Impact of the local environmental variability on the patterns of coral recruitment on Indo-Pacific reefs

Coral reefs are threatened by a range of human activities at both local and global scales. The result of these impacts has resulted in a worldwide decline in the coral reef ecosystems. Corals are the principle reef builders and the maintenance of their populations is fundamental for healthy reef ecosystems. Local environmental factors are critically important in shaping coral populations, particularly at the post-settlement phase, when young coral colonies are most vulnerable to disturbances. In this context, understanding the environmental factors that drive coral recruitment and affect coral survivorship in the early life history stages is vital to effectively manage coral reefs. In this thesis I began by investigating the effect of abiotic and biological factors on coral recruitment and juvenile coral life history stages using settlement panels deployed in the Wakatobi Marine National Park (SE Sulawesi, Indonesia). My objectives were to assess the spatio-temporal variability in coral recruitment rates and juvenile abundance. I used a modelling approach to identify the environmental factors that affected the distribution and abundance patterns of corals. Then, I focused on the main environmental factors, identified from previously published research, affecting coral recruitment. I conducted a caging experiment to assess the impact of fish predation on coral juveniles. Finally, I analysed the development of the benthic community and the interactions between corals and benthic organisms in the first two years of colonisation of artificial bare surfaces. I found high spatial and temporal variability in recruitment rates over seven years of data, values were lower than on other Indo-Pacific reefs and ranged from 9.6 (±8.21 SE) to 317.19 (±12.76 SE) rec. m⁻²; while juvenile abundance ranged from 4.2 (±1.49 SE) to 33 (±6.36 SE) juv. m⁻². The local characteristics of the sites, such as coral cover, influenced the distribution of coral colonies in early life history stages; furthermore differences in coral density between the two life history stages (juvenile and recruits) were consistent over time. However, no single or combination of factors adequately explained abundance patterns for either recruits or juveniles. Fish predation did not appear to be the main cause of coral post-settlement mortality in the Wakatobi and it affected only 10.8% of the coral juveniles in the experiment. In contrast, 58.51% of the coral juveniles were found to be overgrown by algae and other invertebrates, however only turf and green encrusting algae affected coral survivorship. Coral colony abundance and the number of interactions with other benthic organisms, especially crustose coralline algae (CCA) and sponges, increased over time on panels and they were different between the front and back side of the panels, which was attributed to differences in light and predation regimes. Coral recruitment was higher on older benthic communities, although none of the known coral recruitment promoters, such as CCA, or competitors, such as turf algae, were correlated with coral abundance. My results show that changes in coral populations between the recruit and juvenile stages are likely driven by small-scale processes. The site characteristics determine the final patterns, which vary over time following temporal fluctuations in environmental factors. The effect of the interactions between algae and sponges with coral recruits and their influence on juvenile survivorship suggests these organisms having a role in coral recruitment success and highlight their importance as a focus for reef management. Furthermore, the use of long term studies allowed a better understanding of the high variability present in coral recruitment and the trends of the recruitment process, which are useful information for conservative purposes

Development and validation of a scoring system for pre-surgical and early post-surgical prediction of bariatric surgery unsuccess at 2 years

Bariatric surgery (BS) is an effective treatment for morbid obesity. However, a simple and easy-to-use tool for the prediction of BS unsuccess is still lacking. Baseline and follow-up data from 300 consecutive patients who underwent BS were retrospectively collected. Supervised regression and machine-learning techniques were used for model development, in which BS unsuccess at 2 years was defined as a percentage of excess-weight-loss (%EWL) < 50%. Model performances were also assessed considering the percentage of total-weight-loss (%TWL) as the reference parameter. Two scoring systems (NAG-score and ENAG-score) were developed. NAG-score, comprising only pre-surgical data, was structured on a 4.5-point-scale (2 points for neck circumference ≥ 44 cm, 1.5 for age ≥ 50 years, and 1 for fasting glucose ≥ 118 mg/dL). ENAG-score, including also early post-operative data, was structured on a 7-point-scale (3 points for %EWL at 6 months ≤ 45%, 1.5 for neck circumference ≥ 44 cm, 1 for age ≥ 50 years, and 1.5 for fasting glucose ≥ 118 mg/dL). A 3-class-clustering was proposed for clinical application. In conclusion, our study proposed two scoring systems for pre-surgical and early post-surgical prediction of 2-year BS weight-loss, which may be useful to guide the pre-operative assessment, the appropriate balance of patients’ expectations, and the post-operative care

