Search

Tornadic storms with a tornado intensity of F2 or stronger on the Fujita scale that occurred in recent years (between 2013 and 2020) in Germany were analysed in detail. The 20 tornadoes, which developed on 17 different days, occurred in various parts of Germany. The majority of the analysed tornadoes occurred from May to early September. The other four events are typical cold-season cases that differ from the warm-season cases in some aspects which are discussed where applicable. Similarities and differences of the prevailing synoptic and mesoscale conditions are assessed in addition to the convective environment of the events. On the majority of the analysed tornadic days, the event happened on the forward flank of a long wave trough that was slowly propagating eastward. The second typical situation is a short wave trough passing rather fast over the area of interest from West to East. All cold-season cases occurred in high shear, low CAPE environments. Furthermore, the type of convection is analysed using a multi-source approach to best characterise the events. For this purpose, radar reflectivity and rotation data were combined with lightning detection in order to analyse the tornadic storms with respect to storm mode and storm evolution as well as lightning and rotation characteristics. The most common convective mode is linearly organised convection followd by multicellular storms. In many of the warm-season cases, radar radial wind data showed a persistent rotation track. The lightning activity of the warm-season season tornadic storms was high. In many cases, a lightning jump occurred between 5 and 120 minutes before the event.

Hintergrund: In der ersten Phase der COVID-19-Pandemie im Frühjahr 2020 wurden in Bayern im Rahmen des ausgerufenen Katastrophenfalls in Landkreisen und kreisfreien Städten sogenannte Versor-gungsärzt*innen (VÄ) eingesetzt, um die ambulante Versorgung zu koordinieren. Die Erfahrungen mit diesem Ansatz wurden in einem Evaluationsprojekt untersucht. Ein Ziel des Projektes war es, auf Basis der erhobenen Daten über den Versorgungsarztansatz hinausgehende Empfehlungen zur Unterstützung der ambulanten Versorgung in zukünftigen Pandemien zu erarbeiten. Methoden: Zunächst erfolgten Querschnittsbefragungen von Versorgungsund Hausärzt*innen sowie eine interviewbasierte qualitative Befragung von Versorgungs-, Hausärzt*innen und Vertreter*innen von Behörden und der Kassenärztlichen Vereinigung Bayerns. Auf Basis der erhobenen Daten wurden in einem sequenziellen Prozess Empfehlungen für Entscheidungsträger*innen erarbeitet. Ergebnisse: Hauptempfehlungen sind eine stärkere Berücksichtigung der ambulanten Versorgung in Katastrophen- und Notfallsituationen sowie bei der Aktualisierung vorhandener Katastrophen-und Pandemiepläne; der Aufbau systematischer Beratungsund Feedbackstrukturen für Politik und Behörden unter Einbindung erfahrener niedergelassener Ärzt*innen zur Vermeidung von Reibungsverlusten; eine effizientere Nutzung der vorhandenen Stärke des ambulanten Bereichs; Personen, Zuständigkeiten und Aufgaben für die Ebenen Land, Bezirk, Kreis vorab festlegen; angemessene, unterstützende Infrastruktur sicherstellen, damit beratende Ärzt*innen effizient agieren können. Schlussfolgerungen: Obwohl die Empfehlungen im Rahmen einer Evaluation des bayerischen Versorgungsarztansatzes entstanden sind, könnten sie, an die lokalen Gegebenheiten angepasst, auch bundesweit und außerhalb des offiziellen Katastrophenfalles für zukünftige Pandemie- und Notfallpläne hilfreich sein.

This study analyses characteristics of deep moist convection (DMC) over Germany with the aim to select relevant parameters that have the skill to improve the identification of current life cycle phase and the forecast of a lifetime of DMCs in an operational weather forecasting environment. No differentiation between thunderstorm organization types is done, since no simple differentiation method is available in an operational environment. In contrast to previous analyses, multiple data sources are used synchronously to explore an extensive data set of DMCs at high resolution in space and time. Basis of our analysis are all DMC detections in satellite data (using Cb-TRAM – Thunderstorm Tracking and Monitoring) in a five month period (June 2016, May/June/July 2017, and June 2018). For each of these DMCs the time series of selected parameters from satellite, ground-based radar, lightning detection, and numerical weather prediction (NWP) model data are inspected. In search for clear signatures of expectable lifetime and differences between short- and long-lived DMCs, all thunderstorm systems are sorted by their lifetime. In addition, they are separated into four life cycle phases: 1. early growth, 2. advanced growth, 3. maturity, and 4. decay. Generally, it turns out that satellite, radar, and lightning data are the most suitable data to determine the actual life cycle phase of a DMC. It is shown that long-lived DMCs are, on average, related to lower minimum cloud top temperature and mid-level relative humidity and higher maximum of coverage area, vertically integrated water and lightning activity during their life cycle than short-lived systems. The NWP model parameters have a diagnostic potential to identify the remaining lifetime in connection with the observational data, but do not contain information about the actual life cycle phase. The results obtained in this study will be used for an investigation of their potential application in a nowcasting model, in order to determine the current phase of an observed DMC and to predict its remaining lifetime.

