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Background: Heart failure (HF)-related mortality has been exacerbated by the COVID-19 pandemic; however, it is unclear how healthcare reassessment has contributed to the excess mortality versus SARS-CoV-2 infection itself. We aimed to assess how the pandemic affected the therapeutic management and prognosis of HF patients. Methods: We retrospectively reviewed the healthcare utilization databases of the Lombardy region (Italy) to identify all newly-diagnosed HF patients from January 2018 to December 2021. Outcomes were the utilization of HF therapies (Sacubitril/Valsartan; cardiac resynchronization therapy [CRT] and/or implantable cardioverter-defibrillator [ICD]; mechanical circulatory support [MCS]; heart transplantation [HTX]) and mortality. Cox regression models were fitted to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for outcomes associated with the pandemic. Results: 36,130 and 17,263 patients were identified in the pre-pandemic and pandemic eras, respectively. The pandemic reduced Sacubitril/Valsartan utilization (HR = 0.77, 95% CI: 0.65-0.91) and CRT/ICD implantation (HR = 0.85, 95% CI: 0.78-0.92), but not MCS (HR = 1.11, 95% CI: 0.86-1.43) and HTX (HR = 0.88, 95% CI: 0.70-1.09). An increased mortality risk was observed during the pandemic (HR = 1.19, 95% CI: 1.15-1.23), which was attributable to SARS-CoV-2 infection (HR for non-COVID-19-related mortality = 1.01, 95% CI: 0.97-1.04). Conclusions: The COVID-19 pandemic was associated with a reduction in medical and interventional therapies for HF and an increase in mortality for HF patients.

Ozone (O-3) pollution poses a significant threat to global crop productivity, particularly for wheat, one of the most important staple foods. While bread wheat (Triticum aestivum) is unequivocally considered highly sensitive to O-3, durum wheat (Triticum durum) was often found to be more tolerant. This study investigated the O-3 dose-response relationships for durum wheat in the Mediterranean region, focusing mainly on grain yield losses, and utilizing the phytotoxic ozone dose (POD) metric to describe the intensity of the stressor. The results from two experiments with Open-Top Chambers performed in 2013 and 2014 on two relatively sensitive durum wheat cultivars confirmed that this wheat species is far more tolerant than bread wheat. The use of a local parameterization of a stomatal conductance model based on field measurements did not significantly improve the dose-response relationships obtained in comparison to the generic parameterization suggested by the Mapping Manual of the United Nations Economic Commission for Europe (UNECE). The POD6 critical level of 5 mmolO(3) m(-2 )for 5% grain yield loss was remarkably higher than the one established for bread wheat with analogous experiments, highlighting that O3 risk assessments based on bread wheat may largely overestimate the damage in the Mediterranean region where durum wheat cultivation prevails.

Carbon dioxide (CO2) uptake by plant photosynthesis, referred to as gross primary production (GPP) at the ecosystem level, is sensitive to environmental factors, including pollutant exposure, pollutant uptake, and changes in the scattering of solar shortwave irradiance (SWin) − the energy source for photosynthesis. The 2020 spring lockdown due to COVID-19 resulted in improved air quality and atmospheric transparency, providing a unique opportunity to assess the impact of air pollutants on terrestrial ecosystem functioning. However, detecting these effects can be challenging as GPP is influenced by other meteorological drivers and management practices. Based on data collected from 44 European ecosystem-scale CO2 flux monitoring stations, we observed significant changes in spring GPP at 34 sites during 2020 compared to 2015–2019. Among these, 14 sites showed an increase in GPP associated with higher SWin, 10 sites had lower GPP linked to atmospheric and soil dryness, and seven sites were subjected to management practices. The remaining three sites exhibited varying dynamics, with one experiencing colder and rainier weather resulting in lower GPP, and two showing higher GPP associated with earlier spring melts. Analysis using the regional atmospheric chemical transport model (LOTOS-EUROS) indicated that the ozone (O3) concentration remained relatively unchanged at the research sites, making it unlikely that O3 exposure was the dominant factor driving the primary production anomaly. In contrast, SWin increased by 9.4 % at 36 sites, suggesting enhanced GPP possibly due to reduced aerosol optical depth and cloudiness. Our findings indicate that air pollution and cloudiness may weaken the terrestrial carbon sink by up to 16 %. Accurate and continuous ground-based observations are crucial for detecting and attributing subtle changes in terrestrial ecosystem functioning in response to environmental and anthropogenic drivers.

The case study of 'Bosco Fontana', a densely-vegetated forest located in the north of Italy, is analysed both experimentally and numerically to characterise the internal ventilation of a finite forest with a vertically non-homogeneous canopy. Measurements allow for the evaluation of the turbulent exchange across the forest canopy. The case study is then reproduced numerically via a two-dimensional RANS simulation, successfully validated against experimental data. The analysis of the internal ventilation leads to the identification of seven regions of motion along the predominate-wind direction, for whose definition a new in-canopy stability parameter was introduced. In the vertical direction, the non-homogeneity of the canopy leads to the separation of the canopy layer into an upper foliage layer and a lower bush layer, characterised respectively by an increasing streamwise velocity and turbulence intensity, and a weak backflow. The conclusions report an improved description of the dynamic layer and regions of motion presented in the literature.

