Report on the 2-D Model Intercomparison Workshop held January 11-16, 1987 in Fort Myers Beach, Florida, chapter 2

In the attempts to understand the processes which affect ozone in the stratosphere, and to predict future ozone levels, a variety of computer models were developed and employed. To oversimplify somewhat, the models range from 1-D models with intricately detailed photochemistry but only the crudest representation of transport, to 3-D general circulation models with intricately detailed dynamics and no photochemistry at all. Each of these has its appropriate uses. It was felt that there was much to be gained from intermediate models incorporating an extensive treatment of photochemistry with a dynamical framework which at least recognizes that atmospheric motions are advective as well as diffusive, and that both chemistry and dynamics are subject to latitudinal and seasonal variations. Thus the 2-D, zonally averaged models have begun to play a larger role in the last seven years, both in attempting to understand observed distributions of trace species and in attempting to assess the probable effects of antropogenic perturbations. There are many choices to be made in developing the model. It was the purpose of the 2-D model Intercomparison Workshop to permit discussion of the choices made and the behavior of the resulting models. The goal was not to identify a best set of choices, but rather to identify areas in which the models are sensitive to the choices made, and to develop a sense of where these models as a class do well or poorly in simulating the observed atmosphere

Stratosphere chemistry in a 2-D model with residual circulation

The objective of this research was to examine the effects of chemical perturbations on the stratosphere using models which can incorporate fully interactive radiative, chemical, and dynamical responses, in the context of a zonally averaged model. Model runs for the unperturbed, chlorine-perturbed and simultaneously chlorine-and CO2-perturbed cases were completed using the JPL-87 chemical kinetics data. The base case was analyzed and submitted for publication. The perturbed cases show substantial sensitivity of the predicted column ozone depletion to the perturbations affecting lower stratosphere temperature, but less to far dynamical perturbations. The column ozone distribution changed substantially when the kinetics data was changed. This implies a greater-than-expected uncertainty in predicted latitude distributions of ozone depletion, due to uncertainty about the accuracy and completeness of the chemical kinetics data set

Fast two-dimensional model

A two dimensional (altitude and latitude) model of the atmosphere is used to investigate problems relating to the variability of the dynamics and temperature of the atmosphere on the ozone distribution, solar cycle variations of atmospheric constituents, the sensitivity of model results to tropospheric trace gas sources, and assessment computations of changes in ozone related to manmade influences. In a comparison between two dimensional model results in which the odd nitrogen family was transported together and model results in which the odd nitrogen species was transported separately, it was found that the family approximations are adequate for perturbation scenario calculations

Report of the 1988 2-D Intercomparison Workshop, chapter 3

Several factors contribute to the errors encountered. With the exception of the line-by-line model, all of the models employ simplifying assumptions that place fundamental limits on their accuracy and range of validity. For example, all 2-D modeling groups use the diffusivity factor approximation. This approximation produces little error in tropospheric H2O and CO2 cooling rates, but can produce significant errors in CO2 and O3 cooling rates at the stratopause. All models suffer from fundamental uncertainties in shapes and strengths of spectral lines. Thermal flux algorithms being used in 2-D tracer tranport models produce cooling rates that differ by as much as 40 percent for the same input model atmosphere. Disagreements of this magnitude are important since the thermal cooling rates must be subtracted from the almost-equal solar heating rates to derive the net radiative heating rates and the 2-D model diabatic circulation. For much of the annual cycle, the net radiative heating rates are comparable in magnitude to the cooling rate differences described. Many of the models underestimate the cooling rates in the middle and lower stratosphere. The consequences of these errors for the net heating rates and the diabatic circulation will depend on their meridional structure, which was not tested here. Other models underestimate the cooling near 1 mbar. Suchs errors pose potential problems for future interactive ozone assessment studies, since they could produce artificially-high temperatures and increased O3 destruction at these levels. These concerns suggest that a great deal of work is needed to improve the performance of thermal cooling rate algorithms used in the 2-D tracer transport models

The removal of thermally aged films of triacylglycerides by surfactant solutions

Thermal ageing of triacylglycerides (TAG) at high temperatures produces films which resist removal using aqueous surfactant solutions. We used a mass loss method to investigate the removal of thermally aged TAG films from hard surfaces using aqueous solutions of surfactants of different charge types. It was found that cationic surfactants are most effective at high pH, whereas anionics are most effective at low pH and a non-ionic surfactant is most effective at intermediate pH. We showed that the TAG film removal process occurs in several stages. In the first ‘‘lag phase’’ no TAG removal occurs; the surfactant first partitions into the thermally aged film. In the second stage, the TAG film containing surfactant was removed by solubilisation into micelles in the aqueous solution. The effects of pH and surfactant charge on the TAG removal process correlate with the effects of these variables on the extent of surfactant partitioning to the TAG film and on the maximum extent of TAG solubilisation within the micelles. Additionally, we showed how the TAG removal is enhanced by the addition of amphiphilic additives such as alcohols which act as co-surfactants. The study demonstrates that aqueous surfactant solutions provide a viable and more benign alternative to current methods for the removal of thermally aged TAG films

