bluuebunny/crossref_metadata_2025_split huggingface dataset:
Should we test for tetanus immunity in all emergency department patients with wounds?
Authors: McVicar Jane 
Published: June 2012

BackgroundPeople who present to the emergency department often do not know their tetanus immunisation status. The Protetanus test can determine whether a person is immune and can guide treatment decisions.ObjectivesTo examine whether testing all patients for immunity is clinically advisable and cost-effective.Methods200 patients presenting to the emergency department with wounds were asked whether they were covered for tetanus, not covered or did not know. All had their tetanus immunity tested with the Protetanus kit and the result was compared with reported status. The number of unnecessary vaccinations which might have been given based on recall was calculated. The cost of testing and subsequent treatment versus vaccinations based on recall was calculated.Results136 (68%) tested positive for tetanus immunity; 64 (32%) were negative. Age, sex and nationality were not associated with tetanus immunity. 151 (75.5%) did not know their status. Of these, 101 (66.9%) were positive and 50 (33.1%) negative. 49 (24.5%) were sure of their status. 36 said they were covered of whom 10 (27.8%) were wrong. 13 said they were not covered of whom 9 (69.2%) were wrong. If vaccination were based on recall status 38.8% of patients would receive incorrect treatment. Testing all 200 and treating appropriately would save £984, or £4.92 per patient compared with vaccination based on recall.ConclusionOn clinical grounds testing is advisable and it may produce significant cost savings.
Income inequalities in case death of ischaemic heart disease in the Netherlands: a national record-linked study
Authors: Stirbu Irina , Looman Caspar , Nijhof Geesje J , Reulings Petra G , Mackenbach Johan P 
Published: June 2012

BackgroundSocioeconomic inequalities in ischaemic heart disease (IHD) mortality have been found in most European countries, but it is unclear to what extent inequalities in survival, as opposed to incidence, contribute to these inequalities in mortality. The author studied income-related inequalities in short-term and long-term case death after first hospitalisation with acute myocardial infarction (AMI) and chronic ischaemic heart disease (CIHD), as well as inequalities in cardiovascular surgical procedures among patients admitted with IHD, in the Netherlands.MethodsDesign: A nationwide prospective cohort study of patients first admitted for IHD. Data: Obtained by record linkage at individual level of national hospital discharge, cause of death, population and income registries. Patients: 15 416 patients admitted to a hospital with first episode of AMI and 31 209 patients admitted to a hospital with first episode of CIHD in the period 2003–2005. Main outcome measures: Differences by income quintile in short-term (28 days) and long-term (1 year) case death after first hospital admission with AMI and CIHD. Differences by income quintile in Percutaneous Transluminal Coronary Angioplasty (PTCA) and Coronary Artery Bypass Graft operations among patients with first admission for AMI.ResultsAfter adjustment for age, ethnicity and comorbidity, men and women in the lower income quintiles had a higher 28-day and 1-year case death after first hospitalisation with an AMI or CIHD. After adjustment for age and comorbidity, patients admitted to the hospital with a first AMI also had a lower probability of undergoing a PTCA procedure if they belonged to a lower income quintile. There were large between-hospital variations in inequalities in 28-day mortality for patients admitted with a first AMI.ConclusionsHigher mortality from IHD among lower income people is likely to be partly due to higher case death after first hospital admission. Inequalities in utilisation of PTCA and between-hospital variations in inequalities in outcomes suggest that inequalities in access to good quality care may play a role in explaining the higher case death of IHD among people with lower socioeconomic position. Further research is needed to elucidate the causes of these inequalities in case death.
Insights into the timing of repeated testing after treatment forChlamydia trachomatis: data and modelling study
Authors: Heijne Janneke Cornelia Maria , Herzog Sereina Annik , Althaus Christian Lorenz , Tao Guoyu , Kent Charlotte Kathleen , Low Nicola 
Published: June 2012

ObjectivesThe objective of this study was to determine the optimal time interval for a repeatedChlamydia trachomatis(chlamydia) test.MethodsThe authors used claims data for US women aged 15–25 years who were enrolled in commercial health insurance plans in the MarketScan database between 2002 and 2006. The authors determined the numbers of initial positive and negative tests that were followed by a repeated test and the positivity of repeated tests. The authors used a dynamic transmission pair model that reflects the partnership formation and separation processes in 15–25 year olds to determine the time course of repeated infections in women under different levels of notifying the current partner. The authors then explored the additional impact of repeated testing uptake on reducing chlamydia prevalence.Results40% (4949/12 413) of positive tests were followed by a repeated test compared with 22% (89 119/402 659) of negative tests at any time. Positivity of repeated tests followed by an initial positive test was high: 15% (736) after a positive test versus 3% (2886) after a negative test. The transmission model showed a peak in repeated infections between 2 and 5 months after treatment. For a chlamydia testing uptake of 10% per year, the additional impact of repeated testing on reducing chlamydia population prevalence was modest.ConclusionsThe mathematical model predictions support the recommended interval for repeat chlamydia testing. This study provides information that can be used to design randomised controlled trials to determine more effective interventions to prevent chlamydial reinfection.
Cross-sectional study on the prevalence of HPV antibodies in the general population of the Czech Republic
Authors: Hamsikova Eva , Ludvikova Viera , Stasikova Jana , Tachezy Ruth 
Published: June 2012

ObjectivesThe assessment of the prevalence of antibodies to human papillomaviruses (HPV) in the healthy population is essential for effective planning of HPV vaccine implementation into the preventive programmes for HPV-associated diseases and for the prospective monitoring of the impact of HPV vaccines in the Czech population.MethodsThe seropositivity for HPV-6, 11, 16, 18, 31 and 33 virus-like particles was determined in sera from 3150 healthy individuals (age range 6–76 years) by means of enzyme-linked immunoassay.ResultsThe seroprevalences for HPV-6, 11, 16, 18, 31 and 33 were 23.8%, 15.2%, 14.5%, 9.9%, 16.4% and 9.6% in women and 18.4%, 13.7%, 6.5%, 5.4%, 6.1% and 4.3% in men. For both genders, except for HPV11, these rates were age dependent. The prevalence of antibodies to HPV-16 and/or 18 reached the maximum of 27.0% in women 30–39 years of age and of 14.4% in men 50–59 years of age. The highest proportion of individuals' seropositive for any of the vaccine types HPV-6/11/16/18 was in 30- to 39-year-old women (50.0%) and in ≥60-year-old men (37.6%). Antibodies specific for vaccine HPV types were detected in 18.0% of children 6- to 14-year-old but in 26.4%, those older than 14 years.ConclusionsThe data reveal age-specific differences in the HPV seropositivity rates between healthy women and men and support the implementation of HPV vaccination in the Czech Republic before the age of 13.
Use of Primary Prevention Implantable Cardioverter-Defibrillators in a Population-Based Cohort Is Associated With a Significant Survival Benefit
Authors: Parkash Ratika , Sapp John L. , Basta Magdy , Doucette Steve , Thompson Kara , Gardner Martin , Gray Chris , Brownell Brenda , Kidwai Hena , Cox Jafna 
Published: June 2012

Background—
Underuse of implantable defibrillators has been previously noted in patients at risk for sudden cardiac death, as well as for survivors of sudden cardiac death. We sought to determine the utilization rates in a primary prevention implantable cardioverter-defibrillator (ICD)–eligible population and mortality in this group compared with a group that had undergone implantation of this therapy.

Methods and Results—

A retrospective cohort of patients from April 1, 2006, to December 31, 2009, was used to define a primary prevention ICD-eligible population. Two groups were compared on the basis of ICD implantation (no-ICD versus ICD). The primary outcome measure was mortality. Of the 717 patients found to be potentially eligible for a primary prevention ICD, 116 (16%) were referred. The remaining cohort of 601 patients were compared with an existing cohort of primary prevention ICD patients (n=290). A significant survival benefit was associated with primary prevention ICD implantation (hazard ratio, 0.46; 95% CI [0.33–0.64];
P
<0.0001). When adjusted for prespecified variables known to be associated with overall mortality and propensity score, a similar survival benefit was seen (hazard ratio, 0.59; 95% CI [0.40–0.87];
P
=0.01). Appropriate ICD therapy occurred in 26% of those in the ICD group, during a mean follow-up of 2.7 years.

