A consistent approach for probabilistic residential flood loss modeling in Europe

In view of globally increasing flood losses, a significantly improved and more efficient flood risk management and adaptation policy are needed. One prerequisite is reliable risk assessments on the continental scale. Flood loss modeling and risk assessments for Europe are until now based on regional approaches using deterministic depth‐damage functions. Uncertainties associated with the risk estimation are hardly known. To reduce these shortcomings, we present a novel, consistent approach for probabilistic flood loss modeling for Europe, based on the upscaling of the Bayesian Network Flood Loss Estimation MOdel for the private sector, BN‐FLEMOps. The model is applied on the mesoscale in the whole of Europe and can be adapted to regional situations. BN‐FLEMOps is validated in three case studies in Italy, Austria, and Germany. The officially reported loss figures of the past flood events are within the 95% quantile range of the probabilistic loss estimation, for all three case studies. In the Italian, Austrian, and German case studies, the median loss estimate shows an overestimation by 28% (2.1 million euro) and 305% (5.8 million euro) and an underestimation by 43% (104 million euro), respectively. In two of the three case studies, the performance of the model improved, when updated with empirical damage data from the area of interest. This approach represents a step forward in European wide flood risk modeling, since it delivers consistent flood loss estimates and inherently provides uncertainty information. Further validation and tests with respect to adapting the model to different European regions are recommended

Comparison of adjustable male slings and artificial urinary sphincter in the treatment of male urinary incontinence: a retrospective analysis of patient selection and postoperative continence status

Purpose To analyze and compare preoperative patient characteristics and postoperative results in men with stress urinary incontinence (SUI) selected for an adjustable male sling system or an artificial urinary sphincter (AUS) in a large, contemporary, multi-institutional patient cohort.Methods658 male patients who underwent implantation between 2010 and 2012 in 13 participating institutions were included in this study (n=176 adjustable male sling; n=482 AUS). Preoperative patient characteristics and postoperative outcomes were analyzed. For statistical analysis, the independent T test and Mann-Whitney U test were used.ResultsPatients undergoing adjustable male sling implantation were less likely to have a neurological disease (4.5% vs. 8.9%, p=0.021), a history of urethral stricture (21.6% vs. 33.8%, p=0.024) or a radiation therapy (22.7% vs. 29.9%, p=0.020) compared to patients that underwent AUS implantation. Mean pad usage per day (6.87 vs. 5.82; p<0.00) and the ratio of patients with a prior incontinence surgery were higher in patients selected for an AUS implantation (36.7% vs. 22.7%; p<0.001). At maximum follow-up, patients that underwent an AUS implantation had a significantly lower mean pad usage during daytime (p<0.001) and nighttime (p=0.018). Furthermore, the patients' perception of their continence status was better with a subjective complete dry rate of 57.3% vs. 22.0% (p<0.001).ConclusionsPatients selected for an AUS implantation showed a more complex prior history and pathogenesis of urinary incontinence as well as a more severe grade of SUI. Postoperative results reflect a better continence status after AUS implantation, favoring the AUS despite the more complicated patient cohort