scholarly journals The Fast Response of the Tropical Circulation to CO2 Forcing

2018 ◽  
Vol 31 (24) ◽  
pp. 9903-9920 ◽  
Author(s):  
Elina Plesca ◽  
Stefan A. Buehler ◽  
Verena Grützun
Keyword(s):  
Fast Response ◽  
Static Stability ◽  
Independent Effect ◽  
Tropical Circulation ◽  
Total Change ◽  
Upper Troposphere ◽  
Surface Warming ◽  
Considerable Impact ◽  
One Year ◽  
The Impact

Atmosphere-only CMIP5 idealized climate experiments with quadrupling of atmospheric CO2 are analyzed to understand the fast response of the tropical overturning circulation to this forcing and the main mechanism of this response. A new metric for the circulation, based on pressure velocity in the subsidence regions, is defined, taking advantage of the dynamical stability of these regions and their reduced sensitivity to the GCM’s cloud and precipitation parameterization schemes. This definition permits us to decompose the circulation change into a sum of relative changes in subsidence area, static stability, and heating rate. A comparative analysis of aqua- and Earth-like planet experiments reveals the effect of the land–sea contrast on the total change in circulation. On average, under the influence of CO2 increase without surface warming, the atmosphere radiatively cools less, and this drives the 3%–4% slowdown of the tropical circulation. Even in an Earth-like planet setup, the circulation weakening is dominated by the radiatively driven changes in the subsidence regions over the oceans. However, the land–sea differential heating contributes to the vertical pattern of the circulation weakening by driving the vertical expansion of the tropics. It is further found that the surface warming would, independently of the CO2 effect, lead to up to a 12% slowdown in circulation, dominated by the enhancement of the static stability in the upper troposphere. The two mechanisms identified above combine in the coupled experiment with abrupt quadrupling, causing a circulation slowdown (focused in the upper troposphere) of up to 18%. Here, the independent effect of CO2 has a considerable impact only at time scales less than one year, being overtaken quickly by the impact of surface warming.

scholarly journals Changes in the Interaction between Tropical Convection, Radiation, and the Large-Scale Circulation in a Warming Environment

2012 ◽  
Vol 25 (2) ◽  
pp. 557-571 ◽  
Author(s):  
Derek J. Posselt ◽  
Susan van den Heever ◽  
Graeme Stephens ◽  
Matthew R. Igel
Keyword(s):  
Relative Humidity ◽  
Large Scale ◽  
Deep Convection ◽  
Static Stability ◽  
Upper Troposphere ◽  
Surface Warming ◽  
Environmental Relative Humidity ◽  
Projected Changes ◽  
Aggregate Nature ◽  
Total Column

Abstract This paper explores the response of the tropical hydrologic cycle to surface warming through the lens of large-domain cloud-system-resolving model experiments run in a radiative–convective equilibrium framework. Simulations are run for 55 days and are driven with fixed insolation and constant sea surface temparatures (SSTs) of 298 K, 300 K, and 302 K. In each experiment, convection organizes into coherent regions of large-scale ascent separated by areas with relatively clear air and troposphere-deep descent. Aspects of the simulations correspond to observed features of the tropical climate system, including the transition to large precipitation rates above a critical value of total column water vapor, and an increase in convective intensity with SST amidst weakening of the large-scale overturning circulation. However, the authors also find notable changes to the interaction between convection and the environment as the surface warms. In particular, organized convection in simulations with SSTs of 298 and 300 K is inhibited by the presence of a strong midtropospheric stable layer and dry upper troposphere. As a result, there is a decrease in the vigor of deep convection and an increase in stratiform precipitation fraction with an increase in SST from 298 to 300 K. With an increase in SST to 302 K, moistening of the middletroposphere and increase in lower-tropospheric buoyancy serve to overcome these limitations, leading to an overall increase in convective intensity and larger increase in upper-tropospheric relative humidity. The authors conclude that, while convective intensity increases with SST, the aggregate nature of deep convection is strongly affected by the details of the thermodynamic environment in which it develops. In particular, the positive feedback between increasing SST and a moistening upper troposphere found in the simulations, operates as a nonmonotonic function of SST and is modulated by a complex interaction between deep convection and the environmental relative humidity and static stability profile. The results suggest that projected changes in convection that assume a monotonic dependence on SST may constitute an oversimplification.

scholarly journals An Effectiveness Trial of STEADI in an Outpatient, Primary Care Practice

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 774-774
Author(s):  
David Rein ◽  
Madeleine Hackney ◽  
Michele Dougherty ◽  
Camille Vaughan ◽  
Laurie Imhof ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Review ◽  
Primary Care Practice ◽  
Controlled Trial ◽  
Care Practice ◽  
Strength Assessment ◽  
Randomized Controlled ◽  
Study Team ◽  
One Year ◽  
The Impact

