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In order to assess the impact of traffic on local air quality a microscale simulation of pollutant concentration fields was produced for two busy intersections, in Reggio Emilia and in Modena, Italy. The simulation was performed by the model suite Micro-Swift-Spray, a Lagrangian particle dispersion model accounting for buildings. Direct measurements of traffic flow were continuously collected in Reggio Emilia over the period January 13–24, 2014 by a two channel radar traffic counter and in Modena from October 28 to November 8, 2016 by four single channel radar traffic counters and used for the hourly modulation of vehicular emissions. Combining radar counts with vehicular fleet composition for each municipality, specific emission factors were obtained. For both cities, simulated concentration fields were compared to local air quality measurements at the nearest urban traffic and urban background sites. The simulated NOx showed large correlation with the observations, notwithstanding some underestimation. The results proved the reliability of the procedure and provided a fair estimate of the NO2 mass fraction of total NOx (primary NO2) due to vehicular emissions in the investigated traffic sites.

This work sets out the test of the GRAL model (Graz Lagrangian Model, vs.18.1) in the urban area of Modena (Po valley, Northern Italy). The simulation domain sizes 2 000 x 3 000 m2 and it features ‘microscale’ cells of 4 x 4 m2. The simulation focuses on an intersection featured by large traffic flows next to a school and a regulatory air quality monitoring station classified as an urban traffic site. The model is a lagrangian particle dispersion model and it takes into account the presence of buildings as obstacles and generating microscale wind fields accordingly, making this class of model suitable for investigating spatial pattern of atmospheric pollution in urban areas where local accumulation might occur. The simulation investigates traffic emissions of nitrogen oxides (NOx) over the period October 29 to November 10, 2016, when direct measurements of traffic flow were collected by four one-channel doppler radar traffic counters. These counters provided continuous estimate of vehicle length, speed and number. These latter data were combined with available traffic flows at rush hour by PTV VISUM mobility software and the fleet composition of the municipality to estimate the total NOx emissions by vehicular traffic over the roads included in the simulation domain. NOx simulated concentrations showed a moderate correlation with the NOx observations at the nearby monitoring site. To have a better insight on the potential and the limitations of the GRAL model, its results will be compared with the output of the lagrangian particle dispersion model PMSS over the same area.

Vestibular migraine (VM) is one of the most frequent causes of episodic vertigo, with a lifetime prevalence of 0.98 %. Prophylactic therapy includes calcium channel blockers, beta-blockers, antiepileptic drugs and antidepressants. We studied the association of cinnarizine 20 mg and dimenhydrinate 40 mg (Arlevertan©) in a group of 22 patients affected by definite VM. Proposed therapy included one tablet twice a day for 1 month, which was repeated three times with 1 month of interval between drug intake; results were compared with those of a control group of 11 VM patients who asked to observe only lifestyle measures for migraine. The main outcome was the number of vertigo and headache crises in the 6 months before therapy and in the 6 months of follow-up. Subjects performing Arlevertan© presented during the 6 months of therapy a decrease of vertigo attacks from 5.3 to 2.1 and of headaches from 4.3 to 1.7 (p < 0.0001); 68 % of these subjects reported a decrease of at least 50 % of vertigo attacks, while 63 % of headaches. Conversely, vertigo attacks decreased from 3.5 to 2.2 and headaches from 2.6 to 2 in patients observing only lifestyle; 18 % of these subjects reported a decrease of at least 50 % of vertigo crises and 27 % of headaches. Our data do not differ from those of previous works assessing efficacy of different prophylactic therapies for VM and reporting consistent reduction of vertigo spells in a rate of patients ranging from 60 and 80 %.

