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This study examines the geographic and temporal characteristics of the springtime transition to the summer precipitation regime of isolated convection in the southeastern (SE) United States during 2009–12, using a high-resolution surface radar-based precipitation dataset. Isolated convection refers herein to isolated elements or small clusters of precipitation in radar imagery less than 100 km in horizontal dimension. Though the SE United States does not have a monsoon climate, it is useful to apply the established framework of monsoon onset to study the timing and regional variation of the onset of the summer isolated convection regime. Overall, isolated convection rain onset in the SE U.S. domain occurs in late May. Onset begins in south Florida in mid-April, continuing nearly simultaneously across the southeastern coastal plain in early to mid-May. In the northern domain, from Virginia to the Ohio Valley, onset generally occurs much later (mid-June to early July) with more variable onset timing. The sharpness of onset timing is most evident in the coastal plain and Florida. Results suggest the hypothesis, to be examined in a forthcoming study, that the timing of isolated convection onset in the spring may be triggered by specific synoptic-scale events within gradual seasonal changes in atmospheric conditions including extratropical cyclone tracks, convective instability, and the westward migration of the North Atlantic subtropical high. This approach may offer a useful framework for evaluating long-term changes in precipitation for subtropical regimes in an observational and modeling context.

As the earth warms, it is unclear how the organization of precipitation will change, or how these changes will impact regional rainfall and the hydrological cycle. This study combines Weather Research and Forecasting (WRF) model simulations and the pseudo global warming downscaling approach with a precipitation feature identification algorithm to help improve our understanding of the effect of warming on precipitation organization. The WRF model was used to simulate precipitation during a six-day summer period in the southeastern United States under present and future warmer climate conditions. The domain averaged precipitation increased by 45% in the future climate simulation compared to current climate. Modeled precipitation features were classified into either mesoscale precipitation features (MPF) larger than 100 km in length or smaller isolated precipitation features (IPF). In terms of organization, future IPF precipitation fraction decreased while MPF precipitation fraction and feature sizes increased, especially over the ocean, indicating a general increase in mesoscale organization in the future warmer climate. Despite higher thermodynamic instability, future climate IPF precipitation was unchanged over land, possibly responding to stronger subsidence under a strengthened western ridge of the North Atlantic Subtropical High. Yet over the ocean IPF precipitation increased and the amplitude of the IPF diurnal cycle doubled. The most notable precipitation intensity increase, as measured by feature height and rainrate distributions, occurred in oceanic MPFs. These increases in oceanic IPF and MPF precipitation may highlight the role of surface water vapor fluxes in realizing increased precipitation in a warmer climate. This study demonstrates that the application of a simple precipitation feature identification algorithm to WRF simulations can give valuable insight into the effect of climate change upon precipitation organization and intensity. Nevertheless longer simulations are still needed to obtain a robust statistics of the changes of precipitation organization under a warming climate.

Millions of people in the United States regularly acquire information from weather forecasts for a wide variety of reasons. The rapid growth in mobile device technology has created a convenient means for people to retrieve this data, and in recent years, mobile weather applications (MWAs) have quickly gained popularity. Research on weather sources, however, has been unable to sufficiently capture the importance of this form of information gathering. As use of these apps continues to grow, it is important to gain insight on the usefulness of MWAs to consumers. To better examine MWA preferences and behaviors relating to acquired weather information, a survey of 308 undergraduate students from three different universities throughout the southeast United States was undertaken. Analyses of the survey showed that smartphone MWAs are the primary weather forecast source among college students. Additionally, MWA users tend to seek short-term forecast information, like the hourly forecast, from their apps. Results also provide insight into daily MWA use by college students as well as perceptions of and preferential choices for specific MWA features and designs. The information gathered from this study will allow other researchers to better evaluate and understand the changing landscape of weather information acquisition and how this relates to the uses, perceptions, and values people garner from forecasts. Organizations that provide weather forecasts have an ever-growing arsenal of resources to disseminate information, making research of this topic extremely valuable for future development of weather communication technology.

The sea-breeze (SB) is an important source of summertime precipitation in North Carolina (NC, southeast United States). However, not all SB events produce precipitation. A climatology of wet and dry SB events in NC is used to investigate the conditions that are conducive to precipitation associated with the sea breeze. Radar imagery was used to detect 88 SB events that occurred along the NC coast between May-September of 2009-2012. The majority (85%) of SB events occurred during offshore flow (53%) or during flow that was parallel to the coast (22%). SB events were separated into dry (53%) and wet (47%) events and differences in the dynamic and thermodynamic parameters of the environment in which they formed were analyzed. Significant differences in dynamic and thermodynamic conditions were found. SB dry events occurred under stronger winds (6.00 ± 2.36 ms-1) than SB wet events (4.02 ± 2.16 ms-1). Moreover, during SB wet events larger values of convective available potential energy and lower values of convective inhibition were present, conditions that favor precipitation. Overall, the SB wet events accounted for 20-30% of the May-September precipitation along the NC coastal region. The position of the North Atlantic Subtropical High (NASH) controls both moisture availability and winds along the NC coast, thus providing a synoptic-scale control mechanism for SB precipitation. In particular, it was shown that when the NASH western ridge is located along the southeast coast of the United States, it causes a moist southwesterly flow along the NC coast that may favor the occurrence of SB wet events. La brisa marina (BM) es una importante fuente de precipitación de verano en Carolina del Norte (NC en su sigla en inglés), sudeste de Estados Unidos. Sin embargo, no todos los eventos de BM producen precipitación. En este trabajo se utiliza una climatología de eventos de BM lluviosos y secos en NC para investigar las condiciones que conducen a la precipitación. Se utilizaron imágenes de radar para detectar 88 eventos de BM ocurridos a lo largo de la costa NC entre mayo y septiembre de 2009 a 2012. La mayoría (85%) de los eventos de BM ocurrieron durante períodos de viento hacia el mar (53%) o viento paralelo a la costa (22%). Los eventos BM se separaron en eventos secos (53%) y lluviosos (47%) y se analizaron las diferencias en los parámetros dinámicos y termodinámicos del entorno en el que se formaron. Se encontraron diferencias significativas en las condiciones dinámicas y termodinámicas. Eventos de BM secos ocurrieron bajo vientos más fuertes (6,00 ± 2,36 ms-1) que los eventos de BM lluviosos (4,02 ± 2,16 ms-1). Las BM lluviosas ocurrieron bajo valores de energía potencial convectiva disponible más altos y valores del parámetro de inhibición convectiva más bajos, condiciones que favorecen la lluvia. En general, los eventos de BM lluviosos representaron el 20-30% de la precipitación a lo largo de la región costera de NC de mayo a septiembre. La posición de la Alta Subtropical del Atlántico Norte (ASAN) controla la disponibilidad de humedad y los vientos a lo largo de la costa de NC, proporcionando así un mecanismo de control de escala sinóptica para la precipitación de la BM. En particular, cuando la cresta occidental de la ASAN se localiza a lo largo de la costa sureste de los Estados Unidos, se produce un flujo de sudoeste húmedo a lo largo de la costa NC que puede favorecer la ocurrencia de eventos de BM lluviosos. This project was partially funded by the Climate and Large-Scale Dynamics and the Physical and Dynamic Meteorology programs of the National Science Foundation’s Division of Atmospheric and Geospatial Sciences, Award AGS-1118141.

The association between instantaneous extreme precipitation and mesoscale organization over the southeastern United States is not well known. This study addresses whether isolated precipitation features have a distinct distribution and spatial pattern of extreme rain compared to mesoscale precipitation features, and how these distributions and spatial patterns change from spring to summer. Using a four-year surface radar precipitation data set, hourly images of instantaneous extreme rain rates were separated into isolated and mesoscale precipitation features from March through August for the four-year period of 2009&ndash, 2012. Results show that that compared to isolated convection, mesoscale precipitation organization is more commonly associated with higher extremes in instantaneous rainfall in the southeastern U.S. Extreme rain values tied to mesoscale organization shift eastward and toward the coasts from spring to summer, while extreme rain from isolated convection is mainly a summer phenomenon concentrated in Florida and along the coastal plain. The implication is that dynamical processes favoring mesoscale organization such as high shear associated with baroclinic circulations are more associated with higher values of extreme rain, while thermodynamic forcing and local circulations favoring isolated convection are associated with lower values of extreme rain.

This article describes results from a new four-year (2009–2012) radar-based precipitation climatology for the southeastern United States (SE USA). The climatology shows that a size-based classification between mesoscale precipitation features (MPF) and isolated precipitation reveals distinct seasonal and diurnal variability of precipitation. On average, from 70 to 90% of precipitation is associated with MPF, generally less in the summertime and in southern coastal regions. MPF precipitation has a relatively small seasonal cycle except in Florida and the warm offshore waters of the Gulf Stream. In contrast, isolated precipitation has a dramatic seasonal cycle that outlines the SE USA coastline whereas the MPF precipitation does not, consistent with a thermodynamic mechanism for onshore isolated storms in coastal regions. In summer, the isolated precipitation preferentially forms offshore at night, and dramatically ‘flips’ inland by early afternoon. In contrast, MPF precipitation has no clear diurnal variations except in the southern coastal region in the summer, likely associated with sea breeze convection organized on the mesoscale. These results suggest that the MPF versus isolated precipitation system framework provides a useful basis for future studies of large-scale and local controls on precipitation and resulting implications for long-range predictability of precipitation.

Objectives To determine the existence of autoantibodies against apolipoprotein A-1 (anti-apoA-1 IgG) in HIV patients and explore their association with biological features of HIV infection and different inflammatory biomarkers. We also evaluated their impact on CD4 + lymphocytes survival. Methods Anti-apoA-1 IgG plasma levels were assessed by ELISA in 237 HIV positive patients from a national prospective cohort with no current lipid-lowering therapy. Results 58% of patients were found positive for anti-apoA-1 IgG and were associated with lower CD4 + counts, but higher viremia and systemic inflammation. Logistic regression analyses indicated that high anti-apoA-1 IgG levels were associated with a 16-fold increased risk of displaying low CD4 + levels, independent of HIV RNA levels and treatment (adjusted Odds ratio [OR]:16.1, 95% Confidence Interval [95%CI]:1.80–143.6; p = 0.01), and a 6-fold increased risk of having a detectable viremia, independent of antiretroviral treatment (OR:5.47; 95% CI:1.63–18.36; p = 0.006). In vitro , anti-apoA-1 IgG induced dose and time-dependent CD4 + apoptosis that was increased by exposure to HIV RNA. Conclusions In HIV patients, anti-apoA-1 IgG levels are associated with low CD4+ counts, high viremia and a pro-inflammatory systemic profile. Anti-apoA-1 IgG can promote CD4+ lymphocyte apoptosis via undefined pathways.

The seasonal and interannual variability of the structure, evolution, and propagation of midlatitude cyclones in the southeast United States are studied using a composite analysis. In the upper levels, the composites show that the axis of the wintertime upper-level trough remains north–south oriented and propagates eastward along 40°N, while the summertime upper-level trough has a much slower propagation at a farther north latitude and an axis that is tilted in the northeast–southwest direction. Upper-level circulation changes are consistent with a shift from wintertime “cyclonic behavior” to summertime “anticyclonic behavior” midlatitude cyclones. Significant changes in the low-level structure and precipitation patterns of midlatitude cyclones ensue from these upper-level changes. While the winter composite is characterized by eastward-propagating midlatitude cyclones that extend deep into the subtropics, the summer composite is characterized by semistationary midlatitude troughs that only briefly skirt the subtropics. Wintertime precipitation occurs only in and ahead of the surface low pressure center, whereas summertime precipitation occurs in all days of the composite. As a result, over 70% (30%) of wintertime (summertime) precipitation in the Carolinas occurs on days when midlatitude cyclones are present. The wintertime composites also show that midlatitude cyclones produce more precipitation on the windward side of the Appalachians than over the Carolinas, suggesting a rain shadow effect of the mountains. The ENSO-related variability of the structure, evolution, and propagation of midlatitude cyclones shows the presence of a more intense and southward-displaced upper-level jet, stronger midlatitude cyclones, and more intense precipitation over a larger area during El Niño than La Niña or normal years.

Isolated precipitating convection, though a minor contributor to total rainfall in the tropics, is important to regional and seasonal climate variability because its diabatic heating structure is characteristic of the convectively inactive phase of tropical interseasonal oscillations. This study extends a previous analysis of mesoscale convective system (MCS) variability in the South America monsoon system to examine regional differences in the annual cycle of the rainfall and vertical structure of isolated convection over the 10 year period of 1998–2007. The goal is to document the annual variation of shallow and deep isolated convection in order to provide a more complete picture of monsoon onset across South America. Over the 10 year period of 1998–2007, the average rain contribution from isolated convection (compared to MCSs) ranged from 1 to 8% of the total rainfall in the four regions depending on the season. The contribution of rainfall by isolated convection was on the high end of that range during the pre-monsoon months of June to August in the tropical regions. Of the isolated convection rainfall, 4–9% was attributable to shallow ‘warm rain’, with the largest fraction after monsoon onset (December to February) in the coastal Mouth of Amazon region. Mean annual time series of conditional rainfall, lightning activity, 85 GHz ice-scattering signature, and radar echo depth for isolated convective features all suggested that an oceanic regime strongly influences isolated convection at the Mouth of Amazon region in northeastern Brazil. In the interior tropical regions, there was a clear pre-monsoon (August to September) maximum in the vertical intensity of deep isolated convection as indicated by lightning, ice scattering, and radar echo depth. Copyright © 2012 Royal Meteorological Society

This paper presents a case study of an EF3 tornado that adversely impacted Greene and Pitt Counties in eastern North Carolina on 16 April 2011. This was one of the most damaging and longest-lived of the multiple tornados that occurred across central and eastern North Carolina that day, the most extensive outbreak in North Carolina since 1984. This event occurred during the month (April 2011) with the largest number of tornadoes on record in the United States. The focus of this case study was to examine the relationship between the mesocyclone evolution and the location and intensity of surface damage associated with the EF3 tornado. Results indicated that the initial contraction and spin up of the mesocyclone circulation preceded EF3 damage by about 20 minutes. At the time of mesocyclone intensification, the damage swath and tornado were situated much closer to the mesocyclone center than in the formative and dissipating stages. The weakened mesocyclone passed directly over a meteorological station at East Carolina University’s West Research Campus, providing a rare opportunity for surface measurements associated with a weakening tornadic mesocyclone. Abstract: Este trabajo presenta un estudio de caso de un tornado EF3 que impacto negativamente los condados de Greene y Pitt en el este de Carolina del Norte el 16 de abril de 2011. Este fue uno de los mas daninos y de mas larga duracion de los multiples tornados que se produjeron en el centro y el este de Carolina del Norte ese mismo dia, el brote mas extenso en Carolina del Norte desde 1984. Este evento tuvo lugar durante el mes (abril de 2011) con el mayor numero de tornados en el registro en los Estados Unidos. El objetivo de este estudio fue examinar la relacion entre la evolucion del mesociclon y la ubicacion e intensidad de los danos en la superficie asociados con el tornado EF3. Los resultados indicaron que la contraccion inicial y el giro de la circulacion del mesociclon precedio los danos del EF3 por unos 20 minutos. Al momento de intensificacion del mesociclon, la franja de danos y el tornado se encontraban mucho mas cerca del centro del mesociclon que en las etapas de formacion y disipacion. El mesocicon debilitado paso directamente sobre una estacion meteorologica del West Research Campus de East Carolina University, proporcionando una oportunidad unica para las mediciones de la superficie asociada con un debilitamiento del mesociclon de tornados.

In this study, a 10-yr (1998–2007) climatology of observations from the Tropical Rainfall Measuring Mission (TRMM) satellite is used to study regional mechanisms of monsoon onset across tropical and subtropical South America. The approach is to contrast regional differences in the structure, intensity, and rainfall of mesoscale convective systems (MCSs) prior to and after onset, in the context of thermodynamic conditions from the National Centers for Environmental Prediction (NCEP) reanalysis data. This is accomplished by analyzing the mean annual cycle time series, 10-yr frequency histograms, and 3-month-averaged values prior to and following onset in four regions of distinct rainfall variability. Observed MCS metrics and NCEP variables include lightning flash rate, convective rain fraction, height of the 30-dBZ isosurface, minimum 85-GHz polarization corrected temperature, and the fluxes of sensible and latent heat. The west-central Amazon region had a distinct maximum of MCS intensity 2 months prior to the monsoon onset date of each region, which was well correlated with surface sensible heat flux, despite the observation that thermodynamic instability was greatest after onset. At the mouth of the Amazon, the dry season rainfall minimum, the premonsoon maximum in MCS intensity metrics, and monsoon onset were all delayed by 2–3 months relative to the west-central Amazon. This delay in the annual cycle and comparatively large difference in pre- versus postonset MCSs, combined with previous work, suggest that the slow migration of the Atlantic Ocean intertropical convergence zone controls onset characteristics at the mouth of the Amazon. All metrics of convective intensity in the tropical regions decreased significantly following onset. These results, in the context of previous studies, are consistent with the hypothesis that thermodynamic, land surface, and aerosol controls on MCS intensity operate in concert with each other to control the evolution of precipitation system structure from the dry season to the wet season. The other two regions [the South Atlantic convergence zone (SACZ) and the south], associated with the well-documented dipole of intraseasonal rain variability, have a weaker and more variable annual cycle of all MCS metrics. This is likely related to the strong influence of baroclinic circulations and frontal systems in those regions. In the south, fewer but larger and more electrified MCSs prior to onset transition to more, smaller, and less electrified MCSs after onset, consistent with previous climatologies of strong springtime mesoscale convective complexes in that region.

The onset of the South American monsoon season culminates with the abrupt establishment of the South American convergence zone (SACZ). The impact of cold fronts on the abrupt establishment of the SACZ is studied using an 11-year composite analysis of the dynamic and thermodynamic structures, intensity and propagation of cold fronts that occur prior to, during, and after monsoon onset in the SACZ. A significant change in the structure and propagation of cold fronts is observed at the time of monsoon onset in the SACZ, with cold fronts suddenly stalling and becoming stationary in southeastern Brazil. It is proposed that this regime change of the structure and propagation of cold fronts causes the abrupt onset of the monsoon in the SACZ. A mechanism for this sudden change in cold front behaviour is suggested by analyzing changes in the observed upper-level structure of midlatitude waves. Our observations show that, at the time of monsoon onset in the SACZ, midlatitude waves develop a ‘thinning trough’ behaviour, with upper-level troughs becoming thinner, westward tilted, and sometimes forming cut-off lows. This behaviour is characteristic of midlatitude waves that develop in the region of anticyclonic shear on the equatorward side of the upper-level midlatitude jet. During the austral spring, the upper-level midlatitude jet over South America migrates southward leaving subtropical South America in the equatorward, anticyclonic shear side of the jet. It is hypothesized that, as the meridional shear on the equatorward side of the upper-level jet gradually becomes more anticyclonic, it suddenly crosses the critical threshold of horizontal shear that has been shown to produce a sudden transition to a ‘thinning trough’ midlatitude wave regime. At this time a regime change occurs whereby the character of frontal systems crossing South America changes abruptly, causing the onset of the monsoon season in the SACZ. Copyright © 2011 Royal Meteorological Society

The evolution of monsoon onset across South America has complex temporal and regional variability that are controlled by local and remote land–ocean–atmosphere processes. In this study, a three-stage conceptual model for the onset of the South American monsoon season is proposed based on a rain threshold analysis and a rotated empirical orthogonal function (REOF) analysis of the Global Precipitation Climatology Project version 2 (GPCP-v2) dataset. This two-pronged approach allowed the identification of regions of South America that share a common seasonal cycle of rainfall variability and likely have a common mechanism for monsoon onset. According to this model, the first stage of onset starts around pentad 59 (October 18–22) when precipitation begins in the northwestern part of the continent and gradually progresses towards the south and southeast. The second stage is marked by the abrupt establishment of the South Atlantic Convergence Zone (SACZ). This stage occurs on average around pentad 61 (October 28–November 1). The third stage of monsoon onset involves the late arrival of the monsoon to the mouth of the Amazon River, associated with the slow migration of the Atlantic Intertropical Convergence Zone (ITCZ). This final stage of onset occurs on average by pentad 73 (December 27–31). This three-stage model of onset provides a useful framework for the study of regional differences in monsoon onset mechanisms, a subject that is further explored in two companion studies. Copyright © 2010 Royal Meteorological Society

A radar-based analysis of the structure, motion, and rainfall variability of westward-propagating squall-line mesoscale convective systems (SLMCSs) in Niamey, Niger, during the African Monsoon Multidisciplinary Activities (AMMA) 2006 special observing period is combined with an analysis of 700-mb (hPa) winds and relative vorticity to study the relationship between SLMCSs and African easterly waves (AEWs). Radar results show that SLMCSs were the most important rainmakers in Niamey and accounted for about 90% of the rainfall despite being present less than 17% of the time. Analysis of the 700-mb synoptic-scale flow revealed that during the 2006 West African monsoon season the African easterly jet vacillated between about 10° and 15°N on time scales of 1–2 weeks. AEWs followed the jet as it vacillated north and south, thereby producing two preferred paths for AEWs propagating past Niamey’s longitude, a northern track along 8°–16°N and a southern track along 2°–6°N. It was found that Niamey SLMCSs occurred westward of the trough of AEWs propagating along either track. The properties of SLMCSs must then be placed in the context of their location relative to these two AEW tracks, rather than in the trough and ridge pattern of a single AEW track. Radar analysis further indicated that although the total amounts of rainfall produced by SLMCSs occurring in both African easterly jet latitude regimes were similar, significant structural differences occurred between the two groups of systems. SLMCSs that formed to the west of AEW troughs propagating along the northern track had a significantly larger mean stratiform rain fraction in an environment of lower convective available potential energy when compared with the SLMCSs that occurred to the west of the troughs of AEWs in the southern track. The authors conclude that AEWs that propagated farther north provided a more favorable environment for stratiform rain production in Niamey SLMCSs than those AEWs located farther south. These results may be helpful to studies of the two-way interaction between AEWs and convection in West Africa.

The objective of this study was to describe the all-cause mortality of participants in the Swiss Hepatitis C Cohort compared to the Swiss general population. Patients with hepatitis C virus (HCV) infection attending secondary and tertiary care centres in Switzerland. One thousand six hundred and forty-five patients with HCV infection were followed up for a mean of over 2 years. We calculated all-cause standardized mortality ratios (SMR) and 95% confidence intervals (CI) using age, sex and calendar year-specific Swiss all-cause mortality rates. Multivariable Poisson regression was used to model the variability of SMR by cirrhotic status, HCV genotype, infection with hepatitis B virus or HIV, injection drug use and alcohol intake. Sixty-one deaths were recorded out of 1645 participants. The crude all-cause SMR was 4.5 (95% CI: 3.5-5.8). Patients co-infected with HIV had a crude SMR of 20 (95% CI: 11.1-36.1). The SMR of 1.1 (95% CI: 0.63-2.03) for patients who were not cirrhotic, not infected with HBV or HIV, did not inject drugs, were not heavy alcohol consumers (

OBJECTIVES: The aim of the study was to investigate the influence of continued injecting drug use, enrolment in an opiate substitution treatment programme (OSTP), or cessation of injecting drug use on the uptake and course of antiretroviral therapy (ART). Design A prospective observational study of all participants in the Swiss HIV Cohort Study followed between 1997 and 2006 was carried out. METHODS: We distinguished four groups of former or current injecting drug users (IDUs): (i) abstinent former IDUs; (ii) persons in OSTPs without concomitant injecting drug use; (iii) persons in OSTPs with concomitant injecting drug use; (vi) current IDUs. These groups were compared with a group of patients who had never been IDUs. Factors related to ART uptake and virological endpoints were analysed using logistic generalized estimating equations. RESULTS: We followed 8660 participants for 48 477 person-years; 29.7% were in the IDU HIV transmission group. The likelihood of being on ART at biannual visits was lower among individuals in OSTPs with concomitant injecting drug use [odds ratio (OR) 0.79; 95% confidence interval (CI) 0.71-0.89] and current IDUs (OR 0.80; 95% CI 0.67-0.96), compared with those who had never been IDUs (reference), abstinent former IDUs (OR 1.13; 95% CI 1.02-1.25) and individuals in OSTPs without injecting drug use (OR 1.18; 95% CI 1.06-1.31). The likelihood of suppressed viral replication on ART was similar among those who had never been IDUs, abstinent former IDUs and individuals in an OSTP without injecting drug use, and lower among those in OSTPs with concomitant drug use (OR 0.82; 95% CI 0.72-0.93) and current IDUs (OR 0.81; 0.65-1.00). Adherence to ART was decreased among persons with continued injecting drug use, and correlated with virological outcome. CONCLUSIONS: Uptake of and virological response to ART were improved among abstinent former IDUs and persons in OSTPs without concomitant injecting drug use, compared with persons with continued injecting drug use.

This article presents a comparative review of the North and South America Monsoon Systems and highlights the challenges and opportunities presented to those regions by the seasonal rains. Monsoon precipitation represents a major component of the water resources available to the southwestern US and to Brazil. Although each system shares classical features of the well-known southwest Indian monsoon, water use, agriculture, public safety, and energy policy in these two countries have been shaped by the unique regional complexities of monsoon rain across each region. A comparison between these two systems may offer perspective for ways by which these societies may adapt to current and future challenges, and take advantage of new opportunities.

One of the important goals of NASA’s Cirrus Regional Study of Tropical Anvils and Cirrus Layers–Florida Area Cirrus Experiment (CRYSTAL-FACE) was to further the understanding of the evolution of tropical anvil clouds generated by deep convective systems. An important step toward understanding the radiative properties of convectively generated anvil clouds is to study their life cycle. Observations from ground-based radar, geostationary satellite radiometers, aircraft, and radiosondes during CRYSTAL-FACE provided a comprehensive look at the generation of anvil clouds by convective systems over South Florida during July 2002. This study focused on the relationship between convective rainfall and the evolution of the anvil cloud shield associated with convective systems over South Florida on 23 July 2002, during the CRYSTAL-FACE experiment. Anvil clouds emanating from convective cells grew downwind (to the southwest), reaching their maximum area at all temperature thresholds 1–2 h after the active convective cells collapsed. Radar reflectivity data revealed that precipitation-sized anvil particles extended downwind with the cloud tops. The time lag between maximum rainfall and maximum anvil cloud area increased with system size and rainfall. Observations from airborne radar and analysis of in situ cloud particle size distribution measurements in the anvil region suggested that gravitational size sorting of cloud particles dispersed downshear was a likely mechanism in the evolution of the anvil region. Linear regression analysis suggested a positive trend between this time lag and maximum convective rainfall for this case, as well as between the time lag and maximum system cloud cover. The injection of condensate into the anvil region by large areas of intense cells and dispersal in the upper-level winds was a likely explanation to cause the anvil cloud-top area to grow for 1–2 h after the surface convective rainfall began to weaken. In future work these relationships should be evaluated in differing regimes of shear, stability, or precipitation efficiency, such as over the tropical oceans, in order to generalize the results. The results of this study implied that for these cloud systems, the maximum in latent heating (proportional to rainfall) may precede the peak radiative forcing (related to anvil cloud height and area) by a lead time that was proportional to system size and strength. Mesoscale modeling simulations of convective systems on this day are under way to examine anvil evolution and growth mechanisms.

