This study is an extensive revision of the Climatic Research Unit (CRU) land station temperature database that has been used to produce a grid‐box data set of 5° latitude × 5° longitude temperature ...anomalies. The new database (CRUTEM4) comprises 5583 station records of which 4842 have enough data for the 1961–1990 period to calculate or estimate the average temperatures for this period. Many station records have had their data replaced by newly homogenized series that have been produced by a number of studies, particularly from National Meteorological Services (NMSs). Hemispheric temperature averages for land areas developed with the new CRUTEM4 data set differ slightly from their CRUTEM3 equivalent. The inclusion of much additional data from the Arctic (particularly the Russian Arctic) has led to estimates for the Northern Hemisphere (NH) being warmer by about 0.1°C for the years since 2001. The NH/Southern Hemisphere (SH) warms by 1.12°C/0.84°C over the period 1901–2010. The robustness of the hemispheric averages is assessed by producing five different analyses, each including a different subset of 20% of the station time series and by omitting some large countries. CRUTEM4 is also compared with hemispheric averages produced by reanalyses undertaken by the European Centre for Medium‐Range Weather Forecasts (ECMWF): ERA‐40 (1958–2001) and ERA‐Interim (1979–2010) data sets. For the NH, agreement is good back to 1958 and excellent from 1979 at monthly, annual, and decadal time scales. For the SH, agreement is poorer, but if the area is restricted to the SH north of 60°S, the agreement is dramatically improved from the mid‐1970s.
Key Points
Revised and updated version of a data set
Series robust to numerous choices
Series agrees with reanalysis output since 1970s
We present a new version of the Met Office Hadley Centre/Climatic Research Unit global surface temperature data set, HadCRUT5. HadCRUT5 presents monthly average near‐surface temperature anomalies, ...relative to the 1961–1990 period, on a regular 5° latitude by 5° longitude grid from 1850 to 2018. HadCRUT5 is a combination of sea‐surface temperature (SST) measurements over the ocean from ships and buoys and near‐surface air temperature measurements from weather stations over the land surface. These data have been sourced from updated compilations and the adjustments applied to mitigate the impact of changes in SST measurement methods have been revised. Two variants of HadCRUT5 have been produced for use in different applications. The first represents temperature anomaly data on a grid for locations where measurement data are available. The second, more spatially complete, variant uses a Gaussian process based statistical method to make better use of the available observations, extending temperature anomaly estimates into regions for which the underlying measurements are informative. Each is provided as a 200‐member ensemble accompanied by additional uncertainty information. The combination of revised input data sets and statistical analysis results in greater warming of the global average over the course of the whole record. In recent years, increased warming results from an improved representation of Arctic warming and a better understanding of evolving biases in SST measurements from ships. These updates result in greater consistency with other independent global surface temperature data sets, despite their different approaches to data set construction, and further increase confidence in our understanding of changes seen.
Plain Language Summary
We have produced a new version of a data set that measures changes of near‐surface temperature across the globe from 1850 to 2018, called HadCRUT5. We have included an improved data set of sea‐surface temperature, which better accounts for the effects of changes through time in how measurement were made from ships and buoys at sea. We have also included an expanded compilation of measurements made at weather stations on land. There are two variations of HadCRUT5, produced for different uses. The first, the “HadCRUT5 noninfilled data set,” maps temperature changes on a grid for locations close to where we have measurements. The second, the “HadCRUT5 analysis,” extends our estimates to locations further from the available measurements using a statistical technique that makes use of the spatial connectedness of temperature patterns. This improves the representation of less well observed regions in estimates of global, hemispheric and regional temperature change. Together, these updates and improvements reveal a slightly greater rise in near‐surface temperature since the nineteenth century, especially in the Northern Hemisphere, which is more consistent with other data sets. This increases our confidence in our understanding of global surface temperature changes since the mid‐19th century.
Key Points
We have created a new version of the Met Office Hadley Centre and Climatic Research Unit global surface temperature data set for 1850–2018
The new data set better represents sparsely observed regions of the globe and incorporates an improved sea‐surface temperature data set
This data set shows increased global average warming since the mid‐19th century and in recent years, consistent with other analyses
Cough remains a serious unmet clinical problem, both as a symptom of a range of other conditions such as asthma, chronic obstructive pulmonary disease, gastroesophageal reflux, and as a problem in ...its own right in patients with chronic cough of unknown origin. This article reviews our current understanding of the pathogenesis of cough and the hypertussive state characterizing a number of diseases as well as reviewing the evidence for the different classes of antitussive drug currently in clinical use. For completeness, the review also discusses a number of major drug classes often clinically used to treat cough but that are not generally classified as antitussive drugs. We also reviewed a number of drug classes in various stages of development as antitussive drugs. Perhaps surprising for drugs used to treat such a common symptom, there is a paucity of well-controlled clinical studies documenting evidence for the use of many of the drug classes in use today, particularly those available over the counter. Nonetheless, there has been a considerable increase in our understanding of the cough reflex over the last decade that has led to a number of promising new targets for antitussive drugs being identified and thus giving some hope of new drugs being available in the not too distant future for the treatment of this often debilitating symptom.
