Development of the MESH modelling system for hydrological ensemble forecasting of the Laurentian Great Lakes at the regional scale

International audienceEnvironment Canada has been developing a community environmental modelling system (Modélisation Environmentale Communautaire ? MEC), which is designed to facilitate coupling between models focusing on different components of the earth system. The ultimate objective of MEC is to use the coupled models to produce operational forecasts. MESH (MEC ? Surface and Hydrology), a configuration of MEC currently under development, is specialized for coupled land-surface and hydrological models. To determine the specific requirements for MESH, its different components were implemented on the Laurentian Great Lakes watershed, situated on the Canada-US border. This experiment showed that MESH can help us better understand the behaviour of different land-surface models, test different schemes for producing ensemble streamflow forecasts, and provide a means of sharing the data, the models and the results with collaborators and end-users. This modelling framework is at the heart of a testbed proposal for the Hydrologic Ensemble Prediction Experiment (HEPEX) which should allow us to make use of the North American Ensemble Forecasting System (NAEFS) to improve streamflow forecasts of the Great Lakes tributaries, and demonstrate how MESH can contribute to a Community Hydrologic Prediction System (CHPS)

Using the MESH modelling system for hydrological ensemble forecasting of the Laurentian Great Lakes at the regional scale

International audienceEnvironment Canada has been developing a community environmental modelling system (Modélisation Environmentale Communautaire ? MEC), which is designed to facilitate coupling between models focusing on different components of the earth system. The ultimate objective of MEC is to use the coupled models to produce operational forecasts. MESH (MEC ? Surface and Hydrology), a configuration of MEC currently under development, is specialized for coupled land-surface and hydrological models. To determine the specific requirements for MESH, its different components were implemented on the Laurentian Great Lakes watershed, situated on the Canada?U.S. border. This experiment showed that MESH can help us better understand the behaviour of different land-surface models, test different schemes for producing ensemble streamflow forecasts, and provide a means of sharing the data, the models and the results with collaborators and end-users. This modelling framework is at the heart of a testbed proposal for the Hydrologic Ensemble Prediction Experiment (HEPEX) which should allow us to make use of the North American Ensemble Forecasting System (NAEFS) to improve streamflow forecasts of the Great Lakes tributaries, and demonstrate how MESH can contribute to a Community Hydrologic Prediction System (CHPS)

Nurses' knowledge and practices in cases of acute and chronic confusion: a questionnaire survey

PURPOSE: This study aimed to describe nurses' knowledge and practices toward patients with acute or chronic confusion. DESIGN AND METHODS: A cross-sectional design was used, and 249 nurses engaged in clinical practice fulfilled an online self-report questionnaire. FINDINGS: Tools for diagnosing acute confusion/delirium are never used by 57.80% of the nurses. Between 80% and 81% of nursing interventions involve managing patients' physical environment and between 62% and 71% deal with managing communication. Theoretical training in the use of tools for assessing and intervening in cases of confusion was significantly associated with nurses' knowledge and practices. PRACTICE IMPLICATIONS: These results suggest the need for increased investment in nurses' training

Forest processes from stands to landscapes: exploring model forecast uncertainties using cross-scale model comparison

Forest management practices conducted primarily at the stand scale result in simplified forests with regeneration problems and low structural and biological diversity. Landscape models have been used to help design management strategies to address these problems. However, there remains a great deal of uncertainty that the actual management practices result in the desired sustainable landscape structure. To investigate our ability to meet sustainable forest management goals across scales, we assessed how two models of forest dynamics, a scaled-up individual-tree model and a landscape model, simulate forest dynamics under three types of harvesting regimes: clearcut, gap, and uniform thinning. Althougth 50– 100 year forecasts predicted average successional patterns that differed by less than 20% between models, understory dynamics of the landscape model were simplified relative to the scaled-up tree model, whereas successional patterns of the scaled-up tree model deviated from empirical studies on the driest and wettest landtypes. The scale dependencies of both models revealed important weaknesses when the models were used alone; however, when used together, they could provide a heuristic method that could improve our ability to design sustainable forest management practices

Medication adherence and blood pressure control among hypertensive patients with coexisting long-term conditions in primary care settings

Hypertension is a typical example of long-term disease posing formidable challenges to health care. One goal of antihypertensive therapy is to achieve optimal blood pressure (BP) control and reduce co-occurring chronic conditions (multimorbidity). This study aimed to assess the influence of multimorbidity on medication adherence, and to explore the association between poor BP control and multimorbidity, with implications for hypertension management. A cross-sectional design with multistage sampling was adopted to recruit Chinese hypertensive patients attending general out-patient clinics from 3 geographic regions in Hong Kong. A modified systemic sampling methodology with 1 patient as a sampling unit was used to recruit consecutive samples in each general out-patient clinic. Data were collected by face-to-face interviews using a standardized protocol. Poor BP control was defined as having systolic BP/diastolic BP 130/80mm Hg for those with diabetes or chronic kidney disease; and 140/90mmHg for others.Medication adherencewas assessed by a validatedChinese version of the Morisky Medication Adherence Scale. A simple unweighted enumeration was adopted to measure the combinations of coexisting long-term conditions. Binary logistic regression analysis was conducted with medication adherence and multimorbidity as outcome variables, respectively, after controlling for effects of patient-level covariates. The prevalence of multimorbidity was 47.4% (95% confidence interval [CI] 45.4%–49.4%) among a total of 2445 hypertensive patients. The proportion of subjects having 0, 1, and 2 additional long-term conditions was 52.6%, 29.1%, and 18.3%, respectively. The overall rate of poor adherence to medication was 46.6%, whereas the rate of suboptimal BP control was 48.7%. Albeit the influence of multimorbidity on medication adherence was not found to be statistically significant, patients with poorly controlled BP were more likely to have multimorbidity (adjusted odds ratio 2.07, 95% CI 1.70–2.53, P<0.001). Diabetes was the most prevalent concomitant long-term condition among hypertensive patients with poor BP control (38.6%, 95% CI 35.8–41.4 vs 19.7%, 95% CI 17.5–21.9 for patients with good BP control, P<0.001). Multimorbidity was common among hypertensive patients, and was associated with poor BP control. Subjects with coexisting diabetes, heart disease, or chronic kidney disorder should receive more clinical attention to achieve better clinical outcomes

Measurement of the Branching Fraction for B- --> D0 K*-

We present a measurement of the branching fraction for the decay B- --> D0 K*- using a sample of approximately 86 million BBbar pairs collected by the BaBar detector from e+e- collisions near the Y(4S) resonance. The D0 is detected through its decays to K- pi+, K- pi+ pi0 and K- pi+ pi- pi+, and the K*- through its decay to K0S pi-. We measure the branching fraction to be B.F.(B- --> D0 K*-)= (6.3 +/- 0.7(stat.) +/- 0.5(syst.)) x 10^{-4}.Comment: 7 pages, 1 postscript figure, submitted to Phys. Rev. D (Rapid Communications

Measurement of Branching Fraction and Dalitz Distribution for B0->D(*)+/- K0 pi-/+ Decays

We present measurements of the branching fractions for the three-body decays B0 -> D(*)-/+ K0 pi^+/-$and their resonant submodes$B0 -> D(*)-/+ K*+/- using a sample of approximately 88 million BBbar pairs collected by the BABAR detector at the PEP-II asymmetric energy storage ring. We measure: B(B0->D-/+ K0 pi+/-)=(4.9 +/- 0.7(stat) +/- 0.5 (syst)) 10^{-4} B(B0->D*-/+ K0 pi+/-)=(3.0 +/- 0.7(stat) +/- 0.3 (syst)) 10^{-4} B(B0->D-/+ K*+/-)=(4.6 +/- 0.6(stat) +/- 0.5 (syst)) 10^{-4} B(B0->D*-/+ K*+/-)=(3.2 +/- 0.6(stat) +/- 0.3 (syst)) 10^{-4} From these measurements we determine the fractions of resonant events to be : f(B0-> D-/+ K*+/-) = 0.63 +/- 0.08(stat) +/- 0.04(syst) f(B0-> D*-/+ K*+/-) = 0.72 +/- 0.14(stat) +/- 0.05(syst)Comment: 7 pages, 3 figures submitted to Phys. Rev. Let

Evidence for the Rare Decay B -> K*ll and Measurement of the B -> Kll Branching Fraction

We present evidence for the flavor-changing neutral current decay $B\to K^*\ell^+\ell^-$ and a measurement of the branching fraction for the related process $B\to K\ell^+\ell^-$, where $\ell^+\ell^-$ is either an $e^+e^-$ or $\mu^+\mu^-$ pair. These decays are highly suppressed in the Standard Model, and they are sensitive to contributions from new particles in the intermediate state. The data sample comprises $123\times 10^6$ $\Upsilon(4S)\to B\bar{B}$ decays collected with the Babar detector at the PEP-II $e^+e^-$ storage ring. Averaging over $K^{(*)}$ isospin and lepton flavor, we obtain the branching fractions ${\mathcal B}(B\to K\ell^+\ell^-)=(0.65^{+0.14}_{-0.13}\pm 0.04)\times 10^{-6}$ and ${\mathcal B}(B\to K^*\ell^+\ell^-)=(0.88^{+0.33}_{-0.29}\pm 0.10)\times 10^{-6}$, where the uncertainties are statistical and systematic, respectively. The significance of the $B\to K\ell^+\ell^-$ signal is over $8\sigma$, while for $B\to K^*\ell^+\ell^-$ it is $3.3\sigma$.Comment: 7 pages, 2 postscript figues, submitted to Phys. Rev. Let