Differential GPS as a monitoring tool on Volcano Santa Ana (Illamatepec) and the Coatepeque Caldera, El Salvador

We used differential GPS measurements from a 13 station GPS network spanning the Santa Ana Volcano and Coatepeque Caldera to characterize the inter-eruptive activity and tectonic movements near these two active and potentially hazardous features. Caldera-forming events occurred from 70-40 ka and at Santa Ana/Izalco volcanoes eruptive activity occurred as recently as 2005. Twelve differential stations were surveyed for 1 to 2 hours on a monthly basis from February through September 2009 and tied to a centrally located continuous GPS station, which serves as the reference site for this volcanic network. Repeatabilities of the averages from 20-minute sessions taken over 20 hours or longer range from 2-11 mm in the horizontal (north and east) components of the inter-station baselines, suggesting a lower detection limit for the horizontal components of any short-term tectonic or volcanic deformation. Repeatabilities of the vertical baseline component range from 12-34 mm. Analysis of the precipitable water vapor in the troposphere suggests that tropospheric decorrelation as a function of baseline lengths and variable site elevations are the most likely sources of vertical error. Differential motions of the 12 sites relative to the continuous reference site reveal inflation from February through July at several sites surrounding the caldera with vertical displacements that range from 61 mm to 139 mm followed by a lower magnitude deflation event on 1.8-7.4 km-long baselines. Uplift rates for the inflationary period reach 300 mm/yr with 1σ uncertainties of +/- 26 – 119 mm. Only one other station outside the caldera exhibits a similar deformation trend, suggesting a localized source. The results suggest that the use of differential GPS measurements from short duration occupations over short baselines can be a useful monitoring tool at sub-tropical volcanoes and calderas.

A robust reference signal generator for synchronized ventricular assist devices

Ventricular assist devices (VADs) are blood pumps that offer an option to support the circulation of patients with severe heart failure. Since a failing heart has a remaining pump function, its interaction with the VAD influences the hemodynamics. Ideally, the heart's action is taken into account for actuating the device such that the device is synchronized to the natural cardiac cycle. To realize this in practice, a reliable real-time algorithm for the automatic synchronization of the VAD to the heart rate is required. This paper defines the tasks such an algorithm needs to fulfill: the automatic detection of irregular heart beats and the feedback control of the phase shift between the systolic phases of the heart and the assist device. We demonstrate a possible solution to these problems and analyze its performance in two steps. First, the algorithm is tested using the MIT-BIH arrhythmia database. Second, the algorithm is implemented in a controller for a pulsatile and a continuous-flow VAD. These devices are connected to a hybrid mock circulation where three test scenarios are evaluated. The proposed algorithm ensures a reliable synchronization of the VAD to the heart cycle, while being insensitive to irregularities in the heart rate.

A novel clinical scoring system for outcome prediction in dogs with acute kidney injury managed by hemodialysis.

BACKGROUND No reliable tool to predict outcome of acute kidney injury (AKI) exists. HYPOTHESIS A statistically derived scoring system can accurately predict outcome in dogs with AKI managed with hemodialysis. ANIMALS One hundred and eighty-two client-owned dogs with AKI. METHODS Logistic regression analyses were performed initially on clinical variables available on the 1st day of hospitalization for relevance to outcome. Variables with P< or = .1 were considered for further analyses. Continuous variables outside the reference range were divided into quartiles to yield quartile-specific odds ratios (ORs) for survival. Models were developed by incorporating weighting factors assigned to each quartile based on the OR, using either the integer value of the OR (Model A) or the exact OR (Models B or C, when the etiology was known). A predictive score for each model was calculated for each dog by summing all weighting factors. In Model D, actual values for continuous variables were used in a logistic regression model. Receiver-operating curve analyses were performed to assess sensitivities, specificities, and optimal cutoff points for all models. RESULTS Higher scores were associated with decreased probability of survival (P < .001). Models A, B, C, and D correctly classified outcomes in 81, 83, 87, and 76% of cases, respectively, and optimal sensitivities/specificities were 77/85, 81/85, 83/90 and 92/61%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE The models allowed outcome prediction that corresponded with actual outcome in our cohort. However, each model should be validated further in independent cohorts. The models may also be useful to assess AKI severity.

Impact of Team Familiarity in the Operating Room on Surgical Complications

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.

Accuracy of continuous glucose monitoring during differing exercise conditions.

