Non-cross-linked biological mesh in complex abdominal wall hernia: a cohort study

Purpose: Complex abdominal wall hernia repair (CAWHR) is a challenging procedure. Mesh prosthesis is indicated, but the use of synthetic mesh in a contaminated area may add to overall morbidity. Biological meshes may provide a solution, but little is known about long-term results. The aim of our study was to evaluate clinical efficacy and patient satisfaction following Strattice™ (PADM) placement. Methods: In this cohort study, all patients operated for CAWHR with PADM in three large community hospitals in Germany were included. Patients underwent abdominal examination, an ultrasound was performed, and patients completed quality-of-life questionnaires. The study was registered in ClinicalTrials.gov under Identifier NCT02168231. Results: Twenty-seven patients were assessed (14 male, age 67.5 years, follow-up 42.4 months). The most frequent postoperative complication was wound infection (39.1%). In no case, the PADM had to be removed. Four patients had passed away. During outpatient clinic visit, six out of 23 patients (26.1%) had a recurrence of hernia, one patient had undergone reoperation. Five patients (21.7%) had bulging of the abdominal wall. Quality-of-life questionnaires revealed that patients judged their scar with a median 3.5 out of 10 points (0 = best) and judged their restrictions during daily activities with a median of 0 out of 10

Net precipitation over the Baltic Sea for one year using several methods

Precipitation and evaporation over the Baltic Sea are calculated for a one-year period from September 1998 to August 1999 by four different tools, the two atmospheric regional models HIRLAM and REMO, the oceanographic model PROBE-Baltic in combination with the SMHI (1 × 1)° database and Interpolated Fields, based essentially on ship measurements. The investigated period is slightly warmer and wetter than the climatological mean. Correlation coefficients of the differently calculated latent heat fluxes vary between 0.81 (HIRLAM and REMO) and 0.56 (SMHI/PROBE-Baltic and Interpolated Fields), while the correlation coefficients between model fluxes and measured fluxes range from 0.61 and 0.78. Deviations of simulated and interpolated monthly precipitation over the Baltic Sea are less than ±5 mm in the southern Baltic and up to 20 mm near the Finnish coast for the one-year period. The methods simulate the annual cycle of precipitation and evaporation of the Baltic Proper in a similar manner with a broad maximum of net precipitation in spring and early summer and a minimum in late summer. The annual averages of net precipitation of the Baltic Proper range from 57 mm (REMO) to 262 mm (HIRLAM) and for the Baltic Sea from 96 mm (SMHI/PROBE-Baltic) to 209 mm (HIRLAM). This range is considered to give the uncertainty of present-day determination of the net precipitation over the Baltic Sea

Advancing global and continental sacale hidrometeorology:contributions of the GEWEX hydometeorology panel (GHP)

Over the past 9 years, the Global Energy and Water Cycle Experiment (GEWEX), under the auspices of the World Climate Research Programme (WCRP), has coordinated the activities of the Continental Scale Experiments (CSEs) and other related research through the GEWEX Hydrometeorology Panel (GHP). The GHP contributes to the WCRP'S objective of "developing the fundamental scientific understanding of the physical climate system and climate processes [that is] needed to determine to what extent climate can be predicted and the extent of man's influence on climate." It also contributes to more specific GEWEX objectives, such as determining the hydrological cycle and energy fluxes, modeling the global hydrological cycle and its impacts, developing a capability to predict variations in global and regional hydrological processes, and fostering the development of observing techniques, data management and assimilation systems. GHP activities include diagnosis, simulation, and experimental prediction of regional water balances and process and modeling studies aimed at understanding and predicting the variability of the global water cycle, with an emphasis on regional coupled land-atmosphere processes. GHP efforts are central to providing a scientific basis for assessing critical science issues, such as the consequences of climate change for the intensification of the global hydrological cycle and its potential impacts on regional water resources. This article provides an overview of the role and evolution of the GHP and describes scientific issues that the GHP is seeking to address in collaboration with the international science community.Pages: 1917-193

