Consequences of eutrophication in the management of water resources in Mediterranean reservoirs: A case study of Lake Cedrino (Sardinia, Italy)

Abstract One of the primary detrimental effects of eutrophication is the tendency of nuisance cyanobacterial species to increase in number and biomass in freshwater ecosystems. The aim of this study was to investigate possible management actions to control eutrophication and assure water use of a eutrophic deep Mediterranean climate reservoir, dominated by cyanobacteria. With this goal, we defined the trophic state of Lake Cedrino (Sardinia, Italy) and studied its phytoplankton, paying particular attention to cyanobacteria, and to seasonal variation of phytoplankton in relation to seasonal variation of environmental variables. The water samples were collected monthly from September 2010 to August 2011 at differing depths from the surface of the water to the bottom at a station located in the deeper portion of the reservoir. Physical, chemical, nutrient, qualitative and quantitative analyses of phytoplankton were performed, and the trophic state was evaluated based on the Trophic State Index and the OECD model. Abundance of nutrients and phytoplankton (cell density, biomass and chlorophyll a ) indicated a eutrophic condition of the reservoir. In summer, phytoplankton species composition was dominated by nuisance cyanobacteria, particularly Aphanizomenon flosaquae , thereby requiring management plans for harmful blooms. On the base of lake features, we propose management actions at different scales and levels to resolve eutrophication and to allow water use: from nutrient load reduction in the watershed (primarily from point-sources) to deep water aeration, to immediately face an attenuation of eutrophic effects. This study is the first explorative step in planning restoration of Lake Cedrino

Quality of care provided by Multiple Sclerosis Centers during Covid-19 pandemic: Results of an Italian multicenter patient-centered survey

Background: Covid-19 pandemic impacted on management of people with Multiple Sclerosis (pwMS). Level of satisfaction of pwMS regarding the care received by the staff of Multiple Sclerosis Centers (MSCs) during the pandemic was not fully investigated. In a large patient-centered multicenter study, the therapeutic adherence and quality of care of MSCs was assessed. Methods: In April-May 2021, an online survey was widespread by 16 Italian MSCs. Frequencies, percentages and/or means and standard deviations were calculated to describe the sample. ANOVAs were performed to evaluate the effect of sociodemographic and clinical variables on overall pwMS' rating of MSC assistance. Results: 1670 pwMS completed the survey (67.3% women). During the pandemic, 88% did not change their disease modifying therapy schedule, and 89.1% reached their MSCs with no or little difficulties. Even if only 1.3% of participants underwent a tele-health follow-up visit with their MSC staff, the 80.1% believed that tele-health services should be improved regardless of pandemic. 92% of participants were satisfied of how their MSC took charge of their needs; ANOVAs revealed an effect of disease duration on pwMS' level of satisfaction on MSCs management during the pandemic. Conclusions: The results revealed an efficient MSCs response to Covid-19 pandemic and provided the basis for the implementing of tele-health services that would further improve the taking charge of patients, particularly those with longer disease, higher disability, and/or living far from their MSC

Management of hepatitis B virus prophylaxis in patients treated with disease-modifying therapies for multiple sclerosis: a multicentric Italian retrospective study

Background: Patients with multiple sclerosis (MS) often receive disease-modifying therapies (DMTs) that can expose them to reactivation of potential occult hepatitis B virus (HBV) infection (pOBI). We aimed to evaluate the MS Centers behavior regarding HBV screening and prophylaxis in a large cohort of MS patients receiving anti-CD20 or cladribine. Methods: Retrospective, multicentric study recruiting Italian MS patients treated with rituximab, ocrelizumab and cladribine. Results: We included 931 MS patients from 15 centers. All but 38 patients performed a complete HBV screening. Patients' age > 50 years was significantly associated with no history of vaccination and HBsAb titres < 100 mIU at baseline (p < 0.001). No significant correlation was found between post-vaccination HBsAb titres and type of treatment (p = 0.5), pre-or post-therapy vaccination (p = 0.2) and number of previous DMTs (p = 0.2). Among pOBI patients (n = 53), 21 received antiviral prophylaxis, while only 13 had HBV DNA monitoring and 19 patients neither monitored HBV DNA nor received prophylaxis. Conclusions: Baseline HBV screening in patients receiving anti-CD20 and cladribine is a consolidated practice. Nonetheless, HBV vaccination coverage is still lacking in such population and age is a significant factor associated with low HBV protection. Rituximab, ocrelizumab and cladribine did not impair HBV vaccine response. Almost 35% of pOBI patients fail to receive HBVr prevention. Management of HBV prophylaxis could be improved in MS patients and further prospective studies are needed to assess the effectiveness of prophylactic strategies in such patients

Disease-Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis

Objective: This study was undertaken to assess the impact of immunosuppressive and immunomodulatory therapies on the severity of coronavirus disease 2019 (COVID-19) in people with multiple sclerosis (PwMS). Methods: We retrospectively collected data of PwMS with suspected or confirmed COVID-19. All the patients had complete follow-up to death or recovery. Severe COVID-19 was defined by a 3-level variable: mild disease not requiring hospitalization versus pneumonia or hospitalization versus intensive care unit (ICU) admission or death. We evaluated baseline characteristics and MS therapies associated with severe COVID-19 by multivariate and propensity score (PS)-weighted ordinal logistic models. Sensitivity analyses were run to confirm the results. Results: Of 844 PwMS with suspected (n = 565) or confirmed (n = 279) COVID-19, 13 (1.54%) died; 11 of them were in a progressive MS phase, and 8 were without any therapy. Thirty-eight (4.5%) were admitted to an ICU; 99 (11.7%) had radiologically documented pneumonia; 96 (11.4%) were hospitalized. After adjusting for region, age, sex, progressive MS course, Expanded Disability Status Scale, disease duration, body mass index, comorbidities, and recent methylprednisolone use, therapy with an anti-CD20 agent (ocrelizumab or rituximab) was significantly associated (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.18-4.74, p = 0.015) with increased risk of severe COVID-19. Recent use (<1 month) of methylprednisolone was also associated with a worse outcome (OR = 5.24, 95% CI = 2.20-12.53, p = 0.001). Results were confirmed by the PS-weighted analysis and by all the sensitivity analyses. Interpretation: This study showed an acceptable level of safety of therapies with a broad array of mechanisms of action. However, some specific elements of risk emerged. These will need to be considered while the COVID-19 pandemic persists

COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Background and objectives: It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19-related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population. Methods: Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1,362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score > 3 or at least 1 comorbidity, lower risk: EDSS score ≤ 3 and no comorbidities) by the χ2 test, and the risk excess was quantified by risk ratios (RRs). Results: The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization (p < 0.001), RR = 2.19 for ICU admission (p < 0.001), and RR = 2.43 for death (p < 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04). Discussion: Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon

DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39–3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18–0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

Il Fitoplancton del lago Cixerri nei primi cinque anni di esistenza

Between May 1990 and June 1995 a study on phytoplankton of Lake Cixerri (South-West Sardinia) was carried out. This is a shallow man-made lake, filled in February 1990; it is polimitic and eutrophic (Sechi et al. 1994). During the five years studied, the annual mean values of total density, total biomass and chlorophyll a varied respectively from 308 x 106 cell. l-1 in 1991-1992 to 22 x 106 cells l-1 in 1994-1995, from 5 mg l-1 in 1990-1991 to 23 mg l-1 in 1991-1992 and from 20.1 mg m-3 in 1992-1993 to 57.8 mg m-3 in 1994-1995. The number of the most abundant species increased from 16 in the first year to 33 in the last year. Cyanophyceae were the most abundant group and the Cyanophyceae and the Dinophyceae had the greatest biomass; only in 1994-1995 these two groups decreased and the Chlorophyceae increased in density, biomass and number of species. A general seasonal succession of phytoplankton is proposed with Cyanophyceae dominant in numbers in spring, summer and autumn and the Dinoflagellates dominant in biomass in summer and fall; between 1992 and 1994 there was a year-round vegetation of Oscillatoria spp., whereas in 1994-1995 the Chlorophyceae had the maximum growth. It is possible that the lake is still unstable because of its recent formation, and that the high variability of hydrological, hydraulic and management factors might influence the phytoplankton dynamics making its study and interpretation very difficult

