The extratropical upper troposphere and lower stratosphere

The extratropical upper troposphere and lower stratosphere (Ex-UTLS) is a transition region between the stratosphere and the troposphere. The Ex-UTLS includes the tropopause, a strong static stability gradient and dynamic barrier to transport. The barrier is reflected in tracer profiles. This region exhibits complex dynamical, radiative, and chemical characteristics that place stringent spatial and temporal requirements on observing and modeling systems. The Ex-UTLS couples the stratosphere to the troposphere through chemical constituent transport (of, e.g., ozone), by dynamically linking the stratospheric circulation with tropospheric wave patterns, and via radiative processes tied to optically thick clouds and clear-sky gradients of radiatively active gases. A comprehensive picture of the Ex-UTLS is presented that brings together different definitions of the tropopause, focusing on observed dynamical and chemical structure and their coupling. This integral view recognizes that thermal gradients and dynamic barriers are necessarily linked, that these barriers inhibit mixing and give rise to specific trace gas distributions, and that there are radiative feedbacks that help maintain this structure. The impacts of 21st century anthropogenic changes to the atmosphere due to ozone recovery and climate change will be felt in the Ex-UTLS, and recent simulations of these effects are summarized and placed in context

Multimodel assessment of the upper troposphere and lower stratosphere: Extratropics

A multimodel assessment of the performance of chemistry-climate models (CCMs) in the extratropical upper troposphere/lower stratosphere (UTLS) is conducted for the first time. Process-oriented diagnostics are used to validate dynamical and transport characteristics of 18 CCMs using meteorological analyses and aircraft and satellite observations. The main dynamical and chemical climatological characteristics of the extratropical UTLS are generally well represented by the models, despite the limited horizontal and vertical resolution. The seasonal cycle of lowermost stratospheric mass is realistic, however with a wide spread in its mean value. A tropopause inversion layer is present in most models, although the maximum in static stability is located too high above the tropopause and is somewhat too weak, as expected from limited model resolution. Similar comments apply to the extratropical tropopause transition layer. The seasonality in lower stratospheric chemical tracers is consistent with the seasonality in the Brewer-Dobson circulation. Both vertical and meridional tracer gradients are of similar strength to those found in observations. Models that perform less well tend to use a semi-Lagrangian transport scheme and/or have a very low resolution. Two models, and the multimodel mean, score consistently well on all diagnostics, while seven other models score well on all diagnostics except the seasonal cycle of water vapor. Only four of the models are consistently below average. The lack of tropospheric chemistry in most models limits their evaluation in the upper troposphere. Finally, the UTLS is relatively sparsely sampled by observations, limiting our ability to quantitatively evaluate many aspects of model performance

Length of stay to recover from severe acute malnutrition and associated factors among under-five years children admitted to public hospitals in Aksum, Ethiopia.

BackgroundSevere acute malnutrition is defined by MethodsSample size was calculated using STATA version 12.0. A retrospective cohort study was conducted using pretested questionnaire in the public hospitals in Aksum on children aged 0-59 months. Cleaned data was entered to Epi info version 7.1.4 and then exported into SPSS version 21 for analysis. Bivariable and multivariable analyses were performed using Kaplan Meier and Cox regression models. During bivariable analysis, variables with p-value ResultsA total of 564 participants enrolled to the study. The rate of recovery was 56% with median length of stay of 15 days (95% CI: 14.1, 15.9). The independent predictors of length of stay to recovery were presence of diarrhea at admission (AHR = 0.573, 95% CI: 0.415-0.793), being HIV positive (AHR = 0.391, 95% CI: 0.194-0.788), palmar pallor (AHR = 0.575, 95% CI: 0.416-0.794), presence of other co-morbidities at admission (AHR = 0.415, 95% CI: 0.302-0.570) and not being treated with plumpy nut (AHR = 0.368, 95% CI: 0.262-0.518).ConclusionsLength of stay is in the acceptable range of the international and national set of standards. Nevertheless, the recovery rate was lower compared to the Sphere standard. Presence of diarrhea, palmar pallor, HIV other co-morbidities and not treated with plumpy nut were found independent protective factors for recovery from sever acute malnutrition

