A method to estimate trends in distributions of 1 min rain rates from numerical weather prediction data

It is known that the rain rate exceeded 0.01% of the time in the UK has experienced an increasing trend over the last 20 years. It is very likely that rain fade and outage experience a similar trend. This paper presents a globally applicable method to estimate these trends, based on the widely accepted Salonen-Poiares Baptista model. The input data are parameters easily extracted from numerical weather prediction reanalysis data. The method is verified using rain gauge data from the UK, and the predicted trend slopes of 0.01% exceeded rain rate are presented on a global grid

Market Competition in Transition Economies: A Literature Review

This paper provides a survey of the effects of market competition in the transition economies of Eastern Europe and Central Asia. The pivotal element of the transition was inter-firm competition, which replaced economic planning as the method to identify demand. Pro-competitive policies that facilitated the transition are discussed, including international trade, attracting foreign direct investment and firm entry. Research topics with respect to competition changed as the transition advanced. The focus shifted from churn and macroeconomic shock-management in the initial phases toward firm entry, privatisation and restructuring of incumbents. In the later phases of transition, differentials in aggregate economic performance became obvious, pointing at institutional differences and their interplay with transitions. These are equally reflected by the degree of competition of the business environment. Also the methods changed with the evolution of the research agenda. Early case studies were displaced by large-scale, cross-country econometric studies as survey data became increasingly available

Elderly Patients' Perspectives on the Acceptability of Deprescribing Medicines: A Qualitative Study Protocol

The ageing population has resulted in an increase in multimorbidity and polypharmacy, and subsequently the complexity of optimising elderly patients’ medicines. The need for deprescribing can arise from factors such as increased susceptibility to adverse effects of medicines in older age, due to functional and cognitive changes, which increases elderly people’s risk of harm. Previous questionnaire-survey-based research suggests that patients tend not to disagree with deprescribing, but qualitative research on patients’ perspectives on deprescribing appears sparse and focused on specific conditions, circumstances (e.g., terminal illness) or medicines. Further exploration of this area is therefore important for health professionals, and greater understanding in particular is needed about elderly patients’ perspectives on the acceptability of deprescribing and how best to conduct deprescribing consultations. This study aims to explore these issues, with an approach informed by the Theoretical Framework of Acceptability (TFA). Semi-structured, audio-recorded interviews will therefore be undertaken with a purposive sample of approximately 20 hospital in-patients who are ≥65years of age, prescribed at least one regular medicine and have multimorbidities and/or frailty. Two acute Trusts were identified through existing networks where patients will be identified by the ward pharmacist and recruited to the study by the researcher. Due to the nature of the discussion and the potential vulnerable nature of participants, a distress protocol has been created to support management of any distress or fatigue that may occur. The TFA has been used so far to develop the study objectives and interview guide topics. The interview guide has been structured into five broad topics, which will cover the constructs of the TFA. Interview recordings will be transcribed verbatim and analysed using the Framework Analysis technique, informed by the TFA

Derivation of physically based soil hydraulic parameters in New Zealand by combining soil physics and hydropedology

Field-characterised soil morphological data (to 1 m depth) and modelled soil water release characteristics are recorded in the S-map database for soils cover- ing approximately 40% of New Zealand's soil area. This paper shows the devel- opment of the Smap-Hydro database that estimates hydraulic parameters by synergising soil morphologic data recorded in S-map and soil physics. The Smap-Hydro parameters were derived using the bi-modal Kosugi hydraulic function. The validity of the Smap-Hydro parameters was tested by applying them within an uncalibrated physically based hydrological model (HyPix) and comparing results with soil water content, θ, measured with Aquaflex soil moisture probes (0–40 cm deep) at 24 sites across New Zealand. The HyPix model provided an excellent fit with observed soil water content for 25% of the sites, a good fit for 33% of the sites and a poor fit for 42% of the sites. Applying the model to all soils in the S-map database required adjustments for the occurrence of rock fragments, hydraulic discontinuities caused by soil pans and required the addition of boundary conditions for water tables and the occurrence of impermeable rock. A discussion on how we can further syner- gise the development of pedotransfer functions with knowledge of soil physics is provided

Efficacy and feasibility of short-stretch compression therapy for filarial lymphedema in Sri Lanka

