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A higher-resolution version of the Max Planck Institute Earth System Model (MPI-ESM1.2-HR)
The MPI‐ESM1.2 is the latest version of the Max Planck Institute Earth System Model and is the baseline for the Coupled Model Intercomparison Project Phase 6 and current seasonal and decadal climate predictions. This paper evaluates a coupled higher‐resolution version (MPI‐ESM1.2‐HR) in comparison with its lower‐resolved version (MPI‐ESM1.2‐LR). We focus on basic oceanic and atmospheric mean states and selected modes of variability, the El Niño/Southern Oscillation and the North Atlantic Oscillation. The increase in atmospheric resolution in MPI‐ESM1.2‐HR reduces the biases of upper‐level zonal wind and atmospheric jet stream position in the northern extratropics. This results in a decrease of the storm track bias over the northern North Atlantic, for both winter and summer season. The blocking frequency over the European region is improved in summer, and North Atlantic Oscillation and related storm track variations improve in winter. Stable Atlantic meridional overturning circulations are found with magnitudes of ~16 Sv for MPI‐ESM1.2‐HR and ~20 Sv for MPI‐ESM1.2‐LR at 26°N. A strong sea surface temperature bias of ~5°C along with a too zonal North Atlantic current is present in both versions. The sea surface temperature bias in the eastern tropical Atlantic is reduced by ~1°C due to higher‐resolved orography in MPI‐ESM‐HR, and the region of the cold‐tongue bias is reduced in the tropical Pacific. MPI‐ESM1.2‐HR has a well‐balanced radiation budget and its climate sensitivity is explicitly tuned to 3 K. Although the obtained reductions in long‐standing biases are modest, the improvements in atmospheric dynamics make this model well suited for prediction and impact studies
Real-world Utilisation of the Rivastigmine Transdermal Patches Accompanying the Use of Risk Minimisation Tools in Patients with Dementia
BACKGROUND: Transdermal patches are convenient to use, especially in Rotkreuz ZG Rotkreuz ZG patients with Alzheimer's disease (AD)-associated dementia. However, various identified risks of errors in administering the patches cannot be disregarded. Patient Reminder Cards (PRCs, included a Medication record sheet [MRS]) have been recently introduced as a risk minimisation tool to prevent incorrect patch use (IU). OBJECTIVES: This study aimed to assess the effectiveness of PRCs to prevent IU and to investigate the dose titration pattern of rivastigmine patches in a real-world setting. METHODS: This multinational, observational, 11-month study included patients with AD currently using rivastigmine patches (4.6 mg/day, 9.5 mg/day, 13.3 mg/day) accompanied by a caregiver. Study outcomes were IU, including multiple patch use (MPU), incorrect patch placement, other IUs, perceived usefulness of the PRCs, and titration patterns of the patches. RESULTS: Of the total 614 patients included, most were aged ≥ 65 years and had mild-to-moderate AD. Before and during the study, 27.7% and 18.0% of patients reported IU, respectively. Most patients used MRS, and 73.5% rated it 'helpful' and reported lower rates of IU than those who reported it 'not helpful' (13.9%-16.5% vs. 20.2%). Overall, 141 patients had dose titrations, with 75.8% being up-titrated from 4.6 mg/day to 9.5 mg/day after a mean duration of 58 days. Safety findings were consistent with the established profile for the rivastigmine patch. CONCLUSION: PRC was effective as a risk minimisation tool in limiting the inappropriate use of rivastigmine patches. The majority of patients requiring dose-change were up-titrated to 9.5 mg/day patches. Copyright© Bentham Science Publishers; For any queries, please email at [email protected]