Twelve recommendations for advancing marine conservation in European and contiguous seas

Like most ocean regions today, the European and contiguous seas experience cumulative impacts from local human activities and global pressures. They are largely in poor environmental condition with deteriorating trends. Despite several success stories, European policies for marine conservation fall short of being effective. Acknowledging the challenges for marine conservation, a 4-year multi-national network, MarCons, supported collaborative marine conservation efforts to bridge the gap between science, management and policy, aiming to contribute in reversing present negative trends. By consolidating a large network of more than 100 scientists from 26 countries, and conducting a series of workshops over 4 years (2016–2020), MarCons analyzed challenges, opportunities and obstacles for advancing marine conservation in the European and contiguous seas. Here, we synthesize the major issues that emerged from this analysis and make 12 key recommendations for policy makers, marine managers, and researchers. To increase the effectiveness of marine conservation planning, we recommend (1) designing coherent networks of marine protected areas (MPAs) in the framework of marine spatial planning (MSP) and applying systematic conservation planning principles, including re-evaluation of existing management zones, (2) designing MPA networks within a broader transboundary planning framework, and (3) implementing integrated land-freshwater-sea approaches. To address inadequate or poorly informed management, we recommend (4) developing and implementing adaptive management plans in all sites of the Natura 2000 European conservation network and revising the Natura 2000 framework, (5) embedding and implementing cumulative effects assessments into a risk management process and making them operational, and (6) promoting actions to reach ‘good environmental status’ in all European waters. To account for global change in conservation planning and management, we further recommend (7) developing conservation strategies to address the impacts of global change, for example identifying climate-change refugia as high priority conservation areas, and (8) incorporating biological invasions in conservation plans and prioritizing management actions to control invasive species. Finally, to improve current practices that may compromise the effectiveness of conservation actions, we recommend (9) reinforcing the collection of high-quality open-access data, (10) improving mechanisms for public participation in MPA planning and management, (11) prioritizing conservation goals in full collaboration with stakeholders, and (12) addressing gender inequality in marine sciences and conservation

An Investigation of Nurses' Knowledge, Attitudes, and Practices Regarding Disinfection Procedures in Italy

<p>Abstract</p> <p>Background</p> <p>This study assessed the level of knowledge, attitudes, and practice regarding disinfection procedures among nurses in Italian hospitals.</p> <p>Methods</p> <p>A face-to-face interview gathered the following information: demographic and practice characteristics; knowledge about the healthcare-associated infections (HAIs) and the disinfection practices; attitudes towards the utility of guidelines/protocols and perception of the risks of acquiring/transmitting HAIs; compliance with antisepsis/disinfection procedures; and sources of information.</p> <p>Results</p> <p>Only 29% acknowledged that urinary and respiratory tract infections were the two most common HAIs and this knowledge was significantly higher in those with a higher level of education. Attitudes towards the utility of guidelines/protocols for disinfection procedures showed a mean score of 9.1. The results of the linear regression model indicated a more positive attitude in female nurses, in those with a lower number of years of activity, and in those needing additional information about disinfection procedures. Nurses with higher educational level and with a higher perception of risk of transmitting an infectious disease while working were more likely to perform appropriate antisepsis of the surgical wound and handwashing before and after medication.</p> <p>Conclusions</p> <p>Plan of successful prevention activities about HAIs and provide pointers to help optimize disinfection procedures and infection prophylaxis and management are needed.</p

20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years

The administration of endocrine therapy for 5 years substantially reduces recurrence rates during and after treatment in women with early-stage, estrogen-receptor (ER)-positive breast cancer. Extending such therapy beyond 5 years offers further protection but has additional side effects. Obtaining data on the absolute risk of subsequent distant recurrence if therapy stops at 5 years could help determine whether to extend treatment

Intrinsic factors and the embryonic environment influence the formation of extragonadal teratomas during gestation

Background: Pluripotent cells are present in early embryos until the levels of the pluripotency regulator Oct4 drop at the beginning of somitogenesis. Elevating Oct4 levels in explanted post-pluripotent cells in vitro restores their pluripotency. Cultured pluripotent cells can participate in normal development when introduced into host embryos up to the end of gastrulation. In contrast, pluripotent cells efficiently seed malignant teratocarcinomas in adult animals. In humans, extragonadal teratomas and teratocarcinomas are most frequently found in the sacrococcygeal region of neonates, suggesting that these tumours originate from cells in the posterior of the embryo that either reactivate or fail to switch off their pluripotent status. However, experimental models for the persistence or reactivation of pluripotency during embryonic development are lacking. Methods: We manually injected embryonic stem cells into conceptuses at E9.5 to test whether the presence of pluripotent cells at this stage correlates with teratocarcinoma formation. We then examined the effects of reactivating embryonic Oct4 expression ubiquitously or in combination with Nanog within the primitive streak (PS)/tail bud (TB) using a transgenic mouse line and embryo chimeras carrying a PS/TB-specific heterologous gene expression cassette respectively. Results: Here, we show that pluripotent cells seed teratomas in post-gastrulation embryos. However, at these stages, induced ubiquitous expression of Oct4 does not lead to restoration of pluripotency (indicated by Nanog expression) and tumour formation in utero, but instead causes a severe phenotype in the extending anteroposterior axis. Use of a more restricted T(Bra) promoter transgenic system enabling inducible ectopic expression of Oct4 and Nanog specifically in the posteriorly-located primitive streak (PS) and tail bud (TB) led to similar axial malformations to those induced by Oct4 alone. These cells underwent induction of pluripotency marker expression in Epiblast Stem Cell (EpiSC) explants derived from somitogenesis-stage embryos, but no teratocarcinoma formation was observed in vivo. Conclusions: Our findings show that although pluripotent cells with teratocarcinogenic potential can be produced in vitro by the overexpression of pluripotency regulators in explanted somitogenesis-stage somatic cells, the in vivo induction of these genes does not yield tumours. This suggests a restrictive regulatory role of the embryonic microenvironment in the induction of pluripotency