A framework for evaluating the effectiveness of flood emergency management systems in Europe

Society is faced with a range of contemporary threats to everyday life, from natural and technological hazards to accidents and terrorism. These are embodied within integrated emergency management arrangements that are designed to enhance preparedness and response to such incidents, and in turn facilitate a prompt recovery. Such arrangements must be inherently dynamic and evolve as new threats emerge or as existing threats change. An example of the latter is the changing nature of flooding, which is projected to increase in both frequency and severity with climate change. Recognizing this evolving threat, we focus on the evaluation of the effectiveness of domestic Flood Emergency Management Systems (FEMS) as components of integrated emergency management arrangements. Despite the extensive body of literature that documents success conditions of so-called effective emergency management more broadly, there have been only a few attempts to construct a comprehensive evaluation framework to support objective assessment and cross-country comparison. Addressing this gap, we formulate an evaluation framework specifically tailored to the study of FEMS in Europe, which is then provisionally applied to the study of FEMS in England (UK), France, the Netherlands, Poland, and Sweden. Important differences are observed in how FEMS have evolved in relation to differing contextual backgrounds (political, cultural, administrative, and socio-economic) and exposures to flood hazard. From this provisional assessment, a number of opportunities for, and constraints to, enhancing the effectiveness of FEMS in Europe are discerned. The evaluation framework thus serves as an important stepping stone for further indepth inquiry, and as a valuable tool for future comparative study

The undebated issue of justice: silent discourses in Dutch flood risk management

Flood risk for all types of flooding is projected to increase based on climate change projections and increases in damage potential. These challenges are likely to aggravate issues of justice in flood risk management (henceforth FRM). Based on a discursive-institutionalist perspective, this paper explores justice in Dutch FRM: how do institutions allocate the responsibilities and costs for FRM for different types of flooding? What are the underlying conceptions of justice? What are the future challenges with regard to climate change? The research revealed that a dichotomy is visible in the Dutch approach to FRM: despite an abundance of rules, regulations and resources spent, flood risk or its management, are only marginally discussed in terms of justice. Despite that the current institutional arrangement has material outcomes that treat particular groups of citizens differently, depending on the type of flooding they are prone to, area they live in (unembanked/embanked) or category of user (e.g. household, industry, farmer). The paper argues that the debate on justice will (re)emerge, since the differences in distributional outcomes are likely to become increasingly uneven as a result of increasing flood risk. The Netherlands should be prepared for this debate by generating the relevant facts and figures. An inclusive debate on the distribution of burdens of FRM could contribute to more effective and legitimate FRM

Unraveling genetic predisposition to familial or early onset gastric cancer using germline whole-exome sequencing

Recognition of individuals with a genetic predisposition to gastric cancer (GC) enables preventive measures. However, the underlying cause of genetic susceptibility to gastric cancer remains largely unexplained. We performed germline whole-exome sequencing on leukocyte DNA of 54 patients from 53 families with genetically unexplained diffuse-type and intestinal-type GC to identify novel GC-predisposing candidate genes. As young age at diagnosis and familial clustering are hallmarks of genetic tumor susceptibility, we selected patients that were diagnosed below the age of 35, patients from families with two cases of GC at or below age 60 and patients from families with three GC cases at or below age 70. All included individuals were tested negative for germline CDH1 mutations before or during the study. Variants that were possibly deleterious according to in silico predictions were filtered using several independent approaches that were based on gene function and gene mutation burden in controls. Despite a rigorous search, no obvious candidate GC predisposition genes were identified. This negative result stresses the importance of future research studies in large, homogeneous cohorts

Delineating the molecular and phenotypic spectrum of the SETD1B-related syndrome.

PURPOSE: Pathogenic variants in SETD1B have been associated with a syndromic neurodevelopmental disorder including intellectual disability, language delay, and seizures. To date, clinical features have been described for 11 patients with (likely) pathogenic SETD1B sequence variants. This study aims to further delineate the spectrum of the SETD1B-related syndrome based on characterizing an expanded patient cohort. METHODS: We perform an in-depth clinical characterization of a cohort of 36 unpublished individuals with SETD1B sequence variants, describing their molecular and phenotypic spectrum. Selected variants were functionally tested using in vitro and genome-wide methylation assays. RESULTS: Our data present evidence for a loss-of-function mechanism of SETD1B variants, resulting in a core clinical phenotype of global developmental delay, language delay including regression, intellectual disability, autism and other behavioral issues, and variable epilepsy phenotypes. Developmental delay appeared to precede seizure onset, suggesting SETD1B dysfunction impacts physiological neurodevelopment even in the absence of epileptic activity. Males are significantly overrepresented and more severely affected, and we speculate that sex-linked traits could affect susceptibility to penetrance and the clinical spectrum of SETD1B variants. CONCLUSION: Insights from this extensive cohort will facilitate the counseling regarding the molecular and phenotypic landscape of newly diagnosed patients with the SETD1B-related syndrome

Using genomic data to find disease-modifying loci in Huntington's Disease (HD)

In this chapter, genetic modifiers are defined, and the rationale for investigating them in HD explained. Issues involved in modeling the phenotype are discussed, using age at motor onset as an example. The statistical methods for analyzing genetic data (linkage and association) are discussed, along with the advantages and disadvantages of each. In particular, the advantage of a genome-wide approach over one based on candidate genes is stressed. Genome-wide association studies (GWAS) are current method of choice to detect genetic modifiers. The power of GWAS is discussed, along with sources of error, and how these might be detected and corrected. Extensions to GWAS, such as gene- and pathway-wide analyses, are discussed, and also how GWAS may be used to estimate genetic risks and trait heritability. Since GWAS are most effective to detect common genetic variants, methods for analyzing rare variation are also discussed. The uses of other types of genomic data (notably, expression) are discussed, and how they might be integrated with genetic data to find causal genes and variants. The chapter ends with a short overview of future prospects for detecting genetic modifiers of HD

Increased burden of ultra-rare protein-altering variants among 4,877 individuals with schizophrenia

By analyzing the exomes of 12,332 unrelated Swedish individuals – including 4,877 affected with schizophrenia – in ways informed by exome sequences from 45,376 other individuals, we identified 244,246 coding-sequence and splice-site ultra-rare variants (URVs) that were unique to individual Swedes. We found that gene-disruptive and putatively protein-damaging URVs (but not synonymous URVs) were more abundant in schizophrenia cases than controls (P = 1.3 × 10−10). This elevation of protein-compromising URVs was several times larger than an analogously elevated rate for de novo mutations, suggesting that most rare-variant effects on schizophrenia risk are inherited. Among individuals with schizophrenia, the elevated frequency of protein-compromising URVs was concentrated in brain-expressed genes, particularly in neuronally expressed genes; most of this genetic signal arose from large sets of genes whose RNAs have been found to interact with synaptically localized proteins. Our results suggest that synaptic dysfunction may mediate a large fraction of strong, individually rare genetic influences on schizophrenia risk