Reanalysis of multi-temporal aerial images of Storglaciären, Sweden (1959–99) – Part 1: Determination of length, area, and volume changes

Storglaciären, located in the Kebnekaise massif in northern Sweden, has a long history of glaciological research. Early photo documentations date back to the late 19th century. Measurements of front position variations and distributed mass balance have been carried out since 1910 and 1945/46, respectively. In addition to these in-situ measurements, aerial photographs have been taken at decadal intervals since the beginning of the mass balance monitoring program and were used to produce topographic glacier maps. Inaccuracies in the maps were a challenge to early attempts to derive glacier volume changes and resulted in major differences when compared to the direct glaciological mass balances. In this study, we reanalyzed dia-positives of the original aerial photographs of 1959, -69, -80, -90 and -99 based on consistent photogrammetric processing. From the resulting digital elevation models and orthophotos, changes in length, area, and volume of Storglaciären were computed between the survey years, including an assessment of related errors. Between 1959 and 1999, Storglaciären lost an ice volume of 19×106 m3, which corresponds to a cumulative ice thickness loss of 5.69 m and a mean annual loss of 0.14 m. This ice loss resulted largely from a strong volume loss during the period 1959–80 and was partly compensated during the period 1980–99. As a consequence, the glacier shows a strong retreat in the 1960s, a slowing in the 1970s, and pseudo-stationary conditions in the 1980s and 1990s

Reanalysis of multi-temporal aerial images of Storglaciären, Sweden (1959–99) – Part 2: Comparison of glaciological and volumetric mass balances

Seasonal glaciological mass balances have been measured on Storglaciären without interruption since 1945/46. In addition, aerial surveys have been carried out on a decadal basis since the beginning of the observation program. Early studies had used the resulting aerial photographs to produce topographic glacier maps with which the in-situ observations could be verified. However, these maps as well as the derived volume changes are subject to errors which resulted in major differences between the derived volumetric and the glaciological mass balance. As a consequence, the original photographs were re-processed using uniform photogrammetric methods, which resulted in new volumetric mass balances for 1959–69, 1969–80, 1980–90, and 1990–99. We compared these new volumetric mass balances with mass balances obtained by standard glaciological methods including an uncertainty assessment considering all related previous studies. The absolute differences between volumetric and the glaciological mass balances are 0.8 m w.e. for the period of 1959–69 and 0.3 m w.e. or less for the other survey periods. These deviations are slightly reduced when considering corrections for systematic uncertainties due to differences in survey dates, reference areas, and internal ablation, whereas internal accumulation systematically increases the mismatch. However, the mean annual differences between glaciological and volumetric mass balance are less than the uncertainty of the in-situ stake reading and stochastic error bars of both data series overlap. Hence, no adjustment of the glaciological data series to the volumetric one is required

Influence of damping on the excitation of the double giant resonance

We study the effect of the spreading widths on the excitation probabilities of the double giant dipole resonance. We solve the coupled-channels equations for the excitation of the giant dipole resonance and the double giant dipole resonance. Taking Pb+Pb collisions as example, we study the resulting effect on the excitation amplitudes, and cross sections as a function of the width of the states and of the bombarding energy.Comment: 8 pages, 3 figures, corrected typo

Agents intervening against delirium in the intensive care unit (AID-ICU) - Protocol for a randomised placebo-controlled trial of haloperidol in patients with delirium in the ICU

Background Delirium among patients in the intensive care unit (ICU) is a common condition associated with increased morbidity and mortality. Haloperidol is the most frequently used pharmacologic intervention, but its use is not supported by firm evidence. Therefore, we are conducting Agents Intervening against Delirium in the Intensive Care Unit (AID‐ICU) trial to assess the benefits and harms of haloperidol for the treatment of ICU‐acquired delirium. Methods AID‐ICU is an investigator‐initiated, pragmatic, international, randomised, blinded, parallel‐group, trial allocating adult ICU patients with manifest delirium 1:1 to haloperidol or placebo. Trial participants will receive intravenous 2.5 mg haloperidol three times daily or matching placebo (isotonic saline 0.9%) if they are delirious. If needed, a maximum of 20 mg/daily haloperidol/placebo is given. An escape protocol, not including haloperidol, is part of the trial protocol. The primary outcome is days alive out of the hospital within 90 days post‐randomisation. Secondary outcomes are number of days without delirium or coma, serious adverse reactions to haloperidol, usage of escape medication, number of days alive without mechanical ventilation; mortality, health‐related quality‐of‐life and cognitive function at 1‐year follow‐up. A sample size of 1000 patients is required to detect a 7‐day improvement or worsening of the mean days alive out of the hospital, type 1 error risk of 5% and power 90%. Perspective The AID‐ICU trial is based on gold standard methodology applied to a large sample of clinically representative patients and will provide pivotal high‐quality data on the benefits and harms of haloperidol for the treatment ICU‐acquired delirium

A randomised, controlled crossover comparison of the C-MAC videolaryngoscope with direct laryngoscopy in 150 patients during routine induction of anaesthesia

