Factors related to longevity and mortality of dogs in Italy.

Besides its translational value, an improved understanding of dog longevity and mortality is necessary to guide health management decisions, breed selection, and improve dog welfare. In order to analyse the lifespan of dogs in Italy, identify the most common causes of death, and evaluate possible risk factors, anonymised medical records were collected from 9 veterinary teaching hospitals and 2 public health institutions. Data regarding breed, sex, neuter status, age, diagnosis, and mechanism of death were retrieved. Cause of death (COD) was classified by pathophysiologic process (PP) and organ system (OS). Of the 4957 dogs that died between 2004 and 2020 included in the study, 2920 (59.0%) were purebred, 2293 (46.2%) were female, 3005 (60.6%) were intact, 2883 (58.2%) were euthanised. Overall median longevity was 10.0 years. Median longevity was significantly longer for crossbreds, females, neutered dogs, and small-sized breeds. The breeds with the highest median age at death were the Yorkshire terrier, English cocker spaniel, West Highland white terrier, Italian volpino, and Shih Tzu, whilst the American bulldog, English bulldog, American pit bull terrier, Bernese mountain dog and the Maremma and the Abruzzes sheepdog had the lowest median age at death. The most frequent COD by PP was neoplasia (34.0%), which occurred more frequently in large breeds, namely German shepherd, Labrador retriever and Boxer. Degenerative diseases mostly affected small-sized dogs like Miniature pinscher and Dachshund. Regarding the OS involved, diseases of the renal/urinary system were most frequently responsible for COD (15.0%), prevalently degenerative and inflammatory/infectious. Substantial variation in median longevity according to causes of death by PP and OS was observed. These data are relevant for breeders, veterinary practitioners, and owners, to assist breed selection, facilitate early diagnosis, guide choice when purchasing a purebred dog and making health management decisions, and ultimately improve dog welfare.

Effect of a quality improvement program on compliance to the sepsis bundle in non-ICU patients: a multicenter prospective before and after cohort study.

Objective: Sepsis and septic shock are major challenges and economic burdens to healthcare, impacting millions of people globally and representing significant causes of mortality. Recently, a large number of quality improvement programs focused on sepsis resuscitation bundles have been instituted worldwide. These educational initiatives have been shown to be associated with improvements in clinical outcomes. We aimed to evaluate the impact of a multi-faceted quality implementing program (QIP) on the compliance of a "simplified 1-h bundle" (Sepsis 6) and hospital mortality of severe sepsis and septic shock patients out of the intensive care unit (ICU). Methods: Emergency departments (EDs) and medical wards (MWs) of 12 academic and non-academic hospitals in the Lombardy region (Northern Italy) were involved in a multi-faceted QIP, which included educational and organizational interventions. Patients with a clinical diagnosis of severe sepsis or septic shock according to the Sepsis-2 criteria were enrolled in two different periods: from May 2011 to November 2011 (before-QIP cohort) and from August 2012 to June 2013 (after-QIP cohort). Measurements and main results: The effect of QIP on bundle compliance and hospital mortality was evaluated in a before-after analysis. We enrolled 467 patients in the before-QIP group and 656 in the after-QIP group. At the time of enrollment, septic shock was diagnosed in 50% of patients, similarly between the two periods. In the after-QIP group, we observed increased compliance to the "simplified rapid (1 h) intervention bundle" (the Sepsis 6 bundle - S6) at three time-points evaluated (1 h, 13.7 to 18.7%, p = 0.018, 3 h, 37.1 to 48.0%, p = 0.013, overall study period, 46.2 to 57.9%, p < 0.001). We then analyzed compliance with S6 and hospital mortality in the before- and after-QIP periods, stratifying the two patients' cohorts by admission characteristics. Adherence to the S6 bundle was increased in patients with severe sepsis in the absence of shock, in patients with serum lactate <4.0 mmol/L, and in patients with hypotension at the time of enrollment, regardless of the type of admission (from EDs or MWs). Subsequently, in an observational analysis, we also investigated the relation between bundle compliance and hospital mortality by logistic regression. In the after-QIP cohort, we observed a lower in-hospital mortality than that observed in the before-QIP cohort. This finding was reported in subgroups where a higher adherence to the S6 bundle in the after-QIP period was found. After adjustment for confounders, the QIP appeared to be independently associated with a significant improvement in hospital mortality. Among the single S6 procedures applied within the first hour of sepsis diagnosis, compliance with blood culture and antibiotic therapy appeared significantly associated with reduced in-hospital mortality. Conclusion: A multi-faceted QIP aimed at promoting an early simplified bundle of care for the management of septic patients out of the ICU was associated with improved compliance with sepsis bundles and lower in-hospital mortality.

