Beschreibung: Background: Previous validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; however methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM) has been widely used in sick leave research. On the basis of sick leave records from 3,554 and 2,311 eldercare workers in 14 different workplaces, the aim of this study was to: 1) validate registered sickness benefit data from DREAM against workplace-registered sick leave spells of at least 15 days; 2) validate self-reported sick leave days during one year against workplace-registered sick leave. Methods: Agreement between workplace-registered sick leave and DREAM-registered sickness benefit was reported as sensitivities, specificities and positive predictive values. A receiver-operating characteristic curve and a Bland-Altman plot were used to study the concordance with sick leave duration of the first spell. By means of an analysis of agreement between self-reported and workplace-registered sick leave sensitivity and specificity was calculated. Ninety-five percent confidence intervals (95% CI) were used. Results: The probability that registered DREAM data on sickness benefit agrees with workplace-registered sick leave of at least 15 days was 96.7% (95% CI: 95.6-97.6). Specificity was close to 100% (95% CI: 98.3-100). The registered DREAM data on sickness benefit overestimated the duration of sick leave spells by an average of 1.4 (SD: 3.9) weeks. Separate analysis on pregnancy-related sick leave revealed a maximum sensitivity of 20% (95% CI: 4.3-48.1).The sensitivity of self-reporting at least one or at least 56 sick leave day/s was 94.5 (95% CI: 93.4 -- 95.5) % and 58.5 (95% CI: 51.1 -- 65.6) % respectively. The corresponding specificities were 85.3 (95% CI: 81.4 -- 88.6) % and 98.9 (95% CI: 98.3 -- 99.3) %. Conclusions: The DREAM register offered valid measures of sick leave spells of at least 15 days among eldercare employees. Pregnancy-related sick leave should be excluded in studies planning to use DREAM data on sickness benefit. Self-reported sick leave became more imprecise when number of absence days increased, but the sensitivity and specificity were acceptable for lengths not exceeding one week.

Beschreibung: Background: This pilot study (ClinicalTrials.gov ID: NCT01507701) assessed the feasibility and safety of clonidine in adolescent chronic fatigue syndrome (CFS). Specifically, we assessed clonidine dosage in relation to a) plasma concentration levels, b) orthostatic cardiovascular responses, and c) possible adverse effects.FindingsFive adolescent CFS patients (14-19 years old) received 50 mug clonidine twice per day during 14 days in an open, uncontrolled design. Plasma concentration of clonidine was assayed by standard laboratory methods. Changes in orthostatic cardiovascular responses were assessed by a 20o head-up tilt-test (HUT). Adverse effects were mapped by a questionnaire.After 14 days, C0 median (range) of clonidine was 0.21 (0.18-0.36) mug/L, and Cmax median (range) of clonidine was 0.41 (0.38-0.56) mug/L. Also, supine blood pressures and heart rate were lower during clonidine treatment, and the HUT response was closer to the normal response. No serious adverse effects were registered. Conclusion: Clonidine 50 mug BID seems to be safe enough to proceed from a pilot study to a controlled trial in a select group of adolescents with CFS (ClinicalTrials.gov ID: NCT01040429).

Beschreibung: We present stable hydrogen isotope (dD) and carbon isotope (d13C) of sedimentary terrestrial leaf wax, namely n-alkanes, from marine sediment core SO 188-17286-1 (Bay of Bengal, 19°44.58′N, 89°52.76′E, 1428 m water depth) for the last ~130 kyr. There are four different homologues (n-C27, n-C29, n-C31 and n-C33). The concentration data of each homologues are also present here. Identification and quantification (concentration) of the individual compounds was carried out with an Agilent 6890 Gas Chromatograph (GC) with a flame ionization detector in the Geoscience, University of Kiel. The d13C and dD values of n-alkanes were then analyzed at the Leibniz Laboratory for Radiometric Dating and Stable Isotope Research in Kiel University using an Agilent 6890 GC coupled with a Thermo Finnigan MAT 253 isotope ratio mass (IRMS).

