Distribution of ermB, ermF, tet(W), and tet(M) resistance genes in the vaginal ecosystem of women during pregnancy and puerperium

The inhabitants of the vaginal ecosystem can harbor genetic determinants conferring antimicrobial resistance. However, detailed data about the distribution of resistance genes in the vaginal microbiome of pregnant women are still lacking. Therefore, we assessed the presence of macrolide (i.e., erm genes) and tetracycline (i.e., tet genes) resistance markers in the vaginal environment of Caucasian women at different gestational ages. Furthermore, the detection of resistance genes was related to the composition of the vaginal microbiota. A total of 228 vaginal samples, collected at different trimesters of pregnancy or during the puerperium, were tested for the presence of ermB, ermF, tet(W), and tet(M) by in-house end-point PCR assays. The composition of the vaginal microbiota was assessed through a microscopic evaluation (i.e., Nugent score) and by means of sequencing V3–V4 hypervariable regions of the bacterial 16 rRNA gene. Overall, the most detected resistance gene was tet(M) (76.7%), followed by ermB (55.2%). In 17% of women, mainly with a ‘normal’ vaginal microbiota, no resistance genes were found. Except for tet(W), a significant correlation between the positivity of resistance genes and a dysbiotic vaginal status (i.e., bacterial vaginosis (BV)) was noticed. Indeed, samples positive for at least one resistance determinant were characterized by a decrease in Lactobacillus spp. and an increase of BV-related genera (Prevotella, Gardnerella, Atopobium, Sneathia). A high predominance of vaginal Lactobacillus spp. (>85%) was associated with a lower risk of tet(W) gene detection, whereas the presence of Megasphaera (>1%) increased the risk of positivity for all analyzed genes. Different types of vaginal microbiota are associated with peculiar resistance profiles, being a lactobacilli-dominated ecosystem poor in or free of resistance genes. These data could open new perspectives for promoting maternal and neonatal health

Boosting Blue Growth in a Mild Sea: Analysis of the Synergies Produced by a Multi-Purpose Offshore Installation in the Northern Adriatic, Italy

In the near future, the oceans will be subjected to a massive development of marine infrastructures, including offshore wind, tidal and wave energy farms and constructions for marine aquaculture. The development of these facilities will unavoidably exert environmental pressures on marine ecosystems. It is therefore crucial that the economic costs, the use of marine space and the environmental impacts of these activities remain within acceptable limits. Moreover, the installation of arrays of wave energy devices is still far from being economically feasible due to many combined aspects, such as immature technologies for energy conversion, local energy storage and moorings. Therefore, multi-purpose solutions combining renewable energy from the sea (wind, wave, tide), aquaculture and transportation facilities can be considered as a challenging, yet advantageous, way to boost blue growth. This would be due to the sharing of the costs of installation and using the produced energy locally to feed the different functionalities and optimizing marine spatial planning. This paper focuses on the synergies that may be produced by a multi-purpose offshore installation in a relatively calm sea, i.e., the Northern Adriatic Sea, Italy, and specifically offshore Venice. It analyzes the combination of aquaculture, energy production from wind and waves, and energy storage or transfer. Alternative solutions are evaluated based on specific criteria, including the maturity of the technology, the environmental impact, the induced risks and the costs. Based on expert judgment, the alternatives are ranked and a preliminary layout of the selected multi-purpose installation for the case study is proposed, to further allow the exploitation of the synergies among different functionalities

Methodology for integrated socio-economic assessment of offshore platforms : towards facilitation of the implementation of the marine strategy framework directive

In this paper a Methodology for Integrated Socio-Economic Assessment (MISEA) of the viability and sustainability of different designs of Multi-Use Offshore Platforms (MUOPs) is presented. MUOPs are designed for multi-use of ocean space for energy extraction (wind power production and wave energy), aquaculture and transport maritime services. The developed methodology allows identification, valuation and assessment of: the potential range of impacts of a number of feasible designs of MUOP investments, and the likely responses of those impacted by the investment project. This methodology provides decision-makers with a valuable decision tool to assess whether a MUOP project increases the overall social welfare and hence should be undertaken, under alternative specifications regarding its design, the discount rate and the stream of net benefits, if a Cost-Benefit Analysis (CBA) is to be followed or sensitivity analysis of selected criteria in a Multi-Criteria Decision Analysis (MCDA) framework. Such a methodology is also crucial for facilitating of the implementation of the Marine Strategy Framework Directive (MSFD adopted in June 2008) that aims to achieve good environmental status of the EU's marine waters by 2020 and to protect the resource base upon which marine-related economic and social activities depend. According to the MSFD each member state must draw up a program of cost-effective measures, while prior to any new measure an impact assessment which contains a detailed cost-benefit analysis of the proposed measures is required