World Organisation for Animal Health Members' Capacity to Deal With Animal Welfare Emergencies During Natural Disasters in Europe.

OBJECTIVE: Little is known about individual European countries or regional capacity to respond to animal welfare emergencies during natural disasters; therefore, it is important to establish baseline information (eg, types of disasters, training) to enable more focused and data-driven actionable support for future disasters. METHODS: A 55-question survey was distributed by an email link to the 53 World Organisation for Animal Health (WOAH) European Region Members plus 1 observer country. RESULTS: Forty-nine countries (91%, n = 54) responded to the survey. Fifty-one percent (25/49) indicated they incorporated animal welfare into their national disaster regulatory framework, whereas 59% (29/49) indicated animal welfare was incorporated in the Veterinary Service National Disaster Management and Risk Reduction Plan. Thirty-nine percent (19/49) indicated they had "no" or "limited" legal authority to manage animal emergencies in natural disasters. Floods, forest fires, and snowstorm/extreme cold were the 3 most commonly reported disasters over the last 10 years with 79% (27/34) reporting Veterinary Services was involved in managing these disasters. CONCLUSION: The survey results indicated a wide range in the capacity of WOAH European Member Countries to respond to animal welfare in natural disasters, highlighting the gaps and potential areas of improvement in this arena.

Detection of Potential Zoonotic Agents Isolated in Italian Shelters and the Assessment of Animal Welfare Correlation with Antimicrobial Resistance in Escherichia coli Strains.

Welfare conditions in shelters, where dogs might be housed for a long period of time, may have a possible correlation with the occurrence of bacterial pathogens and their antimicrobial resistance (AMR). In this study, we assessed the occurrence of AMR in 54 strains of Escherichia coli isolated from dogs housed in 15 Italian shelters and we correlated the resistance patterns to animal welfare. We also aimed to evaluate the presence of specific pathogens with zoonotic potential in sheltered dogs. Thus, nasopharyngeal, rectal, and oral swabs were collected from a group of 20 dogs in each shelter and totaled 758 swabs. We identified 9 Staphylococcus pseudointermedius, 1 Pasteurella multocida, 9 Staphylococcus aureus, 12 Campylobacter spp., 54 Escherichia coli, 2 Salmonella enterica, and 246 Capnocytophaga spp. The antimicrobial susceptibility was assessed for the E. coli isolates using a panel of 14 antibiotics. The highest level of relative AMR was recorded for ampicillin and sulfamethoxazole. The association found between AMR and the levels of animal welfare scores in shelters was evident although not statistically significant. These results support the hypothesis that the good management of shelters can increase the level of animal welfare, thus reducing the use of antibiotics and, as a consequence, the AMR occurrence found in dogs that share their domestic environment with humans.

A Hybrid Model for 30-Day Syncope Prognosis Prediction in the Emergency Department.

