Estimation of Coast-Wide Population Trends of Marbled Murrelets in Canada Using a Bayesian Hierarchical Model

Species at risk with secretive breeding behaviours, low densities, and wide geographic range pose a significant challenge to conservation actions because population trends are difficult to detect. Such is the case with the Marbled Murrelet (Brachyramphus marmoratus), a seabird listed as ‘Threatened’ by the Species at Risk Act in Canada largely due to the loss of its old growth forest nesting habitat. We report the first estimates of population trend of Marbled Murrelets in Canada derived from a monitoring program that uses marine radar to detect birds as they enter forest watersheds during 923 dawn surveys at 58 radar monitoring stations within the six Marbled Murrelet Conservation Regions on coastal British Columbia, Canada, 1996–2013. Temporal trends in radar counts were analyzed with a hierarchical Bayesian multivariate modeling approach that controlled for variation in tilt of the radar unit and day of year, included year-specific deviations from the overall trend (‘year effects’), and allowed for trends to be estimated at three spatial scales. A negative overall trend of -1.6%/yr (95% credibility interval: -3.2%, 0.01%) indicated moderate evidence for a coast-wide decline, although trends varied strongly among the six conservation regions. Negative annual trends were detected in East Vancouver Island (-9%/yr) and South Mainland Coast (-3%/yr) Conservation Regions. Over a quarter of the year effects were significantly different from zero, and the estimated standard deviation in common-shared year effects between sites within each region was about 50% per year. This large common-shared interannual variation in counts may have been caused by regional movements of birds related to changes in marine conditions that affect the availability of prey.     

Long-Term Trends of Nutrients and Apparent Oxygen Utilization South of the Polar Front in Southern Ocean Intermediate Water from 1965 to 2008

The variation of nutrients over decadal timescales south of the polar front in the Southern Ocean is poorly known because of a lack of continuous observational data in this area. We examined data from long-term continuous hydrographic monitoring of 43 years (1965–2008) in the Indian sector of the Southern Ocean, via the resupply of Antarctic stations under the Japanese Antarctic Research Expedition and Australian Antarctic Research Expedition. We found significant increasing trends in phosphate and nitrate, and a decreasing trend in apparent oxygen utilization (AOU) in intermediate water (neutral density = 27.8–28.1 kgm⁻³) south of the polar front. The rates of phosphate and nitrate increase are 0.004 µmol yr⁻¹ and 0.02 µmol yr⁻¹, respectively. The rate of decline of AOU was 0.32 µmol yr⁻¹. One reason for this phosphate and nitrate increase and AOU decline is reduced horizontal advection of North Atlantic Deep Water, which is characterized by low nutrients and high AOU. The relationship between climate change and nutrient variability remains obscure, emphasizing the importance of long-term monitoring.     

Changes in Remotely Sensed Vegetation Growth Trend in the Heihe Basin of Arid Northwestern China

The Heihe River Basin (HRB) is the second largest inland river basin in China, characterized by high diversity in geomorphology and irrigated agriculture in middle reaches. To improve the knowledge about the relationship between biotic and hydrological processes, this study used Global Inventory Modeling and Mapping Studies Normalized Difference Vegetation Index (NDVI) data (1982–2006) to analyze spatiotemporal variations in vegetation growth by using the Mann—Kendall test together with Sen’s slope estimator. The results indicate that 10.1% and 1.6% of basin area exhibit statistically significant (p < 0.05) upward and downward trends, and maximum magnitude is 0.066/10a and 0.026/10a, respectively. More specifically, an increasing trend was observed in the Qilian Mountains and Hexi Corridor and a decreasing trend detected in the transitional region between them. Increases in precipitation and temperature may be one possible reason for the changes of vegetation growth in the Qilian Mountains. And decreasing trend in transitional region may be driven by the changes in precipitation. Increases of irrigation contribute to the upward trend of NDVI for cropland in the Hexi Corridor, reflecting that agricultural development becomes more intensive. Our study demonstrates the complexity of the response of vegetation growth in the HRB to climate change and anthropogenic activities and correspondingly adopting mechanistic ecological models capable of describing both factors is favorable for reasonable predictions of future vegetation growth. It is also indicated that improving irrigation water use efficiency is one practical strategy to balance water demand between human and natural ecosystems in the HRB.     

