Sticks and carrots for reducing property-level risks from floods: an EU-US comparative perspective

In discussing legal and policy frameworks for flood risk management, the attention is often put on increasing resilience in public spaces. In terms of private properties, discussions are geared toward enhancing the adaptive capacity of future developments. This paper focuses on the instruments associated with resilience of existing privately owned residential buildings mainly from the perspective of post-flood policies and compensation regimes. The paper scrutinizes the relevant legal and policy landscapes in the United States, the European Union and two Member States – the UK and the Netherlands. The goal is to provide mutual lessons learned between the EU, its Member States, and the US and to set forth generally applicable recommendations for improving post-flood policies for existing buildings

Dealing with flood damages: will prevention, mitigation and ex-post compensation provide for a resilient triangle?

There is a wealth of literature on the design of ex-post compensation mechanisms for natural disasters. However, more research needs to be done on the manner in which these mechanisms could steer citizens toward adopting individual level preventive and protection measures in the face of flood risks. This paper provides a comparative legal analysis of the financial compensation mechanisms following floods, be it through insurance, public funds or a combination of both, with an empirical focus on Belgium, the Netherlands, England and France. Similarities and differences between the methods in which these compensation mechanisms for flood damages enhance resilience are analyzed. The comparative analysis especially focuses on the link between the recovery strategy on the one hand and prevention and mitigation strategies on the other. There is great potential within the recovery strategy for promoting preventive action, for example in terms of discouraging citizens from living in high-risk areas, or encouraging the uptake of mitigation measures, such as adaptive building. However, this large potential is yet to be realized, in part due to insufficient consideration and promotion of these connections within existing legal frameworks. Recommendations are made about how the linkages between strategies can be further improved. These recommendations relate to, amongst others, the promotion of resilient reinstatement through recovery mechanisms and the removal of legal barriers preventing the establishment of link-inducing measures

The European Union approach to flood risk management and improving societal resilience: lessons from the implementation of the Floods Directive in six European countries

Diversity in flood risk management approaches is often considered to be a strength. However in some national settings, and especially for transboundary rivers, variability and the incompatibility of approaches can reduce the effectiveness of flood risk management. Placed in the context of increasing flood risks, as well as the potential for flooding to undermine the European Union's sustainable development goals, a desire to increase societal resilience to flooding has prompted the introduction of a common European Framework. This paper provides a legal and policy analysis of the implementation of the Floods Directive (2007/60/EC) in six countries; Belgium (Flemish Region), England, France, the Netherlands, Poland and Sweden. Evaluation criteria from existing legal and policy literature frame the study of the Directive and its impact on enhancing or constraining societal resilience by using an adaptive governance approach. These criteria are initially used to analyze the key components of the EU approach, before providing insight of the implementation of the Directive at a national level. Similarities and differences in the legal translation of European goals into existing flood risk management are analyzed alongside their relative influence on policy and practice. The research highlights that the impact of the Floods Directive on increasing societal resilience has been nationally variable, in part due to its focus on procedural obligations, rather than on more substantive requirements. Analysis shows that despite a focus on transboundary river basin management, in some cases existing traditions of flood risk management, have overridden objectives to harmonize flood risk management. This could be strengthened by requiring more stringent cooperation and providing the competent authorities in International River Basins Districts with more power. Despite some shortcomings in directly impacting flood risk outcomes, the Directive has positively stimulated discussion and flood risk management planning in countries that were perhaps lagging behind

Detection of the tulip breaking virus (TBV) in tulips using optical sensors

The tulip breaking virus (TBV) causes severe economic losses for countries that export tulips such as the Netherlands. Infected plants have to be removed from the field as soon as possible. There is an urgent need for a rapid and objective method of screening. In this study, four proximal optical sensing techniques for the detection of TBV in tulip plants were evaluated and compared with a visual assessment by crop experts as well as with an ELISA (enzyme immunoassay) analysis of the same plants. The optical sensor techniques used were an RGB color camera, a spectrophotometer measuring from 350 to 2500 nm, a spectral imaging camera covering a spectral range from 400 to 900 nm and a chlorophyll fluorescence imaging system that measures the photosynthetic activity. Linear discriminant classification was used to compare the results of these optical techniques and the visual assessment with the ELISA score. The spectral imaging system was the best optical technique and its error was only slightly larger than the visual assessment error. The experimental results appear to be promising, and they have led to further research to develop an autonomous robot for the detection and removal of diseased tulip plants in the open field. The application of this robot system will reduce the amount of insecticides and the considerable pressure on labor for selecting diseased plants by the crop expert. © 2010 The Author(s

