Representation of western disturbances in CMIP5 models

Western disturbances (WDs) are synoptic extratropical disturbances embedded in the subtropical westerly jet stream. They are an integral part of the South Asian winter climate, both for the agriculture-supporting precipitation they bring to the region and for the associated isolated extreme events that can induce devastating flash flooding. Here, WD behaviour and impacts are characterised in 23 CMIP5 historical simulations and compared with reanalysis and observations. It is found that WD frequency has a strong relationship with model resolution: higher resolution models produce significantly more WDs, and a disproportionately high fraction of extreme events. Exploring metrics of jet strength and shape, we find that the most probable cause of this relationship is that the jet is wider in models with coarser resolution, and therefore the northern edge in which WDs are spun up sits too far north of India. The frequency of WDs in both winter and summer is found to be overestimated by most models, and thus the winter frequency of WDs estimated from the multi-model mean (30 winter−1) is above the reanalysis mean (26 winter−1). In this case, the error cannot be adequately explained by local jet position and strength. Instead, we show that it is linked with a positive bias in upstream mid-tropospheric baroclinicity. Despite a positive winter precipitation bias in CMIP5 models over most of India and Pakistan and a dry bias in the western Himalaya, the fraction of winter precipitation for which WDs are responsible is accurately represented. Using partial correlation, it is shown that the overestimation in WD frequency is the largest contributor to this bias, with a secondary, spatially heterogeneous contribution coming from the overestimation of WD intensity

Falling trend of western disturbances in future climate simulations

Western disturbances (WDs) are synoptic-scale cyclonic weather systems advected over Pakistan and north India by the subtropical westerly jet stream. There, they are responsible for most of the winter precipitation, crucial for agriculture of the rabi crop, as well as more extreme precipitation events, which can lead to local flooding and avalanches. Despite their importance, there has not yet been an attempt to objectively determine the fate of WDs in future climate GCMs. Here, a tracking algorithm is used to build up a catalogue of WDs in both CMIP5 historical and representative concentration pathway (RCP) experiments of the future. It is shown that in business-as-usual (RCP8.5) future climate simulations, WD frequency falls by around 15% by the end of the twenty-first century, with the largest relative changes coming in pre- and post-monsoon months. Meanwhile, mean WD intensity will decrease, with central vorticity expected to become less cyclonic by about 12% over the same period. Changes in WD frequency are attributed to the projected widening and weakening of the winter subtropical jet; as well as decreasing meridional wind shear and mid-tropospheric baroclinic vorticity tendency, which also explain the changes in intensity. Finally, the impact of these changes on regional precipitation is explored. The decline in WD frequency and intensity will cause a decrease in mean winter rainfall over Pakistan and north India amounting to about 15% of the mean -- subject to the ability of the models to represent the processes responsible. The effect on extreme precipitation events, however, remains unclear

Effects of Exercise Training on Neuromuscular Junction Morphology and Pre- to Post-Synaptic Coupling in Young and Aged Rats

The objective of this study was to determine whether pre- to post-synaptic coupling of the neuromuscular junction (NMJ) could be maintained in the face of significant morphological remodeling brought about by exercise training, and whether aging altered this capacity. Eighteen young adult (8 mo) and eighteen aged (24 mo) Fischer 344 rats were randomly assigned to either endurance trained (treadmill running) or untrained control conditions resulting in four groups (N = 9 / group). After the 10-week intervention rats were euthanized and hindlimb muscles were surgically removed, quickly frozen at approximate resting length and stored at - 85 degrees C. The plantaris and EDL muscles were selected for study as they have different functions (ankle extensor and ankle flexor, respectively) but both are similarly and overwhelmingly comprised of fast-twitch myofibers. NMJs were stained with immunofluorescent procedures and images were collected with confocal microscopy. Each variable of interest was analyzed with a 2-way ANOVA with main effects of age and endurance training; in all cases significance was set at P \u3c = 0.05. Results showed that no main effects of aging were detected in NMJs of either the plantaris or the EDL. Similarly, endurance training failed to alter any synaptic parameters of EDL muscles. The same exercise stimulus in the plantaris however, resulted in significant pre- and post-synaptic remodeling, but without altering pre- to post-synaptic coupling of the NMJs. Myofiber profiles of the same plantaris and EDL muscles were also analyzed. Unlike NMJs, myofibers displayed significant age-related atrophy in both the plantaris and EDL muscles. Overall, these results confirm that despite significant training-induced reconfiguration of NMJs, pre- to post-synaptic coupling remains intact underscoring the importance of maintaining proper apposition of neurotransmitter release and binding sites so that effective nerve to muscle communication is assured. (C) 2015 IBRO. Published by Elsevier Ltd. All rights reserved

The European Climate Research Alliance (ECRA): collaboration from bottom-up

The European Climate Research Alliance (ECRA) is an association of leading European research institutions in the field of climate research (http://www.ecra-climate.eu/, last access: 6 December 2018). ECRA is a bottom-up initiative and helps to facilitate the development of climate change research, combining the capacities of national research institutions, and inducing closer ties between existing national research initiatives, projects and infrastructures. ECRA works as an open platform to bring together climate researchers, providing excellent scientific expertise for policy makers and of societal relevance. The ECRA Board consists of representatives of ECRA partners and decides on governance, scientific priorities, and organisational matters. Currently organized into four Collaborative Programmes, climate scientists share their knowledge, experience and expertise to identify the most important research requirements for the future, thus developing a foresight approach. The CPs cover the topics: (1) Arctic variability and change, (2) Sea level changes and coastal impacts, (3) Changes in the hydrological cycle and (4) High impact events. The CP activities are planned in workshops and participation is open to all interested scientists from the relevant research fields. In particular, young researchers are actively encouraged to join the network. Each CP develops its joint research priorities for shaping European research into the future. Because scientific themes are interconnected, the four Collaborative Programmes interact with each other, e.g. through the organization of common workshops or joint applications. In addition, the Collaborative Programme leads attend the Board meetings. The different formats of ECRA meetings range from scientific workshops to briefing events and side events at conferences to involve different groups of interests. This facilitates the interaction of scientists, various stakeholder groups and politicians. A biennial open ECRA General Assembly that is organised in Brussels represents an umbrella event and acts as a platform for discussion and contact with stakeholders. This event is an excellent opportunity to jointly discuss research priorities of high societal relevance

Presentation and Outcomes After Medical and Surgical Treatment Versus Medical Treatment Alone of Spontaneous Infectious Spondylodiscitis: A Systematic Literature Review and Meta-Analysis.

Study Design: Systematic literature review. Objectives: The aims of this study were to (1) describe the clinical features, disabilities, and incidence of neurologic deficits of pyogenic spondylodiscitis prior to treatment and (2) compare the functional outcomes between patients who underwent medical treatment alone or in combination with surgery for pyogenic spondylodiscitis. Methods: A systematic literature review was performed using PubMed according to PRISMA guidelines. No year restriction was put in place. Statistical analysis of pooled data, when documented in the original report (ie, number of patients with desired variable and number of patients evaluated), was conducted to determine the most common presenting symptoms, incidence of pre- and postoperative neurologic deficits, associated comorbidities, infectious pathogens, approach for surgery when performed, and duration of hospitalization. Outcomes data, including return to work status, resolution of back pain, and functional recovery were also pooled among all studies and surgery-specific studies alone. Meta-analysis of studies with subgroup analysis of pain-free outcome in surgical and medical patients was performed. Results: Fifty of 1286 studies were included, comprising 4173 patients undergoing either medical treatment alone or in combination with surgery. Back pain was the most common presenting symptom, reported in 91% of patients. Neurologic deficit was noted in 31% of patients. Conclusion: Medical management remains first-line treatment of infectious pyogenic spondylodiscitis. Surgery may be indicated for progressive pain, persistent infection on imaging, deformity or neurologic deficits. If surgery is required, reported literature shows potential for significant pain reduction, improved neurologic function and a high number of patients returning to a normal functional/work status

