Direct Mechanical Intervention Versus Combined Intravenous and Mechanical Intervention in Large Artery Anterior Circulation Stroke: A Matched-Pairs Analysis.

BACKGROUND AND PURPOSE Five randomized controlled trials have consistently shown that mechanical thrombectomy (MT) in addition to best medical treatment (±intravenous tissue-type plasminogen activator) improves outcome after acute ischemic stroke in patients with large artery anterior circulation stroke. Whether direct MT is equally effective as combined intravenous thrombolysis with MT (ie, bridging thrombolysis) remains unclear. METHODS We retrospectively compared clinical and radiological outcomes in 167 bridging patients with 255 patients receiving direct MT because of large artery anterior circulation stroke. We matched all patients from the direct MT group who would have qualified for intravenous tissue-type plasminogen activator with controls from the bridging group, using multivariate and propensity score analyses. Functional independence was defined as modified Rankin Scale score of 0 to 2. RESULTS From February 2009 to August 2014, 40 patients from the direct MT group would have qualified for bridging thrombolysis but were treated with MT only. Clinical and radiological characteristics did not differ from the bridging cohort, except for higher rates of hypercholesterolemia (P=0.019), coronary heart disease (P=0.039), and shorter intervals from symptom onset to endovascular intervention (P=0.01) in the direct MT group. Functional independence, mortality, and intracerebral hemorrhage rates did not differ (P>0.1). After multivariate matching analysis outcome in both groups did not differ, except for lower rates of asymptomatic intracerebral hemorrhage (P=0.023) and lower mortality (P=0.007) in the direct MT group. CONCLUSIONS In patients with large anterior circulation stroke, direct mechanical intervention seems to be equally effective as bridging thrombolysis. A randomized trial comparing direct MT with bridging therapy is warranted.

Deep water provenance and dynamics of the (de)glacial Atlantic meridional overturning circulation

Reconstructing past modes of ocean circulation is an essential task in paleoclimatology and paleoceanography. To this end, we combine two sedimentary proxies, Nd isotopes (εNd) and the 231Pa/230Th ratio, both of which are not directly involved in the global carbon cycle, but allow the reconstruction of water mass provenance and provide information about the past strength of overturning circulation, respectively. In this study, combined 231Pa/230Th and εNd down-core profiles from six Atlantic Ocean sediment cores are presented. The data set is complemented by the two available combined data sets from the literature. From this we derive a comprehensive picture of spatial and temporal patterns and the dynamic changes of the Atlantic Meridional Overturning Circulation over the past ∼25 ka. Our results provide evidence for a consistent pattern of glacial/stadial advances of Southern Sourced Water along with a northward circulation mode for all cores in the deeper (>3000 m) Atlantic. Results from shallower core sites support an active overturning cell of shoaled Northern Sourced Water during the LGM and the subsequent deglaciation. Furthermore, we report evidence for a short-lived period of intensified AMOC in the early Holocene.

A Model Study of the Circulation in the Pearl River Estuary (PRE) and Its Adjacent Coastal Waters: 2. Sensitivity Experiments

The Princeton Ocean Model is used to study the circulation in the Pear River Estuary (PRE) and the adjacent coastal waters in the winter and summer seasons. Wong et al. [2003] compares the simulation results with the in situ measurements collected during the Pearl River Estuary Pollution Project (PREPP). In this paper, sensitivity experiments are carried out to examine the plume and the associated frontal dynamics in response to seasonal discharges and monsoon winds. During the winter, convergence between the seaward spreading plume water and the saline coastal water sets up a salinity front that aligns from the northeast to the southwest inside the PRE. During the summer the plume water fills the PRE at the surface and spreads eastward in the coastal waters in response to the prevailing southwesterly monsoon. The overall alignment of the plume is from the northwest to the southeast. The subsurface front is similar to that in the winter and summer except that the summer front is closer to the mouth and the winter front closer to the head of the estuary. Inside the PRE, bottom flows are always toward the head of the estuary, attributed to the density gradient associated with the plume front. In contrast, bottom flows in the shelf change from offshore in winter to onshore in summer, reflecting respectively the wintertime downwelling and summertime upwelling. Wind also plays an essential role in controlling the plume at the surface. An easterly wind drives the plume westward regardless winter or summer. The eastward spreading of the plume during the summer can be attributed to the southerly component of the wind. On the other hand, the surface area of the plume is positively proportional to the amount of discharge.

OPAC Design Enhancements and Their Effects on Circulation and Resource Sharing within the Library Consortium Environment

A longitudinal study of three discrete online public access catalog (OPAC) design enhancements examined the possible effects such changes may have on circulation and resource sharing within the automated library consortium environment. Statistical comparisons were made of both circulation and interlibrary loan (ILL) figures from the year before enhancement to the year after implementation. Data from sixteen libraries covering a seven-year period were studied in order to determine the degree to which patrons may or may not utilize increasingly broader OPAC ILL options over time. Results indicated that while ILL totals increased significantly after each OPAC enhancement, such gains did not result in significant corresponding changes in total circulation.

(Table 1) Insoluble aerosol concentrations and vertical fluxes at the eastern shelf of the Black Sea during breeze circulation in October 1987

Amounts of aerosols transported to the shelf surface were calculated on the basis of in situ measurements of concentrations of eolian matter (insoluble aerosol fraction) and vertical fluxes of settling dust in five areas of the Black Sea shelf from the Danube delta to the Inguri River mouth. More than 8.3 mln t of eolian matter are annually transported from the land over the shelf of the former USSR. At the same time more than 5.4 mln t are supplied to the northwestern shelf area, 1.7 mln t are supplied to the Crimean area, about 0.8 mln t are supplied to the Kerch-Taman' area, and about 0.45 mln t are supplied to the Caucasian area.

Nd and Pb isotopes in ferromanganese crusts

The intensity of North Atlantic Deep Water (NADW) production has been one of the most important parameters controlling the global thermohaline ocean circulation system and climate. Here we present a new approach to reconstruct the overall strength of NADW export from the North Atlantic to the Southern Ocean over the past 14 Myr applying the deep water Nd and Pb isotope composition as recorded by ferromanganese crusts and nodules. We present the first long-term Nd and Pb isotope time series for deep Southern Ocean water masses, which are compared with previously published time series for NADW from the NW Atlantic Ocean. These data suggest a continuous and strong export of NADW, or a precursor of it, into the Southern Ocean between 14 and 3 Ma. An increasing difference in Nd and Pb isotope compositions between the NW Atlantic and the Southern Ocean over the past 3 Myr gives evidence for a progressive overall reduction of NADW export since the onset of Northern Hemisphere glaciation (NHG). The Nd isotope data allow us to assess at least semiquantitatively that the amount of this reduction has been in the range between 14 and 37% depending on location.

Late Miocene-early Pliocene stable isotope record of benthic foraminifera from ODP Site 177-1088 in the sub-Antarctic South Atlantic

Benthic foraminiferal stable isotope records for the past 11 Myr from a recently drilled site in the sub-Antarctic South Atlantic (Site 1088, Ocean Drilling Program Leg 177, 41°S, 15°E, 2082 m water depth) provide, for the first time, a continuous long-term perspective on deep water distribution patterns and Southern Ocean climate change from the late Miocene through the early Pliocene. I have compiled published late Miocene through Pliocene stable isotope records to place the new South Atlantic record in a global framework. Carbon isotope gradients between the North Atlantic, South Atlantic, and Pacific indicate that a nutrient-depleted watermass, probably of North Atlantic origin, reached the sub-Antarctic South Atlantic after 6.6 Ma. By 6.0 Ma the relative proportion of the northern-provenance watermass was similar to today and by the early Pliocene it had increased to greater than the modern proportion suggesting that thermohaline overturn in the Atlantic was relatively strong prior to the early Pliocene interval of inferred climatic warmth. Site 1088 oxygen isotope values display a two-step increase between ~7.4 Ma and 6.9 Ma, a trend that parallels a published delta18O record of a site on the Atlantic coast of Morocco. This is perhaps best explained by a gradual cooling of watermasses that were sinking in the Southern Ocean. I speculate that relatively strong thermohaline overturn at rates comparable to the present day interglacial interval during the latest Miocene may have provided the initial conditions for early Pliocene climatic warmth. The impact of an emerging Central American Seaway on Atlantic-Pacific Ocean upper water exchange may have been felt in the North Atlantic beginning in the latest Miocene between 6.6 and 6.0 Ma, which would be ~1.5 Myr earlier than previously thought.

Carbonate cements and fluid circulation of ODP Leg 116 samples

The carbonate cements found in Sites 717-719 of ODP Leg 116 correspond to the precipitation of inorganic calcite due to circulation of hot fluid associated with intraplate deformation in the central Indian Ocean. A first burst of hydrothermal activity may have occurred 7.5-9 Ma and a second burst less than 0.5 Ma. These fluids were probably derived from the basaltic basement and the immediately overlying sediments.