Carbon dioxide (CO2) uptake by plant photosynthesis, referred to as gross primary production (GPP) at the ecosystem level, is sensitive to environmental factors, including pollutant exposure, pollutant uptake, and changes in the scattering of solar shortwave irradiance (SWin) − the energy source for photosynthesis. The 2020 spring lockdown due to COVID-19 resulted in improved air quality and atmospheric transparency, providing a unique opportunity to assess the impact of air pollutants on terrestrial ecosystem functioning. However, detecting these effects can be challenging as GPP is influenced by other meteorological drivers and management practices. Based on data collected from 44 European ecosystem-scale CO2 flux monitoring stations, we observed significant changes in spring GPP at 34 sites during 2020 compared to 2015–2019. Among these, 14 sites showed an increase in GPP associated with higher SWin, 10 sites had lower GPP linked to atmospheric and soil dryness, and seven sites were subjected to management practices. The remaining three sites exhibited varying dynamics, with one experiencing colder and rainier weather resulting in lower GPP, and two showing higher GPP associated with earlier spring melts. Analysis using the regional atmospheric chemical transport model (LOTOS-EUROS) indicated that the ozone (O3) concentration remained relatively unchanged at the research sites, making it unlikely that O3 exposure was the dominant factor driving the primary production anomaly. In contrast, SWin increased by 9.4 % at 36 sites, suggesting enhanced GPP possibly due to reduced aerosol optical depth and cloudiness. Our findings indicate that air pollution and cloudiness may weaken the terrestrial carbon sink by up to 16 %. Accurate and continuous ground-based observations are crucial for detecting and attributing subtle changes in terrestrial ecosystem functioning in response to environmental and anthropogenic drivers.

Tropospheric ozone (O3) is a secondary atmospheric pollutant known to cause negative effects on vegetation in terms of physiological oxidative stress, growth rate reductions and yield losses. In recent years, dose-response relationships based on the O3 stomatal flux and effects on the biomass growth have been defined for several crop species. This study was aimed at developing a dual-sink big-leaf model for winter wheat (Triticum aestivum L.) to map the seasonal Phytotoxic Ozone Dose above a threshold of 6nmolm−2s−1 (POD6) in a domain centered on the Lombardy region (Italy). The model runs on local measured data of air temperature, relative humidity, precipitation, wind speed, global radiation and background O3 concentration provided by regional monitoring networks, and includes parameterizations for the crop's geometry and phenology, the light penetration within the canopy, the stomatal conductance, the atmospheric turbulence, and the soil water availability for the plants. For the 2017 an average POD6 of 2.03mmolm−2PLA (Projected Leaf Area) was found for the Lombardy regional domain, corresponding to an average relative yield loss of 7.5%, using the finest spatio-temporal resolution (1×1km2 and 1-h). An analysis of the model's response to different spatio-temporal resolutions (from 2×2 to 50×50km2 and from 1 to 6 h) suggests that coarser resolution maps underestimated the average POD6 regional value from 8to16%, and were unable to detect O3 hotspots. Nevertheless, resolutions of 5×5km2 1-h, and 1×1km2 3-h, can still be considered reliable for the estimation of the O3 risk at the regional level since they presented relatively low root mean squared error. Furthermore, although temperature was the main limiting factor for the wheat stomatal conductance in most of the domain, soil water availability emerged as the key factor for determining the spatial patterns of the POD6.

Objectives: The aim of this study was to assess the clinical course and outcomes of all heart transplant recipients affected by coronavirus disease-2019 (COVID-19) who were followed at the leading heart transplant centers of Northern Italy. Background: The worldwide severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic has created unprecedented challenges for public health, demanding exceptional efforts for the successful management and treatment of affected patients. Heart transplant patients represent a unique cohort of chronically immunosuppressed subjects in which SARS-CoV-2 may stimulate an unpredictable clinical course of infection. Methods: Since February 2020, we enrolled all 47 cases (79% male) in a first cohort of patients, with a mean age of 61.8 ± 14.5 years, who tested positive for SARS-CoV-2, out of 2,676 heart transplant recipients alive before the onset of the COVID-19 pandemic at 7 heart transplant centers in Northern Italy. Results: To date, 38 patients required hospitalization while 9 remained self-home quarantined and 14 died. Compared to the general population, prevalence (18 vs. 7 cases per 1,000) and related case fatality rate (29.7% vs. 15.4%) in heart transplant recipients were doubled. Univariable analysis showed older age (p = 0.002), diabetes mellitus (p = 0.040), extracardiac arteriopathy (p = 0.040), previous PCI (p = 0.040), CAV score (p = 0.039), lower GFR (p = 0.004), and higher NYHA functional classes (p = 0.023) were all significantly associated with in-hospital mortality. During the follow-up two patients died and a third patient has prolonged viral-shedding alternating positive and negative swabs. Since July 1st, 2020, we had 6 new patients who tested positive for SARS-CoV-2, 5 patients asymptomatic were self-quarantined, while 1 is still hospitalized for pneumonia. A standard therapy was maintained for all, except for the hospitalized patient. Conclusions: The prevalence and mortality of SARS-CoV-2 should spur cl