We present a novel, to the best of our knowledge, fabrication process for highly aspherical lenses based on surface deformation due to thermal expansion of a soft polymer, polydimethylsiloxane (PDMS), using laser-structuring, molding, and precise shape optimization. Our fabrication process can be used for almost any lens shape with a large degree of freedom—both individual lenses and dense arrays. We present the design, fabrication, and characterization with examples of four different lenses with 1 mm apertures and surface deviations below 100 nm.

The third European Nowcasting Conference took place in Madrid, Spain, from 24 to 26 April 2019. The conference was structured into four thematic sessions i) observations as basis for nowcasting, ii) seamless prediction, iii) nowcasting techniques, systems and products, iv) verification, societal impacts, applications and user aspects. This report summarizes the scientific contributions presented and the discussed scientific questions.

Heat pumps play a central role in decarbonizing the heat supply of buildings. However, in this article, implementing heat pumps in existing buildings, a significant challenge is still presented due to high temperature requirements. In this article, a systematic analysis of the effects of heat source temperatures, maximum heat pump condenser temperatures, and system temperatures on the seasonal performance of heat pump (HP) systems is presented. The quantitative performance analysis encompasses over 50 heat pumps installed in residential buildings, revealing correlations between the building characteristics, observed temperatures, and heat pump type. The performance of an HP system retrofitted to a 30‐dwelling multifamily building is presented in more detail. The bivalent HP system combines air and ground as heat sources and achieves a seasonal performance factor of 3.25 with a share of the gas boiler of 27% in its first year of operation. In these findings, the technical feasibility of retrofitting heat pumps is demonstrated in existing buildings and insights are provided into overcoming the challenges associated with high temperature requirements. In this article, the challenges of implementing heat pumps (HPs) in existing buildings with high temperature requirements are addressed. It provides a systematic analysis of heat source temperatures, maximum condenser temperatures, and system temperatures on HP performance. Herein, over 50 HPs are included in residential buildings and correlations between building characteristics, observed temperatures, and HP types are identified.

The 2nd European Nowcasting Conference took place in Offenbach, Germany, on 3–5 May 2017. The conference was structured into four thematic sessions i) observations as basis for nowcasting, ii) nowcasting techniques and systems, iii) application, user aspects and verification, and iv) combination of numerical weather prediction and nowcasting. This report summarises the scientific contributions presented and the open scientific questions discussed at the conference.

•The highlight of this article is the determination of central parameters for evaluating the performance of a photovoltaic / heat pump / battery combination in a single-family house on the basis of a detailed metrological investigation, compared with various existing model-based analyses on the subject. This allows the individual properties of the individual hardware and software components and their interconnection to be mapped in real terms. Added to this is the real user behavior of the residents. In this way, variables such as the PV self-consumption, the autarky, the solar fraction and the efficiency (reduction) of the heat pump are determined, taking all real influencing factors into account.

