Changing climate both increases and decreases European river floods.

Climate change has led to concerns about increasing river floods resulting from the greater water-holding capacity of a warmer atmosphere1. These concerns are reinforced by evidence of increasing economic losses associated with flooding in many parts of the world, including Europe2. Any changes in river floods would have lasting implications for the design of flood protection measures and flood risk zoning. However, existing studies have been unable to identify a consistent continental-scale climatic-change signal in flood discharge observations in Europe3, because of the limited spatial coverage and number of hydrometric stations. Here we demonstrate clear regional patterns of both increases and decreases in observed river flood discharges in the past five decades in Europe, which are manifestations of a changing climate. Our results-arising from the most complete database of European flooding so far-suggest that: increasing autumn and winter rainfall has resulted in increasing floods in northwestern Europe; decreasing precipitation and increasing evaporation have led to decreasing floods in medium and large catchments in southern Europe; and decreasing snow cover and snowmelt, resulting from warmer temperatures, have led to decreasing floods in eastern Europe. Regional flood discharge trends in Europe range from an increase of about 11 per cent per decade to a decrease of 23 per cent. Notwithstanding the spatial and temporal heterogeneity of the observational record, the flood changes identified here are broadly consistent with climate model projections for the next century4,5, suggesting that climate-driven changes are already happening and supporting calls for the consideration of climate change in flood risk management.

Performance assessment of NOVA SDS011 low-cost PM sensor in various microenvironments.

Over the last 10 years, as a possible alternative to the conventional approach to air quality monitoring, real-time monitoring systems that use low-cost sensors and sensor platforms have been frequently applied. Generally, the long-term characteristics of low-cost PM sensors and monitoring have not been thoroughly documented except for a few widely used sensors and monitors. This article addresses the laboratory and field validation of three low-cost PM monitors of the same type that use the NOVA SDS011 PM sensor module over a 1-year period. In outdoor environments, we co-located low-cost PM monitors with GRIMM EDM180 monitors at the National Air Quality Monitoring stations. In indoor environments, we co-located them with a Turnkey Osiris PM monitor. Several performance aspects of the PM monitors were examined: operational data coverage, linearity of response, accuracy, precision, and inter-sensor variability. The obtained results show that inter-monitor R values were typically higher than 0.95 regardless of the environment. The tested monitors demonstrate high linearity in comparison with PM10 and PM2.5 concentrations measured in outdoor air with reference-equivalent instrumentation with R2 values ranging from 0.52 up to 0.83. In addition, very good agreement (R2 values ranging from 0.93 up to 0.97) with the gravimetric PM10 and PM2.5 method is obtained in the indoor environment (30 < RH < 70%). High RH (over 70%) negatively affected the PM monitors' response, especially in the case of PM10 concentrations (high overestimation).

Full-endoscopic interlaminar operations in lumbar compressive lesions surgery: prospective study of 350 patients - "ENDOS" Study.

BACKGROUND: Full-endoscopic operations of lumbar spine are truly minimally invasive surgical procedures. Endoscopic techniques have become the standard in many areas because of the advantages they offer intraoperatively and after surgery. With the interlaminar and transforaminal approach, two full-endoscopic procedures are available for lumbar compressive lesion operations. Our aim was to present and explain all aspects of the full-endoscopic operative technique, and presentation of results of lumbar discectomies and monosegmental decompression in full-endoscopic interlaminar technique performed during 3-year period in comparison with conventional microsurgical operations reported in literature. METHODS: A series of 350 patients underwent full-endoscopic interlaminar lumbar discectomy, and spinal canal decompression, during a 3-year period, is analyzed. In addition to general and specific parameters, VAS and ODI scale are used as measuring instruments. RESULTS: In our clinical series of full-endoscopic operations 88% of the patients no longer had leg pain postoperatively, and 7% had only occasional pain. In 7 (2%) patients minor nerve damage resulted in transient paresthesias, and in 2 patients resulted in neurological deficit. Dural tear occurred in 8 (2.3%) patients, and only 1 had reoperation for direct dural repair. The recurrence rate was 5.7% (3.7% had reoperation). Resection of the herniated disc and sufficient decompression was technically possible in all cases. CONCLUSIONS: The clinical results of the full-endoscopic technique are at least equal to those of the conventional microsurgical discectomy with advantages such as reduced tissue trauma, improved patient mobility, and lower overall complication rate. With the possibility of selecting the most adequate approach, lumbar disc herniations inside and outside the spinal canal, can be sufficiently removed using the full-endoscopic technique, when taking the appropriate indication criteria into account.

Air quality monitoring in NIS (SERBIA) and health impact assessment.

The aim of this study is to indicate the significance of air quality monitoring and to determine the air quality fields for the assessment of air pollution health effects, with special attention to risk population. Radial basis function network was used for air quality index mapping. Between 1991 and 2005, on the territory of Nis, several epidemiological studies were performed on risk groups (pre-school children, school children, pregnant women and persons older than 65). The total number of subjects was 5837. The exposed group comprised individuals living in the areas with unhealthy AQI, while the control group comprised individuals living in city areas with good or moderate AQI. It was determined that even relatively low levels of air pollution had impact on respiratory system and the occurrence of anaemia, allergy and skin symptoms.

Face and construct validity of TU-Delft epidural simulator and the value of real-time visualization.

BACKGROUND AND OBJECTIVES: Learning epidural anesthesia traditionally involves bedside teaching. Visualization aids or a simulator can help in acquiring motor skills, increasing patient safety and steepening the learning curve. We evaluated the face and construct validity of the TU-Delft Epidural Simulator and the effect of needle visualization. METHODS: Sixty-eight anesthesiologists, anesthesia residents, and final-year medical students tested the epidural simulator. Participants performed six epidural simulations with and six without needle visualization. We tested face validity on a Likert scale questionnaire. We collected data with the simulator software (spinal taps, dura contacts, bone contacts, attempts, and time) and tested for correlation with the performer's experience (construct validity). A visualization aid was tested in a randomized crossover design. RESULTS: Face validity as rated by the participants was above average, with a mean of 3.7 (2.0-4.8) on a 5-point scale. Construct validity was indicated by significantly more spinal taps (0.4 [0-4) vs 0.07 [0-2], p=0.04) and more dura contacts (0.58 [0-6] vs 0.37 [0-3], p=0.002) by the inexperienced group compared with the expert group. The visualization aid improved performance by reducing the number of bone contacts and the number of attempts, and by decreasing the procedure time. Prior visualization training reduced the total procedure time from 279 s (69-574) to 180 s (53-605) (p=0.01) for the "blind" procedure. CONCLUSIONS: The TU-Delft Epidural Simulator is a useful tool for teaching motor skills during epidural needle placement. Prior use of a visualization tool improves performance even without visual support during consequent simulations.

Changing climate shifts timing of European floods.

A warming climate is expected to have an impact on the magnitude and timing of river floods; however, no consistent large-scale climate change signal in observed flood magnitudes has been identified so far. We analyzed the timing of river floods in Europe over the past five decades, using a pan-European database from 4262 observational hydrometric stations, and found clear patterns of change in flood timing. Warmer temperatures have led to earlier spring snowmelt floods throughout northeastern Europe; delayed winter storms associated with polar warming have led to later winter floods around the North Sea and some sectors of the Mediterranean coast; and earlier soil moisture maxima have led to earlier winter floods in western Europe. Our results highlight the existence of a clear climate signal in flood observations at the continental scale.

Respiratory diseases in preschool children in the city of Nis exposed to suspended particulates and carbon monoxide from ambient air.

Background/Aim: Analysis of air quality in Serbia indicates that the city of Nis belongs to a group of cities characterized by the third category of air quality (excessive air pollution). The aim of the study was to analyze the degree of causality between ambient air quality affected by particulate matter of 10 µm (PM10) and carbon monoxide (CO) and the incidence of respiratory diseases in preschool children in the city of Nis. Methods: We quantified the influence of higher PM10 concentrations and carbon monoxide comprising motor vehicle exhausts in the city of Nis on the occurrence of unwanted health effects in preschool children by means of the hazard quotient (HQ), individual health risk (Ri), and the probability of cancer (ICR). The methodology used was according to the US Environmental Protection Agency (EPA), and it included basic scientific statistical methods, compilation methods, and the relevant mathematical methods for assessing air pollution health risk, based on the use of attribute equations. Results: Measurement of ambient air pollutant concentrations in the analyzed territory for the entire monitoring duration revealed that PM10 concentrations were significantly above the allowed limits during 80% of the days. The maximum measured PM10 concentration was 191.6 µg/m3, and carbon monoxide 5.415 mg/m3. The incidence of respiratory diseases in the experimental group, with a prominent impact of polluted air was 57.17%, whereas the incidence in the control group was considerably lower, 41.10 %. There were also significant differences in the distribution of certain respiratory diseases. Conclusion: In order to perform good causal analysis of air quality and health risk, it is very important to establish and develop a system for long-term monitoring, control, assessment, and prediction of air pollution. We identified the suspended PM10 and CO as ambient air pollutants causing negative health effects in the exposed preschool children population

Giant Vertebrobasilar Fusiform Aneurysm as a Cerebellopontine Angle Mass.

INTRODUCTION: According to the literature, a fusiform aneurysm located in the cerebellopontine angle (CPA) is an extremely rare condition. CASE OUTLINE: We report a case of a 59-year-old patient with initial dizziness and left-sided sensorineural hearing loss that had gradually developed over six months. Vertebrobasilar fusiform aneurysm, with intraluminal thrombus, which was displaced to the right cerebellopontine angle, creating mass effect, was diagnosed using brain magnetic resonance imaging and magnetic resonance angiography. CONCLUSION: Atherosclerosis may be the essential factor in the pathogenesis of a fusiform aneurysm of the basilar artery, especially in elderly patients. The best treatment option is yet to be determined, but in soite of numerous previous large studies, personalized approach is probably the best.

Spontaneous true aneurysm of the superficial temporal artery presenting as an asymptomatic forehead mass.

Superficial temporal artery aneurysms are rare; when they do occur, they are usually associated with head trauma. Spontaneous true aneurysms of the superficial temporal artery are extremely rare. They are classified as true aneurysms when all three layers of the vessel are found to be involved on histologic examination. Therapeutic options include conservative management, image-guided embolization, and surgical excision. We report a case of an extracranial spontaneous aneurysm of the frontal branch of the superficial temporal artery. A 20-year-old man presented with an asymptomatic, pulsatile, 1-cm forehead mass that had gradually increased in size. The aneurysm was evaluated by clinical examination and three-dimensional computed tomographic angiography. Complete resection was performed with local anesthesia. Histologic examination revealed that the aneurysm involved all three layers of the blood vessel: the tunica intima, tunica media, and tunica adventitia. No atherosclerotic changes or inflammatory cells were found. To the best of our knowledge, this is only the third reported case of a histologically verified spontaneous aneurysm of the frontal branch of the superficial temporal artery. Awareness of this rare pathology in the differential diagnosis of a forehead mass may facilitate diagnosis and prevent complications.

Convexity meningioma associated with depression: a case report.

INTRODUCTION: Meningiomas are slow growing, extra-axial lesions, and can be neurologically silent for a long time and present only with depression. CASE OUTLINE: A 65-year-old woman developed major depression and was treated with antidepressants for two years. Depression failed to respond to drug treatment and there was no improvement. Two months before admission to hospital, due to the onset of epilepsy attack the patient underwent rein- vestigation, and a large temporal convexity meningioma, which corresponded in position to the original electroencephalography focus, was diagnosed using the computer topography of the brain. The patient underwent osteoplastic craniotomy, and a left fronto-temporal convexity meningioma of 5 cm in diameter was completely removed with its attachment to the dura. Histological examination confirmed a fibroblastic meningioma. CONCLUSION: Total resection of convexity meningioma and decompression of the brain tissue in the region of limbic pathways that are involved, may contribute to a complete remission of depression symptoms. This case also illustrates the need for a prompt neuroimaging of the brain when patients present any atypical psychiatric symptoms, with late onset (> 50 years old) of the first depressive episode or fast changes of the mental state.

Falx chondroma with hyperostosis of the scull: a case report.

INTRODUCION: Intracranial chondroma is a very rare, slow growing, benign cartilaginous tumor that arises usually from the base of the scull. Chondroma located at the falx is extremely rare. According to our best knowledge 15 cases of falx chondromas have been reported in the literature. CASE OUTLINE: This is the first case report of falx chondroma located in the parietal area associated with hyperostosis. Magnetic resonance imaging of the brain revealed a 3x4x4 cm solid, calcified, ring-shaped, well-defined tumor at the posterior falx.The patient underwent surgery and complete resection was performed. Histological examination confirmed chondroma of the falx. Postoperative CT scan showed no residual of tumor and the patient was discharged. CONCLUSION: The long-term prognosis is good after a total excision of the tumor. Awareness of this rare pathology in the differential diagnosis of falx mass could facilitate the diagnosis.

Spinal metastasis of medulloblastoma in adults: a case report.

INTRODUCTION: Medulloblastoma is a primitive neuro-ectodermal malignant tumor most commonly seen in childhood and rarely and uncommonly in adult age. Treatment consists of surgery followed by radiotherapy. In the case of a relapse there is no overall accepted treatment. Tumor metastasis can be seen along the neural axis, lymph nodes, soft tissues, bones and distant organs. CASE OUTLINE: In this paper we present a 45-year-old female patient with a thoraco-spinal extramedullary metastatic medulloblastoma and progressive neurological deterioration seen 11 months after the first operation and description of magnetic resonance and intraoperative finding. CONCLUSION: Although rare, the presence of metastasis is a poor prognostic factor. The treatment options for patients with metastases are limited and their prognosis continues to remain poor.

Surgical treatment of intradiploic epidermoid cyst treated as depression.

INTRODUCTION: Extradural intradiploic epidermoid cysts are rare, representing less than 0.25% of all primary intracranial tumors. They can be neurologically silent and can only present psychiatric symptoms like depression, cognitive or personality changes. CASE OUTLINE: A 68-year-old male with two year long history of depressive mood, lack of motivation, helplessness, hopelessness and poor response to antidepressive drug therapy was described. CT scan showed a well-defined mass in the parietal scalp with destruction of the scull. He underwent intracranial tumor resection. Surgical resection and cranioplasty were performed. Pathology confirmed intradiploic epidermoid cyst. CONCLUSION: Total removal of these cysts and repeated washing of the cavity with 0.9% saline may prevent recurrence and aseptic meningitis and may improve mental state of the patient. We also emphasize the need for neuroimaging studies in a patient with atypical changes in mental status, even without neurological signs or symptoms.

Simulation of wind-driven dispersion of fire pollutants in a street canyon using FDS.

Air quality in urban areas attracts great attention due to increasing pollutant emissions and their negative effects on human health and environment. Numerous studies, such as those by Mouilleau and Champassith (J Loss Prevent Proc 22(3): 316-323, 2009), Xie et al. (J Hydrodyn 21(1): 108-117, 2009), and Yassin (Environ Sci Pollut Res 20(6): 3975-3988, 2013) focus on the air pollutant dispersion with no buoyancy effect or weak buoyancy effect. A few studies, such as those by Hu et al. (J Hazard Mater 166(1): 394-406, 2009; J Hazard Mater 192(3): 940-948, 2011; J Civ Eng Manag (2013)) focus on the fire-induced dispersion of pollutants with heat buoyancy release rate in the range from 0.5 to 20 MW. However, the air pollution source might very often be concentrated and intensive, as a consequence of the hazardous materials fire. Namely, transportation of fuel through urban areas occurs regularly, because it is often impossible to find alternative supply routes. It is accompanied with the risk of fire accident occurrences. Accident prevention strategies require analysis of the worst scenarios in which fire products jeopardize the exposed population and environment. The aim of this article is to analyze the impact of wind flow on air pollution and human vulnerability to fire products in a street canyon. For simulation of the gasoline tanker truck fire as a result of a multivehicle accident, computational fluid dynamics large eddy simulation method has been used. Numerical results show that the fire products flow vertically upward, without touching the walls of the buildings in the absence of wind. However, when the wind velocity reaches the critical value, the products touch the walls of the buildings on both sides of the street canyon. The concentrations of carbon monoxide and soot decrease, whereas carbon dioxide concentration increases with the rise of height above the street canyon ground level. The longitudinal concentration of the pollutants inside the street increases with the rise of the wind velocity at the roof level of the street canyon.

[Epidemiological features of brain tumors].

Brain tumors account for 1.4% of all cancers and 2.4% of all cancer-related deaths. The incidence of brain tumors varies and it is higher in developed countries of Western Europe, North America, Australia and New Zealand. In Serbia, according to data from 2009, malignant brain tumors account for 2.2 of all tumors, and from all cancer-related deaths, 3.2% is caused by malignant brain tumors. According to recent statistical reports, an overall incidence of brain tumors for benign and malignant tumors combined is 18.71 per 100,000 persons/year. The most common benign brain tumor in adults is meningioma, which is most present in women, and the most common malignant tumor is glioblastoma, which is most present in adult men. Due to high mortality, especially in patients diagnosed with glioblastoma and significant brain tumor morbidity, there is a constant interest in understanding its etiology in order to possibly prevent tumor occurrence in future and enable more efficient treatment strategies for this fatal brain disease. Despite the continuously growing number of epidemiological studies on possible factors of tumor incidence, the etiology remains unclear. The only established environmental risk factor of gliomas is ionizing radiation exposure. Exposure to radiofrequency electromagnetic fields via cell phone use has gained a lot of attention as a potential risk factor of brain tumor development. However, studies have been inconsistent and inconclusive, so more definite results are still expected.