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The Eastern North Atlantic is one of the important source regions for water mass inflow into the North Sea. The inflow of Atlantic Water into the North Sea occurs mainly over its northern border via the Rockall Trough where NAC waters are mixed with waters from the Eastern Boundary Current which is carrying portions of Mediterranean Water northward. Water mass characteristics in the Rockall Trough depend on the mixing rate between its source waters originating in the subpolar and subtropical gyre. The westward movement of the Subpolar Front leads to stronger northward transports of subtropical gyre water masses. The hydrographic conditions along the North West European Shelf are thus governed by different processes: varying transports and water mass proportions from both gyres, as well as trends within the source water masses. To determine these changes we created time series from Argo Float data between 2000 and 2018 for Sub-polar Mode Water (SPMW), Intermediate Water (IW), upper Labrador Sea Water (uLSW) and deep Labrador Sea Water (dLSW) at defined positions along the North West European Shelf. The analysis of the upper Labrador Sea Water layer shows low variability and opposing trends at the source regions, and a low variability in the Rockall Trough compared to regions along the Eastern Boundary Current path. The highest variability in the contributions from the two gyres along the Eastern Boundary Current is observed in a broad area around Goban Spur. Additional mooring observations of hydrographic and transport changes are needed to understand the mixing along the North West European Shelf. For the study of transport fluctuations time series from the NOAC array have been used, which is part of the RACE (Regional circulation and Global change) program (2012-2018) and predecessor programs. These programs have monitored the subpolar gyre in the western basin and provide time series of transports and hydrographic anomalies from moored instruments at the western flank of the Mid Atlantic Ridge (MAR) and within the Eastern Boundary Current at Goban Spur. [ABSTRACT FROM AUTHOR]

Since climate model studies project a decline of the Atlantic Meridional Overturning Circulation (AMOC) in the 21st century, monitoring AMOC changes remains essential. While AMOC variability is expected to be coherent across latitudes on longer than decadal timescales, connectivity on inter‐annual and seasonal timescales is less clear. Model studies and observational estimates disagree on the regions and timescales of meridional connectivity and AMOC observations at multiple latitudes are needed to study its connectivity. We calculate basin‐wide AMOC volume transports (1993–2018) from measurements of the North Atlantic Changes (NOAC) array at 47°N, combining data from moored instruments with hydrography and satellite altimetry. The mean NOAC AMOC is 17.2 Sv exhibiting no long‐term trend. Both the unfiltered and low‐pass filtered NOAC AMOC show a significant correlation with the RAPID‐MOCHA‐WBTS AMOC at 26°N when the NOAC AMOC leads by about one year. Plain Language Summary: In the North Atlantic Ocean, currents transport heat and salt from the warm subtropical regions to the colder and less saline subpolar regions. This current system is part of the Atlantic Meridional Overturning Circulation (AMOC). This enormous northward heat transport associated with the AMOC impacts regional and global climate. In a warming world, climate models project a reduction of the AMOC, affecting, for example, air temperature and rain patterns over the continents. Continuous observations are required to investigate whether climate models realistically simulate the AMOC and assess the validity of these projections. We calculate the AMOC from moored observations, hydrography, and satellite data at 47°N from 1993 to 2018. In this period, the AMOC at 47°N does not show a trend. The 26°N AMOC lags the 47°N AMOC by about one year, indicating that the AMOC evolution at these two latitudes is connected. Key Points: We present a 25‐year observational Atlantic Meridional Overturning Circulation (AMOC) volume transport record at 47°N with a mean basin‐wide AMOC transport of 17.2 SvThe inter‐annual variability at 47°N is similar to the RAPID AMOC at 26°N, while the monthly variability is much stronger at 47°NThe AMOC time series at 47°N and 26°N show a significant lag correlation when the AMOC at 47°N leads by about one year [ABSTRACT FROM AUTHOR]

Abstract: Background:: Pain resulting from injections has a potential influence on the acceptance and thus on the success of insulin treatment. Systematic investigation in humans has suggested that individuals perceive more pain during SC injection of acidic solutions than neutral solutions. Insulin glargine is a long-acting (up to 24-hour duration of effect), parenteral blood glucose-lowering agent. Unlike other insulins, it is injected as an acidic solution (pH 4). Objective:: The aim of this study was to assess whether the SC injection of insulin glargine is more painful than neutral insulin in a clinical setting. Methods:: This single-center, prospective, controlled, noninterventional study was performed in consecutively enrolled male and female pediatric patients (7–21 years) with type 1 diabetes mellitus who self-injected insulin ≥3 times per day and who had diabetes duration of ≥6 months. The study was conducted from September 1, 2005, to December 30, 2005, at the Diabetes Clinic, University Children''s Hospital, Ulm, Germany. No changes to the patients'' current insulin regimen were made. Based on their existing insulin treatment, patients were assigned to 1 of 2 treatment groups: (1) the acidic insulin group, which injected insulin glargine, and (2) the neutral insulin group, which injected neutral protamine Hagedorn or Semilente insulin. All patients also injected shortacting regular insulin or insulin analogs. Pain during SC insulin injection and during self-monitoring of blood glucose (SMBG) (the internal control) was assessed using a standardized, noninterventional protocol and optimized combined 10-cm visual analog scale and 5-point verbal rating scale (minimum = I cannot feel it at all; maximum = it hurts me). Patients were instructed to document pain immediately after insulin injection and SMBG at home 3 times a day on 3 different days. Results:: A total of 112 patients (mean [SD] age, 14.6 [3.0] years; sex, 60 [53.6%] male; mean [SD] glycosylated hemoglobin [HbA1c], 8.0% [1.4%]; mean [SD] diabetes duration, 6.1 [3.9] years) completed the study. Pain scores reported by the acidic group (n = 76) were not significantly different when compared with those of the neutral group (n = 36) (4.0 [2.0] vs 4.2 [1.9]). Pain scores were also similar for the injection of short-acting insulin in those from the acidic group when compared with those from the neutral group (3.7 [1.7] vs 4.1 [2.1]). Insulin injections were generally perceived as more painful than SMBG (3.9 [1.7] vs 2.9 [1.8]; P < 0.001). Using the Spearman rank correlation coefficient, pain perception was determined to be independent of age, gender, HbA1c level, and duration of diabetes. Conclusion:: Despite its acidic formulation (pH 4), insulin glargine was not perceived as more painful during SC injection than neutral long-acting or shortacting insulin in these pediatric patients with type 1 diabetes mellitus. [Copyright &y& Elsevier]