Patterns of millennial variability over the last 500 ka

Millennial variability is a robust feature of many paleoclimate records, at least throughout the last several glacial cycles. Here we use the mean signal from Antarctic climate events 1 to 4 to probe the EPICA Dome C temperature proxy reconstruction through the last 500 ka for similar millennial-scale events. We find that clusters of millennial events occurred in a regular fashion over half of the time during this with a mean recurrence interval of 21 kyr. We find that there is no consistent link between ice-rafted debris deposition and millennial variability. Instead we speculate that changes in the zonality of atmospheric circulation over the North Atlantic form a viable alternative to freshwater release from icebergs as a trigger for millennial variability. We suggest that millennial changes in the zonality of atmospheric circulation over the North Atlantic are linked to precession via sea-ice feedbacks and that this relationship is modified by the presence of the large, Northern Hemisphere ice sheets during glacial periods.

All-cause mortality in treated HIV-infected adults with CD4 >=500/mm3 compared with the general population: evidence from a large European observational cohort collaboration{dagger}

Using data from a large European collaborative study, we aimed to identify the circumstances in which treated HIV-infected individuals will experience similar mortality rates to those of the general population.

Causes and consequences of past and projected Scandinavian summer temperatures, 500-2100 AD

Tree rings dominate millennium-long temperature reconstructions and many records originate from Scandinavia, an area for which the relative roles of external forcing and internal variation on climatic changes are, however, not yet fully understood. Here we compile 1,179 series of maximum latewood density measurements from 25 conifer sites in northern Scandinavia, establish a suite of 36 subset chronologies, and analyse their climate signal. A new reconstruction for the 1483–2006 period correlates at 0.80 with June–August temperatures back to 1860. Summer cooling during the early 17th century and peak warming in the 1930s translate into a decadal amplitude of 2.9°C, which agrees with existing Scandinavian tree-ring proxies. Climate model simulations reveal similar amounts of mid to low frequency variability, suggesting that internal ocean-atmosphere feedbacks likely influenced Scandinavian temperatures more than external forcing. Projected 21st century warming under the SRES A2 scenario would, however, exceed the reconstructed temperature envelope of the past 1,500 years.

Bulking agents: an analysis of 500 cases and review of the literature

Stress urinary incontinence (SUI) is common, impacts women's quality of life, and generates high costs. Physiotherapy is the first-line therapy, and if it fails, suburethral slings are the gold standard in SUI surgery. Bulking agents injected periurethrally might be a beneficial alternative, but there is a paucity of data on bulking therapy. The aim of this study was to prospectively analyze the efficacy and safety of bulking agents in the setting of a tertiary referral center.

Characteristics, determinants, and clinical relevance of CD4 T cell recovery to <500 cells/microL in HIV type 1-infected individuals receiving potent antiretroviral therapy

BACKGROUND: The CD4 T cell count recovery in human immunodeficiency virus type 1 (HIV-1)-infected individuals receiving potent antiretroviral therapy (ART) shows high variability. We studied the determinants and the clinical relevance of incomplete CD4 T cell restoration. METHODS: Longitudinal CD4 T cell count was analyzed in 293 participants of the Swiss HIV Cohort Study who had had a plasma HIV-1 RNA load <1000 copies/mL for > or =5 years. CD4 T cell recovery was stratified by CD4 T cell count 5 years after initiation of ART (> or =500 cells/microL was defined as a complete response, and <500 cells/microL was defined as an incomplete response). Determinants of incomplete responses and clinical events were evaluated using logistic regression and survival analyses. RESULTS: The median CD4 T cell count increased from 180 cells/microL at baseline to 576 cells/microL 5 years after ART initiation. A total of 35.8% of patients were incomplete responders, of whom 47.6% reached a CD4 T cell plateau <500 cells/microL. Centers for Disease Control and Prevention HIV-1 disease category B and/or C events occurred in 21% of incomplete responders and in 14.4% of complete responders (P>.05). Older age (adjusted odds ratio [aOR], 1.71 per 10-year increase; 95% confidence interval [CI], 1.21-2.43), lower baseline CD4 T cell count (aOR, 0.37 per 100-cell increase; 95% CI, 0.28-0.49), and longer duration of HIV infection (aOR, 2.39 per 10-year increase; 95% CI, 1.19-4.81) were significantly associated with a CD4 T cell count <500 cells/microL at 5 years. The median increases in CD4 T cell count after 3-6 months of ART were smaller in incomplete responders (P<.001) and predicted, in conjunction with baseline CD4 T cell count and age, incomplete response with 80% sensitivity and 72% specificity. CONCLUSION: Individuals with incomplete CD4 T cell recovery to <500 cells/microL had more advanced HIV-1 infection at baseline. CD4 T cell changes during the first 3-6 months of ART already reflect the capacity of the immune system to replenish depleted CD4 T lymphocytes.

