Patients' and Doctors' Views and Experiences of the Patient Safety Trajectory of Breast Cancer Care
In: THEBREAST-D-24-80
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In: THEBREAST-D-24-80
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In: Population and environment: a journal of interdisciplinary studies, Band 41, Heft 2, S. 209-234
ISSN: 1573-7810
The Community Land Model (CLM) is the land component of the Community Earth System Model (CESM) and is used in several global and regional modeling systems. In this paper, we introduce model developments included in CLM version 5 (CLM5), which is the default land component for CESM2. We assess an ensemble of simulations, including prescribed and prognostic vegetation state, multiple forcing data sets, and CLM4, CLM4.5, and CLM5, against a range of metrics including from the International Land Model Benchmarking (ILAMBv2) package. CLM5 includes new and updated processes and parameterizations: (1) dynamic land units, (2) updated parameterizations and structure for hydrology and snow (spatially explicit soil depth, dry surface layer, revised groundwater scheme, revised canopy interception and canopy snow processes, updated fresh snow density, simple firn model, and Model for Scale Adaptive River Transport), (3) plant hydraulics and hydraulic redistribution, (4) revised nitrogen cycling (flexible leaf stoichiometry, leaf N optimization for photosynthesis, and carbon costs for plant nitrogen uptake), (5) global crop model with six crop types and time-evolving irrigated areas and fertilization rates, (6) updated urban building energy, (7) carbon isotopes, and (8) updated stomatal physiology. New optional features include demographically structured dynamic vegetation model (Functionally Assembled Terrestrial Ecosystem Simulator), ozone damage to plants, and fire trace gas emissions coupling to the atmosphere. Conclusive establishment of improvement or degradation of individual variables or metrics is challenged by forcing uncertainty, parametric uncertainty, and model structural complexity, but the multivariate metrics presented here suggest a general broad improvement from CLM4 to CLM5. ; National Science Foundation (NSF)National Science Foundation (NSF); National Center for Atmospheric Research - NSF [1852977]; RUBISCO Scientific Focus Area (SFA) - Regional and Global Climate Modeling (RGCM) Program in the Climate and Environmental Sciences Division (CESD) of the Office of Biological and Environmental Research in the U.S. Department of Energy Office of Science; Columbia University Presidential Fellowship; U.S. Department of Agriculture NIFA Award [2015-67003-23485]; NASA Interdisciplinary Science Program Award [NNX17AK19G]; U.S. Department of Energy, Office of Science, Office of Biological and Environmental Research, Terrestrial Ecosystem Science programUnited States Department of Energy (DOE) [DE-SC0008317, DESC0016188]; National Science FoundationNational Science Foundation (NSF) [DEB-1153401]; NASA's CARBON program; NASA's TE program; National Aeronautics and Space AdministrationNational Aeronautics & Space Administration (NASA) ; We would like to thank the reviewers for their insightful comments and helpful suggestions that improved the clarity and presentation of the manuscript. The CESM project is supported primarily by the National Science Foundation (NSF). This material is based upon work supported by the National Center for Atmospheric Research, which is a major facility sponsored by the NSF under Cooperative Agreement 1852977. Computing and data storage resources, including the Cheyenne supercomputer (doi:10.5065/D6RX99HX), were provided by the Computational and Information Systems Laboratory (CISL) at NCAR. D. M. L. was supported in part by the RUBISCO Scientific Focus Area (SFA), which is sponsored by the Regional and Global Climate Modeling (RGCM) Program in the Climate and Environmental Sciences Division (CESD) of the Office of Biological and Environmental Research in the U.S. Department of Energy Office of Science. D. K. and P. G. were supported by Columbia University Presidential Fellowship. G. B., D. L. L., W. R. W., and R. Q. T. were supported by the U.S. Department of Agriculture NIFA Award 2015-67003-23485. W. R. W. and G. K. A. were supported by the NASA Interdisciplinary Science Program Award NNX17AK19G. J. B. F. and M. S. carried out the research in part at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration. California Institute of Technology. Government sponsorship acknowledged. All rights reserved. J. B. F. and M. S. were supported in part by the U.S. Department of Energy, Office of Science, Office of Biological and Environmental Research, Terrestrial Ecosystem Science program under Awards DE-SC0008317 and DESC0016188; the National Science Foundation Ecosystem Science program (DEB-1153401); and NASA's CARBON and TE programs. All model data are archived and publicly available at the UCAR/NCAR Climate Data Gateway (https://doi.org/10.5065/d6154fwh).
