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The Himalayan glaciers contribute significantly to regional water resources. However, limited field observations restrict our understanding of glacier dynamics and behaviour. Here, we investigated the long-term in situ mass balance, meteorology, ice velocity and discharge of the Chhota Shigri Glacier. The mean annual glacier-wide mass balance was negative, −0.46 ± 0.40 m w.e. a−1 for the period 2002–2019 corresponding to a cumulative wastage of −7.87 m w.e. Winter mass balance was 1.15 m w.e. a−1 and summer mass balance was −1.35 m w.e. a−1 over 2009–2019. Surface ice velocity has decreased on average by 25–42% in the lower and middle ablation zone (below 4700 m a.s.l.) since 2003; however, no substantial change was observed at higher altitudes. The decrease in velocity suggests that the glacier is adjusting its flow in response to negative mass balance. The summer discharge begins to rise from May and peaks in July, with a contribution of 43%, followed by 38% and 19% in August and September, respectively. The discharge pattern closely follows the air temperature. The long-term observation on the ‘Chhota Shigri – a benchmark glacier’, shows a mass wastage which corresponds to the slowdown of the glacier in the past two decades.
We present the first-ever mass-balance (MB) observation (2014–19), reconstruction (between 1978 and 2019) and sensitivity of debris-free Stok glacier (33.98°N, 77.45°E), Ladakh Region, India. In-situ MB was negative throughout the study period except in 2018/19 when the glacier witnessed a balanced condition. For MB modelling, three periods were considered based on the available data. Period I (1978–87, 1988/89) witnessed a near balance condition (−0.03 ± 0.35 m w.e. a−1) with five positive MB years. Whereas Period II (1998–2002, 2003–09) and III (2011–19) experienced high (−0.9 ± 0.35 m w.e. a−1) and moderate (−0.46 ± 0.35 m w.e. a−1) negative MBs, respectively. Glacier area for these periods was derived from the Corona, Landsat and PlanetScope imageries using a semi-automatic approach. The in-situ and modelled MBs were in good agreement with RMSE of 0.23 m w.e. a−1, R2 = 0.92, P < 0.05. The average mass loss was moderate (−0.47 ± 0.35 m w.e. a−1) over 28 hydrological years between 1978 and 2019. Sensitivity analysis showed that the glacier was more sensitive to summer temperature (−0.32 m w.e. a−1 °C−1) and winter precipitation (0.12 m w.e. a−1 for ± 10%). It was estimated that ~27% increase in precipitation is required on Stok glacier to compensate for the mass loss due to 1°C rise in temperature.
Little is known about the Himalayan glaciers, although they are of particular interest in terms of future water supply, regional climate change and sea-level rise. In 2002, a long-term monitoring programme was started on Chhota Shigri Glacier (32.2° N, 77.5° E; 15.7 km2, 6263–4050 ma.s.l., 9 km long) located in Lahaul and Spiti Valley, Himachal Pradesh, India. This glacier lies in the monsoon–arid transition zone (western Himalaya) which is alternately influenced by Asian monsoon in summer and the mid-latitude westerlies in winter. Here we present the results of a 4 year study of mass balance and surface velocity. Overall specific mass balances are mostly negative during the study period and vary from a minimum value of –1.4 m w.e. in 2002/03 and 2005/06 (equilibrium-line altitude (ELA) ∼5180 m a.s.l.) to a maximum value of +0.1 m w.e. in 2004/05 (ELA 4855 m a.s.l.). Chhota Shigri Glacier seems similar to mid-latitude glaciers, with an ablation season limited to the summer months and a mean vertical gradient of mass balance in the ablation zone (debris-free part) of 0.7mw.e.(100 m)–1, similar to those reported in the Alps. Mass balance is strongly dependent on debris cover, exposure and the shading effect of surrounding steep slopes.
The earthquake that occurred in Taiwan on 21 September 1999 killed >2,000 people and severely injured many survivors. Despite the large scale and sizeable impact of the event, a complete overview of its consequences and the causes of the inadequate rescue and treatment efforts is limited in the literature. This review examines the way different groups coped with the tragedy and points out the major mistakes made during the process. The effectiveness of Taiwan's emergency preparedness and disaster response system after the earthquake was analyzed.
Problems encountered included: (1) an ineffective command center; (2) poor communication; (3) lack of cooperation between the civil government and the military; (4) delayed prehospital care; (5) overloading of hospitals beyond capacity; (6) inadequate staffing; and (7) mismanaged public health measures.
The Taiwan Chi-Chi Earthquake experience demonstrates that precise disaster planning, the establishment of one designated central command, improved cooperation between central and local authorities, modern rescue equipment used by trained disaster specialists, rapid prehospital care, and medical personnel availability, as well earthquake-resistant buildings and infrastructure, are all necessary in order to improve disaster responses.
Headache is a very common complaint, with three out of four Americans experiencing a headache each year. However, only a small percentage of them seek medical care. Headaches account for approximately 2 million emergency department (ED) visits each year in the US. A patient with a headache may have a serious or minor etiology for his or her headache. The differential diagnosis of headache is complex and long. Headache can be divided into primary or secondary disorders (Table 25.1). Primary headaches, such as migraines, cluster, and tension-type headaches account for 90% of headaches in clinical practice. Secondary headaches include tumors, aneurysms, and meningitis, and have an identifiable, distinct pathologic process in which head pain is a presenting symptom. Most patients presenting to the ED have a benign headache requiring symptomatic treatment and referral. A small subset of patients who present with a headache will have a life-threatening illness; it is the primary goal of the treating clinician to identify these patients and provide appropriate care.
The pain from headache can originate from extracranial or intracranial structures. Extracranial structures that can cause pain include skin, blood vessels, muscles, and bone. The brain parenchyma, most of the dura, the arachnoid, and pia mater have no pain fibers and do not produce pain. Intracranial structures with pain fibers include venous sinuses, the dura at the base of the skull, dural arteries, the falx cerebri, and large arteries at the base of the brain.
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