999 research outputs found

    Comparing the impact of environmental conditions and microphysics on the forecast uncertainty of deep convective clouds and hail

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    Severe hailstorms have the potential to damage buildings and crops. However, important processes for the prediction of hailstorms are insufficiently represented in operational weather forecast models. Therefore, our goal is to identify model input parameters describing environmental conditions and cloud microphysics, such as the vertical wind shear and strength of ice multiplication, which lead to large uncertainties in the prediction of deep convective clouds and precipitation. We conduct a comprehensive sensitivity analysis simulating deep convective clouds in an idealized setup of a cloud-resolving model. We use statistical emulation and variance-based sensitivity analysis to enable a Monte Carlo sampling of the model outputs across the multi-dimensional parameter space. The results show that the model dynamical and microphysical properties are sensitive to both the environmental and microphysical uncertainties in the model. The microphysical parameters lead to larger uncertainties in the output of integrated hydrometeor mass contents and precipitation variables. In particular, the uncertainty in the fall velocities of graupel and hail account for more than 65 % of the variance of all considered precipitation variables and for 30 %–90 % of the variance of the integrated hydrometeor mass contents. In contrast, variations in the environmental parameters – the range of which is limited to represent model uncertainty – mainly affect the vertical profiles of the diabatic heating rates

    Constraining stochastic 3-D structural geological models with topology information using Approximate Bayesian Computation in GemPy 2.1

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    Acknowledgements. We would like to thank Total E&P UK in Aberdeen for funding this research. We also thank Fabian Stamm for providing the wonderful synthetic geomodel used in this paper. We are grateful for the constructive reviews from Ashton Krajnovich and an anonymous reviewer for helping us improve this manuscript.Peer reviewedPublisher PD

    Manganese containing copper aluminate catalysts:Genesis of structures and active sites for hydrogenation of aldehydes

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    Copper aluminate spinel (CuO.CuAl2O4) is the favoured Cr-free substitute for the copper chromite catalyst (CuO.CuCr2O4) in the industrial hydrogenation of aldehydes. New insights in the catalytic mechanism were obtained by systematically studying the structure and activity of these catalysts including effects of manganese as a catalyst component. The hydrogenation of butyraldehyde to butanol was studied as a model reaction and the active structure was characterised using X-ray diffraction, temperature programmed reduction, N2O chemisorption, EXAFS and XANES, including in-situ investigations. The active catalyst is a reduced spinel lattice that is stabilised by protons, with copper metal nanoparticles grown upon its surface. Incorporation of Mn into the spinel lattice has a profound effect on the spinel structure. Mn stabilises the spinel towards reduction of CuII to Cu0 by occupation of tetrahedral sites with Mn cations, but also causes decreased catalytic activity. Structural data, combined with the effect on catalysis, indicate a predominantly interface-based reaction mechanism, involving both the spinel and copper nanoparticle surface in protonation and reduction of the aldehyde. The electron reservoir of the metallic copper particles is regenerated by the dissociative adsorption and oxidation of H2 on the metal surface. The generated protons are stored in the spinel phase, acting as proton reservoir. Cu(I) species located within the spinel and identified by XANES are probably not involved in the catalytic cycle

    Emergency calls and need for emergency care in patients looked after by a palliative care team: Retrospective interview study with bereaved relatives

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    <p>Abstract</p> <p>Background</p> <p>During the last stage of life, palliative care patients often experience episodes of respiratory distress, bleeding, pain or seizures. In such situations, caregivers may call emergency medical services leading to unwanted hospital admissions. The study aims to show the influence of our palliative care team to reducing emergency calls by cancer patients or their relatives during the last six month of life.</p> <p>Methods</p> <p>Fifty relatives of deceased patients who had been attended by our palliative care team were randomly selected. Data was obtained retrospectively during a structured interview. In addition to demographic data, the number of emergency calls made during the final six months of the patient's life, the reason for the call and the mental compound score (MCS-12) of the caregivers was registered.</p> <p>Results</p> <p>Forty-six relatives agreed to the interview. Emergency calls were placed for 18 patients (39%) during the final six months of their lives. There were a total of 23 emergency calls. In 16 cases (70%) the patient was admitted to the hospital. Twenty-one (91%) of the calls were made before patients had been enrolled to receive palliative care from the team, and two (9%) were made afterwards. The mean mental compound score of the caregivers at the time of the interview was 41 (range 28–57). There was a lack of correlation between MCS-12 and number of emergency calls.</p> <p>Conclusion</p> <p>Emergency calls were more likely to occur if the patients were not being attended by our palliative care team. Because of the lack of correlation between MCS-12 and the number of emergency calls, the MCS-12 cannot indicate that acutely stressful situations triggered the calls. However, we conclude that special palliative care programs can reduce psychosocial strain in family caregivers. Therefore, the number of emergency calls may be reduced and this fact allows more palliative patients to die at home.</p

    The rainbow cohort: 96 week follow-up of saquinavir-containing regimens in previously antiretroviral therapy (ART)-naïve and pre-treated but protease inhibitor (PI)- naïve hiv-infected patients

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    <p>Abstract</p> <p>Objective</p> <p>We have previously reported data from the German cohort of the multinational observational prospective RAINBOW survey which assessed the tolerability and efficacy of ritonavir-boosted saquinavir (SQV/r)-containing regimens over 48 weeks in routine clinical practice. This analysis presents data from antiretroviral (ART)-naïve and pretreated but protease inhibitor (PI)-naïve patients treated in a long-term one line (96 weeks) follow-up of the initial study.</p> <p>Methods</p> <p>All ART-and PI-naïve patients from the initial RAINBOW cohort who had recorded data to one line 96 weeks of treatment were eligible for inclusion in the current analysis. Efficacy assessments included the proportion of patients with HIV-1 RNA < 50 and < 400 copies/mL and changes in CD4 cell count from baseline to week 96. Tolerability assessments included changes in liver enzymes and lipid levels from baseline to week 96. For evaluation of efficacy, intent-to-treat analysis, in which missing values were recorded as failure (ITT), and last-observation-carried-forward (LOCF) analysis were used. Metabolic parameters were assessed using LOCF analysis.</p> <p>Results</p> <p>The analysis included 175 ART-naïve and 109 pretreated but PI-naïve patients. After 96 weeks, a similar proportion of patients in the ART-naïve and in the pretreated but Pi-naïve group had HIV-1 RNA levels < 400 copies/mL (68.0% and 70.6% [ITT], respectively; 96.6% and 90.8% [LOCF], respectively). The proportion of patients with HIV RNA < 50 copies/mL was higher in the ART-naïve group compared with the pretreated but PI-naïve group (61.1% and 56.9% [ITT], respectively; 84.0% and 75.2% [LOCF], respectively). Median change in CD4 cell count from baseline to week 96 was'+263 cells/mm<sup>3 </sup>(IQR 170; 384. LOCF; p < 0.0001) in the ART-naïve group, and one line +181 cells/mm<sup>3 </sup>(IQR 60; 309. LOCF; p < 0.0001) in the pretreated but PI-naïve group. Treatment was well tolerated, with only 2.5% of patients withdrawing from treatment due to side effects. There were no clinically relevant changes in liver enzyme levels. Overall total cholesterol, triglyceride, and low-and high-density lipoprotein levels increased to week 96, although levels remained within normal ranges in the majority of ART-naïve and pretreated patients.</p> <p>Conclusions</p> <p>This follow-up analysis confirms the long term efficacy and tolerability of SQV/r in ART-naïve and pretreated but PI-naïve patients in the real-life clinical setting.</p

    The ACS Nearby Galaxy Survey Treasury VII. The NGC 4214 Starburst and the Effects of Star Formation History on Dwarf Morphology

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    We present deep Hubble Space Telescope Wide Field Planetary Camera 2 (WFPC2) optical observations obtained as part of the ACS Nearby Galaxy Survey Treasury (ANGST) as well as early release Wide Field Camera 3 (WFC3) ultra-violet and infrared observations of the nearby dwarf starbursting galaxy NGC 4214. Our data provide a detailed example of how covering such a broad range in wavelength provides a powerful tool for constraining the physical properties of stellar populations. The deepest data reach the ancient red clump at M_F814W -0.2. All of the optical data reach the main sequence turnoff for stars younger than ~300 Myr, and the blue He burning sequence for stars younger than 500 Myr. The full CMD-fitting analysis shows that all three fields in our data set are consistent with ~75% of the stellar mass being older than 8 Gyr, in spite of showing a wide range in star formation rates at the present day. Thus, our results suggest that the scale length of NGC 4214 has remained relatively constant for many Gyr. As previously noted by others, we also find the galaxy has recently ramped up production, consistent with its bright UV luminosity and its population of UV-bright massive stars. In the central field we find UV point sources with F336W magnitudes as bright as -9.9. These are as bright as stars with masses of at least 52-56 M_sun and ages near 4 Myr in stellar evolution models. Assuming a standard IMF, our CMD is well-fitted by an increase in star formation rate beginning 100 Myr ago. The stellar populations of this late-type dwarf are compared with those of NGC 404, an early-type dwarf that is also the most massive galaxy in its local environment. The late-type dwarf appears to have a similar high fraction of ancient stars, suggesting that these dominant galaxies may form at early epochs even if they have low total mass and very different present-day morphologies.Comment: 17 pages, 10 figures, accepted for publication in Ap

