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

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

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

Presenza di Escherichia Coli O157:H7 in latte ovino prodotto in Toscana

RIASSUNTO Escherichia coli O157:H7 è un sierotipo enteroemorragico responsabile di colite emorragica e sindrome emolitico-uremica nell’uomo. La principale via di trasmissione del patogeno si realizza attraverso il consumo di alimenti di origine animale ed in particolare di origine bovina. Per quanto riguarda il latte ed i prodotti derivati è ormai noto il ruolo del latte vaccino non pastorizzato nella trasmissione dell’infezione, mentre non esistono segnalazioni di casi provocati da consumo di latte ovino e derivati. Tuttavia l’isolamento di E. coli O157:H7 da latte ovino è stato effettuato anche in Italia, seppure con percentuali di positività molto basse. In considerazione del fatto che in Toscana esiste una notevole tradizione di produzioni lattierocasearie a latte crudo, è stata effettuata una ricerca con una metodica di immunoseparazione magnetica al fine di valutare la presenza di E. coli O157:H7 in 60 campioni di latte di massa proveniente da altrettante greggi della provincia di Pisa, dove la mungitura viene effettuata manualmente. Nessuno dei campioni in esame ha evidenziato la presenza di E. coli O157:H7. Nonostante il ridotto numero di campioni esaminati non permetta di trarre conclusioni statisticamente significative, il mancato isolamento di E. coli O157:H7 da campioni di latte ovino può essere considerato comunque interessante, vista la scarsità di dati reperibili in bibliografia sul ruolo epidemiologico svolto da questo prodotto. SUMMARY Escherichia coli O157:H7 is an enterohemorrhagic strain that has developed the ability to cause serious gastrointestinal and systemic disease in humans, such as hemorrhagic colitis, haemolytic uremic syndrome and thrombocytopenic purpura. An increasing variety of foods of animal origin has been associated with outbreaks involving this microrganism. Cattle are a major reservoir of E. coli O157:H7 and an important source of human infection. Undercooked ground beef and unpasteurised cow milk are considered to be common vehicles of the pathogen transmission, whereas no cases related to consumption of ewes’ milk or cheese are reported. However the isolation of E. coli O157:H7 from ewes’ milk has been registered also in Italy, even if rarely. Considering that in Tuscany typical cheeses and dairy products are often prepared with raw ewes’ milk, a research was carried out in order to evaluate the presence of E. coli O157:H7. Sixty samples of raw milk from sheep herds of the province of Pisa, where manual milking is prevalent, were analysed using an immunomagnetic separation method. No colonies of E. coli O157:H7 were isolated from the samples. In spite of the restricted number of samples, our findings are interesting because the epidemiological role of ewe’s milk remains to be established

Tests of PoD with ATLAS Prodsys2 and first experience with HTTP Federation

During the LHC Run-1, Grid resources in ATLAS have been managed by the PanDA and DQ2 systems. In order to meet the needs for the LHC Run-2, Prodsys2 and Rucio are used as the new ATLAS Workload and Data Management systems. The data are stored under various formats in ROOT files and end-user physicists have the choice to use either the ATHENA framework or directly ROOT. Within the ROOT data analysis framework it is possible to perform analysis of huge sets of ROOT files in parallel with PROOF on clusters of computers (usually organised in analysis facilities) or multi-core machines. In addition, PROOF-on-Demand (PoD) can be used to enable PROOF on top of an existing resource management system. In this work, we present the first performances obtained enabling PROOF-based analysis in the Italian ATLAS Tier-1/Tier-2 sites within the new ATLAS workload system. Benchmark tests of data access with the httpd protocol, using also the httpd redirector, will be shown. We also present results on the startup latency tests using the new PROOF functionality of dynamic workers addition, which improves the performance of PoD using Grid resources. These new results will be compared with the expected improvements discussed in a previous wor