Nodules et carcinomes thyroïdiens

Face à l’augmentation des incidentalomes thyroïdiens, la gestion appropriée des nodules thyroïdiens est primordiale afin de permettre la détection des cancers relevants et d’éviter le surdiagnostic et le surtraitement des microcarcinomes papillaires. Cet article décrit les grandes lignes de la prise en charge en tenant compte des nouvelles recommandations

Seasonal forecasting of snow resources at Alpine sites

Climate warming in mountain regions is resulting in glacier shrinking, seasonal snow cover reduction, and changes in the amount and seasonality of meltwater runoff, with consequences on water availability. Droughts are expected to become more severe in the future with economical and environmental losses both locally and downstream. Effective adaptation strategies involve multiple timescales, and seasonal forecasts can help in the optimization of the available snow and water resources with a lead time of several months. We developed a prototype to generate seasonal forecasts of snow depth and snow water equivalent with a starting date of 1 November and a lead time of 7 months, so up to 31 May of the following year. The prototype has been co-designed with end users in the field of water management, hydropower production and mountain ski tourism, meeting their needs in terms of indicators, time resolution of the forecasts and visualization of the forecast outputs. In this paper we present the modelling chain, based on the seasonal forecasts of the ECMWF and Meteo-France seasonal prediction systems, made available through the Copernicus Climate Change Service (C3S) Climate Data Store. Seasonal forecasts of precipitation, near-surface air temperature, radiative fluxes, wind and relative humidity are bias-corrected and downscaled to three sites in the Western Italian Alps and finally used as input for the physically based multi-layer snow model SNOWPACK. Precipitation is bias-corrected with a quantile mapping method using ERA5 reanalysis as a reference and then downscaled with the RainFARM stochastic procedure in order to allow an estimate of uncertainties due to the downscaling method. The impacts of precipitation bias adjustment and downscaling on the forecast skill have been investigated. The skill of the prototype in predicting the deviation of monthly snow depth with respect to the normal conditions from November to May in each season of the hindcast period 1995-2015 is demonstrated using both deterministic and probabilistic metrics. Forecast skills are determined with respect to a simple forecasting method based on the climatology, and station measurements are used as reference data. The prototype shows good skills at predicting the tercile category, i.e. snow depth below and above normal, in the winter (lead times: 2-3-4 months) and spring (lead times: 5-6-7 months) ahead: snow depth is predicted with higher accuracy (Brier skill score) and higher discrimination (area under the relative operating characteristics (ROC) curve skill score) with respect to a simple forecasting method based on the climatology. Ensemble mean monthly snow depth forecasts are significantly correlated with observations not only at short lead times of 1 and 2 months (November and December) but also at lead times of 5 and 6 months (March and April) when employing the ECMWFS5 forcing. Moreover the prototype shows skill at predicting extremely dry seasons, i.e. seasons with snow depth below the 10th percentile, while skills at predicting snow depth above the 90th percentile are model-, station- and score-dependent.The bias correction of precipitation forecasts is essential in the case of large biases in the global seasonal forecast system (MFS6) to reconstruct a realistic snow depth climatology; however, no remarkable differences are found among the skill scores when the precipitation input is bias-corrected, downscaled, or bias-corrected and downscaled, compared to the case in which raw data are employed, suggesting that skill scores are weakly sensitive to the treatment of the precipitation input

Impact of HPV vaccination with Gardasil® in Switzerland.

Gardasil®, a quadrivalent vaccine targeting low-risk (6, 11) and high-risk (16, 18) human papillomaviruses (HPV), has been offered to 11-14 year-old schoolgirls in Switzerland since 2008. To evaluate its success and its potential impact on cervical cancer screening, HPV genotypes were examined in 18-year-old girls five years later (sub-study 1) and in outpatients participating to cervical cancer screening before and after vaccine implementation (sub-study 2). For sub-study 1, 3726 females aged 18 in 2013 were invited to fill a questionnaire on personal demographics and HPV risk factors and to provide a self-collected cervicovaginal sample for HPV genotyping and Chlamydia trachomatis PCR. Personal data were evaluated by univariable and multivariable statistics. In sub-study 2, the proportion of the vaccine-type HPV among anogenital HPV was examined with archived genotyping data of 8039 outpatients participating to cervical cancer screening from 1999 till 2015. The yearly evolution of this proportion was evaluated by segmented logistic regression. 690 (18.5%) women participated to sub-study 1 and 327 (8.8%) provided a self-collected sample. Prevalence of Chlamydia trachomatis (4.6%) and demographics confirmed that the subjects were representative of sexually-active Swiss young women. Vaccine (five-year coverage: 77.5%) was preferentially accepted by contraceptive-pill users (P = 0.001) and samples were mainly provided by sexually-active subjects (P < 0.001). The proportion (4%) of the vaccine-type HPV in this population was lower than in sub-study 2 outpatients (n = 849, <26 years old) in the pre-vaccine era (25.7%). The proportion of the high-risk vaccine-type HPV decreased significantly (59%, P = 0.0048) in the outpatients during the post-vaccine era, yet this decrease was restricted to those aged less than 26 years (n = 673, P < 0.0001). The low proportion of vaccine-type HPV in 18-year-old females and its rapid decrease in young women participating to cervical cancer screening extend the success of HPV vaccination to Switzerland. Our data suggest that cervical cancer screening is now entering a stage of reduced proportion of HPV16 and/or 18 in samples reported positive by cytology. In view of the high likelihood of reduced clinical specificity of cytology, primary screening modalities involving HPV testing and cytology should now be re-evaluated in Switzerland