Considering the new IPCC report and its recent suggestions, it is important to pay serious attention to the Urban Heat Island issue. In this study, satellite images acquired by the Worldview3 sensor (WV3) were processed to classify the different kinds of urban surface and to compute the albedo value for each surface. Then several UHI mitigation scenarios were analyzed, varying selectively the surface albedo by choosing solar reflective materials. Clay tile pitched roofs, dark roofs and parking areas were considered as “modifiable surfaces” and their albedo values were increased on the basis of the literature and of data made available by product manufacturers. For each proposed scenario, the reduction of intensity of the Urban Heat Island effect (ATD), the energy saving brought by lower absorption of air conditioning systems (ΔE) and the consequent cost savings were calculated. All the scenarios proved to be convenient and with a relatively fast return on investment. In particular, two scenarios involving the modification of several surfaces at the same time proved to be the most promising ones from the perspective of a public administration, with significant benefits on the well-being of the population, as well as with similar and relatively short payback periods.

Background Epidemiologic studies have raised the possibility that some pesticide compounds induce the neurodegenerative disease amyotrophic lateral sclerosis (ALS), though the available evidence is not entirely consistent. Methods We conducted a population-based case-control study in two Italian populations to assess the extent to which residence in the vicinity of agricultural crops associated with the application of neurotoxic pesticides is a risk factor for ALS, using crop acreage in proximity to the residence as an index of exposure. Results Based on 703 cases and 2737 controls, we computed an ALS odds ratio of 0.92 (95% confidence interval 0.78-1.09) for those in proximity to agricultural land. Results were not substantially different when using alternative exposure categories or when analyzing specific crop types, with the exception of a higher risk related to exposure to citrus orchards and olive groves in Southern Italy, though based on few exposed subjects (N = 89 and 8, respectively). There was little evidence of any dose-response relation between crop proximity and ALS risk, and using long-term residence instead of current residence did not substantially change our estimates. Conclusions Though our index of exposure is indirect and subject to considerable misclassification, our results offer little support for the hypothesis that neurotoxic pesticide exposure increases ALS risk.

La vertigine e l’instabilità sono sintomi molto comuni nella popolazione la cui prevalenza è stimata tra il 20 e il 56%. L’obiettivo del nostro lavoro è stato quello di determinare la prevalenza di questi sintomi in una popolazione di 2672 soggetti. È stato somministrato loro loro un questionario; nella prima parte sono stati richiesti i dati demografici e se avessero mai sofferto di vertigine o instabilità nella loro vita. L’età media del campione è stata di 48,3 ± 15 anni, il 46,7% erano maschi. Sul totale della popolazione 1077 (40,3%) hanno riferito di aver sofferto di vertigine o instabilità nella loro vita, con un primo episodio occorso all’età di 39,2 ± 15,4 anni. Nella seconda parte del questionario sono state indagate le caratteristiche delle vertigini (età del primo episodio, il tipo di vertigine, presenza di più episodi, esacerbazione posizionale della vertigine, presenza di sintomi cocleari infine la presenza di cefalea da moderata o severa nel corso della vita e le sue caratteristiche cliniche (riferita a un emicrania, pulsante, associata a fono o fotofobia, peggiore con l’attività fisica). È stata osservata una correlazione della vertigine con l’età e con il sesso, essendo la prima 4,4 volte più frequente nelle donne e 1,8 volte nei soggetti con oltre 50 anni. Sul campione complessivo di 2672 soggetti, 13,7% hanno riferito vertigine rotatoria, 26,3% episodi recidivanti, 12,9% esacerbazione correlata alla posizione e il 4,8% presenza sintomi cocleari; il 34,8% ha lamentato cefalea nel corso della loro vita. I soggetti affetti da cefalea presentavano un’incidenza aumentata di vertigini recidivanti, di esacerbazione correlata alla posizione, di sintomi cocleari e un’età più giovane di comparsa del primo episodio di vertigine/instabilità. Nella discussione i nostri dati sono stati confrontati con quelli di precedenti studi. Gli autori sottolineano la correlazione tra vertigine/instabilità da un lato e cefalea con caratteristiche emicraniche dall’altro.

