New methodology for mapping wildfire risk in the wildland-urban interface

Wildfires pose a great threat to the wildland-urban interface (WUI), the zone of contact between wildland vegetation and the human-settled environment. In these areas, high fuel loads often coexist with high value assets, which are more exposed to ignition than equivalent structures in an urban context. At the WUI, wildfires can quickly exhaust the resources normally available to urban firefighters, and the value of assets do not allow the use of large-scale, resource-saving techniques common in wildland fires management. Mapping the WUI represents a first important step in wildfire risk management due to the primary importance of prevention in a setting that is difficult to defend in the face of emergencies. In addition, as the WUI is not only a possible target for wildfires, it is often a source of them, prevention of fire in these areas is a critical part of risk management. Several methods are currently available to detect and map the WUI, differing according to the scale and the scope of the analysis. Pioneering methods mainly used aggregated data (e.g. census data, large scale vegetation maps) while recent techniques are increasingly using high precision remote sensing data to identify single structures and local changes in topography and vegetation. In the context of the UE Interreg project Italia-Slovenija CROSSIT SAFER, a new methodology will be described to analyse and map wildfire risk at the WUI relying on state-of-the-art data and technologies. Specifically, high precision LiDAR data and segmentation processes are used to characterise wildland fuel precisely and efficiently

New methodology for mapping wildfire risk in the wildland-urban interface.

Wildfires pose a great threat to the wildland-urban interface (WUI), the zone of contact between wildland vegetation and the human-settled environment. In these areas, high fuel loads often coexist with high value assets, which are more exposed to ignition than equivalent structures in an urban context. At the WUI, wildfires can quickly exhaust the resources normally available to urban firefighters, and the value of assets do not allow the use of large-scale, resource-saving techniques common in wildland fires management. Mapping the WUI represents a first important step in wildfire risk management due to the primary importance of prevention in a setting that is difficult to defend in the face of emergencies. In addition, as the WUI is not only a possible target for wildfires, it is often a source of them, prevention of fire in these areas is a critical part of risk management. Several methods are currently available to detect and map the WUI, differing according to the scale and the scope of the analysis. Pioneering methods mainly used aggregated data (e.g. census data, large scale vegetation maps) while recent techniques are increasingly using high precision remote sensing data to identify single structures and local changes in topography and vegetation. In the context of the UE Interreg project Italia-Slovenija CROSSIT SAFER, a new methodology will be described to analyse and map wildfire risk at the WUI relying on state-of-the-art data and technologies. Specifically, high precision LiDAR data and segmentation processes are used to characterise wildland fuel precisely and efficiently

p16/ki67 and E6/E7 mRNA accuracy and prognostic value in triaging HPV DNA-positive women

Background: The study presents cross-sectional accuracy of E6/E7 mRNA detection and p16/ki67 dual staining, alone or in combination with cytology and HPV16/18 genotyping, as triage test in HPV DNA-positive women and their impact on CIN2+ overdiagnosis. Methods: Women aged 25-64 were recruited. HPV DNA-positives were triaged with cytology and tested for E6/E7 mRNA and p16/ki67. Cytology positives were referred to colposcopy, while negatives were randomised to immediate colposcopy or to one-year HPV retesting. Lesions found within 24 months since recruitment were included. All p-values were two-sided. Results: 40,509 women were recruited and 3147 (7.8%) tested HPV DNA-positive; 174 CIN2+ were found: sensitivity was 61.0% (95% CI = 53.6 to 68.0), 94.4% (95% CI = 89.1 to 97.3), and 75.2% (95% CI = 68.1 to 81.6) for cytology, E6/E7 mRNA, and p16/ki67, respectively. Immediate referral was 25.6%, 66.8%, and 28.3%, respectively. Overall referral was 65.3%, 78.3%, and 63.3%. Cytology or p16/ki67 when combined with HPV16/18 typing reached higher sensitivity with a small impact on referral. Among the 2306 HPV DNA-positive/cytology-negative women, relative CIN2+ detection in those randomized at 1-year retesting vs. immediate colposcopy suggests a -28% CIN2+ regression (95% CI = -57% to + 20%); regression was higher in E6/E7 mRNA-negatives (pinteraction =.29). HPV clearance at 1 year in E6/E7 mRNA and in p16/ki67 negatives was about 2 times higher than in positive women (Pinteraction < .001 for both). Conclusions: p16/ki67 showed good performance as triage test. E6/E7 mRNA showed the highest sensitivity, at the price of too high a positivity rate to be efficient for triage. However, when negative, it showed a good prognostic value for clearance and CIN2+ regression

Molecular Profile of Subungual Melanoma: a MelaNostrum Consortium Study of 68 Cases Reporting BRAF, NRAS, KIT, and TERT promoter status

Background: Subungual melanoma (SM) is an unusual type of melanocytic tumor affecting the nail apparatus. The mutational prevalence of the most prominently mutated genes in melanoma has been reported in small cohorts of SM, with unclear conclusions on whether SM is different from the rest of melanomas arising in acral locations or not. Hence, the molecular profile of a large series of SM is yet to be described. Objectives: The aim of this study was to describe the molecular characteristics of a large series of SM and their association with demographic and histopathological features. Methods: Patients diagnosed with SM between 2001 and 2021 were identified from six Spanish and Italian healthcare centers. The mutational status for BRAF, NRAS, KIT, and the promoter region of TERT (TERTp) were determined either by Sanger sequencing or Next-Generation Sequencing. Clinical data were retrieved from the hospital databases to elucidate potential associations. Results: A total of 68 SM cases were included. Mutations were most common in BRAF (10.3%) and KIT (10%), followed by NRAS (7.6%), and TERTp (3.8%). Their prevalence was similar to that of non-subungual acral melanoma, but higher in SM located on the hand than on the foot. Conclusions: To date, this study represents the largest cohort of SM patients with data on the known driver gene mutations. The low mutation rate supports a different etiopathogenic mechanism for SM in comparison of non-acral cutaneous melanoma, particularly for SM of the foot.Medicin

Interobserver reproducibility of cytologic p16INK4a/Ki-67 dual immunostaining in human papillomavirus-positive women

BACKGROUND: The accumulation of cyclin-dependent kinase inhibitor 2A (p16(ink4a)) protein in a cell is associated with neoplastic progression in precancerous cervical lesions. Dual staining for p16(ink4a) and Ki-67 has been proposed as a triage test in cervical cancer screening for women who test positive for human papillomavirus DNA. In this study, interobserver reproducibility of the interpretation of this test was assessed. METHODS: Forty-two immunostained, liquid-based cytology slides were divided into 2 sets and were interpreted by 17 to 21 readers from 9 different laboratories, yielding a total of 816 reports. Immunostaining results were classified as positive, negative, inconclusive, or inadequate. After evaluation of the first set of slides and before circulation of the second set, the results were discussed in a plenary meeting. The 10 slides with the most discordant results were evaluated again by selected expert cytopathologists. RESULTS: The overall kappa value was 0.612 (95% confidence interval [CI], 0.523-0.701), it was higher for the positive and negative categories (kappa=0.692 and kappa=0.641, respectively), and it was almost null for the inconclusive category (kappa=0.058). Considering only readers from laboratories with documented experience, the kappa value was higher (kappa=0.747; 95% CI, 0.643-0.839) compared with nonexperienced centers (kappa=0.498; 95% CI, 0.388-0.616). The results were similar in both sets of slides (kappa=0.505 [95% CI, 0.358-0.642] and kappa=0.521 [95% CI, 0.240-0.698] for the first and second sets, respectively). Reinterpretation of the slides with the most discordant results did not provide any improvement (first evaluation, kappa=0.616 [95% CI, 0.384-0.866]; second evaluation, kappa=0.403 [95% CI, 0.182-0.643]). CONCLUSIONS: Dual staining for p16(ink4a) and Ki-67 demonstrated good reproducibility, confirming its robustness, which is a necessary prerequisite for its adoption as a triage test in cervical cancer screening programs that use human papillomavirus DNA as a primary test. Cancer Cytopathol 2017; 125:212-20. (C) 2016 American Cancer Society