An observed regime shift in the formation of warm core rings from the gulf stream

© The Author(s), 2019. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Gangopadhyay, A., Gawarkiewicz, G., Silva, E. N. S., Monim, M., & Clark, J. An observed regime shift in the formation of warm core rings from the gulf stream. Scientific Reports, 9(1), (2019): 12319-019-48661-9, doi:10.1038/s41598-019-48661-9.We present observational evidence that a significant regime change occurred around the year 2000 in the formation of Warm Core Rings (WCRs) from the Gulf Stream (GS) between 75° and 55°W. The dataset for this study is a set of synoptic oceanographic charts available over the thirty-eight-year period of 1980–2017. The upward regime change shows an increase to 33 WCRs per year during 2000–2017 from an average of 18 WCRs during 1980 to 1999. A seasonal analysis confirms May-June-July as the peak time for WCR births in agreement with earlier studies. The westernmost region (75°-70°W) is least ring-productive, while the region from 65°W to 60°W is most productive. This regime shift around 2000 is detected in WCR formation for all of the four 5-degree wide sub-regions and the whole region (75°-55°W). This might be related to a reduction of the deformation radius for ring formation, allowing unstable meanders to shed more frequent rings in recent years. A number of possible factors resulting in such a regime shift related to the possible changes in reduced gravity, instability, transport of the GS, large-scale changes in the wind system and atmospheric fluxes are outlined, which suggest new research directions. The increase in WCRs has likely had an impact on the marine ecosystem since 2000, a topic worthy for future studies.The authors acknowledge financial supports from NOAA (NA11NOS0120038), NSF (OCE-0815679), SMAST and UMass Dartmouth. GG was supported by NSF under grant OCE-1657853 as well as a Senior Scientist Chair from WHOI. We have benefitted from many discussions on GS system behavior and variability with Tom Rossby, Charlie Flagg, Kathy Donohue, Randy Watts, Peter Cornillon, Magdalena Andres and on WCR identification with Jim Bisagni. The WCR data from Jenifer Clark (co-author) and Roger Pettipas were used to develop the original census. We wish to thank the Editor and two anonymous reviewers for their helpful comments and encouragement to a previous version which improved the focus of this manuscript

COVID-19 infection and vaccine status in patients with chronic kidney diseases

Background: The COVID-19 virus has had a great effect globally, changing many commonalities. The incidence of COVID-19 had weakened the immune system, leading to more severe outcomes of various common diseases. Since its early development, the vaccination of COVID-19 has also had mixed responses. The aim of the study was to observe the incidence rate of COVID-19 infection and vaccination status among chronic kidney disease patients. Methods: In this study 50 (27 male and 23 female) adult skulls were investigated to determine the type of asterion, its distance from important bony landmarks and also the nearby venous sinuses were measured. Results: Majority (41.61%) of the participants had been between the ages of 41-55 years old, and 64.84% male prevalence was observed. 60.65% of the participants had been from rural areas. A large portion of the participants (38.06%) did not have any comorbidities, while multiple comorbidities were present among many of the remaining participants. Hypertension was the most common comorbidity, observed in 56.45% of the participants. 72.26% of the present study participants had been asymptomatic, while 13.23% had a fever as their symptom of COVID-19. COVID-19 test was done on 81 patients, among whom 64 had tested positive. Among the total 310 participants, 29.03% had not received any vaccinations, while 14.19% had received only 1st dose of vaccination, 47.2% had received up to their 2nd dose, and 9.35% had received their booster dose. Conclusions: The present study observed a low incidence rate of COVID-19 positive patients among those affected by chronic kidney disease. However, the study also observed a significant positive relation between COVID-19 positive patients and the need for additional medical support, leading to the conclusion that COVID-19 can significantly affect the severity of CKD.

