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The neuston layer represents a complex community inhabiting the interface where oceanographic and atmospheric processes interact. Here, our aim was to compare patterns in the distribution and abundance of cnidarian assemblages observed in the neuston to parallel patterns previously observed in epipelagic waters along the spread of the Amazon River Plume over the Western Equatorial Atlantic, to test if the neuston reflects the patterns of the overall community whose core of distribution is located in epipelagic waters or are shaped by specific surface processes. The results show that both initial hypothesis were false. Instead, the cnidarian assemblages showed range-edge effect at the major ecotone placed at the interface between ocean and atmosphere. I.e., when proximate to the superior limits of their three-dimensional geographic ranges, represented here by the neuston, the population of most observed species occur in lower abundance. Specifically at the portion of the continental shelf with influence of the Amazon River Plume, the range-edge effect seems to be more prominent. Such results suggests the core of the cnidarian populations inhabiting this habit may lie in the deeper hypoxic waters beneath the plume. In conclusion, due the marked vertical structure observed here, proper evaluations of spatial patterns in the structure of pelagic cnidarian communities should preferentially be grounded on stratified sampling. [ABSTRACT FROM AUTHOR]

Many animals possess high-contrast body patterns. When moving, these patterns may create confusing or conflicting visual cues that affect a predator's ability to visually target or capture them, a phenomenon called motion dazzle. The dazzle patterns may generate different forms of optical illusion that can mislead observers about the shape, speed, trajectory and range of the animal. Moreover, it is possible that the disruptive visual effects of the high contrast body patterns can be enhanced when moving against a high contrast background. In this study, we used the humbug damselfish (Dascyllus aruanus) to model the apparent motion cues of its high contrast body stripes against high contrast background gratings of different widths and orientations, from the perspective of a predator. We found with higher frequency gratings, when the background is indiscriminable to a viewer, that the humbugs may rely on the confusing motion cues created by internal stripes. With lower frequency gratings, where the background is likely perceivable by a viewer, the humbugs can rely more on confusing motion cues induced by disruption of edges from both the background and body patterning. We also assessed whether humbugs altered their behaviour in response to different backgrounds. Humbugs remained closer and moved less overall in response to backgrounds with a spatial structure similar to their own striped body pattern, possibly to stay camouflaged against the background and thus avoid revealing themselves to potential predators. At backgrounds with higher frequency gratings, humbugs moved more which may represent a greater reliance on the internal contrast of the fish's striped body pattern to generate motion dazzle. It is possible that the humbug stripes provide multiple protective strategies depending on the context and that the fish may alter their behaviour depending on the background to maximise their protection. [ABSTRACT FROM AUTHOR]

The recruitment of marine species in isolated oceanic island systems can be challenged by prevailing currents, as exemplified by the Tropical Southwestern Atlantic. In this region, the Fernando de Noronha ridge hosts several seamounts, the Rocas Atoll and the Fernando de Noronha Archipelago, which are home to great marine biodiversity. However, along the ridge, the central branch of the South Equatorial Current (cSEC), flowing westward, poses a challenge to the recruitment of organisms toward Fernando de Noronha. To unveil critical insights into the intricate processes shaping biodiversity in these insular ecosystems, we use a dispersal Lagrangian tool to explore the role of diel vertical migration (DVM) to depth strata influenced by the South Equatorial Undercurrent (SEUC), which flows eastward bellow the cSEC, in shaping species dispersal and metacommunity dynamics. Our results show that while not a direct journey, the DVM into SEUC‐influenced strata increases the possibility that the seamounts and the Rocas Atoll act as stepping stones between the continental shelf and Fernando de Noronha. Propagules of organisms originating primarily from the continental shelf are transported to the western seamounts of the ridge. Upon reaching the western seamounts, organisms can find suitable habitats to recruit. The progeny of these communities that migrate to SEUC‐influenced strata have the opportunity to reach suitable habitats at the Rocas Atoll and the Eastern seamounts, ultimately connecting to the Fernando de Noronha archipelago. These results provide scientific fundaments for the development of a functional network of marine protected areas in the Tropical Southwestern Atlantic. [ABSTRACT FROM AUTHOR]

The article discusses a study conducted in Italy that evaluated the use of recombinant factor IX-albumin fusion protein (rIX-FP) as a treatment for adult patients with hemophilia B. The study found that rIX-FP prophylaxis was effective in reducing bleeding episodes and required fewer infusions compared to previous treatments. The most common dosing regimen was every 14-15 days, with one patient using a 21-day regimen. The study concluded that rIX-FP is a flexible and effective treatment option for adult patients with hemophilia B, but further research is needed to assess long-term outcomes. It is important to consider physical activity levels and lifestyle when personalizing prophylaxis regimens. [Extracted from the article]

Purpose: We studied the relationship between job engagement and systematic problem solving (SPS) among shop-floor employees and how lean production (LP) and Internet of Things (IoT) systems moderate this relationship. Design/methodology/approach: We collected data from a sample of 440 shop floor workers in 101 manufacturing work units across 33 plants. Because our data is nested, we employed a series of multilevel regression models to test the hypotheses. The application of IoT systems within work units was evaluated by our research team through direct observations from on-site visits. Findings: Our findings indicate a positive association between job engagement and SPS. Additionally, we found that the adoption of lean bundles positively moderates this relationship, while, surprisingly, the adoption of IoT systems negatively moderates this relationship. Interestingly, we found that, when the adoption of IoT systems is complemented by a lean management system, workers tend to experience a higher effect on the SPS of their engagement. Research limitations/implications: One limitation of this research is the reliance on the self-reported data collected from both workers (job engagement, SPS and control variables) and supervisors (lean bundles). Furthermore, our study was conducted in a specific country, Italy, which might have limitations on the generalizability of the results since cross-cultural differences in job engagement and SPS have been documented. Practical implications: Our findings highlight that employees' strong engagement in SPS behaviors is shaped by the managerial and technological systems implemented on the shop floor. Specifically, we point out that implementing IoT systems without the appropriate managerial practices can pose challenges to fostering employee engagement and SPS. Originality/value: This paper provides new insights on how lean and new technologies contribute to the development of learning-to-learn capabilities at the individual level by empirically analyzing the moderating effects of IoT systems and LP on the relationship between job engagement and SPS. [ABSTRACT FROM AUTHOR]

