Increasing Heatwave Hazards in the Southeastern European Union Capitals

Heatwaves (HWs) are one of the “natural” hazards with the greatest impact worldwide in terms of mortality and economic losses, and their effects may be exacerbated in large urban areas. For these reasons, more detailed analyses of urban HW trends represent a priority that cannot be neglected. In this study, HW trends were investigated during the warmest period of the year (May–September) by using a slightly improved version of the EuroHEAT HW definition applied on long meteorological time-series (36-year period, 1980–2015) collected by weather stations located in the capitals of the 28 European Union member countries. Comparisons between two 18-year sub-periods (1980–1997 vs. 1998–2015) were carried out and a city-specific HW hazard index (HWHI), accounting for the main HW characteristics, was proposed. Most of the capitals revealed significant positive trends of the majority of HW hazard characteristics and substantial HWHI increases were observed during the sub-period 1998–2015, especially in the central-eastern and southeastern cities. Conversely, minor HWHI increases were observed in most of the northern capitals and opposite situations were even observed in several northern and especially southwestern cities. The results of this study represent a support for planning urban HW-related mitigation and adaptation strategies with the priority given to the southeastern cities

Chest wall reconstruction with implantable cross-linked porcine dermal collagen matrix: Evaluation of clinical outcomes

Objectives: The aim of the study is to evaluate clinical applications, safety, and effectiveness of a porcine-derived acellular cross-linked dermal matrix biological mesh in chest wall reconstruction. Methods: We retrospectively analyzed a prospective multicenter database of chest wall reconstructions using a biological mesh in adult patients undergoing operation between October 2013 and December 2020. We evaluated preoperative data, type of resection and reconstruction, hospitalization, 30-day morbidity and mortality, and overall survival. Results: A total of 105 patients (36 women [34.2%]; mean age, 57.0 +/- 16.1 years; range, 18-90 years) were included, they have admitted for: primary chest wall tumor (n = 52; 49.5%), secondary chest wall tumor (n = 29; 27.6%), lung hernia (n = 12; 11.4%), trauma (n =10; 9.6%), and infections (n = 2; 1.9%). The surgical sites were preoperatively defined as at high risk of infection in 28 patients (26.7%) or as infected in 16 (15.2%) patients. Thirty-days morbidity was 30.5% (n = 32 patients); 14 patients (13.3%) had postoperative complications directly related to chest wall surgical resection and/or reconstruction. We experienced no 30-day mortality; 1-year and 2-year mortality was 8.4% and 16.8%, respectively. Conclusions: Biological mesh represents a valuable option in chest wall reconstruction even when surgical sites are infected or at high-risk of infections. This mesh shows low early and late postoperative complication rates and excellent long-term stability

Age as a risk factor in the occurrence of pneumothorax after transthoracic fine needle biopsy: Our experience

AbstractTransthoracic needle biopsy (TTNB) of the lung is a well-established technique for diagnosing many thoracic lesions, and is an important alternative to more invasive surgical procedures. Complications of TTNB include pneumothorax, hemoptysis, hemothorax, infection, and air embolism, with the most common complication as pneumothorax. From June 2011 to June 2014 we performed a prospective study of 188 patients who underwent TTNB with CT guidance at University Hospital of Salerno, Italy. Pneumothorax occurred in 14 of 188 biopsies (7.45%). With the respect of age of patients pneumothorax occurred more frequently in patients aged 60–70 years, while it was less frequent in younger (<60 years) and older patients (>70 years). In conclusion, data of our prospective study documented that CT-guided TTNB is a safe and reliable procedure in elderly patients with suspected chest malignancy and is well tolerated

