Criteri di valutazione delle banche dati bibliografiche elettroniche

Introduction: the need for valid and relevant information in clinical healthcare settings raises the problem of how to choose the best biomedical databases to subscribe to. Replicable standard criteria should be defined and should be easy to use and inexpensive. Health technology: electronic databases are useful tools to provide health professionals with good information regarding patients’ care, especially those resources that help support clinical decisions, and that are able to quickly identify documents pertinent to specific health problems. Material and method: the University Hospital “Santa Maria della Misericordia” di Udine has developed an evaluation tool to address the proliferation of proposals available on the market and evaluate potential costs and benefits of individual resources. This instrument is the result of the biomedical documentation service’s experience in the last several years. It consists of 23 questions about the quality of the information and technical-economic aspects of the database in question. The questionnaire’s answers are open or require a "yes" or "no". Results: the application of the instrument to a database results in an overview of the characteristics of each resource and the capacity to compare it with similar databases. Conclusion: the proposed evaluation method offers a quick, objective analysis of possible new purchases and also an indication to what tools are available to clinicians to find the desired information. This approach is part of the methodology of Health Technology Assessment (HTA) and draws attention to the strengths and weaknesses in bibliographic databases, especially in those that are used as clinical decision support system

A comprehensive analysis of coherent rainfall patterns in China and potential drivers. Part I: interannual variability

Interannual rainfall variability in China affects agriculture, infrastructure and water resource management. To improve its understanding and prediction, many studies have associated precipitation variability with particular causes for specific seasons and regions. Here, a consistent and objective method, Empirical Orthogonal Teleconnection (EOT) analysis, is applied to 1951–2007 high-resolution precipitation observations over China in all seasons. Instead of maximizing the explained space–time variance, the method identifies regions in China that best explain the temporal variability in domain-averaged rainfall. The EOT method is validated by the reproduction of known relationships to the El Niño Southern Oscillation (ENSO): high positive correlations with ENSO are found in eastern China in winter, along the Yangtze River in summer, and in southeast China during spring. New findings include that wintertime rainfall variability along the southeast coast is associated with anomalous convection over the tropical eastern Atlantic and communicated to China through a zonal wavenumber-three Rossby wave. Furthermore, spring rainfall variability in the Yangtze valley is related to upper-tropospheric midlatitude perturbations that are part of a Rossby wave pattern with its origin in the North Atlantic. A circumglobal wave pattern in the northern hemisphere is also associated with autumn precipitation variability in eastern areas. The analysis is objective, comprehensive, and produces timeseries that are tied to specific locations in China. This facilitates the interpretation of associated dynamical processes, is useful for understanding the regional hydrological cycle, and allows the results to serve as a benchmark for assessing general circulation models

Interannual rainfall variability over China in the MetUM GA6 and GC2 configurations

Six climate simulations of the Met Office Unified Model Global Atmosphere 6.0 and Global Coupled 2.0 configurations are evaluated against observations and reanalysis data for their ability to simulate the mean state and year-to-year variability of precipitation over China. To analyze the sensitivity to air-sea coupling and horizontal resolution, atmosphere-only and coupled integrations at atmospheric horizontal resolutions of N96, N216 and N512 (corresponding to ~200, 90, and 40 km in the zonal direction at the equator, respectively) are analyzed. The mean and interannual variance of seasonal precipitation are too high in all simulations over China, but improve with finer resolution and coupling. Empirical Orthogonal Teleconnection (EOT) analysis is applied to simulated and observed precipitation to identify spatial patterns of temporally coherent interannual variability in seasonal precipitation. To connect these patterns to large-scale atmospheric and coupled air-sea processes, atmospheric and oceanic fields are regressed onto the corresponding seasonal-mean timeseries. All simulations reproduce the observed leading pattern of interannual rainfall variability in winter, spring and autumn; the leading pattern in summer is present in all but one simulation. However, only in two simulations are the four leading patterns associated with the observed physical mechanisms. Coupled simulations capture more observed patterns of variability and associate more of them with the correct physical mechanism, compared to atmosphere-only simulations at the same resolution. However, finer resolution does not improve the fidelity of these patterns or their associated mechanisms. This shows that evaluating climate models by only geographical distribution of mean precipitation and its interannual variance is insufficient. The EOT analysis adds knowledge about coherent variability and associated mechanisms

Moisture sources for East Asian precipitation: mean seasonal cycle and interannual variability

This study investigates the moisture sources that supply East Asian (EA) precipitation and their interannual variability. Moisture sources are tracked using theWater Accounting Model-2layers (WAM-2layers), based on the Eulerian framework. WAM-2layers is applied to five subregions over EA, driven by the ERA-Interim reanalysis from 1979 to 2015. Due to differences in regional atmospheric circulation and in hydrological and topographic features, the mean moisture sources vary among EA subregions. The tropical oceanic source dominates southeastern EA, while the extratropical continental source dominates other EA subregions. The moisture sources experience large seasonal variations, due to the seasonal cycle of the EA monsoon, the freeze-thaw cycle of the Eurasian continent and local moisture recycling over the Tibetan Plateau. The interannual variability of moisture sources is linked to interannual modes of the coupled ocean-atmosphere system. The negative phase of the North Atlantic Oscillation increases moisture transport to northwestern EA in winter by driving a southward shift in the mid-latitude westerly jet over theMediterranean Sea, the Black Sea and the Caspian Sea. Atmospheric moisture lifetime is also reduced due to the enhanced westerlies. In summers following El Ni ˜nos, an anti-cyclonic anomaly over the western North Pacific increases moisture supplied from the South China Sea to the southeastern EA and shortens the travelling distance. A stronger Somali Jet in summer increases moisture to the Tibetan Plateau and therefore increases precipitation over the eastern Tibetan Plateau. The methods and findings in this study can be used to evaluate hydrological features in climate simulations

