Understanding the heterogeneity of COVID-19 deaths and contagions: The role of air pollution and lockdown decisions

The uneven geographical distribution of the novel coronavirus epidemic (COVID-19) in Italy is a puzzle given the intense flow of movements among the different geographical areas before lockdown decisions. To shed light on it, we test the effect of the quality of air (as measured by particulate matter and nitrogen dioxide) and lockdown restrictions on daily adverse COVID-19 outcomes during the first pandemic wave in the country. We find that air pollution is positively correlated with adverse outcomes of the pandemic, with lockdown being strongly significant and more effective in reducing deceases in more polluted areas. Results are robust to different methods including cross-section, pooled and fixed-effect panel regressions (controlling for spatial correlation), instrumental variable regressions, and difference-in-differences estimates of lockdown decisions through predicted counterfactual trends. They are consistent with the consolidated body of literature in previous medical studies suggesting that poor quality of air creates chronic exposure to adverse outcomes from respiratory diseases. The estimated correlation does not change when accounting for other factors such as temperature, commuting flows, quality of regional health systems, share of public transport users, population density, the presence of Chinese community, and proxies for industry breakdown such as the share of small (artisan) firms. Our findings provide suggestions for investigating uneven geographical distribution patterns in other countries, and have implications for environmental and lockdown policies

A war is forever: The long-run effects of early exposure to World War II on trust

This paper examines the long-term effect of conflict on trust by using changes in places and timing of combats during World War II. We focus on the pre-school period, an important life stage for the formation of trust and an age where war exposure may persist throughout life. We find robust evidence that individuals exposed to combats in the first six years of life display lower trust and social engagement well into adulthood. In light of the well-known relationship between trust and collective action, our results lend credence to the theory that violent conflict inhibits well-functioning government in long run

I am a survivor, keep on surviving: early-life exposure to conflict and subjective survival probabilities in adult life

Life-course studies have shown that early-life conditions predict health and socio-economic status in adult life. This study analyzes whether experiencing a traumatic event in childhood, i.e., the Second World War (WW2), affects subjective survival probabilities (SSPs). We rely on a representative sample of European adults who were differentially exposed to WW2 during childhood as a result of their date and place of birth. Results show that exposure to WW2 increases SSPs, with socio-economic and health characteristics not playing a mediating role. War exposure also counterbalances the adverse effects of health impairments on SSPs, but it does not affect health outcomes per se. This fact, jointly with low mortality rates of the cohort under investigation, suggests that selective mortality and post-traumatic stress are not the main channels. Instead, the results support the hypothesis that personal growth and life appreciation emerge after traumatic events, thereby leading to optimistic perceptions of longevity

Retrieval of the gastric specimen following laparoscopic sleeve gastrectomy. Experience on 275 cases.

Severe obesity leads to a high incidence of complications and a decrease in life expectancy, especially among younger adults. Laparoscopic sleeve gastrectomy (LSG) first intended as the first step of biliopancreatic diversion with duodenal switch is gaining a per-se procedure role because of its effectiveness on weight loss and comorbidity resolution. Different techniques have been described for specimen extraction in LSG. In this article we report the technique adopted in 275 LSGs performed in our department. In the first 120 LSGs performed from 2007, the specimen was extracted through a mini laparotomy. In the following 155 cases the technique has been simplified: the grasped specimen has been withdrawn through the 15 mm trocar site. We registered in the fist group six cases of wound infection (5%), ten cases of hematoma (8.3%) and four cases of port site hernia (3.3%). In the second group only one case of hematoma (0.6%, p = 0.01) but no cases of wound infection (p = 0.01) or port site hernia, (p = 0.03) although we registered a specimen perforation during retrieval in 16 patients, were reported. The technique described in the 155 cases of the control group has shown to be more effective than the technique we used in the case group, allowing significantly lower operative time (112.9 ± 1.0 vs 74.9 ± 9.1 p < 0.001) and complications, and providing unchanged costs

