TeHV3 outbreak characterization in captive Testudo spp.

Italian Tortoises species are considered either endangered or near threatened according to International Union for Conservation of Nature. When pet tortoises are abandoned or found injured or seized following illegal detention, they are sent to wildlife rehabilitation centers. From 2008, the Testudo spp. population housed in the WWF Vanzago’s oasis exhibited clinical signs compatible with Testudinid herpesviurs 3 (TeHV3) infection.  By the end of 2012 all Testudo had died. The presence of TeHV3 was investigated by molecular biology and pathology. All the tortoises housed in Vanzago resulted ELISA positive for the presence of anti-TeHV3 antibodies except one T. hermanni. Of these, 12 animals died and were all necropsied. Lesion frequency distribution was evaluate by histology. PCR was positive in 8/12 tortoises. To better complement the epidemiological evaluation of the virus in northern Italy, 20 retrospective cases were selected from the archive of the University of Milan. Of these, 5 were TeHV3 PCR positive. Lesions closely resembled those of the Vanzago’s population. These results are consistent with a high prevalence of TeHV3 in northern Italy. The finding of intranuclear inclusion bodies demonstrated to be specific but not sensitive. TeHV3 diagnostic pathological lesions have been reported to vary according with host immune response and by the viral replicative status. Molecular techniques were often necessary to confirm the infection. According to the literature and to our findings, T. hermanni spp. seems the species with higher mortality and lower antibody concentrations when infected with TeHV3.Italian Tortoises species are considered either endangered or near threatened according to International Union for Conservation of Nature. When pet tortoises are abandoned or found injured or seized following illegal detention, they are sent to wildlife rehabilitation centers. From 2008, the Testudo spp. population housed in the WWF Vanzago’s oasis exhibited clinical signs compatible with Testudinid herpesviurs 3 (TeHV3) infection.  By the end of 2012 all Testudo had died. The presence of TeHV3 was investigated by molecular biology and pathology. All the tortoises housed in Vanzago resulted ELISA positive for the presence of anti-TeHV3 antibodies except one T. hermanni. Of these, 12 animals died and were all necropsied. Lesion frequency distribution was evaluate by histology. PCR was positive in 8/12 tortoises. To better complement the epidemiological evaluation of the virus in northern Italy, 20 retrospective cases were selected from the archive of the University of Milan. Of these, 5 were TeHV3 PCR positive. Lesions closely resembled those of the Vanzago’s population. These results are consistent with a high prevalence of TeHV3 in northern Italy. The finding of intranuclear inclusion bodies demonstrated to be specific but not sensitive. TeHV3 diagnostic pathological lesions have been reported to vary according with host immune response and by the viral replicative status. Molecular techniques were often necessary to confirm the infection. According to the literature and to our findings, T. hermanni spp. seems the species with higher mortality and lower antibody concentrations when infected with TeHV3

Testing accuracy and repeatability of UAV blocks oriented with gnss-supported aerial triangulation

UAV Photogrammetry today already enjoys a largely automated and efficient data processing pipeline. However, the goal of dispensing with Ground Control Points looks closer, as dual-frequency GNSS receivers are put on board. This paper reports on the accuracy in object space obtained by GNSS-supported orientation of four photogrammetric blocks, acquired by a senseFly eBee RTK and all flown according to the same flight plan at 80 m above ground over a test field. Differential corrections were sent to the eBee from a nearby ground station. Block orientation has been performed with three software packages: PhotoScan, Pix4D and MicMac. The influence on the checkpoint errors of the precision given to the projection centers has been studied: in most cases, values in Z are critical. Without GCP, the RTK solution consistently achieves a RMSE of about 2-3 cm on the horizontal coordinates of checkpoints. In elevation, the RMSE varies from flight to flight, from 2 to 10 cm. Using at least one GCP, with all packages and all test flights, the geocoding accuracy of GNSS-supported orientation is almost as good as that of a traditional GCP orientation in XY and only slightly worse in Z

Decoding the Complexity of Systemic Inflammation Predictors in Locally Advanced Cervical Cancer, with Hemoglobin as the Hidden Key (the ESTHER Study)

Simple Summary We explored whether specific factors, like inflammation indicators in the blood, could help predict treatment outcomes for locally advanced cervical cancer (LACC). LACC is generally treated with a combination of chemotherapy and radiation. We wanted to see if these factors could help physicians personalize treatments for better results. Our study involved looking at various aspects, including inflammation indices in the blood and various clinical treatment details, in LACC patients. While some factors, such as age and hemoglobin levels, seemed to predict outcomes, there was no clear connection between inflammation indicators in the blood and results. These findings challenge previous ideas and highlight the importance of considering multiple factors to predict the prognoses of LACC patients.Abstract Locally advanced cervical cancer (LACC) is treated with concurrent chemoradiation (CRT). Predictive models could improve the outcome through treatment personalization. Several factors influence prognosis in LACC, but the role of systemic inflammation indices (IIs) is unclear. This study aims to assess the correlation between IIs and prognosis in a large patient cohort considering several clinical data. We retrospectively analyzed pretreatment IIs (NLR, PLR, MLR, SII, LLR, COP-NLR, APRI, ALRI, SIRI, and ANRI) in 173 LACC patients. Patient, tumor, and treatment characteristics were also considered. Univariate and multivariate Cox's regressions were conducted to assess associations between IIs and clinical factors with local control (LC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS). Univariate analysis showed significant correlations between age, HB levels, tumor stage, FIGO stage, and CRT dose with survival outcomes. Specific pretreatment IIs (NLR, PLR, APRI, ANRI, and COP-NLR) demonstrated associations only with LC. The multivariate analysis confirmed Hb levels, CRT dose, and age as significant predictors of OS, while no II was correlated with any clinical outcome. The study findings contradict some prior research on IIs in LACC, emphasizing the need for comprehensive assessments of potential confounding variables

Managing Polyploidy in Ex Situ Conservation Genetics: The Case of the Critically Endangered Adriatic Sturgeon (Acipenser naccarii)

While the current expansion of conservation genetics enables to address more efficiently the management of threatened species, alternative methods for genetic relatedness data analysis in polyploid species are necessary. Within this framework, we present a standardized and simple protocol specifically designed for polyploid species that can facilitate management of genetic diversity, as exemplified by the ex situ conservation program for the tetraploid Adriatic sturgeon Acipenser naccarii. A critically endangered endemic species of the Adriatic Sea tributaries, its persistence is strictly linked to the ex situ conservation of a single captive broodstock currently decimated to about 25 individuals, which represents the last remaining population of Adriatic sturgeon of certain wild origin. The genetic variability of three F1 broodstocks available as future breeders was estimated based on mitochondrial and microsatellite information and compared with the variability of the parental generation. Genetic data showed that the F1 stocks have only retained part of the genetic variation present in the original stock due to the few parent pairs used as founders. This prompts for the urgent improvement of the current F1 stocks by incorporating new founders that better represent the genetic diversity available. Following parental allocation based on band sharing values, we set up a user-friendly tool for selection of candidate breeders according to relatedness between all possible parent-pairs that secures the use of non-related individuals. The approach developed here could also be applied to other endangered tetraploid sturgeon species overexploited for caviar production, particularly in regions lacking proper infrastructure and/or expertise

European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria

Correction: Volume16 Issue1 Article Number225 DOI10.1186/s13019-021-01606-8Background: Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient's conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD. Methods: Nineteen centers of cardiac surgery from seven European countries have collaborated to create a multicentre observational registry (ERTAAD), which will enroll consecutive patients who underwent surgery for acute TAAD from January 2005 to March 2021. Analysis of the impact of patient's comorbidities, conditions at referral, surgical strategies and perioperative treatment on the early and late adverse events will be performed. The investigators have developed a classification of the urgency of the procedure based on the severity of preoperative hemodynamic conditions and malperfusion secondary to acute TAAD. The primary clinical outcomes will be in-hospital mortality, late mortality and reoperations on the aorta. Secondary outcomes will be stroke, acute kidney injury, surgical site infection, reoperation for bleeding, blood transfusion and length of stay in the intensive care unit. Discussion: The analysis of this multicentre registry will allow conclusive results on the prognostic importance of critical preoperative conditions and the value of different treatment strategies to reduce the risk of early adverse events after surgery for acute TAAD. This registry is expected to provide insights into the long-term durability of different strategies of surgical repair for TAAD.Peer reviewe

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

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

Stato attuale e prospettive di sviluppo del trasporto marittimo di container nei porti dell'alto adriatico

Le infrastrutture portuali rappresentano un elemento chiave come motore di crescita per l’economia globale. Il 74% delle merci importate ed esportate dall’UE transitano per porti. Per questo motivo sono necessari investimenti in infrastrutture e attrezzature portuali per far fronte alle previsioni di crescita del trasporto merci nel prossimo decennio. La crescita del transhipment, quindi di grossi scali chiamati hub, ha rivoluzionato la scelta delle tratte principali e la scelta degli scali. Nel corso del seguente elaborato ci si è concentrati sulla situazione dell’Alto Adriatico, analizzando lo stato attuale dei principali porti e i possibili sviluppi futuri. La situazione dell’Alto Adriatico è particolare, questi porti si trovano sulle rotte principali del trasporto globale ma vista la crescita di scambi commerciali con la Cina e l’estremo Oriente, per via dello spostamento verso Est del baricentro dell’economia, si trovano in posizione ottimale per diventare un grosso gateway. Questo è l’obbiettivo che si sono prefissati i porti del Nord Adriatico cioè far capire che risalire l’Adriatico, anche se fuori dalle rotte può risultare conveniente visto il risparmio di cinque giorni di navigazione, rispetto ai porti del Nord Europa, che si traduce in un risparmio di tempo e di costi. Per creare attrattiva sono stati svolti, e continuano, numerosi investimenti per lo sviluppo dei fondali e del retroporto, nel tentativo di potersi affermare all’interno del mercato europeo e globale. Nel corso dell’elaborato saranno analizzati i grossi vantaggi di cui godono i porti del Nord Adriatico grazie alla loro posizione geografica, e alcune delle problematiche che ostacolano la crescita