Microhabitat competition between Iberian fish species and the endangered Júcar nase (Parachondrostoma arrigonis; Steindachner, 1866)

"This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Ecohydraulics on 24-01-2017, available online: https://www.tandfonline.com/doi/full/10.1080/24705357.2016.1276417"[EN] Competition with invasive species is recognized as having a major impact on biodiversity conservation. The upper part of the Cabriel River (Eastern Iberian Peninsula) harbours the most important population of the Júcar nase (Parachondrostoma arrigonis; Steindachner, 1866), a fish species in imminent danger of extinction. Currently, this species cohabits with several non-native species, such as the Iberian nase (Pseudochondrostoma polylepis; Steindachner, 1864) and the bermejuela (Achondrostoma arcasii; Steindachner, 1866). The potential habitat competition with these species was studied by analysing the spatial and temporal overlapping of suitable microhabitats. Generalized Additive Mixed Models (GAMMs) were developed to model microhabitat selection and these GAMMs were used to assess the habitat suitability (i.e. probability of presence) under several flows simulated with River2D. The Júcar nase will compete, spatially and temporally, for the few suitable microhabitats with bermejuela and, to a lesser extent, with small Iberian nase; conversely, large Iberian nase was of minor concern, due to increased differences in habitat preferences. This study represents an important assessment of potential competition and, therefore, these results might assist to better define future management practices in the upper part of the Cabriel River.This study was funded by the Spanish Ministry of Economy and Competitiveness through the SCARCE project (Consolider Ingenio 2010 CSD2009 00065); the Universitat Politècnica de València, through the project UPPTE/2012/294 [PAID 06 12]; it was also partially funded by the IMPADAPT project (CGL2013-48424-C2-1-R) with Spanish MINECO (Ministerio de Economía y Competitividad) and FEDER funds. The authors would like to thank the help of the Conselleria de Territori i Vivenda (Generalitat Valenciana) and the Confederación Hidrográfica del Júcar (Spanish government), which provided environmental data to Alfredo Ollero, and the two anonymous reviewers who first suggested the submission of the paper to a regular journal. Finally, we would like to thank TECNOMA S.A. for the development of the hydraulic model.Muñoz Mas, R.; Soares Costa, RM.; Alcaraz-Hernández, JD.; Martinez-Capel, F. (2017). Microhabitat competition between Iberian fish species and the endangered Júcar nase (Parachondrostoma arrigonis; Steindachner, 1866). Journal of Ecohydraulics. 2(1):3-15. https://doi.org/10.1080/24705357.2016.1276417S31521Alcaraz, C., Carmona-Catot, G., Risueño, P., Perea, S., Pérez, C., Doadrio, I., & Aparicio, E. (2014). Assessing population status of Parachondrostoma arrigonis (Steindachner, 1866), threats and conservation perspectives. Environmental Biology of Fishes, 98(1), 443-455. doi:10.1007/s10641-014-0274-3ALMEIDA, D., & GROSSMAN, G. D. (2012). Utility of direct observational methods for assessing competitive interactions between non-native and native freshwater fishes. Fisheries Management and Ecology, 19(2), 157-166. doi:10.1111/j.1365-2400.2012.00847.xAlmeida, D., Merino-Aguirre, R., Vilizzi, L., & Copp, G. H. (2014). Interspecific Aggressive Behaviour of Invasive Pumpkinseed Lepomis gibbosus in Iberian Fresh Waters. PLoS ONE, 9(2), e88038. doi:10.1371/journal.pone.0088038Anderson, D. R., Burnham, K. P., & Thompson, W. L. (2000). Null Hypothesis Testing: Problems, Prevalence, and an Alternative. The Journal of Wildlife Management, 64(4), 912. doi:10.2307/3803199Aparicio, E., Vargas, M. J., Olmo, J. M., & de Sostoa, A. (2000). Environmental Biology of Fishes, 59(1), 11-19. doi:10.1023/a:1007618517557Arlot, S., & Celisse, A. (2010). A survey of cross-validation procedures for model selection. Statistics Surveys, 4(0), 40-79. doi:10.1214/09-ss054Austin, M. (2007). Species distribution models and ecological theory: A critical assessment and some possible