Revisiting the issue of "beach balls" in holmium laser enucleation of prostate: clinical and histological characterization.

PURPOSE: To clinically and histologically characterize prostatic nodules resistant to morcellation ("beach balls," BBs). PATIENTS AND METHODS: We reviewed a consecutive cohort of 559 holmium laser enucleation of the prostate (HoLEP) procedures performed between January 2020 and November 2023. The BBs group comprised 55 men (10%) and the control group comprised 504 men (90%). The clinical, intraoperative, outcome, and histologic data were statistically processed for the prediction of the presence of BBs and their influence on the perioperative course and outcome. RESULTS: The BBs group in comparison to the controls was older (75 vs 73 years, respectively, p = 0.009) and had higher rates of chronic retention (51 vs 29%, p = 0.001), larger prostates on preoperative abdominal ultrasound (AUS) (140 vs 80 cc, p = 0.006E-16), longer operating time (120 vs 80 min, p = 0.001), higher weights of removed tissue (101 vs 60 gr, p = 0.008E-10), higher complication rates (5 vs 1%, p = 0.03), and longer hospitalization (p = 0.014). A multivariate analysis revealed that larger prostates on preoperative AUS and older age independently predicted the presence of BBs which would prolong operating time. ROC analyses revealed that a threshold of 103 cc on AUS predicted BBs with 94% sensitivity and 84% specificity. BBs were mostly characterized histologically by stromal component (p = 0.005). CONCLUSIONS: BBs are expected in older patients and cases of chronic retention. Prostatic volume is the most reliable predictor of their presence. They contribute to prolonged operating time and increased risk of complications. The predominantly stromal composition of the BBs apparently confers their resistance to morcellation.

Evaluating the influence of marine protected areas on surf zone fish.

Marine protected areas (MPAs) globally serve conservation and fisheries management goals, generating positive effects in some marine ecosystems. Surf zones and sandy beaches, critical ecotones bridging land and sea, play a pivotal role in the life cycles of numerous fish species and serve as prime areas for subsistence and recreational fishing. Despite their significance, these areas remain understudied when evaluating the effects of MPAs. We compared surf zone fish assemblages inside and outside MPAs across 3 bioregions in California (USA). Using seines and baited remote underwater videos (BRUVs), we found differences in surf zone fish inside and outside MPAs in one region. Inside south region MPAs, we observed higher abundance (Tukey's honest significant difference [HSD] = 0.83, p = 0.0001) and richness (HSD = 0.22, p = 0.0001) in BRUVs and greater biomass (HSD = 0.32, p = 0.0002) in seine surveys compared with reference sites. Selected live-bearing, fished taxa were positively affected by MPAs. Elasmobranchs displayed greater abundance in BRUV surveys and higher biomass in seine surveys inside south region MPAs (HSD = 0.35, p = 0.0003 and HSD = 0.23, p = 0.008, respectively). Although we observed no overall MPA signal for Embiotocidae, abundances of juvenile and large adult barred surfperch (Amphistichus argenteus), the most abundant fished species, were higher inside MPAs (K-S test D = 0.19, p < 0.0001). Influence of habitat characteristics on MPA performance indicated surf zone width was positively associated with fish abundance and biomass but negatively associated with richness. The south region had the largest positive effect size on all MPA performance metrics. Our findings underscored the variability in species richness and composition across regions and survey methods that significantly affected differences observed inside and outside MPAs. A comprehensive assessment of MPA performance should consider specific taxa, their distribution, and the effects of habitat factors and geography.

Evaluación de la influencia de las áreas marinas protegidas sobre los peces de la zona de rompientes Resumen Las áreas marinas protegidas (AMP) cumplen los objetivos de conservación y manejo de pesquerías a nivel mundial, lo que genera efectos positivos en algunos ecosistemas marinos. Las zonas de rompientes y las playas arenosas, ecotonos importantes que conectan la tierra con el mar, tienen un papel esencial en el ciclo de vida de varios peces y fungen como áreas óptimas para la pesca recreativa y de sustento. A pesar de su importancia, estas áreas están poco estudiadas con respecto a la evaluación del efecto de las AMP. Comparamos la composición de peces del área de rompientes dentro y fuera de las AMP de tres bioregiones de California, EUA. Usamos chinchorros y videos submarinos con carnada (BRUVs) y descubrimos diferencias en los peces de la zona de rompientes dentro y fuera de las AMP en una región. Dentro de las AMP de la región sur observamos una mayor abundancia (diferencia significativa honesta de Tukey [DSH]  =  0.83, p = 0.0001) y riqueza (DSH  =  0.22, p = 0.0001) en los BRUV y una mayor biomasa (DSH  =  0.32, p = 0.0002) en los censos con chinchorro en comparación con los sitios de referencia. Los taxones seleccionados de peces de sustento fueron afectados de manera positiva por las AMP. Los elasmobranquios mostraron una mayor abundancia en los BRUV y una mayor biomasa en los censos con chinchorro dentro de las AMP de la región sur (DSH  =  0.35, p = 0.0003 y DSH  =  0.23, p = 0.008, respectivamente). Aunque no observamos una señal generalizada de las AMP para la familia Embiotocidae, la abundancia de Amphistichus argenteus juveniles y adultos, la especie pescada más abundante, fue mayor dentro de las AMP (prueba K­S D  =  0.19, p < 0.0001). La influencia de las características del hábitat sobre el desempeño de las AMP indicó que el ancho de la zona de rompientes está asociado de forma positiva con la abundancia y biomasa de los peces, pero de forma negativa con la riqueza. La región sur tuvo el mayor tamaño de efecto positivo sobre todas las medidas de desempeño de las AMP. Nuestros hallazgos destacan la variabilidad en la riqueza y composición de especies en todas las regiones y los censos que afectan significativamente las diferencias observadas dentro y fuera de las AMP. Una evaluación completa del desempeño de las AMP debe considerar taxones específicos, su distribución y el efecto de los factores de hábitat y la geografía.

Antimicrobial resistance characterization of Enterococcus faecium, Enterococcus faecalis and Enterococcus hirae isolated from marine coastal recreational waters in the State of São Paulo, Brazil.

Coastal water quality is facing increasing threats due to human activities. Their contamination by sewage discharges poses significant risks to the environment and public health. We aimed to investigate the presence of antibiotic-resistant Enterococcus in beach waters. Over a 10-month period, samples were collected from four beaches in the State of São Paulo (Brazil). Enterococcus isolates underwent matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS) and molecular analysis for accurate genus and species identification. The antimicrobial susceptibility for 14 antibiotics was evaluated using the disc diffusion method followed by a multidrug-resistance (MDR) classification. PCR amplification method was used to detect antimicrobial resistance genes (ARGs). Our findings revealed the prevalence of Enterococcus faecalis, E. faecium and E. hirae. Out of 130 isolates, 118 were resistant to multiple antibiotics. The detection of resistance genes provided evidence of the potential transfer of antibiotic resistance within the environment. Our findings underscore the necessity for continuous research and surveillance to enhance understanding of the pathogenicity and antimicrobial resistance mechanisms of Enterococcus, which is crucial to implement effective measures to preserve the integrity of coastal ecosystems.

Canadian beach cohort study: protocol of a prospective study to assess the burden of recreational water illness.

BACKGROUND: Recreational water activities at beaches are popular among Canadians. However, these activities can increase the risk of recreational water illnesses (RWI) among beachgoers. Few studies have been conducted in Canada to determine the risk of these illnesses. This protocol describes the methodology for a study to determine the risk and burden of RWI due to exposure to fecal pollution at beaches in Canada. METHODS: This study will use a mixed-methods approach, consisting of a prospective cohort study of beachgoers with embedded qualitative research. The cohort study involves recruiting and enrolling participants at public beaches across Canada, ascertaining their water and sand contact exposure status, then following-up after seven days to determine the incidence of acute RWI outcomes. We will test beach water samples each recruitment day for culture-based E. coli, enterococci using rapid molecular methods, and microbial source tracking biomarkers. The study started in 2023 and will continue to 2025 at beaches in British Columbia, Manitoba, Ontario, and Nova Scotia. The target enrollment is 5000 beachgoers. Multilevel logistic regression models will be fitted to examine the relationships between water and sand contact and RWI among beachgoers. We will also examine differences in risks by beachgoer age, gender, and beach location and the influence of fecal indicator bacteria and other water quality parameters on these relationships. Sensitivity analyses will be conducted to examine the impact of various alternative exposure and outcome definitions on these associations. The qualitative research phase will include focus groups with beachgoers and key informant interviews to provide additional contextual insights into the study findings. The study will use an integrated knowledge translation approach. DISCUSSION: Initial implementation of the study at two Toronto, Ontario, beaches in 2023 confirmed that recruitment is feasible and that a high completion rate (80%) can be achieved for the follow-up survey. While recall bias could be a concern for the self-reported RWI outcomes, we will examine the impact of this bias in a negative control analysis. Study findings will inform future recreational water quality guidelines, policies, and risk communication strategies in Canada.

Probabilistic structure of events controlling the after-storm recovery of coastal dunes.

Coastal dunes protect beach communities and ecosystems from rising seas and storm flooding and influence the stability of barrier islands by preventing overwashes and limiting barrier migration. Therefore, the degree of dune recovery after a large storm provides a simple measure of the short-term resiliency (and potential long-term vulnerability) of barrier islands to external stresses. Dune recovery is modulated by low-intensity/high-frequency high-water events (HWEs), which remain poorly understood compared to the low-frequency extreme events eroding mature dunes and dominating the short-term socio-economic impacts on coastal communities. Here, we define HWEs and analyze their probabilistic structure using time series of still-water level and deep-water wave data from multiple locations around the world. We find that HWEs overtopping the beach can be modeled as a marked Poisson process with exponentially distributed sizes or marks and have a mean size that varies surprisingly little with location. This homogeneity of global HWEs is related to the distribution of the extreme values of a wave-runup parameter, [Formula: see text], defined in terms of deep-water significant wave height [Formula: see text] and peak wavelength [Formula: see text] Furthermore, the characteristic beach elevation at any given location seems to be tied to a constant HWE frequency of about one event per month, which suggests a stochastic dynamics behind beach stabilization. Our results open the door to the development of stochastic models of beach, dune, and barrier dynamics, as well as a better understanding of wave-driven nuisance flooding.

Quantifying climatic suitability for tourism in Southwest Indian Ocean Tropical Islands: Applying the Holiday Climate Index to Réunion Island.

Climate is a key resource for tourists and tourism providers. Varied approaches to quantifying climate resources for tourism have been developed in the last 40 years, computing indices from a range of meteorological variables to measure the comparative climatic suitability of different destinations through time. This study provides the first application of a tourism climate index in the tropical southwest Indian Ocean, applying the recently developed Holiday Climate Index (HCI) for Réunion Island. The suitability of this index is evaluated for the case of this French department, with a particular focus on air conditioning availability in tourism accommodation establishments as this index excludes night-time thermal comfort. Both iterations of the HCI (HCIBeach and HCIUrban) are computed with meteorological data from Roland Garros Airport for the period 1991-2020, exploring monthly, annual, and seasonal climatic suitability. Mean monthly HCI scores reveal considerable seasonality in climatic suitability for tourism on the island with scores ranging from 89.3 ('excellent') to 36.9 ('marginal') for the HCIBeach and 85.0 ('excellent') to 27.5 ('unacceptable') for the HCIUrban, with more favourable scores calculated for July and August, displaying a clear austral winter peak seasonal classification. Over the 30-year period, there is no statically significant change in mean annual climatic suitability, and at a monthly scale, only one month of the year for each index displays statistically significant trends. These results are important in informing tourism strategies for the island to maximise visitor satisfaction through targeting advertising more deliberately for peak touristic climate suitability during the winter months.

A life in the surf zone: Age and feeding habits of the pompano (Trachinotus ovatus, Linnaeus, 1758) on the beaches of the Gulf of Cádiz (south-west Iberian Peninsula).

Surf zones are crucial habitats for many fish species, where they spend the initial stages of their lives, finding food and shelter. One such species is the pompano (Trachinotus ovatus). The aim of this study was to examine the age and diet of the pompano within the surf zone, along with any potential variations in the environment. The average size of the specimens was 10.61 ± 4.91 cm. The length-weight relationship was total weight (TW) = 0.0136*total length (TL)2.8512 (parameter a: 95% C.I.: 0.0130-0.0142 and parameter b: 95% C.I.: 2.8318-2.8705). The most abundant age classes were 0+ and 1+, making up 97% of the captured specimens, with significant differences in the abundance of age classes depending on the time of the day and season. The pompano primarily fed on clupeiforms, copepods, and mysids, with significant variations in diet based on the time of the day, season, and size of the specimens. This study contributes new information about the use of the surf zone by T. ovatus in its early years of life, underscoring the importance of these areas and their role as an additional ecosystem service.

A new occupancy index model based on artificial vision for enhancing beach management.

This study proposes a new method to more effectively plan the use of beaches by combining indices and artificial vision systems. The Overcrowding Index (Iocr) measures the number of people on the beach in relation to its surface area, while the Distancing Index (Idis) evaluates the spatial distribution and distance between beachgoers. Both indices are combined to generate an overall index called the Occupancy Index (Iocu). The proposed methodology uses cameras and computer vision algorithms such as YOLOX and ByteTrack to automate the counting of people and measure distances. This allows for continuous monitoring of the quantity (carrying capacity and density) and distribution of beachgoers (degree of social distancing), as well as a functional prototype in which the indices are calculated in real time. It was observed that as density increased, Iocr showed an inverse trend, being close to 0 when approaching maximum density. The calculation of the distance between groups validated that, even with medium densities, close to the shoreline, the reference distance of 2 m was not accomplished, obtaining a very low Idis (0.18). The resulting Iocu was 0.31, validating the appropriate integration of both indices. Overall, the system's effectiveness for accurately monitoring the number of users and their distribution, and calculating the defined indices for beach management, is demonstrated. The proposed approach provides a valuable tool, allowing a more efficient management of beaches according to their actual occupancy and user distribution.

Occurrence and migration patterns of microplastics in different tidal zones of tourist beaches: A case study in the Bohai Bay, North China.

Coastal areas are acknowledged to be significant reservoirs of microplastics, while limited research on their presence and migration in the intertidal zones. This study investigated in a tourist beach in northern China, to reveal the occurrence of microplastics at different intertidal heights, elucidates their migration patterns, and discusses the impact of tourist activities on microplastics. Results showed that the mean microplastic abundance was 2114.8 ± 933.2 items/kg in sediments and 30,670.8 ± 15,094.9 items/m3 in seawater. Fibers were the most common shape; transparent, blue, green and black prevailed in color; and cellulose and PET were the most common components. Microplastic abundances decreased from high tide zone to low tide zone, and the abundances of microplastics in seawater were positively correlated with those in the high tide zone and negatively correlated with those in the low tide zone. Compared to wave disturbance, human activities have a relatively limited impact on microplastic abundance. However, intensive tourist activities contribute to a higher diversity of microplastic types on tourist beaches. This study enhances the understanding of the occurrence and migration patterns of microplastics in tourist beaches, and provides a valuable dataset and theoretical basis for subsequent research on microplastic pollution in coastal areas.

Spatio-temporal variation and ecological risk assessment of microplastics along the touristic beaches of a mediterranean coast transect (Valencia province, East Spain).

Annually, the Mediterranean region attracts around one-third of the global coastal tourism, which is acknowledged as a substantial contributor to plastic pollution. Coastal municipalities mitigate this through periodic sand and shore cleaning. However, the efficacy of these measures remains uncertain. In this study, the occurrence of MPs (10 µm-5 mm) in sand from seven different, regularly cleaned, touristic beaches of the coastline of Valencia province (E Spain) was assessed. Two different sampling campaigns were performed in winter and in summer (2022) to compare the results and understand the influence of the high touristic activity, as well as, the efficiency of the measures taken against MPs pollution. The methodology used was designed specifically for the matrix and employed density separation using a Sediment Microplastic Isolation (SMI) Unit. In addition to conventional visual inspection and ATR-FTIR, automatic quantification and identification of the polymers of lower size was performed by µFTIR. The average MPs concentration in the summer (339 ± 92 MP kg-1 by stereomicroscopy and 339 ± 189 MP kg-1 by µFTIR) was significantly higher than in the winter (71 ± 92 MP kg-1 and 143 ± 85 MP kg-1) (p < 0.05). The combination of these analytical tools provides comprehensive information about the MPs present in beach sand. Fibers were the most abundant form of MPs, while most of the polymers analyzed were polyethylene (PE) and halogenated polystyrene (Cl-PS and Br-PS) with food packaging, swimming equipment and fishing nets being their most probable sources. Ecological risk assessment was performed through the Pollution Load Index (PLI), the Hazardous Index (HI) and the Risk Quotient (RQ), with the results indicating potential risk that ranges from moderate to high depending on the applied approach.

