bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Interhemispheric Tropical Sea Level Seesaw due to El Niño Taimasa
Authors: Widlansky Matthew J. , Timmermann Axel , McGregor Shayne , Stuecker Malte F. , Cai Wenju 
Published: October 2013

AbstractDuring strong El Niño events, sea level drops around some tropical western Pacific islands by up to 20–30 cm. Such events (referred to as taimasa in Samoa) expose shallow reefs, thereby causing severe damage to associated coral ecosystems and contributing to the formation of microatolls. During the termination of strong El Niño events, a southward movement of weak trade winds and the development of an anomalous anticyclone in the Philippine Sea are shown to force an interhemispheric sea level seesaw in the tropical Pacific that enhances and prolongs extreme low sea levels in the southwestern Pacific. Spectral features, in addition to wind-forced linear shallow water ocean model experiments, identify a nonlinear interaction between El Niño and the annual cycle as the main cause of these sea level anomalies.
Horizontal Stratification during Deep Convection in the Labrador Sea
Authors: Frajka-Williams Eleanor , Rhines Peter B. , Eriksen Charles C. 
Published: October 2013

Abstract
Deep convection—the process by which surface waters are mixed down to 1000 m or deeper—forms the primary downwelling of the meridional overturning circulation in the Northern Hemisphere. High-resolution hydrographic measurements from Seagliders indicate that during deep convection—though water is well mixed vertically—there is substantial horizontal variation in density over short distances (tens of kilometers). This horizontal density variability present in winter (January–February) contains sufficient buoyancy to restratify the convecting region to observed levels 2.5 months later, as estimated from Argo floating platforms. These results highlight the importance of small-scale heterogeneities in the ocean that are typically poorly represented in climate models, potentially contributing to the difficulty climate models have in representing deep convection.
Climatological Characteristics of Atmospheric Rivers and Their Inland Penetration over the Western United States
Authors: Rutz Jonathan J. , Steenburgh W. James , Ralph F. Martin 
Published: October 2013

Abstract
Narrow corridors of water vapor transport known as atmospheric rivers (ARs) contribute to extreme precipitation and flooding along the West Coast of the United States, but knowledge of their influence over the interior is limited. Here, the authors use Interim European Centre for Medium-Range Weather Forecasts (ECMWF) Re-Analysis (ERA-Interim) data, Climate Prediction Center (CPC) precipitation analyses, and Snowpack Telemetry (SNOTEL) observations to describe the characteristics of cool-season (November–April) ARs over the western United States. It is shown that AR frequency and duration exhibit a maximum along the Oregon–Washington coast, a strong transition zone upwind (west) of and over the Cascade–Sierra ranges, and a broad minimum that extends from the “high” Sierra south of Lake Tahoe eastward across the central Great Basin and into the deep interior. East of the Cascade–Sierra ranges, AR frequency and duration are largest over the interior northwest, while AR duration is large compared to AR frequency over the interior southwest. The fractions of cool-season precipitation and top-decile 24-h precipitation events attributable to ARs are largest over and west of the Cascade–Sierra ranges. Farther east, these fractions are largest over the northwest and southwest interior, with distinctly different large-scale patterns and AR orientations enabling AR penetration into each of these regions. In contrast, AR-related precipitation over the Great Basin east of the high Sierra is rare. These results indicate that water vapor depletion over major topographic barriers is a key contributor to AR decay, with ARs playing a more prominent role in the inland precipitation climatology where lower or less continuous topography facilitates the inland penetration of ARs.
Assessment of the internal construct validity of the revised High-Level Mobility Assessment Tool for traumatic orthopaedic injuries
Authors: Hill Bridget , Kahn Michelle , Pallant Julie , Williams Gavin 
Published: October 2013

Objective: To determine whether the revised High-Level Mobility Assessment Tool (HiMAT) was valid for measuring mobility for people with multi-trauma orthopaedic lower limb injuries. Design: Cross-sectional study. Subjects: Participants with lower limb multi-trauma orthopaedic injuries. Methods: One complete revised HiMAT was obtained for 106 people within 12 weeks of being allowed to fully weight bear. Rasch analysis was used to assess the overall fit of the model for individuals and items, differential item functioning, local dependency, targeting of items and dimensionality. Results: The mean revised HiMAT score was 10.5 (SD = 6.8) with a range of 5–30. Rasch analysis of revised HiMAT showed adequate overall fit to the model ( P = 0.29) with no misfitting items (fit residual SD = 0.69) or persons (fit residual SD = 0.62). The scale showed good internal consistency (Person Separation Index = 0.91). One item (hopping) demonstrated disordered thresholds, however this item had good fit to the model in all other aspects. The revised HiMAT was unidimensional, and no differential item functioning was detected for gender or age. The revised HiMAT was well targeted for this group with a range of items across all ability levels. Conclusion: The results of this study support the internal construct validity of the revised HiMAT as a well-targeted, unidimensional measure of high-level mobility with no ceiling or floor effect for males and females recovering from multi-trauma orthopaedic lower limb injuries.
Impact of fatigue on health-related quality of life in patients with Parkinson’s disease: a prospective study
Authors: Elbers Roy G , van Wegen Erwin EH , Verhoef John , Kwakkel Gert 
Published: October 2013