Vertical structures of 2-day waves and the Madden–Julian oscillation (MJO) are projected onto vertical normal modes for a quiescent tropical troposphere. Three modes capture the gross tropospheric structure of 2-day waves, while only two modes are needed to represent most of the baroclinic structure of the MJO. Deep circulations that project onto the first baroclinic mode are associated with deep cumulonimbus and stratiform rainfall. Shallow circulations that project onto higher wavenumber modes are associated with precipitating shallow cumulus and congestus and stratiform rainfall. For both disturbances the horizontal divergence contributed by shallow modes is an important factor in the column-integrated moist enthalpy budget. These modes converge moist static energy for a time prior to when deep circulations export moist static energy. These results highlight the importance of properly representing the effects of shallow cumulus, congestus, and stratiform precipitation in theories of convectively coupled waves and in atmospheric models.

BACKGROUND Reducing the fraction of transmissions during recent human immunodeficiency virus (HIV) infection is essential for the population-level success of "treatment as prevention". METHODS A phylogenetic tree was constructed with 19 604 Swiss sequences and 90 994 non-Swiss background sequences. Swiss transmission pairs were identified using 104 combinations of genetic distance (1%-2.5%) and bootstrap (50%-100%) thresholds, to examine the effect of those criteria. Monophyletic pairs were classified as recent or chronic transmission based on the time interval between estimated seroconversion dates. Logistic regression with adjustment for clinical and demographic characteristics was used to identify risk factors associated with transmission during recent or chronic infection. FINDINGS Seroconversion dates were estimated for 4079 patients on the phylogeny, and comprised between 71 (distance, 1%; bootstrap, 100%) to 378 transmission pairs (distance, 2.5%; bootstrap, 50%). We found that 43.7% (range, 41%-56%) of the transmissions occurred during the first year of infection. Stricter phylogenetic definition of transmission pairs was associated with higher recent-phase transmission fraction. Chronic-phase viral load area under the curve (adjusted odds ratio, 3; 95% confidence interval, 1.64-5.48) and time to antiretroviral therapy (ART) start (adjusted odds ratio 1.4/y; 1.11-1.77) were associated with chronic-phase transmission as opposed to recent transmission. Importantly, at least 14% of the chronic-phase transmission events occurred after the transmitter had interrupted ART. CONCLUSIONS We demonstrate a high fraction of transmission during recent HIV infection but also chronic transmissions after interruption of ART in Switzerland. Both represent key issues for treatment as prevention and underline the importance of early diagnosis and of early and continuous treatment.

Die epidemiologische Situation in der Schweiz war gekennzeichnet durch einen deutlichen Rückgang in den Aidsfällen und HIV-assoziierten Todesfällen nach der Einführung der hochaktiven antiretroviralen Therapie (HAART). Die Neuinfektionen haben jedoch in den letzten Jahren wieder zugenommen und die Aidsfälle und Todesfälle nahmen nicht weiter ab. Wir diskutieren beispielhaft drei Fragenkomplexe, die für Epidemiologie und Public Health relevant und aktuell sind: (i) den Gebrauch von SHCS Daten in der Interpretation der Statistiken des Bundesamts für Gesundheit, die auf den Meldungen der Ärzte und Laboratorien beruhen; (ii) Analysen des Zugangs zu und Gebrauch von HAART in verschiedenen Patientengruppen, zum Beispiel Einwanderer, Patienten aus den unteren Sozialschichten und Patienten, die sich durch intravenösen Drogengebrauch mit HIV infiziert hatten; und (iii) die Erfassung von Trends im Sexualverhalten der Studienteilnehmer, inklusive Kondomgebrauch mit stabilen Partnern und bei Gelegenheitskontakten. Anhand dieser Beispiele versuchen wir zu zeigen, dass die SHCS eine wichtige Ressource für die epidemiologische Analyse und Überwachung der Epidemie und die Planung von Public Health Maßnahmen darstellt.

This paper examines the origins of a secondary nocturnal maximum in cloudiness and precipitation in southwestern Amazonia, a diurnal feature observed previously by many investigators. Analysis is based on satellite, radar, sounding, and profiler observations of precipitating systems and cloudiness from the Tropical Rainfall Measuring Mission Large-Scale Biosphere–Atmosphere (TRMM-LBA) and the coincident Wet-Season Atmospheric Mesoscale Campaign (WETAMC) field programs during the early 1999 wet season. The general finding is that following the collapse of the nearly ubiquitous and locally generated afternoon (“noon balloon”) convection, organized deep convection contributes to a postmidnight maximum in raining area and high cloudiness, and to a lesser extent rainfall. Nocturnal convective systems have the effect of weakening and delaying the onset of the following afternoon's convection. Many of these nocturnal convective events are traced to large- scale squall lines, which propagate westward tho...

In this paper, data collected from 51 days of continual upper atmospheric soundings and TOGA radar at ABRACOS Hill during the TRMM-LBA experiment are used to describe the mean thermodynamic and kinematic airmass properties of wet season convection over Rondonia, Brazil. Distinct multi-day easterly and westerly lower tropospheric wind regimes occurred during the campaign with contrasting airmass characteristics. Westerly wind periods featured modest CAPE (1000 J/kg), moist conditions (>90% RH) extending through 700 mb and shallow (900 mb) speed shear on the order of 10(exp -4)/s. This combination of characteristics promoted convective systems that featured a relatively large fraction of stratiform rainfall and weak convection nearly devoid of lightning. The environment is very similar to the general airmass conditions experienced during the Darwin, Australia monsoon convective regime. In contrast, easterly regime convective systems were more strongly electrified and featured larger convective rain rates and reduced stratiform rainfall fraction. These systems formed in an environment with significantly larger CAPE (1500 J/kg), drier lower and middle level humidities (< 80% RH) and a wind shear layer that was both stronger (10(exp -3)/s) and deeper (700 mb). The larger CAPE resulted from strong insolation under relatively cloud-free skies (owing to reduced column humidity) and was also weakly capped in the lowest 1-2 km, thus contributing to a more explosive growth of convection. The time series of low- and mid-level averaged humidity exhibited marked variability between westerly and easterly regimes and was characterized by low frequency (i.e., multi-day to weekly) oscillations. The synoptic scale origins of these moisture fluctuations are examined, which include the effects of variable low-level airmass trajectories and upper-level, westward migrating cyclonic vortices. The results reported herein provide an environmental context for ongoing dual Doppler analyses and numerical modeling case studies of individual TRMM-LBA convective systems.

Switzerland has a complex human immunodeficiency virus (HIV) epidemic involving several populations. We examined transmission of HIV type 1 (HIV 1) in a national cohort study. Latent class analysis was used to identify socioeconomic and behavioral groups among 6027 patients enrolled in the Swiss HIV Cohort Study between 2000 and 2011. Phylogenetic analysis of sequence data available for 4013 patients was used to identify transmission clusters. Concordance between sociobehavioral groups and transmission clusters was assessed in correlation and multiple correspondence analyses. A total of 2696 patients were infected with subtype B 203 with subtype C 196 with subtype A and 733 with recombinant subtypes (mainly CRF02\_AG and CRF01\_AE). Latent class analysis identified 8 patient groups. Most transmission clusters of subtype B were shared between groups of gay men (groups 1 3) or between the heterosexual groups ``heterosexual people of lower socioeconomic position{''} (group 4) and ``injection drug users{''} (group 8). Clusters linking homosexual and heterosexual groups were associated with ``older heterosexual and gay people on welfare{''} (group 5). ``Migrant women in heterosexual partnerships{''} (group 6) and ``heterosexual migrants on welfare{''} (group 7) shared non B clusters with groups 4 and 5. Combining approaches from social and molecular epidemiology can provide insights into HIV 1 transmission and inform the design of prevention strategies.}}}}}

OBJECTIVE: To evaluate the effect of time from seroconversion to a given CD4 cell count on progression to AIDS after that count after adjusting for updated CD4 cell counts. METHODS: Using pooled data from 19 seroconverter cohorts, we examined the association between the time from a CD4

The South China Sea Monsoon Experiment (SCSMEX) is an international field experiment with the objective to better understand the key physical processes for the onset and evolution of the summer monsoon over Southeast Asia and southern China aiming at improving monsoon predictions. In this article, a description of the major meteorological observation platforms during the intensive observing periods of SCSMEX is presented. In addition, highlights of early results and discussions of the role of SCSMEX in providing valuable in situ data for calibration of satellite rainfall estimates from the Tropical Rainfall Measuring Mission are provided. Preliminary results indicate that there are distinctive stages in the onset of the South China Sea monsoon including possibly strong influences from extratropical systems as well as from convection over the Indian Ocean and the Bay of Bengal. There is some tantalizing evidence of complex interactions between the supercloud cluster development over the Indian Oce...

Precipitation estimation over the tropical oceans is commonly performed using passive infrared (IR) measurements of cloud-top brightness temperature from geostationary satellites to infer the location of deep convection. It has been recognized in recent years that the majority of tropical precipitation is produced by mesoscale convective systems (MCSs). However, the relationship between the IR cloud-top patterns associated with MCSs and the underlying precipitation is not well understood. The assumption that the coldest cloud tops are associated with deep, active convection has been central to the characterization of cloud system motion and organization, and to many IR-based rainfall retrievals. Previous studies suggested that this view may be oversimplified when applied to propagating convective systems, such as squall lines. The goal of this study was to understand the evolution of the cold cloud associated with tropical oceanic squall line MCSs, and to discuss the implications for the retrieva...

It has long been known that trade wind cumulus and deep cumulonimbus represent primary components of the broad spectrum of cumulus clouds in the Tropics, which has led to the concept of a bimodal distribution of tropical clouds. However, recent analyses of shipboard radar data from Tropical Ocean Global Atmosphere Coupled Ocean‐Atmosphere Response Experiment (COARE) provide evidence of abundant populations of a third cloud type, cumulus congestus. Congestus clouds constitute over half the precipitating convective clouds in COARE and contribute over one-quarter of the total convective rainfall. Global Atmospheric Research Program Atlantic Tropical Experiment studies reveal a similar midlevel peak in the distribution of radar-echo tops. These findings lead to the conclusion that shallow cumulus, congestus,and cumulonimbus are all prominent tropical cumulus cloud types. They are associated with trimodal distributions of divergence, cloud detrainment, and fractional cloudiness in the Tropics. The peaks in the distributions of radar-echo tops for these three cloud types are in close proximity to prominent stable layers that exist over the Pacific warm pool and the tropical eastern Atlantic: near 2 km (the trade stable layer), ;5 km (near 08C), and ;15‐16 km (the tropopause). These stable layers are inferred to inhibit cloud growth and promote cloud detrainment. The 08C stable layer can produce detrainment from cumulonimbi (attendant shelf clouds) and help retard the growth of precipitation-laden and strongly entraining congestus clouds. Moreover, restriction of growth of congestus clouds to just above the 08C level limits further enhancement of cloud buoyancy through glaciation. The three cloud types are found to vary significantly during COARE on the timescale of the 30‐60-day intraseasonal oscillation. The specific roles of clouds of the congestus variety in the general circulation are not yet clear, but some (the shallower ones) contribute to moistening and preconditioning the atmosphere for deep convection; others (the deeper ones) contribute an important fraction of the total tropical rainfall, and both likely produce many midlevel clouds, thereby modulating the radiative heating of the tropical atmosphere.

An active day during the Coupled Ocean–Atmosphere Response Experiment (COARE) Intensive Observation Period (IOP) is examined in which nine convective systems evolved and moved eastward across the region of shipboard radar coverage in the Intensive Flux Array (IFA) within westerly wind burst conditions. The detailed genesis, morphology, and interactions between these cloud systems are documented from a radar and satellite perspective. One of these systems was a large and complex elliptical cluster, among the largest observed during the Tropical Ocean Global Atmosphere COARE. Multiple, parallel deep convective lines spaced 20–30 km apart and embedded within this system were initially oriented from north-northwest to south-southeast, oblique to the storm motion. Furthermore, the lines underwent counterclockwise realignment as the system moved eastward. The influence of strong lower-tropospheric directional and speed shear on these convective system properties is examined in the context of a dynamic,...

The occurrence frequency and rainfall production of mesoscale convective systems (MCSs) relative to smaller groups of convective clouds over the tropical oceans is not well known. Eighty days of shipboard radar data collected during the recent Tropical Ocean Global Atmosphere Coupled Ocean–Atmosphere Response Experiment (TOGA COARE) were used to provide a detailed view of convection in the western Pacific warm pool, a region of global climatological significance. The aim of this study was to document the frequency of occurrence, rainfall production, and depth of convection observed during TOGA COARE within a simple and meaningful framework of convective horizontal organization. Organization was characterized in terms of the horizontal scale and morphology of convective systems. Precipitation events were defined based on whether they attained the length scale of an MCS, and on whether convection was organized into lines. About four-fifths of rainfall during COARE was associated with MCS-scale squa...

Two features of Yanai et al.’s profiles of Q1 and Q2—the commonly observed double-peak structure to Q2 and an inflection in the Q1 profile below the melting level—are explored using estimates of convective and stratiform rainfall partitioning based on Massachusetts Institute of Technology (MIT) radar reflectivity data collected during TOGA COARE. The MIT radar data allow the Q1 and Q2 profiles to be classified according to stratiform rain fraction within the radar domain and, within the limitations of the datasets, allow interpretations to be made about the relative contributions of convective and stratiform precipitation to the mean profiles. The sorting of Q2 by stratiform rain fraction leads to the confirmation of previous findings that the double-peak structure in the mean profile is a result of a combination of separate contributions of convective and stratiform precipitation. The convective contribution, which has a drying peak in the lower troposphere, combines with a stratiform drying peak aloft and low-level moistening peak to yield a double-peak structure. With respect to the inflection in the Q1 profile below the 0°C level, this feature appears to be a manifestation of melting. It is the significant horizontal dimension of the stratiform components of tropical convective systems that yields a small but measurable imprint on the large-scale temperature and moisture stratification upon which the computations of Q1 and Q2 are based. The authors conclude, then, that the rather subtle features in the Q1/Q2 profiles of Yanai et al. are directly linked to the prominence of stratiform precipitation within tropical precipitation systems.

After structured treatment interruption (STI) of treatment for HIV-1, a fraction of patients maintain suppressed viral loads. Prospective identification of such patients might improve HIV-1 treatment, if selected patients are offered STI.We analysed the effect of previously identified genetic modulators of HIV-1 disease progression on patients' ability to suppress viral replication after STI. Polymorphisms in the genes killer cell immunoglobulin-like receptor 3DLI (KIR3DL1)/KIR3DS1, human leucocyte antigen B (HLA-B) and HLA Complex P5 (HCP5), and a polymorphism affecting HLA-C surface expression were analysed in 130 Swiss HIV Cohort Study patients undergoing STI. Genotypes were correlated with viral load levels after STI.We observed a statistically significant reduction in viral load after STI in carriers of HLA-B alleles containing either the Bw480Thr or the Bw480Ile epitope (mean adjusted effect on post-STI viral load: -0.82 log HIV-1 RNA copies/ml, P 0.001; and -1.12 log copies/ml, P 0.001, respectively). No significant effects were detected for the other polymorphisms analysed. The likelihood of being able to control HIV-1 replication using a prespecified cut-off (viral load increase 1000 copies/ml) increased from 39% in Bw4-negative patients to 53% in patients carrying Bw4-80Thr, and to 65% in patients carrying Bw4-80Ile (P = 0.02).These data establish a significant impact of HLA-Bw4 on the control of viral replication after STI.

Immigrants from high-burden countries and HIV-coinfected individuals are risk groups for tuberculosis (TB) in countries with low TB incidence. Therefore, we studied their role in transmission of Mycobacterium tuberculosis in Switzerland. We included all TB patients from the Swiss HIV Cohort and a sample of patients from the national TB registry. We identified molecular clusters by spoligotyping and mycobacterial interspersed repetitive-unit–variable-number tandem-repeat (MIRU-VNTR) analysis and used weighted logistic regression adjusted for age and sex to identify risk factors for clustering, taking sampling proportions into account. In total, we analyzed 520 TB cases diagnosed between 2000 and 2008; 401 were foreign born, and 113 were HIV coinfected. The Euro-American M. tuberculosis lineage dominated throughout the study period (378 strains; 72.7%), with no evidence for another lineage, such as the Beijing genotype, emerging. We identified 35 molecular clusters with 90 patients, indicating recent transmission; 31 clusters involved foreign-born patients, and 15 involved HIV-infected patients. Birth origin was not associated with clustering (adjusted odds ratio [aOR], 1.58; 95% confidence interval [CI], 0.73 to 3.43; P = 0.25, comparing Swiss-born with foreign-born patients), but clustering was reduced in HIV-infected patients (aOR, 0.49; 95% CI, 0.26 to 0.93; P = 0.030). Cavitary disease, male sex, and younger age were all associated with molecular clustering. In conclusion, most TB patients in Switzerland were foreign born, but transmission of M. tuberculosis was not more common among immigrants and was reduced in HIV-infected patients followed up in the national HIV cohort study. Continued access to health services and clinical follow-up will be essential to control TB in this population.

The long-term outcome of antiretroviral therapy (ART) is not assessed in controlled trials. We aimed to analyse trends in the population effectiveness of ART in the Swiss HIV Cohort Study over the last decade.We analysed the odds of stably suppressed viral load (ssVL: three consecutive values50 HIV-1 RNA copies/mL) and of CD4 cell count exceeding 500 cells/μL for each year between 2000 and 2008 in three scenarios: an open cohort; a closed cohort ignoring the influx of new participants after 2000; and a worst-case closed cohort retaining lost or dead patients as virological failures in subsequent years. We used generalized estimating equations with sex, age, risk, non-White ethnicity and era of starting combination ART (cART) as fixed co-factors. Time-updated co-factors included type of ART regimen, number of new drugs and adherence to therapy.The open cohort included 9802 individuals (median age 38 years; 31% female). From 2000 to 2008, the proportion of participants with ssVL increased from 37 to 64% [adjusted odds ratio (OR) per year 1.16 (95% CI 1.15-1.17)] and the proportion with CD4 count500 cells/μL increased from 40 to50% [OR 1.07 (95% CI 1.06-1.07)]. Similar trends were seen in the two closed cohorts. Adjustment did not substantially affect time trends.There was no relevant dilution effect through new participants entering the open clinical cohort, and the increase in virological/immunological success over time was not an artefact of the study design of open cohorts. This can partly be explained by new treatment options and other improvements in medical care.

Darunavir was designed for activity against HIV resistant to other protease inhibitors (PIs). We assessed the efficacy, tolerability and risk factors for virological failure of darunavir for treatment-experienced patients seen in clinical practice.We included all patients in the Swiss HIV Cohort Study starting darunavir after recording a viral load above 1000 HIV-1 RNA copies/mL given prior exposure to both PIs and nonnucleoside reverse transcriptase inhibitors. We followed these patients for up to 72 weeks, assessed virological failure using different loss of virological response algorithms and evaluated risk factors for virological failure using a Bayesian method to fit discrete Cox proportional hazard models.Among 130 treatment-experienced patients starting darunavir, the median age was 47 years, the median duration of HIV infection was 16 years, and 82% received mono or dual antiretroviral therapy before starting highly active antiretroviral therapy. During a median patient follow-up period of 45 weeks, 17% of patients stopped taking darunavir after a median exposure of 20 weeks. In patients followed beyond 48 weeks, the rate of virological failure at 48 weeks was at most 20%. Virological failure was more likely where patients had previously failed on both amprenavir and saquinavir and as the number of previously failed PI regimens increased.As a component of therapy for treatment-experienced patients, darunavir can achieve a similar efficacy and tolerability in clinical practice to that seen in clinical trials. Clinicians should consider whether a patient has failed on both amprenavir and saquinavir and the number of failed PI regimens before prescribing darunavir.

