Modeling Nonconfined Density Currents Using 3D Hydrodynamic Models

Density currents generated by marine brine discharges, e.g., from desalination plants, can have a negative impact on marine ecosystems. It is therefore important to accurately predict their behavior. Predictions are often made using computational hydrodynamic models, which should be validated using field or laboratory measurements. This paper focuses on the setup and validation of three-dimensional (3D) models for estimating the transport and mixing processes that occur in these types of flows. Through a comprehensive sensitivity analysis based on the reproduction of several laboratory-generated density currents, a set of recommendations are made regarding the modeling aspects, including the domain discretization, the treatment of momentum at the density current source, the hydrostatic hypothesis and the selection of turbulence closure models. Finally, the proposed numerical model setup is validated using different experimental data showing good agreement in terms of the main variables considered: errors of less than 1.3% for dilution and of 6% for velocity. This study serves as a first step toward the full validation of these 3D hydrodynamic models for the simulation of field-scale density currents.This study was partially funded by the Ministry of Economy and Competitiveness (MINECO) under research project TRA2011-28900 (PLVMA3D). B. Pérez-Díaz would like to thank MINECO for providing funding under the FPI Program (research fellowship, reference number BES-2012-053693) and the Coasts and Ocean Group of HRWallingford for their assistance with numerical tasks

Application des recommandations dans la prise en charge du cancer de l’endomètre en pratique clinique. Étude rétrospective bretonne

National audienceObjective - To assess the use of French Cancer Institute recommendations for the diagnosis and treatment of endometrial cancer. Methods - Retrospective observational study involving 137 patients with endometrial cancer between 2011 and 2013. Results - Both MRI and pathological assessment with correct report as recommended were used for 66.4% of patients with endometrial cancer. For patients with correct preoperative assessment, 44.9% of patients were uncorrectly classified and upgraded on final pathological analysis of hysterectomy concerning lymph node involvement risk. These patients did not have confident surgical assessment, according this risk. Conclusion - To improve relevance of preoperative assessment in endometrial cancer, radiological and pathological expertise is required. However, even performed optimally, preoperative assessment does not allow correct risk stratification of lymph node involvement in endometrial cancer. This ineffective stratification leads to propose sentinel lymph node biopsy with hysterectomy in case of preoperative low risk endometrial cancer assessment

A Belgian consensus on the definition of a treat‐to‐target outcome set in psoriasis management

Objective: Treat-to-target (T2T) is an algorithm to reach a predefined outcome. Here, we define a T2T outcome for moderate-to-severe psoriasis vulgaris. Methods: Briefly, the study included a literature review, discussions with key opinion leaders, recruitment of additional dermatologists with experience in managing moderate-to-severe psoriasis, 3 eDelphi survey rounds and a patient focus group. Relevant topics were selected during discussions prior to the survey for the statements. Surveys were based on the eDelphi methodology for consensus-building using a series of statements. Consensus was defined as at least 80% of participants agreeing. A psoriasis patient focus group provided feedback on topic selection and outcome. Results: A total of 5 discussions were held, and 3 eDelphi rounds were conducted with an average of 19 participants per round. The T2T outcome was set assuming shared decision between patient and dermatologist, awareness and referral for comorbidities by the dermatologist and appropriate treatment adherence by the patient. We defined 'ideal' and 'acceptable' targets; the latter referring to conditions restricting certain drugs. The T2T outcome was multidimensional, including >= Delta PASI90/75 or PGA <= 1, itch VAS score <= 1, absence of disturbing lesions, DLQI <= 1/3, incapacity daily functioning VAS score <= 1, safety <= mild side-effects and full/mild tolerability of treatment for the ideal and acceptable target, respectively. Finally, time to achieve the T2T outcome was set at 12 weeks after initiation for all treatments. At all times, safety should not exceed the presence of mild side-effects. Conclusion: With this novel T2T composite outcome for psoriasis, clinicians and patients can make shared decisions on the treatment goals they envisage, as a guidance for future treatment steps - leading to a tight control management of the disease

