The purpose of this review article is to discuss the development and associated estimation of uncertainties in the global and hemispheric surface temperature records. The review begins by detailing ...the groups that produce surface temperature datasets. After discussing the reasons for similarities and differences between the various products, the main issues that must be addressed when deriving accurate estimates, particularly for hemispheric and global averages, are then considered. These issues are discussed in the order of their importance for temperature records at these spatial scales： biases in SST data, particularly before the 1940s; the exposure of land-based thermometers before the development of louvred screens in the late 19th century; and urbanization effects in some regions in recent decades. The homogeneity of land-based records is also discussed; however, at these large scales it is relatively unimportant. The article concludes by illustrating hemispheric and global temperature records from the four groups that produce series in near-real time.
There is a growing demand to collect patients' experiences of their health status (their symptoms, function, and quality of life) in clinical trials, quality assessment initiatives, and in routine ...clinical care. In heart failure, the 23-item, disease-specific Kansas City Cardiomyopathy Questionnaire (KCCQ) has been shown to be valid, reliable, sensitive to clinical change, and prognostic of both clinical events and costs. However, its use has been limited, in part, by its length. We sought to develop a shortened version of the instrument that maintains the psychometric properties of the full KCCQ.
Using data from 3 clinical studies incorporating 4168 patients, we derived and validated a 12-item KCCQ, the KCCQ-12, to capture symptom frequency, physical and social limitations, and quality of life impairment as a result of heart failure, as well as an overall summary score. The KCCQ-12 scores had high correlations with the original scales (>0.93 for all scales in all clinical settings), high test–retest reliability (>0.76 for all domains), high responsiveness (16–31 point improvements after discharge from hospitalization; standardized response mean =0.61–1.12), and comparable prognostic significance and interpretation of clinically important differences as compared with the full KCCQ.
The KCCQ-12 is a shorter version of the original 23-item instrument that should be more feasible to implement while preserving the psychometric properties of the full instrument.
Studies have found that people with Multiple Sclerosis experience relatively high rates of anxiety and depression. Although methodologically robust, many of these studies had access to only modest ...sample sizes (N<200). The aims of this study were to use responses gained via the web portal of the UK MS Register (N>4000) to: describe the depression and anxiety profiles of people with MS; to determine if anxiety and depression are related to age or disease duration; and to assess whether the levels of anxiety and depression differ between genders and types of MS.
From its launch in May 2011 to the end of December 2011, 7786 adults with MS enrolled to take part in the UK MS Register via the web portal. The responses to the Hospital Anxiety and Depression Scale (HADS) were collated with basic demographic and descriptive MS data provided at registration and the resulting dataset was analysed in SPSS (v.16).
The mean HADS score among the 4178 respondents was 15.7 (SE 0.117, SD 7.55) with a median of 15.0 (IQR 11). Anxiety and depression rates were notably high, with over half (54.1%) scoring ≥ 8 for anxiety and 46.9% scoring ≥ 8 for depression. Women with relapsing-remitting MS were more anxious than men with this type (p<0.001), and than women with other types of MS (p = 0.017). Within each gender, men and women with secondary progressive MS were more depressed than men or women with other types of MS (p<0.001, p<0.001).
This largest known study of its kind has shown that anxiety and depression are highly prevalent in people with MS, indicating that their mental health needs could be better addressed. These findings support service planning and further research to provide the best care for people with MS to help alleviate these debilitating conditions.
In this paper, we examine the decision of where to preposition supplies in preparation for a disaster, such as a hurricane or terrorist attack, and how much to preposition at a location. If supplies ...are located closer to the disaster, it can allow for faster delivery of supplies after the disaster. As a result of being closer, though, the supplies may be in a risky location if the disaster occurs. Considering these risks, we derive equations for determining the optimal stocking quantity and the total expected costs associated with delivering to a demand point from a supply point. We provide a sensitivity analysis to show how different parameters impact stocking levels and costs. We show how our cost model can be used to select the single best supply point location from a discrete set of choices and how it can be embedded within existing location algorithms to choose multiple supply points. Our computational experiments involve a variety of relationships between distance and risk and show how these can impact location decisions and stocking levels.
•The climate system is complex but with a simple core, the laws of radiative transfer.•These laws are incorporated in Earth System Models (ESMs), with climate feedbacks.•The core physics leads to ...projected global warming, amplified by climate feedbacks.•ESMs provide a compelling case that ongoing CO2 emissions cause global warming.
Climate warming during the course of the twenty-first century is projected to be between 1.0 and 3.7°C depending on future greenhouse gas emissions, based on the ensemble-mean results of state-of-the-art Earth System Models (ESMs). Just how reliable are these projections, given the complexity of the climate system? The early history of climate research provides insight into the understanding and science needed to answer this question. We examine the mathematical quantifications of planetary energy budget developed by Svante Arrhenius (1859–1927) and Guy Stewart Callendar (1898–1964) and construct an empirical approximation of the latter, which we show to be successful at retrospectively predicting global warming over the course of the twentieth century. This approximation is then used to calculate warming in response to increasing atmospheric greenhouse gases during the twenty-first century, projecting a temperature increase at the lower bound of results generated by an ensemble of ESMs (as presented in the latest assessment by the Intergovernmental Panel on Climate Change). This result can be interpreted as follows. The climate system is conceptually complex but has at its heart the physical laws of radiative transfer. This basic, or “core” physics is relatively straightforward to compute mathematically, as exemplified by Callendar's calculations, leading to quantitatively robust projections of baseline warming. The ESMs include not only the physical core but also climate feedbacks that introduce uncertainty into the projections in terms of magnitude, but not sign: positive (amplification of warming). As such, the projections of end-of-century global warming by ESMs are fundamentally trustworthy: quantitatively robust baseline warming based on the well-understood physics of radiative transfer, with extra warming due to climate feedbacks. These projections thus provide a compelling case that global climate will continue to undergo significant warming in response to ongoing emissions of CO2 and other greenhouse gases to the atmosphere.
To improve the patient-centeredness of care, patient-reported outcomes have been increasingly used to quantify patients' symptoms, function, and quality of life. In heart failure, the Kansas City ...Cardiomyopathy Questionnaire (KCCQ) has been qualified by the U.S. Food and Drug Administration as a Clinical Outcome Assessment and recommended as a performance measure for quantifying the quality of care. By systematically asking the same questions reproducibly over time, the KCCQ can validly and sensitively capture the impact of heart failure on patients' lives and is strongly associated with clinical events over time. This review describes how to interpret the KCCQ, how it should be analyzed in clinical trials to maximize the interpretability of results, and how it can be used in clinical practice and population health. By providing a deeper understanding of the KCCQ, it is hoped that its use can further improve the patient-centeredness of heart failure care.
Optical trapping and manipulation of micrometre-sized particles was first reported in 1970. Since then, it has been successfully implemented in two size ranges: the subnanometre scale, where ...light-matter mechanical coupling enables cooling of atoms, ions and molecules, and the micrometre scale, where the momentum transfer resulting from light scattering allows manipulation of microscopic objects such as cells. But it has been difficult to apply these techniques to the intermediate - nanoscale - range that includes structures such as quantum dots, nanowires, nanotubes, graphene and two-dimensional crystals, all of crucial importance for nanomaterials-based applications. Recently, however, several new approaches have been developed and demonstrated for trapping plasmonic nanoparticles, semiconductor nanowires and carbon nanostructures. Here we review the state-of-the-art in optical trapping at the nanoscale, with an emphasis on some of the most promising advances, such as controlled manipulation and assembly of individual and multiple nanostructures, force measurement with femtonewton resolution, and biosensors.
Adult organisms have to adapt to survive, and the same is true for their tissues. Rates and types of cell production must be rapidly and reversibly adjusted to meet tissue demands in response to both ...local and systemic challenges. Recent work reveals how stem cell (SC) populations meet these requirements by switching between functional states tuned to homoeostasis or regeneration. This plasticity extends to differentiating cells, which are capable of reverting to SCs after injury. The concept of the niche, the micro‐environment that sustains and regulates stem cells, is broadening, with a new appreciation of the role of physical factors and hormonal signals. Here, we review different functions of SCs, the cellular mechanisms that underlie them and the signals that bias the fate of SCs as they switch between roles.
This review compares the structural make‐up of distinct adult stem cell niches, describes their plasticity upon damage/during regeneration and alludes to modes of their physiological regulation.
Agriculture is a major contributor to global greenhouse gas (GHG) emissions and must feature in efforts to reduce emissions. Organic farming might contribute to this through decreased use of farm ...inputs and increased soil carbon sequestration, but it might also exacerbate emissions through greater food production elsewhere to make up for lower organic yields. To date there has been no rigorous assessment of this potential at national scales. Here we assess the consequences for net GHG emissions of a 100% shift to organic food production in England and Wales using life-cycle assessment. We predict major shortfalls in production of most agricultural products against a conventional baseline. Direct GHG emissions are reduced with organic farming, but when increased overseas land use to compensate for shortfalls in domestic supply are factored in, net emissions are greater. Enhanced soil carbon sequestration could offset only a small part of the higher overseas emissions.
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