Beschreibung: During the middle Miocene, Earth's climate transitioned from a relatively warm phase (Miocene climatic optimum) into a colder mode with re-establishment of permanent ice sheets on Antarctica, thus marking a fundamental step in Cenozoic cooling. Carbon sequestration and atmospheric CO2 drawdown through increased terrestrial and/or marine productivity have been proposed as the main drivers of this fundamental transition. We integrate high-resolution (1-3 k.y.) benthic stable isotope data with XRF-scanner derived biogenic silica and carbonate accumulation estimates in an exceptionally well-preserved sedimentary archive, recovered at Integrated Ocean Drilling Program Site U1338, to reconstruct eastern equatorial Pacific productivity variations and to investigate temporal linkages between high- and low-latitude climate change over the interval 16-13 Ma. Our records show that the climatic optimum (16.8-14.7 Ma) was characterized by high amplitude climate variations, marked by intense perturbations of the carbon cycle. Episodes of peak warmth at (southern hemisphere) insolation maxima coincided with transient shoaling of the carbonate compensation depth and enhanced carbonate dissolution in the deep ocean. A switch to obliquity-paced climate variability after 14.7 Ma concurred with a general improvement in carbonate preservation and the onset of stepwise global cooling, culminating with extensive ice growth over Antarctica at ~13.8 Ma. We find that two massive increases in opal accumulation at ~14.0 and ~13.8 Ma occurred just before and during the final and most prominent cooling step, supporting the hypothesis that enhanced siliceous productivity in the eastern equatorial Pacific contributed to CO2 drawdown.

Beschreibung: The Miocene Climatic Optimum (~17-14.7 Ma) represents one of several major interruptions in the long-term cooling trend of the past 50 million years. To date, the processes driving high-amplitude climate variability and sustaining global warmth during this remarkable interval remain highly enigmatic. We present high-resolution benthic foraminiferal and bulk carbonate stable isotope records in an exceptional, continuous, carbonate-rich sedimentary archive (Integrated Ocean Drilling Program Site U1337, eastern equatorial Pacific Ocean), which offer a new view of climate evolution over the onset of the Climatic Optimum. A sharp decline in d18O and d13C at ~16.9 Ma, contemporaneous with a massive increase in carbonate dissolution, demonstrates that abrupt warming was coupled to an intense perturbation of the carbon cycle. The rapid recovery in d13C at ~16.7 Ma, ~200 k.y. after the beginning of the MCO, marks the onset of the first carbon isotope maximum within the long-lasting "Monterey Excursion". These results lend support to the notion that atmospheric pCO2 variations drove profound changes in the global carbon reservoir through the Climatic Optimum, implying a delicate balance between changing CO2 fluxes, rates of silicate weathering and global carbon sequestration. Comparison with a high-resolution d13C record spanning the onset of the Cretaceous Oceanic Anoxic Event 1a (~120 Ma ago) reveals common forcing factors and climatic responses, providing a long-term perspective to understand climate-carbon cycle feedbacks during warmer periods of Earth's climate with markedly different atmospheric CO2 concentrations.

Beschreibung: Proxy records of hydrologic variability in the West Pacific Warm Pool (WPWP) have revealed wide-scale changes in past convective activity in response to orbital and sub-orbital climate forcings. However, attributing proxy responses to regional changes in WPWP hydrology versus local variations in precipitation requires independent records linking the terrestrial and marine realms. We present high-resolution stable isotope, UK'37 sea-surface temperature, X-ray fluorescence (XRF) core scanning and coccolithophore-derived paleoproductivity records covering the past 120 ka from International Marine Global Change (IMAGES) Program Core MD06-3075 (6°29' N, 125°50' E, water depth 1878 m), situated in the Davao Gulf on the southern side of Mindanao. XRF-derived log(Fe/Ca) records provide a robust proxy for runoff-driven sedimentary discharge from Mindanao, whilst past changes in local productivity are associated with variable freshwater runoff and stratification of the surface layer. Significant precessional-scale variability in sedimentary discharge occurred during Marine Isotope Stage (MIS) 5, with peaks in discharge contemporaneous with Northern Hemisphere summer insolation minima. We attribute these changes to the latitudinal migration of the Intertropical Convergence Zone (ITCZ) over the WPWP together with variability in the strength of the Walker circulation acting on precessional timescales. Between 60 and 15 ka sedimentary discharge at Mindanao was muted, displaying little orbital- or millennial-scale variability, likely in response to weakened precessional insolation forcing and lower sea level driving increased subsidence of air masses over the exposed Sunda Shelf. These results highlight the high degree of local variability in the precipitation response to past climate changes in the WPWP.