The MEV project: design and testing of a new high-resolution telescope for Muography of Etna Volcano

The MEV project aims at developing a muon telescope expressly designed for the muography of Etna Volcano. In particular, one of the active craters in the summit area of the volcano would be a suitable target for this experiment. A muon tracking telescope with high imaging resolution was built and tested during 2017. The telescope is a tracker based on extruded scintillating bars with WLS fibres and featuring an innovative read-out architecture. It is composed of three XY planes with a sensitive area of \SI{1}{m^2}; the angular resolution does not exceeds \SI{0.4}{\milli\steradian} and the total angular aperture is about $\pm$\SI{45}{\degree}. A special effort concerned the design of mechanics and electronics in order to meet the requirements of a detector capable to work in a hostile environment such as the top of a tall volcano, at a far distance from any facility. The test phase started in January 2017 and ended successfully at the end of July 2017. An extinct volcanic crater (the Monti Rossi, in the village of Nicolosi, about 15km from Catania) is the target of the measurement. The detector acquired data for about 120 days and the preliminary results are reported in this work

Seasonal forecasting of snow resources at Alpine sites

Climate warming in mountain regions is resulting in glacier shrinking, seasonal snow cover reduction, and changes in the amount and seasonality of meltwater runoff, with consequences on water availability. Droughts are expected to become more severe in the future with economical and environmental losses both locally and downstream. Effective adaptation strategies involve multiple timescales, and seasonal forecasts can help in the optimization of the available snow and water resources with a lead time of several months. We developed a prototype to generate seasonal forecasts of snow depth and snow water equivalent with a starting date of 1 November and a lead time of 7 months, so up to 31 May of the following year. The prototype has been co-designed with end users in the field of water management, hydropower production and mountain ski tourism, meeting their needs in terms of indicators, time resolution of the forecasts and visualization of the forecast outputs. In this paper we present the modelling chain, based on the seasonal forecasts of the ECMWF and Météo-France seasonal prediction systems, made available through the Copernicus Climate Change Service (C3S) Climate Data Store. Seasonal forecasts of precipitation, near-surface air temperature, radiative fluxes, wind and relative humidity are bias-corrected and downscaled to three sites in the Western Italian Alps and finally used as input for the physically based multi-layer snow model SNOWPACK. Precipitation is bias-corrected with a quantile mapping method using ERA5 reanalysis as a reference and then downscaled with the RainFARM stochastic procedure in order to allow an estimate of uncertainties due to the downscaling method. The impacts of precipitation bias adjustment and downscaling on the forecast skill have been investigated. The skill of the prototype in predicting the deviation of monthly snow depth with respect to the normal conditions from November to May in each season of the hindcast period 1995–2015 is demonstrated using both deterministic and probabilistic metrics. Forecast skills are determined with respect to a simple forecasting method based on the climatology, and station measurements are used as reference data. The prototype shows good skills at predicting the tercile category, i.e. snow depth below and above normal, in the winter (lead times: 2–3–4 months) and spring (lead times: 5–6–7 months) ahead: snow depth is predicted with higher accuracy (Brier skill score) and higher discrimination (area under the relative operating characteristics (ROC) curve skill score) with respect to a simple forecasting method based on the climatology. Ensemble mean monthly snow depth forecasts are significantly correlated with observations not only at short lead times of 1 and 2 months (November and December) but also at lead times of 5 and 6 months (March and April) when employing the ECMWFS5 forcing. Moreover the prototype shows skill at predicting extremely dry seasons, i.e. seasons with snow depth below the 10th percentile, while skills at predicting snow depth above the 90th percentile are model-, station- and score-dependent. The bias correction of precipitation forecasts is essential in the case of large biases in the global seasonal forecast system (MFS6) to reconstruct a realistic snow depth climatology; however, no remarkable differences are found among the skill scores when the precipitation input is bias-corrected, downscaled, or bias-corrected and downscaled, compared to the case in which raw data are employed, suggesting that skill scores are weakly sensitive to the treatment of the precipitation input.</p

A durable coating to prevent stress corrosion effects on the surface strength of annealed glass

The durability of an innovative polymeric coating recently developed by the authors to prevent stress corrosion in annealed glass is herein examined. The coating, having functional graded properties through the thickness, is optimised to provide a very good adhesion with glass and an excellent hydrophobic behavior on the side exposed to the environment, thus creating a good barrier to humidity, which is the triggering agent for stress corrosion. Three scenarios are analysed in terms of ageing: (i) cyclic loading, accomplished by subjecting coated samples to repetitive loading; (ii) natural weathering, performed by exposing coated samples to atmospheric agents; (iii) artificial weathering, carried out by exposing coated specimens to fluorescent UV lamps, heat and water. The durability of the coating is assessed indirectly, on the base of its residual effectiveness in preventing stress corrosion, by comparing the bending strength, obtained with the coaxial double ring test, of aged coated glass specimens with that of un-coated and freshly coated specimens. The obtained results prove that the proposed formulation is almost insensitive to cyclic loading, maintains a very good performance in case of natural weathering, whereas is slightly more sensitive to artificial weathering

Relaxation processes in thiophene-based random copolymers

The relaxation dynamics of soluble polyalkylthiophenes obtained by the random copolymerisation of 3,4-dibutylthiophene and 3-butylthiophene monomers is investigated. In these systems, the effective conjugation length, the optical gap and the non-radiative decay rate are controlled by varying the content of disubstituted monomers, the steric hindrance of which induces a twisting angle between thiophene rings. Several indications are reported in favour of spectral diffusion of the photoexcitations. Migration processes mainly occur within a few tens of picoseconds