EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369

A multi-sensor satellite assessment of SO2 emissions from the 2012–13 eruption of Plosky Tolbachik volcano, Kamchatka

Abstract Prolonged basaltic effusive eruptions at high latitudes can have significant atmospheric and environmental impacts, but can be challenging to observe in winter conditions. Here, we use multi-sensor satellite data to assess sulfur dioxide (SO2) emissions from the 2012–2013 eruption of Plosky Tolbachik volcano (Kamchatka), which lasted ~ 9–10 months and erupted ~ 0.55 km3 DRE. Observations from the Ozone Monitoring Instrument (OMI), the Ozone Mapping and Profiler Suite (OMPS), the Atmospheric Infrared Sounder (AIRS), and the Moderate Resolution Imaging Spectroradiometer (MODIS) are used to evaluate volcanic activity, SO2 emissions and heat flux associated with the effusion of lava flows. Gaps in the primary OMI SO2 time-series dataset occurred due to instrument limitations and adverse meteorological conditions. Four methods were tested to assess how efficiently they could fill these data gaps and improve estimates of total SO2 emissions. When available, using data from other {SO2} observing instruments was the most comprehensive way to address these data gaps. Satellite measurements yield a total SO2 loading of ~ 200 kt SO2 during the 10-month Plosky Tolbachik eruption, although actual SO2 emissions may have been greater. Based on the satellite SO2 measurements, the Fast Fourier Transform (FFT) multi-taper method (MTM) was used to analyze cyclical behavior in the complete data series and a 55-day cycle potentially attributable to the eruptive behavior of Plosky Tolbachik during the 2012 – 2013 eruption was identified

A comparison of AIRS, MODIS and OMI sulphur dioxide retrievals in volcanic clouds

Volcanic degassing is a major contributor to the global sulphur dioxide (SO 2) budget, characterized by quiescent emissions in the lower troposphere with sporadic, spatially variable explosive eruptions into the upper troposphere and lower stratosphere (UTLS). The volcanic input of SO 2 to the atmosphere can be quantified using a suite of satellite-based instruments with a range of orbits and resolutions, resulting in differing estimates of SO 2 extent and concentration from eruptions. We compare near-coincident retrievals of SO 2 from the Moderate Resolution Imaging Spectroradiometer (MODIS), Atmospheric Infrared Radiation Sounder (AIRS) and OzoneMonitoring Instrument (OMI) at four eruptive settings. The OMI instrument is the most sensitive, with the ability to detect both low and high altitude clouds, but as an ultraviolet sensor, retrievals are limited to daytime, unlike the infrared sensors. AIRS retrievals are up to an order of magnitude less sensitive than OMI, restricted to water-free clouds in the upper troposphere. MODIS has the lowest sensitivity and is therefore constrained to the largest eruptions. Total tonnages from each sensor reflect these varying sensitivities along with potential calibration discrepancies. Results suggest that by using a number of instruments in synergy a more complete method of eruption detection is achieved. © 2011 Taylor & Francis

SO2 data from the ozone monitoring instrument

We discuss collection 2 SO2 data from the Dutch-Finnish Ozone Monitoring Instrument (OMI) on board NASA EOS/Aura spacecraft and show examples of detected volcanic and anthropogenic SO2 emissions. Quantification of anthropogenic SO2 emissions requires collection 3 reprocessing available in the fall 2007

Retrieval of large volcanic SO2 columns from the Aura Ozone Monitoring Instrument: Comparison and limitations

