Plastic pollution on the world's coral reefs.

Coral reefs are losing the capacity to sustain their biological functions1. In addition to other well-known stressors, such as climatic change and overfishing1, plastic pollution is an emerging threat to coral reefs, spreading throughout reef food webs2, and increasing disease transmission and structural damage to reef organisms3. Although recognized as a global concern4, the distribution and quantity of plastics trapped in the world's coral reefs remains uncertain3. Here we survey 84 shallow and deep coral ecosystems at 25 locations across the Pacific, Atlantic and Indian ocean basins for anthropogenic macrodebris (pollution by human-generated objects larger than 5 centimetres, including plastics), performing 1,231 transects. Our results show anthropogenic debris in 77 out of the 84 reefs surveyed, including in some of Earth's most remote and near-pristine reefs, such as in uninhabited central Pacific atolls. Macroplastics represent 88% of the anthropogenic debris, and, like other debris types, peak in deeper reefs (mesophotic zones at 30-150 metres depth), with fishing activities as the main source of plastics in most areas. These findings contrast with the global pattern observed in other nearshore marine ecosystems, where macroplastic densities decrease with depth and are dominated by consumer items5. As the world moves towards a global treaty to tackle plastic pollution6, understanding its distribution and drivers provides key information to help to design the strategies needed to address this ubiquitous threat.

Moving conferences online: lessons learned from an international virtual meeting.

We consider the opportunities and challenges associated with organizing a conference online, using a case study of a medium-sized (approx. 400 participants) international conference held virtually in August 2020. In addition, we present quantifiable evidence of the participants' experience using the results from an online post-conference questionnaire. Although the virtual meeting was not able to replicate the in-person experience in some aspects (e.g. less engagement between participants) the overwhelming majority of respondents found the meeting an enjoyable experience and would join similar events again. Notably, there was a strong desire for future in-person meetings to have at least some online component. Online attendance by lower-income researchers was higher compared with a past, similar-themed in-person meeting held in a high-income nation, but comparable to one held in an upper-middle-income nation. This indicates that online conferences are not a panacea for diversity and inclusivity, and that holding in-person meetings in developing economies can be at least as effective. Given that it is now relatively easy to stream contents of meetings online using low-cost methods, there are clear benefits in making all presented content accessible online, as well as organizing online networking events for those unable to attend in person.

An underwater imagery identification guide for shallow, mesophotic and deep-sea benthos in Maldives.

Background: During the 2022 Nekton Maldives Mission, we deployed a variety of platforms (snorkelling, remotely-operated vehicles and manned submersibles) to conduct video surveys of the biodiversity and composition of shallow (< 30 m), mesophotic (30-150 m) and deep-sea (> 150 m) benthos found in the Maldives' central and southern atolls. In total, ~ 80 hrs of stereo-video footage were collected during the benthic transect surveys, which were subsequently processed using annotation software in order to evaluate benthic biodiversity and community composition. Here, we present a photographic guide for the visual, in situ identification of reef benthos encountered, including corals, sponges and other invertebrates that inhabit Maldives' nearshore habitats. We hope that this identification guide will aid future imagery-based surveys or observations of organisms during fieldwork. New information: A total of 283 morphotypes were identified, including those belonging to Octocorallia (61), Scleractinia (57), Porifera (38), Asteroidea (22), Antipatharia (15), Decapoda (13), Hydrozoa (12), Holothuroidea (10), Actiniaria (9), Echinoidea (8), Annelida (6), Chlorophyta (5), Gastropoda (4), Bivalvia (4), Ascidiacea (3), Crinoidea (3), Bryozoa (2), Cyanobacteria (2), Zoantharia (2), Cephalopoda (1), Ceriantharia (1), Corallimorpharia (1), Ctenophora (1), Ophiuroidea (1), Rhodophyta (1) and to an unknown category (1). Out of these, we identified 40 to species level, 120 to genus, 47 to family, 14 to order and suborder, 58 to class and subclass, two to phylum and one was of unknown phylum. This represents the first attempt to catalogue the mesophotic and deep-sea benthic megafaunal diversity in the Maldives using underwater imagery.

Statins in patients with chronic kidney disease: new evidence.

Dyslipidemia represents a common metabolic alteration in chronic kidney disease (CKD). Alterations can be different depending on the stage of the disease and the extent of proteinuria. Despite the high cardiovascular risk in patients with renal impairment, only a small percentage of patients receive adequate cholesterol-lowering therapy. The use of statins, inhibitors of the endogenous synthesis of cholesterol in patients with CKD, represents an efficient therapeutic instrument for reducing cardiovascular risk, at least in the early stage of the disease. Such evidence is currently lacking in dialysis, that is a setting where cardiovascular mortality is not consistently due to classical atherosclerosis. In addition to their efficacy, statins are proved as safe drugs with a high tolerability profile in CKD. In the case of intolerant patients, a new therapeutic perspective is represented by ezetimibe, inhibitor of intestinal absorption of cholesterol, whose effectiveness and tolerability allow its use throughout all stages of the renal disease.

Trait-based approaches reveal that deep reef ecosystems in the Western Indian Ocean are functionally distinct.

Tropical deep reefs (>30 m) are biologically and ecologically unique ecosystems with a higher geographic reach to shallow (<30 m) reefs. Yet they are poorly understood and rarely considered in conservation practices. Here, we characterise benthic and fish communities across a depth gradient (10-350 m) in remote coral atolls in Seychelles, Western Indian Ocean. Using taxonomic and trait-based approaches we present the taxonomic and functional composition of shallow and deep reef communities, with distinct communities and traits dominating different depths. Depth-related changes in community metrics (taxa richness, abundance and biomass) and functional diversity metrics (richness, dispersion, and evenness) indicate complex relationships across different biological components (fish, benthos) that differ between shallow and deep reefs. These in turn translate into different patterns of reef resilience against disturbance or species invasions with depth. Notably, deep reefs host on average fewer and less abundant taxa but with higher functional contribution and originality scores, some of which are of conservation concern. Overall, the results highlight the unique nature of deep reefs that requires their explicit consideration in conservation and management activities.

Turning the tide of parachute science.

Parachute science is the practice whereby international scientists, typically from higher-income countries, conduct field studies in another country, typically of lower income, and then complete the research in their home country without any further effective communication and engagement with others from that nation. It creates dependency on external expertise, does not address local research needs, and hinders local research efforts. As global hotspots of marine biodiversity, lower-income nations in the tropics have for too long been the subject of inequitable and unfair research practices1. However, to date there has been little quantifiable evidence of this phenomenon in marine science. Here, we provide evidence through systematic literature searches and queries that parachute science practices are still widespread in marine research and make some recommendations to help change the current status quo. VIDEO ABSTRACT.

Reef benthos of Seychelles - A field guide.

BACKGROUND: During the 2019 First Descent: Seychelles Expedition, shallow and deep reef ecosystems of the Seychelles Outer Islands were studied by deploying a variety of underwater technologies to survey their benthic flora and fauna. Submersibles, remotely operated vehicles (ROVs) and SCUBA diving teams used stereo-video camera systems to record benthic communities during transect surveys conducted at 10 m, 30 m, 60 m, 120 m, 250 m and 350 m depths. In total, ~ 45 h of video footage was collected during benthic transect surveys, which was subsequently processed using annotation software in order to assess reef biodiversity and community composition. Here, we present a photographic guide for the visual identification of the marine macrophytes, corals, sponges and other common invertebrates that inhabit Seychelles' reefs. It is hoped that the resulting guide will aid marine biologists, conservationists, managers, divers and naturalists with the coarse identification of organisms as seen in underwater footage or live in the field. NEW INFORMATION: A total of 184 morphotypes (= morphologically similar individuals) were identified belonging to Octocorallia (47), Porifera (35), Scleractinia (32), Asteroidea (19), Echinoidea (10), Actiniaria (9), Chlorophyta (8), Antipatharia (6), Hydrozoa (6), Holothuroidea (5), Mollusca (2), Rhodophyta (2), Tracheophyta (2), Annelida (1), Crinoidea (1), Ctenophora (1), Ochrophyta (1) and Zoantharia (1). Out of these, we identified one to phylum level, eight to class, 14 to order, 27 to family, 110 to genus and 24 to species. This represents the first attempt to catalogue the benthic diversity from shallow reefs and up to 350 m depth in Seychelles.

Androgens and ovarian function: translation from basic discovery research to clinical impact.

In the last decade, it has been revealed that androgens play a direct and important role in regulating female reproductive function. Androgens mediate their actions via the androgen receptor (AR), and global and cell-specific Ar-knockout mouse models have confirmed that AR-mediated androgen actions play a role in regulating female fertility and follicle health, development and ovulation. This knowledge, along with the clinical data reporting a beneficial effect of androgens or androgen-modulating agents in augmenting in vitro fertilization (IVF) stimulation in women termed poor responders, has supported the adoption of this concept in many IVF clinics worldwide. On the other hand, substantial evidence from human and animal studies now supports the hypothesis that androgens in excess, acting via the AR, play a key role in the origins of polycystic ovary syndrome (PCOS). The identification of the target sites of these AR actions and the molecular mechanisms involved in underpinning the development of PCOS is essential to provide the knowledge required for the future development of novel, mechanism-based therapies for the treatment of PCOS. This review will summarize the basic scientific discoveries that have enhanced our knowledge of the roles of androgens in female reproductive function, discuss the impact these findings have had in the clinic and how a greater understanding of the role androgens play in female physiology may shape the future development of effective strategies to improve IVF outcomes in poor responders and the amelioration of symptoms in patients with PCOS.