Decrease in Vitamin D Status in the Greenlandic Adult Population from 1987–2010

Background

Low vitamin D status may be pronounced in Arctic populations due to limited sun exposure and decreasing intake of traditional food.

Objective

To investigate serum 25(OH)D3 as a measure of vitamin D status among adult Inuit in Greenland, predictors of low serum 25(OH)D3 concentrations and the trend from 1987 to 2005–2010.

Design

A total of 2877 randomly selected Inuit (≥18 years) from the Inuit Health in Transition study were included. A sub-sample (n = 330) donated a blood sample in 1987 which allowed assessment of time trends in vitamin D status.

Results

The geometric mean serum 25(OH)D3 (25[OH]D2 concentrations were negligible and not reported) in 2005–2010 was lowest among the 18–29 year old individuals (30.7 nmol/L; 95% CI: 29.7; 31.7) and increased with age. In all age-groups it decreased from 1987 to 2005–2010 (32%–58%). Low 25(OH)D3 concentrations (<50 nmol/L) were present in 77% of the 18–29 year old and decreased with age. A characteristic seasonal variation in 25(OH)D3 concentrations was observed (range 33.2–57.1 nmol/L, p<0.001), with the highest concentrations in August to October. Age (2.0% per year increase; CI: 1.7, 2.2), female gender (7.1%; CI: 2.0; 12.5), alcohol intake (0.2% per increase in drinks/week; 0.0; 0.4), and traditional diet (10.0% per 100 g/d increase; CI: 7.9; 12.1) were associated with increased serum 25(OH)D3, whereas smoking (−11.6%; CI: −16.2; −6.9), BMI (−0.6%; CI: −1.1; −0.2) and latitude (−0.7% per degree increase; CI: −1.3; −0.2) were associated with decreased concentrations.

Conclusion

We identified a remarkable decrease in vitamin D status from 1987 to 2005–2010 and a presently low vitamin D status among Inuit in Greenland. A change away from a traditional diet may well explain the observed decline. The study argues for the need of increased dietary intake of vitamin D and supplementation might be considered.     

近50年黄土高原地区降水时空变化特征

根据黄土高原地区214个地面气象站最近50年(1961-2010年)的逐日降水量数据, 采用非参数Mann-Kendall和Mann-Whitney法,从黄土高原地区、典型黄土高原和综合治理分区3个层面,对本地区年降水量(PTOT)、侵蚀性降水量(R12mm)、汛期降水量(RJJAS)和暴雨量(R50mm)的时空变化特点进行了研究。结果表明:(1)在黄土高原地区,PTOT、R12mm和RJJAS变化的空间格局基本一致,从东南向西北,其减少幅度逐渐变小,至西北部和最西部,其反而略有增加。但是R50mm变化的空间趋势不大明显。相比之下,典型黄土高原PTOT、R12mm和RJJAS变化的空间趋势更为突出。(2)在黄土高原地区,约83%的站点PTOT呈减少趋势,69%的站点R12mm和RJJAS呈减少趋势;其中20%的站点PTOT减少显著,10%的站点R12mm和RJJAS减少显著。而约68%的站点R50mm变化率为零。相比之下,在典型黄土高原,呈减少或显著减少趋势的站点比例较高,约92%的站点PTOT呈减少趋势,80%的站点R12mm和RJJAS呈减少趋势;其中24%的站点PTOT减少显著,12%的站点R12mm和RJJAS减少显著。R50mm变化率为零的站点比例则较底,约占62%。(3)近50a黄土高原地区的PTOT和R12mm总体上分别呈显著和接近显著减少趋势,递减率分别为9.9mm/10a和5.9mm/10a;但是其RJJAS和R50mm的减少不显著。近50a典型黄土高原的PTOT和R12mm均呈显著减少趋势,递减率分别为13.4 mm/10a和8.1mm/10a。其RJJAS减少趋势接近显著,递减率为7.6mm/10a。但是其R50mm减少不显著。(4)就5个综合治理区而言,第Ⅰ区和第Ⅱ区的PTOT总体呈显著减少趋势,这两个区的R12mm分别呈接近显著和显著减少趋势,而第Ⅲ至Ⅴ区的PTOT和R12mm总体呈不显著增加趋势。仅第Ⅱ区的RJJAS呈显著减少趋势。R50mm在第Ⅰ区、第Ⅱ区和第Ⅳ区减少不显著,在第Ⅲ区和第Ⅴ区变化率为零。(5)近50aPTOT减少的突变时间在黄土高原地区、典型黄土高原和综合治理第Ⅱ区始于1986年, 在第Ⅰ区始于1991年。PTOT在其余3个区没有出现突变现象。这些结果表明,在典型黄土高原,尤其是其水土保持重点区(即第Ⅱ区),近50a的年降水量、侵蚀性降水量和汛期降水量明显减少,但暴雨量却未显著减少。这意味着如果此种趋势继续下去,尽管因水蚀导致的土壤侵蚀量总体上会有所减少,但是缺水情形会更为严峻,因暴雨导致的剧烈水土流失仍不会有明显缓解。     

