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Mediterranean pine plantations provide several ecosystem services but are vulnerable to climate change. Forest management might play a strategic role in the adaptation of Mediterranean forests, but the joint effect of climate change and diverse management options have seldom been investigated together. Here, we simulated the development of a Laricio pine (Pinus nigra subsp. laricio) stand in the Bonis watershed (southern Italy) from its establishment in 1958 up to 2095 using a state-of-the-science process-based forest model. The model was run under three climate scenarios corresponding to increasing levels of atmospheric CO 2 concentration and warming, and six management options with different goals, including wood production and renaturalization. We analysed the effect of climate change on annual carbon fluxes (i.e., gross and net primary production) and stocks (i.e., basal area, standing and harvested carbon woody stocks) of the autotrophic compartment, as well as the impact of different management options compared to a no management baseline. Results show that higher temperatures (+3 to +5 °C) and lower precipitation (-20 % to -22 %) will trigger a decrease in net primary productivity in the second half of the century. Compared to no management, the other options had a moderate effect on carbon fluxes over the whole simulation (between -14 % and +11 %). While standing woody biomass was reduced by thinning interventions and the shelterwood system (between -5 % and -41 %), overall carbon stocks including the harvested wood were maximized (between +41 % and +56 %). Results highlight that management exerts greater effects on the carbon budget of Laricio pine plantations than climate change alone, and that climate change and management are largely independent (i.e., no strong interaction effects). Therefore, appropriate silvicultural strategies might enhance potential carbon stocks and improve forest conditions, with cascading positive effects on the provision of ecosystem services in Mediterranean pine plantations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

In March 2020, the first known cases of COVID-19 occurred in Europe. Subsequently, the pandemic developed a seasonal pattern. The incidence of COVID-19 comprises spatial heterogeneity and seasonal variations, with lower and/or shorter peaks resulting in lower total incidence and higher and/or longer peaks resulting higher total incidence. The reason behind this phenomena is still unclear. Unraveling factors that explain why certain places have higher versus lower total COVID-19 incidence can help health decision makers understand and plan for future waves of the pandemic. We test whether differences in the total incidence of COVID-19 within five European countries (Norway, Sweden, Germany, Italy, and Spain), correlate with two environmental factors: the Köppen-Geiger climate zones and the Continentality Index, while statistically controlling for crowding. Our results show that during the first 16 months of the pandemic (March 2020 to July 2021), climate zones with larger annual differences in temperature and annually distributed precipitation show a higher total incidence than climate zones with smaller differences in temperature and dry seasons. This coincides with lower continentality values. Total incidence increases with continentality, up to a Continentality Index value of 19, where a peak is reached in the semicontinental zone. Low continentality (high oceanic influence) appears to be a strong suppressing factor for COVID-19 spread. The incidence in our study area is lowest at open low continentality west coast areas., Competing Interests: The authors declare no conflicts of interest relevant to this study., (© 2022 The Authors. GeoHealth published by Wiley Periodicals LLC on behalf of American Geophysical Union.)

Multi-purpose crops as maize, rice, soybean, and wheat are key in the debate concerning food, land, water and energy security and sustainability. While strong evidence exists on the effects of climate variability on the production of these crops, so far multifaceted attributes of droughts-magnitude, frequency, duration, and timing-have been tackled mainly separately, for a limited part of the cropping season, or over small regions. Here, a more comprehensive assessment is provided on how droughts with their complex patterns-given by their compound attributes-are consistently related to negative impacts on crop yield on a global scale. Magnitude and frequency of both climate and yield variability are jointly analysed from 1981 to 2016 considering multiscale droughts, i.e., dry conditions occurring with different durations and timings along the whole farming season, through two analogous and standardized indicators enabling comparison among crops, countries, and years. Mainly winter wheat and then spring wheat, soybean and the main maize's season reveal high susceptibility of yield under more complex drought patterns than previously assessed. The second maize's season and rice present less marked and more uncertain results, respectively. Overall, southern and eastern Europe, the Americas and sub-Saharan Africa presents multi-crop susceptibility, with eastern Europe, Middle East and Central Asia appearing critical regions for the most vulnerable crop, which is wheat. Finally, yield losses for wheat and soybean clearly worsen when moving from moderate to extreme multiscale droughts., (© 2022. The Author(s).)