Changes in zooplankton communities from epipelagic to lower mesopelagic waters.

Zooplankton form a trophic link between primary producers and higher trophic levels, and exert significant influence on the vertical transport of carbon through the water column ('biological carbon pump'). Using a MultiNet we sampled and studied mesozooplankton communities (i.e. >0.2 mm) from six locations around Bermuda targeting four depth zones: ∼0-200 m, ∼200-400 m, ∼400-600 m (deep-scattering layer), and ∼600-800 m. Copepoda, our focal taxonomic group, consistently dominated samples (∼80% relative abundance). We report declines in zooplankton and copepod abundance with depth, concurrent with decreases in food availability. Taxonomic richness was lowest at depth and below the deep-scattering layer. In contrast, copepod diversity peaked at these depths, suggesting lower competitive displacement in these more food-limited waters. Finally, omnivory and carnivory, were the dominant trophic traits, each one affecting the biological carbon pump in a different way. This highlights the importance of incorporating data on zooplankton food web structure in future modelling of global ocean carbon cycling.

Low connectivity between shallow, mesophotic and rariphotic zone benthos.

Worldwide coral reefs face catastrophic damage due to a series of anthropogenic stressors. Investigating how coral reefs ecosystems are connected, in particular across depth, will help us understand if deeper reefs harbour distinct communities. Here, we explore changes in benthic community structure across 15-300 m depths using technical divers and submersibles around Bermuda. We report high levels of floral and faunal differentiation across depth, with distinct assemblages occupying each depth surveyed, except 200-300 m, corresponding to the lower rariphotic zone. Community turnover was highest at the boundary depths of mesophotic coral ecosystems (30-150 m) driven largely by taxonomic turnover and to a lesser degree by ordered species loss (nestedness). Our work highlights the biologically unique nature of benthic communities in the mesophotic and rariphotic zones, and their limited connectivity to shallow reefs, thus emphasizing the need to manage and protect deeper reefs as distinct entities.

A framework for the development of a global standardised marine taxon reference image database (SMarTaR-ID) to support image-based analyses.

Video and image data are regularly used in the field of benthic ecology to document biodiversity. However, their use is subject to a number of challenges, principally the identification of taxa within the images without associated physical specimens. The challenge of applying traditional taxonomic keys to the identification of fauna from images has led to the development of personal, group, or institution level reference image catalogues of operational taxonomic units (OTUs) or morphospecies. Lack of standardisation among these reference catalogues has led to problems with observer bias and the inability to combine datasets across studies. In addition, lack of a common reference standard is stifling efforts in the application of artificial intelligence to taxon identification. Using the North Atlantic deep sea as a case study, we propose a database structure to facilitate standardisation of morphospecies image catalogues between research groups and support future use in multiple front-end applications. We also propose a framework for coordination of international efforts to develop reference guides for the identification of marine species from images. The proposed structure maps to the Darwin Core standard to allow integration with existing databases. We suggest a management framework where high-level taxonomic groups are curated by a regional team, consisting of both end users and taxonomic experts. We identify a mechanism by which overall quality of data within a common reference guide could be raised over the next decade. Finally, we discuss the role of a common reference standard in advancing marine ecology and supporting sustainable use of this ecosystem.

Nosogogy: when the learner is a patient with chronic renal failure.

Patient education approaches are currently derived from a biomedical 'acute' model characterized by the sequence of health, disease, and recovery resulting from our professional intervention. Unfortunately, this model proves to be totally inadequate when applied to a chronic disease such as kidney failure. Our patients never fully regain their health and may continue to worsen under our care, even after many state-of-the-art treatments. The solution is represented in acquiring a new professional identity, shifting from the 'biomedical' acute model to a 'bio-psycho-social-educational model'. Within this model, a Therapeutic Education approach in predialysis has been proven to provide both short- and long-term positive results for renal patients. There is a tremendous difference between the learning processes in children and adults and two different sciences have already been described. 'Pedagogy' deals with child learning and 'Andragogy' with adult learning. Nevertheless, when the learner is a patient with a chronic disease, we believe that new considerations must be taken into account. We propose to create a novel science and to call it 'Nosogogy', derived from the ancient Greek word (see text), meaning 'disease'. Nosogogy could be defined as the science of teaching adults affected by chronic disease. The new educator is someone deeply involved in renal care who knows and understands the characteristic conflicts and dynamics that arise in the renal patient, and possesses adequate communication skills to deal with him. In our experience, we prefer to have educational sessions run by nephrologists and nurses who have great experience in the field.

