Intracranial thrombus composition is associated with occlusion location and endovascular treatment outcomes: results from ITACAT multicenter study.

BACKGROUND: The impact of thrombolytics directed towards different thrombus components regarding site of occlusion in combination with mechanical thrombectomy (MT) to achieve endovascular complete recanalization is unclear. METHODS: Retrospective analysis of a prospective database in two stroke centers. Intracranial thrombi retrieved by MT were analyzed using hematoxylin-eosin staining for fibrin and red blood cell proportions, and CD61 immunostaining for platelets proportion in thrombus (PLTPT) assessment. Thrombi composition, baseline variables, etiology, treatment features and occlusion location were analyzed. RESULTS: Overall, 221 patients completed the per protocol analysis and 110 cases achieved a final expanded Thrombolysis in Cerebral Infarction (eTICI) 3 (49%) of which 70 were MT (32%) by first pass effect (FPE). Thrombi from medium distal vessel occlusions had higher PLTPT compared with thrombi from proximal large vessel occlusions (68% vs 61%, P=0.026). In particular, middle cerebral artery M2-M3 segment thrombi had the highest PLTPT (70%), and basilar artery thrombi the lowest PLTPT (41%). After logistic regression analysis adjusted for occlusion location and intravenous fibrinolysis, lower baseline National Institutes of Health Stroke Scale score (adjusted OR (aOR) 0.95, 95% CI 0.913 to 0.998) and PLTPT (aOR 0.97, 95% CI 0.963 to 0.993) were independently associated with FPE. Fewer MT passes (aOR 0.67, 95% CI 0.538 to 0.842) and platelet poor thrombus (<62% PLTPT; aOR 2.39, 95% CI 1.288 to 4.440) were independently associated with final eTICI 3. CONCLUSIONS: Occlusion location might be a surrogate parameter for thrombus composition. Platelet poor clots and fewer MT passes were independently associated with complete endovascular recanalization. Clinical trials testing the benefits of combining selective intra-arterial platelet antagonists with MT to improve endovascular outcomes are warranted.

Removal and fate of microplastics in permeable pavements: An experimental layer-by-layer analysis.

The increasing prevalence of microplastics (MP) in urban environments has raised concerns over their negative effects on ecosystems and human health. Stormwater runoff, and road dust and sediment, act as major vectors of these pollutants into natural water bodies. Sustainable urban drainage systems, such as permeable pavements, are considered as potential tools to retain particulate pollutants. This research evaluates at laboratory scale the efficiency of permeable interlocking concrete pavements (PICP) and porous concrete pavements (PCP) for controlling microplastics, including tire wear particles (TWP) which constitute a large fraction of microplastics in urban environments, simulating surface pollution accumulation and Mediterranean rainfall conditions. Microplastic levels in road dust and sediments and stormwater runoff inputs were 4762 ± 974 MP/kg (dry weight) and 23.90 ± 17.40 MP/L. In infiltrated effluents, microplastic levels ranged from 2.20 ± 0.61 to 5.17 ± 1.05 MP/L; while tire wear particle levels ranged between 0.28 ± 0.28 and 3.30 ± 0.89 TWP/L. Distribution of microplastics within the layers of PICP and PCP were also studied and quantified. Microplastics tend to accumulate on the pavements surface and in geotextile layers, allowing microplastic retention efficiencies from 89 % to 99.6 %. Small sized (< 0.1 mm) fragment shaped microplastics are the most common in effluent samples. The results indicate that permeable pavements are a powerful tool to capture microplastics and tire wear particles, especially by surface and geotextile layers. The study aims to shed light on the complex mobilisation mechanisms of microplastics, providing valuable insights for addressing the growing environmental concern of microplastic pollution in urban areas.

Understanding the sources of marine litter in remote islands: The Galapagos islands as a case study.

Determining the sources of marine litter is necessary to mitigate this increasing global problem. Plastic bottles are useful tracers of marine litter and constitute the main item (24%) stranding on remote beaches in the Galapagos Islands. The aim of this study was to estimate the abundance of plastic bottles in remote beaches and inferred their sources. To do so, we collected plastic bottles at 60 remote Galapagos Island beaches from 2018 to 2022. 76% of beaches were qualified as badly polluted, with >34 bottles·100 m-1. Most identified bottles came from Peru (71%), followed by China (17%) and Ecuador (9%). Although most locally-sold products are made in Ecuador, they contribute little to beach litter loads. Polyethylene terephthalate bottles with lid (necessary for litter dispersal) represented 88% of all bottles, demonstrating that most of the litter reaching the Galapagos comes from distant sources, mainly from South America. However, bottle ages indicate that at least 10% of Peruvian, 26% of Ecuadorian, and all Chinese bottles likely were dumped from ships. Reducing marine litter reaching the Galapagos Islands requires tackling litter leakage from land-based sources in South America and better compliance with regulations banning the dumping of plastics and other persistent wastes from ships.