Conclusions—
A significant mortality benefit was observed for patients who underwent primary prevention ICD implantation compared with those who did not. Vigilance is required to ensure that patients eligible for primary prevention ICDs are appropriately referred and assessed to allow such patients to benefit from this life-saving therapy.
Cardiac Microinjury Measured by Troponin T Predicts Collagen Metabolism in Adults Aged ≥65 Years With Heart Failure
Authors: Kop Willem J. , Gottdiener John S. , deFilippi Christopher R. , Barasch Eddy , Seliger Stephen L. , Jenny Nancy S. , Christenson Robert H. 
Published: June 2012

Background—
Repeated myocardial microinjuries lead to collagen deposition and fibrosis, thereby increasing the risk of clinical heart failure. Little is known about the longitudinal association between increases in myocardial injury and the biology of collagen synthesis and deposition.

Methods and Results—

Repeated measures of highly sensitive cardiac troponin T (cTnT) were obtained in participants of the Cardiovascular Health Study (N=353; mean age, 74±6 years; 52% women) at baseline and at 3 years follow-up. Biomarkers of collagen metabolism were obtained at follow-up and included carboxyterminal propeptide of procollagen type I, carboxyterminal telopeptide of type I collagen, and aminoterminal propeptide of procollagen III. Multivariable linear regression analyses were used to examine the association between baseline cTnT and changes in cTnT with collagen metabolism markers at follow-up adjusting for demographics, heart failure status, and cardiovascular risk factors. Results indicated that cTnT increases over 3-years were significantly associated with higher levels of carboxyterminal telopeptide of type I collagen (β=0.22,
P
<0.001) and aminoterminal propeptide of procollagen III (β=0.12,
P
=0.035) at follow-up when adjusting for demographic, clinical, and biochemical covariates including baseline cTnT. These associations were stronger in patients with heart failure than in control subjects.

Conclusions—
Increases in myocardial microinjury measured by changes in cTnT adversely affect markers of collagen metabolism. These findings are important to the biology of myocardial fibrosis and tissue repair. Serial evaluation of cTnT combined with collagen metabolism markers may further elucidate the pathophysiology of heart failure.
Modeling Study of Ice Formation in Warm-Based Precipitating Shallow Cumulus Clouds
Authors: Sun Jiming , Ariya Parisa A. , Leighton Henry G. , Yau Man Kong 
Published: June 2012

Abstract
Observations of large concentrations of ice particles in the dissipating stage of warm-based precipitating shallow cumulus clouds point to the limitations of scientists’ understanding of the physics of such clouds and the possible role of cloud dynamics. The most commonly accepted mechanisms of ice splinter production in the riming process have limitations to properly explain the rapid production of ice bursts. A more detailed description of the temporal and spatial evolution of hydrometeors and their interaction with cloud condensation nuclei and ice nuclei is needed to understand this phenomenon. A cloud model with bin-resolved microphysics can describe the time-dependent evolution of liquid droplets and ice particles and provide insights into how the physics and dynamics and their interaction may result in ice initiation and ice multiplication. The authors developed a 1.5-dimensional nonhydrostatic convective cloud and aerosol interaction model with spectral (bin) microphysics. The number and mass concentrations of aerosols, including ice nuclei and cloud condensation nuclei, were explicitly followed. Since both in situ observations of bioaerosols and laboratory experiments pointed to efficient nucleation capabilities at relative warm temperatures, it was assumed that ice-nucleating bioaerosols are involved in primary ice particle formation in condensation and immersion modes. Results show that bioaerosols can be the source of primary ice pellets, which in turn lead to high ice concentrations.
Midlatitude Eddies, Storm-Track Diffusivity, and Poleward Moisture Transport in Warm Climates
Authors: Caballero Rodrigo , Hanley John 
Published: June 2012

Abstract
Recent work using both simplified and comprehensive GCMs has shown that poleward moisture transport across midlatitudes follows Clausius–Clapeyron scaling at temperatures close to modern, but that it reaches a maximum at sufficiently elevated temperatures and then decreases with further warming. This study explores the reasons for this nonmonotonic behavior using a sequence of NCAR Community Atmosphere Model, version 3 (CAM3) simulations in an aquaplanet configuration spanning a broad range of climates. No significant change is found in the scale, structure, or organization of midlatitude eddies across these simulations. Instead, the high-temperature decrease in poleward moisture transport is attributed to the combined effect of decreasing eddy velocities and contracting mixing lengths. The contraction in mixing length is, in turn, a consequence of the decreasing eddy velocities in combination with constant eddy decorrelation time scales.
Tornadogenesis in a Simulated Mesovortex within a Mesoscale Convective System
Authors: Schenkman Alexander D. , Xue Ming , Shapiro Alan 
Published: June 2012

Abstract
The Advanced Regional Prediction System (ARPS) is used to simulate a tornadic mesovortex with the aim of understanding the associated tornadogenesis processes. The mesovortex was one of two tornadic mesovortices spawned by a mesoscale convective system (MCS) that traversed southwestern and central Oklahoma on 8–9 May 2007. The simulation used 100-m horizontal grid spacing, and is nested within two outer grids with 400-m and 2-km grid spacing, respectively. Both outer grids assimilate radar, upper-air, and surface observations via 5-min three-dimensional variational data assimilation (3DVAR) cycles. The 100-m grid is initialized from a 40-min forecast on the 400-m grid.
Results from the 100-m simulation provide a detailed picture of the development of a mesovortex that produces a submesovortex-scale tornado-like vortex (TLV). Closer examination of the genesis of the TLV suggests that a strong low-level updraft is critical in converging and amplifying vertical vorticity associated with the mesovortex. Vertical cross sections and backward trajectory analyses from this low-level updraft reveal that the updraft is the upward branch of a strong rotor that forms just northwest of the simulated TLV. The horizontal vorticity in this rotor originates in the near-surface inflow and is caused by surface friction. An additional simulation with surface friction turned off does not produce a rotor, strong low-level updraft, or TLV. Comparison with previous two-dimensional numerical studies of rotors in the lee of mountains shows striking similarities to the rotor formation presented herein.
The findings of this study are summarized in a four-stage conceptual model for tornadogenesis in this case that describes the evolution of the event from mesovortexgenesis through rotor development and finally TLV genesis and intensification.
Multiplicative MJO Forcing of ENSO
Authors: Kapur Atul , Zhang Chidong 
Published: June 2012

Abstract
The Madden–Julian oscillation (MJO) is parameterized to study the role of the feedback it receives from sea surface temperature (SST) in its influence on El Niño–Southern Oscillation (ENSO). The parameterization describes MJO surface westerlies in terms of a few basic parameters that include amplitude, zonal propagation extent, propagation speed, and the interval between adjacent events. It is used to drive a coupled ocean–atmosphere model of intermediate complexity tuned to a marginally stable regime. The MJO parameters acquire values either additively (i.e., based on observed estimates of most probable value and stochasticity) or multiplicatively (i.e., modulated by an evolving model ENSO SST, albeit with some stochasticity). Simulations reveal that ENSO variance increases with the stochasticity of MJO amplitude but is insensitive to the stochasticity of zonal extent and speed, except that ENSO vanishes completely when the propagation speed is zero. Likewise, ENSO strengthens linearly with the SST modulation of MJO amplitude, but not of speed and zonal extent—even though the two are known to be significantly influenced by SST. Ensemble comparisons between simulations with and without SST feedback demonstrate that SST feedback to the MJO acting in a stable regime can be responsible for the observed ENSO variance. The multiplicative case has a larger ensemble spread than the additive case, which manifests in a larger interdecadal variability of ENSO. The results emphasize that ENSO reproduction in coupled models depends on correctly representing the MJO, especially its amplitude and SST feedback.
Homogenization of the Global Radiosonde Temperature Dataset through Combined Comparison with Reanalysis Background Series and Neighboring Stations
Authors: Haimberger Leopold , Tavolato Christina , Sperka Stefan 
Published: June 2012

Abstract
This article describes progress in the homogenization of global radiosonde temperatures with updated versions of the Radiosonde Observation Correction Using Reanalyses (RAOBCORE) and Radiosonde Innovation Composite Homogenization (RICH) software packages. These are automated methods to homogenize the global radiosonde temperature dataset back to 1958. The break dates are determined from analysis of time series of differences between radiosonde temperatures (obs) and background forecasts (bg) of climate data assimilation systems used for the 40-yr European Centre for Medium-Range Weather Forecasts (ECMWF) Re-Analysis (ERA-40) and the ongoing interim ECMWF Re-Analysis (ERA-Interim).
RAOBCORE uses the obs−bg time series also for estimating the break sizes. RICH determines the break sizes either by comparing the observations of a tested time series with observations of neighboring radiosonde time series (RICH-obs) or by comparing their background departures (RICH-τ). Consequently RAOBCORE results may be influenced by inhomogeneities in the bg, whereas break size estimation with RICH-obs is independent of the bg. The adjustment quality of RICH-obs, on the other hand, may suffer from large interpolation errors at remote stations. RICH-τ is a compromise that substantially reduces interpolation errors at the cost of slight dependence on the bg.
Adjustment uncertainty is estimated by comparing the three methods and also by varying parameters in RICH. The adjusted radiosonde time series are compared with recent temperature datasets based on (Advanced) Microwave Sounding Unit [(A)MSU] radiances. The overall spatiotemporal consistency of the homogenized dataset has improved compared to earlier versions, particularly in the presatellite era. Vertical profiles of temperature trends are more consistent with satellite data as well.
Mechanisms Maintaining Southern Ocean Meridional Heat Transport under Projected Wind Forcing
Authors: Spence Paul , Saenko Oleg A. , Dufour Carolina O. , Le Sommer Julien , England Matthew H. 
Published: June 2012

Abstract
Meridional heat transport (MHT) in the Southern Ocean (SO) and its components are analyzed with two eddy-permitting climate models. The two models present a consistent picture of the MHT response to projected twenty-first-century changes in SO winds. In agreement with a recent analysis based on an ocean data synthesis product, much of the MHT in the SO is found to be due to the time-mean fields of meridional velocity and temperature. The change in the net MHT tends to be small relative to the interannual variability at most SO latitudes. However, both models exhibit significant changes at most latitudes south of 30°S in individual components of MHT. A simple framework wherein changes in the eddy and mean heat transports tend to compensate each other is not supported by the authors’ results. Instead, the MHT response is composed of sizeable contributions from essentially all of the MHT components, with the eddy and mean heat transports often having the same sign.
Role of Rossby Waves in the Remote Effects of the North Indian Ocean Tropical Disturbances
Authors: Ratnam J. V. , Behera S. K. , Masumoto Y. , Yamagata T. 
Published: June 2012

Abstract
Remote effects due to the tropical disturbances in the north Indian Ocean are investigated by analyzing long-lasting (≥5 days) tropical disturbances, which reached at least the strength of tropical storms. The present analysis is carried out for both the pre- and postmonsoon periods. The spatial and temporal distribution of the outgoing longwave radiation (OLR) during the premonsoon disturbances over the Bay of Bengal reveals several interesting features. Temporal distribution of the OLR anomalies shows that the intraseasonal oscillations play an important role in the formation of those disturbances. The spatial distribution of the OLR anomalies shows a dipole with negative OLR anomalies over the bay and positive OLR anomalies over the Indonesian region. The atmospheric response to the negative OLR anomalies results in positive temperature anomalies over northwest India, Pakistan, Afghanistan, Iran, and Saudi Arabia, remote from the disturbance; and the response to the positive anomalies causes slight increase in the sea surface temperature of the Arabian Sea. Negative OLR anomalies are also seen over western Japan due to the Rossby waves generated by the heating over the Bay of Bengal besides the enhancement of the so-called “Pacific–Japan” teleconnection pattern. However, the analysis shows that the postmonsoon disturbances over the Bay of Bengal and the disturbances formed over the Arabian Sea in both pre- and postmonsoon seasons do not develop remote teleconnections associated with the above type of Rossby wave mechanism. These results are significant for the short- to medium-range weather forecast over a wide range covering Japan, Pakistan, Afghanistan, Iran, and Saudi Arabia.