To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Apolipoprotein E (APOE) E4 is the main genetic risk factor for Alzheimer’s disease (AD). Due to the consistent association, there is interest as to whether E4 influences the risk of other neurodegenerative diseases. Further, there is a constant search for other genetic biomarkers contributing to these phenotypes, such as microtubule-associated protein tau (MAPT) haplotypes. Here, participants from the Ontario Neurodegenerative Disease Research Initiative were genotyped to investigate whether the APOE E4 allele or MAPT H1 haplotype are associated with five neurodegenerative diseases: (1) AD and mild cognitive impairment (MCI), (2) amyotrophic lateral sclerosis, (3) frontotemporal dementia (FTD), (4) Parkinson’s disease, and (5) vascular cognitive impairment.
Genotypes were defined for their respective APOE allele and MAPT haplotype calls for each participant, and logistic regression analyses were performed to identify the associations with the presentations of neurodegenerative diseases.
Our work confirmed the association of the E4 allele with a dose-dependent increased presentation of AD, and an association between the E4 allele alone and MCI; however, the other four diseases were not associated with E4. Further, the APOE E2 allele was associated with decreased presentation of both AD and MCI. No associations were identified between MAPT haplotype and the neurodegenerative disease cohorts; but following subtyping of the FTD cohort, the H1 haplotype was significantly associated with progressive supranuclear palsy.
This is the first study to concurrently analyze the association of APOE isoforms and MAPT haplotypes with five neurodegenerative diseases using consistent enrollment criteria and broad phenotypic analysis.
To describe the identification, management, and clinical characteristics of hospitalized patients with influenza-like illness (ILI) during the peak period of activity of the 2009 pandemic strain of influenza A virus subtype H1N1 (2009 H1N1).
Retrospective review of electronic medical records.
Patients and Setting.
Hospitalized patients who presented to the emergency department during the period October 18 through November 14, 2009, at 4 hospitals in Cook County, Illinois, with the capacity to perform real-time reverse-transcriptase polymerase chain reaction testing for influenza.
Vital signs and notes recorded within 1 calendar day after emergency department arrival were reviewed for signs and symptoms consistent with ILI. Cases of ILI were classified as recognized by healthcare providers if an influenza test was performed or if influenza was mentioned as a possible diagnosis in the physician notes. Logistic regression was used to determine the patient attributes and symptoms that were associated with ILI recognition and with influenza infection.
We identified 460 ILI case patients, of whom 412 (90%) had ILI recognized by healthcare providers, 389 (85%) were placed under airborne or droplet isolation precautions, and 243 (53%) were treated with antiviral medication. Of 401 ILI case patients tested for influenza, 91 (23%) had a positive result. Fourteen (3%) ILI case patients and none of the case patients who tested positive for influenza had sore throat in the absence of cough.
Healthcare providers identified a high proportion of hospitalized ILI case patients. Further improvements in disease detection can be made through the use of advanced electronic health records and efficient diagnostic tests. Future studies should evaluate the inclusion of sore throat in the ILI case definition.
A survey of publicly available data from the Intergovernmental Panel on Climate Change (IPCC) suggests that the Middle East will become significantly drier as greenhouse gas levels rise – with potentially devastating consequences. Simulating the climate of the eastern Mediterranean and the Middle East is, however, a tough challenge for climate models and those results should be interpreted with caution. The cyclones which migrate from west to east across the Mediterranean in winter and early spring, and which deliver much of the annual precipitation to the Middle East, are not well resolved by global climate models of the type included in the IPCC archive. Furthermore, the local climate is modified by coastlines and mountains throughout the region. For these reasons we provide a supplement to the IPCC results with simulations from a regional climate model. As in the global models, the regional model projects that, under an A2 (business-as-usual) scenario, precipitation will decrease significantly in the Middle East. Further investigation of the daily statistics of the weather, along with tracking of weather systems in the present day and future climate scenarios, suggest that the dominant mechanism for these changes is a reduction in the strength of the Mediterranean storm track. The Mediterranean storm track is fairly well simulated by the regional climate model, increasing confidence in this projection. […]
Driving hydrological models with climate data is a tough challenge – whether the data are from the observational record or climate models. One reason for this is that many hydrological models require long daily time-series of precipitation and evaporation. The scarcity of appropriate observed data in many parts of the MENA region is therefore a potential constraint for the development of such models. Although climate models have the capacity to produce daily time-series for the whole region, the results of impacts studies driven directly by model output would be prejudiced by model error – particularly in precipitation, which is one of the most difficult variables to simulate. This chapter describes how these problems can be addressed by using a simple statistical rainfall model (weather generator) in conjunction with a regional climate model. This enables climate model bias to be corrected, observed monthly data to be disaggregated and the length of a precipitation time-series to be extended.
Driving hydrological models with climate model data provides a key means to understand the hydrological systems of the MENA region, how water availability has changed in the past and how it is projected to change in the future. In cases when it is not appropriate or not possible to use raw model output to drive a hydrological model, a statistical rainfall model (also known as a stochastic weather generator) can be used as an intermediate step.
As noted at the start of this volume, the Water, Life and Civilisation (WLC) project aimed:
to assess the changes in the hydrological climate of the Middle East and North Africa (MENA) region and their impact on human communities between 20,000 BP and AD 2100, with a case study of the Jordan Valley.
The 28 chapters within this volume have certainly made a contribution towards that aim, although inevitably falling short of providing a comprehensive coverage of the vast array of topics that would need to be addressed to meet that aim in full. In this overview, we will highlight selected conclusions made as part of the project, and those areas of research that have now been revealed to require further attention. We will reflect on the challenges involved in developing interdisciplinary research within our study region, the overall achievements and the shortcomings of our project.
MODELS FOR PRESENT, PAST AND FUTURE CLIMATE CHANGE
The analysis of present-day rainfall and the modelling of past, present and future climates within Chapters 2, 3 and 4 have provided a series of studies of the Middle East and Mediterranean region climate throughout the Holocene and forward to the end of the current century, with sufficient resolution to assess regional climate variability. The use of similar (although not identical) model set-ups to simulate the past and future climate provided an unprecedented opportunity to compare the past, present and future (Chapter 8).
A unique interdisciplinary study of the relationships between climate, hydrology and human society from 20,000 years ago to the present day within the Jordan Valley. It describes how state-of-the-art models can simulate the past, present and future climates of the Near East, reviews and provides new evidence for environmental change from geological deposits, builds hydrological models for the River Jordan and associated wadis and explains how present day urban and rural communities manage their water supply. The volume provides a new approach and new methods that can be applied for exploring the relationships between climate, hydrology and human society in arid and semi-arid regions throughout the world. It is an invaluable reference for researchers and advanced students concerned with the impacts of climate change and hydrology on human society, especially in the Near East.
The Dead Sea has played a crucial role in the past development of communities in the Jordan Valley, as evidenced by the wide range of archaeological sites close to the sea or potential old sea shorelines. There is also considerable debate concerning how levels have changed over the recent past and also how water resources in the Jordan Valley will be managed in the future. Over the past 50 years there has been a significant reduction in the level of the Dead Sea driven by abstractions from the Jordan River, the main source of fresh water to the sea. Falling levels have created problems for the tourism industry, and there are plans to restore levels using a water transfer from the Red Sea or the Mediterranean to the Dead Sea. A new model of the Dead Sea levels is described, based on historical rainfall and level data from 1860 to 1960. The model is used to simulate the impacts of abstractions on Dead Sea levels that have resulted in a 45-m reduction in levels since the 1960s. The model is also used to evaluate the impacts of future climate change: it is shown that the projected changes in rainfall have a far smaller impact on Dead Sea levels than do the abstractions. The model also shows that the only way to avoid this problem is to transfer water into the Dead Sea from either the Red Sea or the Mediterranean. […]
This chapter is concerned with a model-based assessment of the effects of projected climate change on water security in the rural west of Jordan. The study area is the Wadi Hasa, a large (2,520 km2) catchment which drains from the Jordanian plateau to the Dead Sea at Ghor Safi. The Wadi Hasa is regionally important in terms of both water resources and archaeology. A substantial database was collated to describe the hydrological functioning of the catchment and a new monthly time-step hydrological model, HYSIMM, was developed and applied within a modelling framework, which also includes the HadRM3 regional climate model and a weather generator, to provide future projections of mean monthly flows. Under the A2 storyline, the climate in the region of Wadi Hasa in 2071–2100 was projected to become drier, with a mean annual precipitation 25% less than the present day, and warmer; winter and summer temperatures were projected to increase by approximately 4 and 6 degrees centigrade, respectively. Spatial differences in the projected precipitation depths and temperatures are apparent across the region. The modelled outcomes suggest that the mean monthly flows will decrease in winter because of the reduced precipitation, and the modelled flows were more sensitive to changes in precipitation than potential evapotranspiration. Overall, the monthly flood flows are predicted to decrease by 22% and the base flow by 7% by the end of the century under the A2 storyline. […]
The arid climate of the Middle East means that variations in rainfall on all timescales from days to years have an enormous impact on the people who live in the region. Understanding this variability is crucial if we are to interpret model simulations of the region's climate and make meaningful predictions of how the climate may change in the future and how it has changed in the past (Chapters 3 and 4). This study uses rain gauge measurements in conjunction with other meteorological data to address the following questions. How does rainfall vary from day to day and from year to year? How does rainfall vary spatially within Jordan and Israel? How does the atmospheric circulation over the Mediterranean region affect the daily probability of rain? What effect do large-scale modes of variability such as the North Atlantic Oscillation have on rainfall variability in the region?
Variability in precipitation has posed a considerable challenge to the population of the Middle East throughout the Holocene, and continues to be a key issue today. Understanding this variability is crucial for the design and interpretation of climate model experiments that characterise how precipitation has changed in the past and predict how it will change in the future.
In this chapter, we develop an improved understanding of the Mediterranean's past climate through a series of ‘time-slice’ climate integrations relating to the past 12,000 years, performed using a version of the Met Office Hadley Centre's global climate model (HadSM3). The output is dynamically downscaled using a regional version of the same model to offer unprecedented spatial detail over the Mediterranean. Changes in seasonal surface air temperatures and precipitation are discussed at both global and regional scales along with their underlying physical drivers.
In the experiments the Mediterranean experiences more precipitation in the early Holocene than the late Holocene, although the difference is not uniform across the eastern Mediterranean. The results suggest that there may have been a relatively strong reduction in precipitation over the eastern Mediterranean coast during the period around 6–10 thousand years before present (kaBP). The early Holocene also shows a stronger seasonal cycle of temperature throughout the Northern Hemisphere but, over the northeast Mediterranean, this is mitigated by the influence of milder maritime air carried inland from the coast.
Understanding the changes in the Mediterranean climate during the Holocene period is a challenging problem, but one that is critical to interpreting long-term change in human settlement. The region at present displays marked seasonality with dry, hot summers and cool, wet winters.