Ice Cores from the St. Elias Mountains, Yukon, Canada: Their Significance for Climate, Atmospheric Composition and Volcanism in the North Pacific Region

A major achievement in research supported by the Kluane Lake Research Station was the recovery, in 2001 –02, of a suite of cores from the icefields of the central St. Elias Mountains, Yukon, by teams of researchers from Canada, the United States, and Japan. This project led to the development of parallel, long (103 – 104 year) ice-core records of climate and atmospheric change over an altitudinal range of more than 2 km, from the Eclipse Icefield (3017 m) to the ice-covered plateau of Mt. Logan (5340 m). These efforts built on earlier work recovering single ice cores in this region. Comparison of these records has allowed for variations in climate and atmospheric composition to be linked with changes in the vertical structure and dynamics of the North Pacific atmosphere, providing a unique perspective on these changes over the Holocene. Owing to their privileged location, cores from the St. Elias Icefields also contain a remarkably detailed record of aerosols from various sources around or across the North Pacific. In this paper we review major scientific findings from the study of St. Elias Mountain ice cores, focusing on five main themes: (1) The record of stable water isotopes (δ18O, δD), which has unique characteristics that differ from those of Greenland, other Arctic ice cores, and even among sites in the St. Elias; (2) the snow accumulation history; (3) the record of pollen, biomass burning aerosol, and desert dust deposition; (4) the record of long-range air pollutant deposition (sulphate and lead); and (5) the record of paleo-volcanism. Our discussion draws on studies published since 2000, but based on older ice cores from the St. Elias Mountains obtained in 1980 and 1996

Coastal Ice-Core Record of Recent Northwest Greenland Temperature and Sea-Ice Concentration

Coastal ice cores provide an opportunity to investigate regional climate and sea-ice variability in the past to complement hemispheric-scale climate reconstructions from ice-sheet-interior ice cores. Here we describe robust proxies of Baffin Bay temperature and sea-ice concentration from the coastal 2Barrel ice core collected in the Thule region of northwest Greenland. Over the 1990–2010 record, 2Barrel annually averaged methanesulfonic acid (MSA) concentrations are significantly correlated with May–June Baffin Bay sea-ice concentrations and summer temperatures. Higher MSA is observed during warmer years with less sea ice, indicative of enhanced primary productivity in Baffin Bay. Similarly, 2Barrel annually averaged deuterium excess (d-excess) values are significantly correlated with annual Baffin Bay sea-ice concentrations and summer and annual temperatures. Warm (cool) years with anomalously low (high) sea-ice concentration are associated with proportionally more (less) low-d-excess Baffin Bay moisture at the ice-core site. Multilinear regression models incorporating 2Barrel MSA, d-excess and snow accumulation account for 38–51% of the Baffin Bay sea-ice and temperature variance. The annual temperature model is significantly correlated with temperatures throughout most of Greenland and eastern Arctic Canada due to the strong influence of the North Atlantic Oscillation and Atlantic Multidecadal Oscillation

Industrial-Age Doubling of Snow Accumulation in the Alaska Range Linked to Tropical Ocean Warming

Future precipitation changes in a warming climate depend regionally upon the response of natural climate modes to anthropogenic forcing. North Pacific hydroclimate is dominated by the Aleutian Low, a semi-permanent wintertime feature characterized by frequent low-pressure conditions that is influenced by tropical Pacific Ocean temperatures through the Pacific-North American (PNA) teleconnection pattern. Instrumental records show a recent increase in coastal Alaskan precipitation and Aleutian Low intensification, but are of insufficient length to accurately assess low frequency trends and forcing mechanisms. Here we present a 1200-year seasonally- to annually-resolved ice core record of snow accumulation from Mt. Hunter in the Alaska Range developed using annual layer counting and four ice-flow thinning models. Under a wide range of glacier flow conditions and layer counting uncertainty, our record shows a doubling of precipitation since ~1840 CE, with recent values exceeding the variability observed over the past millennium. The precipitation increase is nearly synchronous with the warming of western tropical Pacific and Indian Ocean sea surface temperatures. While regional 20th Century warming may account for a portion of the observed precipitation increase on Mt. Hunter, the magnitude and seasonality of the precipitation change indicate a long-term strengthening of the Aleutian Low

Ice Cores from the St. Elias Mountains, Yukon, Canada: Their Significance for Climate, Atmospheric Composition and Volcanism in the North Pacific Region

A major achievement in research supported by the Kluane Lake Research Station was the recovery, in 2001 –02, of a suite of cores from the icefields of the central St. Elias Mountains, Yukon, by teams of researchers from Canada, the United States, and Japan. This project led to the development of parallel, long (103 – 104 year) ice-core records of climate and atmospheric change over an altitudinal range of more than 2 km, from the Eclipse Icefield (3017 m) to the ice-covered plateau of Mt. Logan (5340 m). These efforts built on earlier work recovering single ice cores in this region. Comparison of these records has allowed for variations in climate and atmospheric composition to be linked with changes in the vertical structure and dynamics of the North Pacific atmosphere, providing a unique perspective on these changes over the Holocene. Owing to their privileged location, cores from the St. Elias Icefields also contain a remarkably detailed record of aerosols from various sources around or across the North Pacific. In this paper we review major scientific findings from the study of St. Elias Mountain ice cores, focusing on five main themes: (1) The record of stable water isotopes (δ18O, δD), which has unique characteristics that differ from those of Greenland, other Arctic ice cores, and even among sites in the St. Elias; (2) the snow accumulation history; (3) the record of pollen, biomass burning aerosol, and desert dust deposition; (4) the record of long-range air pollutant deposition (sulphate and lead); and (5) the record of paleo-volcanism. Our discussion draws on studies published since 2000, but based on older ice cores from the St. Elias Mountains obtained in 1980 and 1996

Climate Change Impacts on Iowa, 2010

Climate change is already affecting the way Iowans live and work. Without action to mitigate these effects, our future responses will become more complex and costly . The following policy recommendations are offered as initial steps to help safeguard our state’s economy, environment, and residents

Community Health and Socioeconomic Issues Surrounding Concentrated Animal Feeding Operations

A consensus of the Workgroup on Community and Socioeconomic Issues was that improving and sustaining healthy rural communities depends on integrating socioeconomic development and environmental protection. The workgroup agreed that the World Health Organization’s definition of health, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,” applies to rural communities. These principles are embodied in the following main points agreed upon by this workgroup. Healthy rural communities ensure a) the physical and mental health of individuals, b) financial security for individuals and the greater community, c) social well-being, d ) social and environmental justice, and e) political equity and access. This workgroup evaluated impacts of the proliferation of concentrated animal feeding operations (CAFOs) on sustaining the health of rural communities. Recommended policy changes include a more stringent process for issuing permits for CAFOs, considering bonding for manure storage basins, limiting animal density per watershed, enhancing local control, and mandating environmental impact statements

Adherence to cardioprotective medications and mortality among patients with diabetes and ischemic heart disease

BACKGROUND: Patients with diabetes and ischemic heart disease (IHD) are at high risk for adverse cardiac outcomes. Clinical practice guidelines recommend multiple cardioprotective medications to reduce recurrent events. We evaluated the association between cardioprotective medication adherence and mortality among patients with diabetes and IHD. METHODS: In a retrospective cohort study of 3,998 patients with diabetes and IHD, we evaluated use of ACE inhibitors or angiotensin receptor blockers, β-blockers, and statin medications. Receipt of cardioprotective medications was based on filled prescriptions. Medication adherence was calculated as the proportion of days covered (PDC) for filled prescriptions. The primary outcome of interest was all-cause mortality. RESULTS: The majority of patients (92.8%) received at least 1 cardioprotective medication. Patients receiving any medications had lower unadjusted mortality rates compared to patients not receiving any medications (7.9% vs. 11.5%; p = 0.03). In multivariable analysis, receipt of any cardioprotective medication remained associated with lower all-cause mortality (OR 0.65; 95% CI 0.43–0.99). Among patients receiving cardioprotective medications, the majority (80.3%) were adherent (PDC ≥ 0.80). Adherent patients had lower unadjusted mortality rates (6.7% vs. 12.1%; p < 0.01). In multivariable analysis, medication adherence remained associated with lower all-cause mortality (OR 0.52; 95% CI 0.39–0.69) compared to non-adherence. In contrast, there was no mortality difference between patients receiving cardioprotective medications who were non-adherent compared to patients not receiving any medications (OR 1.01; 95% CI 0.64–1.61). CONCLUSION: In conclusion, medication adherence is associated with improved outcomes among patients with diabetes and IHD. Quality improvement interventions are needed to increase medication adherence in order for patients to maximize the benefit of cardioprotective medications

A self administered reliable questionnaire to assess lower bowel symptoms

<p>Abstract</p> <p>Background</p> <p>Bowel symptoms are considered indicators of the presence of colorectal cancer and other bowel diseases. Self administered questionnaires that elicit information about lower bowel symptoms have not been assessed for reliability, although this has been done for upper bowel symptoms. Our aim was to develop a self administered questionnaire for eliciting the presence, nature and severity of lower bowel symptoms potentially related to colorectal cancer, and assess its reliability.</p> <p>Methods</p> <p>Immediately before consulting a gastroenterologist or colorectal surgeon, 263 patients likely to have a colonoscopy completed the questionnaire. Reliability was assessed in two ways: by assessing agreement between patient responses and (a) responses given by the doctor at the consultation; and (b) responses given by patients two weeks later.</p> <p>Results</p> <p>There was more than 75% agreement for 78% of the questions for the patient-doctor comparison and for 92% of the questions for the patient-patient comparison. Agreement for the length of time a symptom was present, its severity, duration, frequency of occurrence and whether or not medical consultation had been sought, all had agreement of greater than 70%. Over all questions, the chance corrected agreement for the patient-doctor comparison had a median kappa of 65% (which represents substantial agreement), interquartile range 57–72%. The patient-patient comparison also showed substantial agreement with a median kappa of 75%, interquartile range 68–81%.</p> <p>Conclusion</p> <p>This self administered questionnaire about lower bowel symptoms is a useful way of eliciting details of bowel symptoms. It is a reliable instrument that is acceptable to patients and easily completed. Its use could guide the clinical consultation, allowing a more efficient, comprehensive and useful interaction, ensuring that all symptoms are assessed. It will also be a useful tool in research studies on bowel symptoms and their predictive value for colorectal cancer and other diseases. Studies assessing whether bowel symptoms predict the presence of colorectal cancer should provide estimates of the reliability of the symptom elicitation.</p

Dynamic oscillatory signatures of central neuropathic pain in spinal cord injury

Central Neuropathic Pain (CNP) is believed to be accompanied by increased activation of the sensory and motor cortices. Our knowledge on this interaction is based mainly on fMRI studies, but there is little direct evidence on how these changes manifest in terms of dynamic neuronal activity. This study reports on the presence of transient EEG based measures of brain activity during motor imagery in spinal cord injured patients with CNP. We analyse dynamic EEG responses during imaginary movements of arms and legs in 3 groups of 10 volunteers each, comprising able-bodied people, paraplegic patients with CNP (lower abdomen and legs) and paraplegic patients without CNP. Paraplegic patients with CNP had increased event-related desynchronisation in the theta, alpha and beta bands (16-24 Hz) during imagination of movement of both non-painful (arms) and painful limbs (legs). Compared to patients with CNP, paraplegics with no pain showed a much reduced power in relaxed state and reduced event-related desynchronisation during imagination of movement. Understanding these complex dynamic, frequency-specific activations in CNP in the absence of nociceptive stimuli could inform the design of interventional therapies for patients suffering from CNP and possibly further understanding of the mechanisms involved

Improved adherence with once-daily versus twice-daily dosing of mometasone furoate administered via a dry powder inhaler: a randomized open-label study

Background Poor adherence with prescribed asthma medication is a major barrier to positive treatment outcomes. This study was designed to determine the effect of a once-daily administration of mometasone furoate administered via a dry powder inhaler (MF-DPI) on treatment adherence compared with a twice-daily administration. Methods This was a 12-week open-label study designed to mimic an actual clinical setting in patients ≥12 years old with mild-to-moderate persistent asthma. Patients were randomized to receive MF-DPI 400 μg once-daily in the evening or MF-DPI 200 μg twice-daily. Adherence was assessed primarily using the number of actual administered doses reported from the device counter divided by the number of scheduled doses. Self-reports were also used to determine adherence. Health-related quality of life, healthcare resource utilization, and days missed from work or school were also reported. Results 1233 patients were randomized. The mean adherence rates, as measured by the automatic dose counter, were significantly better (P < 0.001) with MF-DPI 400 μg once-daily in the evening (93.3%) than with MF-DPI 200 μg twice-daily (89.5%). Mean adherence rates based on self-reports were also significantly better (P < 0.001) with MF-DPI 400 μg QD PM (97.2%) than with MF-DPI 200 μg twice-daily (95.3%). Adherence rates were lower in adolescents (12-17 years old). Health-related quality of life improved by 20% in patients using MF-DPI once-daily in the evening and by 14% in patients using MF-DPI twice-daily. Very few (<8%) patients missed work/school. Conclusion Mean adherence rates were greater with a once-daily dosing regimen of MF-DPI than with a twice-daily dosing regimen. This trial was completed prior to the ISMJE requirements for trial registration