Weather-Related Flood and Landslide Damage: A Risk Index for Italian Regions

The frequency of natural hazards has been increasing in the last decades in Europe and specifically in Mediterranean regions due to climate change. For example heavy precipitation events can lead to disasters through the interaction with exposed and vulnerable people and natural systems. It is therefore necessary a prevention planning to preserve human health and to reduce economic losses. Prevention should mainly be carried out with more adequate land management, also supported by the development of an appropriate risk prediction tool based on weather forecasts. The main aim of this study is to investigate the relationship between weather types (WTs) and the frequency of floods and landslides that have caused damage to properties, personal injuries, or deaths in the Italian regions over recent decades. In particular, a specific risk index (WT-FLARI) for each WT was developed at national and regional scale. This study has identified a specific risk index associated with each weather type, calibrated for each Italian region and applicable to both annual and seasonal levels. The risk index represents the seasonal and annual vulnerability of each Italian region and indicates that additional preventive actions are necessary for some regions. The results of this study represent a good starting point towards the development of a tool to support policy-makers, local authorities and health agencies in planning actions, mainly in the medium to long term, aimed at the weather damage reduction that represents an important issue of the World Meteorological Organization mission

A web survey to evaluate the thermal stress among healthcare workers during the COVID-19 pandemic in Italy

COVID 19 is a major planetary emergency and intense workloads and the potential heat stress create critical conditions for healthcare workers. A web survey was carried out in Italy during summer 2020 as part of WORKLIMATE project with the aim of assessing the interaction between Personal Protective Equipment (PPE) and heat stress in healthcare workers. Preliminary results on 191 questionnaires show an increase of heat stress perception in the areas covered by PPE determining symptoms such as thirst, sweating and general distress. This information could be useful to allow preventive measure to safeguard health and productivity of these workers

The Universal Thermal Climate Index as an operational forecasting tool of human biometeorological conditions in Europe

In operational weather forecasting standard environmental parameters, such as air temperature and humidity, are traditionally used to predict thermal conditions in the future. These parameters, however, are not enough to describe the thermal stress induced by the outdoor environment to the human body as they neglect the human heat budget and personal characteristics (e.g. clothing). The Universal Thermal Climate Index (UTCI) overcomes these limitations by using an advanced thermo-physiological model coupled with a state-of-the-art clothing model. Several systems have been recently developed to operationally forecast human biometeorological conditions via the UTCI, i.e. by computing UTCI from the forecasts of air temperature, humidity, wind speed and radiation as provided by numerical weather prediction models. Here we describe the UTCI-based forecasting systems developed in Czech Republic, Italy, Poland, Portugal and at the pan-European scale. Their characteristics are illustrated and their potential as warning systems for thermal hazards discussed

An occupational heat-health warning system for Europe: the HEAT-SHIELD Platform

Existing heat?health warning systems focus on warning vulnerable groups in order to reduce mortality. However, human health and performance are affected at much lower environmental heat strain levels than those directly associated with higher mortality. Moreover, workers are at elevated health risks when exposed to prolonged heat. This study describes the multilingual ?HEAT-SHIELD occupational warning system? platform (https://heatshield.zonalab.it/) operating for Europe and developed within the framework of the HEAT-SHIELD project. This system is based on probabilistic medium-range forecasts calibrated on approximately 1800 meteorological stations in Europe and provides the ensemble forecast of the daily maximum heat stress. The platform provides a non-customized output represented by a map showing the weekly maximum probability of exceeding a specific heat stress condition, for each of the four upcoming weeks. Customized output allows the forecast of the personalized local heat-stress-risk based on workers? physical, clothing and behavioral characteristics and the work environment (outdoors in the sun or shade), also taking into account heat acclimatization. Personal daily heat stress risk levels and behavioral suggestions (hydration and work breaks recommended) to be taken into consideration in the short term (5 days) are provided together with long-term heat risk forecasts (up to 46 days), all which are useful for planning work activities. The HEAT-SHIELD platform provides adaptation strategies for ?managing? the impact of global warmingFinancial support for this work is provided by the HEAT-SHIELD Project (HORIZON 2020, research and innovation programme under the grant agreement 668786). L.N and B.R.M.K were also supported by the ClimApp project coordinated via ERA4CS (European Research for Climate Service) and funded by FORMAS (SWE), IFD (DK), NWO (NL) with co-funding from the European Union (grant agreement 690462)

Erratum to nodal management and upstaging of disease. Initial results from the Italian VATS Lobectomy Registry

[This corrects the article DOI: 10.21037/jtd.2017.06.12.]