This study is an extensive revision of the Climatic Research Unit (CRU) land station temperature database that has been used to produce a grid‐box data set of 5° latitude × 5° longitude temperature ...anomalies. The new database (CRUTEM4) comprises 5583 station records of which 4842 have enough data for the 1961–1990 period to calculate or estimate the average temperatures for this period. Many station records have had their data replaced by newly homogenized series that have been produced by a number of studies, particularly from National Meteorological Services (NMSs). Hemispheric temperature averages for land areas developed with the new CRUTEM4 data set differ slightly from their CRUTEM3 equivalent. The inclusion of much additional data from the Arctic (particularly the Russian Arctic) has led to estimates for the Northern Hemisphere (NH) being warmer by about 0.1°C for the years since 2001. The NH/Southern Hemisphere (SH) warms by 1.12°C/0.84°C over the period 1901–2010. The robustness of the hemispheric averages is assessed by producing five different analyses, each including a different subset of 20% of the station time series and by omitting some large countries. CRUTEM4 is also compared with hemispheric averages produced by reanalyses undertaken by the European Centre for Medium‐Range Weather Forecasts (ECMWF): ERA‐40 (1958–2001) and ERA‐Interim (1979–2010) data sets. For the NH, agreement is good back to 1958 and excellent from 1979 at monthly, annual, and decadal time scales. For the SH, agreement is poorer, but if the area is restricted to the SH north of 60°S, the agreement is dramatically improved from the mid‐1970s.
Key Points
Revised and updated version of a data set
Series robust to numerous choices
Series agrees with reanalysis output since 1970s
Recent developments in observational near‐surface air temperature and sea‐surface temperature analyses are combined to produce HadCRUT4, a new data set of global and regional temperature evolution ...from 1850 to the present. This includes the addition of newly digitized measurement data, both over land and sea, new sea‐surface temperature bias adjustments and a more comprehensive error model for describing uncertainties in sea‐surface temperature measurements. An ensemble approach has been adopted to better describe complex temporal and spatial interdependencies of measurement and bias uncertainties and to allow these correlated uncertainties to be taken into account in studies that are based upon HadCRUT4. Climate diagnostics computed from the gridded data set broadly agree with those of other global near‐surface temperature analyses. Fitted linear trends in temperature anomalies are approximately 0.07°C/decade from 1901 to 2010 and 0.17°C/decade from 1979 to 2010 globally. Northern/southern hemispheric trends are 0.08/0.07°C/decade over 1901 to 2010 and 0.24/0.10°C/decade over 1979 to 2010. Linear trends in other prominent near‐surface temperature analyses agree well with the range of trends computed from the HadCRUT4 ensemble members.
Key Points
Updated version of a global temperature data set
An ensemble approach is adopted to describe correlated uncertainties
Improved estimates of uncertainty in global and regional temperature timeseries
Standard management of borderline ovarian tumours (BOT) is historically radical and based on hysterectomy, bilateral salpingo-oophorectomy and peritoneal staging. But, as 1/3 of BOTs are diagnosed in ...patients aged less than 40 years, treatments preserving fertility-potential (with preservation of the uterus and at least part of one ovary) has seen great developments in the last decade. Such treatments increase the rate of recurrences (between 15% and 35% depending on the type of conservative surgery), but without any impact on patient survival as most recurrent diseases are of the borderline type, easily curable and with excellent prognosis. The spontaneous pregnancy rate is nearly 50%. In case of persistent infertility, it seems that the use of ovarian induction or in vitro fertilization procedures could be proposed in selected cases. Follow-up is essential and based on clinical examination and routine ultrasonography. The interest of completion surgery (removal of the retained ovary) in patients who obtained pregnancy remains debated. In conclusion, conservative management of at least part of one ovary and uterus could be safely proposed at least to patients with early stage BOT, in order to preserve fertility-potential. The rate of recurrence is increased but without any impact on survival.
