[1] The stable carbon isotope composition (dC) of tree rings in a climate-sensitive region can provide a retrospective view of changes in environment and climate. Here, we report on the development of the first annually resolved dC tree ring chronology obtained from natural forests on the northeastern Tibetan Plateau. Climate data show a warming trend and more frequent droughts occurring in the...

The clinical course of bronchiectasis is unpredictable, posing a challenge both in clinical practice and in research. Two mortality prediction scores, the bronchiectasis severity index (BSI) and FACED scores, have recently been developed. The aim of this study was to assess the ability of these scores to predict long-term mortality and to compare the two scores.The study was a single-centre ret...

BACKGROUND Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a pauci...

The Palmer Drought Severity Index (PDSI) was calculated globally using gridded monthly air temperature and precipitation. From 1900 to 1995, there are large multiyear to decadal variations in the percentage areas in severe drought (PDSI < −3.0) and severe moisture surplus (PDSI > +3.0) over many land areas while secular trends are small. Since the late 1970s, however, there have been some incre...

PURPOSE Effective trauma resuscitation requires efficient and coordinated care from a team of providers; however, providers are rarely instructed on how to be effective members of trauma teams. Team-based learning using Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) has been shown to improve team dynamics among practicing professionals, including physicians and...

The prevalence of surgical trauma as a global public health hazard has been severely neglected. Trauma surgeons in Uganda and Canada have developed the Kampala Trauma Score (KTS), a trauma severity index specific to east African contexts. Hospitals in Tanzania have begun to use this tool to measure their own trauma management protocols in order to measure the validity of this index regionally. ...

Bitmap indexes (BIs) allow fast access to individual attribute values that are needed to answer a query by storing a bit for each distinct value and tuple. A BI is defined for a single attribute and the encodings are based solely on data values; the property map (PMap) is a multidimensional indexing technique that precomputes attribute expressions for each tuple and stores the results as bit st...

BACKGROUND The Prehospital Trauma Life Support (PHTLS) course has been widely implemented and approximately half a million prehospital caregivers in over 50 countries have taken this course. Still, the effect on injury outcome remains to be established. The objective of this study was to investigate the association between PHTLS training of ambulance crew members and the mortality in trauma pat...

BACKGROUND Insomnia is one of the most common complaints faced by primary care practitioners after pain. Non-pharmacological management of Insomnia that is noninvasive is gaining interest among patients with insomnia. PURPOSE To determine the feasibility of recruiting and retaining participants in a clinical trial on shirodhara, Ayurvedic oil dripping therapy, for insomnia in the United State...

BACKGROUND Trauma registries offer distinct advantages and disadvantages when assessing the effectiveness of trauma systems. Detailed injury data and statistical comparisons that use TRISS methodology and the Major Trauma Outcome Study norms provide advantages over population-based or preventable death studies. However, miscodings and registry differences in injury severity coding limit the val...