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BackgroundIrreversible Electroporation (IRE) is a novel image-guided tissue ablation technology that induces cell death via very short but strong pulsed electric fields. IRE has been shown to have preserving properties towards vessels and nerves and the extracellular matrix. This makes IRE an ideal candidate to treat prostate cancer (PCa) where other treatment modalities frequently unselectively destroy surrounding structures inducing severe side effects like incontinence or impotence. We report the retrospective assessment of 471 IRE treatments in 429 patients of all grades and stages of PCa with 6-year maximum follow-up time.Material and findingsThe patient cohort consisted of low (25), intermediate (88) and high-risk cancers (312). All had multi-parametric magnetic resonance imaging, and 199 men had additional 3D-mapping biopsy for diagnostic work-up prior to IRE. Patients were treated either focally (123), sub-whole-gland (154), whole-gland (134) or for recurrent disease (63) after previous radical prostatectomy, radiation therapy, etc. Adverse effects were mild (19.7%), moderate (3.7%) and severe (1.4%), never life-threatening. Urinary continence was preserved in all cases. IRE-induced erectile dysfunction persisted in 3% of the evaluated cases 12 months post treatment. Mean transient IIEF-5-Score reduction was 33% within 12-month post IRE follow-up and 15% after 12 months. Recurrences within the follow-up period occurred in 10% of the treated men, 23 in or adjacent to the treatment field and 18 outside the treatment field (residuals). Including residuals for worst case analysis, Kaplan Maier estimation on recurrence rate at 5 years resulted in 5.6% (CI95: 1.8-16.93) for Gleason 6, 14.6% (CI95: 8.8-23.7) for Gleason 7 and 39.5% (CI95: 23.5-61.4) for Gleason 8-10.ConclusionThe results indicate comparable efficacy of IRE to standard radical prostatectomy in terms of 5-year recurrence rates and better preservation of urogenital function, proving the safety and suitability of IRE for PCa treatment. The data also shows that IRE, besides focal therapy of early PCa, can also be used for whole-gland ablations, in patients with recurrent PCa, and as a problem-solver for local tumor control in T4-cancers not amenable to surgery and radiation therapy anymore.

Efforts to estimate the physical and economic impacts of future climate change face substantial challenges. To enrich the currently popular approaches to impact analysis-which involve evaluation of a damage function or multi-model comparisons based on a limited number of standardized scenarios-we propose integrating a geospatially resolved physical representation of impacts into a coupled human-Earth system modeling framework. Large internationally coordinated exercises cannot easily respond to new policy targets and the implementation of standard scenarios across models, institutions and research communities can yield inconsistent estimates. Here, we argue for a shift toward the use of a self-consistent integrated modeling framework to assess climate impacts, and discuss ways the integrated assessment modeling community can move in this direction. We then demonstrate the capabilities of such a modeling framework by conducting a multi-sectoral assessment of climate impacts under a range of consistent and integrated economic and climate scenarios that are responsive to new policies and business expectations.

Efforts to estimate the physical and economic impacts of future climate change face substantial challenges. To enrich the currently popular approaches to impact analysis-which involve evaluation of a damage function or multi-model comparisons based on a limited number of standardized scenarios-we propose integrating a geospatially resolved physical representation of impacts into a coupled human-Earth system modeling framework. Large internationally coordinated exercises cannot easily respond to new policy targets and the implementation of standard scenarios across models, institutions and research communities can yield inconsistent estimates. Here, we argue for a shift toward the use of a self-consistent integrated modeling framework to assess climate impacts, and discuss ways the integrated assessment modeling community can move in this direction. We then demonstrate the capabilities of such a modeling framework by conducting a multi-sectoral assessment of climate impacts under a range of consistent and integrated economic and climate scenarios that are responsive to new policies and business expectations.

Precipitation-gauge observations and atmospheric reanalysis are combined to develop an analogue method for detecting heavy precipitation events based on prevailing large-scale atmospheric conditions. Combinations of atmospheric variables for circulation (geopotential height and wind vector) and moisture (surface specific humidity, column and up to 500-hPa precipitable water) are examined to construct analogue schemes for the winter [December-February (DJF)] of the "Pacific Coast California" (PCCA) region and the summer [June-August (JJA)] of the Midwestern United States (MWST). The detection diagnostics of analogue schemes are calibrated with 1979-2005 and validated with 2006-14 NASA Modern-Era Retrospective Analysis for Research and Applications (MERRA). All analogue schemes are found to significantly improve upon MERRA precipitation in characterizing the occurrence and interannual variations of observed heavy precipitation events in the MWST. When evaluated with the late twentieth-century climate model simulations from phase 5 of the Coupled Model Intercomparison Project (CMIP5), all analogue schemes produce model medians of heavy precipitation frequency that are more consistent with observations and have smaller intermodel discrepancies than model-based precipitation. Under the representative concentration pathways (RCP) 4.5 and 8.5 scenarios, the CMIP5-based analogue schemes produce trends in heavy precipitation occurrence through the twenty-first century that are consistent with model-based precipitation, but with smaller intermodel disparity. The median trends in heavy precipitation frequency are positive for DJF over PCCA but are slightly negative for JJA over MWST. Overall, the analyses highlight the potential of the analogue as a powerful diagnostic tool for model deficiencies and its complementarity to an evaluation of heavy precipitation frequency based on model precipitation alone.

In this study, we present a new modeling framework and a large ensemble of climate projections to investigate the uncertainty in regional climate change over the United States (US) associated with four dimensions of uncertainty. The sources of uncertainty considered in this framework are the emissions projections, global climate system parameters, natural variability and model structural uncertainty. The modeling framework revolves around the Massachusetts Institute of Technology (MIT) Integrated Global System Model (IGSM), an integrated assessment model with an Earth System Model of Intermediate Complexity (EMIC) (with a two-dimensional zonal-mean atmosphere). Regional climate change over the US is obtained through a two-pronged approach. First, we use the IGSM-CAM framework, which links the IGSM to the National Center for Atmospheric Research (NCAR) Community Atmosphere Model (CAM). Second, we use a pattern-scaling method that extends the IGSM zonal mean based on climate change patterns from various climate models. Results show that the range of annual mean temperature changes are mainly driven by policy choices and the range of climate sensitivity considered. Meanwhile, the four sources of uncertainty contribute more equally to end-of-century precipitation changes, with natural variability dominating until 2050. For the set of scenarios used in this study, the choice of policy is the largest driver of uncertainty, defined as the range of warming and changes in precipitation, in future projections of climate change over the US.

An analogue method is presented to detect the occurrence of heavy precipitation events without relying on modeled precipitation. The approach is based on using composites to identify distinct large-scale atmospheric conditions associated with widespread heavy precipitation events across local scales. These composites, exemplified in the south-central, midwestern, and western United States, are derived through the analysis of 27-yr (1979-2005) Climate Prediction Center (CPC) gridded station data and the NASA Modern-Era Retrospective Analysis for Research and Applications (MERRA). Circulation features and moisture plumes associated with heavy precipitation events are examined. The analogues are evaluated against the relevant daily meteorological fields from the MERRA reanalysis and achieve a success rate of around 80% in detecting observed heavy events within one or two days. The method also captures the observed interannual variations of seasonal heavy events with higher correlation and smaller RMSE than MERRA precipitation. When applied to the same 27-yr twentieth-century climate model simulations from Phase 5 of the Coupled Model Intercomparison Project (CMIP5), the analogue method produces a more consistent and less uncertain number of seasonal heavy precipitation events with observation as opposed to using model-simulated precipitation. The analogue method also performs better than model-based precipitation in characterizing the statistics (minimum, lower and upper quartile, median, and maximum) of year-to-year seasonal heavy precipitation days. These results indicate the capability of CMIP5 models to realistically simulate large-scale atmospheric conditions associated with widespread local-scale heavy precipitation events with a credible frequency. Overall, the presented analyses highlight the improved diagnoses of the analogue method against an evaluation that considers modeled precipitation alone to assess heavy precipitation frequency. © 2014 American Meteorological Society.

The Project for Intercomparison of Land-Surface Parameterization Schemes phase 2(d) experiment at Valdai, Russia, offers a unique opportunity to evaluate land surface schemes, especially snow and frozen soil parameterizations. Here, the ability of the 21 schemes that participated in the experiment to correctly simulate the thermal and hydrological properties of the soil on several different timescales was examined. Using observed vertical profiles of soil temperature and soil moisture, the impact of frozen soil schemes in the land surface models on the soil temperature and soil moisture simulations was evaluated. It was found that when soil-water freezing is explicitly included in a model, it improves the simulation of soil temperature and its variability at seasonal and interannual scales. Although change of thermal conductivity of the soil also affects soil temperature simulation, this effect is rather weak. The impact of frozen soil on soil moisture is inconclusive in this experiment due to the particular climate at Valdai, where the top 1 m of soil is very close to saturation during winter and the range for soil moisture changes at the time of snowmelt is very limited. The results also imply that inclusion of explicit snow processes in the models would contribute to substantially improved simulations. More sophisticated snow models based on snow physics tend to produce better snow simulations, especially of snow ablation. Hysteresis of snow-cover fraction as a function of snow depth is observed at the catchment but not in any of the models.

The Project for the Intercomparison of Land-Surface Parameterization Schemes (PILPS) aims to improve understanding and modeling of land surface processes. PILPS phase 2(d) uses a set of meteorological and hydrological data spanning 18 yr (1966-83) from a grassland catchment at the Valdai water-balance research site in Russia. A suite of stand-alone simulations is performed by 21 land surface schemes (LSSs) to explore the LSSs' sensitivity to downward longwave radiative forcing, timescales of simulated hydrologic variability, and biases resulting from single-year simulations that use recursive spinup. These simulations are the first in PILPS to investigate the performance of LSSs at a site with a well-defined seasonal snow cover and frozen soil. Considerable model scatter for the control simulations exists. However, nearly all the LSS scatter in simulated root-zone soil moisture is contained within the spatial variability observed inside the catchment. In addition, all models show a considerable sensitivity to longwave forcing for the simulation of the snowpack, which during the spring melt affects runoff, meltwater infiltration, and subsequent evapotranspiration. A greater sensitivity of the ablation, compared to the accumulation, of the winter snowpaek to the choice of snow parameterization is found. Sensitivity simulations starting at prescribed conditions with no spinup demonstrate that the treatment of frozen soil (moisture) processes can affect the long-term variability of the models. The single-year recursive runs show large biases, compared to the corresponding year of the control run, that can persist through the entire year and underscore the importance of performing multiyear simulations.

Off-line simulations of improved bucket hydrology and Simplified Simple Biosphere (SSiB) models are performed for a grassland vegetation catchment region, located at the Valdai water-balance research station in Russia, forced by observed meteorological and simulated actinometric data for 1966-83. Evaluation of the model simulations is performed using observations of total soil moisture in the top 1 m, runoff, evaporation, snow depth, and water-table depth made within the catchment. The Valdai study demonstrates that using only routine meteorological measurements, long-term simulations of land-surface schemes suitable for model evaluation can be made. The Valdai dataset is available for use in the evaluation of other land-surface schemes. Both the SSiB and the bucket models reproduce the observed hydrology averaged over the simulation period (1967-83) and its interannual variability reasonably well. However, the models' soil moisture interannual variability is too low during the fall and winter when compared to observations. In addition, some discrepancies in the models' seasonal behavior with respect to observations are seen. The models are able to reproduce extreme hydrological events to some degree, but some inconsistencies in the model mechanisms are seen. The bucket model's soil-moisture variability is limited by its inability to rise above its prescribed field capacity for the case where the observed water table rises into the top 1-m layer of soil, which can lead to erroneous simulations of evaporation and runoff. SSiB's snow depth simulations are generally too low due to high evaporation from the snow surface. SSiB typically produces drainage out of its bottom layer during the summer, which appears inconsistent to the runoff observations of the catchment.

In this paper, SSiB's development and some of its major parameterizations in the model are briefly reviewed. The soil moisture parameterizations, which are a key element in the model, are comprehensively described. The sensitivity study shows that hydraulic conductivity at saturation, B parameter, and wilting point have a profound impact on the simulation of soil moisture, but with different features. Both hydraulic conductivity at saturation and B parameter influence the soil moisture simulation by changing the soil hydraulic conductivity and the field capacity. The changes in equilibrium soil water content in this study are consistent with the changes in field capacity. The wilting point affects the soil moisture through vegetation transpiration. Through these sensitivity studies, improvements in modeling the soil moisture content of HAPEX-Mobilhy data are made. The soil moisture simulations at six Russian sites are also re-examined. After applying the results from the sensitivity studies of the HAPEX-Mobilhy data, the soil moisture simulation of the Russian data is significantly improved.

Some early and current general circulation models (GCMs) use bucket models for soil hydrology calculations. More recently, the Simple Biosphere Model (SiB) was developed to incorporate the effects of vegetation on fluxes of moisture, momentum, and energy at the earth's surface into soil hydrology models. In this study, a Simplified SiB (SSiB) soil hydrology model and a 15-cm bucket model are forced by observed meteorological and actinometric data every 3 h for 6-yr simulations at the six stations. The model calculations of soil moisture are compared to observations of soil moisture, literally "ground truth', snow cover, surface albedo, and net radiation, and with each other. While producing similar soil moisture simulations, the models produce very different surface latent and sensible heat fluxes, which would have large effects on GCM simulations. -from Authors