Forest habitat management and conservation priorities: a multi-scale and multi-taxon approach

Habitat degradation, fragmentation and destruction are major causes of biodiversity loss. Management of natural and semi-natural habitats and control of human disturbance are fundamental to preserving their distinct character and biodiversity. Multiple levels must be considered when setting conservation management actions because species responses and ecological processes vary at different spatial scales. Legal instruments are now in place, with the European Union being among the pioneers, to protect and maintain habitats, and to implement management measures. Therefore, research efforts are needed to understand how to manage habitats in the current complex and constantly changing environmental and social context. For example, management of invasive alien species, which are among the most important threats to biodiversity, is a challenge nowadays. Furthermore, forest habitats are among the most important in terms of covered land and hosted species and, therefore, need particular attention. Indeed, several management approaches can be applied towards the achievement of biodiversity conservation objectives. However, the knowledge on the effects of different conservation management options on biodiversity is limited and must be further investigated. The overall research follows a multi-disciplinary and integrated approach towards the conservation management of habitats particularly focusing on forest biodiversity. The thesis aims to (i) propose and test the application of integrated approaches in respect to conservation management of natural and semi-natural habitats focusing on forests, and (ii) to broaden the knowledge on the biodiversity effects of management abandonment. Six scientific papers, published and to be published, form the bulk of the thesis. In the first paper a novel approach that aims to prioritize habitat conservation is proposed and tested in the Italian Alpine and Continental biogeographical regions. In the second paper a method is proposed and applied to assess the effects of human activities on habitats and species using as case study a forest road plan within a protected area. In the third paper a novel perspective on the potentiality of forest management to control invasive alien species is given. In the fourth paper a multi-scale landscape analysis was performed to identify habitat pattern changes due to different management regimes and to understand possible biodiversity implications. In the fifth paper a comparison between low intensity managed and abandoned forests was made to understand the effects on three beetle taxa. Finally, in the sixth paper the vegetation communities developing after management abandonment into novel forest habitats were investigated. This thesis has highlighted that sound conservation management is fundamental to maintain the variety of habitats, both natural and semi-natural, occurring in Europe. On the one hand novel approaches, such as those presented in the thesis, are required to face the never-ending changes in the legal, economic, social and environmental conditions. On the other hand, deep knowledge on the effects of management and planning choices on habitats and species is essential for adapting to biodiversity’s intrinsic variability and complexity in order to achieve conservation goals

Synergies of planning for forests and planning for Natura 2000: Evidences and prospects from northern Italy

Improvements in the management of Natura 2000 sites are essential to achieve the targets set out by the Habitats and Birds Directives of the European Union. A current focus is on the development of management plans, which are fundamental instruments in the implementation of conservation measures. This study explores the viability of using existing forest plans to assist in this purpose. As case study, we consider the regulatory framework of the Veneto Region, northern Italy. We collected quantitative and qualitative data on forest plans at the regional and at three sub-regional spatial scales: local, district, and biogeographical. Forest plans cover about 54% of the terrestrial area of Natura 2000 sites in Veneto, and 75% of Sites of Community Importance in the Alpine biogeographical region. At the local scale of analysis, metrics from forest plans represent a valuable historical record which can be used to interpret the current state and future trends, especially for forests with long management records. These data can be used to assess biodiversity indicators for the monitoring of Natura 2000 forest and non-forest habitats, in compliance with Article 17 of the Habitats Directive. Moreover, the heterogeneous stand conditions which are promoted by some forest management approaches can improve the conservation efforts for some habitats and species. The scale of local forest plans are typically the most appropriate for implementing habitat management strategies. From this study, we conclude that management authorities should take advantage of the wide spatial coverage and distribution of existing forest plans, especially in mountain areas inside and outside the Natura 2000 network, for the successful conservation of European Union habitats and species

Editorial: Non-native tree species: Impacts and management

2 p.Ministerio de Universidades e Investigación (Italia

Forest management plans as data source for the assessment of the conservation status of European Union habitat types

Natura 2000 is a European network of protected sites that should enable natural habitats to be maintained or restored at a favorable conservation status. Progress toward this objective must be periodically reported by states members of the European Union. We investigated how forest management plans might provide data to support the reporting. The study was done in the forests of the Dolomites and Venetian Prealps, Italy. Here, about 200 forest management plans, divided into several forest compartments, have been drawn up and revised every 10–15 years. Stand structure variables were retrieved from past (OR, 1970–1980) and more recent revisions (NR, 2000–2010) of 331 forest compartments ranging between 0.35 and 53.1 ha. In the beech and spruce forest habitat types (coded 9130 and 9410 in Annex I of the Directive 92/43/EEC, respectively), we found an increase from OR to NR in the density of large trees (from 32 to 46/ha and from 31 to 50/ha, respectively for the two habitats), basal area (from 27.3 to 31.5 m2/ha and from 31 to 34.5 m2/ha), mean diameter (from 34.1 to 36.2 cm and from 33.9 to 36 cm) and Gini index (from 0.35 to 0.37 and from 0.33 to 0.36). Pursuant to the Directive 92/43/EEC, the conservation status of these two habitat types should be taken as “favorable” with regards to the criterion related to the habitats’ specific structure and functions that are necessary for its long-term maintenance. We conclude that forest management plans provide a great portion of the information needed for assessing and monitoring the conservation status of forest habitat types in the Natura 2000 framework

Words apart: Standardizing forestry terms and definitions across European biodiversity studies

Forest biodiversity studies conducted across Europe use a multitude of forestry terms, often inconsistently. This hinders the comparability across studies and makes the assessment of the impacts of forest management on biodiversity highly context-dependent. Recent attempts to standardize forestry and stand description terminology mostly used a top-down approach that did not account for the perspectives and approaches of forest biodiversity experts. This work aims to establish common standards for silvicultural and vegetation definitions, creating a shared conceptual framework for a consistent study on the effects of forest management on biodiversity. We have identified both strengths and weaknesses of the silvicultural and vegetation information provided in forest biodiversity studies. While quantitative data on forest biomass and dominant tree species are frequently included, information on silvicultural activities and vegetation composition is often lacking, shallow, or based on broad and heterogeneous classifications. We discuss the existing classifications and their use in European forest biodiversity studies through a novel bottom-up and top-driven review process, and ultimately propose a common framework. This will enhance the comparability of forest biodiversity studies in Europe, and puts the basis for effective implementation and monitoring of sustainable forest management policies. The standards here proposed are potentially adaptable and applicable to other geographical areas and could be extended to other forest interventions. Forest management Multi-taxon Terminology Silviculture Data harmonizationpublishedVersio

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgery for Bismuth-Corlette Type 4 Perihilar Cholangiocarcinoma: Results from a Western Multicenter Collaborative Group

Background Although Bismuth-Corlette (BC) type 4 perihilar cholangiocarcinoma (pCCA) is no longer considered a contraindication for curative surgery, few data are available from Western series to indicate the outcomes for these patients. This study aimed to compare the short- and long-term outcomes for patients with BC type 4 versus BC types 2 and 3 pCCA undergoing surgical resection using a multi-institutional international database. Methods Uni- and multivariable analyses of patients undergoing surgery at 20 Western centers for BC types 2 and 3 pCCA and BC type 4 pCCA. Results Among 1138 pCCA patients included in the study, 826 (73%) had BC type 2 or 3 disease and 312 (27%) had type 4 disease. The two groups demonstrated significant differences in terms of clinicopathologic characteristics (i.e., portal vein embolization, extended hepatectomy, and positive margin). The incidence of severe complications was 46% for the BC types 2 and 3 patients and 51% for the BC type 4 patients (p = 0.1). Moreover, the 90-day mortality was 13% for the BC types 2 and 3 patients and 12% for the BC type 4 patients (p = 0.57). Lymph-node metastasis (N1; hazard-ratio [HR], 1.62), positive margins (R1; HR, 1.36), perineural invasion (HR, 1.53), and poor grade of differentiation (HR, 1.25) were predictors of survival (all p ≤0.004), but BC type was not associated with prognosis. Among the N0 and R0 patients, the 5-year overall survival was 43% for the patients with BC types 2 and 3 pCCA and 41% for those with BC type 4 pCCA (p = 0.60). Conclusions In this analysis of a large Western multi-institutional cohort, resection was shown to be an acceptable curative treatment option for selected patients with BC type 4 pCCA although a more technically challenging surgical approach was required

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide