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The files provided here include the Canadian Land Surface Scheme'sincluding biogeochemical Cycles(CLASSIC;https://cccma.gitlab.io/classic_pages/) source code for the standard 9-PFT CLASSIC configuration as well as the 14-PFT configuration.Template run parameters, job-options-files, and initialization filesare also included. Global CLASSIC outputs fort the manuscript submitted to theJournal of Advances in Modeling Earth Systems (JAMES)for all model configurations are also included. The AMBER package repository version used to evaluate the model results is also included. &nbsp

IntroductionThe aortic valve opening area (AVA), used to quantify aortic stenosis severity, depends on the transvalvular flow rate (Q). The currently accepted clinical echocardiographic method assumes a linear relation between AVA and Q. We studied whether a sigmoid model better describes this relation and determined “isostiffness-lines” across a wide flow spectrum, thus allowing building a nomogram for the non-invasive estimation of valve stiffness.MethodsBoth AVA and instantaneous Q (Qinst) were measured at 10 different mean cardiac outputs of porcine aortic valves mounted in a pulsatile flow loop. The valves' cusps were chemically stiffened to obtain three stiffness grades and the procedure was repeated for each grade. The relative stiffness was defined as the ratio between LV work at grade with the added stiffness and at native stiffness grade. AVApeak¯ corresponding to the selected Qpeak¯ of the highest 3 and 5 cardiac output values was predicted in K-fold cross-validation using sequentially a linear and a sigmoid model. The accuracy of each model was assessed with the Akaike information criterion (AIC).ResultsThe sigmoid model predicted more accurately AVApeak¯ (AIC for prediction of AVA with Qpeak¯ of the 3 highest cardiac output values: –1,743 vs. –1,048; 5 highest cardiac output values: –1,471 vs. –878) than the linear model.ConclusionThis study suggests that the relation between AVA and Q can be better described by a sigmoid than a linear model. This construction of “isostiffness-lines” may be a useful method for the assessment of aortic stenosis in clinical echocardiography.

The Canadian Land Surface Scheme Including Biogeochemical Cycles (CLASSIC) is an open-source community model designed to address research questions that explore the role of the land surface in the global climate system. Here, we evaluate how well CLASSIC reproduces the energy, water, and carbon cycle when forced with quasi-observed meteorological data. Model skill scores summarize how well model output agrees with observation-based reference data across multiple statistical metrics. A lack of agreement may be due to deficiencies in the model, its forcing data, and/or reference data. To address uncertainties in the forcing, we evaluate an ensemble of CLASSIC runs that is based on three meteorological data sets. To account for observational uncertainty, we compute benchmark skill scores that quantify the level of agreement among independent reference data sets. The benchmark scores demonstrate what score values a model may realistically achieve given the uncertainties in the observations. Our results show that uncertainties associated with the forcing and observations are considerably large. For instance, for 10 out of 19 variables assessed in this study, the sign of the bias changes depending on what forcing and reference data are used. Benchmark scores are much lower than expected, implying large observational uncertainties. Model and benchmark score values are mostly similar, indicating that CLASSIC performs well when considering observational uncertainty. Future model development should address (i) a positive albedo bias and resulting shortwave radiation bias in parts of the Northern Hemisphere (NH) extratropics and Tibetan Plateau, (ii) an out-of-phase seasonal gross primary productivity cycle in the humid tropics of South America and Africa, (iii) a lacking spatial correlation of annual mean net ecosystem exchange with site-level measurements, (iv) an underestimation of fractional area burned and corresponding emissions in the boreal forests, (v) a negative soil organic carbon bias in high latitudes, and (vi) a time lag in seasonal leaf area index maxima in parts of the NH extratropics. Our results will serve as a baseline for guiding and monitoring future CLASSIC development.

Background: To compare the diagnostic yield of echocardiography and cardiovascular MRI (CMR) to detect structural sources of embolism, in patients with ischemic stroke with a secondary analysis of non-stroke populations. Methods and Results: We searched MEDLINE/Embase (from 01.01.2000 to 24.04.2021) for studies including CMR to assess prespecified sources of embolism. Comparison included transthoracic and/or transesophageal echocardiography. Two authors independently screened studies, extracted data and assessed bias using the QUADAS-2 tool. Estimates of diagnostic yield were reported and pooled. Twenty-seven studies with 2,525 patients were included in a study-level analysis. Most studies had moderate to high risk of bias. Persistent foramen ovale, complex aortic plaques, left ventricular and left atrial thrombus were the most common pathologies. There was no difference in the yield of left ventricular thrombus detection between both modalities for stroke populations (4 studies), but an increased yield of CMR in non-stroke populations (28.1 vs. 16.0%, P < 0.001, 10 studies). The diagnostic yield in stroke patients for detection of persistent foramen ovale was lower in CMR compared to transoesophageal echocardiography (29.3 vs. 53.7%, P < 0.001, 5 studies). For both echocardiography and CMR the clinical impact of the management consequences derived from many of the diagnostic findings remained undetermined in the identified studies. Conclusions: Echocardiography and CMR seem to have similar diagnostic yield for most cardioaortic sources of embolism except persistent foramen ovale and left ventricular thrombus. Randomized controlled diagnostic trials are necessary to understand the impact on the management and potential clinical benefits of the assessment of structural cardioaortic stroke sources. Registration: PROSPERO: CRD42020158787.

INTRODUCTION In patients with chronic coronary syndrome, percutaneous coronary intervention targets haemodynamically significant stenoses, that is, those thought to cause ischaemia. Intracoronary ECG (icECG) detects ischaemia directly where it occurs. Thus, the goal of this study was to test the accuracy of icECG during pharmacological inotropic stress to determine functional coronary lesion severity in comparison to the structural parameter of quantitative angiographic per cent diameter stenosis (%S), as well as to the haemodynamic indices of fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR). METHOD The primary study endpoint of this prospective trial was the maximal change in icECG ST-segment shift during pharmacological inotropic stress induced by dobutamine plus atropine obtained within 1 min after reaching maximal heart rate(=220 - age). IcECG was acquired by attaching an alligator clamp to the angioplasty guidewire positioned downstream of the stenosis. For the pressure-derived stenosis severity ratios, coronary perfusion pressure and simultaneous aortic pressure were continuously recorded. RESULTS There was a direct linear relation between icECG ST-segment shift and %S: icECG=-0.8+0.03*%S (r2=0.164; p