Abstract The STEADI Options trial uses a randomized, controlled-trial design to assess the effectiveness and cost-effectiveness of the STEADI Initiative . Beginning March, 2020, we will randomize 3,000 adults ≥ 65 years of age at risk for falls seen in an Emory Clinic primary care practice to: (1) full STEADI; (2) a STEADI-derived gait, balance, and strength assessment with physical therapy referrals; (3) a STEADI-derived medication review and management; or (4) usual care. This presentation will discuss decisions made by the study team to facilitate implementation of STEADI including electronically conducting screening prior to the date of encounter, the use of dedicated nursing staff to conduct assessments, implementation of strength, balance, orthostatic hypotension, and vision testing, methods to facilitate medication review, and communication of assessment information to providers. The results from this study will be used to estimate the impact of STEADI on falls, service utilization, and costs over one year.

scholarly journals Ventricular arrhythmias in patients with functional mitral regurgitation and implantable cardiac devices: implications of mitral valve repair with Mitraclip

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Benito Gonzalez ◽  
X Freixa ◽  
C Godino ◽  
M Taramasso ◽  
R Estevez-Loureiro ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
One Year ◽  
The Impact

Abstract Background Limited information has been reported regarding the impact of percutaneous mitral valve repair (PMVR) on ventricular arrhythmic (VA) burden. The aim of this study was to address the incidence of VA and appropriate antitachycardia implantable cardiac defibrillator (ICD) therapies before and after PMVR. Methods We retrospectively analyzed all consecutive patients with heart failure with reduce left ventricular ejection fraction, functional mitral regurgitation grade 3+ or 4+ and an active ICD or cardiac resynchronizer who underwent PMVR in any of the eleven recruiting centers. Only patients with complete available device VA monitoring from one-year before to one year after PMVR were included. Baseline clinical and echocardiographic characteristics were collected before PMVR and at 12-months follow-up. Results 93 patients (68.2±10.9 years old, male 88.2%) were enrolled. PMVR was successfully performed in all patients and device success at discharge was 91.4%. At 12-months follow-up, we observed a significant reduction in mitral regurgitation severity, NT-proBNP and prevalence of severe pulmonary hypertension and severe kidney disease. Patients also referred a significant improvement in NYHA functional class and showed a non-significant trend to reserve left ventricular remodeling. After PMVR a significant decrease in the incidence of non-sustained ventricular tachycardia (VT) (5.0–17.8 vs 2.7–13.5, p=0.002), sustained VT or ventricular fibrillation (0.9–2.5 vs 0.5–2.9, p=0.012) and ICD antitachycardia therapies (2.5–12.0 vs 0.9–5.0, p=0.033) were observed. Conclusion PMVR was related to a reduction in arrhythmic burden and ICD therapies in our cohort. Proportion of patients who presented ven Funding Acknowledgement Type of funding source: None

scholarly journals Infant Safe Sleep Promotion: Increasing Capacity of Child Protective Services Employees

2021 ◽  
Vol 18 (8) ◽  
pp. 4227
Author(s):  
Carolyn R. Ahlers-Schmidt ◽  
Christy Schunn ◽  
Ashley M. Hervey ◽  
Maria Torres ◽  
Cherie Sage ◽  
...  
Keyword(s):  
Infant Death ◽  
Child Protective Services ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Protective Services ◽  
Safe Sleep ◽  
Train The Trainer ◽  
Baseline Knowledge ◽  
One Year ◽  
The Impact

Sleep-related infant deaths, including Sudden Infant Death Syndrome (SIDS), are the number one cause of death in infants between 28 days and one year of life. Nearly half of families experiencing a sleep-related infant death in Kansas were involved with the Department of Children and Families Child Protective Services (CPS), making CPS staff a priority for safe sleep training. This study assessed the impact of the two-day Kansas Infant Death and SIDS (KIDS) Network Safe Sleep Instructor (SSI) train-the-trainer program on CPS staffs’ knowledge of the American Academy of Pediatrics safe sleep recommendations. Training was attended by 43 participants, 27 (63%) of whom were employed by CPS. CPS staff had significantly lower baseline knowledge on the 10-item pretest (t = 3.33, p = 0.002), but both CPS and other attendees showed significant improvement by posttest (t = 8.53, p < 0.001 and t = 4.44, p < 0.001, respectively). Following SSI certification, CPS SSIs provided more safe sleep training to professionals than other SSIs (1051 vs. 165, respectively), and both groups of SSIs were able to significantly increase the knowledge of their trainees. Overall, the KIDS Network SSI training was successful. The innovative partnership with CPS allowed for provision of training to a group not historically targeted for safe sleep education.

