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Abstract The El Niño‐Southern Oscillation (ENSO) phenomenon—the dominant source of climate variability on seasonal to multi‐year timescales—is predictable a few seasons in advance. Forecast skill at longer multi‐year timescales has been found in a few models and forecast systems, but the robustness of this predictability across models has not been firmly established owing to the cost of running dynamical model predictions at longer lead times. In this study, we use a massive collection of multi‐model hindcasts performed using model analogs to show that multi‐year ENSO predictability is robust across models and arises predominantly due to skillful prediction of multi‐year La Nina events following strong El Niño events.

The Decadal Climate Prediction Project (DCPP) is a coordinated multi-model investigation into decadal climate prediction, predictability, and variability. The DCPP makes use of past experience in simulating and predicting decadal variability and forced climate change gained from the fifth Coupled Model Intercomparison Project (CMIP5) and elsewhere. It builds on recent improvements in models, in the reanalysis of climate data, in methods of initialization and ensemble generation, and in data treatment and analysis to propose an extended comprehensive decadal prediction investigation as a contribution to CMIP6 (Eyring et al., 2016) and to the WCRP Grand Challenge on Near Term Climate Prediction (Kushnir et al., 2016). The DCPP consists of three components. Component A comprises the production and analysis of an extensive archive of retrospective forecasts to be used to assess and understand historical decadal prediction skill, as a basis for improvements in all aspects of end-to-end decadal prediction, and as a basis for forecasting on annual to decadal timescales. Component B undertakes ongoing production, analysis and dissemination of experimental quasi-real-time multi-model forecasts as a basis for potential operational forecast production. Component C involves the organization and coordination of case studies of particular climate shifts and variations, both natural and naturally forced (e.g. the “hiatus”, volcanoes), including the study of the mechanisms that determine these behaviours. Groups are invited to participate in as many or as few of the components of the DCPP, each of which are separately prioritized, as are of interest to them.The Decadal Climate Prediction Project addresses a range of scientific issues involving the ability of the climate system to be predicted on annual to decadal timescales, the skill that is currently and potentially available, the mechanisms involved in long timescale variability, and the production of forecasts of benefit to both science and society.

The study aims to evaluate the ability of global, coupled climate models to reproduce the synoptic regime of the Mediterranean Basin. The output of simulations of the 9 models included in the IPCC CMIP3 effort is compared to the NCEP-NCAR reanalyzed data for the period 1961–1990. The study examined the spatial distribution of cyclone occurrence, the mean Mediterranean upper- and lower-level troughs, the inter-annual variation and trend in the occurrence of the Mediterranean cyclones, and the main large-scale circulation patterns, represented by rotated EOFs of 500 hPa and sea level pressure. The models reproduce successfully the two maxima in cyclone density in the Mediterranean and their locations, the location of the average upper- and lower-level troughs, the relative inter-annual variation in cyclone occurrences and the structure of the four leading large scale EOFs. The main discrepancy is the models' underestimation of the cyclone density in the Mediterranean, especially in its western part. The models' skill in reproducing the cyclone distribution is found correlated with their spatial resolution, especially in the vertical. The current improvement in model spatial resolution suggests that their ability to reproduce the Mediterranean cyclones would be improved as well.

Rats are commonly used as an animal model to study glaucoma, which is induced experimentally using invasive painful procedures. Peribulbar anesthesia (PBA) is frequently used in people and domestic animals prior to ophthalmic surgeries to provide excellent perioperative analgesia. The goal of this study was to develop a PBA technique adapted to rat anatomy, to improve welfare of animals used as a glaucoma model. Eighteen rat cadavers were used to establish the optimal injection technique and the volume of injectate required. Four injection techniques using lidocaine 2% and contrast agent (1:1 volume ratio) were compared using computed tomography (CT) imaging performed before and after injection. A board-certified radiologist, masked regarding the injection techniques used, reviewed all CT images and scored injectate distribution at 4 locations: extraconal, intraconal, around the optic nerve and at the orbital fissure (scale 0-8; 0=none, 8=excellent). Injectate distribution scoring (median; range) was significantly higher (i.e., better) using the dorso-medial (5; 2-6) and medial-canthus (4.5; 2-8) techniques compared with mid-ventral (3; 2-5) and ventro-lateral (2; 1-3) techniques. A volume of 0.1 mL/100 g body weight provided overall good distribution, while a volume of 0.2 mL/100 g produced excessive exophthalmos. Presence of intracranial contrast was observed following all technique. In conclusion, PBA using the dorso-medial or medial-canthus techniques are most likely to provide local anesthesia. The intracranial contrast observed could be the result of post-mortem vessel leakage. Results of this preliminary study will be used to assess the efficacy and safety of these techniques in experimental rats. [ABSTRACT FROM AUTHOR]