The Impact of Food and Nutrient-Based Standards on Primary School Children’s Lunch and Total Dietary Intake: A Natural Experimental Evaluation of Government Policy in England

In 2005, the nutritional content of children’s school lunches in England was widely criticised, leading to a major policy change in 2006. Food and nutrient-based standards were reintroduced requiring primary schools to comply by September 2008. We aimed to determine the effect of the policy on the nutritional content at lunchtime and in children’s total diet. We undertook a natural experimental evaluation, analysing data from cross-sectional surveys in 12 primary schools in North East England, pre and post policy. Dietary data were collected on four consecutive days from children aged 4–7 years (n = 385 in 2003–4; n = 632 in 2008–9). We used linear mixed effect models to analyse the effects of gender, year, and lunch type on children’s mean total daily intake. Both pre- and post-implementation, children who ate a school lunch consumed less sodium (mean change −128 mg, 95% CI: −183 to −73 mg) in their total diet than children eating home-packed lunches. Post-implementation, children eating school lunches consumed a lower % energy from fat (−1.8%, −2.8 to −0.9) and saturated fat (−1.0%; −1.6 to −0.5) than children eating packed lunches. Children eating school lunches post implementation consumed significantly more carbohydrate (16.4 g, 5.3 to 27.6), protein (3.6 g, 1.1 to 6.0), non-starch polysaccharides (1.5 g, 0.5 to 1.9), vitamin C (0.7 mg, 0.6 to 0.8), and folate (12.3 µg, 9.7 to 20.4) in their total diet than children eating packed lunches. Implementation of school food policy standards was associated with significant improvements in the nutritional content of school lunches; this was reflected in children’s total diet. School food- and nutrient-based standards can play an important role in promoting dietary health and may contribute to tackling childhood obesity. Similar policy measures should be considered for other environments influencing children’s diet.     

The precipitation change in Eastern Forest Regions of China in recent 50 years

The Eastern Forest Region is of importance for its economic timber forest and water and soil conservation in China. It provides basic information and response to climate change by analysis on the precipitation change of the Eastern Forest Region. In this study, the missing daily precipitation data was interpolated by spatial correlation and stepwise regression methods, and the Standard Normal Homogeneity Test (SNHT) was used to examine the homogeneity of the data serial with the interpolated value(s) on all individual discontinuous points among the entire annual data serial, to obtain the interpolated value of any missed data by passing the STHT test. Finally, the full precipitation data set with a full annual series of 853 Observation Stations in the Region was completely obtained. Based upon that precipitation data set from 1961 to 2010, the long-term change trend of the annual precipitation, numbers of precipitation days, seasonal precipitation and extreme precipitation were analyzed. The results revealed that the annual precipitation increased insignificantly with a tendency of 5.58 mm/10a, but with an obvious decadal fluctuation; however, the spatial distribution of precipitation is not uniform, with decreasing trends in northern part, but increasing trends in the southern part of the Eastern Forest Region. Annual number of precipitation days had a significance reduce; showing a consistent decreasing trend in many stations in the Eastern Forest Region. The proportion of the annual amount of light rain (0.1–9.9 mm/d) and moderate rain (10.0–24.9 mm/d) to the annual precipitation and the annual number of the light rain and moderate rain days were significantly decreasing in recent 50 years. Both the percentage of annual extreme precipitation and percentage of annual extreme precipitation days had a significant tendency of increase, both intensity and frequency of extreme precipitation events have contributed to the rising of the extreme precipitation amount, extreme precipitation events which were tending to become frequencies and intensified, it might have increased the risk of severe floods in the Eastern Forest Region. In the recent 50 years, the trends of amount and days of the rainstorms (50.0–99.9 mm/d) and the heavy rainstorms (?100 mm/d) in the region increased significantly, with the values 5.59 mm/10a, 0.07d/10a and 4.27 mm/10a, 0.03d/10a respectively. The Mann-Kendall abrupt change test was conducted on the two different intensity rains, and the results showed the amount and days of both rainstorms and heavy rainstorms exhibited an abrupt change, the amount and days had significant increasing shift. While the remarkable increase of both the amount and days of the rainstorms presented since the middle 1980s, the heavy rainstorms since 1990s. The basic characteristics of seasonal precipitation in the Eastern Forest Region during the recent 50 years are investigated. For the seasonal precipitation in June to August and December to next February had an increasing tendency, with linear trends of 11.22 mm/10a and 5.91 mm/10a, respectively; while the decreasing tendencies in March to May and September to November in the Region, with linear trends of ?2.59 mm/10a and ?8.96 mm/10a, respectively.     

Spatiotemporal Clusters and Trend of Trichomonas vaginalis Infection in Korea

This study was done to provide an overview of the latest trichomoniasis status in Korea by finding disease clusters and analyzing temporal trends during 2012–2020. Data were obtained from the Health Insurance Review & Assessment Service (HIRA) of Korea. SaTScan and Joinpoint programs were used for statistical analyses. Gyeonggi-do had the highest average population and highest number of cases. The high incidence of T. vaginalis infections were observed among women aged 40–49 and 30–39 years (33,830/year and 33,179/year, respectively). Similarly, the 40–49 and 30–39 age group in men showed the highest average cases (1,319/year and 1,282/year, respectively). Jeollabuk-do was the most likely cluster, followed by Busan/Gyeongsangnam-do/Ulsan/Daegu and Jeju-do and Gwangju. Urban and rural differences were prominent. Trichomoniasis has decreased significantly in most clusters, except for Incheon. Trichomoniasis was decreasing in women recently after peaking around 2014. Men showed different trends according to age. Trichomoniasis was increasing in the 10–39 age groups, but decreasing in the 40–59 age groups. This study might provide an analytic basis for future health measures, policy-makers, and health authorities in developing effective system for prevention of trichomoniasis.     

Sensitivity of Temperate Desert Steppe Carbon Exchange to Seasonal Droughts and Precipitation Variations in Inner Mongolia,China

Arid grassland ecosystems have significant interannual variation in carbon exchange; however, it is unclear how environmental factors influence carbon exchange in different hydrological years. In this study, the eddy covariance technique was used to investigate the seasonal and interannual variability of CO₂ flux over a temperate desert steppe in Inner Mongolia, China from 2008 to 2010. The amounts and times of precipitation varied significantly throughout the study period. The precipitation in 2009 (186.4 mm) was close to the long-term average (183.9±47.6 mm), while the precipitation in 2008 (136.3 mm) and 2010 (141.3 mm) was approximately a quarter below the long-term average. The temperate desert steppe showed carbon neutrality for atmospheric CO₂ throughout the study period, with a net ecosystem carbon dioxide exchange (NEE) of −7.2, −22.9, and 26.0 g C m⁻² yr⁻¹ in 2008, 2009, and 2010, not significantly different from zero. The ecosystem gained more carbon in 2009 compared to other two relatively dry years, while there was significant difference in carbon uptake between 2008 and 2010, although both years recorded similar annual precipitation. The results suggest that summer precipitation is a key factor determining annual NEE. The apparent quantum yield and saturation value of NEE (NEE_sat) and the temperature sensitivity coefficient of ecosystem respiration (R_eco) exhibited significant variations. The values of NEE_sat were −2.6, −2.9, and −1.4 µmol CO₂ m⁻² s⁻¹ in 2008, 2009, and 2010, respectively. Drought suppressed both the gross primary production (GPP) and R_eco, and the drought sensitivity of GPP was greater than that of R_eco. The soil water content sensitivity of GPP was high during the dry year of 2008 with limited soil moisture availability. Our results suggest the carbon balance of this temperate desert steppe was not only sensitive to total annual precipitation, but also to its seasonal distribution.     

