Distribution of medium- to large-sized African mammals based on habitat suitability models

The knowledge of the areas inhabited by a species within its distribution range and the connections among patches are critical pieces of information for successful conservation actions. The internal structure of the extent of occurrence (EO) of a species is almost always unknown, even for "well-known" flagship species. We developed a methodology to infer the area of occupancy (AO) within the EO of a species using the limited available data. We present here the results of a three years project funded by European Union to develop high-resolution models of habitat suitability for 281 medium- to large-sized African mammals across the whole continent. The existing literature was reviewed and all data on the geographic distribution and environmental preferences of the selected species were collected. For each species, these data were then expressed in terms of key variables available as GIS layers at a resolution of 1 km(2) over the entire African continent. The AO of each species was obtained merging the information on the ecological needs of the species and the values of ecological variables over the region identified as EO. The habitat suitability models were evaluated through direct field work in four countries (Morocco, Cameroon, Uganda, Botswana) chosen as representatives of the environmental and species diversity of Africa. More than 81% of models had positive true skill statistics (TSS) values, indicating models performing better than random. Rigorous modeling procedures supported by ad-hoc field evaluation allowed the production of high-resolution habitat suitability models useful for conservation applications

Ecological Footprint and tourism: Development and sustainability monitoring of ecotourism packages in Mediterranean Protected Areas

Ecotourism is a potential lever for sustainable development, but common standards and approaches lack to manage and monitor the impact of defined packages on natural resources and local communities. A customized version of Ecological Footprint Accounting is evaluated here to assess its usefulness as analytical tool to quantitatively analyse the environmental pressures associated with ecotourism packages developed in and around Protected Areas in the Mediterranean Region. Within the framework of the EU-funded DestiMED project, a bottom-up, participatory approach was developed for managing and monitoring 13 ecotourism packages by involving local tourism stakeholders and service providers. The application of Ecological Footprint Accounting relied on data sourced from local service providers to complement existing statistics and datasets, and was used in an empirical iterative process to provide local tourism stakeholders with recommendations to guide them in the management of a low-impact tourism offer. International travel to and from the 13 destinations was found to place a Footprint on the environment – mainly because of carbon emissions – higher than that of the entire stay at destination. Footprint results of the packages revealed some overlooked tourism's impacts on ecosystems due to unexpected drivers, such as the Food & Drink services offered to tourists at destination. Results indicate that managing tourism product development at destination, and investing in providing knowledge on the principles of sustainability, could lower ecotourism's impacts whilst contributing to building resilience and aiding the post-COVID recovery of destinations

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2

Effects of pre‐operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or &gt;= 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care