Magnitude and factors associated with anemia among pregnant women attending antenatal care in public health centers in central zone of Tigray region, northern Ethiopia: a cross sectional study

Abstract Introduction Anemia is defined as a low blood hemoglobin concentration (< 11 mg/dl). It is a global public health problem especially in pregnant women and is associated with higher risk for both maternal and perinatal mortality and morbidity. In developing countries, like Ethiopia where anemia is common, determining the magnitude and identifying factors that are associated with anemia is necessary to control it. Methods Facility based cross sectional study design were conducted among 638 pregnant women attending antenatal care in public health centers in central zone of Tigray region, Northern Ethiopia from November 1/2017 to January 30/2018 using stratified multi stage sampling method. The data was collected through interviewing the pregnant women face to face after getting informed consent using structured and pre-tested questionnaire. The data was coded and entered in to Epi-info 7 then exported to Stata 14 for cleaning and further analysis. Both Bivariable and multi variable logistic regression model was used in the data analysis. Results The overall magnitude of anemia (hemoglobin level < 11 mg/dl) were found that 16.88% (95% CI: 13.95%, 19.8%). Factors which were significantly associated with anemia in the multivariable analysis were: history of malaria attack 1 year prior to study period (AOR = 4.73, 95% CI: 2.64, 8.46), women who had history of excessive menstrual bleeding (AOR = 3.94, 95% CI: 2.11, 7.35), unplanned pregnancy (AOR = 2.5, 95% CI: 1.4, 4.42) and three times or less meal frequency (AOR = 1.89, 95% CI: 1.02, 3.5). Conclusion The magnitude of anemia among pregnant were found that 16.88%. Malaria attack, excessive menstrual bleeding, pregnancy planning and meal frequency were found that significantly associated with anemia in the multivariable analysis. Pregnant women are recommended to increase meal frequency. Health providers should give attention to pregnant women who had history of malaria attack, excessive menstrual bleeding and women whose pregnancy were not planned

Determinants of diabetic nephropathy in Ayder Referral Hospital, Northern Ethiopia: A case-control study

<div><p>Background</p><p>Diabetic nephropathy is the most serious complication of diabetes which leads to end-stage renal failure and other complication of diabetes mellitus. Determinants of Diabetic nephropathy are not consistent in different studies and associated factors to chronic complications of diabetes are not specific and there are limited studies specific to diabetic nephropathy. Thus, the aim of this study is to identify determinants of diabetic nephropathy in Ayder Referral Hospital, Northern Ethiopia.</p><p>Methods</p><p>A case-control study was conducted from February 14 to May 8 2016. Diabetic patients who developed nephropathy in the last two years were the cases and diabetic patients free of nephropathy were controls. Cases and controls were identified detailed review of the chronic care follow up chart. Then simple random sampling was used to select sample of 420 (with control to case ratio of 4:1) resulting in 84 cases and 336 controls. Record review and interviewer administered questionnaire were used to collect data. Data was coded and entered in to Epi-Data version 3.1 and then exported to STATA 12 for analysis. Variables with P-values< 0.25 in Bivariate logistic regression were selected for multiple logistic regressions to determine independent determinants of diabetic nephropathy. OR was calculated with 95% CI to show strength of association.</p><p>Result</p><p>The mean age (±Standard deviation) for the cases and the controls were 52(SD: ±1.34) and 42.4(SD: ±0.8) respectively. In multiple logistic regressions age of patient (AOR: 1.037 95%CI: 1.01–1.064), duration of diabetes after diagnosis (AOR for one year increase: 1.09 95%CI: 1.036–1.15), not-adhered to blood glucose measurement at home (AOR: 6.81 95%CI: 1.15–40.24), having Systolic Hypertension (AOR;2.13 (1.002–4.51), poor glycemic control (AOR;2.71 95%CI: (1.49–4.95), being overweight(AOR;2.7(1.47–4.96) were the independent predictors of diabetic nephropathy.</p><p>Conclusion</p><p>In the light of these findings, targeted interventions should be designed at the follow up clinic to address the risk of developing diabetic nephropathy among the risk groups.</p></div

Determinants of diabetic nephropathy in Ayder Referral Hospital, Northern Ethiopia: A case-control study