Validity of U.S. Nutritional Surveillance: National Health and Nutrition Examination Survey Caloric Energy Intake Data, 1971–2010

Importance

Methodological limitations compromise the validity of U.S. nutritional surveillance data and the empirical foundation for formulating dietary guidelines and public health policies.

Objectives

Evaluate the validity of the National Health and Nutrition Examination Survey (NHANES) caloric intake data throughout its history, and examine trends in the validity of caloric intake estimates as the NHANES dietary measurement protocols evolved.

Design

Validity of data from 28,993 men and 34,369 women, aged 20 to 74 years from NHANES I (1971–1974) through NHANES 2009–2010 was assessed by: calculating physiologically credible energy intake values as the ratio of reported energy intake (rEI) to estimated basal metabolic rate (BMR), and subtracting estimated total energy expenditure (TEE) from NHANES rEI to create ‘disparity values’.

Main Outcome Measures

1) Physiologically credible values expressed as the ratio rEI/BMR and 2) disparity values (rEI–TEE).

Results

The historical rEI/BMR values for men and women were 1.31 and 1.19, (95% CI: 1.30–1.32 and 1.18–1.20), respectively. The historical disparity values for men and women were −281 and −365 kilocalorie-per-day, (95% CI: −299, −264 and −378, −351), respectively. These results are indicative of significant under-reporting. The greatest mean disparity values were −716 kcal/day and −856 kcal/day for obese (i.e., ≥30 kg/m2) men and women, respectively.

Conclusions

Across the 39-year history of the NHANES, EI data on the majority of respondents (67.3% of women and 58.7% of men) were not physiologically plausible. Improvements in measurement protocols after NHANES II led to small decreases in underreporting, artifactual increases in rEI, but only trivial increases in validity in subsequent surveys. The confluence of these results and other methodological limitations suggest that the ability to estimate population trends in caloric intake and generate empirically supported public policy relevant to diet-health relationships from U.S. nutritional surveillance is extremely limited.     

Malignant Lymphatic and Hematopoietic Neoplasms Mortality in Serbia, 1991–2010: A Joinpoint Regression Analysis

Background

Limited data on mortality from malignant lymphatic and hematopoietic neoplasms have been published for Serbia.

Methods

The study covered population of Serbia during the 1991–2010 period. Mortality trends were assessed using the joinpoint regression analysis.

Results

Trend for overall death rates from malignant lymphoid and haematopoietic neoplasms significantly decreased: by −2.16% per year from 1991 through 1998, and then significantly increased by +2.20% per year for the 1998–2010 period. The growth during the entire period was on average +0.8% per year (95% CI 0.3 to 1.3). Mortality was higher among males than among females in all age groups. According to the comparability test, mortality trends from malignant lymphoid and haematopoietic neoplasms in men and women were parallel (final selected model failed to reject parallelism, P = 0.232). Among younger Serbian population (0–44 years old) in both sexes: trends significantly declined in males for the entire period, while in females 15–44 years of age mortality rates significantly declined only from 2003 onwards. Mortality trend significantly increased in elderly in both genders (by +1.7% in males and +1.5% in females in the 60–69 age group, and +3.8% in males and +3.6% in females in the 70+ age group). According to the comparability test, mortality trend for Hodgkin''s lymphoma differed significantly from mortality trends for all other types of malignant lymphoid and haematopoietic neoplasms (P<0.05).

Conclusion

Unfavourable mortality trend in Serbia requires targeted intervention for risk factors control, early diagnosis and modern therapy.     

Decadal Changes in the World's Coastal Latitudinal Temperature Gradients

Most of the world''s living marine resources inhabit coastal environments, where average thermal conditions change predictably with latitude. These coastal latitudinal temperature gradients (CLTG) coincide with important ecological clines,e.g., in marine species diversity or adaptive genetic variations, but how tightly thermal and ecological gradients are linked remains unclear. A first step is to consistently characterize the world''s CLTGs. We extracted coastal cells from a global 1°×1° dataset of weekly sea surface temperatures (SST, 1982–2012) to quantify spatial and temporal variability of the world''s 11 major CLTGs. Gradient strength, i.e., the slope of the linear mean-SST/latitude relationship, varied 3-fold between the steepest (North-American Atlantic and Asian Pacific gradients: −0.91°C and −0.68°C lat⁻¹, respectively) and weakest CLTGs (African Indian Ocean and the South- and North-American Pacific gradients: −0.28, −0.29, −0.32°C lat⁻¹, respectively). Analyzing CLTG strength by year revealed that seven gradients have weakened by 3–10% over the past three decades due to increased warming at high compared to low latitudes. Almost the entire South-American Pacific gradient (6–47°S), however, has considerably cooled over the study period (−0.3 to −1.7°C, 31 years), and the substantial weakening of the North-American Atlantic gradient (−10%) was due to warming at high latitudes (42–60°N, +0.8 to +1.6°C,31 years) and significant mid-latitude cooling (Florida to Cape Hatteras 26–35°N, −0.5 to −2.2°C, 31 years). Average SST trends rarely resulted from uniform shifts throughout the year; instead individual seasonal warming or cooling patterns elicited the observed changes in annual means. This is consistent with our finding of increased seasonality (i.e., summer-winter SST amplitude) in three quarters of all coastal cells (331 of 433). Our study highlights the regionally variable footprint of global climate change, while emphasizing ecological implications of changing CLTGs, which are likely driving observed spatial and temporal clines in coastal marine life.     

Precipitation Increases the Occurrence of Sporadic Legionnaires’ Disease in Taiwan

Legionnaires’ disease (LD) is an acute form of pneumonia, and changing weather is considered a plausible risk factor. Yet, the relationship between weather and LD has rarely been investigated, especially using long-term daily data. In this study, daily data was used to evaluate the impacts of precipitation, temperature, and relative humidity on LD occurrence in Taiwan from 1995–2011. A time-stratified 2:1 matched-period case-crossover design was used to compare each case with self-controlled data using a conditional logistic regression analysis, and odds ratios (ORs) for LD occurrence was estimated. The city, gender and age were defined as a stratum for each matched set to modify the effects. For lag day- 0 to 15, the precipitation at lag day-11 significantly affected LD occurrence (p<0.05), and a 2.5% (95% CIs = 0.3–4.7%) increased risk of LD occurrence was associated with every 5-mm increase in precipitation. In addition, stratified analyses further showed that positive associations of precipitation with LD incidence were only significant in male and elderly groups and during the warm season ORs = 1.023–1.029). However, such an effect was not completely linear. Only precipitations at 21–40 (OR = 1.643 (95% CIs = 1.074–2.513)) and 61–80 mm (OR = 2.572 (1.106–5.978)) significantly increased the risk of LD occurrence. Moreover, a negative correlation between mean temperature at an 11-day lag and LD occurrence was also found (OR = 0.975 (0.953–0.996)). No significant association between relative humidity and LD occurrence was identified (p>0.05). In conclusion, in warm, humid regions, an increase of daily precipitation is likely to be a critical weather factor triggering LD occurrence where the risk is found particularly significant at an 11-day lag. Additionally, precipitation at 21–40 and 61–80 mm might make LD occurrence more likely.     

CT Morphometric Analysis to Determine the Anatomical Basis for the Use of Transpedicular Screws during Reconstruction and Fixations of Anterior Cervical Vertebrae

Background

Accurate placement of pedicle screw during Anterior Transpedicular Screw fixation (ATPS) in cervical spine depends on accurate anatomical knowledge of the vertebrae. However, little is known of the morphometric characteristics of cervical vertebrae in Chinese population.

Methods

Three-dimensional reconstructions of CT images were performed for 80 cases. The anatomic data and screw fixation parameters for ATPS fixation were measured using the Mimics software.

Findings

The overall mean OPW, OPH and PAL ranged from 5.81 to 7.49 mm, 7.77 to 8.69 mm, and 33.40 to 31.13 mm separately, and SPA was 93.54 to 109.36 degrees from C3 to C6, 104.99 degrees at C7, whereas, 49.00 to 32.26 degrees from C4 to C7, 46.79 degrees at C3 (TPA). Dl/rSIP had an increasing trend away from upper endplate with mean value from 1.87 to 5.83 mm. Dl/rTIP was located at the lateral portion of the anterior cortex of vertebrae for C3 to C5 and ipsilateral for C6 to C7 with mean value from −2.70 to −3.00 mm, and 0.17 to 3.18 mm. The entrance points for pedicular screw insertion for C3 to C5 and C6 to C7 were recommended −2∼−3 mm and 0–4 mm from the median sagittal plane, respectively, 1–4 mm and 5–6 mm from the upper endplate, with TPA being 46.79–49.00 degrees and 40.89–32.26 degrees, respectively, and SPA being 93.54–106.69 degrees and 109.36–104.99 degrees, respectively. The pedicle screw insertion diameter was recommended 3.5 mm (C3 and C4), 4.0 mm (C5 to C7), and the pedicle axial length was 21–24 mm for C3 to C7 for both genders. However, the ATPS insertion in C3 should be individualized given its relatively small anatomical dimensions.

