Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study

Objective To evaluate if a specific exercise strategy, targeting the rotator cuff and scapula stabilisers, improves shoulder function and pain more than unspecific exercises in patients with subacromial impingement syndrome, thereby decreasing the need for arthroscopic subacromial decompression

Meteorological effects of the solar eclipse of 20 March 2015: analysis of UK Met Office automatic weather station data and comparison with automatic weather station data from the Faroes and Iceland.

Here, we analyse high-frequency (1 min) surface air temperature, mean sea-level pressure (MSLP), wind speed and direction and cloud-cover data acquired during the solar eclipse of 20 March 2015 from 76 UK Met Office weather stations, and compare the results with those from 30 weather stations in the Faroe Islands and 148 stations in Iceland. There was a statistically significant mean UK temperature drop of 0.83±0.63°C, which occurred over 39 min on average, and the minimum temperature lagged the peak of the eclipse by about 10 min. For a subset of 14 (16) relatively clear (cloudy) stations, the mean temperature drop was 0.91±0.78 (0.31±0.40)°C but the mean temperature drops for relatively calm and windy stations were almost identical. Mean wind speed dropped significantly by 9% on average during the first half of the eclipse. There was no discernible effect of the eclipse on the wind-direction or MSLP time series, and therefore we can discount any localized eclipse cyclone effect over Britain during this event. Similar changes in air temperature and wind speed are observed for Iceland, where conditions were generally clearer, but here too there was no evidence of an eclipse cyclone; in the Faroes, there was a much more muted meteorological signature.This article is part of the themed issue 'Atmospheric effects of solar eclipses stimulated by the 2015 UK eclipse'

Pressurized groundwater outflow experiments and numerical modeling for outflow channels on Mars

The landscape of Mars shows incised channels that often appear abruptly in the landscape, suggesting a groundwater source. However, groundwater outflow processes are unable to explain the reconstructed peak discharges of the largest outflow channels based on their morphology. Therefore, there is a disconnect between groundwater outflow processes and the resulting morphology. Using a combined approach with experiments and numerical modeling, we examine outflow processes that result from pressurized groundwater. We use a large sandbox flume, where we apply a range of groundwater pressures at the base of a layer of sediment. Our experiments show that different pressures result in distinct outflow processes and resulting morphologies. Low groundwater pressure results in seepage, forming a shallow surface lake and a channel when the lake overflows. At intermediate groundwater pressures, fissures form and groundwater flows out more rapidly. At even higher pressures, the groundwater initially collects in a subsurface reservoir that grows due to flexural deformation of the surface. When this reservoir collapses, a large volume of water is released to the surface. We numerically model the ability of these processes to produce floods on Mars and compare the results to discharge estimates based on previous morphological studies. We show that groundwater seepage and fissure outflow are insufficient to explain the formation of large outflow channels from a single event. Instead, formation of a flexure-induced subsurface reservoir and subsequent collapse generates large floods that can explain the observed morphologies of the largest outflow channels on Mars and their source areas

Spatial Analysis of Cirques from Three Regions of Iceland: Implications for Cirque Formation and Palaeoclimate

This study is a quantitative analysis of cirques in three regions of Iceland: Tröllaskagi, the East Fjords and Vestfirðir. Using Google Earth and the National Land Survey of Iceland Map Viewer, we identified 347 new cirques on Tröllaskagi and the East Fjords region, and combined these data with 100 cirques previously identified on Vestfirðir. We used ArcGIS to measure length, width, aspect, latitude and distance to coastline of each cirque. Palaeo‐equilibrium‐line altitudes (palaeo‐ELAs) of palaeo‐cirque glaciers were calculated using the altitude‐ratio method, cirque‐floor method and minimum‐point method. The mean palaeo‐ELA values in Tröllaskagi, the East Fjords and Vestfirðir are 788, 643 and 408 m a.s.l, respectively. Interpolation maps of palaeo‐ELAs demonstrate a positive relationship between palaeo‐ELA and distance to coastline. A positive relationship between palaeo‐ELA and latitude is observed on Vestfirðir, a negative relationship is observed on Tröllaskagi and no statistically significant relationship is present on the East Fjords. The modal orientation of cirques on Tröllaskagi and Vestfirðir is northeast, while orientation of cirques in the East Fjords is north. Palaeo‐wind reconstructions for the LGM show that modal aspect is aligned with the prevailing north‐northeast wind directions, although aspect measurements demonstrate wide dispersion. Cirque length is similar on Tröllaskagi and the East Fjords, but cirques are approximately 200 m shorter in Vestfirðir. Cirque widths are similar in all three regions. Comparisons with a global data set show that cirques in Iceland are smaller and more circular than cirques in other regions of the world. Similar to glaciers in Norway and Kamchatka, our results demonstrate that access to a moisture source is a key parameter in determining palaeo‐ELAs in Iceland. Temperatures interpreted from palaeo‐ELA depressions suggest that these cirques may have been glaciated as recently as the Little Ice Age

