Evaluating several satellite precipitation estimates and global ground-based dataset on Sicily (Italy)

The developing of satellite-based precipitation retrieval systems, presents great potentialities for several applications ranging from weather and meteorological applications to hydrological modelling. Evaluating performances for these estimates is essential in order to understand their real capabilities and suitability related to each application. In this study an evaluation analysis of satellite precipitation retrieval systems has been carried out for the area of Sicily (Italy). Sicily is an island in the Mediterranean sea with a particular climatology and morphology, which is considered as an interesting test site for satellite precipitation products on the European mid-latitude area. A high density rain-gauges network has been used to evaluate selected satellite precipitation products. Sicily has an area of 26,000 km2 and the gauge density of the network considered in this study is about 250 km2/gauge. Four satellite products (CMORPH, PERSIANN, TMPA-RT, PERSIANN-CCS) along with two adjusted products (TMPA and PERSIANN Adjusted) have been selected for the evaluation. Evaluation and comparisons among selected products is performed with reference to the data provided by the gauge network of Sicily and using statistical and visualization tools. Results show that bias is relevant for all satellite products and climatic considerations are reported to address this issue. Moreover bias errors are observed for the adjusted products even though they are reduced respect to only-satellite products. In order to analyze this result, the ground-based precipitation dataset used by adjusted products (GPCC dataset), has been examined and weaknesses arising from spatial sampling of precipitation process have been identified for the study area. Therefore possible issues deriving from using global ground-based datasets for local scales are pointed out from this application. © 2012 SPIE

Evaluation and comparison of satellite precipitation estimates with reference to a local area in the Mediterranean Sea

Precipitation is one of the major variables for many applications and disciplines related to water resources and the geophysical Earth system. Satellite retrieval systems, rain-gauge networks, and radar systems are complementary to each other in terms of their coverage and capability of monitoring precipitation. Satellite-rainfall estimate systems produce data with global coverage that can provide information in areas for which data from other sources are unavailable. Without referring to ground measurements, satellite-based estimates can be biased and, although some gauge-adjusted satellite-precipitation products have been already developed, an effective way of integrating multi-sources of precipitation information is still a challenge.In this study, a specific area, the Sicilia Island (Italy), has been selected for the evaluation of satellite-precipitation products based on rain-gauge data. This island is located in the Mediterranean Sea, with a particular climatology and morphology, which can be considered an interesting test site for satellite-precipitation products in the European mid-latitude area. Four satellite products (CMORPH, PERSIANN, PERSIANN-CCS, and TMPA-RT) and two GPCP-adjusted products (TMPA and PERSIANN Adjusted) have been selected. Evaluation and comparison of selected products is performed with reference to data provided by the rain-gauge network of the Island Sicilia and by using statistical and graphical tools. Particular attention is paid to bias issues shown both by only-satellite and adjusted products. In order to investigate the current and potential possibilities of improving estimates by means of adjustment procedures using GPCC ground precipitation, the data have been retrieved separately and compared directly with the reference rain-gauge network data set of the study area.Results show that bias is still considerable for all satellite products, then some considerations about larger area climatology, PMW-retrieval algorithms, and GPCC data are discussed to address this issue, along with the spatial and seasonal characterization of results. © 2013 Elsevier B.V

Ge quantum dot arrays grown by ultrahigh vacuum molecular beam epitaxy on the Si(001) surface: nucleation, morphology and CMOS compatibility