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The Coronavirus Disease 2019 (COVID-19) has had a continuous and robust impact on world health. The resulting COVID-19 pandemic has had a devastating physical, mental and fiscal impact on the millions of people living with noncommunicable diseases (NCDs). In addition to older age, people living with CVD, stroke, obesity, diabetes, kidney disease, and hypertension are at a particularly greater risk for severe forms of COVID-19 and its consequences. Meta-analysis indicates that hypertension, diabetes, chronic kidney disease, and thrombotic complications have been observed as both the most prevalent and most dangerous co-morbidities in COVID-19 patients. And despite the nearly incalculable physical, mental, emotional, and economic toll of this pandemic, forthcoming public health figures continue to place cardiovascular disease as the number one cause of death across the globe in the year 2020. The world simply cannot wait for the next pandemic to invest in NCDs. Social determinants of health cannot be addressed only through the healthcare system, but a more holistic multisectoral approach with at its basis the Sustainable Development Goals (SDGs) is needed to truly address social and economic inequalities and build more resilient systems. Yet there is reason for hope: the 2019 UN Political Declaration on UHC provides a strong framework for building more resilient health systems, with explicit calls for investment in NCDs and references to fiscal policies that put such investment firmly within reach. By further cementing the importance of addressing circulatory health in a future Framework Convention on Emergency Preparedness, WHO Member States can take concrete steps towards a pandemic-free future. As the chief representatives of the global circulatory health community and patients, the Global Coalition for Circulatory Health calls for increased support for the healthcare workforce, global vaccine equity, embracing new models of care and digital health solutions, as well as fiscal policies on unhealthy commodities to support these investments.
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We present a search for gravitational waves from 116 known millisecond and young pulsars using data from the fifth science run of the LIGO detectors. For this search, ephemerides overlapping the run period were obtained for all pulsars using radio and X-ray observations. We demonstrate an updated search method that allows for small uncertainties in the pulsar phase parameters to be included in the search. We report no signal detection from any of the targets and therefore interpret our results as upper limits on the gravitational wave signal strength. The most interesting limits are those for young pulsars. We present updated limits on gravitational radiation from the Crab pulsar, where the measured limit is now a factor of 7 below the spin-down limit. This limits the power radiated via gravitational waves to be less than similar to 2% of the available spin-down power. For the X-ray pulsar J0537-6910 we reach the spin-down limit under the assumption that any gravitational wave signal from it stays phase locked to the X-ray pulses over timing glitches, and for pulsars J1913+1011 and J1952+3252 we are only a factor of a few above the spin-down limit. Of the recycled millisecond pulsars, several of themeasured upper limits are only about an order of magnitude above their spin-down limits. For these our best (lowest) upper limit on gravitational wave amplitude is 2.3 x 10(-26) for J1603-7202 and our best (lowest) limit on the inferred pulsar ellipticity is 7.0 x 10(-8) for J2124-3358. ; Australian Research Council ; Council of Scientific and Industrial Research of India ; Istituto Nazionale di Fisica Nucleare of Italy ; Spanish Ministerio de Educacion y Ciencia ; Conselleria d'Economia Hisenda i Innovacio of the Govern de les Illes Balears ; Netherlands Organisation for Scientific Research ; Royal Society ; Scottish Funding Council ; Polish Ministry of Science and Higher Education ; Foundation for Polish Science ; Scottish Universities Physics Alliance ; National Aeronautics and Space Administration ; Carnegie Trust ; Leverhulme Trust ; David and Lucile Packard Foundation ; Research Corporation ; Alfred P. Sloan Foundation ; Natural Sciences and Engineering Research Council of Canada ; Commonwealth Government ; Astronomy
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