Explore the vast range of titles available.

Background and Objective: Sepsis is a worldwide severe disease with a high incidence and mortality rate. Sepsis is a frequent cause of admission to the emergency department (ED). Although prognostic scores (Sequential Organ Failure Assessment, SOFA; New Early Warning Score, NEWS; Rapid Emergency Medicine Score, REMS) are commonly used for risk stratification in septic patients, many of these scores are of poor utility in the ED. In this setting, biomarkers are promising alternatives, easier to perform and potentially more specific. Bio-adrenomedullin (Bio-ADM) and Proenkephalin (PenKid) seem to have a key role in the development of organ dysfunctions induced by sepsis and, therefore, could help in the risk stratification of patients with sepsis at ED admission. The aim of this study was to evaluate the utility of Bio-ADM and PenKid, obtained through a point of care (POCT) device, in predicting 30 days mortality for patients presenting to the ED with sepsis. Methods and Results: In total, 177 consecutive adult patients with a diagnosis of sepsis presenting to the ED of San Giovanni Addolorata Hospital in Rome, Italy, between May 2021 and April 2022 were enrolled in this prospective observational study. For each patient, Bio-ADM and PenKid were obtained at ED admission together with SOFA, NEWS and REMS scores. Next, 30 days follow-up data were collected to evaluate patient mortality. Both biomarkers (Bio-ADM and PenKid) and clinical scores (SOFA, NEWS and REMS) were good predictors of mortality at 30 days, with Bio-ADM and REMS outperforming the others. Moreover, PenKid resulted in being linked with the worsening of kidney function. Conclusions: In patients presenting with sepsis in the ED, Bio-ADM and PenKid, evaluated with a POCT device, predicted 30-day mortality. These two biomarkers seem even more useful when integrated with clinical risk scores at ED admission.

Background and Objectives: In patients with acute heart failure (AHF), there is no definite evidence on the relationship between high-sensitivity cardiac troponin (hs-cTnI) and the left ventricular ejection fraction (LVEF) comparing the reduced and preserved EF conditions. Materials and Methods: Between January and April 2022, we retrospectively analyzed the data from 386 patients admitted to the emergency departments (ED) of five hospitals in Rome, Italy, for AHF. The criteria for inclusion were a final diagnosis of AHF; a cardiac ultrasound and hs-cTnI evaluations in the ED; and age > 18 yrs. We excluded patients with acute coronary syndrome (ACS). Based on echocardiography and hs-cTnI evaluations, the patients were grouped for (1) preserved (HFpEF) or (2) reduced LVEF (HFrEF) and a a) negative (within the normal range value) or b) positive (above the normal range value) of hs-cTnI, respectively. Results: There was a significant negative relationship between a positive test for hs-cTnI and LVEF. When compared to the group with a negative hs-cTnI test, the patients with a positive test, both from the HFpEF and HFrEF subgroups, were significantly more likely to have an adverse outcome, such as being admitted to the intensive care unit (ICU) or dying in the ED. Moreover, a reduced ejection fraction was linked with a final disposition to a higher level of care. Conclusions: In patients admitted to the ED for AHF without ACS, there is a negative relationship between hs-cTnI and a reduced LVEF, although a significant percentage of patients with a preserved LVEF also resulted to have high levels of hs-cTnI. In the absence of ACS, hs-cTnI seems to be a reliable biomarker of myocardial injury in AHF in the ED and should be considered as a risk stratification parameter for these subjects regardless of the left ventricular function. Further larger prospective studies are needed to confirm these preliminary data.

Rare evidences support that Marine Protected Areas (MPAs) enhance the stability of marine habitats and assemblages. Based on nine years of observation (2001-2009) inside and outside a well managed MPA, we assessed the potential of conservation and management actions to modify patterns of spatial and/or temporal variability of Posidonia oceanica meadows, the lower midlittoral and the shallow infralittoral rock assemblages. Significant differences in both temporal variations and spatial patterns were observed between protected and unprotected locations. A lower temporal variability in the protected vs. unprotected assemblages was found in the shallow infralittoral, demonstrating that, at least at local scale, protection can enhance community stability. Macrobenthos with long-lived and relatively slow-growing invertebrates and structurally complex algal forms were homogeneously distributed in space and went through little fluctuations in time. In contrast, a mosaic of disturbed patches featured unprotected locations, with small-scale shifts from macroalgal stands to barrens, and harsh temporal variations between the two states. Opposite patterns of spatial and temporal variability were found for the midlittoral assemblages. Despite an overall clear pattern of seagrass regression through time, protected meadows showed a significantly higher shoot density than unprotected ones, suggesting a higher resistance to local human activities. Our results support the assumption that the exclusion/management of human activities within MPAs enhance the stability of the structural components of protected marine systems, reverting or arresting threat-induced trajectories of change.