THESEUS decision support system for coastal risk management

While planning coastal risk management strategies, coastal managers need to assess risk across a range of spatial and temporal scales. GIS-based tools are one efficient way to support them in the decision making process through a scenarios analysis starting from social, economic and environmental information integrated into a common platform. However, this integration process requires a significant effort from a team of scientists in terms of a) identifying the appropriate scales and data resolution for analysing social, environmental and economic issues; b) selecting and linking an appropriate set of tools to build a coupled model; c) representing key emerging (and hence challenging) research issues, such as risk perception and social resilience in the model; d) developing multi-criteria analysis to integrate social, environmental, economic impacts; and e) accounting for the expectations of the stakeholders and therefore optimizing the opportunity for them to interact with the tool development and with the final tool itself. In this spirit, this paper presents an open-source Spatial Decision Support System developed within the THESEUS Project to help decision makers to scopeg optimal strategies to minimise coastal risks. The exploratory tool allows the users to perform an integrated coastal risk assessment, to analyse the effects of different combinations of engineering, social, economic and ecologically based mitigation options, across short (2020s), medium (2050s) and long-term (2080s) scenarios, taking into account physical and non-physical drivers, such as climate change, subsidence, population and economic growth

THESEUS decision support system for coastal risk management

While planning coastal risk management strategies, coastal managers need to assess risk across a range of spatial and temporal scales. GIS-based tools are one efficient way to support them in the decision making process through a scenarios analysis starting from social, economic and environmental information integrated into a common platform. However, this integration process requires a significant effort from a team of scientists in terms of a) identifying the appropriate scales and data resolution for analysing social, environmental and economic issues; b) selecting and linking an appropriate set of tools to build a coupled model; c) representing key emerging (and hence challenging) research issues, such as risk perception and social resilience in the model; d) developing multi-criteria analysis to integrate social, environmental, economic impacts; and e) accounting for the expectations of the stakeholders and therefore optimizing the opportunity for them to interact with the tool development and with the final tool itself.In this spirit, this paper presents an open-source Spatial Decision Support System developed within the THESEUS Project to help decision makers to scopeg optimal strategies to minimise coastal risks. The exploratory tool allows the users to perform an integrated coastal risk assessment, to analyse the effects of different combinations of engineering, social, economic and ecologically based mitigation options, across short (2020s), medium (2050s) and long-term (2080s) scenarios, taking into account physical and non-physical drivers, such as climate change, subsidence, population and economic growt

Uterine and fetal cerebral Doppler predict the outcome of third trimester small for gestational age fetuses with normal umbilical artery Doppler.

OBJECTIVE: To assess the value of different admission tests in predicting the outcome of small-for-gestational age (SGA) fetuses with normal Doppler waveforms in the umbilical artery. METHODS: Criteria for admission into this retrospective study included: singleton pregnancy with a birth weight < 10th centile; absence of severe maternal complications; no evidence of fetal anomalies on the sonogram; normal umbilical artery Doppler; and availability of complete follow-up. At the first antenatal sonogram classifying the fetus as SGA, Doppler analysis of the uterine and middle cerebral arteries was performed and amniotic fluid volume was assessed. Outcome variables included adverse perinatal outcome (perinatal death, severe morbidity) and emergency Cesarean section for fetal distress. RESULTS: Two hundred and thirty-one pregnancies were included in the study. The mean +/- standard deviation birth weight and gestational age at delivery were 2222 +/- 502 g and 37.3 +/- 2.9 weeks, respectively. In 37 cases (16%), an emergency Cesarean section was performed. There was one intrauterine death and three fetuses delivered by emergency Cesarean section developed severe morbidity. Logistic regression demonstrated that abnormal velocimetry of the uterine arteries and fetal middle cerebral artery were independently correlated with the occurrence of Cesarean section. CONCLUSIONS: SGA fetuses with normal umbilical artery Doppler waveforms and abnormal uterine arteries and fetal middle cerebral artery waveforms have an increased risk of developing distress and being delivered by emergency Cesarean section. Particularly when both uterine and fetal cerebral waveforms are altered at the same time, the risk is exceedingly high (86%) and delivery as soon as fetal maturity is achieved seems advisable. On the other hand, when both vessels have normal waveforms, the chances of fetal distress are small (4%) and expectant management is the most reasonable choice