First record of planktonic crustaceans in Sardinian reservoirs

Sardinian man-made lakes are reservoirs of species richness, hosting zooplankton taxa from the Mediterranean region and North Africa. To provide a first record of the taxa composition and diversity of zooplankton communities, we sampled 15 reservoirs during 2008–2009, from the north of the island to the south, representative of a range of size, depth, renewal time, and trophy. The survey was complemented by seasonal sampling in one of the largest lakes studied. Water samples collected from surface to bottom provided data on hydrochemistry and trophy. Crustacean dormant stages were inspected from sediments of the richest, and most diverse, Lake Sos Canales. RDA suggested that productivity, water depth, renewal time and altitude were the main variables related to taxa composition. The ubiquitous Copidodiaptomus numidicus, and its persistence in the water column, resulted from the production of subitaneous eggs throughout the year, an adaptive strategy in perennial water bodies. Genetic analyses of DNA sequences of the diagnostic gene ND5 placed the Sardinian Daphnia pulex in the North American group. Moreover, the ND5 sequence found in Sardinia was identical with that of an asexual hybrid clone between the American D. pulex and American D. pulicaria that replaced native D. pulex throughout Africa. The presence of this ND5 haplotype in Sardinia shows that this invasive clone also poses an invasive threat to native populations in Europe

First detection of the bloom forming Unruhdinium penardii (Dinophyceae) in a Mediterranean reservoir: insights on its ecology, morphology and genetics

13 pages, 5 figures, 2 tables, supplementary material https://doi.org/10.4081/aiol.2020.9500The freshwater genus Unruhdinium includes dinoflagellates hosting a tertiary diatom endosymbiont. Some of the species belonging to this genus form high-biomass blooms. In this study, data on the ecology, morphology and molecular identity of Unruhdinium penardii were reported for the first time from a Mediterranean reservoir (Cedrino Lake, Sardinia, Italy). The ecology of the species and its bloom events were examined along a multiannual series of data (2010-2017). Cell morphology was investigated using field samples and six cultures established by cell isolation. A molecular identification of the six strains was performed. Wild and cultured cells shared the same morphology, showing a prominent apical pore complex and two/three more or less prominent hypothecal spines as distinctive characters in light microscopy. Molecularly, the six cultured strains corresponded to the same taxonomic entity with sequences only differing in a few polymorphic positions for the studied markers SSU rDNA, LSU rDNA, ITS and endosymbiont SSU rDNA. All markers showed 99.5%−100% similarity with the available U. penardii sequences. Seasonality of U. penardii revealed its preference for the colder semester (from December to June) with bloom events restricted to late winter/early spring months. Three blooms resulting in reddish water discolorations were observed along the study period (2011, 2012 and 2017). GLMs revealed a significant role of water depth, temperature, and reactive phosphorous in determining the highest cell densities (>5 x 104 cells L-1). The results obtained contribute to the increase of field ecology knowledge on this species, demonstrating it is well established in the Mediterranean area, and being able to produce recurrent high biomass blooms in the studied reservoiThe activities of Prof Antonella Lugliè and Dr. Mario Padedda were supported by the research fund of the University of Sassari (Fondo di Ateneo per la Ricerca 2019).With the funding support of the ‘Severo Ochoa Centre of Excellence’ accreditation (CEX2019-000928-S), of the Spanish Research Agency (AEI)Peer reviewe