Conclusions

The data provided a morphometric basis for the ATPS fixation technique in lower cervical fixation. It will help in preoperative planning and execution of this surgery.     

Did School Food and Nutrient-Based Standards in England Impact on 11–12Y Olds Nutrient Intake at Lunchtime and in Total Diet? Repeat Cross-Sectional Study

Introduction

In September 2009, middle and secondary schools in England were required to comply with food and nutrient-based standards for school food. We examined the impact of this policy change on children’s lunchtime and total dietary intake.

Methods

We undertook repeat cross-sectional surveys in six Northumberland middle schools in 1999–2000 and 2009–10. Dietary data were collected from 11–12 y olds (n = 298 in 1999–2000; n = 215 in 2009–10). Children completed two consecutive 3-day food diaries, each followed by an interview. Linear mixed effect models examined the effect of year, lunch type and level of socio-economic deprivation on children’s mean total dietary intake.

Results

We found both before and after the introduction of the food and nutrient-based standards children consuming a school lunch, had a lower per cent energy from saturated fat (−0.5%; p = 0.02), and a lower intake of sodium (−143 mg; p = 0.02), and calcium (−81 mg; p = 0.001) in their total diet, compared with children consuming a home-packed lunch. We found no evidence that lunch type was associated with mean energy, or absolute amounts of NSP, vitamin C and iron intake. There was marginal evidence of an association between lunch type and per cent energy NMES (p = 0.06). In 1999–2000, children consuming a school lunch had a higher per cent energy from fat in their total diet compared with children consuming a home-packed lunch (2.8%), whereas by 2009–10, they had slightly less (−0.2%) (year by lunch type interaction p<0.001; change in mean differences −3%).

Conclusions

We found limited evidence of an impact of the school food and nutrient-based standards on total diet among 11–12 year olds. Such policies may need to be supported by additional measures, including guidance on individual food choice, and the development of wider supportive environments in school and beyond the school gates.     

Drugs-Related Death Soon after Hospital-Discharge among Drug Treatment Clients in Scotland: Record Linkage,Validation, and Investigation of Risk-Factors

We validate that the 28 days after hospital-discharge are high-risk for drugs-related death (DRD) among drug users in Scotland and investigate key risk-factors for DRDs soon after hospital-discharge. Using data from an anonymous linkage of hospitalisation and death records to the Scottish Drugs Misuse Database (SDMD), including over 98,000 individuals registered for drug treatment during 1 April 1996 to 31 March 2010 with 705,538 person-years, 173,107 hospital-stays, and 2,523 DRDs. Time-at-risk of DRD was categorised as: during hospitalization, within 28 days, 29–90 days, 91 days–1 year, >1 year since most recent hospital discharge versus ‘never admitted’. Factors of interest were: having ever injected, misuse of alcohol, length of hospital-stay (0–1 versus 2+ days), and main discharge-diagnosis. We confirm SDMD clients’ high DRD-rate soon after hospital-discharge in 2006–2010. DRD-rate in the 28 days after hospital-discharge did not vary by length of hospital-stay but was significantly higher for clients who had ever-injected versus otherwise. Three leading discharge-diagnoses accounted for only 150/290 DRDs in the 28 days after hospital-discharge, but ever-injectors for 222/290. Hospital-discharge remains a period of increased DRD-vulnerability in 2006–2010, as in 1996–2006, especially for those with a history of injecting.     

