Coupling a distributed grid based hydrological model and MM5 meteorological model for flooding alert mapping

International audienceThe increased number of extreme rainfall events seems to be one of the common feature of climate change signal all over the world (Easterlin et al., 2000; Meehl et al., 2000). In the last few years a large number of floods caused by extreme meteorological events has been observed over the river basins of Mediterranean area and they mainly affected small basins (few hundreds until few thousands of square kilometres of drainage area) . A strategic goal of applied meteorology is now to try to predict with high spatial resolution the segments of drainage network where floods may occur. A possible way to reach this aim is the coupling of meteorological mesoscale model with high resolution hydrological model. In this work few case studies of observed floods in the Italian Mediterranean area will be presented. It is shown how a distributed hydrological model, using the precipitation fields predicted by MM5 meteorological model, is able to highlight the area where the major floods may occur

Thermally driven circulation in a region of complex topography: comparison of wind-profiling radar measurements and MM5 numerical predictions

The diurnal variation of regional wind patterns in the complex terrain of Central Italy was investigated for summer fair-weather conditions and winter time periods using a radar wind profiler. The profiler is located on a site where interaction between the complex topography and land-surface produces a variety of thermally and dynamically driven wind systems. The observational data set, collected for a period of one year, was used first to describe the diurnal evolution of thermal driven winds, second to validate the Mesoscale Model 5 (MM5) that is a three-dimensional numerical model. This type of analysis was focused on the near-surface wind observation, since thermally driven winds occur in the lower atmosphere. According to the valley wind theory expectations, the site – located on the left sidewall of the valley (looking up valley) – experiences a clockwise turning with time. Same characteristics in the behavior were established in both the experimental and numerical results. <P style="line-height: 20px;"> Because the thermally driven flows can have some depth and may be influenced mainly by model errors, as a third step the analysis focuses on a subset of cases to explore four different MM5 Planetary Boundary Layer (PBL) parameterizations. The reason is to test how the results are sensitive to the selected PBL parameterization, and to identify the better parameterization if it is possible. For this purpose we analysed the MM5 output for the whole PBL levels. The chosen PBL parameterizations are: 1) Gayno-Seaman; 2) Medium-Range Forecast; 3) Mellor-Yamada scheme as used in the ETA model; and 4) Blackadar

Determining the date of diagnosis – is it a simple matter? The impact of different approaches to dating diagnosis on estimates of delayed care for ovarian cancer in UK primary care

Background Studies of cancer incidence and early management will increasingly draw on routine electronic patient records. However, data may be incomplete or inaccurate. We developed a generalisable strategy for investigating presenting symptoms and delays in diagnosis using ovarian cancer as an example. Methods The General Practice Research Database was used to investigate the time between first report of symptom and diagnosis of 344 women diagnosed with ovarian cancer between 01/06/2002 and 31/05/2008. Effects of possible inaccuracies in dating of diagnosis on the frequencies and timing of the most commonly reported symptoms were investigated using four increasingly inclusive definitions of first diagnosis/suspicion: 1. "Definite diagnosis" 2. "Ambiguous diagnosis" 3. "First treatment or complication suggesting pre-existing diagnosis", 4 "First relevant test or referral". Results The most commonly coded symptoms before a definite diagnosis of ovarian cancer, were abdominal pain (41%), urogenital problems(25%), abdominal distension (24%), constipation/change in bowel habits (23%) with 70% of cases reporting at least one of these. The median time between first reporting each of these symptoms and diagnosis was 13, 21, 9.5 and 8.5 weeks respectively. 19% had a code for definitions 2 or 3 prior to definite diagnosis and 73% a code for 4. However, the proportion with symptoms and the delays were similar for all four definitions except 4, where the median delay was 8, 8, 3, 10 and 0 weeks respectively. Conclusion Symptoms recorded in the General Practice Research Database are similar to those reported in the literature, although their frequency is lower than in studies based on self-report. Generalisable strategies for exploring the impact of recording practice on date of diagnosis in electronic patient records are recommended, and studies which date diagnoses in GP records need to present sensitivity analyses based on investigation, referral and diagnosis data. Free text information may be essential in obtaining accurate estimates of incidence, and for accurate dating of diagnoses

Does dapagliflozin regress left ventricular hypertrophy in patients with type 2 diabetes?:A prospective, double-blind, randomised, placebo-controlled study

Background: Patients with diabetes have a two to fourfold increased risk for development of and death from cardiovascular disease [CVD]. The current oral hypoglycaemic agents result in limited reduction in this cardiovascular risk. Sodium glucose linked co-transporter type 2 [SGLT2] inhibitors are a relatively new class of antidiabetic agent that have been shown to have potential cardiovascular benefits. In support of this, the EMPA-REG trial showed a striking 38% and 35% reduction in cardiovascular mortality and heart failure [HF] hospitalisation respectively. The exact mechanism (s) responsible for these effects remain (s) unclear. One potential mechanism is regression of Left ventricular hypertrophy (LVH).Methods: The DAPA-LVH trial is a prospective, double-blind, randomised, placebo-controlled 'proof of concept' single-centre study that has been ongoing since January 2017. It is designed specifically to assess whether the SGLT2 inhibitor dapagliflozin regresses left ventricular [LV] mass in patients with diabetes and left ventricular hypertrophy [LVH]. We are utilising cardiac and abdominal magnetic resonance imaging [MRI] and ambulatory blood pressure monitoring to quantify the cardiovascular and systemic effects of dapagliflozin 10 mg once daily against standard care over a 1 year observation period. The primary endpoint is to detect the changes in LV mass. The secondary outcomes are to assess the changes in, LV volumes, blood pressure, weight, visceral and subcutaneous fat.Discussion: This trial will be able to determine if SGLT2 inhibitor therapy reduces LV mass in patient with diabetes and LVH thereby strengthening their position as oral hypoglycaemic agents with cardioprotective benefits.Trial Registration: Clinical Trials.gov: NCT02956811 . Registered November 2016.</p

Identification of Source Faults of Large Earthquakes in the Turkey‐Syria Border Region Between 1000 CE and the Present, and Their Relevance for the 2023 Mw 7.8 Pazarcık Earthquake

The 6 February 2023, Mw 7.8 Pazarcık earthquake in the Turkey-Syria border region raises the question of whether such a large earthquake could have been foreseen, as well as what is the maximum possible magnitude (Mmax) of earthquakes on the East Anatolian Fault (EAF) system and on continental transform faults in general. To answer such questions, knowledge of past earthquakes and of their causative faults is necessary. Here, we integrate data from historical seismology, paleoseismology, archeoseismology, and remote sensing to identify the likely source faults of fourteen Mw ≥ 7 earthquakes between 1000 CE and the present in the region. We find that the 2023 Pazarcık earthquake could have been foreseen in terms of location (the EAF) and timing (an earthquake along this fault was if anything overdue), but not magnitude. We hypothesize that the maximum earthquake magnitude for the EAF is in fact 8.2, that is, a single end-to-end rupture of the entire fault, and that the 2023 Pazarcık earthquake did not reach Mmax by a fortuitous combination of circumstances. We conclude that such unusually large events are hard to model in terms of recurrence intervals, and that seismic hazard assessment along continental transforms cannot be done on individual fault systems but must include neighboring systems as well, because they are not kinematically independent at any time scale

Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems

Serial assessment of the electrocardiographic strain pattern for prediction of new‐onset heart failure during antihypertensive treatment: the LIFE study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106144/1/ejhfhfq224.pd

Age adjustment of cancer survival rates: methods, point estimates and standard errors

We empirically evaluated the performance of a new method for age adjustment of cancer survival compared to traditional age adjustment using data from the Finnish Cancer Registry. We find that both methods provide almost identical results for absolute survival but the new method generally provides more meaningful estimates of relative survival with often a smaller standard error