The mechanisms underlying the current greenhouse gas (GHG) forced decline in Mediterranean rainfall remain a matter of debate. To inform our understanding of the current and projected drying, we examined extended arid intervals in the late Quaternary, Eastern Mediterranean (EM) Levant indicated by substantial salt deposits in a Dead Sea sediment core covering the past 220 kyr. These arid events occurred during interglacials, when the Earth was at perihelion to the sun in boreal fall and during glacial-interglacial transitions, associated with icesheet melting. Climate models forced with realistic late Quaternary insolation variations show that when the Earth is closest to the Sun in boreal fall, the North Atlantic latitudinal surface temperature gradient in the winter intensifies. In response, the overlying midlatitude North Atlantic jet stream and the extratropical storm track move poleward while sea-level pressure rises in the subtropics. These changes bring about a weakening of the Mediterranean storm track and a decline in rainfall over the entire basin. During glacial-interglacial transitions, meltwater from continental icesheets forced abrupt subpolar North Atlantic cooling. This also strengthened the latitudinal surface temperature gradient, likely causing similar atmospheric response and aridity in the Mediterranean. There is a strong resemblance between this paleoclimate scenario and the climatic changes corresponding to the present and projected GHG drying of the EM. Hence, the late Quaternary palaeohydrology of the Dead Sea indicates an important North Atlantic centered response to external forcing, which leads to Mediterranean drying and is relevant in the present., Competing Interests: Competing interests statement:The authors declare no competing interest.

Rats are a commonly used animal model for the study of the pathogenesis and novel treatments of glaucoma, which is induced experimentally using invasive, painful procedures. Peribulbar anaesthesia (PBA) is frequently used in people and domestic animals prior to ophthalmic surgeries to provide excellent perioperative analgesia. Our goal was to develop a PBA technique adapted to rat anatomy, improving the welfare of animals used as a model for glaucoma. Eighteen rat cadavers ( n  = 36 eyes) were used to establish the optimal needle insertion location. Five injection techniques using 0.1 mL/100 g lidocaine 2% and a contrast agent (1:1 volume ratio) were compared via computed tomography (CT). CT images were scored for injectate distribution at four locations: extraconal, intraconal, around the optic nerve and at the orbital fissure (scale 0-8, where 0 = none and 8 = excellent). Median scores using the dorso-medial-75° (5; range 2-6) and medial-canthus (4.5; range 2-8) injection techniques were not different from the dorso-medial-45° (4; range 3-6) technique and were higher (better distribution) compared with mid-ventral (3; range 2-5) and ventro-lateral (2; range 1-3) techniques. The two superior techniques were used in two experimental rats ( n  = 4 eyes) to determine the volume of bupivacaine 0.5% necessary to affect corneal touch threshold (CTT) and periocular skin sensitivity (PSS). A volume of 0.05 mL/100 g decreased CTT and PSS for several hours, while a larger volume produced excessively long effects. Dorso-medial-75° or medial-canthus PBA using 0.05 mL/100 g bupivacaine are likely to provide ocular and periocular analgesia in rats, with minor transient adverse effects., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Abstract: Physiological or pathology-mediated changes in neuronal activity trigger structural plasticity of the action potential generation site-the axon initial segment (AIS). These changes affect intrinsic neuronal excitability, thus tuning neuronal and overall network output. Using behavioral, immunohistochemical, electrophysiological, and computational approaches, we characterized inflammation-related AIS plasticity in rat's superficial (lamina II) spinal cord dorsal horn (SDH) neurons and established how AIS plasticity regulates the activity of SDH neurons, thus contributing to pain hypersensitivity. We show that in naive conditions, AIS in SDH inhibitory neurons is located closer to the soma than in excitatory neurons. Shortly after inducing inflammation, when the inflammatory hyperalgesia is at its peak, AIS in inhibitory neurons is shifted distally away from the soma. The shift in AIS location is accompanied by the decrease in excitability of SDH inhibitory neurons. These AIS location and excitability changes are selective for inhibitory neurons and reversible. We show that AIS shift back close to the soma, and SDH inhibitory neurons' excitability increases to baseline levels following recovery from inflammatory hyperalgesia. The computational model of SDH inhibitory neurons predicts that the distal shift of AIS is sufficient to decrease the intrinsic excitability of these neurons. Our results provide evidence of inflammatory pain-mediated AIS plasticity in the central nervous system, which differentially affects the excitability of inhibitory SDH neurons and contributes to inflammatory hyperalgesia., (Copyright © 2023 International Association for the Study of Pain.)

The objectives of this clinical study were to compare the effectiveness and safety of medetomidine-ketamine-midazolam (MKM) versus medetomidine-ketamine-butorphanol (MKB) for immobilization of captive red kangaroos ( Osphranter rufus ). Twenty red kangaroos were randomly immobilized for routine treatments using intramuscular injection of MKM (0.065 ± 0.004, 2.2 ± 0.3, and 0.12 ± 0.04 mg/kg, respectively) or MKB (0.070 ± 0.015, 2.3 ± 0.5, and 0.23 ± 0.05 mg/kg, respectively) ( n = 10/group). Induction, immobilization, and recovery times were recorded; vital signs monitored; and quality of induction, immobilization, and recovery scored using a single-blinded design. Oxygen was not supplemented. For reversal, atipamezole at five times the medetomidine dosage was administered intramuscularly (both groups), and flumazenil (0.020 ± 0.003 mg/kg; MKM) or naltrexone (0.23 ± 0.05 mg/kg; MKB) were administered intravenously. Induction time was significantly shorter in the MKB group versus the MKM group (7:26 ± 04:22 and 11:54 ± 04:50 minutes, respectively). Induction quality in both groups was rated "excellent" and immobilization quality was "excellent" in MKM and "very good" in MKB. Heart rate was significantly lower and hemoglobin oxygen saturation (SpO 2 ) was significantly higher in the MKM versus the MKB group. However, SpO 2 < 90% occurred with both protocols. Following antagonists administration, recovery time and quality were 17:40 ± 08:33 minutes and "very good" in the MKM group, and 14:28 ± 05:27 minutes and "excellent" in the MKB group, respectively. Both protocols provided smooth induction, good immobilization, and generally quick recovery. MKB is recommended for shorter induction time. Oxygen supplementation should be available with both protocols.

There is little scientific consensus on the importance of external climate forcings-including anthropogenic aerosols, volcanic aerosols, and greenhouse gases (GHG)-relative to each other and to internal variability in dictating past and future Sahel rainfall. We address this query by relating a 3-tiered multi-model mean (MMM) over the Climate Model Intercomparison Project phase 5 "twentieth century" and pre-Industrial control simulations to observations. The comparison of single-forcing and historical simulations highlights the importance of anthropogenic and volcanic aerosols over GHG in generating forced Sahel rainfall variability in models. However, the forced MMM only accounts for a small fraction of observed variance. A residual consistency test shows that simulated internal variability cannot explain the residual observed multidecadal variability, and points to model deficiency in simulating multidecadal variability in the forced response, internal variability, or both.

Objective: To evaluate analgesic effects and complications associated with intraorbital insertion of an absorbable gelatin hemostatic sponge (AGHS) soaked with 1% ropivacaine solution following enucleation in dogs., Animals: 20 client-owned dogs undergoing enucleation., Procedures: Dogs were randomly assigned to receive an AGHS soaked with 1% ropivacaine solution (n = 10) or saline (0.9% NaCl) solution (control group; 10) inserted intraorbitally prior to skin closure following enucleation. Carprofen (2 mg/kg [0.9 mg/lb]) was administered SC once after orotracheal extubation and then PO twice a day for 5 days. During the postoperative recovery period, apparent pain level was scored at various points with a modified short-form Glasgow Composite Pain Scale (score range, 0 to 19), and methadone was administered for rescue analgesia if any score was ≥ 5. After dogs returned home, owners recorded their behavior and apparent pain level for the first 3 days following enucleation., Results: At extubation, the median (range) pain score was significantly higher in the control group (8 [2 to 14]) versus the ropivacaine group (3 [1 to 7]). A greater proportion of dogs in the control group received methadone (7/10 vs 1/10) and had crying or attention-seeking behavior on the first day following enucleation (7/10 vs 1/10). No complications were observed in either group., Conclusions and Clinical Relevance: Addition of intraorbital insertion of a ropivacaine-soaked AGHS to the analgesic protocol for dogs undergoing enucleation provided better analgesia than was achieved without this treatment as measured immediately and the first day after surgery, with no noted adverse effects.

