Forecast errors with respect to wind, temperature, moisture, clouds, and precipitation largely correspond to the limited capability of current Earth system models to capture and simulate ...land–atmosphere feedback. To facilitate its realistic simulation in next-generation models, an improved process understanding of the related complex interactions is essential. To this end, accurate 3D observations of key variables in the land–atmosphere (L–A) system with high vertical and temporal resolution from the surface to the free troposphere are indispensable.
Recently, we developed a synergy of innovative ground-based, scanning active remote sensing systems for 2D to 3D measurements of wind, temperature, and water vapor from the surface to the lower troposphere that is able to provide comprehensive datasets for characterizing L–A feedback independently of any model input. Several new applications are introduced, such as the mapping of surface momentum, sensible heat, and latent heat fluxes in heterogeneous terrain; the testing of Monin–Obukhov similarity theory and turbulence parameterizations; the direct measurement of entrainment fluxes; and the development of new flux-gradient relationships. An experimental design taking advantage of the sensors’ synergy and advanced capabilities was realized for the first time during the Land Atmosphere Feedback Experiment (LAFE), conducted at the Atmospheric Radiation Measurement Program Southern Great Plains site in August 2017. The scientific goals and the strategy of achieving them with the LAFE dataset are introduced. We envision the initiation of innovative L–A feedback studies in different climate regions to improve weather forecast, climate, and Earth system models worldwide.
The greatest prevalence of asthma is in preschool children; however, the clinical utility of asthma therapy for this age group is limited by a narrow therapeutic index, long-term tolerability, and ...frequency and/or difficulty of administration. Inhaled corticosteroids and inhaled cromolyn are the most commonly prescribed controller therapies for young children with persistent asthma, although very young patients may have difficulty using inhalers, and dose delivery can be variable. Moreover, reduced compliance with inhaled therapy relative to orally administered therapy has been reported. One potential advantage of montelukast is the ease of administering a once-daily chewable tablet; additionally, no tachyphylaxis or change in the safety profile has been evidenced after up to 140 and 80 weeks of montelukast therapy in adults and pediatric patients aged 6 to 14 years, respectively. To our knowledge, this represents the first large, multicenter study to address the effects of a leukotriene receptor antagonist in children younger than 5 years of age with persistent asthma, as well as one of the few asthma studies that incorporated end points validated for use in preschool children.
Our primary objective was to determine the safety profile of montelukast, an oral leukotriene receptor antagonist, in preschool children with persistent asthma. Secondarily, the effect of montelukast on exploratory measures of asthma control was also studied. DESIGN AND STATISTICAL ANALYSIS: We conducted a double-blind, multicenter, multinational study at 93 centers worldwide: including 56 in the United States, and 21 in countries in Africa, Australia, Europe, North America, and South America. In this study, we randomly assigned 689 patients (aged 2-5 years) to 12 weeks of treatment with placebo (228 patients) or 4 mg of montelukast as a chewable tablet (461 patients) after a 2-week placebo baseline period. Patients had a history of physician-diagnosed asthma requiring use of beta-agonist and a predefined level of daytime asthma symptoms. Caregivers answered questions twice daily on a validated, asthma-specific diary card and, at specified times during the study, completed a validated asthma-specific quality-of-life questionnaire. Physicians and caregivers completed a global evaluation of asthma control at the end of the study. Efficacy end points included: daytime and overnight asthma symptoms, daily use of beta-agonist, days without asthma, frequency of asthma attacks, number of patients discontinued because of asthma, need for rescue medication, physician and caregiver global evaluations of change, asthma-specific caregiver quality of life, and peripheral blood eosinophil counts. Although exploratory, the efficacy end points were predefined and their analyses were written in a data analysis plan before study unblinding. At screening and at study completion, a complete physical examination was performed. Routine laboratory tests were drawn at screening and weeks 6 and 12, and submitted to a central laboratory for analysis. Adverse effects were collected from caregivers at each clinic visit. An intention-to-treat approach, including all patients with a baseline measurement and at least 1 postrandomization measurement, was performed for all efficacy end points. An analysis-of-variance model with terms for treatment, study center and stratum (inhaled/nebulized corticosteroid use, cromolyn use, or none) was used to estimate treatment group means and between-group differences and to construct 95% confidence intervals. Treatment-by-age, -sex, -race, -radioallergosorbent test, -stratum, and -study center interactions were evaluated by including each term separately. Fisher's exact test was used for between-group comparisons of the frequency of asthma attacks, discontinuations from the study because of worsening asthma, need for rescue medication, and the frequencies of adverse effects. Because of an imbalance in baseline values for eosinophil counts for the 2 treatment groups, an analysis of covariance was performed on the eosinophil change from baseline with the patient's baseline as covariate.
Of the 689 patients enrolled, approximately 60% were boys and 60% were white. Patients were relatively evenly divided by age: 21%, 24%, 30%, and 23% were aged 2, 3, 4, and 5 years, respectively. For 77% of the patients, asthma symptoms first developed during the first 3 years of life. During the placebo baseline period, patients had asthma symptoms on 6.1 days/week and used beta-agonist on 6.0 days/week.
In over 12 weeks of treatment of patients aged 2 to 5 years, montelukast administered as a 4-mg chewable tablet produced significant improvements compared with placebo in multiple parameters of asthma control including: daytime asthma symptoms (cough, wheeze, trouble breathing, and activity limitation); overnight asthma symptoms (cough); the percentage of days with asthma symptoms; the percentage of days without asthma; the need for beta-agonist or oral corticosteroids; physician global evaluations; and peripheral blood eosinophils. The clinical benefit of montelukast was evident within 1 day of starting therapy. Improvements in asthma control were consistent across age, sex, race, and study center, and whether or not patients had a positive radioallergosorbent test. Montelukast demonstrated a consistent effect regardless of concomitant use of inhaled/nebulized corticosteroid or cromolyn therapy. Caregiver global evaluations, the percentage of patients experiencing asthma attacks, and improvements in quality-of-life scores favored montelukast, but were not significantly different from placebo. There were no clinically meaningful differences between treatment groups in overall frequency of adverse effects or of individual adverse effects, with the exception of asthma, which occurred significantly more frequently in the placebo group. There were no significant differences between treatment groups in the frequency of laboratory adverse effects or in the frequency of elevated serum transaminase levels. Approximately 90% of the patients completed the study.
Oral montelukast (4-mg chewable tablet) administered once daily is effective therapy for asthma in children aged 2 to 5 years and is generally well tolerated without clinically important adverse effects. Similarly, in adults and children aged 6 to 14 years, montelukast improves multiple parameters of asthma control. Thus, this study confirms and extends the benefit of montelukast to younger children with persistent asthma.
Land-atmosphere interactions play a critical role in both the atmospheric water and energy cycles. Changes in soil moisture and vegetation alter the partitioning of surface water and energy fluxes, ...influencing diurnal evolution of the planetary boundary layer (PBL). The mixing diagram framework has proven useful in understanding the evolution of the heat and moisture budget within the convective boundary layer (CBL). Herein we demonstrate that observations from the Department of Energy Atmospheric Radiation Measurement (ARM) Southern Great Plains (SGP) site provide all of the needed inputs needed for the mixing diagram framework, allowing us to quantify the impact from the surface fluxes, advection, radiative heating, encroachment, and entrainment on the evolution of the CBL. Profiles of temperature and humidity retrieved from the ground-based infrared spectrometer (called the Atmospheric Emitted Radiance Interferometer, or AERI) are a critical component in this analysis. Large eddy simulation results demonstrate that mean mixed-layer values derived are shown to be critical to close the energy and moisture budgets. A novel approach demonstrated here is the use of network of AERIs and Doppler lidars to quantify the advective fluxes of heat and moisture. The framework enables the estimation of the entrainment fluxes as a residual, providing a way to observe the entrainment fluxes without using multiple lidar systems. Finally, the high temporal resolution of the AERI observations enable the morning, midday, and afternoon evolution of the CBL to be quantified. This work provides a new way to use observations in this framework to evaluate weather and climate models.
While efforts to examine the coupled behavior of LSMs were explored and some critical facilitating technologies were introduced e.g., a Network Common Data Form (NetCDF) protocol for defining output ...variables and metadata, Assistance for Land-Surface Modelling Activities (ALMA); see Table 1, along with a common land surface coupler (Polcher et al. 1998), PILPS could not resolve the full spectrum of land surface challenges alone. Reflecting WCRP's emphasis to contribute to operational modeling centers, the National Centers for Environmental Prediction (NCEP), Japan Meteorological Agency (JMA), Met Office (UKMO), Météo-France, and European Centre for Medium-Range Weather Forecasts (ECMWF), among others, have used GLASS activities to improve their forecast models.
In recent decades, spaceborne microwave and hyperspectral infrared sounding instruments have significantly benefited weather forecasting and climate science. However, existing retrievals of lower ...troposphere temperature and humidity profiles have limitations in vertical resolution, and often cannot accurately represent key features such as the mixed layer thermodynamic structure and the inversion at the planetary boundary layer (PBL) top. Because of the existing limitations in PBL remote sensing from space, there is a compelling need to improve routine, global observations of the PBL and enable advances in scientific understanding and weather and climate prediction. To address this, we have developed a new 3D deep neural network (DNN) which enhances detail and reduces noise in Level 2 granules of temperature and humidity profiles from the Atmospheric Infrared Sounder (AIRS)/Advanced Microwave Sounding Unit (AMSU) sounder instruments aboard NASA’s Aqua spacecraft. We show that the enhancement improves accuracy and detail including key features such as capping inversions at the top of the PBL over land, resulting in improved accuracy in estimations of PBL height.
The utility of hydrologic land surface models (LSMs) can be enhanced by using information from observational platforms, but mismatches between the two are common. This study assesses the degree to ...which model agreement with observations is affected by two mechanisms in particular: 1) physical incongruities between the support volumes being characterized and 2) inadequate or inconsistent parameterizations of physical processes. The Noah and Noah-MP LSMs by default characterize surface soil moisture (SSM) in the top 10 cm of the soil column. This depth is notably different from the 5-cm (or less) sensing depth of L-band radiometers such as NASA’s Soil Moisture Active Passive (SMAP) satellite mission. These depth inconsistencies are examined by using thinner model layers in the Noah and Noah-MP LSMs and comparing resultant simulations to in situ and SMAP soil moisture. In addition, a forward radiative transfer model (RTM) is used to facilitate direct comparisons of LSM-based and SMAP-based L-band Tb retrievals. Agreement between models and observations is quantified using Kolmogorov–Smirnov distance values, calculated from empirical cumulative distribution functions of SSM and Tb time series. Results show that agreement of SSM and Tb with observations depends primarily on systematic biases, and the sign of those biases depends on the particular subspace being analyzed (SSM or Tb). This study concludes that the role of increased soil layer discretization on simulated soil moisture and Tb is secondary to the influence of component parameterizations, the effects of which dominate systematic differences with observations.
