Urban mobility: preparing for the future, learning from the past - CREATE project summary and recommendations

Transport decisions, and their resulting impacts on land use patterns, fundamentally shape and define a city, both physically and through the daily living patterns of its citizens and visitors. As policy priorities change, so do the types of measures that are introduced, with resulting shifts in travel behaviour and lifestyles. What at one point in a city’s history is often seen as the ‘inevitable’ need to adapt the urban fabric to accommodate the growing use of the motor car, may later be replaced by a focus on people movement and sustainable mobility, and a growing interest in urban quality and vitality – a city of places for people. CREATE (Congestion Reduction in Europe: Advancing Transport Efficiency) charts these changes in policy priorities and travel behaviour through the experiences of five Western European capital cities over the last 50 years, noting the policy tensions and competing city visions, the triggers leading to change and the evolving governance arrangements that have facilitated, or sometimes retarded, such developments. As policy priorities change, so do measures of success; in a car-focused city congestion is the dominant concern, but this becomes less important as more people travel by rail or on foot or by cycle, and when cities put a greater value on high quality places. Alongside this there have been technical changes, in the types of methods used to model behaviour and appraise schemes, and in the ways in which these tools are used. This document provides an introduction to the CREATE project, focusing on findings and lessons of value to practitioners, and those developing or updating their Sustainable Urban Mobility Plans. It is underpinned by extensive qualitative and quantitative research, which is fully documented in several deliverables, and summarised in a series of Technical Notes. A more comprehensive set of Guidelines is also available

What Drives Different Types of Capital Flows and their Volatilities in Developing Asia?

Understanding the determinants of capital inflows is essential to designing an effective policy framework to manage volatile capital flows and their disruptive potential. This paper aims to identify factors that explain the size and volatility of various types of capital flows to developing Asia, vis-à-vis other emerging market economies. The estimates for a panel dataset show that per capita income growth, trade openness, and change in stock market capitalization are important determinants of capital inflows to developing Asia. Trade openness increases the volatility of all types of capital inflows; while change in stock market capitalization, global liquidity growth and institutional quality lowers the volatility. A regional factor plays an important role in determining the size and volatility of capital inflows in emerging Europe and emerging Latin America, suggesting that regional economic cooperation and policy coordination may be an important element in designing a policy framework to manage capital inflows

Landscape of alcohol-related hepatocellular carcinoma in the last 15 years highlights the need to expand surveillance programs

Background & Aims: Alcohol abuse and metabolic disorders are leading causes of hepatocellular carcinoma (HCC) worldwide. Alcohol-related aetiology is associated with a worse prognosis compared with viral agents, because of the lower percentage of patients diagnosed with HCC under routine surveillance and a higher burden of comorbidity in alcohol abusers. This study aimed to describe the evolving clinical scenario of alcohol-related HCC over 15 years (2006–2020) in Italy. Methods: Data from the Italian Liver Cancer (ITA.LI.CA) registry were used: 1,391 patients were allocated to three groups based on the year of HCC diagnosis (2006–2010; 2011–2015; 2016–2020). Patient characteristics, HCC treatment, and overall survival were compared among groups. Survival predictors were also investigated. Results: Approximately 80% of alcohol-related HCCs were classified as cases of metabolic dysfunction-associated fatty liver disease. Throughout the quinquennia, <50% of HCCs were detected by surveillance programmes. The tumour burden at diagnosis was slightly reduced but not enough to change the distribution of the ITA.LI.CA cancer stages. Intra-arterial and targeted systemic therapies increased across quinquennia. A modest improvement in survival was observed in the last quinquennia, particularly after 12 months of patient observation. Cancer stage, HCC treatment, and presence of oesophageal varices were independent predictors of survival. Conclusions: In the past 15 years, modest improvements have been obtained in outcomes of alcohol-related HCC, attributed mainly to underuse of surveillance programmes and the consequent low amenability to curative treatments. Metabolic dysfunction-associated fatty liver disease is a widespread condition in alcohol abusers, but its presence did not show a pivotal prognostic role once HCC had developed. Instead, the presence of oesophageal varices, an independent poor prognosticator, should be considered in patient management and refining of prognostic systems. Impact and Implications: Alcohol abuse is a leading and growing cause of hepatocellular carcinoma (HCC) worldwide and is associated with a worse prognosis compared with other aetiologies. We assessed the evolutionary landscape of alcohol-related HCC over 15 years in Italy. A high cumulative prevalence (78%) of metabolic dysfunction-associated fatty liver disease, with signs of metabolic dysfunction, was observed in HCC patients with unhealthy excessive alcohol consumption. The alcohol + metabolic dysfunction-associated fatty liver disease condition tended to progressively increase over time. A modest improvement in survival occurred over the study period, likely because of the persistent underuse of surveillance programmes and, consequently, the lack of improvement in the cancer stage at diagnosis and the patients’ eligibility for curative treatments. Alongside the known prognostic factors for HCC (cancer stage and treatment), the presence of oesophageal varices was an independent predictor of poor survival, suggesting that this clinical feature should be carefully considered in patient management and should be included in prognostic systems/scores for HCC to improve their performance