New Model of Macrophage Acquisition of the Lymphatic Endothelial Phenotype

Macrophage-derived lymphatic endothelial cell progenitors (M-LECPs) contribute to new lymphatic vessel formation, but the mechanisms regulating their differentiation, recruitment, and function are poorly understood. Detailed characterization of M-LECPs is limited by low frequency in vivo and lack of model systems allowing in-depth molecular analyses in vitro. Our goal was to establish a cell culture model to characterize inflammation-induced macrophage-to-LECP differentiation under controlled conditions.Time-course analysis of diaphragms from lipopolysaccharide (LPS)-treated mice revealed rapid mobilization of bone marrow-derived and peritoneal macrophages to the proximity of lymphatic vessels followed by widespread (∼50%) incorporation of M-LECPs into the inflamed lymphatic vasculature. A differentiation shift toward the lymphatic phenotype was found in three LPS-induced subsets of activated macrophages that were positive for VEGFR-3 and many other lymphatic-specific markers. VEGFR-3 was strongly elevated in the early stage of macrophage transition to LECPs but undetectable in M-LECPs prior to vascular integration. Similar transient pattern of VEGFR-3 expression was found in RAW264.7 macrophages activated by LPS in vitro. Activated RAW264.7 cells co-expressed VEGF-C that induced an autocrine signaling loop as indicated by VEGFR-3 phosphorylation inhibited by a soluble receptor. LPS-activated RAW264.7 macrophages also showed a 68% overlap with endogenous CD11b(+)/VEGFR-3(+) LECPs in the expression of lymphatic-specific genes. Moreover, when injected into LPS- but not saline-treated mice, GFP-tagged RAW264.7 cells massively infiltrated the inflamed diaphragm followed by integration into 18% of lymphatic vessels.We present a new model for macrophage-LECP differentiation based on LPS activation of cultured RAW264.7 cells. This system designated here as the "RAW model" mimics fundamental features of endogenous M-LECPs. Unlike native LECPs, this model is unrestricted by cell numbers, heterogeneity of population, and ability to change genetic composition for experimental purposes. As such, this model can provide a valuable tool for understanding the LECP and lymphatic biology

Oil spill risk assessments for coastal zone protection In the Arabian Gulf

Introduction. Oil spills can be disastrous in terms of their ecological, social and economic effects on the coastal zone. In the Arabian Gulf, oil has the potential for accidental release into the marine environment across a range of operations, including coastal developments (ports, terminals, etc.), as well as offshore activities (oil and gas exploration, shipping, etc.). Accurate predictions of the fate and behaviour of spilled oil are therefore important and usually require the use of computational models. Simulations rely on a range of model predictions – including detailed hydrodynamic and meteorological fields – as well as adequate representation of the properties and physics of the spilled oil. Oil spill model assessment procedures. The authors have recently carried out research to establish best practice procedures for the assessment of the fate of spilled oil and its impact in coastal and offshore regions (Henno et al., 2015). An integrated framework for oil spill assessment was developed, using both established modelling tools and enhanced Lagrangian models. The study brought together expertise in coastal processes, metocean studies, the maritime industry and marine ecology. The procedure was demonstrated and validated using data for a real spill incident in coastal waters. Coastal zone protection in the Arabian Gulf. The Arabian Gulf is an area of rapid industrial development. Over the last decade in particular, there have been significant expansions in ports, refineries and other coastal facilities across the region. As a relatively enclosed basin, water exchange occurs over long periods, with estimated residence times of 2-5 years (Elshorbagy et al, 2006). This means that pollutants and spills in coastal waters can have both local and regional effects, potentially over long time-scales. Therefore it is important that planning studies and pollution risk assessments for each new coastal development do not occur in isolation. Regional level pollution and oil spill assessments are one way to inform Coastal Zone Management (CZM) plans, protecting the environment from the potential harmful effects of spills. Modelling to support management plans. To support CZM and planning for new coastal developments, the authors applied their validated spill assessment procedure to sites in the Arabian Gulf. The study used a combination of calibrated hydrodynamic models, validated oil spill models, and state-of-the-art parallel computing capabilities. Model simulations demonstrate the potential fate of spills from a range of industrial sites, and their transport over the wider Gulf by tidal- and wind-driven currents. These can be readily refined and extended to inform Environmental Impact Assessments (EIAs), risk assessments and Coastal Zone Management (CZM) plans for new developments. The outputs include the likelihood of shoreline or sensitive receiver impact, and minimum transport times for oil to reach designated sites. Sensitive coastal areas can then be protected from potential spills through suitable management and spill response plans

