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Population growth in coastal tourist areas is leading to enhanced waste production, raising concerns about potential nutrient release increases and the resulting impact on marine ecosystems through eutrophication. Knowledge of the specific impacts of eutrophication on plankton communities in many of these regions is limited, highlighting the need for further research and appropriate environmental management strategies. To help address these gaps, we conducted a 30-day mesocosm study in the coastal waters of Gran Canaria, Canary Islands, a major European tourist destination, and the third most densely populated autonomous community in Spain. With the aim of assessing the effects of nutrient input on biomass, primary production (PP) and recycling processes by phytoplankton, zooplankton, and bacterioplankton, we simulated three nutrient discharge intensities (Low, Medium, and High), with daily additions of 0.1, 1, and 10 μmol L -1 of nitrate, respectively, along with phosphate and silicate. We observed that PP, chlorophyll a (Chl-a), and biomass increased linearly with nutrient input, except in the High treatment, where CO 2 depletion (<1.0 μmol L -1 ) and an alkalinity increase (>2500 μmol L -1 ) resulted in reduced PP. Despite limitations in nitrogen (Control, Low, and Medium) or carbon (High) availability across treatments, which led to stabilized or decreased PP rates and dissolved organic carbon (DOC) concentrations, bacterial degradation remained active in all treatments. This microbial activity resulted in an accumulation of recalcitrant chromophoric dissolved organic matter (CDOM), indicating the resilience of carbon recycling processes under varying nutrient conditions. Furthermore, a clear succession was evident in all enriched treatments, transitioning from an oligotrophic condition dominated by pico- and nanophytoplankton to a eutrophic state primarily composed of diatoms. However, under CO 2 depletion, diatoms experienced a decline in the High treatment, leading to the proliferation of potentially mixotrophic dinoflagellates. Microzooplankton was less sensitive than mesozooplankton to the decrease in prey availability and high pH caused by CO 2 depletion. Interestingly, the Medium treatment showed high efficiency in terms of PP, despite reaching CO 2 levels near of 1.0 μmol L -1 by the end of the experiment. PP rates increased from 10 to 100 μg C·L -1 ·d -1 during the first week and remained stable as diatoms predominated throughout the study period. These findings provide valuable insights into the responses of plankton communities to varying nutrient inputs and emphasize the importance of considering the effects of DIC depletion, along with changes in total alkalinity, in eutrophication scenarios as well as in ocean alkalinity enhancement experiments aimed at reducing carbon dioxide emissions., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Javier Aristegui reports article publishing charges and equipment, drugs, or supplies were provided by University of Las Palmas de Gran Canaria. Javier Aristegui reports a relationship with University of Las Palmas de Gran Canaria that includes: employment. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Enhancing ocean productivity by artificial upwelling is evaluated as a nature-based solution for food security and climate change mitigation. Fish production is intended through diatom-based plankton food webs as these are assumed to be short and efficient. However, our findings from mesocosm experiments on artificial upwelling in the oligotrophic ocean disagree with this classical food web model. Here, diatoms did not reduce trophic length and instead impaired the transfer of primary production to crustacean grazers and small pelagic fish. The diatom-driven decrease in trophic efficiency was likely mediated by changes in nutritional value for the copepod grazers. Whilst diatoms benefitted the availability of essential fatty acids, they also caused unfavorable elemental compositions via high carbon-to-nitrogen ratios (i.e. low protein content) to which the grazers were unable to adapt. This nutritional imbalance for grazers was most pronounced in systems optimized for CO 2 uptake through carbon-to-nitrogen ratios well beyond Redfield. A simultaneous enhancement of fisheries production and carbon sequestration via artificial upwelling may thus be difficult to achieve given their opposing stoichiometric constraints. Our study suggest that food quality can be more critical than quantity to maximize food web productivity during shorter-term fertilization of the oligotrophic ocean., (© 2024. The Author(s).)

Gelatinous zooplankton are increasingly recognized to play a key role in the ocean's biological carbon pump. Appendicularians, a class of pelagic tunicates, are among the most abundant gelatinous plankton in the ocean, but it is an open question how their contribution to carbon export might change in the future. Here, we conducted an experiment with large volume in situ mesocosms (~55-60 m 3 and 21 m depth) to investigate how ocean acidification (OA) extreme events affect food web structure and carbon export in a natural plankton community, particularly focusing on the keystone species Oikopleura dioica, a globally abundant appendicularian. We found a profound influence of O. dioica on vertical carbon fluxes, particularly during a short but intense bloom period in the high CO 2 treatment, during which carbon export was 42%-64% higher than under ambient conditions. This elevated flux was mostly driven by an almost twofold increase in O. dioica biomass under high CO 2 . This rapid population increase was linked to enhanced fecundity (+20%) that likely resulted from physiological benefits of low pH conditions. The resulting competitive advantage of O. dioica resulted in enhanced grazing on phytoplankton and transfer of this consumed biomass into sinking particles. Using a simple carbon flux model for O. dioica, we estimate that high CO 2 doubled the carbon flux of discarded mucous houses and fecal pellets, accounting for up to 39% of total carbon export from the ecosystem during the bloom. Considering the wide geographic distribution of O. dioica, our findings suggest that appendicularians may become an increasingly important vector of carbon export with ongoing OA., (© 2023 The Authors. Global Change Biology published by John Wiley & Sons Ltd.)

