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This study was focused on the metropolitan area of Florence in Tuscany (Italy) with the aim of mapping and evaluating thermal summer diurnal hot- and cool-spots in relation to the features of greening, urban surfaces, and city morphology. The work was driven by Landsat 8 land surface temperature (LST) data related to 2015–2019 summer daytime periods. Hot-spot analysis was performed adopting Getis-Ord Gi* spatial statistics applied on mean summer LST datasets to obtain location and boundaries of hot- and cool-spot areas. Each hot- and cool-spot was classified by using three significance threshold levels: 90% (LEVEL-1), 95% (LEVEL-2), and 99% (LEVEL-3). A set of open data urban elements directly or indirectly related to LST at local scale were calculated for each hot- and cool-spot area: (1) Normalized Difference Vegetation Index (NDVI), (2) tree cover (TC), (3) water bodies (WB), (4) impervious areas (IA), (5) mean spatial albedo (ALB), (6) surface areas (SA), (7) Shape index (SI), (8) Sky View Factor (SVF), (9) theoretical solar radiation (RJ), and (10) mean population density (PD). A General Dominance Analysis (GDA) framework was adopted to investigate the relative importance of urban factors affecting thermal hot- and cool-spot areas. The results showed that 11.5% of the studied area is affected by cool-spots and 6.5% by hot-spots. The average LST variation between hot- and cold-spot areas was about 10 °C and it was 15 °C among the extreme hot- and cool-spot levels (LEVEL-3). Hot-spot detection was magnified by the role of vegetation (NDVI and TC) combined with the significant contribution of other urban elements. In particular, TC, NDVI and ALB were identified as the most significant predictors (p-values < 0.001) of the most extreme cool-spot level (LEVEL-3). NDVI, PD, ALB, and SVF were selected as the most significant predictors (p-values < 0.05 for PD and SVF; p-values < 0.001 for NDVI and ALB) of the hot-spot LEVEL-3. In this study, a reproducible methodology was developed applicable to any urban context by using available open data sources.

Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥ 65). A long time-series (2001-2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using \"Crichton's Risk Triangle\" hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public health operators and facilitate coordination for heat-related emergencies.

The study of risk perception (RP) has much increased in the last years to improve flood risk management. Effective communication requires an understanding of how the risk of flooding is perceived by residents of different areas. In this work, RP is investigated through a survey involving 483 people living in Tuscany. RP was assessed through a score built on four items covering personal, residence, and sociodemographic variables concerning flood RP. Results showed that: (a) flood RP was moderate; (b) RP was positively correlated with age, higher education, proximity to a river and direct experience; (c) people who experienced floods felt themselves to be more informed and prepared; (d) subjectively perceived risk and experts' risk assessment seemed generally correlated, even if people living in areas at “high risk” tend to underestimate the actual flood risk level; (e) the majority of the respondents considered the government and themselves as equally responsible for personal preparedness; and (f) less than 20% was aware of a Local Emergency Plan. The need of focusing on people living in the riskiest areas with targeted communication campaigns on risk awareness, hazard preparedness, and other implications of the findings in terms of communication strategies are discussed.

Dietary (co)-exposure to mycotoxins is associated with human and animal health concerns as well as economic losses. This study aims to give a data-based insight from the scientific literature on the (co-)occurrence of mycotoxins (i.e., parent and modified forms) in European core cereals, and to estimate potential patterns of co-exposure in humans and animals. Mycotoxins were mainly reported in wheat and maize showing the highest concentrations of fumonisins (FBs), deoxynivalenol (DON), aflatoxins (AFs), and zearalenone (ZEN). The maximum concentrations of FB1+FB2 were reported in maize both in feed and food and were above legal maximum levels (MLs). Similar results were observed in DON-food, whose max concentrations in wheat, barley, maize, and oat exceeded the MLs. Co-occurrence was reported in 54.9% of total records, meaning that they were co-contaminated with at least two mycotoxins. In the context of parental mycotoxins, co-occurrence of DON was frequently observed with FBs in maize and ZEN in wheat; DON + NIV and DON + T2/HT2 were frequently reported in barley and oat, respectively. Apart from the occurrence of ZEN and its phase I and phase II modified forms, only a limited number of quantified data were available for other modified forms; i.e., mainly the acetyl derivatives of DON. Data gaps are highlighted together with the need for monitoring studies on multiple mycotoxins to identify co-occurrence patterns for parent mycotoxins, metabolites, and their modified forms.

In the context of global warming, the general trend towards earlier flowering dates of many temperate tree species is likely to result in an increased risk of damage from exposure to frost. To test this hypothesis, a phenological model of apple flowering was applied to a temperature series from two locations in an important area for apple production in Europe (Trentino, Italy). Two simulated 50-year climatic projections (A2 and B2 of the Intergovernmental Panel on Climate Change - Special Report on Emission Scenarios) from the HadCM3 general circulation model were statistically downscaled to the two sites. Hourly temperature records over a 40-year period were used as the reference for past climate. In the phenological model, the heat requirement (degree hours) for flowering was parameterized using two approaches; static (constant over time) and dynamic (climate dependent). Parameterisation took into account the trees' adaptation to changing temperatures based on either past instrumental records or the downscaled outputs from the climatic simulations. Flowering dates for the past 40 years and simulated flowering dates for the next 50 years were used in the model. A significant trend towards earlier flowering was clearly detected in the past. This negative trend was also apparent in the simulated data. However, the significance was less apparent when the “dynamic” setting for the degree hours requirement was used in the model. The number of frost episodes and flowering dates, on an annual basis, were graphed to assess the risk of spring frost. Risk analysis confirmed a lower risk of exposure to frost at present than in the past, and probably either constant or a slightly lower risk in future, especially given that physiological processes are expected to acclimate to higher temperatures.

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 warming.

This study presents the exposure scenario to mycotoxins of adult population throughout Europe. The urinary biomarkers values were obtained by modelling data from two European projects. Exposure to AFB1, OTA, CIT, FBs, DON, NIV and T2/HT2 are presented. The main output obtained refers to a concern for public health about AFM1, FBs, T2/HT2 and NIV, and low concern for OTA, DON and CIT. The margin of exposure for AFM1 did not respect the reference value of 10,000 considered of low priority for risk; for Fusarium toxins, FBs and T2/HT2, probable daily intake (PDI) values resulted about ten times higher than their tolerable daily intake and NIV presented the most critical situation with a calculated PDI 30 times higher than the reference TDI value. North and South Europe scenarios were also depicted by clustering biomonitoring data. OTA and DON showed to be prevalent in Northern countries and the opposite was noticed for ZEN, higher in Southern countries. The critical issues of the availability of records feeding the dataset and of the accuracy of excretion rate for some mycotoxins are source of uncertainty for the reliability of the outputs, nevertheless the time is ripe for asking for more concrete HBM values and/or HBM-HBGV which would help in interpreting the burden of mycotoxins in Europe.

With the increasing of the prevalence of pediatric urolithiasis (1–5%), retrograde intrarenal surgery (RIRS) is emerging as preferred option for the management of stones in pediatric patients. Although the principles of RIRS developed in adults can be applied in children, also expert adult endourologists feel uncomfortable to approach young patients due to long learning curve that usually is expected to be required in this particular setting. The aim of the study was to compare peri- and postoperative outcomes of RIRS in pediatric and adult patients performed by a single surgeon expert in adult endourology (> 500 RIRS) with no experience in pediatric urology. Data on patient characteristics of 30 consecutive patients (15 adults and 15 children) undergoing RIRS at our institution were collected retrospectively from January 2016 to October 2018. Mean age for the pediatric group was 11.8 years (IQR 8–16) and for the adult group was 56 years (IQR 49–58). No significative differences between the two groups in terms of peri- and postoperative outcomes were found. The most common complication was hematuria in 2/30 patients (1 children vs 1 adults) and fever 2/30 (1 pediatric patient vs 1 adult) (p = 1.00) that required antibiotic treatment (Clavien Dindo 2). Median length of stay was 1 day (IQR 1–1 days) in both groups (p = 1.00). Stone-free rate was 86.7% in children and 80% in adults (p = 0.624). Our preliminary experience suggests that expert adult endourologist can manage successfully also pediatric cases with results comparable to adults and low complication rate.

Background: The evidence supporting personalized surveillance strategies for upper-tract urothelial carcinoma (UTUC) remains limited. This study seeks to explore how smoking habits influence the oncological outcomes of UTUC Methods: Data on disease characteristics from UTUC patients were gathered prospectively. Recurrence-free survival was the primary outcome measured. Patients were stratified based on smoking status for Kaplan–Meier and multivariable Cox regression analyses. Results: A total of 1952 patients were involved, including 684 (35%) patients who never smoked, 572 (29%) that were ex-smokers, and 696 (36%) that were current smokers. For female patients, most of them were nonsmokers (n = 328). Current smokers were significantly younger and had higher American Society of Anesthesiologist (ASA) scores and Charlson Comorbidity Index. A total of 19.9% (n = 236) of patients developed tumor recurrence. Kaplan–Meier analyses showed that smoking status was associated with a greater likelihood of urothelial carcinoma recurrence (p = 0.011) and intravesical recurrence (p = 0.021). The multivariable Cox regression analysis identified the smoking status as an independent risk factor for urothelial carcinoma recurrence (p = 0.046). When compared with former smokers, current smokers showed a higher urothelial carcinoma recurrence (p = 0.016) and intravesical recurrence (p = 0.006). Conclusion: Smoking at the time of diagnosis was significantly associated with an increased risk of tumor recurrence in the bladder but not significantly in the upper urinary tract. This study confirms that cumulative smoking exposure accelerates the risk of tumor recurrence and underlines the importance of smoking cessation. Trial registration: NCT02281188. Plain language summary The influence of smoking status for patients with UTUC Based on the CROES-UTUC registry, we confirmed that both previous non-urothelial and urothelial cancers could accelerate the risk of tumour recurrence and, more personalized follow-up plans and active treatment strategies should be considered for UTUC patients.

Although younger generations are not always given a prominent role in ethnobotanical surveys, studying intergenerational knowledge transfer should still be a primary interest, in the context of traditions’ erosion, globalization, disinterest and plant blindness. Our study was designed to describe the situation of knowledge transfer and to find potential solutions to counteract erosion by involving the children. This ethnobotanical survey involved students from primary and secondary schools of Valle Imagna (Bergamo, Italy) through different meetings and structured questionnaires to record their traditional knowledge on medicinal plants. The children were then asked to become an active part of the project by interviewing their families. All data recorded were archived in a database for statistical analysis. Students (number = 112) reported 41 plant species, with 36% reporting at least 3 species each. Forty percent of their use reports were related to exotic species or purchased plant material. The most reported species were Matricaria chamomilla L. and Camellia sinensis (L.) Kuntze with common preparations such as infusions from commercial products. Parents (n = 96) reported 76 species and grandparents (n = 35) 52. Statistical analysis showed correlation between traditional knowledge and age/gender, with older generations and female gender correlated to deeper knowledge. Our results suggest deep erosion and a clear lack of intergenerational knowledge transfer. However, our project serves as evidence of the concrete role ethnobotany holds in safeguarding the remaining cultural heritage of a territory, fostering preservation from the outset with the participation of younger generations.