Intrauterine Adhesions following Conservative Treatment of Uterine Fibroids

Uterine fibroids are common in women of reproductive age and various conservative treatments are available. In order to achieve a successful conservative treatment of fibroids, functional integrity of the uterus is as important as tumor removal or symptoms relief. In this context, intrauterine adhesions must be recognized as a possible complication of conservative management of uterine fibroids, but diagnostic pitfalls might justify an underestimation of their incidence. Hysteroscopic myomectomy can cause adhesions as a result of surgical trauma to the endometrium. The average reported incidence is around 10% at second-look hysteroscopy, but it is higher in certain conditions, such as the case of multiple, apposing fibroids. Transmural myomectomies also have the potential for adhesion, especially when combined with uterine ischemia. Uterine arteries embolization also carries a risk of intracavitary adhesions. Prevention strategies including bipolar resection, barrier gel or postoperative estradiol, might be useful, but stronger evidence is needed. In view of current knowledge, we would recommend a prevention strategy based on a combination of surgical trauma minimization and identification of high-risk cases. Early hysteroscopic diagnosis and lysis possibly represents the best means of secondary prevention and treatment of postoperative intrauterine adhesions

Holocene glacier fluctuations and tephrochronology of the Öræfi district, Iceland

The aims of this thesis are to refine the tephrochronology of the Öræfi district, SE Iceland and assess the Holocene glacier fluctuations of the Öræfajökull ice cap. The pattern and timing of glacier fluctuations are determined using glacial geomorphology and tephrochronology, and the implications for palaeoclimate are assessed. Iceland is important to the study of global and regional climatic change because it is located close to both the marine and atmospheric Polar Fronts widely regarded as the key factors in the climate of the North Atlantic region. Six outlet glaciers were studied: Svinafellsjökull, Virkisjökull, Kotárjökull and Kviárjökull originating from the Öræfajökull ice cap and Skaftafellsjökull and Morsárjökull originating from the Vatnajökull ice cap. A long history of glacier fluctuations were found with a similar temporal pattern of glacier oscillation between the outlets of Vatnajökull and Öræfajökull. A maximum of eight advances have been identified. The oldest advance is inferred to date from the maximum of the last Glaciation ca. 18000 yrs BP. The first advance in the Holocene occurred ca. 9700 BP during a still-stand of the last Termination. The onset of the Neoglaciation occurred between 6000 BP and 4600 BP with an expansion of all of the studied glaciers. Subsequent smaller advances have been dated to ca. 3200 BP, ca. 1800 BP, ca. 700 BP, ca. 200 BP and ca. 80 BP. The most significant movement of the Polar front during the Holocene is likely to have occurred around 5000 BP, and, as a consequence, an estimated temperature cooling of ca. 2.5°C took place in Iceland, perhaps the greatest cooling since the last Termination. Within the broad pattern of change, glaciers in the study area show variability which represents local precipitation patterns, contrasting topography and change in glacier process. In this thesis a total of 22 silicic tephra layers are identified from over 90 profiles in the study area. The majority of these layers are dated to the latter part of the Holocene. Three silicic tephras were deposited during historical time (post 900 AD) namely, Vö ca. 900AD,HI104 and Ö1362. The Vö ca. 900 AD and the H1104 tephras are located for the first time. Specific prehistoric (pre 900 AD) tephras identified include Hekla-Ö, Hekla-4 and Hekla-S. The tephrochronology of the Öræfi district is also used to assess the eruption history of the Öræfajökull stratovolcano during the Holocene. Prehistoric eruptions are dated to ca. 9200 BP, ca. 6500 BP(?), ca. 4700 BP, ca. 2800 BP and ca. 1500 BP. Jökulhlaups accompanied the eruptions of 1727 AD, 1362 AD and ca. 1500 BP and are likely to have followed older eruptions of the volcano. A strong relationship occurs between volcanic activity of the Öræfajökull stratovolcano and the pattern of glacier fluctuations. This is explained as a response to isostatic crustal adjustment during ice cap growth and decay, and indicates a general relationship between volcanic activity and climate change

Responsibility of major emitters for country-level warming and extreme hot years

The contributions of single greenhouse gas emitters to country-level climate change are generally not disentangled, despite their relevance for climate policy and litigation. Here, we quantify the contributions of the five largest emitters (China, US, EU-27, India, and Russia) to projected 2030 country-level warming and extreme hot years with respect to pre-industrial climate using an innovative suite of Earth System Model emulators. We find that under current pledges, their cumulated 1991–2030 emissions are expected to result in extreme hot years every second year by 2030 in twice as many countries (92%) as without their influence (46%). If all world nations shared the same fossil CO2 per capita emissions as projected for the US from 2016–2030, global warming in 2030 would be 0.4 °C higher than under actual current pledges, and 75% of all countries would exceed 2 °C of regional warming instead of 11%. Our results highlight the responsibility of individual emitters in driving regional climate change and provide additional angles for the climate policy discourse

Design of 280 GHz feedhorn-coupled TES arrays for the balloon-borne polarimeter SPIDER

