The role of ice-sheet topography in the Alpine hydro-climate at glacial times

In this study, we investigate the sensitivity of the glacial Alpine hydro-climate to northern hemispheric and local ice-sheet changes. Bridging the scale gap by using a chain of global and regional climate models, we perform sensitivity simulations of up to 2 km horizontal resolution over the Alps for the Last Glacial Maximum (LGM) and the Marine Isotope Stage 4 (MIS4). In winter, we find wetter conditions in the southern part of the Alps during LGM compared to present day, to which dynamical processes, i.e. changes in the wind speed and direction, contribute substantially. During summer, we find the expected drier conditions in most of the Alpine region during LGM, as thermodynamics suggests drier conditions under lower temperatures. The MIS4 climate shows enhanced winter precipitation compared to the LGM, which is explained by its warmer climate compared to the LGM - thus, again explained by thermodynamics. The sensitivity simulations of the northern hemispheric ice-sheet changes show that an increase of the ice-sheet thickness leads to a significant intensification of glacial Alpine hydro-climate conditions, which is mainly explained by dynamical processes. Changing only the Fennoscandian ice sheet is less influential on the Alpine precipitation, whereas modifications in the local Alpine ice-sheet topography significantly alter the Alpine precipitation; in particular, we find a reduction of summer precipitation at the southern face of the Alps when lowering the Alpine ice sheet. The findings demonstrate that the northern hemispheric and local ice-sheet topography play an important role in regulating the Alpine hydro-climate and thus permits a better understanding of the precipitation patterns in the complex Alpine terrain at glacial times.ISSN:1814-9324ISSN:1814-933

Simulating Hail and Lightning Over the Alpine Adriatic Region—A Model Intercomparison Study

Hail is a significant convective weather hazard, often causing considerable crop and property damage across the world. Although extremely damaging, hail still remains a challenging phenomenon to model and forecast, given the limited computational resolution and the gaps in understanding the processes involved in hail formation. Here, eight hailstorms occurring over the Alpine-Adriatic region are analyzed using simulations with the Weather Research and Forecasting (WRF) and the Consortium for Small Scale Modeling (COSMO) models, with embedded HAILCAST and Lightning Potential Index (LPI) diagnostics at kilometer-scale grid spacing (∼2.2 km). In addition, a systematic model intercomparison study is performed to investigate the ability of the different modeling systems in reproducing such convective extremes, and to further assess the uncertainties associated with simulations of such localized phenomena. The results are verified by hailpad observations over Croatia, radar estimates of hail over Switzerland, and lightning measurements from the LINET network. The analysis reveals that both HAILCAST and LPI are able to reproduce the affected area and intensities of hail and lightning. Moreover, hail and lightning fields produced by both models are similar, although a slight tendency of WRF to produce smaller hail swaths with larger hailstones and higher LPI compared to COSMO is visible. It is found that these differences can be explained by systematic differences in vertical profiles of microphysical properties and updraft strength between the models. Overall, results are promising and indicate that both HAILCAST and LPI could be valuable tools for real-time forecasting and climatological assessment of hail and lightning in current and changing climate.ISSN:0148-0227ISSN:2169-897

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery