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A mass mortality event (MME) affected the endemic bivalve Pinna nobilis across the Mediterranean Sea in autumn 2016. This event affected specimens of all sizes, depth ranges and habitat types, resulting in a drastic decline in the species population close to 100%. Indeed, the consequences of a potential recovery, and therefore the viability of the populations of the species are unknown. To evaluate the likelihood of success when designing the reintroduction of the species in optimal areas, knowledge of population dynamics is essential. Here we compare two population subunits of Pinna nobilis from two areas with different environmental conditions, located in Cabrera National Park (protected area with low exposure to hydrodynamic activity) and San Telmo (unprotected area exposed to hydrodynamic activity), both in the Balearic Islands. A total of 259 individuals were tagged and monitored annually between 2011 and 2014, prior to the MME. Matrix population models were used to reduce the complexity of the age-structured population dynamics and assessing the degree of elasticity of the population. We showed that the subunit of San Telmo showed highly variable values of demographic rates, higher stochasticity and higher sensitivity to environmental variability than the population subunit of Cabrera National Park. The study shows the importance of the buffering effect of a large population as there are many adult individuals of many size classes in the population subunit of Cabrera National Park, as its age structure helps to cope with highly variable reproductive success. Therefore, these population subunits are more stable regardless of depth and would be a more suitable site for future reintroduction programs. • Pinna nobilis shows phenotypic variation in nearby subpopulations. • There are differences in demographic stochasticity and adaptation to contrasting environments. • Buffering effect of a large population with many adult individuals of many size classes is of great importance. • Cabrera National Park is a suitable site for a future Pinna nobilis reintroduction program. [ABSTRACT FROM AUTHOR]

This chapter is focused on two vulnerable bivalve sessile species present in the Cabrera National Park, Pinna nobilis and Pinna rudis. Both species are protected by law and are vulnerable to many impacts. Prior to the creation of the park, the presence of these species was known in the waters of Cabrera but the presence was occasional. A summary of the knowledge acquired during the last years in aspects such as density and distribution of populations, habitat and depth preferences, population demography of the two species (recruitment rate, mortality rate and net growth rate); the size structure, age, and growth rate of both species are provided. In addition, in the case of P. nobilis we investigated the larval establishment and inference of the time of implantation in the study of gonad development, isotopic level of d13C and d15N, capacity as an indicator of heavy metals, antioxidant response, markers of oxidative damage and production of reactive oxygen species. It emphasizes the importance that the Park had for these two species and the result of the effectiveness of more than 20 years of effective protection since the populations of Cabrera presented one of the highest density of all the Mediterranean for both species. The mass mortality event that in a few months has reached Cabrera with catastrophic consequences for the endemic species Pinna nobilis is also discussed. Finally, all this information is discussed in a global context highlighting key points for management strategies. [ABSTRACT FROM AUTHOR]

Hydroxychloroquine (HCQ) is the first-line treatment for systemic lupus erythematosus (SLE); however, there is heterogeneity in its clinical use. This consensus aims to bridge the gap in SLE treatment by providing practical and valuable recommendations for health professionals. The methodology used is based on a systematic literature review and a nominal group technique (NGT). A ten-member scientific committee formulated eight clinically relevant questions. First, a systematic review was conducted to identify the available evidence, which the scientific committee evaluated to developed recommendations based on their expertise, achieving consensus through NGT. 1673 titles and abstracts were screened, and 43 studies were included for meeting the inclusion criteria. The scientific committee established 11 recommendations for HCQ use in initiation, maintenance, and monitoring, considering benefits and potential adverse effects of HCQ. Unanimous agreement was achieved on all recommendations. The available evidence supports HCQ's effectiveness and safety for SLE. Individualized assessment of the initial HCQ dose is important, especially in situations requiring dose reduction or discontinuation. This risk–benefit assessment, specifically focusing on the balance between retinal toxicity and the risk of SLE relapse, should guide decisions regarding medication withdrawal, considering disease activity, risk factors, and HCQ potential benefits. Close monitoring is essential for optimal disease management and minimize potential risks, such as QT prolongation or retinal toxicity. [ABSTRACT FROM AUTHOR]

Autoimmune diseases are known to be associated with an elevated risk of cardiovascular diseases; however, there exists a lack of awareness regarding this increased risk among patients. This study aimed to assess the prevalence of cardiovascular risk factors and events in various systemic autoimmune diseases, including Systemic Sclerosis (SSc), Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), and Sjögren's syndrome (SS), matched by age, sex, and disease duration. Additionally, the study aimed to evaluate the perceived and actual risks of cardiovascular disease among patients. A cross-sectional self-reported survey on the patient's perspective of cardiovascular risk was conducted between January and June 2023. Sociodemographic and clinical data, including disease activity, were collected through medical records and questionnaires. Traditional cardiovascular risk factors and events were assessed, alongside the perceived cardiovascular risk. The SCORE calculation and Charlson Comorbidity Index (CCI) were employed for cardiovascular risk assessment. Survey responses from 180 patients (45 patients each with SSc, SLE, RA, and SS) with systemic autoimmune diseases revealed that 20% perceived a low risk, 23% perceived neither lower nor higher, and 56% perceived a higher risk of developing cardiovascular diseases in the next ten years. Only 45% agreed that their autoimmune disease could increase the risk of a heart attack, even in the absence of other risk factors, and 46.7% were unaware that NSAIDs pose a cardiovascular risk. An association between cardiovascular risk measured by SCORE, comorbidities, and risk perception was observed in RA, SSc, and SS patients, with no association found in SLE patients (p = 0.27). Except for SS patients (p = 0.02), no association between CCI and disease activity level was found. Regarding the influence of age, working status, and education in CVD risk perception, an association between CVD risk perception and age was observed (p = 0.01), with patients over 40 years exhibiting a higher perception of CVD risk. No differences were found regarding working status (p = 0.19) nor education level (p = 0.06). Patients with SS, RA, and SSc displayed a heightened perception of cardiovascular risk, correlating with their actual risk and preexisting comorbidities. However, patients exhibited unawareness of certain cardiovascular risk behaviors. This underscores the need for tailored education programs on cardiovascular risk for autoimmune disease patients, to be implemented at the time of diagnosis and during follow-up in outpatient clinics. [ABSTRACT FROM AUTHOR]

Background: The incidence of all periprosthetic fractures (PPF), which require complex surgical treatment associated with high morbidity and mortality, is predicted to increase. The evolving surgical management has created a knowledge gap regarding its impact on immediate outcomes. This study aimed to describe current management strategies for PPF and their repercussions for in-hospital outcomes as well as to evaluate their implications for the community. Methods: PIPPAS (Peri-Implant PeriProsthetic Survival Analysis) was a prospective multicentre observational study of 1387 PPF performed during 2021. Descriptive statistics summarized the epidemiology, fracture characteristics, management, and immediate outcomes. A mixed-effects logistic regression model was employed to evaluate potential predictors of in-hospital mortality, complications, discharge status, and weight-bearing restrictions. Results: The study encompassed 32 (2.3%) shoulder, 4 (0.3%) elbow, 751 (54.1%) hip, 590 (42.5%) knee, and 10 (0.7%) ankle PPF. Patients were older (median 84 years, IQR 77–89), frail [median clinical frailty scale (CFS) 5, IQR 3–6], presented at least one comorbidity [median Charlson comorbidity index (CCI) 5, IQR 4–7], were community dwelling (81.8%), and had outdoor ambulation ability (65.6%). Femoral knee PPF were most frequently associated with uncemented femoral components, while femoral hip PPF occurred equally in cemented and uncemented stems. Patients were managed surgically (82%), with co-management (73.9%), through open approaches (85.9%) after almost 4 days (IQR, 51.9–153.6 h), with prosthesis revision performed in 33.8% of femoral hip PPF and 6.5% of femoral knee PPF. For half of the patients, the discharge instructions mandated weight-bearing restrictions. In-hospital mortality rates were 5.2% for all PPF and 6.2% for femoral hip PPF. Frailty, age > 84 years, mild cognitive impairment, CFS > 3, CCI > 3, and non-geriatric involvement were candidate predictors for in-hospital mortality, medical complications, and discharge to a nursing care facility. Management involving revision arthroplasty by experienced surgeons favoured full weight-bearing, while an open surgical approach favoured weight-bearing restrictions. Conclusions: Current arthroplasty fixation check and revision rates deviate from established guidelines, yet full weight-bearing is favoured. A surgical delay of over 100 h and a lack of geriatric co-management were related to in-hospital mortality and medical complications. This study recommends judicious hypoaggressive approaches. Addressing complications and individualizing the surgical strategy can lead to enhanced functional outcomes, alleviating the economic and social burdens upon hospital discharge. Level of Evidence Level IV case series. Trial registration: registered at ClinicalTrials.gov (NCT04663893), protocol ID: PI 20-2041. [ABSTRACT FROM AUTHOR]