The ideal finger tourniquet must be easy to use and provide a completely bloodless field with control of the pressure exerted at the compression site. The primary objective of this study was to evaluate the effectiveness of the T–RING™ digital tourniquet in emergency hand surgery; the secondary objective was to define the optimal indications and possible contraindications. This prospective study, undertaken between May 4 and July 30, 2015, comprised the application of 100 finger tourniquets in the following indications: all single or multiple digital wounds, distal from the base of the proximal phalanx, irrespective of their nature and the suspected structural damage. Data were collected with a questionnaire at the end of each surgical use of the finger tourniquet. An overall grade out of 30 was obtained by combining these scores. The facility of opening the packing was rated on average at 4/4, the facility of applying the finger tourniquet was rated at 3.8/4, the quality of the exsanguination at the beginning and at the end of the procedure were rated at 3.4/4 and 3.1/4, respectively, the difficulty related to positioning of the finger tourniquet was rated at 2.7/3, the facility of removing the finger tourniquet was rated at 3.6/4, the risk of forgetting the finger tourniquet at the end of the procedure was rated to 2.8/3, the comparison with an arm tourniquet was rated at 1.9/4. The overall grade was 25.1/30 on average. In current practice, use of the T–Ring™ tourniquet did not cause any difficulty. The tourniquet was never forgotten and the risk of forgetting it was considered low by the surgeons. The exsanguination appeared satisfactory, with a reduction in its effectiveness over time. We identified specific situations where its use could be indispensable: contraindication to trunk or plexus regional anesthesia, or as a relay to a pneumatic arm tourniquet after more than 2hours.

Comminuted radial head fractures are usually associated with destabilizing lesions of the elbow. The radial head prosthesis (RHP) is a therapeutic alternative when fracture fixation is impossible, as it restores one of the elbow's secondary stabilizers. The aim of this study was to assess healing of the medial collateral ligament (MCL) after implantation of a RHP. All patients implanted with a RHP during the 2003–2012 period were eligible for follow-up ultrasound evaluation of MCL healing. A clinical evaluation with standardized tests (DASH and MEPS) was performed and the patients asked to evaluate their elbow's stability during the same follow-up visit. Out of the 33 eligible patients, 20 were included with a mean follow-up of 73 months. The MCL had been torn in 15 of these 20 patients; the MCL appeared healed on the ultrasound images in 13 patients. The elbow was considered subjectively stable in 19 patients. The mean DASH score was 21.4 (±16.67) and the mean MEPS was 84.7 (±13.9); these scores were 17.19 (±14.0) and 88.3 (±10.9) for patients with a healed MCL, versus 32.5 (±10.6) and 70 (±0.0) for patients with a non-healed MCL. Our findings suggest that a torn MCL can heal after RHP implantation, even without surgical ligament repair or reattachment.

The better understanding of the systems of the human body and their specific functions has led to minimally invasive and microsurgical procedures being carried out on an ever smaller scale. New therapies will require precision of 10 fim or better, which will only be achievable with robotic teleoperators. Experience with existing robot-assisted surgery systems shows that the human-machine interface is a critical component for acceptance of this technology, but no universally satisfactory interface has yet been found. Therefore, this article investigates a new concept based on kinesthetic motion feedback and presents details of the implementation of a first prototype.

This study measures the effect of personality disorders on the efficacy of treatment of agoraphobia. Forty-one patients suffering from panic disorder with agoraphobia are evaluated for the presence of a personality disorder (according to DSM-III-R criteria) before the onset of treatment. The treatment consists in 14 sessions of behavioural cognitive therapy. Various measures of agoraphobic avoidance are obtained before (pre-test) and after the end of treatment (post-test, three month follow-up). Effect of treatment reaches statistical and clinical significance for all patients. Grouping of patients according to presence or absence of personality disorder shows no significant difference between the groups before or after treatment on scores of agoraphobia. A subgroup of patients with dependent personality disorder does not differ on measures of agoraphobic avoidance from patients without personality disorders or with other personality disorders. The discussion points out methodological limitations, differences in our study from other studies regarding the effect of personality on the treatment outcome of panic disorder with agoraphobia, as well as possibilities for future studies.

Are medical manipulators just wishful thinking by engineers or a real benefit to minimally invasive surgery? Based on an analysis of current practice in minimally invasive surgery, this paper will argue the case for medical manipulators. Three critical components are discussed in detail: the design of the endoscopes and surgical instruments, the man-machine interface and the actual manipulator itself. On the basis of first evaluation results for a virtual prototype of the system, the paper concludes that the first question should be answered with yes.

