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ABSTRACT This study describes an improved seasonal sea level forecasting scheme by the Pacific ENSO Applications Climate Center ( PEAC). Since 2005, an operational sea level forecasting scheme (3-5 months in advance) for the US-affiliated Pacific Islands ( USAPI) has been instrumental (). The El Niño-Southern Oscillation ( ENSO) climate cycle and the sea-surface temperatures ( SSTs) in the tropical Pacific Ocean are taken as the primary factors in modulating these forecasts on seasonal time scales. The current SST-based canonical correlations analysis ( CCA) hindcast forecasts have been found to be skillful. However, the skill gradually decreases as the lead-time increases. This has motivated us to revisit the forecasting scheme at PEAC. In contrast to previous endeavours which relied only on SSTs, we now incorporate both trade winds and SSTs for modulating sea level variability on seasonal time scales. The average forecasts for zero to three seasons' lead-times are found to be 0.647, 0.598, and 0.625 for combined SST and the zonal component of the trade wind (U), SST, and wind (U), respectively. It is therefore revealed that the combined SST-wind-based forecasts are more skillful than the SST or wind-based forecasts alone. It is particularly more efficient on longer time scales for most of the stations (e.g. 10-25% improvement on two to three seasons' lead-times). The improvements of these forecasts have enabled the capability of our clients in the USAPI region to develop a more efficient long-term response plan for hazard management. [ABSTRACT FROM AUTHOR]

Background: Aspiration Pneumonia is a common complication in patients with altered consciousness if general supportive care is not taken properly. There is no national study on incidence of aspiration pneumonia in hospitalized patients with altered consciousness. This study was done to see the incidence of aspiration pneumonia in patients with altered consciousness admitted in a tertiary care hospital in our country. Methods: This was a prospective observational study conducted among the 50 adult patients of aspiration pneumonia with altered consciousness admitted in the medicine department of DMCH, during January 2010 to December 2010. Aspiration pneumonia was confirmed by clinical examination and laboratory investigations. Assessment of altered conscious patient was done by application of the Glasgow Coma Scale. Case record forms with appropriate questionnaire were filled for all patients. Results: The mean (±SD) age was 38.9±17.3 years. Maximum numbers (24.5%) of patients were found in the age group of 51-60 years. Male female ratio was 3:1. Fever, chest pain and productive cough were the most common clinical features. Stroke (64%), Encephalitis (16%) and Hepatic encephalopathy (16%) were found as main precipitating factors. [ABSTRACT FROM AUTHOR]