The ectodermal dysplasias (EDs) are a large and complex group of inherited disorders. In various combinations, they all share anomalies in ectodermal derived structures: hair, teeth, nails and sweat gland function. Clinical overlap is present among EDs. Few causative genes have been identified, to date. Altered gene expression is not limited to the ectoderm but a concomitant effect on developing mesenchymal structures, with modification of ectodermal-mesenchymal signaling, takes place. The two major categories of ED include the hidrotic and hypohidrotic form, the latter more frequent; they differentiate each other for the presence or absence of sweat glands. We report Ear Nose Throat manifestations of ED, linked to the reduction of mucous glands in the nasal fossae with reduced ciliar function, and decrease salivary glands function. Often patients report an increased rate of infections of the upper respiratory tract and of the ear. Nasal obstruction due to the presence of nasal crusting, hearing loss and throat hoarseness are the most represented symptoms. Environmental measures, including a correct air temperature and humidification, is mandatory above all in subjects affected by hypohidrotic form.

The ECO System Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS) is a new space mission developed by NASA-JPL which launched on July 2018. It includes a multispectral thermal infrared radiometer that measures the radiances in five spectral channels between 8 and 12 μm. The primary goal of the mission is to study how plants use water by measuring their temperature from the vantage point of the International Space Station. However, as ECOSTRESS retrieves the surface temperature, the data can be used to measure other heat-related phenomena, such as heat waves, volcanic eruptions, and fires. We have cross-compared the temperatures obtained by ECOSTRESS, the Advanced Spaceborne Thermal Emission and Reflectance radiometer (ASTER) and the Landsat 8 Thermal InfraRed Sensor (TIRS) in areas where thermal anomalies are present. The use of ECOSTRESS for temperature analysis as well as ASTER and Landsat 8 offers the possibility of expanding the availability of satellite thermal data with very high spatial and temporal resolutions. The Temperature and Emissivity Separation (TES) algorithm was used to retrieve surface temperatures from the ECOSTRESS and ASTER data, while the single-channel algorithm was used to retrieve surface temperatures from the Landsat 8 data. Atmospheric effects in the data were removed using the moderate resolution atmospheric transmission (MODTRAN) radiative transfer model driven with vertical atmospheric profiles collected by the University of Wyoming. The test sites used in this study are the active Italian volcanoes and the Parco delle Biancane geothermal area (Italy). In order to test and quantify the difference between the temperatures retrieved by the three spaceborne sensors, a set of coincident imagery was acquired and used for cross comparison. Preliminary statistical analyses show a very good agreement in terms of correlation and mean values among sensors over the test areas.

Background/aim Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with still unknown aetiology. Among environmental factors, pesticides have been investigated due to their potential neurotoxic effects. Within a population-based case-control study conducted in two Italian regions, we aimed to investigate ALS risk due to passive residential exposure to pesticides using two methodologies. Methods The exposure assessment was carried with an individual questionnaire, which collected information of the entire residential history of subjects, focusing on rural residence or in the vicinity of agricultural areas. It was compared with assessment based on geographical information system (GIS), avoiding direct contact with study subjects. To do that, we computed the percentage (≥50%) of rural land use within the 100 m round buffer around each subjects’ residence, according to cover maps of two periods available from the Department of Agriculture, recent (2003–2009) and historical (1978–1989) ones. Risk for passive residential exposure to pesticides was computed using a sex and age adjusted logistic regression model for both methods, and their agreement was assessed using Cohen’s kappa (k). Results The odds ratio (OR) with their 95% confidence intervals (CI) for passive residential exposure to pesticides was 1.67 (95% CI 0.87 to 3.20) from the questionnaire-based assessment, while ORs from the GIS-based assessment were 1.05 (0.40 to 2.73) and 1.13 (0.49 to 2.63) for the recent and historical period, respectively. The agreement between two methods considering all participants was generally moderate to high, with k of 0.564 (95% CI: 0.361 to 0.767) and 0.648 (0.494–0.802) for recent and historical periods, respectively. Analyses divided between cases and controls yielded similar results, with k of 0.468 (0.133–0.803) in cases and 0.630 (0.382–0.879) in controls for recent period, and 0.642 (0.380–0.904) in cases and 0.652 (0.464–0.840) in controls for historical one. Conclusion Our results showed a slight increased risk of passive exposure to pesticides using the questionnaire-based assessment, with less conclusive results from the GIS-based one. The similar agreement either between periods and case/control status, suggested also that no substantial information bias and differential exposure misclassification occurred when assessing pesticides exposure in our population.

The literature on death expectation in ill old age is mostly medical. A social science standpoint (especially quantitative) is practically absent. However, whether families, social and healthcare services can anticipate, support and prepare for the deaths of ill old adults is not reducible to the biomedical paradigm. Yet it is critical for end of life care (EOLC) policy. This study's aim is to investigate relatives' perception of death as unexpected in relation to both disease-related and care-related factors. Using the English Longitudinal Study of Ageing End-of-life Interviews Wave 6 this paper draws on probit regression analysis of unexpected (vs. expected) death in ill adults aged 50+. Findings are interpreted considering the containment of sudden death and the trajectories of dying in ill old age. The latter display overall visible decline preceding death. On this basis, EOLC literature and policy evidence death's uncertain timing as much as death's certain emergence in the horizon of expectation. Therefore, unexpected death in ill old age was interpreted as a failure to acknowledge dying, rather than the impossibility of discerning its approach. Very old age, dementia diagnoses and supported care environments were found to shape unexpected death.

Municipal solid waste incinerators emissions contain pollutants that, despite their low concentration, might adversely affect reproductive health. In the present study, we examined rates of miscarriage and birth defects among women who resided or were employed in the vicinity of a municipal solid waste incinerator plant from 2003 to 2013. In 2009, a progressive shutdown of the old incineration lines and operation of a new line caused considerably higher atmospheric release of polycyclic aromatic hydrocarbons, particularly of dioxins, due to these irregular operating conditions, technological renovation, and increased capacity. We used dioxin emission levels, based on a dispersion model, to define exposure status of the residing population to air pollutants emitted by the waste incinerator. In women who resided in areas characterized by higher emission exposures compared with a referent area, the relative risk (RR) of miscarriage was 1.04 (95% confidence interval (CI) 0.80-1.32) based on 62 cases overall, with little evidence of a dose-response relation. RRs were similarly null for both 2003-2008 and 2010-2013 periods (RR 1.12 (95% CI 0.80-1.53) and 0.98 (95% CI 0.63-1.48), respectively). Concerning birth defects in the offspring of women residing in the exposed area, no evidence of increased risk emerged, since the prevalence ratio at birth was 0.64 (95% CI 0.29-1.26), with comparable results in the 2003-2008 and 2010-2013 period. Corresponding analyses carried out in municipal residents who worked in the exposed area confirmed these findings. We also did not detect abnormally high rates of miscarriage and birth defects in the exposed cohorts in the single year 2009. Overall, these results do not suggest an effect of exposure to the emissions of the municipal solid waste incinerator we investigated on two indicators of reproductive health. However, the limited statistical stability of the estimates and the absence of individual-based information on some potential confounders suggest caution in the interpretation of study findings.

The development of a natural gas-fired tri-generation power plant (520 MW Combined Cycle Gas Turbines + 58 MW Tri-generation) in the Republic of San Marino, a small independent country in Northern Italy, is under assessment. This work investigates the impact of atmospheric emissions of NOx by the plant, under the Italian and European regulatory framework. The impact assessment was performed by the means of the Aria Industry package, including the 3D Lagrangian stochastic particle dispersion model SPRAY, the diagnostic meteorological model SWIFT, and the turbulence model SURFPRO (Aria Technologies, France, and Arianet, Italy). The Republic of San Marino is almost completely mountainous, 10 km west of the Adriatic Sea and affected by land-sea breeze circulation. SPRAY is suitable for simulations under non-homogenous and non-stationary conditions, over a complex topography. The emission scenario included both a worst-case meteorological condition and three 10-day periods representative of typical atmospheric conditions for 2014. The simulated NOx concentrations were compared with the regulatory air quality limits. Notwithstanding the high emission rate, the simulation showed a spatially confined environmental impact, with only a single NOx peak at ground where the plume hits the hillside of the Mount Titano (749 m a.s.l.), 5 km west of the future power plant.

