Since 2002, global snow water equivalent (SWE) estimates have been generated using Advanced Microwave Scanning Radiometer (AMSR-E)/Aqua data. Accurate estimates of SWE are important to improve monitoring and managing of water resources in specific regions. SWE and snow map product accuracy are functions of topography and of land cover type because landscape characteristics have a strong influence on redistribution and physical properties of snow cover, and influence the microwave properties of the surface. Here we evaluate the AMSR-E SWE and derived snow map products in the Mackenzie River Basin (MRB), Canada, which is characterized by complex topography and varying land cover types from tundra to boreal forest. We compare in situ snow depth observations and Moderate Resolution Imaging Spectroradiometer (MODIS) snow cover maps from January 2003 to December 2007 with passive microwave remotely sensed SWE from AMSR-E and derived snow cover maps. In the MRB the mean absolute error ranges from 12 mm in the early winter season to 50 mm in the late winter season and overestimations of snow cover maps based on a 1 mm threshold of AMSR-E SWE varies from 4% to 8%. The optimal threshold for AMSR-E SWE to classify the pixels as snow ranges from 6 mm to 9 mm. The overall accuracy of new snow cover maps from AMSR-E varies from 91% to 94% in different sub-basins in the MRB. © 2010 by the authors.

We use monthly measurements of time-variable gravity from the GRACE (Gravity Recovery and Climate Experiment) satellite mission to quantify changes in terrestrial water storage (TWS) in the Lena river basin, Eurasia, during the period April 2002 to September 2010. We estimate a TWS increase of 32 ± 10 km³/yr for the entire basin, equivalent to an increase in water thickness of 1.3 ± 0.4 cm/yr over a basin of 2.4 million km². We compare TWS estimates from GRACE with time series of precipitation (P) minus evapotranspiration (ET) from ERA-Interim reanalysis minus observational river discharge (R). We find an excellent agreement in annual and inter-annual variability between the two time series. Furthermore, we find that a bias of −20 ± 10% in P-ET is sufficient to effectively close the water budget with GRACE. When we account for this bias, the time series of cumulative TWS from GRACE and climatological data agree to within ±3.8 cm of water thickness, or ±9% of the mean annual P. The TWS increase is not uniform across the river basin and exhibits a peak, over an area of 502,400 km², centered at 118.5°E, 62.5°N, and underlain by discontinuous permafrost. In this region, we attribute the observed TWS increase of 68 ± 19 km³ to an increase in subsurface water storage. This large subsurface water signal will have a significant impact on the terrestrial hydrology of the region, including increased baseflow and alteration of seasonal runoff.

We use monthly measurements of time-variable gravity from the GRACE (Gravity Recovery and Climate Experiment) satellite mission to quantify changes in terrestrial water storage (TWS) in the Lena river basin, Eurasia, during the period April 2002 to September 2010. We estimate a TWS increase of 32 ± 10 km³/yr for the entire basin, equivalent to an increase in water thickness of 1.3 ± 0.4 cm/yr over a basin of 2.4 million km². We compare TWS estimates from GRACE with time series of precipitation (P) minus evapotranspiration (ET) from ERA-Interim reanalysis minus observational river discharge (R). We find an excellent agreement in annual and inter-annual variability between the two time series. Furthermore, we find that a bias of −20 ± 10% in P-ET is sufficient to effectively close the water budget with GRACE. When we account for this bias, the time series of cumulative TWS from GRACE and climatological data agree to within ±3.8 cm of water thickness, or ±9% of the mean annual P. The TWS increase is not uniform across the river basin and exhibits a peak, over an area of 502,400 km², centered at 118.5°E, 62.5°N, and underlain by discontinuous permafrost. In this region, we attribute the observed TWS increase of 68 ± 19 km³ to an increase in subsurface water storage. This large subsurface water signal will have a significant impact on the terrestrial hydrology of the region, including increased baseflow and alteration of seasonal runoff.

We use monthly measurements of time-variable gravity from the GRACE (Gravity Recovery and Climate Experiment) satellite mission to quantify changes in terrestrial water storage (TWS) in the Lena river basin, Eurasia, during the period April 2002 to September 2010. We estimate a TWS increase of 32 10 km ³/yr for the entire basin, equivalent to an increase in water thickness of 1.3 0.4cm/yr over a basin of 2.4 million km². We compare TWS estimates from GRACE with time series of precipitation (P) minus evapotranspiration (ET) from ERA-Interim reanalysis minus observational river discharge (R). We find an excellent agreement in annual and inter-annual variability between the two time series. Furthermore, we find that a bias of -20 10% in P-ET is sufficient to effectively close the water budget with GRACE. When we account for this bias, the time series of cumulative TWS from GRACE and climatological data agree to within 3.8 cm of water thickness, or 9% of the mean annual P. The TWS increase is not uniform across the river basin and exhibits a peak, over an area of 502,400 km², centered at 118.5E, 62.5N, and underlain by discontinuous permafrost. In this region, we attribute the observed TWS increase of 68 19 km³ to an increase in subsurface water storage. This large subsurface water signal will have a significant impact on the terrestrial hydrology of the region, including increased baseflow and alteration of seasonal runoff. © 2012 by the American Geophysical Union.

Background Detecting failing tissue flaps before they are clinically apparent has the potential to improve postoperative flap management and salvage rates. This study demonstrates a model to quantitatively compare clinical appearance, as recorded via digital camera, with spatial frequency domain imaging (SFDI), a noninvasive imaging technique using patterned illumination to generate images of total hemoglobin and tissue oxygen saturation (stO2). Methods Using a swine pedicle model in which blood flow was carefully controlled with occlusion cuffs and monitored with ultrasound probes, throughput was reduced by 25%, 50%, 75%, and 100% of baseline values in either the artery or the vein of each of the flaps. The color changes recorded by a digital camera were quantified to predict which occlusion levels were visible to the human eye. SFDI was also used to quantify the changes in physiological parameters including total hemoglobin and oxygen saturation associated with each occlusion. Results There were no statistically significant changes in color above the noticeable perception levels associated with human vision during any of the occlusion levels. However, there were statistically significant changes in total hemoglobin and stO2 levels detected at the 50%, 75%, and 100% occlusion levels for arterial and venous occlusions. Conclusions As demonstrated by the color imaging data, visual flap changes are difficult to detect until significant occlusion has occurred. SFDI is capable of detecting changes in total hemoglobin and stO2 as a result of partial occlusions before they are perceivable, thereby potentially improving response times and salvage rates.

Postoperative delirium is a geriatric syndrome that manifests as changes in cognition, attention, and levels of consciousness after surgery. It occurs in up to 50% of patients after major surgery and is associated with adverse outcomes, including increased hospital length of stay, higher cost of care, higher rates of institutionalization after discharge, and higher rates of readmission. Furthermore, it is associated with functional decline and cognitive impairments after surgery. As the age and medical complexity of our surgical population increases, practitioners need the skills to identify and prevent delirium in this high-risk population. Because delirium is a common and consequential postoperative complication, there has been an abundance of recent research focused on delirium, conducted by clinicians from a variety of specialties. There have also been several reviews and recommendation statements; however, these have not been based on robust evidence. The Sixth Perioperative Quality Initiative (POQI-6) consensus conference brought together a team of multidisciplinary experts to formally survey and evaluate the literature on postoperative delirium prevention and provide evidence-based recommendations using an iterative Delphi process and Grading of Recommendations Assessment, Development and Evaluation (GRADE) Criteria for evaluating biomedical literature.

Postoperative acute kidney injury (PO-AKI) is a common complication of major surgery that is strongly associated with short-term surgical complications and long-term adverse outcomes, including increased risk of chronic kidney disease, cardiovascular events and death. Risk factors for PO-AKI include older age and comorbid diseases such as chronic kidney disease and diabetes mellitus. PO-AKI is best defined as AKI occurring within 7 days of an operative intervention using the Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI; however, additional prognostic information may be gained from detailed clinical assessment and other diagnostic investigations in the form of a focused kidney health assessment (KHA). Prevention of PO-AKI is largely based on identification of high baseline risk, monitoring and reduction of nephrotoxic insults, whereas treatment involves the application of a bundle of interventions to avoid secondary kidney injury and mitigate the severity of AKI. As PO-AKI is strongly associated with long-term adverse outcomes, some form of follow-up KHA is essential; however, the form and location of this will be dictated by the nature and severity of the AKI. In this Consensus Statement, we provide graded recommendations for AKI after non-cardiac surgery and highlight priorities for future research.