Aims: Lymph node metastases (LNM) are one of the most important prognostic indicators in solid tumours and a major component of cancer staging. Neoadjuvant therapy might influence nodal status by induction of regression. Our aim is to determine the prevalence and role of regression of LNM on outcomes in patients with rectal cancer. Methods and results: Four independent study populations of rectal cancer patients treated with similar regimens of chemoradiotherapy were pooled together to obtain a total cohort of 469 patients. Post‐treatment nodal status (ypN) and signs of tumour regression (Reg) were incorporated to form three‐tiered (ypN− Reg+, ypN− Reg− and ypN+) and four‐tiered (ypN− Reg+, ypN− Reg−, ypN+ Reg+ and ypN+ Reg−) classifications. In our cohort, 31% of patients presented with ypN+ rectal cancer. As expected, we found significantly worse overall survival (OS) in ypN+ patients compared to ypN− patients (P = 0.002). The percentage of ypN− patients with lymph nodes with complete regression was 20% in our cohort. While node‐negative patients with and without regression had similar OS (P = 0.09), disease‐free survival (DFS) was significantly better in node‐negative patients with regression (P = 0.009). Conclusions: Regression in lymph nodes is frequent, and node‐negative patients with evidence of lymph node regression have better DFS compared to node‐negative patients without such evidence. [ABSTRACT FROM AUTHOR]

Dispersal is more intense in the ocean than on land because most marine taxa present planktonic life stages that are transported by currents even without specific morphological traits. Thus, species dispersal shapes the distribution of biodiversity along seascapes and drives the composition of biodiversity assemblages. To identify marine assembling zones which characterise spatial areas particularly prone to receive and retain similar animal assemblages from the regional pool of species through passive dispersal, we propose a community‐based approach grounded on Lagrangian simulations of plankton dispersal. This novel approach was applied to communities (coast, outer shelf, slope, seamounts and islands; 0–80 m depth) of the Tropical Southwestern Atlantic and used to assess connectivity pathways. For that, we classified the modelled particles in 15 categories according to biological traits (planktonic life duration and spawning habitat) of representative planktonic communities. From the hierarchical clustering of the multivariate matrix containing the amount of arriving particles from each category in each cell we defined 14 assembling zones. Results highlighted that the assembling zones were mostly shaped by the degree of exposure to currents and the presence of mesoscale features (eddies, recirculation) derived from the interaction between these currents and coastlines. The boundaries, dispersal and connectivity patterns of these zones consistently align with local and regional in situ spatial distribution and abundance patterns of organisms, and provide an appropriate basis for the formulation of ecological hypotheses in the metacommunity framework to be tested in situ, such as the balance between species sorting and mass effect assembling archetypes. This approach, when coupled with the knowledge of other processes shaping communities' structure and distribution, provides important insights for regions and animal groups for which knowledge is limited or absent, and more generally allows for a comprehensive overview of the distribution of distinct communities and connectivity pathways along marine environments. [ABSTRACT FROM AUTHOR]

Although the use of prophylaxis regimens with prolonged half-life factors is now widespread in the world of hemophilia A, there is a lack of real-life evidence on the impact of these products on joint health, adherence, and quality of life of patients. Turoctocog alfa pegol is a glycoPEGylated recombinant factor VIII (FVIII) with an extended half-life (EHL), developed for prophylaxis, treatment of bleeds, and perioperative management in patients with hemophilia A. We report here on three cases of three patients affected by severe hemophilia A, with variable bleeding phenotype and lifestyle, to describe our clinical practice on prophylaxis with turoctocog alfa pegol. As confirmed in our cases, FVIII trough levels remained coherent with those experienced in the registration trial after the switch to the commercial EHL drug. Moreover, the cases highlight how the current clinical management of hemophilia can personalize treatment in several specific conditions. [ABSTRACT FROM AUTHOR]

Treatment of lenalidomide refractory (Len-R) multiple myeloma (MM) patients still represents an unmet clinical need. In the last years, daratumumab-bortezomib-dexamethasone (D-VD) combination was extensively used in this setting, even though only a small fraction of Len-R patients was included in the pivotal trial. This real-life study aimed to evaluate the efficacy and safety of the D-VD regimen in a cohort that exclusively enrolled Len exposed or refractory MM patients. The study cohort included 57 patients affected by relapsed/refractory MM. All patients were previously exposed to Len, with 77.2% being refractory. The overall response rate (ORR) was 79.6% with 43% of cases obtaining at least a very good partial response (VGPR). The D-VD regimen showed a favorable safety profile, with low frequency of grade 3–4 adverse events, except for thrombocytopenia observed in 21.4% of patients. With a median follow-up of 13 months, median progression-free survival (PFS) was 17 months. No significant PFS differences were observed according to age, ISS, LDH levels, type of relapse, and high-risk FISH. Len exposed patients displayed a PFS advantage as compared to Len refractory patients (29 vs 16 months, p = 0.2876). Similarly, patients treated after Len maintenance showed a better outcome as compared to patients who had received a full-dose Len treatment (23 vs 13 months, p = 0.1728). In conclusion, our real-world data on D-VD combination showed remarkable efficacy in Len-R patients, placing this regimen as one of the standards of care to be properly taken into account in this MM setting. [ABSTRACT FROM AUTHOR]

This article examines the impact of the COVID-19 pandemic on mortality rates associated with hematological malignancies in Italy. The study found that deaths with any mention of hematological malignancies increased in 2020 compared to the previous year, while deaths classified as the underlying cause of death declined. The increase in mortality was most pronounced for chronic lymphocytic leukemia (CLL) and less prominent for non-Hodgkin lymphoma (NHL) and multiple myeloma (MM). The study highlights the importance of considering multiple causes of death in assessing the mortality burden in hematological patients during the pandemic. [Extracted from the article]

Aim: Water column acoustic backscatter is regularly registered during oceanographic surveys, providing valuable information on the composition and distribution of pelagic life in the ocean. We propose an objective approach based on functional data analysis to classify these acoustic seascapes into biogeographical regions. Location: Tropical South Atlantic Ocean off northeastern Brazil. Taxon: Sound‐scattering pelagic fauna detected with acoustic echosounders, principally small fish, crustaceans, squid and diverse gelatinous life‐forms. Methods: We use acoustic backscatter as a function of depth, simultaneously at three frequencies, to numerically describe the vertical distribution and composition of sound‐scattering organisms in the water column. This information is used to classify the acoustic seascape through functional principal component analysis. The analysis routine is tested and illustrated with data collected at 38, 70 and 120 kHz in waters affected by contrasting environmental conditions. Results: Acoustic seascape partitioning mirrored the distribution of current systems, fronts and taxonomically based regionalization. The study area was divided between slope‐boundary and open‐ocean waters, and between spring and fall hydrological regimes. Main Conclusions: The acoustic seascape consistency and the spatiotemporal coherence of the regions classified show that the method is efficient at identifying homogeneous and cohesive sound‐scattering communities. Comparisons against hydrological and biological regionalization prove that the method is reliable at delineating distinct pelagic ecosystems in a cost‐efficient and non‐intrusive way. [ABSTRACT FROM AUTHOR]

The impact of the Amazon River freshwater plume on planktonic cnidarians over neritic and oceanic provinces is unknown. To provide further knowledge we took advantage of an oceanographic cruise performed in October 2012 in the Western Atlantic off the North Brazilian coast (8°N, 51°W—3.5°S, 37°W). A complex and dynamic system was observed, with strong currents and eddies dispersing the plume over a large area. Our results show that the Amazon River shapes marine habitats with a thin highly productive surface layer compressed by a deeper oxygen minimum zone both over the shelf and in the open ocean. We hypothesized that such habitat structure is particularly advantageous to planktonic cnidarians, which have low metabolic rates, being able to survive in hypoxic zones, resulting in high species richness and abundance. Over the shelf, distinctions were sharp and the area under the influence of the plume presented a diverse assemblage occurring in large abundance, while outside the plume, the hydromedusa Liriope tetraphylla was dominant and occurred almost alone. Divergences in the oceanic province were less pronounced, but still expressive being mostly related to the abundance of dominant species. We concluded that Amazon River plume is a paramount physical feature that profoundly affects the dynamics of the mesoscale habitat structure in the Western Equatorial Atlantic Ocean and that such habitat structure is responsible for shaping planktonic cnidarian assemblages both in neritic and oceanic provinces. [ABSTRACT FROM AUTHOR]

Many animal species can rapidly change their body colouration and patterning, but often the ecological drivers of such changes are unknown. Here, we explored dynamic colour change in the bluelined goatfish, Upeneichthys lineatus, a temperate marine teleost species. Upeneichthus lineatus can change in a matter of seconds, from a uniform white colour to display prominent, vertical, dark red stripes. Initial observations suggested that rapid colour change in U. lineatus was associated with feeding and may act as a signal to both conspecifics and heterospecifics that are frequently observed to follow feeding goatfish. Field observations of the colour and behaviour of individual U. lineatus were collected to (1) document the repertoire of behaviours that U. lineatus displays and categorise associated colour patterns; (2) quantify the speed of dynamic colour change; (3) establish the context in which U. lineatus changes colour and pattern; and (4) test whether the behaviour of follower fishes is influenced by colour patterning or specific behaviours of the focal goatfish. We found that U. lineatus changed colouration from white to the red banded pattern in less than 10 s. The key driver of rapid colour change in U. lineatus was feeding, particularly when the fish fed with its head buried in sediment. Conspecific followers were most likely to be white in colour and adopt searching behaviour, regardless of the focal fish colour or behaviour. Other species of follower fish spent significantly more time following U. lineatus that were displaying dark red stripes when searching or eating, implying the red stripes may be an interspecific signalling mechanism. Our findings indicate that rapid colour change in teleost fish may be used for social communication and may provide U. lineatus with increased protection from predation when feeding via a safety‐in‐numbers approach. [ABSTRACT FROM AUTHOR]

In this paper, based on fieldwork and herbaria surveys, new data concerning the presence of 32 native and alien vascular species for Sicily (Italy) are provided. Among the native species, the occurrence of the following taxa is reported for the first time or confirmed after many decades of non-observation: Aira multiculmis, Arum maculatum, Carex flacca subsp. flacca, Mentha longifolia, Oxybasis chenopodioides, Najas minor and Xiphion junceum. Furthermore, we document the presence of three native species (Cornus mas, Juncus foliosus and Limonium avei) that, despite being repeatedly observed in Sicily and reported in the literature, are inexplicably omitted by the most recent authoritative checklists regarding the flora of Italy. Finally, fifteen alien species new to Sicily (including one new to Europe, i.e., Pyrus betulifolia) are reported and seven poorly documented allochthonous taxa are confirmed for the island, and for two of them, a status change is proposed. These new or confirmed records allow us to better define the European and national distribution of the targeted taxa and offer new insights on the native and alien flora of Sicily. [ABSTRACT FROM AUTHOR]

There is a rapid and extensive decline of our marine biodiversity due to human impacts. However, our ability to understand the extent of these effects is hindered by our lack of knowledge of the occurrence and ecology of some species groups. One such group of understudied organisms are marine flatworms of the order Polycladida, a conspicuous component of southeastern Australia's marine ecosystems that has received little attention over the years. Intertidal boulder beaches support a diverse range of polyclad flatworms in other countries, but the role of these environments in maintaining biodiversity is not well understood. In this study, we identified hotspots of flatworm occurrence by assessing the diversity and overall abundance of flatworms at boulder beaches along the southeast Australian coast. Bottle and Glass, Sydney Harbour, was found to be the most diverse site for flatworms. We also identified a higher occurrence of flatworms under large boulders and less exposed beaches and noted an increased presence of flatworms at higher latitudes. Probable influences on these patterns such as the requirement for shelter and protection are discussed. This study contributes to our knowledge of Australia's coastal biodiversity and can be used to assist in the management and conservation of our marine environments. [ABSTRACT FROM AUTHOR]

