SARS-CoV-2 infection in health workers: analysis from Verona SIEROEPID Study during the pre-vaccination era

Background: To report the baseline phase of the SIEROEPID study on SARS-CoV-2 infection seroprevalence among health workers at the University Hospital of Verona, Italy, between spring and fall 2020; to compare performances of several laboratory tests for SARS-CoV-2 antibody detection. Methods: 5299 voluntary health workers were enrolled from 28 April 2020 to 28 July 2020 to assess immunological response to SARS-CoV-2 infection throughout IgM, IgG and IgA serum levels titration by four laboratory tests. Association of antibody titre with several demographic variables, swab tests and performance tests (sensitivity, specificity, and agreement) were statistically analyzed. Results: The overall seroprevalence was 6%, considering either IgG and IgM, and 4.8% considering IgG. Working in COVID-19 Units was not associated with a statistically significant increase in the number of infected workers. Cohen's kappa of agreement between MaglumiTM and VivaDiagTM was quite good when considering IgG only (Cohen's kappa = 78.1%, 95% CI 74.0-82.0%), but was lower considering IgM (Cohen's kappa = 13.3%, 95% CI 7.8-18.7%). Conclusion: The large sample size with high participation (84.7%), the biobank and the longitudinal design were significant achievements, offering a baseline dataset as the benchmark for risk assessment, health surveillance and management of SARS-CoV-2 infection for the hospital workforce, especially considering the ongoing vaccination campaign. Study results support the national regulator guidelines on using swabs for SARS-CoV-2 screening with health workers and using the serological tests to contribute to the epidemiological assessment of the spread of the virus

Some Like It Fat: Comparative Ultrastructure of the Embryo in Two Demosponges of the Genus Mycale (Order Poecilosclerida) from Antarctica and the Caribbean

0000-0002-7993-1523© 2015 Riesgo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License [4.0], which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The attached file is the published version of the article

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Visual acquisition system for georeferenced monitoring and reconstruction of the sea bottom using audio for data synchronisation

This work describes a Smart Dive Scooter (SDS) to be used as a support tool for monitoring application of different marine species. Professional divers of Environmental Protection Agencies are periodically involved in monitoring activities. Ligurian Regional Agency for the Environmental Protection (ARPAL) and the University of Pisa (UNIPI) are collaborating towards the integration of classical methodologies with ICT tools to support the work of divers in terms of safety, cost effectiveness and time effectiveness. The SDS is the first step in this direction. It is a classical Dive Scooter, used for rapid movements underwater, that is integrated with sensors for environment monitoring (a set of cameras) and for data georeferencing (acoustic localisation system). The SDS will be used by ARPAL divers to quickly acquire images of the bottom of a target area. Processing of optical and positioning data will allow to build a virtual model on which perform all the analysis and measurement activities. This approach results in limiting the time underwater for operators increasing the area mapper per each dive. The paper focuses on the technique used for the synchronization of optical data among the various cameras and of them with the acoustic position measurements. This goal is obtained exploiting the audio tracks acquired by the cameras avoiding the necessity of bulky and energy expensive dedicated computers. Results of the validation based on experimental data collected at sea are reported

I medici veronesi e le problematiche deontologiche della professione

Viene presentato l'esito di un'indagine rivolta a tutti i medici della provincia di Verona iscritti all'ordine professionale e muniti di indirizzo di posta elettronica e disponibili a rispondere a delle interviste. Si tratta di oltre un migliaio di medici a cui è stata chiesta la reatiività personale relativamente a problematiche che li coinvolgono attualmente: invecchiamento della popolazione, immigrazione e multiculturalità, rifiuto della sofferenza e della morte, medicalizzazione impropria di problemi esistenziali, rischio professionale, riduzione delle risorse economiche, burocratizzazione dell'assistenza sanitaria, difficoltà di aggiornamento, difficoltà di comunicazione con i pazienti, implicazioni etiche del medico, carenza di supporti

An approach to evaluate the quality of radiological reports in Head and Neck cancer loco-regional staging: experience of two Academic Hospitals

none24Objectives: To evaluate the quality of the reports of loco-regional staging computed tomography (CT) or magnetic resonance imaging (MRI) in head and neck (H&N) cancer. Methods: Consecutive reports of staging CT and MRI of all H&N cancer cases from 2018 to 2020 were collected. We created lists of quality indicators for tumor (T) for each district and for node (N). We marked these as 0 or 1 in the report calculating a report score (RS) and a maximum sum (MS) of each list. Two radiologists and two otolaryngologists in consensus classified reports as low quality (LQ) if the RS fell in the percentage range 0-59% of MS and as high quality (HQ) if it fell in the range 60-100%, annotating technique and district. We evaluated the distribution of reports in these categories. Results: Two hundred thirty-seven reports (97 CT and 140 MRI) of 95 oral cavity, 52 laryngeal, 47 oropharyngeal, 19 hypo-pharyngeal, 14 parotid, and 10 nasopharyngeal cancers were included. Sixty-six percent of all the reports were LQ for T, 66% out of all the MRI reports, and 65% out of all CT reports were LQ. Eight-five percent of reports were HQ for N, 85% out of all the MRI reports, and 82% out of all CT reports were HQ. Reports of oral cavity, oro-nasopharynx, and parotid were LQ, respectively, in 76%, 73%, 100% and 92 out of cases. Conclusion: Reports of staging CT/MRI in H&N cancer were LQ for T description and HQ for N description.noneGiannitto, Caterina; Esposito, Andrea Alessandro; Spriano, Giuseppe; De Virgilio, Armando; Avola, Emanuele; Beltramini, Giada; Carrafiello, Gianpaolo; Casiraghi, Elena; Coppola, Alessandra; Cristofaro, Valentina; Farina, Davide; Gaino, Francesca; Lastella, Giulia; Lofino, Ludovica; Maroldi, Roberto; Piccoli, Francesca; Pignataro, Lorenzo; Preda, Lorenzo; Russo, Elena; Solimeno, Lorenzo; Vatteroni, Giulia; Vidiri, Antonello; Balzarini, Luca; Mercante, GiuseppeGiannitto, Caterina; Esposito, Andrea Alessandro; Spriano, Giuseppe; De Virgilio, Armando; Avola, Emanuele; Beltramini, Giada; Carrafiello, Gianpaolo; Casiraghi, Elena; Coppola, Alessandra; Cristofaro, Valentina; Farina, Davide; Gaino, Francesca; Lastella, Giulia; Lofino, Ludovica; Maroldi, Roberto; Piccoli, Francesca; Pignataro, Lorenzo; Preda, Lorenzo; Russo, Elena; Solimeno, Lorenzo; Vatteroni, Giulia; Vidiri, Antonello; Balzarini, Luca; Mercante, Giusepp

Selective oviposition of the mayfly Baetis bicaudatus

Abstract Selective oviposition can have important consequences for recruitment limitation and population dynamics of organisms with complex life cycles. Temporal and spatial variation in oviposition may be driven by environmental or behavioral constraints. The goals of this study were to: (1) develop an empirical model of the substrate characteristics that best explain observed patterns of oviposition by Baetis bicaudatus (Ephemeroptera), whose females lay eggs under rocks protruding from high-elevation streams in western Colorado; and (2) test experimentally selective oviposition of mayfly females. We surveyed the number and physical characteristics of potential oviposition sites, and counted the number and density of egg masses in different streams of one watershed throughout two consecutive flight seasons. Results of surveys showed that variability in the proportion of protruding rocks with egg masses and the density of egg masses per rock were explained primarily by seasonal and annual variation in hydrology, and variation in geomorphology among streams. Moreover, surveys and experiments showed that females preferred to oviposit under relatively large rocks located in places with high splash associated with fast current, which may provide visual, mechanical or both cues to females. Experiments also showed that high densities of egg masses under certain rocks were caused by rock characteristics rather than behavioral aggregation of ovipositing females. While aggregations of egg masses provided no survival advantage, rocks selected by females had lower probabilities of desiccating during egg incubation. Our data suggest that even when protruding rocks are abundant, not all rocks are used as oviposition sites by females, due to female selectivity and to differences in rock availability within seasons, years, or streams depending on variation in climate and hydrogeomorphology. Therefore, specialized oviposition behavior combined with variation in availability of quality oviposition substrata has the potential to limit recruitment of this species

Medici a Verona 2: Indagine sui fattori di benessere/malessere dei professionisti veronesi (parte seconda)

Questo secondo articolo presenta altri dati relativi alla pratica professionale, emersi dall\u2019elaborazione delle risposte a un questionario sulle cause di malessere e benessere dei medici ed odontoiatri veronesi. Tra i molti risultati quelli pi\uf9 significativi indicano un minore interesse per la comunicazione-relazione con i pazienti nei professionisti che maggiormente avvertono il peso della responsabilit\ue0 nei confronti dei loro pazienti e in quelli che maggiormente si preoccupano per le possibili denunce di questi ultimi.Viceversa, due fattori di malessere come la preoccupazione per la sofferenza dei pazienti e la solitudine professionale si accompagnano a una maggiore propensione alla relazione e quindi a una maggiore attenzione a comportamenti eticamente rilevanti, con un ricorso minore alla medicina difensiva. Esiste inoltre una relazione tra fattori di malessere del medico e ricorso alla medicina difensiva, intesa sia come eccesso che come difetto di prestazioni.In sintesi, \ue8 stato rilevato un nesso stretto tra modalit\ue0 di comunicazione con i pazienti, livello di soddisfazione dei professionisti della cura e ricorso alla medicina difensiva.In letteratura esistono gi\ue0 dati che dimostrano il rapporto tra modalit\ue0 di comunicazione e soddisfazione del paziente, e rispettivamente tra comunicazione ed efficacia delle cure (dati recenti stimano una riduzione degli errori di circa il 50% per il miglioramento della comunicazione interna ai reparti e una riduzione dei ricoveri di circa il 30% per il miglioramento della comunicazione tra strutture specialistiche e del territorio). Altri dati della letteratura evidenziano l\u2019esistenza di correlazioni molto strette tra modalit\ue0 di comunicazione e contenzioso da parte di pazienti (\ue8 noto che circa il 70% dei casi di contenzioso in medicina sono dovuti a cattiva comunicazione).Anche i risultati di questo studio confermano la necessit\ue0 e l\u2019urgenza di un forte impegno nella formazione pre- e post-laurea per il miglioramento delle competenze comunicative e relazionali dei professionisti sanitari, questo al fine di migliorare efficacia ed efficienza delle cure e soddisfazione sia dei pazienti che dei medici

La communication environnementale

Conférences internationales, controverses scientifiques et débats médiatiques…l'environnement est devenu un enjeu de communication global. C'est à l'étude des différentes formes et évolutions de la communication environnementale, de sa naissance dans les années 1990, sous le coup de catastrophes écologiques à répétition, aux grandes déclarations officielles sans lendemain, que s'attache cet ouvrage entièrement inédit. Du « développement durable » à la « transition écologique », ce nouveau grand récit fédérateur s'intègre désormais dans la démarche marketing des entreprises et dans les politiques des institutions publiques. Il influe sur les positionnements stratégiques des partis politiques et incite à de nouvelles pratiques individuelles. Aux discours de crise axés sur la peur et la responsabilité répond le risque de l'éco-lassitude des uns et de « greenwashing » des autres..