110 research outputs found

    A Digital Archive of Northern Hemisphere Snow Cover, November 1966 through December 1980

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    The purpose of this article is to acquaint the research community with a new data base—a digitized archive of Northern Hemisphere snow cover. Historically, those researchers who needed snow cover data for climatic and atmospheric boundary layer studies have had to rely on the irregularly spaced (and in some regions, sparse) grid of point observations. Northern Hemisphere Weekly Snow and Ice Cover Charts, which are created from analyzed satellite imagery at the National Earth Satellite Service (NESS), have been available on an operational basis since late 1966. Each of these weekly charts for the period November 1966 through December 1980 was digitized and stored in a new data archive. Snow cover area and snow cover frequency climatologies were created and examples are presented. The significance of this unique data archive is examined by comparing the 14-year mean annual snow cover frequency climatology with several published snow cover climatologies. The potential uses for this data archive in meteorological and climatological studies also are reviewed

    Daily Maximum and Minimum Temperature Forecasts and the Influence of Snow Cover

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    Research into the relationship between snow cover and observed maximum and minimum temperatures is reviewed. An example of the importance of snow cover and forecasting max/min temperatures is presented for this past winter (1976-77). It is shown that there was a warm bias in the MOS temperature forecasts for the northern Great Plains following the receipt of a fresh cover of snowfall. it is proposed that snow cover be incorporated as a conditional predictor to be used only during specific synoptic conditions

    Lake Erie Induced Mesosystems- An Operational Forecast Model

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    All Lake Erie lake-effect days for a 10-year period prior to the 1976-77 snowfall season were utilized in the development of an operational lake-effect snowfall forecast model. Upper air and surface observation were combined with overlake data and analyzed, using stepwise multiple-discriminant analysis. A nine-predictor mesoscale forecast model resulted from this statistical test and its performance was evaluated during the 1976-77 and 1977-78 snowfall seasons. The results of this evaluation indicate that it is possible to predict six intensities of the Lake Erie lake-effect snowstorm using this mesoscale model

    A Digital Archive of Northern Hemisphere Snow Cover, November 1966 through December 1980

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    The purpose of this article is to acquaint the research community with a new data base—a digitized archive of Northern Hemisphere snow cover. Historically, those researchers who needed snow cover data for climatic and atmospheric boundary layer studies have had to rely on the irregularly spaced (and in some regions, sparse) grid of point observations. Northern Hemisphere Weekly Snow and Ice Cover Charts, which are created from analyzed satellite imagery at the National Earth Satellite Service (NESS), have been available on an operational basis since late 1966. Each of these weekly charts for the period November 1966 through December 1980 was digitized and stored in a new data archive. Snow cover area and snow cover frequency climatologies were created and examples are presented. The significance of this unique data archive is examined by comparing the 14-year mean annual snow cover frequency climatology with several published snow cover climatologies. The potential uses for this data archive in meteorological and climatological studies also are reviewed

    Climatology of the daily temperature range annual cycle in the United States

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    Many researchers are presently interested in detecting long-term trends in annual or seasonal daily temperature range (DTR), and attributing these changes to anthropogenic origins. However, very little work has been done to confirm the mechanisms that are important to determining the long-term average annual cycle of the DTR. Therefore, the focus of this work is to examine the spatial and temporal difference in the DTR average annual cycle across the United States, and to associate the patterns of these cycles with potential causal variables. Three major types of DTR annual cycle exist in the United States: high sun season maximum (northern and western U.S.), low sun season maximum (south central and southeast U.S.), and transitional season maxima (middle latitude in the U.S.). The annual cycles of the DTR in the northern and western U.S. are well related to average annual cycles of cloud cover and dew point temperature; only areas to the west of the Rocky Mountains have a strong linkage between DTR and precipitation frequency annual cycles. Across the northern tier of the U.S., the loss of snow cover is important to DTR transitions during the spring season. However, the onset of snow cover in the fall does not appear to be the major factor in DTR variations, which are instead more strongly associated with cloud cover effects. As expected from their sinusoidal annual cycle, maximum and minimum temperature cycles are linearly related to the DTR in regions with a warm season or cold season DTR maximum, while non-linear relationships exist where the DTR annual cycle has maxima in the transition seasons

    Why small-quantity lipid-based nutrient supplements should be integrated into comprehensive strategies to prevent child undernutrition in nutritionally vulnerable populations : response to Gupta et al.’s commentary

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    We write in response to the commentary by Gupta et al. (2023) on small-quantity lipid-based nutrient supplements (SQ-LNS) for infants and young children 6 to 24 months of age, which was prompted by the recent brief guidance note from UNICEF (2023) explaining when, why and how SQ-LNS are being prioritized as part of their package of preventive actions to combat early childhood malnutrition. The UNICEF document was disseminated shortly after publication of a correspondence in Nature Food (Aguayo et al. 2023), authored by nutrition leaders from several organizations, that summarized the evidence on the benefits of SQ-LNS and called for this intervention to be scaled up and integrated into programs for populations in which child undernutrition is prevalent and dietary quality is very poor. We agree with Gupta et al. that child malnutrition is the result of many factors and there is no single “quick fix” or “magic bullet”. In fact, the above-cited documents state clearly and frequently that provision of SQ-LNS is not a stand-alone intervention and must be integrated into comprehensive strategies to improve infant and young child feeding (IYCF), including the promotion of dietary diversity, as well as other actions needed to prevent malnutrition. SQ-LNS are intended for vulnerable populations who lack access to an affordable, nutritionally adequate complementary feeding diet and have high rates of stunting, wasting and mortality. In such populations, we agree with Gupta et al. that IYCF messages alone are not enough. This is precisely why SQ-LNS were originally developed

    Endovascular Thrombectomy for Ischemic Stroke Increases Disability-Free Survival, Quality of Life, and Life Expectancy and Reduces Cost

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    Background: Endovascular thrombectomy improves functional outcome in large vessel occlusion ischemic stroke. We examined disability, quality of life, survival and acute care costs in the EXTEND-IA trial, which used CT-perfusion imaging selection. Methods: Large vessel ischemic stroke patients with favorable CT-perfusion were randomized to endovascular thrombectomy after alteplase versus alteplase-only. Clinical outcome was prospectively measured using 90-day modified Rankin scale (mRS). Individual patient expected survival and net difference in Disability/Quality-adjusted life years (DALY/QALY) up to 15 years from stroke were modeled using age, sex, 90-day mRS, and utility scores. Level of care within the first 90 days was prospectively measured and used to estimate procedure and inpatient care costs (USreferenceyear2014).Results:Therewere70patients,35ineacharm,meanage69,medianNIHSS15(IQR1219).Themedian(IQR)disabilityweightedutilityscoreat90dayswas0.65(0.000.91)inthealteplaseonlyversus0.91(0.651.00)intheendovasculargroup(p=0.005).Modeledlifeexpectancywasgreaterintheendovascularversusalteplaseonlygroup(median15.6versus11.2years,p=0.02).TheendovascularthrombectomygrouphadfewersimulatedDALYslostover15years[median(IQR)5.5(3.28.7)versus8.9(4.713.8),p=0.02]andmoreQALYgained[median(IQR)9.3(4.213.1)versus4.9(0.38.5),p=0.03].Endovascularpatientsspentlesstimeinhospital[median(IQR)5(311)daysversus8(514)days,p=0.04]andrehabilitation[median(IQR)0(028)versus27(065)days,p=0.03].Theestimatedinpatientcostsinthefirst90dayswerelessinthethrombectomygroup(averageUS reference year 2014). Results: There were 70 patients, 35 in each arm, mean age 69, median NIHSS 15 (IQR 12-19). The median (IQR) disability-weighted utility score at 90 days was 0.65 (0.00-0.91) in the alteplase-only versus 0.91 (0.65-1.00) in the endovascular group (p = 0.005). Modeled life expectancy was greater in the endovascular versus alteplaseonly group (median 15.6 versus 11.2 years, p = 0.02). The endovascular thrombectomy group had fewer simulated DALYs lost over 15 years [median (IQR) 5.5 (3.2-8.7) versus 8.9 (4.7-13.8), p = 0.02] and more QALY gained [median (IQR) 9.3 (4.2-13.1) versus 4.9 (0.3-8.5), p = 0.03]. Endovascular patients spent less time in hospital [median (IQR) 5 (3-11) days versus 8 (5-14) days, p = 0.04] and rehabilitation [median (IQR) 0 (0-28) versus 27 (0-65) days, p = 0.03]. The estimated inpatient costs in the first 90 days were less in the thrombectomy group (average US15,689 versus US30,569,p=0.008)offsettingthecostsofinterhospitaltransportandthethrombectomyprocedure(averageUS30,569, p = 0.008) offsetting the costs of interhospital transport and the thrombectomy procedure (average US10,515). The average saving per patient treated with thrombectomy was US$4,365. c Conclusion: Thrombectomy patients with large vessel occlusion and salvageable tissue on CT-perfusion had reduced length of stay and overall costs to 90 days. There was evidence of clinically relevant improvement in long-term survival and quality of life.Peer reviewe

    Small-quantity lipid-based nutrient supplements for children age 6-24 months: a systematic review and individual participant data meta-analysis of effects on developmental outcomes and effect modifiers

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    BACKGROUND: Small-quantity (SQ) lipid-based nutrient supplements (LNSs) provide many nutrients needed for brain development. OBJECTIVES: We aimed to generate pooled estimates of the effect of SQ-LNSs on developmental outcomes (language, social-emotional, motor, and executive function), and to identify study-level and individual-level modifiers of these effects. METHODS: We conducted a 2-stage meta-analysis of individual participant data from 14 intervention against control group comparisons in 13 randomized trials of SQ-LNSs provided to children age 6-24 mo (total n = 30,024). RESULTS: In 11-13 intervention against control group comparisons (n = 23,588-24,561), SQ-LNSs increased mean language (mean difference: 0.07 SD; 95% CI: 0.04, 0.10 SD), social-emotional (0.08; 0.05, 0.11 SD), and motor scores (0.08; 95% CI: 0.05, 0.11 SD) and reduced the prevalence of children in the lowest decile of these scores by 16% (prevalence ratio: 0.84; 95% CI: 0.76, 0.92), 19% (0.81; 95% CI: 0.74, 0.89), and 16% (0.84; 95% CI: 0.76, 0.92), respectively. SQ-LNSs also increased the prevalence of children walking without support at 12 mo by 9% (1.09; 95% CI: 1.05, 1.14). Effects of SQ-LNSs on language, social-emotional, and motor outcomes were larger among study populations with a higher stunting burden (≥35%) (mean difference: 0.11-0.13 SD; 8-9 comparisons). At the individual level, greater effects of SQ-LNSs were found on language among children who were acutely malnourished (mean difference: 0.31) at baseline; on language (0.12), motor (0.11), and executive function (0.06) among children in households with lower socioeconomic status; and on motor development among later-born children (0.11), children of older mothers (0.10), and children of mothers with lower education (0.11). CONCLUSIONS: Child SQ-LNSs can be expected to result in modest developmental gains, which would be analogous to 1-1.5 IQ points on an IQ test, particularly in populations with a high child stunting burden. Certain groups of children who experience higher-risk environments have greater potential to benefit from SQ-LNSs in developmental outcomes.This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42020159971

    Genome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure

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    Heart failure (HF) is a leading cause of morbidity and mortality worldwide. A small proportion of HF cases are attributable to monogenic cardiomyopathies and existing genome-wide association studies (GWAS) have yielded only limited insights, leaving the observed heritability of HF largely unexplained. We report results from a GWAS meta-analysis of HF comprising 47,309 cases and 930,014 controls. Twelve independent variants at 11 genomic loci are associated with HF, all of which demonstrate one or more associations with coronary artery disease (CAD), atrial fibrillation, or reduced left ventricular function, suggesting shared genetic aetiology. Functional analysis of non-CAD-associated loci implicate genes involved in cardiac development (MYOZ1, SYNPO2L), protein homoeostasis (BAG3), and cellular senescence (CDKN1A). Mendelian randomisation analysis supports causal roles for several HF risk factors, and demonstrates CAD-independent effects for atrial fibrillation, body mass index, and hypertension. These findings extend our knowledge of the pathways underlying HF and may inform new therapeutic strategies

    Neonatal mortality risk of vulnerable newborns : A descriptive analysis of subnational, population-based birth cohorts for 238 143 live births in low- and middle-income settings from 2000 to 2017

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    Objective: We aimed to understand the mortality risks of vulnerable newborns (defined as preterm and/or born weighing smaller or larger compared to a standard population), in low- and middle-income countries (LMICs). Design: Descriptive multi-country, secondary analysis of individual-level study data of babies born since 2000. Setting: Sixteen subnational, population-based studies from nine LMICs in sub-Saharan Africa, Southern and Eastern Asia, and Latin America. Population: Live birth neonates. Methods: We categorically defined five vulnerable newborn types based on size (large- or appropriate- or small-for-gestational age [LGA, AGA, SGA]), and term (T) and preterm (PT): T + LGA, T + SGA, PT + LGA, PT + AGA, and PT + SGA, with T + AGA (reference). A 10-type definition included low birthweight (LBW) and non-LBW, and a four-type definition collapsed AGA/LGA into one category. We performed imputation for missing birthweights in 13 of the studies. Main Outcome Measures: Median and interquartile ranges by study for the prevalence, mortality rates and relative mortality risks for the four, six and ten type classification. Results: There were 238 143 live births with known neonatal status. Four of the six types had higher mortality risk: T + SGA (median relative risk [RR] 2.8, interquartile range [IQR] 2.0–3.2), PT + LGA (median RR 7.3, IQR 2.3–10.4), PT + AGA (median RR 6.0, IQR 4.4–13.2) and PT + SGA (median RR 10.4, IQR 8.6–13.9). T + SGA, PT + LGA and PT + AGA babies who were LBW, had higher risk compared with non-LBW babies. Conclusions: Small and/or preterm babies in LIMCs have a considerably increased mortality risk compared with babies born at term and larger. This classification system may advance the understanding of the social determinants and biomedical risk factors along with improved treatment that is critical for newborn health.Peer reviewe
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