Changing Seasonal Rainfall Distribution With Climate Directs Contrasting Impacts at Evapotranspiration and Water Yield in the Western Mediterranean Region

Over the past century, climate change has been reflected in altered precipitation regimes worldwide. Because evapotranspiration is sensitive to both water availability and atmospheric demand for water vapor, it is essential to assess the likely consequences of future changes of these climate variables to evapotranspiration and, thus, runoff. We propose a simplified approach for annual evapotranspiration predictions, based on seasonal evapotranspiration estimates, accounting for the strong seasonality of meteorological conditions typical of Mediterranean climate, still holding the steady state assumption of basin water balance at mean annual scale. Sardinian runoff decreased over the 1975-2010 period by more than 40% compared to the preceding 1922-1974 period. Most of annual runoff in Sardinian basins is produced by winter precipitation, a wet season with relatively high evaporation rates. We derived linear seasonal evapotranspiration responses to seasonal precipitation, and, in turn, a relationship between the parameters of the linear functions and the seasonal vapor pressure deficit (D), accounting for residuals with basin properties. We then used these relationships to predict evapotranspiration and runoff using future Intergovernmental Panel on Climate Change climate scenarios, considering changing precipitation and D seasonality. We show that evapotranspiration is insensitive to D scenario changes. Although both evapotranspiration and runoff are sensitive to precipitation seasonality, future changes in runoff are related only to changes of winter precipitation, while evapotranspiration changes are related to those of spring and summer precipitation. Future scenario predicting further runoff decline is particularly alarming for the Sardinian water resources system, requiring new strategies and designs in water resources planning and management.Peer reviewe

Precipitation and temperature ensemble forecasts from single-value forecasts

International audienceA procedure is presented to construct ensemble forecasts from single-value forecasts of precipitation and temperature. This involves dividing the spatial forecast domain and total forecast period into a number of parts that are treated as separate forecast events. The spatial domain is divided into hydrologic sub-basins. The total forecast period is divided into time periods, one for each model time step. For each event archived values of forecasts and corresponding observations are used to model the joint distribution of forecasts and observations. The conditional distribution of observations for a given single-value forecast is used to represent the corresponding probability distribution of events that may occur for that forecast. This conditional forecast distribution subsequently is used to create ensemble members that vary in space and time using the "Schaake Shuffle" (Clark et al, 2004). The resulting ensemble members have the same space-time patterns as historical observations so that space-time joint relationships between events that have a significant effect on hydrological response tend to be preserved. Forecast uncertainty is space and time-scale dependent. For a given lead time to the beginning of the valid period of an event, forecast uncertainty depends on the length of the forecast valid time period and the spatial area to which the forecast applies. Although the "Schaake Shuffle" procedure, when applied to construct ensemble members from a time-series of single value forecasts, may preserve some of this scale dependency, it may not be sufficient without additional constraint. To account more fully for the time-dependent structure of forecast uncertainty, events for additional "aggregate" forecast periods are defined as accumulations of different "base" forecast periods. The generated ensemble members can be ingested by an Ensemble Streamflow Prediction system to produce ensemble forecasts of streamflow and other hydrological variables that reflect the meteorological uncertainty. The methodology is illustrated by an application to generate temperature and precipitation ensemble forecasts for the American River in California. Parameter estimation and dependent validation results are presented based on operational single-value forecasts archives of short-range River Forecast Center (RFC) forecasts and medium-range ensemble mean forecasts from the National Weather Service (NWS) Global Forecast System (GFS)

Induction therapy with ipilimumab and nivolumab followed by consolidative chemoradiation as organ-sparing treatment in urothelial bladder cancer:study protocol of the INDIBLADE trial

Introduction: Studies that assessed the efficacy of pre-operative immune checkpoint blockade (ICB) in locally advanced urothelial cancer of the bladder showed encouraging pathological complete response rates, suggesting that a bladder-sparing approach may be a viable option in a subset of patients. Chemoradiation is an alternative for radical cystectomy with similar oncological outcomes, but is still mainly used in selected patients with organ-confined tumors or patients ineligible to undergo radical cystectomy. We propose to sequentially administer ICB and chemoradiation to patients with (locally advanced) muscle-invasive bladder cancer. Methods: The INDIBLADE trial is an investigator-initiated, single-arm, multicenter phase 2 trial. Fifty patients with cT2-4aN0-2M0 urothelial bladder cancer will be treated with ipilimumab 3 mg/kg on day 1, ipilimumab 3 mg/kg plus nivolumab 1 mg/kg on day 22, and nivolumab 3 mg/kg on day 43 followed by chemoradiation. The primary endpoint is the bladder-intact event-free survival (BI-EFS). Events include: local or distant recurrence, salvage cystectomy, death and switch to platinum-based chemotherapy. We will also evaluate the potential of multiparametric magnetic resonance imaging of the bladder to identify non-responders, and we will assess the clearance of circulating tumor DNA as a biomarker for ICB treatment response. Discussion: This is the first trial in which the efficacy of induction combination ICB followed by chemoradiation is being evaluated to provide bladder-preservation in patients with (locally advanced) urothelial bladder cancer. Clinical Trial Registration: The INDIBLADE trial was registered on clinicaltrials.gov on January 21, 2022 (NCT05200988).</p

