Spatio-chromatic vision with multifocal diffractive intraocular lens

Background This study aims to detect alterations in the spatio-chromatic pseudophakic vision produced by multifocal diffractive intraocular lenses (IOLs) and provides a physical interpretation. Methods In vitro characterization of the imaging performance of two diffractive IOLs: AT LISA Tri (Zeiss) and FineVision (PhysIOL) in on-bench model eye illuminated with red (R, 625 nm), green (G, 530 nm) and blue (B, 455 nm) lights. We used the metrics: energy efficiency (EE), area under the modulation transfer function, longitudinal chromatic aberration (LCA), and halo intensity. Through-focus (TF) analysis and calculation of the expected defocus curve under white (W) daylight were included. In vivo visual acuity (VA) of 50 pseudophakics (60 eyes) was assessed under W, R, G, B lights at far and near. Two clinical experiments evaluated LCA and R, G, B TF-EE effects on pseudophakic vision and their relative importance. Results Clinical mean VA values under W light agreed with the predicted values at far and near for both IOLs. LCA measurements and R, G, B TF-EE curves were consistent with their lens design based on the 0th and 1st diffraction orders operative for far and near vision, respectively. LCA effects were compensated at near but noticed at far (-¿0.75 D under B light). We detected strong asymmetry in visual resolution depending on the object distance and the illuminating wavelength—red predominance at far, blue predominance at near—in consistency with the TF-EE measurements. Conclusions Diffractive multifocal IOL designs produce asymmetries in the spatio-chromatic vision of pseudophakics beyond the alterations strictly due to LCA. VA asymmetry for far/near object distance under R and B illumination is clinically detectable in subjects implanted with IOLs with 0th and 1st diffraction orders for far and near vision, respectively. Such VA asymmetry cannot be explained solely from the influence of defocus, as would be derived from a chromatic difference of power, but mainly from the wavelength dependence of the EE.Agencia Estatal de Investigación from Spanish Government (Grant No. PID2020-114582RB-I00/AEI/10. 13039/501100011033).Peer ReviewedPostprint (published version

A new source of representative secondary PET nanoplastics. Obtention, characterization, and hazard evaluation

Acord transformatiu CRUE-CSICAltres ajuts: Juan de la Cierva IJC2020-2686IMicro and nanoplastics (MNPLs) are emergent environmental pollutants requiring urgent information on their potential risks to human health. One of the problems associated with the evaluation of their undesirable effects is the lack of representative samples, matching those resulting from the environmental degradation of plastic wastes. To such end, we propose an easy method to obtain polyethylene terephthalate nanoplastics from water plastic bottles (PET-NPLs) but, in principle, applicable to any other plastic goods sources. An extensive characterization indicates that the proposed process produces uniform samples of PET-NPLs of around 100 nm, as determined by using AF4 and multi-angle and dynamic light scattering methodologies. An important point to be highlighted is that to avoid the metal contamination resulting from methods using metal blades/burrs for milling, trituration, or sanding, we propose to use diamond burrs to produce metal-free samples. To visualize the toxicological profile of the produced PET-NPLs we have evaluated their ability to be internalized by cells, their cytotoxicity, their ability to induce oxidative stress, and induce DNA damage. In this preliminary approach, we have detected their cellular uptake, but without the induction of significant biological effects. Thus, no relevant increases in toxicity, reactive oxygen species (ROS) induction, or DNA damage -as detected with the comet assay- have been observed. The use of representative samples, as produced in this study, will generate relevant data in the discussion about the potential health risks associated with MNPLs exposures

Telemedicine Strategy to Rescue CPAP Therapy in Sleep Apnea Patients with Low Treatment Adherence: A Pilot Study

Patients with sleep apnea are usually treated with continuous positive airway pressure (CPAP). This therapy is very effective if the patient's adherence is satisfactory. However, although CPAP adherence is usually acceptable during the first months of therapy, it progressively decreases, with a considerable number of patients accepting average treatment duration below the effectiveness threshold (4 h/night). Herein, our aim was to describe and evaluate a novel telemedicine strategy for rescuing CPAP treatment in patients with low adherence after several months/years of treatment. This two-week intervention includes (1) patient support using a smartphone application, phone and voice recorder messages to be answered by a nurse, and (2) daily transmission and analysis of signals from the CPAP device and potential variation of nasal pressure if required. On average, at the end of the intervention, median CPAP adherence considerably increased by 2.17 h/night (from 3.07 to 5.24 h/night). Interestingly, the procedure was able to markedly rescue CPAP adherence: the number of patients with poor adherence (<4 h/night) was considerably reduced from 38 to 7. After one month, adherence improvement was maintained (median 5.09 h/night), and only 13 patients had poor adherence (<4 h/night). This telemedicine intervention (103€ per included patient) is a cost-effective tool for substantially increasing the number of patients with CPAP adherence above the minimum threshold for achieving positive therapeutic effects

A Roadmap for the Restoration of Mediterranean Macroalgal Forests

Canopy-forming macroalgae play a crucial role in coastal primary production and nutrient cycling, providing food, shelter, nurseries, and habitat for many vertebrate and invertebrate species. However, macroalgal forests are in decline in various places and natural recovery is almost impossible when populations become locally extinct. Hence, active restoration emerges as the most promising strategy to rebuild disappeared forests. In this regard, significant efforts have been made by several EU institutions to research new restoration tools for shallow and mesophotic reef habitats (e.g., MERCES EU project, AFRIMED, and ROCPOP-life) and effective techniques have subsequently been proposed to promote self-sustaining populations. Recent research indicates that macroalgal forest recovery requires a broad spectrum of measures, ranging from mitigating human impacts to restoring the most degraded populations and habitats, and that the viability of large restoration actions is compromised by ongoing human pressures (e.g., pollution, overgrazing, and climate change). We propose a roadmap for Mediterranean macroalgal restoration to assist researchers and stakeholders in decision-making, considering the most effective methods in terms of cost and costeffectiveness, and taking background environmental conditions and potential threats into account. Last, the challenges currently faced by the restoration of rocky coastal ecosystems under changing climate conditions are also discussed

Severe cardiac and abdominal manifestations without lung involvement in a child With COVID-19

Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic, affecting humans of all ages. Clinical features of the pediatric population have been published, but there is not yet enough information to make a definitive description. Fever is typical, as it is respiratory symptom. Rarely are the infection and complications severe, and, when they are, it is almost always in a patient with another underlying disease. However, some otherwise healthy children with COVID-19 do suffer critical organ injury, such as acute myocarditis, heart failure and gastrointestinal inflammation. The mechanism of these organ damages remains unclear. An otherwise normally healthy 13-year-old male was admitted to the pediatric intensive care unit with acute abdomen pain, possible myocarditis and a suspected diagnosis of COVID-19. Noteworthy basal findings were ventricular extrasystoles in the electrocardiogram (EKG) and moderate left ventricular systolic dysfunction. Chest X-ray was normal. Blood tests revealed altered levels of inflammation factors (C-reactive protein (CRP), D-dimer, fibrinogen, interleukin 6 (IL-6)), lymphopenia and elevated cardiac enzymes. The first test for polymerase chain reaction (PCR) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was negative. The patient’s condition worsened, and he entered cardiogenic shock (hypotension, tachycardia and oliguria). He was vomiting continuously, which made pain control difficult; imaging of his abdomen was undertaken. There was no response to fluid resuscitation, and so milrinone and epinephrine were administered. Empiric treatment began with azithromycin, foscarnet, carnitine and immunoglobulins. Hydroxychloroquine was given before the results of repeated SARSCoV-2 and serology tests were available. Tocilizumab was administered once COVID-19 had been confirmed and massive inflammation had been observed. Progressively the clinical situation and the levels of the parameters studied improved. The patient was discharged 8 days after admission. Most children with SARS-CoV-2 infection are asymptomatic or present only mild symptoms. However, physicians should be aware of atypical and severe manifestations that may occur in the hyperinflammatory phase of the illness

Acceleration of infectious disease drug discovery and development using a humanized model of drug metabolism

A key step in drug discovery, common to many disease areas, is preclinical demonstration of efficacy in a mouse model of disease. However, this demonstration and its translation to the clinic can be impeded by mouse-specific pathways of drug metabolism. Here we show that a mouse line extensively humanized for the cytochrome P450 gene superfamily (“8HUM”) can circumvent these problems. The pharmacokinetics, metabolite profiles and magnitude of drug-drug interactions of a test set of approved medicines were in much closer alignment with clinical observations than in wild-type mice. Infection with Mycobacterium tuberculosis, Leishmania donovani and Trypanosoma cruzi was well tolerated in 8HUM, permitting efficacy assessment. During such assessments, mouse-specific metabolic liabilities were bypassed while the impact of clinically relevant active metabolites and DDI on efficacy were well-captured. Removal of species differences in metabolism by replacement of wild-type mice with 8HUM therefore reduces compound attrition while improving clinical translation, accelerating drug discovery

A Roadmap for the Restoration of Mediterranean Macroalgal Forests

Este artículo contiene 14 páginas, 3 figuras, 1 tabla.Canopy-forming macroalgae play a crucial role in coastal primary production and nutrient cycling, providing food, shelter, nurseries, and habitat for many vertebrate and invertebrate species. However, macroalgal forests are in decline in various places and natural recovery is almost impossible when populations become locally extinct. Hence, active restoration emerges as the most promising strategy to rebuild disappeared forests. In this regard, significant efforts have been made by several EU institutions to research new restoration tools for shallow and mesophotic reef habitats (e.g., MERCES EU project, AFRIMED, and ROCPOP-life) and effective techniques have subsequently been proposed to promote self-sustaining populations. Recent research indicates that macroalgal forest recovery requires a broad spectrum of measures, ranging from mitigating human impacts to restoring the most degraded populations and habitats, and that the viability of large restoration actions is compromised by ongoing human pressures (e.g., pollution, overgrazing, and climate change). We propose a roadmap for Mediterranean macroalgal restoration to assist researchers and stakeholders in decision-making, considering the most effective methods in terms of cost and costeffectiveness, and taking background environmental conditions and potential threats into account. Last, the challenges currently faced by the restoration of rocky coastal ecosystems under changing climate conditions are also discussed.This work was supported by the CSIC Library will cover 25% of the APC. AFRIMED. European Maritime and Fisheries Fund EMFF (Grant/Award No. EASME/EMFF/2017/1.2.1.12/S4/01/SI2.789059), MERCES, Horizon 2020 Framework Programme (Grant/Award No. 689518), FoRestA, Spanish Ministry of Science and Innovation (Grant/Award No. PID2020-112985GB-I00), Generalitat de Catalunya (Grant/Award No. 2017 SGR 1521), Universitat de Girona, Ph.D. Grant to JV (Award No. IFUdG-2016), and the Fundación tatiana Pérez de Guzman el Bueno Ph.D. Grant to CG.With the institutional support of the ‘Severo OchoaCentre of Excellence’ accreditation (CEX2019-000928-S).Peer reviewe

