Response of the Asian Summer Monsoons to a High-latitude Thermal Forcing: Mechanisms and Nonlinearities

This study investigates mechanisms and nonlinearities in the response of the Asian Summer Monsoons (ASM) to high-latitude thermal forcings of different amplitudes. Using a suite of runs carried out with an intermediate-complexity atmospheric general circulation model, we find that the imposed forcings produce a strong precipitation response over the eastern ASM but a rather weak response over the southern ASM. The forcing also causes a precipitation dipole with wet conditions over the eastern Tibetan Plateau (TP) and dry conditions over the Bay of Bengal (BoB) and southeast Asia. A moderate increase of precipitation along the southern margin of the TP is also produced. Simulations designed to isolate the causal mechanisms show that thermodynamic interactions involving the tropical surface oceans are far less important than the water-vapour feedback for the transmission of information from the high-latitudes to the ASM. Additionally, we assess the nonlinearity of the ASM precipitation response to the forcing amplitude using a novel application of the empirical orthogonal function method. The response can be decomposed in two overlapping patterns. The first pattern represents a precipitation dipole with wet conditions over the eastern TP and dry conditions over BoB, which linearly increases with forcing amplitude becoming quasi-stationary for large forcing amplitudes (i.e. amplitudes leading to Arctic temperature anomalies larger than 10 degrees C). The second pattern is associated with increased precipitation over the southeastern TP and is nonlinearly dependent on forcing, being most important for intermediate forcing amplitudes (i.e. amplitudes leading to Arctic temperature anomalies between 5 and 10 degrees C)

Response of the Asian summer Monsoons to a high-latitude thermal forcing: mechanisms and nonlinearities

This study investigates mechanisms and nonlinearities in the response of the Asian Summer Monsoons (ASM) to high-latitude thermal forcings of different amplitudes. Using a suite of runs carried out with an intermediate-complexity atmospheric general circulation model, we find that the imposed forcings produce a strong precipitation response over the eastern ASM but a rather weak response over the southern ASM. The forcing also causes a precipitation dipole with wet conditions over the eastern Tibetan Plateau (TP) and dry conditions over the Bay of Bengal (BoB) and southeast Asia. A moderate increase of precipitation along the southern margin of the TP is also produced. Simulations designed to isolate the causal mechanisms show that thermodynamic interactions involving the tropical surface oceans are far less important than the water-vapour feedback for the transmission of information from the high-latitudes to the ASM. Additionally, we assess the nonlinearity of the ASM precipitation response to the forcing amplitude using a novel application of the empirical orthogonal function method. The response can be decomposed in two overlapping patterns. The first pattern represents a precipitation dipole with wet conditions over the eastern TP and dry conditions over BoB, which linearly increases with forcing amplitude becoming quasi-stationary for large forcing amplitudes (i.e. amplitudes leading to Arctic temperature anomalies larger than 10 °C). The second pattern is associated with increased precipitation over the southeastern TP and is nonlinearly dependent on forcing, being most important for intermediate forcing amplitudes (i.e. amplitudes leading to Arctic temperature anomalies between 5 and 10 °C). © 2020, The Author(s)

Respective impacts of Arctic sea ice decline and increasing greenhouse gases concentration on Sahel precipitation

The impact of climate change on Sahel precipitation is uncertain and has to be widely documented. Recently, it has been shown that Arctic sea ice loss leverages the global warming effects worldwide, suggesting a potential impact of Arctic sea ice decline on tropical regions. However, defining the specific roles of increasing greenhouse gases (GHG) concentration and declining Arctic sea ice extent on Sahel climate is not straightforward since the former impacts the latter. We avoid this dependency by analysing idealized experiments performed with the CNRM-CM5 coupled model. Results show that the increase in GHG concentration explains most of the Sahel precipitation change. We found that the impact due to Arctic sea ice loss depends on the level of atmospheric GHG concentration. When the GHG concentration is relatively low (values representative of 1980s), then the impact is moderate over the Sahel. However, when the concentration in GHG is levelled up, then Arctic sea ice loss leads to increased Sahel precipitation. In this particular case the ocean-land meridional gradient of temperature strengthens, allowing a more intense monsoon circulation. We linked the non-linearity of Arctic sea ice decline impact with differences in temperature and sea level pressure changes over the North Atlantic Ocean. We argue that the impact of the Arctic sea ice loss will become more relevant with time, in the context of climate change

