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Atmospheric rivers (ARs) are long, narrow synoptic scale weather features important for Earth’s hydrological cycle typically transporting water vapor poleward, delivering precipitation important for local climates. Understanding ARs in a warming climate is problematic because the AR response to climate change is tied to how the feature is defined. The Atmospheric River Tracking Method Intercomparison Project (ARTMIP) provides insights into this problem by comparing 16 atmospheric river detection tools (ARDTs) to a common data set consisting of high resolution climate change simulations from a global atmospheric general circulation model. ARDTs mostly show increases in frequency and intensity, but the scale of the response is largely dependent on algorithmic criteria. Across ARDTs, bulk characteristics suggest intensity and spatial footprint are inversely correlated, and most focus regions experience increases in precipitation volume coming from extreme ARs. The spread of the AR precipitation response under climate change is large and dependent on ARDT selection.

Recent studies have demonstrated that high-resolution (∼25 km) Earth System Models (ESMs) have the potential to skillfully predict tropical cyclone (TC) occurrence and intensity. However, biases in ESM TCs still exist, largely due to the need to parameterize processes such as boundary layer (PBL) turbulence. Building on past studies, we hypothesize that the depiction of the TC PBL in ESMs is sensitive to the configuration of the PBL parameterization scheme, and that the targeted perturbation of tunable parameters can reduce biases. The Morris one-at-a-time (MOAT) method is implemented to assess the sensitivity of the TC PBL to tunable parameters in the PBL scheme in an idealized configuration of the Community Atmosphere Model, version 6 (CAM6). The MOAT method objectively identifies several parameters in an experimental version of the Cloud Layers Unified by Binormals (CLUBB) scheme that appreciably influence the structure of the TC PBL. We then perturb the parameters identified by the MOAT method within a suite of CAM6 ensemble simulations and find a reduction in model biases compared to observations and a high-resolution, cloud-resolving model. We demonstrate that the high-sensitivity parameters are tied to PBL processes that reduce turbulent mixing and effective eddy diffusivity, and that in CAM6 these parameters alter the TC PBL in a manner consistent with past modeling studies. In this way, we provide an initial identification of process-based input parameters that, when altered, have the potential to improve TC predictions by ESMs.

Previous analyses of the GIM (Gruppo Italiano Mammella) 2 study showed that addition of fluorouracil to epirubicin, cyclophosphamide, and paclitaxel in patients with node-positive early breast cancer does not improve outcome, whereas dose-dense chemotherapy induces a significant improvement in both disease-free survival and overall survival as compared with a standard schedule. Here, we present long-term results of the study.In this 2 × 2 factorial, open-label, randomised, phase 3 trial, we enrolled patients aged 18-70 years with operable, node-positive, breast cancer with Eastern Cooperative Oncology Group performance status of 0-1 from 81 hospitals in Italy. Eligible patients were randomly allocated (1:1:1:1) to one of the four following study groups: four cycles of standard-interval intravenous EC (epirubicin 90 mg/mBetween April 24, 2003, and July 3, 2006, 2091 patients were randomly assigned to treatment: 545 to q3EC-P, 544 to q3FEC-P, 502 to q2EC-P, and 500 to q2FEC-P. 88 patients were enrolled in centres providing only standard interval schedule and were assigned only to q3FEC-P and q3EC-P; thus, 2091 patients were included in the intention-to-treat analysis for the comparison of EC-P (1047 patients) versus FEC-P (1044 patients) and 2003 patients were included in the intention-to-treat analysis for the comparison of dose-dense (1002 patients) versus standard interval analysis (1001 patients). After a median follow-up of 15·1 years (IQR 8·4-16·3), median disease-free survival was not significantly different between FEC-P and EC-P groups (17·09 years [95% CI 15·51-not reached] vs not reached [17·54-not reached]; unadjusted hazard ratio 1·12 [95% CI 0·98-1·29]; log-rank p=0·11). Median disease-free survival was significantly higher in the dose-dense interval group than the standard-interval group (not reached [95% CI 17·45-not reached] vs 16·52 [14·24-17·54]; 0·77 [95% CI 0·67-0·89]; p=0·0004). The most common grade 3-4 adverse events were neutropenia (200 [37%] of 536 patients in the q3EC-P group vs 257 [48%] of 533 in the q3FEC-P group vs 50 [10%] of 496 q2EC-P vs 97 [20%] of 492) and alopecia (238 [44%] vs 249 [47%] vs 228 [46%] vs 235 [48%]). During extended follow-up, no further grade 3-4 adverse events or deaths related to toxic-effects were reported. Treatment-related serious adverse events were reported in nine (2%) patients in the q3EC-P group, seven (1%) in the q3FEC-P group, nine (2%) in the q2EC-P group, and nine (2%) in the q2FEC-P group. No treatment-related deaths occurred.Updated results from the GIM2 study support that optimal adjuvant chemotherapy for patients with high-risk early breast cancer should not include fluorouracil and should use a dose-dense schedule.Bristol-Myers Squibb, Pharmacia, Dompè Biotec Italy, Italian Ministry of Health, Fondazione Italiana per la Ricerca sul Cancro, and Alliance Against Cancer.