State of the knowledge on European marine habitat mapping and degraded habitats

During the last decades, several EU Directives and other international legislations have generated a large number of national initiatives (e.g. marine atlases) and EU programmes on habitat mapping. Nevertheless, the outcomes of these initiatives are fragmented and, to our best knowledge, to date there is no systematic assessment regarding the nature, quality and availability of information across the European seas. One of the main goals of the MERCES project (www.merces-project.eu) is to produce a census of available maps of European key marine habitats, along with their degradation status and restoration potential in the European Seas, providing a potential basis for future discussion on restoration activities. MERCES is producing a census of European marine key habitat maps, degraded habitat maps and investigating key habitat restoration potential. To do this MERCES has i. reviewed known existing habitat maps of European regional seas and provided source citations for all of the information ii. reviewed degraded habitat map resources by regional sea and habitat type (e.g. seagrass, macroalgae, coral gardens, sponge aggregations, seamounts, vents), associated habitat deterioration (e.g. extent of decline), the most common human activities and pressures reported, and the recovery and restoration potential of these habitats iii. reviewed 6 key habitats (including kelp and macroalgal forests, seagrass meadows, coralligenous assemblages, coral gardens and deep-sea bottom communities) and linked 6 major habitat features, such as dynamics, connectivity, structural complexity and vulnerability, to consequences for restoration and the likelihood of restoration succes

Current marine pressures and mechanisms driving changes in marine habitats

Human activities and the resultant pressures they place on the marine environment have been widely demonstrated to contribute to habitat degradation, therefore, their identification and quantification is an essential step towards any meaningful restoration effort. The overall scope of MERCES Deliverable 1.2 is to review current knowledge regarding the major marine pressures placed upon marine ecosystems in EU waters and the mechanisms by which they impact habitats in order to determine potential restoration pathways. An understanding of their geographical distribution is critical for any local assessment of degradation, as well as for planning conservation and restoration actions. This information would ideally be in the form of maps, which: (a) compile single or multiple activities and pressures over broad scales, integrating and visualizing available data and allowing direct identification of aggregations as well as gaps and (b) may be overlaid with habitat maps (or any other map layer containing additional information), thus combining different data levels and producing new information to be used for example when implementing EU policies. The deliverable also documents typical example habitat case studies, the prominent impacts and consequences of activities and pressures towards the identification of possible restoration or mitigation actions. Finally the deliverable discusses pressures, assessments, marine spatial planning and blue growth potential. Activities and pressures are used in a strict sense, where marine activities are undertaken to satisfy the needs of societal drivers (e.g. aquaculture or tourism) and pressures are considered to be the mechanism through which an activity has an actual or potential effect on any part of the ecosystem (e.g. for demersal trawling activity, one pressure would be abrasion of the seabed). Habitats are addressed using a nested approach from large-scale geological features (e.g. shallow soft bottoms) to species-characterised habitats (e.g. Posidonia meadows) because of the way they are referred to in current policy documents which lack standard and precise definitions

Where Is More Important Than How in Coastal and Marine Ecosystems Restoration

Restoration is considered an effective strategy to accelerate the recovery of biological communities at local scale. However, the effects of restoration actions in the marine ecosystems are still unpredictable.We performed a global analysis of published literature to identify the factors increasing the probability of restoration success in coastal and marine systems. Our results confirm that the majority of active restoration initiatives are still concentrated in the northern hemisphere and that most of information gathered from restoration efforts derives from a relatively small subset of species. The analysis also indicates that many studies are still experimental in nature, covering small spatial and temporal scales. Despite the limits of assessing restoration effectiveness in absence of a standardized definition of success, the context (degree of human impact, ecosystem type, habitat) of where the restoration activity is undertaken is of greater relevance to a successful outcome than how (method) the restoration is carried out. Contrary to expectations, we found that restoration is not necessarily more successful closer to protected areas (PA) and in areas of moderate human impact. This result can be motivated by the limits in assessing the success of interventions and by the tendency of selecting areas in more obvious need of restoration, where the potential of actively restoring a degraded site is more evident. Restoration sites prioritization considering human uses and conservation status present in the region is of vital importance to obtain the intended outcomes and galvanize further actions