The gut microbiota regulates chronic inflammation and has been implicated in the pathogenesis of a broad spectrum of disease including autoimmunity and cancer. Microbial short-chain fatty acids (SCFAs) e.g., butyrate have demonstrated immunomodulatory effects and are thought to be key mediators of the host-microbiome interaction. Here, we investigated the effect of butyrate on effector functions of blood derived human NK cells stimulated for 18 h with a combination of IL-12/IL-15, a potent mix of cytokines that drive NK cell activation. We show that butyrate has a strong anti-inflammatory effect on NK cells. NK cells cultured in the presence of butyrate expressed lower levels of activating receptors (TRAIL, NKp30, NKp44) and produced lower levels of cytokines (IFNγ, TNF-α, IL-22, granzyme B, granzyme A, perforin) in response to IL-12/IL-15. Butyrate restricted NK cell function by downregulation of mTORC1 activity, c-Myc mRNA expression and metabolism. Using a shotgun proteomic approach, we confirmed the effect of butyrate on NK cell cytokine signaling and metabolism and identified BRD2, MAT2A and EHD1 as downstream mediators of these effects. This insight into the immunomodulatory activity of butyrate on human NK cell function might help to develop new ways to limit NK cell function during chronic inflammation. [ABSTRACT FROM AUTHOR]

We provide a new study of previously published eurhinodelphinid materials from the early Miocene of Piedmont (NW Italy) based on a new preparation of the fossil specimens. We studied specimens previously assigned to Tursiops miocaenus and Dalpiazella sp. and provide new anatomical data on the eurhinodelphinid skull and ear bones. In particular, we suggest that a skull that was previously assigned to Tursiops miocaenus must be reassigned to Ziphiodelphis sigmoideus (Cetacea, Odontoceti, Eurhinodelphinidae) based on new comparisons of the squamosal. This finding enabled us to provide new anatomical information on the ear bone anatomy of Z. sigmoideus that was previously unknown. The material originally assigned to Tursiops miocaenus is currently lost. For this reason and due to the fact that the partial illustration of this species by Portis does not allow us to find diagnostic characters for this species, we decided that Tursiops miocaenus is a nomen dubium. Analysis of additional isolated teeth previously assigned to Tursiops miocaenus led to the conclusion that these specimens represent Odontoceti incertae sedis. We performed a new phylogenetic analysis by adding newly discovered character states to a previous dataset and a paleobiogeographic analysis of Eurhinodelphinidae. We found two monophyletic clades within this family. The paleobiogeographic pattern found by the present work suggests the existence of North Atlantic and Mediterranean clades with some species distributed among both basins. We analyzed the virtual endocast of Ziphiodelphis sigmoideus and found that it resembles that of Schizodelphis in several respects, suggesting that some of the more derived characters of the odontocete brain were still absent in these early Miocene eurhinodelphinids. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the neurovascular bundle preservation grades during robotic-assisted radical prostatectomy and compared to the trifecta combined outcome (oncologic control, continence, and sexual function) twelve months after the surgery. Methods: Cohort of patients who underwent nerve-sparing robotic-assisted radical prostatectomy had the neurovascular bundle preservation retrospectively graded from 0 to 8 according to the Hopkins subjective visual classification. Patients then were divided into two groups, according to the median of nerve-sparing grading: those with score six or high and those with score less than six. Main outcome was the trifecta combined outcome and secondary outcomes was the individual trifecta criteria (prospective analysis). A secondary analysis with groups divided according to pre-operatory SHIM score was made. Results: One hundred robotic-assisted nerve-sparing radical prostatectomy were performed, of which 83 were included. There were 53 patients with grading greater than or equal to six (group 1) and 30 patients less than six (group 2). 66.6% patients (35/53) in group 1 had a trifecta combined outcome of compared to 33.3% (10/30) in group 2 (p = 0.017). Individually, the erectile function was higher in group 1 (73.6%) compared to group 2 (46.7%) (p = 0.014). Both the results of the combined endpoint trifecta and erection were also maintained in the group with preoperative SHIM ≥ 17. Conclusions: The grading of preservation of the neurovascular bundle in radical prostatectomy is related to a better combined trifecta outcome one year after surgery. [ABSTRACT FROM AUTHOR]

In western boundary current systems, strong currents transport oligotrophic oceanic waters towards the coast. Thaliaceans may have an advantage in these systems due their ability to filter small particles such as the bacterioplankton, typically responsible for the primary production in oligotrophic waters. Here, we evaluated the structure of the thaliacean community present in the tropical South Atlantic Ocean western boundary current system to test the hypothesis that species distribution and abundance are structured by the circulation and thermohaline features. For that purpose, we used data collected though 40 mm mesopelagic trawls above the slope and around oceanic seamounts and islands. Results reveal distinct patterns in the thaliacean community structure. Over the continental slope, under the influence of the strong North Brazilian Undercurrent, Pyrosoma atlanticum was highly abundant. Soestia zonaria was also present but in a lesser amount. Offshore, around oceanic islands and Seamounts under the influence of the central branch of South Equatorial Current, Doliolida spp. were the dominant thaliacean, co-occurring with P. atlanticum in lower abundance. Mesh selectivity is a potential drawback in these results since the coarse aperture may have lost smaller species and early life stages. [ABSTRACT FROM AUTHOR]

