2,198 research outputs found
Limited Area Numerical Weather Prediction
No full textTwo limited area model derivatives of the numerical weather prediction model COSMO-DE operated by the German Meteorological Service are introduced. The aim is to obtain frequently updated highly re-solved predictions in a limited area as an aerodrome. The predictions include dynamic parameters as wind and turbulence kinetic energy and thermodynamic quantities as temperature and humidity but also the amount of snow, rain and hail. The models are used in the airport environments of Frankfurt (COSMO-FRA) and Munich (COSMO-MUC) for aircraft wake vortex, thunderstorm activity, and wintry weather warning applications, as detailed in Sections 2.1 to 2.4
The antiquarian photography of Cosmo Innes
No full textThe article focuses on the photography of historian Cosmo Innes. The author provides a brief historical background on Innes, discusses his interest in photographing pre-Reformation Scottish churches, and contrasts his work depicting church architecture to his photographs of country mansions, including Cawdor Castle, Auldbar Castle, and Gordon Castle
Evaluating Ice Microphysics in NWP Models with Satellite Observations
No full textIce clouds are an important part of the Earth’s atmospheric water cycle and have a large impact on the global radiation budget. Yet ice clouds are still poorly understood and their correct representation remains a major challenge for state-of-the-art atmospheric models. Also, the evaluation of the models’ performance with respect to ice clouds is not straightforward; remote sensing instruments, for example, measure other quantities than the models predict. Therefore, two basic evaluation approaches exist: observation-to-model (commonly termed retrieval) and model-to-observation (commonly termed forward operator). Both approaches introduce errors into the comparison of models and observations because of the necessary intrinsic assumptions. The common practice in model evaluation of choosing either the one or the other of these approaches might give an incomplete picture.
The present study evaluates the ice microphysics of two numerical weather prediction (NWP) models currently operational at the German weather service (Deutscher Wetterdienst, DWD): the global model GME and the regional model COSMO-DE (an application of the Consortium for Small-scale Modelling, COSMO). In doing so, this study contributes significantly to ongoing model development at DWD. Both case studies and long-term evaluations are carried out. Cloud Satellite (CloudSat) Cloud Profiling Radar (CPR) observations are heavily relied on; the CPR is the first and — up to date — only cloud radar in space and is able to vertically resolve even optically thick clouds. This study focuses on one specific question raised for each of the respective models and while doing so applies both approaches; the standard CloudSat radar reflectivity factor–ice water content (IWC) retrieval for the observation-to-model approach and the forward operator QuickBeam for the model-to-observation approach. This enables for one, to profit from the full informational content, and for the other, to compare both approaches directly to each other and evaluate them.
For the global model GME, two precipitation schemes, a diagnostic and a prognostic one, are compared and evaluated. The focus is on the question whether the new prognostic scheme is capable of capturing ice clouds more realistically than the old diagnostic scheme. The prognostic scheme is shown to exhibit improved performance in comparison to the diagnostic scheme in terms of IWC magnitude. In both models snow is found to dominate over cloud ice in total IWC, emphasizing the need for including snow in the model’s radiation budget in the future. Furthermore, one reason for the remaining difference between the prognostic scheme and the observations — the unrealistic fall speed of snow — is identified. As a consequence, the new prognostic scheme with an adapted parameterization for snow fall speed was successfully introduced into operational service at DWD.
In the regional NWP model COSMO-DE, a long-known bias between brightness temperatures simulated from COSMO-DE forecasts and those observed by Meteosat Second Generation (MSG) Spinning Enhanced Visible and Infrared Imager (SEVIRI) is investigated. The pivotal question is whether a novel two-moment cloud ice scheme exhibits improved
performance with respect to this bias and, if that is so, why. It is shown that the novel two-moment cloud ice scheme does indeed reduce this bias and can therefore be considered an improvement in comparison to two standard schemes, the two-category ice scheme and the currently operational three-category ice scheme. The improvement in simulated brightness temperatures is due to a vertical redistribution of cloud ice to lower model levels. Furthermore, sensitivity studies identify two of the four changes introduced, which are responsible for most of the improved performance: the change to a different heterogeneous nucleation scheme and the inclusion of cloud ice sedimentation. Enhanced vertical level number and modifications in aerosol number concentrations reveal comparatively little effect. As a consequence, cloud ice sedimention will be included per se in DWD’s future NWP model, the Icosahedral non-hydrostatic (ICON) model, currently still under development.
Concerning the two evaluation approaches conducted, the present study finds the general features in the two evaluations to be captured by both approaches. Some details are captured merely by the one or the other approach, in which case both approaches together give the more complete picture. However, the model-to-observation approach appears to be easier to interpret; its uncertainties are easier to assess than those of the observation-to-model approach and it ensures a better control over the comparison
Rilevamento geomorfologico e gestione dati spaziali attraverso l'uso combinato hardware-software Open-Source per il controllo e la gestione del rischio geologico
No full textThis thesis was designed and built to test a new system of hardware-software combined study for the control and management of geological risk arising from mud flow landslides and slopes slow movements.
The various issues that arise at present in the landslide management risk are related to poor knowledge of the territory from the geological, geomorphological and specially geodynamic point of view. In risk management modern technical software and hardware very often are neglected, probably because no direct knowledge, that would allow a more advanced risk management in real time.
The latest hardware and software generation can identify, if associated with the availability of appropriate and correct data, any type of risk triggering cause arising from natural or anthropogenic factors.
This thesis focuses on the resolution of the above mentioned issues and finding detailed use not only at the civil protection level but also in the freelance profession.
In this thesis has been tested, with positive results, the Open - Source (OS) software applied to geological, geomorphological and geodynamic data collected on field in two areas; Olvera in Spain (detection area) and Oliveto Lucano in Italy (test area). OS software are indeed available and freely accessible at no cost.
The development of the project was divided into three main phases coinciding with the duration of doctorate (three years). They are: Geological and geomorphological survey (1st phase), server management versus UMPC and Open Source software (2nd phase) and two and three dimensional simulations of mud flow landslides with verify on test area (3rd phase).
More specifically, in the first year, in addition to the bibliographic collection and the choice of detection area (Olvera, Cadiz, Andalucia, Spain) and the test area (Oliveto Lucano, Matera, Basilicata, Italy) was carried out an intensive geological and geomorphological survey with the collection of all available data through the use of an Ultra Mobile Personal Computer (UMPC) above all in the Olvera. During the field work were selected and tested some of the OS software for digitization and data acquisition. Meanwhile in the laboratory was achieved on the network server, the web site, the DBMS database and the GUI of the WebGIS.
In the second year were improved techniques for survey detection through the use of UMPC and its direct connection with the server via HSDPA (High Speed Downlink Packet Access). Have also completed the selection, installation and development of other OS software needed to complete the project for the DBMS and the WebGIS area. Most important was the realization, through GIS and graphics tools chosen, geological and geomorphological maps and especially the map of susceptibility. After the realization of map of susceptibility, was performed a new detection phase on the field for a map validation.
In the third year the software development for the monitoring of movements by comparison of automatic objects placement on the territory from orthophotos or aerial photos of different years was performed and also the simulated two-and three-dimensional mud flow phenomena and slopes slow movements. All the simulations and tests carried out on landslides in the Olvera was verified on field. Even the simulation of landslides in the area of Oliveto Lucano have been tested on field.
