Change over time of COVID-19 hospital presentation in Northern Italy

none40After the first autochthonous case described on February 19, also in Italy the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARSCoV-2) infection rapidly circulated, mainly in the Northern regions of the country. The earliest reports on Coronavirus disease-19 (COVID-19) have described worldwide a high prevalence of severe respiratory illness [1]. A suggestive feature of COVID-19 has been a rapid progression of the respiratory impairment, leading to acute respiratory distress syndrome (ARDS) and often requiring ventilation support [2]. To date, whether clinical features at hospital presentation and outcome of COVID-19 have changed over the outbreak course is unknown. We explored this issue in a multicenter cohort of patients hospitalized for COVID-19 in Northern Italy.mixedPatti G.; Mennuni M.; Della Corte F.; Spinoni E.; Sainaghi P. P.; COVID-UPO Clinical Team; Azzolina D; Hayden E; Rognon A; Grisafi L; Colombo C; Lio V; Pirisi M; Vaschetto R; Aimaretti G; Krengli M; Avanzi GC; Balbo PE; Capponi A; Castello LM; Bellan M; Malerba M; Garavelli PL; Zeppegno P; Savoia P; Chichino G; Olivieri C; Re R; Maconi A; Comi C; Roveta A; Bertolotti M; Carriero A; Betti M; Mussa M; Borrè S; Cantaluppi V; Cantello R; Bobbio F; GavellI F.Patti, G.; Mennuni, M.; Della Corte, F.; Spinoni, E.; Sainaghi, P. P.; COVID-UPO Clinical, Team; Azzolina, D; Hayden, E; Rognon, A; Grisafi, L; Colombo, C; Lio, V; Pirisi, M; Vaschetto, R; Aimaretti, G; Krengli, M; Avanzi, Gc; Balbo, Pe; Capponi, A; Castello, Lm; Bellan, M; Malerba, M; Garavelli, Pl; Zeppegno, P; Savoia, P; Chichino, G; Olivieri, C; Re, R; Maconi, A; Comi, C; Roveta, A; Bertolotti, M; Carriero, A; Betti, M; Mussa, M; Borrè, S; Cantaluppi, V; Cantello, R; Bobbio, F; Gavelli, F

Global exposure of population and land‐use to meteorological droughts under different warming levels and SSPs: a CORDEX‐based study

Global warming is likely to cause a progressive drought increase in some regions, but how population and natural resources will be affected is still underexplored. This study focuses on global population, forests, croplands and pastures exposure to meteorological drought hazard in the 21st century, expressed as frequency and severity of drought events. As input, we use a large ensemble of climate simulations from the Coordinated Regional Climate Downscaling Experiment (CORDEX), population projections from the NASA-SEDAC dataset and land-use projections from the Land-Use Harmonization 2 project for 1981–2100. The exposure to drought hazard is presented for five Shared Socioeconomic Pathways (SSP1-SSP5) at four Global Warming Levels (GWLs: 1.5°C to 4°C). Results show that considering only Standardized Precipitation Index (SPI; based on precipitation), the SSP3 at GWL4 projects the largest fraction of the global population (14%) to experience an increase in drought frequency and severity (versus 1981–2010), with this value increasing to 60% if temperature is considered (indirectly included in the Standardized Precipitation-Evapotranspiration Index, SPEI). With SPEI, considering the highest GWL for each SSP, 8 (for SSP2, SSP4, SSP5) and 11 (SSP3) billion people, that is, more than 90%, will be affected by at least one unprecedented drought. For SSP5 at GWL4, approximately 2 × 10$^{6}$ km$^{2}$ of forests and croplands (respectively, 6% and 11%) and 1.5 × 10$^{6}$ km$^{2}$ of pastures (19%) will be exposed to increased drought frequency and severity according to SPI, but for SPEI this extent will rise to 17 × 10$^{6}$ km$^{2}$ of forests (49%), 6 × 10$^{6}$ km$^{2}$ of pastures (78%) and 12 × 10$^{6}$ km$^{2}$ of croplands (67%), being mid-latitudes the most affected. The projected likely increase of drought frequency and severity significantly increases population and land-use exposure to drought, even at low GWLs, thus extensive mitigation and adaptation efforts are needed to avoid the most severe impacts of climate change