In western boundary current systems (WBCSs), strong currents flow coastward carrying oceanic water masses and their associated planktonic fauna. Variation in the intensity of these currents and in the continental runoff may affect the dynamic interplay between oceanic and coastal communities. In addition, changes in the continental runoff and the thermohaline structure modulate the primary production, adding complexity to the dynamics of these oligotrophic systems. These dynamics likely shape the planktonic cnidarian communities. To further understand such relationships, we used a comprehensive dataset encompassing samples collected above the shelf and slope and around oceanic seamounts and islands of the Fernando de Noronha Ridge in the western tropical South Atlantic, in two seasons characterised by distinct thermohaline structure and circulation patterns. Results show that in the tropical South Atlantic and, likely, other western boundary systems with narrow continental shelves, coastward currents spread oceanic waters and their associated cnidarian species over the continental shelf. However, while both coastal and oceanic communities co-occur when the continental runoff is notable, oceanic species dominate almost the entire shelf during the dry season characterised by a stronger boundary current intensity. We also conclude that when the mixed-layer depth and associated nutricline are shallower, the enhanced primary productivity supports larger populations of planktonic cnidarian species through a bottom–up control. [ABSTRACT FROM AUTHOR]

We surveyed the epipelagic cnidarian fauna from the Western Equatorial Atlantic Ocean. A characteristic feature in this area is the freshwater discharge of the Amazon River, the largest continental inflow in the world’s oceans. We analyzed 87 plankton and 90 neuston samples collected at the neritic and oceanic provinces of the Western Tropical Atlantic under the influence of the Amazon River Plume off the north coast of Brazil. We studied 34,772 organisms corresponding to 7 orders, 31 families, and 93 species. Among them, Forskalia tholoides was a new record to the coast off South America, and 20 taxa were new regional records. Species accumulation curves and diversity estimators did not reach an asymptote and clearly suggested the occurrence of a considerably higher number of species. Sampling in different seasons, with different gears, and including deeper waters certainly will further increase the number of known pelagic cnidarian species in the area. Open ocean had higher diversity than the continental shelf, both for holoplanktonic and some meroplanktonic taxa. This trend can be related to complex circulation and topography. In conclusion, we observed high diversity in the epipelagic cnidarian community. The heterogeneity of habitats in the area is likely the main factor responsible for the high biodiversity, with samples from estuarine, coastal, neritic (with a large reef system), and oceanic waters. The wide salinity range caused by the Amazon River Plume and other oceanographic mesoscale processes such as eddies and opposite currents add further complexity to the environment. [ABSTRACT FROM AUTHOR]

In western boundary current systems (WBCS), strong currents flow coastward carrying oceanic water masses and their associated planktonic fauna. Variation in the intensity of these currents and in the continental runoff may affect the dynamic interplay between oceanic and coastal communities. In addition, changes in the continental runoff and the thermohaline structure modulate the primary production, adding complexity to the dynamics of these oligotrophic systems. These dynamics likely shape the planktonic cnidarian communities. To further understand such relationships, we used a comprehensive dataset encompassing samples collected above the shelf, slope and around oceanic seamounts and islands of the Fernando de Noronha Ridge in the Western Tropical South Atlantic, in two seasons characterized by distinct thermohaline structure and circulation patterns. Results show that in this WBCS, coastward currents spread oceanic waters and their associated cnidarian species over the continental shelf. However, while both costal and oceanic communities co-occur when the continental runoff is notable, oceanic species dominate almost the entire shelf during the dry season characterized by a stronger boundary current intensity. We also conclude that when the mixed-layer depth and associated nutricline is shallower, the enhanced primary productivity supports larger populations of planktonic cnidarian species through a bottom-up control. [ABSTRACT FROM AUTHOR]

In western boundary current systems (WBCS), strong currents flow coastward carrying oceanic water masses and their associated planktonic fauna. Variation in the intensity of these currents and in the continental runoff may affect the dynamic interplay between oceanic and coastal communities. In addition, changes in the continental runoff and the thermohaline structure modulate the primary production, adding complexity to the dynamics of these oligotrophic systems. These dynamics likely shape the planktonic cnidarian communities. To further understand such relationships, we used a comprehensive dataset encompassing samples collected above the shelf, slope and around oceanic seamounts and islands of the Fernando de Noronha Ridge in the Western Tropical South Atlantic, in two seasons characterized by distinct thermohaline structure and circulation patterns. Results show that in this WBCS, coastward currents spread oceanic waters and their associated cnidarian species over the continental shelf. However, while both costal and oceanic communities co-occur when the continental runoff is notable, oceanic species dominate almost the entire shelf during the dry season characterized by a stronger boundary current intensity. We also conclude that when the mixed-layer depth and associated nutricline is shallower, the enhanced primary productivity supports larger populations of planktonic cnidarian species through a bottom-up control. [ABSTRACT FROM AUTHOR]

Background: Von Willebrand Disease (VWD) is a common inherited bleeding disorder. Patients with VWD suffering from severe bleeding may benefit from the use of secondary long‐term prophylaxis. Aim: Systematically summarize the evidence on the clinical outcomes of secondary long‐term prophylaxis in patients with VWD and severe recurrent bleedings. Methods: We searched Medline and EMBASE through October 2019 for relevant randomized clinical trials (RCTs) and comparative observational studies (OS) assessing the effects of secondary long‐term prophylaxis in patients with VWD. We used Cochrane Risk of Bias (RoB) tool and the RoB for Non‐Randomized Studies of interventions (ROBINS‐I) tool to assess the quality of the included studies. We conducted random‐effects meta‐analyses and assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: We included 12 studies. Evidence from one placebo controlled RCT suggested that VWD prophylaxis as compared to no prophylaxis reduced the rate of bleeding episodes (Rate ratio [RR],.24; 95% confidence interval [CI],.17–.35; low certainty evidence), and of epistaxis (RR,.38; 95%CI,.21–.67; moderate certainty evidence), and may increase serious adverse events RR 2.73 (95%CI.12–59.57; low certainty). Evidence from four before‐and‐after studies in which researchers reported comparative data suggested that VWD prophylaxis reduced the rate of bleeding (RR.34; 95%CI,.25–.46; very low certainty evidence). Conclusion: VWD prophylaxis treatment seems to reduce the risk of spontaneous bleeding, epistaxis, and hospitalizations. More RCTs should be conducted to increase the certainty in these benefits. [ABSTRACT FROM AUTHOR]

