Global COVID-19 lockdown highlights humans as both threats and custodians of the environment

The global lockdown to mitigate COVID-19 pandemic health risks has altered human interactions with nature. Here, we report immediate impacts of changes in human activities on wildlife and environmental threats during the early lockdown months of 2020, based on 877 qualitative reports and 332 quantitative assessments from 89 different studies. Hundreds of reports of unusual species observations from around the world suggest that animals quickly responded to the reductions in human presence. However, negative effects of lockdown on conservation also emerged, as confinement resulted in some park officials being unable to perform conservation, restoration and enforcement tasks, resulting in local increases in illegal activities such as hunting. Overall, there is a complex mixture of positive and negative effects of the pandemic lockdown on nature, all of which have the potential to lead to cascading responses which in turn impact wildlife and nature conservation. While the net effect of the lockdown will need to be assessed over years as data becomes available and persistent effects emerge, immediate responses were detected across the world. Thus, initial qualitative and quantitative data arising from this serendipitous global quasi-experimental perturbation highlights the dual role that humans play in threatening and protecting species and ecosystems. Pathways to favorably tilt this delicate balance include reducing impacts and increasing conservation effectiveness.

A Gulf in lockdown: How an enforced ban on recreational vessels increased dolphin and fish communication ranges

From midnight of 26 March 2020, New Zealand became one of the first countries to enter a strict lockdown to combat the spread of COVID-19. The lockdown banned all non-essential services and travel both on land and sea. Overnight, the country's busiest coastal waterway, the Hauraki Gulf Marine Park, became devoid of almost all recreational and non-essential commercial vessels. An almost instant change in the marine soundscape ensued, with ambient sound levels in busy channels dropping nearly threefold the first 12 h. This sudden drop led fish and dolphins to experience an immediate increase in their communication ranges by up to an estimated 65%. Very low vessel activity during the lockdown (indicated by the presence of vessel noise over the day) revealed new insights into cumulative noise effects from vessels on auditory masking. For example, at sites nearer Auckland City, communication ranges increased approximately 18 m (22%) or 50 m (11%) for every 10% decrease in vessel activity for fish and dolphins, respectively. However, further from the city and in deeper water, these communication ranges were increased by approximately 13 m (31%) or 510 m (20%). These new data demonstrate how noise from small vessels can impact underwater soundscapes and how marine animals will have to adapt to ever-growing noise pollution.

Long-term changes in the breeding period diet of Bonelli

Context Dietary analyses are essential to achieve a better understanding of animal ecology. In the case of endangered species, assessing dietary requirements is crucial to improve their management and conservation. The Bonelli’s eagle (Aquila fasciata) has experienced a severe decline throughout its breeding range in Europe and, in Italy, fewer than 50 pairs remain, and only in Sicily. This species is subject to major threats, including changes in landscape composition and, consequently, prey availability, which is further aggravated by the occurrence of viral diseases in the case of rabbits. Aims To provide current data on the diet of the Bonelli’s eagle in Sicily during the breeding period and to examine dietary shifts with regard to previous studies conducted in the same study area. To discuss possible implications for conservation of the Italian population of this endangered species. Methods We used a combination of three methods, including pellet analysis, collection of prey remains, and imagery from camera-traps installed at nests, to examine the diet of 12 breeding pairs of Bonelli’s eagle from 2011 to 2017. We compared this information with data collected between 1993 and 1998 in the same study area. Key results In number, birds were the most frequently predated items (61.6%), followed by mammals (36.88%) and reptiles (1.52%). However, in terms of biomass, mammals were the main prey (65.71%), followed by birds (34.12%) and reptiles (0.17%). There was a decrease over the course of the current decade in the consumption of European wild rabbit (Oryctolagus cuniculus), which was compensated for with an increase in both dietary diversity and breadth in bird consumption, a trend not observed in the earlier study in the same region. Conclusions Here, we provide an updated assessment of diet composition of Bonelli’s eagle during the breeding period. Interestingly, we found significant differences within the study period (2011–2017) in terms of frequency of occurrence, percentage of biomass, dietary diversity and dietary breadth in a species at risk. Furthermore, we found significant differences between the two study periods in both frequency and percentage of biomass, with significant changes in the consumption of lagomorphs and birds. Implications Our results indicated that shifts in the diet are linked to changes in prey abundance, which may be contributing to population declines in the Bonelli’s eagle population in Sicily. Overall, measures aimed at increasing main dietary prey should be promoted to favour occupation of new territories and enhance vital demographic parameters (i.e. breeding success and survival rate) of Bonelli’s eagle across the species range. This would be particularly important for small isolated populations such as the Sicilian one.

Training in Colposcopy: Experience with a Videocolposcopy Test

The authors evaluate the results of a videocolposcopy test (330 total cases, 12 cases of histologically confirmed CIN2 or more severe lesions) taken by 9 accredited and 17 unaccredited colposcopists during 1995. Seven of 9 accredited and 4 of 13 unaccredited colposcopists reached the requested standard (sensitivity >90%, biopsy rate «60%). Performance was definitely better when the test was not blind to the cytologic report (4 of 13 reached the requested standard) with respect to blind reading (none of 17). The study confirmed that colposcopy at unaccredited practices is poorly accurate. Colposcopy assessment of patients with abnormal smears should be centralized in accredited practices, which should undergo periodic quality control to guarantee screening efficacy. Tape-recorded videocolposcopy tests are a good, simple, practical and inexpensive method for interobserver quality control of colposcopic performance.

[The influence of Cytoflavin therapy on the cerebral hemodynamics in patients with various stages of hypertensive disease]

AIM

To study an influence of cytoflavin therapy on the cerebral hemodynamics in patients with various stages of hypertensive disease (HD).

MATERIAL AND METHODS

One hundred and forty patients with HD, I-III stages, were randomized into 2 groups: patients of group 1 received complex treatment (antihypertensive therapy and cytoflavin), patients of group 2 were treated with antihypertensive therapy. The control group consisted of 30 healthy people. The changes in cerebral hemodynamics using the algorithm of the complex ultrasound study of cerebral vascular system were assessed.

RESULTS

Disturbances of hemodynamics at all structural/functional levels of cerebral vascular system were found in all HD stages. There were a decrease in the blood flow through the common carotid, inner carotid, spinal and middle cerebral arteries, reactivity of veins of Rosenthal, blood flow through veins of Rosenthal and inner jugular veins and an increase of blood flow through spinal veins. The hemodynamic study showed that in group 1 there was the increase of blood flow through common carotid, inner carotid, middle cerebral arteries in stage I and through spinal arteries in stage I-II of HD; improvement of the reactivity of veins of Rosenthal, restoration of blood flow parameters through the veins of Rosenthal and inner jugular veins to control values, the decrease in blood flow velocity through the spinal veins in all HD stages.

CONCLUSION

HD is accompanied by the damage of all structural/functional levels of cerebral vascular system. The use of cytoflavin in the complex therapy of HD exerts a positive influence on the cerebral hemodynamics reducing the severity of arterial insufficiency in the initial stages of disease, improving microcirculation and venous hemodynamics in all HD stages.

Cold storage of Acartia tonsa eggs: a practical use in ecotoxicological studies

The calanoid copepod Acartia tonsa has been recommended as a marine organism for ecotoxicological tests due to its wide distribution, short life cycle and high productivity. This species is used in acute and chronic toxicity tests to assess water and sediment quality; egg hatching success and the survival of the first larval stages are considered endpoints. Toxicity test protocols require a large number of organisms and an appropriate culture system. Eggs stored under conditions that delay hatching could ensure sufficient quantities of biological materials for ecotoxicological tests. In the current study early-spawned eggs were stored at 3 °C (±1) up to 240 days and their hatching success was evaluated on a monthly basis. Our results showed that the percentage of hatching success for eggs stored for 30 days was >80 % and decreased by about 8 % for every 20 days of storage, up to 120 days. A further increase of time in cold storage brought about a significant reduction, in statistical term, of hatching success compared with the control group (43.69 ± 22.19 %). Almost 50 % of eggs hatched or died during the cold storage period, with more than 80 % lost after periods longer than 150 days. To verify the suitability of stored eggs for toxicity test, 48 h acute tests were performed using nickel chloride as a referent toxicant. Eggs stored for 30, 60, 90 and 120 days gave EC50 values ranging from 0.130 to 0.221 mg L(-1), similar to the value recorded for early-spawned eggs, suggesting that these eggs can be used for ecotoxicological tests. Our results open new possibilities for a wider use of the Mediterranean strain of A. tonsa copepod for ecotoxicological tests.

