61 research outputs found

    Greenland ice sheet motion coupled with daily melting in late summer

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    We use ground-based and satellite observations to detect large diurnal and longer-period variations in the flow of the Greenland Ice Sheet (GrIS) during late summer that are strongly coupled with changes in its surface hydrology. The diurnal signals are associated with periodic changes in surface melting, and the longer-period signals are associated with the episodic drainage of supra-glacial lakes. Ice velocity doubles around 2 hours after peak daily melting and returns approximately to wintertime levels around 12 hours afterwards, demonstrating an intimate link between the surface and basal hydrology. During late summer, the ice sheet accelerates by 35% per positive degree-day of melting. The observed link between surface melting and enhanced flow is typical of Alpine glaciers, which may provide an appropriate analogue for the evolution of the GrIS in a warming climate

    Hypertensive extracorporeal limb perfusion (HELP): A new technique for managing critical lower limb ischemia

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    ObjectiveThe concept of repeatedly connecting an extracorporeal blood pump to produce pancycle suprasystolic inflow pressures to ischemic limbs is introduced. Balloon catheters allow for limb isolation from the systemic circulation. In the acute phase, it is assumed that pressure is proportion to flow (Poiseuille's Law) and in the chronic phase that collateral growth is related to endothelial shear stress and wall tension. The primary objective was to establish that increased flow could be achieved through collateral circulation in animals and in man with extracorporeal limb hyperperfusion. The second objective was to develop and test an arterial access system capable of intermittent regional hyperperfusion similar in concept to intermittent hemodialysis. Finally, to demonstrate the translocation of these concepts into humans facing major limb amputation where all standard treatment options had been exhausted.MethodsTwelve sheep (6 hyperperfusion and 6 controls) were attached to a cardiac vortex pump and perfused at 200 mm Hg pancycle with the superficial femoral artery doubly ligated and isolated from the systemic circulation with a balloon catheter. Pressure transducers measured carotid and distal femoral pressures and the carotid-femoral index was calculated. To allow hyperperfusion to be repeated transcutaneously, a peripheral access system (PAS [Allvascular, St Leonards, New South Wales, Australia]) was constructed. This device was implanted in the common carotid artery in 8 sheep and opened approximately 3 days a week for continuous arterial access up to 37 days for 67 openings. To demonstrate these principles in humans, 3 patients with critically ischemic limbs were hyperperfused intermittently. Digital thermography compared the other limb as controls and provided objective evidence of the vascular changes.ResultsThe mean carotid-femoral index was 0.6 ± 0.01 for controls compared with 1.1 ± 0.28 for the hyperperfusion group (P < .001). The collateral flow was superior to normal flow (ie, with the superficial femoral not occluded). Continuous access to the carotid arterial tree via the access device was 25.3 ± 8.8 days with 5 of 8 devices open for the entire observational period (maximum 37 days). The human ischemic limbs were hyperperfused at 2-4 times the mean arterial pressure producing 3-6 times an increase in pump flow measurements intermittently for 53 ± 16 hours. The clinical findings of rest pain, paresthesia, capillary return, and movement showed dramatic improvement as did thermographic emissions. Major amputation was avoided in the cases presented.ConclusionBlood flow through collaterals can be very significantly augmented by connection to an extracorporeal pump with isolation from the systemic circulation. The pancycle hyperperfusion can be safely repeated by implantation of an arterial access device. In the longer term, there is evidence of collateral development. When amputation is the only alternative, hypertensive extracorporeal limb perfusion should be considered

    Comparison of ADCP observations and 3D model simulations of turbulence at a tidal energy site

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    Field measurement of turbulence in strong tidal currents is difficult and expensive, but the tidal energy industry needs to accurately quantify turbulence for adequate resource characterisation and device design. Models that can predict such turbulence could reduce measurement costs. We compare a Regional Ocean Modelling System (ROMS) simulation with acoustic Doppler current profiler (ADCP) measurements from a highly-energetic tidal site. This comparison shows the extent to which turbulence can be quantified by ROMS, using the conventional k−ε turbulence closure model. Both model and observations covered the same time period, encompassing two spring-neap cycles. Turbulent kinetic energy (TKE) density was calculated from measurements using the variance method; turbulent dissipation, ε, was calculated using the structure function method. Measurements show that wave action dominates turbulent fluctuations in the upper half of the water column; comparing results for deeper water, however, shows very strong agreement. A best fit between ROMS and ADCP results for mean velocity yields R2=0.98; for TKE, R2 is 0.84 when strongly wave-dominated times are excluded. Dissipation agrees less well: although time series of ε are well-correlated at similar depths, ROMS estimates a greater magnitude of dissipation than is measured, by a factor of up to 4.8

    Equivalent glycemic load (EGL): a method for quantifying the glycemic responses elicited by low carbohydrate foods

