Propagation of Thermohaline Anomalies and Their Predictive Potential along the Atlantic Water Pathway

We assess to what extent seven state-of-the-art dynamical prediction systems can retrospectively predict winter sea surface temperature (SST) in the subpolar North Atlantic and the Nordic seas in the period 1970-2005. We focus on the region where warm water flows poleward (i.e., the Atlantic water pathway to the Arctic) and on interannual-to-decadal time scales. Observational studies demonstrate predictability several years in advance in this region, but we find that SST skill is low with significant skill only at a lead time of 1-2 years. To better understand why the prediction systems have predictive skill or lack thereof, we assess the skill of the systems to reproduce a spatiotemporal SST pattern based on observations. The physical mechanism underlying this pattern is a propagation of oceanic anomalies from low to high latitudes along the major currents, the North Atlantic Current and the Norwegian Atlantic Current. We find that the prediction systems have difficulties in reproducing this pattern. To identify whether the misrepresentation is due to incorrect model physics, we assess the respective uninitialized historical simulations. These simulations also tend to misrepresent the spatiotemporal SST pattern, indicating that the physical mechanism is not properly simulated. However, the representation of the pattern is slightly degraded in the predictions compared to historical runs, which could be a result of initialization shocks and forecast drift effects. Ways to enhance predictions could include improved initialization and better simulation of poleward circulation of anomalies. This might require model resolutions in which flow over complex bathymetry and the physics of mesoscale ocean eddies and their interactions with the atmosphere are resolved. SIGNIFICANCE STATEMENT: In this study, we find that dynamical prediction systems and their respective climate models struggle to realistically represent ocean surface temperature variability in the eastern subpolar North Atlantic and Nordic seas on interannual-to-decadal time scales. In previous studies, ocean advection is proposed as a key mechanism in propagating temperature anomalies along the Atlantic water pathway toward the Arctic Ocean. Our analysis suggests that the predicted temperature anomalies are not properly circulated to the north; this is a result of model errors that seems to be exacerbated by the effect of initialization shocks and forecast drift. Better climate predictions in the study region will thus require improving the initialization step, as well as enhancing process representation in the climate models

Can energy fluxes be used to interpret glacial/interglacial precipitation changes in the Tropics?

Recent theoretical advances in the relationship between heat transport and the position of the inter tropical convergence zone (ITCZ) present an elegant framework through which to interpret past changes in tropical precipitation patterns. Using a very large ensemble of climate model simulations we investigate whether it is possible to use this framework to interpret changes in the position of the ITCZ in response to glacial and interglacial boundary conditions. We find that the centroid of tropical precipitation, which represents the evolution of precipitation in the whole tropics, is best correlated with heat transport changes. We find that the response of the annual mean ITCZ to glacial and interglacial boundary conditions is quite different to the response of the climatological annual cycle of the ITCZ to the seasonal cycle of insolation. We show that the reason for this is that while the Hadley Circulation plays a dominant role in transporting heat over the seasonal cycle, in the annual mean response to forcing, the Hadley Circulation is not dominant. When we look regionally, rather than at the zonal mean, we find that local precipitation is poorly related to either the zonal mean ITCZ or to meridional heat transport. We demonstrate that precipitation is spatially highly variable even when the zonal mean ITCZ is in the same location. This suggests only limited use for heat transport in explaining local precipitation records, thus there is limited scope for using heat transport changes to explain individual paleo-precipitation records

Microneurosurgical Anastomoses for Cerebral Ischemia [Contents]

From jacket: The purpose of this volume is to present a series of important papers on the rapidly growing surgical field of microneurosurgical anastomoses for cerebral ischemia. It includes papers on the indications and results of microneurosurgical bypass anastomoses; on the techniques used to study patients before and after surgery, including cerebral blood flow psychometic testing, etc.; and on the basic mechanisms of cerebral ischemia studies in animals. New ideas are suggested for techniques involving increased use of the occipital arteries and the development of vein, arterial, or prosthetic grafts in place of the STA (superficial temporal artery). Also discussed are the importance of measuring blood flow in the STA where possible, and the measurement of cerebral blood flow pre- and postoperatively to monitor the results. Psychometric studies are shown to be of importance pre- and postoperatively in addition to careful neurologic evaluation