Syncope is a challenging problem in the emergency department (ED) as the available risk prediction tools have suboptimal predictive performances. Predictive models based on machine learning (ML) are promising tools whose application in the context of syncope remains underexplored. The aim of the present study was to develop and compare the performance of ML-based models in predicting the risk of clinically significant outcomes in patients presenting to the ED for syncope. We enrolled 266 consecutive patients (age 73, IQR 58-83; 52% males) admitted for syncope at three tertiary centers. We collected demographic and clinical information as well as the occurrence of clinically significant outcomes at a 30-day telephone follow-up. We implemented an XGBoost model based on the best-performing candidate predictors. Subsequently, we integrated the XGboost predictors with knowledge-based rules. The obtained hybrid model outperformed the XGboost model (AUC = 0.81 vs. 0.73, p < 0.001) with acceptable calibration. In conclusion, we developed an ML-based model characterized by a commendable capability to predict adverse events within 30 days post-syncope evaluation in the ED. This model relies solely on clinical data routinely collected during a patient's initial syncope evaluation, thus obviating the need for laboratory tests or syncope experienced clinical judgment.

Campylobacter and risk factors associated with dog ownership: a retrospective study in household and in shelter dogs.

Campylobacteriosis has been the most frequently reported zoonotic disease in humans in Europe. The scientific literature has reported that the role of dogs may be relevant. The objectives of this work are to improve the knowledge about Campylobacter spp. carriage, infection and antimicrobial resistance in household and shelter dogs in Italy, and to assess risk factors at the dog/human interface. During the 2015­2016 period, rectal swabs were collected from 431 household vet­visiting dogs and 173 dogs housed in shelters. A total of 3 veterinary clinics, located in three Italian regions (Abruzzo, Molise and Tuscany) and 10 shelters, five in Abruzzo and five in Molise, were included in the study. Relevant risk factors for the transmission of Campylobacter spp. from dogs to humans were assessed by means of a questionnaire administered to owners of household dogs. For Campylobacter spp. isolation, selective cultivation methods were used, followed by confirmation and species identification with the PCR method. Phenotypic antibiotic resistance profiles assayed using antimicrobial susceptibility testing were combined. Campylobacter spp. were isolated from 9 household dogs (2.1% CI 1.1% ­ 3.9%) and from 13 shelter dogs (7.5 % CI 4.5% ­ 12.4%). In household dogs C. jejuni was the most represented species (0.9%). In shelter dogs, the most common species was C. jejuni (5.2%). Campylobacter spp. isolates were resistant to ciprofloxacin (22.73%), nalidixic acid (22.73%), tetracyclines (27.27%), streptomycin (9.09%) and erythromycin (4.55%). The main C. jejuni Clonal Complex identified in dogs were CC21, CC45, CC206, CC403, CC42 and CC658. The risk of contracting Campylobacteriosis from dogs remains a concrete reality. This risk is increased in the presence of common habits, as shown by the data from the questionnaire. Prevalence control of Campylobacter spp. in household and shelter dogs would be important in order to reduce the transmission to humans.

Population dynamics of free-roaming dogs in two European regions and implications for population control.

Changes in free-roaming dog population size are important indicators of the effectiveness of dog population management. Assessing the effectiveness of different management methods also requires estimating the processes that change population size, such as the rates of recruitment into and removal from a population. This is one of the first studies to quantify the size, rates of recruitment and removal, and health and welfare status of free-roaming dog populations in Europe. We determined the size, dynamics, and health status of free-roaming dog populations in Pescara, Italy, and Lviv, Ukraine, over a 15-month study period. Both study populations had ongoing dog population management through catch-neuter-release and sheltering programmes. Average monthly apparent survival probability was 0.93 (95% CI 0.81-1.00) in Pescara and 0.93 (95% CI 0.84-0.99) in Lviv. An average of 7 dogs km-2 were observed in Pescara and 40 dogs km-2 in Lviv. Per capita entry probabilities varied between 0.09 and 0.20 in Pescara, and 0.12 and 0.42 in Lviv. In Lviv, detection probability was lower on weekdays (odds ratio: 0.74, 95% CI 0.53-0.96) and higher on market days (odds ratio: 2.58, 95% CI 1.28-4.14), and apparent survival probability was lower in males (odds ratio: 0.25, 95% CI 0.03-0.59). Few juveniles were observed in the study populations, indicating that recruitment may be occurring by movement between dog subpopulations (e.g. from local owned or neighbouring free-roaming dog populations), with important consequences for population control. This study provides important data for planning effective dog population management and for informing population and infectious disease modelling.

