The First Cases of Sudden Sensorineural Hearing Loss Post Coronavirus Disease in Children.

To investigate the incidence, characteristics, diagnosis, treatment, and prognosis of coronavirus disease (COVID-19)-related sudden sensorineural hearing loss (SSNHL) in children, three cases of SSNHL after COVID-19 infection in children were analyzed. ENT clinical examination of all cases was normal. Only the third child had a first degree left-beating optokinetic nystagmus, compatible with right peripheral vestibulopathy. The audiogram indicated unilateral severe SSNHL in all frequencies. Computed tomography and magnetic resonance imaging of the brain and temporal bones also showed absence of pathology of the related structures. Oral methylprednisolone was administered to the first two cases, whereas intravenous methylprednisolone in a tapering form was administered to the third case. Additionally, the children underwent intratympanic dexamethasone injections and hyperbaric oxygen therapy with hearing improvement in lower and middle frequencies. The prognosis of COVID-19-related SSNHL in children is closely related to the onset of treatment. The combination of glucocorticoids, intratympanic dexamethasone injections, and hyperbaric oxygen therapy could be effective for COVID- 19-related SSNHL in children. Further large-scale, multicenter studies should be conducted to investigate the pathophysiology, diagnosis, treatment, and prognosis of COVID- 19-related SSNHL.

Hearing Outcomes in the Audiology Department of a Children Hospital.

The incidence of sensorineural hearing loss is between 1 and 3 per 1000 in healthy neonates and 2-4 per 100 in high-risk infants. In this study, we assessed the incidence of hearing impairment in normal term (≥ 37 wga) infants (control group), in children with suspicion and/or risk factors of hearing loss, included premature infants (< 37 weeks gestational age (wga) and/or low birth weight < 2,5 Kgr), in children diagnosed with a specific syndrome and in children with speech disorder, candidate for speech therapy. Hearing impairment is a severe consequence of prematurity and its prevalence is inversely related to the maturity of the baby based on gestation age and /or birth weight. Both above parameters are of particular importance and it has not been found that one factor prevails over the other. Premature infants have many concomitant risk factors for hearing impairment. The most important other risk factors were ototoxic medications, very low birth weight and "treatment in the intensive care unit '' (low Apgar score and mechanical ventilation). Frequent risk factors such as congenital infections and family history of hearing loss, although frequently recorded, does not seem to be very significant. Children with speech disorder do not seem to suffer from hearing impairment more frequently than children in general population.

Reproductive dynamics of the invasive lionfish (Pterois miles) in the Eastern Mediterranean Sea.

The lionfish Pterois miles invaded the Mediterranean Sea in 2012 and spread fast to the entire eastern basin. This study provides evidence of successful spawning and the first detailed analysis of P. miles ovarian dynamics in the Mediterranean Sea. The ovarian reproductive phases of mature females collected from Cyprus (eastern Mediterranean) between September 2017 and August 2018 were analysed, both macroscopically and histologically. The results suggested a prolonged oocyte recruitment and development season, and a spawning season that primarily occurred during summertime, even though spawning-capable females were caught also in autumn. A year-round spawning activity may have been inhibited due to seasonal variations in water temperature. Multiple oocyte developmental stages co-occurred in females at different reproductive phases, indicating that more than one oocyte batches were released per spawning season. The analysis of the spawning batch formation enabled the batch fecundity estimation at 3225-63149 oocytes. The oocyte development pattern described in this study shared characteristics with the indeterminate fecundity type, where new oocytes are recruited to the secondary growth phase in parallel with spawning activity. Climate change is likely to extend the spawning season of lionfish in the Mediterranean Sea and further favour its invasion. The information provided in this study is vital for the design of strategic and effective management plans to restrain the expansion of this highly invasive fish.

Resilience of seagrass populations to thermal stress does not reflect regional differences in ocean climate.

The prevalence of local adaptation and phenotypic plasticity among populations is critical to accurately predicting when and where climate change impacts will occur. Currently, comparisons of thermal performance between populations are untested for most marine species or overlooked by models predicting the thermal sensitivity of species to extirpation. Here we compared the ecological response and recovery of seagrass populations (Posidonia oceanica) to thermal stress throughout a year-long translocation experiment across a 2800-km gradient in ocean climate. Transplants in central and warm-edge locations experienced temperatures > 29°C, representing thermal anomalies > 5°C above long-term maxima for cool-edge populations, 1.5°C for central and < 1°C for warm-edge populations. Cool-edge, central and warm-edge populations differed in thermal performance when grown under common conditions, but patterns contrasted with expectations based on thermal geography. Cool-edge populations did not differ from warm-edge populations under common conditions and performed significantly better than central populations in growth and survival. Our findings reveal that thermal performance does not necessarily reflect the thermal geography of a species. We demonstrate that warm-edge populations can be less sensitive to thermal stress than cooler, central populations suggesting that Mediterranean seagrasses have greater resilience to warming than current paradigms suggest.

They are here to stay: the biology and ecology of lionfish (Pterois miles) in the Mediterranean Sea.

The lionfish, Pterois miles, is one of the most recent Lessepsian immigrants into the Mediterranean Sea, and it poses a serious threat to marine ecosystems in the region. This study assesses the basic biology and ecology of lionfish in the Mediterranean, examining morphometrics, reproduction and diet as well as population structure and distribution. The population density of lionfish has increased dramatically in Cyprus since the first sighting in late 2012; by 2018 aggregations of up to 70 lionfish were found on rocky grounds with complex reefs and artificial reefs in depths of 0-50 m. Lionfish in Cyprus become mature within a year, and adults are capable of spawning year-round, with peak spawning in summer when the sea-surface temperature reaches 28.4°C. The Cypriot lionfish grow faster and bigger than in their native range, and females are more common than males. Lionfish are generalist predators in these waters, as also found in their native range, consuming a range of teleost and crustacean prey, some of which are of high economic value (e.g., Spicara smaris and Sparisoma cretense) or have an important role in local trophic webs (e.g., Chromis chromis). Overall, the reproductive patterns, the presence of juveniles and adults throughout the year, the rapid growth rates and the generalist diet indicate that lionfish are thriving and are now already well established in the region and could potentially become the serious nuisance that they are in their temperate and tropical western Atlantic-invasive range.

Tropical seagrass Halophila stipulacea shifts thermal tolerance during Mediterranean invasion.

Exotic species often face new environmental conditions that are different from those that they are adapted to. The tropical seagrass Halophila stipulacea is a Lessepsian migrant that colonized the Mediterranean Sea around 100 years ago, where at present the minimum seawater temperature is cooler than in its native range in the Red Sea. Here, we tested if the temperature range in which H. stipulacea can exist is conserved within the species or if the exotic populations have shifted their thermal breadth and optimum due to the cooler conditions in the Mediterranean. We did so by comparing the thermal niche (e.g. optimal temperatures, and upper and lower thermal limits) of native (Saudi Arabia in the Red Sea) and exotic (Greece and Cyprus in the Mediterranean Sea) populations of H. stipulacea. We exposed plants to 12 temperature treatments ranging from 8 to 40°C for 7 days. At the end of the incubation period, we measured survival, rhizome elongation, shoot recruitment, net population growth and metabolic rates. Upper and lower lethal thermal thresholds (indicated by 50% plant mortality) were conserved across populations, but minimum and optimal temperatures for growth and oxygen production were lower for Mediterranean populations than for the Red Sea one. The displacement of the thermal niche of exotic populations towards the colder Mediterranean Sea regime could have occurred within 175 clonal generations.

Seagrass recovery after fish farm relocation in the eastern Mediterranean.

Finfish aquaculture has damaged seagrass meadows worldwide as wastes from the farms can kill these habitat-forming plants. In Cyprus, the Mediterranean endemic Posidonia oceanica is at its upper thermal limits yet forms extensive meadows all around the island. Understanding this under-studied isolated population may be important for the long-term survival of the species given that the region is warming rapidly. When fish farming began around Cyprus in the mid-nineties, cages were moored above seagrass beds, but as production expanded they were moved into deeper water further away from the meadows. Here, we monitored the deepest edge of meadows near fish farms that had been moved into deeper waters as well as at a decommissioned farm site. Four P. oceanica monitoring systems were set up using methods developed by the Posidonia Monitoring Network. Seagrass % coverage, shoot density, % of plagiotropic rhizomes, shoot exposure, leaf morphometry, and sediment organic matter content and grain size were monitored at 11 fixed plots within each system, in 2012-2014 and in 2017. Expansion at the lower depth limit of seagrass meadows was recorded at all monitoring sites. Most other P. oceanica descriptors either did not change significantly or declined. Declines were most pronounced at a site that was far from mariculture activities but close to other anthropogenic pressures. The most important predictor affecting P. oceanica was depth. Monitoring using fixed plots allowed direct comparisons of descriptors over time, removes patchiness and intra-meadow variability increasing our understanding of seagrass dynamics and ecosystem integrity. It seems that moving fish farms away from P. oceanica has helped ensure meadow recovery at the deepest margins of their distribution, an important success story given that these meadows are at the upper thermal limits of the species.

Thermal tolerance of Mediterranean marine macrophytes: Vulnerability to global warming.

The Mediterranean Sea is warming at three times the rate of the global ocean raising concerns about the vulnerability of marine organisms to climate change. Macrophytes play a key role in coastal ecosystems, therefore predicting how warming will affect these key species is critical to understand the effects of climate change on Mediterranean coastal ecosystems. We measured the physiological performance of six dominant native Mediterranean macrophytes under ten temperature treatments ranging from 12 to 34°C to examine their thermal niche, and vulnerability to projected warming in the western Mediterranean up until 2100. Among the macrophytes tested, Cymodocea nodosa was the species with the highest thermal optima and it was beyond current summer temperature. Therefore, C. nodosa may benefit from projected warming over the coming century. The optimal temperature for growth of the other species (Posidonia oceanica, Cystoseira compressa, Padina pavonica, Caulerpa prolifera, and Halimeda tuna) was lower. Similarly, the species presented different upper lethal limits, spanning at least across 5.1°C between 28.9°C (P. oceanica) and >34°C (C. nodosa). Our results demonstrate the variable physiological responses of species within the same local community to temperature changes and highlight important potential differences in climate change vulnerability, among species within coastal marine ecosystems.