Efficiency of evolutionary algorithms in water network pipe sizing

The pipe sizing of water networks via evolutionary algorithms is of great interest because it allows the selection of alternative economical solutions that meet a set of design requirements. However, available evolutionary methods are numerous, and methodologies to compare the performance of these methods beyond obtaining a minimal solution for a given problem are currently lacking. A methodology to compare algorithms based on an efficiency rate (E) is presented here and applied to the pipe-sizing problem of four medium-sized benchmark networks (Hanoi, New York Tunnel, GoYang and R-9 Joao Pessoa). E numerically determines the performance of a given algorithm while also considering the quality of the obtained solution and the required computational effort. From the wide range of available evolutionary algorithms, four algorithms were selected to implement the methodology: a PseudoGenetic Algorithm (PGA), Particle Swarm Optimization (PSO), a Harmony Search and a modified Shuffled Frog Leaping Algorithm (SFLA). After more than 500,000 simulations, a statistical analysis was performed based on the specific parameters each algorithm requires to operate, and finally, E was analyzed for each network and algorithm. The efficiency measure indicated that PGA is the most efficient algorithm for problems of greater complexity and that HS is the most efficient algorithm for less complex problems. However, the main contribution of this work is that the proposed efficiency ratio provides a neutral strategy to compare optimization algorithms and may be useful in the future to select the most appropriate algorithm for different types of optimization problems

Patterns of Recurrence and Survival After Pelvic Treatment for Locally Advanced Penile Cancer

BACKGROUND: Penile cancer (PeCa) is rare, and the survival of patients with advanced disease remains poor. A better understanding of where treatment fails could aid the development of new treatment strategies. OBJECTIVE: To describe the disease course after pelvic lymph node (LN) treatment for PeCa. DESIGN, SETTING, AND PARTICIPANTS: We retrospectively analysed 228 patients who underwent pelvic LN treatment with curative intent from 1969 to 2016. The main treatment modalities were neoadjuvant chemotherapy, chemoradiation, and pelvic LN dissection. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: In the case of multiple recurrence locations, the most distant location was taken and recorded as follows: local (penis), regional (inguinal and pelvic LN), and distant (any other location). A competing risk analysis was used to calculate the time to recurrence per location, and a Kaplan-Meier analysis was used for overall survival (OS). RESULTS AND LIMITATIONS: The median follow-up of the surviving patients was 79 mo. The reason for pelvic treatment was pelvic involvement on imaging (29%), two or more tumour-positive inguinal LNs (61%), or inguinal extranodal extension (52%). More than half of the patients (61%) developed a recurrence. The median recurrence-free survival was 11 mo. The distribution was local in 9%, regional in 27%, and distant in 64% of patients. The infield control rate of nonsystemically treated patients was 61% (113/184). From the start of pelvic treatment, the median OS was 17 mo (95% confidence interval 12–22). After regional or distant recurrence, all but one patient died of PeCa with median OS after a recurrence of 4.4 (regional) and 3.1 (distant) mo. This study is limited by its retrospective nature. CONCLUSIONS: The prognosis of PeCa patients treated on their pelvis who recur despite locoregional treatment is poor. The tendency for systemic spread emphasises the need for more effective systemic treatment strategies. PATIENT SUMMARY: In this report, we looked at the outcomes of penile cancer patients in an expert centre undergoing various treatments on their pelvis. We found that survival is poor after recurrence despite locoregional treatment. Therefore, better systemic treatments are necessary

A self-adaptive boundary search genetic algorithm and its application to water distribution systems

The success of the application of genetic algorithms (GA) or evolutionary optimization methods to the design and rehabilitation of water distribution systems has been shown to be an innovative approach for the water industry. The optimal design and rehabilitation of water distribution systems is a constrained non-linear optimization problem. Constraints (for example, the minimum pressure requirements) are generally handled within genetic algorithm optimization by introducing a penalty cost function. The optimal or near optimal solution is found when the pressures at some nodes are close to the minimum required pressure or at the boundary of critical constraints. This paper presents a new approach called the self-adaptive boundary search strategy for selection of penalty factor within genetic algorithm optimization. The approach co-evolves and self-adapts the penalty factor such that the genetic algorithm search is guided towards and preserved around constraint boundaries. Thus it reduces the amount of simulation computations within the GA search and enhances the efficacy at reaching the optimal or near optimal solution. To demonstrate its effectiveness, the self-adaptive boundary search strategy is applied to a case study of the optimization of a water distribution system in this paper. It has been shown that the boundary GA search strategy is effective at adapting the feasibility of GA populations for a wide range of penalty factors. As a consequence, the boundary GA has been able to successfully find the least cost solution in the case study more effectively than a GA without the boundary search strategy. Thus a reliable least cost solution is guaranteed for the GA optimization of a water distribution system.Wu, Zheng Y.; Simpson, Angus