Issues of morphology, nucleation and growth of Ge cluster arrays deposited by ultrahigh vacuum molecular beam epitaxy on the Si(001) surface are considered. Difference in nucleation of quantum dots during Ge deposition at low (<600 deg C) and high (>600 deg. C) temperatures is studied by high resolution scanning tunneling microscopy. The atomic models of growth of both species of Ge huts---pyramids and wedges---are proposed. The growth cycle of Ge QD arrays at low temperatures is explored. A problem of lowering of the array formation temperature is discussed with the focus on CMOS compatibility of the entire process; a special attention is paid upon approaches to reduction of treatment temperature during the Si(001) surface pre-growth cleaning, which is at once a key and the highest-temperature phase of the Ge/Si(001) quantum dot dense array formation process. The temperature of the Si clean surface preparation, the final high-temperature step of which is, as a rule, carried out directly in the MBE chamber just before the structure deposition, determines the compatibility of formation process of Ge-QD-array based devices with the CMOS manufacturing cycle. Silicon surface hydrogenation at the final stage of its wet chemical etching during the preliminary cleaning is proposed as a possible way of efficient reduction of the Si wafer pre-growth annealing temperature.Comment: 30 pages, 11 figure

"I'd been like freaking out the whole night": exploring emotion regulation based on junior doctors' narratives

This is the final version of the article. Available from the publisher via the DOI in this record.The importance of emotions within medical practice is well documented. Research suggests that how clinicians deal with negative emotions can affect clinical decision-making, health service delivery, clinician well-being, attentiveness to patient care and patient satisfaction. Previous research has identified the transition from student to junior doctor (intern) as a particularly challenging time. While many studies have highlighted the presence of emotions during this transition, how junior doctors manage emotions has rarely been considered. We conducted a secondary analysis of narrative data in which 34 junior doctors, within a few months of transitioning into practice, talked about situations for which they felt prepared or unprepared for practice (preparedness narratives) through audio diaries and interviews. We examined these data deductively (using Gross' theory of emotion regulation: ER) and inductively to answer the following research questions: (RQ1) what ER strategies do junior doctors describe in their preparedness narratives? and (RQ2) at what point in the clinical situation are these strategies narrated? We identified 406 personal incident narratives: 243 (60%) contained negative emotion, with 86 (21%) also containing ER. Overall, we identified 137 ER strategies, occurring prior to (n = 29, 21%), during (n = 74, 54%) and after (n = 34, 25%) the situation. Although Gross' theory captured many of the ER strategies used by junior doctors, we identify further ways in which this model can be adapted to fully capture the range of ER strategies participants employed. Further, from our analysis, we believe that raising medical students' awareness of how they can handle stressful situations might help smooth the transition to becoming a doctor and be important for later practice.We acknowledge the General Medical Council for their funding of this projec

Ranking hospitals based on preventable hospital death rates:a systematic review with implications for both direct measurement and indirect measurement through standardized mortality rates

Objectives There is interest in monitoring avoidable or preventable deaths measured directly or indirectly through standardized mortality rates (SMRs). We reviewed studies that use implicit case note reviews to estimate the range of preventable death rates observed, the measurement characteristics of those estimates, and the measurement procedures used to generate them. We comment on the implications for monitoring SMRs and illustrate a way to calculate the number of reviews needed to establish a reliable estimate of preventability of one death or the hospital preventable death rate. Design Systematic review of the literature supplemented by re-analysis of authors previously published and un-published data and measurement design calculations. Data source Searches in PubMed, MEDLINE (OvidSP) and Web of Knowledge in June 2012, updated December 2017. Eligibility criteria Studies of hospital-wide admissions from general and acute medical wards where preventable deaths rates are provided or can be estimate and which can provide inter- observer variations. Results Twenty-four studies were included from 1983-2017. Recent larger studies suggest consistently low rates of preventable deaths (3.0-6.5% since 2012). Reliability of a single review for distinguishing between individual cases with regard to the preventability of death had a Kappa rate of 0.27-0.50 for deaths and 0.24-0.76 for adverse events. A Kappa of 0.35 would require an average of 8-17 reviews of a single case to be precise enough to have confidence about high stakes decisions to change care procedures or impose sanctions within a hospital as a result. No study estimated the variation in preventable deaths across hospitals, although we were able to re-analyse one study to obtain an estimate. Based on this estimate, 200-300 total case-note reviews per hospital could be required to reliably distinguish between hospitals. The studies display considerable heterogeneity: 13/24 studies defined preventable with a threshold of ≥4 in a six-category Likert scale; 11/24 involved a two-stage screening process with nurses at the first stage and physicians at the second. Fifteen studies provided expert clinical review support for reviewer disagreements, advice, or quality control. A ‘generalist/internist’ was the modal physician specialty for reviewers and they received 1-3 days of generic tools orientation and case-note review practice. Methods did not consider the influence of human or environmental factors. Conclusions The literature provides limited information about the measurement characteristics of preventable deaths that suggests substantial numbers of reviews may be needed to create reliable estimates of preventable deaths at the individual or hospital level. Any operational program would require population specific estimates of reliability. Preventable death rates are low, which is likely to make it difficult to use SMRs based on all deaths to validly profile hospitals. The literature provides little information to guide improvements in the measurement procedures. Systematic review registration The systematic review was conceived prior to PROSPERO, and so has not been registered

CMOS-compatible dense arrays of Ge quantum dots on the Si(001) surface: hut cluster nucleation, atomic structure and array life cycle during UHV MBE growth

We report a direct observation of Ge hut nucleation on Si(001) during UHV molecular beam epitaxy at 360°C. Nuclei of pyramids and wedges were observed on the wetting layer (WL) (M × N) patches starting from the coverage of 5.1 Å and found to have different structures. Atomic models of nuclei of both hut species have been built as well as models of the growing clusters. The growth of huts of each species has been demonstrated to follow generic scenarios. The formation of the second atomic layer of a wedge results in rearrangement of its first layer. Its ridge structure does not repeat the nucleus. A pyramid grows without phase transitions. A structure of its vertex copies the nucleus. Transitions between hut species turned out to be impossible. The wedges contain point defects in the upper corners of the triangular faces and have preferential growth directions along the ridges. The derived structure of the {105} facet follows the paired dimer model. Further growth of hut arrays results in domination of wedges, and the density of pyramids exponentially drops. The second generation of huts arises at coverages >10 Å; new huts occupy the whole WL at coverages ~14 Å. Nanocrystalline Ge 2D layer begins forming at coverages >14 Å

Does audio-visual information result in improved health-related decision-making compared with audio-only or visual-only information? Protocol for a systematic review and meta-analysis

Introduction: Making health-related decisions can be difficult due to the amount and complexity of information available. Audio-visual information may improve memory for health information but whether audio-visual information can enhance health-related decisions has not been explored using quantitative methods. The objective of this systematic review is to understand how effective audio-visual information is for informing health-related decision-making compared with audio-only or visual-only information. Methods and analysis: Randomised controlled trials (RCTs) will be included if they include audio-visual and either audio-only or visual-only information provision and decision-making in a health setting. Studies will be excluded if they are not reported in English. Twelve databases will be searched including: Ovid MEDLINE, PubMed and PsychINFO. The Cochrane Risk of Bias tool (V.7) will be used to assess risk of bias in included RCTs. Results will be synthesised primarily using a meta-analysis; where quantitative data are not reported, a narrative synthesis will be used. Ethics and dissemination: No ethical issues are foreseen. Data will be disseminated via academic publication and conference presentations. Findings may also be published in scientific newsletters and magazines. This review is funded by the Economic and Social Research Council

Serious sports-related injury in England and Wales from 2012-2017: a study protocol