1.Taxonomic sufficiency concerns the use of higher-taxon diversity as a surrogate for species diversity.It represents a fast and cost-effective method to assess community responses to natural and anthropogenic environmental drivers. In spite of the potential applications of using higher taxa as surrogates for species, little research has been carried out to determine the underlying reasons that might make taxonomic surrogacy effective for detecting diversity changes. 2. Here, we determine whether the effectiveness of higher taxa as species surrogates relies mostly on taxonomic relatedness of species (i.e. the relative closeness of species in the Linnaean taxonomic hierarchy) or depends simply on the numerical ratio between species and higher taxa (i.e. the degree of species aggregation). We reviewed the current literature on taxonomic sufficiency to check for any correlation between the effectiveness of higher taxa and the degree of species aggregation across different types of organisms. Tests based on random simulations from diverse marine mollusc assemblages were also carried out to ascertain whether the ability of higher taxa to detect variation in the multivariate structure of assemblages depended on the degree of species aggregation. 3. Mollusc data showed that information loss and the ensuing decrease in statistical power to detect natural or human-driven changes in assemblages at higher taxonomic levels depend on the degree of species aggregation, rather than on the taxonomic resolution employed. Analyses of the literature suggested that such outcomes could be generalizable to a wide range of organisms and environmental settings. 4. Our findings do not support the idea of a direct relationship between taxonomic relatedness and ecological similarity among species. This indicates that taxonomic ranks higher than species may not provide ecologically meaningful information, because higher taxa can behave as random groups of species unlikely to convey consistent responses to natural or human-driven environmental changes. 5. Synthesis and applications. Surrogates of species-level information can be based on the ' highest practicable aggregation' of species, irrespective of their taxonomic relatedness. Our findings cast doubt on static taxonomical groupings, legitimizing the use of alternative ways to aggregate species to maximize the use of species surrogacy.

Hydrozoa of the Mediterranean Sea are well known and a recent monograph covers 457 species. Mediterranean non-Siphonophoran Hydrozoa comprises 398 species, an increasing number due to continuous updates, representing about 10 % of the 3,702 currently valid species reported in a recent world assessment of hydrozoan diversity. Many new records are non indigenous species, previously described species that occurred elsewhere and whose arrival was presumably caused by human activities. However, many species reported in the past are not recorded in recent times. Realistic assessments of species pools require addition of new species, but also subtraction of species not found since a certain period. With the confidence of extinction index, cases of putative extinction can be raised. Out of the 398 known species, only 162 (41 %) have been reported in the last decade, while 53 (13 %) are not recorded in the literature since at least 41 years. According to the confidence of extinction index, 60 % of the 53 missing species are extinct, and 11 % are putatively extinct from the basin. From a biogeographical point of view, the missing species are: 34 % endemic, 19 % boreal, 15 % Mediterranean-Atlantic, 11 % Indo-Pacific, 11 % circumtropical, 4 % cosmopolitan, 2 % tropical-Atlantic, 4 % non-classifiable. Fluctuations in species composition into a certain area cause heavy variability in the expression of both structural and functional biodiversity. As consequence, the regional biodiversity should be analyzed through its temporal evolution, to detect changes and their possible causes. This approach has profound consequences on biodiversity assessments and also on the compilation of red lists.

Hypotheses on the spatial and temporal distribution of sessile assemblages in submerged marine caves have rarely been tested. Classically, the distribution of cave benthos has been related mainly to the physical gradients along the exterior-interior axis. Using a multifactorial sampling design, we examined the distribution of species assemblages within 3 different caves in Southern Italy. Non-destructive sampling was repeated at 4 different times over a period of 11 mo. Results showed an overall pattern of change in the structure of the assemblages along the exterior-interior axis of the 3 caves (i.e. among sectors). Significant differences in species assemblages, however, were also observed within sectors (i.e. among areas), and changes in assemblages varied inconsistently with time and among caves. This result suggests a high complexity of the processes determining spatio-temporal distribution patterns in marine caves, which are context- and scale-dependent. Results also showed the uniqueness of these assemblages, which has important implications for their conservation and management.

