Climatology of Tibetan Plateau Vortices in reanalysis data and a high-resolution global climate model

The Tibetan Plateau (TP) and surrounding high mountains constitute an important forcing of the atmospheric circulation due to their height and extent, and thereby impact weather and climate in downstream regions of East Asia. Mesoscale Tibetan Plateau Vortices (TPVs) are one of the major precipitation-producing systems on the TP. A fraction of TPVs moves off the TP to the east and can trigger extreme precipitation in parts of China, e.g. the Sichuan province and the Yangtze River valley, that can result in severe flooding. In this study, the climatology of TPV occurrence is examined in two reanalyses and, for the first time, in a high-resolution global climate model using an objective feature tracking algorithm. Most TPVs are generated in the north-western part of the TP; the centre of this main genesis region is small and stable throughout the year. The strength and position of the subtropical westerly jet is correlated to the distance TPVs can travel eastwards and therefore could have an effect on whether or not a TPV is moving-off the TP. TPV-associated precipitation can account for up to 40% of the total precipitation in parts of China in selected months, often due to individual TPVs. The results show that the global climate model is able to simulate TPVs at N512 (~25 km) horizontal resolution and in general agrees with the reanalyses. The fact that the global climate model can represent the TPV climatology opens a wide range of options for future model-based research on TPVs

Sensemaking and Success in the Transition from Community Colleges to University IS/CS/CE Programs

Increasing the enrollment of women, minority, and other underrepresented populations in undergraduate information systems and computing programs is an important social issue. We explore ways of attracting and retaining community college transfer students—an important source of underrepresented students —by examining their sensemaking efforts as they transition to four-year universities. We conducted a qualitative study to test sensemaking theory and develop recommendations for retaining community college transfer students in undergraduate information systems, computer science, and computer engineering programs

Which exercise for low back pain? (WELBack trial) Predicting response to exercise treatments for patients with low back pain : a validation randomized controlled trial protocol

Introduction Exercise therapy is the most recommended treatment for chronic low back pain (LBP). Effect sizes for exercises are usually small to moderate and could be due to the heterogeneity of people presenting with LBP. Thus, if patients could be better matched to exercise based on individual factors, then the effects of treatment could be greater. A recently published study provided evidence of better outcomes when patients are matched to the appropriate exercise type. The study demonstrated that a 15-item questionnaire, the Lumbar Spine Instability Questionnaire (LSIQ), could identify patients who responded best to one of the two exercise approaches for LBP (motor control and graded activity). The primary aim of the current study isill be to evaluate whether preidentified baseline characteristics, including the LSIQ, can modify the response to two of the most common exercise therapies for non-specific LBP. Secondary aims include an economic evaluations with a cost-effectiveness analysis. Methods and analysis Participants (n=414) will be recruited by primary care professionals and randomised (1:1) to receive motor control exercises or graded activity. Participants will undergo 12 sessions of exercise therapy over an 8-week period. The primary outcome will be physical function at 2 months using the Oswestry Disability Index. Secondary outcomes will be pain intensity, function and quality of life measured at 2, 6 and 12 months. Potential effect modifiers will be the LSIQ, self-efficacy, coping strategies, kinesiophobia and measures of nociceptive pain and central sensitisation. We will construct linear mixed models with terms for participants (fixed), treatment group, predictor (potential effect modifier), treatment group×predictor (potential effect modifier), physiotherapists, treatment group×physiotherapists and baseline score for the dependent variable

Future changes in the Western North Pacific tropical cyclone activity projected by a multidecadal simulation with a 16-km global atmospheric GCM

How tropical cyclone (TC) activity in the northwestern Pacific might change in a future climate is assessed using multidecadal Atmospheric Model Intercomparison Project (AMIP)-style and time-slice simulations with the ECMWF Integrated Forecast System (IFS) at 16-km and 125-km global resolution. Both models reproduce many aspects of the present-day TC climatology and variability well, although the 16-km IFS is far more skillful in simulating the full intensity distribution and genesis locations, including their changes in response to El Niño–Southern Oscillation. Both IFS models project a small change in TC frequency at the end of the twenty-first century related to distinct shifts in genesis locations. In the 16-km IFS, this shift is southward and is likely driven by the southeastward penetration of the monsoon trough/subtropical high circulation system and the southward shift in activity of the synoptic-scale tropical disturbances in response to the strengthening of deep convective activity over the central equatorial Pacific in a future climate. The 16-km IFS also projects about a 50% increase in the power dissipation index, mainly due to significant increases in the frequency of the more intense storms, which is comparable to the natural variability in the model. Based on composite analysis of large samples of supertyphoons, both the development rate and the peak intensities of these storms increase in a future climate, which is consistent with their tendency to develop more to the south, within an environment that is thermodynamically more favorable for faster development and higher intensities. Coherent changes in the vertical structure of supertyphoon composites show system-scale amplification of the primary and secondary circulations with signs of contraction, a deeper warm core, and an upward shift in the outflow layer and the frequency of the most intense updrafts. Considering the large differences in the projections of TC intensity change between the 16-km and 125-km IFS, this study further emphasizes the need for high-resolution modeling in assessing potential changes in TC activity