This study presents a new global gridded dataset of bioclimatic indicators at 0.5° by 0.5° resolution for historical and future conditions. The dataset, called CMCC-BioClimInd, provides a set of 35 bioclimatic indices, expressed as mean values over each time interval, derived from post-processing both climate reanalysis for historical period (1960-1999) and an ensemble of 11 bias corrected CMIP5 simulations under two greenhouse gas concentration scenarios for future climate projections along two periods (2040-2079 and 2060-2099). This new dataset complements the availability of spatialized bioclimatic information, crucial aspect in many ecological and environmental wide scale applications and for several disciplines, including forestry, biodiversity conservation, plant and landscape ecology. The data of individual indicators are publicly available for download in the commonly used Network Common Data Form 4 (NetCDF4) format.

Forest conservation strategies and plans can be unsuccessful if the new habitat conditions determined by climate change are not considered. Our work aims at investigating the likelihood of future suitability, distribution and diversity for some common European forest species under the projected changes in climate, focusing on Southern Europe. We combine an Ensemble Platform for Species Distribution Models (SDMs) to five Global Circulation Models (GCMs) driven by two Representative Concentration Pathways (RCPs), to produce maps of future climate-driven habitat suitability for ten categories of forest species and two time horizons. For each forest category and time horizon, ten maps of future distribution (5 GCMs by 2 RCPs) are thus combined in a single suitability map supplied with information about the "likelihood" adopting the IPCC terminology based on consensus among projections. Then, the statistical significance of spatially aggregated changes in forest composition at local and regional level is analyzed. Finally, we discuss the importance, among SDMs, that environmental predictors seem to have in influencing forest distribution. Future impacts of climate change appear to be diversified across forest categories. A strong change in forest regional distribution and local diversity is projected to take place, as some forest categories will find more suitable conditions in previously unsuitable locations, while for other categories the same new conditions will become less suited. A decrease in species diversity is projected in most of the area, with Alpine region showing the potentiality to become a refuge for species migration.

Involvement of the ankle joint in Charcot osteoarthropathy may be associated with severe instability and fracture or collapse of the talus. Recalcitrant ulceration may result over the lateral malleolus, increasing the risk of major amputation. This study evaluated ankle arthrodesis with a compressive intramedullary nail in 14 patients with diabetes affected by Charcot of the ankle. The mean patient age was 58 +/- 12 years, and the mean duration of diabetes was 17 +/- 5 years. Transcutaneous oxygen pressures were > or = 50 mm Hg in all patients, indicating a good distal blood supply. A below-knee amputation had previously been suggested because of severe ankle joint instability. None of the patients were able to walk without a brace. Four patients had an ulceration that had healed before the index procedure. All procedures were performed in the quiescent phase of the disease. After a mean follow-up of 18 +/- 4 months, 10 patients (71.4%) achieved a solid arthrodesis, returning to walking with protective shoes. Three patients (21.4%) developed breakage of the calcaneus screws, necessitating removal of the screws in 2 cases and removal of the entire nail in 2 cases. These 3 patients went on to fibrous union that allowed walking with a brace. One patient (7.2%) required a below-knee amputation because of postoperative osteomyelitis of the distal tibia. The data from our study demonstrate a high rate of limb salvage (92.8%), suggesting that this device is safe and effective in the treatment of Charcot arthropathy of the ankle.

Objective: To evaluate the clinical efficacy and safety of HYAFF 11-based autologous dermal and epidermal grafts in the management of diabetic foot ulcers., Research Design and Methods: A total of 79 patients with diabetic dorsal (n = 37) or plantar (n = 42) ulcers were randomized to either the control group with nonadherent paraffin gauze (n = 36) or the treatment group with autologous tissue-engineered grafts (n = 43). Weekly assessment, aggressive debridement, wound infection control, and adequate pressure relief (fiberglass off-loading cast for plantar ulcers) were provided in both groups. Complete wound healing was assessed within 11 weeks. Safety was monitored by adverse events., Results: Complete ulcer healing was achieved in 65.3% of the treatment group and 49.6% of the control group (P = 0.191). The Kaplan-Meier mean time to closure was 57 and 77 days, respectively, for the treatment versus control groups. Plantar foot ulcer healing was 55% and 50% in the treatment and control groups, respectively. Dorsal foot ulcer healing was significantly different, with 67% in the treatment group and 31% in the control group (P = 0.049). The mean healing time in the dorsal treatment group was 63 days, and the odds ratio for dorsal ulcer healing compared with the control group was 4.44 (P = 0.037). Adverse events were equally distributed between the two groups, and none were related to the treatments., Conclusions: The autologous tissue-engineered treatment exhibited improved healing in dorsal ulcers when compared with the current standard dressing. For plantar ulcers, the off-loading cast was presumably paramount and masked or nullified the effects of the autologous wound treatment. This treatment, however, may be useful in patients for whom the total off-loading cast is not recommended and only a less effective off-loading device can be applied.