Diagnosis and treatment of primary lymphedema. Consensus document of the International Union of Phlebology (IUP)-2013

Primary lymphedema can be managed effectively as a form of chronic lymphedema by a sequenced and targeted treatment and management program based around a combination of Decongestive Lymphatic Therapy (DLT) with compression therapy, when the latter is desired as an adjunct to DLT. Treatment in the maintenance phase should include compression garments, self-management, including self-massage, meticulous personal hygiene and skin care, in addition to lymphtransport-promoting excercises and activities, and, if desired, pneumatic compression therapy applied in the home. When conservative treatment fails, or gives sub-optimal outcomes, the management of primary lymphedema can be improved, where appropriate, with the proper addition of surgical interventions, either reconstructive or ablative. These two surgical therapies can be more effective when fully integrated with manual lymphatic drainage (MLD)-based DLT postoperatively. Compliance with a long-term commitment to MLD/DLT and particularly compression postoperatively is a critical factor in determining the success of any new treatment strategy involving either reconstructive or palliative surgery. The future of management of primary lymphedema has never been brighter with the new prospect of gene-and perhaps stem-cell oriented management.

Sustainability evaluation of Sicily's lemon and orange production: an energy, economic and environmental analysis

The island of Sicily has a long standing tradition in citrus growing. We evaluated the sustainability of orange and lemon orchards, under organic and conventional farming, using an energy, environmental and economic analysis of the whole production cycle by using a life cycle assessment approach. These orchard systems differ only in terms of a few of the inputs used and the duration of the various agricultural operations. The quantity of energy consumption in the production cycle was calculated by multiplying the quantity of inputs used by the energy conversion factors drawn from the literature. The production costs were calculated considering all internal costs, including equipment, materials, wages, and costs of working capital. The performance of the two systems (organic and conventional), was compared over a period of fifty years. The results, based on unit surface area (ha) production, prove the stronger sustainability of the organic over the conventional system, both in terms of energy consumption and environmental impact, especially for lemons. The sustainability of organic systems is mainly due to the use of environmentally friendly crop inputs (fertilizers, not use of synthetic products, etc.). In terms of production costs, the conventional management systems were more expensive, and both systems were heavily influenced by wages. In terms of kg of final product, the organic production system showed better environmental and energy performances.

Treatment of chronic venous disease with flavonoids: recommendations for treatment and further studies

OBJECTIVES

A variety of studies have suggested that flavonoids are effective for the treatment of CVD. However, many questions remain about their mechanism of action and when, how, and for what signs and symptoms they should be used.

METHOD

A panel of experts in CVD met in Budapest, Hungary in December 2011 to discuss the current state of knowledge of CVD and the role of flavonoids in its treatment. The discussion was based on a literature search in the current databases. The goals of this paper are recommendations for further studies on the use of flavonoids in the treatment of CVD.

RESULTS

There is good evidence to recommend the use of flavonoids in the treatment of CVD. However, because of the poor quality of some older clinical trials, inadequate reporting, and insufficient information, much work is still needed to firmly establish their clinical efficacy and to determine when and how they should be employed. In particular, long-term randomized, placebo-controlled, double-blind studies are needed to establish the efficacy and safety of flavonoids. Additional studies are also needed to establish their mechanism of action, pharmacokinetics, toxicity, and cost-effectiveness.

CONCLUSIONS

Aside from good evidence for the use of flavonoids in CVD further studies are indicated to establish long term treatment in this indication.

Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program

AIM

The Vein Consult Program is an international, observational, prospective survey aiming to collect global epidemiological data on chronic venous disorders (CVD) based on the CEAP classification, and to identify CVD management worldwide. The survey was organized within the framework of ordinary consultations, with general practitioners (GPs) properly trained on the use of the CEAP classification.

METHODS

Screening for CVD was to be performed by enrolling in the survey all consecutive outpatients >18 years whatever the reason for consultation, to record patient's data and classify them according to the CEAP, from the stage C0s to C6. The program enrolled 6232 GPs 91545 subjects were analysed. Their mean age was 50.6±16.9 years, younger patients being in the Middle East and older ones in Europe, and the proportion of women was higher than that of men.

RESULTS

The worldwide prevalence of CVD was 83.6%: 63.9% of the subjects ranging C1 to C6, and 19.7% being C0s subjects. C0s patients were more frequently men whatever the age and the geographical zone. C1-C3 appeared to be more frequent among women whatever the country but the rate of severe stages (C4-C6) did not differ between men and women. GPs consider CVD subjects as patients eligible to specialist referral beginning from C2 but some geographical disparities were observed.

CONCLUSION

The VCP survey provides reliable results on CVD global epidemiology and shows that CVD affects a significant part of the populations worldwide, underlining the importance of adequate screening for CVD and training of both GPs and specialist physicians.

Microphthalmia due to congenital varicella infection: a case report

The authors report the clinical case of a newborn affected by congenital varicella syndrome, occurred about the 12th gestational week, with ophthalmic involvement. The ocular anomalies consisted in right microphthalmia, with lens opacities and atrophic chorioretinitis, without any involvement of other pathologies. The ophthalmic lesions and the sierological data confirmed that the infection occurred during the first weeks of gestation. Although the manifestation limited to the eyes is extremely rare, the authors point out the necessity of an appropriate prevention to avoid irreversible involvements of important organs.

Ophthalmological manifestations in segmental neurofibromatosis type 1

AIMS

To study the ophthalmological manifestations in individuals with the typical features of neurofibromatosis type 1 (NF1) circumscribed to one or more body segments, usually referred to as segmental NF1.

METHODS

Visual acuity and colour tests, visual field examination, slit lamp biomicroscopy of the anterior segment, and a detailed examination of the retina by indirect ophthalmoscopy were performed at diagnosis and follow up in 72 consecutive subjects (29 males, 43 females; aged 1-64 years; mean age 14.6 years) seen at the university departments of paediatrics in Catania and Rome, Italy, during years 1990-2003, who had in restricted body areas: (1) typical pigmentary manifestations of NF1 (cafe au lait spots and freckling) only (n = 48); (2) NF1 pigmentary manifestations and neurofibromas alone (n = 2); (3) neurofibromas only (n = 15); and (4) plexiform neurofibromas only (n = 7).

RESULTS

None of the 72 patients had Lisch nodules in the iris irrespective of age at eye examination or hypertelorism (a "minor" NF1 feature) and none developed typical associated ophthalmological NF1 complications. An additional child had an isolated optic pathways glioma (OPG), which behaved both biologically and radiographically as an NF1 associated OPG.

CONCLUSIONS

This represents the first systematic study reporting on eye involvement in the largest series of individuals at different ages having segmental NF1. As one of the postulated mechanisms to explain segmental NF1 is somatic mosaicism for the NF1 gene (so far demonstrated only in two patients) the present findings could be explained either by the fact that the eye is too far from the mutated area with NF1 lesions in most cases or by the NF1 (or other "predisposing" or "cooperating") gene mutation restricted to too few cellular clones or to tissues embryologically different from the eye.

The incidence of venous disease in Brazil based on the CEAP classification

BACKGROUND

Venous disease presents an extremely complex problem with various clinical manifestations. This is an epidemiological study of venous disease as it occurs in an area of Brazil. For the first time in Brazil the CEAP classification is used.

METHODS

A total of 2104 people, were randomly recruited at the registration desks of the General Policlinic Department of the University Hospital and public health centers. The "C" of the CEAP classification was used to classify the clinical features of the venous diseases. The subjects were categorized according to sex and age. In addition, women were also subdivided according to number of their pregnancies.