Kentucky UST Field Manual

This study was undertaken to address the removal and closure of defective petroleum underground storage tanks in Kentucky. Goals for the study included: To address standards for levels of contamination requiring corrective action consistent with accepted scientific and technical principles. To recommend a matrix or scoring system to be used for (a) ranking sites as to actual or potential harm to human health and the environment caused by release of petroleum from a petroleum storage tank, and (2) establishing standards and procedures for corrective action that shall adequately protect human health and the environment. To address all compounds individually and collectively known as petroleum. To produce a report that shall be scientifically defensible

Use of the Behavior Assessment Tool in 18 Pilot Residency Programs

Background: The purpose of this study was to determine the feasibility and evaluate the effectiveness of the American Board of Orthopaedic Surgery Behavior Tool (ABOSBT) for measuring professionalism. Methods: Through collaboration between the American Board of Orthopaedic Surgery and American Orthopaedic Association\u27s Council of Residency Directors, 18 residency programs piloted the use of the ABOSBT. Residents requested assessments from faculty at the end of their clinical rotations, and a 360° request was performed near the end of the academic year. Program Directors (PDs) rated individual resident professionalism (based on historical observation) at the outset of the study, for comparison to the ABOSBT results. Results: Nine thousand eight hundred ninety-two evaluations were completed using the ABOSBT for 449 different residents by 1,012 evaluators. 97.6% of all evaluations were scored level 4 or 5 (high levels of professional behavior) across all of the 5 domains. In total, 2.4% of all evaluations scored level 3 or below reflecting poorer performance. Of 431 residents, the ABOSBT identified 26 of 32 residents who were low performers (2 or more \u3c level 3 scores in a domain) and who also scored below expectations by the PD at the start of the pilot project (81% sensitivity and 57% specificity), including 13 of these residents scoring poorly in all 5 domains. Evaluators found the ABOSBT was easy to use (96%) and that it was an effective tool to assess resident professional behavior (81%). Conclusions: The ABOSBT was able to identify 2.4% low score evaluations ( Level of Evidence: Level II

Does a local financial incentive scheme reduce inequalities in the delivery of clinical care in a socially deprived community? A longitudinal data analysis.

BACKGROUND: Socioeconomic deprivation is associated with inequalities in health care and outcomes. Despite concerns that the Quality and Outcomes Framework pay-for-performance scheme in the UK would exacerbate inequalities in primary care delivery, gaps closed over time. Local schemes were promoted as a means of improving clinical engagement by addressing local health priorities. We evaluated equity in achievement of target indicators and practice income for one local scheme. METHODS: We undertook a longitudinal survey over four years of routinely recorded clinical data for all 83 primary care practices. Sixteen indicators were developed that covered five local clinical and public health priorities: weight management; alcohol consumption; learning disabilities; osteoporosis; and chlamydia screening. Clinical indicators were logit transformed from a percentage achievement scale and modelled allowing for clustering of repeated measures within practices. This enabled our study of target achievements over time with respect to deprivation. Practice income was also explored. RESULTS: Higher practice deprivation was associated with poorer performance for five indicators: alcohol use registration (OR 0.97; 95 % confidence interval 0.96,0.99); recorded chlamydia test result (OR 0.97; 0.94,0.99); osteoporosis registration (OR 0.98; 0.97,0.99); registration of repeat prednisolone prescription (OR 0.98; 0.96,0.99); and prednisolone registration with record of dual energy X-ray absorptiometry (DEXA) scan/referral (OR 0.92; 0.86,0.97); practices in deprived areas performed better for one indicator (registration of osteoporotic fragility fracture (OR 1.26; 1.04,1.51). The deprivation-achievement gap widened for one indicator (registered females aged 65-74 with a fracture referred for a DEXA scan; OR 0.97; 0.95,0.99). Two other indicators indicated a similar trend over two years before being withdrawn (registration of fragility fracture and over-75 s with a fragility fracture assessed and treated for osteoporosis risk). For one indicator the deprivation-achievement gap reduced over time (repeat prednisolone prescription (OR 1.01; 1.01,1.01). Larger practices and those serving more affluent areas earned more income per patient than smaller practices and those serving more deprived areas (t = -3.99; p =0.0001). CONCLUSIONS: Any gaps in achievement between practices were modest but mostly sustained or widened over the duration of the scheme. Given that financial rewards may not reflect the amount of work undertaken by practices serving more deprived patients, future pay-for-performance schemes also need to address fairness of rewards in relation to workload

Effect on life expectancy of temporal sequence in a multimorbidity cluster of psychosis, diabetes, and congestive heart failure among 1·7 million individuals in Wales with 20-year follow-up : a retrospective cohort study using linked data