Helicobacter Genotyping and Detection in Peroperative Lavage Fluid in Patients with Perforated Peptic Ulcer

Introduction and Objectives Certain Helicobacter pylori genotypes are associated with peptic ulcer disease; however, little is known about associations between the H. pylori genotype and perforated peptic ulcer (PPU). The primary aim of this study was to evaluate which genotypes are present in patients with PPU and which genotype is dominant in this population. The secondary aim was to study the possibility of determining the H. pylori status in a way other than by biopsy. Materials and Methods Serum samples, gastric tissue biopsies, lavage fluid, and fluid from the nasogastric tube were collec

До питання підготовки музейної експозиції з історії культури первісного суспільства

In Europe, water management is moving from flood defense to a risk management approach, which takes both the probability and the potential consequences of flooding into account. In this report, we will look at Directives and (non-)EU- initiatives in place to deal with flood risk in Europe indirectly and directly. Emphasis will lie on the two Directives most specifically aimed at floods: the Water Framework Directive (WFD) and the Floods Directive (FD) – how are they related and how they have been or are implemented in the Member States (MSs)? In February 1995, the Netherlands and France took the initiative for a discussion on streamlining the water legislation of the European Union (EU) which resulted in the creation of the WFD in 2000. The WFD provided a new system for the protection and improvement of Europe’s water environment – its rivers, lakes, estuaries, coastal waters and groundwaters. Its main innovation is the requirement that water be managed in an integrated way, with river basin management as leading managing unit. Since flood protection is not explicitly addressed in the WFD, the need to clarify the role of the WFD in flood protection was put on the European agenda as early as 2003, and in 2007, the FD became a fact. The FD is to be implemented in coordination with the WFD, notably by coordinating Flood Risk Management Plans (FRMPs) and River Basin Management Plans (RBMPs). Both the WFD and the FD reflect a shift in EU-governance. Instead of the more traditional top-down legalistic approach they emphasise the importance of more bottom up initiatives from the actors who have to implement the Directives. Combined with the expanded freedom and flexibility for national and local governments, with this new approach, the FD is the first Water Directive in EU law that does not offer an equal minimum level of protection for EU citizens. While both Directives are meant to harmonise European legislation, much flexibility on objectives and measures in the FD is left to the MSs, justified by the nature of flooding and the subsidiarity principle. This creates multi-actor, multi-level and multi-sector challenges addressed in report D1.1.2 (Hegger et al. 2013). For instance, the FD sets out general obligations for transboundary cooperation, but at the national level, the scope and distributions of duties, rights and powers of the various organizations involved should be set out in law. Other challenges identified in the literature are concrete issues related to mandatory flood risks assessments, flood risk maps, and Flood Risk Management plans, but also the involvement of the public and stakeholders, the science-policy interface, uncertainties related to climate change predictions and effects, the coordination with the WFD, the lack of safety standards, the lack of possibilities for EU citizens to rely on substantive provisions before the administrative courts and finally, transboundary aspects such as issues of scale, mismatches between national policies, the assessment of transboundary effects and division of costs related to this. In sum, this report has clarified the development, content and implementation of the current European flood risk governance policies, possible synergies between the two most important Directives linked to floods, and identified topics and questions for more in-depth questions relevant for the next work packages, pertaining to, in no particular order, a) the level of implementation and level of ambition as well as the competent authorities in the case study countries; b) the transboundary nature of floods; c) synergies and conflicts between FD and WFD and other issues not mentioned in these Directives; d) the degree of harmonization, for instance when it comes to flood safety standards and e) the subsidiarity principle – is this conform the requirements set out in the FD? Because while current European flood regulation specified in the WFD and FD provides several potential opportunities for improving flood risk governance, it is not self-evident that all of these opportunities will materialise in all MSs

International Guillain-Barré Syndrome Outcome Study (IGOS): protocol of a prospective observational cohort study on clinical and biological predictors of disease course and outcome in Guillain-Barré syndrome

Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy with a highly variable clinical presentation, course, and outcome. The factors that determine the clinical variation of GBS are poorly understood which complicates the care and treatment of individual patients. The protocol of the ongoing International GBS Outcome Study (IGOS), a prospective, observational, multi-centre cohort study that aims to identify the clinical and biological determinants and predictors of disease onset, subtype, course and outcome of GBS is presented here. Patients fulfilling the diagnostic criteria for GBS, regardless of age, disease severity, variant forms, or treatment, can participate if included within two weeks after onset of weakness. Information about demography, preceding infections, clinical features, diagnostic findings, treatment, course and outcome is collected. In addition, cerebrospinal fluid and serial blood samples for serum and DNA is collected at standard time points. The original aim was to include at least 1000 patients with a follow-up of 1-3 years. Data are collected via a web-based data entry system and stored anonymously. IGOS started in May 2012 and by January 2017 included more than 1400 participants from 143 active centres in 19 countries across 5 continents. The IGOS data/biobank is available for research projects conducted by expertise groups focusing on specific topics including epidemiology, diagnostic criteria, clinimetrics, electrophysiology, antecedent events, antibodies, genetics, prognostic modelling, treatment effects and long-term outcome of GBS. The IGOS will help to standardize the international collection of data and biosamples for future research of GBS. ClinicalTrials.gov Identifier: NCT01582763

The efficacy of topical imiquimod in high-grade cervical intraepithelial neoplasia:A systematic review and meta-analysis

Objective: A major side effect of cervical excision for high-grade cervical intraepithelial neoplasia (CIN) is premature birth. A non-invasive treatment for reproductive age women is warranted. The aim of the present study was to determine the efficacy of topical imiquimod in the treatment of high-grade CIN, defined as a regression to ≤CIN 1, and to determine the clearance rate of high-risk human papillomavirus (hr-HPV), compared with surgical treatment and placebo. Methods: Databases were searched for articles from their inception to February 2023.The study protocol number was INPLASY2022110046. Original studies reporting the efficacy of topical imiquimod in CIN 2, CIN 3 or persistent hr-HPV infections were included. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist. Results: Five studies were included (n = 463). Histological regression to ≤CIN 1 was 55% in imiquimod versus 29% in placebo, and 93% in surgical treatment. Imiquimod-treated women had a greater odds of histological regression to ≤CIN 1 than placebo (odds ratio [OR] 4.17, 95% confidence interval [CI] 2.03–8.54). In comparison to imiquimod, surgical treatment had an OR of 14.81(95% CI 6.59–33.27) for histological regression to ≤CIN 1. The hr-HPV clearance rate was 53.4% after imiquimod and 66% after surgical treatment (95% CI 0.62–23.77). Conclusions: The histological regression rate is highest for surgical treatment followed by imiquimod treatment and placebo.</p

The effect of hormone therapy on breast density following risk-reducing salpingo-oophorectomy in women with an increased risk for breast and ovarian cancer

OBJECTIVE: To compare the effect of tibolone to conjugated estrogens with medroxyprogesterone-acetate (CEE + MPA) on breast density, as a predictor for breast cancer risk, in women with a high risk of breast and ovarian cancer. METHODS: Women aged 30-50 (N = 114) who had undergone risk-reducing salpingo-oophorectomy (RRSO) were randomized to tibolone or CEE + MPA. RESULTS: Breast density decreased 46% after RRSO in untreated women, 39% after treatment with tibolone, and 17% after treatment with CEE + MPA; the decrease in breast density after CEE + MPA was significantly different compared with that of untreated women (P = 0.017). CONCLUSIONS: A decline in breast density is seen after premenopausal RRSO despite the use of both CEE + MPA or tibolone, although lower breast density is seen after tibolone use