Marine Strategy Framework Directive - Descriptor 2, Non-Indigenous Species, Delivering solid recommendations for setting threshold values for non-indigenous species pressure on European seas

Marine Non-Indigenous Species (NIS) are animals and plants introduced accidently or deliberately into the European seas, originating from other seas of the globe. About 800 marine non-indigenous species (NIS) currently occur in the European Union national marine waters, several of which have negative impacts on marine ecosystem services and biodiversity. Under the Marine Strategy Framework Directive (MSFD) Descriptor 2 (D2), EU Member States (MSs) need to consider NIS in their marine management strategies. The Descriptor D2 includes one primary criterion (D2C1: new NIS introductions), and two secondary criteria (D2C2 and D2C3). The D2 implementation is characterized by a number of issues and uncertainties which can be applicable to the Descriptor level (e.g. geographical unit of assessment, assessment period, phytoplanktonic, parasitic, oligohaline NIS, etc.), to the primary criterion D2C1 level (e.g. threshold values, cryptogenic, questionable species, etc), and to the secondary criteria D2C2 and D2C3. The current report tackles these issues and provides practical recommendations aiming at a smoother and more efficient implementation of D2 and its criteria at EU level. They constitute a solid operational output which can result in more comparable D2 assessments among MSs and MSFD regions/subregions. When it comes to the policy-side, the current report calls for a number of different categories of NIS to be reported in D2 assessments, pointing the need for the species to be labelled/categorised appropriately in the MSFD reporting by the MSs. These suggestions are proposed to be communicated to the MSFD Working Group of Good Environmental Status (GES) and subsequently to the Marine Strategy Coordination Group (MSCG) of MSFD. Moreover, they can serve as an input for revising the Art. 8 Guidelines

Impact of the local environmental variability on the patterns of coral recruitment on Indo-Pacific reefs

Coral reefs are threatened by a range of human activities at both local and global scales. The result of these impacts has resulted in a worldwide decline in the coral reef ecosystems. Corals are the principle reef builders and the maintenance of their populations is fundamental for healthy reef ecosystems. Local environmental factors are critically important in shaping coral populations, particularly at the post-settlement phase, when young coral colonies are most vulnerable to disturbances. In this context, understanding the environmental factors that drive coral recruitment and affect coral survivorship in the early life history stages is vital to effectively manage coral reefs. In this thesis I began by investigating the effect of abiotic and biological factors on coral recruitment and juvenile coral life history stages using settlement panels deployed in the Wakatobi Marine National Park (SE Sulawesi, Indonesia). My objectives were to assess the spatio-temporal variability in coral recruitment rates and juvenile abundance. I used a modelling approach to identify the environmental factors that affected the distribution and abundance patterns of corals. Then, I focused on the main environmental factors, identified from previously published research, affecting coral recruitment. I conducted a caging experiment to assess the impact of fish predation on coral juveniles. Finally, I analysed the development of the benthic community and the interactions between corals and benthic organisms in the first two years of colonisation of artificial bare surfaces. I found high spatial and temporal variability in recruitment rates over seven years of data, values were lower than on other Indo-Pacific reefs and ranged from 9.6 (±8.21 SE) to 317.19 (±12.76 SE) rec. m⁻²; while juvenile abundance ranged from 4.2 (±1.49 SE) to 33 (±6.36 SE) juv. m⁻². The local characteristics of the sites, such as coral cover, influenced the distribution of coral colonies in early life history stages; furthermore differences in coral density between the two life history stages (juvenile and recruits) were consistent over time. However, no single or combination of factors adequately explained abundance patterns for either recruits or juveniles. Fish predation did not appear to be the main cause of coral post-settlement mortality in the Wakatobi and it affected only 10.8% of the coral juveniles in the experiment. In contrast, 58.51% of the coral juveniles were found to be overgrown by algae and other invertebrates, however only turf and green encrusting algae affected coral survivorship. Coral colony abundance and the number of interactions with other benthic organisms, especially crustose coralline algae (CCA) and sponges, increased over time on panels and they were different between the front and back side of the panels, which was attributed to differences in light and predation regimes. Coral recruitment was higher on older benthic communities, although none of the known coral recruitment promoters, such as CCA, or competitors, such as turf algae, were correlated with coral abundance. My results show that changes in coral populations between the recruit and juvenile stages are likely driven by small-scale processes. The site characteristics determine the final patterns, which vary over time following temporal fluctuations in environmental factors. The effect of the interactions between algae and sponges with coral recruits and their influence on juvenile survivorship suggests these organisms having a role in coral recruitment success and highlight their importance as a focus for reef management. Furthermore, the use of long term studies allowed a better understanding of the high variability present in coral recruitment and the trends of the recruitment process, which are useful information for conservative purposes