The Baltic Sea experiment BALTEX: a brief overview and some selected results

The mechanisms responsible for the transfer of energy and water within the climate system are under worldwide investigation within the framework of the Global Energy and Water Cycle Experiment (GEWEX) to improve the predictability of natural and man-made climate changes at short and long ranges and their impact on water resources. Five continental-scale experiments have been established within GEWEX to enable a more complete coupling between atmospheric and hydrodlogical models. One of them is the Baltic Sea Experiment (BALTEX). In this paper, the goals and structure of BALTEX are outlined. A short overview of measuring and modelling strategies is given. Atmospheric and hydrological model results of the authors are presented. This includes validation of precipitation using station measurements as well as validation of modelled cloud cover with cloud estimates form satellite data. Furthermore, results of a large-scale grid based hydrological model to be coupled to atmospheric models are presented. (orig.)Im Rahmen des Programmes GEWEX (Globales Energie- und Wasserkreislauf-Experiment) werden weltweite Untersuchungen derjenigen Mechanismen unternommen, die die Uebertragung von Energie und Wasser innerhalb des Klimasystems bestimmen. Dadurch soll die Vorhersagebarkeit von natuerlichen und anthropogenen Klimaaenderungen in kurzen und laengeren Zeitraeumen und deren Wirkung auf die verfuegbaren Wasservorraete verbessert werden. Insgesamt fuenf kontinentweite Experimente wurden innerhalb von GEWEX fuer diese Zwecke begonnen. In ihnen soll vordringlich eine Kopplung von Hydrologiemodellen an Atmosphaermodelle erfolgen. Eines dieser Experimente ist das BALTEX (Baltic Sea Experiment). In dieser Arbeit werden die Ziele und die Struktur von BALTEX vorgestellt. Es wird auch ein kurzer Ueberblick ueber die Mess- und Modellierstrategie vermittelt. Ferner werden erste Ergebnisse der Autoren vorgestellt. Diese schliessen auch einen Vergleich zwischen gemessenen und modellierten Verteilungen des Niederschlages und der Bewoelkung im BALTEX-Gebiet. Weiterhin werden erste Ergebnisse des in einem gitterorientierten Abflussmodell berechneten Abflusses vorgestellt. Dieses Modell soll spaeter an das Regionalmodell fuer das BALTEX-Gebiet angekoppelt werden. (orig.)SIGLEAvailable from TIB Hannover: RA 3251(97/E/13) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Diatom demography in winter – simulated by the Lagrangian Ensemble method

According to Sverdrup's (1953) model of the spring bloom, phytoplankton biomass decreases in winter when the mixed layer depth exceeds the critical depth. We have used a one-dimensional mathematical model integrated by the Lagrangian Ensemble method to simulate a population of diatoms during the winter between two growing seasons off the Azores. The model allows us to diagnose the demographic changes in the simulated diatom population from a variety of perspectives. The total population falls to a minimum of 70 million diatoms m-2 at the end of February. The vertical distribution of the population dynamics is first analysed in terms of daily Eulerian averages over 1 m depth intervals. Growth starts in February when the diurnal thermocline becomes shallower than 50 m, but while the mixed layer is still 200 m deep. The natural mortality has a minimum in winter because it is reduced (in the model) with temperature and population density. Eulerian analysis suggests that in winter, diatoms have a life expectancy of more than 3 months, so a significant number will survive the months of December, January and February when there is very little growth. Losses to grazing are negligible in winter. Lagrangian analysis shows how an individual diatom responds to its changing ambient environment caused by variation in depth (due to turbulent mixing) and the diurnal and seasonal changes in the photosynthetically active radiance. The different trajectories followed by the thousands of plankton particles simulated by the model produce diversity in growth rate ranging over several orders of magnitude, so care has to be taken in statistical analysis. The paper ends with a re-assessment of the value of the critical depth and compensation depth as predictors for onset of the spring bloom. The compensation depth was computed by Eulerian averaging over 1 m depth inter-vals each day. For 1 month after the vernal equinox the compensation depth follows the ascent of the mixed layer as it rises from a depth of 100 m to 40 m. Lagrangian analysis reveals that this is due to the photo-adaptation better matching the ambient irradiance experienced by diatoms in the mixed layer compared with those at the same depth in the seasonal thermo-cline. By mid-April the spring bloom has already ad-vanced so far that self shading influences the compensation depth, which then rises into the mixed layer. We conclude that Sverdrup's criterion is not useful for predicting changes in the diatom population simulated by our model