How much Northern Hemisphere precipitation is associated with extratropical cyclones?

This is the final version of the article. Available from the publisher via the DOI in this record.Extratropical cyclones are often associated with heavy precipitation events and can have major socio-economic impacts. This study investigates how much of the total precipitation in the Northern Hemisphere is associated with extratropical cyclones. An objective feature tracking algorithm is used to locate cyclones and the precipitation associated with these cyclones is quantified to establish their contribution to total precipitation. Climatologies are produced from the Global Precipitation Climatology Project (GPCP) daily dataset and the ERA-Interim reanalysis. The magnitude and spatial distribution of cyclone associated precipitation and their percentage contribution to total precipitation is closely comparable in both datasets. In some regions, the contribution of extratropical cyclones exceeds 90/85% of the total DJF/JJA precipitation climatology. The relative contribution of the most intensely precipitating storms to total precipitation is greater in DJF than JJA. The most intensely precipitating 10% of storms contribute over 20% of total storm associated precipitation in DJF, whereas they provide less than 15% of this total in JJA. © 2012. American Geophysical Union. All Rights Reserved.MKH is supported by the Natural Environment Research Council’s project ‘Testing and Evaluating Model Predictions of European Storms’ (TEMPEST). The precipitation composites included in the auxiliary material were produced using scripts based on the work of Jennifer L. Catto and we thank her for their use. The authors would like to thank the reviewers for their helpful comments

Assessing Professionalism: A theoretical framework for defining clinical rotation assessment criteria

Although widely accepted as an important graduate competence, professionalism is a challenging outcome to define and assess. Clinical rotations provide an excellent opportunity to develop student professionalism through the use of experiential learning and effective feedback, but without appropriate theoretical frameworks, clinical teachers may find it difficult to identify appropriate learning outcomes. The adage “I know it when I see it” is unhelpful in providing feedback and guidance for student improvement, and criteria that are more specifically defined would help students direct their own development. This study sought first to identify how clinical faculty in one institution currently assess professionalism, using retrospective analysis of material obtained in undergraduate teaching and faculty development sessions. Subsequently, a faculty workshop was held in which a round-table type discussion sought to develop these ideas and identify how professionalism assessment could be improved. The output of this session was a theoretical framework for teaching and assessing professionalism, providing example assessment criteria and ideas for clinical teaching. This includes categories such as client and colleague interaction, respect and trust, recognition of limitations, and understanding of different professional identities. Each category includes detailed descriptions of the knowledge, skills, and behaviors expected of students in these areas. The criteria were determined by engaging faculty in the development of the framework, and therefore they should represent a focused development of criteria already used to assess professionalism, and not a novel and unfamiliar set of assessment guidelines. The faculty-led nature of this framework is expected to facilitate implementation in clinical teaching

Borneo Vortices in a warmer climate

This is the final version. Available from Nature Research via the DOI in this record. DATA AVAILABILITY: The CMIP6 HighResMIP data are downloaded from the data node website of the Lawrence Livermore National Laboratory (https://esgf-node.llnl.gov/projects/cmip6/). The ERA5 climate reanalysis datasets can be downloaded from the website of the Copernicus Programme (https://cds.climate.copernicus.eu/cdsapp#!/dataset/ reanalysis-era5-pressure-levels?tab=overview). The TRACK outputs for the identified BV features based on the datasets above are available upon request from the corresponding author Ju Liang: [email protected] Vortices (BVs) are weather systems that are responsible for devastating hydro-climatic extremes and significant losses of life and property in Southeast Asia. The typical resolution of most current climate models is insufficient to resolve these high-impact, synoptic-scale weather systems. Here, an ensemble of high-resolution models projects that future BVs may become less frequent and more stationary, driven by the weakening of the Northeast monsoon flow and associated cold surges across North Borneo. However, substantial increases in both the intensity and the total amount of precipitation from BVs are projected. Such changes are driven by the more humid and convectively unstable lower troposphere. As a result, the contribution of BVs to the accumulation of both total precipitation and extreme precipitation is projected to increase considerably in the vicinity of the southern South China Sea, making individual BVs more threatening to the adjacent coastal regions.Natural Environment Research CouncilMinistry of Higher Education MalaysiaMinistry of Higher Education Malaysi

A blood gene expression marker of early Alzheimer's disease.