Impact of the COVID-19 Pandemic on Total and Cause-Specific Mortality in Pavia, Northern Italy

The COVID-19 pandemic had an unfavorable impact on overall mortality in Italy, with the strongest consequences in northern Italy. Scant data are available on cause-specific mortality. This study aims at investigating the impact of the pandemic on the overall and cause-specific mortality in one province in northern Italy, Pavia. We linked individual-level administrative data (i.e., death certification and population data) from the Health Protection Agency (HPA) in Pavia province between 2015 and 2020. We computed age-standardized mortality rates (Italian population 2011) by cause, sex, and calendar year, and computed the rate ratio and the corresponding 95% confidence intervals to compare rates in 2020 versus 2015&ndash;2019. The 2020 excess total mortality in Pavia was 24% in men and 25% in women, reaching rates of 1272.6/100,000 and 1304.4/100,000, respectively. Significant excesses were found for infectious and parasitic diseases, excluding COVID-19 (about +30% in both sexes); respiratory system diseases (44% in men; 30% in women); and dementia and Alzheimer&rsquo;s disease among men (24%). Reductions were reported for neoplasms (&minus;14% in men); cerebrovascular diseases (&minus;25% in men); and ischemic diseases (&minus;13% in women), but also for transport accidents in men. COVID-19 was the third cause of death in both sexes with rates of 274.9/100,000 men (859 total deaths) and 213.9/100,000 women (758 total deaths). Excess mortality in Pavia was higher than Italy but lower than Lombardy. Increases in mortality from causes related to infectious and respiratory diseases can likely be explained by underdiagnosed deaths from COVID-19

Twenty years of gastroenteropancreatic neuroendocrine tumors: is reclassification worthwhile and feasible?

Gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) are rare neoplasms with heterogeneous clinical behavior and potential long-term survival. In 2006/2007, the European Neuroendocrine Tumors Society introduced an important parameter, grade (based on mitoses and Ki-67 proliferation rate), which became part of the latest 2010-WHO classification. Since this is an important tool in the choice of therapeutic algorithm of patients with NETs, our aim was to audit whether retrospective reclassification is possible and feasible and correlate pathological findings with survival. From the histopathology archive, 338 GEP-NETs (1994-2014) were identified, of which 250 were diagnosed pre-2010 and 80 of these have needed, up till now, classification (morphology and grade-mitotic count/Ki-67). Morphology was well differentiated (WD) in 74 cases while only 6 cases were poorly differentiated (PD). Grade was reclassified: G1-45 cases (56 %); G2-28 cases (35 %); G3-7 cases (9 %). Overall survival (OS) in WD NETs was strikingly better compared to PD neoplasms. Differences in OS between grade were statistically significant (p &lt; 0.0001) and, in particular, grade identified a subgroup of patients with WD lesions but with less favorable clinical behavior (OS at 5 years: G1-89 %; G2-48 %; G3-0 %; G1 vs G2 p = 0.03). Feasibility analysis quantified time for reclassification to be between 45 and 64 min/case. Our series confirms the importance of grade in prognostic stratification and underlines that reclassification is feasible, and may prove worthwhile in patient management, especially in view of the potential long survival of patients with NETs and risk of use of inappropriate therapies

Pelagic habitats under MSFD D1

The pelagic habitat is the largest biome on Earth, key for temperature regulation, oxygen, and food production. Its physical and biological components and processes vary spatially and temporally depending on multiple drivers. Understanding this variability, processes and interactions is fundamental to identify the drivers of changes and properly assess pelagic habitats under the Marine Strategy Framework Directive (MSFD). A JRC workshop was organised to align scientific and policy expectations for an improved MSFD pelagic habitat assessment. The workshop brought together experts from the 17 EU Member States and other organisations (e.g. Regional Sea Conventions) across Europe to share knowledge and methods and provide a coordinated regional input towards a harmonised assessment. This report summarizes the workshop outcomes and the way forward for pelagic Good Environmental Status (GES) determination

Effects of magnesium supplementation on post-thyroidectomy hypocalcemia: a prospective single-center study

Background: Severe and/or symptomatic hypocalcemia due to hypoparathyroidism is the main contraindication for discharge in patients who have undergone thyroid surgery. Hypomagnesemia may contribute to the onset of hypoparathyroidism and is frequently observed after thyroid surgery in hypocalcemic patients. The impact of prophylactic and postoperative Magnesium supplementation on postoperative hypocalcemia and hypomagnesemia was prospectively evaluated by comparing patients undergoing prophylactic supplementation to a control group of patients who had only received Magnesium after evidence of postoperative hypoMg. Methods: One hundred and twenty patients who underwent a total thyroidectomy participated in the study. Seventy-three patients were included in the study group, 47 in the control group. Prior to surgery, patients in the study group were given Magnesium orally for 5 days; postoperatively, Calcium and Magnesium was administered to all patients who displayed hypocalcemia and hypomagnesemia. Results: Postoperative biochemical hypocalcemia (serum Calcium&lt;8.5 mg/dL, regardless of its clinical severity) was found in 60 patients (50%) on D1 and in 58 patients (48.4%) on D2. Among hypocalcemic patients, hypomagnesemia was recorded in 29 at D1 (48%), and in 46 at D2 (79%). A significant positive correlation was found between Magnesium, Calcium, and parathyroid hormone in the first two postoperative days, while a significant inverse correlation occurred for these same parameters and length of hospital stay (p&lt;0.001). One hundred and five patients (87.5%) were discharged as expected on the second postoperative day (Study group = 65, Control group = 40, p = 0.724), whereas 15 patients (12.5%) required prolonged hospitalization (Study group = 8, Control group = 7, p = 0.721). The Study group only showed significantly higher Magnesium levels on the first postoperative day (p=0.03). Conclusions: Although Magnesium and Calcium levels showed the same trend after thyroidectomy, neither Magnesium prophylaxis nor Magnesium treatment influenced the clinical course of postoperative hypocalcemia

The Effect of COVID-19 Pandemic on Overall and Cause-Specific Mortality in Pavia, Northern Italy: Updated Estimates for the Year 2021

Excess mortality estimates are considered relevant indicators of direct and indirect pandemic effects on the population. Scant data have been published on cause-specific excess mortality. Using individual-level administrative data covering the Pavia province of Italian northern Lombardy region, we provided all-cause and cause-specific raw (RMR) and age-standardized (ASMR) mortality rates in 2021 and 2015–2019, the rate ratio, and 95% confidence intervals, overall and by sex. We obtained the excess deaths in 2021 as the difference between the number of observed and expected deaths from all causes and the two leading causes of death (all neoplasms and circulatory system diseases) by fitting over-dispersed quasi-Poisson regression models, accounting for temporal, seasonal and demographic changes. The total ASMR in 2021 was 972.4/100,000 (6836 certified deaths), with the highest ASMRs for circulatory system diseases (272.6/100,000) and all neoplasms (270.3/100,000), followed by COVID-19 (94.8/100,000 and 662 deaths). Compared to the expected, we estimated a total of 6.2% excess deaths in 2021 (7.2% in males and 5.4% in females), with no excess deaths from all neoplasms and a 6.2% reduction from circulatory system diseases. COVID-19 continued to affect total mortality in 2021, albeit to a lesser extent than in 2020, consistently with national patterns