Tree Rings Show Recent High Summer-Autumn Precipitation in Northwest Australia Is Unprecedented within the Last Two Centuries

An understanding of past hydroclimatic variability is critical to resolving the significance of recent recorded trends in Australian precipitation and informing climate models. Our aim was to reconstruct past hydroclimatic variability in semi-arid northwest Australia to provide a longer context within which to examine a recent period of unusually high summer-autumn precipitation. We developed a 210-year ring-width chronology from Callitris columellaris, which was highly correlated with summer-autumn (Dec–May) precipitation (r = 0.81; 1910–2011; p < 0.0001) and autumn (Mar–May) self-calibrating Palmer drought severity index (scPDSI, r = 0.73; 1910–2011; p < 0.0001) across semi-arid northwest Australia. A linear regression model was used to reconstruct precipitation and explained 66% of the variance in observed summer-autumn precipitation. Our reconstruction reveals inter-annual to multi-decadal scale variation in hydroclimate of the region during the last 210 years, typically showing periods of below average precipitation extending from one to three decades and periods of above average precipitation, which were often less than a decade. Our results demonstrate that the last two decades (1995–2012) have been unusually wet (average summer-autumn precipitation of 310 mm) compared to the previous two centuries (average summer-autumn precipitation of 229 mm), coinciding with both an anomalously high frequency and intensity of tropical cyclones in northwest Australia and the dominance of the positive phase of the Southern Annular Mode.     

Variations in Mortality in Children Admitted with Pneumonia to Kenyan Hospitals

Background

The existing case fatality estimates of inpatient childhood pneumonia in developing countries are largely from periods preceding routine use of conjugate vaccines for infant immunization and such primary studies rarely explore hospital variations in mortality. We analysed case fatality rates of children admitted to nine Kenyan hospitals with pneumonia during the era of routine infant immunization with Hib conjugate vaccine to determine if significant variations exist between hospitals.

Methods

Pneumonia admissions and outcomes in paediatric wards are described using data collected over two time periods: a one-year period (2007–2008) in nine hospitals, and data from a 9.25-year period (1999-March 2008) in one of the participating hospitals. Hospital case fatality rates for inpatient pneumonia during 2007 to 2008 were modeled using a fixed effect binomial regression model with a logit link. Using an interrupted time series design, data from one hospital were analysed for trends in pneumonia mortality during the period between 1997 and March 2008.

Results

Overall, 195 (5.9%) children admitted to all 9 hospitals with pneumonia from March 2007 to March 2008 died in hospital. After adjusting for child’s sex, comorbidity, and hospital effect, mortality was significantly associated with child’s age (p<0.001) and pneumonia severity (p<0.001). There was evidence of significant variations in mortality between hospitals (LR χ² = 52.19; p<0.001). Pneumonia mortality remained stable in the periods before (trend −0.03, 95% CI −0.1 to 0.02) and after Hib introduction (trend 0.04, 95% CI −0.04 to 0.11).

Conclusions

There are important variations in hospital-pneumonia case fatality in Kenya and these variations are not attributed to temporal changes. Such variations in mortality are not addressed by existing epidemiological models and need to be considered in allocating resources to improve child health.     

Spatio-Temporal Characteristics of Global Warming in the Tibetan Plateau during the Last 50 Years Based on a Generalised Temperature Zone - Elevation Model

Temperature is one of the primary factors influencing the climate and ecosystem, and examining its change and fluctuation could elucidate the formation of novel climate patterns and trends. In this study, we constructed a generalised temperature zone elevation model (GTEM) to assess the trends of climate change and temporal-spatial differences in the Tibetan Plateau (TP) using the annual and monthly mean temperatures from 1961–2010 at 144 meteorological stations in and near the TP. The results showed the following: (1) The TP has undergone robust warming over the study period, and the warming rate was 0.318°C/decade. The warming has accelerated during recent decades, especially in the last 20 years, and the warming has been most significant in the winter months, followed by the spring, autumn and summer seasons. (2) Spatially, the zones that became significantly smaller were the temperature zones of −6°C and −4°C, and these have decreased 499.44 and 454.26 thousand sq km from 1961 to 2010 at average rates of 25.1% and 11.7%, respectively, over every 5-year interval. These quickly shrinking zones were located in the northwestern and central TP. (3) The elevation dependency of climate warming existed in the TP during 1961–2010, but this tendency has gradually been weakening due to more rapid warming at lower elevations than in the middle and upper elevations of the TP during 1991–2010. The higher regions and some low altitude valleys of the TP were the most significantly warming regions under the same categorizing criteria. Experimental evidence shows that the GTEM is an effective method to analyse climate changes in high altitude mountainous regions.