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Heat waves (HWs) and cold waves (CWs) can have considerable impact on people. Mapping risks of extreme temperature at local scale, accounting for the interactions between hazard, exposure, and vulnerability, remains a challenging task. In this study, we quantify risks from HWs and CWs for the Trentino-Alto Adige region of Italy from 1980 to 2018 at high spatial resolution. We use the Heat Wave Magnitude Index daily (HWMId) and the Cold Wave Magnitude Index daily (CWMId) as the hazard indicators. To obtain HWs and CW risk maps we combined the following: (i) occurrence probability maps of the hazard obtained using the zero-inflated Tweedie distribution (accounting directly for the absence of events for certain years), (ii) normalized population density maps, and (iii) normalized vulnerability maps based on eight socioeconomic indicators. The methodology allowed us to disentangle the contributions of each component of the risk relative to total change in risk. We find a statistically significant increase in HW hazard and exposure, while CW hazard remained stagnant in the analyzed area over the study period. A decrease in vulnerability to extreme temperature spells is observed through the region except in the larger cities where vulnerability increased. HW risk increased in 40 % of the region, with the increase being greatest in highly populated areas. Stagnant CW hazard and declining vulnerability result in reduced CW risk levels overall, except for the four main cities where increased vulnerability and exposure increased risk levels. These findings can help to steer investments in local risk mitigation, and this method can potentially be applied to other regions where there are sufficient detailed data.

TKIs long-term treatment in CML may lead to persistent adverse events (AEs) that can promote relevant morbidity and mortality. Consequently, TKIs dose reduction is often used to prevent AEs. However, data on its impact on successful treatment-free remission (TFR) are quite scarce. We conducted a retrospective study on the outcome of CML subjects who discontinued low-dose TKIs from 54 Italian hematology centers participating in the Campus CML network. Overall, 1.785 of 5.108 (35.0%) regularly followed CML patients were treated with low-dose TKIs, more frequently due to relevant comorbidities or AEs (1.288, 72.2%). TFR was attempted in 248 (13.9%) subjects, all but three while in deep molecular response (DMR). After a median follow-up of 24.9 months, 172 (69.4%) patients were still in TFR. TFR outcome was not influenced by gender, Sokal/ELTS risk scores, prior interferon, number and last type of TKI used prior to treatment cessation, DMR degree, reason for dose reduction or median TKIs duration. Conversely, TFR probability was significantly better in the absence of resistance to any prior TKI. In addition, patients with a longer DMR duration before TKI discontinuation (i.e., >6.8 years) and those with an e14a2 BCR::ABL1 transcript type showed a trend towards prolonged TFR. It should also be emphasized that only 30.6% of our cases suffered from molecular relapse, less than reported during full-dose TKI treatment. The use of low-dose TKIs does not appear to affect the likelihood of achieving a DMR and thus trying a treatment withdrawal, but might even promote the TFR rate.

Background: Cortico-cortical evoked potentials (CCEPs) recorded by stereo-electroencephalography (SEEG) are a valuable tool to investigate brain reactivity and effective connectivity. However, invasive recordings are spatially sparse since they depend on clinical needs. This sparsity hampers systematic comparisons across-subjects, the detection of the whole-brain effects of intracortical stimulation, as well as their relationships to the EEG responses evoked by non-invasive stimuli. Objective: To demonstrate that CCEPs recorded by high-density electroencephalography (hd-EEG) provide additional information with respect SEEG alone and to provide an open, curated dataset to allow for further exploration of their potential. Methods: The dataset encompasses SEEG and hd-EEG recordings simultaneously acquired during Single Pulse Electrical Stimulation (SPES) in drug-resistant epileptic patients (N = 36) in whom stimulations were delivered with different physical, geometrical, and topological parameters. Differences in CCEPs were assessed by amplitude, latency, and spectral measures. Results: While invasively and non-invasively recorded CCEPs were generally correlated, differences in pulse duration, angle and stimulated cortical area were better captured by hd-EEG. Further, intracranial stimulation evoked site-specific hd-EEG responses that reproduced the spectral features of EEG responses to transcranial magnetic stimulation (TMS). Notably, SPES, albeit unperceived by subjects, elicited scalp responses that were up to one order of magnitude larger than the responses typically evoked by sensory stimulation in awake humans. Conclusions: CCEPs can be simultaneously recorded with SEEG and hd-EEG and the latter provides a reliable descriptor of the effects of SPES as well as a common reference to compare the whole-brain effects of intracortical stimulation to those of non-invasive transcranial or sensory stimulations in humans.

This study analyzes future climate for the Mediterranean region projected with the high-resolution coupled CM2.5 model, which incorporates a new and improved land model (LM3). The simulated climate changes suggest pronounced warming and drying over most of the region. However, the changes are distinctly smaller than those of the CMIP5 multi-model ensemble. In addition, the changes over much of southeast and central Europe indicate very modest warming compared to the CMIP5 projections and also a tendency toward wetter conditions. These differences indicate a possible role of factors such as land surface–atmospheric interactions in these regions. Our analysis also highlights the importance of correctly projecting the magnitude of changes in the summer North Atlantic Oscillation, which has the capacity to partly offset anthropogenic warming and drying over the western and central Mediterranean. Nevertheless, the projections suggest a decreasing influence of local atmospheric dynamics and teleconnections in maintaining the regional temperature and precipitation balance, in particular over arid regions like the eastern and southern Mediterranean, which show a local maximum of warming and drying. The intensification of the heat low in these regions rather suggests an increasing influence of warming land surface on the local surface atmospheric circulation and progressing desertification.

Focal cortical lesions are known to result in large-scale functional alterations involving distant areas; however, little is known about the electrophysiological mechanisms underlying these network effects. Here, we addressed this issue by analysing the short and long distance intracranial effects of controlled structural lesions in humans. The changes in Stereo-Electroencephalographic (SEEG) activity after Radiofrequency-Thermocoagulation (RFTC) recorded in 21 epileptic subjects were assessed with respect to baseline resting wakefulness and sleep activity. In addition, Cortico-Cortical Evoked Potentials (CCEPs) recorded before the lesion were employed to interpret these changes with respect to individual long-range connectivity patterns. We found that small structural ablations lead to the generation and large-scale propagation of sleep-like slow waves within the awake brain. These slow waves match those recorded in the same subjects during sleep, are prevalent in perilesional areas, but can percolate up to distances of 60 mm through specific long-range connections, as predicted by CCEPs. Given the known impact of slow waves on information processing and cortical plasticity, demonstrating their intrusion and percolation within the awake brain add key elements to our understanding of network dysfunction after cortical injuries.

Severe winter storms in combination with precipitation extremes pose a serious threat to Europe. Located at the southeastern exit of the North Atlantic's storm track, European coastlines are directly exposed to impacts by high wind speeds, storm floods and coastal erosion. In this study we analyze potential changes in simulated winter storminess and extreme precipitation, which may occur under 1.5 or 2 °C warming scenarios. Here we focus on a first simulation suite of the atmospheric model CAM5 performed within the HAPPI project and evaluate how changes of the horizontal model resolution impact the results regarding atmospheric pressure, storm tracks, wind speed and precipitation extremes. The comparison of CAM5 simulations with different resolutions indicates that an increased horizontal resolution to 0.25° not only refines regional-scale information but also improves large-scale atmospheric circulation features over the Euro-Atlantic region. The zonal bias in monthly pressure at mean sea level and wind fields, which is typically found in low-resolution models, is considerably reduced. This allows us to analyze potential changes in regional- to local-scale extreme wind speeds and precipitation in a more realistic way. Our analysis of the future response for the 2 °C warming scenario generally confirms previous model simulations suggesting a poleward shift and intensification of the meridional circulation in the Euro-Atlantic region. Additional analysis suggests that this shift occurs mainly after exceeding the 1.5 °C global warming level, when the midlatitude jet stream manifests a strengthening northeastward. At the same time, this northeastern shift of the storm tracks allows an intensification and northeastern expansion of the Azores high, leading to a tendency of less precipitation across the Bay of Biscay and North Sea. Regions impacted by the strengthening of the midlatitude jet, such as the northwestern coasts of the British Isles, Scandinavia and the Norwegian Sea, and over the North Atlantic east of Newfoundland, experience an increase in the mean as well as daily and sub-daily precipitation, wind extremes and storminess, suggesting an important influence of increasing storm activity in these regions in response to global warming.

Winter warming and sea-ice retreat observed in the Arctic in the last decades may be related to changes of large-scale atmospheric circulation pattern, which may impact the transport of black carbon (BC) to the Arctic and its deposition on the sea ice, with possible feedbacks on the regional and global climate forcing. In this study we developed and applied a statistical algorithm, based on the maximum likelihood estimate approach, to determine how the changes of three large-scale weather patterns associated with increasing temperatures in winter and sea-ice retreat in the Arctic impact the transport of BC to the Arctic and its deposition. We found that two atmospheric patterns together determine a decreasing winter deposition trend of BC between 1980 and 2015 in the eastern Arctic while they increase BC deposition in the western Arctic. The increasing BC trend is mainly due to a pattern characterized by a high-pressure anomaly near Scandinavia favouring the transport in the lower troposphere of BC from Europe and North Atlantic directly into to the Arctic. Another pattern with a high-pressure anomaly over the Arctic and low-pressure anomaly over the North Atlantic Ocean has a smaller impact on BC deposition but determines an increasing BC atmospheric load over the entire Arctic Ocean with increasing BC concentrations in the upper troposphere. The results show that changes in atmospheric circulation due to polar atmospheric warming and reduced winter sea ice significantly impacted BC transport and deposition. The anthropogenic emission reductions applied in the last decades were, therefore, crucial to counterbalance the most likely trend of increasing BC pollution in the Arctic.

Long-term dynamic monitoring of the masonry façade of Palazzo Ducale known as Doge’s palace in Venice, Italy was performed from September 2010 to October 2012. This article demonstrates the results of preliminary analysis on the data set of the first 12-month long monitoring campaign for out-of-plumb dynamic responses of the medieval façade of the monument. The aim of the analysis of the dynamic signals is to validate the data set and investigate dynamic characteristics of the vibration signature of the historical masonry wall in the long-term. Palazzo Ducale is a heavily visited heritage due to its high cultural importance and architectural value. Nevertheless, little is known about the dynamic behaviour of the double-leaf masonry façade. In this study, the dynamic properties of the structure are presented by dynamic identification carried out with the effect of the ambient vibration measured at four different locations on the façade and portico level. The trend and intensity of the vibration at each measurement locations are identified over the year. In addition, the issue on eliminating the noise blended in the signals for reliable analysis are also discussed.

The purpose of this article is to show the extreme temperature regime of heat waves across Africa over recent years (1981–2015). Heat waves have been quantified using the Heat Wave Magnitude Index daily (HWMId), which merges the duration and the intensity of extreme temperature events into a single numerical index. The HWMId enables a comparison between heat waves with different timing and location, and it has been applied to maximum and minimum temperature records. The time series used in this study have been derived from (1) observations from the Global Summary of the Day (GSOD) and (2) reanalysis data from ERA-Interim. The analysis shows an increasing number of heat waves of both maxima and minima temperatures in the last decades. Results from heat wave analysis of maximum temperature (HWMIdtx) indicate an increase in intensity and frequency of extreme events. Specifically, from 1996 onwards it is possible to observe HWMIdtx spread with the maximum presence during 2006–2015. Between 2006 and 2015 the frequency (spatial coverage) of extreme heat waves had increased to 24.5 observations per year (60.1 % of land cover), as compared to 12.3 per year (37.3 % of land area) in the period from 1981 to 2005 for GSOD stations (reanalysis).

Despite the strict rules of the current legislation, road transport origins countless stress factors to animals. The purpose of this retrospective study is to assess the current welfare conditions during animal transport in Calabria and all related operations in the three years 2013-2015.The results showed that during this period 2015 the checks carried out by regional police are increased whereas sanctions imposed are decreased. The most frequent irregularities registered regard documentations (74.8%), animal welfare irregularities shows low incidence (6.5%), and percentage of irregularities regarding inadequate of the vehicle is halved in 2014 and 2015 respect to 2013. Data reported demonstrate the need for the competent Authorities to continue in their inspection actions in order to contrast the irregularities in the animal transport and improve animal welfare.

Lo scopo di questo lavoro è quello di evidenziare come una metodica ricostruttiva inusuale, datata ed impopolare come il lembo di massetere possa invece rappresentare, per casi selezionati, una soluzione affidabile, semplice ed efficace nelle ricostruzioni del cavo orale. Riportiamo di seguito l’utilizzo del lembo di massetere in due pazienti che presentavano un secondo tumore del cavo orale e che in precedenza erano già stati sottoposti ad intervento chirurgico nel distretto testa collo; in entrambi i casi sono stati ottenuti eccellenti risultati funzionali e soddisfacenti risultati estetici. In letteratura, fino ad oggi, sono stati riportati solo 60 casi di ricostruzione del cavo orale e dell’orofaringe con il lembo di massetere. L’utilità clinica del lembo di massetere, anche nell’ambito di un approccio moderno alle ricostruzioni del distretto testa collo, viene discussa approfonditamente in questo articolo. Riteniamo che il lembo di massetere debba far parte del bagaglio culturale di ogni chirurgo del testa-collo ed essere considerato fra le alternative proponibili, in quanto ha dimostrato di essere una metodica elegante ed estremamente semplice in casi in cui sussistono delle perplessità sulle procedure microvascolari.

In recent decades there has been an increase in magnitude and occurrence of heat waves and a decrease of cold waves, both of which may be related to the anthropogenic influence. This study describes the extreme temperature regime of heat waves and cold waves across South America over recent years (1980–2014). Temperature records come from the Global Surface Summary of the Day (GSOD), a climatological data set produced by the National Climatic Data Center that provides records of daily maximum and minimum temperatures acquired worldwide. The magnitude of heat waves and cold waves for each GSOD station are quantified on an annual basis by means of the Heat Wave Magnitude Index and the Cold Wave Magnitude Index. Results indicate an increase in intensity and in frequency of heat waves, especially in the last 10 years. Conversely, no significant changes are detected for cold waves. In addition, the trend of the annual temperature range (i.e. yearly mean of Tmax – yearly mean of Tmin) is positive – up to 1 °C per decade – over the extratropics and negative – up to 0.5 °C per decade – over the tropics.

The aim of the study is to estimate the pension costs incurred for patients with musculoskeletal disorders (MDs) and specifi cally with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) in Italy between 2009 and 2012. We analyzed the database of the Italian National Social Security Institute (Istituto Nazionale Previdenza Sociale i.e. INPS) to estimate the total costs of three types of social security benefi ts granted to patients with MDs, RA and AS: disability benefi ts (for people with reduced working ability), disability pensions (for people who cannot qualify as workers) and incapacity pensions (for people without working ability). We developed a probabilistic model with a Monte Carlo simulation to estimate the total costs for each type of benefi t associated with MDs, RA and AS. We also estimated the productivity loss resulting from RA in 2013. From 2009 to 2012 about 393 thousand treatments were paid for a total of approximately €2.7 billion. The annual number of treatments was on average 98 thousand and cost in total €674 million per year. In particular, the total pension burden was about €99 million for RA and €26 million for AS. The productivity loss for AR in 2013 was equal to €707,425,191 due to 9,174,221 working days lost. Our study is the fi rst to estimate the burden of social security pensions for MDs based on data of both approved claims and benefi ts paid by the national security system. From 2009 to 2012, in Italy, the highest indirect costs were associated with disability pensions (54% of the total indirect cost), followed by disability benefi ts (44.1% of cost) and incapacity pensions (1.8% of cost). In conclusion, MDs are chronic and highly debilitating diseases with a strong female predominance and very signifi cant economic and social costs that are set to increase due to the aging of the population.

The present paper reports on experiments of fluidized bed combustion of dry and wet olive husks. The olive husks are a biogenic residue of the olive oil industry, accounting for around 80 % of olive mass on wet basis. They have residual water content up to 70 % and rather high heating value (i.e. 22.3 MJ/kg on dry basis). Huge production of olive husks occurs seasonally in the Mediterranean area, posing problems for proper disposal and valorisation because of the difficulty to store this material for long times. The research demonstrated that the olive husks can be smoothly and effectively burnt in fluidized bed with high combustion efficiency and very low emissions of pollutants and solid particulate in a bed temperature range between 800 and 850 °C. The energy balance on the combustor shows that a fraction of 10-15 % of the heat input can be directly extracted from the fluidized bed, the remaining being available in the hot flue gases. The focus was also on the emissions of nitrogen oxide. The research can have practical application for small scale and local installation, e.g. at olive oil factory, as demonstrated by the experimental campaign at pilot scale.

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