We describe 280 GHz bolometric detector arrays that instrument the balloon-borne polarimeter SPIDER. A primary science goal of SPIDER is to measure the large-scale B-mode polarization of the cosmic microwave background in search of the cosmic-inflation, gravitational-wave signature. 280 GHz channels aid this science goal by constraining the level of B-mode contamination from galactic dust emission. We present the focal plane unit design, which consists of a 16$\times$16 array of conical, corrugated feedhorns coupled to a monolithic detector array fabricated on a 150 mm diameter silicon wafer. Detector arrays are capable of polarimetric sensing via waveguide probe-coupling to a multiplexed array of transition-edge-sensor (TES) bolometers. The SPIDER receiver has three focal plane units at 280 GHz, which in total contains 765 spatial pixels and 1,530 polarization sensitive bolometers. By fabrication and measurement of single feedhorns, we demonstrate 14.7$^{\circ}$ FHWM Gaussian-shaped beams with $<$1% ellipticity in a 30% fractional bandwidth centered at 280 GHz. We present electromagnetic simulations of the detection circuit, which show 94% band-averaged, single-polarization coupling efficiency, 3% reflection and 3% radiative loss. Lastly, we demonstrate a low thermal conductance bolometer, which is well-described by a simple TES model and exhibits an electrical noise equivalent power (NEP) = 2.6 $\times$ 10$^{-17}$ W/$\sqrt{\mathrm{Hz}}$, consistent with the phonon noise prediction.Comment: Proceedings of SPIE Astronomical Telescopes + Instrumentation 201

Results of the third Marine Ice Sheet Model Intercomparison Project (MISMIP+)

We present the result of the third Marine Ice Sheet Model Intercomparison Project, MISMIP+. MISMIP+ is intended to be a benchmark for ice-flow models which include fast sliding marine ice streams and floating ice shelves and in particular a treatment of viscous stress that is sufficient to model buttressing, where upstream ice flow is restrained by a downstream ice shelf. A set of idealized experiments first tests that models are able to maintain a steady state with the grounding line located on a retrograde slope due to buttressing and then explore scenarios where a reduction in that buttressing causes ice stream acceleration, thinning, and grounding line retreat. The majority of participating models passed the first test and then produced similar responses to the loss of buttressing. We find that the most important distinction between models in this particular type of simulation is in the treatment of sliding at the bed, with other distinctions - notably the difference between the simpler and more complete treatments of englacial stress but also the differences between numerical methods - taking a secondary role. © 2020 Wolters Kluwer Medknow Publications. All rights reserved

Results of the third Marine Ice Sheet Model Intercomparison Project (MISMIP+)

We present the result of the third Marine Ice Sheet Model Intercomparison Project, MISMIP+. MISMIP+ is intended to be a benchmark for ice-flow models which include fast sliding marine ice streams and floating ice shelves and in particular a treatment of viscous stress that is sufficient to model buttressing, where upstream ice flow is restrained by a downstream ice shelf. A set of idealized experiments first tests that models are able to maintain a steady state with the grounding line located on a retrograde slope due to buttressing and then explore scenarios where a reduction in that buttressing causes ice stream acceleration, thinning, and grounding line retreat. The majority of participating models passed the first test and then produced similar responses to the loss of buttressing. We find that the most important distinction between models in this particular type of simulation is in the treatment of sliding at the bed, with other distinctions – notably the difference between the simpler and more complete treatments of englacial stress but also the differences between numerical methods – taking a secondary role

The Simons Observatory microwave SQUID multiplexing detector module design

Advances in cosmic microwave background (CMB) science depend on increasing the number of sensitive detectors observing the sky. New instruments deploy large arrays of superconducting transition-edge sensor (TES) bolometers tiled densely into ever larger focal planes. High multiplexing factors reduce the thermal loading on the cryogenic receivers and simplify their design. We present the design of focal-plane modules with an order of magnitude higher multiplexing factor than has previously been achieved with TES bolometers. We focus on the novel cold readout component, which employs microwave SQUID multiplexing ($\mu$mux). Simons Observatory will use 49 modules containing 60,000 bolometers to make exquisitely sensitive measurements of the CMB. We validate the focal-plane module design, presenting measurements of the readout component with and without a prototype detector array of 1728 polarization-sensitive bolometers coupled to feedhorns. The readout component achieves a $95\%$ yield and a 910 multiplexing factor. The median white noise of each readout channel is 65 $\mathrm{pA/\sqrt{Hz}}$. This impacts the projected SO mapping speed by $< 8\%$, which is less than is assumed in the sensitivity projections. The results validate the full functionality of the module. We discuss the measured performance in the context of SO science requirements, which are exceeded.Comment: Accepted to The Astrophysical Journa

Migraine in women: the role of hormones and their impact on vascular diseases

Migraine is a predominantly female disorder. Menarche, menstruation, pregnancy, and menopause, and also the use of hormonal contraceptives and hormone replacement treatment may influence migraine occurrence. Migraine usually starts after menarche, occurs more frequently in the days just before or during menstruation, and ameliorates during pregnancy and menopause. Those variations are mediated by fluctuation of estrogen levels through their influence on cellular excitability or cerebral vasculature. Moreover, administration of exogenous hormones may cause worsening of migraine as may expose migrainous women to an increased risk of vascular disease. In fact, migraine with aura represents a risk factor for stroke, cardiac disease, and vascular mortality. Studies have shown that administration of combined oral contraceptives to migraineurs may further increase the risk for ischemic stroke. Consequently, in women suffering from migraine with aura caution should be deserved when prescribing combined oral contraceptives