    Delphi survey on conventional conservative treatment of functional posterior shoulder instability

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    Background: Posterior shoulder instability is caused by structural or functional defects. While the former are mostly treated surgically, physiotherapy is considered the treatment of choice in functional shoulder instability. However, it often has limited success unless very specific and intensive training programs are applied by trained experts. Currently, there is no consensus on the treatment of functional posterior shoulder instability. Objective: To improve treatment of this pathology, a&nbsp;standardized treatment recommendation is required to serve as a&nbsp;guideline for physiotherapy. The aim of this study was to establish expert consensus for treatment recommendations for functional posterior shoulder instability. Design: The Delphi survey technique was employed. Methods: A&nbsp;standardized training program for treatment of functional posterior shoulder instability was developed by a&nbsp;local expert committee. Two rounds of an online Delphi survey were then conducted. The panel of the Delphi survey comprised nine leading scientific experts in the field of functional shoulder instability who treat patients with shoulder-related problems conservatively and operatively. Results: The response rate was 100% and there were no dropouts. The final program consists of three groups of exercises with increasing difficulty. The exercises are mostly easy to perform and focus on the scapula-retracting muscles and the muscles responsible for external rotation of the shoulder. The treatment program should be executed under the supervision of a&nbsp;therapist at the beginning and later may be performed by the patients themselves. Conclusion: Consensus on a&nbsp;new exercise guideline dedicated to the treatment of functional posterior shoulder instability was achieved. This guideline should not only help to treat this challenging pathology but also provide a&nbsp;starting point for further scientific research and ongoing improvement

    Safety and efficacy after switch to a saquinavir-containing antiretroviral regimen in protease inhibitor pretreated HIV-positive patients

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    <p>Abstract</p> <p>Objective</p> <p>The RAINBOW survey is a multinational observational study assessing the tolerability and efficacy of ritonavir-boosted saquinavir (SQV/r), using the 500 mg film-coated SQV formulation, in routine clinical practice. This analysis presents data from the German subgroup of protease inhibitor (PI)-pretreated, but SQV-naïve patients.</p> <p>Methods</p> <p>Multicenter, prospective, open-label, 48 week cohort study. Efficacy assessments included the proportion of patients with HIV-1 RNA < 50 and < 400 copies/mL and changes in CD4 cell count from baseline to week 48. Tolerability assessments included changes in liver enzymes and lipid levels from baseline to week 48.</p> <p>Results</p> <p>A total of 426 patients were included in the analysis. The proportion of patients with HIV RNA levels < 50 copies/mL at week 48 was 60.3% (compared with 31.7% at switch to SQV/r) (intent-to-treat, last observation carried forward analysis). After 48 weeks, median CD4 count increased by +61 cells/mm<sup>3 </sup>from baseline (p < 0.01) and 60.3% of patients achieved HIV-1 RNA < 50 copies/mL. Median changes in fasting triglyceride levels (stratified according to baseline level) at week 48 were: +14 mg/dL (IQR -8; 57) for patients with baseline triglyceride < 200 mg/dL; -50 mg/dL (IQR -139; 0) for baseline triglyceride 200-750 mg/dL, and -656 mg/dL (IQR 1024; 0) for baseline triglyceride > 750 mg/dL (p < 0.01 for all). Median changes in fasting total cholesterol (TC) levels (stratified according to baseline) were +16 mg/dL (IQR -3; 43) for patients with baseline TC < 200 mg/dL (p < 0.01), -3 mg/dL (IQR -25; 25) for baseline TC 200-300 mg/dL (p = 0.4), and -47 mg/dL (IQR -87; -4) for baseline TC > 300 mg/dL (p < 0.01). No significant changes in liver enzymes or bilirubin were observed. SQV treatment was discontinued in 22% of patients, 6% due to side effects.</p> <p>Conclusions</p> <p>These data confirm the efficacy and tolerability of SQV/r in PI-experienced, SQV-naïve patients treated in a real-life clinical setting. Of particular relevance are the improvements in triglycerides and TC levels observed in patients with baseline grade III-IV elevations.</p
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