Background: Intracranial hemorrhage (ICH) is a highly serious event in patients with haemophilia (PWH) which leads to disability and in some cases to death. ICH occurs among all ages but is particularly frequent in newborns. Aim: The primary aim was to assess the incidence and mortality due to ICH in an Italian population of PWH. Secondary aims were to evaluate the risk factors for ICH, the role of prophylaxis, and the clinical management of patients presenting ICH. Methods: A retrospective-prospective registry was established in the network of the Italian Association of Haemophilia Centers to collect all ICHs in PWH from 2009 to 2019 reporting clinical features, treatments, and outcomes. Results: Forty-six ICHs were collected from 13 Centers. The ICHs occurred in 15 children (10 < 2 years), and in 31 adults, 45.2% of them with mild hemophilia. Overall, 60.9% patients had severe haemophilia (15/15 children). Overall ICH incidence (×1000 person/year) was 0.360 (0.270–0.480 95% CI), higher in children <2 years, 1.995 (1.110–3.442 95% CI). Only 7/46 patients, all with severe haemophilia, had received a prophylactic regimen before the ICH, none with mild. Inhibitors were present in 10.9% of patients. In adult PWHs 17/31 suffered from hypertension; 85.7% of the mild subjects and 29.4% of the moderate/severe ones (p < 0.05). ICH was spontaneous in the 69.6% with lower rate in children (46.7%). Surgery was required in 21/46 patients for cerebral hematoma evacuation. Treatment with coagulation factor concentrates for at least three weeks was needed in 76.7% of cases. ICH was fatal in 30.4% of the cases. Of the survivors, 50.0% became permanently disabled. Only one-third of adult patients received long term prophylaxis after the acute treatment. Conclusion: The results from our Registry confirm the still high incidence of ICH in infants <2 years and in adults, particularly in mild PWHs presenting hypertension and its unfavorable outcomes. The majority of PWHs were treated on-demand before ICH occurred, suggesting the important role of prophylaxis in preventing such life-threatening bleeding. [ABSTRACT FROM AUTHOR]

Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by enhanced platelet production and thrombotic complications. The inhibition of platelet cyclooxygenase (COX) activity by the standard once‐daily aspirin is mostly incomplete due to accelerated thrombopoiesis. The phase II Aspirin Regimens in EsSential thrombocythemia (ARES) trial has recently compared the efficacy of once‐ vs. twice‐ or three‐times daily low‐dose aspirin in inhibiting platelet thromboxane (TX) A2 production, as reflected by serum (s) TXB2 measurements. The present substudy characterized the determinants of the highly variable response to the standard aspirin 100 mg once‐daily regimen in fully compliant patients with ET and the effects of the experimental dosing regimens on response variability. By multivariable analysis, the platelet count (directly) and cytoreductive treatment (inversely) were significantly associated with sTXB2 values in 218 patients with ET. However, the platelet count positively correlated with sTXB2 in patients not being treated with cytoreductive drugs (ρ = 0.51, P < 0.01, n = 84), but not in patients on cytoreduction. Patients in the lowest sTXB2 quartile were older, more often on cytoreductive drugs, had lower platelet count and Janus‐Associated Kinase2 (JAK2)‐V617F allele frequency as compared with patients in the upper sTXB2 quartiles. After 2 weeks of a twice‐ or 3‐times daily aspirin regimen, the association between the platelet count and sTXB2 became similar in cytoreduced and non‐cytoreduced patients. In conclusion, the platelet count appears the strongest determinant of TXA2 inhibition by once‐daily low‐dose aspirin in ET, with different patterns depending of cytoreductive treatment. More frequent aspirin dosing restores adequate platelet inhibition and reduces interindividual variability, independently of cytoreduction. [ABSTRACT FROM AUTHOR]

Bluelined goatfish (Upeneichthys lineatus) exhibit dynamic body colour changes and transform rapidly from a pale, buff/white, horizontally banded pattern to a conspicuous, vertically striped, red pattern when foraging. This red pattern is potentially an important foraging signal for communication with conspecifics, provided that U. lineatus can detect and discriminate the pattern. Using both physiological and behavioural experiments, we first examined whether U. lineatus possess visual pigments with sensitivity to long ("red") wavelengths of light, and whether they can discriminate the colour red. Microspectrophotometric measurements of retinal photoreceptors showed that while U. lineatuslack visual pigments dedicated to the red part of the spectrum, their pigments likely confer some sensitivity in this spectral band. Behavioural colour discrimination experiments suggested that U. lineatuscan distinguish a red reward stimulus from a grey distractor stimulus of variable brightness. Furthermore, when presented with red stimuli of varying brightness they could mostly discriminate the darker and lighter reds from the grey distractor. We also obtained anatomical estimates of visual acuity, which suggest that U. lineatus can resolve the contrasting bands of conspecifics approximately 7 m away in clear waters. Finally, we measured the spectral reflectance of the red and white colouration on the goatfish body. Visual models suggest that U. lineatus can discriminate both chromatic and achromatic differences in body colouration where longer wavelength light is available. This study demonstrates that U. lineatus have the capacity for colour vision and can likely discriminate colours in the long-wavelength region of the spectrum where the red body pattern reflects light strongly. The ability to see red may therefore provide an advantage in recognising visual signals from conspecifics. This research furthers our understanding of how visual signals have co-evolved with visual abilities, and the role of visual communication in the marine environment. [ABSTRACT FROM AUTHOR]

