Space-time extremes of sea wave states: field, analytical and numerical investigations

Evaluation of wave extremes occurring in short-crested sea states is the research topic of this doctoral thesis. Short-crestedness is the typical condition in sea storms. In fact, engineering practice and reports from people working offshore (e.g. on fixed platforms or routing ships) are raising questions on the adequacy of conventional wave statistics for the prediction of extremes during short-crested storm conditions. Indeed, wave statistics has been traditionally derived from time measurements, i.e. at a fixed point. Recently, experimental evidence has proved that the maximum sea surface elevation occurring at a fixed point of the sea is smaller than the maximum occurring over a surrounding area. Hence, unless the space dynamics of wave groups is fully included inside the area, the measured maximum at a point or over a smaller area underestimates the actual maximum. To overcome this fact, during the last decade stochastic models to calculate maxima of Gaussian multidimensional random fields, i.e. Piterbarg's theorem and Adler and Taylor's Euler Characteristic approach, have been applied to wave statistics. According to these theories, we should be able to estimate the expected maxima that can occur over an area (space) during a short-crested sea state of given duration (time), giving an explanation to the experimental evidence. The aim of this doctoral thesis is to investigate and discuss these recently applied stochastic models, in order to contribute changing the paradigm of wave analysis: from time to space-time domain. Thus, we worked on multiple fronts with multiple approaches. Field campaigns allowed us to validate stochastic models and to propose a data analysis procedure to characterize sea states at a given location with respect to space-time wave extremes. Analytical and numerical approaches served us to give possible solutions to the well-recognized lack of directional wave spectra, i.e. the input of the multidimensional stochastic models. Indeed, we propose closed formulae to calculate the input spectral parameters in a context of idealized sea states and we develop an ad hoc version of the SWAN (Simulating WAves Nearshore) model, called SWAN-ST (SWAN Space-Time), to allow space-time extreme analysis to be performed on realistic domains. Moreover, analytical and numerical model outputs were used to investigate the dependence of wave extremes upon specific physical parameters governing wind wave mechanics (i.e. wind speed, fetch length, ambient current speed and bottom slope). Finally, we tested the numerical modeling of space-time extremes on realistic domains by running a 3 years hindcast of on the Mediterranean Sea

SUGAMMADEX versus neostigmine after ROCURONIUM continuous infusion in patients undergoing liver transplantation

Background: Rapid neuromuscular block reversal at the end of major abdominal surgery is recommended to avoid any postoperative residual block. To date, no study has evaluated sugammadex performance after rocuronium administration in patients undergoing liver transplantation. This is a randomized controlled trial with the primary objective of assessing the neuromuscular transmission recovery time obtained with sugammadex versus neostigmine after rocuronium induced neuromuscular blockade in patients undergoing orthotopic liver transplantation. Methods: The TOF-Watch SX\uae, calibrated and linked to a portable computer equipped with TOF-Watch SX Monitor Software\uae, was used to monitor and record intraoperative neuromuscular block maintained with a continuous infusion of rocuronium. Anaesthetic management was standardized as per our institution's internal protocol. At the end of surgery, neuromuscular moderate block reversal was obtained by administration of 2 mg/kg of sugammadex or 50 mcg/kg of neostigmine (plus 10 mcg/kg of atropine). Results: Data from 41 patients undergoing liver transplantation were analysed. In this population, recovery from neuromuscular block was faster following sugammadex administration than neostigmine administration, with mean times\ub1SD of 9.4 \ub1 4.6 min and 34.6 \ub1 24.9 min, respectively (p < 0.0001). Conclusion: Sugammadex is able to reverse neuromuscular block maintained by rocuronium continuous infusion in patients undergoing liver transplantation. The mean reversal time obtained with sugammadex was significantly faster than that for neostigmine. It is important to note that the sugammadex recovery time in this population was found to be considerably longer than in other surgical settings, and should be considered in clinical practice. Trial registration: ClinicalTrials.gov NCT02697929 (registered 3rd March 2016)

Transesophageal echocardiography in orthotopic liver transplantation: a comprehensive intraoperative monitoring tool

Intraoperative transesophageal echocardiography is a minimally invasive monitoring tool that can provide real-time visual information on ventricular function and hemodynamic volume status in patients undergoing liver transplantation. The American Association for the Study of Liver Diseases states that transesophageal echocardiography should be used in all liver transplant candidates in order to assess chamber sizes, hypertrophy, systolic and diastolic function, valvular function, and left ventricle outflow tract obstruction. However, intraoperative transesophageal echocardiography can be used to â\u80\u9cvisualizeâ\u80\u9d other organs too; thanks to its proximity and access to multiple acoustic windows: liver, lung, spleen, and kidney. Although only limited scientific evidence exists promoting this comprehensive use, we describe the feasibility of TEE in the setting of liver transplantation: it is a highly valuable tool, not only as a cardiovascular monitoring, but also as a tool to evaluate lungs and pleural spaces, to assess hepatic vein blood flow and inferior vena cava anastomosis and patency, i.e., in cases of modified surgical techniques. The aim of this case series is to add our own experience of TEE as a comprehensive intraoperative monitoring tool in the field of orthotopic liver transplantation (and major liver resection) to the literature

An exceptionally high wave at the CNR-ISMAR oceanographic tower in the Northern Adriatic Sea

On December 15, 2009, a very high wave crest was recorded by a local camera at the CNR-ISMAR oceanographic tower, 15km offshore Venice in the Northern Adriatic Sea (Italy). The height of the estimated crest elevation appears well beyond the value (1,25.H-s) commonly used to identify a wave as freak. We document the wave event with a full description of the corresponding met-ocean conditions and related measurements, of which we provide a critical analysis

Observation of extreme sea waves in a space-time ensemble

In this paper, an observational space-time ensemble of sea surface elevations is investigated in search of the highest waves of the sea state. Wave data were gathered by means of a stereo camera system, which was installed on top of a fixed oceanographic platform located in the Adriatic Sea (Italy). Waves were measured during a mature sea state with an average wind speed of 11 m s-1. By examining the space-time ensemble, the 3D wave groups have been isolated while evolving in the 2D space and grabbed "when and where" they have been close to the apex of their development, thus exhibiting large surface displacements. The authors have selected the groups displaying maximal crest height exceeding the threshold adopted to define rogue waves in a time record, that is, 1.25 times the significant wave height (Hs). The records at the spatial positions where such large crests occurred have been analyzed to derive the empirical distributions of crest and wave heights, which have been compared against standard statistical linear and nonlinear models. Here, the maximal observed wave crests have resulted to be outliers of the standard statistics, behaving as isolated members of the sample, apparently uncorrelated with other waves of the record. However, this study has found that these unexpectedly large wave crests are better approximated by a space-time model for extreme crest heights. The space-time model performance has been improved, deriving a second-order approximation of the linear model, which has provided a fair agreement with the empirical maxima. The present investigation suggests that very large waves may be more numerous than generally expected.In this paper, an observational space-time ensemble of sea surface elevations is investigated in search of the highest waves of the sea state. Wave data were gathered by means of a stereo camera system, which was installed on top of a fixed oceanographic platform located in the Adriatic Sea (Italy). Waves were measured during a mature sea state with an average wind speed of 11 m s(-1). By examining the space-time ensemble, the 3D wave groups have been isolated while evolving in the 2D space and grabbed "when and where" they have been close to the apex of their development, thus exhibiting large surface displacements. The authors have selected the groups displaying maximal crest height exceeding the threshold adopted to define rogue waves in a time record, that is, 1.25 times the significant wave height (H-s). The records at the spatial positions where such large crests occurred have been analyzed to derive the empirical distributions of crest and wave heights, which have been compared against standard statistical linear and nonlinear models. Here, the maximal observed wave crests have resulted to be outliers of the standard statistics, behaving as isolated members of the sample, apparently uncorrelated with other waves of the record. However, this study has found that these unexpectedly large wave crests are better approximated by a space-time model for extreme crest heights. The space-time model performance has been improved, deriving a second-order approximation of the linear model, which has provided a fair agreement with the empirical maxima. The present investigation suggests that very large waves may be more numerous than generally expected

Wave extreme characterization using self-organizing maps

Abstract. The self-organizing map (SOM) technique is considered and extended to assess the extremes of a multivariate sea wave climate at a site. The main purpose is to obtain a more complete representation of the sea states, including the most severe states that otherwise would be missed by a SOM. Indeed, it is commonly recognized, and herein confirmed, that a SOM is a good regressor of a sample if the frequency of events is high (e.g., for low/moderate sea states), while a SOM fails if the frequency is low (e.g., for the most severe sea states). Therefore, we have considered a trivariate wave climate (composed by significant wave height, mean wave period and mean wave direction) collected continuously at the Acqua Alta oceanographic tower (northern Adriatic Sea, Italy) during the period 1979–2008. Three different strategies derived by SOM have been tested in order to capture the most extreme events. The first contemplates a pre-processing of the input data set aimed at reducing redundancies; the second, based on the post-processing of SOM outputs, consists in a two-step SOM where the first step is applied to the original data set, and the second step is applied on the events exceeding a given threshold. A complete graphical representation of the outcomes of a two-step SOM is proposed. Results suggest that the post-processing strategy is more effective than the pre-processing one in order to represent the wave climate extremes. An application of the proposed two-step approach is also provided, showing that a proper representation of the extreme wave climate leads to enhanced quantification of, for instance, the alongshore component of the wave energy flux in shallow water. Finally, the third strategy focuses on the peaks of the storms

Thoracic ultrasound for pleural effusion in the intensive care unit: A narrative review from diagnosis to treatment

Pleural effusion (PLEFF), mostly caused by volume overload, congestive heart failure, and pleuropulmonary infection, is a common condition in critical care patients. Thoracic ultrasound (TUS) helps clinicians not only to visualize pleural effusion, but also to distinguish between the different types. Furthermore, TUS is essential during thoracentesis and chest tube drainage as it increases safety and decreases life-threatening complications. It is crucial not only during needle or tube drainage insertion, but also to monitor the volume of the drained PLEFF. Moreover, TUS can help diagnose co-existing lung diseases, often with a higher specificity and sensitivity than chest radiography and without the need for X-ray exposure. We review data regarding the diagnosis and management of pleural effusion, paying particular attention to the impact of ultrasound. Technical data concerning thoracentesis and chest tube drainage are also provided

Wave Statistics and Space-time Extremes via Stereo Imaging

We present an analysis of the space-time dynamics of oceanic sea states exploiting stereo imaging techniques. In particular, a novel Wave Acquisition Stereo System (WASS) has been developed and deployed at the oceanographic tower Acqua Alta in the Northern Adriatic Sea, off the Venice coast in Italy. The analysis of WASS video measurements yields accurate estimates of the oceanic sea state dynamics, the associated directional spectra and wave surface statistics that agree well with theoretical models. Finally, we show that a space-time extreme, defined as the expected largest surface wave height over an area, is considerably larger than the maximum crest observed in time at a point, in agreement with theoretical predictions