The effects of cocaine on pulsatile secretion of adrenocorticotropic hormone (ACTH) in men were studied under controlled clinical research ward conditions. Eight men with a Diagnostic and Statistical Manual of the American Psychiatric Association Version III, revised, diagnosis of concurrent cocaine and opioid dependence provided their informed consent for participation in this study. After an overnight fast, a challenge dose of cocaine (30 mg i.v.) or placebo was administered under single-blind conditions in a randomized order on 2 study days. Blood samples were collected at 2-min intervals for 76 min during base line and for an additional 76 min after i.v. administration of the challenge dose. Peak plasma cocaine levels of 313.8 +/- 46.5 ng/ml were detected within 2 min after cocaine administration. The cluster analysis program originally described by Veldhuis and Johnson (1986) was used to characterize ACTH pulsatile secretion (Iranmanesh et al., 1990). Acute cocaine administration (30 mg i.v.) significantly increased ACTH mean peak amplitude (P < .05), mean percent increase in peak amplitude, (P < .05), mean peak area (P < .04), total peak area (P < .04) and incremental peak height (P < .04). Mean ACTH valley levels (P < .02) and mean valley nadir (P < .02) were also significantly increased after cocaine administration. We postulate that cocaine stimulates the release of corticotropin releasing factor and that the cocaine-induced secretion of corticotropin releasing factor increases the amplitude of ACTH pulses, because ACTH pulse frequency was not altered by cocaine.

AbstractThis paper describes a test prototype for precision robot-assisted surgery using a hexapod operating robot and a movable operating cockpit for tactile feedback. The objective of the work described is twofold: 1, to evaluate the use of hexapod robots for precisely manipulating endoscopes and surgical instruments in submillimeter surgery; 2, to test a new user interface concept based on tactile feedback. Based on the principle of a flight simulator, the aim is to give the surgeon motion cues in addition to the endoscope image, to assist his spatial orientation. The paper gives a detailed description of the system components and the potential applications. [Neurol Res 1999; 21: 28–30]

Beginning with a general description of virtual reality (VR) applications, this paper investigates three areas in which the application of VR in medicine seems feasible: education and training systems, therapy (as an assistance tool) and as a development environment for new methods and procedures. Examples of current implementations are discussed for each application. The final discussion gives an overview of advances in algorithms and computer power which may be expected and the resulting feasibility of using VR applications in everyday medical practice.

Les fractures comminutives de tête radiale sont fréquemment associées à des lésions déstabilisant le coude. La prothèse de tête radiale (PTR) est une alternative thérapeutique permettant de s’affranchir de l’ostéosynthèse quand elle est impossible, tout en rétablissant un élément de stabilité secondaire du coude. Cette étude cherchait à évaluer la cicatrisation du ligament collatéral ulnaire (LCU) après la mis en place d’une PTR.

Les fractures-luxations olécraniennes sont des lésions rares et complexes. Une imagerie de qualité doit être réalisée afin de déterminer le type de fracture-luxation et les lésions associées. Nous rapportons les résultats d’une étude rétrospective évaluant les ostéosynthèses et complications de ces fractures.

A limited area model (LAM) intercomparison study is conducted based on a tropical monsoonal deep convection case observed during the Tropical Warm Pool ‐ International Cloud Experiment (TWP‐ICE). The LAM simulations are compared with the variational analyses (VA) based on the Atmospheric Radiation Measurement (ARM) observations and the cloud resolving model (CRM) simulations forced by the VA. Driven by the ECMWF analyses or global model forecasts, LAMs are able to produce the large‐scale thermodynamic field reasonably well compared with the VA. However, the LAM simulated dynamic fields, such as the large‐scale horizontal divergence, vertical velocity, and cyclogenesis in the monsoonal trough, have a large inter‐model spread and deviate substantially from observations. Despite the differences in large‐scale forcing, there is certain consistency between the CRM and LAM simulations: stratiform (w≤ 1 m s−1) ice clouds dominate the cloud fraction and convective (w> 3 m s−1) clouds occupy less than 3 percent of the total cloudy area. But the hydrometeor content of stratiform ice clouds is only one tenth of that of convective and transitional (1 m s−1< w≤ 3 m s−1) ice clouds. However, there is a large inter‐LAM spread in the simulated cloud fraction and hydrometeor mixing ratios. The inter‐LAM difference in solid phase hydrometeors (cloud ice, snow, and graupel) can be up to nearly a factor of 10. Among all the hydrometeor types, the stratiform ice clouds are simulated least consistently by the LAMs. The large inter‐LAM spread suggests that obtaining consistent and reliable dynamic and cloud fields remains a challenge for the LAM approach. Limited area model simulations are used to study a TWP‐ICE deep convective caseModel intercomparisonMonsoonal convection