The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure

Introduction: The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (SIUCP: Società Italiana Unitaria di Colon-Proctologia) on the diagnosis and management of anal fissure, with the purpose to guide every physician in the choice of the best treatment option, according with the available literature. Methods: A panel of experts was designed and charged by the Board of the SIUCP to develop key-questions on the main topics covering the management of anal fissure and to performe an accurate search on each topic in different databanks, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in different rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to the PICO criteria, and the statements developed adopting the GRADE methodology. Conclusions: In patients with acute anal fissure the medical therapy with dietary and behavioral norms is indicated. In the chronic phase of disease, the conservative treatment with topical 0.3% nifedipine plus 1.5% lidocaine or nitrates may represent the first-line therapy, eventually associated with ointments with film-forming, anti-inflammatory and healing properties such as Propionibacterium extract gel. In case of first-line treatment failure, the surgical strategy (internal sphincterotomy or fissurectomy with flap), may be guided by the clinical findings, eventually supported by endoanal ultrasound and anal manometry

The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease

The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse

European candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM Candida III study.

The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25-33%) while Italy and Turkey had the highest C. parapsilosis proportions (24-26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence

Predictors for prolonged hospital stay solely to complete intravenous antifungal treatment in patients with candidemia: Results from the ECMM candida III multinational European observational cohort study

Background To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx). Methods Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~ 10 blood culture proven adult candidemia cases occurring consecutively after July 1st, 2018, and treating physicians answered the question on whether hospital stay was prolonged only for completion of intravenous antifungal therapy. Descriptive analyses as well as binary logistic regression was used to assess for predictors of prolonged hospitalization solely to complete iv AF Tx. Findings Hospital stay was prolonged solely for the completion of iv AF Tx in 16% (100/621) of candidemia cases by a median of 16 days (IQR 8 – 28). In the multivariable model, initial echinocandin treatment was a positive predictor for prolonged hospitalization to complete iv AF Tx (aOR 2.87, 95% CI 1.55 – 5.32, p < 0.001), while (i) neutropenia, (ii) intensive care unit admission, (iii) catheter related candidemia, (iv) total parenteral nutrition, and (v) C. parapsilosis as causative pathogen were found to be negative predictors (aOR 0.22 – 0.45; p < 0.03). Interpretation Hospital stays were prolonged due to need of iv AF Tx in 16% of patients with candidemia. Those patients were more likely to receive echinocandins as initial treatment and were less severely ill and less likely infected with C. parapsilosis

Cidadão baiano site de jornalismo político com foco na cidadania

Este trabalho é a memória descritiva do site de jornalismo político Cidadão Baiano, integrando o projeto experimental de conclusão do curso de Graduação em Jornalismo da Faculdade de Comunicação da Universidade Federal da Bahia. Trata da criação de um site de jornalismo político com um novo foco de cobertura, mais voltado ao cidadão e se afastando da tradicional competição política que recebe atenção majoritária da mídia. O objetivo é mostrar como as decisões dos Três Poderes (Executivo, Legislativo e Judiciário) afetam o dia a dia da população baiana

Cidadão baiano: site de jornalismo político com foco na cidadania

Este trabalho é a memória descritiva do site de jornalismo político Cidadão Baiano, integrando o projeto experimental de conclusão do curso de Graduação em Jornalismo da Faculdade de Comunicação da Universidade Federal da Bahia. Trata da criação de um site de jornalismo político com um novo foco de cobertura, mais voltado ao cidadão e se afastando da tradicional competição política que recebe atenção majoritária da mídia. O objetivo é mostrar como as decisões dos Três Poderes (Executivo, Legislativo e Judiciário) afetam o dia a dia da população baiana