scholarly journals The Impact of Energy Storage along with the Allocation of RES on the Reduction of Energy Costs Using MILP

Energies ◽  
2021 ◽  
Vol 14 (13) ◽  
pp. 3783
Author(s):  
Mateusz Andrychowicz
Keyword(s):  
Energy Storage ◽  
Mixed Integer Linear Programming ◽  
Distribution Systems ◽  
Operating Costs ◽  
Mixed Integer ◽  
Energy Costs ◽  
Power Exchange ◽  
Local Initiatives ◽  
One Year ◽  
The Impact

The paper shows a method of optimizing local initiatives in the energy sector, such as energy cooperatives and energy clusters. The aim of optimization is to determine the structure of generation sources and energy storage in order to minimize energy costs. The analysis is carried out for the time horizon of one year, with an hourly increment, taking into account various RES (wind turbines (WT), photovoltaic installations (PV), and biogas power plant (BG)) and loads (residential, commercial, and industrial). Generation sources and loads are characterized by generation/demand profiles in order to take into account their variability. The optimization was carried out taking into account the technical aspects of the operation of distribution systems, such as power flows and losses, voltage levels in nodes, and power exchange with the transmission system, and economic aspects, such as capital and fixed and variable operating costs. The method was calculated by sixteen simulation scenarios using Mixed-Integer Linear Programming (MILP).

Malnutrition and biological frailty are independent and complementary predictors of one-year mortality in women after primary angioplasty for ST-segment elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Arroyo-Espliguero ◽  
M.C Viana-Llamas ◽  
A Silva-Obregon ◽  
A Estrella-Alonso ◽  
C Marian-Crespo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rate ◽  
Primary Angioplasty ◽  
Prognostic Impact ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Kaplan Meier ◽  
St Segment ◽  
One Year ◽  
The Impact

Abstract Background Malnutrition and sarcopenia are common features of frailty. Prevalence of frailty among ST-segment elevation myocardial infarction (STEMI) patients is higher in women than men. Purpose Assess gender-based differences in the impact of nutritional risk index (NRI) and frailty in one-year mortality rate among STEMI patients following primary angioplasty (PA). Methods Cohort of 321 consecutive patients (64 years [54–75]; 22.4% women) admitted to a general ICU after PA for STEMI. NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (actual body weight [kg]/ideal weight [kg]). Vulnerable and moderate to severe NRI patients were those with Clinical Frailty Scale (CFS)≥4 and NRI&lt;97.5, respectively. We used Kaplan-Meier survival model. Results Baseline and mortality variables of 4 groups (NRI-/CFS-; NRI+/CFS-; NRI+/CFS- and NRI+/CFS+) are depicted in the Table. Prevalence of malnutrition, frailty or both were significantly greater in women (34.3%, 10% y 21.4%, respectively) than in men (28.9%, 2.8% y 6.0%, respectively; P&lt;0.001). Women had greater mortality rate (20.8% vs. 5.2%: OR 4.78, 95% CI, 2.15–10.60, P&lt;0.001), mainly from cardiogenic shock (P=0.003). Combination of malnutrition and frailty significantly decreased cumulative one-year survival in women (46.7% vs. 73.3% in men, P&lt;0.001) Conclusion Among STEMI patients undergoing PA, the prevalence of malnutrition and frailty are significantly higher in women than in men. NRI and frailty had an independent and complementary prognostic impact in women with STEMI. Kaplan-Meier and Cox survival curves Funding Acknowledgement Type of funding source: None

scholarly journals Decomposition Analysis of the Evolution of the Local Energy System as a Tool to Assess the Effect of Local Actions: Methodology and Example of Malmö, Sweden

Energies ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 461
Author(s):  
Isabel Azevedo ◽  
Vítor Leal
Keyword(s):  
Local Level ◽  
Ghg Emissions ◽  
Decomposition Analysis ◽  
Specific Effect ◽  
Energy System ◽  
Local Energy ◽  
Total Change ◽  
The Impact ◽  
Change Mitigation

This paper proposes the use of decomposition analysis to assess the effect of local energy-related actions towards climate change mitigation, and thus improve policy evaluation and planning at the local level. The assessment of the impact of local actions has been a challenge, even from a strictly technical perspective. This happens because the total change observed is the result of multiple factors influencing local energy-related greenhouse gas (GHG) emissions, many of them not even influenced by local authorities. A methodology was developed, based on a recently developed decomposition model, that disaggregates the total observed changes in the local energy system into multiple causes/effects (including local socio-economic evolution, technology evolution, higher-level governance frame and local actions). The proposed methodology, including the quantification of the specific effect associated with local actions, is demonstrated with the case study of the municipality of Malmö (Sweden) in the timeframe between 1990 and 2015.

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