Beach nourishment for coastal aquifersimpacted by climate change and population growth using machine learning approaches.

Groundwater in coastal regions is threatened by saltwater intrusion (SWI). Beach nourishment is used in this study to manage SWI in the Biscayne aquifer, Florida, USA, using a 3D SEAWAT model nourishment considering the future sea level rise and freshwater over-pumping. The present study focused on the development and comparative evaluation of seven machine learning (ML) models, i.e., additive regression (AR), support vector machine (SVM), reduced error pruning tree (REPTree), Bagging, random subspace (RSS), random forest (RF), artificial neural network (ANN) to predict the SWI using beach nourishment. The performance of ML models was assessed using statistical indicators such as coefficient of determination (R2), Nash-Sutcliffe efficiency (NSE), means absolute error (MAE), root mean square error (RMSE), and root relative squared error (RRSE) along with the graphical inspection (i.e., Radar and Taylor diagram). The findings indicate that applying SVM, Bagging, RSS, and RF models has great potential in predicting the SWI values with limited data in the study area. The RF model emerged as the best fit and closely matched observed values; it obtained R2 (0.999), NSE (0.999), MAE (0.324), RRSE (0.209), and RMSE (0.416) during the testing process. The present study concludes that the RF model could be a valuable tool for accurate predictions of SWI and effective water management in coastal areas.

High contribution of an invasive macroalgae species to beach wrack CO2 emissions.

Accumulations of macroalgal wrack are important for adequate functioning of the beach ecosystem. However, the sudden beaching of seaweed masses smothers the coastline and forms decomposing piles on the shore, harming tourism-based economies, but also affecting the beach ecosystem metabolism. The decomposition of sudden pulses of wrack can modify the biogeochemistry of beach sands and increase greenhouse gas (GHG) emissions. The presence of invasive species in the wrack deposits can superimpose harmful effects on the beach functioning. We quantified the wrack biomass of Rugulopteryx okamurae, an invasive species of extreme impact, on five sandy beaches from the Atlantic coast of the Strait of Gibraltar (Spain), and we tested the effects on in situ respiratory CO2 fluxes using an infrared gas analyser. All the beaches showed massive accumulations of Rugulopteryx wrack deposits. However, the biomass changed significantly between beaches, ranging (mean ± SE) from 968.3 ± 287.7 kg m-1 to 9210 ± 1279.4 kg m-1 of wet weight. Wrack supported high respiration rates, with CO2 fluxes averaging (±SE) 19.15 ± 5.5 µmol CO2 m-2 s-1 across beaches, reaching astounding maximum peaks of 291 µmol CO2 m-2 s-1. The within-beach variability was related to the distance of the wrack deposits from the shoreline, as the average metabolic rates tended to increase significantly from the swash to the drift line. Thicker wrack and a more degraded algae stage showed significantly higher CO2 fluxes. We estimated that the annual CO2 flux of R. okamurae in our study area ranged between 0.39 (±0.01) and 23.30 (±11.33) kg C m-2 y-1. We suggest that massive amounts of beach wrack can become a globally significant contributor to GHG emissions that can offset any potential carbon-sink capacity of macroalgal forests. However, the piles of wrack located several meters above the drift line showed non-measurable CO2 efflux. Transferring beach wrack from swash to drier upper-beach areas, a common practice in many coastal regions suffering from massive wrack accumulations, might help reduce GHG emissions while removing the wrack stockpiles from the intertidal. However, this practice is not necessarily suitable for all beaches and can create ecological and conservation problems in the dune system. There is an urgent need to implement practical and sustainable management practices for massive wrack deposits capable of presenting various solutions to achieve a balance between conservation and recreation actions, answering the consequences of a problem that links both, environmental and economic issues.

Postoperative cognitive dysfunction after beach chair positioning compared to supine position in orthopaedic surgery in the elderly.