Anthropogenic and environmental factors partly co-determine the level, composition and temporal variation of beach debris.

The accumulation of human-derived waste on our coasts is an escalating phenomenon, yet the relative importance and potential interactions among its main drivers are not fully understood. We used citizen-science standardized collections to investigate how anthropogenic and environmental factors influence the level, composition, and temporal variation of beach debris. An average of 58 kg and 803 items/100 m, dominated by single-use items of land (rather than sea) origin, were collected in the 881 beaches sampled. Interactions between anthropogenic and environmental factors (e.g., human use × beach substrate) were the strongest predictors of beach debris, accounting for 34% of the variance explained in its amount and composition. Beach debris showed a highly stochastic temporal variation (adjusted R2 = 0.05), partly determined by interactions between different local and landscape anthropogenic pressures. Our results show that both environmental and anthropogenic factors (at the local and landscape scale) co-determine the level and composition of beach debris. We emphasize the potential of citizen-science to inform environmental policy, showing that land-originated single-use items dominate beach debris, and the importance of considering their multiple anthropogenic and environmental drivers to improve our low predictive power regarding their spatio-temporal distribution.

Microplastic in clams: An extensive spatial assessment in south Brazil.

Microplastic pollution is becoming a continuously growing environmental concern, while bivalve mollusks are particularly vulnerable due to their sessile habits and feeding through water filtration processes. Microplastic incidence in soft tissues of the clam Amarilladesma mactroides was assessed along unconsolidated substrates distributed in extensive coastal regions of southern Brazil. Influence of urbanization levels, distance to rivers and local hydrodynamics on microplastic accumulation by the clam was tested. The average concentration of microplastics was high (3.09 ± 2.11 particles.g-1), considering 16 sampled sites. Particles were mainly composed by polyamide, polyethylene and polyethylene terephthalate, while were mainly smaller, fibrous and colorless. High urbanization and closer proximity to rivers insured higher contamination, which is a trend observed globally. No influence of coastal hydrodynamics was seen. Considering obtained findings, A. mactroides presents good potential to be used as a valuable tool to assess microplastic contamination in unconsolidated substrates of beach areas.

Microplastics in rocky shore mollusks of different feeding habits: An assessment of sentinel performance.

Microplastics (MPs) accumulation in rocky shore organisms has limited knowledge. This study investigated MPs accumulation in filter-feeding oysters, herbivorous limpets and carnivorous snails to assess their performance as sentinel species in the MPs trophic transfer. The samples were obtained along a contamination gradient in the Santos Estuarine System, Brazil. All three studied species showed MPs concentrations related to the contamination gradient, being the oysters the species that showed the highest levels, followed by limpets and snails (average of less and most contaminated sites of 1.06-8.90, 2.28-5.69 and 0.44-2.10 MP g-1, respectively), suggesting that MPs ingestion rates are linked to feeding habits. MPs were mainly polystyrene and polyacetal. The polymer types did not vary among sites nor species. Despite minor differences in percentages and diversity of size, shape, and color classes, the analyzed species were equally able to demonstrate dominance of small, fiber, transparent, black and blue MPs. Thus, oysters, limpets, and snails are proposed as sentinels of MPs in monitoring assessments.

Platelet Analysis in the Thrombus Plus Serum BNP for Detecting Clot-Related Atrial Fibrillation. Results From the ITACAT Multicentric Registry.

Occult atrial fibrillation (AF) is a common cause of cryptogenic stroke. This study aimed to investigate the utility of surrogate markers within the clot (clot markers), in combination with serum biomarkers, to identify AF-associated clots in patients who underwent mechanical thrombectomy. Each retrieved thrombus was analyzed to identify fibrin, red blood cells, platelets - CD61 staining (PLT) and T-CD4 lymphocyte/macrophage/monocyte (CD4) profile. Serum biomarkers such as D-dimer, lipoprotein (A), and brain natriuretic peptide (BNP) were also assessed in the acute phase of the stroke. Patients with stroke-related AF and large artery atherosclerosis (LAA) stroke were compared by matched case-control design to identify markers associated with AF clot profile. The predictive abilities of clot markers and serum biomarkers to detect AF clot were tested in patients with cryptogenic stroke. In patients with AF clot, the PLT percentage was higher (66.64% vs. 55.43%, OR = 1.03); CD4 percentage was lower (3.84% vs. 7.95%, OR = 0.95); and BNP marker was higher (2114 pg/ml vs. 276 pg/ml, OR = 1.04) compared to LAA clot. PLT was independently associated to AF-clot (OR, 1.04) but demonstrated moderate ability to identify AF-clot cases (C-test 0.668, p = 0.018). The combination of PLT with BNP significantly improved AF-clot prediction (C-test 0.847, p < 0.001). The clot composition of patients with cryptogenic stroke and AF detection showed four-fold higher PLT and BNP pattern of risk than patients with cryptogenic stroke without AF detection (38.5% vs. 8.7%) (OR = 1.40). Integrating intra-thrombus platelet with serum BNP offers a promising approach for detecting AF-associated clots in patients with cryptogenic stroke.

Increasing the number of stressors reduces soil ecosystem services worldwide.

Increasing the number of environmental stressors could decrease ecosystem functioning in soils. Yet this relationship has never been globally assessed outside laboratory experiments. Here, using two independent global standardized field surveys, and a range of natural and human factors, we test the relationship between the number of environmental stressors exceeding different critical thresholds and the maintenance of multiple ecosystem services across biomes. Our analysis shows that, multiple stressors, from medium levels (>50%), negatively and significantly correlates with impacts on ecosystem services, and that multiple stressors crossing a high-level critical threshold (over 75% of maximum observed levels), reduces soil biodiversity and functioning globally. The number of environmental stressors >75% threshold was consistently seen as an important predictor of multiple ecosystem services, therefore improving prediction of ecosystem functioning. Our findings highlight the need to reduce the dimensionality of the human footprint on ecosystems to conserve biodiversity and function.

Oysters and mussels as equivalent sentinels of microplastics and natural particles in coastal environments.

Filter-feeder organisms such as oyster and mussels are exposed to particles like microplastics (MPs). Although widely used to monitor MPs contamination, little is known about their performance as sentinels, which are biological monitors accumulating contaminants without significant adverse effects. This study comparatively evaluated the quantitative and qualitative accumulation of MPs by oysters (Crassostrea brasiliana) and mussels (Perna perna) along a gradient of contamination in a highly urbanized estuarine system of Brazil. In the most contaminated site, both species presented the worst status of nutrition and health, and also one of the highest MPs levels reported for molluscs to date (up to 44.1 particles·g-1). Despite some inter-specific differences, oysters and mussels were suitable and showed an equivalent performance as sentinels, reflecting the gradient condition demonstrated for other contaminants in the region. The similarity in MPs accumulation was also observed for qualitative aspects (polymer composition, sizes, shapes and colors). Particles were mostly <1000 µm, fibrous, colorless and composed by cellulose and polymethyl methacrylate (PMMA). Thus, despite small variations, the usage of C. brasiliana and P. perna is recommended and provides reliable information for environmental levels of microplastics.

Soil contamination in nearby natural areas mirrors that in urban greenspaces worldwide.

Soil contamination is one of the main threats to ecosystem health and sustainability. Yet little is known about the extent to which soil contaminants differ between urban greenspaces and natural ecosystems. Here we show that urban greenspaces and adjacent natural areas (i.e., natural/semi-natural ecosystems) shared similar levels of multiple soil contaminants (metal(loid)s, pesticides, microplastics, and antibiotic resistance genes) across the globe. We reveal that human influence explained many forms of soil contamination worldwide. Socio-economic factors were integral to explaining the occurrence of soil contaminants worldwide. We further show that increased levels of multiple soil contaminants were linked with changes in microbial traits including genes associated with environmental stress resistance, nutrient cycling, and pathogenesis. Taken together, our work demonstrates that human-driven soil contamination in nearby natural areas mirrors that in urban greenspaces globally, and highlights that soil contaminants have the potential to cause dire consequences for ecosystem sustainability and human wellbeing.

Darwin's paradise contaminated by marine debris. Understanding their sources and accumulation dynamics.☆.