Benthic foraminiferal carbon isotopic records and the development of abyssal circulation at DSDP Sites 9-77, 12-119, 30-289, 82-563 and 94-608

The North Atlantic at present is ventilated by overflow of the Denmark Strait, Iceland-Faeroe Ridge, Faeroe Bank Channel, and Wyville-Thompson Ridge. The evolution of Cenozoic abyssal circulation of this region was related to tectonic opening and subsidence of these sills. We used d13C records of the benthic foraminifer Cibicidoides to decipher the timing of tectonically controlled changes in bottom-water circulation in the eastern basins (Biscay and Iberian) of the northern North Atlantic. Records from Site 608 (Kings Trough, northeastern North Atlantic) show that from about 24 to 15 Ma (early to early middle Miocene), d13C values in the Kings Trough area were depleted relative to western North Atlantic values and were more similar to Pacific d13C values. This reflects less ventilation of the Kings Trough region as compared to the well-oxygenated western North Atlantic. Comparison of Oligocene d13C records from Site 119 (Bay of Biscay) with western North Atlantic records suggests that the eastern basin was also relatively isolated prior to 24 Ma. At about 15 Ma, d13C values at Site 608 attained values similar to the western North Atlantic, indicating increased eastern basin ventilation in the middle Miocene. This increased advection into the eastern basin predated a major d18O increase which occurred at about 14.6 Ma. Subsidence estimates of the Greenland-Scotland Ridge indicate that the deepening of the Iceland-Faeroe Ridge was coincident with the marked change in eastern basin deep-water ventilation.

Stable carbon and oxygen isotope ratios of Planulina wuellerstorfi from sediments of the Sierra Leone Rise

Causes of change in deep water delta13C can be either global or local in extent. Global causes include (1) climatically-induced changes in the amount of terrestrial biomass which alter the average carbon isotopic composition of the oceanic reservoir (Shackleton, 1977), and (2) erosion and deposition of organic-rich, continental shelf sediments during sea level fluctuations which change the mean oceanic carbon: phosphorus ratio (Broecker, 1982 doi:10.1016/0079-6611(82)90007-6). Regional gradients of delta13C are created by remineralization of organic detritus within the deep ocean itself thus reflecting the distribution of water masses and modern thermohaline flow. Changes in a single geological record of benthic foraminiferal delta13C can result from any combination of these global and abyssal circulation effects. By sampling a large number of cores collected over a wide bathymetric range yet confined to a small geographical region we have minimized the ambiguity. We can assume that each delta13C record was equally affected by global causes of delta13C variation. The differences seen between the delta13C records must, therefore, reflect changes in the distribution of delta13C in the deep ocean. We interpret these differences in distribution in terms of changes in the ocean's abyssal circulation. Benthic foraminiferal carbon isotopic evidence from a suite of Sierra Leone Rise cores indicates that the deeper parts of the eastern Atlantic basins underwent a reduction in [O2] during the maximum of the last glaciation. Reduced advection of O2-rich deep water through low-latitude fracture zones, associated with increased delivery of organic matter to the deep ocean, lowered the delta13C of deep water SumCO2 at all depths below the sill separating the eastern and western Atlantic basins (Metcalf et al., 1964 doi:10.1016/0011-7471(64)91078-2). This decreased advection into the eastern Atlantic Ocean coincides with the overall decrease in deep water production in the North Atlantic during the last glacial maximum (Curry and Lohmann, 1982 doi:10.1016/0033-5894(82)90071-0; Boyle and Keigwin, 1982 doi:10.1126/science.218.4574.784; Schnitker, 1979 doi:10.1016/0377-8398(79)90020-3; Streeter and Shackleton, 1979 doi:10.1126/science.203.4376.168).

Past circulation along the western Iberian margin

Fifteen Iberian margin sediment cores, distributed between 43°12'N and 35°53'N, have been used to reconstruct spatial and temporal (sub)surface circulation along the Iberian margin since the Last Glacial period. Time-slice maps of planktonic foraminiferal derived summer sea surface temperature (SST) and export productivity (Pexp) were established for specific time intervals within the last 35 ky: the Holocene (Recent and last 8 ky), Younger Dryas (YD), Heinrich Stadials (HS) 1, 2a, 2b, 3, and the Last Glacial Maximum (LGM). The SST during the Holocene shows the same latitudinal gradient along the western Iberian margin as present-day with cold but productive areas that reflect the influence of coastal upwelling centers. The LGM appears as a slightly less warm, but more productive period relative to the Holocene and present-day conditions, suggesting that sea-level minima forced a westward displacement of the coastal upwelling centers possibly accompanied by a strengthening of northward winds. During the YD, a longitudinal thermal front is depicted at 10°W, with cold polar waters offshore and warmer subtropical waters inshore, suggesting that the subtropical Paleo-Iberian Poleward Current more likely flowed at a more inshore location masking the local SST signal and amplitude of variation. A substantial cooling and drop in productivity is observed during all HS, in particular HS1 and HS3, reflecting the penetration of icebergs-derived meltwater. These most extreme southward extensions of very cold waters define a strong SST gradient that marks a possible Paleo-Azores Front. Higher production south of this front was likely fed by frontal nutrient advection.

Stable oxygen and carbon isotope record of benthic foraminifera in Pliocene sediments of the Californian margin

New benthic foraminiferal stable isotopic records of northeast Pacific intermediate water (ODP Site 1014, 1177 m) and mid-depth water (ODP Site 1018, 2476 m) were compared to isotopic records of deep water in the tropical Pacific (ODP Site 849, 3851 m) for the reconstruction of vertical profiles of nutrient and physical properties from the Early Pliocene to the Early Pleistocene (approx. 5-1.4 Ma). Our data indicate that, for the entire interval, there was enhanced north Pacific intermediate water ventilation relative to today, and a similar to modern circulation pattern with northward flowing Pacific Bottom Water (PBW) beneath its southward flowing return flow. However, the core of maximally aged return flow resided as deep as ~2500 m (as compared to ~1500 m today), probably due to the strengthened intermediate water flow. Less apparent aging of deep water along its path before 2.7 Ma indicates that thermohaline overturning may have been more rapid in the warm period of the Early Pliocene. In addition, prior to 2.7 Ma, foraminiferal oxygen isotopic values at mid-depth sites are higher than at deep sites (a reversed vertical gradient relative to today) in both the Atlantic and Pacific Oceans. We suggest that NADW was warmer and more saline than today and that it influenced mid-depth waters throughout the Atlantic and Pacific Oceans. Enhanced Pliocene formation of warmer/saltier intermediate water in the north Pacific, and deep water in the north Atlantic, may have been a result of higher than modern high/mid-latitude sea surface temperatures, evaporation, and salinity.

(Table 2) Correlation of Mi zones with hiatuses in ODP Site 181-1124

Results from Ocean Drilling Program sites 1121-1124 show the Eastern New Zealand Oceanic Sedimentary System (ENZOSS) evolved in response to: (1) the inception of the circum-Antarctic circulation, (2) orbital and nonorbital regulation of the global thermohaline flow, and (3) development of the New Zealand plate boundary. ENZOSS began in the early Oligocene following opening of the Tasmanian gateway and inception of the ancestral Antarctic Circumpolar Current (ACC) and SW Pacific Deep Western Boundary Current (DWBC). Widespread erosion, marked by the Marshall Paraconformity, was followed by extensive drift formation in the late Oligocene- early Miocene. Alternating nannofossil chalk and nannofossil-rich mud deposited in response to 41-kyr orbital regulation of the abyssal circulation, with the mudstones representing times of increased inflow of corrosive southernsource waters. Drift deposition at the deepest sites was interrupted by bouts of erosion coincident with Mi 1-5 isotopic events signifying expansions of the East Antarctic Ice Sheet and enhanced bottom water formation. By late Miocene times, the basic ENZOSS was established. South of Bounty Trough, the energetic ACC instigated an erosional/low depositional regime. To the north, where the DWBC prevailed, orbitally regulated drift deposition continued. Increased convergence at the New Zealand plate boundary enhanced the terrigenous supply, but little of this sediment reached the deep ENZOSS as the three main sediment conduits - Solander, Bounty and Hikurangi channels - had not fully developed. The Plio-Pleistocene heralded a change from a carbonate- to terrigenous-dominant supply caused by interception of the DWBC by the three channels (~1.6 Ma for Bounty and Hikurangi, time of Solander interception unknown). The Solander and Bounty fans, and Hikurangi Fan-drift systems formed, and drifts downstream of those systems, received terrigenous detritus. Supply increased with accelerating uplift along the plate boundary, but delivery to the DWBC was regulated by eustatic fluctuations of sea level. Times of maximum supply to all three channels was during glacial lowstands whereas the supply either ceased (Bounty, Solander), or reduced (Hikurangi) in highstands. In glacial times, sediment was entrained by a DWBC invigorated by an increased input of Antarctic bottom water. The ACC also accelerated under strengthened glacial winds. Thus, glacials were times of optimum sediment supply to ENZOSS depocentres where depositional rates were 2-3 times more than interglacial rates.

Isopollen maps for 18,000 years B.P. of the offshore of Northwest Africa: Evidence for paleowind circulation

Distribution patterns of the most important pollen types from southern European and northwest African source areas for the 18,000 years B.P. time slice are reconstructed from pollen records of 14 well-dated deep-sea cores located between 37° and 9°N and compared with the modern pollen distribution in this area. It is concluded that the belt with maximum African Easterly Jet transport did not shift latitudinally during the last glacial-interglacial transition but remained at about 20°N. Furthermore, it is substantiated that the trade winds did not shift latitudinally during the last glacial-interglacial transition. This evidence is not compatible with an atmospheric circulation model that assumes a zone of surface westerlies in the northern part of northwest Africa. Trade winds during glacial episodes did, however, intensify, especially from about 36° to 24° N.