The tropical rain belts with an annual cycle and a continent model intercomparison project: TRACMIP

This paper introduces the Tropical Rain belts with an Annual cycle and a Continent Model Intercomparison Project (TRACMIP). TRACMIP studies the dynamics of tropical rain belts and their response to past and future radiative forcings through simulations with 13 comprehensive and one simplified atmosphere models coupled to a slab ocean and driven by seasonally varying insolation. Five idealized experiments, two with an aquaplanet setup and three with a setup with an idealized tropical continent, fill the space between prescribed-SST aquaplanet simulations and realistic simulations provided by CMIP5/6. The simulations reproduce key features of present-day climate and expected future climate change, including an annual-mean intertropical convergence zone (ITCZ) that is located north of the equator and Hadley cells and eddy-driven jets that are similar to present-day climate. Quadrupling CO$_{2}$ leads to a northward ITCZ shift and preferential warming in Northern high latitudes. The simulations show interesting CO$_{2}$-induced changes in the seasonal excursion of the ITCZ and indicate a possible state dependence of climate sensitivity. The inclusion of an idealized continent modulates both the control climate and the response to increased CO$_{2}$; for example, it reduces the northward ITCZ shift associated with warming and, in some models, climate sensitivity. In response to eccentricity-driven seasonal insolation changes, seasonal changes in oceanic rainfall are best characterized as a meridional dipole, while seasonal continental rainfall changes tend to be symmetric about the equator. This survey illustrates TRACMIP’s potential to engender a deeper understanding of global and regional climate and to address questions on past and future climate change

The immediate and long-term effects of exercise and patient education on physical, functional, and quality-of-life outcome measures after single-level lumbar microdiscectomy: a randomized controlled trial protocol

BACKGROUND: Low back pain remains a costly quality-of-life-related health problem. Microdiscectomy is often the surgical procedure of choice for a symptomatic, single-level, lumbar disc herniation in younger and middle-aged adults. The question of whether a post-microdiscectomy exercise program enhances function, quality of life, and disability status has not been systematically explored. Thus, the overall purpose of this study is to assess immediate and long-term outcomes of an exercise program, developed at University of Southern California (USC), targeting the trunk and lower extremities (USC Spine Exercise Program) for persons who have undergone a single-level microdiscectomy for the first time. METHODS/DESIGN: One hundred individuals between the ages of 18 and 60 who consent to undergo lumbar microdiscectomy will be recruited to participate in this study. Subjects will be randomly assigned to one of two groups: 1) one session of back care education, or 2) a back care education session followed by the 12-week USC Spine Exercise Program. The outcome examiners (evaluators), as well as the data managers, will be blinded to group allocation. Education will consist of a one-hour "one-on-one" session with the intervention therapist, guided by an educational booklet specifically designed for post-microdiscectomy care. This session will occur four to six weeks after surgery. The USC Spine Exercise Program consists of two parts: back extensor strength and endurance, and mat and upright therapeutic exercises. This exercise program is goal-oriented, performance-based, and periodized. It will begin two to three days after the education session, and will occur three times a week for 12 weeks. Primary outcome measures include the Oswestry Disability Questionnaire, Roland-Morris Disability Questionnaire, SF-36(® )quality of life assessment, Subjective Quality of Life Scale, 50-foot Walk, Repeated Sit-to-Stand, and a modified Sorensen test. The outcome measures in the study will be assessed before and after the 12-week post-surgical intervention program. Long-term follow up assessments will occur every six months beginning one year after surgery and ending five years after surgery. Immediate and long-term effects will be assessed using repeated measures multivariate analysis of variance (MANOVA). If significant interactions are found, one-way ANOVAs will be performed followed by post-hoc testing to determine statistically significant pairwise comparisons. DISCUSSION: We have presented the rationale and design for a randomized controlled trial evaluating the effectiveness of a treatment regimen for people who have undergone a single-level lumbar microdiscectomy

