The global warming hiatus: Slowdown or redistribution?

Global mean surface temperatures (GMST) exhibited a smaller rate of warming during 1998-2013, compared to the warming in the latter half of the 20th Century. Although, not a "true" hiatus in the strict definition of the word, this has been termed the "global warming hiatus" by IPCC (2013). There have been other periods that have also been defined as the "hiatus" depending on the analysis. There are a number of uncertainties and knowledge gaps regarding the "hiatus." This report reviews these issues and also posits insights from a collective set of diverse information that helps us understand what we do and do not know. One salient insight is that the GMST phenomenon is a surface characteristic that does not represent a slowdown in warming of the climate system but rather is an energy redistribution within the oceans. Improved understanding of the ocean distribution and redistribution of heat will help better monitor Earth's energy budget and its consequences. A review of recent scientific publications on the "hiatus" shows the difficulty and complexities in pinpointing the oceanic sink of the "missing heat" from the atmosphere and the upper layer of the oceans, which defines the "hiatus." Advances in "hiatus" research and outlooks (recommendations) are given in this report.

CLIMATE CHANGE. Possible artifacts of data biases in the recent global surface warming hiatus.

Much study has been devoted to the possible causes of an apparent decrease in the upward trend of global surface temperatures since 1998, a phenomenon that has been dubbed the global warming "hiatus." Here, we present an updated global surface temperature analysis that reveals that global trends are higher than those reported by the Intergovernmental Panel on Climate Change, especially in recent decades, and that the central estimate for the rate of warming during the first 15 years of the 21st century is at least as great as the last half of the 20th century. These results do not support the notion of a "slowdown" in the increase of global surface temperature.

Changes in weather and climate extremes: state of knowledge relevant to air and water quality in the United States.

Air and water quality are impacted by extreme weather and climate events on time scales ranging from minutes to many months. This review paper discusses the state of knowledge of how and why extreme events are changing and are projected to change in the future. These events include heat waves, cold waves, floods, droughts, hurricanes, strong extratropical cyclones such as nor'easters, heavy rain, and major snowfalls. Some of these events, such as heat waves, are projected to increase, while others, with cold waves being a good example, will decrease in intensity in our warming world. Each extreme's impact on air or water quality can be complex and can even vary over the course of the event.

Are we improving after 10 years of humanitarian paediatric cardiac assistance?

BACKGROUND: Paediatric cardiovascular services are frequently absent or poorly developed in many countries around the world. Our foundation made 83 trips in support of cardiovascular services between April 1993 and March 2003 to help alleviate this problem. In this study, we present an analysis of our results over these period of 10 years. METHODS: We performed a review of all available records relating to the trips, including patient databases, audited financial statements, donated product inventory lists, lists of team members, and follow-up data from the host sites concerning the state of the patients treated. RESULTS: We made 83 trips to 14 countries, 40 of these being in Central Europe, 5 in Eastern Europe, 10 in Caribbean, and Central America, 18 in South America, 9 in Asia, and 1 in the Middle East. In the first 5 years, we made 23, as opposed to 60 in the second 5 years, this difference being significant (p less than 0.01). The total number of primary operations performed over 10 years was 1,580. The number of procedures performed yearly increased over the two intervals from 97.0 plus or minus 32.7 to 219.0 plus or minus 41.7, p less than 0.002. The probability of survival between the periods increased from 84.6 to 93.3 per cent, and this was also significantly different (p less than 0.001). Overall, the rate of survival for the period of 10 years was 90.5 per cent. Moreover, the value of services donated to support each trip also differed significantly, decreasing from 105,900 dollars plus or minus 14,581 dollars for the first period to 54,617 dollars plus or minus 11,425 dollars for the second period (p less than 0.001). CONCLUSIONS: Improving paediatric cardiac services in under-served countries requires significant financial and personnel commitments, but can produce reasonable outcomes.

Climate (communication arising): impact of land-use change on climate.

Urbanization and other changes in land use have an impact on surface-air temperatures. Kalnay and Cai report that the observed surface-temperature trend in part of the United States exceeds the trend in the NCEP/NCAR 50-year reanalysis (NNR) and conclude that changes in land use account for the difference (0.035 degrees C per decade according to their corrected values). Although land-use change may explain some of this discrepancy, the authors do not quantify the impact of the many changes in observational practice that occurred during the analysis period. Our findings indicate that these 'non-climatic' changes have a systematic effect that overwhelms the reported difference in trends and therefore calls Kalnay and Cai's central conclusion into question.

Modern global climate change.

Modern climate change is dominated by human influences, which are now large enough to exceed the bounds of natural variability. The main source of global climate change is human-induced changes in atmospheric composition. These perturbations primarily result from emissions associated with energy use, but on local and regional scales, urbanization and land use changes are also important. Although there has been progress in monitoring and understanding climate change, there remain many scientific, technical, and institutional impediments to precisely planning for, adapting to, and mitigating the effects of climate change. There is still considerable uncertainty about the rates of change that can be expected, but it is clear that these changes will be increasingly manifested in important and tangible ways, such as changes in extremes of temperature and precipitation, decreases in seasonal and perennial snow and ice extent, and sea level rise. Anthropogenic climate change is now likely to continue for many centuries. We are venturing into the unknown with climate, and its associated impacts could be quite disruptive.

Modified ultrafiltration postextracorporeal membrane oxygenation.

Modified ultrafiltration (MUF) has been widely used for the removal of extracellular water in the immediate postcardiopulmonary bypass (CPB) period. The reported benefits of this technique are improved hematological status and hemodynamic stability post-CPB, as well as a decrease in blood utilization during the operation. MUF has also been associated with improved pulmonary status along with enhanced myocardial performance. With these benefits in mind, we have explored the possible advantages of using MUF following extracorporeal membrane oxygenation (ECMO). The theoretical advantages of using MUF post-ECMO are the reduction of blood use prior to removal from ECMO for optimization of hemoglobin levels, improved pulmonary compliance decreasing the duration of ventilatory support, improved myocardial function, as well as the other reported benefits described with MUF post-CPB. This report communicates the technique used to perform MUF post-ECMO, as well as a simple MUF circuit design for use in the intensive care unit setting.