INTRODUCTION: Postoperative cognitive dysfunction (POCD) occurs in up to 26% of patients older than 60 years 1 week after non-cardiac surgery. Intraoperative beach chair positioning (BCP) is advantageous for some types of shoulder surgery. However, this kind of positioning leads to a downward bound redistribution of blood volume, with possible hypoperfusion of the brain. We hypothesized that patients > 60 years undergoing orthopaedic shoulder surgery in a BCP might experience more POCD than patients operated in the supine position (SP). MATERIAL AND METHODS: A single-centre, prospective observational trial of 114 orthopaedic patients was performed. Study groups were established according to the type of intraoperative positioning. Anaesthesiological management was carried out similarly in both groups, including types of anaesthetics and blood pressure levels. POCD was evaluated using the Trail Making Test, the Letter-Number Span and the Regensburger Word Fluency Test. The frequency of POCD 1 week after surgery was considered primary outcome. RESULTS: Baseline characteristics, including duration of surgery, were comparable in both groups. POCD after 1 week occurred in 10.5% of SP patients and in 21.1% of BCP patients (p = 0.123; hazard ratio 2.0 (CI 95% 0.794-5.038)). After 4 weeks, the incidence of POCD decreased (SP: 8.8% vs. BCP: 5.3%; p = 0.463). 12/18 patients with POCD showed changes in their Word Fluency Tests. Near-infrared spectroscopy (NIRS) values were not lower in patients with POCD compared to those without POCD (54% (50/61) vs. 57% (51/61); p = 0.671). CONCLUSION: POCD at 1 week after surgery tended to occur more often in patients operated in beach chair position compared to patients in supine position without being statistically significant.

Increasing Salt Marsh Elevation Using Sediment Augmentation: Critical Insights from Surface Sediments and Sediment Cores.

Sea-level rise is particularly concerning for tidal wetlands that reside within an area with steep topography or are constrained by human development and alteration of sedimentation. Sediment augmentation to increase wetland elevations has been considered as a potential strategy for such areas to prevent wetland loss over the coming decades. However, there is little information on the best approaches and whether adaptive management actions can mimic natural processes to build sea-level rise resilience. In addition, the lack of information on long-term marsh characteristics, processes, and variability can hamper development of effective augmentation strategies. Here, we assess a case study in a southern California marsh to determine the nature of the pre-existing sediments and variability of the site in relation to sediments applied during an augmentation experiment. Although sediment cores revealed natural variations in the grain size and organic content of sediments deposited at the site over the past 1500 years, the applied sediments were markedly coarser in grain size than prehistoric sediments at the site (100% maximum sand versus 76% maximum sand). The rate of the experimental sediment application (25.1 ± 1.09 cm in ~2 months) was also much more rapid than natural accretion rates measured for the site historically. In contrast, post-augmentation sediment accretion rates on the augmentation site have been markedly slower than pre-augmentation rates or current rates on a nearby control site. The mismatch between the characteristics of the applied sediment and thickness of application and the historic conditions are likely strong contributors to the slow initial recovery of vegetation. Sediment augmentation has been shown to be a useful strategy in some marshes, but this case study illustrates that vegetation recovery may be slow if applied sediments are not similar or at a thickness similar to historic conditions. However, testing adaptation strategies to build wetland elevations is important given the long-term risk of habitat loss with sea-level rise. Lessons learned in the case study could be applied elsewhere.

Assessment of microplastics pollution level on clam farming and bathing beaches: a case study of Thanh Phu in Ben Tre, Vietnam.

This study focused on the investigation microplastics (MPs) with a size of ≤1.0 mm in sand samples from Thanh Phu beach, Ben Tre, Vietnam. MPs in sand from the clam beach (from 39.67 ± 6.67 to 92.00 ± 12.93 items kg-1 dried sand) were higher than those from the bathing beach (from 21.33 ± 8.76 to 51.67 ± 16.11 items kg-1 dried sand), indicating a direct contribution of MPs from coastal aquaculture. For the clam beach, MPs in surface samples (0-4 cm) were lower than in deep samples (4-6 cm). In contrast, MPs in surface samples (0-2 cm) from the bathing beach were higher than deep samples (2-5 cm). A combination of microscopy and Fourier-transform infrared spectroscopy methods confirmed that 62.5% of the representative MPs samples or 18.9% of the suspected MPs samples were plastics. Low-density polyethylene, polypropylene and polyethylene terephthalate were the largest in abundance. Further studies are needed to assess the environmental risk of MPs accumulation.