Rasl11b Knock Down in Zebrafish Suppresses One-Eyed-Pinhead Mutant Phenotype

The EGF-CFC factor Oep/Cripto1/Frl1 has been implicated in embryogenesis and several human cancers. During vertebrate development, Oep/Cripto1/Frl1 has been shown to act as an essential coreceptor in the TGFβ/Nodal pathway, which is crucial for germ layer formation. Although studies in cell cultures suggest that Oep/Cripto1/Frl1 is also implicated in other pathways, in vivo it is solely regarded as a Nodal coreceptor. We have found that Rasl11b, a small GTPase belonging to a Ras subfamily of putative tumor suppressor genes, modulates Oep function in zebrafish independently of the Nodal pathway. rasl11b down regulation partially rescues endodermal and prechordal plate defects of zygotic oep−/− mutants (Zoep). Rasl11b inhibitory action was only observed in oep-deficient backgrounds, suggesting that normal oep expression prevents Rasl11b function. Surprisingly, rasl11b down regulation does not rescue mesendodermal defects in other Nodal pathway mutants, nor does it influence the phosphorylation state of the downstream effector Smad2. Thus, Rasl11b modifies the effect of Oep on mesendoderm development independently of the main known Oep output: the Nodal signaling pathway. This data suggests a new branch of Oep signaling that has implications for germ layer development, as well as for studies of Oep/Frl1/Cripto1 dysfunction, such as that found in tumors

Modeling community integration in workers with delayed recovery from mild traumatic brain injury

Background: Delayed recovery in persons after mild traumatic brain injury (mTBI) is poorly understood. Community integration (CI) is endorsed by persons with neurological disorders as an important outcome. We aimed to describe CI and its associated factors in insured Ontario workers with delayed recovery following mTBI. Methods: A cross-sectional study of insured workers in the chronic phase following mTBI was performed at a rehabilitation hospital in Ontario, Canada. Sociodemographic, occupational, injury-related, clinical, and claim-related data were collected from self-reports, medical assessments, and insurers’ referral files. Community Integration Questionnaire (CIQ) scores were compared using analysis of variance or Spearman’s correlation tests. Stepwise multivariable linear regression models were used to evaluate the associations with CI. Results: Ninety-four workers with mTBI (45.2 ± 9.9 years old, 61.2 % male) at 197 days post-injury (interquartile range, 139–416 days) were included. The CIQ total and subscale scores were similar to those reported in more severe TBI samples. The CIQ scores were moderately to strongly correlated with various sociodemographic, claim-related, and clinical variables. In the multivariable regression analysis, several covariates accounted for 36.4 % of the CIQ variance in the final fully adjusted model. Discussion: This study evaluated CI in workers with mTBI, and analyzed its associated variables. Analysis revealed insomnia, head or neck pain, being married or in a relationship, time since injury, and a diagnosis of possible/probable malingering were independently associated with limited CI. Conclusions: Workers with delayed recovery from mTBI experience difficulty with CI. Insomnia is a particularly relevant covariate, explaining the greater part of its variance. To enhance participation, care should focus on clinical and non-clinical covariates

Gamma entrainment frequency affects mood, memory and cognition: an exploratory pilot study

Here we provide evidence with an exploratory pilot study that through the use of a Gamma 40 Hz entrainment frequency, mood, memory and cognition can be improved with respect to a 9-participant cohort. Participants constituted towards three binaural entrainment frequency groups: the 40 Hz, 25 Hz and 100 Hz. Participants attended a total of eight entrainment frequency sessions twice over the duration of a 4-week period. Additionally, participants were assessed based on their cognitive abilities, mood as well as memory, where the cognitive and memory assessments occurred before and after a 5-min binaural beat stimulation. The mood assessment scores were collected from sessions 1, 4 and 8, respectively. With respect to the Gamma 40 Hz entrainment frequency population, we observed a mean improvement in cognitive scores, elevating from 75% average to 85% average upon conclusion of the experimentation at weak statistical significance (α = 0.10, p = 0.076). Similarly, memory score improvements at a greater significance (α = 0.05, p = 0.0027) were noted, elevating from an average of 87% to 95%. In pertinence to the mood scores, a negative correlation across all populations were noted, inferring an overall increase in mood due to lower scores correlating with elevated mood. Finally, correlation analysis revealed a stronger R2 value (0.9838) within the 40 Hz group between sessions as well as mood score when compared across the entire frequency group cohort