A daily Azores–Iceland North Atlantic Oscillation index back to 1850

We present the construction of a continuous, daily (09:00 UTC), station-based (Azores–Iceland) North Atlantic Oscillation (NAO) Index back to 1871 which is extended back to 1850 with additional daily mean data. The constructed index more than doubles the length of previously existing, widely available, daily NAO time series. The index is created using entirely observational sea-level pressure (SLP) data from Iceland and 73.5% of observational SLP data from the Azores – the remainder being filled in via reanalysis (Twentieth Century Reanalysis Project and European Mean Sea Level Pressure) SLP data. Icelandic data are taken from the Southwest Iceland pressure series. We construct and document a new Ponta Delgada SLP time series based on recently digitized and newly available data that extend back to 1872. The Ponta Delgada time series is created by splicing together several fractured records (from Ponta Delgada, Lajes, and Santa Maria) and filling in the major gaps (pre-1872, 1888–1905, and 1940–1941) and occasional days (145) with reanalysis data. Further homogeneity corrections are applied to the Azores record, and the daily (09:00 UTC) NAO index is then calculated. The resulting index, with its extended temporal length and daily resolution, is the first reconstruction of daily NAO back into the 19th Century and therefore is useful for researchers across multiple disciplines

Inter-decadal variability in potential glacier surface melt energy at Vestari Hagafellsjökull (Langjökull, Iceland) and the role of synoptic circulation

The surface energy balance (SEB) of glaciers, although of considerable importance for understanding the melt response to climate change, is rarely analysed for more than a few melt seasons due to the logistical challenges of meteorological measurement campaigns on glaciers. Insight into low-frequency (inter-decadal) changes in the SEB in response to climate warming and variable atmospheric circulation patterns has thus been limited. Here this problem is addressed by using ERA-Interim reanalysis data to extend glacier-meteorological records at two locations on Vestari Hagafellsjökull (Iceland) for the period 1979–2012. Trend analysis is conducted for this series before the role of synoptic circulation in modulating surface energetics is investigated. The results indicate that potential melt energy has increased significantly throughout the period of simulation at both locations (by 19.7 and 32.4%), with the largest increase evident for the turbulent heat fluxes (36.3 and 93.1%). The synoptic conditions associated with the recent high melt rates on the proximate Greenland Ice Sheet (GrIS) do not result in similarly extreme melt conditions for our Icelandic location. We also find that the North Atlantic Oscillation Index is significantly correlated with the radiative and latent heat components of the SEB. This association remains hidden if the melt rate is assessed in isolation, highlighting the utility of the SEB approach presented here for assessing synoptic aspects of glacier-climate interactions