Climatic Research Unit temperature version 5 (CRUTEM5) is an extensive revision of our land surface air temperature data set. We have expanded the underlying compilation of monthly temperature ...records from 5,583 to 10,639 stations, of which those with sufficient data to be used in the gridded data set has grown from 4,842 to 7,983. Many station records have also been extended or replaced by series that have been homogenized by national meteorological and hydrological services. We have improved the identification of potential outliers in these data to better capture outliers during the reference period; to avoid classifying some real regional temperature extremes as outliers; and to reduce trends in outlier counts arising from climatic warming. Due to these updates, the gridded data set shows some regional increases in station density and regional changes in temperature anomalies. Nonetheless, the global‐mean timeseries of land air temperature is only slightly modified compared with previous versions and previous conclusions are not altered. The standard gridding algorithm and comprehensive error model are the same as for the previous version, but we have explored an alternative gridding algorithm that removes the under‐representation of high latitude stations. The alternative gridding increases estimated global‐mean land warming by about 0.1°C over the course of the whole record. The warming from 1861–1900 to the mean of the last 5 years is 1.6°C using the standard gridding (with a 95% confidence interval for errors on individual annual means of −0.11 to +0.10°C in recent years), while the alternative gridding gives a change of 1.7°C.
Key Points
We describe the fifth major update of a data set of global land air temperature, CRUTEM5
CRUTEM5 is based on an expanded network of 7,983 stations (up from 4,842) and improved identification of outlier values
The estimated increase in global land air temperature from 1861–1900 to 2015–2019 is 1.6°C (or 1.7°C with an alternative gridding method)
We report on preliminary steps in the homogenisation of HadISD, a sub-daily, station-based data set covering 1973-2013. Using temperature, dew point temperature, sea-level pressure and wind speeds, ...change points are detected using the Pairwise Homogenisation Algorithm from Menne and Williams Jr. (2009). Monthly-mean values and monthly-mean diurnal ranges (temperature and dew point temperature) or monthly-maximum values (wind speeds) are processed using the full network of 6103 stations in HadISD. Where multiple change points are detected within 1 year, they are combined and the average date is used. Under the assumption that the underlying true population of inhomogeneity magnitudes is Gaussian, inhomogeneity magnitudes as small as around 0.5 °C, 0.5 hPa or 0.5 m s-1 have been successfully detected. The change point dates and inhomogeneity magnitudes for each of the calculation methods will be provided alongside the data set to allow users to select stations which have different levels of homogeneity. We give an example application of this change point information in calculating global temperature values from HadISD and comparing these to CRUTEM4. Removing the most inhomogeneous stations results in a better match between HadISD and CRUTEM4 when matched to the same coverage. However, further removals of stations with smaller and fewer inhomogeneities worsen the match.
Gastro-oesophageal reflux disease (GERD) is one of the commonest diseases of Western populations, affecting 20 to 30% of adults. GERD is multifaceted and the classical oesophageal symptoms such as ...heartburn and regurgitation often overlap with atypical symptoms that impact upon the respiratory system and airways. This is referred to as extra-oesophageal reflux disease (EERD), or laryngopharyngeal reflux (LPR), which manifests as chronic cough, laryngitis, hoarseness, voice disorders and asthma.
The 'Reflux and its consequences' conference was held in Hull in 2010 and brought together a multidisciplinary group of experts all with a common interest in the many manifestations of reflux disease to present recent research and clinical progress in GERD and EERD. In particular new techniques for diagnosing reflux were showcased at the conference.
Both clinical and non-clinical key opinion leaders were invited to write a review on key areas presented at the `Reflux and its consequences' conference for inclusion in this supplement.
Eleven chapters contained in this supplement reflected the sessions of the conference and included discussion of the nature of the refluxate (acid, pepsin, bile acids and non-acid reflux); mechanisms of tissue damage and protection in the oesophagus, laryngopharynx and airways. Clinical conditions with a reflux aetiology including asthma, chronic cough, airway disease, LPR, and paediatric EERD were reviewed. In addition methods for diagnosis of reflux disease and treatment strategies, especially with reference to non-acid reflux, were considered.
Abstract
We develop a statistical method to assess CMIP6 simulations of large-scale surface temperature change during the historical period (1850–2014), considering all time scales, allowing for the ...different unforced variability of each model and the observations, observational uncertainty, and variable ensemble size. The generality of this method, and the fact that it incorporates information about the unforced variability, makes it a useful model assessment tool. We apply this method to the historical simulations of the CMIP6 multimodel ensemble. We use three indices that measure different aspects of large-scale surface air temperature change: global mean, hemispheric gradient, and a recently developed index that captures the sea surface temperature (SST) pattern in the tropics (SST
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; see Fueglistaler and Silvers). We use the following observations: HadCRUT5 for the first two indices, and AMIPII and ERSSTv5 for SST
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. In each case, we test the hypothesis that the model’s forced response is compatible with the observations, accounting for unforced variability in both models and observations as well as measurement uncertainty. This hypothesis is accepted more often (75% of the models) for the hemispheric gradient than for the global mean, for which half of the models fail the test. The tropical SST pattern is poorly simulated in all models. Given that the tropical SST pattern can strongly modulate the relationship between energy imbalance and global-mean surface temperature anomalies on annual to decadal time scales (short-term feedback parameter), we suggest this should be a focus area for future improvements due to its potential implications for the global-mean temperature evolution in decadal time scales.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Described herein is the first version release of monthly temperature holdings of a new Global Land Surface Meteorological Databank. Organized under the auspices of the International Surface ...Temperature Initiative (ISTI), an international group of scientists have spent three years collating and merging data from numerous sources to create a merged holding. This release in its recommended form consists of over 30 000 individual station records, some of which extend over the past 300 years. This article describes the sources, the chosen merge methodology, and the resulting databank characteristics. Several variants of the databank have also been released that reflect the structural uncertainty in merging datasets. Variants differ in, for example, the order in which sources are considered and the degree of congruence required in station geolocation for consideration as a merged or unique record. Also described is a version control protocol that will be applied in the event of updates. Future updates are envisaged with the addition of new data sources, and with changes in processing, where public feedback is always welcomed. Major updates, when necessary, will always be accompanied by a new journal paper. This databank release forms the foundation for the construction of new global land surface air temperature analyses by the global research community and their assessment by the ISTI's benchmarking and assessment working group.
In a randomized trial, over 1900 patients with left main coronary artery disease were assigned to percutaneous coronary intervention or coronary-artery bypass grafting. At 3 years, PCI was ...noninferior to CABG with respect to the rate of death, stroke, or myocardial infarction.
Left main coronary artery disease is associated with high morbidity and mortality owing to the large amount of myocardium at risk. European and U.S. guidelines recommend that most patients with left main coronary artery disease undergo coronary-artery bypass grafting (CABG).
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Randomized trials have suggested that percutaneous coronary intervention (PCI) with drug-eluting stents might be an acceptable alternative for selected patients with left main coronary disease.
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Specifically, in the subgroup of patients with left main coronary disease in the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial, the rate of a composite of death, stroke, myocardial infarction, . . .
•In stage IB1 cervical cancer, the recurrence rate observed after simple cone/trachelectomy is 4%.•In stage IB2 disease, the lower rate of recurrence is observed after radical trachelectomy by ...abdominal approach.•In stage IB2 disease, the highest recurrence rate is observed after neo-adjuvant chemotherapy and conservative surgery.•The lower fertility results are observed after radical trachelectomy by laparotomic approach.
Several techniques can be proposed as fertility sparing surgery in young patients treated for cervical cancer but uncertaincies remain concerning their outcomes. Analysis of oncological issues is then the first aim of this review in order to evaluate the best strategy.
Data were identified from searches of MEDLINE, Current Contents, PubMed and from references in relevant articles from January 1987 to 15th of September 2021. We carry out an updated systematic review involving 5862 patients initially selected for fertility-sparing surgery in 275 series.
In patients having a stage IB1 disease, recurrence rate/RR in patients undergoing simple conisation/trachelectomy, radical trachelectomy/RT by laparoscopico-vaginal approach, laparotomic or laparoscopic approaches are respectively: 4.1%, 4.7%, 2.4% and 5.2%. In patients having a stage IB2 disease, RR after neoadjuvant chemotherapy or RT by laparotomy are respectively 13.2% and 4.8% (p = .0035). After neoadjuvant treatment a simple cone/trachelectomy was carried out in 91 (30%) patients and a radical one in 210 (70%) cases. But the lowest pregnancy rate is observed in patients undergoing RT by laparotomy (36%).
The choice between these treatments should be based above all, on objective oncological data that strike a balance for each procedure between the best chances for cure and the fertility results. In patients having a stage IB1 disease, oncological results are quite similar according to the procedure used. In patients having a stage IB2 disease, RT by open approach has the lowest RR. Anyway the lowest pregnancy rate is observed in patients undergoing RT by laparotomy.
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