Summary Cystic echinococcosis (CE) immunodiagnosis is still imperfect. We recently set‐up a whole‐blood test based on the interleukin (IL)‐4 response to the native Antigen B (AgB) of Echinococcus granulosus. However, AgB is encoded by a multigene family coding for five putative subunits. Therefore, the aims of this study were to analyse the IL‐4 response to peptides spanning the immunodominant regions of the five AgB subunits and to evaluate the accuracy of this assay for CE diagnosis. Peptides corresponding to each subunit were combined into five pools. A pool containing all peptides was also used (total pool). IL‐4 evaluated by enzyme‐linked immunosorbent assay was significantly higher in patients with CE compared to those without (NO‐CE subjects) when whole‐blood was stimulated with AgB1 and with the total pool. Moreover, IL‐4 levels in response to the total pool were significantly increased in patients with active cysts. Receiver Operator Curve analysis identified a cut‐off point of 0.59 pg/mL predicting active cysts diagnosis with 71% sensitivity and 82% specificity in serology‐positive CE patients. These data, if confirmed in a larger cohort, offer the opportunity to develop new diagnostic tools for CE based on a standardized source of AgB as the peptides.

The atmospheric dispersion of the NOX plume that will be emitted from a new power–plant, at present under installation, was simulated at micro–scale with Micro–Swift–Spray (MSS) Model. The plant will be constructed in a residential urban area in the town of Modena (Po Valley, Northern Italy), where low wind speeds and thermal inversions are quite frequent. Simulation results point out a different behavior of urban canopy in influencing the 3D dispersion patterns among urban obstacles, according to atmospheric mixing conditions: in case of moderate wind events, urban canyon phenomena may occur with a consequent increasing of NOX concentration gradients among buildings, while with low winds the near–field influence of the buildings emphasizes pollutant accumulation. The MSS simulated NOX concentrations result always much lower than the regulatory limits for air quality. The comparison of simulation results with measured concentration data for NOX shows the importance of micro–scale dispersion modeling to perform an accurate and reliable assessment of meteorological condition effects on pollutant distribution, and the ability of MSS in providing reliable simulations of atmospheric dispersion.

Urban areas usually experience higher tem- peratures when compared to their rural surroundings. Several studies underlined that specific urban conditions are strictly connected with the Urban heat island (UHI) phenomenon, which consists in the environmental over- heating related to anthropic activities. As a matter of fact, urban areas, characterized by massive constructions that reduce local vegetation coverage, are subject to the absorption of a great amount of solar radiation (short wave) which is only partially released into the atmosphere by radiation in the thermal infrared (long wave). On the contrary, green areas and rural environments in general show a reduced UHI effect, that is lower air temperatures, due to evapo-transpiration fluxes. Several studies demon- strate that urban microclimate affects buildings' energy consumption and calculations based on typical meteoro- logical year could misestimate their actual energy con- sumption. In this study, two different sets of meteorological data are used for the calculation of the heating and cooling energy needs of an existing university building. The building is modeled using TRNSYS v.17 software. The first set of data was collected by a weather station located in the city center of Modena, while the second set of data was collected by another station, located in the surrounding area of the city, near to the studied building. The influence of the different meteorological situations described by the two weather stations are analyzed and assumed to be representative of the UHI effect. Furthermore, the effects of UHI mitigation strate- gies on the building energy needs are evaluated and discussed.

New advances in understanding the pathophysiology of vestibular migraine (VM) have suggested a large overlap between migraine and vestibular pathways. We explored the regional distribution of gray (GM) and white matter (WM) abnormalities in VM patients in comparison to migraine patients with (MWA) and without aura (MWoA) and their correlations with patients’ clinical manifestations. Using a 3.0 Tesla scanner, brain T2-weighted and 3D T1-weighted MRI scans were acquired from 19 VM, 19 MWA, 19 MWoA and 20 age-matched controls. GM and WM volumetric abnormalities were estimated using voxel-based morphometry (SPM12). Compared to controls, migraine patients had decreased GM volume of the left cerebellum and an increased GM volume of the left temporal lobe. VM patients had a selective GM volume increase of frontal and occipital regions compared to controls and the other two groups of migraineurs and no regions with decreased GM volume. Compared to MWoA and MWA, VM had increased GM volume of the left thalamus. Regional GM abnormalities did not correlate with disease duration and attack frequency. No WM volumetric differences were detected between migraine patients and controls. These results show that GM volume abnormalities of nociceptive and multisensory vestibular brain areas occur in VM patients. Overall, our findings suggest that an abnormal brain sensitization might lead to a dismodulation of multimodal sensory integration and processing cortical areas in VM patients.

Vertigo and dizziness are common symptoms in the general population, with an estimated prevalence between 20% and 56%. The aim of our work was to assess the point prevalence of these symptoms in a population of 2672 subjects. Patients were asked to answer a questionnaire; in the first part they were asked about demographic data and previous vertigo and or dizziness. Mean age of the sample was 48.3 ± 15 years, and 46.7% were males. A total of 1077 (40.3%) subjects referred vertigo/dizziness during their lifetime, and the mean age of the first vertigo attack was 39.2 ± 15.4 years; in the second part they were asked about the characteristics of vertigo (age of first episode, rotational vertigo, relapsing episodes, positional exacerbation, presence of cochlear symptoms) and lifetime presence of moderate to severe headache and its clinical features (hemicranial, pulsatile, associated with phono and photophobia, worse on effort). An age and sex effect was demonstrated, with symptoms 4.4 times more elevated in females and 1.8 times in people over 50 years. In the total sample of 2672 responders, 13.7% referred a sensation of spinning, 26.3% relapsing episodes, 12.9% positional exacerbation and 4.8% cochlear symptoms; 34.8% referred headache during their lifetime. Subjects suffering from headache presented an increased rate of relapsing episodes, positional exacerbation, cochlear symptoms and a lower age of occurrence of the first vertigo/dizziness episode. In the discussion, our data are compared with those of previous studies, and we underline the relationship between vertigo/dizziness from one side and headache with migrainous features on the other.La vertigine e l’instabilità sono sintomi molto comuni nella popolazione la cui prevalenza è stimata tra il 20 e il 56%. L’obiettivo del nostro lavoro è stato quello di determinare la prevalenza di questi sintomi in una popolazione di 2672 soggetti. È stato somministrato loro loro un questionario; nella prima parte sono stati richiesti i dati demografici e se avessero mai sofferto di vertigine o instabilità nella loro vita. L’età media del campione è stata di 48,3 ± 15 anni, il 46,7% erano maschi. Sul totale della popolazione 1077 (40,3%) hanno riferito di aver sofferto di vertigine o instabilità nella loro vita, con un primo episodio occorso all’età di 39,2 ± 15,4 anni. Nella seconda parte del questionario sono state indagate le caratteristiche delle vertigini (età del primo episodio, il tipo di vertigine, presenza di più episodi, esacerbazione posizionale della vertigine, presenza di sintomi cocleari infine la presenza di cefalea da moderata o severa nel corso della vita e le sue caratteristiche cliniche (riferita a un emicrania, pulsante, associata a fono o fotofobia, peggiore con l’attività fisica). È stata osservata una correlazione della vertigine con l’età e con il sesso, essendo la prima 4,4 volte più frequente nelle donne e 1,8 volte nei soggetti con oltre 50 anni. Sul campione complessivo di 2672 soggetti, 13,7% hanno riferito vertigine rotatoria, 26,3% episodi recidivanti, 12,9% esacerbazione correlata alla posizione e il 4,8% presenza sintomi cocleari; il 34,8% ha lamentato cefalea nel corso della loro vita. I soggetti affetti da cefalea presentavano un’incidenza aumentata di vertigini recidivanti, di esacerbazione correlata alla posizione, di sintomi cocleari e un’età più giovane di comparsa del primo episodio di vertigine/instabilità. Nella discussione i nostri dati sono stati confrontati con quelli di precedenti studi. Gli autori sottolineano la correlazione tra vertigine/instabilità da un lato e cefalea con caratteristiche emicraniche dall’altro.