Keynote Lecture – The Interplay of Multiple Hazards and Urban Development: The context of Istanbul

Tomorrow’s Cities is the UK Research and Innovation (UKRI) Global Challenges Research Fund (GCRF) Urban Disaster Risk Hub – an interdisciplinary research hub with the aim to catalyse a transition from crisis management to multi-hazard risk-informed and inclusive planning in four cities in low-and-middle income countries. Istanbul in Turkey is one of the four cities investigated. It is one of the largest urban agglomerations in Europe where more than 15 million people reside in more than 1 million buildings. Considering that the population was 4.75 million in 1980, Istanbul’s urban sprawl was inevitable. Due to an imbalance between the population growth and housing supply, Istanbul’s urbanization was shaped by illegal construction processes producing the gecekondus in almost every part of the city (Gencer and Mentese, 2016). Unplanned urban expansion was so rapid that the urban master plan of 1980, which set the limits and strategies for urban development, became completely invalid by 1989 (Tapan, 1998). This situation led to the development of a new urban master plan in 1994 that included geoscientific analysis, and which highlighted the possibility of losses due to an earthquake on the segments of the North Anatolian Fault in the Marmara Sea. Uncontrolled and unplanned development continued in Istanbul until 1999 when two major earthquakes hit the region causing at least 18.000 deaths and $16 billion economic loss. These events changed the authorities’ perspective to earthquake risk and its mitigation. As a result, the 1998 earthquake resistant design code (published one year before the 1999 earthquakes) was widely embraced and implemented. Furthermore, several urban transformation projects have taken place in the last 20 years for reducing disaster risk. These have had varied success, with research to date showing that areas selected for urban transformation were often chosen on the basis of land value rather than hazard risk, and that a pro-poor approach is missing. Despite these efforts, Istanbul’s earthquake risk remains high. Furthermore, recent urban development plans are seeing the city expand into undeveloped lands to the west, increasing exposure to new hazards, namely flash flooding and landslides. The combined impact of these hazards is not evenly distributed, and the associated risks are heightened by poor infrastructural resilience and social vulnerabilities. Therefore, it is crucial to integrate different types of hazards and risks into the urban development context for future scenarios, so that a physically and socio-economically safer development that prioritizes the wellbeing of local communities can be facilitated. This presentation summarises the research conducted in Istanbul over the first 18 months of the Tomorrow’s Cities Project by a consortium of Turkish and UK researchers. This research spans the better characterisation of earthquake and landslide hazards, development of analysis methods for predicting the response of case study buildings to multiple hazards and a Bayesian network based approach for assessing road infrastructure resilience under multiple hazard scenarios. Furthermore, plans for building a Resilient Urban Development Decision Support Environment (RUD-DSE) for communicating the relevance of this research on future urban planning is described

Adhesion of alumina surfaces through confined water layers containing various molecules

When two surfaces confine water layers between them at the nanoscale, the behaviour of these confined water molecules can deviate significantly from the behaviour of bulk water and it could reflect on the adhesion of such surfaces. Thus, the aim of this study is to assess the role of confined water layers on the adhesion of hydrophilic surfaces and how sensitive this adhesion is to the presence of contaminants. Our methodology used under water AFM force measurements with an alumina sputtered sphere-tipped cantilever and a flat alumina single crystal, then added fractions of ethanol, dimethylformamide, formamide, trimethylamine, and trehalose to water, as contaminants. Such solutions were designed to illuminate the influences of dielectric constant, molecular size, refractive index and number of hydrogen bonds from donors and acceptors of solutes to water. Apart from very dilute solutions of dimethylformamide, all solutions decreased the ability of confined water to give adhesion of the alumina surfaces. The predicted theoretical contribution of van der Waals and electrostatic forces was not observed when the contaminants distorted the way water organizes itself in confinement. The conclusion was that adhesion was sensitive mostly to hydrogen bonding network within water layers confined by the hydrophilic alumina surfaces

Minimal Extrathyroidal Extension in Predicting 1-Year Outcomes: A Longitudinal Multicenter Study of Low-to-Intermediate-Risk Papillary Thyroid Carcinoma (ITCO#4)

Background: The role of minimal extrathyroidal extension (mETE) as a risk factor for persistent papillary thyroid carcinoma (PTC) is still debated. The aims of this study were to assess the clinical impact of mETE as a predictor of worse initial treatment response in PTC patients and to verify the impact of radioiodine therapy after surgery in patients with mETE. Methods: We reviewed all records in the Italian Thyroid Cancer Observatory database and selected 2237 consecutive patients with PTC who satisfied the inclusion criteria (PTC with no lymph node metastases and at least 1 year of follow-up). For each case, we considered initial surgery, histological variant of PTC, tumor diameter, recurrence risk class according to the American Thyroid Association (ATA) risk stratification system, use of radioiodine therapy, and initial therapy response, as suggested by ATA guidelines. Results: At 1-year follow-up, 1831 patients (81.8%) had an excellent response, 296 (13.2%) had an indeterminate response, 55 (2.5%) had a biochemical incomplete response, and 55 (2.5%) had a structural incomplete response. Statistical analysis suggested that mETE (odds ratio [OR] 1.16, p = 0.65), tumor size >2 cm (OR 1.45, p = 0.34), aggressive PTC histology (OR 0.55, p = 0.15), and age at diagnosis (OR 0.90, p = 0.32) were not significant risk factors for a worse initial therapy response. When evaluating the combination of mETE, tumor size, and aggressive PTC histology, the presence of mETE with a >2 cm tumor was significantly associated with a worse outcome (OR 5.27 [95% confidence interval], p = 0.014). The role of radioiodine ablation in patients with mETE was also evaluated. When considering radioiodine treatment, propensity score-based matching was performed, and no significant differences were found between treated and nontreated patients (p = 0.24). Conclusions: This study failed to show the prognostic value of mETE in predicting initial therapy response in a large cohort of PTC patients without lymph node metastases. The study suggests that the combination of tumor diameter and mETE can be used as a reliable prognostic factor for persistence and could be easily applied in clinical practice to manage PTC patients with low-to-intermediate risk of recurrent/persistent disease

Experimental antiproton nuclear stopping power in H2 and D2

Data about antiprotons slowing down in gaseous targets at very low energies (E<1 keV) show that the stopping power in D2 is lower than in H2; the right way to explain this behavior seems to be through a nuclear stopping power derived from the classical Rutherford formula

Antiproton stopping power in hydrogen below 120 keV and the Barkas effect

The simultaneous measurement of the spatial coordinates and times of p¯s annihilating at rest in a H2 target at very low density ρ (ρ/ρ0<10-2, ρ0 being the STP density) gives the possibility of evaluating the behavior of the p¯ stopping power in H2 at low energies (below 120 keV). It is different from that of protons (the Barkas effect). Moreover, it is shown that a rise at low-energy values (≲1 keV) is needed to agree with experimental data

Probing atmospheric electric fields in thunderstorms through radio emission from cosmic-ray-induced air showers

We present measurements of radio emission from cosmic ray air showers that took place during thunderstorms. The intensity and polarization patterns of these air showers are radically different from those measured during fair-weather conditions. With the use of a simple two-layer model for the atmospheric electric field, these patterns can be well reproduced by state-of-the-art simulation codes. This in turn provides a novel way to study atmospheric electric fields

Antiproton slowing Down in H2 and He and evidence of nuclear stopping power

We report stopping powers of hydrogen and helium for antiprotons of kinetic energies ranging from about 0.5 keV to 1.1 MeV. The Barkas effect, i.e., a difference in the stopping power for antiprotons and protons of the same energy in the same material, shows up clearly in either of the gases. Moreover, below ≈0.5 keV there is indirect evidence for an increase of the antiproton stopping power. This "nuclear" effect, i.e., energy losses in quasimolecular interactions, shows up in fair agreement with theoretical predictions

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with &gt;80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR &lt; 60 mL/min/1.73 m2) or eGFR reduction &gt; 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR &lt; 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR &gt; 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening