Synergies of planning for forests and planning for Natura 2000: Evidences and prospects from northern Italy

Improvements in the management of Natura 2000 sites are essential to achieve the targets set out by the Habitats and Birds Directives of the European Union. A current focus is on the development of management plans, which are fundamental instruments in the implementation of conservation measures. This study explores the viability of using existing forest plans to assist in this purpose. As case study, we consider the regulatory framework of the Veneto Region, northern Italy. We collected quantitative and qualitative data on forest plans at the regional and at three sub-regional spatial scales: local, district, and biogeographical. Forest plans cover about 54% of the terrestrial area of Natura 2000 sites in Veneto, and 75% of Sites of Community Importance in the Alpine biogeographical region. At the local scale of analysis, metrics from forest plans represent a valuable historical record which can be used to interpret the current state and future trends, especially for forests with long management records. These data can be used to assess biodiversity indicators for the monitoring of Natura 2000 forest and non-forest habitats, in compliance with Article 17 of the Habitats Directive. Moreover, the heterogeneous stand conditions which are promoted by some forest management approaches can improve the conservation efforts for some habitats and species. The scale of local forest plans are typically the most appropriate for implementing habitat management strategies. From this study, we conclude that management authorities should take advantage of the wide spatial coverage and distribution of existing forest plans, especially in mountain areas inside and outside the Natura 2000 network, for the successful conservation of European Union habitats and species

Prognostic system for cholangiocarcinoma.

Introduzione:Il colangiocarcinoma perilare (PCC) \ue8 un tumore primitivo della via biliare con progressivo incremento di incidenza negli ultimi anni e la sua classificazione e gestione clinica e chirurgica sta modificando negli anni recenti. PCC ha una prognosi infausta ma la resezione radicale chirurgica pu\uf2 prolungare la sopravvivenza.Sono disponibili diverse classificazioni prognostiche e sistemi stadiativi ma nonostante ci\uf2 non esiste accordo diffuso sul loro significato prognostico. Obiettivo dello studio \ue8 di creare un nomogramma con funzione di valutare la prognosi per pazienti sottoposti ad intervento chirurgico per PCC con intento radicale. Materiali e Metodi: Una serie progressiva di 69 pazienti sottoposti ad intervento chirurgico per PCC tra il 1990 e il 2012 in uno stesso reparto chirurgico sono stata la base per i dati per costituire il nomogramma. Variabili cliniche e patologiche sono state valutate. Dalle variabili risultate significative all\u2019analisi multivariata \ue8 stato creato un modello prognostico per valutare il rischio di mortalit\ue0 a 3 anni dall\u2019intervento chirurgico. Un nomogramma \ue8 stato creato dal modello prognostico. Il nomogramma \ue8 stato validato internamente. La capacit\ue0 di predire la sopravvivenza dopo intervento chirurgico per pazienti con PCC \ue8 stata confrontata tra il nostro nuovo modello prognostico e altri quattro precedenti sistemi stadiativi e prognostici. Risultati: Fattori prognostici per la sopravvivenza all\u2019analisi multivariata sono risultati: CA 19.9 preoperatorio aumentato, il numero di linfonodi prelevati, il numero di linfonodi risultati positivi, la resezione del caudato, la resezione e ricostruzione portale. Dalle variabili significative alla multivariata \ue8 stato creato un sistema prognostico, che \ue8 riuscito a distinguere i pazienti operati in tre gruppi a seconda del rischio di morire entro 3 anni dall\u2019intervento, basso (75%). La curva di calibrazione ha mostrato una buona concordanza tra la sopravvivenza prevista dal nomogramma e la sopravvivenza attesa. Il nostro modello prognostico \ue8 stato confrontato con altri sistemi stadiativi pre esistenti: AJCC/UICC TNM, classificazione di MSKCC, sistema stadiativo JSBS e score prognostico di Kaiser dimostrando una migliore capacit\ue0 di predire la sopravvivenza (AIC 268.9). Conclusione: Il nostro nomogramma prognostico ha dimostrato di avere maggiore capacit\ue0 di predire la sopravvivenza per i pazienti con PCC sottoposti ad intervento chirurgico.Introduction:Perihilar cholangiocarcinoma (PCC) is primary biliary malignancy increasing worldwide and its classification and management is evolving progressively. Perihilar cholangiocarcinoma has poor prognosis however surgical resection can prolong survival. Prognostic classification and scoring systems are available but there is not general agreement about their prognostic significance. Aim of this study was to create an effective prognostic nomogram for patients submitted to surgical resection for perihilar cholangiocarcinoma. Material and Methods: Creation of nomogram was based on consecutive series of 69 patients submitted to surgical resection for perihilar cholangiocarcinoma between 1990 and 2012. Clinical and pathological variables were evaluated. Prognostic model for risk to die within 3 years after surgical resection was created according to variables selected at multivariate analysis. Nomogram was created by prognostic model. Internal validation of nomogram was performed. Predictive accuracy and discriminative capability of our prognostic model was compared with other four prognostic systems for PCC. Results: Independent significant prognostic factor for survival at multivariate analysis were increased CA 19.9, number of lymph node harvested, number of positive lymph node, caudate lobe resection and portal vein resection; all these variables were selected for prognostic model. Three group of patients according to low (75%) risk to die within 3 year were identified by nomogram. Calibration curve for probability of survival showed good agreement between prediction of nomogram and actual observation. Our prognostic model resulted more accurate in predict survival compared to AJCC/UICC TNM staging system, MSKCC classification, JSBS staging system and Kaiser prognostic scoring system (AIC 268.9). Conclusion: Our prognostic nomogram resulted to be more accurate in predict survival for patients with perihilar cholangiocarcinoma submitted to surgical resection than previous staging system

