Multi-decadal improvements in the ecological quality of European rivers are not consistently reflected in biodiversity metrics.

Humans impact terrestrial, marine and freshwater ecosystems, yet many broad-scale studies have found no systematic, negative biodiversity changes (for example, decreasing abundance or taxon richness). Here we show that mixed biodiversity responses may arise because community metrics show variable responses to anthropogenic impacts across broad spatial scales. We first quantified temporal trends in anthropogenic impacts for 1,365 riverine invertebrate communities from 23 European countries, based on similarity to least-impacted reference communities. Reference comparisons provide necessary, but often missing, baselines for evaluating whether communities are negatively impacted or have improved (less or more similar, respectively). We then determined whether changing impacts were consistently reflected in metrics of community abundance, taxon richness, evenness and composition. Invertebrate communities improved, that is, became more similar to reference conditions, from 1992 until the 2010s, after which improvements plateaued. Improvements were generally reflected by higher taxon richness, providing evidence that certain community metrics can broadly indicate anthropogenic impacts. However, richness responses were highly variable among sites, and we found no consistent responses in community abundance, evenness or composition. These findings suggest that, without sufficient data and careful metric selection, many common community metrics cannot reliably reflect anthropogenic impacts, helping explain the prevalence of mixed biodiversity trends.

A biodiversity monitoring program for macroinvertebrates inhabiting streams and rivers of South Tyrol (Italy): aims, methodologies, and publicly accessible dataset.

Despite very limited in their extension - about 1% of the total surface of our planet - freshwater habitats greatly contribute to the biodiversity of Earth, since 10% of the known species and 33% of the vertebrates inhabit freshwaters. However, continuous monitoring of habitats and biodiversity - not only aquatic - is considered as a complex task due to the long-term perspective these monitoring programs should have, and the connected required financial needs. Here, within the framework of a regional-scale program of biodiversity monitoring started in the mountainous region of the Autonomous Province of Bolzano/Bozen (Italy) - including terrestrial and aquatic habitats - we present a dataset covering the first year of the fieldwork campaign aiming at sampling and identifying the benthic macroinvertebrates inhabiting the running-waters of the region. First, we developed a GIS model with the aim of classifying all the running-waters of the region on the base of their water origin, elevation, mean discharge, slope, and geology of the catchment. After having identified a final set of 12 different stream types, 10 sampling points per each type were selected throughout the region, 2 of which - defined as "reference points" - were scheduled to be sampled each year, in order to keep a "year-by-year" temporal resolution in addition to a long-term one. Thus, every year, 48 points are sampled: 24 "reference points" (2 sites x 12 stream types), and 24 additional sites whose re-sampling is scheduled to happen every 4 years. In summary, in a 4 year-period all the 120 sites are sampled, and the same sampling campaign is planned to be repeated every 4 years, in order to build an ecological time series in a long-term perspective. At each site, we collect benthic macroinvertebrates through a kick-net sampler (mesh size 500 µm), following a detailed protocol involving, among other aspects, characterization and quantification of the habitats present in the stretch selected for the sampling, as well as measurement of the water velocity associated to each habitat. The benthic samples are then sorted in the lab - with no application of sub-sampling - and identified mostly to family or genus level using appropriate literature. In addition, at each site, water samples are collected and analyzed within the same day, through a spectrophotometer, looking for a set of chemical species of nitrogen and phosphorous.

Effects of rapid maxillary expansion on hearing loss and otitis media in cleft palate children.

PURPOSE: Otitis media with effusion (OME), recurrent acute otitis media and conductive hearing loss (CHL) are significantly prevalent in children with cleft palate (CP) and cleft lip and palate (CLP). Rapid Maxillary Expansion (RME) appears to have a positive effect also on middle ear disorders in these patients. The study aims to offer a prospective evaluation of RME effects in a group of patients with CP/CLP in terms of OME, CHL. METHODS: A prospective observational study was conducted. Thirty-four CP, CLP and submucosa cleft patients who received orthodontic indication to RME treatment for OME or conductive hearing loss in a tertiary institutional Care Unit of San Paolo Hospital, Milan (IT), were included. Twenty-two patients matched for age and with analogous inclusion criteria except for indication to RME treatment were enrolled in the control group. Clinical otolaryngological evaluation, pure tone audiometry and tympanogram were performed at the beginning of treatment (T0), at the end of the expansion (T1) and at 6-month follow-up (T2). MAIN OUTCOME MEASURES: Air-bone gaps and tympanogram results at each time interval. RESULTS: In the main group, RME allowed a statistically significant improvement of air-bone gaps (according to frequency, p < 0.001-0.089 T0 vs. T1 and < 0.001-0.044 T0 vs. T2, Friedman's test) and tympanometry results (p = 0.002 T0 vs. T1 and p < 0.001 T0 vs. T2, Friedman's test). Improvements were stable during follow-up and were significantly better in the main group than in the control group. CONCLUSION: CHL and middle ear effusion improved significantly overtime during RME and after 6 months of follow-up.

Adenoidectomy for middle ear disease in cleft palate children: a systematic review.

PURPOSE: Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. METHODS: A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. RESULTS: Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution. CONCLUSION: Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.

Prevalence of Maxillary Sinus Hypoplasia and Silent Sinus Syndrome: A Radiological Cross-Sectional Retrospective Cohort Study.

BACKGROUND: Maxillary sinus hypoplasia (MSH), associated with enophthalmos and hypoglobus in the silent sinus syndrome (SSS), is a poorly studied condition. The real incidence of MSH and SSS in the adult population is not known. Our study aims at estimating the radiological prevalence of MSH and identifying undiagnosed cases of SSS in a retrospective cohort. METHODS: A cross-sectional retrospective cohort study was performed in adults, without a history of maxillofacial surgery or trauma, undergoing head CT scans. A radiological database of 1012 consecutive scans was reviewed independently by two authors to identify patients with signs of MSH and SSS and associated findings (septal deviation, uncinate deviation, concha bullosa, sinus opacification, bony rarefaction, and pterygopalatine fossa enlargement). The findings of MSH and SSS were compared with radiological reports. RESULTS: 891 eligible CT scans were analyzed. MSH and SSS prevalences were 6.17% (n = 55) and 0,56% (n = 5), respectively. The maxillary sinus was normally or partially ventilated in 96.36% of MSH patients. Lateralization of the uncinate process was detected in about 50% of MSH patients, while a septal deviation towards the affected sinus was detected in 21.82%. In 20% of MSH scans, a concha bullosa was identified. Radiological reports identified a single MSH case. CONCLUSIONS: Our study confirmed the literature data on MSH prevalence, while it determined a precedently unknown prevalence for SSS, underestimated in the radiology reports. This prevalence needs further confirmation but suggests a routine accurate comparison of both maxillary sinuses in CT scans.

A first attempt at a holistic analysis of various influencing factors on the fish fauna in the Eastern European Alps.

Fish are some of the most threatened vertebrates in the world due to their often-sensitive response to environmental changes. Major land-use changes in the European Alps have direct and indirect impacts on fish communities, and these impacts are expected to increase in the future. Therefore, the identification of factors that are associated with the distribution of fish communities is of great importance to develop guidelines for management, precautions and sustainable use of running waters. In this study, the relationship of various factors - landscape structure and land use, topography, morphology, hydrology, physical and chemical water characteristics, hormonally active substances, pesticides, food availability, fisheries and piscivores birds - with fish assemblages are analysed. Field data from 81 stream sections from 2001 metres above sea level (m.a.s.l.) down to 219 m.a.s.l. are used in the study. The results reveal that the number of fish species has a strong association with topographic characteristics in the catchment area as well as with landscape configuration. Fish abundance and biomass are associated mostly with land-use type, hydrology, morphology as well as topography. In addition, there are indirect connections between fish abundance and biomass through land-use type, topography, water properties and hydromorphology. The results clearly indicate that not a single factor, but a multitude of factors are associated with the fish communities in the Eastern European Alps.

Fine-scale multiannual survey of benthic invertebrates in a glacier-fed stream used for hydropower generation.

The present dataset contains information about aquatic macroinvertebrates and environmental variables collected before and after the implementation of a small "run-of-river" hydropower plant on the Saldur stream, a glacier-fed stream located in the Italian Central-Eastern Alps. Between 2015 and 2019, with two sampling events per year, we collected and identified 34,836 organisms in 6 sampling sites located within a 6 km stretch of the stream. Given the current boom of the hydropower sector worldwide, and the growing contribution of small hydropower plants to energy production, data here included may represent an important - and long advocated - baseline to assess the effects that these kinds of powerplants have on the riverine ecosystem. Moreover, since the Saldur stream is part of the International Long Term Ecological Research network, this dataset also constitutes part of the data gathered within this research programme. All samples are preserved at Eurac Research facilities.

Isolated olfactory cleft involvement in SARS-CoV-2 infection: prevalence and clinical correlates.

PURPOSE: Smell alterations are a symptom of COVID-19 and have been associated with olfactory cleft mucosal thickening (OCMT). Although their pathogenesis is unclear, evidences link them to viral neuroinvasive potential. This study aims at estimating the prevalence of OCMT in CT scans of COVID-19 patients and investigating its clinical correlates. METHODS: In a single-institution retrospective cross-sectional study, we included all patients hospitalized for COVID-19 undergoing head CT scan for any reason. Exclusion criteria were history of recent head trauma or chronic rhinosinusitis; opacification > 2 mm in any sinonasal space other than the olfactory cleft; CT performed during/after invasive ventilation or feeding via nasogastric tube. We recorded the prevalence of OCMT and related it to age, sex, need for invasive ventilation during hospital stay, outcome, length of hospital stay, diffusion of lung SARS-CoV-19 lesions and outcome. RESULTS: 63 eligible patients were identified (39 male, 24 female; median age 77.82 ± 17.77 years). OCMT was identified in 16 patients (25.4%; 95% CI 15.3-37.9%). Patients with OCMT had longer hospital stays (median 16 ± 4 vs. 9 ± 14.5 days, p = .009, Mann-Whitney U test) and required invasive ventilation more frequently than patients without mucosal thickening (OR 4.89, 95% CI 0.96-24.89, p = .063, Fisher's test). No other difference was observed. CONCLUSION: OCMT affects nearly one in four patients hospitalized for COVID-19. It is associated with a worse disease course irrespective of age, sex and diffusion of lung lesions, although with no direct effect on survival.

Stream benthic macroinvertebrates abundances over a 6-year monitoring period of an Italian glacier-fed stream.

BACKGROUND: Aquatic macroinvertebrates are widely used as bioindicators for water quality assessments involving different kinds of disruptive factors, such as hydrological regime variations or pollutant spills. Recently, they demonstrated to be effective in monitoring effects of climate change in alpine stream and rivers. Indeed, since the distribution of macroinvertebrates in glacier-fed streams has been succesfully investigated and described by several authors, the discrepancy in presence/absence and quantity of specific taxa from the established models may represent an early warning of the effects of climatic changes occurring in alpine riverine ecosystems. NEW INFORMATION: Together with the present paper, we provide a dataset covering a period of 6 years (2010-2015) sampling of aquatic macroinvertebrates along a longitudinal transect of a glacier-fed stream located in the Italian Alps, inside the International Long Term Ecological Research (ILTER) macrosite of Matsch|Mazia (IT-25). Data were collected during the glacial melt period (April - September), with monthly resolution. Owing to the unique temporal resolution of the dataset, we aim to produce a reliable tool (i.e. reference point) for future ecological assessment on the same stream, but also to similar streams worldwide.

Odontogenic rhinosinusitis and sinonasal complications of dental disease or treatment: prospective validation of a classification and treatment protocol.

PURPOSE: Odontogenic sinusitis and sinonasal complications of dental disease or treatment (SCDDT) represent a heterogeneous group of conditions that often require multidisciplinary care. The present study aims to prospectively validate a classification and treatment protocol for SCDDT patients. METHODS: One hundred twenty-eight consecutive patients (73 females and 45 males, mean age 52.4 years) affected by SCDDT not responding to dental and medical therapy were classified and surgically treated according to the proposed protocol. The protocol classified patients into three aetiology-based groups (preimplantologic, implantologic, and related to traditional dental diseases and procedures, respectively). The groups were further divided into classes according to the presence of oro-antral communications and/or dislocated dental hardware. Each condition was treated according to the class-related, protocol-defined treatment, by either a transnasal or combined transnasal/transoral approach. All patients were successfully classified according to our protocol. None of the proposed classes were redundant, and no condition fell outside the definitions. RESULTS: The surgical treatment protocol proved to be adequate and effective, in that 125 of the 128 patients completely recovered after surgical treatment. CONCLUSIONS: The term SCDDT and the consequent classification proposed by the authors appear, therefore, to be nosologically correct. Furthermore, the protocol-related proposed treatment appears to be clinically sound, with a success rate nearing 98%.

One-Step Maxillary Sinus Augmentation in Association With Endoscopic Sinus Surgery: Case Series and Review of the Literature.

INTRODUCTION: Sinonasal anatomical anomalies and inflammatory conditions may reduce success rates of maxillary sinus elevation (MSE) procedures used to allow implant placement in the atrophic posterior maxilla. Approaches combining endoscopic sinus surgery (ESS) and MSE were firstly proposed by our group and have already been described in the literature. This article aims to re-evaluate the procedure in a larger sample of patients comparing results and indications with the pertaining literature. MATERIALS AND METHODS: Thirty-three patients (19 men and 14 women, mean age 52.79 ± 11.95 years) underwent combined ESS/MSE with 48 MSE procedures performed. RESULTS: No intraoperative complications were reported. An uneventful and complete graft integration was obtained after 6 months in all but one patient. All patients completed prosthetic rehabilitation within 9 to 12 months. CONCLUSION: Combined ESS and MSE has proven to be a safe and reliable procedure, which can be proposed to selected patients presenting with reversible sinonasal contraindications to MSE and should be no more considered an experimental procedure.

The formation and fate of internal waves in the South China Sea.

