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A resilient city includes multiple energy carriers, high-efficiency infrastructure, lower resource demand to decarbonize and sustain the urban system in accordance with the Paris Agreement, the United Nations 2030 Agenda for Sustainable Development, and the various recovery plans following the COVID-19 pandemic period. To achieve these goals, a key role is played by all urban sectors, which can reduce environmental impacts and accelerate the green transition at larger scale. Intervening on a district scale obviously requires the evaluation of different aspects, taking into account both economic and non-economic criteria, as well as different points of view, involving all stakeholders. This paper proposes a multi-step evaluation procedure that extends the European manual-based Cost-Benefit Analysis (CBA) to include the extra-economic benefits and the stakeholders' opinion in the evaluation, according to the COmpoSIte Model for Assessment (COSIMA) method. This is the first application of COSIMA in the urban design sectors (i.e. buildings, water, public lighting, transportation and waste management) where different sustainable measures for a real case study located in Turin (Italy) were compared to define the most suitable transformation scenario according to multiple criteria. The results have shown how invasive scenarios allow achieving the greatest benefits, despite the huge initial costs of realization. © 2022 Elsevier Ltd
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The Millennium Ecosystem Assessment in 2005 defined and categorized the concept of Ecosystem Services and the strategic role of natural capital. The need to rethink our cities and public spaces is even more pressing in the COVID-19 era. In this context, green strategies could be the answer to the new demands raised by citizens about the built and natural environment. Green roofs, along with the other green spaces, form the city’s green network, contribute to improving the quality of life and wellbeing of citizens. The present contribution aims to evaluate green roofs from an ecosystem perspective, by considering the evidence of their benefits on inhabitants’ wellbeing, their ability to mitigate climate change and preserve biodiversity. A proposal for an integrated evaluation model is presented to take into account the different dimensions of value in the study of Ecosystem Services (ESs) and to support decision makers (DMs) in the definition of actions able to increase the quality of life in cities. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Purpose or Objective To assess the pattern of response on dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) of presumed local lesions in the setting of salvage radiotherapy (sRT) after radical prostatectomy (RP). Materials and Methods The present prospective study (NCT04703543) was conducted at a single Institution between August 2017 and June 2020. Eligibility criteria were: undetectable prostate specific antigen (PSA) after RP;biochemical recurrence (2 consecutive PSA rises to 0.2 ng/ml or greater);a presumed local failure at DCE-MRI (early/fast enhancing discrete lesion on DCE sequences);no distant metastases at choline-PET/CT;no previous history of androgen deprivation therapy and/or RT. Accrued patients underwent sRT as it follows: 66-69 Gy/30 fractions to the prostatic bed, 73.5 Gy/30 fractions to the local failure at DCE-MRI, 54 Gy/30 fractions to the pelvic nodes (when treated). All patients were offered DCE-MRI 3 months after sRT, and repeated at 3-month intervals until complete disappearance or a maximum of 4 scans. The endpoint of the study, complete response (CR), was defined as the complete disappearance of the target lesion at DCE-MRI. In case of misses before CR, the observation was considered as a persisting partial response (PR). Results 62 patients with 72 nodules at DCE-MRI were accrued. All patients underwent the 1st DCE-MRI at a median of 3.3 months (IQR: 3.1-4.1) after sRT, 33 patients (53.2%) presented a CR, 27 (43,5%) a PR, 2 (3.2%) no response. One patient, implanted with a cardiac device, did not undergo further MRI. Three more patients declined further testing after the 1st (N=2) or the 2nd (N=1) re-evaluation due to the COVID-19 pandemic. Twenty-eight patients underwent a 2nd DCE-MRI after a median of 6.8 months (IQR: 6.5-7.6) from sRT, 20 had a CR, 8 had a PR. After a median time of 10.7 months (IQR: 10.6-12.6), 6 patients were scanned for a 3nd DCE-MRI: 4 CR, 2 PR. The last patient reported a CR after 16.7 months. The majority (94.3%, 95%CI: 88.0-100.0%) of lesions had completely disappeared by the 3rd re-evaluation or a median time of 10.7 months from the end of sRT (Figure).(Figure Presented) Independent predictors of CR at 1st re-evaluation on multivariable analysis were: the volume of the lesion at pre-sRT DCEMRI (OR 0.076, 95%CI 0.009-0.667;p=0.02), the time of re-evaluation from treatment (OR 3.39, 95%CI 1.156-9.993;p=0.026) and the PSA percent decrease at the 5th week of sRT (OR 1.02, 95%CI 0.999-1.050;p= 0.058) (Table). (Table Presented) Receiver-operating characteristic curve (ROC) analysis identified the best cut-off on CR for baseline volume at 0.545 cc, AUC 0.683 (95%CI: 0.548-0.818, p=0.014). The probability of a CR for lesions larger than the cut-off identified at ROC analysis was only around 75% at 10.7 months. Conclusion The vast majority of local lesions disappears at DCE-MRI after sRT, though larger lesions may require more than 10 months from treatment end.
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A resilient, diversified, and efficient energy system, comprising multiple energy carriers and high-efficiency infrastructure, is the way to decarbonise the European economy in line with the Paris Agreement, the UN 2030 Agenda for Sustainable Development, and the various recovery plans after the COVID-19 pandemic period. To achieve these goals, a key role is played by the private construction sector, which can reduce economic and environmental impacts and accelerate the green transition. Nevertheless, while traditionally decision-making problems in large urban transformations were supported by economic assessment based on Life Cycle Thinking and Cost-Benefit Analysis (CBA) approaches, these are now obsolete. Indeed, the sustainable neighbourhood paradigm requires the assessment of different aspects, considering both economic and extra-economic criteria, as well as different points of view, involving all stakeholders. In this context, the paper proposes a multi-stage assessment procedure that first investigates the energy performance, through a dynamic simulation model, and then the socio-economic performance of regeneration operations at the neighbourhood scale, through a Multi-Criteria Decision Analysis (MCDA). The model based on the proposed Preference Ranking Organisation Method for Enrichment Evaluations II (PROMETHEE II) aims to support local decision makers (DMs) in choosing which retrofit operations to implement and finance. The methodology was applied to a real-world case study in Turin (Italy), where various sustainable measures were ranked using multiple criteria to determine the best transformation scenario.
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Nowadays, due to the constant increase of outdoor air pollution, the impact on people’s health is alarming. Moreover, in the current vulnerable and crucial historical period during which society is experiencing and dealing with the COVID-19 pandemic consequences, this issue is becoming even more important. In line with this, there is an urgent need to provide scientific input to decision-makers to include the assessment of the health-related benefits and costs into urban planning processes. Special attention is devoted to the building sector since the heating service is considered among the main sources of air pollution in the urban environment. In the light of this, the paper aims to estimate the social costs associated with the thermal uses of the residential buildings in Turin (Northern Italy), integrating the energy assessment of the residential building stock, taking advantage of the Reference Building approach for the stock characterization, and the economic quantification and monetization of the air pollution health impacts, using the Cost of Illness (COI) method. Starting from the current situation, different retrofit scenarios for the residential buildings of Turin are hypothesized, to evaluate their capability in reducing the environmental impact of the sector, as well as to increase the social benefits they can guarantee. © 2021, Springer Nature Switzerland AG.
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The COVID-19 pandemic in Italy, as in many countries around the world, has imposed rigid restrictions on outdoor activities, resulting in forced confinement. The new condition requires an analysis and a rethinking of the way of life and of the new pre- and post-pandemic needs related to the use of domestic spaces, necessary to work, study or carry out other daily activities. Politecnico di Milano and Politecnico di Torino, with the collaboration of the institute of studies and research Scenari Immobiliari, have launched a survey for exploring the new needs and preferences of residents. These needs, which arose in conjunction with the pandemic, concern not only the desire to readapt their homes, but also to change them. In order to investigate these preferences, a questionnaire was developed using the Best to Worst Scaling (BWS). The items consider both modifications of the internal distribution and interventions on the efficiency of domestic appliances and systems components. The study aims to highlight how the spread of the pandemic has changed housing needs and how physical space affects people’s well-being. © 2021, Springer Nature Switzerland AG.