Applications of a spatially variable advection correction technique for temporal correction of dual-doppler analyses of tornadic supercells

© 2018 American Meteorological Society. In many instances, synchronization of Doppler radar data among multiple platforms for multiple-Doppler analysis is challenging. This study describes the production of dual-Doppler wind analyses from several case studies using data from a rapid-scanning, X-band, polarimetric, Doppler radar-the RaXPol radar-and data from nearby WSR-88Ds. Of particular interest is mitigating difficulties related to the drastic differences in scanning rates of the two radars. To account for differences in temporal resolution, a variational reflectivity tracking scheme [a spatially variable advection correction technique (SVAC)] has been employed to interpolate (in a Lagrangian sense) the coarser temporal resolution data (WSR-88D) to the times of the RaXPol volume scans. The RaXPol data and temporally interpolated WSR-88D data are then used to create quasi-rapid scan dual-Doppler analyses. This study focuses on the application of the SVAC technique to WSR-88D data to create dual-Doppler analyses of three tornadic supercells: the 19 May 2013 Edmond-Carney and Norman-Shawnee, Oklahoma, storms and the 24 May 2016 Dodge City, Kansas, storm. Results of the dual-Doppler analyses are briefly examined, including observations of the ZDR columns as a proxy for updrafts. Potential improvements to this technique are also discussed

Second asymptomatic carotid surgery trial (ACST-2) : a randomised comparison of carotid artery stenting versus carotid endarterectomy

Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86-1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91-1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable