Hydrological Web Services for Operational Flood Risk Monitoring and Forecasting at Local Scale in Niger

Emerging hydrological services provide stakeholders and political authorities with useful and reliable information to support the decision-making process and develop flood risk management strategies. Most of these services adopt the paradigm of open data and standard web services, paving the way to increase distributed hydrometeorological services’ interoperability. Moreover,sharing of data, models, information, and the use of open-source software, greatly contributes to expanding the knowledge on flood risk and to increasing flood preparedness. Nevertheless, services’ interoperability and open data are not common in local systems implemented in developing countries. This paper presents the web platform and related services developed for the Local Flood Early Warning System of the Sirba River in Niger (SLAPIS) to tailor hydroclimatic information to the user’s needs, both in content and format. Building upon open-source software components and interoperable web services, we created a software framework covering data capture and storage, data flow management procedures from several data providers, real-time web publication, and service-based information dissemination. The geospatial infrastructure and web services respond to the actual and local decision-making context to improve the usability and usefulness of information derived from hydrometeorological forecasts, hydraulic models, and real-time observations. This paper presents also the results of the three years of operational campaigns for flood early warning on the Sirba River in Niger. Semiautomatic flood warnings tailored and provided to end users bridge the gap between available technology and local users’ needs for adaptation, mitigation, and flood risk management, and make progress toward the sustainable development goals

Neuroplastic changes related to pain occur at multiple levels of the human somatosensory system: A somatosensory-evoked potentials study in patients with cervical radicular pain

Studies suggest that pain may play a major role in determining cortical rearrangements in the adult human somatosensory system. Most studies, however, have been performed under conditions whereby pain coexists with massive deafferentation (e.g., amputations). Moreover, no information is available on whether spinal and brainstem changes contribute to pain-related reorganizational processes in humans. Here we assess the relationships between pain and plasticity by recording somatosensoryevoked potentials (SEPs) in patients who complained of pain to the right thumb after a right cervical monoradiculopathy caused by compression of the sixth cervical root, but did not present with clinical or neurophysiological signs of deafferentation. Subcortical and cortical potentials evoked by stimulation of digital nerves of the right thumb and middle finger were compared with those obtained after stimulation of the left thumb and middle finger and with those obtained in a control group tested in comparable conditions. Amplitudes of spinal N13, brainstem P14, parietal N20 and P27, and frontal N30 potentials after stimulation of the painful right thumb were greater than those of the nonpainful left thumb and showed a positive correlation with magnitude of pain. This right-left asymmetry was absent after stimulation of the patients' middle fingers and in control subjects. Results suggest that chronic cervical radicular pain is associated with changes in neural activity at multiple levels of the somatosensory system. The absence of correlation between the amplitude of spinal, brainstem, and cortical components of SEPs suggests that enhancement of cortical activity is not a simple amplification of subcortical enhancement

Liver involvement and mortality in COVID-19: A retrospective analysis from the CORACLE study group

INTRODUCTION: liver abnormalities are common in COVID-19 patients and associated with higher morbidity and mortality. We aimed to investigate clinical significance and effect on the mortality of abnormal liver function tests (ALFTs) in COVID-19 patients. METHODS: we retrospectively evaluated in a multicentre study all patients admitted with confirmed diagnosis of COVID-19. RESULTS: 434 patients were included in this analysis. Among overall patients, 311 (71.6%) had normal baseline ALT levels. 123 patients showed overall abnormal liver function tests (ALFTs) at baseline [101 ALFTs <2x UNL and 22 ≥2 UNL]. Overall in-hospital mortality was 14% and mean duration of hospitalization was 10.5 days. Hypertension (50.5%), cardiovascular diseases (39.6%), diabetes (23%) were frequent comorbidities and 53.7% of patients had ARDS. At multivariate analysis, the presence of ARDS at baseline (OR=6.11; 95% CI: 3.03–12.32; p<0.000); cardiovascular diseases (OR=4; 95% CI: 2.05–7.81; p<0.000); dementia (OR=3.93; 95%CI:1.87–8.26; p<0.000) and no smoking (OR=4.6; 95% CI: 1.45–14.61; p=0.010) resulted significantly predictive of in-hospital mortality. The presence of ALFTs at baseline was not significantly associated with mortality (OR=3.44; 95% CI=0.81–14.58; p=0.094). CONCLUSION: ALFTs was frequently observed in COVID-19 patients, but the overall in-hospital mortality was mainly determined by the severity of illness, comorbidities and presence of ARDS

Characterisation of refined marc distillates with alternative oak products using different analytical approaches

The use of oak barrel alternatives, including oak chips, oak staves and oak powder, is quite common in the production of spirits obtained from the distillation of vegetal fermented products such as grape pomace. This work explored the use of unconventional wood formats such as peeled and sliced wood. The use of poplar wood was also evaluated to verify its technological uses to produce aged spirits. To this aim, GC-MS analyses were carried out to obtain an aromatic characterisation of experimental distillates treated with these products. Moreover, the same spirits were studied for classification purposes using NMR, NIR and e-nose. A significant change in the original composition of grape pomace distillate due to sorption phenomena was observed; the intensity of this effect was greater for poplar wood. The release of aroma compounds from wood depended both on the toasting level and wood assortment. Higher levels of xylovolatiles, namely, whisky lactone, were measured in samples aged using sliced woods. Both the NIR and NMR analyses highlighted similarities among samples refined with oak tablets, differentiating them from the other wood types. Finally, E-nose seemed to be a promising alternative to spectroscopic methods both for the simplicity of sample preparation and method portability

Recent Changes in Hydroclimatic Patterns over Medium Niger River Basins at the Origin of the 2020 Flood in Niamey (Niger)

Niamey, the capital of Niger, is particularly prone to floods, since it is on the banks of the Niger River, which in its middle basin has two flood peaks: one in summer (the red flood) and one in winter (the black flood). In 2020, the Niger River in Niamey reached its all-time highest levels following an abundant rainy season. On the other hand, the floods in Niamey have been particularly frequent in the last decade, a symptom of a change in hydroclimatic behaviour already observed since the end of the great droughts of the 1970s and 1980s and which is identified with the name of Sahelian Paradox. This study, starting from the analysis of the 2020 flood and from the update of the rating curve of the Niamey hydrometric station, analyses the rainfall–runoff relationship on the Sahelian basins of the Medium Niger River Basin (MNRB) that are at the origin of the local flood. The comparative analysis of runoffs, annual maximum flows (AMAX) and runoff coefficients with various rainfall indices calculated on gridded datasets allowed to hydroclimatically characterise the last decade as a different period from the wet one before the drought, the dry one and the postdrought one. Compared to the last one, the current period is characterised by a sustained increase in hydrological indicators (AMAX +27%) consistent with the increase in both the accumulation of precipitation (+11%) and the number (+51%) and magnitude (+54%) of extreme events in the MNRB. Furthermore, a greater concentration of rainfall and extremes (+78%) in August contributes to reinforcing the red flood’s positive anomalies (+2.23 st.dev in 2020). The study indicates that under these conditions the frequency of extreme hydrological events in Niamey will tend to increase further also because of the concurrence of drivers such as river-bed silting and levee effects. Consequently, the study concludes with the need for a comprehensive flood-risk assessment on the Niamey city that considers both recent hydroclimatic trends and urbanisation dynamics in flood zones hence defining the most appropriate risk-reduction strategies

Trends in Net Survival from Vulvar Squamous Cell Carcinoma in Italy (1990–2015)

Objective: In many Western countries, survival from vulvar squamous cell carcinoma (VSCC) has been stagnating for decades or has increased insufficiently from a clinical perspective. In Italy, previous studies on cancer survival have not taken vulvar cancer into consideration or have pooled patients with vulvar and vaginal cancer. To bridge this knowledge gap, we report the trend in survival from vulvar cancer between 1990 and 2015. (2) Methods: Thirty-eight local cancer registries covering 49% of the national female population contributed the records of 6274 patients. Study endpoints included 1- and 2-year net survival (NS) calculated using the Pohar-Perme estimator and 5-year NS conditional on having survived two years (5|2-year CNS). The significance of survival trends was assessed with the Wald test on the coefficient of the period of diagnosis, entered as a continuous regressor in a Poisson regression model. (3) Results: The median patient age was stable at 76 years. One-year NS decreased from 83.9% in 1990–2001 to 81.9% in 2009–2015 and 2-year NS from 72.2% to 70.5%. Five|2-year CNS increased from 85.7% to 86.7%. These trends were not significant. In the age stratum 70–79 years, a weakly significant decrease in 2-year NS from 71.4% to 65.7% occurred. Multivariate analysis adjusting for age group at diagnosis and geographic area showed an excess risk of death at 5|2-years, of borderline significance, in 2003–2015 versus 1990–2002. (4) Conclusions: One- and 2-year NS and 5|2-year CNS showed no improvements. Current strategies for VSCC control need to be revised both in Italy and at the global level

Long-term outcomes and predictive ability of non-invasive scoring systems in patients with non-alcoholic fatty liver disease

[Background & Aims] Non-invasive scoring systems (NSS) are used to identify patients with non-alcoholic fatty liver disease (NAFLD) who are at risk of advanced fibrosis, but their reliability in predicting long-term outcomes for hepatic/extrahepatic complications or death and their concordance in cross-sectional and longitudinal risk stratification remain uncertain.[Methods] The most common NSS (NFS, FIB-4, BARD, APRI) and the Hepamet fibrosis score (HFS) were assessed in 1,173 European patients with NAFLD from tertiary centres. Performance for fibrosis risk stratification and for the prediction of long-term hepatic/extrahepatic events, hepatocarcinoma (HCC) and overall mortality were evaluated in terms of AUC and Harrell’s c-index. For longitudinal data, NSS-based Cox proportional hazard models were trained on the whole cohort with repeated 5-fold cross-validation, sampling for testing from the 607 patients with all NSS available.[Results] Cross-sectional analysis revealed HFS as the best performer for the identification of significant (F0-1 vs. F2-4, AUC = 0.758) and advanced (F0-2 vs. F3-4, AUC = 0.805) fibrosis, while NFS and FIB-4 showed the best performance for detecting histological cirrhosis (range AUCs 0.85-0.88). Considering longitudinal data (follow-up between 62 and 110 months), NFS and FIB-4 were the best at predicting liver-related events (c-indices>0.7), NFS for HCC (c-index = 0.9 on average), and FIB-4 and HFS for overall mortality (c-indices >0.8). All NSS showed limited performance (c-indices <0.7) for extrahepatic events.[Conclusions] Overall, NFS, HFS and FIB-4 outperformed APRI and BARD for both cross-sectional identification of fibrosis and prediction of long-term outcomes, confirming that they are useful tools for the clinical management of patients with NAFLD at increased risk of fibrosis and liver-related complications or death.[Lay summary] Non-invasive scoring systems are increasingly being used in patients with non-alcoholic fatty liver disease to identify those at risk of advanced fibrosis and hence clinical complications. Herein, we compared various non-invasive scoring systems and identified those that were best at identifying risk, as well as those that were best for the prediction of long-term outcomes, such as liver-related events, liver cancer and death.This study has been supported by the EPoS (Elucidating Pathways of Steatohepatitis) consortium funded by the Horizon 2020 Framework Program of the European Union under Grant Agreement 634413 and the Newcastle NIHR Biomedical Research Centre. The authors are contributing members of The European NAFLD Registry. The study was also supported by the Italian Ministry of Health, grant RF-2016-02364358 (Ricerca Finalizzata, Ministero della Salute), and the Italian Ministry for Education, University and Research (Ministero dell’Istruzione, dell’Università e della Ricerca - MIUR) under the programme “Dipartimenti di Eccellenza 2018 – 2022” Project code D15D18000410001.Peer reviewe