, frequently anticipated, and involve a rescuer physician with knowledge of the patient's comorbidities and coexisting anesthetic or surgically related pathophysiology. When the health care provider identifies the probable cause of arrest, the practitioner has the ability to initiate medical management rapidly. Recommendations for management must be predicated on expert opinion and physiological understanding rather than on the standards currently being used in the generation of ACLS protocols in the community. Adapting ACLS algorithms and considering the differential diagnoses of these perioperative events may prevent cardiac arrest

Altimetry for the future: Building on 25 years of progress

In 2018 we celebrated 25 years of development of radar altimetry, and the progress achieved by this methodology in the fields of global and coastal oceanography, hydrology, geodesy and cryospheric sciences. Many symbolic major events have celebrated these developments, e.g., in Venice, Italy, the 15th (2006) and 20th (2012) years of progress and more recently, in 2018, in Ponta Delgada, Portugal, 25 Years of Progress in Radar Altimetry. On this latter occasion it was decided to collect contributions of scientists, engineers and managers involved in the worldwide altimetry community to depict the state of altimetry and propose recommendations for the altimetry of the future. This paper summarizes contributions and recommendations that were collected and provides guidance for future mission design, research activities, and sustainable operational radar altimetry data exploitation. Recommendations provided are fundamental for optimizing further scientific and operational advances of oceanographic observations by altimetry, including requirements for spatial and temporal resolution of altimetric measurements, their accuracy and continuity. There are also new challenges and new openings mentioned in the paper that are particularly crucial for observations at higher latitudes, for coastal oceanography, for cryospheric studies and for hydrology. The paper starts with a general introduction followed by a section on Earth System Science including Ocean Dynamics, Sea Level, the Coastal Ocean, Hydrology, the Cryosphere and Polar Oceans and the ‘‘Green” Ocean, extending the frontier from biogeochemistry to marine ecology. Applications are described in a subsequent section, which covers Operational Oceanography, Weather, Hurricane Wave and Wind Forecasting, Climate projection. Instruments’ development and satellite missions’ evolutions are described in a fourth section. A fifth section covers the key observations that altimeters provide and their potential complements, from other Earth observation measurements to in situ data. Section 6 identifies the data and methods and provides some accuracy and resolution requirements for the wet tropospheric correction, the orbit and other geodetic requirements, the Mean Sea Surface, Geoid and Mean Dynamic Topography, Calibration and Validation, data accuracy, data access and handling (including the DUACS system). Section 7 brings a transversal view on scales, integration, artificial intelligence, and capacity building (education and training). Section 8 reviews the programmatic issues followed by a conclusion

Prevention of acute kidney injury and protection of renal function in the intensive care unit

Acute renal failure on the intensive care unit is associated with significant mortality and morbidity. To determine recommendations for the prevention of acute kidney injury (AKI), focusing on the role of potential preventative maneuvers including volume expansion, diuretics, use of inotropes, vasopressors/vasodilators, hormonal interventions, nutrition, and extracorporeal techniques. A systematic search of the literature was performed for studies using these potential protective agents in adult patients at risk for acute renal failure/kidney injury between 1966 and 2009. The following clinical conditions were considered: major surgery, critical illness, sepsis, shock, and use of potentially nephrotoxic drugs and radiocontrast media. Where possible the following endpoints were extracted: creatinine clearance, glomerular filtration rate, increase in serum creatinine, urine output, and markers of tubular injury. Clinical endpoints included the need for renal replacement therapy, length of stay, and mortality. Studies are graded according to the international Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) group system Several measures are recommended, though none carries grade 1A. We recommend prompt resuscitation of the circulation with special attention to providing adequate hydration whilst avoiding high-molecular-weight hydroxy-ethyl starch (HES) preparations, maintaining adequate blood pressure using vasopressors in vasodilatory shock. We suggest using vasopressors in vasodilatory hypotension, specific vasodilators under strict hemodynamic control, sodium bicarbonate for emergency procedures administering contrast media, and periprocedural hemofiltration in severe chronic renal insufficiency undergoing coronary intervention

EUREC⁴A

The science guiding the EUREC⁴A campaign and its measurements is presented. EUREC⁴A comprised roughly 5 weeks of measurements in the downstream winter trades of the North Atlantic – eastward and southeastward of Barbados. Through its ability to characterize processes operating across a wide range of scales, EUREC⁴A marked a turning point in our ability to observationally study factors influencing clouds in the trades, how they will respond to warming, and their link to other components of the earth system, such as upper-ocean processes or the life cycle of particulate matter. This characterization was made possible by thousands (2500) of sondes distributed to measure circulations on meso- (200 km) and larger (500 km) scales, roughly 400 h of flight time by four heavily instrumented research aircraft; four global-class research vessels; an advanced ground-based cloud observatory; scores of autonomous observing platforms operating in the upper ocean (nearly 10 000 profiles), lower atmosphere (continuous profiling), and along the air–sea interface; a network of water stable isotopologue measurements; targeted tasking of satellite remote sensing; and modeling with a new generation of weather and climate models. In addition to providing an outline of the novel measurements and their composition into a unified and coordinated campaign, the six distinct scientific facets that EUREC⁴A explored – from North Brazil Current rings to turbulence-induced clustering of cloud droplets and its influence on warm-rain formation – are presented along with an overview of EUREC⁴A's outreach activities, environmental impact, and guidelines for scientific practice. Track data for all platforms are standardized and accessible at https://doi.org/10.25326/165 (Stevens, 2021), and a film documenting the campaign is provided as a video supplement

EUREC⁴A

The science guiding the EUREC⁴A campaign and its measurements is presented. EUREC⁴A comprised roughly 5 weeks of measurements in the downstream winter trades of the North Atlantic – eastward and southeastward of Barbados. Through its ability to characterize processes operating across a wide range of scales, EUREC⁴A marked a turning point in our ability to observationally study factors influencing clouds in the trades, how they will respond to warming, and their link to other components of the earth system, such as upper-ocean processes or the life cycle of particulate matter. This characterization was made possible by thousands (2500) of sondes distributed to measure circulations on meso- (200 km) and larger (500 km) scales, roughly 400 h of flight time by four heavily instrumented research aircraft; four global-class research vessels; an advanced ground-based cloud observatory; scores of autonomous observing platforms operating in the upper ocean (nearly 10 000 profiles), lower atmosphere (continuous profiling), and along the air–sea interface; a network of water stable isotopologue measurements; targeted tasking of satellite remote sensing; and modeling with a new generation of weather and climate models. In addition to providing an outline of the novel measurements and their composition into a unified and coordinated campaign, the six distinct scientific facets that EUREC⁴A explored – from North Brazil Current rings to turbulence-induced clustering of cloud droplets and its influence on warm-rain formation – are presented along with an overview of EUREC⁴A's outreach activities, environmental impact, and guidelines for scientific practice. Track data for all platforms are standardized and accessible at https://doi.org/10.25326/165 (Stevens, 2021), and a film documenting the campaign is provided as a video supplement

Altimetry for the future: building on 25 years of progress

In 2018 we celebrated 25 years of development of radar altimetry, and the progress achieved by this methodology in the fields of global and coastal oceanography, hydrology, geodesy and cryospheric sciences. Many symbolic major events have celebrated these developments, e.g., in Venice, Italy, the 15th (2006) and 20th (2012) years of progress and more recently, in 2018, in Ponta Delgada, Portugal, 25 Years of Progress in Radar Altimetry. On this latter occasion it was decided to collect contributions of scientists, engineers and managers involved in the worldwide altimetry community to depict the state of altimetry and propose recommendations for the altimetry of the future. This paper summarizes contributions and recommendations that were collected and provides guidance for future mission design, research activities, and sustainable operational radar altimetry data exploitation. Recommendations provided are fundamental for optimizing further scientific and operational advances of oceanographic observations by altimetry, including requirements for spatial and temporal resolution of altimetric measurements, their accuracy and continuity. There are also new challenges and new openings mentioned in the paper that are particularly crucial for observations at higher latitudes, for coastal oceanography, for cryospheric studies and for hydrology. The paper starts with a general introduction followed by a section on Earth System Science including Ocean Dynamics, Sea Level, the Coastal Ocean, Hydrology, the Cryosphere and Polar Oceans and the “Green” Ocean, extending the frontier from biogeochemistry to marine ecology. Applications are described in a subsequent section, which covers Operational Oceanography, Weather, Hurricane Wave and Wind Forecasting, Climate projection. Instruments’ development and satellite missions’ evolutions are described in a fourth section. A fifth section covers the key observations that altimeters provide and their potential complements, from other Earth observation measurements to in situ data. Section 6 identifies the data and methods and provides some accuracy and resolution requirements for the wet tropospheric correction, the orbit and other geodetic requirements, the Mean Sea Surface, Geoid and Mean Dynamic Topography, Calibration and Validation, data accuracy, data access and handling (including the DUACS system). Section 7 brings a transversal view on scales, integration, artificial intelligence, and capacity building (education and training). Section 8 reviews the programmatic issues followed by a conclusion

Agulhas Ring Heat Content and Transport in the South Atlantic Estimated by Combining Satellite Altimetry and Argo Profiling Floats Data

International audienceThe Agulhas leakage of Indian Ocean waters into the Atlantic has been shown to be a key link in global ocean circulation and climate; an increased understanding of this process is therefore of more than just of local interest. While knowledge of the Agulhas leakage has increased over the past 30 years, the precise mechanisms at play and water properties transferred are still not sufficiently documented. This study covers the Agulhas rings heat content and transport, which contribute to the meridional overturning circulation of the global ocean during their route across the South Atlantic Ocean. By applying TOEddies, an eddy detection and tracking algorithm that takes into account eddy merging and splitting, to satellite altimetry maps combined with a colocation of the detected eddies with Argo floats vertical profiles, we are able to document the important heat anomaly characterizing Agulhas rings and their evolution across the Cape Basin and the South Atlantic Ocean. Notwithstanding that in situ data coverage is still limited at the ocean mesoscale, we have estimated an averaged Agulhas rings subsurface heat transport of 2.5 × 10-2 PW and 1.5 × 10-2 PW across the eastern and western South Atlantic Ocean, respectively