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The article discusses a study conducted on a number of loggerhead sea turtles Caretta caretta to establish the physiological reference ranges that enable the identification of their pathological values. The study analyzed blood samples from several healthy adult loggerhead sea turtles captured and delivered to the Sea Turtle Rescue Center of Linosa, Italy by conducting serum biochemistry and serum protein electrophoresis. It was found that the individual variations in serum glucose observed from the samples were probably associated with the stress of capture, transportation and restraint before clinical examination.

Age at first calving (AFC) represents the nonproductive period of ∼2 yr in Holstein cows, and thus, it has a relevant effect on the cost of rearing replacements in the dairy herd. In the present study, we aimed to evaluate genetic and genomic aspects of AFC in the Italian Holstein population. Data of 4,206,218 heifers with first calving between 1996 and 2020 were used. Age at first calving averaged 26.09 ± 3.07 mo and decreased across years. Heritability was estimated using a linear animal model which included the fixed effects of herd-year-season of birth and classes of gestation length, and the random animal additive genetic effect fitted to a pedigree-based relationship matrix. The EBV and genomically EBV (GEBV) were obtained, and they were standardized to mean 100 and standard deviation 5, where animals above the mean are those contributing to reduce AFC. Heritability estimates of AFC ranged from 0.031 to 0.045. The trend of sires' GEBV was favorable and indicated a reduced AFC across years. Approximate genetic correlations between GEBV of AFC and GEBV of other economically important traits were calculated on a subset of genotyped females born after 2015. Moderate favorable associations of AFC with production traits (0.39-0.51), udder depth (0.40), interval from first to last insemination in heifer (-0.43), and longevity (0.34) were assessed. Overall, the greatest lifetime productive performances and most favorable days open in first lactation were observed when heifers calved at 22 to 23 mo. In contrast, progeny of sires with GEBV of AFC above the mean yielded more milk, fat, and protein in first lactation, and had shorter days open than progeny of sires with GEBV of AFC below the mean. Results suggested that breeding strategies to improve AFC should be pursued, also considering genetic correlations between AFC and traits which are already part of the Italian Holstein breeding objective. The inclusion of AFC in an aggregate index is expected to contribute to enhance farm income., (The Authors. Published by Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Objective: At present, there is no proficiency-based curriculum for endovascular treatment of aortic aneurysm repair (EVAR) using virtual reality (VR) surgical simulators, whereas such curricula are available for the treatment of iliac and/or superficial femoral artery disease. The purpose of this work was to compute proficiency, defined by a benchmark level determined by the performance of experts, using a commercial VR simulator as a first step of a curriculum on EVAR., Materials and Methods: Expert endovascular surgeons (with more than 150 EVAR cases as first operators) from 12 major Italian centers completed three cases of EVAR of increasing difficulty level 3 times each, using the Angio Mentor simulator (by Simbionix) and Gore devices. Proficiency level was based on performance of expert surgeons, as assessed by metrics from a VR simulator., Results: The participating surgeons had a median of 20 years of experience and executed a median of 440 EVAR. For the 3 simulated cases, the following proficiency values were respectively obtained: total procedure time: 22 minutes 32 seconds, 23 minutes 05 seconds, and 20 minutes 32 seconds; total amount of contrast injected: 85.16 mL, 89.97 mL, and 98.01 mL total fluoroscopy time: 10 minutes 39 seconds, 12 minutes 22 seconds, and 10 minutes 17 seconds; time to contralateral gate cannulation: 5 minutes 51 seconds, 7 minutes 09 seconds, and 3 minutes 32 seconds., Conclusions: We computed proficiency levels for 3 simulated cases of EVAR using a VR simulator. Our next step is to determine whether surgical residents can reach this level. Translational research will then be required to assess the impact of such training on real patients., (Copyright © 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Background: Despite many publications reporting on the increased hospital cost of robotic-assisted surgery (RAS) compared to direct manual laparoscopic surgery (DMLS) and open surgery (OS), the reported health economic studies lack details on clinical outcome, precluding valid health technology assessment (HTA)., Methods: The present prospective study reports total cost analysis on 699 patients undergoing general surgical, gynecological and thoracic operations between 2011 and 2014 in the Italian Public Health Service, during which period eight major teaching hospitals treated the patients. The study compared total healthcare costs of RAS, DMLS and OS based on prospectively collected data on patient outcome in addition to healthcare costs incurred by the three approaches., Results: The cost of RAS operations was significantly higher than that of OS and DMLS for both gynecological and thoracic operations (p < 0.001). The study showed no significant difference in total costs between OS and DMLS. Total costs of general surgery RAS were significantly higher than those of OS (p < 0.001), but not against DMLS general surgery. Indirect costs were significantly lower in RAS compared to both DMLS general surgery and OS gynecological surgery due to the shorter length of hospital stay of RAS approach (p < 0.001). Additionally, in all specialties compared to OS, patients treated by RAS experienced a quicker recovery and significantly less pain during the hospitalization and after discharge., Conclusions: The present HTA while confirming higher total healthcare costs for RAS operations identified significant clinical benefits which may justify the increased expenditure incurred by this approach., Competing Interests: Compliance with ethical standards Disclosures Prof. Giuseppe Turchetti, Dr. Francesca Pierotti, Dr. Ilaria Palla, Dr. Stefania Manetti, Dr. Cinzia Freschi, Dr. Vincenzo Ferrari and Prof. Alfred Cuschieri have no conflicts of interest or financial ties to disclose.