Validation of computational models for hypersaline and other dense marine discharges

Accurate and appropriate assessment of the dispersion and dilution of effluent is important when planning marine discharges. Environmental impact and engineering constraints must be considered. Studies carried out to support the design and planning processes usually involve computational models. Such computational models are relatively well validated for positively-buoyant discharges, due to the availability of field study and laboratory data. However, validation data for dense discharges is scarcer, particularly in the far-field, and so computational models are rarely fully validated for this type of discharge. As part of its continuous work to develop and validate computational modelling approaches, HR Wallingford has carried out validation work using newly available field data sets. This paper presents the results of initial validation work, implications for model studies, and the intended direction of future research

Oil spill model assessment procedures for coastal and offshore developments

Oil spills can be disastrous in terms of their ecological, social and economic effects. Recent global marine pollution events have demonstrated the potential scale of such incidents. Oil has the potential for accidental release into the marine environment across a range of operations, including coastal developments (ports, terminals, etc.), as well as offshore activities (oil and gas exploration, shipping, etc.). Accurate predictions of the fate and behaviour of spilled oil are therefore important to support environmental studies, clean-up operations, and to inform risk assessments. This usually requires the use of computational models. Simulations rely on a range of model predictions – including detailed hydrodynamic and meteorological fields – as well as adequate representation of the properties and physics of the spilled oil. This paper presents the results of recent research carried out by HR Wallingford to establish best practice procedures for the assessment of the fate of spilled oil and its impact in coastal and offshore regions. An integrated framework for oil spill assessment is presented, using both established modelling tools and the newly-enhanced Lagrangian model OIL RW. The study brings together expertise in coastal processes, metocean studies, the maritime industry and marine ecology. The model is demonstrated and validated using data for a real spill incident in coastal waters

A pre-operative scoring system for adnexal mass in children and adolescents to preserve their future fertility

International audienceSTUDY OBJECTIVE: To develop a predictive score for ovarian malignancy to avoid unnecessary adnexectomy in cases of adnexal mass in pediatric and adolescent girls.DESIGN: A population-based retrospective study on girls who underwent surgery for an ovarian mass with normal levels of human chorionic gonadotrophin (hCG) and alpha fœtoprotein (aFP) between 1996 and 2016.SETTING: Rennes University Hospital, Rennes, France.PARTICIPANTS: Eighty-one patients operated on for ovarian tumor.MAIN OUTCOME MEASURES: The main outcome measure was the rate of malignant and borderline tumor. A pre-operative scoring system was constructed after multivariate analysis.RESULTS: The rate of malignant ovarian tumor was 7%, borderline tumor was 9% (i.e., outcome measure: 16%), and benign tumor was 84%. In a univariate analysis, the characteristics significantly associated with malignancy were early puberty, palpable mass, size and content of the tumor, and positive epithelial tumor markers [CA 125, CEA, and CA 19-9]. The predictive malignancy score was based on two variables obtained after multivariate analysis: tumor size and cystic content. The score defined 3 groups at risk for malignancy: low risk, middle-risk and high-risk. The sensitivity for detecting malignancy was 1.3% (95%CI: 0.1–18.4), 26.2% (95%CI: 11.6-49.0) and 53.1% (95%CI: 29.1–75.8), respectively.CONCLUSION: We set up a simple predictive score of malignancy based on objective criteria to help decision making on whether or not ovarian-sparing surgery is feasible in case of children and adolescents with ovarian tumors and normal hCG and aFP levels while ensuring oncologic safety