RESULTS

In the age group of females aged 14 to 22, we found 46.42% without symptoms and obvious veins (CEAP 0A/0A). Only 12.29% were symptomatic, and 41.25% of all patients in this group presented with visible veins or telangiectasias, though without symptoms. In the age group of women ranging from 23 to 48, 66.47% had had up to 3 pregnancies. In this group 10.43% were (CEAP 0A/0A). Those who had symptoms with prominent veins totaled 37.53% and those who presented with prominent veins without symptoms, 51.83%. In the female group over 48 years of age, only 4.67% were (CEAP 0A/0A). The majority (62.79%) had symptoms and prominent veins. In the male group, the greater part (65.54%) was (CEAP 0A/0A). Only 13.97% were considered symptomatic with some kind of prominent veins.

CONCLUSIONS

This large epidemiological study is the first in Brazil to validate the CEAP classification as an important tool in the epidemiology of venous pathology: a method allowing an objective approach to venous disease. The data in this study were similar to those of western countries. Venous disease was found to be much more frequent in females than males. Age and number of pregnancies are important factors in the development of the disease. Over 50% of young women presented with visible veins in their legs but were without symptoms and this was considered a purely esthetic problem.

[Incidence of ROP (Retinopathy of Prematurity) in hypoxemic neonates: case contribution]

In this retrospective study the Authors correlated the hypoxia with the severity of retinopathy of prematurity (ROP) in a population of 683 outborn preterm infants (bw < 2500 g and gestational age < 38 weeks). They excluded all cases with specific pathological conditions. Among neonates with the same gestational age the incidence of ROP was higher (p < .05) in those with hypoxia (pH < 7.25, tcPO2 < 50 mmHg). These data suggest that hypoxia plays a role in the pathogenesis of ROP.

SHORT syndrome: a new case with probable autosomal dominant inheritance

A further case of SHORT syndrome is reported. This 9-year-old Italian boy was short of stature and had partial lipodystrophy, minor facial anomalies, mild hyperextensibility of joints, ocular depression, Rieger anomaly, delay in speech development and in dental eruption. The father and sister showed a striking similarity to the propositus. Moreover, the sister had bilateral and symmetrical lens opacities, which have not been reported previously in affected subjects or their relatives. A variable expression of an autosomal dominant gene can be considered in the present family.

Carbohydrate deficient glycoprotein syndrome type I: ophthalmic aspects in four Sicilian patients

Four patients with carbohydrate deficient glycoprotein (CDG) syndrome type I underwent ophthalmic examination. All of them had retinitis pigmentosa with extinguished scotopic electroretinogram. The importance of CDG syndromes as one of the metabolic causes of retinal dystrophy with 'bony spicule' pigment is stressed.

[Variations of blood bilirubin levels in the newborn with and without retinopathy of prematurity (ROP)]

Retinopathy of prematurity (ROP) is a multifactorial disease where production of free radicals is a pathogenic factor. Bilirubin is regarded today as the most powerful antioxidant substance "in vitro". To test such effect "in vivo" we studied 219 premature infants, admitted to our Neonatal Intensive Case Unit from April 1991 to October 1992, evaluating their serum bilirubin levels from day two to seven and mean bilirubin level of first week for each child. We also calculated the mean rate of daily increase of bilirubin. Our results show that bilirubin parameters considered are higher in neonates which will develop ROP of every stage than in the control ones. These results therefore do not support the concept that bilirubin could have a role in the prevention of ROP.

[Epidemiological,and physiopathological findings in retinopathy of prematurity: the authors' personal cases]

The authors present a retrospective epidemiological study on retinopathy of prematurity (ROP), performed on 738 newborns with a gestational age of 34 +/- 2.41 weeks and birth weight of 1971 +/- 351 g. They excluded all cases with severe respiratory distress and other pathological conditions. First stage of ROP shows no correlation with gestational age and birth weight, whereas second and third stages of ROP show an inverse correlation with the above mentioned factors, particularly birth weight. Among neonates with the same gestational age, the incidence of ROP is higher in those "small for date". Regarding the pathogenesis of ROP, the authors outline the importance of perinatal hypoxia.

