Abstract
The Global Environmental Multiscale (GEM) model is the Canadian atmospheric model used for meteorological forecasting at all scales. A limited-area version now also exists. It is a gridpoint ...model with an implicit semi-Lagrangian iterative space–time integration scheme. In the “horizontal,” the equations are written in spherical coordinates with the traditional shallow atmosphere approximations and are discretized on an Arakawa C grid. In the “vertical,” the equations were originally defined using a hydrostatic-pressure coordinate and discretized on a regular (unstaggered) grid, a configuration found to be particularly susceptible to noise. Among the possible alternatives, the Charney–Phillips grid, with its unique characteristics, and, as the vertical coordinate, log-hydrostatic pressure are adopted. In this paper, an attempt is made to justify these two choices on theoretical grounds. The resulting equations and their vertical discretization are described and the solution method of what is forming the new dynamical core of GEM is presented, focusing on these two aspects.
Growth differentiation factor-15 (GDF-15) has been identified as a strong marker of cardiovascular disease; however, no data are available concerning the role of GDF-15 in the occurrence of organ ...dysfunction during coronary artery bypass grafting (CABG) associated with cardiopulmonary bypass (CPB).
Five arterial blood samples were taken sequentially in 34 patients from anesthesia induction (IND) until 24 h after arrival at the intensive care unit (ICU). Plasma levels of GDF-15, follistatin-like 1 (FLST1), myeloperoxidases (MPO), hydroperoxides and plasma antioxidant status (PAS) were measured at each time-point. Markers of cardiac (cardiac-troponin I, cTnI) and renal dysfunction (neutrophil gelatinase-associated lipocalin, NGAL) and other classical biological factors and clinical data were measured.
Plasma GDF-15 levels increased gradually during and after surgery, reaching nearly three times the IND levels in the ICU (3,075±284 ng/L vs. 1,061±90 ng/L, p<0.001). Plasma MPO levels increased dramatically during surgery, attaining their highest level after unclamping (UNCLAMP) (49±11 ng/mL vs. 1,679±153 ng/mL, p<0.001) while PAS significantly decreased between IND and UNCLAMP (p<0.05), confirming the high oxidative status induced by this surgical procedure. ICU levels of GDF-15 correlated positively with cTnI and NGAL (p = 0.006 and p = 0.036, respectively), and also with hemoglobin and estimated glomerular filtration rate (eGFR). Among all the post-operative biomarkers available, only eGFR, NGAL and GDF-15 measured at ICU arrival were significantly associated with the onset of acute kidney injury (AKI). Patients with a EuroSCORE >3 were shown to have higher GDF-15 levels.
During cardiac surgery associated with CPB, GDF-15 levels increased substantially and were associated with markers of cardiac injury and renal dysfunction.
Numerical weather prediction (NWP) systems operational at many national centers are nowadays used at the kilometer scale. The next generation of NWP models will provide forecasts at the subkilometer ...scale. Large impacts are expected in mountainous terrain characterized by highly variable orography. This study investigates the ability of the Canadian NWP system to provide an accurate forecast of near-surface variables at the subkilometer scale in the Canadian Rocky Mountains in wintertime when the region is fully covered by snow. Observations collected at valley and high-altitude stations are used to evaluate forecast accuracy at three different grid spacing (2.5, 1, and 0.25 km) over a period of 15 days. Decreasing grid spacing was found to improve temperature forecasts at high-altitude stations because of better orography representation. In contrast, no improvement is obtained at valley stations due to an inability of the model to fully capture at all resolutions the intensity of valley cold pools forming during nighttime. Errors in relative humidity reveal that the model tends to overestimate relative humidity at all resolutions, without improvement with decreasing grid spacing. Wind speed forecasts show large improvements with decreasing grid spacing for high-altitude stations exposed to or sheltered from wind. However, no systematic improvement with decreasing grid spacing is found for all stations, which is similar to previous studies. In addition, the model's sensitivity at subkilometer grid spacing is investigated by evaluating the effects of (i) accounting for additional drag generated by subgrid orographic features, (ii) considering slope angle and aspect on surface radiation, and (iii) using high-resolution initialization for the surface fields.
Abstract Background Pre-operative GDF-15 plasma levels significantly improve the prognostic value of the EuroSCORE for mortality after cardiac surgery. However, despite the strong correlation between ...GDF-15 and renal function, no data are available regarding the potential interest of pre-operative GDF-15 levels to improve the prediction of acute kidney injury (AKI) after cardiac artery bypass graft (CABG) surgery. Methods All patients operated on by 2 surgeons for CABG surgery at our university hospital from September 2011 to March 2013 were screened for participation in this prospective, observational study. Exclusion criteria: age < 18 years or > 80 years, previous atrial fibrillation/flutter, previous severe renal failure, previous cardiac surgery, emergency surgery. AKI was defined according to KDIGO criteria. GDF-15 levels in plasma were measured before induction and 12 h after surgery. Results 134 patients were included in this study. 42 (31%) developed post-operative AKI. AKI patients had a significantly higher pre-operative log-GDF-15 level (OR = 3.64; 95% CI = 1.41–9.40, p = 0.008), a lower pre-operative eGFR (OR = 0.98; 95% CI = 0.96–0.99; p = 0.026), and most often underwent on-pump surgery (OR = 2.60; 95% CI = 1.14–5.96, p = 0.024). On ROC curves, GDF-15 before induction was found to be the best pre-operative biomarker to predict AKI (AUC = 0.83; CI = 0.75–0.89), compared with eGFR (AUC = 0.67; 95% CI = 0.59–0.75), p = 0.003 and NT-proBNP (AUC = 0.62; CI = 0.51–0.72), p < 0.001. Pre-operative GDF-15 was also significantly better than the EuroSCORE in predicting AKI (AUC 0.62, 95% CI = 0.54–0.70), p < 0.001. Conclusions Pre-operative GDF-15 plasma levels are associated with post-operative AKI in CABG patients. If confirmed in larger cohorts, pre-operative GDF-15 may be of value to improve pre-operative risk stratification among candidates for surgery.
The role and impact that boundary layer and shallow cumulus clouds have on the medium-range forecast of a large-scale weather system is discussed in this study. A mesoscale version of the Global ...Environmental Multiscale (GEM) atmospheric model is used to produce a 5-day numerical forecast of a midlatitude large-scale weather system that occurred over the Pacific Ocean during February 2003. In this version of GEM, four different schemes are used to represent (i) boundary layer clouds (including stratus, stratocumulus, and small cumulus clouds), (ii) shallow cumulus clouds (overshooting cumulus), (iii) deep convection, and (iv) nonconvective clouds. Two of these schemes, that is, the so-called MoisTKE and Kuo Transient schemes for boundary layer and overshooting cumulus clouds, respectively, have been recently introduced in GEM and are described in more detail. The results show that GEM, with this new cloud package, is able to represent the wide variety of clouds observed in association with the large-scale weather system. In particular, it is found that the Kuo Transient scheme is mostly responsible for the shallow/intermediate cumulus clouds in the rear portion of the large-scale system, whereas MoisTKE produces the low-level stratocumulus clouds ahead of the system. Several diagnostics for the rear portion of the system reveal that the role of MoisTKE is mainly to increase the vertical transport (diffusion) associated with the boundary layer clouds, while Kuo Transient is acting in a manner more consistent with convective stabilization. As a consequence, MoisTKE is not able to remove the low-level shallow cloud layer that is incorrectly produced by the GEM nonconvective condensation scheme. Kuo Transient, in contrast, led to a significant reduction of these nonconvective clouds, in better agreement with satellite observations. This improved representation of stratocumulus and cumulus clouds does not have a large impact on the overall sea level pressure patterns of the large-scale weather system. Precipitation in the rear portion of the system, however, is found to be smoother when MoisTKE is used, and significantly less when the Kuo Transient scheme is switched on.
Minimal invasive heart surgery (MIHS) presents several benefits, but provides intense and prolonged post-operative pain. Our objective was to compare efficacy of serratus anterior plane block (SAPB) ...with continuous wound infiltration (CWI) for management of post-operative pain following MIHS.