Attitudes towards free-roaming dogs and dog ownership practices in Bulgaria, Italy, and Ukraine.

Free-roaming dog population management is conducted to mitigate risks to public health, livestock losses, wildlife conservation, and dog health and welfare. This study aimed to determine attitudes towards free-roaming dogs and their management and describe dog ownership practices in three European countries. We distributed an online questionnaire comprising questions relating to dog ownership practices and attitudes towards free-roaming dogs using social media. We used logistic regression and ordinal probit models to determine associations between demographic and other factors with ownership practices and attitudes towards free-roaming dogs. This study found that most surveyed respondents wanted to see a reduction in free-roaming dog numbers, and felt that this should be achieved through sheltering, catch-neuter-release, and by controlling owned dog breeding. We identified significant associations between both attitudes and ownership practices with gender, religious beliefs, age, education level, reason for dog ownership, previous experience with free-roaming dogs, and country of residence. Respondents who identified as: (i) male, (ii) holding religious beliefs, (iii) owning dogs for practical reasons, (iv) being young, or (v) having no schooling or primary education had a lower probability of neutering and a higher probability of allowing dogs to roam. Respondents who identified as: (i) female, (ii) feeling threatened by free-roaming dogs, (iii) older, or (iv) having more education had a higher probability of answering that increases in free-roaming dog numbers should be prevented. These findings can help to inform future dog population management interventions in these countries. We emphasise the importance of considering local attitudes and dog ownership practices in the development of effective dog population management approaches.

Using vital signs measurements to identify patients with COVID-19 who require early continuous positive airway pressure.

BACKGROUND: The coronavirus disease 2019 (COVID-19) can result in severe pneumonia, leading to acute respiratory distress syndrome, which are treated using continuous positive airway pressure (CPAP). Patients must be evaluated quickly to commence early CPAP if required. AIM: To identify patients with COVID-19 in the emergency department (ED) who require early CPAP, using vital signs measurements during triage. METHOD: This was a retrospective, observational, single-centre cohort study of patients with COVID-19 admitted to the ED of a university hospital in Lombardy, Italy, between 21 February 2020 and 30 April 2020. These patients were divided into two groups: those who required CPAP and those did not require CPAP. Recordings of their vital signs were retrieved from triage medical records. The vital signs values recorded in the two groups on their arrival at the ED were compared. RESULTS: Of 601 patients, 120 (20%) required CPAP. It was identified that the typical characteristics of patients requiring early CPAP were: male (P=.013) with a median age of 68 years (P=.000), oxygen saturation of 92% (P=.000), temperature ≥38°C (P=.008), respiratory rate of 26 breaths per minute (P=.000) and had received pre-hospital oxygen therapy before arriving at the ED (P=.000). The CPAP group was divided into two subgroups: patients who had received pre-hospital oxygen therapy and those who had not. The median respiratory rate values between the two subgroups presented a statistically significant difference (P=.004). CONCLUSION: This study identified the characteristics of a typical patient with COVID-19 who requires early CPAP. Based on the results, the authors have devised a triage flow chart that uses selected vital signs measurements (oxygen saturation, respiratory rate and receipt of pre-hospital oxygen therapy) to identify patients requiring early CPAP. This flow chart should be trialled in a prospective study before it is used to inform clinical decision-making.

A Pilot Study to Develop an Assessment Tool for Dogs Undergoing Trap-Neuter-Release (TNR) in Italy. An Overview on the National Implementation of TNR Programmes.