Introduction: Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease characterized by a chronic grade of inflammation. Cardiovascular events represent the major causes of morbidity and mortality in patients with inflammatory rheumatic diseases; however, the significance and prevalence of cardiovascular disease in patients with pSS remain unclear. Objective: To determine the clinical significance of cardiovascular disease in pSS and analyze the risk of cardiovascular disease according to glandular/extraglandular involvement and positivity to anti-Ro/SSA and/or anti-La/SSB autoantibodies. Methods: A retrospective study including patients diagnosed with pSS fulfilling the 2016 ACR/EULAR classification criteria was followed and evaluated in our outpatient clinic between 2000 and 2022. The prevalence of cardiovascular risk factors with pSS was evaluated, and a possible association with clinical and immunological characteristics, the treatments received, and the impact on cardiovascular disease were determined. Univariate and multivariate regression analyses were performed in an attempt to determine potential risk factors associated with cardiovascular involvement. Results: A total of 102 pSS patients were included. Eighty-two percent were female, with a mean age of 65±24 years and a disease duration of 12.5 ±6 years. Thirty-six patients (36%) had at least one cardiovascular risk factor. Arterial hypertension was diagnosed in 60 (59%) patients, dyslipidemia in 28 (27%), diabetes in 15 (15%), obesity in 22 (22%), and hyperuricemia in 19 (18%). History of arrhythmia was found in 25 (25%), conduction defects in 10 (10%), arterial peripheral vascular disease in 7 (7%), venous thrombosis in 10 (10%), coronary artery disease in 24 (24%), and cerebrovascular disease in 22 (22%) of patients. Patients with extraglandular involvement had a higher prevalence of arterial hypertension (p=0.04), dyslipidemia (p=0.003), LDL mean values (p=0.038), hyperuricemia (p=0.03), and coronary artery disease (p=0.01) after adjusting for age, sex, disease duration, and the significant variables in the univariate analysis. Patients with Ro/SSA and La/SSB autoantibodies had a substantially higher risk of hyperuricemia (p=0.01), arrhythmia (p=0.01), coronary artery disease (p=0.02), cerebrovascular disease (p=0.02), and venous thrombosis (p =0.03). In the multivariate logistic regression analysis, higher odds of cardiovascular risk factors were associated with extraglandular involvement (p=0.02), treatment with corticosteroids (p=0.02), ESSDAI>13 (p=0.02), inflammatory markers including ESR levels (p 0.007), and serologic markers such as low C3 levels (p=0.03) and hypergammaglobulinemia (p=0.02). Conclusions: Extraglandular involvement was associated with a higher prevalence of arterial hypertension, dyslipidemia, hyperuricemia, and coronary artery disease. Anti-Ro/SSA and anti-La/SSB seropositivity was associated with a higher prevalence of cardiac rhythm abnormalities, hyperuricemia, venous thrombosis, coronary artery disease, and cerebrovascular disease. Raised inflammatory markers, disease activity measured by ESSDAI, extraglandular involvement, serologic markers including hypergammaglobulinemia and low C3, and treatment with corticosteroids were associated with a higher risk for cardiovascular comorbidities. Key Points • Patients with pSS are vulnerable to cardiovascular risk factors. There is an interconnection between extraglandular involvement, disease activity, inflammatory markers, and cardiovascular risk comorbidities. • Anti-Ro/SSA and anti-La/SSB seropositivity was associated with a higher frequency of cardiac conduction abnormalities, coronary artery disease, venous thrombosis, and stroke. • Hypergammaglobulinemia, elevated ESR, and low C3 are associated with a higher prevalence of cardiovascular comorbidities. • Valid risk stratification tools to help with prevention and consensus on the management of CVDs in pSS patients are warranted. [ABSTRACT FROM AUTHOR]

[Display omitted] This OBSErve Spain study, a part of the international OBSErve programme, evaluated belimumab real-world use and effectiveness following 6 months of treatment in patients with active systemic lupus erythematosus (SLE) in clinical practice in Spain. In this retrospective, observational study (GSK Study 200883), eligible patients with SLE receiving intravenous belimumab (10 mg/kg) had their disease activity (physician assessed), SELENA-SLEDAI scores, corticosteroid use, and healthcare resource utilisation (HCRU), assessed after 6 months of treatment versus index (belimumab initiation) or 6 months pre-index. Overall, 64 patients initiated belimumab, mainly due to ineffectiveness of previous treatments (78.1%) and to reduce corticosteroid use (57.8%). Following 6 months of treatment, 73.4% of patients achieved ≥20% overall clinical improvement, while only 3.1% of patients worsened. Mean (standard deviation, SD) SELENA-SLEDAI score decreased from 10.1 (6.2) at index to 4.5 (3.7) 6 months post-index. HCRU decreased from 6 months pre-index to 6 months post-index, with fewer hospitalisations (10.9% vs 4.7% patients) and ER visits (23.4% vs 9.4% patients). Mean (SD) corticosteroid dose decreased from 14.5 (12.5) mg/day at index to 6.4 (5.1) mg/day 6 months post-index. Patients with SLE receiving belimumab for 6 months in real-world clinical practice in Spain experienced clinical improvements and a reduction in HCRU and corticosteroid dose. [ABSTRACT FROM AUTHOR]

Background: Pregnancies in Systemic lupus erythematosus (SLE) are considered high risk and associated with maternal and obstetric complications. Objectives: To determine the most important predictors for each of the main adverse pregnancy outcomes in SLE patients. Methods: Patients with SLE were retrospectively analysed from 1990 to 2020. Maternal and fetal complications in pregnant women with SLE were retrieved. We compared clinical and analytical characteristics of SLE patients with adverse pregnancy outcomes to controls with SLE diagnosis without adverse pregnancy outcomes. Qualitative data were analysed by Chi‐square test and Fisher's exact test. Continuous variables were analysed by using Student's t test. Multiple logistic regression was performed to determine the predictive factors for adverse pregnancy outcomes with adjustment of confounding factors. Results: 135 multiparous women were included (42% with adverse pregnancy outcomes). A total of 57 pregnancies (42%) were linked to adverse outcomes. The occurrence of abortion was correlated with anti‐DNAds (β = 0.71, p = 0.04), renal involvement (β = 0.28, p 0.03), antiphospholipid antibodies (APA) (β = 0.29, p 0.03), erythrocyte sedimentation rate (ESR) elevation (β = 0.81, p = 0.02) and C‐reactive protein (CPR) elevation (β = 0.91, p = 0.01). Stillbirth was also correlated with renal involvement (β = 0.26, p = 0.04), APA (β = 0.22, p = 0.03) and ESR elevation (β = 0.53, p = 0.02). Preeclampsia was correlated with direct Coombs positivity (β = 0.42, p = 0.01), serositis (β = 0.31, p = 0.02), ESR elevation (β = 0.52, p = 0.03) and CPR elevation (β = 0.32, p = 0.04). Neonatal Lupus was correlated with anti‐RNP (β = 0.16, p = 0.03) and anti‐Ro/SSA (β = 0.16, p 0.02). Conclusions: The most unfavourable pregnancy outcome in women with SLE was spontaneous abortion. Renal involvement, anti‐DNAds positivity, antiphospholipid antibody positivity, anti‐Ro/SSA, elevated ESR and a younger age at disease onset increased the risk of pregnancy complications. [ABSTRACT FROM AUTHOR]

Coastal degradation and habitat disruption are severely compromising sessile marine species. The fan shell Pinna nobilis is an endemic, vulnerable species and the largest bivalve in the Mediterranean basin. In spite of species legal protection, fan shell populations are declining. Models analyzed the contributions of environmental (mean depth, wave height, maximum wave height, period of waves with high energy and mean direction of wave source) versus human-derived stressors (anchoring, protection status, sewage effluents, fishing activity and diving) as explanatory variables depicting Pinna nobilis populations at a mesoscale level. Human stressors were explaining most of the variability in density spatial distribution of fan shell, significantly disturbing benthic communities. Habitat protection affected P. nobilis structure and physical aggression by anchoring reveals a high impact on densities. Environmental variables instead played a secondary role, indicating that global change processes are not so relevant in coastal benthic communities as human-derived impacts. [ABSTRACT FROM AUTHOR]

Background: Clinical guidelines should be updated to maintain their validity. Our aim was to estimate the length of time before recommendations become outdated. Methods: We used a retrospective cohort design and included recommendations from clinical guidelines developed in the Spanish National Health System clinical guideline program since 2008. We performed a descriptive analysis of references, recommendations and resources used, and a survival analysis of recommendations using the Kaplan-Meier method. Results: We included 113 recommendations from 4 clinical guidelines with a median of 4 years since the most recent search (range 3.9-4.4 yr). We retrieved 39 136 references (range 3343-14 787) using an exhaustive literature search, 668 of which were related to the recommendations in our sample. We identified 69 (10.3%) key references, corresponding to 25 (22.1%) recommendations that required updating. Ninety-two percent (95% confidence interval 86.9-97.0) of the recommendations were valid 1 year after their development. This probability decreased at 2 (85.7%), 3 (81.3%) and 4 years (77.8%). Interpretation: Recommendations quickly become outdated, with 1 out of 5 recommendations being out of date after 3 years. Waiting more than 3 years to review a guideline is potentially too long. [ABSTRACT FROM AUTHOR]

To identify risk factors predisposing patients to poor outcomes after fixation of periprosthetic hip fractures around femoral stems. Prospective multicentre cohort study of fractures around a hip replacement stem managed by internal fixation. The primary outcome was one-year mortality, while secondary outcomes were local complications and healthcare burden-related outcomes (nursing facility utilization and hospital length of stay). One-year mortality was 16.2%. Age-adjusted Charlson Comorbidity Index score (OR=1.17; 95%CI=1.03-1.33)), Pfeiffer Short Portable Mental Status Questionnaire (SPMSQ) score (OR=1.16; 1.06-1.28), prosthetic dysfunction (OR=1.90; 1.00-3.61), and postoperative medical complications (OR=1.97; 1.06-3.68) were predictors of mortality. Patients with prior prosthetic dysfunction, lower Pfeiffer SPMSQ scores, Vancouver A fractures, and fractures fixed only using cerclages were at higher risk of local complications, which occurred in 9.3% of cases. Medical (OR=1.81; 1.05-3.13) and local complications (OR=5.56; 2.42-3.13) emerged as consistent risk factors for new institutionalization. Average hospitalization time was 13.9±9.2 days. Each day of fixation delay led to an average 1.4-day increase in total hospitalization. Frail periprosthetic hip-fracture patients with poorer functional status, dysfunctional replacements, and postoperative complications are at increased risk of mortality. Postoperative complications are more common in patients with dysfunctional arthroplasties, Vancouver A fractures, and fixation using cerclages alone. Postoperative complications were the most consistent predictor of higher healthcare resource utilization. [ABSTRACT FROM AUTHOR]

The article presents a study on the state of fish population and influence of the artificial reefs (ARs) deployed in the Balearic Island after its deployment in the early 1990s. According to earlier studies, it was concluded that the concentrated medium and large sizes of commercial fishes in the area could lead to overfishing. The result indicates that there is no increased in overfishing due to the moderate fishing effort in the area.

