Revisiting the parameterization of potential evaporation as a driver of long-term water balance trends

We examine the effects of two different parameterizations of potential evaporation on long-term trends in soil moisture, evaporative flux and runoff simulated by the water balance model underlying the Palmer Drought Severity Index. The first, traditiona

Estimation of potential evapotranspiration from extraterrestrial radiation, air temperature and humidity to assess future climate change effects on the vegetation of the Northern Great Plains, USA

The potential evapotranspiration (PET) that would occur with unlimited plant access to water is a central driver of simulated plant growth in many ecological models. PET is influenced by solar and long wave radiation, temperature, wind speed, and humidity, but it is often modeled as a function of temperature alone. This approach can cause biases in projections of future climate impacts in part because it confounds the effects of warming due to increased greenhouse gases with that which would be caused by increased radiation from the sun. We developed an algorithm for linking PET to extraterrestrial solar radiation (incoming top-of atmosphere solar radiation), as well as temperature and atmospheric water vapor pressure, and incorporated this algorithm into the dynamic global vegetation model MC1. We tested the new algorithm for the Northern Great Plains, USA, whose remaining grasslands are threatened by continuing woody encroachment. Both the new and the standard temperature-dependent MC1 algorithm adequately simulated current PET, as compared to the more rigorous PenPan model of Rotstayn et al. (2006). However, compared to the standard algorithm, the new algorithm projected a much more gradual increase in PET over the 21st century for three contrasting future climates. This difference led to lower simulated drought effects and hence greater woody encroachment with the new algorithm, illustrating the importance of more rigorous calculations of PET in ecological models dealing with climate change

Estimation of potential evapotranspiration from extraterrestrial radiation, air temperature and humidity to assess future climate change effects on the vegetation of the Northern Great Plains, USA

The potential evapotranspiration (PET) that would occur with unlimited plant access to water is a central driver of simulated plant growth in many ecological models. PET is influenced by solar and long wave radiation, temperature, wind speed, and humidity, but it is often modeled as a function of temperature alone. This approach can cause biases in projections of future climate impacts in part because it confounds the effects of warming due to increased greenhouse gases with that which would be caused by increased radiation from the sun. We developed an algorithm for linking PET to extraterrestrial solar radiation (incoming top-of atmosphere solar radiation), as well as temperature and atmospheric water vapor pressure, and incorporated this algorithm into the dynamic global vegetation model MC1. We tested the new algorithm for the Northern Great Plains, USA, whose remaining grasslands are threatened by continuing woody encroachment. Both the new and the standard temperature-dependent MC1 algorithm adequately simulated current PET, as compared to the more rigorous PenPan model of Rotstayn et al. (2006). However, compared to the standard algorithm, the new algorithm projected a much more gradual increase in PET over the 21st century for three contrasting future climates. This difference led to lower simulated drought effects and hence greater woody encroachment with the new algorithm, illustrating the importance of more rigorous calculations of PET in ecological models dealing with climate change

Pre-print -In review for publication in Water Resources Research Trends in Regional Evapotranspiration across the United States under the Complementary Relationship Hypothesis

Abstract The hypothesis of a complementary relationship in regional evapotranspiration allows for estimation of actual evapotranspiration on a regional scale by simple, physically based models that take into account feedbacks in land surface-atmosphere dynamics. A regional, seasonal Advection-Aridity model is used to create a spatially distributed, monthly time-series of actual evapotranspiration for a period of 27 years at a 5-km resolution over the conterminous United States. For the conterminous United States as a whole, a 4.3% increase in annual actual evapotranspiration over the period WY 1962WY -1988 was observed, a trend that was significant at the 90% confidence level according to the Mann-Kendall test. Trends in annual evapotranspiration are analyzed across the spatial scales of the continental United States, a Water Resources Region (WRR), a river basin of 16,000 km 2 , and an individual 5-km square cell. Reducing the spatial scale allowed for clearer identification of areas with significant trends. To establish a base-line for the study of climate change and/or variability, a methodology for rigorous examination of past trends in actual evapotranspiration is proposed, wherein such trends are broken down into the climatic components of actual evapotranspiration in the context of the complementary relationship, and no assumptions are made about the temporal stationarity of the net available energy. Trends in actual evapotranspiration can thus be determined to originate in either the energy budget or the water budget, or both

Patient characteristics, treatment and survival in pulmonary carcinoid tumours: an analysis from the UK National Lung Cancer Audit

