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[Display omitted] • Cap de Creus shelf and submarine canyon host a diverse benthic ecosystem. • Over 165 (morpho)species identified in the images, organized in nine megabenthic communities. • These include CWCs, octocoral gardens, sponge grounds and echinoderm aggregations. • Spatial distribution is mainly determined by depth, substrate type & bottom currents. The continental shelf and submarine canyon off Cap de Creus (NW Mediterranean) were declared a Site of Community Importance (SCI) within the Natura 2000 Network in 2014. Implementing an effective management plan to preserve its biological diversity and monitor its evolution through time requires a detailed characterization of its benthic ecosystem. Based on 60 underwater video transects performed between 2007 and 2013 (before the declaration of the SCI), we thoroughly describe the composition and structure of the main megabenthic communities dwelling from the shelf down to 400 m depth inside the submarine canyon. We then mapped the spatial distribution of the benthic communities using the Random Forest algorithm, which incorporated geomorphological and oceanographic layers as predictors, as well as the intensity of the bottom-trawling fishing fleet. Although the study area has historically been exposed to commercial fishing practices, it still holds a rich benthic ecosystem with over 165 different invertebrate (morpho)species of the megafauna identified in the video footage, which form up to 9 distinct megabenthic communities. The continental shelf is home to coral gardens of the sea fan Eunicella cavolini , sea pen and soft coral assemblages, dense beds of the crinoid Leptometra phalangium , diverse sponge grounds and massive aggregations of the brittle star Ophiothrix fragilis. The submarine canyon off Cap de Creus is characterized by a cold-water coral community dominated by the scleractinian coral Madrepora oculata , found in association with several invertebrate species including oysters, brachiopods and a variety of sponge species, as well as by a community dominated by cerianthids and sea urchins, mostly in sedimentary areas. The benthic communities identified in the area were then compared with habitats/biocenoses described in reference habitat classification systems that consider circalittoral and bathyal environments of the Mediterranean. The complex environmental setting characteristic of the marine area off Cap de Creus likely produces the optimal conditions for communities dominated by suspension- and filter-feeding species to develop. The uniqueness of this ecosystem and the anthropogenic pressures that it faces should prompt the development of effective management actions to ensure the long-term conservation of the benthic fauna representative of this marine area. [ABSTRACT FROM AUTHOR]

Objective To describe an alternative analysis in the frequency-domain of the temporal relationship between 2 biological signals and evaluate the method's predictive capacity for classifying infants at risk for an adverse outcome. Study design We studied 54 infants (mean gestational age 27 weeks) with invasive mean arterial blood pressure monitoring. The bivariate autoregressive spectral coherence (BiAR-COH) method and the spectral coherence methods were used to analyze the relationship between spontaneous changes in mean arterial blood pressure and the near-infrared tissue oxygenation index. Results The mean postnatal age at the beginning and end of the autoregulation study was 6.0 (3.0) and 29.0 (7.5) hours, respectively. The BiAR-COH was superior to the spectral coherence in predicting low superior vena cava (SVC) flow (≤41 mL/kg per minute), with an area under the receiver operating characteristic curve of 0.84 (95% CI, 0.77-0.90; P < .001). The BiAR-COH threshold for identifying low SVC flow was 0.577, with 0.8 sensitivity and 0.76 specificity. After adjusting for the repeated measures effect (multiple epochs) in a given patient, the averaged BiAR-COH per patient and averaged COH per patient were calculated as the average value per patient. The pBiAR-COH (but not the pCOH) was associated with intraventricular hemorrhage grades 3 and 4 and predicted mortality. Conclusions The BiAR-COH classifier identifies low SVC flow infants who are at risk for brain hypoperfusion. The BiAR-COH is superior to frequency domain methods in predicting adverse outcomes in infants. [ABSTRACT FROM AUTHOR]

We analyzed litter occurrence in 68 underwater video transects performed on the middle/outer continental shelf and submarine canyon off Cap de Creus (NW Mediterranean), an area recently declared Site of Community Importance (SCI). Low densities of urban litter were registered on the shelf (7.2 items ha−1), increasing in abundance towards the deepest part of the submarine canyon, with 188 items ha−1 below 1000 m depth. We hypothesize that the strong bottom currents that recurrently affect this area efficiently move litter objects from the shelf towards the deep. Of all litter items, approximately 50% had a fishing-related origin, mostly longlines entangled on rocks in the canyon head and discarded trawl nets in deeper areas. Over 10% of cold-water colonies observed had longlines entangled, indicating the harmful effects of such practices over benthic habitats. These results should be considered when designing mitigation measures to reduce litter pollution in Cap de Creus SCI. Unlabelled Image • Urban litter increased with depth, reaching 188 items ha−1 on the middle canyon. • Strong bottom currents push lighter items downslope to generate litter hotspots. • Entangled longlines reached a density of 219 lines ha−1 in the canyon head. • Over 10% of calcifying cold-water coral colonies were in contact with longlines. [ABSTRACT FROM AUTHOR]

Objective To gather information for a future confirmatory trial of dobutamine (DB) for circulatory impairment (ie, low superior vena cava [SVC] flow). Study design A total of 127 infants born at <31 weeks gestational age were serially scanned from birth to 96 hours after birth. The infants were randomly assigned to 2 groups and were treated with DB (stepwise dose increase, 5-10-15-20 μg/kg/min) or placebo if they had an SVC flow <41 mL/kg/min within the first 24 hours after birth. The primary outcome measures were the achievement and maintenance of an SVC flow ≥41 mL/kg/min. Secondary outcome measures were the short-term evolution of clinical and biochemical variables, near-infrared spectroscopy, cranial Doppler ultrasound, and clinical outcomes. Results SVC flow increased throughout the first 96 hours for the entire cohort. All of the randomized infants (n = 28) except 2 achieved and maintained an SVC flow ≥41 mL/kg/min after intervention; however, the infants treated with DB (n = 16) showed a higher heart rate and improved base excess compared with those treated with placebo (n = 12). Low SVC flow was associated with low gestational age ( P = .02) and poor condition at birth ( P = .02). Low SVC flow significantly increased the risk of severe ischemic events (OR, 13; 95% CI, 2.4-69.2; P < .01). Conclusion This exploratory trial demonstrates a tendency toward improved short-term clinical and biochemical perfusion variable outcomes in infants with low SVC flow treated with DB. Trial registration ClinicalTrials.gov ( NCT01605279 ) and the European Clinical Trials Database (EurodraCT 2009-010901-35). [ABSTRACT FROM AUTHOR]

Landscapes result from the interaction between nature and society. To understand current landscapes, it is essential to disentangle this interaction; to accomplish this, an historical approach is necessary.Here we focus on the interaction between humans and lakes during thelast century in two sites in Wisconsin, USA, a state where lakes, inexcess of 10,000, have played an important role in the evolution of the landscapes they belong to. We draw contrasts between the two localities, which are set in landscapes that differ in their physiographic setting, environmental history, and current structure. One, in northern Wisconsin, is a forested recreational lake district; the other, in southern Wisconsin, is dominated by agricultural uses and urban and suburban development. We contend that a common development in both localities has been the increase in the value that society attaches to lakes. As a consequence, lakes are playing a bigger role in the evolution of the terrestrial landscapes surrounding them. [ABSTRACT FROM AUTHOR]

[Display omitted] • Individual outcome prediction models have been proposed for COVID-19 ICU patients. • Patient' data have been collected within the first day of ICU admission. • Models used are based on binary logistic regression and artificial neural network analysis. • A statistical analysis of different variables for ICU patients who survived and those who did not. • Our study could provide helpful information on how to develop prediction models. • Our study provides valuable information on which variables could predict a fatal outcome. Currently, good prognosis and management of critically ill patients with COVID-19 are crucial for developing disease management guidelines and providing a viable healthcare system. We aimed to propose individual outcome prediction models based on binary logistic regression (BLR) and artificial neural network (ANN) analyses of data collected in the first 24 h of intensive care unit (ICU) admission for patients with COVID-19 infection. We also analysed different variables for ICU patients who survived and those who died. Data from 326 critically ill patients with COVID-19 were collected. Data were captured on laboratory variables, demographics, comorbidities, symptoms and hospital stay related information. These data were compared with patient outcomes (survivor and non-survivor patients). BLR was assessed using the Wald Forward Stepwise method, and the ANN model was constructed using multilayer perceptron architecture. The area under the receiver operating characteristic curve of the ANN model was significantly larger than the BLR model (0.917 vs 0.810; p < 0.001) for predicting individual outcomes. In addition, ANN model presented similar negative predictive value than the BLR model (95.9% vs 94.8%). Variables such as age, pH, potassium ion, partial pressure of oxygen, and chloride were present in both models and they were significant predictors of death in COVID-19 patients. Our study could provide helpful information for other hospitals to develop their own individual outcome prediction models based, mainly, on laboratory variables. Furthermore, it offers valuable information on which variables could predict a fatal outcome for ICU patients with COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Human papillomavirus-vaccinated cohorts, irrespective of age, will likely reduce their subsequent screening requirements, thus opening opportunities for global cost reduction and program sustainability. The determinants of uptake and completion of a 3-dose human papillomavirus vaccination program by adult women in a European context were estimated.Study Design: This was an intervention study.Setting/participants: Study participants were women aged 25-45 years, attending opportunistic or population-based cervical cancer screening in Belgium, Denmark, Finland, France, Germany, Slovenia, Spain, Sweden, and the United Kingdom between April 2016 and May 2018.Intervention: Study participants completed a questionnaire on awareness and attitudes on adult female human papillomavirus vaccination and were invited to receive free human papillomavirus vaccination.Main Outcome Measures: Main outcome measures were acceptance, uptake, and completion of vaccination schedule. Determinants of vaccine uptake were explored using multilevel logistic models in 2019.Results: Among 3,646 participants, 2,748 (range by country=50%-96%) accepted vaccination, and 2,151 (range=30%-93%) received the full vaccination course. The factors associated with higher vaccine acceptance were previous awareness of adult female (OR=1.22, 95% CI=1.00, 1.48) and male (OR=1.59, 95% CI=1.28, 1.97) vaccination. Women in stable relationships (OR=0.56, 95% CI=0.45, 0.69) or with higher educational level (OR=0.76, 95% CI=0.63, 0.93) were more likely to refuse vaccination. Recruitment by postal invitation versus personal invitation from a healthcare professional resulted in lower vaccine acceptance (OR=0.13, 95% CI=0.02, 0.76). Vaccination coverage of >70% of adolescent girls in national public programs was of borderline significance in predicting human papillomavirus vaccine uptake (OR=3.23, 95% CI=0.95, 10.97). The main reasons for vaccine refusal were vaccine safety concerns (range=30%-59%) and the need for more information on human papillomavirus vaccines (range=1%-72%). No safety issues were experienced by vaccinated women.Conclusions: Acceptance and schedule completion were largely dependent on recruitment method, achieved coverage of national vaccination programs, and personal relationship status. Knowledge of benefits and safety reassurance may be critical to expanding vaccination target ages. Study results suggest that there are no major opinion barriers in adult women to human papillomavirus vaccination, especially when vaccination is offered face to face in healthcare settings.Trial Registration: EudraCT Number 2014-003177-42. [ABSTRACT FROM AUTHOR]