Internal gravity waves, the subsurface analogue of the familiar surface gravity waves that break on beaches, are ubiquitous in the ocean. Because of their strong vertical and horizontal currents, and the turbulent mixing caused by their breaking, they affect a panoply of ocean processes, such as the supply of nutrients for photosynthesis, sediment and pollutant transport and acoustic transmission; they also pose hazards for man-made structures in the ocean. Generated primarily by the wind and the tides, internal waves can travel thousands of kilometres from their sources before breaking, making it challenging to observe them and to include them in numerical climate models, which are sensitive to their effects. For over a decade, studies have targeted the South China Sea, where the oceans' most powerful known internal waves are generated in the Luzon Strait and steepen dramatically as they propagate west. Confusion has persisted regarding their mechanism of generation, variability and energy budget, however, owing to the lack of in situ data from the Luzon Strait, where extreme flow conditions make measurements difficult. Here we use new observations and numerical models to (1) show that the waves begin as sinusoidal disturbances rather than arising from sharp hydraulic phenomena, (2) reveal the existence of >200-metre-high breaking internal waves in the region of generation that give rise to turbulence levels >10,000 times that in the open ocean, (3) determine that the Kuroshio western boundary current noticeably refracts the internal wave field emanating from the Luzon Strait, and (4) demonstrate a factor-of-two agreement between modelled and observed energy fluxes, which allows us to produce an observationally supported energy budget of the region. Together, these findings give a cradle-to-grave picture of internal waves on a basin scale, which will support further improvements of their representation in numerical climate predictions.

Redefining boundaries in odontogenic sinusitis: a retrospective evaluation of extramaxillary involvement in 315 patients.

BACKGROUND: Odontogenic sinusitis and "sinonasal complications of dental disease or dental treatment" (SCDDT) have been assumed to be limited to the maxillary sinus. Nevertheless, many patients also show more extensive sinonasal involvement and, occasionally, also have associated bilateral disease. We evaluated the incidence of extramaxillary extension over an 11-year period in our clinic. METHODS: We retrospectively evaluated 315 surgically treated SCDDT patients. Sinonasal involvement was assessed with presurgical imaging and confirmed with intraoperative findings. Patients were subsequently categorized into 3 groups, based on the sinonasal extension. RESULTS: In 40.3% of patients the sinonasal condition was limited to the maxillary sinus. Forty-one percent of patients had unilateral extramaxillary involvement, and in 18.7% of patients, we found bilateral involvement. CONCLUSION: Complete presurgery evaluation with endoscopy and a computed tomography (CT) scan in SCDDT patients is essential. SCDDT patients not responding to medical and dental treatment should be addressed with a planned approach targeting the extramaxillary extension, which may necessitate a combined oral and endonasal approach. It is unclear whether disease in the maxillary sinus contralateral to the primary maxillary sinus demonstrating odontogenic-induced disease is incidental, associated, or represents a subclinical odontogenic infection.

Results of TRT after eighteen months: our experience.

The aim of this study was to evaluate the efficacy of TRT in patients suffering from tinnitus. The tinnitus disorder affects about 10-15% of the population and, in one person out of a hundred, it is a disabling disorder. TRT treatment is based on Jastreboff's neurophysiological model. TRT consists of two parts: counselling, and sound therapy by means of dedicated hearing aids and sound generators. It proved to be useful to reduce the symptoms related to tinnitus. Jastreboff's structured interviews were proposed to a sample of 51 patients with tinnitus belonging to the I-II-III-IV classes according to Jastreboff. These patients were treated for 18 months. Sixty-eight percent of patients reported a reduction in the symptoms related to tinnitus, such as sleep disturbance, problems in concentration, and inability to relax. A percentage (64.7%) of patients thought that their quality of life was improved. Patients who had suffered from tinnitus for less than one year achieved significantly better results than patients who had suffered for a longer period of time. TRT is an effective tool in the treatment of tinnitus.

Arachnoid cyst of the cranial posterior fossa causing sensorineural hearing loss and tinnitus: a case report.

Arachnoid cysts are developmental collections of cerebrospinal fluid covered by layers of arachnoidal epithelium and are usually located in the middle cranial fossa. Localizations in the posterior fossa are uncommon and generally remain asymptomatic or cause vague and non-specific symptoms. We here report the unusual case of a young patient with an arachnoid cyst of the posterior fossa that had become manifest in the form of left-sided hypoacusia and tinnitus. Audiometric evaluation, auditory brainstem responses and transient-evoked otoacoustic emissions tests revealed a progressive monolateral sensorineural retrocochlear hearing loss with cochlear involvement. Magnetic-resonance imaging showed an arachnoid cyst of the cerebellar convexity compressing the cerebellar hemisphere and thus the homolateral cerebellopontine angle. Because of the progressive worsening of the retrocochlear impairment after a 6-month wait-and-see period, the patient finally underwent endoscopic cyst decompression. This was judged to be successful as it stopped the progression of hearing loss and the impairment of the auditory brainstem responses and made the tinnitus more tolerable.