FUNDAMENTAL AND APPLIED RESEARCH ON FRESHWATER DECAPODS IN ITALY

The study group of freshwater decapods established within the Italian Association of Freshwater Ichthyologists aims at improving knowledge on the biology of both native and alien freshwater crayfish, shrimps, and crabs which currently inhabit Italian lentic and lotic waters, promoting at the same time the establishment of a network of experts that guarantees an adequate spread of correct useful and usable information, not only for management activities by the local and national competent authorities, but even by non-experts. The group deals with taxonomy, systematic, zoogeography, ecology, ethology, physiology, anatomy, genetics, conservation (of natives) and management (of aliens) of freshwater decapods in Italy. Our main aim is to update the status of freshwater decapods within the national territory, useful for monitoring programs on these species and the habitats where they inhabit. It is necessary to study all the aspects of this order because many species represent an ecological (as a keystone species), fauna (some taxa are interesting peninsular endemisms), biogeographical (the Whole order includes peculiar models of dispersion, migration and vicariance) and evolutionary (there are stimulating case studies of adaptive radiation phenomena linked to a specific ecological value) heritage. Also from an applied perspective, freshwater decapods have a peculiar double aspect linked to the conservation of aquatic environments: on the one side some species can be considered as valuable biological indicators, but on the other side many alien species are reported to be invasive and their management is mandatory, according to the new European and Italian legislations, and should be ecologically, economically and culturally examined to evaluate their effects on environment, human activities and health

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

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

Problematiche nell'affinamento delle comunit\ue0 ittiche di riferimento per l\u2019applicazione dell\u2019ISECI in aree con carenze informative e quadro zoogeografico incerto. Il caso di studio del bacino del Basento in Basilicata.

The ISECI is the index identified by the D.L.152 / 2006 in agreement with the Water Framework Directive 2000/60/EC for assessing the BQE fish fauna for inland surface waters. It provides a judgment on the ecological status of the observed fish community by assessing differences with the reference fish community theoretically present in natural conditions. The definition of the reference fish community is therefore a critical step that significantly influences the final result of the index and which sometimes is extremely unreliable. Many taxawidely distributed throughout Italy are under review by the scientific community and there iscurrently no clear recommendation on the checklist of native species of the different italian zoogeographical districts. In this study, an overview of issues related to the definition of a reference fish community and a comprehensive picture of the discrepancies within published studies on the autochthony of several fish species in the Basento river basin in Basilicata are reported. Basento river basin, like other Jonian arc basins, shows an unresolved zoogeography which needs further geological and molecular-genetic studies. In addition, the consequences of choosing incorrect reference conditions, both in terms of loss in analytical power of the index and in terms of implications in respecting ecological quality limits imposed by the WDF, were evaluated byapplying the ISECI to 23 sampled ichthyic peopling under different theoretical zoogeographical scenariosL\u2019ISECI \ue8 l\u2019indice individuato dal D.L.152/2006 in adeguamento alla Water Framework Directive (WDF) 2000/60/CE per la valutazione dell\u2019EQB fauna ittica nelle acque interne superficiali. Fornisce un giudizio sullo stato ecologico della comunit\ue0 ittica osservata, valutando quanto questa differisca dalla comunit\ue0 ittica di riferimento teoricamente presente in condizioni di naturalit\ue0. La definizione della comunit\ue0 ittica di riferimento \ue8, quindi, un passaggio fondamentale che influenza profondamente la veridicit\ue0 del risultato finale dell\u2019indice ma che ha talora un grado di incertezza estremamente elevato. Molti taxa diffusi sul territorio nazionale sono oggetto di revisione da parte della comunit\ue0 scientifica e non vi \ue8 parere univoco riguardo la checklist delle specie autoctone dei singoli distretti zoogeografici italiani. In questo studio \ue8 presentata una panoramica delle problematiche relative alla definizione della comunit\ue0 ittica di rifermento nel bacino del fiume Basento in Basilicata fornendo un quadro complessivo delle discordanze fra i principali autori in merito allo status di autoctonia delle diverse specie ittiche. Il bacino del Basento, come gli altri bacini dell\u2019arco jonico, ha un quadro zoogeografico poco chiaro che necessita di approfondimenti di carattere geologico e genetico-molecolare. Le conseguenze della scelta di condizioni di riferimento errate, sia in termini di perdita di potere analitico dell\u2019indice sia per le implicazioni relative al rispetto dei limiti di qualit\ue0 ecologica imposti dalla WDF, vengono presentate tramite l\u2019applicazione dell\u2019ISECI a 23 popolamenti di fauna ittica secondo diversi possibili scenari zoogeografici teorici