Objective: To identify landmarks and to describe a technique for nerve blockade of the dorsal cranium in dogs., Study Design: Anatomic cadaveric study., Animals: A total of 39 dog cadavers, weighing 18.0 ± 9.7 kg (mean ± standard deviation)., Methods: The study was performed in three parts. In the initial part, cadavers were dissected to determine the location of the frontal, zygomaticotemporal, and major occipital nerves, and to identify prominent landmarks for their blockade. In the second part, one technique was developed to block each of the frontal and zygomaticotemporal nerves, and two techniques, rostral and caudal, were developed to block the major occipital nerve. Injection solution was 0.05% methylene blue in 0.5% bupivacaine. In the third part, cadavers were used to test the techniques developed in the second part with 0.04 mL kg -1 of the same injectate administered at each site (maximal volume 0.5 mL per site). The length of nerve stained was measured, with a length ≥6 mm considered successful. Confidence intervals were calculated using Fisher's exact test., Results: Success rates (95% confidence interval) for the frontal, zygomaticotemporal, and rostral and caudal locations for the major occipital nerve were 94% (80-99%), 91% (76-98%), 74% (58-86%) and 77% (59-89%), respectively. With a combination of both locations, the success rate for the major occipital nerve was 100% (90-100%)., Conclusion and Clinical Relevance: This study describes a simple regional anaesthesia technique using palpable anatomical landmarks that may provide analgesia for dogs undergoing craniotomy., (Copyright © 2018 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Winter storms pose numerous hazards to the Northeast United States, including rain, snow, strong wind, and flooding. These hazards can cause millions of dollars in damages from one storm alone. This study investigates meteorological intensity and impacts of winter storms from 2001 to 2014 on coastal counties in Connecticut, New Jersey, and New York and underscores the consequences of winter storms. The study selected 70 winter storms on the basis of station observations of surface wind strength, heavy precipitation, high storm tide, and snow extremes. Storm rankings differed between measures, suggesting that intensity is not easily defined with a single metric. Several storms fell into two or more categories (multiple-category storms). Following storm selection, property damages were examined to determine which types lead to high losses. The analysis of hazards (or events) and associated damages using the Storm Events Database of the National Centers for Environmental Information indicates that multiple-category storms were responsible for a greater portion of the damage. Flooding was responsible for the highest losses, but no discernible connection exists between the number of storms that afflict a county and the damage it faces. These results imply that losses may rely more on the incidence of specific hazards, infrastructure types, and property values, which vary throughout the region., (© 2017 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals Inc. on behalf of The New York Academy of Sciences.)

Objective: To evaluate whether intratesticular and incisional ropivacaine infiltration produces sufficient intra- and postoperative analgesia for castrating dogs under sedation., Study Design: Randomized, blinded, controlled clinical study., Animals: Twenty-three healthy dogs weighing 5.8-35.6 kg admitted for castration., Methods: Dogs were sedated with medetomidine (0.01 mg kg -1 ), butorphanol (0.2 mg kg -1 ) and midazolam (0.2 mg kg -1 ) intramuscularly, and were randomly assigned to group R, 0.2-0.4 mL kg -1 of ropivacaine 0.5%, or group S, an equivalent volume of saline injected intratesticularly and along the incision line. If persistent motion was observed during surgery, sedation was considered to be insufficient and general anaesthesia was induced. Carprofen 2.2 mg kg -1 was administered postoperatively. Pain was evaluated in all dogs before sedation and postoperatively following atipamezole administration at 1, 2, 4, 8 and 24 hours using an interactive visual analogue scale (IVAS; 0-100), the Glasgow composite pain scale-short form (CMPS-SF; 0-24), and a mechanical algometer. Methadone 0.3 mg kg -1 was administered intravenously to dogs if IVAS >30 or CMPS-SF >4., Results: There was no significant difference between groups for the number of dogs administered general anaesthesia. The time from the beginning of surgery to induction of general anaesthesia was significantly shorter [median (range)] in group S [6 (3-25) minutes] than in group R [56 (36-76) minutes]. At 8 hours IVAS was significantly higher in group S (14 ± 10) than in group R (6 ± 4)., Conclusions and Clinical Relevance: Intratesticular and incisional ropivacaine infiltration delayed the time to anaesthesia induction, and provided analgesia after castration performed under deep sedation in dogs. Intratesticular local anaesthesia can be an important part of the anaesthetic plan for castration., (Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

A 19-yr-old captive male Syrian bear ( Ursus arctos syriacus) presented with a right hind limb lameness that progressed to nonambulatory paraparesis over the course of 2 wk. When night enclosure confinement and a short course of glucocorticoids and antibiotics did not lead to improvement, radiographs were performed, followed by cerebrospinal fluid analysis and myelography, revealing a dynamic spinal cord compression at the level of T2-T3. Dorsal laminectomy of both T2 and T3 was performed to allow decompression. The bear recovered uneventfully with first sign of neurological improvement apparent at 10 days postoperatively. Following 6 mo of rehabilitation the bear was walking and using his hind limbs normally.

