Indirect Impact Assessment of Pluvial Flooding in Urban Areas Using a Graph-Based Approach: The Mexico City Case Study

This paper presents the application of a graph-based methodology for the assessment of flood impacts in an urban context. In this methodology, exposed elements are organized as nodes on a graph, which is used to propagate impacts from directly affected nodes to other nodes across graph links. Compared to traditional approaches, the main advantage of the adopted methodology lies in the possibility of identifying and understanding indirect impacts and cascading effects. The application case concerns floods numerically reconstructed in Mexico City in response to rainfall events of increasing return periods. The hazard reconstruction was carried out by using a simplified hydrological/hydraulic model of the urban drainage system, implemented in EPASWMM, the Storm Water Management Model developed by the United States Environmental Protection Agency. The paper shows how the impacts are propagated along different orders of the impact chain for each return period and compares the risk curves between direct and indirect impact. It also highlights the extent to which the reduction in demand of services from consumers and the loss of services from suppliers are respectively contributing to the final indirect impacts. Finally, it illustrates how different impact mitigation measures can be formulated based on systemic information provided by the analysis of graph properties and taking into account indirect impacts

trabecular bone score tbs and bone metabolism in patients affected with type 1 neurofibromatosis nf1

In patients with neurofibromatosis type 1 (NF1), decreased bone mineral density (BMD) and low levels of 25-hydroxy vitamin D3 (25OHD) have been reported. Recently, the trabecular bone score (TBS) measurement has been proposed as index of bone microarchitecture and fracture risk. In 74 NF1 patients (48 females, 26 males, age 41 ± 12), we measured TBS and investigated clinical stage, lifestyle, vitamin D, serum bone turnover markers, vertebral and femoral BMD. A homogenous cohort of 61 healthy subjects was used as control group. TBS was lower in NF1 patients (1.266 ± 0.113 vs. 1.346 ± 0.105) without differences between sexes. No correlations with 25OHD, low exercise, low calcium intake, reduced sun exposure, and number of skin neurofibromas were observed. As expected, hypovitaminosis D was common (98.6%), as well as BMD reduction in hip and spine sites: In NF1 patients, bone texture evaluated by TBS was low in both sexes without any correlation with clinical or metabolic parameters, suggesting a direct role of the fibromin mutation

Assessment of the Disaster Resilience of Complex Systems: The Case of the Flood Resilience of a Densely Populated City

In the last decades, resilience became officially the worldwide cornerstone to reduce the risk of disasters and improve preparedness, response, and recovery capacities. Although the concept of resilience is now clear, it is still under debate how to model and quantify it. The aim of this work was to quantify the resilience of a complex system, such as a densely populated and urbanized area, by modelling it with a graph, the mathematical representation of the system element and connections. We showed that the graph can account for the resilience characteristics included in its definition according to the United Nations General Assembly, considering two significant aspects of this definition in particular: (1) resilience is a property of a system and not of single entities and (2) resilience is a property of the system dynamic response. We proposed to represent the exposed elements of the system and their connections (i.e., the services they exchange) with a weighted and redundant graph. By mean of it, we assessed the systemic properties, such as authority and hub values and highlighted the centrality of some elements. Furthermore, we showed that after an external perturbation, such as a hazardous event, each element can dynamically adapt, and a new graph configuration is set up, taking advantage of the redundancy of the connections and the capacity of each element to supply lost services. Finally, we proposed a quantitative metric for resilience as the actual reduction of the impacts of events at different return periods when resilient properties of the system are activated. To illustrate step by step the proposed methodology and show its practical feasibility, we applied it to a pilot study: the city of Monza, a densely populated urban environment exposed to river and pluvial floods

Service Accessibility Risk (SAR) Assessment for Pluvial and Fluvial Floods in an Urban Context

The development of strategies to adapt to and mitigate the potential adverse consequences of natural hazards requires support from risk assessment studies that quantify the impacts of hazardous events on our society. A comprehensive analysis of risk commonly evaluates the elements exposed to the hazard probabilistic scenarios and their vulnerabilities. However, while significant advances have been made in the assessment of direct losses, indirect impacts are less frequently examined. This work assesses the indirect consequences of two hydrologic hazards, i.e., pluvial and fluvial floods, in an urban context from a system perspective. It presents a methodology to estimate the services accessibility risk (SAR) that considers the accessibility of roads and the connection between providers and users of services in a city. The feasibility of the proposed approach is illustrated by an application to a pilot study in Monza city (northern Italy) considering pluvial and fluvial flood hazard with different return periods. The results in terms of the social and economic impacts are analyzed considering features of age, disability, and the different economic sectors

Indirect Impact Assessment of Pluvial Flooding in Urban Areas Using a Graph-Based Approach: The Mexico City Case Study

This paper presents the application of a graph-based methodology for the assessment of flood impacts in an urban context. In this methodology, exposed elements are organized as nodes on a graph, which is used to propagate impacts from directly affected nodes to other nodes across graph links. Compared to traditional approaches, the main advantage of the adopted methodology lies in the possibility of identifying and understanding indirect impacts and cascading effects. The application case concerns floods numerically reconstructed in Mexico City in response to rainfall events of increasing return periods. The hazard reconstruction was carried out by using a simplified hydrological/hydraulic model of the urban drainage system, implemented in EPASWMM, the Storm Water Management Model developed by the United States Environmental Protection Agency. The paper shows how the impacts are propagated along different orders of the impact chain for each return period and compares the risk curves between direct and indirect impact. It also highlights the extent to which the reduction in demand of services from consumers and the loss of services from suppliers are respectively contributing to the final indirect impacts. Finally, it illustrates how different impact mitigation measures can be formulated based on systemic information provided by the analysis of graph properties and taking into account indirect impacts

Integrated Flood Impact and Vulnerability Assessment Using a Multi-Sensor Earth Observation Mission with the Perspective of an Operational Service in Lombardy, Italy

The frequency and the accumulation of medium–small flood events can cause severe impacts. In a climate change context, real-time monitoring and a fast risk assessment are needed to support the post-disaster phases. The present work presents a novel methodology that leverages the potential of earth observation data to produce a proof-of-concept for flood vulnerability assessment, serving as the basis for a Map Operational Service for the Lombardy region. The proof-of-concept is related to both flood hazard estimation and vulnerability assessment, considering the evaluation of the potentialities of the synthetic aperture radar data when used to feed a downstream service. Using the city of Pavia (Italy), which was affected by a flood event in November 2019, as a case study, we present an integrated flood impact approach that includes a combination of social and physical parameters. The results contribute to a processing chain designed as a pre-operational service where each data analytic retrieves thematic products to support the exposure and damage estimates based on earth observation-derived hazard products for emergency and recovery responses. Three different satellites covered more than 40 h of the flood’s evolution, supporting the great potential of the multi-sensor approach. Therefore, different sensor configurations in terms of spectral bands (X and C bands) and resolutions (from 10 to 1 m) provide a near real-time view of the event. Comparing the results obtained through the three hazard scenarios, a final social and physical Integrated Impact Index is obtained. The added value information leads to the determination of hotspots with which to prioritize effective interventions during emergency and recovery phases, crucial for capturing inherent conditions that allow communities to absorb impacts and cope with a damaging flood event

Reevaluation of Acromegalic Patients in Long-Term Remission according to Newly Proposed Consensus Criteria for Control of Disease

Acromegaly guidelines updated in 2010 revisited criteria of disease control: if applied, it is likely that a percentage of patients previously considered as cured might present postglucose GH nadir levels not adequately suppressed, with potential implications on management. This study explored GH secretion, as well as hormonal, clinical, neuroradiological, metabolic, and comorbid profile in a cohort of 40 acromegalic patients considered cured on the basis of the previous guidelines after a mean follow-up period of 17.2 years from remission, in order to assess the impact of the current criteria. At the last follow-up visit, in the presence of normal IGF-I concentrations, postglucose GH nadir was over 0.4 mu g/L in 11 patients (Group A) and below 0.4 mu g/L in 29 patients (Group B); moreover, Group A showed higher basal GH levels than Group B, whereas a significant decline of both GH and postglucose GH nadir levels during the follow-up was observed in Group B only. No differences in other evaluated parameters were found. These results seem to suggest that acromegalic patients considered cured on the basis of previous guidelines do not need a more intensive monitoring than patients who met the current criteria of disease control, supporting instead that the cut-off of 0.4 mcg/L might be too low for the currently used GH assay

Thermal Stability and Thermodynamic Performances of Pure Siloxanes and Their Mixtures in Organic Rankine Cycles

Organic Rankine cycles are often the best solution for the conversion of thermal energy. The many working fluids include silicon oils. One crucial issue that determines the choice of a working fluid is its thermochemical stability, as this sets a limit to the maximum temperature at which the fluidcanbeusedinapowerplant. Asecondsubject,muchdebatedtoday,istheuseofmixtures in ORCs. In the first part of this study, an investigation into the thermal stability of siloxanes using two different approaches was carried out. The results confirmed a limit working temperature for the considered siloxanes of about 300 °C, with a degradation that advanced significantly over time at 350 °C. In the second part of the study, an analysis of the thermodynamic performances of some siloxane mixtures was carried out. It was found that the efficiencies of the corresponding thermodynamic cycles were substantially the same as for the pure fluids used today. By changing the composition of the mixture, it was also possible to vary, within reasonable limits, the values of the condensation pressure, adapting the thermodynamic cycle to the different situations that can be encountered in current practice

Nuove terapie ipolipemizzanti per i pazienti con ipercolesterolemia familiare Position Paper della Società Italiana per lo studio della Arteriosclerosi

Familial hypercholesterolaemia (FH) is the main genetic cause of premature coronary heart disease (CHD), characterized by raised serum LDL-cholesterol levels, which result in excess deposition of cholesterol in tissues. FH results from defects in the hepatic uptake and degradation of LDL via the LDL-receptor pathway. Owing to severe underdiagnosis and undertreatment of FH, there is an urgent worldwide need for diagnostic screening together with early and aggressive treatment. This position paper aims to improve awareness of the need for early detection and management of FH patients, to determine treatment objectives, and to delineate treatment priorities.FH is diagnosed either on phenotypic criteria and/or positive genetic testing. We recommend cascade screening of families using a combined phenotypic and genotypic strategy. A healthy lifestyle and early maximal statin treatment are the cornerstones of management of FH. In heterozygous FH patients, LDLcholesterol targets are <2.5 mmol/L (<100 mg/dL) and <1.8 mmol/L (<70 mg/dL) for adults with known CHD, other major risk factors, or documented preclinical atherosclerosis. In addition to lifestyle and dietary counselling, treatment priorities are maximal potent statin dose, ezetimibe, and bile acid binding resins. PCSK9 inhibitors and lipoprotein apheresis can be offered in treatment-resistant or intolerant patients. In homozygous FH patients, LDL-cholesterol targets are <1.8 mmol/L (<70 mg/dL) or at least 50% reduction. Lifestyle intervention and maximal statin therapy are the mainstays of treatment. Even at the highest doses of the most efficacious statins, however, only modest reductions in LDL-C plasma levels are observed in most patients. Adjunctive lipoprotein apheresis is recommended where available, together with new therapeutic approaches recently approved: lomitapide and mipomersen (the latter not in Italy). In FH patients, we recommend regular follow-up, including liver function tests, steatosis, vascular status