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    BACKGROUND: Glycemic load (GL) is used to quantify the glycemic impact of high-carbohydrate (CHO) foods, but cannot be used for low-CHO foods. Therefore, we evaluated the accuracy of equivalent-glycemic-load (EGL), a measure of the glycemic impact of low-CHO foods defined as the amount of CHO from white-bread (WB) with the same glycemic impact as one serving of food. METHODS: Several randomized, cross-over trials were performed by a contract research organization using overnight-fasted healthy subjects drawn from a pool of 63 recruited from the general population by newspaper advertisement. Incremental blood-glucose response area-under-the-curve (AUC) elicited by 0, 5, 10, 20, 35 and 50 g CHO portions of WB (WB-CHO) and 3, 5, 10 and 20 g glucose were measured. EGL values of the different doses of glucose and WB and 4 low-CHO foods were determined as: EGL = (F-B)/M, where F is AUC after food and B is y-intercept and M slope of the regression of AUC on grams WB-CHO. The dose-response curves of WB and glucose were used to derive an equation to estimate GL from EGL, and the resulting values compared to GL calculated from the glucose dose-response curve. The accuracy of EGL was assessed by comparing the GL (estimated from EGL) values of the 4 doses of oral-glucose with the amounts actually consumed. RESULTS: Over 0–50 g WB-CHO (n = 10), the dose-response curve was non-linear, but over the range 0–20 g the curve was indistinguishable from linear, with AUC after 0, 5, 10 and 20 g WB-CHO, 10 ± 1, 28 ± 2, 58 ± 5 and 100 ± 6 mmol × min/L, differing significantly from each other (n = 48). The difference between GL values estimated from EGL and those calculated from the dose-response curve was 0 g (95% confidence-interval, ± 0.5 g). The difference between the GL values of the 4 doses of glucose estimated from EGL, and the amounts of glucose actually consumed was 0.2 g (95% confidence-interval, ± 1 g). CONCLUSION: EGL, a measure of the glycemic impact of low-carbohydrate foods, is valid across the range of 0–20 g CHO, accurate to within 1 g, and at least sensitive enough to detect a glycemic response equivalent to that produced by 3 g oral-glucose in 10 subjects

    A Reconciled Estimate of Ice-Sheet Mass Balance

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    We combined an ensemble of satellite altimetry, interferometry, and gravimetry data sets using common geographical regions, time intervals, and models of surface mass balance and glacial isostatic adjustment to estimate the mass balance of Earth's polar ice sheets. We find that there is good agreement between different satellite methods-especially in Greenland and West Antarctica-and that combining satellite data sets leads to greater certainty. Between 1992 and 2011, the ice sheets of Greenland, East Antarctica, West Antarctica, and the Antarctic Peninsula changed in mass by -142 plus or minus 49, +14 plus or minus 43, -65 plus or minus 26, and -20 plus or minus 14 gigatonnes year(sup 1), respectively. Since 1992, the polar ice sheets have contributed, on average, 0.59 plus or minus 0.20 millimeter year(sup 1) to the rate of global sea-level rise

    Behavioral Outcomes Following Brain–Computer Interface Intervention for Upper Extremity Rehabilitation in Stroke: A Randomized Controlled Trial

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    Stroke is a leading cause of persistent upper extremity (UE) motor disability in adults. Brain–computer interface (BCI) intervention has demonstrated potential as a motor rehabilitation strategy for stroke survivors. This sub-analysis of ongoing clinical trial (NCT02098265) examines rehabilitative efficacy of this BCI design and seeks to identify stroke participant characteristics associated with behavioral improvement. Stroke participants (n = 21) with UE impairment were assessed using Action Research Arm Test (ARAT) and measures of function. Nine participants completed three assessments during the experimental BCI intervention period and at 1-month follow-up. Twelve other participants first completed three assessments over a parallel time-matched control period and then crossed over into the BCI intervention condition 1-month later. Participants who realized positive change (≥1 point) in total ARAT performance of the stroke affected UE between the first and third assessments of the intervention period were dichotomized as “responders” (&lt;1 = “non-responders”) and similarly analyzed. Of the 14 participants with room for ARAT improvement, 64% (9/14) showed some positive change at completion and approximately 43% (6/14) of the participants had changes of minimal detectable change (MDC = 3 pts) or minimally clinical important difference (MCID = 5.7 points). Participants with room for improvement in the primary outcome measure made significant mean gains in ARATtotal score at completion (ΔARATtotal = 2, p = 0.028) and 1-month follow-up (ΔARATtotal = 3.4, p = 0.0010), controlling for severity, gender, chronicity, and concordance. Secondary outcome measures, SISmobility, SISadl, SISstrength, and 9HPTaffected, also showed significant improvement over time during intervention. Participants in intervention through follow-up showed a significantly increased improvement rate in SISstrength compared to controls (p = 0.0117), controlling for severity, chronicity, gender, as well as the individual effects of time and intervention type. Participants who best responded to BCI intervention, as evaluated by ARAT score improvement, showed significantly increased outcome values through completion and follow-up for SISmobility (p = 0.0002, p = 0.002) and SISstrength (p = 0.04995, p = 0.0483). These findings may suggest possible secondary outcome measure patterns indicative of increased improvement resulting from this BCI intervention regimen as well as demonstrating primary efficacy of this BCI design for treatment of UE impairment in stroke survivors.Clinical Trial Registration:ClinicalTrials.gov, NCT02098265
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