Examining reliability of seasonal to decadal sea surface temperature forecasts: the role of ensemble dispersion

Useful probabilistic climate forecasts on decadal timescales should be reliable (i.e. forecast probabilities match the observed relative frequencies) but this is seldom examined. This paper assesses a necessary condition for reliability, that the ratio of ensemble spread to forecast error being close to one, for seasonal to decadal sea surface temperature retrospective forecasts from the Met Office Decadal Prediction System (DePreSys). Factors which may affect reliability are diagnosed by comparing this spread-error ratio for an initial condition ensemble and two perturbed physics ensembles for initialized and uninitialized predictions. At lead times less than 2 years, the initialized ensembles tend to be under-dispersed, and hence produce overconfident and hence unreliable forecasts. For longer lead times, all three ensembles are predominantly over-dispersed. Such over-dispersion is primarily related to excessive inter-annual variability in the climate model. These findings highlight the need to carefully evaluate simulated variability in seasonal and decadal prediction systems.Useful probabilistic climate forecasts on decadal timescales should be reliable (i.e. forecast probabilities match the observed relative frequencies) but this is seldom examined. This paper assesses a necessary condition for reliability, that the ratio of ensemble spread to forecast error being close to one, for seasonal to decadal sea surface temperature retrospective forecasts from the Met Office Decadal Prediction System (DePreSys). Factors which may affect reliability are diagnosed by comparing this spread-error ratio for an initial condition ensemble and two perturbed physics ensembles for initialized and uninitialized predictions. At lead times less than 2 years, the initialized ensembles tend to be under-dispersed, and hence produce overconfident and hence unreliable forecasts. For longer lead times, all three ensembles are predominantly over-dispersed. Such over-dispersion is primarily related to excessive inter-annual variability in the climate model. These findings highlight the need to carefully evaluate simulated variability in seasonal and decadal prediction systems

Upper ocean manifestations of a reducing meridional overturning circulation

Most climate models predict a slowing down of the Atlantic Meridional Overturning Circulation during the 21st century. Using a 100year climate change integration of a high resolution coupled climate model, we show that a 5.3Sv reduction in the deep southward transport in the subtropical North Atlantic is balanced solely by a weakening of the northward surface western boundary current, and not by an increase in the southward transport integrated across the interior ocean away from the western boundary. This is consistent with Sverdrup balance holding to a good approximation outside of the western boundary region on decadal time scales, and may help to spatially constrain past and future change in the overturning circulation. The subtropical gyre weakens by 3.4Sv over the same period due to a weakened wind stress curl. These changes combine to give a net 8.7Sv reduction in upper western boundary transport. © 2012. American Geophysical Union. All Rights Reserved

Is There a Patient Profile That Characterizes a Patient With Adult Spinal Deformity as a Candidate for Minimally Invasive Surgery?

Study designRetrospective review.ObjectivesThe goal of this study was to evaluate the baseline characteristics of patients chosen to undergo traditional open versus minimally invasive surgery (MIS) for adult spinal deformity (ASD).MethodsA multicenter review of 2 databases including ASD patients treated with surgery. Inclusion criteria were age >45 years, Cobb angle minimum of 20°, and minimum 2-year follow-up. Preoperative radiographic parameters and disability outcome measures were reviewed.ResultsA total of 350 patients were identified: 173 OPEN patients and 177 MIS. OPEN patients were significantly younger than MIS patients (61.5 years vs 63.74 years, P = .013). The OPEN group had significantly more females (87% vs 76%, P = .006), but both groups had similar body mass index. Preoperative lumbar Cobb was significantly higher for the OPEN group (34.2°) than for the MIS group (26.0°, P < .001). The mean preoperative Oswestry Disability Index was significantly higher in the MIS group (44.8 in OPEN patients and 49.8 in MIS patients, P < .011). The preoperative Numerical Rating Scale value for back pain was 7.2 in the OPEN group and 6.8 in the MIS group preoperatively, P = .100.ConclusionsPatients chosen for MIS for ASD are slightly older and have smaller coronal deformities than those chosen for open techniques, but they did not have a substantially lesser degree of sagittal malalignment. MIS surgery was most frequently utilized for patients with an sagittal vertical axis under 6 cm and a baseline pelvic incidence and lumbar lordosis mismatch under 30°