PublishedJournal ArticleResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov'tA marker of Alzheimer's disease (AD) that can accurately diagnose disease at the earliest stage would significantly support efforts to develop treatments for early intervention. We have sought to determine the sensitivity and specificity of peripheral blood gene expression as a diagnostic marker of AD using data generated on HT-12v3 BeadChips. We first developed an AD diagnostic classifier in a training cohort of 78 AD and 78 control blood samples and then tested its performance in a validation group of 26 AD and 26 control and 118 mild cognitive impairment (MCI) subjects who were likely to have an AD-endpoint. A 48 gene classifier achieved an accuracy of 75% in the AD and control validation group. Comparisons were made with a classifier developed using structural MRI measures, where both measures were available in the same individuals. In AD and control subjects, the gene expression classifier achieved an accuracy of 70% compared to 85% using MRI. Bootstrapping validation produced expression and MRI classifiers with mean accuracies of 76% and 82%, respectively, demonstrating better concordance between these two classifiers than achieved in a single validation population. We conclude there is potential for blood expression to be a marker for AD. The classifier also predicts a large number of people with MCI, who are likely to develop AD, are more AD-like than normal with 76% of subjects classified as AD rather than control. Many of these people do not have overt brain atrophy, which is known to emerge around the time of AD diagnosis, suggesting the expression classifier may detect AD earlier in the prodromal phase. However, we accept these results could also represent a marker of diseases sharing common etiology.InnoMed, European Union of the Sixth Framework programAlzheimer’s Research UKJohn and Lucille van Geest FoundationNIHRBiomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation TrustInstitute of Psychiatry Kings College LondonNIA/NIH RC

Integrated genomics and proteomics define huntingtin CAG length-dependent networks in mice.

To gain insight into how mutant huntingtin (mHtt) CAG repeat length modifies Huntington's disease (HD) pathogenesis, we profiled mRNA in over 600 brain and peripheral tissue samples from HD knock-in mice with increasing CAG repeat lengths. We found repeat length-dependent transcriptional signatures to be prominent in the striatum, less so in cortex, and minimal in the liver. Coexpression network analyses revealed 13 striatal and 5 cortical modules that correlated highly with CAG length and age, and that were preserved in HD models and sometimes in patients. Top striatal modules implicated mHtt CAG length and age in graded impairment in the expression of identity genes for striatal medium spiny neurons and in dysregulation of cyclic AMP signaling, cell death and protocadherin genes. We used proteomics to confirm 790 genes and 5 striatal modules with CAG length-dependent dysregulation at the protein level, and validated 22 striatal module genes as modifiers of mHtt toxicities in vivo

Surgical Task Shifting in Sub-Saharan Africa

Kathryn Chu and colleagues discuss some of the experiences of surgical task shifting to date, and outline lessons from task shifting in the delivery of HIV/AIDS care

Motor control or graded activity exercises for chronic low back pain? A randomised controlled trial

Background: Chronic low back pain remains a major health problem in Australia and around the world. Unfortunately the majority of treatments for this condition produce small effects because not all patients respond to each treatment. It appears that only 25-50% of patients respond to exercise. The two most popular types of exercise for low back pain are graded activity and motor control exercises. At present however, there are no guidelines to help clinicians select the best treatment for a patient. As a result, time and money are wasted on treatments which ultimately fail to help the patient

Family and Early Life Factors Associated With Changes in Overweight Status Between Ages 5 and 14 Years: Findings From The Mater University Study Of Pregnancy and its Outcomes

Objective To describe different patterns of overweight status between ages 5 and 14 y and examine the role of modifiable family and early life characteristics in explaining different patterns of change between these two ages. Design A population-based prospective birth cohort. Subjects A total of 2934 children (52% males) who were participants in the Mater-University study of pregnancy, Brisbane, and who were examined at ages 5 and 14 y. Main outcome measures Four patterns of change in overweight/obesity status between ages 5 and 14 y: (i) normal at both ages; (ii) normal at 5 y and overweight/obese at 14 y; (iii) overweight/obese at 5 y and normal at 14 y; (iv) overweight/obese at both ages. Results Of the 2934 participants, 2018 (68.8%) had a normal body mass index (BMI) at ages 5 and 14 y, 425 (14.5%) changed from a normal BMI at age 5 y to overweight or obese at age 14 y, 175 (6.0%) changed from being overweight or obese at age 5 y to normal weight at age 14 y and 316 (10.8%) were overweight or obese at both ages 5 and 14 y. Girls were more likely to make the transition from overweight or obese at age 5 y to normal at 14 y than their boy counterparts. Children whose parents were overweight or obese were more likely to change from having a normal BMI at age 5 y to being overweight at 14 y (fully adjusted RR: 6.17 (95% CI: 3.97, 9.59)) and were more likely to be overweight at both ages (7.44 (95% CI: 4.60, 12.02)). Birth weight and increase in weight over the first 6 months of life were both positively associated with being overweight at both ages. Other explanatory factors were not associated with the different overweight status transitions. Conclusions Parental overweight status is an important determinant of whether a child is overweight at either stage or changes from being not overweight at 5 y to becoming so at 14 y

Affective recognition from EEG signals: an integrated data-mining approach

Emotions play an important role in human communication, interaction, and decision making processes. Therefore, considerable efforts have been made towards the automatic identification of human emotions, in particular electroencephalogram (EEG) signals and Data Mining (DM) techniques have been then used to create models recognizing the affective states of users. However, most previous works have used clinical grade EEG systems with at least 32 electrodes. These systems are expensive and cumbersome, and therefore unsuitable for usage during normal daily activities. Smaller EEG headsets such as the Emotiv are now available and can be used during daily activities. This paper investigates the accuracy and applicability of previous affective recognition methods on data collected with an Emotiv headset while participants used a personal computer to fulfill several tasks. Several features were extracted from four channels only (AF3, AF4, F3 and F4 in accordance with the 10–20 system). Both Support Vector Machine and Naïve Bayes were used for emotion classification. Results demonstrate that such methods can be used to accurately detect emotions using a small EEG headset during a normal daily activity

Extratropical cyclones and the projected decline of winter Mediterranean precipitation in the CMIP5 models

The Mediterranean region has been identified as a climate change "hot-spot" due to a projected reduction in precipitation and fresh water availability which has potentially large socio-economic impacts. To increase confidence in these projections, it is important to physically understand how this precipitation reduction occurs. This study quantifies the impact on winter Mediterranean precipitation due to changes in extratropical cyclones in 17 CMIP5 climate models. In each model, the extratropical cyclones are objectively tracked and a simple approach is applied to identify the precipitation associated to each cyclone. This allows us to decompose the Mediterranean precipitation reduction into a contribution due to changes in the number of cyclones and a contribution due to changes in the amount of precipitation generated by each cyclone. The results show that the projected Mediterranean precipitation reduction in winter is strongly related to a decrease in the number of Mediterranean cyclones. However, the contribution from changes in the amount of precipitation generated by each cyclone are also locally important: in the East Mediterranean they amplify the precipitation trend due to the reduction in the number of cyclones, while in the North Mediterranean they compensate for it. Some of the processes that determine the opposing cyclone precipitation intensity responses in the North and East Mediterranean regions are investigated by exploring the CMIP5 inter-model spread