During the three years of the PhD were produced poster, pbstract and articles. Here are the headlines: A tiicks published:
-A new approach to landslide geomorphological mapping using Open-Source software in the Olvera area (Cadiz, Spain), F. Mantovani, P. D. de Cosmo, A. Suma & F.J. Gracia. Su Landslides magazine. Poster:
-"Aplicacion del software Open Source (Web GIS) a la cartograffa geologica y geomorfologica del area de Olvera (Cadiz)" P.D. de Cosmo, A. Suma, F.J. Gracia y F. Mantovani, alia X Reunion Nacional de Geomorfologfa Cadiz, 16-19 Settembre 2008 Abstract:
Gypsum Karst in the Olvera Area (Cadiz Province, Andalucia, Spain), Andrea Suma, Francisco Javier Gracia Prieto, Pietro Domenico de Cosmo; 17th International Karstological School, Postojna Slovenija, 15th to 20th June, 200
Is sedation for endoscopy as safe as you think?
No full text1118 Minerva Anestesiologica N November 2017
I
n this issue of Minerva Anestesiologica, Brumby et al.8 report an observational pilot study assessing the incidence of failure to recover at day 1 and in subsequent days and weeks after either colonoscopy, gastroscopy, or both procedures combined in 102 patients of over the age of 18 years. Recovery was evaluated not only using physiologic endpoints but also evaluating other aspects such as nociception, emotion, activities of daily living (ADL), and cognition on the following day as well as over a 1-month follow-up period using the multidimensional Postoperative Quality of Recovery Scale (PostopQRS ). All the patients received total intravenous anesthesia with propofol alone or in combination with opioids. Some participants received midazolam or opioids in the pre-operative period. The authors have seen that incomplete recovery is common after colonoscopy, gastroscopy or both procedures. Failure to recover was mainly due to failure in nociceptive and cognitive recovery at day 1 with modest but clinically important differences in early quality of recovery between the procedures.
C
orrectly, the authors underline that recovery after endoscopic procedures should be defined by a multidimensional tool able to assess emotive, functional and cognitive domains.
T
his is particularly important because the patients must be discharged as soon as possible and should return to preoperative levels of independency in activities of daily living.
Anesthesia demand for colonoscopy and gastroscopy is increasing each year and this is due to need of diagnostic or screening programs and therapeutic management of acute pathologies or neoplastic diseases. Because of the air or CO 2 insufflation for adequate distention and visualization of the gastrointestinal lumen, the endoscopic procedures are associated with significant pain and discomfort, therefore sedation is often required to improve patient tolerance and safety.1, 2 Propofol alone or combined with midazolam and opioids is commonly used for sedation although drugs as etomidate and dexmedetomidine have been introduced.3, 4 Usually, the procedures are ambulatory and the patients must be discharged soon after the endoscopy. Adverse events during sedation for endoscopy are very low and anesthetic techniques are performed to provide sedation minimizing hemodynamic changes and allowing faster emergence and patient’s discharge. Patients can return to their daily lives safely and promptly as soon as have recovered to pre-procedural baseline physical performance.5 However, optimal recovery after sedation for endoscopy is not always observed.
C
ommonly, a patient’s discharge is related to recovery time, adverse events and physiological parameters such as level of consciousness and stability of vital signs.6, 7
EDITORIAL
I
s sedation for endoscopy as safe as you think?
Germano DE COS MO 1 *, Elisabetta CONGEDO 2
1Department of Anesthesia and Intensive Care, Sacro Cuore Catholic University, Rome, Italy; 2Department of Anesthesia and Intensive Care, Antonio Perrino Hospital, Brindisi, Italy
*Corresponding author: Germano De Cosmo, Department of Anesthesia and Intensive Care, Sacro Cuore Catholic University, via G. Moscati 31, 00168 Rome, Italy. E-mail: [email protected]
C
omment on p. 1161.
Minerva Anestesiologica 2017 November;83(11):1118-20
DOI : 10.23736/S0375-9393.17.12260-1
© 2017 EDIZIONI MINERVA INERVAINERVA MEDICA
O
nline version at http://www.minervamedica.it
COPYRIGHT© 2017 EDIZIONI MINERVA MEDICA
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo,
or other proprietary information of the Publisher.