Beschreibung: Upwelling intensity in the South China Sea has changed over glacial-interglacial cycles in response to orbital-scale changes in the East Asian Monsoon. Here, we evaluate new multi-proxy records of two sediment cores from the north-eastern South China Sea to uncover millennial-scale changes in winter monsoondriven upwelling over glacial Terminations I and II. On the basis of U/Th-based speleothem chronology, we compare these changes with sediment records of summer monsoondriven upwelling east of South Vietnam. Ocean upwelling is traced by reduced (UK'37-based) temperature and increased nutrient and productivity estimates of sea surface water (d13C on planktic foraminifera, accumulation rates of alkenones, chlorins, and total organic carbon). Accordingly, strong winter upwelling occurred north-west of Luzon (Philippines) during late Marine Isotope Stage 6.2, Heinrich (HS) and Greenland stadials (GS) HS-11, GS-26, GS-25, HS-1, and the Younger Dryas. During these stadials, summer upwelling decreased off South Vietnam and sea surface salinity reached a maximum suggesting a drop in monsoon rains, concurrent with speleothem records of aridity in China. In harmony with a stadial-to-interstadial see-saw pattern, winter upwelling off Luzon in turn was weak during interstadials, in particular those of glacial Terminations I and II, when summer upwelling culminated east of South Vietnam. Most likely, this upwelling terminated widespread deep-water stratification, coeval with the deglacial rise in atmospheric CO2. Yet, a synchronous maximum in precipitation fostered estuarine overturning circulation in the South China Sea, in particular as long as the Borneo Strait was closed when sea level dropped below -40 m.

Beschreibung: The Mozambique Channel is a conduit of trade wind-driven throughflow that is a key component of the Agulhas Current and Agulhas leakage, a flux of warm and salty water from the tropical Indo-Pacific to the Atlantic Ocean. Agulhas leakage is thought to modulate Atlantic meridional overturning circulation variability. Previous studies from the Cape Basin suggest that enhanced Agulhas leakage played an important role in accelerating glacial terminations. The southern African monsoon response to abrupt climate changes associated with meltwater-induced reorganizations of the North Atlantic meridional overturning circulation, and its impact on the Mozambique Channel throughflow and, by extension, on the Agulhas leakage is not well understood. Here we present a high-resolution 26,000 year-long hydroclimate record of northern Madagascar, a core region of the southern hemisphere monsoon domain, and a mixed layer temperature reconstruction using sediment cores collected from the runoff-influenced eastern Mozambique Channel. The record indicates precipitation increases centered at 11.7-12.5 thousand years before present (kyr BP), 14.5-19 kyr BP, 23-24 kyr BP, 25-26 kyr BP. Considering age model uncertainties, this is the first strong evidence for southern African monsoon strengthening in response to meltwater-induced northern high latitude climate instabilities during the Younger Dryas (YD), Heinrich Stadial 1 (HS1), HS2 and the HS-like event prior to HS2, in agreement with the results of transient climate simulations. Furthermore, our study shows a reversal of the mixed layer temperature gradient between the western and eastern Mozambique Channel during Heinrich event 1 (HE1). We posit that the gradient reversal indicates a weakening of the trade wind-driven South Equatorial Current and Mozambique Channel throughflow that likely weakened the Agulhas leakage, potentially creating a feedback that may have contributed to the sustained weakening of the AMOC during HE1 by reducing the amount of heat and salt leakage into the Atlantic.

Beschreibung: We integrate benthic foraminiferal stable isotopes, X-ray fluorescence elemental ratios, and carbonate accumulation estimates in a continuous sedimentary archive recovered at International Ocean Discovery Program Site U1443 (Ninetyeast Ridge, Indian Ocean) to reconstruct changes in carbonate deposition and climate evolution over the interval 13.5 to 8.2 million years ago. Declining carbonate percentages together with a marked decrease in carbonate accumulation rates after ~13.2 Ma signal the onset of a prolonged episode of reduced carbonate deposition. This extended phase, which lasted until ~8.7 Ma, coincides with the middle to late Miocene Carbonate Crash, originally identified in the eastern equatorial Pacific Ocean and the Caribbean Sea. Inter-ocean comparison reveals that intense carbonate impoverishment at Site U1443 (~11.5 to ~10 Ma) coincides with prolonged episodes of reduced carbonate deposition in all major tropical ocean basins. This implies that global changes in the intensity of chemical weathering and riverine input of calcium and carbonate ions into the ocean reservoir were instrumental in driving the Carbonate Crash. An increase in U1443 Log(Ba/Ti) together with a change in sediment color from red to green indicate a rise in organic export flux to the sea floor after ~11.2 Ma, which predates the global onset of the Biogenic Bloom. This early rise in export flux from biological production may have been linked to increased advection of nutrients and intensification of upper ocean mixing, associated with changes in the seasonality and intensity of the Indian Monsoon.