Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Collaborative Database to Track Mass Mortality Events in the Mediterranean Sea

Anthropogenic climate change, and global warming in particular, has strong and increasing impacts on marine ecosystems (Poloczanska et al., 2013; Halpern et al., 2015; Smale et al., 2019). The Mediterranean Sea is considered a marine biodiversity hot-spot contributing to more than 7% of world's marine biodiversity including a high percentage of endemic species (Coll et al., 2010). The Mediterranean region is a climate change hotspot, where the respective impacts of warming are very pronounced and relatively well documented (Cramer et al., 2018). One of the major impacts of sea surface temperature rise in the marine coastal ecosystems is the occurrence of mass mortality events (MMEs). The first evidences of this phenomenon dated from the first half of'80 years affecting the Western Mediterranean and the Aegean Sea (Harmelin, 1984; Bavestrello and Boero, 1986; Gaino and Pronzato, 1989; Voultsiadou et al., 2011). The most impressive phenomenon happened in 1999 when an unprecedented large scale MME impacted populations of more than 30 species from different phyla along the French and Italian coasts (Cerrano et al., 2000; Perez et al., 2000). Following this event, several other large scale MMEs have been reported, along with numerous other minor ones, which are usually more restricted in geographic extend and/or number of affected species (Garrabou et al., 2009; Rivetti et al., 2014; Marbà et al., 2015; Rubio-Portillo et al., 2016, authors' personal observations). These events have generally been associated with strong and recurrent marine heat waves (Crisci et al., 2011; Kersting et al., 2013; Turicchia et al., 2018; Bensoussan et al., 2019) which are becoming more frequent globally (Smale et al., 2019). Both field observations and future projections using Regional Coupled Models (Adloff et al., 2015; Darmaraki et al., 2019) show the increase in Mediterranean sea surface temperature, with more frequent occurrence of extreme ocean warming events. As a result, new MMEs are expected during the coming years. To date, despite the efforts, neither updated nor comprehensive information can support scientific analysis of mortality events at a Mediterranean regional scale. Such information is vital to guide management and conservation strategies that can then inform adaptive management schemes that aim to face the impacts of climate change.MV-L was supported by a postdoctoral contract Juan de la Cierva-Incorporación (IJCI-2016-29329) of Ministerio de Ciencia, Innovación y Universidades. AI was supported by a Technical staff contract (PTA2015-10829-I) Ayudas Personal Técnico de Apoyo of Ministerio de Economía y Competitividad (2015). Interreg Med Programme (grant number Project MPA-Adapt 1MED15_3.2_M2_337) 85% cofunded by the European Regional Development Fund, the MIMOSA project funded by the Foundation Prince Albert II Monaco and the European Union's Horizon 2020 research and innovation programme under grant agreement no 689518 (MERCES). DG-G was supported by an FPU grant (FPU15/05457) from the Spanish Ministry of Education. J-BL was partially supported by the Strategic Funding UID/Multi/04423/2013 through national funds provided by FCT - Foundation for Science and Technology and European Regional Development Fund (ERDF), in the framework of the programme PT2020

Titanium dioxide nanoparticles promote arrhythmias via a direct interaction with rat cardiac tissue

BackgroundIn light of recent developments in nanotechnologies, interest is growing to better comprehend the interaction of nanoparticles with body tissues, in particular within the cardiovascular system. Attention has recently focused on the link between environmental pollution and cardiovascular diseases. Nanoparticles <50 nm in size are known to pass the alveolar¿pulmonary barrier, enter into bloodstream and induce inflammation, but the direct pathogenic mechanisms still need to be evaluated. We thus focused our attention on titanium dioxide (TiO2) nanoparticles, the most diffuse nanomaterial in polluted environments and one generally considered inert for the human body.MethodsWe conducted functional studies on isolated adult rat cardiomyocytes exposed acutely in vitro to TiO2 and on healthy rats administered a single dose of 2 mg/Kg TiO2 NPs via the trachea. Transmission electron microscopy was used to verify the actual presence of TiO2 nanoparticles within cardiac tissue, toxicological assays were used to assess lipid peroxidation and DNA tissue damage, and an in silico method was used to model the effect on action potential.ResultsVentricular myocytes exposed in vitro to TiO2 had significantly reduced action potential duration, impairment of sarcomere shortening and decreased stability of resting membrane potential. In vivo, a single intra-tracheal administration of saline solution containing TiO2 nanoparticles increased cardiac conduction velocity and tissue excitability, resulting in an enhanced propensity for inducible arrhythmias. Computational modeling of ventricular action potential indicated that a membrane leakage could account for the nanoparticle-induced effects measured on real cardiomyocytes.ConclusionsAcute exposure to TiO2 nanoparticles acutely alters cardiac excitability and increases the likelihood of arrhythmic events