SA
FET Y OF SE DATIONATION FOR EN DOSCO PY DE COS MO
V
ol. 83 - No. 11 Minerva Anestesiologica 1119sedated with propofol or remifentanil.14 Allen et al. have shown that the incidence of post-procedural cognitive impairment was similar in patients randomized to light versus deep sedation. In addition, the authors have not considered pain an important risk factor for post procedural cognitive dysfunction, especially if the endoscopic procedure is diagnostic and not operative.16
S
harma et al. have investigated cognitive function in 108 patients with cirrhosis undergoing endoscopy under sedation with propofol. Before and two hours after endoscopy psychometric tests have been administered to evaluate cognitive function. The authors have not found a worsening of the psychometric tests after the endoscopy.17
T
hese differences can be due to several factors: the type and sensitivity of the psychometric tests used, the variation also in the healthy subjects’ performance at a few days away, the too small simple size. There is a wide confidence interval of evaluated parameters that indicates that there is a great variation of response in the various subjects, due to a small simple size.18-20
I
n conclusion, thousands of endoscopic procedures are performed daily and the main question that this article raises is to understand what means recovery from a procedure: an adequate recovering goes beyond vital functions. Incomplete recovery can last up to one month and is mainly due to nociceptive and cognitive impairment that could also occur in young people undergoing minor procedures. Therefore, subsequent studies might need to investigate if and how a low impact procedure can induce cognitive impairment and the main parameters that should be assessed to consider a patient overall recovered utilizing appropriate tests that can identify the most vulnerable patients.
References
1. A Allen ML. Safety of deep sedation in the endoscopy suite. Curr Opin Anaesthesiol 2017;30:501-6.
2. L Leslie K, Allen ML, Hessian EC , Peyton PJ, Kasza J, Courtney A, et al. Safety of sedation for gastrointestinal
I
n literature, the reported incidence of Postoperative Cognitive Dysfunction (POC D) varies from 20% to 60% between 6 weeks to 3 months after surgery and the causes of this variability are related to type of surgery, duration, patient’s age and cultural level.9
T
he prevalence of POC D has primarily been studied in elderly patients undergoing cardiac surgery.10 However, its frequency should be very rare after endoscopic procedure especially in young people because stress associated to endoscopic procedures is very low as well as the increase of pro-inflammatory cytokines that play a pivotal role in cognitive dysfunction.11, 12
T
he novelty of the study by Brumby et al. is that the people enrolled are young, without risk factors for postoperative cognitive dysfunction, and not undergoing major surgery.
S
urprisingly, a not negligible percentage of patients had a cognitive impairment not only in the early post-procedural period but until one month and perhaps for a longer time if follow-up period would be prolonged. Patients in the gastroscopy group have a lower frequency of overall recovery.
We have to consider that both endoscopic procedures have affected not only cognitive function but also pain. Authors do not report if there is a correlation between POC D and the presence of pain despite they have seen that patients undergoing combined procedures had more pain over the entire 1-month follow-up period and a more cognitive impairment at day 1 than participants having only colonoscopy.
However, these results should be observed with caution not only because endoscopic procedures have been considered with little impact on daily physiological activity and on cognitive and nociceptive domain but also because few studies have been performed, and only for few days.13-15 Moreover, the studies performed give different results.
T
heodorou et al. have demonstrated cognitive impairment up to 120 minutes after propofol/midazolam/fentanyl or nitrous oxide/sevoflurane sedation for colonoscopy.13 Instead, Moerman et al. have not found cognitive dysfunction
after 15 min in colonoscopy patients
COPYRIGHT© 2017 EDIZIONI MINERVA MEDICA
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo,
or other proprietary information of the Publisher.
DE COS MO SA SA FET Y OF SE DATIONATION FOR EN DOSCO PY
1120 Minerva Anestesiologica N November 2017gedo E, De Cosmo G. Cognitive Dysfunction after Surgery: An Emergent Problem. J Alzheimers Dis Parkinsonism 2017;7:1.