Our aim is to demonstrate a general-purpose data and knowledge validation approach that enables reproducible metrics for data and knowledge quality and safety. We researched widely accepted statistical process control methods from high-quality, high-safety industries and applied them to pharmacy prescription data being migrated between EHRs. Natural language medication instructions from prescriptions were independently categorized by two terminologists as a first step toward encoding those medication instructions using standardized terminology. Overall, the weighted average of medication instructions that were matched by reviewers was 43%, with strong agreement between reviewers for short instructions (K=0.82) and long instructions (K=0.85), and moderate agreement for medium instructions (K=0.61). Category definitions will be refined in future work to mitigate discrepancies. We recommend incorporating appropriate statistical tests, such as evaluating inter-rater and intra-rater reliability and bivariate comparison of reviewer agreement over an adequate statistical sample, when developing benchmarks for health data and knowledge quality and safety., (©2022 AMIA - All rights reserved.)

We collected samples for oxidative stress and antioxidants in a high CO 2 mesocosm experiment for two weeks, focussing on two common crustacean copepods Calanus finmarchicus and Temora longicornis. The samples were collected during a field experiment campaign studying responses of plankton communities to future ocean acidification (OA), off the Norwegian coast south of Bergen. The main results showed that there were species-specific differences between Temora and Calanus, especially in antioxidant defences (glutathione system) and oxidative stress (lipid peroxidation and reduced:oxidised glutathione ratio). Regular monitoring of chlorophyll a and jellyfish abundances taking place during the field campaign revealed that both chl a and predators may have affected the eco-physiological response. Antioxidant and oxidative stress levels are known to respond sensitively to both the food quality and quantity and the predator pressure, apart from environmental (i.e., abiotic) changes. Calanus was more robust towards OA, perhaps due to its high tolerance to a wide range of vertical physical-chemical conditions. Both top-down and bottom-up factors seem to play a role for the outcome of copepod responses to future ocean acidification., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

We analyzed the dispositional decisions taken in a unit for clinical decision making (UCDM) which was set up to examine all emergency inpatient referrals to a psychiatric hospital. Hospitalization proved unnecessary for at least 17 % of the N = 2,026 inpatient referrals over a one year period. Instead, these patients were admitted to day-hospitals or outpatient treatments, resulting in annual cost savings of approximately 3.3 million. Merely 8 % of those non-admitted patients had to be hospitalized within 28 days of the decision for non-admission being taken. Thus, a specialized UCDM run by clinical experts can help identify cost-effective alternatives to hospitalization.

Risperidone is metabolized by polymorphic enzymes, and a large variability in plasma concentration and therapeutic response is observed. Risperidone long-acting injection (RLAI) avoids the first-pass effect, and little is known about the influence of gene polymorphisms involved in its pharmacokinetics. The influence on plasma concentrations of risperidone (RIS), its metabolite 9-hydroxy-risperidone, and on adverse effects were investigated for polymorphisms of cytochrome P450 2D6 (CYP2D6) (*3, *4, *5, *6), CYP3A (CYP3A4*1B, CYP3A4 rs4646437, CYP3A5*3, CYP3A7*1C), ABCB1 (1236C>T, 2677G>T, 3435C>T), NR1/2 coding for pregnane X receptor (rs1523130, rs2472677, rs7643645), and for CYP3A activity measured by a phenotyping test. Forty-two patients with at least 4 consecutive unchanged doses of RLAI were included in a multicenter cross-sectional study. A 55% lower dose-adjusted plasma levels of RIS were observed for CYP2D6 ultrarapid metabolizers (n = 5) as compared with CYP2D6 intermediate metabolizers (P < 0.007). NR1/2 polymorphism (rs7643645A>G) influenced RIS exposure with a 2.8-fold lower active moiety (P = 0.031) in GG compared with the AA genotype. This was confirmed in a second independent cohort (n = 16). Furthermore, high-density lipoprotein cholesterol was positively correlated with CYP3A activity (P = 0.01), and the NR1/2 (rs2472677) polymorphism was associated with different adverse effects including prolactin plasma levels adjusted for age and sex. In conclusion, our results confirmed the influence of CYP2D6 genotype on plasma levels of RIS. This is the first report on the influence of NR1/2 polymorphisms on RLAI exposure and on drug-induced adverse effects. These results should be validated in larger cohorts.

Data collected by nurses have the potential to aid in the disaster response if the necessary information can be extracted. The Disaster Nursing Minimum Data Set is proposed to strengthen the interoperability of information and data sharing between agencies to improve relief services to individuals and communities affected by a disaster. This study will examine disaster-related data elements need to be collected by all relief agencies to facilitate interoperability and secondary use of data for research and disaster management.

Rigour is needed in the construction of health terminologies to avoid introducing ambiguity and error into clinical records. When two large scale terminologies (SNOMED RT and Clinical terms Version 3) were merged to form SNOMED CT) a number duplicate and ambiguous concepts were introduced. The SNOMED nursing working group was tasked with producing a draft editorial policy to resolve duplications and ambiguities in terms related to education, advice and counselling. Consultation and input from two opportunistic workshops resulted in a draft policy that was tested before being approved for use. Education and counselling were identified as different concepts but the consensus view was it was not possible to differentiate between related concepts such as advice about, teaching and training in a way that will allow unambiguous use in practice. Expansion of existing working groups and improved communications infrastructure will support more widespread clinical input to SNOMED CT maintenance and updating.