A descriptive analysis, inter-observer and test-retest reliability of the animal-based measures (ABMs) included in the protocol were performed. This study aimed at the development of a welfare assessment protocol for dogs recruited in the trap-neuter-release (TNR) programmes and the description of the implantation of these programmes in Italy. Nine Italian regions carried out TNR programmes. A varied scenario, along with some critical issues, emerged. Fifty dogs were recruited and assessed simultaneously by two assessors to determine the reliability of ABMs included in the protocol. A subsample of ten dogs were assessed three times to assess test-retest reliability. All females were neutered against 36% of males. Most dogs were adults (58%) and of a large size (68%). Vaccine prophylaxis and parasitic prevention were regular in 13% and 76% of dogs, respectively. Few dogs showed lameness, evidence of pain, other clinical problems, or thermal discomfort. Overall, 82% of dogs did not show fear or aggression to unfamiliar people. The level of agreement between the two assessors was quite high, ranging from substantial (0.61-0.80) to perfect (1) for the majority of measures. This study highlighted some critical issues in TNR implementation and the suitability of the protocol as a tool for animal welfare assessment.

Leaf reflectance can surrogate foliar economics better than physiological traits across macrophyte species.

BACKGROUND: Macrophytes are key players in aquatic ecosystems diversity, but knowledge on variability of their functional traits, among and within species, is still limited. Remote sensing is a high-throughput, feasible option for characterizing plant traits at different scales, provided that reliable spectroscopy models are calibrated with congruous empirical data, but existing applications are biased towards terrestrial plants. We sampled leaves from six floating and emergent macrophyte species common in temperate areas, covering different phenological stages, seasons, and environmental conditions, and measured leaf reflectance (400-2500 nm) and leaf traits (dealing with photophysiology, pigments, and structure). We explored optimal spectral band combinations and established non-parametric reflectance-based models for selected traits, eventually showing how airborne hyperspectral data could capture spatial-temporal macrophyte variability. RESULTS: Our key finding is that structural-leaf dry matter content, leaf mass per area-and biochemical-chlorophyll-a content and chlorophylls to carotenoids ratio-traits can be surrogated by leaf reflectance with normalized error under 17% across macrophyte species. On the other hand, the performance of reflectance-based models for photophysiological traits substantively varies, depending on macrophyte species and target parameters. CONCLUSIONS: Our main results show the link between leaf reflectance and leaf economics (structure and biochemistry) for aquatic plants, thus envisioning a crucial role for remote sensing in enhancing the level of detail of macrophyte functional diversity analysis to intra-site and intra-species scales. At the same time, we highlighted some difficulties in establishing a general link between reflectance and photosynthetic performance under high environmental heterogeneity, potentially opening further investigation directions.

Diagnostic performance of chest radiography in high COVID-19 prevalence setting: experience from a European reference hospital.

PURPOSE: The study's aim is to analyse the diagnostic performance of chest radiography (CXR) in patients with suspected coronavirus disease 19 (COVID-19). METHODS: We retrospectively considered 826 consecutive patients with suspected COVID-19 presenting to our emergency department (ED) from February 21 to March 31, 2020, in a high disease prevalence setting. We enrolled patients who underwent CXR and rhino-oropharyngeal swab for real-time reverse transcription-polymerase chain reaction (rRT-PCR). CXRs were evaluated by an expert radiologist; a second independent analysis was performed by two residents in consensus. All readers, blinded to rRT-PCR results, classified CXRs positive/negative depending on presence/absence of typical findings of COVID-19, using rRT-PCR as reference standard. RESULTS: We finally analysed 680 patients (median age 58); 547 (80%) tested positive for COVID-19. The diagnostic performance of CXR, interpreted by the expert reader, was as follows: sensitivity (79.0%; 95% CI: 75.3-82.3), specificity (81.2%; 95% CI: 73.5-87.5), PPV (94.5%;95% CI: 92.0-96.4), NPV (48.4%; 95% CI: 41.7-55.2), and accuracy (79.3%; 95% CI: 76.0-82.2). For the residents: sensitivity (75.1%; 95% CI: 71.2-78.7), specificity (57.9%; 95% CI: 49.9-66.4), PPV (88.0%; 95% CI: 84.7-90.8), NPV (36.2%; 95% CI: 29.7-43.0), and accuracy (71.6%; 95% CI: 68.1-75.0). We found a significant difference between the reporting sensitivity (p = 0.013) and specificity (p < 0.0001) of expert radiologist vs residents. CXR sensitivity was higher in patients with symptom onset > 5 days before ED presentation compared to ≤ 5 days (84.4% vs 70.7%). CONCLUSIONS: CXR showed a sensitivity of 79% and a specificity of 81% in diagnosing viral pneumonia in symptomatic patients with clinical suspicion of COVID-19. Further studies in lower prevalence settings are needed.

Multicentre external validation of the Canadian Syncope Risk Score to predict adverse events and comparison with clinical judgement.

BACKGROUND: The Canadian Syncope Risk Score (CSRS) has been proposed for syncope risk stratification in the emergency department (ED). The aim of this study is to perform an external multicenter validation of the CSRS and to compare it with clinical judgement. METHODS: Using patients previously included in the SyMoNE database, we enrolled subjects older than 18 years who presented reporting syncope at the ED. For each patient, we estimated the CSRS and recorded the physician judgement on the patients' risk of adverse events. We performed a 30-day follow-up. RESULTS: From 1 September 2015 to 28 February 2017, we enrolled 345 patients; the median age was 71 years (IQR 51-81), 174 (50%) were men and 29% were hospitalised. Serious adverse events occurred in 43 (12%) of the patients within 30 days. The area under the curve of the CSRS and clinical judgement was 0.75 (95% CI 0.68 to 0.81) and 0.68 (95% CI 0.61 to 0.74), respectively. The risk of adverse events of patients at low risk according to the CSRS and clinical judgement was 6.7% and 2%, with a sensitivity of 70% (95% CI 54% to 83%) and 95% (95% CI 84% to 99%), respectively. CONCLUSION: This study represents the first validation analysis of CSRS outside Canada. The overall predictive accuracy of the CSRS is similar to the clinical judgement. However, patients at low risk according to clinical judgement had a lower incidence of adverse events as compared with patients at low risk according to the CSRS. Further studies showing that the adoption of the CSRS improve patients' outcomes is warranted before its widespread implementation.

Public opinions on seven different stray cat population management scenarios in Flanders, Belgium.

Stray cat population management is an important worldwide issue. Understanding citizen attitudes towards stray cat control options is vital to the success of controlling stray cat numbers, as public perception affects the acceptance of, support for and collaboration in stray cat management policies. Audience segmentation, as to enable each group to be engaged in the stray cat management policy, is important for the success of the interventions. Therefore a web-based survey was conducted among Flemish citizens in order to examine differences in acceptance towards seven management scenarios: household cat neutering with financial support for the owner, household cat neutering without financial support for the owner, encouraging responsible household cat ownership, trapping stray cats and taking them to a shelter, trapping and neutering stray cats for release into a managed "cat colony" (composed by so called "community cats"), trapping and killing of stray cats, and undertaking no action. A total of 4059 valid responses were collected and the proportions of agreement were compared across the different management scenarios using the two-sample z-test. Interactions among factors that influenced each management scenario were investigated using the CHAID (Chi-squared Automatic Interaction Detection) analysis and visualized on a tree. Our results showed that fostering responsible household cat ownership (89.9%) and conversion of stray cats to "community cats" (76.3%) were most supported by respondents in our sample (which consisted mainly of females, cat-lovers, and families without children). Least supported were the killing of stray cats (7.7%) and undertaking no action (3.3%). The demographic analyses revealed that for the acceptance of management scenarios there were three important factors (attitude towards cats, area of residence, and gender), two weaker factors (education and having children) and two which had almost no impact (age and cat ownership). We propose that future studies should focus on the effect of 'area of residence', 'having children' and 'education'. In conclusion, our research confirms that management of and communication on stray cat strategies should not be developed with a one-size-fits-all approach. Efforts should be tailored to each audience segment, thus adapted to the area of residence and human characteristics.

Prevalence and outcome of silent hypoxemia in COVID-19.

BACKGROUND: In the early stages of COVID-19 pneumonia, hypoxemia has been described in absence of dyspnea ("silent" or "happy" hypoxemia). Our aim was to report its prevalence and outcome in a series of hypoxemic patients upon Emergency Department admission. METHODS: In this retrospective observational cohort study we enrolled a study population consisting of 213 COVID-19 patients with PaO2/FiO2 ratio <300 mmHg at hospital admission. Two groups (silent and dyspneic hypoxemia) were defined. Symptoms, blood gas analysis, chest X-ray (CXR) severity, need for intensive care and outcome were recorded. RESULTS: Silent hypoxemic patients (68-31.9%) compared to the dyspneic hypoxemic patients (145-68.1%) showed greater frequency of extra respiratory symptoms (myalgia, diarrhea and nausea) and lower plasmatic LDH. PaO2/FiO2 ratio was 225±68 mmHg and 192±78 mmHg in silent and dyspneic hypoxemia respectively (P=0.002). Eighteen percent of the patients with PaO2/FiO2 from 50 to 150 mmHg presented silent hypoxemia. Silent and dyspneic hypoxemic patients had similar PaCO2 (34.2±6.8 mmHg vs. 33.5±5.7 mmHg, P=0.47) but different respiratory rates (24.6±5.9 bpm vs. 28.6±11.3 bpm respectively, P=0.002). Even when CXR was severely abnormal, 25% of the population was silent hypoxemic. Twenty-six point five percent and 38.6% of silent and dyspneic patients were admitted to the ICU respectively (P=0.082). Mortality rate was 17.6% and 29.7% (log-rank P=0.083) in silent and dyspneic patients. CONCLUSIONS: Silent hypoxemia is remarkably present in COVID-19. The presence of dyspnea is associated with a more severe clinical condition.

Retinal findings in patients with COVID-19: Results from the SERPICO-19 study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has been associated to microvascular alterations. We screened the fundus of patients with COVID-19 to detect alterations of the retina and its vasculature and to assess possible correlations with clinical parameters. METHODS: Cross-sectional study. The presence of retinal alterations in patients with COVID-19 and subjects unexposed to the virus was assessed using fundus photographs and their prevalence was compared. Mean arteries diameter (MAD) and mean veins diameter (MVD) were compared between patients and unexposed subjects with multiple linear regression including age, sex, ethnicity, body mass index, smoking/alcohol consumption, hypertension, hyperlipidaemia, diabetes as covariates. The influence of clinical/lab parameters on retinal findings was tested in COVID-19 patients. FINDINGS: 54 patients and 133 unexposed subjects were enrolled. Retinal findings in COVID-19 included: haemorrhages (9·25%), cotton wools spots (7·4%), dilated veins (27·7%), tortuous vessels (12·9%). Both MAD and MVD were higher in COVID-19 patients compared to unexposed subjects (98·3 ± 15·3 µm vs 91·9 ± 11·7 µm, p = 0.006 and 138·5 ± 21·5 µm vs 123·2 ± 13·0 µm, p<0.0001, respectively). In multiple regression accounting for covariates MVD was positively associated with COVID-19 both in severe (coefficient 30·3, CI95% 18·1-42·4) and non-severe (coefficient 10·3, CI95% 1·6-19·0) cases compared to unexposed subjects. In COVID-19 patients MVD was negatively correlated with the time from symptoms onset (coefficient -1·0, CI 95% -1·89 to -0·20) and positively correlated with disease severity (coefficient 22·0, CI 95% 5·2-38·9). INTERPRETATION: COVID-19 can affect the retina. Retinal veins diameter seems directly correlated with the disease severity. Its assessment could have possible applications in the management of COVID-19. FUNDING: None.

Study on the Public Perception of "Community-Owned Dogs" in the Abruzzo Region, Central Italy.

The Abruzzo Regional Law Nr. 47/2013, following a circular from the Italian Ministry of Health and OIE recommendations, allows the local municipalities to release free-roaming dogs (FRDs) caught on the territory once the local veterinary services (LVSs) have rated the dogs as unowned and not aggressive, have neutered them, as well as identified them through a microchip and a visible collar. The responsibility of these "community-owned dogs" (CODs) falls under the mayor of the local municipality that can entrust their custody to qualified people. The present study was conducted in the Abruzzo region, located in central Italy, to investigate public perception towards CODs, and in particular whether their presence is perceived as a problem or a benefit by the local communities. The data were collected by both direct interviews and an online survey, based on a questionnaire developed by a multidisciplinary team. The questionnaire was distributed in 31 municipalities sampled on the basis of the urbanization rate, and 497 people were interviewed over a 9-month period. More than half of the respondents (54%) stated that CODs can contribute to the control of stray dogs. The majority (83%) believed that a greater commitment is needed to involve the local communities on issues regarding CODs. The findings of this study highlighted the general difficulty for people to distinguish stray dogs from CODs that are not fully known, as evidenced by the fact that 59% of the respondents did not know the aforementioned Regional Law that defines and regulates the presence of the CODs.

A New Information System for the Management of Non-Epidemic Veterinary Emergencies.

The Italian National Veterinary Services, public health professionals, and policy makers are asked to participate at different levels in the decision-making process for the management of non-epidemic emergencies. A decision support system offering the different administrative and operational emergency management levels with a spatial and decisional tool to be used in the case of natural disasters is still missing at the national level. Within this context, the Italian General Directorate for Animal Health of the Ministry of Health funded a research project for the implementation of a new Veterinary Information System for Non-Epidemic Emergencies (SIVENE), an innovative real-time decision support tool for emergency response in a disaster management scenario. SIVENE was developed according to a multi-layer architecture with four integrated components: the database layer, which was implemented by an RDBMS Oracle 11 g; the ReST service layer, which was created using J2EE, Spring, and MyBatis technologies; the web application (business framework and user interface), which was developed in Angular4 framework using TypeScript language; and the web Geographic Information Systems (GIS), which was realized through the implementation of a geodatabase in Oracle RDBMS 11 g. This system allows us to build up and dynamically create a set of dedicated checklists to be used in the field when gathering the information needed for the management of non-epidemic emergencies; employ the application on mobile devices, such as tablets and smartphones; and use the web GIS to manage and visualize data of veterinary interest and territorial maps of risk and damage.

Impact of upstream landslide on perialpine lake ecosystem: An assessment using multi-temporal satellite data.

Monitoring freshwater and wetland systems and their response to stressors of natural or anthropogenic origin is critical for ecosystem conservation. A multi-temporal set of 87 images, acquired by Sentinel-2 satellites over three years (2016-2018), provided quantitative information for assessing the temporal evolution of key ecosystem variables in the perialpine Lake Mezzola (northern Italy), which has suffered from the impacts of a massive landslide that took place upstream of the lake basin in summer 2017. Sentinel-2 derived products revealed an increase in lake turbidity triggered by the landslide that amounted to twice the average values scored in the years preceding and following the event. Hotspots of turbidity within the lake were in particular highlighted. Moreover, both submerged and riparian vegetation showed harmful impacts due to sediment deposition. A partial loss of submerged macrophyte cover was found, with delayed growth and a possible community shift in favor of species adapted to inorganic substrates. Satellite-derived seasonal dynamics showed that exceptional sediment load can overwrite climatic factors in controlling phenology of riparian reed beds, resulting in two consecutive years with shorter than normal growing season and roughly 20% drop in productivity, according to spectral proxies. Compared to 2016, senescence came earlier by around 20 days on average in 2017 season, and green-up was delayed by up to 50 days (20 days, on average) in 2018, following the landslide. The approach presented could be easily implemented for continuous monitoring of similar ecosystems subject to external pressures with periods of high sediment loads.