Evaluation of the Stormwater Capture Potential of New York City Soils: Implications of Infiltration Rate Variability on Urban Runoff Predictions

The properties used to characterize soils and, more specifically, those that are used to describe the rate at which water infiltrates into them, are key parameters in most rainfall-runoff models. Because these parameters are known to be highly variable, they are a known source of uncertainty in our ability to predict runoff from pervious surfaces. The goals of this study were to a) characterize the heterogeneity in soil and infiltration characteristics in specific types of pervious surfaces found in New York City, and b) to study the potential effect of this heterogeneity on prediction of the total volume and peak rate of runoff from specific rainfall hyetographs. Characterization of soil and infiltration characteristics was performed at a variety of sites throughout NYC during Summer and Fall 2009. As expected, statistical analysis of the data, which includes nearly two dozen individual tests, showed high variability. The USEPA Stormwater Management Model, (SWMM) an industry standard, was then used to examine the impact of this heterogeneity on predictions of peak flow and total runoff volume for a design storm. The preliminary results of this work suggest that although soil and infiltration properties are highly variable, only a small portion of this range can significantly alter the runoff predictions obtained from SWMM using this particular design storm. Future research will address the significance of the variability in runoff predictions given a more diverse set of storm events for more generalizeable results

Participatory Climate Research in a Dynamic Urban Context: Activities of the Consortium for Climate Risk in the Urban Northeast (CCRUN)

The Consortium for Climate Risk in the Urban Northeast (CCRUN), one of ten NOAA-RISAs, supports resilience efforts in the urban corridor stretching from Philadelphia to Boston. Challenges and opportunities include the diverse set of needs in broad urban contexts, as well as the integration of interdisciplinary perspectives. CCRUN is addressing these challenges through strategies including: 1) the development of an integrated project framework, 2) stakeholder surveys, 3) leveraging extreme weather events as focusing opportunities, and 4) a seminar series that enables scientists and stakeholders to partner. While recognizing that the most extreme weather events will always lead to surprises (even with sound planning), CCRUN endeavors to remain flexible by facilitating place-based research in an interdisciplinary context

Using a Participatory Stakeholder Process to Plan Water Development in Koraro, Ethiopia

This article reports the results of a one-day participatory workshop in Koraro, Ethiopia conducted prior to major development interventions in the region. The methodology of the workshop, structured to generate data useful for understanding the physical and social systems integral to water resources planning, provides a framework for future water need explorations in similar settings in Ethiopia and elsewhere. The use of only improved water sources as a metric for access to water under-represents the situation in Koraro, as many rely on streambeds for water due to the perceived cleanliness and low salinity of this unimproved water source. The reliance on metrics common in the Millennium Development Goals and Sustainable Development Goals, such as a minimum distance to a water source and the categorization of potable water based on type of water source, using varying figures (from as many as 30 to as few as four) can lead to assessments regarding the amount of additional sources necessary to allow access to specific locales, that are not consistent with actual need. Since the workshop, the Millennium Village Project has constructed over 30 wells in the region, following the most commonly used distance and source type metrics with less than desirable results. The water access evaluations alone do not address the needs of Koraro residents

Flow Optimization, Management, and Prevention of LV Distention during VA-ECMO

Cardiogenic shock (CS) still carries an unacceptably high mortality (30–60%), despite several therapeutic approaches; the SHOCK II trial questioned the benefit of intra-aortic balloon pump (IABP), while IMPRESS and CULPRIT-SHOCK trials confirmed heterogeneity in disease spectrum and patient selection for acute myocardial infarction-related CS requiring acute mechanical circulatory support (AMCS). The heterogeneity of devices employed as AMCS, including temporary micro-axial flow pumps (Impella), percutaneous bypass (TandemHeart), and extracorporeal life support (VA-ECMO), contributed to the actual dramatic scenario, where CS is defined clinically rather than hemodynamically. To date, the role of VA-ECMO is emerging as rapid strategy to mitigate mortality rates of severe refractory states, despite the lack of data regarding the best practices of management and flows control. VA-ECMO’s flow represents the “dose” of treatment and higher flows are less tolerated percutaneously requiring, to prevent deleterious pulmonary edema and ventricular distention, additional approaches such as pulmonary, left atrial, or left ventricular unloading. Any efforts have to be directed to (1) determine adequate management of patients on VA-ECMO, (2) define the safer duration of VA-ECMO support, and (3) establish algorithms and techniques to predict and obtain stable weaning from ECMO or ensure fast transition to durable VAD and/or heart transplant

Maximizing Green Infrastructure in a Philadelphia Neighborhood

While the Philadelphia Water Department (PWD) is counting on Green Stormwater Infrastructure (GI) as a key component of its long-term plan for reducing combined sewer overflows, many community stakeholders are also hoping that investment in greening can help meet other ancillary goals, collectively referred to as sustainable redevelopment. This study investigates the challenges associated with implementation of GI in Point Breeze, a residential neighborhood of South Philadelphia. The project team performed a detailed study of physical, social, legal, and economic conditions in the pilot neighborhood over the course of several years, culminating in the development of an agent-based model simulation of GI implementation. The model evaluates a) whether PWD’s GI goals can be met in a timely manner, b) what kinds of assumptions regarding participation would be needed under different theoretical GI policies, and c) the extent to which GI could promote sustainable redevelopment. The model outcomes underscore the importance of private land in helping PWD achieve its GI goals in Point Breeze. Achieving a meaningful density of GI in the neighborhoods most in need of sustainable redevelopment may require new and creative strategies for GI implementation tailored for the types of land present in those particular communities

Gender, Disaster, and Resilience: Assessing Women\u27s Water and Sanitation Needs in Leogane, Haiti, before and after the 201 O Earthquake

This study investigates differences in men\u27s and women\u27s access to water and sanitation in Leogane, Haiti (population -300,000), a town situated at the epicenter of the January 2010 earthquake. While research suggests that women\u27s water and sanitation access is crucial to health, security, and equity in post-disaster situations, there are a number of limitations to current participa­tory approaches in post-disaster reconstruction. Underlining the social impor­tance of water access in Haiti were reports citing a Jack of potable water and sanitation as one factor contributing to the spread of cholera, which was intro­duced by UN peacekeepers aher the earthquake. Limited access to water and sanitation facilities was also reported as a factor in the lack of security for women and children in the internally displaced persons camps. The results of this NSF-RAPID study are presented pertaining to gender issues in the context of post-disaster infrastructure reconstruction efforts in Haiti. We ask specifically how gender dimensions can be integrated into community-based participatory processes of water and sanitation planning, which face many challenges in post-disaster situations. We conclude that more robust participatory processes that include women and other marginalized groups in planning and decision ­making can be used to elicit and support local knowledge, practices and preferences, ultimately leading to more appropriate infrastructure systems that will be more socially, economically, and ecologically sustainable

Mapping the Design Process for Urban Ecology Researchers

The integration of research into the design process is an opportunity to build ecologically informed urban design solutions. To date, designers have traditionally relied on environmental consultants to provide the best available science; however, serious gaps in our understanding of urban ecosystems remain. To evaluate ecosystem processes and services for sustainable urban design and to further advance our understanding of social-ecological processes within the urban context, we need to integrate primary research into the urban design process. In this article, we develop a road map for such a synthesis. Supporting our proposals by case studies, we identify strategic entry points at which urban ecology researchers can integrate their work into the design process

A Framework for Multifunctional Green Infrastructure Investment in Camden, NJ

This study demonstrates a decision-support framework for planning Green Infrastructure (GI) systems that maximize urban ecosystem services in Camden, NJ. Seven key ecosystem services are evaluated (urban agriculture expansion, combined sewer overflow reduction, heat island reduction, flooding reduction, capacity building/green jobs expansion, fitness expansion, and stress reduction), to produce a normalized value for each service for each drainage sub-basin within the city. Gaps in ecosystem services are then mapped and utilized to geographically prioritize different kinds of multifunctional GI. Conceptual designs are developed for four site typologies: parks, schools, vacant lots, and brownfield sites. For one demonstration site, additional analysis is presented on urban engagement, life cycle cost reduction, and new sources of funding. What results is an integrated, long-term vision where multifunctional GI systems can be readily customized to meet multiple needs within urban communities. This study provides a portable and replicable framework for leveraging the regulatory requirement to manage stormwater to meet broader urban revitalization goals, all through a decentralized network of green infrastructure assets

Effects of the dose of erythropoiesis stimulating agents on cardiovascular events, quality of life, and health-related costs in hemodialysis patients: the clinical evaluation of the dose of erythropoietins (C.E. DOSE) trial protocol

<p>Abstract</p> <p>Background</p> <p>Anemia is a risk factor for death, adverse cardiovascular outcomes and poor quality of life in patients with chronic kidney disease (CKD). Erythropoietin Stimulating Agents (ESA) are commonly used to increase hemoglobin levels in this population. In observational studies, higher hemoglobin levels (around 11-13 g/dL) are associated with improved survival and quality of life compared to hemoglobin levels around 9-10 g/dL. A systematic review of randomized trials found that targeting higher hemoglobin levels with ESA causes an increased risk of adverse vascular outcomes. It is possible, but has never been formally tested in a randomized trial, that ESA dose rather than targeted hemoglobin concentration itself mediates the increased risk of adverse vascular outcomes. The Clinical Evaluation of the DOSe of Erythropoietins (C.E. DOSE) trial will assess the benefits and harms of a high versus a low fixed ESA dose for the management of anemia in patients with end stage kidney disease.</p> <p>Methods/Design</p> <p>This is a randomized, prospective open label blinded end-point (PROBE) trial due to enrol 2204 hemodialysis patients in Italy. Patients will be randomized 1:1 to 4000 IU/week versus 18000 IU/week of intravenous epoietin alfa or beta, or any other ESA in equivalent doses. The dose will be adjusted only if hemoglobin levels fall outside the 9.5-12.5 g/dL range. The primary outcome will be a composite of all-cause mortality, non fatal stroke, non fatal myocardial infarction and hospitalization for cardiovascular causes. Quality of life and costs will also be assessed.</p> <p>Discussion</p> <p>The C.E.DOSE study will help inform the optimal therapeutic strategy for the management of anemia of hemodialysis patients, improving clinical outcomes, quality of life and costs, by ascertaining the potential benefits and harms of different fixed ESA doses.</p> <p>Trial registration</p> <p>Clinicaltrials.gov NCT00827021</p

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin