Towards a fair comparison of statistical and dynamical downscaling in the framework of the EURO-CORDEX initiative

Both statistical and dynamical downscaling methods are well established techniques to bridge the gap between the coarse information produced by global circulation models and the regional-to-local scales required by the climate change Impacts, Adaptation, and Vulnerability (IAV) communities. A number of studies have analyzed the relative merits of each technique by inter-comparing their performance in reproducing the observed climate, as given by a number of climatic indices (e.g. mean values, percentiles, spells). However, in this paper we stress that fair comparisons should be based on indices that are not affected by the calibration towards the observed climate used for some of the methods. We focus on precipitation (over continental Spain) and consider the output of eight Regional Climate Models (RCMs) from the EURO-CORDEX initiative at 0.44? resolution and five Statistical Downscaling Methods (SDMs) ?analog resampling, weather typing and generalized linear models? trained using the Spain044 observational gridded dataset on exactly the same RCM grid. The performance of these models is inter-compared in terms of several standard indices ?mean precipitation, 90th percentile on wet days, maximum precipitation amount and maximum number of consecutive dry days? taking into account the parameters involved in the SDM training phase. It is shown, that not only the directly affected indices should be carefully analyzed, but also those indirectly influenced (e.g. percentile-based indices for precipitation) which are more difficult to identify. We also analyze how simple transformations (e.g. linear scaling) could be applied to the outputs of the uncalibrated methods in order to put SDMs and RCMs on equal footing, and thus perform a fairer comparison.We acknowledge the World Climate Research Programme’s Working Group on Regional Climate, and theWorking Group on CoupledModelling, former coordinating body of CORDEX and responsible panel for CMIP5. We also thank the climate modeling groups (listed in Table 1 of this paper) for producing and making available their model output. We also acknowledge the Earth System Grid Federation infrastructure and AEMET and University of Cantabria for the Spain02 dataset (available at http: //www.meteo.unican.es/en/datasets/spain02). All the statistical downscaling experiments have been computed using theMeteoLab software (http://www.meteo.unican.es/software/meteolab), which is an open-source Matlab toolbox for statistical downscaling. This work has been partially supported by CORWES (CGL2010-22158-C02) and EXTREMBLES (CGL2010-21869) projects funded by the Spanish R&D programme. AC thanks the Spanish Ministry of Economy and Competitiveness for the funding provided within the FPI programme (BES-2011-047612 and EEBB-I-13-06354), JMG acknowledges the support from the SPECS project (FP7-ENV-2012-308378) and JF is grateful to the EUPORIAS project (FP7-ENV-2012-308291). We also thank three anonymous referees for their useful comments that helped to improve the original manuscript

Routinely reported ejection fraction and mortality in clinical practice: where does the nadir of risk lie?

Aims: We investigated the relationship between clinically assessed left ventricular ejection fraction (LVEF) and survival in a large, heterogeneous clinical cohort. Methods and results: Physician-reported LVEF on 403 977 echocardiograms from 203 135 patients were linked to all-cause mortality using electronic health records (1998–2018) from US regional healthcare system. Cox proportional hazards regression was used for analyses while adjusting for many patient characteristics including age, sex, and relevant comorbidities. A dataset including 45 531 echocardiograms and 35 976 patients from New Zealand was used to provide independent validation of analyses. During follow-up of the US cohort, 46 258 (23%) patients who had undergone 108 578 (27%) echocardiograms died. Overall, adjusted hazard ratios (HR) for mortality showed a u-shaped relationship for LVEF with a nadir of risk at an LVEF of 60–65%, a HR of 1.71 [95% confidence interval (CI) 1.64–1.77] when ≥70% and a HR of 1.73 (95% CI 1.66–1.80) at LVEF of 35–40%. Similar relationships with a nadir at 60–65% were observed in the validation dataset as well as for each age group and both sexes. The results were similar after further adjustments for conditions associated with an elevated LVEF, including mitral regurgitation, increased wall thickness, and anaemia and when restricted to patients reported to have heart failure at the time of the echocardiogram. Conclusion: Deviation of LVEF from 60% to 65% is associated with poorer survival regardless of age, sex, or other relevant comorbidities such as heart failure. These results may herald the recognition of a new phenotype characterized by supra-normal LVEF

PSYCHOMETRIC EVALUATION OF THE PEDIATRIC QUALITY OF LIFE INVENTORY (TM) 3.0 DIABETES MODULE FOR TURKISH CHILDREN WITH TYPE I DIABETES MELLITUS

Quality of life is assessed by various standardised quality of life instruments, which make data comparisons possible. In Turkey, there are no adequate substitutes for diabetes-related scales used in other countries to measure the effects of diabetes on children quality of life. Because of this shortcoming in the field, the present methodological study was conducted to investigate the validity, reliability and other psychometric properties of a Turkish version of the Pediatric Quality of Life Inventory (TM) 3.0 Diabetes Module-Parent Report for Children 8-12. The study sample consisted of 111 parents. Data were statistically analysed by frequency counts, percentages and content analysis index, factor analysis, and the Cronbach alpha

Acute Unilateral Vestibulopathy Does Not Impair Cognition

6th Congress of the European-Academy-of-Neurology (EAN) -- MAY 23-26, 2020 -- ELECTR NETWORKWOS: 000534616800354[No abstract available]Europ Acad Neuro

Connection Between Smoking Statuses and Anger-Anger Style of the Health Services Vocational School Students

This study was carried out at Sabuncuoğlu Şerefeddin Vocational School of Health Services, Amasya University. In this study, the relationship between smoking habits and rage and anger of the Vocational School students was examined for identification purposes. Within the scope of this study, the survey was performed to reach 608 out of 822 students in 2015-2016. The youth socioeconomic factors influencing smoking, cultural characteristics, as well as peer influence, emulation, school failure, loneliness, alcohol and drug use, social students' range and anger along with psychological factors, such as stress were analyzed cross-sectionally. The demographic questionnaire used for the data collection, information about smoking habits and the anger-anger scale were used. The independent variables were age, gender, type of school, parents' educational level, parental occupational status, income, and income perception. The reasons for smoking initiation, trying, quitting and continuing to smoke of smokers and non-smokers and anger styles related to these reasons were compared. Consequently, in our study, the smoking habits of males have been found more pronounced when compared to females. However, no significant relationship was found between the smoking habits and the anger-anger style. The age of smoking initiation has been determined to be proportional to the beginning of adolescence. This study will shed light on possibilities of smoking prevention and will facilitate quitting of smoking

Interaction Between Grapefruit Juice and Drugs

Clinically significant grapefruit juice-drug interactions are an interesting development in the last ten years of research process in the scope of drug interactions. In 1989 a group of Canadian researchers found incidentally that grapefruit juice, used as a carrier system, interacts with some calcium channel blockers, while applying alcohol during a study on alcohol-drug interactions, and presented it in Lancet as a "short report". In this report it is stated that this effect of grapefruit juice is specific and there is no similar interaction with orange juice. The grapefruit juice interactions with drugs and changes in drug pharmacokinetics, individual responses to grapefruit juice in the relationship between the drug concentration and the effect began to gain a larger clinical significance. Drugs interacting with grapefruit juice are metabolized by cytochrome P450 enzyme system in liver or intestinal section. Flavonoids contained in grapefruit juice inhibit the enzyme, bind as a substrate to the enzyme system and disrupt its bioavailability. Naringin is an essential bioflavonoid in the grapefruit juice. Naringin is not a potent inhibitor of cytochrome P450, but it is partly metabolised to "Naringenin" by intestinal bacteria. This substance is a powerful inhibitor of cytochrome P450 and it is believed by some researchers, that these are components responsible for the effect of grapefruit juice. In 2008 the number of drugs that can cause danger when taken together with grapefruit was 17. It has been reported that this number has risen to 43 in 2012. However, while the research of the possible effects of other not yet identified components of the grapefruit juice is still in progress, FDA has begun to put cautionary statement to many drug prescriptions

Interaction Between Grapefruit Juice and Drugs

Clinically significant grapefruit juice-drug interactions are an interesting development in the last ten years of research process in the scope of drug interactions. In 1989 a group of Canadian researchers found incidentally that grapefruit juice, used as a carrier system, interacts with some calcium channel blockers, while applying alcohol during a study on alcohol-drug interactions, and presented it in Lancet as a "short report". In this report it is stated that this effect of grapefruit juice is specific and there is no similar interaction with orange juice. The grapefruit juice interactions with drugs and changes in drug pharmacokinetics, individual responses to grapefruit juice in the relationship between the drug concentration and the effect began to gain a larger clinical significance. Drugs interacting with grapefruit juice are metabolized by cytochrome P450 enzyme system in liver or intestinal section. Flavonoids contained in grapefruit juice inhibit the enzyme, bind as a substrate to the enzyme system and disrupt its bioavailability. Naringin is an essential bioflavonoid in the grapefruit juice. Naringin is not a potent inhibitor of cytochrome P450, but it is partly metabolised to "Naringenin" by intestinal bacteria. This substance is a powerful inhibitor of cytochrome P450 and it is believed by some researchers, that these are components responsible for the effect of grapefruit juice. In 2008 the number of drugs that can cause danger when taken together with grapefruit was 17. It has been reported that this number has risen to 43 in 2012. However, while the research of the possible effects of other not yet identified components of the grapefruit juice is still in progress, FDA has begun to put cautionary statement to many drug prescriptions

Connection Between Smoking Statuses and Anger-Anger Style of the Health Services Vocational School Students

This study was carried out at Sabuncuoğlu Şerefeddin Vocational School of Health Services, Amasya University. In this study, the relationship between smoking habits and rage and anger of the Vocational School students was examined for identification purposes. Within the scope of this study, the survey was performed to reach 608 out of 822 students in 2015-2016. The youth socioeconomic factors influencing smoking, cultural characteristics, as well as peer influence, emulation, school failure, loneliness, alcohol and drug use, social students' range and anger along with psychological factors, such as stress were analyzed cross-sectionally. The demographic questionnaire used for the data collection, information about smoking habits and the anger-anger scale were used. The independent variables were age, gender, type of school, parents' educational level, parental occupational status, income, and income perception. The reasons for smoking initiation, trying, quitting and continuing to smoke of smokers and non-smokers and anger styles related to these reasons were compared. Consequently, in our study, the smoking habits of males have been found more pronounced when compared to females. However, no significant relationship was found between the smoking habits and the anger-anger style. The age of smoking initiation has been determined to be proportional to the beginning of adolescence. This study will shed light on possibilities of smoking prevention and will facilitate quitting of smoking