Abstract: Patch dynamics of the Mediterranean slow-growing seagrass Posidonia oceanica was studied in two shallow sites (3–10m) of the Balearic Archipelago (Spain) through repeated censuses (1–2year−1). In the sheltered site of Es Port Bay (Cabrera Island), initial patch density (October 2001) was low: 0.05patchesm−2, and the patch size (number of shoots) distribution was bimodal: most of the patches had less than 6 shoots or between 20 and 50 shoots. Mean patch recruitment in Es Port Bay (0.006±0.002patchesm−2 year−1) exceeded mean patch loss (0.001±0.001patchesm−2 year−1), yielding positive net patch recruitment (0.004±0.003patchesm−2 year−1) and a slightly increased patch density 3 years later (July 2004, 0.06patchesm−2). In the exposed site of S’Estanyol, the initial patch density was higher (1.38patchesm−2, August 2003), and patch size frequency decreased exponentially with size. Patch recruitment (0.26patchesm−2 year−1) and loss (0.24patchesm−2 year−1) were high, yielding a slightly increased patch density in the area 1 year later (October 2004, 1.40patchesm−2). Most recruited patches consisted of rooting vegetative fragments of 1–2 shoots. Seedling recruitment was observed in Summer 2004 at both sites. Episodic, seedling recruitment comprised 30% and 25% of total patch recruitment in Es Port Bay and S’Estanyol, respectively. Patch survival increased with patch size and no direct removal was observed among patches of 5 shoots or more. Most patches grew along the study, shifting patch distribution towards larger sizes. Within the size range studied (1–150 shoots), absolute shoot recruitment (shootsyear−1) increased linearly with patch size (R 2 =0.64, p <4×10−5, N =125), while specific shoot recruitment was constant (about 0.25±0.05year−1), although its variance was large for small patches. Given the slow growth rate and the high survival of patches with 5 or more shoots, even the low patch recruitment rates reported here could play a significant role in the colonisation process of P. oceanica. [Copyright &y& Elsevier]

The intensive reconstructive sampling (1957–2004, 39 localities), a systematic direct observation (1992–2004, 1 locality) and particular direct observations (66 localities) of Posidonia oceanica meadows were analysed together with temporal series of flowering available in the literature (19 localities). This allowed the examination of temporal and spatial variability in annual flowering prevalence (FP, the fraction of meadows flowering in a given year) and of annual meadow flowering intensity (FI, number of inflorescences per shoot) for the period 1979–2004 across the Western Mediterranean, as well as spatial variability of flowering frequency (FF, the fraction of years that a given meadow has flowered) and shoot flowering probability (Pf, fraction of flowering stalks appeared per annual segment). Each year, on an average 17% of the investigated meadows flowered, ranging from 3 to 86% of meadows among the years. The highest annual FP and FI values were obtained in 2003 (FP=0.86 and mean FI=0.23±0.03 inflorescences shoot−1). A secondary peak of FP and mean FI occurred 9 years earlier, in 1994 (FP=0.44 and mean FI=0.08±0.02). Both peaks of flowering occurred after hot summers. Flowering synchrony in particular years across the Western Mediterranean and clines of increased meadow flowering frequency towards the North and East, suggests the existence of large-scale environmental mechanisms controlling the floral induction. On the other hand, meadow FF and Pf were highly heterogeneous among and within the meadows, indicating that local factors also may play a significant role in flowering induction. When flowering, the Western Mediterranean meadows showed an average 0.11±0.02 inflorescences shoot−1, but FI greatly varied among and along the series (from 0.002 to 0.54 inflorescences shoot−1) and decreased significantly with depth but was independent of meadow shoot density and meadow latitude or longitude. The shoot flowering probability was quite low (0.007±0.002 inflorescences shoot−1 year−1) and exponentially increased with shoot age. [ABSTRACT FROM AUTHOR]

The prevalence of overweight and obesity in the population, along with their associated complications, is a major factor contributing to increased morbidity and mortality in developed countries. The liver is a vital organ for maintaining metabolic homeostasis, especially in the adjustment periods in fasting and feeding. Per-Arnt-Sim (PAS) kinase (PASK) controls glucose homeostasis and energy metabolism in response to nutritional status. PASK-deficient mice with a high-fat diet (HFD) resist the development of obesity and hepatic steatosis, with improved insulin sensitivity. We have investigated the regulation of the PASK expression in an HFD, as well as its role in adapting to fasting and feeding conditions. PASK-deficient mice with an HFD record improved parameters for the following: body weight, glucose tolerance, insulin resistance and serum lipid parameters. An HFD alters the down-regulation of Pask expression produced by fasting, as normally happens in a standard-fat diet. PASK deficiency blocks or diminishes the expression of many genes overexpressed in HFD-fed mice, such as the following: transcription factors involved in the regulation of gluconeogenic enzymes, the transport of fatty acid into mitochondria, beta-oxidation and de novo lipogenesis. PASK also regulates gene expression posttranscriptionally through the short noncoding RNAs involved in lipid metabolism and glucose homeostasis. The expression of miR-33a and miR-143 changes in PASK-deficient mice with an HFD. Thus, PASK-deficient mice improved their adaptation to feeding/fasting through a highly regulated molecular mechanism that controls the expression and function of the transcription factors, enzymes and miRNAs involved in glucose and insulin signaling. [ABSTRACT FROM AUTHOR]

Due to the rise in aquaculture production, a global increase in Integrated Multi-Trophic Aquaculture Systems (IMTA) combining species and optimizing niches is expected to mitigate environmental impacts. However, these facilities are currently composed of plastic materials that can directly or indirectly be released into the marine environment and become available for reared species such as fish and mussels. This study aims to contribute to the quantification of plastics from IMTA systems with a holistic approach. For this purpose, we evaluated plastic ingestion in two edible species (Sparus aurata and Mytilus galloprovincialis) from sea-based experimental aquaculture facilities in Mallorca, as well as plastic loads in the surrounding surface waters. Plastics were observed at the IMTA system in 33% of Sparus aurata samples, 94% of Mytilus galloprovincialis samples, and 100% of sea surface water samples. Plastic ingestion was approximately twice as high in filter feeder mussels as in fish. Additionally, the type and composition of ingested particles differed between species; fish ingested up to 70% films and filaments of HDPE and LDPE, while mussels ingested 97% fibers composed of cellulose acetate. Our results suggest that bioindicator species such as S. aurata and M. galloprovincialis should be included in monitoring programs of aquaculture facilities to better understand the fate of plastics derived from these practices. [Display omitted] • Plastics are present in 33% of fish, 94% of mussels, and 100% of water samples. • Plastic films and filaments predominate in fish, and fibers in mussels. • Plastic fragments predominate in coastal surface waters. • HDPE polymers are most common in fish and water, and cellulose acetate in mussels. • Bioindicators for plastics should be integrated into aquaculture monitoring schemes. [ABSTRACT FROM AUTHOR]

Background: Clinical practice guidelines (CPGs) become quickly outdated and require a periodic reassessment of evidence research to maintain their validity. However, there is little research about this topic. Our project will provide evidence for some of the most pressing questions in this field: 1) what is the average time for recommendations to become out of date?; 2) what is the comparative performance of two restricted search strategies to evaluate the need to update recommendations?; and 3) what is the feasibility of a more regular monitoring and updating strategy compared to usual practice?. In this protocol we will focus on questions one and two. Methods: The CPG Development Programme of the Spanish Ministry of Health developed 14 CPGs between 2008 and 2009. We will stratify guidelines by topic and by publication year, and include one CPG by strata. We will develop a strategy to assess the validity of CPG recommendations, which includes a baseline survey of clinical experts, an update of the original exhaustive literature searches, the identification of key references (reference that trigger a potential recommendation update), and the assessment of the potential changes in each recommendation. We will run two alternative search strategies to efficiently identify important new evidence: 1) PLUS search based in McMaster Premium LiteratUre Service (PLUS) database; and 2) a Restrictive Search (ReSe) based on the least number of MeSH terms and free text words needed to locate all the references of each original recommendation. We will perform a survival analysis of recommendations using the Kaplan-Meier method and we will use the log-rank test to analyse differences between survival curves according to the topic, the purpose, the strength of recommendations and the turnover. We will retrieve key references from the exhaustive search and evaluate their presence in the PLUS and ReSe search results. Discussion: Our project, using a highly structured and transparent methodology, will provide guidance of when recommendations are likely to be at risk of being out of date. We will also assess two novel restrictive search strategies which could reduce the workload without compromising rigour when CPGs developers check for the need of updating. [ABSTRACT FROM AUTHOR]

Abstract: The decline of important coastal habitats, like seagrass meadows, is likely to influence populations of associated species, like the noble pen shell, Pinna nobilis. Here we used a Bayesian formulation of individual covariate models to derive a reliable estimate of populations of P. nobilis in shallow, and thus usually most impacted, areas around the island of Majorca, Balearic Islands, Spain. At six evaluated sites we find quite distinct densities ranging from 1.4 to 10.0 individuals/100m2. These differences in density could not be explained by habitat factors like shoot density and meadow cover, nor did dislodgement by storms (evaluated by maximum wind speeds at the sites) seem to play an important role. However, noble pen shell density was related to anchoring as at sites where anchoring was not permitted the average density was 7.9 individuals/100m2 while in sites where ships anchored the density was on average 1.7 individuals/100m2. As for the conservation of Posidonia oceanica meadows, for the associated population of P. nobilis it would be of utmost importance to reduce anchoring pressure as a conservation measure for these endangered and protected bivalves. [Copyright &y& Elsevier]

