High-frequency climate variability in the Holocene from a coastal-dome ice core in east-central Greenland

An ice core drilled on the Renland ice cap in east-central Greenland contains a continuous climate record dating through the last glacial period. The Renland record is valuable because the coastal environment is more likely to reflect regional sea surface conditions compared to inland Greenland ice cores that capture synoptic variability. Here we present the δ¹⁸O water isotope record for the Holocene, in which decadal-scale climate information is retained for the last 8 kyr, while the annual water isotope signal is preserved throughout the last 2.6 kyr. To investigate regional climate information preserved in the water isotope record, we apply spectral analysis techniques to a 300-year moving window to determine the mean strength of varying frequency bands through time. We find that the strength of 15–20-year δ¹⁸O variability exhibits a millennial-scale signal in line with the well-known Bond events. Comparison to other North Atlantic proxy records suggests that the 15–20-year variability may reflect fluctuating sea surface conditions throughout the Holocene, driven by changes in the strength of the Atlantic Meridional Overturning Circulation. Additional analysis of the seasonal signal over the last 2.6 kyr reveals that the winter δ¹⁸O signal has experienced a decreasing trend, while the summer signal has predominantly remained stable. The winter trend may correspond to an increase in Arctic sea ice cover, which is driven by a decrease in total annual insolation, and is also likely influenced by regional climate variables such as atmospheric and oceanic circulation. In the context of anthropogenic climate change, the winter trend may have important implications for feedback processes as sea ice retreats in the Arctic

High-frequency climate variability in the Holocene from a coastal-dome ice core in east-central Greenland

An ice core drilled on the Renland ice cap in east-central Greenland contains a continuous climate record dating through the last glacial period. The Renland record is valuable because the coastal environment is more likely to reflect regional sea surface conditions compared to inland Greenland ice cores that capture synoptic variability. Here we present the δ¹⁸O water isotope record for the Holocene, in which decadal-scale climate information is retained for the last 8 kyr, while the annual water isotope signal is preserved throughout the last 2.6 kyr. To investigate regional climate information preserved in the water isotope record, we apply spectral analysis techniques to a 300-year moving window to determine the mean strength of varying frequency bands through time. We find that the strength of 15–20-year δ¹⁸O variability exhibits a millennial-scale signal in line with the well-known Bond events. Comparison to other North Atlantic proxy records suggests that the 15–20-year variability may reflect fluctuating sea surface conditions throughout the Holocene, driven by changes in the strength of the Atlantic Meridional Overturning Circulation. Additional analysis of the seasonal signal over the last 2.6 kyr reveals that the winter δ¹⁸O signal has experienced a decreasing trend, while the summer signal has predominantly remained stable. The winter trend may correspond to an increase in Arctic sea ice cover, which is driven by a decrease in total annual insolation, and is also likely influenced by regional climate variables such as atmospheric and oceanic circulation. In the context of anthropogenic climate change, the winter trend may have important implications for feedback processes as sea ice retreats in the Arctic

Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention

Abstract Background Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. Methods/Design This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to implementation. Discussion Data collection began in May 2010 and is expected to be completed by July 2012. A collaborative nurse-led strategy may provide a feasible, acceptable and effective means for improving the health of older home care clients by improving the prevention, recognition, and management of depression in this vulnerable population. The challenges involved in designing a practical, transferable and sustainable nurse-led intervention in home care are also discussed. Trial Registration ClinicalTrials.gov: NCT0140792

Seasonal temperatures in West Antarctica during the Holocene

The recovery of long-term climate proxy records with seasonal resolution is rare because of natural smoothing processes, discontinuities and limitations in measurement resolution. Yet insolation forcing, a primary driver of multimillennial-scale climate change, acts through seasonal variations with direct impacts on seasonal climate1. Whether the sensitivity of seasonal climate to insolation matches theoretical predictions has not been assessed over long timescales. Here, we analyse a continuous record of water-isotope ratios from the West Antarctic Ice Sheet Divide ice core to reveal summer and winter temperature changes through the last 11,000 years. Summer temperatures in West Antarctica increased through the early-to-mid-Holocene, reached a peak 4,100 years ago and then decreased to the present. Climate model simulations show that these variations primarily reflect changes in maximum summer insolation, confirming the general connection between seasonal insolation and warming and demonstrating the importance of insolation intensity rather than seasonally integrated insolation or season duration2,3. Winter temperatures varied less overall, consistent with predictions from insolation forcing, but also fluctuated in the early Holocene, probably owing to changes in meridional heat transport. The magnitudes of summer and winter temperature changes constrain the lowering of the West Antarctic Ice Sheet surface since the early Holocene to less than 162 m and probably less than 58 m, consistent with geological constraints elsewhere in West Antarctica4-7

