Pattern-based downscaling of snowpack variability in the western United States

The decline in snowpack across the western United States is one of the most pressing threats posed by climate change to regional economies and livelihoods. Earth system models are important tools for exploring past and future snowpack variability, yet their coarse spatial resolutions distort local topography and bias spatial patterns of accumulation and ablation. Here, we explore pattern-based statistical downscaling for spatially-continuous interannual snowpack estimates. We find that a few leading patterns capture the majority of snowpack variability across the western US in observations, reanalyses, and free-running simulations. Pattern-based downscaling methods yield accurate, high resolution maps that correct mean and variance biases in domain-wide simulated snowpack. Methods that use large-scale patterns as both predictors and predictands perform better than those that do not and all are superior to an interpolation-based “delta change” approach. These findings suggest that pattern-based methods are appropriate for downscaling interannual snowpack variability and that using physically meaningful large-scale patterns is more important than the details of any particular downscaling method.

Sleep Quality and Electroencephalogram Delta Power

Delta activity on electroencephalogram (EEG) is considered a biomarker of homeostatic sleep drive. Delta power is often associated with sleep duration and intensity. Here, we reviewed the literature to explore how sleep quality was influenced by changes in delta power. However, we found that both the decrease and increase in delta power could indicate a higher sleep quality due to the various factors below. First, the differences in changes in delta power in patients whose sleep quality is lower than that of the healthy controls may be related to the different diseases they suffered from. We found that the patients mainly suffered from borderline personality disorder, and Rett syndrome may have a higher delta power than healthy individuals. Meanwhile, patients who are affected by Asperger syndrome, respiratory failure, chronic fatigue, and post-traumatic stress disorder have lower delta power. Second, if the insomnia patients received the therapy, the difference may be caused by the treatment method. Cognitive or music therapy shows that a better therapeutic effect is associated with decreased delta power, whereas in drug treatment, there is an opposite change in delta power. Last, for healthy people, the difference in delta change may be related to sleep stages. The higher sleep quality is associated with increased delta power during the NREM period, whereas a deceased delta change accompanies higher sleep quality during the REM period. Our work summarizes the effect of changes in delta power on sleep quality and may positively impact the monitoring and intervention of sleep quality.

Integrated framework for rapid climate stress testing on a monthly timestep

“Bottom-up” methods are increasingly used to assess the vulnerability of water systems to climate change. Central to these methods is the climate “stress test”, where the system is subjected to various climatic changes to test for unacceptable outcomes. We present a framework for climate stress testing on a monthly timestep, suitable for systems whose dominant dynamic is seasonal or longer (eg. water resource systems with carry-over storage). The framework integrates multi-site stochastic climate generation with perturbation methods and in-built rainfall runoff modelling. The stochastic generation includes a low frequency component suitable for representing multi-annual fluctuations. Multiple perturbation options are provided, ranging from simple delta change through to altered seasonality and low frequency dynamics. The framework runs rapidly, supporting comprehensive multi-dimensional stress testing without recourse to supercomputing facilities. We demonstrate the framework on a large water resource system in southern Australia. The Matlab/Octave framework is freely available for download from https://doi.org/10.5281/zenodo.5617008.

Effect of Dipeptidyl Peptidase-4 Inhibitors on Bone Health in Patients with Type 2 Diabetes Mellitus

Patients with type 2 diabetes (T2DM) have a higher risk of bone fracture even when bone mineral density (BMD) values are normal. The trabecular bone score (TBS) was recently developed and used for evaluating bone strength in various diseases. We investigated the effect of DPP-4 inhibitors on bone health using TBS in patients with T2DM. This was a single-center, retrospective case-control study of 200 patients with T2DM. Patients were divided into two groups according to whether they were administered a DPP-4 inhibitor (DPP-4 inhibitor group vs. control group). Parameters related to bone health, including BMD, TBS, and serum markers of calcium homeostasis, were assessed at baseline and after one year of treatment. We found TBS values increased in the DPP-4 group and decreased in the control, indicating a significant difference in delta change between them. The BMD increased in both groups, with no significant differences in delta change between the two groups observed. Serum calcium and 25-hydroxy vitamin D3 increased only in the DPP-4 inhibitor group, while other glycemic parameters did not show significant differences between the two groups. Treatment with DPP-4 inhibitors was associated with favorable effects on bone health evaluated by TBS in patients with T2DM.