Plastic pollution is a global environmental threat. Remote and pristine islands are not safe from this threat. Here, we estimated beach macro- (>25 mm), meso- (5-25 mm) and microdebris (<5 mm) levels in Galapagos and studied the role of environmental variables determining their accumulation. The vast majority of beach macro- and mesodebris were plastic, while most microdebris were cellulosic. The levels of beach macro-, meso- and microplastics were notably high and comparable with exceptional levels reported in contaminated areas. Oceanic currents and the anthropic pressure of use of the beach were the main factors that determined the level of macro- and mesoplastics, as well as the diversity of items, with more types of items in the beaches facing the predominant current. Microplastic levels were mainly driven by the slope and, to some extent, the grain size of the sediment in the beach. The absence of relationship between the levels of large size debris and the level of microplastics suggests that secondary microplastics that accumulated in the beaches were previously fragmented before arriving to the beach. This differential influence of environmental factors in the accumulation of marine debris according to their size should be taken into account when developing strategies to mitigate plastic pollution. Additionally, this study reports high levels of marine debris reported in a remote and protected area such as Galapagos, which are comparable to areas with direct sources of marine debris. This is especially worrying for Galapagos since the sampled beaches are cleaned at least annually. This fact highlights the global dimension of this environmental threat that demands further extensive international commitment to conserve some of the last paradises on Earth.

Factors affecting populations of the endemic Iberian hare (Lepus granatensis) after the first myxomatosis outbreaks in Central Spain.

The Iberian hare (Lepus granatensis) is an endemic species distributed in Spain and Portugal. Myxomatosis outbreaks affecting this species were detected in 2018 in Central and Southern Spain, spreading afterward. Aiming to evaluate factors affecting the status of hare population after the arrival of myxomatosis, we conducted 108 nocturnal hare counts in Central Spain during two study periods (winter/spring and summer/autumn) in 54 different hunting grounds, covering 1071 km and observing 884 individuals. The mean density in winter/spring was 7.66 hares/100 ha, (range 6.14-9.54/100 ha), while in summer/autumn, it was 3.4 hares/100 ha (range 2.6-4.4/100 ha). Densities of hares were not affected by the dominant habitat and the presence/absence of myxomatosis outbreaks. Hares were more abundant at hunting grounds at a higher altitude and in those conducting targeted management, while detection of myxomatosis was related to lower altitude and higher levels of game management. A MaxEnt model used to generate a risk map for myxomatosis occurrence showed that the temperature annual range was the most important predictor, which suggests that environmental factors affecting myxomatosis vectors (mosquitoes, fleas, and ticks) could play a key role in disease transmission. As myxomatosis in hares is becoming endemic, hare densities may be improved by game management and the monitoring and surveillance of this emerging disease. These surveillance programs could be the basis of effective collaborations between hunters, researchers, and environmental managers.

Update in Diagnosis and Management of Primary Cutaneous B-Cell Lymphomas.

Primary cutaneous lymphomas are a rare group of diseases, with an estimated incidence of 0.5-1 case per 100,000 people per year. Primary cutaneous B-cell lymphomas (pCBCLs) represent 25-30% of all primary cutaneous lymphomas. There are three main subtypes of pCBCL: primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, and primary cutaneous diffuse large B-cell lymphoma, leg type. Cutaneous B-cell lymphomas have a broad spectrum of clinical presentations, which makes diagnostic and therapeutic strategies challenging. To date, treatment recommendations for cutaneous B-cell lymphomas have been largely based on small retrospective studies and institutional experience. Recently, the pharmacotherapeutic landscape has expanded to include drugs that may modify the underlying disease pathology of pCBCLs, representing new therapeutic modalities for this rare group of diseases. Novel therapies used for other systemic B-cell lymphomas show promise for the treatment of pCBCLs and are being increasingly considered. These new therapies are divided into five main groups: monoclonal antibodies, immune checkpoint inhibitors, small-molecule inhibitors, bispecific T-cell engaging, and chimeric antigen receptor T cell. In this review, we discuss the clinical, histopathological, molecular, and cytogenetic features of the most common pCBCL subtypes with a focus on current and innovative therapeutic developments in their management. These emerging treatment strategies for B-cell lymphomas and cutaneous B-cell lymphomas may represent novel first-line options for the management of these rare diseases.

Rosacea Granulomatosis in a Neutropenic Leukemic Patient.

