932 resultados para Gross operating margin
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Regional climate simulations are conducted using the Polar fifth-generation Pennsylvania State University (PSU)-NCAR Mesoscale Model (MM5) with a 60-km horizontal resolution domain over North America to explore the summer climate of the Last Glacial Maximum (LGM: 21 000 calendar years ago), when much of the continent was covered by the Laurentide Ice Sheet (LIS). Output from a tailored NCAR Community Climate Model version 3 (CCM3) simulation of the LGM climate is used to provide the initial and lateral boundary conditions for Polar MM5. LGM boundary conditions include continental ice sheets, appropriate orbital forcing, reduced CO2 concentration, paleovegetation, modified sea surface temperatures, and lowered sea level. The simulated LGM summer climate is characterized by a pronounced low-level thermal gradient along the southern margin of the LIS resulting from the juxtaposition of the cold ice sheet and adjacent warm ice-free land surface. This sharp thermal gradient anchors the midtropospheric jet stream and facilitates the development of synoptic cyclones that track over the ice sheet, some of which produce copious liquid precipitation along and south of the LIS terminus. Precipitation on the southern margin is orographically enhanced as moist southerly low-level flow (resembling a contemporary, Great Plains low-level jet configuration) in advance of the cyclone is drawn up the ice sheet slope. Composites of wet and dry periods on the LIS southern margin illustrate two distinctly different atmospheric flow regimes. Given the episodic nature of the summer rain events, it may be possible to reconcile the model depiction of wet conditions on the LIS southern margin during the LGM summer with the widely accepted interpretation of aridity across the Great Plains based on geological proxy evidence.
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Assuming a channelized drainage system in steady state, we investigate the influence of enhanced surface melting on the water pressure in subglacial channels, compared to that of changes in conduit geometry, ice rheology and catchment variations. The analysis is carried out for a specific part of the western Greenland ice-sheet margin between 66 degrees N and 66 degrees 30' N using new high-resolution digital elevation models of the subglacial topography and the ice-sheet surface, based on an airborne ice-penetrating radar survey in 2003 and satellite repeat-track interferometric synthetic aperture radar analysis of European Remote-sensing Satellite 1 and 2 (ERS-1/-2) imagery, respectively. The water pressure is calculated up-glacier along a likely subglacial channel at distances of 1, 5 and 9 km from the outlet at the ice margin, using a modified version of Rothlisberger's equation. Our results show that for the margin of the western Greenland ice sheet, the water pressure in subglacial channels is not sensitive to realistic variations in catchment size and mean surface water input compared to small changes in conduit geometry and ice rheology.
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bearb. von [R.] Berndt
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von J. Berberich
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Schizophrenia is associated with heterogeneous course of positive and negative symptoms. In addition, reduced motor activity as measured by wrist actigraphy has been reported. However, longitudinal studies of spontaneous motor activity are missing. We aimed to explore whether activity levels were stable within and between psychotic episodes. Furthermore, we investigated the association with the course of negative symptoms. In 45 medicated patients, we investigated motor behavior within a psychotic episode. In addition, we followed 18 medicated patients across 2 episodes. Wrist actigraphy and psychopathological ratings were applied. Within an episode symptoms changed but activity levels did not vary systematically. Activity at baseline predicted the course of negative symptoms. Between two episodes activity recordings were much more stable. Again, activity at the index episode predicted the outcome of negative symptoms. In sum, spontaneous motor activity shares trait and state characteristics, the latter are associated with negative symptom course. Actigraphy may therefore become an important ambulatory instrument to monitor negative symptoms and treatment outcome in schizophrenia.
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BACKGROUND: The quality of surgical performance depends on the technical skills of the surgical team as well as on non-technical skills, including teamwork. The present study evaluated the impact of familiarity among members of the surgical team on morbidity in patients undergoing elective open abdominal surgery. METHODS: A retrospective analysis was performed to compare the surgical outcomes of patients who underwent major abdominal operations between the first month (period I) and the last month (period II) of a 6-month period of continuous teamwork (stable dyads of one senior and one junior surgeon formed every 6 months). Of 117 patients, 59 and 58 patients underwent operations during period I and period II, respectively, between January 2010 and June 2012. Team performance was assessed via questionnaire by specialized work psychologists; in addition, intraoperative sound levels were measured. RESULTS: The incidence of overall complications was significantly higher in period I than in period II (54.2 vs. 34.5 %; P = 0.041). Postoperative complications grade <3 were significantly more frequently diagnosed in patients who had operations during period I (39.0 vs. 15.5 %; P = 0.007), whereas no between-group differences in grade ≥3 complications were found (15.3 vs. 19.0 %; P = 0.807). Concentration scores from senior surgeons were significantly higher in period II than in period I (P = 0.033). Sound levels during the middle third part of the operations were significantly higher in period I (median above the baseline 8.85 dB [range 4.5-11.3 dB] vs. 7.17 dB [5.24-9.43 dB]; P < 0.001). CONCLUSIONS: Team familiarity improves team performance and reduces morbidity in patients undergoing abdominal surgery.