Post-Exertional Malaise May Be Related to Central Blood Pressure, Sympathetic Activity and Mental Fatigue in Chronic Fatigue Syndrome Patients

Post-exertional malaise (PEM) is regarded as the hallmark symptom in chronic fatigue syndrome (CFS). The aim of the current study is to explore differences in CFS patients with and without PEM in indicators of aortic stiffness, autonomic nervous system function, and severity of fatigue. One-hundred and one patients met the Fukuda criteria. A Chronic Fatigue Questionnaire (CFQ) and Fatigue Impact Scale (FIS) were used to assess the level of mental and physical fatigue. Aortic systolic blood pressure (sBPaortic) and the autonomic nervous system were measured with the arteriograph and Task Force Monitor, respectively. Eighty-two patients suffered prolonged PEM according to the Fukuda criteria, while 19 did not. Patients with PEM had higher FIS scores (p = 0.02), lower central systolic blood pressure (p = 0.02) and higher mental fatigue (p = 0.03). For a one-point increase in the mental fatigue component of the CFQ scale, the risk of PEM increases by 34%. For an sBPaortic increase of 1 mmHg, the risk of PEM decreases by 5%. For a one unit increase in sympathovagal balance, the risk of PEM increases by 330%. Higher mental fatigue and sympathetic activity in rest are related to an increased risk of PEM, while higher central systolic blood pressure is related to a reduced risk of PEM. However, none of the between group differences were significant after FDR correction, and therefore conclusions should be treated with caution and replicated in further studies

Comparison of a manual and an automated tracking method for Tibetan Plateau vortices

Tibetan Plateau vortices (TPVs) are mesoscale cyclones originating over the Tibetan Plateau (TP) during the extended summer season (April-September). Most TPVs stay on the TP while a small number can move off the TP to the east. TPVs are known to be one of the main precipitation-bearing systems on the TP and moving-off TPVs have been associated with heavy precipitation and flooding downstream of the TP (e.g. Sichuan province, Yangtze River Valley). Identifying and tracking TPVs is difficult both due to their comparatively small horizontal extent (400 – 800 km) and the limited availability of soundings over the TP, which, in turn, constitutes a challenge for short-term predictions of TPV-related impacts and for the climatological study of TPVs. In this study, (i) manual tracking (MT) results using radiosonde data from a network over and downstream of the TP are compared with (ii) results obtained by an automated tracking (AT) algorithm applied to ERA-Interim reanalysis. Ten MT-TPV cases are selected based on method (i) and matched to and compared with the corresponding AT-TPVs identified with method (ii). Conversely, ten AT-TPVs are selected and compared with the corresponding MT-TPVs. In general, the comparison shows good results in cases where the underlying data are in good agreement, but considerable differences are also seen in some cases and explained in terms of differences in the tracking methods, data availability/coverage and disagreement between sounding and ERA-Interim data. Recommendations are given for future efforts in TPV detection and tracking, including in an operational weather forecasting context

A pragmatic group sequential placebo controlled randomised trial to determine the effectiveness of Glyceryl trinitrate for retained placenta (GOT-IT): a study protocol

A retained placenta is diagnosed when the placenta is not delivered following delivery of the baby. It is a major cause of postpartum haemorrhage and treated by the operative procedure of manual removal of placenta (MROP).The aim of this pragmatic, randomised, placebo-controlled, double-blind UK-wide trial, with an internal pilot and nested qualitative research to adjust strategies to refine delivery of the main trial, is to determine whether sublingual glyceryl trinitrate (GTN) is (or is not) clinically and cost-effective for (medical) management of retained placenta. The primary clinical outcome is need for MROP, defined as the placenta remaining undelivered 15 min poststudy treatment and/or being required within 15 min of treatment due to safety concerns. The primary safety outcome is measured blood loss between administration of treatment and transfer to the postnatal ward or other clinical area. The primary patient-sided outcome is satisfaction with treatment and a side effect profile. The primary economic outcome is net incremental costs (or cost savings) to the National Health Service of using GTN versus standard practice. Secondary outcomes are being measured over a range of clinical and economic domains. The primary outcomes will be analysed using linear models appropriate to the distribution of each outcome. Health service costs will be compared with multiple trial outcomes in a cost-consequence analysis of GTN versus standard practice.Ethical approval has been obtained from the North-East Newcastle and North Tyneside 2 Research Ethics Committee (13/NE/0339). Dissemination plans for the trial include the Health Technology Assessment Monograph, presentation at international scientific meetings and publication in high-impact, peer-reviewed journals.ISCRTN88609453; Pre-results