Human activities determine dramatic changes in natural systems, especially in marine coastal areas. This is especially true when economic development is fast and scarcely regulated, representing a serious threat to biodiversity. Besides the obvious prediction of impairment of natural systems, forecasting the effects of human activities can be particularly challenging since they affect species and assemblages, the patterns of distribution and extent of which are often totally unknown. In Vlora Bay, we show through an interdisciplinary project that 15 y of coastal development can result in a loss of over 50% of seagrass cover and a decline in macroalgae cover such as Cystoseira spp., which are structurally and functionally crucial habitats that provide essential goods and services for local human communities and recreation. Furthermore, illegal fishery practices (date mussel fishery, trawling, and use of explosives) contribute to depict a scenario of fragmentation and loss of shallow species-rich assemblages. Large-scale changes in sedimentation patterns have been recognised as one of the main drivers of those changes. This model of development, associated with nearly irreversible environmental consequences, as observed in Albania, can serve as an example for many other Mediterranean areas, showing a combination of high biodiversity and low protection regime. We discuss the urgent need for ecosystem-based management to ensure sustainable development while conserving and managing natural biodiversity and resources.

Quantitative information about spatial patterns in subtidal hard substrate assemblages is scant. Such information is necessary to understand the responses to anthropogenic disturbances in these habitats. Along the coast of Apulia (Southern Italy), the collection of the European date musselLithophaga lithophagais a strong source of disturbance: harvesting is carried out by demolition of the rocky substrate and causes epibiota disappearance. A hierarchical sampling design was used to quantify the spatial variability of subtidal epibenthic assemblages and the extent of rock damage due toL. lithophagaharvesting along 360 km of rocky coasts in Apulia. The surveyed coast was divided into 8 adjacent sectors, and replicate samples were taken by visual inspection at each of the 3 sites nested in each sector. Multivariate analyses indicated that assemblages differed consistently with spatial scale, variability being higher at the largest scale. However, variability among sites within each sector was also detected. Patchiness (i.e., average similarity among quadrats) was consistent among sectors. Some species were identified as ‘important’ in characterising and/or differentiating sectors. The pattern of distribution of these species as well as total cover and number of species were analysed by analysis of variance. Results recorded a considerable source of variation at site level. Damage byL. lithophagafishing was shown to be extremely widespread. A humped relationship between patchiness and disturbances byL. lithophagafisheries was obtained. In particular, patchiness at a small scale was highest at ‘intermediate’ levels of damage, because disturbance produces patches of different size and/or age, leading to ‘mosaic’ landscapes of epibenthic assemblages.

1. Understanding whether Marine Protected Areas (MPAs) can be considered as a suitable tool for restoring the structure and function of populations and assemblages is urgently needed to achieve an effective policy of mitigation of human impact in coastal management. However, to date, the role played by MPAs in enhancing ecosystems resilience has been more advocated than unambiguously documented. 2. This study was designed to test whether full protection in marine reserves facilitates recovery of benthos impacted by the date mussel Lithophaga lithophaga fishery, one of the most harmful human activities affecting subtidal rocky habitats in the Mediterranean Sea. 3. The effects of this destructive fishery were reproduced at one fully protected location (P) and at two unprotected control locations (Cs) in the SW Mediterranean Sea. At each location, three plots (4 m2) of rocky surface at 4-6 m depth were disturbed experimentally, while another three plots served as reference. In each plot, the species composition and relative cover of the sessile benthic assemblages were sampled photographically on each of five occasions during a period of 20 months. 4. Over and above variation in habitat features among locations, multivariate and univariate analyses revealed significant differences between P-vs.-Cs in patterns of assemblage recovery and showed that, at the fully protected location, recovery was faster than at the unprotected control locations. 5. Our results suggest that MPAs have the potential to change the trajectories of recovery of disturbed assemblages by accelerating the processes of recolonization and call for further investigation to identify the specific mechanisms underlying increased resilience.