The spatial distribution and annual cycle of upper ocean thermohaline structure

Author Posting. © American Geophysical Union, 2012. 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 117 (2012): C02027, doi:10.1029/2011JC007033.Observations of the spatial distribution and persistence of thermohaline structure are presented, and show how advection and diffusion affect a passive tracer. More than two years of underwater glider observations in the central subtropical North Pacific showed thermohaline variability over horizontal scales from 5 to 1300 km. Thermohaline fluctuations along isopycnals (spice fluctuations) were elevated in layers throughout the water column with the largest fluctuations near the surface and subtropical frontal regions. Fluctuations were uncorrelated between the layers but stirred by the same velocity field. Spice variance had local extrema in the vertical because of differences in source water properties and the influence of neighboring water masses. Spice variance spanned about three orders of magnitude along deeper isopycnals with larger variance where different water masses met and where velocity and vorticity variance were elevated. Horizontal wave number spectra of spice had slopes of −2 everywhere in the upper 1000 m. Submesoscale spice fluctuations had slopes in physical space near the ratio of the Coriolis parameter to the buoyancy frequency (f/N), consistent with predictions of quasi-geostrophic theory. In the mixed layer, thermohaline structure had a significant annual cycle with smaller interannual differences. Thermohaline fluctuations left behind during restratification and isolated from the mixed layer decayed with time because of diffusion along isopycnals. Horizontal diffusivity estimates in the remnant mixed layer were 0.4 m2 s−1 at 15–28 km wavelengths and 0.9 m2 s−1 at 35–45 km wavelengths.We gratefully acknowledge the National Science Foundation for funding this work under grant number OCE0452574.2012-08-1

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Transforming the learning environment in a Canadian high school

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Characteristics of interleaving in the western equatorial Pacific

The characteristics of intrusive thermohaline features in the thermocline of the western equatorial Pacific are examined during two different climatic states. The vertical and meridional structure of the features is determined from a total of 12 high-resolution meridional sections. Although there is considerable variability of the broader structure of the flow and temperature/salinity fields, the spatial scale of the interleaving is found to be persistent over all sections. The Turner angle and correlations between the spice anomaly and density anomaly suggest that double-diffusive processes may be important in the vertical flux of properties. The characteristics of the interleaving are compared with the results from the theories of double-diffusive interleaving and inertial instability. It is found that the observations are consistent with both. It is difficult to differentiate between the two theories in explaining the presence of the layers. Indeed, both mechanisms may be playing a role. The magnitude of the cross-equatorial fluxes of heat and salt due to the features is estimated and shown to be comparable with estimates due to other processes. There is a strong potential for the interleaving to impinge on the large-scale dynamics of the equatorial Pacific Ocean