The Wind Energy Potential of Iceland

AbstractDownscaling simulations performed with the Weather Research and Forecasting (WRF) model were used to determine the large-scale wind energy potential of Iceland. Local wind speed distributions are represented by Weibull statistics. The shape parameter across Iceland varies between 1.2 and 3.6, with the lowest values indicative of near-exponential distributions at sheltered locations, and the highest values indicative of normal distributions at exposed locations in winter. Compared with summer, average power density in winter is increased throughout Iceland by a factor of 2.0–5.5. In any season, there are also considerable spatial differences in average wind power density. Relative to the average value within 10 km of the coast, power density across Iceland varies between 50 and 250%, excluding glaciers, or between 300 and 1500 W m−2 at 50 m above ground level in winter. At intermediate elevations of 500–1000 m above mean sea level, power density is independent of the distance to the coast. In addition to seasonal and spatial variability, differences in average wind speed and power density also exist for different wind directions. Along the coast in winter, power density of onshore winds is higher by 100–700 W m−2 than that of offshore winds. Based on these results, 14 test sites were selected for more detailed analyses using the Wind Atlas Analysis and Application Program (WAsP)

The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears: Structural and clinical outcomes after repair of 42 shoulders

Background and purpose Few authors have considered the outcome after acute traumatic rotator cuff tears in previously asymptomatic patients. We investigated whether delay of surgery, age at repair, and the number of cuff tendons involved affect the structural and clinical outcome. Patients and methods 42 patients with pseudoparalysis after trauma and no previous history of shoulder symptoms were included. A full-thickness tear in at least 1 of the rotator cuff tendons was diagnosed in all patients. Mean time to surgery was 38 (6-91) days. Follow-up at a mean of 39 (12-108) months after surgery included ultrasound, plain radiographs, Constant-Murley score, DASH score, and western Ontario rotator cuff (WORC) score. Results At follow-up, 4 patients had a full-thickness tear and 9 had a partial-thickness tear in the repaired shoulder. No correlation between the structural or clinical outcome and the time to repair within 3 months was found. The patients with a tendon defect at follow-up had a statistically significantly lower Constant-Murley score and WORC index in the injured shoulder and were significantly older than those with intact tendons. The outcomes were similar irrespective of the number of tendons repaired. Interpretation A delay of 3 months to repair had no effect on outcome. The patients with cuff defects at follow-up were older and they had a worse clinical outcome. Multi-tendon injury did not generate worse outcomes than single-tendon tears at follow-up

Minimally invasive robot-assisted and laparoscopic distal pancreatectomy in a pan-European registry a retrospective cohort study

BACKGROUND: International guidelines recommend monitoring the use and outcome of minimally invasive pancreatic surgery (MIPS). However, data from prospective international audits on minimally invasive distal pancreatectomy (MIDP) are lacking. This study examined the use and outcome of robot-assisted (RDP) and laparoscopic (LDP) distal pancreatectomy in the E-MIPS registry. PATIENTS AND METHODS: Post-hoc analysis in a prospective audit on MIPS, including consecutive patients undergoing MIDP in 83 centers from 19 European countries (01-01-2019/31-12-2021). Primary outcomes included intraoperative events (grade 1: excessive blood loss, grade 2: conversion/change in operation, grade 3: intraoperative death), major morbidity, and in-hospital/30-day mortality. Multivariable logistic regression analyses identified high-risk groups for intraoperative events. RDP and LDP were compared in the total cohort and high-risk groups. RESULTS: Overall, 1672 patients undergoing MIDP were included; 606 (36.2%) RDP and 1066 (63.8%) LDP. The annual use of RDP increased from 30.5% to 42.6% ( P &lt;0.001). RDP was associated with fewer grade 2 intraoperative events compared with LDP (9.6% vs. 16.8%, P &lt;0.001), with longer operating time (238 vs. 201 min, P &lt;0.001). No significant differences were observed between RDP and LDP regarding major morbidity (23.4% vs. 25.9%, P =0.264) and in-hospital/30-day mortality (0.3% vs. 0.8%, P =0.344). Three high-risk groups were identified; BMI greater than 25 kg/m 2 , previous abdominal surgery, and vascular involvement. In each group, RDP was associated with fewer conversions and longer operative times. CONCLUSION: This European registry-based study demonstrated favorable outcomes for MIDP, with mortality rates below 1%. LDP remains the predominant approach, whereas the use of RDP is increasing. RDP was associated with fewer conversions and longer operative time, including in high-risk subgroups. Future randomized trials should confirm these findings and assess cost differences.</p