Funding: This work was supported by Health Data Research UK (HDRUK) Measuring and Understanding Multimorbidity using Routine Data in the UK (MUrMuRUK; award numbers HDR-9006 and CFC0110). HDRUK is funded by the UK Medical Research Council (MRC), Engineering and Physical Sciences Research Council, Economic and Social Research Council, NIHR (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust. This work also was co-funded by the MRC and NIHR (grant number MR/S027750/1). The work was supported by the Administrative Data Research (ADR) Wales programme of work, part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). RKO is supported by a Springboard award (SBF006\1122) funded by the Academy of Medical Sciences, Wellcome Trust, Government Department of Business, Energy and Industrial Strategy, British Heart Foundation, and Diabetes UK. SS is part funded by the NIHR Applied Research Collaboration West Midlands, the NIHR Health Protection Research Unit (HPRU) in Gastrointestinal Infections, and the NIHR HPRU in Genomics and Enabling Data.Background To inform targeted public health strategies, it is crucial to understand how coexisting diseases develop over time and their associated impacts on patient outcomes and health-care resources. This study aimed to examine how psychosis, diabetes, and congestive heart failure, in a cluster of physical–mental health multimorbidity, develop and coexist over time, and to assess the associated effects of different temporal sequences of these diseases on life expectancy in Wales. Methods In this retrospective cohort study, we used population-scale, individual-level, anonymised, linked, demographic, administrative, and electronic health record data from the Wales Multimorbidity e-Cohort. We included data on all individuals aged 25 years and older who were living in Wales on Jan 1, 2000 (the start of follow-up), with follow-up continuing until Dec 31, 2019, first break in Welsh residency, or death. Multistate models were applied to these data to model trajectories of disease in multimorbidity and their associated effect on all-cause mortality, accounting for competing risks. Life expectancy was calculated as the restricted mean survival time (bound by the maximum follow-up of 20 years) for each of the transitions from the health states to death. Cox regression models were used to estimate baseline hazards for transitions between health states, adjusted for sex, age, and area-level deprivation (Welsh Index of Multiple Deprivation [WIMD] quintile). Findings Our analyses included data for 1 675 585 individuals (811 393 [48·4%] men and 864 192 [51·6%] women) with a median age of 51·0 years (IQR 37·0–65·0) at cohort entry. The order of disease acquisition in cases of multimorbidity had an important and complex association with patient life expectancy. Individuals who developed diabetes, psychosis, and congestive heart failure, in that order (DPC), had reduced life expectancy compared with people who developed the same three conditions in a different order: for a 50-year-old man in the third quintile of the WIMD (on which we based our main analyses to allow comparability), DPC was associated with a loss in life expectancy of 13·23 years (SD 0·80) compared with the general otherwise healthy or otherwise diseased population. Congestive heart failure as a single condition was associated with mean a loss in life expectancy of 12·38 years (0·00), and with a loss of 12·95 years (0·06) when preceded by psychosis and 13·45 years (0·13) when followed by psychosis. Findings were robust in people of older ages, more deprived populations, and women, except that the trajectory of psychosis, congestive heart failure, and diabetes was associated with higher mortality in women than men. Within 5 years of an initial diagnosis of diabetes, the risk of developing psychosis or congestive heart failure, or both, was increased. Interpretation The order in which individuals develop psychosis, diabetes, and congestive heart failure as combinations of conditions can substantially affect life expectancy. Multistate models offer a flexible framework to assess temporal sequences of diseases and allow identification of periods of increased risk of developing subsequent conditions and death.Publisher PDFPeer reviewe

Microcalorimetry and spectroscopic studies on the binding of dye janus green blue to deoxyribonucleic acid

The interaction of the phenazinium dye janus green blue (JGB) with deoxyribonucleic acid was investigated using isothermal titration calorimetry and thermal melting experiments. The calorimetric data were supplemented by spectroscopic studies. Calorimetry results suggested the binding affinity of the dye to DNA to be of the order of 105 M-1. The binding was predominantly entropy driven with a small negative favorable enthalpy contribution to the standard molar Gibbs energy change.The binding became weaker as the temperature and salt concentration was raised. The temperature dependence of the standard molar enthalpy changes yielded negative values of standard molar heat capacity change for the complexation revealing substantial hydrophobic contribution in the DNA binding. An enthalpy–entropy compensation behavior was also observed in the system. The salt dependence of the binding yielded the release of 0.69 number of cations on binding of each dye molecule. The non-polyelectrolytic contribution was found to be the predominant force in the binding interaction. Thermal melting studies revealed that the DNA helix was stabilized against denaturation by the dye. The binding was also characterized by absorbance, resonance light scattering and circular dichroism spectral measurements. The binding constants from the spectral results were close to those obtained from the calorimetric data. The energetic aspects of the interaction of the dye JGB to double stranded DNA are supported by strong binding revealed from the spectral data