The dispersal of marine organisms can be restricted by a set of isolation mechanisms including hard barriers or hydrological features. In the Western Atlantic Ocean, the Amazon River discharge has been shown to act as a biogeographical barrier responsible for the differences in reef fish communities between Caribbean Sea and Northeast Brazil continental shelves. Here, we compare the diversity of all Animalia phyla from biogeographic ecoregions along the Tropical Western Atlantic continental shelf to test the hypothesis that the Amazon River plume spatially structures species diversity. For that, we used beta diversity estimators and multivariate ecological analysis on a database of species occurrence of the whole animal kingdom including 175,477 occurrences of 8,375 species from six ecoregions along the Western Tropical Atlantic. Results of the whole animal kingdom and the richest phyla showed that the Caribbean Sea and Tropical Brazil ecoregions are isolated by the Amazon River Plume, broadening and confirming the hypothesis that it acts as a soft barrier to animal dispersal in the Western Tropical Atlantic. Species sharing is larger northwestwards, in direction of the Caribbean than the opposite direction. Beyond species isolation due to local characteristics such as low salinity and high turbidity, our results suggest the dominant northwestward currents probably play a major role in animal dispersion: it enhances the flux of larvae and other planktonic organisms with reduced mobility from Brazil to Caribbean and hinders their contrary movement. Thus, the Amazon area is a strong barrier for taxa with reduced dispersal capacity, while species of pelagic taxa with active swimming may transpose it more easily. [ABSTRACT FROM AUTHOR]

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Introduction: The growing number of older people and the increasing burden of non-communicable diseases highlight the need for the integration between social and health services. To ensure high quality home care, common and consistent standards are essential. Our aim is to develop a validated accreditation tool for home care. Description: An integrated home care accreditation tool was developed including 26 standards and 144 items divided into six domains: Organization&Governance, Patient Safety&Risk Management, Professionals knowledge, Skills&Competences, Information&Communication, Care Integration, and Improvement&Innovation. Expert evaluation was conducted between August and November 2019; relevance and feasibility (RF) and expert agreement were analyzed. Discussion: A total of 21 experts participated in the validation process, with a response rate of 53%. A good RF score and agreement were obtained for 70% of the items and 65% of the standards. The best scores were obtained for Individualized care project (RF 8.4, agreement 100%), Integrated care pathways (RF 7.5, agreement 81%), Access to the integrated health and social care system (RF 8.1, agreement 86%), and Multidimensional assessment of needs (RF 8.1, agreement 86%). Conclusion: The existence of an integrated health and social care accreditation tool would help to improve the quality of home care, and make patients' quality of life better and safer. [ABSTRACT FROM AUTHOR]

Cancer children experience long periods of hospitalization, which are associated with limited performance in several developmental domains and participation restrictions in age appropriate occupations. Fine motor abilities represent building blocks in performing daily life skills and have been found to be closely connected with later academic success. Moreover, medical and psychological sequelae for cancer inpatients may result in diminished daily activities functioning, poor perceived health related quality of life (HRQOL), and increase the likelihood of long-term impairments. This study examines the variations in the occupational performance of children hospitalized for acute lymphoblastic leukemia (ALL) after their participation to a stimulation program designed to enhance fine motor skills. Parents reported significant gains in children's motor functioning, a slight improvement in overall occupational performance related to an increase in the area of productivity and self-care, and a better quality of life perception following the stimulation activities. Feasibility of the stimulation program in a health care setting are discussed evaluating its benefits for cancer children and their families. [ABSTRACT FROM AUTHOR]

In marine western boundary systems, strong currents flowing coastward spread oceanic water masses over the continental shelves. Here we propose to test the hypothesis according to which oceanic cnidarian species may dominate western boundary system regions even in coastal waters. For that purpose we use a set of data collected above the shelf, slope and around oceanic seamounts and islands in the Western Tropical South Atlantic. Samples were acquired with a plankton net with 300 μm mesh size over 34 stations during an oceanographic cruise carried out in October 2015. Results reveal a diverse cnidarian assemblage in the area, extending the known distribution of many species. In addition, the Fernando de Noronha Chain and most of the narrow continental shelf presented a typical oceanic cnidarian community, dominated by holoplanktonic siphonophores. In this western boundary system, this condition was likely driven by the strong currents, which carry the oceanic tropical water and associated planktonic fauna toward the coast. A specific area with reduced influence of oceanic currents presented typical coastal species. The pattern we observed with the dominance of oceanic plankton communities up to coastal areas may be typical in western boundary systems characterized by a narrow continental shelf. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the impact of 5-alpha-reductase inhibitors (5ARI) for prostate cancer (PCa) primary prevention on specific and overall mortality (primary outcomes), the incidence of PCa diagnosis and disease aggressiveness (secondary outcomes). Methods: We searched MEDLINE, EMBASE, Cochrane, ClinicalTrials and BVS through April 2018 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement to identify randomized clinical trials (RCT) and cohort studies (CS). We included articles with data on mortality or PCa incidence for men using 5ARI previously to PCa diagnosis. Results: Regarding the included studies, nine had data on mortality, 16 on PCa incidence and 12 on Gleason scores (GS). We found that the use of 5ARI had no impact on overall mortality (RR 0.93 95% CI 0.78–1.11) and PCa-related mortality (RR 1.35 95% CI 0.50–3.94), nor on high-grade PCa diagnosis (RR 1.06 95% CI 0.72–1.56). We identified a relative risk reduction of 24% in moderate-grade PCa diagnosis (RR 0.76 95% CI 0.59–0.98) and low-grade PCa diagnosis (RR 0.76 95% CI 0.59–0.97) Also, a reduction of 26% in overall PCa diagnosis was observed in the RCT subgroup analysis (RR 0.74 95% CI 0.65–0.84). Conclusion: 5ARI significantly reduced the risk of being diagnosed with PCa, not increasing high-grade disease, overall or cancer-specific mortality. Due to the relatively short mean follow-up of most studies, the mortality analysis is limited. [ABSTRACT FROM AUTHOR]