Impacts of Climate Change on Urban Drainage Systems by Future Short-Duration Design Rainstorms

The adverse impacts of climate change and urbanization are converging to challenge the waterlogging control measures established in the Dong Hao Chong (DHC) Basin. Based on representative concentration pathway (RCP) scenarios, the future (2030–2050) waterlogging was assessed for the DHC basin and combined with future design rainfall. The delta change factors were projected using the regional climate model, RegCM4.6, and the annual maximum one-day rainstorm was modified to develop the annual maximum value method. By combining the delta change and annual maximum value methods, a future short-duration design rainstorm formula is developed in this study. The Chicago hyetograph shapes indicated that the peak rainfall intensity and amount both increase in the five return periods with two RCP scenarios. The InfoWorks ICM urban flood model is used to simulate the hydrological response. The results show that climate change will exacerbate urban waterlogging in DHC Basin. The maximum inundation volume and number of inundation nodes were expected to increase in the five return periods under the RCP4.5 and RCP8.5 scenarios, respectively. The submerged area is increasing due to climate change. This study highlights the link between climate change and urban drainage systems, and suggests that the effect of climate change in extreme rainfall should be considered in urban waterlogging management and drainage system design.

Management of toxic optic neuropathy via a combination of Wharton’s jelly-derived mesenchymal stem cells with electromagnetic stimulation

Purpose To investigate the effect of the combination of Wharton's jelly derived mesenchymal stem cells (WJ-MSC) and high frequency repetitive electromagnetic stimulation (rEMS) in the therapy of toxic optic neuropathies with severe symptoms after the available current therapy modalities which were unsucessful. Material and methods This prospective, open-label clinical phase-3 study was conducted at Ankara University Faculty of Medicine, Department of Ophthalmology between April 2019 and April 2021. Thirty-six eyes of 18 patients with toxic optic neuropathy (TON) were included in the study. Within 1–3 months after the emergency interventions, patients with various degrees of sequela visual disturbances were studied in this clinical trial. The cases were divided into three groups according to similar demographic characteristics. Group 1: Consists of 12 eyes of 12 patients treated with the WJ-MSC and rEMS combination in one eye. Group 2: Consists of 12 eyes of 12 patients treated with only rEMS in one eye. Group 3: Consists of 12 eyes of six patients treated with only WJ-MSC in both eyes. The course was evaluated by comparing the quantitive functional and structural assessment parameters measured before and at the fourth month of applications in each group. Results The mean best corrected visual acuity (BCVA) delta change percentages of the groups can be ranked as: Group 1 (47%) > Group 3 (32%) > Group 2 (21%). The mean fundus perimetry deviation index (FPDI) delta change percentages of the groups can be ranked as: Group 1 (95%) > Group 2 (33%) > Group 3 (27%). The mean ganglion cell complex (GCC) thickness delta change (decrease in thickness) percentages can be ranked as: Group 1 (− 21%) > Group 3 (− 15%) > Group 2 (− 13%). The visual evoked potential (VEP) P100 latency delta change percentages of the groups can be ranked as: Group 1 (− 18%) > Group 3 (− 10%) > Group 2 (− 8%). The P100 amplitude delta change percentages of the groups can be ranked as: Group 1 (105%) > Group 3 (83%) > Group 2 (24%). Conclusion Toxic optic neuropathies are emergent pathologies that can result in acute and permanent blindness. After poisoning with toxic substances, progressive apoptosis continues in optic nerve axons and ganglion cells. After the proper first systemic intervention in intensive care clinic, the WJ-MSC and rEMS combination seems very effective in the short-term period in cases with TON. To prevent permanent blindness, a combination of WJ-MSC and rEMS application as soon as possible may increase the chance of success in currently untreatable cases. Trial Registration ClinicalTrials.gov ID: NCT04877067.

Bias correction and downscaling of snow cover fraction projections from regional climate models using remote sensing for the European Alps

Mountain seasonal snow cover is undergoing major changes due to global climate change. Assessments of future snow cover usually rely on physical based models, and often include post-processed meteorology. Alternatively, here we propose a direct statistical adjustment of snow cover fraction from regional climate models by using long-term remote sensing observations. We compared different bias correction routines (delta change, quantile mapping, and quantile delta mapping) and explore a downscaling based on historical observations for the Greater Alpine Region in Europe. All bias correction methods adjust for systematic biases, for example due to topographic smoothing, and reduce model spread in future projections. Averaged over the study region and whole year, snow cover fraction decreases from 12.5 % in 2000–2020 to 10.4 (8.9, 11.5; model spread) % in 2071–2100 under RCP2.6, and 6.4 (4.1, 7.8) % under RCP8.5. In addition, changes strongly depended on season and altitude. The comparison of the statistical downscaling to a high-resolution physical based model yields similar results for the altitude range covered by the climate models, but different altitudinal gradients of change above and below. We found trend-preserving bias correction methods (delta change, quantile delta mapping) more plausible for snow cover fraction than quantile mapping. Downscaling showed potential but requires further research. Since climate model and remote sensing observations are available globally, the proposed methods are potentially widely applicable, but are limited to snow cover fraction only.