An Observational Study of Patient Characteristics and Environmental Risk Factors of Stingray Envenomations in San Diego, California.

INTRODUCTION: Current literature on stingray envenomations focuses on the incidence, presentation, and complications of these injuries, with some studies providing such data for specific geographic locations. This is the first study to evaluate the influence of environmental factors and human characteristics on stingray envenomation patterns in San Diego, California. METHODS: Incident reports of injuries documented by the San Diego Fire-Rescue Department/Lifeguard Division (SDFR-LG) during 2017 were analyzed. Water temperature and tide height were populated based on date and time. Data was analyzed for associations between stingray injuries incidence and tide height, water temperature, time, month, age and sex of the injured person, and whether they were local. RESULTS: 1722 stingray injuries were reported to the SDFR-LG in 2017. Stingray injuries were associated with water temperature (p < 0.001), more frequently occurring between 18.8 °C and 19.5 °C. Most envenomations occurred at tide heights between 1.7 ft and 3.1 ft. Most victims were aged 20-29, and there were more males than females injured. Beaches separated from the greater ocean or with a reef bottom had a lower incidence. Stingray injuries were more frequent during summer months. More stingray envenomations were documented for out-of-town beachgoers. CONCLUSIONS: Beachgoers with certain characteristics had more reported stingray envenomations than others. Males, nonlocal beachgoers, and individuals in their twenties had more injuries than their counterparts. Stingray injuries were more common at water temperatures between 18.8 and 19.5 °C. These findings may lead to future research on the prevention of stingray injuries.

'I actually thought that I was going to die': Lessons on the rip current hazard from survivor experiences.

BACKGROUND: Rip currents are strong, narrow, fast-flowing currents of water that occur on many beaches and in Australia contributing to 26 drowning deaths and several thousand lifeguard/lifesaver rescues each year. Educating the public about the rip current hazard is a primary focus of beach safety practitioners, but there has been a lack of qualitative research exploring the firsthand experiences of being caught in a rip current to assist in this regard. The aim of this study was to analyse interviews of rip current survivors to understand more about how people react when unintentionally caught in a rip current in order to help guide future public education to mitigate rip current drowning. METHODS: Semi-structured interviews were conducted with 56 individuals (primarily Australian-born) about their experience of being caught in a rip current. Interviewees were recruited via an online survey and varied in age and self-reported swimming ability. RESULTS: Thematic analysis revealed three key temporal elements to the rip current experience: Before the Rip in which lack of awareness and knowledge, complacency, over-confidence, and attitude were prevalent themes; During the Rip which identified panic and temporary inhibition of decision-making, physical response, prior experience, and relationships with other beach users as themes; and After the Rip where post-rip effects and rip safety messaging and education were key themes. The importance of experiential immersion was a prevalent thread throughout all phases of the thematic analysis. DISCUSSION: Our research shows that being caught in a rip current can be an intense and traumatic experience and that lessons learned from survivors have significant implications for improving existing and future rip current education efforts. In this regard, we provide several recommendations based on evidence-based insights gained from our interviews including the development of immersive rip current experience using virtual reality. SO WHAT: Despite the prevalence of rip currents causing drowning deaths and rescues, there has been a lack of qualitative research on firsthand experiences to aid in public education. These interviews emphasise the intense and traumatic nature of being caught in a rip current, underscoring the need for improved rip current education to aid in prevention of this, often harrowing, experience.

What do we know about beach soccer injuries? Systematic video analysis of four consecutive years with 580 match injuries.

The aim of the present study was to evaluate the characteristics of match injury in male beach soccer players. Video recordings of all official beach soccer tournaments in which the European national male beach soccer teams participated from 2018 to 2021 were analysed by two sports medicine specialists retrospectively. Regarding each injury, data including the mechanism, location of the injury, whether the injury led to time-loss, and the relationship of the injury to the bicycle kick (BK), etc. were documented. A total of 632 injuries were documented, corresponding to 234.9 injuries/1000 player hours. Video footage was available for 580 injuries. Whilst 79.8% of medical attention injuries occurred due to opponent contact, 19.5% of time-loss injuries occurred due to non-contact, and 12.2% of indirect opponent contact (p < 0.01). The most common location of the BK related injury was the head/neck (68.7%), whereas most common location of the BK unrelated injury was the lower extremity (54.1%) (p < 0.01). The findings demonstrated that beach soccer injury incidence was quite high; the most common injury location was head/neck and head/neck injuries were associated with BK. In light of these results, some rule regulations, particularly those associated with BK, and the use of protective equipment should be considered to prevent these injuries.

Genetic Determinants of Escherichia coli Survival in Beach Sand.

Escherichia coli contain a high level of genetic diversity and are generally associated with the guts of warm-blooded animals but have also been isolated from secondary habitats outside hosts. We used E. coli isolates from previous in situ microcosm experiments conducted under actual beach conditions and performed population-level genomic analysis to identify accessory genes associated with survival within the beach sand environment. E. coli strains capable of surviving had been selected for by seeding isolates originating from sand, sewage, and gull waste (n = 528; 176 from each source) into sand, which was sealed in microcosm chambers and buried for 45 days in the backshore beach of Lake Michigan. In the current work, survival-associated genes were identified by comparing the pangenome of viable E. coli populations at the end of the microcosm experiment with the original isolate collection and identifying loci enriched in the out put samples. We found that environmental survival was associated with a wide variety of genetic factors, with the majority corresponding to metabolism enzymes and transport proteins. Of the 414 unique functions identified, most were present across E. coli phylogroups, except B2 which is often associated with human pathogens. Gene modules that were enriched in surviving populations included a betaine biosynthesis pathway, which produces an osmoprotectant, and the GABA (gamma-aminobutyrate) biosynthesis pathway, which aids in pH homeostasis and nutrient use versatility. Overall, these results demonstrate that the genetic flexibility within this species allows for survival in the environment for extended periods. IMPORTANCE Escherichia coli is commonly used as an indicator of recent fecal pollution in recreational water despite its known ability to survive in secondary environments, such as beach sand. These long-term survivors from sand reservoirs can be introduced into the water column through wave action or runoff during precipitation events, thereby impacting the perception of local water quality. Current beach monitoring methods cannot differentiate long-term environmental survivors from E. coli derived from recent fecal input, resulting in inaccurate monitoring results and unnecessary beach closures. This work identified the genetic factors that are associated with long-term survivors, providing insight into the mechanistic basis for E. coli accumulation in beach sand. A greater understanding of the intrinsic ability of E. coli to survive long-term and conditions that promote such survival will provide evidence of the limitations of beach water quality assessments using this indicator.

Nocardia australiensis sp. nov. and Nocardia spumae sp. nov., isolated from sea foam in Queensland, Australia.

Strains USC-21046T and USC-21048T were isolated from foaming coastal marine waters on the Sunshine Coast, Queensland, Australia. Both strains displayed growth and morphological characteristics typical for members belonging to the genus Nocardia. The major polar lipids were diphosphatidylglycerol and phosphatidylethanolamine, and the major fatty acids were C16 : 0, C18 : 1 ω9c, C18 : 0 and C18 : 0 10-methyl. The mycolic acids of strains USC-21046T and USC-21048T consisted of chain lengths between 50-64 and 56-68, respectively. Moreover, both of those strains contained meso-diaminopimelic acid and ribose, arabinose, glucose and galactose as whole cell sugars. Based on the phylogenomic results, both strains belonged to the genus Nocardia with strain USC-21046T showing an 80.4 % genome similarity to N. vinacea NBRC 16497T and N. pseudovaccinii NBRC 100343T, whereas USC-21048T strain showed an 83.6 % genome similarity to N. aobensis NBRC 100429T. Both strains were delineated from their closely related relatives based on physiological (e.g. growth on sole carbon source) and chemotaxonomic (e.g. cellular fatty composition) differences. The digital DNA-DNA hybridization (dDDH) values between USC-21046T and USC-21048T and their closely related relatives were below the dDDH threshold value of ≤70 % used for the taxonomic classification of novel species status. The genome length of strains USC-21046T and USC-21048T were 6 878 863 and 7 066 978 bp, with G+C contents of 65.2 and 67.8 mol%, respectively. For the novel isolates, we propose the names Nocardia australiensis sp. nov. with the type strain USC-21046T (=DSM 111727T=NCCB 100867T) and Nocardia spumae sp. nov. with the type strain USC-21048T (=DSM 111726T=NCCB 100868T).