Adelaide Ristori was among the first actresses to build an iconic image of herself, which spread internationally since her Parisian debut in 1855. Aware of the importance of photography, she did not hesitate to be portrayed by the most important photographers. Ristori thus entered the pantheon of illustrious people, known throughout Europe and beyond its borders. Her portraits in carte de visite format quickly integrated into the circuit of the press, establishing a complex relationship with pre-existing graphic techniques, such as engraving. The article analyses the progressive diffusion of Adelaide Ristori’s photographs, focusing in particular on the carte de visite format and on newspapers. The corpus includes three photographs of the actress kept at the Bibliothèque Nationale de France (BNF): a portrait by August Bertsch and two cartes de visite by André Adolphe Eugène Disdéri and Étienne Carjat. What image of the actress do these pictures convey? How do press, graphic arts and photography interact in creating the iconic image of the actress? [ABSTRACT FROM AUTHOR]

Congenital absence of skin (CAS) is a clinical sign associated with the main types of epidermolysis bullosa (EB). Very few studies have investigated the genetic background that may influence the occurrence of this condition. Our objective was to investigate genotype‐phenotype correlations on EB with CAS through a literature revision on the pathogenic variants previously reported. A total of 171 cases (49 EB simplex, EBS; 23 junctional EB, JEB; and 99 dystrophic EB, DEB), associated with 132 pathogenic variants in eight genes, were included in the genotype‐phenotype analysis. In EBS, CAS showed to be a recurrent clinical sign in EBS with pyloric atresia (PA) and EBS associated with kelch‐like protein 24; CAS was also described in patients with keratins 5/14 alterations, particularly involving severe phenotypes. In JEB, this is a common clinical sign in JEB with PA associated with premature termination codon variants and/or amino acid substitutions located in the extracellular domain of integrin α6β4 genes. In DEB with CAS, missense variants occurring close to non‐collagenous interruptions of the triple‐helix domain of collagen VII appear to influence this condition. This study is the largest review of patients with EB and CAS and expands the spectrum of known variants on this phenomenon. [ABSTRACT FROM AUTHOR]

Knowledge of the distribution of risk factors for superficial thrombosis (SVT) in low-risk population is fundamental to improve the prevention of the disease in each individual and high-risk settings of patients. Exact frequency data for the low-risk population are scarce, but could be useful for optimal use of prophylactic strategies against venous thrombosis. Blood donors represent a low-risk population, because are healthier than the general population. The objective of this study was to assess the prevalence of vein thrombosis, particularly SVT, and associated risk factors in a low-risk population such as blood donors. In this multicentre cross-sectional study, donors from six Italian blood banks responded to a self-administered questionnaire. The enrolment lasted from 1st June 2017 to 30th July 2018. History of vein thrombosis was referred by 89 (0.76%) individuals, (49 men) with an age-dependent effect. The prevalence reached 2.9% in women and 0.8% in men aged ≥ 49 years, with a significant difference only for women. After controlling for potential confounders, a significant and independent association was found between a history of vein thrombosis and age (OR: 1.03, 95%CI 1.01–1.05), varicose veins (OR: 15.8, 95%CI 7.7–32.6), plaster cast/bed rest (OR: 2.3, 95% CI 1.0–5.3) and transfusion (OR: 5.1, 95% CI 1.3–19.5). This study shows that low-risk individuals share the same risk factors for SVT as patients in secondary care. It also suggests that transfusion confers an increased risk of SVT in healthy population. [ABSTRACT FROM AUTHOR]

HLA-DR, an MHC class II molecule that mediates antigen presentation, is a favourable prognostic indicator in colorectal cancer (CRC). However, the dynamics and location of HLA-DR expression during CRC development are unclear. We aimed to define HLA-DR expression by immunohistochemistry in colorectal epithelium and stromal tissue at different stages of cancer development, assessing non-neoplastic colorectal adenocarcinoma–adjacent tissue, adenomas and carcinoma tissues, and to associate HLA-DR levels with clinical outcomes. Patients with higher than median HLA-DR expression survived at least twice as long as patients with lower expression. This association was significant for HLA-DR staining in the colorectal carcinoma epithelium (n = 152, p = 0.011, HR 1.9, 95% CI 1.15–3.15) and adjacent non-neoplastic epithelium (n = 152, p < 0.001, HR 2.7, 95% CI 1.59–4.66), but not stroma. In stage II cases, however, the prognostic value of HLA-DR expression was significant only in adjacent non-neoplastic tissues, for both epithelium (n = 63, p = 0.015, HR 3.6, 95% CI 1.279–10.25) and stroma (n = 63, p = 0.018, HR 5.07, 95% CI 1.32–19.49). HLA-DR was lower in carcinoma tissue compared to matched adenomas (n = 35), in epithelium (p < 0.01) and stroma (p < 0.001). HLA-DR was further reduced in late-stage carcinoma (n = 101) compared to early stage (n = 105), in epithelium (p < 0.001) and stroma (p < 0.01). HLA-DR expression was lower (p < 0.05) in the adjacent non-neoplastic epithelium of patients with cancer recurrence. We demonstrate a progressive loss of HLA-DR in epithelial and stromal tissue compartments during CRC development and show prognostic ability in carcinoma–adjacent non-neoplastic tissues, highlighting the importance of this molecule in the anti-cancer immune response. These findings may have wider implications for immunotherapeutic interventions. [ABSTRACT FROM AUTHOR]

Patients on anticoagulant treatment are constantly increasing, with an estimated prevalence in Italy of 2% of the total population. The recent spreadout of the COVID-19 pandemic requires a re-organization of Anticoagulation Clinics to prevent person-to-person viral diffusion and continue to offer the highest possible quality of assistance to patients. In this paper, based on the Italian Federation of Anticoagulation Clinics statements, we offer some advice aimed at improving patient care during COVID-19 pandemic, with particular regard to the lockdown and reopening periods. We give practical guidance regarding the following points: (1) re-thinking the AC organization, (2) managing patients on anticoagulants when they become infected by the virus, (3) managing anticoagulation surveillance in non-infected patients during the lockdown period, and (4) organizing the activities during the reopening phases. [ABSTRACT FROM AUTHOR]