13. T Theodorou T, Hales P, Gillespie P, Robertson B. Total intravenous versus inhalational anaesthesia for colonoscopy: a prospective study of clinical recovery and psychomotor function. Anaesth Intensive Care 2001;29:124-36.
14. Moerman ATAT, Foubert LA , Herregods LL , Struys MM, De Wolf DJ, De Looze DA, et al. Propofol versus remifentanil for monitored anaesthesia care during colonoscopy. Eur J Anaesthesiol 2003;20:461-6.
15. Fredman B, Lahav M, Zohar E, Golod M, Paruta I, Jedeikin R. The effect of midazolam premedication on mental and psychomotor recovery in geriatric patients undergoing brief surgical procedures. Anesth Analg 1999;89:1161-6.
16. A Allen M, Leslie K, Hebbard G, Jones I, Mettho T, Maruff P. A randomized controlled trial of ligh versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural condition and recovery. Can J Anesth 2015;62:1169-78.
17. S Sharma P, Singh S, Sharma BC, Kumar M, Garg H, Kumar A, et al. Propofol sedation during endoscopy in patients with cirrhosis, and utility of psychometric tests and critical flicker frequency in assessment of recovery from sedation. Endoscopy 2011;43:400-5.
18. S tark PA, Myles PS, Burke JA. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology 2013; 118:1332-40.
19. Bowyer AJ, Royse CF. Postoperative recovery and outcomes--what are we measuring and for whom? Anaesthesia 2016;71(Suppl 1):72-7.
20. N Newman S, Wilkinson DJ, Royse CF. Assessment of early cognitive recovery after surgery using the Post-operative Quality of Recovery Scale. Acta Anaesthesiol Scand 2014;58:185-91.
endoscopy in a group of university-affiliated hospitals: a prospective cohort study. Br J Anaesth 2017;118:90-9.
3. Padmanabhan U, Leslie K. Australian anaesthetists’ practice of sedation for gastrointestinal endoscopy in adult patients. Anaesth Intensive Care 2008;36:436-41.
4. Davy A, Fessler J, Fischler M, le Guen M. Dexmedetomidine and general anesthesia: a narrative literature review of its major indications for use in adults undergoing non-cardiac surgery. Minerva Anestesiol 2017 Jun 22. [Epub ahead of print]
5. L Leung FW. Trend in use of sedation for low-risk endoscopy. Looking beyond monitored anesthesis care. JAMA 2017;317:2006-7.
6. Feldman LS , Lee L, Fiore J Jr. What outcomes are important in the assessment of Enhanced Recovery After Surgery (ERAS ) pathways? Can J Anaesth 2015;62:120-30.
7. L Lee L, Tran T, Mayo NE , Carli F, Feldman LS . What does it really mean to “recover” from an operation? Surgery 2014;155:211-6.
8. Brumby AM, Heiberg J, Te C, Royse CF. Quality of recovery after gastroscopy, colonoscopy or both endoscopic procedures: an observational pilot study. Minerva Anestesiol 2017;83:1161-8.
9. R Royse CF, Andrews DT, Newman SN , Stygall J, Williams Z, Pang J, et al. The influence of propofol or desflurane on postoperative cognitive dysfunction in patients undergoing coronary artery bypass surgery. Anaesthesia 2011;66:455-64.
10. N Newman MF, Mathew JP, Grocott HP, Mackensen GB, Monk T, Welsh-Bohmer KA, et al. Central nervous system injury associated with cardiac surgery. Lancet 2006;368:694-703.
11. De Cosmo G, Sessa F, Fiorini F, Congedo E. Effect of remifentanil and fentanyl on postoperative cognitive function and cytokines level in elderly patients undergoing major abdominal surgery. J Clin Anesth 2016;35:40-6.