A census of the warm-core rings of the Gulf Stream: 1980-2017

Author Posting. © American Geophysical Union, 2020. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research: Oceans 125(8), (2020): e2019JC016033, doi:10.1029/2019JC016033.A census of Gulf Stream (GS) warm‐core rings (WCRs) is presented based on 38 years (1980–2017) of data. The census documents formation and demise times and locations, and formation size for all 961 WCRs formed in the study period that live for a week or more. A clear regime shift was observed around the Year 2000 and was reported by a subset of authors (Gangopadhyay et al., 2019, https://doi.org/10.1038/s41598-019-48661-9). The WCR formation over the whole region (75–55°W) increased from an average of 18 per year during Regime 1 (1980–1999) to 33 per year during Regime 2 (2000–2017). For geographic analysis formation locations were grouped in four 5° zones between 75°W and 55°W. Seasonally, WCR formations show a significant summer maxima and winter minima, a pattern that is consistent through all zones and both temporal regimes. The lifespan and size distribution show progressively more rings with higher longevity and greater size when formed to the east of 70°W. The average lifespan of the WCRs in all four zones decreased by 20–40% depending on zones and/or seasons from Regime 1 to Regime 2, while the size distribution remained unchanged across regimes. The ring footprint index, a first‐order signature of impact of the WCRs on the slope, increased significantly (26–90%) for all zones from Regime 1 to Regime 2, with the highest percent increase in Zone 2 (70–65°W). This observational study establishes critical statistical and dynamical benchmarks for validating numerical models and highlights the need for further dynamical understanding of the GS‐ring formation processes.The authors acknowledge financial support from NOAA (NA11NOS0120038), NSF (OCE‐0815679 and OCE‐1851242), and SMAST and UMass Dartmouth. G. G. was supported by NSF under Grant OCE‐1657853 as well as a Senior Scientist Chair from WHOI. We have benefitted from many discussions on Gulf Stream and WCR with Magdalena Andres, Andre Schmidt, Paula Fratantoni, Jon Hare, Wendell Brown, Kathy Donohue, Tom Rossby, Peter Cornillon, and Randy Watts.2020-12-2

The changing nature of shelf-break exchange revealed by the OOI Pioneer Array

Author Posting. © The Oceanography Society, 2018. This article is posted here by permission of The Oceanography Society for personal use, not for redistribution. The definitive version was published in Oceanography 31, no. 1 (2018): 60–70, doi:10.5670/oceanog.2018.110.Although the continental shelf and slope south of New England have been the subject of recent studies that address decadal-scale warming and interannual variability of water mass properties, it is not well understood how these changes affect shelf-break exchange processes. In recent years, observations of anomalous shelf and slope conditions obtained from the Ocean Observatories Initiative Pioneer Array and other regional observing programs suggest that onshore intrusions of warm, salty waters are becoming more prevalent. Mean cross-shelf transects constructed from Pioneer Array glider observations collected from April 2014 through December 2016 indicate that slope waters have been warmer and saltier. We examine shelf-break exchange events and anomalous onshore intrusions of warm, salty water associated with warm core rings located near the shelf break in spring 2014 and winter 2017 using observations from the Pioneer Array and other sources. We also describe an additional cross-shelf intrusion of ring water in September 2014 to demonstrate that the occurrence of high-salinity waters extending across the continental shelf is rare. Observations from the Pioneer Array and other sources show warm core ring and Gulf Stream water masses intrude onto the continental shelf more frequently and penetrate further onshore than in previous decades.GG, WZ, RT, and MD were supported by the National Science Foundation under grant OCE-1657853. WZ was also supported by grant OCE-1634965. JP is grateful for the support of the Woods Hole Oceanographic Institution Summer Student Fellow Program. AMM was supported by a grant from the MacArthur Foundation. GG and AMM were also supported by a grant from the van Beuren Charitable Foundation for collection and analysis of hydrographic data collected by the CFRF Shelf Research Fleet

A survival analysis of the gulf stream warm core rings

Author Posting. © American Geophysical Union, 2020. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research: Oceans 125(10),(2020): e2020JC016507, https://doi.org/10.1029/2020JC016507.Survival of Gulf Stream (GS) warm core rings (WCRs) was investigated using a census consisting of a total of 961 rings formed during the period 1980–2017. Kaplan‐Meier survival probability and Cox hazard proportional models were used for the analysis. The survival analysis was performed for rings formed in four 5° zones between 75° W and 55° W. The radius, latitude, and distance from the shelf‐break of a WCR at formation all had a significant effect on the survival of WCRs. A pattern of higher survival was observed in WCRs formed in Zone 2 (70°–65° W) or Zone 3 (65°–60° W) and then demised in Zone 1 (75°–70° W). Survival probability of the WCRs increased to more than 70% for those formed within a latitude band from 39.5° to 41.5° N. Survival probability is reduced when the WCRs are formed near the New England Seamounts.We are grateful for financial supports from NOAA (NA11NOS0120038), NSF (OCE‐1851242), SMAST, and UMass Dartmouth. G. G. was supported by NSF under grant OCE‐1851261.2021-04-1