Global warming and mass mortalities of benthic invertebrates in the Mediterranean Sea

Satellite data show a steady increase, in the last decades, of the surface temperature (upper few millimetres of the water surface) of the Mediterranean Sea. Reports of mass mortalities of benthic marine invertebrates increased in the same period. Some local studies interpreted the two phenomena in a cause-effect fashion. However, a basin-wide picture of temperature changes combined with a systematic assessment on invertebrate mass mortalities was still lacking. Both the thermal structure of the water column in the Mediterranean Sea over the period 1945-2011 and all documented invertebrate mass mortality events in the basin are analysed to ascertain if: 1- documented mass mortalities occurred under conditions of positive temperature trends at basin scale, and 2- atypical thermal conditions were registered at the smaller spatial and temporal scale of mass mortality events. The thermal structure of the shallow water column over the last 67 years was reconstructed using data from three public sources: MEDAR-MEDATLAS, World Ocean Database, MFS-VOS programme. A review of the mass mortality events of benthic invertebrates at Mediterranean scale was also carried out. The analysis of in situ temperature profiles shows that the Mediterranean Sea changed in a non-homogeneous fashion. The frequency of mass mortalities is increasing. The areas subjected to these events correspond to positive thermal anomalies. Statistically significant temperature trends in the upper layers of the Mediterranean Sea show an increase of up to 0.07°C/yr for a large fraction of the basin. Mass mortalities are consistent with both the temperature increase at basin scale and the thermal changes at local scale, up to 5.2°C. Our research supports the existence of a causal link between positive thermal anomalies and observed invertebrate mass mortalities in the Mediterranean Sea, invoking focused mitigation initiatives in sensitive areas

Anomalies of the upper water column in the Mediterranean Sea

The evolution of the upper water column in the Mediterranean Sea during more than 60 years is reconstructed in terms of few parameters describing the mixed layer and the seasonal thermocline. The analysis covers the period 1945–2011 using data from three public sources: MEDAR-MEDATLAS, World Ocean Database, MFS-VOS program. Five procedures for estimating the mixed layer depth are described, discussed and compared using the 20-year long time series of temperature profiles of the DYFAMED station in the Ligurian Sea. On this basis the so-called three segments profile model (which approximates the upper water column with three segments representing mixed layer, thermocline and deep layer) has been selected for a systematic analysis at Mediterranean scale. A widespread increase of the thickness and temperature of the mixed layer, increase of the depth and decrease of the temperature of the thermocline base have been observed in summer and autumn during the recent decades. It is shown that positive temperature extremes of the mixed layer and of its thickness are potential drivers of the mass mortalities of benthic invertebrates documented since 1983. Hotspots of mixed layer anomalies have been also identified. These results refine previous analyses showing that ongoing and future warming of upper Mediterranean is likely to increase mass mortalities by producing environmental conditions beyond the limit of tolerance of some benthic species

Monthly average temperature profiles and mass mortality in the Ligurian Sea.

<p>Analysed months are September (a), October (b) and November (c). Black and blue lines are the monthly-averaged temperature profiles for the periods 1945–1982 and 1983–2011, shaded areas are their standard deviations. The dashed lines are the average temperature profiles for September 1999 (red), September 2003 (magenta), October and November 2006 (yellow), October 2008 (cyan) and October 2009 (orange) when mass mortalities occurred.</p

Distribution of observed mortalities over temperature trend intervals.

<p>Temperature trend is measured in °C/yr. The grey background corresponds to a negative temperature trend, while the white background corresponds to a positive one.</p

Monthly average temperature profiles and mass mortality in the Eastern Tyrrhenian.

<p>Analyzed months are July (a), August (b), September (c), October (d) and November (e). Black and blue lines are the monthly-averaged temperature profiles for the periods 1945–1982 and 1983–2011, shaded areas are their standard deviations. The dashed lines represent the average temperature profile for September 2003 (magenta), September 2005 (green) and September 2009 (orange), when mass mortality occurred.</p

Temperature trends at Mediterranean basin scale.

<p>Temperature trends at 0–10 m (a), 11–30 m (b), 31–50 m (c) depth layers for the period 1945–2011 in July-November. Linear regressions have been calculated on grids of 1° latitude by 1° longitude and tested for statistical significance at the 90%. Significant increased/decreased temperature trends are reported as coloured cells, not significant increased/decreased temperature trends are reported as grey areas. Dots refers to the locations of documented mass mortalities for depth layer, each colour represents a single event. The asterisks in the legend of mass mortalities (MM) events refer to the taxa affected: * stands for sponges, ** for cnidarians, *** for bryozoans, **** for ascidians, ***** for bivalves.</p