Patient re-training in peritoneal dialysis: why and when it is needed.

The aim of this multicenter, quantitative, observational study was to analyze compliance and re-training needs of patients on peritoneal dialysis (PD) through the assessment of patient knowledge (with a Patient Questionnaire; phase 1) and patient behavior (home visit with a Score Card; phase 2). A total of 353 patients from 11 Italian centers participated in the first phase and 191 patients from nine centers in the second phase. Overall, 66% of questions on the Patient Questionnaire were answered correctly. Correct answers were more frequent in females than males, in patients under 55 years of age, and in those with higher education. The lowest rate of correct answers involved questions related to diet and physical activity (67% and 51%, respectively). Data collected during the home visit showed that 25% of patients were partially compliant with their drug therapy. Twenty-three percent of patients were non-compliant with the exchange protocol procedures, with a significant association between compliance and the incidence of peritonitis, and 11% were non-compliant with the exit-site protocol procedures without a statistically significant correlation to peritonitis. By combining the two evaluations, we found that approximately one-third (29%) of patients needed reinforcement of knowledge and ability to correctly perform PD as related to infection control and 27% for the correct use of drugs. Looking at the combined evaluation of infection control and drug use, results showed that 47% of patients needed re-training. This need for re-training was greater for younger patients (less than 55 years old), patients with lower education degree and patients in the early or late phase of PD therapy (less than 18 months or more than 36 months). Gender and degree of autonomy had no effect on the need for re-training.

Preoperative radio-chemotherapy response as prognostic factor in colorectal cancer.

In order to demonstrate if radiotherapy (RT) is able to reduce the number of local recurrences and to increase the survival rate of patients (pts) with colorectal cancer, the authors are participating in a large randomized international trial with the goal of comparing patients treated with preoperative radiotherapy plus surgery and patients treated only by surgery. The authors noticed that some patients treated with preoperative radiotherapy showed a reduction in tumor size at the time of endorectal ultrasonography. The authors considered the incidence of recurrences in patients responsive to radiotherapy (RT responsive group), in patients non responsive to radiotherapy (RT non responsive group) and in patients not treated with radiotherapy (no RT group) with the aim of establishing if the responsiveness to preoperative radiotherapy could be considered a prognostic factor in colorectal cancer. After a three year follow-up RT responsive group (41 pts) showed no recurrences (0%); RT non responsive group (27 pts) showed 7 (25%) recurrences; no RT group (66 pts) showed 27 (41%) recurrences. Our data indicates that responsiveness to preoperative RT can be considered a prognostic factor. A large number of patients is required to confirm this observation.

Patient flow analysis and referrals--how 1,137 ESRD patients started dialysis during 1998-1999.

The study consisted in collecting and analysing data from 15 dialysis centres on referral modalities of 1,137 patients with end-stage renal failure starting renal replacement therapy. All the centres in question had implemented PFA Patient Flow Analysis, a management programme for pre-dialysis care from Baxter designed to help improve the collection of data on dialysis patients, from the first visit to a centre through to the start of renal replacement therapy. The aims of the study were threefold: a) describe patient referral modalities and the eligibility of patients for renal replacement treatment; b) determine how many early referrals (ERs) and late referrals (LRs)* have a permanent PD (Peritoneal Dialysis) or HD (Haemodialysis) access at the first treatment; c) for the main outcomes (permanent access at the first treatment and permanent dialysis treatment), compare the performance of centres that offer enhanced education with those that do not. The main characteristics (sex and age) of ERs (54%) are comparable to those of LRs. However, ERs generally have greater access to PD or the opportunity to choose the dialysis treatment. The vast majority (86%) have permanent access at the first dialysis treatment and a large number (44%) have PD as permanent dialysis treatment. Centres with structured pre-dialysis educational programmes experience a larger number of ERs, therefore ensuring better outcomes. For example, 66.3% of patients at centres with structured pre-dialysis educational programmes (compared to 48.2% at centres without enhanced education) start the dialysis treatment with permanent access; and more patients (40% vs. 22%) receive permanent PD.