This paper illustrates a land consumption map for Italy (year 2017) at a scale 1:1,300,000, and the assessment of its changes (2012-2017). We define land consumption as the replacement of a non-artificial land cover to an artificial land cover, both permanent and no-permanent. The maps are a 10 m spatial resolution raster, produced by photointerpretation of very high resolution images and semiautomatic classification of high resolution remote sensing images. An overall accuracy of 97.7% for the map of 2012 and of 99.66% for the map of 2017 was obtained. The results suggest that the method proposed is appropriate to detect land consumption, both for the urban densification and for the sprawling phenomena, from national to local level. Furthermore, because of the high spatial resolution and the classification scheme adopted, it is suitable for an effective monitoring system, compared to other existing classification systems or monitoring programs.

There are both semantic and technical differences between land use (LU) and land cover (LC) measurements. In cartographic approaches, these differences are often neglected, giving rise to a hybrid classification. The aim of this paper is to provide a better understanding and characterization of the two classification schemes using a comparison that allows maximization of the informative power of both. The analysis was carried out in the Molise region (Central Italy) using sample information from the Italian Land Use Inventory (IUTI). The sampling points were classified with a visual interpretation of aerial photographs for both LU and LC in order to estimate surfaces and assess the changes that occurred between 2000 and 2012. The results underscore the polarization of land use and land cover changes resulting from the following: (a) recolonization of natural surfaces, (b) strong dynamisms between the LC classes in the natural and semi-natural domain and (c) urban sprawl on the lower hills and plains. Most of the observed transitions are attributable to decreases in croplands, natural grasslands and pastures, owing to agricultural abandonment. The results demonstrate that a comparison between LU and LC estimates and their changes provides an understanding of the causes of misalignment between the two criteria. Such information may be useful for planning policies in both natural and semi-natural contexts as well as in urban areas.

The diabetic foot is a very complex and challenging disease involving the lower limb of 8 to 10 million people around the world. 1 Its prevalence has dramatically increased in recent years, leading to significant loss of quality and years of life of the affected patient and creating a dramatic need for effective therapeutic answers. 2 Furthermore, 12% to 15% of overall diabetes costs are due to diabetic foot syndrome, and this percentage increases in developed countries up to 40%. 3 While pathogenetic mechanisms have been well explained during recent years, 4 current available treatments are still quite far from being adequately evidence-based. 5 This is partially explained taking into account that awareness of diabetic foot syndrome and its management is only recently spreading among health care professionals after being relatively neglected for decades. 6 The management of acute infected diabetic foot represents probably the most dangerous goal for a diabetic foot specialist. 7 Foot anatomy indicates an organ rigidly divided into portions only minimally expandable, thus leading an initially superficial infection that rapidly evolve toward deep structures, involved early, and subsequently upward proximally to the leg. 8 This evolution not infrequently puts the patient at high risk for major amputation. 9 In such a context, international guidelines recommend us to promptly and aggressively drain or debride the abscess or fasciitis,

Aim: To evaluate the distinct contribution of obesity and diabetes (DM) to the skin modification in metabolic diseases. Methods: We analysed all patients admitted for bariatric surgery in our hospital with BMI between 38 and 47 kg/m 2 , with (Group 1) or without (Group 2) DM and compared them with a group of nonobese diabetic patients (Group 3) and healthy volunteers (Group 4). The following features were evaluated: hardness, temperature, hydration and thickness alongside with anthropometric measures of foot and leg.

We aimed to analyze sex-related differences in clinical outcomes among patients with diabetic foot disease (DFD) managed in a third-level referral center. We retrospectively analyzed data of admissions performed in our department between 2011 and 2015 for DFD. We collected demographic and clinical data, procedures performed during the admission, and short- and long-term outcomes in terms of healing rate and healing time, major amputation, and mortality rates during the follow-up. We focused on differences between genders and tried to figure out if sex could be considered a predictive factor. We collected data from 1237 admission performed in 842 patients (615 men [73%] and 227 women [27%]; age: 68.6 ± 27.9 years; diabetes duration: 16.4 ± 13.4 years; body mass index: 28.2 ± 6.4 kg/m2; hemoglobin A1c 7.9 ± 1.9%). Men showed a higher prevalence of comorbidities and previous ulcers or revascularization procedures. Men had a significantly higher healing rate compared with women (85.4% vs 63.2%, P < .001), but a longer healing time (124 ± 27 days vs 87 ± 14 days, P = .02). Major amputation did not differ between groups, while mortality rate was significantly higher in men (24.5% vs 16.1%, P = .02). In Cox’s regression analysis, male sex was a positive predictive factor for healing and a negative one for time to heal and mortality. The difference in mortality was confirmed by a Kaplan-Meier analysis (log rank test: P = .03). DFD represents a severe disease and a strong marker of mortality affecting more severely on clinical outcomes and survival on men.