Background Echocardiographic reference values for interventricular septal (IVS) thickness (upper reference limit [URL] 11.2 mm in women vs. 12.4 mm in men), and posterior wall (PW) thickness (URL 11.5 mm vs. 12.3 mm, respectively) exist. According to a European Society of Cardiology position statement, cardiac amyloidosis (CA) should be suspected when left ventricular (LV) wall thickness is ≥12 mm and at least one red flag is present. Given the normal difference between men and women, a same cut–off might cause a diagnostic delay in women. Methods Consecutive patients diagnosed with amyloid transthyretin (ATTR)–CA at 3 centers were evaluated. Results The cohort included 302 patients (Pisa, n=215; Brescia, n=58; Trieste, n=29). Women (n=49, 16%) were older than men (median age 83 years [interquartile range 80–85] vs. 80 years [76–84], p=0.009), but their survival free from all–cause death (p=0.380) or heart failure (HF) hospitalization (p=0.381) did not differ significantly. N–terminal pro–B–type natriuretic peptide values (p=0.897), the proportion of patients with variant ATTR (p=0.369), the prevalence of hypertension (p=0.659), diabetes (p=0.629), or New York Heart Association class III–IV (p=0.613) were not different. LV ejection fraction was 53% (43–60%) in women vs. 50% (43–65%) in men (p=0.066), and tricuspid annular plane systolic excursion was 16 mm (13–20) in women vs. 16 mm (14–19) in men (p=0.674). Even relative wall thickness (RWT) did not differ significantly (0.61 [0.49–0.98] in women vs. 0.69 [0.57–0.87] in men; p=0.448). Conversely, women had lower IVS (15 mm [14–18] vs. 17 mm [15–20]) and PW thickness (13 mm [12–16] vs. 15 mm [13–17]). These differences disappeared when IVS and PW thicknesses were indexed for height (as m), height2,7, or body surface area: IVS, p=0.150, 0.212, 0.325, respectively; PW, p=0.309, 0.107, 0.743, respectively. Conclusions At the time of diagnosis, women with ATTR–CA are older, but their biventricular function, the pattern of LV remodeling, and final outcome did not differ significantly from men, suggesting a similar disease stage. Even indexed IVS or PW thicknesses are similar, while non–indexed measures may point to a less advanced disease and then be misleading. Indexed measures or sex–specific cut–offs (e.g., 11 mm in women vs. 12 mm in men) to suspect CA might be considered.

Background The APOA1 gene encodes the precursor of apolipoprotein AI (ApoAI), whose mature form is the major component of high–density lipoproteins. APOA1 mutations may cause a form of hereditary amyloidosis (AApoAI). Only very small case series of patients with AApoAI are available. Methods We examined 189 consecutive subjects with the heterozygous APOA1 Leu75Pro mutation referred for cardiac screening over a 10–year timespan at the Spedali Civili of Brescia (Italy). Results Subjects (men 54%, median age 55 years, renal disease 39%, liver disease 31%) had a median left ventricular ejection fraction (LVEF) of 60% (55–66), did not display a prominent diastolic dysfunction (E/e’ ratio 7 [6–10]) nor LV hypertrophy (LV mass index [LVMI] 92 g/m2 [74–111]). LV global longitudinal strain (GLS) (–19% [–21 to –17]), and mass to strain ratio (MSR) (10.0 [6.8–12.1]) were within normal limits. Age correlated with several echocardiographic parameters, including interventricular septal (IVS) thickness (r = 0.484), LVMI (r = 0.459), E/e’ (r = 0.501), and right ventricular free wall thickness (r = 0.459) (all p Conclusions In subjects with an amyloidogenic APOA1 mutation, transthoracic echocardiography showed only minor signs of cardiac disease. The correlations between age and echocardiographic findings suggested a progressive increase in wall thickness, a decline in systolic and diastolic function, and a greater uncoupling between LV mass and contractility over time. Subjects with both renal and liver disease displayed the most evident signs of biventricular involvement and had a worse outcome.

Although useful at short and medium ranges, current dynamical models provide little additional skill for precipitation forecasts beyond week 2 (14 days). However, recent studies have demonstrated that downstream forcing by the Madden–Julian oscillation (MJO) and quasi-biennial oscillation (QBO) influences subseasonal variability, and predictability, of sensible weather across North America. Building on prior studies evaluating the influence of the MJO and QBO on the subseasonal prediction of North American weather, we apply an empirical model that uses the MJO and QBO as predictors to forecast anomalous (i.e., categorical above- or below-normal) pentadal precipitation at weeks 3–6 (15–42 days). A novel aspect of our study is the application and evaluation of the model for subseasonal prediction of precipitation across the entire contiguous United States and Alaska during all seasons. In almost all regions and seasons, the model provides “skillful forecasts of opportunity” for 20%–50% of all forecasts valid weeks 3–6. We also find that this model skill is correlated with historical responses of precipitation, and related synoptic quantities, to the MJO and QBO. Finally, we show that the inclusion of the QBO as a predictor increases the frequency of skillful forecasts of opportunity over most of the contiguous United States and Alaska during all seasons. These findings will provide guidance to forecasters regarding the utility of the MJO and QBO for subseasonal precipitation outlooks.

The Atmospheric River (AR) Tracking Method Intercomparison Project (ARTMIP) is a community effort to systematically assess how the uncertainties from AR detectors (ARDTs) impact our scientific understanding of ARs. This study describes the ARTMIP Tier 2 experimental design and initial results using the Coupled Model Intercomparison Project (CMIP) Phases 5 and 6 multi-model ensembles. We show that AR statistics from a given ARDT in CMIP5/6 historical simulations compare remarkably well with the MERRA-2 reanalysis. In CMIP5/6 future simulations, most ARDTs project a global increase in AR frequency, counts, and sizes, especially along the western coastlines of the Pacific and Atlantic oceans. We find that the choice of ARDT is the dominant contributor to the uncertainty in projected AR frequency when compared with model choice. These results imply that new projects investigating future changes in ARs should explicitly consider ARDT uncertainty as a core part of the experimental design.

Introduction Environmental determinants of health, such as greenness, play an increasing role in our understanding of cardiovascular disease, and can inform how to address geographic cardiovascular disparities. This study assesses the impact of greenness and changes in greenness on cardiovascular disease. Purpose The purpose of this study is to investigate the impact of greenness and changes in greenness on cardiovascular disease diagnoses. Methods The sample for this prospective, longitudinal study was comprised of 243,558 U.S. Medicare beneficiaries 65 years or older, residing on the same Census Block from 2011 through 2016, and who had a Miami-Dade residential 9-digit zip code. Analyses examined the impact of greenness, measured by mean block-level Normalized Difference Vegetation index (NDVI) from satellite imagery to incidence of new cardiovascular conditions including: acute myocardial infarction, atrial fibrillation, heart failure, ischemic heart disease, hypertension, and stroke/ transient ischemic attack. Zero-inflated poisson regression was used to model the odds of developing any new cardiovascular disease and number of new cardiovascular conditions based on block level greenness while adjusting for individual age, gender, race/ethnicity, number of baseline cardiovascular conditions, and neighborhood characteristics including income and walkability. Results Living in a higher greenness Census Block was associated with lower odds of having at least one new cardiovascular condition and having a small number of new conditions, adjusting for individual and neighborhood level characteristics. When compared to individuals living in the lowest tertile of greenness throughout the study, those individuals living in the highest tertile of greenness throughout the study had a 16% lower odds of having any new cardiovascular conditions (OR=0.84, 95% CI: 0.79–0.90, p Conclusions High greenness is associated with lower rates of cardiovascular conditions over time, both when greenness increases and when a Census Block maintains high greenness. It is remarkable that these effects appear in five years, a relatively short amount of time for a positive environmental impact; and that even for those who began in the lowest greenness tertile, an increase to the high greenness tertile had a significant effect. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Robert Wood Johnson Evidence for Action Grant

Traditionally, events collected at relativistic heavy-ion colliders are classified according to some centrality estimator (e.g. the number of produced charged particles) related to the initial energy density and volume of the system. In a naive picture the latter are directly related to the impact parameter of the two nuclei, which sets also the initial eccentricity of the system: zero in the case of the most central events and getting larger for more peripheral collisions. A more realistic modelling requires to take into account event-by-event fluctuations, in particular in the nucleon positions within the colliding nuclei: collisions belonging to the same centrality class can give rise to systems with different initial eccentricity and hence different flow harmonics for the final hadron distributions. This issue can be addressed by an event-shape-engineering analysis, consisting in selecting events with the same centrality but different magnitude of the average bulk anisotropic flow and therefore of the initial-state eccentricity. In this paper we present the implementation of this analysis in the POWLANG transport model, providing predictions for the transverse-momentum and angular distributions of charm and beauty hadrons for event-shape selected collisions. In this way it is possible to get information on how the heavy quarks propagating (and hadronizing) in a hot environment respond both to its energy density and to its geometric asymmetry, breaking the perfect correlation between eccentricity and impact parameter which characterizes a modelling of the medium based on smooth average initial conditions.

We extend our POWLANG transport setup for the modelling of heavy-flavour production in heavy-ion collisions to the case of full 3+1 simulations, dropping the approximation of longitudinal boost-invariance of the background medium. This enables us to provide predictions for observables for which the rapidity dependence is essential in order to obtain a non-vanishing signal, like the directed flow $v_1$, and to get reliable results also for kinematic distributions of heavy-flavour particles at forward rapidity. We compare our predictions with experimental data obtained in Au-Au and Pb-Pb collisions at RHIC and at the LHC., Revised version

In this paper, we address the problem of anomaly detection in decentralised settings. We took inspiration from the current edge computing trend, pushing towards the development of decentralised ML algorithms, i.e., the devices that collected or generated data are in charge of collaborating to train the ML models without sharing raw data . The challenges connected to this scenario are (i) data distributions of local datasets might be different, (ii) data is very often unlabelled, and (iii) devices have limited computational resources. We address them by proposing an unsupervised ensemble method for decentralised anomaly detection where the base learners are lightweight autoencoders. We aim to investigate whether an ensemble of lightweight models trained in isolation on non-IID and unlabelled local data can compete with heavier models trained in centralised settings. In a task of multi-category anomaly detection, our results show that our method exploits the data imbalance successfully to make accurate predictions.

Atmospheric rivers (ARs)—narrow corridors of high atmospheric water vapor transport—occur globally and are associated with flooding and maintenance of the water supply. Therefore, it is important to improve forecasts of AR occurrence and characteristics. Although prior work has examined the skill of numerical weather prediction (NWP) models in forecasting atmospheric rivers, these studies only cover several years of reforecasts from a handful of models. Here, we expand this previous work and assess the performance of 10–30 years of wintertime (November–February) AR landfall reforecasts from the control runs of nine operational weather models, obtained from the International Subseasonal to Seasonal (S2S) Project database. Model errors along the west coast of North America at leads of 1–14 days are examined in terms of AR occurrence, intensity, and landfall location. Occurrence-based skill approaches that of climatology at 14 days, while models are, on average, more skillful at shorter leads in California, Oregon, and Washington compared to British Columbia and Alaska. We also find that the average magnitude of landfall integrated water vapor transport (IVT) error stays fairly constant across lead times, although overprediction of IVT is common at later lead times. Finally, we show that northward landfall location errors are favored in California, Oregon, and Washington, although southward errors occur more often than expected from climatology. These results highlight the need for model improvements, while helping to identify factors that cause model errors.

Many atmospheric river detection tools (ARDTs) have now been developed. However, their relative performance is not well documented. This paper compares a diverse set of ARDTs by applying them to a single location where a unique 12-year-long time-series from an atmospheric river observatory at Bodega Bay, California is available. The study quantifies the sensitivity of the diagnosed number, duration, and intensity of ARs at this location to the choice of ARDT, and to the choice of reanalysis data set. The ARDTs compared here represent a range of methods that vary in their use of different variables, fixed vs. percentile-based thresholds, geometric shape requirements, Eulerian vs. Lagrangian approaches, and reanalyses. The ARDTs were evaluated first using the datasets documented in their initial publication, which found an average annual count of 19 ± 7. Applying the ARDTs to the same reanalysis dataset yields an average annual count of 19 ± 4. Applying a single ARDT to three reanalyses of varying grid sizes (0.5°, 1.0°–2.5°) showed little sensitivity to the choice of reanalysis. While the annual average AR event count varied by about a factor of two (10–25 per year) depending on the ARDT, average AR duration and maximum intensity varied by less than ± 10%, i.e., 24 ± 2 h duration; 458 ± 44 kg m− 1 s− 1 maximum IVT. ARDTs that use a much higher threshold for integrated vapor transport were compared separately, and yielded just 1–2 ARs annually on average. Generally, ARDTs that include either more stringent geometric criteria or higher thresholds identified the fewest AR events.

Due to an oversight of ours in proofreading and a communication problem with the publisher, the figures published in F. Becattini et al. Eur. Phys. J. C (2015) 75: 406 were not correct. This Erratum contains the correct figures as in arXiv 1501.04468v2, submitted on March 12 2015, and the post-publication version arXiv 1501.04468v3, submitted on August 17 2015.

We study the development of heavy-flavor flow harmonics in high-energy nuclear collisions. The elliptic and triangular flow of heavy-flavor hadrons, arising from the finite impact parameter of the two nuclei and from event-by-event fluctuations of the initial geometry, is analyzed in detail, considering the contribution from particles decoupling from the fireball at various times. We also study the dependence of the flow harmonics on the event-shape fluctuations, considering events belonging to the same centrality class but characterized by very different eccentricities (or vice-versa)., Comment: Quark-Matter 2018 proceedings

The aim of this study is to compare the results of a survey carried out on a sample of mothers and fathers about the knowledge and personal attitudes towards their own oral health and in terms of attention to that of their children. Mutual analogy and cognitive and behavioral differences between parents have been evaluated; in particular as the early assumption of a healthy lifestyle can influence the proper development of their children.This survey was conducted using a paper questionnaire distributed to a population of parents, men and women, in several private dental practices in Rome. The study lasted about three months.The results obtained from this study show that values obtained by mothers and fathers are essentially equivalent, there are no statistically significant differences (p0.05).This study has shown that there are no significant thinking and behavioral differences between parents regarding their oral hygiene and that of their children. Both parents have been shown to recognize the importance of continuous monitoring and to be aware of techniques and oral hygiene aids suitable for adults and children, although this knowledge is not always applied in daily lifestyles and oral hygiene.

We employ the POWLANG transport setup, developed over the last few years, to provide new predictions for several heavy-flavour observables in relativistic heavy-ion collisions from RHIC to LHC center-of-mass energies. In particular, we focus on the development of the flow-harmonics v2 and v3 arising from the initial geometric asymmetry in the initial conditions and its associated event-by-event fluctuations. Within the same transport framework, for the sake of consistency, we also compare the nuclear modification factor of the p T spectra of charm and beauty quarks, heavy hadrons and their decay electrons. We compare our findings to the most recent data from the experimental collaborations. We also study in detail the contribution to the flow harmonics from the quarks decoupling from the fireball during the various stages of its evolution: although not directly accessible to the experiments, this information can shed light on the major sources of the final measured effect.