Urban mobility: preparing for the future, learning from the past - CREATE project summary and recommendations

Transport decisions, and their resulting impacts on land use patterns, fundamentally shape and define a city, both physically and through the daily living patterns of its citizens and visitors. As policy priorities change, so do the types of measures that are introduced, with resulting shifts in travel behaviour and lifestyles. What at one point in a city's history is often seen as the 'inevitable' need to adapt the urban fabric to accommodate the growing use of the motor car, may later be replaced by a focus on people movement and sustainable mobility, and a growing interest in urban quality and vitality - a city of places for people. CREATE (Congestion Reduction in Europe: Advancing Transport Efficiency) charts these changes in policy priorities and travel behaviour through the experiences of five Western European capital cities over the last 50 years, noting the policy tensions and competing city visions, the triggers leading to change and the evolving governance arrangements that have facilitated, or sometimes retarded, such developments. As policy priorities change, so do measures of success; in a car-focused city congestion is the dominant concern, but this becomes less important as more people travel by rail or on foot or by cycle, and when cities put a greater value on high quality places. Alongside this there have been technical changes, in the types of methods used to model behaviour and appraise schemes, and in the ways in which these tools are used. This document provides an introduction to the CREATE project, focusing on findings and lessons of value to practitioners, and those developing or updating their Sustainable Urban Mobility Plans. It is underpinned by extensive qualitative and quantitative research, which is fully documented in several deliverables, and summarised in a series of Technical Notes. A more comprehensive set of Guidelines is also available. Document type: Repor

The Changing Epidemiology of Hepatocellular Carcinoma : Experience of a Single Center

Aims: To analyze the main etiological factors and some clinical features of patients with hepatocellular carcinoma (HCC) at diagnosis and to compare them with those we described ten years ago. Materials and Methods. We compared two groups of patients with HCC, Group 1 consisting of 132 patients (82 M, 50 F) diagnosed in the 2003-2008 period and Group 2 including 119 patients (82 M, 37 F) diagnosed in the 2013-2018 period. For all patients, age, sex, viral markers, alcohol consumption, serum alpha-fetoprotein (AFP) levels, and the main liver function parameters were recorded. The diagnosis of HCC was based on AASLD, EASL guidelines. The staging was classified according to the "Barcelona Clinic Liver Cancer staging system" (BCLC). Results: Mean age was 69.0 ± 8 years in Group 1 and 71.0 ± 9 in Group 2 (P < 0.05). HCV subjects were significantly older in Group 2 (P < 0.05). HCV subjects were significantly older in Group 2 (P < 0.05). HCV subjects were significantly older in Group 2 (P < 0.05). HCV subjects were significantly older in Group 2 (P < 0.05). HCV subjects were significantly older in Group 2 (P < 0.05). HCV subjects were significantly older in Group 2 (P < 0.05). HCV subjects were significantly older in Group 2 (P < 0.05). HCV subjects were significantly older in Group 2 (. Conclusions: This study shows that over the last decade a number of features of patients with HCC in our region have changed, particularly age at onset, etiological factors, and staging of HCC