Attribution of forced decadal climate change in coupled and uncoupled ocean-atmosphere model experiments

There is still no consensus about the best methodology for attributing observed changes in climate or climate events. One widely-used approach relies on experiments in which the time periods of interest are simulated using an atmospheric general circulation model (AGCM) forced by prescribed sea surface temperatures (SSTs), with and without estimated anthropogenic influences. A potential limitation of such experiments is the lack of explicit atmosphere–ocean coupling; therefore a key question is whether the attribution statements derived from such studies are in fact robust. In this research we have carried out climate model experiments to test attribution conclusions in a situation where the answer is known – a so-called “perfect model” approach. The study involves comparing attribution conclusions for decadal changes derived from experiments with a coupled climate model (specifically an AGCM coupled to an ocean mixed-layer model) with conclusions derived from parallel experiments with the same AGCM forced by SSTs derived from the coupled model simulations. Results indicate that attribution conclusions for surface air temperature changes derived from AGCM experiments are generally robust and not sensitive to air-sea coupling. However, changes in seasonal mean and extreme precipitations, and circulation in some regions show large sensitivity to air-sea coupling, notably in the summer monsoons over East Asia and Australia. Comparison with observed changes indicates that the coupled simulations generally agree better with observations. These results demonstrate that the AGCM–based attribution method has limitations and may lead to erroneous attribution conclusions in some regions for local circulation, mean and extreme precipitation. The coupled mixed–layer model used in this study offers an alternative and, in some respects, superior tool for attribution studies

Clinically Significant Thromboembolic Disease in Adult Spinal Deformity Surgery: Incidence and Risk Factors in 737 Patients.

Study Design:Retrospective cohort study. Objectives:Describe the rate and risk factors for venous thromboembolic events (VTEs; defined as deep venous thrombosis [DVT] and/or pulmonary embolism [PE]) in adult spinal deformity (ASD) surgery. Methods:ASD patients with VTE were identified in a prospective, multicenter database. Complications, revision, and mortality rate were examined. Patient demographics, operative details, and radiographic and clinical outcomes were compared with a non-VTE group. Multivariate binary regression model was used to identify predictors of VTE. Results:A total of 737 patients were identified, 32 (4.3%) had VTE (DVT = 14; PE = 18). At baseline, VTE patients were less likely to be employed in jobs requiring physical labor (59.4% vs 79.7%, P < .01) and more likely to have osteoporosis (29% vs 15.1%, P = .037) and liver disease (6.5% vs 1.4%, P = .027). Patients with VTE had a larger preoperative sagittal vertical axis (SVA; 93 mm vs 55 mm, P < .01) and underwent larger SVA corrections. VTE was associated with a combined anterior/posterior approach (45% vs 25%, P = .028). VTE patients had a longer hospital stay (10 vs 7 days, P < .05) and higher mortality rate (6.3% vs 0.7%, P < .01). Multivariate analysis demonstrated osteoporosis, lack of physical labor, and increased SVA correction were independent predictors of VTE (r2 = .11, area under the curve = 0.74, P < .05). Conclusions:The incidence of VTE in ASD is 4.3% with a DVT rate of 1.9% and PE rate of 2.4%. Osteoporosis, lack of physical labor, and increased SVA correction were independent predictors of VTE. Patients with VTE had a higher mortality rate compared with non-VTE patients