Prevalence, Outcome, and Prevention of Congenital Cytomegalovirus Infection in Neonates Born to Women with Preconception Immunity (CHILd Study)

Background: Human cytomegalovirus (HCMV) is the leading infectious cause of congenital disabilities. We designed a prospective study to investigate the rate, outcome, and risk factors of congenital CMV (cCMV) infection in neonates born to immune women, and the potential need and effectiveness of hygiene recommendations in this population. Methods: The study was composed of 2 sequential parts: an epidemiology (part 1) and a prevention (part 2) study. Performance of part 2 depended upon a cCMV rate >0.4%. Women enrolled in part 1 did not receive hygiene recommendations. Newborns were screened by HCMV DNA testing in saliva and cCMV was confirmed by urine testing. Results: Saliva swabs were positive for HCMV DNA in 45/9661 newborns and cCMV was confirmed in 18 cases. The rate of cCMV was. 19% (95% confidence interval [CI]:. 11-.29%), and 3 out of 18 infants with cCMV had symptoms of CMV at birth. Age, nationality, occupation, and contact with children were similar between mothers of infected and noninfected newborns. Twin pregnancy (odds ratio [OR]: 7.2; 95% CI: 1.7-32.2; P =. 037) and maternal medical conditions (OR: 3.9; 95% CI: 1.5-10.1; P =. 003) appeared associated with cCMV. Given the rate of cCMV was lower than expected, the prevention part of the study was cancelled. Conclusions: Newborns from women with preconception immunity have a low rate of cCMV, which appears to be mostly due to reactivation of the latent virus. Therefore, serological screening in childbearing age would be pivotal to identify HCMV-seropositive women, whose newborns have a low risk of cCMV. Clinical trials registration: www.clinicaltrials.gov (NCT03973359)

Drought Impact Is Alleviated in Sugar Beets (Beta vulgaris L.) by Foliar Application of Fullerenol Nanoparticles

Over the past few years, significant efforts have been made to decrease the effects of drought stress on plant productivity and quality. We propose that fullerenol nanoparticles (FNPs, molecular formula C-60(OH)(24)) may help alleviate drought stress by serving as an additional intercellular water supply. Specifically, FNPs are able to penetrate plant leaf and root tissues, where they bind water in various cell compartments. This hydroscopic activity suggests that FNPs could be beneficial in plants. The aim of the present study was to analyse the influence of FNPs on sugar beet plants exposed to drought stress. Our results indicate that intracellular water metabolism can be modified by foliar application of FNPs in drought exposed plants. Drought stress induced a significant increase in the compatible osmolyte proline in both the leaves and roots of control plants, but not in FNP treated plants. These results indicate that FNPs could act as intracellular binders of water, creating an additional water reserve, and enabling adaptation to drought stress. Moreover, analysis of plant antioxidant enzyme activities (CAT, APx and GPx), MDA and GSH content indicate that fullerenol foliar application could have some beneficial effect on alleviating oxidative effects of drought stress, depending on the concentration of nanoparticles applied. Although further studies are necessary to elucidate the biochemical impact of FNPs on plants; the present results could directly impact agricultural practice, where available water supplies are often a limiting factor in plant bioproductivity

Simple Parameters from Complete Blood Count Predict In-Hospital Mortality in COVID-19

The clinical course of Coronavirus Disease 2019 (COVID-19) is highly heterogenous, ranging from asymptomatic to fatal forms. The identification of clinical and laboratory predictors of poor prognosis may assist clinicians in monitoring strategies and therapeutic decisions

Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study

Background: Hydroxychloroquine (HCQ) was proposed as potential treatment for COVID-19. Objective: We set-up a multicenter Italian collaboration to investigate the relationship between HCQ therapy and COVID-19 in-hospital mortality. Methods: In a retrospective observational study, 3,451 unselected patients hospitalized in 33 clinical centers in Italy, from February 19, 2020 to May 23, 2020, with laboratory-confirmed SARS-CoV-2 infection, were analyzed. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received HCQ with patients who did not. We used multivariable Cox proportional-hazards regression models with inverse probability for treatment weighting by propensity scores, with the addition of subgroup analyses. Results: Out of 3,451 COVID-19 patients, 76.3% received HCQ. Death rates (per 1,000 person-days) for patients receiving or not HCQ were 8.9 and 15.7, respectively. After adjustment for propensity scores, we found 30% lower risk of death in patients receiving HCQ (HR=0.70; 95%CI: 0.59 to 0.84; E-value=1.67). Secondary analyses yielded similar results. The inverse association of HCQ with inpatient mortality was particularly evident in patients having elevated C-reactive protein at entry. Conclusions: HCQ use was associated with a 30% lower risk of death in COVID-19 hospitalized patients. Within the limits of an observational study and awaiting results from randomized controlled trials, these data do not discourage the use of HCQ in inpatients with COVID-19

Loss and Damage in the Rapidly Changing Arctic

Arctic climate change is happening much faster than the global average. Arctic change also has global consequences, in addition to local ones. Scientific evidence shows that meltwater of Arctic sources contributes to sea-level rise significantly while accounting for 35% of current global sea-level rise. Arctic communities have to find ways to deal with rapidly changing environmental conditions that are leading to social impacts such as outmigration, similarly to the global South. International debates on Loss and Damage have not addressed the Arctic so far. We review literature to show what impacts of climate change are already visible in the Arctic, and present local cases in order to provide empirical evidence of losses and damages in the Arctic region. This evidence is particularly well presented in the context of outmigration and relocation of which we highlight examples. The review reveals a need for new governance mechanisms and institutional frameworks to tackle Loss and Damage. Finally, we discuss what implications Arctic losses and damages have for the international debate

Dürre in Europa

Dürre in Europa: In den letzten Jahrzehnten wurden ausgedehnte Regionen Europas wiederholt von Dürren heimgesucht, oftmals mit schwerwiegenden Auswirkungen auf Wirtschaft, Gesellschaft und Umwelt. Der Schweregrad dieser Auswirkungen hängt dabei nicht nur von der Intensität und Dauer der Dürre, sondern auch vom jeweiligen Schadenspotenzial und der Schadensanfälligkeit ab. Seit Mitte des 20. Jahrhunderts ist dabei ein Trend zu einer zunehmenden Dürrehäufigkeit und -intensität, vor allem in Südeuropa aber auch in Teilen von West-, Mittel- und Osteuropa festzustellen. Unter einem fortschreitenden Klimawandel wird sich dieser Trend bis zum Ende des 21. Jahrhunderts fortsetzen und zu einen zunehmenden Süd-Nord Gradienten führen. Neuere Gesetzesinitiativen zeugen von einem zunehmenden politischen und öffentlichen Bewusstsein für die Problematik und von einem langsamen Wechsel weg vom Katastrophenmanagement hin zu einem vorbeugenden Risikomanagement. Letzteres bedarf adäquater Überwachungs- und Vorhersageinstrumente, eines öffentlichen Bewusstseinswandels und der Einführung von gesetzlichen Regelungen und Praktiken zum Dürremanagement. Droughts in Europe: Europe was repeatedly affected by droughts of varying extent, duration and intensity with severe impacts on the economy, society and natural ecosystems. The severity of these impacts not only depends on the characteristics of the drought event, but also on the exposed assets, the economic and natural vulnerability of the affected regions and the coping capacity of societies. Over the second half of the 20th and the beginning of the 21st century, a trend for an increase in drought frequency, duration and intensity is recognisable for various European regions, notably for the Mediterranean. The adverse effects of climate change will likely exacerbate this situation, leading to an increasing gradient from the more drought-prone southern regions to the less affected northern regions, without sparing Western and Central Europe. Recent political initiatives demonstrate a growing political and public awareness of the problem and try to promote a change of paradigm, away from the prevailing disaster management to a pro-active risk management. The latter entails the development of appropriate monitoring and forecasting systems, the promotion of a water-saving culture, and the implementation of drought policies and drought management plans across the European continent