Urban stormwater retention capacity of nature-based solutions at different climatic conditions

Climate change and the continuing increase in human population creates a growing need to tackle urban stormwater problems. One promising mitigation option is by using nature-based solutions (NBS) – especially sustainable urban stormwater management technologies that are key elements of NBS action. We used a synthesis approach to compile available information about urban stormwater retention capacity of the most common sustainable urban drainage systems (SUDS) in different climatic conditions. Those SUDS targeting stormwater management through water retention and removal solutions (mainly by infiltration, overland flow and evapotranspiration), were addressed in this study. Selected SUDS were green roofs, bioretention systems (i.e. rain gardens), buffer and filter strips, vegetated swales, constructed wetlands, and water-pervious pavements. We found that despite a vast amount of data available from real-life applications and research results, there is a lack of decisive information about stormwater retention and removal capacity of selected SUDS. The available data show large variability in performance across different climatic conditions. It is therefore a challenge to set conclusive widely applicable guidelines for SUDS implementation based on available water retention data. Adequate data were available only to evaluate the water retention capacity of green roofs (average 56±20%) and we provide a comprehensive review on this function. However, as with other SUDS, still the same problem of high variability in the performance (min 11% and max 99% of retention) remains. This limits our ability to determine the capacity of green roofs to support better planning and wider implementation across climate zones. The further development of SUDS to support urban stormwater retention should be informed by and developed concurrently with the adaptation strategies to cope with climate change, especially with increasing frequency of extreme precipitation events that lead to high volumes of stormwater runoff

Adjuvant Radio-chemotherapy for extrahepatic biliary tract cancers

<p>Abstract</p> <p>Background</p> <p>Extrahepatic biliary duct cancers (EBDC) are uncommon malignancies characterized by a poor prognosis with high rate of loco-regional recurrence. The purpose of the present study is to assess the feasibility and the potential impact of adjuvant radiotherapy (RT) in a series of patients treated in one institution.</p> <p>Methods</p> <p>Twenty three patients with non-metastatic bile duct cancer treated surgically with curative intent (4 gallbladder, 7 ampullary and 12 cholangiocarcinoma) received 3D conformal external beam RT to a median total dose of 50.4Gy. Concurrent chemotherapy based on 5-FU was delivered to 21 patients (91%). Surgical margins were negative in 11 patients (48%), narrow in 2 (9%), and microscopically involved in 8 (35%). Eleven patients (55%) had metastatic nodal involvement. The average follow-up time for all patients was 30 months (ranging from 3-98).</p> <p>Results</p> <p>Acute gastrointestinal grade 2 toxicity (RTOG scale) was recorded in 2 patients (9%). Nausea or vomiting grade 1 and 2 was observed in 8 (35%) and 2 patients (9%) respectively. Only one patient developed a major late radiation-induced toxicity. The main pattern of recurrence was both loco-regional and distant (liver, peritoneum and/or lung). No difference was observed in loco-regional control according to the tumor location. The 5-year actuarial loco-regional control rate was 48.3% (67% and 30% for patients operated on with negative and positive/narrow/unknown margins respectively, p = 0.04). The 5-year actuarial overall survival was of 35.9% for the entire group (61.4% in case of negative margins and 16.7% in case of positive/narrow/unknown margins, p = 0.07).</p> <p>Conclusions</p> <p>Postoperative RT with 50-60 Gy is feasible with acceptable acute and late toxicities. The potential benefit observed in our series may support the use of adjuvant RT in patients with locally advanced disease. Prospective randomized trials are warranted to confirm definitively the role of RT in this tumor location.</p