It's retrospective, monocentric study between November 2016 to April 2017. The study was performed at the University hospital of Dijon, Burgundy, France. All patients scheduled for MIHS was included. Data was collected retrospectively. During this period, 20 patients had SAPB and 26 had CWI. SAPB was performed before extubation with a single injection of 0.5 mg/kg of ropivacaïne (5 mg/ml). In the CWI group, catheter was inserted in the subcutaneous space by the surgeon at the end of the procedure. A 10 ml bolus of ropivacaïne (7.5 mg/mL) was followed by a continuous infusion (2 mg/ml) between 7 and 12 ml/h for 48 h. Morphine consumption and visual analog score (VAS) were recorded for 48 h. Length of stay in intensive care unit and hospital was also collected.
Morphine consumption and VAS score were significantly lower in SAPB group (p < 0.01). Length of stay in intensive care and hospital was significantly was decreased in SAPB group.
SAPB appears effective in reducing postoperative MIHS pain.
Current sea ice models use numerical schemes based on a splitting in time between the momentum and continuity equations. Because the ice strength is explicit when solving the momentum equation, this ...can create unrealistic ice stress gradients when using a large time step. As a consequence, noise develops in the numerical solution and these models can even become numerically unstable at high resolution. To resolve this issue, we have implemented an iterated IMplicit–EXplicit (IMEX) time integration method. This IMEX method was developed in the framework of an already implemented Jacobian-free Newton–Krylov solver. The basic idea of this IMEX approach is to move the explicit calculation of the sea ice thickness and concentration inside the Newton loop such that these tracers evolve during the implicit integration. To obtain second-order accuracy in time, we have also modified the explicit time integration to a second-order Runge–Kutta approach and by introducing a second-order backward difference method for the implicit integration of the momentum equation. These modifications to the code are minor and straightforward. By comparing results with a reference solution obtained with a very small time step, it is shown that the approximate solution is second-order accurate in time. The new method permits to obtain the same accuracy as the splitting in time but by using a time step that is 10 times larger. Results show that the second-order scheme is more than five times more computationally efficient than the splitting in time approach for an equivalent level of error.
Atmospheric dynamical cores are a fundamental component of global atmospheric modeling systems and are responsible for capturing the dynamical behavior of the Earth's atmosphere via numerical ...integration of the Navier–Stokes equations. These systems have existed in one form or another for over half of a century, with the earliest discretizations having now evolved into a complex ecosystem of algorithms and computational strategies. In essence, no two dynamical cores are alike, and their individual successes suggest that no perfect model exists. To better understand modern dynamical cores, this paper aims to provide a comprehensive review of 11 non-hydrostatic dynamical cores, drawn from modeling centers and groups that participated in the 2016 Dynamical Core Model Intercomparison Project (DCMIP) workshop and summer school. This review includes a choice of model grid, variable placement, vertical coordinate, prognostic equations, temporal discretization, and the diffusion, stabilization, filters, and fixers employed by each system.
Most numerical weather prediction models rely on a terrain-following coordinate framework. The computational mesh is thus characterized by inhomogeneities with scales determined by the underlying ...topography. Such inhomogeneities may affect the truncation error of numerical schemes. In this study, a new class of terrain-following coordinate systems for use in atmospheric prediction models is proposed. Unlike conventional systems, the new smooth level vertical (SLEVE) coordinate yields smooth coordinates at mid- and upper levels. The basic concept of the new coordinate is to employ a scale-dependent vertical decay of underlying terrain features. The decay rate is selected such that small-scale topographic variations decay much faster with height than their large-scale counterparts. This generalization implies a nonlocal coordinate transformation. The new coordinate is tested and compared against standard sigma and hybrid coordinate systems using an idealized advection test. It is demonstrated that the presence of coordinate transformations induces substantial truncation errors. These are critical for grid inhomogeneities with wavelengths smaller than approximately eight grid increments, and may overpower the regular-grid truncation error of the underlying finite-difference approximation. These results are confirmed by a theoretical analysis of the truncation error. In addition, the new coordinate is tested in idealized and real-case numerical experiments using a nonhydrostatic model. The simulations using the new coordinate yield a substantial reduction of small-scale noise in dynamical and thermodynamical model fields.
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