During the last two decades, several Marine Heatwaves (MHWs) have affected coralligenous assemblages in the Mediterranean Sea, causing catastrophic mass mortalities of several habitat-forming species such as gorgonians, corals, and sponges. Even though Marine Protected Areas (MPAs) are contributing to effectively protect marine ecosystems, the impacts associated to extreme climatic events within MPAs are jeopardizing their protective role. Therefore, minimizing local stressors within MPAs is crucial to minimize interactive effects with global, more difficult to manage, stressors. To address this, we assessed to what extent the regulation of diving frequentation can support more effective protection to climate change, focusing on the case study of the Medes Islands, which has recently suffered the impacts of different global stressors and is one of the most visited MPAs in the Mediterranean Sea. We combined 6 years of demographic data of the red gorgonian Paramuricea clavata with population modelling tools, to explore the long-term viability of this species to different managing schemes and mass mortality events scenarios. Overall, our results show that climate-adaptive management of the recreational diving activity under climate change can enhance the long-term viability of this key Mediterranean habitat-forming octocoral, which is otherwise predicted to go locally extinct at shallow depths (<25 m) within the next 20 years. This study provides one of the few attempts to quantify to what extent an adaptive management scheme may help delay climate change impacts in a Marine Protected Area. • Marine heatwaves are severely impacting key Mediterranean octocorals. • Over-frequentation by divers can be detrimental in no-take marine protected areas. • Interactions between local and global stressors can be synergistic. • Adaptive management on local impacts gives borrowed time to face climate change. • Long-term monitoring and modelling are key to design adaptive management schemes. [ABSTRACT FROM AUTHOR]

Exercise in thermally stressful environmental conditions can enhance oxidative stress. We sought to measure the plasma antioxidant defenses and cytokine response together with oxidative damage post-exercise in a temperate versus a hot environment. The plasma concentrations of vasoactive endothelin-1 and vascular angiogenic growth factor were also evaluated. Male athletes ( n =9) volunteered to participate. The athletes randomly performed two bouts of treadmill exercise of 45 min at 75–80% of maximal oxygen uptake in a climatic-controlled chamber under two different conditions: temperate environment (10–12 °C, 40–55% humidity) and hot, humid environment (30–32 °C, 75–78% humidity). Venous blood samples were obtained immediately pre- and post-bout and on recovery after 2 h. Serum glucose, malondialdehyde and lactate concentrations were significantly increased post-exercise in hot but maintained in the temperate environment; these post-exercise values were significantly higher after exercise in hot than in temperate. Urinary 8-hydroxy-2′-deoxyguanosine concentration, plasma phosphocreatine kinase and catalase activities, creatinine and monocyte chemoattractant protein-1, and interleukin-6 significantly increased post-exercise in hot but maintained in temperate environment. The post-exercise circulating values of antioxidant enzyme paraoxonase-1 and endothelin were significantly higher in the hot than in temperate environment. Exercise in a hot and humid environment resulted in mild hyperthermia with elevated perceived exertion and thermal stress. Hyperthermic environment induced hyperglycemia, lactatecidemia and more cellular and oxidative damage than exercise in a temperate environment but also induced a post-exercise antioxidant and anti-inflammatory response in plasma. These results suggest that environmental temperature needs to be taken into account when evaluating exercise-related oxidative stress and inflammation. [ABSTRACT FROM AUTHOR]