North Atlantic Deep Water Formation

Various studies concerning differing aspects of the North Atlantic are presented. The three major topics under which the works are classified include: (1) oceanography; (2) paleoclimate; and (3) ocean, ice and climate modeling

Measuring patient-perceived quality of care in US hospitals using Twitter

BACKGROUND: Patients routinely use Twitter to share feedback about their experience receiving healthcare. Identifying and analysing the content of posts sent to hospitals may provide a novel real-time measure of quality, supplementing traditional, survey-based approaches. OBJECTIVE: To assess the use of Twitter as a supplemental data stream for measuring patient-perceived quality of care in US hospitals and compare patient sentiments about hospitals with established quality measures. DESIGN: 404 065 tweets directed to 2349 US hospitals over a 1-year period were classified as having to do with patient experience using a machine learning approach. Sentiment was calculated for these tweets using natural language processing. 11 602 tweets were manually categorised into patient experience topics. Finally, hospitals with ≥50 patient experience tweets were surveyed to understand how they use Twitter to interact with patients. KEY RESULTS: Roughly half of the hospitals in the US have a presence on Twitter. Of the tweets directed toward these hospitals, 34 725 (9.4%) were related to patient experience and covered diverse topics. Analyses limited to hospitals with ≥50 patient experience tweets revealed that they were more active on Twitter, more likely to be below the national median of Medicare patients (p<0.001) and above the national median for nurse/patient ratio (p=0.006), and to be a non-profit hospital (p<0.001). After adjusting for hospital characteristics, we found that Twitter sentiment was not associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings (but having a Twitter account was), although there was a weak association with 30-day hospital readmission rates (p=0.003). CONCLUSIONS: Tweets describing patient experiences in hospitals cover a wide range of patient care aspects and can be identified using automated approaches. These tweets represent a potentially untapped indicator of quality and may be valuable to patients, researchers, policy makers and hospital administrators

A Human Development Framework for CO2 Reductions

Although developing countries are called to participate in CO2 emission reduction efforts to avoid dangerous climate change, the implications of proposed reduction schemes in human development standards of developing countries remain a matter of debate. We show the existence of a positive and time-dependent correlation between the Human Development Index (HDI) and per capita CO2 emissions from fossil fuel combustion. Employing this empirical relation, extrapolating the HDI, and using three population scenarios, the cumulative CO2 emissions necessary for developing countries to achieve particular HDI thresholds are assessed following a Development As Usual approach (DAU). If current demographic and development trends are maintained, we estimate that by 2050 around 85% of the world's population will live in countries with high HDI (above 0.8). In particular, 300Gt of cumulative CO2 emissions between 2000 and 2050 are estimated to be necessary for the development of 104 developing countries in the year 2000. This value represents between 20% to 30% of previously calculated CO2 budgets limiting global warming to 2{\deg}C. These constraints and results are incorporated into a CO2 reduction framework involving four domains of climate action for individual countries. The framework reserves a fair emission path for developing countries to proceed with their development by indexing country-dependent reduction rates proportional to the HDI in order to preserve the 2{\deg}C target after a particular development threshold is reached. Under this approach, global cumulative emissions by 2050 are estimated to range from 850 up to 1100Gt of CO2. These values are within the uncertainty range of emissions to limit global temperatures to 2{\deg}C.Comment: 14 pages, 7 figures, 1 tabl

Methodological approaches to determining the marine radiocarbon reservoir effect

The marine radiocarbon reservoir effect is an offset in 14C age between contemporaneous organisms from the terrestrial environment and organisms that derive their carbon from the marine environment. Quantification of this effect is of crucial importance for correct calibration of the &lt;sup&gt;14&lt;/sup&gt;C ages of marine-influenced samples to the calendrical timescale. This is fundamental to the construction of archaeological and palaeoenvironmental chronologies when such samples are employed in &lt;sup&gt;14&lt;/sup&gt;C analysis. Quantitative measurements of temporal variations in regional marine reservoir ages also have the potential to be used as a measure of process changes within Earth surface systems, due to their link with climatic and oceanic changes. The various approaches to quantification of the marine radiocarbon reservoir effect are assessed, focusing particularly on the North Atlantic Ocean. Currently, the global average marine reservoir age of surface waters, R(t), is c. 400 radiocarbon years; however, regional values deviate from this as a function of climate and oceanic circulation systems. These local deviations from R(t) are expressed as +R values. Hence, polar waters exhibit greater reservoir ages (&#948;R = c. +400 to +800 &lt;sup&gt;14&lt;/sup&gt;C y) than equatorial waters (&#948;R = c. 0 &lt;sup&gt;14&lt;/sup&gt;C y). Observed temporal variations in &#948;R appear to reflect climatic and oceanographic changes. We assess three approaches to quantification of marine reservoir effects using known age samples (from museum collections), tephra isochrones (present onshore/offshore) and paired marine/terrestrial samples (from the same context in, for example, archaeological sites). The strengths and limitations of these approaches are evaluated using examples from the North Atlantic region. It is proposed that, with a suitable protocol, accelerator mass spectrometry (AMS) measurements on paired, short-lived, single entity marine and terrestrial samples from archaeological deposits is the most promising approach to constraining changes over at least the last 5 ky BP

Global predictability of temperature extremes

Extreme temperatures are one of the leading causes of death and disease in both developed and developing countries, and heat extremes are projected to rise in many regions. To reduce risk, heatwave plans and cold weather plans have been effectively implemented around the world. However, much of the world’s population is not yet protected by such systems, including many data-scarce but also highly vulnerable regions. In this study, we assess at a global level where such systems have the potential to be effective at reducing risk from temperature extremes, characterizing (1) long-term average occurrence of heatwaves and coldwaves, (2) seasonality of these extremes, and (3) short-term predictability of these extreme events three to ten days in advance. Using both the NOAA and ECMWF weather forecast models, we develop global maps indicating a first approximation of the locations that are likely to benefit from the development of seasonal preparedness plans and/or short-term early warning systems for extreme temperature. The extratropics generally show both short-term skill as well as strong seasonality; in the tropics, most locations do also demonstrate one or both. In fact, almost 5 billion people live in regions that have seasonality and predictability of heatwaves and/or coldwaves. Climate adaptation investments in these regions can take advantage of seasonality and predictability to reduce risks to vulnerable populations

Pacific origin of the abrupt increase in Indian Ocean heat content during the warming hiatus

Global mean surface warming has stalled since the end of the twentieth century1, 2, but the net radiation imbalance at the top of the atmosphere continues to suggest an increasingly warming planet. This apparent contradiction has been reconciled by an anomalous heat flux into the ocean3, 4, 5, 6, 7, 8, induced by a shift towards a La Niña-like state with cold sea surface temperatures in the eastern tropical Pacific over the past decade or so. A significant portion of the heat missing from the atmosphere is therefore expected to be stored in the Pacific Ocean. However, in situ hydrographic records indicate that Pacific Ocean heat content has been decreasing9. Here, we analyse observations along with simulations from a global ocean–sea ice model to track the pathway of heat. We find that the enhanced heat uptake by the Pacific Ocean has been compensated by an increased heat transport from the Pacific Ocean to the Indian Ocean, carried by the Indonesian throughflow. As a result, Indian Ocean heat content has increased abruptly, which accounts for more than 70% of the global ocean heat gain in the upper 700 m during the past decade. We conclude that the Indian Ocean has become increasingly important in modulating global climate variability

Assessing reconstruction techniques of the Atlantic Ocean circulation variability during the last millennium

We assess the use of the meridional thermal-wind transport estimated from zonal density gradients to reconstruct the oceanic circulation variability during the last millennium in a forced simulation with the ECHO-G coupled climate model. Following a perfect-model approach, model-based pseudo-reconstructions of the Atlantic meridional overturning circulation (AMOC) and the Florida Current volume transport (FCT) are evaluated against their true simulated variability. The pseudo-FCT is additionally verified as proxy for AMOC strength and compared with the available proxy-based reconstruction. The thermal-wind component reproduces most of the simulated AMOC variability, which is mostly driven by internal climate dynamics during the preindustrial period and by increasing greenhouse gases afterwards. The pseudo-reconstructed FCT reproduces well the simulated FCT and reasonably well the variability of the AMOC strength, including the response to external forcing. The pseudo-reconstructed FCT, however, underestimates/overestimates the simulated variability at deep/shallow levels. Density changes responsible for the pseudo-reconstructed FCT are mainly driven by zonal temperature differences; salinity differences oppose but play a minor role. These results thus support the use of the thermal-wind relationship to reconstruct the oceanic circulation past variability, in particular at multidecadal timescales. Yet model-data comparison highlights important differences between the simulated and the proxy-based FCT variability. ECHO-G simulates a prominent weakening in the North Atlantic circulation that contrasts with the reconstructed enhancement. Our model results thus do not support the reconstructed FC minimum during the Little Ice Age. This points to a failure in the reconstruction, misrepresented processes in the model, or an important role of internal ocean dynamics

Nutrients, oxygen and inferred new production in the Northeast Water Polynya 1992

Nutrient and oxygen distributions were measured during a hydrographic survey of the Northeast Water Polynya off the northeast coast of Greenland (77–81°N, 6–17°W) during July–August 1992 and were interpreted in the context of satellite imagery of the region. Satellite imagery revealed a convoluted plume of cold water flowing along isobaths from underneath fast ice in the southwestern portion of the polynya toward the northeast. This plume carried relatively high nutrient and low oxygen inventories. Nitrate to phosphate ratios were low in the polar water, consistent with an ultimate source of this water mass in the Pacific sector of the Arctic Ocean. It is hypothesized that the low N:P Arctic outflow might be the cause of nitrate limitation along the east coast of America as far as Cape Hatteras. Gradients of both nutrients and oxygen inventories in the euphotic zone were observed along and across the axis of mean flow within the polynya and are shown to be due to net production of organic matter. On the basis of these spatial gradients of nitrate and oxygen, an assumed along-axis current velocity of 10 cm s−1, and the observed relationships of biologically removed inorganic carbon with nitrate and oxygen, the net organic matter production was estimated to be 40–60 mmol(C) m−2 d−1. This represents the organic carbon available for export from the polynya euphotic zone. Nutrient-deficient and oxygen-rich waters were observed merging with the southward flowing East Greenland Current, suggestive of possible export, however, the ultimate fate of organic carbon produced within the polynya requires further study