Staged surgical therapy of basal cell carcinoma of the head and neck region: an evaluation of 500 procedures

QUESTIONS UNDER STUDY / PRINCIPLES: The surgical therapy of basal cell carcinoma (BCC) is especially demanding in the facial area. This retrospective study was undertaken to evaluate the outcome of staged surgical therapy (SST) of BCC of the head and neck region performed on an interdisciplinary basis at our institution. METHODS: Patients treated for BCC in the head and neck area between 1/1/1997 and 31/12/2001 were included in the study. The lesions were histologically evaluated. Diameter of lesion, number of stages, defect coverage, operation time, and recurrence and infection rates were analysed using descriptive and inferential statistical procedures. RESULTS: 281 patients were included in the study. SST was performed in two stages in 43.7%, in three stages in 12.9% and in four or more stages in 2.7%, depending on the type of tumour and the patient's pretreatment status. The total operating time per lesion averaged one hour. Defect coverage was achieved by direct closure (37.7%), by full thickness skin graft (39.5%), by split skin graft (1.1%), by local flaps (20.3%) or by composite grafts (1.1%). Median follow-up time was 58.5 months. Low rates of recurrence (3.6%) and infection (2%) were observed with this technique. CONCLUSIONS: The staged surgical therapy of basal cell carcinoma evaluated here offers a series of advantages in respect of patient comfort and safety and economy, while allowing precise histological safety with low infection rates and reliable long-term results.

1509 - Johannes Calvin - 2009. Sein Wirken in Kirche und Gesellschaft. Essays zum 500. Geburtstag

Welche bleibenden Impulse haben Johannes Calvin und der Calvinismus Kirche und Gesellschaft bis heute gegeben? Mit dieser Frage beschäftigen sich anlässlich des 500. Geburtstags des Genfer Reformators die Autorinnen und die Autoren der vorliegenden Beiträge anhand ausgewählter theologischer und wirkungsgeschichtlicher Themen. Gleichzeitig bieten sie eine grundlegende und allgemein verständliche Einführung in Calvins Leben und Theologie, in seine kontinuierliche Relevanz für kirchliche, gesellschaftliche und politische Fragen sowie in die Geschichte der Reformation in der Schweiz und weltweit. Sie blenden dabei auch die kritischen Anfragen an Calvin nicht aus. Der im Auftrag des Schweizerischen Evangelischen Kirchenbunds herausgegebene Sammelband ist eine wissenschaftlich fundierte, leserfreundliche Einführung, die Fragestellungen anregt, Perspektiven eröffnet und Austausch ermöglicht. Mit Beiträgen von Philip Benedict, James D. Bratt, Emidio Campi, Eva-Maria Faber, Eric Fuchs, Wulfert de Greef, Christopher L. Elwood, Ulrich H. J. Körtner, Christian Link, Christian Moser, Andrew Pettegree, Christoph Strohm, Mario Turchetti

Winter precipitation trends for two selected European regions over the last 500 years and their possible dynamical background

We analyse winter (DJF) precipitation over the last 500 years on trends using a spatially and temporally highly resolved gridded multi-proxy reconstruction over European land areas. The trends are detected applying trend matrices, and the significance is assessed with the Mann–Kendall-trend test. Results are presented for southwestern Norway and southern Spain/northern Morocco, two regions that show high reconstruction skill over the entire period. The absolute trend values found in the second part of the 20th century are unprecedented over the last 500 years in both regions. During the period 1715–1765, the precipitation trends were most pronounced in southwestern Norway as well as southern Spain/northern Morocco, with first a distinct negative trend followed by a positive countertrend of similar strength. Relating the precipitation time series to variations of the North Atlantic Oscillation Index (NAOI) and the solar irradiance using running correlations revealed a couple of instationarities. Nevertheless, it appears that the NAO is responsible in both regions for most of the significant winter precipitation trends during the earlier centuries as well as during recent decades. Some of the significant winter precipitation trends over southwestern Norway and southern Spain/northern Morocco might be related to changes in the solar irradiance.