The Impact of the Delta Change Approach on the Severity of Ice-jam Flooding Under Future Climate Scenarios

Projection of the impact of future climate on ice-jam flood intensity is an essential component of a flood mitigation strategy for many northern communities. General Circulation Model (GCM) outputs are used to derive hydrological conditions under future climate scenarios. Although GCMs are often downscaled to a point of interest, there can still be significant differences between modelled climate scenarios and historically observed climate scenarios. Therefore, the model-indicated changes between baseline and future values of climatic scenarios are applied to observed baseline values to estimate projected future values. This can be carried out by using the delta change method which is an approach for adjusting GCM output. This study evaluates the impact of the delta change method on the frequency and severity of ice-jam flooding under a future climate scenario. The Athabasca River at Fort McMurray is presented as the test site. Streamflow conditions were derived from a physically-based hydrological model, Modélisation Environnementale communautaire-Surface Hydrology (MESH), by forcing the Canadian Regional Climate Model (CRCM) driven by the Third Generation Coupled Climate Model (CGCM3) for both baseline (1971–2000) and future (2041–2070) periods. Streamflow under future climatic conditions was developed based on the delta change method for both absolute and relative changes. The adjusting streamflow was then used in a fully dynamic river ice hydraulic model, RIVICE, to project future ice-jam scenarios using a stochastic modelling framework. Finally, the impact of the delta changes on the frequency and severity of simulated ice-jam flooding was assessed by producing ice-jam stage-frequency distributions (SFDs) under future climatic conditions. The results indicate that there is a notable difference in the projected frequency and severity of ice-jam flooding between absolute and relative change approaches.

FSH Stimulated Inhibin B in Disorders of Puberty

Background: Predicting puberty is a clinical challenge. Available tests include basal gonadotropins, GnRH and GnRH analogue stimulation test, hCG stimulation test and basal inhibin B(INHB). Unlike GnRH and GnRH analogue stimulated LH, no study has investigated for possibility of rapidly releasable pool of inhibin B from gonads so far. Therefore, in quest of a better diagnostic test present study was undertaken to explore stimulability of inhibin B and if found stimulable, potential role of FSH stimulated inhibin B(FSH-INHB) as marker of entry into puberty. Methods: A total of forty-two subjects fulfilling eligibility criteria were enrolled into this prospective interventional study. Study cohort was divided into Cohort A (Healthy children in puberty; n=26) and Cohort B (Patients of hypogonadotropic hypogonadism; n=16). All participants were subjected to FSH stimulation test and GnRHa stimulation test as per study protocol. Data was analysed for male and female separately. Results: Mean delta change between INHB and FSH-INHB in cohort A (Male; n=18) was 188.8 pg/ml (p value-0.002) while in cohort B(Male; n=8) was 16.64 pg/ml (p value-0.076). Mean delta change in cohort A(Female; n=8) was 1065 pg/ml (p value- 0.023) while in cohort B (Female; n=8) was 9.8 pg/ml (p value-0.128). On ROC analysis, INHB of 68.88 pg/ml in male had 94.4 % sensitivity and 87.5% specificity while 51.47 pg/ml in female had 75% sensitivity and 100% specificity for entry into puberty. Cut off for FSH-INHB were 116.14 pg/ml and 116.50 pg/ml for male and female respectively (100% sensitivity/100% specificity). Conclusion: Inhibin B was stimulable in both male and female after entry into puberty, highlighting the presence of rapidly releasable pool in ovaries and testes. FSH stimulated inhibin B may emerge as promising tool for entry into puberty.

Echocardiographic changes and quality of life after surgical unroofing of myocardial bridges

Objective To examine the echocardiographic changes and quality of life (QoL) after surgical unroofing of myocardial bridges (MBs) involving the left anterior descending (LAD) coronary artery compared with optimal medical therapy (OMT). Methods Twenty-two patients (median age, 24 years; interquartile range, 16–40 years) with MBs of the LAD artery and exertional angina from 2018 to 2019 were retrospectively analyzed. Twelve patients underwent OMT and 10 underwent surgery. Both groups underwent clinical and echocardiographic examinations during hospitalization and follow-up (mean, 1.0 ± 0.8 years). QoL was assessed with the Seattle Angina Questionnaire, short version (SAQ-7). Results Surgery resulted in significantly better QoL than OMT, with a significant improvement in left ventricular global longitudinal strain (GLS) [mean (standard error): 19% (0.19) to 22% (0.34) and 19% (0.15) to 20% (0.24), respectively; delta-change (delta-GLS) of 0.15 vs. 0.067]. In the univariate and multivariable analyses, delta-GLS was positively correlated with the SAQ-7 score and MB length (rho = 0.64 and 0.71, respectively), with a significant interaction between MB length and surgical treatment (beta coefficient, 1.95; 95% confidence interval, 0.14–3.77). Conclusions MB unroofing surgery provided benefits in terms of QoL and left ventricular GLS improvement compared with 1 year of OMT.