Eddy-mediated transport of warm Circumpolar Deep Water across the Antarctic Shelf Break

The Antarctic Slope Front (ASF) modulates ventilation of the abyssal ocean via the export of dense Antarctic Bottom Water (AABW) and constrains shoreward transport of warm Circumpolar Deep Water (CDW) toward marine-terminating glaciers. Along certain stretches of the continental shelf, particularly where AABW is exported, density surfaces connect the shelf waters to the middepth Circumpolar Deep Water offshore, offering a pathway for mesoscale eddies to transport CDW directly onto the continental shelf. Using an eddy-resolving process model of the ASF, the authors show that mesoscale eddies can supply a dynamically significant transport of heat and mass across the continental shelf break. The shoreward transport of surface waters is purely wind driven, while the shoreward CDW transport is entirely due to mesoscale eddy transfer. The CDW flux is sensitive to all aspects of the model's surface forcing and geometry, suggesting that shoreward eddy heat transport may be localized to favorable sections of the continental slope

Carbon dynamics of the Weddell Gyre, Southern Ocean

The accumulation of carbon within the Weddell Gyre and its exchanges across the gyre boundaries are investigated with three recent full-depth oceanographic sections enclosing this climatically important region. The combination of carbonmeasurements with ocean circulation transport estimates from a box inverse analysis reveals that deepwater transports associated with Warm Deep Water (WDW) and Weddell Sea Deep Water dominate the gyre’s carbon budget, while a dual-cell vertical overturning circulation leads to both upwelling and the delivery of large quantities of carbon to the deep ocean. Historical sea surface pCO2 observations, interpolated using a neural network technique, confirm the net summertime sink of 0.044 to 0.058 ± 0.010 Pg C / yr derived from the inversion. However, a wintertime outgassing signal similar in size results in a statistically insignificant annual air-to-sea CO2 flux of 0.002± 0.007 Pg C / yr (mean 1998–2011) to 0.012 ± 0.024 Pg C/ yr (mean 2008–2010) to be diagnosed for the Weddell Gyre. A surface layer carbon balance, independently derived fromin situ biogeochemical measurements, reveals that freshwater inputs and biological drawdown decrease surface ocean inorganic carbon levels more than they are increased by WDW entrainment, resulting in an estimated annual carbon sink of 0.033 ± 0.021 Pg C / yr. Although relatively less efficient for carbon uptake than the global oceans, the summertime Weddell Gyre suppresses the winter outgassing signal, while its biological pump and deepwater formation act as key conduits for transporting natural and anthropogenic carbon to the deep ocean where they can reside for long time scales

Jets and Topography: Jet Transitions and the Impact on Transport in the Antarctic Circumpolar Current

The Southern Ocean’s Antarctic Circumpolar Current (ACC) naturally lends itself to interpretations using a zonally averaged framework. Yet, navigation around steep and complicated bathymetric obstacles suggests that local dynamics may be far removed from those described by zonally symmetric models. In this study, both observational and numerical results indicate that zonal asymmetries, in the form of topography, impact global flow structure and transport properties. The conclusions are based on a suite of more than 1.5 million virtual drifter trajectories advected using a satellite altimetry–derived surface velocity field spanning 17 years. The focus is on sites of “cross front” transport as defined by movement across selected sea surface height contours that correspond to jets along most of the ACC. Cross-front exchange is localized in the lee of bathymetric features with more than 75% of crossing events occurring in regions corresponding to only 20% of the ACC’s zonal extent. These observations motivate a series of numerical experiments using a two-layer quasigeostrophic model with simple, zonally asymmetric topography, which often produces transitions in the front structure along the channel. Significantly, regimes occur where the equilibrated number of coherent jets is a function of longitude and transport barriers are not periodic. Jet reorganization is carried out by eddy flux divergences acting to both accelerate and decelerate the mean flow of the jets. Eddy kinetic energy is amplified downstream of topography due to increased baroclinicity related to topographic steering. The combination of high eddy kinetic energy and recirculation features enhances particle exchange. These results stress the complications in developing consistent circumpolar definitions of the ACC fronts

Perceptions and experiences of medical student first responders: a mixed methods study

Context Medical Student First Responders (MSFRs) are volunteers who respond to emergency calls, managing patients before ambulance staff attend. The MSFR role provides opportunities to manage acutely unwell patients in the prehospital environment, not usually offered as part of formal undergraduate medical education. There are few previous studies describing activities or experiences of MSFRs or exploring the potential educational benefits. We aimed to investigate the activity of MSFRs and explore their experiences, particularly from an educational perspective. Methods We used a mixed methods design, combining quantitative analysis of ambulance dispatch data with qualitative semi-structured interviews of MSFRs. Dispatch data were from South Central and East Midlands Ambulance Service NHS Trusts from 1st January to 31st December 2019. Using propensity score matching, we compared incidents attended by MSFRs with those attended by other Community First Responders (CFRs) and ambulance staff. We interviewed MSFRs from five English (UK) medical schools in those regions about their experiences and perceptions and undertook thematic analysis supported by NVivo 12. Results We included 1,939 patients (median age 58.0 years, 51% female) attended by MSFRs. Incidents attended were more urgent category calls (category 1 n = 299, 14.9% and category 2 n = 1,504, 77.6%), most commonly for chest pain (n = 275, 14.2%) and shortness of breath (n = 273, 14.1%). MSFRs were less likely to attend patients of white ethnicity compared to CFRs and ambulance staff, and more likely to attend incidents in areas of higher socioeconomic deprivation (IMD – index of multiple deprivation) (p < 0.05). Interviewees (n = 16) consistently described positive experiences which improved their clinical and communication skills. Conclusion MSFRs’ attendance at serious medical emergencies provide a range of reported educational experiences and benefits. Further studies are needed to explore whether MSFR work confers demonstrable improvements in educational or clinical performance

Limited Relationship between Cervico-Vaginal Fluid Cytokine Profiles and Cervical Shortening in Women at High Risk of Spontaneous Preterm Birth

Objective: to determine the relationship between high vaginal pro-inflammatory cytokines and cervical shortening in women at high risk of spontaneous preterm labor and to assess the influence of cervical cerclage and vaginal progesterone on this relationship. Methods: this prospective longitudinal observational study assessed 112 women with at least one previous preterm delivery between 16 and 34 weeks’ gestation. Transvaginal cervical length was measured and cervico-vaginal fluid sampled every two weeks until 28 weeks. If the cervix shortened (<25 mm) before 24 weeks’ gestation, women (cases) were randomly assigned to cerclage or progesterone and sampled weekly. Cytokine concentrations were measured in a subset of cervico-vaginal fluid samples (n = 477 from 78 women) by 11-plex fluid-phase immunoassay. Results: all 11 inflammatory cytokines investigated were detected in cervico-vaginal fluid from women at high risk of preterm birth, irrespective of later cervical shortening. At less than 24 weeks’ gestation and prior to intervention, women destined to develop a short cervix (n = 36) exhibited higher cervico-vaginal concentrations than controls (n = 42) of granulocyte-macrophage colony-stimulating factor [(GM-CSF) 16.2 fold increase, confidence interval (CI) 1.8–147; p = 0.01] and monocyte chemotactic protein-1 [(MCP-1) 4.8, CI 1.0–23.0; p = 0.05]. Other cytokines were similar between cases and controls. Progesterone treatment did not suppress cytokine concentrations. Interleukin (IL)-6, IL-8, granulocyte colony-stimulating factor (G-CSF), interferon (IFN)-γ and tumour necrosis factor (TNF)-α concentrations were higher following randomization to cerclage versus progesterone (p<0.05). Cerclage, but not progesterone treatment, was followed by a significant increase in cervical length [mean 11.4 mm, CI 5.0–17.7; p<0.001]. Conclusions: although GM-CSF and MCP-1 cervico-vaginal fluid concentrations were raised, the majority of cervico-vaginal cytokines did not increase in association with cervical shortening. Progesterone treatment showed no significant anti-inflammation action on cytokine concentrations. Cerclage insertion was associated with an increase in the majority of inflammatory markers and cervical length