<p>Abstract</p> <p>Background</p> <p>The C-MAC^®(Karl Storz, Tuttlingen, Germany) has recently been introduced as a new device for videolaryngoscopy guided intubation. The purpose of the present study was to compare for the first time the C-MAC with conventional direct laryngoscopy in 150 patients during routine induction of anaesthesia.</p> <p>Methods</p> <p>After approval of the institutional review board and written informed consent, 150 patients (ASA I-III) with general anaesthesia were enrolled. Computer-based open crossover randomisation was used to determine the sequence of the three laryngoscopies: Conventional direct laryngoscopy (HEINE Macintosh classic, Herrsching, Germany; blade sizes 3 or 4; <it>DL </it>group), C-MAC size 3 (<it>C-MAC3 </it>group) and C-MAC size 4 (<it>C-MAC4 </it>group) videolaryngoscopy, respectively. After 50 patients, laryngoscopy technique in the C-MAC4 group was changed to the straight blade technique described by Miller (C-MAC4/SBT).</p> <p>Results</p> <p>Including all 150 patients (70 male, aged (median [range]) 53 [20-82] years, 80 [48-179] kg), there was no difference of glottic view between DL, C-MAC3, C-MAC4, and C-MAC4/SBT groups; however, worst glottic view (C/L 4) was only seen with DL, but not with C-MAC videolaryngoscopy. In the subgroup of patients that had suboptimal glottic view with DL (C/L≥2a; n = 24), glottic view was improved in the C-MAC4/SBT group; C/L class improved by three classes in 5 patients, by two classes in 2 patients, by one class in 8 patients, remained unchanged in 8 patients, or decreased by two classes in 1 patient. The median (range) time taken for tracheal intubation in the DL, C-MAC3, C-MAC4 and C-MAC4/SBT groups was 8 sec (2-91 sec; n = 44), 10 sec (2-60 sec; n = 37), 8 sec (5-80 sec; n = 18) and 12 sec (2-70 sec; n = 51), respectively.</p> <p>Conclusions</p> <p>Combining the benefits of conventional direct laryngoscopy and videolaryngoscopy in one device, the C-MAC may serve as a standard intubation device for both routine airway management and educational purposes. However, in patients with suboptimal glottic view (C/L≥2a), the C-MAC size 4 with straight blade technique may reduce the number of C/L 3 or C/L 4 views, and therefore facilitate intubation. Further studies on patients with difficult airway should be performed to confirm these findings.</p

Levofloxacin versus placebo for the prevention of tuberculosis disease in child contacts of multidrug-resistant tuberculosis: study protocol for a phase III cluster randomised controlled trial (TB-CHAMP)

Background Multidrug-resistant (MDR) tuberculosis (TB) presents a challenge for global TB control. Treating individuals with MDR-TB infection to prevent progression to disease could be an effective public health strategy. Young children are at high risk of developing TB disease following infection and are commonly infected by an adult in their household. Identifying young children with household exposure to MDR-TB and providing them with MDR-TB preventive therapy could reduce the risk of disease progression. To date, no trials of MDR-TB preventive therapy have been completed and World Health Organization guidelines suggest close observation with no active treatment. Methods The tuberculosis child multidrug-resistant preventive therapy (TB-CHAMP) trial is a phase III cluster randomised placebo-controlled trial to assess the efficacy of levofloxacin in young child contacts of MDR-TB cases. The trial is taking place at three sites in South Africa where adults with MDR-TB are identified. If a child aged < 5 years lives in their household, we assess the adult index case, screen all household members for TB disease and evaluate any child aged < 5 years for trial eligibility. Eligible children are randomised by household to receive daily levofloxacin (15–20 mg/kg) or matching placebo for six months. Children are closely monitored for disease development, drug tolerability and adverse events. The primary endpoint is incident TB disease or TB death by one year after recruitment. We will enrol 1556 children from approximately 778 households with an average of two eligible children per household. Recruitment will run for 18–24 months with all children followed for 18 months after treatment. Qualitative and health economic evaluations are embedded in the trial. Discussion If the TB-CHAMP trial demonstrates that levofloxacin is effective in preventing TB disease in young children who have been exposed to MDR-TB and that it is safe, well tolerated, acceptable and cost-effective, we would expect that that this intervention would rapidly transfer into policy. Trial registration ISRCTN Registry, ISRCTN92634082. Registered on 31 March 2016

Metabolomics and Age-Related Macular Degeneration

Age-related macular degeneration (AMD) leads to irreversible visual loss, therefore, early intervention is desirable, but due to its multifactorial nature, diagnosis of early disease might be challenging. Identification of early markers for disease development and progression is key for disease diagnosis. Suitable biomarkers can potentially provide opportunities for clinical intervention at a stage of the disease when irreversible changes are yet to take place. One of the most metabolically active tissues in the human body is the retina, making the use of hypothesis-free techniques, like metabolomics, to measure molecular changes in AMD appealing. Indeed, there is increasing evidence that metabolic dysfunction has an important role in the development and progression of AMD. Therefore, metabolomics appears to be an appropriate platform to investigate disease-associated biomarkers. In this review, we explored what is known about metabolic changes in the retina, in conjunction with the emerging literature in AMD metabolomics research. Methods for metabolic biomarker identification in the eye have also been discussed, including the use of tears, vitreous, and aqueous humor, as well as imaging methods, like fluorescence lifetime imaging, that could be translated into a clinical diagnostic tool with molecular level resolution