AIM Depending on intensity, exercise may induce a strong hormonal and metabolic response, including acid-base imbalances and changes in microcirculation, potentially interfering with the accuracy of continuous glucose monitoring (CGM). The present study aimed at comparing the accuracy of the Dexcom G4 Platinum (DG4P) CGM during continuous moderate and intermittent high-intensity exercise (IHE) in adults with type 1 diabetes (T1DM). METHODS Ten male individuals with well-controlled T1DM (HbA1c 7.0±0.6% [54±6mmol/mol]) inserted the DG4P sensor 2 days prior to a 90min cycling session (50% VO2peak) either with (IHE) or without (CONT) a 10s all-out sprint every 10min. Venous blood samples for reference glucose measurement were drawn every 10min and euglycemia (target 7mmol/l) was maintained using an oral glucose solution. Additionally, lactate and venous blood gas variables were determined. RESULTS Mean reference blood glucose was 7.6±0.2mmol/l during IHE and 6.7±0.2mmol/l during CONT (p<0.001). IHE resulted in significantly higher levels of lactate (7.3±0.5mmol/l vs. 2.6±0.3mmol/l, p<0.001), while pH values were significantly lower in the IHE group (7.27 vs. 7.38, p=0.001). Mean absolute relative difference (MARD) was 13.3±2.2% for IHE and 13.6±2.8% for CONT suggesting comparable accuracy (p=0.90). Using Clarke Error Grid Analysis, 100% of CGM values during both IHE and CONT were in zones A and B (IHE: 77% and 23%; CONT: 78% and 22%). CONCLUSIONS The present study revealed good and comparable accuracy of the DG4P CGM system during intermittent high intensity and continuous moderate intensity exercise, despite marked differences in metabolic conditions. This corroborates the clinical robustness of CGM under differing exercise conditions. CLINICAL TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT02068638.

Continuous safety screens for randomized controlled clinical trials with blinded treatment information

Standard methods for testing safety data are needed to ensure the safe conduct of clinical trials. In particular, objective rules for reliably identifying unsafe treatments need to be put into place to help protect patients from unnecessary harm. DMCs are uniquely qualified to evaluate accumulating unblinded data and make recommendations about the continuing safe conduct of a trial. However, it is the trial leadership who must make the tough ethical decision about stopping a trial, and they could benefit from objective statistical rules that help them judge the strength of evidence contained in the blinded data. We design early stopping rules for harm that act as continuous safety screens for randomized controlled clinical trials with blinded treatment information, which could be used by anyone, including trial investigators (and trial leadership). A Bayesian framework, with emphasis on the likelihood function, is used to allow for continuous monitoring without adjusting for multiple comparisons. Close collaboration between the statistician and the clinical investigators will be needed in order to design safety screens with good operating characteristics. Though the math underlying this procedure may be computationally intensive, implementation of the statistical rules will be easy and the continuous screening provided will give suitably early warning when real problems were to emerge. Trial investigators and trial leadership need these safety screens to help them to effectively monitor the ongoing safe conduct of clinical trials with blinded data.^

Part of the global seawater delta oxygen-18 database from reference Vetshteyn 1974

Data from polar stations

SIRGAS reference frame realization SIR11P01

To estimate the kinematics of the SIRGAS reference frame, the Deutsches Geodätisches Forschungsinstitut (DGFI) as the IGS Regional Network Associate Analysis Centre for SIRGAS (IGS RNNAC SIR), yearly computes a cumulative (multi-year) solution containing all available weekly solutions delivered by the SIRGAS analysis centres. These cumulative solutions include those models, standards, and strategies widely applied at the time in which they were computed and cover different time spans depending on the availability of the weekly solutions. This data set corresponds to the multi-year solution SIR11P01. It is based on the combination of the weekly normal equations covering the time span from 2000-01-02 (GPS week 1043) to 2011-04-16 (GPS week 1631), when the IGS08 reference frame was introduced. It refers to ITRF2008, epoch 2005.0 and contains 230 stations with 269 occupations. Its precision was estimated to be ±1.0 mm (horizontal) and ±2.4 mm (vertical) for the station positions, and ±0.7 mm/a (horizontal) and ±1.1 mm/a (vertical) for the constant velocities. Computation strategy and results are in detail described in Sánchez and Seitz (2011). The IGS RNAAC SIR computation of the SIRGAS reference frame is possible thanks to the active participation of many Latin American and Caribbean colleagues, who not only make the measurements of the stations available, but also operate SIRGAS analysis centres processing the observational data on a routine basis (more details in http://www.sirgas.org). The achievements of SIRGAS are a consequence of a successful international geodetic cooperation not only following and meeting concrete objectives, but also becoming a permanent and self-sustaining geodetic community to guarantee quality, reliability, and long-term stability of the SIRGAS reference frame. The SIRGAS activities are strongly supported by the International Association of Geodesy (IAG) and the Pan-American Institute for Geography and History (PAIGH). The IGS RNAAC SIR highly appreciates all this support.

Crustal uplift rates of 4 GPS stations near Jakobshavn Isbrae (2006-2009)

We analyze 2006-2009 data from four continuous Global Positioning System (GPS) receivers located between 5 and 150 km from the glacier Jakobshavn Isbrae, West Greenland. The GPS stations were established on bedrock to determine the vertical crustal motion due to the unloading of ice from Jakobshavn Isbrae. All stations experienced uplift, but the uplift rate at Kangia North, only 5 km from the glacier front, was about 10 mm/yr larger than the rate at Ilulissat, located only ~45 km further away. This suggests that most of the uplift is due to the unloading of the Earth's surface as Jakobshavn thins and loses mass. Our estimate of Jakobshavn's contribution to uplift rates at Kangia North and Ilulissat are 14.6 ± 1.7 mm/yr and 4.9 ± 1.1 mm/yr, respectively. The observed rates are consistent with a glacier thinning model based on repeat altimeter surveys from NASA's Airborne Topographic Mapper (ATM), which shows that Jakobshavn lost mass at an average rate of 22 ± 2 km**3/yr between 2006 and 2009. At Kangia North and Ilulissat, the predicted uplift rates computed using thinning estimates from the ATM laser altimetry are 12.1 ± 0.9 mm/yr and 3.2 ± 0.3 mm/yr, respectively. The observed rates are slightly larger than the predicted rates. The fact that the GPS uplift rates are much larger closer to Jakobshavn than further away, and are consistent with rates inferred using the ATM-based glacier thinning model, shows that GPS measurements of crustal motion are a potentially useful method for assessing ice-mass change models.

Tab. 6+7: Altitudes and variations of altitudes in the area of the Filchner and Neumayer Stations

The determination of the strain and velocity behaviour of the ice surface near the two German Antarctic Stations on Filchner/Ronne and Ekström ice shelves was performed by the use of various geodetic measuring techniques. The relative positions and heights of control points valid for reference data were deduced from terrestrial observations (horizontal and vertical angle selectro optical distances). After a second sampling of data, these values served as the basis for the deformation analyses. Doppler-Satellite-observations (Navy Navigation Satellite System) made absolute positioning (latitude, longitude, height) of special points possible. These Doppler observations, supported by azimuth measurements (gyro-theodolite and sun observations) provided the datum of control networks (translations and orientation). After the repetition of these observations, the drift rates and azimuths of the control points as wenas the rotanon rates of the surface elements could be given. From vertical angles and horizontal distances differences in height end refraction coefficients were calculated. On days without clouds the refraction coefflcients increased by arnounts of up to 3.0 (in extreme cases up to 5.0). Distances over 1 km have to be subdivided to reach a standard deviation level of an heigh: difference better than 0.05 m. In order to determine the heterögeneity of refraction, some height differences should be measured with higher accuracy end-by subdivision of distances.

Tab. 1: Direct beam solar radiation measurements for selected stations in Polar regions

As part of a larger experiment, atmospheric turbidity measurements were carried out during the austral summer 1985/86 in Adelie Land, Eastern Antarctica at 1560 m elevation. A comparison of our measurements of the solar beam with those of other areas in the Arctic and Antarctic was carried out. Our values were higher than all measurements from the Arctic. For Antarctica, Plateau and Mizuho Stations, both higher in altitude, had somewhat higher values, while the value of the coastal stations were lower. We calculated also turbidity indexes such as Unke's turbidity factor T and Angstrom's turbidity coefficient ß. Mean values of T were around 2.0, which are low values indeed. Beta values were around 0.04, a rather typical value for polar regions. No trend in turbidity could be observed for the time of observation. Further, it could be shown that the decrease in intensity with increasing optical air mass was less pronounced for larger wavelengths than for shorter ones.