There is an ongoing debate as to whether combined antiretroviral treatment (cART) during pregnancy is an independent risk factor for prematurity in HIV-1-infected women.The aim of the study was to examine (1) crude effects of different ART regimens on prematurity, (2) the association between duration of cART and duration of pregnancy, and (3) the role of possibly confounding risk factors for prematurity.We analysed data from 1180 pregnancies prospectively collected by the Swiss Mother and Child HIV Cohort Study (MoCHiV) and the Swiss HIV Cohort Study (SHCS).Odds ratios for prematurity in women receiving mono/dual therapy and cART were 1.8 [95% confidence interval (CI) 0.85-3.6] and 2.5 (95% CI 1.4-4.3) compared with women not receiving ART during pregnancy (P=0.004). In a subgroup of 365 pregnancies with comprehensive information on maternal clinical, demographic and lifestyle characteristics, there was no indication that maternal viral load, age, ethnicity or history of injecting drug use affected prematurity rates associated with the use of cART. Duration of cART before delivery was also not associated with duration of pregnancy.Our study indicates that confounding by maternal risk factors or duration of cART exposure is not a likely explanation for the effects of ART on prematurity in HIV-1-infected women.

BACKGROUND: The advent of highly active antiretroviral therapy (HAART) in 1996 led to a decrease in the incidence of Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL), but not of other cancers, among people with HIV or AIDS (PWHA). It also led to marked increases in their life expectancy. METHODS: We conducted a record-linkage study between the Swiss HIV Cohort Study and nine Swiss cantonal cancer registries. In total, 9429 PWHA provided 20,615, 17,690, and 15,410 person-years in the pre-, early-, and late-HAART periods, respectively. Standardised incidence ratios in PWHA vs the general population, as well as age-standardised, and age-specific incidence rates were computed for different periods. RESULTS: Incidence of KS and NHL decreased by several fold between the pre- and early-HAART periods, and additionally declined from the early- to the late-HAART period. Incidence of cancers of the anus, liver, non-melanomatous skin, and Hodgkin's lymphoma increased in the early- compared with the pre-HAART period, but not during the late-HAART period. The incidence of all non-AIDS-defining cancers (NADCs) combined was similar in all periods, and approximately double that in the general population. CONCLUSIONS: Increases in the incidence of selected NADCs after the introduction of HAART were largely accounted for by the ageing of PWHA.

Radar and electrical measurements for deep tropical convection are examined for both “break period” and “monsoonal” regimes in the vicinity of Darwin, Australia. Break period convection consists primarily of deep continental convection, whereas oceanic-based convection dominates during monsoonal periods, associated with the monsoon trough over Darwin. Order-of-magnitude enhancements in lightning flash rates for the “break period” regime are associated with 10–20-dB enhancements in radar reflectivity in the mixed-phase region of the convection compared with the monsoonal regime. The latter differences are attributed to the effect of convective available potential energy (CAPE) and its nonlinear influence on the growth and accumulation of ice particles aloft, which are believed to promote charge separation by differential particle motions. CAPE, in turn, is largely determined by the boundary-layer wet-bulb temperature. Modest differences (1°–3°C) in wet-bulb potential temperature between land and s...

[1] Surface radar observations near Niamey, Niger, during the African Monsoon Multidisciplinary Analyses (AMMA) campaign in 2006 documented the structure, motion, and precipitation of cloud systems during the monsoon season. These unique observations for that part of the Sahel were combined with satellite rain estimates and infrared satellite imagery to study the diurnal cycle of rainfall in Niamey, Niger. This study confirms the bimodal structure of the diurnal rainfall cycle in Niamey during AMMA, seen by previous studies of West African rainfall. Radar analysis of squall line mesoscale convective systems (SLMCS) and non-MCS isolated convection clearly demonstrated that the nocturnal maximum was associated with the observed arrival time of westward propagating SLMCS. Satellite imagery suggested that these SLMCS formed in elevated terrain to the east of Niamey the prior afternoon. Radar observations showed that local isolated convection produced the smaller afternoon maximum. Early in the monsoon season, locally generated convection produced an afternoon diurnal rainfall maximum that was delayed by several hours compared to midseason when African easterly wave (AEW) activity was much greater. We suggest that the observed greater mean convective inhibition early in the season, perhaps tied to the absence of large-scale forcing from AEW, played a role in the delayed initiation time.

BACKGROUND: Hepatitis C virus (HCV) infection is associated with decreased health-related quality of life (HRQOL). Although HCV has been suggested to directly impair neuropsychiatric functions, other factors may also play a role. PATIENTS AND METHODS: In this cross-sectional study, we assessed the impact of various host-, disease- and virus-related factors on HRQOL in a large, unselected population of anti-HCV-positive subjects. All individuals (n = 1736) enrolled in the Swiss Hepatitis C Cohort Study (SCCS) were asked to complete the Short Form 36 (SF-36) and the Hospital Anxiety Depression Scale (HADS). RESULTS: 833 patients (48%) returned the questionnaires. Survey participants had significantly worse scores in both assessment instruments when compared to a general population. By multivariable analysis, reduced HRQOL (mental and physical summary scores of SF-36) was independently associated with income. In addition, a low physical summary score was associated with age and diabetes, whereas a low mental summary score was associated with intravenous drug use. HADS anxiety and depression scores were independently associated with income and intravenous drug use. In addition, HADS depression score was associated with diabetes. None of the SF-36 or HADS scores correlated with either the presence or the level of serum HCV RNA. In particular, SF-36 and HADS scores were comparable in 555 HCV RNA-positive and 262 HCV RNA-negative individuals. CONCLUSIONS: Anti-HCV-positive subjects have decreased HRQOL compared to controls. The magnitude of this decrease was clinically important for the SF-36 vitality score. Host and environmental, rather than viral factors, seem to impact on HRQOL level.

OBJECTIVES: To investigate delayed HIV diagnosis and late initiation of antiretroviral therapy (ART) in the Swiss HIV Cohort Study. METHODS: Two sub-populations were included: 1915 patients with HIV diagnosis from 1998 to 2007 and within 3 months of cohort registration (group A), and 1730 treatment-naïve patients with CD4>or=200 cells/microL before their second cohort visit (group B). In group A, predictors for low initial CD4 cell counts were examined with a median regression. In group B, we studied predictors for CD4or=200 cells/microL; 18% and 2% dropped to CD4