new approaches. Ecological Modelling, 200(1-2), 1-19. doi:10.1016/j.ecolmodel.2006.07.005Baltz, D. M., Vondracek, B., Brown, L. R., & Moyle, P. B. (1991). Seasonal Changes in Microhabitat Selection by Rainbow Trout in a Small Stream. Transactions of the American Fisheries Society, 120(2), 166-176. doi:10.1577/1548-8659(1991)1202.3.co;2Barbet-Massin, M., Jiguet, F., Albert, C. H., & Thuiller, W. (2012). Selecting pseudo-absences for species distribution models: how, where and how many? Methods in Ecology and Evolution, 3(2), 327-338. doi:10.1111/j.2041-210x.2011.00172.xBeakes, M. P., Moore, J. W., Retford, N., Brown, R., Merz, J. E., & Sogard, S. M. (2012). EVALUATING STATISTICAL APPROACHES TO QUANTIFYING JUVENILE CHINOOK SALMON HABITAT IN A REGULATED CALIFORNIA RIVER. River Research and Applications, 30(2), 180-191. doi:10.1002/rra.2632BROOK, B., SODHI, N., & BRADSHAW, C. (2008). Synergies among extinction drivers under global change. Trends in Ecology & Evolution, 23(8), 453-460. doi:10.1016/j.tree.2008.03.011Brosse, S., Laffaille, P., Gabas, S., & Lek, S. (2001). Is scuba sampling a relevant method to study fish microhabitat in lakes? Examples and comparisons for three European species. Ecology of Freshwater Fish, 10(3), 138-146. doi:10.1034/j.1600-0633.2001.100303.xCLAVERO, M. (2011). Assessing the risk of freshwater fish introductions into the Iberian Peninsula. Freshwater Biology, 56(10), 2145-2155. doi:10.1111/j.1365-2427.2011.02642.xCollares-Pereira, M. J., & Coelho, M. M. (1983). Biometrical analysis of Chondrostoma polylepis x Rutilus arcasi natural hybrids (Osteichthyes-Cypriniformes-Cyprinidae). Journal of Fish Biology, 23(5), 495-509. doi:10.1111/j.1095-8649.1983.tb02930.xCosta, R. M. S., Martínez-Capel, F., Muñoz-Mas, R., Alcaraz-Hernández, J. D., & Garófano-Gómez, V. (2011). HABITAT SUITABILITY MODELLING AT MESOHABITAT SCALE AND EFFECTS OF DAM OPERATION ON THE ENDANGERED JúCAR NASE, PARACHONDROSTOMA ARRIGONIS (RIVER CABRIEL, SPAIN). River Research and Applications, 28(6), 740-752. doi:10.1002/rra.1598Dal Pozzolo A, Caelen O, Bontempi G. 2015. unbalanced: Racing for unbalanced methods selection. R package version 2.0.Elith, J., & Leathwick, J. R. (2009). Species Distribution Models: Ecological Explanation and Prediction Across Space and Time. Annual Review of Ecology, Evolution, and Systematics, 40(1), 677-697. doi:10.1146/annurev.ecolsys.110308.120159Elvira, B., & Almodovar, A. (2001). Freshwater fish introductions in Spain: facts and figures at the beginning of the 21st century. Journal of Fish Biology, 59(sa), 323-331. doi:10.1111/j.1095-8649.2001.tb01393.xElvira, B., & Almodóvar, A. (2006). Threatened fishes of the world: Chondrostoma arrigonis (Steindachner, 1866) (Cyprinidae). Environmental Biology of Fishes, 81(1), 27-28. doi:10.1007/s10641-006-9172-7Friedman, J. H. (2001). machine. The Annals of Statistics, 29(5), 1189-1232. doi:10.1214/aos/1013203451Fukuda, S., De Baets, B., Waegeman, W., Verwaeren, J., & Mouton, A. M. (2013). Habitat prediction and knowledge extraction for spawning European grayling (Thymallus thymallus L.) using a broad range of species distribution models. Environmental Modelling & Software, 47, 1-6. doi:10.1016/j.envsoft.2013.04.005Girard, V., Monti, D., Valade, P., Lamouroux, N., Mallet, J.-P., & Grondin, H. (2013). HYDRAULIC PREFERENCES OF SHRIMPS AND FISHES IN TROPICAL INSULAR RIVERS. River Research and Applications, 30(6), 766-779. doi:10.1002/rra.2675Gozlan, R. E., Britton, J. R., Cowx, I., & Copp, G. H. (2010). Current knowledge on non-native freshwater fish introductions. Journal of Fish Biology, 76(4), 751-786. doi:10.1111/j.1095-8649.2010.02566.xGuay, J. C., Boisclair, D., Rioux, D., Leclerc, M., Lapointe, M., & Legendre, P. (2000). Development and validation of numerical habitat models for juveniles of Atlantic salmon (Salmo salar). Canadian Journal of Fisheries and Aquatic Sciences, 57(10), 2065-2075. doi:10.1139/f00-162Guisan, A., Graham, C. H., Elith, J., & Huettmann, F. (2007). Sensitivity of predictive species distribution models to change in grain size. Diversity and Distributions, 13(3), 332-340. doi:10.1111/j.1472-4642.2007.00342.xHeggenes, J., Brabrand, Åg., & Saltveit, S. (1990). Comparison of Three Methods for Studies of Stream Habitat Use by Young Brown Trout and Atlantic Salmon. Transactions of the American Fisheries Society, 119(1), 101-111. doi:10.1577/1548-8659(1990)1192.3.co;2Jowett, I. G., & Davey, A. J. H. (2007). A Comparison of Composite Habitat Suitability Indices and Generalized Additive Models of Invertebrate Abundance and Fish Presence–Habitat Availability. Transactions of the American Fisheries Society, 136(2), 428-444. doi:10.1577/t06-104.1Jowett, I. G., & Duncan, M. J. (2012). Effectiveness of 1D and 2D hydraulic models for instream habitat analysis in a braided river. Ecological Engineering, 48, 92-100. doi:10.1016/j.ecoleng.2011.06.036Laurikkala, J. (2001). Improving Identification of Difficult Small Classes by Balancing Class Distribution. Lecture Notes in Computer Science, 63-66. doi:10.1007/3-540-48229-6_9Leunda, P. (2010). Impacts of non-native fishes on Iberian freshwater ichthyofauna: current knowledge and gaps. Aquatic Invasions, 5(3), 239-262. doi:10.3391/ai.2010.5.3.03Lin, X., & Zhang, D. (1999). Inference in generalized additive mixed modelsby using smoothing splines. Journal of the Royal Statistical Society: Series B (Statistical Methodology), 61(2), 381-400. doi:10.1111/1467-9868.00183Liu, C., Berry, P. M., Dawson, T. P., & Pearson, R. G. (2005). Selecting thresholds of occurrence in the prediction of species distributions. Ecography, 28(3), 385-393. doi:10.1111/j.0906-7590.2005.03957.xMaceda-Veiga, A. (2012). Towards the conservation of freshwater fish: Iberian Rivers as an example of threats and management practices. Reviews in Fish Biology and Fisheries, 23(1), 1-22. doi:10.1007/s11160-012-9275-5Maggini, R., Lehmann, A., Zimmermann, N. E., & Guisan, A. (2006). Improving generalized regression analysis for the spatial prediction of forest communities. Journal of Biogeography, 33(10), 1729-1749. doi:10.1111/j.1365-2699.2006.01465.xMarr, S. M., Olden, J. D., Leprieur, F., Arismendi, I., Ćaleta, M., Morgan, D. L., … García-Berthou, E. (2013). A global assessment of freshwater fish introductions in mediterranean-climate regions. Hydrobiologia, 719(1), 317-329. doi:10.1007/s10750-013-1486-9MARTÍNEZ-CAPEL, F., GARCÍA DE JALÓN, D., WERENITZKY, D., BAEZA, D., & RODILLA-ALAMÁ, M. (2009). Microhabitat use by three endemic Iberian cyprinids in Mediterranean rivers (Tagus River Basin, Spain). Fisheries Management and Ecology, 16(1), 52-60. doi:10.1111/j.1365-2400.2008.00645.xMouton, A. M., Alcaraz-Hernández, J. D., De Baets, B., Goethals, P. L. M., & Martínez-Capel, F. (2011). Data-driven fuzzy habitat suitability models for brown trout in Spanish Mediterranean rivers. Environmental Modelling & Software, 26(5), 615-622. doi:10.1016/j.envsoft.2010.12.001Mouton, A. M., De Baets, B., & Goethals, P. L. M. (2010). Ecological relevance of performance criteria for species distribution models. Ecological Modelling, 221(16), 1995-2002. doi:10.1016/j.ecolmodel.2010.04.017Muñoz-Mas, R., Fukuda, S., Vezza, P., & Martínez-Capel, F. (2016). Comparing four methods for decision-tree induction: A case study on the invasive Iberian gudgeon ( Gobio lozanoi ; Doadrio and Madeira, 2004). Ecological Informatics, 34, 22-34. doi:10.1016/j.ecoinf.2016.04.011Muñoz-Mas, R., Lopez-Nicolas, A., Martínez-Capel, F., & Pulido-Velazquez, M. (2016). Shifts in the suitable habitat available for brown trout (Salmo trutta L.) under short-term climate change scenarios. Science of The Total Environment, 544, 686-700. doi:10.1016/j.scitotenv.2015.11.147Muñoz-Mas, R., Martínez-Capel, F., Garófano-Gómez, V., & Mouton, A. M. (2014). Application of Probabilistic Neural Networks to microhabitat suitability modelling for adult brown trout (Salmo trutta L.) in Iberian rivers. Environmental Modelling & Software, 59, 30-43. doi:10.1016/j.envsoft.2014.05.003Muñoz-Mas, R., Martínez-Capel, F., Schneider, M., & Mouton, A. M. (2012). Assessment of brown trout habitat suitability in the Jucar River Basin (SPAIN): Comparison of data-driven approaches with fuzzy-logic models and univariate suitability curves. Science of The Total Environment, 440, 123-131. doi:10.1016/j.scitotenv.2012.07.074Muñoz-Mas, R., Papadaki, C., Martínez-Capel, F., Zogaris, S., Ntoanidis, L., & Dimitriou, E. (2016). Generalized additive and fuzzy models in environmental flow assessment: A comparison employing the West Balkan trout (Salmo farioides; Karaman, 1938). Ecological Engineering, 91, 365-377. doi:10.1016/j.ecoleng.2016.03.009Olaya-Marín, E. J., Martínez-Capel, F., Soares Costa, R. M., & Alcaraz-Hernández, J. D. (2012). Modelling native fish richness to evaluate the effects of hydromorphological changes and river restoration (Júcar River Basin, Spain). Science of The Total Environment, 440, 95-105. doi:10.1016/j.scitotenv.2012.07.093Paredes-Arquiola, J., Solera, A., Martinez-Capel, F., Momblanch, A., & Andreu, J. (2014). Integrating water management, habitat modelling and water quality at the basin scale and environmental flow assessment: case study of the Tormes River, Spain. Hydrological Sciences Journal, 59(3-4), 878-889. doi:10.1080/02626667.2013.821573Platts, P. J., McClean, C. J., Lovett, J. C., & Marchant, R. (2008). Predicting tree distributions in an East African biodiversity hotspot: model selection, data bias and envelope uncertainty. Ecological Modelling, 218(1-2), 121-134. doi:10.1016/j.ecolmodel.2008.06.028Reyjol, Y., Hugueny, B., Pont, D., Bianco, P. G., Beier, U., Caiola, N., … Virbickas, T. (2007). Patterns in species richness and endemism of European freshwater fish. Global Ecology and Biogeography, 16(1), 65-75. doi:10.1111/j.1466-8238.2006.00264.xRibeiro, F., Elvira, B., Collares-Pereira, M. J., & Moyle, P. B. (2007). Life-history traits of non-native fishes in Iberian watersheds across several invasion stages: a first approach. Biological Invasions, 10(1), 89-102. doi:10.1007/s10530-007-9112-2RIBEIRO, F., & LEUNDA, P. M. (2012). Non-native fish impacts on Mediterranean freshwater ecosystems: current knowledge and research needs. Fisheries Management and Ecology, 19(2), 142-156. doi:10.1111/j.1365-2400.2011.00842.xRincon, P. A., Correas, A. M., Morcillo, F., Risueno, P., & Lobon-Cervia, J. (2002). Interaction between the introduced eastern mosquitofish and two autochthonous Spanish toothcarps. Journal of Fish Biology, 61(6), 1560-1585. doi:10.1111/j.1095-8649.2002.tb02498.xRobalo, J. I., Almada, V. C., Levy, A., & Doadrio, I. (2007). Re-examination and phylogeny of the genus Chondrostoma based on mitochondrial and nuclear data and the definition of 5 new genera. Molecular Phylogenetics and Evolution, 42(2), 362-372. doi:10.1016/j.ympev.2006.07.003Romão, F., Quintella, B. R., Pereira, T. J., & Almeida, P. R. (2011). Swimming performance of two Iberian cyprinids: the Tagus nase Pseudochondrostoma polylepis (Steindachner, 1864) and the bordallo Squalius carolitertii (Doadrio, 1988). Journal of Applied Ichthyology, 28(1), 26-30. doi:10.1111/j.1439-0426.2011.01882.xShiroyama, R., & Yoshimura, C. (2016). Assessing bluegill (Lepomis macrochirus) habitat suitability using partial dependence function combined with classification approaches. Ecological Informatics, 35, 9-18. doi:10.1016/j.ecoinf.2016.06.005Thomas, J. A., & Bovee, K. D. (1993). Application and testing of a procedure to evaluate transferability of habitat suitability criteria. Regulated Rivers: Research & Management, 8(3), 285-294. doi:10.1002/rrr.3450080307Vezza, P., Muñoz-Mas, R., Martinez-Capel, F., & Mouton, A. (2015). Random forests to evaluate biotic interactions in fish distribution models. Environmental Modelling & Software, 67, 173-183. doi:10.1016/j.envsoft.2015.01.005Vilizzi, L., Copp, G. H., & Roussel, J.-M. (2004). Assessing variation in suitability curves and electivity profiles in temporal studies of fish habitat use. River Research and Applications, 20(5), 605-618. doi:10.1002/rra.767Wood, S. N. (2004). Stable and Efficient Multiple Smoothing Parameter Estimation for Generalized Additive Models. Journal of the American Statistical Association, 99(467), 673-686. doi:10.1198/016214504000000980Wood, S. N. (2006). Generalized Additive Models. doi:10.1201/9781420010404Zuur, A. F., Ieno, E. N., Walker, N., Saveliev, A. A., & Smith, G. M. (2009). Mixed effects models and extensions in ecology with R. Statistics for Biology and Health. doi:10.1007/978-0-387-87458-

Effects of water re-allocation in the Ebro river basin: A multiregional input-output and geographical analysis

The quality and availability of water are affected by numerous variables, through which the evaluation of water uses from different perspectives, and policy proposals to save water have now become essential. This paper aims to study water use and the water footprint from a river basin perspective, taking into account regions, sectors, and municipalities, while considering the physical frontier along with the administrative sectors. To this end, we have constructed a multi-regional input-output table for the Ebro river basin, disaggregating the primary sector into 18 different crops and 6 livestock groups. We pay special attention to crop production because it is the most water-consuming industry. The construction of the multi-regional input-output model represents an important contribution to the literature, in itself, since, to the best of our knowledge, it is the first to be built for this large basin. We extend this multi-regional input-output model to assess the water footprint by sectors and regions within the basin. We use these data to propose two scenarios: reallocating final demand to reduce the blue water footprint (scenario 1), and increasing value added (scenario 2). These scenarios outline the opportunity costs of saving water in socioeconomic terms in the basin. In another application, we downscale the multi-regional input-output model results at the municipal level and depict them using a geographical information system, identifying the hotspots and the areas that would pay for the socioeconomic opportunity costs of saving water. Our results suggest that saving 1 hm 3 of blue water could cost around €41, 500 of value added if we consider the entire basin. However, this water re-allocation implies losses and gains at the municipal level: some municipalities would reduce value added by more than €30, 000, while others would gain more than €85, 000 of value added. These tools and results can be useful for policy makers when considering re-allocating water. The contribution and the novelty of this paper is the construction of the multiregional input-output model for the Ebro river basin, and its link with geographical systems analysis at the municipal level

Study protocol of cost-effectiveness and cost-utility of a biopsychosocial multidisciplinary intervention in the evolution of non-specific sub-acute low back pain in the working population: cluster randomised trial.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Low back pain (LBP), with high incidence and prevalence rate, is one of the most common reasons to consult the health system and is responsible for a significant amount of sick leave, leading to high health and social costs. The objective of the study is to assess the cost-effectiveness and cost-utility analysis of a multidisciplinary biopsychosocial educational group intervention (MBEGI) of non-specific sub-acute LBP in comparison with the usual care in the working population recruited in primary healthcare centres. Methods/design: The study design is a cost-effectiveness and cost-utility analysis of a MBEGI in comparison with the usual care of non-specific sub-acute LBP.Measures on effectiveness and costs of both interventions will be obtained from a cluster randomised controlled clinical trial carried out in 38 Catalan primary health care centres, enrolling 932 patients between 18 and 65 years old with a diagnosis of non-specific sub-acute LBP. Effectiveness measures are: pharmaceutical treatments, work sick leave (% and duration in days), Roland Morris disability, McGill pain intensity, Fear Avoidance Beliefs (FAB) and Golberg Questionnaires. Utility measures will be calculated from the SF-12. The analysis will be performed from a social perspective. The temporal horizon is at 3 months (change to chronic LBP) and 12 months (evaluate the outcomes at long term. Assessment of outcomes will be blinded and will follow the intention-to-treat principle. Discussion: We hope to demonstrate the cost-effectiveness and cost-utility of MBEGI, see an improvement in the patients' quality of life, achieve a reduction in the duration of episodes and the chronicity of non-specific low back pain, and be able to report a decrease in the social costs. If the intervention is cost-effectiveness and cost-utility, it could be applied to Primary Health Care Centres. Trial registration: ISRCTN: ISRCTN5871969

Decline in age at menarche among Spanish women born from 1925 to 1962

<p>Abstract</p> <p>Background</p> <p>While the timing of reproductive events varies across populations, a downward trend in age at menarche has nevertheless been reported in most of the developed world over the past century. Given the impact of change in age at menarche on health conditions, this study sought to examine secular trends in age at menarche among women living in Navarre (Northern Spain) who participated in a population-based breast cancer screening programme.</p> <p>Methods</p> <p>The study was based on 110545 women born from 1925 to 1962. Trends were tested using a linear regression model, in which year of birth was entered continuously as the predictor and age at menarche (years) as the response variable, using size of town and region of birth as covariates.</p> <p>Results</p> <p>Among women born in Navarre between 1925 and 1962, age at menarche declined steadily from an average of 13.72 years in the 1925-1929 birth-cohorts to 12.83 years in the 1958-1962 birth-cohorts. Controlling for size of town or city of birth, age at menarche declined by an average of 0.132 years every 5 years over the period 1925-1962. This decline was greater in women born in rural versus urban settings. Trends were also different among regions of birth.</p> <p>Conclusion</p> <p>We report a population-based study showing a downward trend in age of onset of menarche among Spanish women born in the period 1925-1962, something that is more pronounced among women born in rural settings and varies geographically.</p

La estadistica de I+D en EspaNa 35 aNos de historia

Centro de Informacion y Documentacion Cientifica (CINDOC). C/Joaquin Costa, 22. 28002 Madrid. SPAIN / CINDOC - Centro de Informaciòn y Documentaciòn CientìficaSIGLEESSpai

Natural history and mortality of chronic epilepsy in an untreated population of rural Bolivia: A follow-up after 10 years.

International audiencePurpose: To evaluate the natural history and mortality of chronic epilepsy in an untreated prevalence cohort of people with epilepsy (PWE) in a rural area of Bolivia. Methods: During 1994-1996 we carried out an epidemiologic survey in a sample of 9,995 subjects in the Cordillera province. At the end of the survey we identified 130 PWE, of whom 118 were classified as having "active epilepsy." We revisited this cohort 10 years after the prevalence survey. Results: We were able to trace 103 (87.3%) of the 118 PWE previously identified. Ten of the 103 subjects died during the follow-up period. Of the 93 PWE still alive, adequate information on the occurrence of seizures was available for 71 subjects, of whom 31 (43.7%) were seizure-free for more than 5 years; only 3 of these 31 subjects have taken an antiepileptic drug (AED) for more than 1 year. Generalized seizures were associated with a better prognosis. Mortality rate in our prevalent cohort was 10.0/1,000 person-year at risk [95% confidence interval (CI) 5.5-18.3], without a significant increased risk respect to the general population [standardized mortality rate (SMR) 1.34; 95% CI 0.68-2.39]; a significant increased risk of death was found for patients with remote symptomatic epilepsy (SMR 3.0; 95% CI 1.2-6.3) but not with idiopathic epilepsy. Three of the 10 subjects died of causes possibly related to epilepsy. Discussion: Our data suggest that spontaneous remission of epilepsy occurs in a substantial proportion of untreated patients affected by chronic epilepsy; concerning mortality, we found a 3-fold increased mortality in patients with remote symptomatic epilepsy