Abstract: The relationship between sedimentary Fe inputs and net seagrass population growth across a range of Posidonia oceanica meadows growing in carbonate Mediterranean sediments (Balearic Islands, Spain; SE Iberian Peninsula, Spain; Limassol, Cyprus; Sounion, Greece) was examined using comparative analysis. Sedimentary Fe inputs were measured using benthic sediment traps and the net population growth of P. oceanica meadows was assessed using direct census of tagged plants. The meadows examined ranged from meadows undergoing a severe decline to expanding meadows (specific net population growth, from −0.14yr−1 to 0.05yr−1). Similarly, Fe inputs to the meadows ranged almost an order of magnitude across meadows (8.6–69.1mgFem−2 d−1). There was a significant, positive relationship between sedimentary iron inputs and seagrass net population growth, accounting for 36% of the variability in population growth across meadows. The relationship obtained suggested that seagrass meadows receiving Fe inputs below 43mgFem−2 d−1 are vulnerable and in risk of decline, confirming the pivotal role of Fe in the control of growth and the stability of seagrass meadows in carbonate sediments. [Copyright &y& Elsevier]

We conducted a 2-year in situ experiment to test the capacity of iron additions to reverse the decline experienced by a Posidonia oceanica meadow colonizing carbonate, iron poor sediment. Iron additions improved the sediment conditions that support seagrass growth by decreasing the sediment sulfide concentration and sulfate reduction rates, and decreased sulfide intrusion into the plants. Iron additions for 2 years did not significantly change survivorship of shoots present at the onset of the experiment, but significantly increased shoot recruitment and survivorship of shoots recruited during the experiment. After 2 years, iron additions reversed seagrass decline and yielded positive growth rates of shoots relative to control populations where seagrass continued to decline. This research demonstrates that seagrass decline in carbonate sediments may be reversed by targeting critical processes such are sediment sulfide pools and seagrass nutritional status, controlling the functioning of the ecosystem. [ABSTRACT FROM AUTHOR]

Abstract: The usefulness of vertical rhizome growth as an early indicator of fish farm impacts to Posidonia oceanica meadows was tested by comparing annual estimates of vertical rhizome growth, quantified retrospectively, at distances ranging between 5 and 1200m from fish cages at four Mediterranean locations (Cyprus, Greece, Italy and Spain). The studied fish farms had been operating since, at least, 1997, producing between 150 and 1150tonsyr−1 of sea bream (Sparus aurata) and sea bass (Dicentrachus labrax), and, at Italy, also sharpsnout sea bream (Diplodus puntazzo). The reconstructed vertical rhizome growth spanned from 19 to 25 years of growth, depending on sites, and the average vertical rhizome growth before the onset of fish farm operations ranged between 4.48 and 8.79mmyr−1. The vertical rhizome growth after the onset of farming activities declined significantly (t-test, P <0.05) from the control station (at >800m from the farm; vertical growth rate averaged 6.79, 5.52, 3.89 and 3.70mmyr−1 at Cyprus, Greece, Italy and Spain control stations, respectively) to the impacted one (at 5–300m from the farm; vertical growth rate was 4.82, 3.52, 2.77 and 1.92mmyr−1 at Cyprus, Greece, Italy and Spain impacted stations, respectively) at each farm. Moreover, vertical growth significantly (t-test, P <0.05) declined by about twofold following the onset of fish farm operations for the extant meadow nearest to the cages, as well as those supporting intermediate impacts at distances 35–400m from the cages. Vertical rhizome growth was not significantly affected after the onset of fish farm operations for the meadows located more than 800m from the farm, except in those from the Italian site, the largest farm. Examination of the time course of vertical growth for individual rhizomes in the areas of the meadow nearest to the farms, except for those at Cyprus, showed that the decline in vertical growth was initiated within the year of the onset of farming activities, suggesting a negligible resistance of seagrass meadows to fish farm impacts. The results obtained confirm that fish farm activities strongly affect seagrass health on the surrounding meadows, and clearly demonstrate the value of reductions in vertical rhizome growth as an early warning symptom of stress and impacts to P. oceanica meadows. [Copyright &y& Elsevier]

• The ingestion of MPs alters the behavior of the individuals. • MPs treatment groups are more active than control group. • Significant differences were found for all biomarkers except for MDA in liver. • Weathered group presented significantly higher values for CAT and SOD in brain. • Additional pollutants in MPs trigger higher physiological responses than virgin MPs. Increasing global research has identified microplastics (MPs) to be impacting marine organisms. The present work aimed at investigating the physiological and behavioral effects of thirty-six juvenile Sparus aurata exposed to control, virgin and weathered MPs enriched diets during a 21-day period under controlled conditions. Physiological effects were assessed in liver and brain using the following biomarkers: activities of the antioxidant enzymes catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GRd), the detoxifying enzyme glutathione S-transferase (GST) and malondialdehyde (MDA) as indicative of lipid peroxidation. Individuals were recorded for behavior analysis (i.e. social interactions and feeding behavior). Results revealed an increase in cellular stress from control to weathered fish groups, with the virgin group showing intermediate levels in all quantified biomarkers. Significant differences were found in the liver for all biomarkers except for MDA, suggesting that exposure time to MPs in this experiment is long enough to trigger the activation of antioxidant enzymes but not to produce cell damage by lipid peroxidation. In brain tissue samples, fish from the weathered group presented significantly higher values for CAT and SOD, highlighting its function as primary antioxidants. Regarding behavioral effects, results showed that the two MPs enriched groups were significantly bolder during social interactions and, although no significantly, tended to be more active during feeding. In conclusion, MPs which have been weathered in marine environmental conditions produces a higher physiological response than virgin MPs but also, a physiological response is variable depending on the tissue analyzed. In addition, a short period to MP exposure seems to affect overall social and feeding behavior but, further research is needed to assess long-term effects of MP ingestion and its potential consequences on fish populations. [ABSTRACT FROM AUTHOR]

A mass mortality event is devastating the populations of the endemic bivalve Pinna nobilis in the Mediterranean Sea from early autumn 2016. A newly described Haplosporidian endoparasite (Haplosporidium pinnae) is the most probable cause of this ecological catastrophe placing one of the largest bivalves of the world on the brink of extinction. As a pivotal step towards Pinna nobilis conservation, this contribution combines scientists and citizens' data to address the fast- and vast-dispersion and prevalence outbreaks of the pathogen. Therefore, the potential role of currents on parasite expansion was addressed by means of drift simulations of virtual particles in a high-resolution regional currents model. A generalized additive model was implemented to test if environmental factors could modulate the infection of Pinna nobilis populations. The results strongly suggest that the parasite has probably dispersed regionally by surface currents, and that the disease expression seems to be closely related to temperatures above 13.5 °C and to a salinity range between 36.5–39.7 psu. The most likely spread of the disease along the Mediterranean basin associated with scattered survival spots and very few survivors (potentially resistant individuals), point to a challenging scenario for conservation of the emblematic Pinna nobilis, which will require fast and strategic management measures and should make use of the essential role citizen science projects can play. [ABSTRACT FROM AUTHOR]

Background: Clinical practice guidelines (CPGs) become quickly outdated and require a periodic reassessment of evidence research to maintain their validity. However, there is little research about this topic. Our project will provide evidence for some of the most pressing questions in this field: 1) what is the average time for recommendations to become out of date?; 2) what is the comparative performance of two restricted search strategies to evaluate the need to update recommendations?; and 3) what is the feasibility of a more regular monitoring and updating strategy compared to usual practice?. In this protocol we will focus on questions one and two.Methods: The CPG Development Programme of the Spanish Ministry of Health developed 14 CPGs between 2008 and 2009. We will stratify guidelines by topic and by publication year, and include one CPG by strata.We will develop a strategy to assess the validity of CPG recommendations, which includes a baseline survey of clinical experts, an update of the original exhaustive literature searches, the identification of key references (reference that trigger a potential recommendation update), and the assessment of the potential changes in each recommendation.We will run two alternative search strategies to efficiently identify important new evidence: 1) PLUS search based in McMaster Premium LiteratUre Service (PLUS) database; and 2) a Restrictive Search (ReSe) based on the least number of MeSH terms and free text words needed to locate all the references of each original recommendation.We will perform a survival analysis of recommendations using the Kaplan-Meier method and we will use the log-rank test to analyse differences between survival curves according to the topic, the purpose, the strength of recommendations and the turnover. We will retrieve key references from the exhaustive search and evaluate their presence in the PLUS and ReSe search results.Discussion: Our project, using a highly structured and transparent methodology, will provide guidance of when recommendations are likely to be at risk of being out of date. We will also assess two novel restrictive search strategies which could reduce the workload without compromising rigour when CPGs developers check for the need of updating. [ABSTRACT FROM AUTHOR]

The fan mussel Pinna nobilis is a long lived species endemic to the Mediterranean Sea and is considered one of the biggest bivalve molluscs of the Mediterranean. A multitude of threats has provoked a great reduction in P. nobilis populations. To increase the knowledge about the recruitment period and number of Pinna nobilis recruits, two types of recruitment devices were deployed in July 2007 on a Marine Protected Area of Palma Bay, Mallorca (western Mediterranean). A total of 614 juveniles of P. nobilis, with a mean length and width of 2.76±0.04 and 1.10±0.01 cm respectively, were collected inside the artificial microhabitat generated by the knots of ‘device Type I’. Similarly, 691 P. nobilis were recruited with a mean length and width of 5.38±0.08 and 2.10±0.04 cm respectively from ‘device Type II’. Moreover, in the year 2007, the present study determined that P. nobilis recruitment takes place between the last week of August and the first week of September. This study produces some crucial information for effective protection and conservation of the fan mussel. Moreover, a Pinna nobilis artificial recruitment with seed collectors would permit an alternative tool for field studies without compromising the concentration of the vulnerable populations of this mollusc. [ABSTRACT FROM PUBLISHER]