Climate model projections suggest widespread drying in the Mediterranean Basin and wetting in Fennoscandia in the coming decades largely as a consequence of greenhouse gas forcing of climate. To place these and other "Old World" climate projections into historical perspective based on more complete estimates of natural hydroclimatic variability, we have developed the "Old World Drought Atlas" (OWDA), a set of year-to-year maps of tree-ring reconstructed summer wetness and dryness over Europe and the Mediterranean Basin during the Common Era. The OWDA matches historical accounts of severe drought and wetness with a spatial completeness not previously available. In addition, megadroughts reconstructed over north-central Europe in the 11th and mid-15th centuries reinforce other evidence from North America and Asia that droughts were more severe, extensive, and prolonged over Northern Hemisphere land areas before the 20th century, with an inadequate understanding of their causes. The OWDA provides new data to determine the causes of Old World drought and wetness and attribute past climate variability to forced and/or internal variability.

Approximately half of the world's population lives in the tropics, and future changes in the hydrological cycle will impact not just the freshwater supplies but also energy production in areas dependent upon hydroelectric power. It is vital that we understand the mechanisms/processes that affect tropical precipitation and the eventual surface hydrological response to better assess projected future regional precipitation trends and variability. Paleo-climate proxies are well suited for this purpose as they provide long time series that pre-date and complement the present, often short instrumental observations. Here we present paleo-precipitation data from a speleothem located in Mesoamerica that reveal large multi-decadal declines in regional precipitation, whose onset coincides with clusters of large volcanic eruptions during the nineteenth and twentieth centuries. This reconstruction provides new independent evidence of long-lasting volcanic effects on climate and elucidates key aspects of the causal chain of physical processes determining the tropical climate response to global radiative forcing.

Before the Syrian uprising that began in 2011, the greater Fertile Crescent experienced the most severe drought in the instrumental record. For Syria, a country marked by poor governance and unsustainable agricultural and environmental policies, the drought had a catalytic effect, contributing to political unrest. We show that the recent decrease in Syrian precipitation is a combination of natural variability and a long-term drying trend, and the unusual severity of the observed drought is here shown to be highly unlikely without this trend. Precipitation changes in Syria are linked to rising mean sea-level pressure in the Eastern Mediterranean, which also shows a long-term trend. There has been also a long-term warming trend in the Eastern Mediterranean, adding to the drawdown of soil moisture. No natural cause is apparent for these trends, whereas the observed drying and warming are consistent with model studies of the response to increases in greenhouse gases. Furthermore, model studies show an increasingly drier and hotter future mean climate for the Eastern Mediterranean. Analyses of observations and model simulations indicate that a drought of the severity and duration of the recent Syrian drought, which is implicated in the current conflict, has become more than twice as likely as a consequence of human interference in the climate system.

Objectives: To assess the usefulness of clinical and clinicopathological parameters as prognostic markers of survival in dogs undergoing positive pressure ventilation., Methods: Retrospective study of case records of 58 client-owned dogs undergoing positive pressure ventilation. Dogs were divided into two groups; inadequate oxygenation due to pulmonary parenchymal disease (Group 1) and inadequate ventilation (Group 2)., Results: Median duration of positive pressure ventilation was 30 (range 10 to 136) hours. Survival rate was 32% (19 dogs). Survivors were significantly younger (P<0·005) and had significantly higher (P<0·002) median PaO2 /FiO2 ratio at 4 to 12 hours postinitiation of positive pressure ventilation, and immediately before weaning (P<0·006) compared to non-survivors. A receiver operator characteristics analysis of PaO2 /FiO2 immediately before weaning as predictor of survival had an area under the curve of 0·76 (95% confidence interval 0·54 to 0·97), with optimal cut-off point of 252 mmHg, corresponding to a sensitivity and specificity of 0·80 and 0·79, respectively. The survival rates of dogs with PaO2 /FiO2 less than 200 mmHg at 4 to 12 hours postinitiation of positive pressure ventilation, or immediately before weaning were 15% (3/20 dogs) and 6% (1/16 dogs), respectively., Clinical Significance: The PaO2 /FiO2 ratio is an early prognostic indicator of successful weaning in dogs undergoing positive pressure ventilation., (© 2014 British Small Animal Veterinary Association.)

Heterocyst differentiation in the filamentous cyanobacterium Anabaena sp. strain PCC 7120 occurs at regular intervals under nitrogen starvation and is regulated by a host of signaling molecules responsive to availability of fixed nitrogen. The heterocyst differentiation inhibitor PatS contains the active pentapeptide RGSGR (PatS-5) at its C-terminus considered the minimum PatS fragment required for normal heterocyst pattern formation. PatS-5 is known to bind HetR, the master regulator of heterocyst differentiation, with a moderate affinity and a submicromolar dissociation constant. Here we characterized the affinity of HetR for several PatS C-terminal fragments by measuring the relative ability of each fragment to knockdown HetR binding to DNA in electrophoretic mobility shift assays and using isothermal titration calorimetry (ITC). HetR bound to PatS-6 (ERGSGR) >30 times tighter (K(d) = 7 nM) than to PatS-5 (K(d) = 227 nM) and >1200 times tighter than to PatS-7 (DERGSGR) (K(d) = 9280 nM). No binding was detected between HetR and PatS-8 (CDERGSGR). Quantitative binding constants obtained from ITC measurements were consistent with qualitative results from the gel shift knockdown assays. CW EPR spectroscopy confirmed that PatS-6 bound to a MTSL spin-labeled HetR L252C mutant at a 10-fold lower concentration compared to PatS-5. Substituting the PatS-6 N-terminal glutamate to aspartate, lysine, or glycine did not alter binding affinity, indicating that neither the charge nor size of the N-terminal residue's side chain played a role in enhanced HetR binding to PatS-6, but rather increased binding affinity resulted from new interactions with the PatS-6 N-terminal residue peptide backbone.

How anthropogenic climate change will affect hydroclimate in the arid regions of southwestern North America has implications for the allocation of water resources and the course of regional development. Here we show that there is a broad consensus among climate models that this region will dry in the 21st century and that the transition to a more arid climate should already be under way. If these models are correct, the levels of aridity of the recent multiyear drought or the Dust Bowl and the 1950s droughts will become the new climatology of the American Southwest within a time frame of years to decades.

Objective: Retirement can be traumatic, and physicians are not immune. The Israeli Medical Association (IMA) has been conducting a preparatory course for retirement for its members reaching retirement. The objective of the present study was to survey the characteristics of participating physicians, to map their activities following retirement, to gauge their appreciation of the course, and to assess their willingness to continue their association with the IMA., Methods: Questionnaires were mailed to 210 attendees of the IMA course in 2000-2002, and responses were tabulated and analyzed., Results: The response rate was 33%--40 male and 30 female physicians, and 75% of them were still working at the time of response. They classified their quality-of-life as appropriate (70%), modest (2%), and unfitting (27%). Continued work was directly related to the preservation of fitting lifestyle (p < 0.0001), and of the 17 physicians not working only 4 defined their quality of living as suitable. Of the respondents, 83% were in good health, 50% needed medical attention, and 77% received proper care. The vast majority spent time with family and friends, reading, listening to music, going on trips and cultural events and engaged in sports; the minority spent time learning, busy with hobbies or volunteer work. Approximately half of the respondents attended continuing medical education classes. Much satisfaction was recorded for most activities, but television, friends, volunteer work or continuing education were only partly enjoyable. The IMA preparatory course was satisfactory according to 94% of the respondents, but many requested to broaden its scope. Over 92% wanted to maintain an "open-line" with the IMA, for obtaining information, counseling, and participation in social activities and continuing education. The majority was willing to volunteer in the IMA. No gender bias was found in most of the responses., Conclusion: This preliminary survey of physician retirement in Israel found that once physicians ceased working, many considered their life quality unfitting. The need to remain associated with the IMA is indicative of the large social and emotional importance of this membership.

An analysis of historical sea surface temperatures provides evidence for global warming since 1900, in line with land-based analyses of global temperature trends, and also shows that over the same period, the eastern equatorial Pacific cooled and the zonal sea surface temperature gradient strengthened. Recent theoretical studies have predicted such a pattern as a response of the coupled ocean-atmosphere system to an exogenous heating of the tropical atmosphere. This pattern, however, is not reproduced by the complex ocean-atmosphere circulation models currently used to simulate the climatic response to increased greenhouse gases. Its presence is likely to lessen the mean 20th-century global temperature change in model simulations.