Development and Internal Validation of a Novel Nomogram Predicting the Outcome of Salvage Radiation Therapy for Biochemical Recurrence after Radical Prostatectomy in Patients without Metastases on Restaging Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography

BACKGROUND AND OBJECTIVE: Owing to the greater use of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) in patients with biochemical recurrence (BCR) of prostate cancer (PCa) after robot-assisted radical prostatectomy (RARP), patient selection for local salvage radiation therapy (sRT) has changed. Our objective was to determine the short-term efficacy of sRT in patients with BCR after RARP, and to develop a novel nomogram predicting BCR-free survival after sRT in a nationwide contemporary cohort of patients who underwent PSMA PET/CT before sRT for BCR of PCa, without evidence of metastatic disease.METHODS: All 302 eligible patients undergoing PCa sRT in four reference centers between September 2015 and August 2020 were included. We conducted multivariable logistic regression analysis using a backward elimination procedure to develop a nomogram for predicting biochemical progression of PCa, defined as prostate-specific antigen (PSA) ≥0.2 ng/ml above the post-sRT nadir within 1 yr after sRT.KEY FINDINGS AND LIMITATIONS: Biochemical progression of disease within 1 yr after sRT was observed for 56/302 (19%) of the study patients. The final predictive model included PSA at sRT initiation, pathological grade group, surgical margin status, PSA doubling time, presence of local recurrence on PSMA PET/CT, and the presence of biochemical persistence (first PSA result ≥0.1 ng/ml) after RARP. The area under the receiver operating characteristic curve for this model was 0.72 (95% confidence interval 0.64-0.79). Using our nomogram, patients with a predicted risk of &gt;20% had a 30.8% chance of developing biochemical progression within 1 yr after sRT.CONCLUSIONS: Our novel nomogram may facilitate better patient counseling regarding early oncological outcome after sRT. Patients with high risk of biochemical progression may be candidates for more extensive treatment.PATIENT SUMMARY: We developed a new tool for predicting cancer control outcomes of radiotherapy for patients with recurrence of prostate cancer after surgical removal of their prostate. This tool may help in better counseling of these patients with recurrent cancer regarding their early expected outcome after radiotherapy.</p

Development and Internal Validation of a Novel Nomogram Predicting the Outcome of Salvage Radiation Therapy for Biochemical Recurrence after Radical Prostatectomy in Patients without Metastases on Restaging Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography

BACKGROUND AND OBJECTIVE: Owing to the greater use of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) in patients with biochemical recurrence (BCR) of prostate cancer (PCa) after robot-assisted radical prostatectomy (RARP), patient selection for local salvage radiation therapy (sRT) has changed. Our objective was to determine the short-term efficacy of sRT in patients with BCR after RARP, and to develop a novel nomogram predicting BCR-free survival after sRT in a nationwide contemporary cohort of patients who underwent PSMA PET/CT before sRT for BCR of PCa, without evidence of metastatic disease.METHODS: All 302 eligible patients undergoing PCa sRT in four reference centers between September 2015 and August 2020 were included. We conducted multivariable logistic regression analysis using a backward elimination procedure to develop a nomogram for predicting biochemical progression of PCa, defined as prostate-specific antigen (PSA) ≥0.2 ng/ml above the post-sRT nadir within 1 yr after sRT.KEY FINDINGS AND LIMITATIONS: Biochemical progression of disease within 1 yr after sRT was observed for 56/302 (19%) of the study patients. The final predictive model included PSA at sRT initiation, pathological grade group, surgical margin status, PSA doubling time, presence of local recurrence on PSMA PET/CT, and the presence of biochemical persistence (first PSA result ≥0.1 ng/ml) after RARP. The area under the receiver operating characteristic curve for this model was 0.72 (95% confidence interval 0.64-0.79). Using our nomogram, patients with a predicted risk of &gt;20% had a 30.8% chance of developing biochemical progression within 1 yr after sRT.CONCLUSIONS: Our novel nomogram may facilitate better patient counseling regarding early oncological outcome after sRT. Patients with high risk of biochemical progression may be candidates for more extensive treatment.PATIENT SUMMARY: We developed a new tool for predicting cancer control outcomes of radiotherapy for patients with recurrence of prostate cancer after surgical removal of their prostate. This tool may help in better counseling of these patients with recurrent cancer regarding their early expected outcome after radiotherapy.</p