Subclinical vulvar papillomavirus infection

Eighty-eight cases of subclinical human papillomavirus (HPV) vulvar infection were detected in a consecutive colposcopic series of 968 women. Three patterns of acetowhite lesions had a 72% predictive value (88/122) for histologically assessed HPV. The prevalence of subclinical vulvar HPV in self-referred patients was 7.9% (73/918); it was 9% (88/968) in the overall series and significantly higher in younger patients (age less than 25 years: 21/106, or 19.8%) or in those with cervical HPV or cervical intraepithelial neoplasia (CIN) (40/100, or 40%). Routine inspection of the vulva after acetic acid lavage in association with a Papanicolaou test might help identify Papanicolaou-test-negative patients at high risk of developing cervical HPV or CIN. Treatment with beta-interferon (2,000,000 IU daily intramuscularly for 10 days) was given to 30 consecutive patients, but the results were poor: regression was observed in only 2 cases.

Routine colposcopic survey of patients with squamous atypia. A method for identifying cases with false-negative smears

Routine colposcopy was performed on 376 women with cervical squamous atypia (originally reported as "inflammatory atypia"). Colposcopy showed no abnormalities in 240 cases and a lesion in 136 cases; the latter were sampled by colposcopy-guided biopsy. The biopsy samples showed evidence of human papillomavirus (HPV) infection and/or grade I cervical intraepithelial neoplasia (CIN I) in 42 cases (11.1%), CIN II in 4 cases (1.1%) and CIN III in 5 cases (1.3%); the other 85 biopsied cases were histologically negative. Most cases of HPV/CIN I (35 of 42) and all of the cases of CIN II-III occurred in women under the age of 40. The detection rates were 4.4% for CIN II-III in women under the age of 40, 4.0% for HPV/CIN I in women 40 and older and 17.2% for HPV/CIN I in women under the age of 40 (P less than .001). It thus appears that women under the age of 40 who show cytologic evidence of squamous atypia would benefit from colposcopic examination.

Retinopathy of prematurity (ROP): optimal timing of clinical evaluation and standard procedures

The authors present the protocol currently used in their institution for initial and follow-up evaluation of infants at high risk for developing retinopathy of prematurity (ROP). After topical anesthesia and lid speculum insertion, the examination is carried out using an indirect binocular ophthalmoscope with a +20 or +28-diopter lens. Mydriasis is achieved by instilling one drop of 1% tropicamide, followed by one drop of 0.5% tropicamide + 2.5% phenylephrine 15 minutes later and after an additional 15 minute interval, another drop of 1% tropicamide. If mydriasis is insufficient after one hour, one drop of a 0.5% tropicamide-5.0% phenylephrine solution may be instilled. The initial examination is performed between the third and fourth weeks of life. If any areas of retinal immaturity are found, the examination is repeated every other week and, later, every three to four weeks, until vascularization has reached the ora serrata. Should any sign of ROP be present during the first examination, the patient is examined weekly or every other week depending on the severity of clinical findings.

[Platelet factor 4 levels in full-term newborns undergoing phototherapy]

PF4 levels and platelets counts were studied in a group of 15 term newborn infants before treatment and after 24-48-72 and 96 hours of phototherapy and in a control group of 10 babies. Unlike data found by other AA. in vitro and in preterm infants, our values show only minimal, not statistically significant, differences in PF4 levels and platelets counts between the two groups. The AA. believe that in term infants, with adequate weight for gestational age, proper phototherapy treatment does not cause any change in platelet function, owing to the thicker and more mature skin and to the better bone marrow compensation typical of term versus preterm infants.

Urethral cytology of Cytobrush specimens. A new technique for detecting subclinical human papillomavirus infection in men

Cytologic examination of urethral smears prepared with the Cytobrush and colposcopic examination of the penis were performed in 53 male partners of women with cervical human papillomavirus (HPV) infections and in 14 healthy controls. A diagnosis of HPV infection was recorded in 28 subjects (52.8%). Cytology was positive in 26 cases (49%) and colposcopy was positive in 5 cases, with both tests positive in 3 cases. No controls were positive by cytology or colposcopy. These findings suggest that urethral cytology and colposcopic examination should be routinely performed in partners of women with HPV infections to detect inapparent infections. The Cytobrush should be employed for the urethral cytologic sampling; smears prepared by other techniques (urine collection or urethral swabbing) yield lower detection rates.