Extratropical forcing and tropical rainfall distribution: energetics framework and ocean Ekman advection

Intense tropical rainfall occurs in a narrow belt near the equator, called the inter-tropical convergence zone (ITCZ). In the past decade, the atmospheric energy budget has been used to explain changes in the zonal-mean ITCZ position. The energetics framework provides a mechanism for extratropics-to-tropics teleconnections, which have been postulated from paleoclimate records. In atmosphere models coupled with a motionless slab ocean, the ITCZ shifts toward the warmed hemisphere in order for the Hadley circulation to transport energy toward the colder hemisphere. However, recent studies using fully coupled models show that tropical rainfall can be rather insensitive to extratropical forcing when ocean dynamics is included. Here, we explore the effect of meridional Ekman heat advection while neglecting the upwelling effect on the ITCZ response to prescribed extratropical thermal forcing. The tropical component of Ekman advection is a negative feedback that partially compensates the prescribed forcing, whereas the extratropical component is a positive feedback that amplifies the prescribed forcing. Overall, the tropical negative feedback dominates over the extratropical positive feedback. Thus, including Ekman advection reduces the need for atmospheric energy transport, dampening the ITCZ response. We propose to build a hierarchy of ocean models to systematically explore the full dynamical response of the coupled climate system

High-Resolution Model Intercomparison Project phase 2 (HighResMIP2) towards CMIP7

Robust projections and predictions of climate variability and change, particularly at regional scales, rely on the driving processes being represented with fidelity in model simulations. Consequently, the role of enhanced horizontal resolution in improved process representation in all components of the climate system continues to be of great interest. Recent simulations suggest the possibility of significant changes in both large-scale aspects of the ocean and atmospheric circulations and in the regional responses to climate change, as well as improvements in representations of small-scale processes and extremes, when resolution is enhanced. The first phase of the High-Resolution Model Intercomparison Project (HighResMIP1) was successful at producing a baseline multi-model assessment of global simulations with model grid spacings of 25-50 km in the atmosphere and 10-25 km in the ocean, a significant increase when compared to models with standard resolutions on the order of 1° that are typically used as part of the Coupled Model Intercomparison Project (CMIP) experiments. In addition to over 250 peer-reviewed manuscripts using the published HighResMIP1 datasets, the results were widely cited in the Intergovernmental Panel on Climate Change report and were the basis of a variety of derived datasets, including tracked cyclones (both tropical and extratropical), river discharge, storm surge, and impact studies. There were also suggestions from the few ocean eddy-rich coupled simulations that aspects of climate variability and change might be significantly influenced by improved process representation in such models. The compromises that HighResMIP1 made should now be revisited, given the recent major advances in modelling and computing resources. Aspects that will be reconsidered include experimental design and simulation length, complexity, and resolution. In addition, larger ensemble sizes and a wider range of future scenarios would enhance the applicability of HighResMIP. Therefore, we propose the High-Resolution Model Intercomparison Project phase 2 (HighResMIP2) to improve and extend the previous work, to address new science questions, and to further advance our understanding of the role of horizontal resolution (and hence process representation) in state-of-the-art climate simulations. With further increases in high-performance computing resources and modelling advances, along with the ability to take full advantage of these computational resources, an enhanced investigation of the drivers and consequences of variability and change in both large- and synoptic-scale weather and climate is now possible. With the arrival of global cloud-resolving models (currently run for relatively short timescales), there is also an opportunity to improve links between such models and more traditional CMIP models, with HighResMIP providing a bridge to link understanding between these domains. HighResMIP also aims to link to other CMIP projects and international efforts such as the World Climate Research Program lighthouse activities and various digital twin initiatives. It also has the potential to be used as training and validation data for the fast-evolving machine learning climate models

Prognostic significance of vascular endothelial cell growth factors -A, -C and -D in breast cancer and their relationship with angio- and lymphangiogenesis

Vascular endothelial cell growth factors (VEGF)-A, -C and -D have potent angio and lymphangiogenic functions in experimental models, although their role in the progression of human breast cancer is unclear. The aims of the current study were to examine the relationship between the expression of the aforementioned growth factors with the angio and lymphangiogenic characteristics of breast cancer, and to assess their suitability as potential prognostic factors. Paraffin-embedded sections of 177 primary invasive breast cancer, with complete clinical follow-up information for 10 years, were stained for VEGF-A, -C, -D, podoplanin and CD34 using standard immunohistochemical approaches. The expression of the growth factors was correlated with clinicopathological criteria and patients' survival. Lymph vessel density (LVD) and microvessel density (MVD) were assessed and correlated with expression of the growth factors. Vascular endothelial cell growth factor-A, -C and -D were highly expressed in 40, 37 and 42% of specimens, respectively. High expression of VEGF-A and - C, but not of -D, was associated with a higher LVD (P=0.013 and P=0.014, respectively), a higher MVD (P<0.001 and P=0.002, respectively), the presence of lymph node metastasis (P<0.001 and P<0.001, respectively), distant metastasis (P=0.010 and P=0.008, respectively) and a shorter Overall Survival (P=0.029 and 0.028, respectively). In conclusion, breast cancers that express high levels of VEGF-A and -C are characterised by a poor prognosis, likely through the induction of angio and lymphangiogenesis. Examination of expression of VEGF-A and -C in breast cancer may be beneficial in the identification of a subset of tumours that have a higher probability of recurrence and metastatic spread

Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial

Background: Semaglutide, a GLP-1 receptor agonist, reduces the risk of major adverse cardiovascular events (MACE) in people with overweight or obesity, but the effects of this drug on outcomes in patients with atherosclerotic cardiovascular disease and heart failure are unknown. We report a prespecified analysis of the effect of once-weekly subcutaneous semaglutide 2·4 mg on ischaemic and heart failure cardiovascular outcomes. We aimed to investigate if semaglutide was beneficial in patients with atherosclerotic cardiovascular disease with a history of heart failure compared with placebo; if there was a difference in outcome in patients designated as having heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction; and if the efficacy and safety of semaglutide in patients with heart failure was related to baseline characteristics or subtype of heart failure. Methods: The SELECT trial was a randomised, double-blind, multicentre, placebo-controlled, event-driven phase 3 trial in 41 countries. Adults aged 45 years and older, with a BMI of 27 kg/m2 or greater and established cardiovascular disease were eligible for the study. Patients were randomly assigned (1:1) with a block size of four using an interactive web response system in a double-blind manner to escalating doses of once-weekly subcutaneous semaglutide over 16 weeks to a target dose of 2·4 mg, or placebo. In a prespecified analysis, we examined the effect of semaglutide compared with placebo in patients with and without a history of heart failure at enrolment, subclassified as heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, or unclassified heart failure. Endpoints comprised MACE (a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death); a composite heart failure outcome (cardiovascular death or hospitalisation or urgent hospital visit for heart failure); cardiovascular death; and all-cause death. The study is registered with ClinicalTrials.gov, NCT03574597. Findings: Between Oct 31, 2018, and March 31, 2021, 17 604 patients with a mean age of 61·6 years (SD 8·9) and a mean BMI of 33·4 kg/m2 (5·0) were randomly assigned to receive semaglutide (8803 [50·0%] patients) or placebo (8801 [50·0%] patients). 4286 (24·3%) of 17 604 patients had a history of investigator-defined heart failure at enrolment: 2273 (53·0%) of 4286 patients had heart failure with preserved ejection fraction, 1347 (31·4%) had heart failure with reduced ejection fraction, and 666 (15·5%) had unclassified heart failure. Baseline characteristics were similar between patients with and without heart failure. Patients with heart failure had a higher incidence of clinical events. Semaglutide improved all outcome measures in patients with heart failure at random assignment compared with those without heart failure (hazard ratio [HR] 0·72, 95% CI 0·60-0·87 for MACE; 0·79, 0·64-0·98 for the heart failure composite endpoint; 0·76, 0·59-0·97 for cardiovascular death; and 0·81, 0·66-1·00 for all-cause death; all pinteraction&gt;0·19). Treatment with semaglutide resulted in improved outcomes in both the heart failure with reduced ejection fraction (HR 0·65, 95% CI 0·49-0·87 for MACE; 0·79, 0·58-1·08 for the composite heart failure endpoint) and heart failure with preserved ejection fraction groups (0·69, 0·51-0·91 for MACE; 0·75, 0·52-1·07 for the composite heart failure endpoint), although patients with heart failure with reduced ejection fraction had higher absolute event rates than those with heart failure with preserved ejection fraction. For MACE and the heart failure composite, there were no significant differences in benefits across baseline age, sex, BMI, New York Heart Association status, and diuretic use. Serious adverse events were less frequent with semaglutide versus placebo, regardless of heart failure subtype. Interpretation: In patients with atherosclerotic cardiovascular diease and overweight or obesity, treatment with semaglutide 2·4 mg reduced MACE and composite heart failure endpoints compared with placebo in those with and without clinical heart failure, regardless of heart failure subtype. Our findings could facilitate prescribing and result in improved clinical outcomes for this patient group. Funding: Novo Nordisk

Using EC-Earth for climate prediction research

Climate prediction at the subseasonal to interannual time range is now performed routinely and operationally by an increasing number of institutions. The feasibility of climate prediction largely depends on the existence of slow and predictable variations in the ocean surface temperature, sea ice, soil moisture and snow cover, and on our ability to model the atmosphere’s interactions with those variables. Climate prediction is typically performed with statistical-empirical or process-based models. The two methods are complementary. Although forecasting systems using global climate models (GCMs) have made substantial progress in the last few decades (Doblas-Reyes et al., 2013), systematic errors and misrepresentations of key processes still limit the value of dynamical prediction in certain areas of the globe. At the same time, model initialisation, ensemble generation, understanding the processes at the origin of predictability, forecasting extremes, bias adjustment and model evaluation are all challenging aspects of the climate prediction problem. Addressing them requires both a large base of researchers with expertise in physics, mathematics, statistics, high-performance computing and data analysis interested in climate prediction issues and a tool for them to work with. This article illustrates how one of these tools, the EC-Earth climate model (Box A), has been used to train scientists in climate prediction and to address scientific challenges in this field. The use of model components from ECMWF’s Integrated Forecasting System (IFS) in EC-Earth means that some of the results obtained with EC-Earth can feed back into ECMWF’s activities. EC-Earth has been run extensively on ECMWF’s high-performance computing facility (HPCF), among a range of HPCFs across Europe and North America. The availability of ECMWF’s HPCF to EC-Earth partners, including the use of the successful ECMWF Special Project programme, means that a substantial amount of EC-Earth’s collaborative work, both within the consortium and with ECMWF, takes place on this platform.Postprint (published version