<div><p>Background</p><p>Diabetic nephropathy is the most serious complication of diabetes which leads to end-stage renal failure and other complication of diabetes mellitus. Determinants of Diabetic nephropathy are not consistent in different studies and associated factors to chronic complications of diabetes are not specific and there are limited studies specific to diabetic nephropathy. Thus, the aim of this study is to identify determinants of diabetic nephropathy in Ayder Referral Hospital, Northern Ethiopia.</p><p>Methods</p><p>A case-control study was conducted from February 14 to May 8 2016. Diabetic patients who developed nephropathy in the last two years were the cases and diabetic patients free of nephropathy were controls. Cases and controls were identified detailed review of the chronic care follow up chart. Then simple random sampling was used to select sample of 420 (with control to case ratio of 4:1) resulting in 84 cases and 336 controls. Record review and interviewer administered questionnaire were used to collect data. Data was coded and entered in to Epi-Data version 3.1 and then exported to STATA 12 for analysis. Variables with P-values< 0.25 in Bivariate logistic regression were selected for multiple logistic regressions to determine independent determinants of diabetic nephropathy. OR was calculated with 95% CI to show strength of association.</p><p>Result</p><p>The mean age (±Standard deviation) for the cases and the controls were 52(SD: ±1.34) and 42.4(SD: ±0.8) respectively. In multiple logistic regressions age of patient (AOR: 1.037 95%CI: 1.01–1.064), duration of diabetes after diagnosis (AOR for one year increase: 1.09 95%CI: 1.036–1.15), not-adhered to blood glucose measurement at home (AOR: 6.81 95%CI: 1.15–40.24), having Systolic Hypertension (AOR;2.13 (1.002–4.51), poor glycemic control (AOR;2.71 95%CI: (1.49–4.95), being overweight(AOR;2.7(1.47–4.96) were the independent predictors of diabetic nephropathy.</p><p>Conclusion</p><p>In the light of these findings, targeted interventions should be designed at the follow up clinic to address the risk of developing diabetic nephropathy among the risk groups.</p></div

Factors associated with diabetic nephropathy in Ayder referral Hospital, Ethiopia, 2016.

<p>Factors associated with diabetic nephropathy in Ayder referral Hospital, Ethiopia, 2016.</p

Socio demographic characteristics of diabetic patients who follow at Ayder referral Hospital, Ethiopia, 2016.

<p>Socio demographic characteristics of diabetic patients who follow at Ayder referral Hospital, Ethiopia, 2016.</p

Depression among Adult HIV/AIDS Patients Attending ART Clinics at Aksum Town, Aksum, Ethiopia: A Cross-Sectional Study

Background. Depression is consistently associated with increased risk of Human Immunodeficiency Virus infection and poor antiretroviral treatment adherence. Though many factors have been reported as determinant factors of depression, site-specific evidence is needed to identify factors associated with depression among adults on antiretroviral treatment. Methods. An institution based cross-sectional study was carried out from March to May 2015 among 411 adults HIV/AIDS patients on ART clinic follow-up. Participants were selected using systematic random sampling techniques. Data were collected using chart review and interviewer- administered techniques. Both bivariable and multivariable logistic regressions were used to compute the statistical test associations by SPSS version-20. Variables with p value < 0.05 were considered as statistically significant. Results. Four hundred eleven patients with a mean age ± Standard Deviation of 36.1±9.2 years and with a total response rate of 97.6% were enrolled in the study. The prevalence of depression was 14.6% (95% CI, 10.90-18.2). Factors independently associated with depression were nonadherence to ART, eating two meals per day or less, having side effect of ART medication, being in the WHO Stage II or above of HIV/AIDS, and living alone with AOR (95% CI) of 3.3 (1.436, 7.759), 2.8 (1.382, 5.794), 4.7 (1.317, 16.514), 2.8 (0.142, 0.786), and 2.4 (1.097, 5.429), respectively. Conclusion. Though the magnitude of depression was found relatively low, it was commonly observed as a mental health problem among adult patients with HIV/AIDS on ART. Programs on counseling and close follow-up of adherence to ART, drug side effects, and nutrition should be strengthened. Health facilities should link adult patients with HIV/AIDS who live alone to governmental and nongovernmental social supporter organizations