669 research outputs found

    MSWEP : 3-hourly 0.25° global gridded precipitation (1979-2015) by merging gauge, satellite, and reanalysis data

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    Current global precipitation (P) datasets do not take full advantage of the complementary nature of satellite and reanalysis data. Here, we present Multi-Source Weighted-Ensemble Precipitation (MSWEP) version 1.1, a global P dataset for the period 1979-2015 with a 3hourly temporal and 0.25 degrees ffi spatial resolution, specifically designed for hydrological modeling. The design philosophy of MSWEP was to optimally merge the highest quality P data sources available as a function of timescale and location. The long-term mean of MSWEP was based on the CHPclim dataset but replaced with more accurate regional datasets where available. A correction for gauge under-catch and orographic effects was introduced by inferring catchment-average P from streamflow (Q) observations at 13 762 stations across the globe. The temporal variability of MSWEP was determined by weighted averaging of P anomalies from seven datasets; two based solely on interpolation of gauge observations (CPC Unified and GPCC), three on satellite remote sensing (CMORPH, GSMaP-MVK, and TMPA 3B42RT), and two on atmospheric model reanalysis (ERA-Interim and JRA-55). For each grid cell, the weight assigned to the gauge-based estimates was calculated from the gauge network density, while the weights assigned to the satellite-and reanalysis-based estimates were calculated from their comparative performance at the surrounding gauges. The quality of MSWEP was compared against four state-of-the-art gauge-adjusted P datasets (WFDEI-CRU, GPCP-1DD, TMPA 3B42, and CPC Unified) using independent P data from 125 FLUXNET tower stations around the globe. MSWEP obtained the highest daily correlation coefficient (R) among the five P datasets for 60.0% of the stations and a median R of 0.67 vs. 0.44-0.59 for the other datasets. We further evaluated the performance of MSWEP using hydrological modeling for 9011 catchments (< 50 000 km(2)) across the globe. Specifically, we calibrated the simple conceptual hydrological model HBV (Hydrologiska Byrans Vattenbalansavdelning) against daily Q observations with P from each of the different datasets. For the 1058 sparsely gauged catchments, representative of 83.9% of the global land surface (excluding Antarctica), MSWEP obtained a median calibration NSE of 0.52 vs. 0.29-0.39 for the other P datasets. MSWEP is available via http://www.gloh2o.org

    An unusual case of redo tricuspid valve replacement and repair of a previously unidentified anomalous pulmonary venous return in a patient with congenitally corrected transposition of the great arteries

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    Contains fulltext : 225333.pdf (publisher's version ) (Open Access)Associated cardiovascular malformations in congenitally corrected transposition of the great arteries (CCTGA) should not be missed when a patient requires surgical correction. We present a case of an adult CCTGA patient who required redo surgery for recurrent tricuspid (left atrioventricular) valve regurgitation and previously unidentified partial anomalous pulmonary venous return. Publisher: Abstract available from the publisher

    Global-scale regionalization of hydrologic model parameters

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    Current state-of-the-art models typically applied at continental to global scales (hereafter called macroscale) tend to use a priori parameters, resulting in suboptimal streamflow (Q) simulation. For the first time, a scheme for regionalization of model parameters at the global scale was developed. We used data from a diverse set of 1787 small-to-medium sized catchments ( 10-10,000 km(2)) and the simple conceptual HBV model to set up and test the scheme. Each catchment was calibrated against observed daily Q, after which 674 catchments with high calibration and validation scores, and thus presumably good-quality observed Q and forcing data, were selected to serve as donor catchments. The calibrated parameter sets for the donors were subsequently transferred to 0.5 degrees grid cells with similar climatic and physiographic characteristics, resulting in parameter maps for HBV with global coverage. For each grid cell, we used the 10 most similar donor catchments, rather than the single most similar donor, and averaged the resulting simulated Q, which enhanced model performance. The 1113 catchments not used as donors were used to independently evaluate the scheme. The regionalized parameters outperformed spatially uniform (i.e., averaged calibrated) parameters for 79% of the evaluation catchments. Substantial improvements were evident for all major Koppen-Geiger climate types and even for evaluation catchments>5000 km distant from the donors. The median improvement was about half of the performance increase achieved through calibration. HBV with regionalized parameters outperformed nine state-of-the-art macroscale models, suggesting these might also benefit from the new regionalization scheme. The produced HBV parameter maps including ancillary data are available via

    Two year cumulative incidence of trunk abnormalities in a schoolpopulation in Rotterdam, the Netherlands

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    We conducted a study of the 2 year cumulative incidence of trunk abnormalities in a cohort of 3,071 11 year old children (1,621 boys, 1,450 girls). The following data were recorded: height, weight, signs of puberty and menarche. Trunk abnormality was assessed in the erect child (asymmetry of shoulders and waistline, imbalance of the trunk, scoliosis, lordosis, kyphosis, swayback and flexibility) and by the forward bending test (FBT) (rib hump or lumbar prominence, persisting scoliosis, kyphosis and deviant lateral aspect). A normal FBT both at baseline and at follow-up was found in 84% of the boys and in 79% of the girls. The 2 year cumulative incidence of an abnormal FBT was 10% in boys and 13% in girls

    Phase-based treatment versus immediate trauma-focused treatment for post-traumatic stress disorder due to childhood abuse:Randomised clinical trial

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    Background It is unclear whether people with post-traumatic stress disorder (PTSD) and symptoms of complex PTSD due to childhood abuse need a treatment approach different from approaches in the PTSD treatment guidelines. Aims To determine whether a phase-based approach is more effective than an immediate trauma-focused approach in people with childhood-trauma related PTSD (Netherlands Trial Registry no.: NTR5991). Method Adults with PTSD following childhood abuse were randomly assigned to either a phase-based treatment condition (8 sessions of Skills Training in Affect and Interpersonal Regulation (STAIR), followed by 16 sessions of eye-movement desensitisation and reprocessing (EMDR) therapy; n = 57) or an immediately trauma-focused treatment condition (16 sessions of EMDR therapy; n = 64). Participants were assessed for symptoms of PTSD and complex PTSD, and other forms of psychopathology before, during and after treatment and at 3- and 6-month follow-ups. Results Data were analysed with linear mixed models. No significant differences between the two treatments on any variable at post-treatment or follow-up were found. Post-treatment, 68.8% no longer met PTSD diagnostic criteria. Self-reported PTSD symptoms significantly decreased for both STAIR–EMDR therapy (d = 0.93) and EMDR therapy (d = 1.54) from pre- to post-treatment assessment, without significant difference between the two conditions. No differences in drop-out rates between the conditions were found (STAIR–EMDR 22.8% v. EMDR 17.2%). No study-related adverse events occurred. Conclusions This study provides compelling support for the use of EMDR therapy alone for the treatment of PTSD due to childhood abuse as opposed to needing any preparatory intervention

    An unusual case of redo tricuspid valve replacement and repair of a previously unidentified anomalous pulmonary venous return in a patient with congenitally corrected transposition of the great arteries

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    Associated cardiovascular malformations in congenitally corrected transposition of the great arteries (CCTGA) should not be missed when a patient requires surgical correction. We present a case of an adult CCTGA patient who required redo surgery for recurrent tricuspid (left atrioventricular) valve regurgitation and previously unidentified partial anomalous pulmonary venous return

    Phase-based treatment versus immediate trauma-focused treatment for post-traumatic stress disorder due to childhood abuse:Randomised clinical trial

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    Background It is unclear whether people with post-traumatic stress disorder (PTSD) and symptoms of complex PTSD due to childhood abuse need a treatment approach different from approaches in the PTSD treatment guidelines. Aims To determine whether a phase-based approach is more effective than an immediate trauma-focused approach in people with childhood-trauma related PTSD (Netherlands Trial Registry no.: NTR5991). Method Adults with PTSD following childhood abuse were randomly assigned to either a phase-based treatment condition (8 sessions of Skills Training in Affect and Interpersonal Regulation (STAIR), followed by 16 sessions of eye-movement desensitisation and reprocessing (EMDR) therapy; n = 57) or an immediately trauma-focused treatment condition (16 sessions of EMDR therapy; n = 64). Participants were assessed for symptoms of PTSD and complex PTSD, and other forms of psychopathology before, during and after treatment and at 3- and 6-month follow-ups. Results Data were analysed with linear mixed models. No significant differences between the two treatments on any variable at post-treatment or follow-up were found. Post-treatment, 68.8% no longer met PTSD diagnostic criteria. Self-reported PTSD symptoms significantly decreased for both STAIR-EMDR therapy (d = 0.93) and EMDR therapy (d = 1.54) from pre- to post-treatment assessment, without significant difference between the two conditions. No differences in drop-out rates between the conditions were found (STAIR-EMDR 22.8% v. EMDR 17.2%). No study-related adverse events occurred. Conclusions This study provides compelling support for the use of EMDR therapy alone for the treatment of PTSD due to childhood abuse as opposed to needing any preparatory intervention.</p

    Cost-effectiveness analysis of the treatment of posttraumatic stress disorder related to childhood abuse: comparison of phase-based treatment and direct trauma-focused treatment

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    BackgroundPolicymakers, health insurers, and health care providers are becoming increasingly interested in cost-effectiveness analyses (CEA’s) when choosing between possible treatment alternatives, as costs for mental health care have been increasing in recent years.ObjectiveThe current study compared the cost-effectiveness and cost-utility of a phased-based treatment approach that included a preparatory stabilization phase with direct trauma-focused treatment in patients with PTSD and a history of childhood abuse.MethodsA cost-effectiveness analysis was conducted based on data from a randomized controlled trial of 121 patients with PTSD due to childhood abuse. A phase-based treatment (Eye Movement Desensitization and Reprocessing [EMDR] therapy preceded by Skills Training in Affect and Interpersonal Regulation [STAIR]; n = 57) was compared with a direct trauma-focused treatment (EMDR therapy only; n = 64). The primary outcome of cost-effectiveness was the proportion of patients with remitted PTSD. Quality-adjusted life years (QALY) were used as the primary outcome measure for cost-utility analysis.ResultsAlthough the results of the cost-effectiveness analyses yielded no statistically significant differences between the two groups, the mean societal costs per patient differed significantly between the STAIR-EMDR and EMDR therapy groups (€19.599 vs. €13.501; M cost differences = €6.098, CI (95%) = [€117; €12.644]).ConclusionSTAIR-EMDR is not cost-effective compared with EMDR-only therapy. Since trauma-focused treatment is less time-consuming, non-trauma-focused phase-based, treatment does not seem to be a viable alternative for the treatment of PTSD due to adverse childhood events.Clinical trial registration: https://onderzoekmetmensen.nl/nl/trial/22074, identifier NL5836
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