To improve global measurements of atmospheric sulfur dioxide (SO2), we have developed a new technique, called the linear fit (LF) algorithm, which uses the radiance measurements from the Ozone Monitoring Instrument (OMI) at a few discrete ultraviolet wavelengths to derive SO2, ozone, and effective reflectivity simultaneously. We have also developed a sliding median residual correction method for removing both the along- and cross-track biases from the retrieval results. The achieved internal consistencies among the LF-retrieved geophysical parameters clearly demonstrate the success of this technique. Comparison with the results from the Band Residual Difference technique has also illustrated the drastic improvements of this new technique at high SO2 loading conditions. We have constructed an error equation and derived the averaging kernel to characterize the LF retrieval and understand its limitations. Detailed error analysis has focused on the impacts of the SO2 column amounts and their vertical distributions on the retrieval results. The LF algorithm is robust and fast; therefore it is suitable for near real-time application in aviation hazards and volcanic eruption warnings. Very large SO2 loadings (>100 DU) require an off-line iterative solution of the LF equations to reduce the retrieval errors. Both the LF and sliding median techniques are very general so that they can be applied to measurements from other backscattered ultraviolet instruments, including the series of Total Ozone Mapping Spectrometer (TOMS) missions, thereby offering the capability to update the TOMS long-term record to maintain consistency with its OMI extension. Copyright 2007 by the American Geophysical Union. U7 - Export Date: 2 August 2010 U7 - Source: Scopus U7 - Art. No.: D24S4

The unexpected awakening of Chaitén volcano, Chile

On 2 May 2008, a large eruption began unexpectedly at the inconspicuous Chaitén volcano in Chile’s southern volcanic zone. Ash columns abruptly jetted from the volcano into the stratosphere, followed by lava dome effusion and continuous low- altitude ash plumes [Lara, 2009]. Apocalyptic photographs of eruption plumes suffused with lightning were circulated globally.Effects of the eruption were extensive. Floods and lahars inundated the town of Chaitén, and its 4625 residents were evacuated. Widespread ashfall and drifting ash clouds closed regional airports and cancelled hundreds of domestic flights in Argentina and Chile and numerous international flights [Guffanti et al., 2008]. Ash heavily affected the aquaculture industry in the nearby Gulf of Corcovado, curtailed ecotourism, and closed regional nature preserves. To better prepare for future eruptions, the Chilean government has boosted support for monitoring and hazard mitigation at Chaitén and at 42 other highly hazardous, active volcanoes in Chile.The Chaitén eruption discharged rhyolite magma, a high-silica composition associated with extremes of eruptive behavior ranging from gentle lava effusion to violent, gas-driven explosions. As the first major rhyolitic eruption since that of Alaska’s Katmai-Novarupta in 1912, it permits observations that are benchmarks for future such events. It also reignites the debate on what processes rekindle long-dormant volcanoes, justifies efforts to mitigate rare but significant hazards through ground-based monitoring, and confi rms the value of timely satellite observations

SO2 data from the ozone monitoring instrument

We discuss collection 2 SO2 data from the Dutch-Finnish Ozone Monitoring Instrument (OMI) on board NASA EOS/Aura spacecraft and show examples of detected volcanic and anthropogenic SO2 emissions. Quantification of anthropogenic SO2 emissions requires collection 3 reprocessing available in the fall 2007

Improving retrieval of volcanic sulphur dioxide from backscattered UV satellite observations

Existing algorithms that use satellite measurements of solar backscattered ultraviolet (BUV) radiances to retrieve sulfur dioxide (SO2) vertical columns underestimate the large SO2 amounts encountered in fresh volcanic eruption clouds. To eliminate this underestimation we have developed a new technique, named the Iterative Spectral Fitting (ISF) algorithm, for accurate retrieval of SO2 vertical columns in the full range of volcanic emissions. The ISF algorithm is applied to Ozone Monitoring Instrument (OMI) BUV measurements of the Sierra Negra eruption (Galàpagos Islands, Ecuador) in October 2005. The results represent major improvements over the operational OMI SO2 products. Based on the ISF data, we report the largest SO2 vertical column amount (>1000 Dobson Units (DU), where 1 DU = 2.69 × 1016 molecules/cm2) ever observed by a space borne instrument, implying that very high concentrations of SO2 can occur in the lower troposphere during effusive eruptions