Rosacea granulomatosis is a common, chronic skin disorder that primarily affects the central face, namely the cheek, nose, chin, and central forehead. Although rosacea is mainly a disorder of innate and adaptive immunity, a variety of endogenous and exogenous triggers such as Demodex may stimulate it. Often found as commensal organisms in human skin, Demodex ​​​​​​​can be parasitic if there is a change in the host's cutaneous environment. This is especially relevant for immunosuppressed patients, who need prompt treatment to prevent further complications. We review the literature regarding rosacea granulomatosis in immunosuppression and present an acute myelogenous leukemia patient with severe neutropenia, which may have promoted the development of rosacea due to Demodex ​​​​​​​mite proliferation. This local proliferation of the ectoparasite on the face can cause an atypical skin rash that mimics severe infections in the setting of neutropenia.

Anthropogenic pressures enhance the deleterious effects of extreme storms on rocky shore communities.

Climate change is not only changing the mean values of environmental parameters that modulate ecosystems, but also the regime of disturbances. Among them, extreme events have a key role in structuring biological communities. Ecosystems are frequently suffering multiple anthropogenic pressures which can cause effects that are not additive. Thus, the effects of extreme events need to be studied in combination with other pressures to adequately evaluate their consequences. We performed a manipulative approach in two rocky shores in the Mediterranean with contrasting levels of anthropogenic pressure (mainly eutrophication) simulating storms with different disturbance regimes in the intertidal and subtidal zones. In the short-term, an extreme storm had a greater impact on the species assemblage than other disturbance regimes, being especially notable in the area suffering from a high anthropogenic pressure. In this area, the species assemblages that suffered from an extreme storm took a longer time to recover than the ones affected by other disturbance regimes and were generally more affected after the disturbance. The intertidal zone, having more variable environmental conditions than the subtidal zone, was more resistant and able to recover from extreme storms. Our results suggest that the effects of extreme events on biological communities could be strengthened when co-occurring with anthropogenic pressures, especially ecosystems adapted to less variable environmental conditions. Thus, limiting other anthropogenic pressures that ecosystems are suffering is crucial to maintain the natural resistance and recovery capacity of ecosystems towards extreme events such as storms.

The environmental effect on the seabed of an offshore marine fish farm in the tropical Pacific.

Marine aquaculture is expanding offshore, where the environmental interactions are not yet fully understood. We performed a benthic environmental assessment of an offshore fish farm on unconsolidated sediment. The physicochemical variables showed marked changes just under the fish farm, although the structure of the community and its bioturbation potential were not influenced. Under no or minimum influence from the fish farm, the physicochemical variables, including acid-volatile sulphides and redox, were notably different to those found in unaffected coastal areas. For this reason, classifications of the environmental status based on physicochemical variables should be adapted to offshore areas. Despite the low degree of impact detected, the organic matter carrying capacity should be carefully determined to avoid environmental drawbacks in terms of fine-grained offshore sediments. Offshore aquaculture could have a lower environmental impact than other types of aquaculture located closer to the coast, but further research is needed to obtain conclusive results.

Are biodegradable plastics an environmental rip off?

While the use of biodegradable polymers is recognized as a global strategy to minimize plastic pollution, the technical standards (TS) used to attest their biodegradability may not be in compliance with most environmental parameters observed aquatic ecosystems. Indeed, through a careful assessment of the TS currently in use, this study evidenced that these guidelines cover only a fraction of the biogeochemical parameters seen in nature and largely disregard those that occur in the deep-sea. Thus, these TS may not be able to ensure the degradation of such polymers in natural environments, where microbial activity, pH, temperature, salinity, UV radiation and pressure are highly variable. This raises environmental concern, since relevant parcel of plastic ends up in the oceans reaching deep zones. Therefore, there is an urgent need to revise these TS, which must consider the actual fate of most plastic debris and include assessments under the challenging conditions found at these types of environment, alongside microplastic formation and ecotoxicology effects. Moreover, the next generation of biodegradability tests must be designed to enable a cost-effective implementation and incorporate accurate analytical techniques to assess polymer transformation. Furthermore, certification should provide information on time scale and degradation rates and, preferably, be globally harmonized.

Polarization inhibits the phase transition of Axelrod's model.

We study the effect of polarization in Axelrod's model of cultural dissemination. This is done through the introduction of a cultural feature that takes only two values, while the other features can present a larger number of possible traits. Our numerical results and mean-field approximations show that polarization reduces the characteristic phase transition of the original model to a finite-size effect, since at the thermodynamic limit only the ordered phase is present. Furthermore, for finite system sizes, the stationary state depends on the percolation threshold of the network where the model is implemented: a polarized phase is obtained for percolation thresholds below 1/2, and a fragmented multicultural one otherwise.