Effects of horizontal resolution and air-sea coupling on simulated moisture source for East Asian precipitation

Precipitation over East Asia in six MetUM simulations are compared with observation and ERA-Interim reanalysis. These simulations include three different horizontal resolutions, from low, medium to high, and including atmosphere-only version (GA6.0) and air-sea coupling version (GC2.0). Precipitations in simulations are systematically different from that of observation and reanalysis. Increasing horizontal resolution and including air-sea coupling improve simulated precipitation but cannot eliminate bias. % Moisture sources of East Asian precipitations are identified using the WAM-2layers - a moisture tracking model that traces moisture source using collective information of evaporation, atmospheric moisture and circulation. Similar to precipitation, moisture sources in simulations are systematically different from that of ERA-Interim. Major differences in moisture sources include underestimated moisture contribution from tropical Indian Ocean and overestimate contribution from Eurasian continent. % By increasing horizontal resolution, precipitation bias over the Tibetan Plateau is improved. From the moisture source point of view, this is achieved by reducing contribution from remote moisture source and enhancing local contribution over its eastern part. % Although including air-sea coupling does not necessarily change East Asian precipitation, moisture sources show differences between coupled and atmospheric-only simulations. These differences in moisture sources indicate different types of models biases caused by surface flux or/and atmospheric circulation on different locations. These information can be used to target model biases on specified locations and due to different mechanisms

A comprehensive analysis of coherent rainfall patterns in China and potential drivers. Part II: intraseasonal variability

The causes of subseasonal precipitation variability in China are investigated using observations and reanalysis data for extended winter (November–April) and summer (May–October) seasons from 1982 to 2007. For each season, the three dominant regions of coherent intraseasonal variability are identified with Empirical Orthogonal Teleconnection (EOT) analysis. While previous studies have focused on particular causes for precipitation variability or on specific regions, here a comprehensive analysis is carried out with an objective method. Furthermore, the associated rainfall anomaly timeseries are tied to specific locations in China, which facilitates their interpretation. To understand the underlying processes associated with spatially coherent patterns of rainfall variability, fields from observations and reanalysis are regressed onto EOT timeseries. The three dominant patterns in winter together explain 43% of the total space–time variance and have their origins in midlatitude disturbances that appear two pentads in advance. Winter precipitation variability along the Yangtze River is associated with wave trains originating over the Atlantic and northern Europe, while precipitation variability in southeast China is connected to the Mediterranean storm track. In summer, all patterns have a strong relationship with the Boreal Summer Intraseasonal Oscillation and are modulated by the seasonal cycle of the East Asian summer monsoon. The wet and dry phases of the regional patterns can substantially modulate the frequency of daily rainfall across China. The discovered links between weather patterns, precursors, and effects on local and remote precipitation may provide a valuable basis for hydrological risk assessments and the evaluation of numerical weather prediction models

The contributions of local and remote atmospheric moisture fluxes to East Asian precipitation and its variability

We investigate the contribution of the local and remote atmospheric moisture fluxes to East Asia (EA) precipitation and its interannual variability during 1979-2012. We use and expand the \citet{Brubaker_etal_JC_1993} method, which connects the area-mean precipitation to area-mean evaporation and the horizontal moisture flux into the region. Due to its large landmass and hydrological heterogeneity, EA is divided into five sub-regions: Southeast (SE), Tibetan Plateau (TP), Central East (CE), Northwest (NW) and Northeast (NE). For each region, we first separate the contributions to precipitation of local evaporation from those of the horizontal moisture flux by calculating the precipitation recycling ratio: the fraction of precipitation over a region that originates as evaporation from the same region. Then, we separate the horizontal moisture flux across the region's boundaries by direction. We estimate the contributions of the horizontal moisture fluxes from each direction, as well as the local evaporation, to the mean precipitation and its interannual variability. We find that the major contributors to the mean precipitation are not necessarily those that contribute most to the precipitation interannual variability. Over SE, the moisture flux via the southern boundary dominates the mean precipitation and its interannual variability. Over TP, in winter and spring, the moisture flux via the western boundary dominates the mean precipitation; however, variations in local evaporation dominate the precipitation interannual variability. The western moisture flux is the dominant contributor to the mean precipitation over CE, NW and NE. However, the southern or northern moisture flux or the local evaporation dominates the precipitation interannual variability over these regions, depending on the season. Potential mechanisms associated with interannual variability in the moisture flux are identified for each region. The methods and results presented in this study can be readily applied to model simulations, to identify simulation biases in precipitation that relate to the simulated moisture supplies and transport

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Earth Virtualization Engines (EVE)

To manage Earth in the Anthropocene, new tools, new institutions, and new forms of international cooperation will be required. Earth Virtualization Engines is proposed as an international federation of centers of excellence to empower all people to respond to the immense and urgent challenges posed by climate change