| 1. |
- Khatri, C, et al.
(författare)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Tidskriftsartikel (refereegranskat)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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| 2. |
- Babkovskaia, Natalia, et al.
(författare)
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A DNS study of aerosol and small-scale cloud turbulence interaction
- 2016
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Ingår i: Atmospheric Chemistry and Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 16:12, s. 7889-7898
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study is to investigate the interaction between small-scale turbulence and aerosol and cloud microphysical properties using direct numerical simulations (DNS). We consider the domain located at the height of about 2000 m from the sea level, experiencing transient high supersaturation due to atmospheric fluctuations of temperature and humidity. To study the effect of total number of particles (Ntot) on air temperature, activation and supersaturation, we vary Ntot. To investigate the effect of aerosol dynamics on small-scale turbulence and vertical air motion, we vary the intensity of turbulent fluctuations and the buoyant force. We find that even a small number of aerosol particles (55.5 cm-3), and therefore a small droplet number concentration, strongly affects the air temperature due to release of latent heat. The system comes to an equilibrium faster and the relative number of activated particles appears to be smaller for larger Ntot. We conclude that aerosol particles strongly affect the air motion. In a case of updraught coursed by buoyant force, the presence of aerosol particles results in acceleration of air motion in vertical direction and increase of turbulent fluctuations.
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| 3. |
- Bergman, Tommi, et al.
(författare)
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Description and evaluation of a secondary organic aerosol and new particle formation scheme within TM5-MP v1.2
- 2022
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Ingår i: Geoscientific Model Development. - : Copernicus GmbH. - 1991-959X .- 1991-9603. ; 15:2, s. 683-713
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Tidskriftsartikel (refereegranskat)abstract
- We have implemented and evaluated a secondary organic aerosol scheme within the chemistry transport model TM5-MP in this work. In earlier versions of TM5-MP the secondary organic aerosol (SOA) was emitted as Aitken-sized particle mass emulating the condensation. In the current scheme we simulate the formation of secondary organic aerosol from oxidation of isoprene and monoterpenes by ozone and hydroxyl radicals, which produce semi-volatile organic compounds (SVOCs) and extremely low-volatility compounds (EVOCs). Subsequently, SVOCs and ELVOCs can condense on particles. Furthermore, we have introduced a new particle formation mechanism depending on the concentration of ELVOCs. For evaluation purposes, we have simulated the year 2010 with the old and new scheme; we see an increase in simulated production of SOA from 39.9ĝ€¯Tgĝ€¯yr-1 with the old scheme to 52.5ĝ€¯Tgĝ€¯yr-1 with the new scheme. For more detailed analysis, the particle mass and number concentrations and their influence on the simulated aerosol optical depth are compared to observations. Phenomenologically, the new particle formation scheme implemented here is able to reproduce the occurrence of observed particle formation events. However, the modelled concentrations of formed particles are clearly lower than in observations, as is the subsequent growth to larger sizes. Compared to the old scheme, the new scheme increases the number concentrations across the observation stations while still underestimating the observations. The organic aerosol mass concentrations in the US show a much better seasonal cycle and no clear overestimation of mass concentrations anymore. In Europe the mass concentrations are lowered, leading to a larger underestimation of observations. Aerosol optical depth (AOD) is generally slightly increased except in the northern high latitudes. This brings the simulated annual global mean AOD closer to the observational estimate. However, as the increase is rather uniform, biases tend to be reduced only in regions where the model underestimates the AOD. Furthermore, the correlations with satellite retrievals and ground-based sun-photometer observations of AOD are improved. Although the process-based approach to SOA formation causes a reduction in model performance in some areas, overall the new scheme improves the simulated aerosol fields.
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| 4. |
- Deshmukh, Akash, et al.
