Clinical efficacy and safety of a light mask for prevention of dark adaptation in treating and preventing progression of early diabetic macular oedema at 24 months (CLEOPATRA): a multicentre, phase 3, randomised controlled trial

Background: We aimed to assess 24-month outcomes of wearing an organic light-emitting sleep mask as an intervention to treat and prevent progression of non-central diabetic macular oedema. Methods: CLEOPATRA was a phase 3, single-blind, parallel-group, randomised controlled trial undertaken at 15 ophthalmic centres in the UK. Adults with non-centre-involving diabetic macular oedema were randomly assigned (1:1) to wearing either a light mask during sleep (Noctura 400 Sleep Mask, PolyPhotonix Medical, Sedgefield, UK) or a sham (non-light) mask, for 24 months. Randomisation was by minimisation generated by a central web-based computer system. Outcome assessors were masked technicians and optometrists. The primary outcome was the change in maximum retinal thickness on optical coherence tomography (OCT) at 24 months, analysed using a linear mixed-effects model incorporating 4-monthly measurements and baseline adjustment. Analysis was done using the intention-to-treat principle in all randomised patients with OCT data. Safety was assessed in all patients. This trial is registered with Controlled-Trials.com, number ISRCTN85596558. Findings: Between April 10, 2014, and June 15, 2015, 308 patients were randomly assigned to wearing the light mask (n=155) or a sham mask (n=153). 277 patients (144 assigned the light mask and 133 the sham mask) contributed to the mixed-effects model over time, including 246 patients with OCT data at 24 months. The change in maximum retinal thickness at 24 months did not differ between treatment groups (mean change −9·2 μm [SE 2·5] for the light mask vs −12·9 μm [SE 2·9] for the sham mask; adjusted mean difference −0·65 μm, 95% CI −6·90 to 5·59; p=0·84). Median compliance with wearing the light mask at 24 months was 19·5% (IQR 1·9–51·6). No serious adverse events were related to either mask. The most frequent adverse events related to the assigned treatment were discomfort on the eyes (14 with the light mask vs seven with the sham mask), painful, sticky, or watery eyes (14 vs six), and sleep disturbance (seven vs one). Interpretation: The light mask as used in this study did not confer long-term therapeutic benefit on non-centre-involving diabetic macular oedema and the study does not support its use for this indication. Funding: The Efficacy and Mechanism Evaluation Programme, a Medical Research Council and National Institute for Health Research partnership

The Biodiversity of the Mediterranean Sea: Estimates, Patterns, and Threats

The Mediterranean Sea is a marine biodiversity hot spot. Here we combined an extensive literature analysis with expert opinions to update publicly available estimates of major taxa in this marine ecosystem and to revise and update several species lists. We also assessed overall spatial and temporal patterns of species diversity and identified major changes and threats. Our results listed approximately 17,000 marine species occurring in the Mediterranean Sea. However, our estimates of marine diversity are still incomplete as yet—undescribed species will be added in the future. Diversity for microbes is substantially underestimated, and the deep-sea areas and portions of the southern and eastern region are still poorly known. In addition, the invasion of alien species is a crucial factor that will continue to change the biodiversity of the Mediterranean, mainly in its eastern basin that can spread rapidly northwards and westwards due to the warming of the Mediterranean Sea. Spatial patterns showed a general decrease in biodiversity from northwestern to southeastern regions following a gradient of production, with some exceptions and caution due to gaps in our knowledge of the biota along the southern and eastern rims. Biodiversity was also generally higher in coastal areas and continental shelves, and decreases with depth. Temporal trends indicated that overexploitation and habitat loss have been the main human drivers of historical changes in biodiversity. At present, habitat loss and degradation, followed by fishing impacts, pollution, climate change, eutrophication, and the establishment of alien species are the most important threats and affect the greatest number of taxonomic groups. All these impacts are expected to grow in importance in the future, especially climate change and habitat degradation. The spatial identification of hot spots highlighted the ecological importance of most of the western Mediterranean shelves (and in particular, the Strait of Gibraltar and the adjacent Alboran Sea), western African coast, the Adriatic, and the Aegean Sea, which show high concentrations of endangered, threatened, or vulnerable species. The Levantine Basin, severely impacted by the invasion of species, is endangered as well

Population characteristics of the Limpet Patella caerulea (Linnaeus, 1758) in Eastern Mediterranean (Central Greece)

Limpets are pivotal for structuring and regulating the ecological balance of littoral communities and arewidely collected for human consumption and as fishing bait. Limpets of the species Patella caerulea were collected between April 2016 and April 2017 from two sites, and two samplings per each site with varying degree of exposure to wave action and anthropogenic pressure, in Eastern Mediterranean (Pagasitikos Gulf, Central Greece). This study addresses a knowledge gap on population characteristics of P. caerulea populations in Eastern Mediterranean, assesses population structure, allometric relationships, and reproductive status. Morphometric characteristics exhibited spatio-temporal variation. Population density was significantly higher at the exposed site. Spatial relationship between members of thepopulation exhibitedclumpedpattern ofdispersionduring spring. Broadcast spawning of the population occurred during summer. Seven dominant age groupswere identified, with the dominant cohort in the third-year class. Significant negative allometric relationships were exhibited between morphometric characteristics. Differences in growth patterns among populations were indicated. © 2020 by the authors

Contribution of sea cucumber Holothuria tubulosa on organic load reduction from fish farming operation

An investigation was carried out in the field and in the laboratory in order to evaluate the contribution of sea cucumber Holothuria tubulosa on organic load reduction from fish farming in the Eastern Mediterranean. Five experimental cages and three double systems of seawater aquaria were used for this purpose. The mean reduction of OM and OC was 30.73% and 58.58%, respectively. Moreover, the mean absorption efficiency of OM and OC during transit in the intestine of H. tubulosa was 43.40% and 54.65%, respectively. One-way ANOVA indicated significant differences on OM and OC accumulation rate between holothurians and control (p <.05). The results indicated that the feeding activity of H. tubulosa seemed to reduce the total organic load of the fish farm biodeposits, demonstrating their potential as an important organic-reducing component for the sustainability of aquaculture in the Mediterranean region. © 2018 Elsevier B.V

Population structure of two benthic species with different larval stages in the eastern mediterranean sea

Population structure in the marine environment is sometimes cryptic due to complex demographic expansion and distribution of the species. Benthic organisms possess different reproductive strategies with regards to larvae dispersal ability. The hypothesis of variation in biogeographic structure in two benthic species, sea urchin Paracentrotus lividus and ascidian Microcosmus saba-tieri using Random Amplifed Polymorphism (RAPD) was tested. Analyses indicate near panmixia and low but significant genetic differentiation between Amvrakikos Gulf and open sean P. lividus, mostly attributed to the documented nanism in the area. M. sabatieri populations showed substantial genetic differentiation over a latitudinal gradient. Results suggest that benthic species with a long-lived larval phase favour large geographical dispersal while those with a short-lived phase utilise a shorter dispersal range

Bedrock detection beneath river terrace deposits using three-dimensional electrical resistivity tomography

We describe the use of a fully volumetric geophysical imaging approach, three-dimensional electrical resistivity (3D ERT), for bedrock detection below mixed sand and gravel deposits typical of fluvial valley-fill terraces. We illustrate the method through an analysis of terrace deposits of the Great Ouse River (UK), where up to 4 m of sand and gravel have filled the valley bottom during the latest Pleistocene. We use an edge detector to identify the steepest gradient in first-derivative resistivity profiles, which yields an estimate of bedrock depth (verified by drilling) to a precision better than 0.2 m (average) and 0.4 m (standard deviation). The 3D ERT method provides a high spatial resolution, which enabled a previously unknown erosional bedrock structure, associated with the change from deeper first terrace to second terrace deposits, to be identified in the Great Ouse valley. The method provides a relatively quick method to quantify terrace fill volume to a greater degree of precision than currently available

The reproductive cycle of Norway lobster

The reproductive biology of female Norway lobster Nephrops norvegicus was studied throughout an annual cycle from January to December 2007 in Pagasitikos Gulf, a large semi-enclosed Gulf in the central west Aegean Sea, in Greece. Six ovarian maturation stages were described to follow gonadal development, based on the combined external observation and histological examination of the ovary. Reproduction showed clear seasonality both in terms of ovarian maturation and brooding period. The proportion of fully mature females in the catch increased from January to the summer months with a peak in June. The species has a protracted brooding period that peaks in November and December, while the release of eggs from females' pleopods occurs from January to March. The size at which 50% of females reached sexual maturity was estimated, using a logistic model, to be 28.1 mm of carapace length. The undiscovered reproductive dynamics will be valuable for optimizing population models and management strategies for this important fishery resource