12. C Canistro G, Levantesi L, Oggiano M, Sicuranza R, ConConflicts
of interest.—The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
Article first published online: July 12, 2017. - Manuscript accepted: July 5, 2017. - Manuscript received: June 27, 2017.
(Cite this article as: De Cosmo G, Congedo E. Is sedation for endoscopy as safe as you think? Minerva Anestesiol 2017;83:1118-20. DOI : 10.23736/S0375-9393.17.12260-1)
COPYRIGHT© 2017 EDIZIONI MINERVA MEDICA
This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies
(either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other
means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is
not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo,
or other proprietary information of the Publisher
Concentration on circles for nonlinear schrödinger-poisson systems with unbounded potentials vanishing at infinity
No full textThe present paper is devoted to weighted nonlinear Schrödinger-Poisson systems with potentials possibly unbounded and vanishing at infinity. Using a purely variational approach, we prove the existence of solutions concentrating on a circle. © 2012 World Scientific Publishing Company
Low Altitude Tethered Mars Probe
No full textAbstract - A long tether connects a Martian orbiter to a small probe orbiting in the dense atmosphere of the planet. The minimum altitude reachable by the probe is estimated based upon considerations of dynamic stability, tether temperature, resistance of the tether material, and propellant consumption required to maintain a constant orbital altitude. The results obtained by means of a static-force model are then verified by dynamics simulation carried out by using a lumped-mass computer code. The scientific applications of this tethered system include probing of the Martian upper atmosphere and gravity mapping of the planet carried out by collecting gradiometric data from the probe. Another application involves the release of Martian rovers and penetrators from the probe at low altitude. Copyright © 1990 Published by Elsevier Ltd
Postseismic Deformation Monitoring With the COSMO/SKYMED Constellation
No full textCOSMO/SKYMED is currently the unique constellation of synthetic aperture radar (SAR) sensors operative, which is also for civilian use. On April 6, 2009, an Mw 6.3 earthquake struck the city of l'Aquila in Central Italy. The constellation acquired data stacks over the hit area at an unprecedented temporal rate. In this letter, the results obtained by processing several data set via two independent multitemporal differential interferometric SAR techniques are presented to demonstrate the capability of this constellation in postseismic deformations monitoring
Validating precipitation forecasts using remote sensor synergy: A case study approach
No full textSeveral types of remote sensing data are applied synergistically to evaluate the chain of microphysical
processes leading to precipitation in a high-resolution numerical weather prediction model. The data provides
information relating to (i) cloud-top temperature and optical depth (SEVERI), (ii) ice cloud amount (AMSUB),
(iii) type and amount of precipitation particles (polarimetric radar), and (iv) surface precipitation
(raingauge-calibrated radar data). Forecasts are produced by the COSMO-DE model of the German weather
service, with a horizontal resolution of 2.8 km. The comparison with data is done in a model-to-observation
framework, that is, forward operators are applied to the model output to produce synthetic data sets that
can be directly compared to the observations. Additional diagnostics based on diurnal cycle and system
tracking are also considered. Two case studies over Germany from the summer of 2006 are examined. The
first case is dominated by widespread stratiform precipitation. Together the various data sets show that the
model overestimates the amount of high cloud, while underestimating the concentration of ice scatterers
and overestimating reflectivity and differential reflectivity (ZDR). This indicates errors in both the amount
and the size distributions of cloud and precipitation particles in the model’s microphysical parameterization.
In the second case a narrow band of convective precipitation is embedded in a cold front, with significant
modulation by the diurnal cycle. The model fails to show a significant diurnal cycle in cloud amount, and
the timing and duration of convective cells is incorrect. In this case, both the microphysical parameterization,
and errors in the interaction of the simulated front with the orography of the Alps appear to contribute. These
results demonstrate the potential of combinations of remote sensing data for model evaluation, although a
long-term trial will be required to determine whether the errors seen in the case studies are characteristic for
COSMO-DE
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