OBJECTIVES: Pulmonary carcinoid (PC) is a rare tumour with good prognosis following surgical resection. However, little is known regarding patient characteristics and use of other treatments modalities. Our objective was to review patient characteristics, treatment and survival for patients with PC and contrast these results with other forms of non-small cell lung cancer (NSCLC). SETTING: Audit data from UK National Lung Cancer Audit (NLCA) 2008–2013. PARTICIPANTS: 184 906 lung cancer cases were submitted to the NLCA. OUTCOME MEASURES: Primary outcome—survival rates between PC and NSCLC. Secondary outcome—differences in performance status, lung function and treatment modality between PC and NSCLC. RESULTS: PC histology was recorded in 1341 (0.73%) patients and non-carcinoid NSCLC histology in 162 959 (87.4%) cases. 91% of patients with PC had good performance status (Eastern Cooperative Oncology Group (ECOG) 0–1), compared with only 53% of NSCLC. 66% of PC had localised disease. Of all PC cases, 77% were treated with surgery, 6.2% received chemotherapy and 3.6% received radiotherapy, with the remainder treated with best supportive care. Overall 1-year and 3-year survival rates for PC were 92% and 84.7%, respectively. In contrast, 1-year and 3-year survival rates for NSCLC were 36.2% and 15.6%, However, 3-year survival for PC markedly decreased with worsening performance status and advanced disease to 23.8% for performance status ECOG 3–4 and 33.6% for stage IV disease. CONCLUSIONS: In contrast to other forms of NSCLC, the majority of patients with PC present with good performance status, preserved lung function and early stage disease amenable to surgical resection. However, 1 in 5 patients with PC has metastatic disease which is associated with poor prognosis, as is poor performance status at presentation. We believe these data will help clinicians provide accurate prognostic predictions stratified according to patient characteristics at presentation, as well as guide future clinical trials

Demand-side financing in the form of baby packages in Northern Mozambique : results from an observational study

The Maternal Mortality Ratio in Mozambique has stagnated at 405 deaths per 100,000 live births with virtually no progress over the last 15 years. Low Institutional Birth Rates (IBRs) levelling around 50% in many rural areas constitute one of the contributing reasons. Demand-side financing has successfully increased usage of maternal health services in other countries, but little information exists on in-kind incentives in rural Africa. The objective was to test the impact on Institutional Birth Rates of giving a USD 5.50 baby package incentive to every woman who came to give birth in a health centre in a rural, poor district of Cabo Delgado, Mozambique.; The intervention was implemented in one district in 2010 with the remaining 15 districts serving as controls. The total population in the 16 districts in 2006 was just under 1.5 million people. IBRs were observed from 2006 to 2013 (53 months before and 55 months after the intervention began). The non-intervention districts showed a slight increase, from a mean IBR of 0.39 (SD = 0.10) in 2006 to 0.67 (SD = 0.13) in 2014. The intervention district had a dramatic increase in IBRs within six months of the start of the intervention in 2010, which was sustained until the end of the study. Adjusting for the background increase and for confounders, including health facilities and health personnel per district, and taking clustering in districts into account, the estimated rate ratio of institutional births in the intervention district was 1.80 (95% CI 1.72, 1.89 p<0.001).; Women were almost twice as likely to have an institutional birth following the introduction of the baby package

Effect of the Friendship Bench Intervention on Antiretroviral Therapy Outcomes and Mental Health Symptoms in Rural Zimbabwe: A Cluster Randomized Trial.

IMPORTANCE Common mental disorders (CMD), which include depression and anxiety, are prevalent among people living with HIV and are associated with suboptimal antiretroviral therapy (ART) adherence. OBJECTIVE To assess the effect of a lay health worker-led psychological intervention on ART adherence, virologic suppression, and mental health symptoms. DESIGN, SETTING, AND PARTICIPANTS Open-label pragmatic cluster trial with 1:1 block randomization of 16 health facilities in rural Bikita, Zimbabwe. Recruitment occurred from October 2018 to December 2019, and participants were followed up for 12 months, ending in December 2020. Participants were adults aged 18 years and older, who spoke English or Shona, screened positive for CMD (Shona Symptoms Questionnaire [SSQ]-14 score ≥9), received first-line ART for 6 or more months, had no World Health Organization stage 4 disease, no psychosis, were not pregnant, and provided informed consent. Data were analyzed from March 2021 to February 2022. INTERVENTION The Friendship Bench, consisting of 6 lay health worker-led weekly problem-solving therapy sessions and optional peer-led group support. MAIN OUTCOMES AND MEASURES The primary outcome was mean adherence during 2 to 6 months of follow-up, and the secondary outcomes were mean adherence during 1 to 12 months of follow-up, change in SSQ-14 and Patient Health Questionnaire (PHQ-9) scores (3, 6, 9, and 12 months), and viral load suppression (6 and 12 months). RESULTS A total of 516 participants were recruited (244 in Friendship Bench and 272 in enhanced standard care facilities); 438 (84.9%) were female and the mean (SD) age was 45.6 (10.9) years. Mean (SD) adherence between 2 to 6 months was 89.9% (18.4%) in the Friendship Bench group and 87.2% (20.1%) in the control group. The intervention had no statistically significant effect on adherence between 2 to 6 months (unadjusted mean difference, 1.93 percentage points; 95% CI, -1.20 to 5.06 percentage points; P = .23), between months 1 to 12 (mean difference 0.79 percentage points; 95% CI, -2.14 to 3.71 percentage points; P = .60), or viral suppression. Declines in SSQ-14 scores from baseline to 3 months (difference, -1.65; 95% CI, -3.07 to -0.24), 6 months (difference, -1.57; 95% CI, -2.98 to -0.15), and 9 months (difference, -1.63; 95% CI, -3.05 to -0.22) were greater in the Friendship Bench than the standard care group (P < .05). There were no differences in the decline in the SSQ-14 scores from baseline to 12 months and in declines in PHQ-9 scores from baseline to 3, 6, 9, and 12 months. CONCLUSIONS AND RELEVANCE In this randomized trial of HIV-positive participants with CMD, the Friendship Bench intervention had no effect on adherence and viral suppression, possibly due to the absence of skill-based adherence training and a ceiling effect. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03704805

Estimation of potential evapotranspiration from extraterrestrial radiation, air temperature and humidity to assess future climate change effects on the vegetation of the Northern Great Plains, USA

The potential evapotranspiration (PET) that would occur with unlimited plant access to water is a central driver of simulated plant growth in many ecological models. PET is influenced by solar and longwave radiation, temperature, wind speed, and humidity, but it is often modeled as a function of temperature alone. This approach can cause biases in projections of future climate impacts in part because it confounds the effects of warming due to increased greenhouse gases with that which would be caused by increased radiation from the sun. We developed an algorithm for linking PET to extraterrestrial solar radiation (incoming top-of atmosphere solar radiation), as well as temperature and atmospheric water vapor pressure, and incorporated this algorithm into the dynamic global vegetation model MC1. We tested the new algorithm for the Northern Great Plains, USA, whose remaining grasslands are threatened by continuing woody encroachment. Both the new and the standard temperature-dependent MC1 algorithm adequately simulated current PET, as compared to the more rigorous PenPan model of Rotstayn et al. (2006). However, compared to the standard algorithm, the new algorithm projected a much more gradual increase in PET over the 21st century for three contrasting future climates. This difference led to lower simulated drought effects and hence greater woody encroachment with the new algorithm, illustrating the importance of more rigorous calculations of PET in ecological models dealing with climate change.Keywords: Potential evapotranspiration, Great Plains USA, Climate change, Vegetation dynamics, MC

Retention in care of HIV-infected pregnant and lactating women starting art under Option B+ in rural Mozambique.

OBJECTIVE In 2013, Mozambique adopted Option B+, universal lifelong antiretroviral therapy (ART) for all pregnant and lactating women, as national strategy for prevention of mother-to-child transmission of HIV. We analyzed retention in care of pregnant and lactating women starting Option B+ in rural northern Mozambique. METHODS We compared ART outcomes in pregnant ("B+pregnant"), lactating ("B+lactating") and non-pregnant-non-lactating women of childbearing age starting ART after clinical and/or immunological criteria ("own health") between July 2013 and June 2014. Lost to follow-up was defined as no contact >180 days after the last visit. Multivariable competing risk models were adjusted for type of facility (type 1 vs. peripheral type 2 health center), age, WHO stage and time from HIV diagnosis to ART. RESULTS Over 333 person-years of follow-up (of 243 "B+pregnant", 65″B+lactating" and 317 "own health" women), 3.7% of women died and 48.5% were lost to follow-up. "B+pregnant" and "B+lactating" women were more likely to be lost in the first year (57% vs. 56.9% vs. 31.6%; p<0.001) and to have no follow-up after the first visit (42.4% vs. 29.2% vs. 16.4%; p<0.001) than "own health" women. In adjusted analyses, risk of being lost to follow-up was higher in "B+pregnant" (adjusted subhazard ratio [asHR]: 2.77; 95% CI: 2.18-3.50; p<0.001) and "B+lactating" (asHR: 1.94; 95% CI: 1.37-2.74; p<0.001). Type 2 health center was the only additional significant risk factor for loss to follow-up. CONCLUSIONS Retaining pregnant and lactating women in option B+ ART was poor; losses to follow-up were mainly early. The success of Option B+ for prevention of mother-to-child transmission of HIV in rural settings with weak health systems will depend on specific improvements in counseling and retention measures, especially at the beginning of treatment. This article is protected by copyright. All rights reserved