Objective: To investigate the longitudinal association between the impact of fatigue and health-related quality of life and to determine if potential confounders distorted this association. Design: Baseline, 3-, 6- and 12-week assessments of a randomized clinical trial were used. Setting: Outpatient rehabilitation centre. Subjects: Patients with idiopathic Parkinson’s disease. Methods: Quality of life was assessed with the Parkinson’s Disease Questionnaire-39 and the Multidimensional Fatigue Inventory was used to assess fatigue. Time-independent and time-dependent factors were investigated for their bivariate association with quality of life by applying random coefficient analysis. Candidate confounders were successively added to the longitudinal association model to determine if the relationship between quality of life and fatigue was distorted. A change beyond 15% of found regression coefficient of the Multidimensional Fatigue Inventory was considered significant. Results: One hundred and fifty-three patients were included. Impact of fatigue was significantly associated with poorer quality of life (β = 0.24, 95% confidence interval = 0.18 to 0.30). This association was significantly distorted by depression (30.0%) and anxiety (24.1%). No distortion was found for other factors. After controlling for confounders, fatigue remained significantly associated with quality of life (β = 0.12, 95% confidence interval = 0.06 to 0.18, r2 = 2.3%). Conclusions: Our results suggest that patients who experience fatigue tend to report lower levels of quality of life. However, this longitudinal relationship is confounded by depression and anxiety and suggests that the unique contribution of fatigue to overall quality of life is rather small.
Tuberculosis transmission between foreign- and native-born populations in the EU/EEA: a systematic review
Authors: Sandgren Andreas , Sañé Schepisi Monica , Sotgiu Giovanni , Huitric Emma , Migliori Giovanni Battista , Manissero Davide , van der Werf Marieke J. , Girardi Enrico 
Published: October 2013

Tuberculosis (TB) control programmes of many low TB incidence countries of the European Union/European Economic Area (EU/EEA) perceive challenges in controlling TB due to high numbers of TB in migrants from high-incidence countries.To assess the extent of TB transmission from the foreign-born to the native-born population, we quantitatively investigated the dynamics of TB transmission between these populations in the EU/EEA, using published molecular epidemiological studies. We searched PubMed and EMBASE databases from 1990 to August 2012.We identified 15 studies performed during 1992–2007 covering 12,366 cases, of which median (range) 49.2% (17.7%–86.4%) were foreign-born. The proportion of clustered isolates ranged between 8.5% and 49.1% of the total number of TB cases genotyped and among these, foreign-born cases were equally or more likely to have unique isolates compared to native-born cases. One third of the clusters were “mixed”,i.e.composed of foreign- and native-born cases, involving 0–34.2% of all genotyped cases. Cross-transmission among foreign and native populations was bidirectional, with wide differences across studies.This systematic review provides evidence that TB in a foreign-born population does not have a significant influence on TB in the native population in EU/EEA.
An exploration of risk for recurrent falls in two geriatric care settings
Authors: Tariq Humeira , Kloseck Marita , Crilly Richard G , Gutmanis Iris , Gibson Maggie 
Published: October 2013

Abstract

Background
Fall events were examined in two distinct geriatric populations to identify factors associated with repeat fallers, and to examine whether patients who use gait aids, specifically a walker, were more likely to experience repeat falls. Each unit already had a generic program for falls prevention in place.

Methods
Secondary data analysis was conducted on information collected during the pilot testing of a new quality assurance Incident Reporting Tool between October 2006 and September 2008. The study settings included an in-patient geriatric rehabilitation unit (GRU) and a long stay veterans’ unit (LSVU) in a rehabilitation and long-stay hospital in Ontario. Participants were two hundred and twenty three individuals, aged 65 years or older on these two units, who experienced one or more fall incidents during the study period.

Results
Logistic regression analyses showed that on the GRU age was significantly associated with repeat falls. On the LSVU first falls in the morning or late evening were associated with repeat falling. Walker as a gait aid listed at time of first fall was not associated with repeat falls.

Conclusions
This study suggests that different intervention may be necessary in different geriatric settings to identify, for secondary prevention, certain individuals for which the generic programs prove inadequate. Information collection with a specific focus on the issue of repeat falls may be necessary for greater insight.
Exogenous surfactant therapy in 2013: what is next? who, when and how should we treat newborn infants in the future?
Authors: Lopez Emmanuel , Gascoin Géraldine , Flamant Cyril , Merhi Mona , Tourneux Pierre , Baud Olivier ,   for the French Young Neonatologist Club
Published: October 2013

AbstractBackgroundSurfactant therapy is one of the few treatments that have dramatically changed clinical practice in neonatology. In addition to respiratory distress syndrome (RDS), surfactant deficiency is observed in many other clinical situations in term and preterm infants, raising several questions regarding the use of surfactant therapy.ObjectivesThis review focuses on several points of interest, including some controversial or confusing topics being faced by clinicians together with emerging or innovative concepts and techniques, according to the state of the art and the published literature as of 2013. Surfactant therapy has primarily focused on RDS in the preterm newborn. However, whether this treatment would be of benefit to a more heterogeneous population of infants with lung diseases other than RDS needs to be determined. Early trials have highlighted the benefits of prophylactic surfactant administration to newborns judged to be at risk of developing RDS. In preterm newborns that have undergone prenatal lung maturation with steroids and early treatment with continuous positive airway pressure (CPAP), the criteria for surfactant administration, including the optimal time and the severity of RDS, are still under discussion. Tracheal intubation is no longer systematically done for surfactant administration to newborns. Alternative modes of surfactant administration, including minimally-invasive and aerosolized delivery, could thus allow this treatment to be used in cases of RDS in unstable preterm newborns, in whom the tracheal intubation procedure still poses an ethical and medical challenge.ConclusionThe optimization of the uses and methods of surfactant administration will be one of the most important challenges in neonatal intensive care in the years to come.
Evaluation of drinking patterns and their impact on alcohol-related aggression: a national survey of adolescent behaviours
Authors: Siciliano Valeria , Mezzasalma Lorena , Lorenzoni Valentina , Pieroni Stefania , Molinaro Sabrina 
Published: October 2013

Abstract

Background
Although there have been a wide range of epidemiological studies examining the impact of patterns of alcohol consumption among adolescents, there remains considerable variability in both defining these patterns and the ability to comprehensively evaluate their relationship to behavioural patterns. This study explores a new procedure for defining and evaluating drinking patterns and integrating well-established indicators. The composite measure is then used to estimate the impact of these patterns on alcohol-related aggressive behaviour among Italian adolescents.

Methods
Data were collected as part of the 2011 European School Survey Project on Alcohol and other Drugs (ESPAD). A national sample of 14,199 students aged 15–19 years was collected using an anonymous, self-administered questionnaire completed in a classroom setting. Drinking patterns were established using principal component analysis. Alcohol-related aggression was analysed as to its relationship to patterns of drinking, behaviour of friends towards alcohol use, substance use/abuse, school performance, family relationships and leisure activities.

Results
Several specific drinking patterns were identified: “Drinking to Excess” (DE), “Drinking with Intoxication” (DI) and “Drinking but Not to Excess” (DNE). A higher percentage of males were involved in alcohol-related aggression compared with females. In males, the DE and DI patterns significantly increased the likelihood of alcohol-related aggression, whereas the DNE pattern was negatively associated. Similar results were found in females, although the DI pattern was not significantly associated with alcohol-related aggression. Overall, cigarette smoking, illegal drug use, truancy, limited parental monitoring, frequent evenings spent outside of the home and peer influence associated strongly with alcohol-related aggression.

Conclusions
Our findings suggest that drinking patterns, as uniquely monitored with an integrated metric, can: 1) explain drinking habits better than commonly used indicators of alcohol use and 2) provide a better understanding of behavioural risks such as alcohol-related aggression. Environmental background also appears to strongly associate with this type of aggressive behaviour.
The health outcomes and costs of people attending an interdisciplinary chronic disease service in regional Australia: protocol for a longitudinal cohort investigation
Authors: Tyack Zephanie , Frakes Kerrie-Anne , Cornwell Petrea , Kuys Suzanne S , Barnett Adrian G , McPhail Steven M 
Published: October 2013

Abstract

Background
Rates of chronic disease are escalating around the world. To date health service evaluations have focused on interventions for single chronic diseases. However, evaluations of the effectiveness of new intervention strategies that target single chronic diseases as well as multimorbidity are required, particularly in areas outside major metropolitan centres where access to services, such as specialist care, is difficult and where the retention and recruitment of health professionals affects service provision.

Methods
This study is a longitudinal investigation with a baseline and three follow-up assessments comparing the health and health costs of people with chronic disease before and after intervention at a chronic disease clinic, in regional Australia. The clinic is led by students under the supervision of health professionals. The study will provide preliminary evidence regarding the effectiveness of the intervention, and evaluate the influence of a range of factors on the health outcomes and costs of the patients attending the clinic. Patients will be evaluated at baseline (intake to the service), and at 3-, 6-, and 12-months after intake to the service. Health will be measured using the SF-36 and health costs will be measured using government and medical record sources. The intervention involves students and health professionals from multiple professions working together to treat patients with programs that include education and exercise therapy programs for back pain, and Healthy Lifestyle programs; as well as individual consultations involving single professions.