The WHO-recommended essential package of care (EPC) for filarial limb lymphedema consists of daily limb washing, entry lesion management, limb protection, exercises, and elevation. Decongestive therapy (DT) with compression bandaging by trained lymphedema therapists adds additional benefit but is unavailable for most in low- and middle-income countries (LMICs). To determine whether DT using self-adjustable, short-stretch compression garments (SSCG), prefitted using portable, three-dimensional infrared imaging (3DII), would be effective and feasible in LMIC settings, we conducted a pilot 6-week, interventional, single-group, open-label pilot study in Galle, Sri Lanka. Ten participants with Dreyer stage 3 lymphedema used SSCG for 2 weeks after a 4-week lead-in EPC period. Effect of EPC and compression on quality of life was assessed using the 12-item WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Median participant age was 73 years (range: 32-85 years). Median percent limb volume reduction due to compression was 11.3% (range: 1.1-27.2%). WHODAS 2.0 scores did not change significantly between enrollment and study end. Garment acceptability was high throughout the study. These results provide proof of concept for 3DII-enabled SSCG in LMICs where trained therapists for filarial lymphedema may not be available

Lenses on metacognition: Teachers' perceptions toward strategies in reading in a Pakistani context

The research in the field of metacognition for developing reading is not new; metacognition has been used for many years to identify ways to develop students' reading comprehension. Most previous research has addressed either primary or secondary level students. However, notably few studies have been conducted at the undergraduate level. This study has attempted to initiate strategies to assist first-year engineering students in developing their reading abilities within a Pakistani context. The primary objective of this research was to identify what strategies first-year engineering students use in developing their reading at Quaid-e-Awam University of engineering science and technology in Pakistan. This study used qualitative instruments that included semi-structured interviews with teachers and classroom observations during read-aloud sessions. The data were organized through NVivo version 8 for obtaining nodes, codes, and main themes for interpreting the results. The results of this study demonstrated that teachers should use metacognitive strategies for developing students' reading abilities. Findings also revealed that reading strategies, such as text scanning, guesses from contextual clues, drawing on prior knowledge, and using a dictionary, are the most important strategies to use for developing the reading skills and comprehension of engineering students. This study has suggested metacognitive strategies be used for promoting students' reading abilities and that teachers should design and develop more courses using these strategies to enhance the reading and listening skills of engineering students. © Lomonosov Moscow State University, 2017

Cost-effectiveness of testosterone treatment utilising individual patient data from randomised controlled trials in men with low testosterone levels

ACKNOWLEDGEMENTS Professor Graham Scotland (Health Services Research Unit and Health Economics Research Unit, University of Aberdeen, UK) for providing comments on an earlier draft of this article. The project was funded by the NIHR Health Technology Assessment Programme (project number: 17/68/01). The Section of Endocrinology and Investigative Medicine is funded by grants from the MRC and NIHR and is supported by the NIHR Biomedical Research Centre Funding Scheme and the NIHR/Imperial Clinical Research Facility. The views expressed are those of the author(s) and not necessarily those of the NHS, NIHR or Department of Health. Channa N. Jayasena was funded by NIHR post-doctoral fellowship and Waljit S. Dhillo by NIHR Senior Investigator Award.Peer reviewe

Evaluation of retinal nerve fibre layer thickness as a possible measure of diabetic retinal neurodegeneration in the EPIC-Norfolk Eye Study

Background/aims: Markers to clinically evaluate structural changes from diabetic retinal neurodegeneration (DRN) have not yet been established. To study the potential role of peripapillary retinal nerve fibre layer (pRNFL) thickness as a marker for DRN, we evaluated the relationship between diabetes, as well as glycaemic control irrespective of diabetes status and pRNFL thickness. Methods: Leveraging data from a population-based cohort, we used general linear mixed models (GLMMs) with a random intercept for patient and eye to assess the association between pRNFL thickness (measured using GDx) and demographic, systemic and ocular parameters after adjusting for typical scan score. GLMMs were also used to determine: (1) the relationship between: (A) glycated haemoglobin (HbA1c) irrespective of diabetes diagnosis and pRNFL thickness, (B) diabetes and pRNFL thickness and (2) which quadrants of pRNFL may be affected in participants with diabetes and in relation to HbA1c. Results: 7076 participants were included. After controlling for covariates, inferior pRNFL thickness was 0.94 µm lower (95% CI −1.28 µm to −0.60 µm), superior pRNFL thickness was 0.83 µm lower (95% CI −1.17 µm to −0.49 µm) and temporal pRNFL thickness was 1.33 µm higher (95% CI 0.99 µm to 1.67 µm) per unit increase in HbA1c. Nasal pRNFL thickness was not significantly associated with HbA1c (p=0.23). Similar trends were noted when diabetes was used as the predictor. Conclusion: Superior and inferior pRNFL was significantly thinner among those with higher HbA1c levels and/or diabetes, representing areas of the pRNFL that may be most affected by diabetes