Precise interpolar phasing of abrupt climate change during the last ice age

The last glacial period exhibited abrupt Dansgaard–Oeschger climatic oscillations, evidence of which is preserved in a variety of Northern Hemisphere palaeoclimate archives¹. Ice cores show that Antarctica cooled during the warm phases of the Greenland Dansgaard–Oeschger cycle and vice versa[superscript 2,3], suggesting an interhemispheric redistribution of heat through a mechanism called the bipolar seesaw[superscript 4–6]. Variations in the Atlantic meridional overturning circulation (AMOC) strength are thought to have been important, but much uncertainty remains regarding the dynamics and trigger of these abrupt events[superscript 7–9]. Key information is contained in the relative phasing of hemispheric climate variations, yet the large, poorly constrained difference between gas age and ice age and the relatively low resolution of methane records from Antarctic ice cores have so far precluded methane-based synchronization at the required sub-centennial precision[superscript 2,3,10]. Here we use a recently drilled high-accumulation Antarctic ice core to show that, on average, abrupt Greenland warming leads the corresponding Antarctic cooling onset by 218 ± 92 years (2σ) for Dansgaard–Oeschger events, including the Bølling event; Greenland cooling leads the corresponding onset of Antarctic warming by 208 ± 96 years. Our results demonstrate a north-to-south directionality of the abrupt climatic signal, which is propagated to the Southern Hemisphere high latitudes by oceanic rather than atmospheric processes. The similar interpolar phasing of warming and cooling transitions suggests that the transfer time of the climatic signal is independent of the AMOC background state. Our findings confirm a central role for ocean circulation in the bipolar seesaw and provide clear criteria for assessing hypotheses and model simulations of Dansgaard–Oeschger dynamics

Sonographic appearance of canal of Nuck hydrocele

We present a case of a relatively uncommon entity in a 17-year-old girl who presented to the emergency department with right inguinal pain and discomfort. On sonography, she was thought to have a hydrocele of a patent processus vaginalis, although differentials could not be excluded. The hydrocele was subsequently confirmed at surgery. Because this is an uncommonly reported condition, a high index of suspicion must be maintained in the appropriate clinical setting. We present various sonographic appearances and techniques that have been proposed in the literature. © Springer-Verlag 2007

Early Selection in Gag by Protective HLA Alleles Contributes to Reduced HIV-1 Replication Capacity That May Be Largely Compensated for in Chronic Infection▿ †

Mutations that allow escape from CD8 T-cell responses are common in HIV-1 and may attenuate pathogenesis by reducing viral fitness. While this has been demonstrated for individual cases, a systematic investigation of the consequence of HLA class I-mediated selection on HIV-1 in vitro replication capacity (RC) has not been undertaken. We examined this question by generating recombinant viruses expressing plasma HIV-1 RNA-derived Gag-Protease sequences from 66 acute/early and 803 chronic untreated subtype B-infected individuals in an NL4-3 background and measuring their RCs using a green fluorescent protein (GFP) reporter CD4 T-cell assay. In acute/early infection, viruses derived from individuals expressing the protective alleles HLA-B*57, -B*5801, and/or -B*13 displayed significantly lower RCs than did viruses from individuals lacking these alleles (P < 0.05). Furthermore, acute/early RC inversely correlated with the presence of HLA-B-associated Gag polymorphisms (R = −0.27; P = 0.03), suggesting a cumulative effect of primary escape mutations on fitness during the first months of infection. At the chronic stage of infection, no strong correlations were observed between RC and protective HLA-B alleles or with the presence of HLA-B-associated polymorphisms restricted by protective alleles despite increased statistical power to detect these associations. However, RC correlated positively with the presence of known compensatory mutations in chronic viruses from B*57-expressing individuals harboring the Gag T242N mutation (n = 50; R = 0.36; P = 0.01), suggesting that the rescue of fitness defects occurred through mutations at secondary sites. Additional mutations in Gag that may modulate the impact of the T242N mutation on RC were identified. A modest inverse correlation was observed between RC and CD4 cell count in chronic infection (R = −0.17; P < 0.0001), suggesting that Gag-Protease RC could increase over the disease course. Notably, this association was stronger for individuals who expressed B*57, B*58, or B*13 (R = −0.27; P = 0.004). Taken together, these data indicate that certain protective HLA alleles contribute to early defects in HIV-1 fitness through the selection of detrimental mutations in Gag; however, these effects wane as compensatory mutations accumulate in chronic infection. The long-term control of HIV-1 in some persons who express protective alleles suggests that early fitness hits may provide lasting benefits