Background Physical activity is an important component of healthy lifestyles, with a central role in morbidity prevention. However, sporting and physical activity also involve an inherent injury risk. Some sports and activities have a higher injury risk, and may involve more severe injuries. Furthermore, injuries of a severe nature have substantial individual and societal consequences, including the burden of assessment, treatment, and potential on-going care costs. There are limited data on severe sports injury risk in England and Wales, and no national data describing risk across sports. The aims of this study are to identify the cases and incidence of: i) paediatric and ii) adult severe sports injury from 2012 to 2017; and to describe injury incidence in individual sports. Methods This study is an analysis of prospectively collected sport-related injuries, treated from January 2012 to December 2017. Incidents involving a severe injury (in-patient trauma care) in England and Wales, will be identified from the Trauma Audit Research Network registry. Data for patients who were: transfers or direct hospital admissions, with inpatient stays of ≥3 days, admissions to High Dependency areas, or in-hospital mortality after admission; and whose injury mechanism was sport, or incident description included one of 62 sporting activities, will be extracted. Data will be categorised by sport, and sports participation data will be derived from Sport England participation surveys. Descriptive statistics will be estimated for all demographic, incident, treatment and sport fields, and crude serious annual injury incidence proportions estimated. Poisson confidence intervals will be estimated for each sport and used to describe injury risk (incidence) across sporting activities. Discussion This study will be the first to describe the number of, and trends in severe sport-related injuries in England and Wales. These data are useful to monitor the number and burden of severe sports injury, and inform injury prevention efforts. The monitoring and mitigation of sports injury risk is essential for individuals, health services and policy, and to encourage physically active lifestyles and safer participation for adults and children

Impacts of selected Ecological Focus Area options in European farmed landscapes on climate regulation and pollination services: a systematic map protocol

Background: This systematic map protocol responds to an urgent policy need to evaluate key environmental benefits of new compulsory greening measures in the European Union’s Common Agricultural Policy (CAP), with the aim of building a policy better linked to environmental performance. The systematic map will focus on Ecological Focus Areas (EFAs), in which larger arable farmers must dedicate 5% of their arable land to ecologically beneficial habitats, landscape features and land uses. The European Commission’s Joint Research Centre has used a software tool called the ‘EFA calculator’ to inform the European Commission about environmental benefits of EFA implementation. However, there are gaps in the EFA calculator’s coverage of ecosystem services, especially ‘global climate regulation’, and an opportunity to use systematic mapping methods to enhance its capture of evidence, in advance of forthcoming CAP reforms. We describe a method for assembling a database of relevant, peer-reviewed research conducted in all agricultural landscapes in Europe and neighbouring countries with similar biogeography, addressing the primary question: what are the impacts of selected EFA features in agricultural land on two policy-relevant ecosystem service outcomes—global climate regulation and pollination? The method is streamlined to allow results in good time for the current, time-limited opportunity to influence reforms of the CAP greening measures at European and Member State level. Methods: We will search four bibliographic databases in English, using a predefined and tested search string that focuses on a subset of EFA options and ecosystem service outcomes. The options and outcomes are selected as those with particular policy relevance and traction. Only articles in English will be included. We will screen search results at title, abstract and full text levels, recording the number of studies deemed non-relevant (with reasons at full text). A systematic map database that displays the meta-data (i.e. descriptive summary information about settings and methods) of relevant studies will be produced following full text assessment. The systematic map database will be published as a MS-Excel database. The nature and extent of the evidence base will be discussed, and the applicability of methods to convert the available evidence into EFA calculator scores will be assessed

Keratoconus associated with choroidal neovascularization: a case report

<p>Abstract</p> <p>Introduction</p> <p>Keratoconus and choroidal neovascularization can occur as a result of dysfunction of the epithelium and its basement membrane.</p> <p>Case presentation</p> <p>A 17-year-old Asian man, who was diagnosed with myopic choroidal neovascularization in both eyes and who subsequently underwent intravitreal injection of ranibizumab (Lucentis^®) five times over six months, presented with further vision decrease and pain in his right eye. Examination showed corneal steepening and stromal edema in the inferocentral cornea of his right eye, both of which were indicative of advanced keratoconus with acute hydrops. Corneal topography also showed features consistent with keratoconus in his left eye. Fluorescein angiography and optical coherence tomography revealed choroidal neovascularization-associated subretinal hemorrhages and lacquer cracks in both eyes.</p> <p>Conclusion</p> <p>Keratoconus and choroidal neovascularization, possibly resulting from dysfunction of the epithelium and its basement membrane, can occur together in the same individual. This would suggest a possible connection in pathogenesis between these two conditions.</p