Wastewater-based epidemiological surveillance to monitor the prevalence of SARS-CoV-2 in developing countries with onsite sanitation facilities

Wastewater-based epidemiology (WBE) has emerged as a valuable approach for forecasting disease outbreaks in developed countries with a centralized sewage infrastructure. On the other hand, due to the absence of well-defined and systematic sewage networks, WBE is challenging to implement in developing countries like Bangladesh where most people live in rural areas. Identification of appropriate locations for rural Hotspot Based Sampling (HBS) and urban Drain Based Sampling (DBS) are critical to enable WBE based monitoring system. We investigated the best sampling locations from both urban and rural areas in Bangladesh after evaluating the sanitation infrastructure for forecasting COVID-19 prevalence. A total of 168 wastewater samples were collected from 14 districts of Bangladesh during each of the two peak pandemic seasons. RT-qPCR commercial kits were used to target ORF1ab and N genes. The presence of SARS-CoV-2 genetic materials was found in 98% (165/168) and 95% (160/168) wastewater samples in the first and second round sampling, respectively. Although wastewater effluents from both the marketplace and isolation center drains were found with the highest amount of genetic materials according to the mixed model, quantifiable SARS-CoV-2 RNAs were also identified in the other four sampling sites. Hence, wastewater samples of the marketplace in rural areas and isolation centers in urban areas can be considered the appropriate sampling sites to detect contagion hotspots. This is the first complete study to detect SARS-CoV-2 genetic components in wastewater samples collected from rural and urban areas for monitoring the COVID-19 pandemic. The results based on the study revealed a correlation between viral copy numbers in wastewater samples and SARS-CoV-2 positive cases reported by the Directorate General of Health Services (DGHS) as part of the national surveillance program for COVID-19 prevention. The findings of this study will help in setting strategies and guidelines for the selection of appropriate sampling sites, which will facilitate in development of comprehensive wastewater-based epidemiological systems for surveillance of rural and urban areas of low-income countries with inadequate sewage infrastructure.This research was supported by Water Aid Bangladesh, North South University, Dhaka, COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University (NSTU), Noakhali, Bangladesh, the International Training Network of Bangladesh University of Engineering and Technology (ITN-BUET) - Centre for Water Supply and Waste Management, and KTH Royal Institute of Technology, Sweden. We acknowledge the sincere help and support of the staff and volunteers of NSTU-COVID-19 Diagnostic Lab, Noakhali Science and Technology University, Bangladesh during the different phases of the study. PB and MTI acknowledge the Life Science Technology Platform, Science for Life Laboratory for the seed funding to initiate the wastewater-based epidemiological studies for SARS-CoV-2 in Bangladesh. We would also like to acknowledge the two anonymous reviewers for their critical comments as well as their thoughtful insights, which has significantly improved the manuscript.Peer reviewe

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Photoacoustic raster scan imaging using an optomechanical ultrasound sensor in silicon photonics

Photoacoustic tomography defines new challenges for ultrasound detection compared to ultrasonography. To address these challenges, a sensitive, small, scalable, and broadband optomechanical ultrasound sensor (OMUS) has been developed. The OMUS is an on-chip optical ultrasound sensor, using optical interferometric ultrasound detection. It consists of an acoustic membrane on top of an optical ring resonator that modulates the optical ring resonance with high efficiency enabled by an innovative optomechanical waveguide. Raster scanning photoacoustic tomography has been demonstrated with a single-element OMUS. Based on performance and form factor, the OMUS combined with passive optical multiplexing may enable new applications in photoacoustic imaging.</p