Risk of Complications in Patients Undergoing Completion Thyroidectomy after Hemithyroidectomy for Thyroid Nodule with Indeterminate Cytology: An Italian Multicentre Retrospective Study

There is still controversy as to whether patients undergoing a completion thyroidectomy after a hemithyroidectomy for a thyroid nodule with an indeterminate cytology have a comparable, increased or decreased risk of complications compared to those submitted to primary thyroid surgery. The main aim of this study was to investigate this topic. Patients undergoing a thyroidectomy for thyroid nodular disease with an indeterminate cytology in four high-volume thyroid surgery centres in Italy, between January 2017 and December 2020, were retrospectively analysed. Based on the surgical procedure performed, four groups were identified: the TT Group (total thyroidectomy), HT Group (hemithyroidectomy), CT Group (completion thyroidectomy) and HT + CT Group (hemithyroidectomy with subsequent completion thyroidectomy). A total of 751 patients were included. As for the initial surgery, 506 (67.38%) patients underwent a total thyroidectomy and 245 (32.62%) a hemithyroidectomy. Among all patients submitted to a hemithyroidectomy, 66 (26.94%) were subsequently submitted to a completion thyroidectomy. No statistically significant difference was found in terms of complications comparing both the TT Group with the HT + CT Group and the HT Group with the CT Group. The risk of complications in patients undergoing a completion thyroidectomy after a hemithyroidectomy for a thyroid nodule with an indeterminate cytology was comparable to that of patients submitted to primary thyroid surgery (both a total thyroidectomy and hemithyroidectomy)

ExoClock Project. III. 450 New Exoplanet Ephemerides from Ground and Space Observations

The ExoClock project has been created to increase the efficiency of the Ariel mission. It will achieve this by continuously monitoring and updating the ephemerides of Ariel candidates, in order to produce a consistent catalog of reliable and precise ephemerides. This work presents a homogenous catalog of updated ephemerides for 450 planets, generated by the integration of ∼18,000 data points from multiple sources. These sources include observations from ground-based telescopes (the ExoClock network and the Exoplanet Transit Database), midtime values from the literature, and light curves from space telescopes (Kepler, K2, and TESS). With all the above, we manage to collect observations for half of the postdiscovery years (median), with data that have a median uncertainty less than 1 minute. In comparison with the literature, the ephemerides generated by the project are more precise and less biased. More than 40% of the initial literature ephemerides had to be updated to reach the goals of the project, as they were either of low precision or drifting. Moreover, the integrated approach of the project enables both the monitoring of the majority of the Ariel candidates (95%), and also the identification of missing data. These results highlight the need for continuous monitoring to increase the observing coverage of the candidate planets. Finally, the extended observing coverage of planets allows us to detect trends (transit-timing variations) for a sample of 19 planets. All the products, data, and codes used in this work are open and accessible to the wider scientific community

Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures

Procedure for prolapsing hemorrhoids (PPH) and stapled transanal rectal resection for obstructed defecation (STARR) carry low postoperative pain, but may be followed by unusual and severe postoperative complications. This review deals with the pathogenesis, prevention and treatment of adverse events that may occasionally be life threatening. PPH and STARR carry the expected morbidity following anorectal surgery, such as bleeding, strictures and fecal incontinence. Complications that are particular to these stapled procedures are rectovaginal fistula, chronic proctalgia, total rectal obliteration, rectal wall hematoma and perforation with pelvic sepsis often requiring a diverting stoma. A higher complication rate and worse results are expected after PPH for fourth-degree piles. Enterocele and anismus are contraindications to PPH and STARR and both operations should be used with caution in patients with weak sphincters. In conclusion, complications after PPH and STARR are not infrequent and may be difficult to manage. However, if performed in selected cases by skilled specialists aware of the risks and associated diseases, some complications may be prevented