Discussion
Understanding the effect of a range of factors on the health state and health costs of people attending an interdisciplinary clinic will inform health service provision for this clinical group and will determine which factors need to be controlled for in future observational studies. Preliminary evidence regarding changes in health and health costs associated with the intervention will be a platform for future clinical trials of intervention effectiveness. The results will be of interest to teams investigating new chronic disease programs particularly for people with multimorbidity, and in areas outside major metropolitan centres.

Trial registration
Australia and New Zealand Clinical Trials Registry: ACTRN12611000724976
The effect of insecticide-treated bed nets on the incidence and prevalence of malaria in children in an area of unstable seasonal transmission in western Myanmar
Authors: Smithuis Frank M , Kyaw Moe Kyaw , Phe U Ohn , van der Broek Ingrid , Katterman Nina , Rogers Colin , Almeida Patrick , Kager Piet A , Stepniewska Kasia , Lubell Yoel , Simpson Julie A , White Nicholas J 
Published: October 2013

Abstract

Background
Insecticide-treated bed nets (ITN) reduce malaria morbidity and mortality consistently in Africa, but their benefits have been less consistent in Asia. This study’s objective was to evaluate the malaria protective efficacy of village-wide usage of ITN in Western Myanmar and estimate the cost-effectiveness of ITN compared with extending early diagnosis and treatment services.

Methods
A cluster-randomized controlled trial was conducted in Rakhine State to assess the efficacy of ITNs in preventing malaria and anaemia in children and their secondary effects on nutrition and development. The data were aggregated for each village to obtain cluster-level infection rates. In total 8,175 children under 10 years of age were followed up for 10 months, which included the main malaria transmission period. The incidence and prevalence of Plasmodium falciparum and Plasmodium vivax infections, and the biting behaviour of Anopheles mosquitoes in the area were studied concurrently. The trial data along with costs for current recommended treatment practices were modelled to estimate the cost-effectiveness of ITNs compared with, or in addition to extending the coverage of early diagnosis and treatment services.

Results
In aggregate, malaria infections, spleen rates, haemoglobin concentrations, and weight for height, did not differ significantly during the study period between villages with and without ITNs, with a weighted mean difference of −2.6 P. falciparum episodes per 1,000 weeks at risk (95% Confidence Interval −7 to 1.8). In areas with a higher incidence of malaria there was some evidence ITN protective efficacy. The economic analysis indicated that, despite the uncertainty and variability in their protective efficacy in the different study sites, ITN could still be cost-effective, but not if they displaced funding for early diagnosis and effective treatment which is substantially more cost-effective.

Conclusion
In Western Myanmar deployment of ITNs did not provide consistent protection against malaria in children living in malaria endemic villages. Early diagnosis and effective treatment is a more cost effective malaria control strategy than deployment of ITNs in this area where the main vector bites early in the evening, often before people are protected by an ITN.
Predictors of continued HIV-risk behaviors among drug users in methadone maintenance therapy program in China—A prospective study
Authors: Chen Wen , Xia Yinghua , Hong Yan , Hall Brian J , Ling Li 
Published: October 2013

Abstract

Background
To examine the predictors of continued drug- and sex-related HIV-risk behaviors among drug users in methadone maintenance therapy (MMT) programs in China.

Methods
We followed a sample of 5,035 drug users enrolled for the first time in MMT programs at baseline, 6 months, and 12 months utilizing a longitudinal prospective study design. Drug users’ HIV-risk behaviors, MMT characteristics, and drug use, were assessed at all three waves using a structured interview and HIV/HCV status was assessed at baseline and 12-month follow-up using biological specimens.

Results
The point prevalence of HIV was 7.6% and 78.4% for HCV at baseline. Results of generalized linear mixed logistic regression models revealed that HIV-positive MMT clients were more likely to engage in drug injection (aOR = 1.70) and syringe sharing (aOR = 4.73). HCV-positive clients were more likely to inject drugs (aOR = 2.58), share syringes (aOR = 1.97), and have multiple sexual partners (aOR = 1.47). Adherence to MMT was the most significant predictor of reduced HIV-risk behaviors.

Conclusions
Our data confirmed the positive effects of MMT on HIV prevention and underscored the urgency for programs to reduce HIV risk in HIV- and HCV-positive clients. There is a pressing need to strengthen existing counseling services for HIV-positive drug users to reduce their drug-related risk behaviors and to provide counseling for HCV-positive drug users. Further studies are needed to explore interventions to address high dropout rates and low adherence among MMT clients.