Distributed vs. semi-distributed simulations of snowpack dynamics in alpine areas: case study in the upper Arve catchment, French Alps, 1989–2015

We evaluated distributed and semi-distributed modeling approaches to simulating the spatial and temporal evolution of snow and ice over an extended mountain catchment, using the Crocus snowpack model. The distributed approach simulated the snowpack dynamics on a 250-m grid, enabling inclusion of terrain shadowing effects. The semi-distributed approach simulated the snowpack dynamics for discrete topographic classes characterized by elevation range, aspect, and slope. This provided a categorical simulation that was subsequently spatially re-projected over the 250-m grid used for the distributed simulations. The study area (the upper Arve catchment, western Alps, France) is characterized by complex topography, including steep slopes, an extensive glaciated area, and snow cover throughout the year. Simulations were carried out for the period 1989–2015 using the SAFRAN meteorological forcing system. The simulations were compared using four observation datasets including point snow depth measurements, seasonal and annual glacier surface mass balance, snow covered area evolution based on optical satellite sensors, and the annual equilibrium-line altitude of glacier zones, derived from satellite images. The results showed that in both approaches the Crocus snowpack model effectively reproduced the snowpack distribution over the study period. Slightly better results were obtained using the distributed approach because it included the effects of shadows and terrain characteristics

Randomised controlled trials for evaluating the prescribing impact of information meetings led by pharmacists and of new information formats, in General Practice in Italy

<p>Abstract</p> <p>Background</p> <p>Suboptimal translation of valid and relevant information in clinical practice is a problem for all health systems. Lack of information independent from commercial influences, limited efforts to actively implement evidence-based information and its limited comprehensibility are important determinants of this gap and may influence an excessive variability in physicians' prescriptions. This is quite noticeable in Italy, where the philosophy and methods of Evidence-Based Medicine still enjoy limited diffusion among practitioners. Academic detailing and pharmacist outreach visits are interventions of proven efficacy to make independent and evidence-based information available to physicians; this approach and its feasibility have not yet been tested on a large scale and, moreover, they have never been formally tested in Italy.</p> <p>Methods/Design</p> <p>Two RCTs are planned:</p> <p>1) a two-arm cluster RCT, carried out in Emilia-Romagna and Friuli Venezia Giulia, will evaluate the effectiveness of small group meetings, randomising about 150 Primary Care Groups (corresponding to about 2000 GPs) to pharmacist outreach visits on two different topics. Physicians' prescriptions (expressed as DDD per 1000 inhabitants/day), knowledge and attitudes (evaluated through the answers to a specific questionnaire) will be compared for target drugs in the two groups (receiving/not receiving each topic).</p> <p>2) A three-arm RCT, carried out in Sardinia, will evaluate both the effectiveness of one-to-one meetings (one pharmacist visiting one physician per time) and of a 'new' information format (compared to information already available) on changing physicians' prescription of specific drugs. About 900 single GPs will be randomised into three groups: physicians receiving a visit supported by "traditional" information material, those receiving a visit with "new" information material on the same topic and those not receiving any visit/material.</p> <p>Discussion</p> <p>The two proposed RCTs aim to evaluate the organisational feasibility and barriers to the implementation of independent information programs led by NHS pharmacists. The objective to assess a 10 or 15% decreases in the prescription of the targeted drugs is quite ambitious in such 'natural' settings, which will be minimally altered by the interventions themselves; this in spite of the quite large sample sizes used comparing to other studies of these kind. Complex interventions like these are not easy to evaluate, given the many different variables into play. Anyway, the pragmatic nature of the two RCTs appears to be also one of their major strengths, helping to provide a deeper insight on what is possible to achieve – in terms of independent information – in a National Health System, with special reference to Italy.</p> <p>Trial registration</p> <p>ISRCTN05866587 (cluster RCT) and ISRCTN28525676 (single GPs RCT)</p

EFFECT OF ENDOTHELIN-1 INDUCED ISCHEMIA ON PEROXIDATIVE DAMAGE AND MEMBRANE-PROPERTIES IN RAT STRIATUM SYNAPTOSOMES

Synaptosomes obtained from rat striata lesioned by central injection of endothelin-1 (ET-1) were analyzed for the levels of lipid peroxidation products, the susceptibility to lipid peroxidation, the phospholipid and free fatty acid composition and the activity of Na+,K+-ATPase one hour after ET-1 treatment. The intrastriatal injection of ET-1 promoted an increase of endogenous thiobarbituric reactive substances (TEARS), as index of free radical mediated lipid damage, and a greater susceptibility to iron/ascorbate-induced lipid peroxidation. The pattern of free fatty acids showed a significant decrease of arachidonic and docosahexaenoic acid consequent to ET-1 treatment. The analysis of lipid composition showed a significant loss of phospholipids: among phospholipid species, sphingomyelin and phosphatidylethanolamine plasmalogen were particularly reduced by ET-1 treatment. The activity of membrane-bound Na+,K+-ATPase was also significantly reduced in synaptosomes obtained from ET-1 lesioned striata. Taken together these results indicate a significant modification of synaptosomal membrane of ET-1 treated rat striata, possibly due to a free radical mediated damage

DNA methyl transferase 3A -448A >G variant in foreskin tissue from children with hypospadia

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