(författare)
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New Empirical Formulation for the Sublimational Breakup of Graupel and Dendritic Snow
- 2022
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Ingår i: Journal of the Atmospheric Sciences. - 1520-0469. ; 79:1, s. 317-336
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Tidskriftsartikel (refereegranskat)abstract
- Ice fragments are generated by sublimation of ice particles in subsaturated conditions in natural clouds. Conceivably, such sublimational breakup would be expected to cause ice multiplication in natural clouds. Any fragment that survives will grow to become ice precipitation that may sublimate and fragment further. As a first step toward assessing this overlooked process, a formulation is proposed for the number of ice fragments from sublimation of ice particles for an atmospheric model. This is done by amalgamating laboratory observations from previously published studies. The concept of a “sublimated mass activity spectrum” for the breakup is applied to the dataset. The number of ice fragments is determined by the relative humidity over ice and the initial size of the parent ice particles. The new formulation applies to dendritic crystals and heavily rimed particles only. Finally, a thought experiment is performed for an idealized scenario of subsaturation with in-cloud descent. Scaling analysis yields an estimate of an ice enhancement ratio of about 5 (10) within a weak deep convective downdraft of about 2 m s−1, for an initial monodisperse population of dendritic snow (graupel) particles of 3 L−1 and 2 mm. During descent, there is a dynamic equilibrium between continual emission of fragments and their depletion by sublimation. A simplified bin microphysics parcel model exhibits this dynamical quasi equilibrium, consistent with the thought experiment. The fragments have average lifetimes of around 90 and 70 s for dendrites and graupel, respectively. Sublimational breakup is predicted to cause significant secondary ice production.
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| 5. |
- Gupta, Ashok Kumar, et al.
(författare)
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The microphysics of the warm-rain and ice crystal processes of precipitation in simulated continental convective storms
- 2023
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Ingår i: Communications Earth and Environment. - 2662-4435. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- Precipitation in clouds can form by either warm-rain or ice crystal processes, referred to as warm and cold formation pathways, respectively. Here, we investigate the warm and cold pathway contributions to surface precipitation in simulated continental convective storms. We analyze three contrasting convective storms that are cold-based, slightly warm-based and very warm-based. We apply tracer-tagging techniques in our aerosol-cloud model to determine simulated microphysical pathways that lead to precipitation. We find cold components of graupel and rain mass were higher than warm components in cold- and slightly warm-based clouds. By contrast, in very warm-based clouds nearly 80% of surface precipitation was formed via warm-rain processes. Lowering of cloud base altitude to levels about 10–20 K warmer switched surface precipitation to being mostly warm, due to enhanced moisture content in the planetary boundary layer and larger cloud droplets aloft intensifying raindrop freezing. Our simulations indicate that warm and cold processes co-exist in any storm and the balance between them is determined by cloud base temperature and solute aerosol conditions.
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| 6. |
- Iguchi, Takamichi, et al.
(författare)
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WRF-SBM Simulations of Melting-Layer Structure in Mixed-Phase Precipitation Events Observed during LPVEx
- 2014
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Ingår i: Journal of Applied Meteorology and Climatology. - 1558-8424. ; 53:12, s. 2710-2731
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Tidskriftsartikel (refereegranskat)abstract
- Two mixed-phase precipitation events were observed on 21 September and 20 October 2010 over the southern part of Finland during the Light Precipitation Validation Experiment (LPVEx). These events have been simulated using the Weather Research and Forecasting Model coupled with spectral bin microphysics (WRF-SBM). The detailed ice-melting scheme with prognosis of the liquid water fraction during melting enables explicit simulation of microphysical properties in the melting layer. First, the simulations have been compared with C-band 3D radar measurements for the purpose of evaluating the overall profiles of cloud and precipitation. The simulation has some artificial convective patterns and errors in the forecast displacement of the precipitation system. The overall overestimation of reflectivity is consistent with a bias toward the range characterized by large-diameter droplets in the surface drop size distribution. Second, the structure of the melting bands has been evaluated against vertically pointing K-band radar measurements. A peak in reflectivity and a gradual change in Doppler velocity are observed and similarly simulated in the common temperature range from approximately 0 degrees to 3 degrees C. The effectiveness of the time-dependent melting scheme has been justified by intercomparison with a corresponding simulation using an instantaneous melting scheme. A weakness of the new melting scheme is that melting particles having high liquid water fractions on the order of 80%-90% cannot be simulated. This situation may cause underestimation of radar reflectivity in the melting layer because of the assumptions of melting-particle structure used to calculate the scattering properties.
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| 7. |
- Ilotoviz, Eyal, et al.