Helicopter landing on a ship is a visually regulated "rendezvous" task during which pilots must use fine control to land a powerful rotorcraft on the deck of a moving ship tossed by the sea while ...minimizing the energy at impact. Although augmented reality assistance can be hypothesized to improve pilots' performance and the safety of landing maneuvers by guiding action toward optimal behavior in complex and stressful situations, the question of the optimal information to be displayed to feed the pilots' natural information-movement coupling remains to be investigated. Novice participants were instructed to land a simplified helicopter on a ship in a virtual reality simulator while minimizing energy at impact and landing duration. The wave amplitude and related ship heave were manipulated. We compared the benefits of two types of visual augmentation whose design was based on either solving cockpit-induced visual occlusion problems or strengthening the online regulation of the deceleration by keeping the current tau variable around an ideal value of -0.5 to conduct smooth and efficient landing. Our results showed that the second augmentation, ecologically grounded, offers benefits at several levels of analysis. It decreases the landing duration, improves the control of the helicopter displacement, and sharpens the sensitivity to changes in tau. This underlines the importance for designers of augmented reality systems to collaborate with psychologists to identify the relevant perceptual-motor strategy that must be encouraged before designing an augmentation that will enhance it.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Since the last two decades, the feasibility of fertility-sparing surgery (FSS) in early-stage epithelial ovarian cancer (EOC) has been explored by several teams and is reconsidered in this systematic ...review undertaken using the PRISMA guidelines. Borderline ovarian tumours and non-EOCs were excluded. This review comprises 1150 patients and 139 relapsing patients reported by 21 teams. This conservative treatment can be safely carried out for stage IA and IC grade 1 and 2 disease and stage IC1 according to the new FIGO staging system. Nevertheless, the number of patients reported with grade 2 disease is too small to definitively confirm whether FSS is safe in this subgroup. For patients with ‘less favourable’ prognostic factors (grade 3 or stage IC3 disease), the safety of FSS could not be confirmed, but patients should be informed that radical treatment probably may not necessarily improve their oncological outcome, because the poorest survival observed could be related to the natural history of the disease itself and not specifically to the use of conservative therapy. FSS could probably be considered in stage I clear-cell tumours but should remain contraindicated for stage II/III disease (whatever the histologic subtype). As the disease stage and the histologic data (tumour type and grade) are crucial to patient selection for this treatment, this implies careful and mandatory complete surgical staging surgery in this context and a pathological analysis (or review) of the tumour by an expert pathologist.
Lymphocytic infiltration at diagnosis is prognostic in EOC, however, the impact of NACT on tumour infiltrating lymphocytes (TILs) or PD-L1 expression remains poorly described.
Patients with EOC and ...sequential samples (pre-NACT, post-NACT or relapse) were retrospectively identified. TILs were evaluated on whole sections; stromal TILs (sTILs) scored as percentage of stromal area with high sTILs defined as ≥50%; intra-epithelial TILs (ieTILs) scored semi-quantitatively (0–3) with high ieTILs ≥2. A smaller number were available for PD-L1 evaluation, cut-off for positivity was ≥5% staining.
sTILs were detected in all tumours at diagnosis (range 2–90%, median 20%), with 22% (25/113) showing high sTILs. Among evaluable paired pre/post-NACT samples (N=83), an overall increase in median sTILs from 20% to 30% was seen following NACT (P=0.0005); individually the impact of NACT varied with sTILs increasing in 51% (42/83), decreasing in 25%, and stable in 24%. Post-NACT sTILs were predictive of platinum-free interval (PFI), patients with PFI ≥6 months had significantly higher post-NACT sTILs (sTILs 28% versus 18% for PFI <6 months,P=0.026); pre-NACT sTILS were not predictive. At diagnosis, 23% showed high ieTILs, and following NACT 33% showed increasing ieTILs. Proportion of tumours with PD-L1-positive immune cells was 30% (15/50) pre-NACT and 53% (27/51) post-NACT (P=0.026). Among paired tumours, 63% of PD-L1-negative tumours became positive after NACT, furthermore cisplatin induced PD-L1 expression in PD-L1-negative EOC cell lines. On multivariate analysis, high sTILs both pre- and post-NACT were independent prognostic factors for progression-free survival (PFS) (HR 0.49,P=0.02 and HR 0.60,P=0.05, respectively). No prognostic impact of ieTILs or PD-L1 expression was detected.
In EOC, sTILs levels are prognostic at diagnosis and remain prognostic after NACT. TILs and PD-L1 expression increase following NACT. Evaluation of immune parameters in the post-NACT tumour may help select patients for immunotherapy trials.
•In stage IB1 cervical cancer, the recurrence rate observed after simple cone/trachelectomy is 4%.•In stage IB2 disease, the lower rate of recurrence is observed after radical trachelectomy by ...abdominal approach.•In stage IB2 disease, the highest recurrence rate is observed after neo-adjuvant chemotherapy and conservative surgery.•The lower fertility results are observed after radical trachelectomy by laparotomic approach.
Several techniques can be proposed as fertility sparing surgery in young patients treated for cervical cancer but uncertaincies remain concerning their outcomes. Analysis of oncological issues is then the first aim of this review in order to evaluate the best strategy.
Data were identified from searches of MEDLINE, Current Contents, PubMed and from references in relevant articles from January 1987 to 15th of September 2021. We carry out an updated systematic review involving 5862 patients initially selected for fertility-sparing surgery in 275 series.
In patients having a stage IB1 disease, recurrence rate/RR in patients undergoing simple conisation/trachelectomy, radical trachelectomy/RT by laparoscopico-vaginal approach, laparotomic or laparoscopic approaches are respectively: 4.1%, 4.7%, 2.4% and 5.2%. In patients having a stage IB2 disease, RR after neoadjuvant chemotherapy or RT by laparotomy are respectively 13.2% and 4.8% (p = .0035). After neoadjuvant treatment a simple cone/trachelectomy was carried out in 91 (30%) patients and a radical one in 210 (70%) cases. But the lowest pregnancy rate is observed in patients undergoing RT by laparotomy (36%).
The choice between these treatments should be based above all, on objective oncological data that strike a balance for each procedure between the best chances for cure and the fertility results. In patients having a stage IB1 disease, oncological results are quite similar according to the procedure used. In patients having a stage IB2 disease, RT by open approach has the lowest RR. Anyway the lowest pregnancy rate is observed in patients undergoing RT by laparotomy.
When attempting to land on a ship deck tossed by the sea, helicopter pilots must make sure that the helicopter can develop sufficient lift to be able to safely touchdown. This reminder of affordance ...theory led us to model and study the affordance of deck-landing-ability, which defines whether it is possible to land safely on a ship deck depending on the helicopter's available lift and the ship's deck heave movements. Two groups of participants with no piloting experience using a laptop helicopter simulator attempted to land either a low-lifter or a heavy-lifter helicopter on a virtual ship deck by either triggering a pre-programmed lift serving as the descent law if it was deemed possible to land, or aborting the deck-landing maneuver. The deck-landing-ability was manipulated by varying the helicopter's initial altitude and the ship's heave phase between trials. We designed a visual augmentation making visible the deck-landing-ability, and thus enabling participants to maximize the safety of their deck-landing attempts and reduce the number of unsafe deck-landing. The visual augmentation presented here was perceived by participants as a means of facilitating this decision-making process. The benefits were found to have originated from the clear-cut distinction it helped them to make between safe and unsafe deck-landing windows and the display of the optimal time for initiating the landing.
Abstract
The development of guidelines recommendations is one of the core activities of the European Society for Medical Oncology (ESMO) and European Society of Gynaecologial Oncology (ESGO), as part ...of the mission of both societies to improve the quality of care for patients with cancer across Europe. ESMO and ESGO jointly developed clinically relevant and evidence-based recommendations in several selected areas in order to improve the quality of care for women with ovarian cancer. The ESMO–ESGO consensus conference on ovarian cancer was held on 12–14 April 2018 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of ovarian cancer. Before the conference, the expert panel worked on five clinically relevant questions regarding ovarian cancer relating to each of the following four areas: pathology and molecular biology, early-stage and borderline tumours, advanced stage disease and recurrent disease. Relevant scientific literature, as identified using a systematic search, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. The recommendations presented here are thus based on the best available evidence and expert agreement. This article presents the recommendations of this ESMO–ESGO consensus conference, together with a summary of evidence supporting each recommendation.
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