Introduction: The trend of surgical robotics is to follow the evolution of laparoscopy, which is now moving towards single-incision laparoscopic surgery. The main drawback of this approach is the limited maneuverability of the surgical tools. Promising solutions to improve the surgeon's dexterity are based on bimanual robots. However, since both robot arms are completely inserted into the patient's body, issues related to possible unwanted collisions with structures adjacent to the target organ may arise., Materials and Methods: This paper presents a simulator based on patient-specific data for the positioning and workspace evaluation of bimanual surgical robots in the pre-operative planning of single-incision laparoscopic surgery., Results: The simulator, designed for the pre-operative planning of robotic laparoscopic interventions, was tested by five expert surgeons who evaluated its main functionalities and provided an overall rating for the system., Discussion: The proposed system demonstrated good performance and usability, and was designed to integrate both present and future bimanual surgical robots.

In avian medicine, hematologic and biochemical laboratory investigations are still in their infancy, because of the difficulty involved in collecting data. This has led to a lack of reference values and a nonstandardized approach to specimens obtained in critical conditions. The Eurasian Buzzard (Buteo buteo) is one of the most common raptors in Italy, yet little is known about the physiologic blood parameters of this species. Serum biochemistry and electrophoretic investigations were performed in 40 healthy Eurasian Buzzards in different Italian wildlife rescue centers waiting to be released after recovering from trauma injuries. Mean values for biochemistry parameters were pancreatic amylase 626.9 IU/l, uric acid 7.5 mg/dl, aspartate aminotransferase 330.9 IU/l, glucose 375.1 mg/dl, lipase 26.3 IU/ l, total protein 38.4 g/l, total bilirubin 0.04 mg/ dl, lactate dehydrogenase 2,008.4 IU/l, creatinine kinase 1,604.1 IU/l, alanine aminotransferase 40.4 IU/l, alkaline phosphatase 89.8 IU/l, magnesium 2.3 mg/dl, calcium 10.2 mg/dl, phosphorus 2.02 mg/dl, cholesterol 192.2 mg/ dl, triglyceride 116.4 mg/dl, albumin 14.5 g/l, creatinine 0.1 mg/dl. Mean electrophoretic values were prealbumin 1.4 g/l, albumin 14.2 g/l, alpha 1 globulin 5.9 g/l, alpha 2 globulin 4.7 g/l, beta globulin 7.5 g/l, gamma globulin 3.6 g/l, albumin/globulins ratio 0.8 g/l.

The aim of this study was to examine the association of cannabis use with risky behaviors and suicide risk in university students. A convenience sample of 246 students was recruited from four universities in Rome during the 2004 academic year. Participants completed the Zung scales for anxiety and depression, the Suicide Score Scale, and an ad hoc questionnaire assessing risky behaviors. The findings indicated a widespread use of cannabis among students and its association with risky behaviors, anxiety and depression, and suicide risk. A regression tree analysis resulted in 3 splits indicating that the Zung Self-Rating Depression Scale is a good predictor of suicide risk, discriminating individuals at lower risk from those at higher risk. Individuals at higher risk for suicide could also be discriminated by self-reported lifetime drug use. Limitations of the study are related to the small sample size and use of a convenience sample.

Attitudes and feelings towards the body may be a source of pleasure and well-being; on the other hand, bodily dissatisfaction may lead to suffering, depression and even suicide. The study population consisted of 500 university students (190 males, 310 females); mean age of participants was 21.62 (SD = 2.70). Participants were assessed by means of the Body Uneasiness Test (BUT), the Reason for Living Inventory (RFL), and the Zung Self Depression Scale (SDS). Data underline a linear relationship between uneasiness linked to body image and possible suicide risk. Such evidence suggests that body uneasiness can be a source of psychological pain and in serious cases expose the individuals to an increased suicide risk. Yet, depression was the strongest correlate of increased suicide risk.