The NASA LIS/WRF-Hydro system is a coupled modeling framework that combines the modeling and data assimilation (DA) capabilities of the NASA Land Information System (LIS) with the multi-scale surface ...hydrological modeling capabilities of the WRF-Hydro model, both of which are widely used in both operations and research. This coupled modeling framework builds on the linkage between land surface models (LSMs), which simulate surface boundary conditions in atmospheric models, and distributed hydrologic models, which simulate horizontal surface and sub-surface flow, adding new land DA capabilities. In the present study, we employ this modeling framework in the Tuolumne River basin in central California. We demonstrate the added value of the assimilation of NASA Airborne Snow Observatory (ASO) snow water equivalent (SWE) estimates in the Tuolumne basin. This analysis is performed in both LIS as an LSM column model and LIS/WRF-Hydro, with hydrologic routing. Results demonstrate that ASO DA in the basin reduced snow bias by as much as 30% from an open-loop (OL) simulation compared to three independent datasets. It also reduces downstream streamflow runoff biases by as much as 40%, and improves streamflow skill scores in both wet and dry years. Analysis of soil moisture and evapotranspiration (ET) also reveals the impacts of hydrologic routing from WRF-Hydro in the simulations, which would otherwise not be resolved in an LSM column model. By demonstrating the beneficial impact of SWE DA on the improving streamflow forecasts, the article outlines the importance of such observational inputs for reservoir operations and related water management applications.
Land-atmosphere interactions play a critical role in both the atmospheric water and energy cycles. Changes in soil moisture and vegetation alter the partitioning of surface water and energy fluxes, ...influencing diurnal evolution of the planetary boundary layer (PBL). The mixing diagram framework has proven useful in understanding the evolution of the heat and moisture budget within the convective boundary layer (CBL). We demonstrate that observations from the Department of Energy Atmospheric Radiation Measurement (ARM) Southern Great Plains (SGP) site provide all of the needed inputs needed for the mixing diagram framework, allowing us to quantify the impact from the surface fluxes, advection, radiative heating, encroachment, and entrainment on the evolution of the CBL. Profiles of temperature and humidity retrieved from the ground-based infrared spectrometer (called the Atmospheric Emitted Radiance Interferometer, or AERI) are a critical component in this analysis. Large eddy simulation results demonstrate that mean mixed-layer values derived are shown to be critical to close the energy and moisture budgets. A novel approach demonstrated here is the use of network of AERIs and Doppler lidars to quantify the advective fluxes of heat and moisture. The framework enables the estimation of the entrainment fluxes as a residual, providing a way to observe the entrainment fluxes without using multiple lidar systems. Finally, the high temporal resolution of the AERI observations enable the morning, midday, and afternoon evolution of the CBL to be quantified. This work provides a new way to use observations in this framework to evaluate weather and climate models.
The 31-gene expression profile test (Class 1A: low-risk; 1B/2A: intermediate-risk; 2B: high-risk) is validated to identify patients with cutaneous melanoma who can safely forego sentinel lymph node ...biopsy (SLNB). The objective of the current study is to quantify SLNB reduction by clinicians using 31-GEP.
Patients with T1-T2 tumors eligible for SLNB were seen by surgical oncologists (89.1%), dermatologists (7.8%), and medical oncologists (3.1%). After receiving 31-GEP results but before SLNB, clinicians were asked which clinical and pathological features influenced SLNB decisions (n = 191). The Exact binomial test was used to compare SLNB procedure rates to a contemporary study (78% SLNB baseline rate). Logistic regression modeling (odds ratio OR, 95% CI) was used to identify features associated with SLNB procedure rates.
One hundred clinical decisions (52.4%) were influenced by the 31-GEP to forego SLNB and 70% (70/100) were not performed. Of the 30 performed, 0% (0/30) were positive. The 31-GEP influenced sixty-three clinical decisions (33.0%) to perform SLNB, and 92.1% (58/63) were performed. There was a clinically meaningful 29.4% reduction of SLNBs performed in patients with a Class 1A result relative to the baseline rate of 78.0% (p < .01). In patients ≥55 or ≥65-year-old, SLNB reduction was 32.3% (p < .01), 28.3% (p < .01), respectively. Overall, 85.3% of decisions relating to SLNB were influenced by 31-GEP results.
In this prospective, multicenter study, clinicians demonstrated clinically meaningful use of the 31-GEP test to forego or pursue SLNB in patients with T1-T2 tumors resulting in a significant, risk appropriate decrease in SLNBs.
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