Forest management plans as data source for the assessment of the conservation status of European Union habitat types

Natura 2000 is a European network of protected sites that should enable natural habitats to be maintained or restored at a favorable conservation status. Progress toward this objective must be periodically reported by states members of the European Union. We investigated how forest management plans might provide data to support the reporting. The study was done in the forests of the Dolomites and Venetian Prealps, Italy. Here, about 200 forest management plans, divided into several forest compartments, have been drawn up and revised every 10–15 years. Stand structure variables were retrieved from past (OR, 1970–1980) and more recent revisions (NR, 2000–2010) of 331 forest compartments ranging between 0.35 and 53.1 ha. In the beech and spruce forest habitat types (coded 9130 and 9410 in Annex I of the Directive 92/43/EEC, respectively), we found an increase from OR to NR in the density of large trees (from 32 to 46/ha and from 31 to 50/ha, respectively for the two habitats), basal area (from 27.3 to 31.5 m2/ha and from 31 to 34.5 m2/ha), mean diameter (from 34.1 to 36.2 cm and from 33.9 to 36 cm) and Gini index (from 0.35 to 0.37 and from 0.33 to 0.36). Pursuant to the Directive 92/43/EEC, the conservation status of these two habitat types should be taken as “favorable” with regards to the criterion related to the habitats’ specific structure and functions that are necessary for its long-term maintenance. We conclude that forest management plans provide a great portion of the information needed for assessing and monitoring the conservation status of forest habitat types in the Natura 2000 framework

Assessment of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and platelet count as predictors of long-term outcome after R0 resection for colorectal cancer

Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and platelet count (PC) were shown to be prognostic in several solid malignancies. We analysed 603 R0 resected patients to assess whether NLR, PLR and PC correlate with other well-known prognostic factors and survival of patients with colorectal cancer (CRC). Receiver operating characteristic (ROC) curve analysis was performed to define cut-off values for high and low ratios of these indices. Univariate and multivariate analysis were used to determine the prognostic value of NLR, PLR and PC for overall and cancer-related survival. The distribution of NLR, PLR and PC in CRC patients was compared with 5270 healthy blood donors. The distribution of NLR, PLR and PC was significantly different between CRC patients and controls (all p\u2009<\u20090.05). A significant but heterogeneous association was found between the main CRC prognostic factors and high values of NLR, PLR and PC. Survival appeared to be worse in patients with high NLR with cancers in AJCC/UICC TNM Stages I-IV; nonetheless its prognostic value was not confirmed for cancer-related survival in multivariate analysis. After stratification of patients according to AJCC/UICC TNM stages, high PC value was significantly correlated with overall and cancer-related survival in TNM stage IV patients

Role of inflammatory and immune-nutritional prognostic markers in patients undergoing surgical resection for biliary tract cancers

The relationship between immune-nutritional status and tumor growth; biological aggressiveness and survival, is still debated. Therefore, this study aimed to evaluate the prognostic performance of different inflammatory and immune-nutritional markers in patients who underwent surgery for biliary tract cancer (BTC). The prognostic role of the following inflammatory and immune-nutritional markers were investigated: Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), Prognostic Index (PI), Neutrophil to Lymphocyte ratio (NLR), Platelet to Lymphocyte ratio (PLR), Lymphocyte to Monocyte ratio (LMR), Prognostic Nutritional Index (PNI). A total of 282 patients undergoing surgery for BTC were included. According to Cox regression and ROC curves analysis for survival, LMR had the best prognostic performances, with hazard ratio (HR) of 1.656 (p = 0.005) and AUC of 0.652. Multivariable survival analysis identified the following independent prognostic factors: type of BTC (p = 0.002), T stage (p = 0.014), N stage (p < 0.001), histological grading (p = 0.045), and LMR (p = 0.025). Conversely, PNI was related to higher risk of severe morbidity (p < 0.001) and postoperative mortality (p = 0.005). In conclusion, LMR appears an independent prognostic factor of long-term survival, whilst PNI seems associated with worse short-term outcomes

Impact of age on short-term outcomes of liver surgery: Lessons learned in 10-years' experience in a tertiary referral hepato-pancreato-biliary center

We investigate the surgical outcomes of patients undergoing hepatectomy according to different age intervals, identify the clinical factors related to surgical outcomes, and propose clinical risk scores for severe morbidity and mortality based on the clinical factors.Eight hundred three patients undergoing liver resection were divided into 3 groups: young patients (YP), <65 years (n = 387), elderly patients (EP), from 65 to 74 years (n = 279); very-elderly patients (VEP), ≥75 years (n = 137).Severe morbidity was 10.6%, 12.2%, and 17.5% (P = .103), and mortality was 0.3%, 1.4%, and 4.4% (P = .002) in group YP, EP, and VEP, respectively. Ischemic heart disease, cirrhosis, major hepatectomy, biliary tract-associated procedure, and red blood cells (RBC) transfusion ≥3 U were related with severe morbidity. Ischemic heart disease, cirrhosis, major hepatectomy, and RBC transfusion were independent risk factors for postoperative mortality. Age did not result an independent factor related to mortality and severe morbidity. Two different scores were developed and have proved to be statistically related with severe morbidity and mortality. Moreover, in patients with score ≥2, severe morbidity increased from 24.2% in YP, to 29.3% in EP, and to 40.0% in VEP, P = .047. Likewise, mortality increased from 2.3% in YP, to 7.0% in EP, and to 22.7% in VEP, in patients with score ≥2, P = .017.Age alone should not be considered a contraindication for hepatectomy. We identified factors and proposed 2 scores that can be useful to stratify the risk of morbidity and mortality after hepatectomy. Moreover, severe morbidity and mortality increases according to the different age intervals in patients with scores ≥2

DNA Methylation and Hydroxymethylation in Primary Colon Cancer and Synchronous Hepatic Metastasis

Colon cancer is one of the most frequent solid tumor and simultaneous diagnosis of primary colon cancer and liver metastases occurs in about one fourth of cases. The current knowledge on epigenetic signatures, especially those related to hydroxymethylation in primary cancer tissue, synchronous metastasis, and blood circulating cells is lacking. This study aimed to investigate both methylcytosine (mCyt) and hydroxymethylcytosine (hmCyt) status in the DNA of individual patients from colon cancer tissue, synchronous liver metastases, and in cancer-free colon and liver tissues and leukocytes. Patients undergoing curative surgery (n= 16) were enrolled and their laboratory and clinical history data collected. The contents of mCyt and hmCyt were determined by a liquid chromatography/mass spectrometry (LC/MS/MS) method in DNA extracted from primary colon cancer, synchronous hepatic metastatic tissues and homologous cancer-free tissues, i.e., colon and liver tissues as well as leukocytes. The mCyt and hmCyt levels were compared between cancerous and cancer-free tissues, and correlations between leukocytes and colon/liver tissues for both the mCyt and hmCyt levels were evaluated. The mCyt levels were similar in primary colon cancer and liver metastasis tissues (4.69 \ub1 0.37% vs. 4.77 \ub1 0.38%, respectively,p= 0.535), and both primary and metastatic tissues were hypomethylated compared to cancer-free colon (4.98 \ub1 0.26%). The difference in the mCyt content between cancerous and cancer-free colon tissues was significantly lower in primary colon cancer (p= 0.004), but not in liver metastasis (p= 0.148). The hmCyt content was similar in primary colon cancer compared to liver metastasis (0.035%, C.I. 0.024-0.052% versus 0.035%, C.I. 0.021-0.058%, respectively,p =0.905) and markedly depleted compared to the cancer-free colon (0.081%, C.I. 0.055-0.119%) with a statistically significant difference (p< 0.05) for both comparisons. The mCyt levels showed a borderline correlation between leukocytes and colon cancer tissue (Pearson's correlation coefficient = 0.51,p= 0.052) while no correlations were detected for the hmCyt levels. In conclusion, primary colon cancer and synchronous liver metastasis tissues showed a similar epigenetic status but were significantly hypomethylated and hypohydroxymethylated as compared to homologous cancer-free colon tissues

Words apart: Standardizing forestry terms and definitions across European biodiversity studies

Forest biodiversity studies conducted across Europe use a multitude of forestry terms, often inconsistently. This hinders the comparability across studies and makes the assessment of the impacts of forest management on biodiversity highly context-dependent. Recent attempts to standardize forestry and stand description terminology mostly used a top-down approach that did not account for the perspectives and approaches of forest biodiversity experts. This work aims to establish common standards for silvicultural and vegetation definitions, creating a shared conceptual framework for a consistent study on the effects of forest management on biodiversity. We have identified both strengths and weaknesses of the silvicultural and vegetation information provided in forest biodiversity studies. While quantitative data on forest biomass and dominant tree species are frequently included, information on silvicultural activities and vegetation composition is often lacking, shallow, or based on broad and heterogeneous classifications. We discuss the existing classifications and their use in European forest biodiversity studies through a novel bottom-up and top-driven review process, and ultimately propose a common framework. This will enhance the comparability of forest biodiversity studies in Europe, and puts the basis for effective implementation and monitoring of sustainable forest management policies. The standards here proposed are potentially adaptable and applicable to other geographical areas and could be extended to other forest interventions. Forest management Multi-taxon Terminology Silviculture Data harmonizationpublishedVersio