A process-based evaluation of dust-emitting winds in the CMIP5 simulation of HadGEM2-ES

Despite the importance of dust aerosol in the Earth system, state-of-the-art models show a large variety for North African dust emission. This study presents a systematic evaluation of dust emitting-winds in 30 years of the historical model simulation with the UK Met Office Earth-system model HadGEM2-ES for the Coupled Model Intercomparison Project Phase 5. Isolating the effect of winds on dust emission and using an automated detection for nocturnal low-level jets (NLLJs) allow an in-depth evaluation of the model performance for dust emission from a meteorological perspective. The findings highlight that NLLJs are a key driver for dust emission in HadGEM2-ES in terms of occurrence frequency and strength. The annually and spatially averaged occurrence frequency of NLLJs is similar in HadGEM2-ES and ERA-Interim from the European Centre for Medium-Range Weather Forecasts. Compared to ERA-Interim, a stronger pressure ridge over northern Africa in winter and the southward displaced heat low in summer result in differences in location and strength of NLLJs. Particularly the larger geostrophic winds associated with the stronger ridge have a strengthening effect on NLLJs over parts of West Africa in winter. Stronger NLLJs in summer may rather result from an artificially increased mixing coefficient under stable stratification that is weaker in HadGEM2-ES. NLLJs in the Bodélé Depression are affected by stronger synoptic-scale pressure gradients in HadGEM2-ES. Wintertime geostrophic winds can even be so strong that the associated vertical wind shear prevents the formation of NLLJs. These results call for further model improvements in the synoptic-scale dynamics and the physical parametrization of the nocturnal stable boundary layer to better represent dust-emitting processes in the atmospheric model. The new approach could be used for identifying systematic behavior in other models with respect to meteorological processes for dust emission. This would help to improve dust emission simulations and contribute to decreasing the currently large uncertainty in climate change projections with respect to dust aerosol.

Targeting medication non-adherence behavior in selected autoimmune diseases: a systematic approach to digital health program development

Background 29 autoimmune diseases, including Rheumatoid Arthritis, gout, Crohn’s Disease, and Systematic Lupus Erythematosus affect 7.6-9.4% of the population. While effective therapy is available, many patients do not follow treatment or use medications as directed. Digital health and Web 2.0 interventions have demonstrated much promise in increasing medication and treatment adherence, but to date many Internet tools have proven disappointing. In fact, most digital interventions continue to suffer from high attrition in patient populations, are burdensome for healthcare professionals, and have relatively short life spans. Objective Digital health tools have traditionally centered on the transformation of existing interventions (such as diaries, trackers, stage-based or cognitive behavioral therapy programs, coupons, or symptom checklists) to electronic format. Advanced digital interventions have also incorporated attributes of Web 2.0 such as social networking, text messaging, and the use of video. Despite these efforts, there has not been little measurable impact in non-adherence for illnesses that require medical interventions, and research must look to other strategies or development methodologies. As a first step in investigating the feasibility of developing such a tool, the objective of the current study is to systematically rate factors of non-adherence that have been reported in past research studies. Methods Grounded Theory, recognized as a rigorous method that facilitates the emergence of new themes through systematic analysis, data collection and coding, was used to analyze quantitative, qualitative and mixed method studies addressing the following autoimmune diseases: Rheumatoid Arthritis, gout, Crohn’s Disease, Systematic Lupus Erythematosus, and inflammatory bowel disease. Studies were only included if they contained primary data addressing the relationship with non-adherence. Results Out of the 27 studies, four non-modifiable and 11 modifiable risk factors were discovered. Over one third of articles identified the following risk factors as common contributors to medication non-adherence (percent of studies reporting): patients not understanding treatment (44%), side effects (41%), age (37%), dose regimen (33%), and perceived medication ineffectiveness (33%). An unanticipated finding that emerged was the need for risk stratification tools (81%) with patient-centric approaches (67%). Conclusions This study systematically identifies and categorizes medication non-adherence risk factors in select autoimmune diseases. Findings indicate that patients understanding of their disease and the role of medication are paramount. An unexpected finding was that the majority of research articles called for the creation of tailored, patient-centric interventions that dispel personal misconceptions about disease, pharmacotherapy, and how the body responds to treatment. To our knowledge, these interventions do not yet exist in digital format. Rather than adopting a systems level approach, digital health programs should focus on cohorts with heterogeneous needs, and develop tailored interventions based on individual non-adherence patterns.

FACSGen: a tool to synthesize emotional facial expressions through systematic manipulation of facial action units

To investigate the perception of emotional facial expressions, researchers rely on shared sets of photos or videos, most often generated by actor portrayals. The drawback of such standardized material is a lack of flexibility and controllability, as it does not allow the systematic parametric manipulation of specific features of facial expressions on the one hand, and of more general properties of the facial identity (age, ethnicity, gender) on the other. To remedy this problem, we developed FACSGen: a novel tool that allows the creation of realistic synthetic 3D facial stimuli, both static and dynamic, based on the Facial Action Coding System. FACSGen provides researchers with total control over facial action units, and corresponding informational cues in 3D synthetic faces. We present four studies validating both the software and the general methodology of systematically generating controlled facial expression patterns for stimulus presentation.

Cognitive-behavior therapy for low self-esteem: a case example

Low self-esteem is a common, disabling, and distressing problem that has been shown to be involved in the etiology and maintenance of range of Axis I disorders. Hence, it is a priority to develop effective treatments for low self-esteem. A cognitive-behavioral conceptualization of low self-esteem has been proposed and a cognitive-behavioral treatment (CBT) program described (Fennell, 1997, 1999). As yet there has been no systematic evaluation of this treatment with routine clinical populations. The current case report describes the assessment, formulation, and treatment of a patient with low self-esteem, depression, and anxiety symptoms. At the end of treatment (12 sessions over 6 months), and at 1-year follow-up, the treatment showed large effect sizes on measures of depression, anxiety, and self-esteem. The patient no longer met diagnostic criteria for any psychiatric disorder, and showed reliable and clinically significant change on all measures. As far as we are aware, there are no other published case studies of CBT for low self-esteem that report pre- and posttreatment evaluations, or follow-up data. Hence, this case provides an initial contribution to the evidence base for the efficacy of CBT for low self-esteem. However, further research is needed to confirm the efficacy of CBT for low self-esteem and to compare its efficacy and effectiveness to alternative treatments, including diagnosis-specific CBT protocols.