(författare)
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Effect of Aerosols on Freezing Drops, Hail, and Precipitation in a Midlatitude Storm
- 2016
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Ingår i: Journal of Atmospheric Sciences. - 1520-0469. ; 73:1, s. 109-144
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Tidskriftsartikel (refereegranskat)abstract
- A midlatitude hail storm was simulated using a new version of the spectral bin microphysics Hebrew University Cloud Model (HUCM) with a detailed description of time-dependent melting and freezing. In addition to size distributions of drops, plate-, columnar-, and branch-type ice crystals, snow, graupel, and hail, new distributions for freezing drops as well as for liquid water mass within precipitating ice particles were implemented to describe time-dependent freezing and wet growth of hail, graupel, and freezing drops.Simulations carried out using different aerosol loadings show that an increase in aerosol loading leads to a decrease in the total mass of hail but also to a substantial increase in the maximum size of hailstones. Cumulative rain strongly increases with an increase in aerosol concentration from 100 to about 1000 cm(-3). At higher cloud condensation nuclei (CCN) concentrations, the sensitivity of hailstones' size and surface precipitation to aerosols decreases. The physical mechanism of these effects was analyzed. It was shown that the change in aerosol concentration leads to a change in the major mechanisms of hail formation and growth. The main effect of the increase in the aerosol concentration is the increase in the supercooled cloud water content. Accordingly, at high aerosol concentration, the hail grows largely by accretion of cloud droplets in the course of recycling in the cloud updraft zone. The main mechanism of hail formation in the case of low aerosol concentration is freezing of raindrops.
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| 8. |
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| 9. |
- Jakobsson, Jonas K.F., et al.
(författare)
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Time dependence of heterogeneous ice nucleation by ambient aerosols : laboratory observations and a formulation for models
- 2022
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Ingår i: Atmospheric Chemistry and Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 22:10, s. 6717-6748
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Tidskriftsartikel (refereegranskat)abstract
- The time dependence of ice-nucleating particle (INP) activity is known to exist, yet for simplicity it is often omitted in atmospheric models as an approximation. Hitherto, only limited experimental work has been done to quantify this time dependency, for which published data are especially scarce regarding ambient aerosol samples and longer timescales. In this study, the time dependence of INP activity is quantified experimentally for six ambient environmental samples. The experimental approach includes a series of hybrid experiments with alternating constant cooling and isothermal experiments using a recently developed cold-stage setup called the Lund University Cold-Stage (LUCS). This approach of observing ambient aerosol samples provides the optimum realism for representing their time dependence in any model. Six ambient aerosol samples were collected at a station in rural Sweden representing aerosol conditions likely influenced by various types of INPs: marine, mineral dust, continental pristine, continental-polluted, combustion-related and rural continental aerosol. Active INP concentrations were seen to be augmented by about 40% to 100% (or 70% to 200%), depending on the sample, over 2h (or 10h). Mineral dust and rural continental samples displayed the most time dependence. This degree of time dependence observed was comparable to, but weaker than, that seen in previous published works. A general tendency was observed for the natural timescale of the freezing to dilate increasingly with time. The fractional freezing rate was observed to decline steadily with the time since the start of isothermal conditions following a power law. A representation of time dependence for incorporation into schemes of heterogeneous ice nucleation that currently omit it is proposed. Our measurements are inconsistent with the simplest purely stochastic model of INP activity, which assumes that the fractional freezing rate of all unfrozen drops is somehow constant and would eventually overpredict active INPs. In reality, the variability of efficiencies among INPs must be treated with any stochastic theory.
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| 10. |
- James, Rachel L., et al.
(författare)
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Secondary ice production during the break-up of freezing water drops on impact with ice particles
- 2021
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Ingår i: Atmospheric Chemistry and Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 21:24, s. 18519-18530
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Tidskriftsartikel (refereegranskat)abstract
- We provide the first dedicated laboratory study of collisions of supercooled water drops with ice particles as a secondary ice production mechanism. We experimentally investigated collisions of supercooled water drops (∼5 mm in diameter) with ice particles of a similar size (∼6 mm in diameter) placed on a glass slide at temperatures >-12 °C. Our results showed that secondary drops were generated during both the spreading and retraction phase of the supercooled water drop impact. The secondary drops generated during the spreading phase were emitted too fast to quantify. However, quantification of the secondary drops generated during the retraction phase with diameters >0.1 mm showed that 5-10 secondary drops formed per collision, with approximately 30 % of the secondary drops freezing over a temperature range between-4 and-12 ° C. Our results suggest that this secondary ice production mechanism may be significant for ice formation in atmospheric clouds containing large supercooled drops and ice particles.
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