Regional evaluation of three day snow depth for avalanche hazard mapping in Switzerland

The distribution of the maximum annual three day snow fall depth <i>H<sub>72</sub></i>, used for avalanche hazard mapping according to the Swiss procedure (<i>Sp</i>), is investigated for a network of 124 stations in the Alpine part of Switzerland, using a data set dating back to 1931. Stationarity in time is investigated, showing in practice no significant trend for the considered period. Building on previous studies about climatology of Switzerland and using an iterative approach based on statistical tests for regional homogeneity and scaling of <i>H<sub>72</sub></i> with altitude, seven homogenous regions are identified. A regional approach based on the index value is then developed to estimate the <i>T</i>-years return period quantiles of <i>H<sub>72</sub></i> at each single site <i>i</i>, <i>H<sub>72i</sub>(T)</i>. The index value is the single site sample average μ<sub><i>H<sub>72i</sub></i></sub>. The dimensionless values of <i>H<sup>*</sup><sub>72i</sub>=H<sub>72i</sub> / μ<sub>H<sub>72i</sub></sub></i> are grouped in one sample for each region and their frequency of occurrence is accommodated by a General Extreme Value, GEV, probability distribution, including Gumbel. The proposed distributions, valid in each site of the homogeneous regions, can be used to assess the <i>T</i>-years return period quantiles of <i>H<sup>*</sup><sub>72i</sub></i>. It is shown that the value of <i>H<sub>72i</sub>(T)</i> estimated with the regional approach is more accurate than that calculated by single site distribution fitting, particularly for high return periods. A sampling strategy based on accuracy is also suggested to estimate the single site index value, i.e. the sample average μ<sub><i>H<sub>72i</sub></i></sub>, critical for the evaluation of the distribution of <i>H<sub>72i</sub></i>. The proposed regional approach is valuable because it gives more accurate snow depth input to dynamics models than the present procedure based on single site analysis, so decreasing uncertainty in hazard mapping procedure

The Movember Foundation's GAP3 cohort : a profile of the largest global prostate cancer active surveillance database to date

Objectives: The Movember Foundation launched the Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative to create a global consensus on the selection and monitoring of men with low-risk prostate cancer (PCa) on active surveillance (AS). The aim of this study is to present data on inclusion and follow-up for AS in this unique global AS database. Patients and Methods: Between 2014 and 2016, the database was created by combining patient data from 25 established AS cohorts worldwide (USA, Canada, Australasia, UK and Europe). Data on a total of 15 101 patients were included. Descriptive statistics were used to report patients' clinical and demographic characteristics at the time of PCa diagnosis, clinical follow-up, discontinuation of AS and subsequent treatment. Cumulative incidence curves were used to report discontinuation rates over time. Results: At diagnosis, the median (interquartile range [IQR]) patient age was 65 (60\u201370) years and the median prostate-specific antigen level was 5.4 (4.0\u20137.3) ng/mL. Most patients had clinical stage T1 disease (71.8%), a biopsy Gleason score of 6 (88.8%) and one tumour-positive biopsy core (60.3%). Patients on AS had a median follow-up time of 2.2 (1.0\u20135.0) years. After 5, 10 and 15 years of follow-up, respectively, 58%, 39% and 23% of patients were still on AS. The current version of GAP3 has limited data on magnetic resonance imaging (MRI), quality of life and genomic testing. Conclusions: GAP3 is the largest worldwide collaboration integrating patient data from men with PCa on AS. The results will allow individual patients and clinicians to have greater confidence in the personalized decision to either delay or proceed with active treatment. Longer follow-up and the evaluation of MRI, new genomic markers and patient-related outcomes will result in even more valuable data and eventually in better patient outcomes

The Movember Foundation's GAP3 cohort: a profile of the largest global prostate cancer active surveillance database to date

OBJECTIVES: The Movember Foundation launched the Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative to create a global consensus on the selection and monitoring of men with low‐risk prostate cancer (PCa) on active surveillance (AS). The aim of this study is to present data on inclusion and follow‐up for AS in this unique global AS database. PATIENTS AND METHODS: Between 2014 and 2016, the database was created by combining patient data from 25 established AS cohorts worldwide (USA, Canada, Australasia, UK and Europe). Data on a total of 15 101 patients were included. Descriptive statistics were used to report patients' clinical and demographic characteristics at the time of PCa diagnosis, clinical follow‐up, discontinuation of AS and subsequent treatment. Cumulative incidence curves were used to report discontinuation rates over time. RESULTS: At diagnosis, the median (interquartile range [IQR]) patient age was 65 (60–70) years and the median prostate‐specific antigen level was 5.4 (4.0–7.3) ng/mL. Most patients had clinical stage T1 disease (71.8%), a biopsy Gleason score of 6 (88.8%) and one tumour‐positive biopsy core (60.3%). Patients on AS had a median follow‐up time of 2.2 (1.0–5.0) years. After 5, 10 and 15 years of follow‐up, respectively, 58%, 39% and 23% of patients were still on AS. The current version of GAP3 has limited data on magnetic resonance imaging (MRI), quality of life and genomic testing. CONCLUSIONS: GAP3 is the largest worldwide collaboration integrating patient data from men with PCa on AS. The results will allow individual patients and clinicians to have greater confidence in the personalized decision to either delay or proceed with active treatment. Longer follow‐up and the evaluation of MRI, new genomic markers and patient‐related outcomes will result in even more valuable data and eventually in better patient outcomes

New evidence from Italy (Adamello Group, Lombardy) for analysing the ongoing decline of Alpine glaciers

Glaciers worldwide are showing overwhelming evidence of the impact of climatic change. In the Alpine region the warming experienced since the early 1980s, while synchronous with warming at the global scale, is of a far greater amplitude and exceeds 1 \ub0C, which represents roughly a three-fold amplification of the global climate signal. To evaluate the magnitude of climate change impacts, recent data covering large and representative areas are needed. This paper is aimed at contributing to describe the recent evolution of Alpine glaciers by analysing surface area changes in a representative subset of data (34 glaciers located in the Adamello Group, Lombardy, Italy). Four surface area records, for the years 1983, 1991, 1999 and 2003, were analysed. The 1983, 1999 and 2003 surface area records were compiled by the authors by combining aerial photo analysis, Differential Global Positioning System (DGPS) surveys of glaciers and Geographic Information System (GIS) data processing. The analysis led to a quantification of surface reduction: c. 19% from 1983 to 2003 for glaciers in the Adamello group. Small glaciers proved to contribute strongly to total area loss: in 2003, 31 glaciers (c. 91% of the total number) were smaller than 1 km2, covering 2.28 km2 (c. 10% of the total area), but accounted for 39% of the total loss in area (losing 2.05 km2 from 1983 to 2003). The rate of area change accelerated in the later period, with surface reduction between 1999 and 2003 amounting to c. 5.5% (with respect to the 1999 total glacier coverage), equal to a mean area loss of c. 0.34 km 2 /year; the mean yearly loss over the previous period (1991-1999) was found equal to 0.23 km2/year. This acceleration coincided with a clear local warming and a small local decrease in snow cover depth and duration which resulted strongly related to North Atlantic Oscillation (NAO) winter variability

Survival benefits of different antiadrenergic interventions in pressure overload left ventricular hypertrophy/failure

We observed previously that in rats with aortic banding (Bd), development of left ventricular (LV) hypertrophy is opposed by beta-blockade, whereas interventions interfering with alpha-adrenoceptor function also inhibit interstitial fibrosis. To assess whether these differential structural effects do translate into different effects on LV function and on heart failure mortality, Bd or sham Bd 8-week-old rats were randomized to vehicle treatment (Vh), chemical sympathectomy ([Sx] 6-hydroxydopamine, 150 mg/kg IP twice a week), beta-adrenoceptor blockade (propranolol [Pro], 40 mg/kg per day PO), or alpha-adrenoceptor blockade (doxazosin [Dox], 5 mg/kg per day PO). After monitoring survival for 10 weeks, the survivors were anesthetized to undergo echocardiography and intraarterial blood pressure measurement. Bd-Vh rats showed increased LV and lung weights, as well as LV dilation, depressed endocardial and midwall fractional shortening and a restrictive transmitral diastolic flow velocity pattern. Compared with Bd-Vh rats, all of the actively treated Bd rats showed less LV hypertrophy, LV dilation, and lung congestion but no less depression of midwall fractional shortening. In contrast, Sx and Dox but not Pro treatment were also associated with lesser degrees of diastolic dysfunction and, even more importantly, with a striking increase in survival (sham banded rats, 100%; Bd-Vh, 40%; Bd-Pro, 51%; Bd-Sx, 83%; and Bd-Dox, 82%). Although Pro, Sx, and Dox provide similar midterm protection from development of LV hypertrophy and dysfunction and from circulatory congestion, only Sx and Dox favorably affected mortality. These findings indicate that in the aortic banding rat model, alpha-adrenoceptors are importantly involved in the pathogenesis of cardiovascular deterioration and disease progression