43 research outputs found

    Intensification of the North American Monsoon Rainfall as Observed From a Long‐Term High‐Density Gauge Network

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    As the atmosphere gets warmer, rainfall intensification is expected across the planet with anticipated impacts on ecological and human systems. In the southwestern United States and northwestern Mexico, the highly variable and localized nature of rainfall during the North American Monsoon makes it difficult to detect temporal changes in rainfall intensities in response to climatic change. This study addresses this challenge by using the dense, subdaily, and daily observations from 59 rain gauges located in southeastern Arizona. We find an intensification of monsoon subdaily rainfall intensities starting in the mid-1970s that has not been observed in previous studies or simulated with high-resolution climate models. Our results highlight the need for long-term, high spatiotemporal observations to detect environmental responses to a changing climate in highly variable environments and show that analyses based on limited observations or gridded data sets fail to capture temporal changes potentially leading to erroneous conclusions.Public domain articleThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

    Safety and feasibility study of non-invasive robot-assisted high-intensity focused ultrasound therapy for the treatment of atherosclerotic plaques in the femoral artery: protocol for a pilot study

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    Introduction Peripheral arterial disease (PAD) is an atherosclerotic disease leading to stenosis and/or occlusion of the arterial circulation of the lower extremities. The currently available revascularisation methods have an acceptable initial success rate, but the long-term patency is limited, while surgical revascularisation is associated with a relatively high perioperative risk. This urges the need for development of less invasive and more effective treatment modalities. This protocol article describes a study investigating a new non-invasive technique that uses robot assisted high-intensity focused ultrasound (HIFU) to treat atherosclerosis in the femoral artery. Methods and analysis A pilot study is currently performed in 15 symptomatic patients with PAD with a significant stenosis in the common femoral and/or proximal superficial femoral artery. All patients will be treated with the dual-mode ultrasound array system to deliver imaging-guided HIFU to the atherosclerotic plaque. Safety and feasibility are the primary objectives assessed by the technical feasibility of this therapy and the 30-day major complication rate as primary endpoints. Secondary endpoints are angiographic and clinical success and quality of life. Ethics and dissemination Ethical approval for this study was obtained in 2019 from the Medical Ethics Committee of the University Medical Center Utrecht, the Netherlands. Data will be presented at national and international conferences and published in a peer-reviewed journal. Trial registration number NL7564

    The treatment of AL amyloidosis in the Netherlands in 2013

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    AL amyloidosis is the only form of amyloidosis caused by a small plasma cell clone in the bone marrow. The produced aberrant free light chain forms, together with serum amyloid P, deposits in several organs leading to organ dysfunction. Involvement of the heart is the most important prognostic factor. Treatment of systemic AL amyloidosis is based on treatments as used in multiple myeloma, however is much more complicated due to organ dysfunction and worse clinical condition of the patients. Aim of treatment is to achieve a complete haematological response. Organ responses can occur later on. High dose melphalan followed by stem cell transplantation is given to younger en fit patients. Older patients are treated with oral melphalan and dexamethasone. Bortezomib also seems to be well tolerated by patients and has good clinical efficacy. Several randomised phase III studies, such as the HOVON 104, have started to investigate superiority of treatment with proteasome inhibitors. Treatment of patients in clinical studies is highly recommended
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