A temperature-controlled radio frequency combined with ultrasounds and laser for skin laxity and cellulitis.

Skin laxity and Oedematous Fibrosclerotic Panniculopathy are common issues affecting the women population. Finding and developing treatments to counteract ageing indications and conform to social norms of beauty has been increasingly important in aesthetic medicine in recent times. Many non-invasive techniques, including radiofrequency, lasers, and ultrasounds, have been created. This study used a multi-handpiece device with laser (808 nm) and ultrasound (37 kHz) handpieces, as well as radiofrequency and various temperature-controlling applicators depending on the body site (3 or 6 tips). Based on their clinical features, 12 women with skin laxity on their arms, face/neck area, or lower limbs at phases I-III were divided evenly into two study groups. The majority of patients reported 'Excellent-3' treatment outcomes after it was over, and their impression of the course of treatment was generally better than the investigators. An objective analysis of the anthropometric measurement data shows a progressive decrease in circumferences, tight plicometry and body weight. In summary, the specific use of an radiofrequency handpiece with a temperature sensor decreased the likelihood of side effects, even with a small study population group. This increased patient compliance with treatment and overall satisfaction with the outcomes.

Seasonal Trophic Ecology and Diet Shift in the Common Sole Solea solea in the Central Adriatic Sea.

The common sole, Solea solea, is one the most important commercial species in Europe and, within the Mediterranean, the Adriatic basin is the most crucial area for its production. Although the species is overexploited in the basin, data on its trophic ecology are fragmentary, even though this is one of the most important features within the Ecosystem Approach to Fishery. Here, we analysed temporal variations in the feeding ecology of the species by using an integrated approach of stomach contents and stable isotope analyses coupled with the analysis of some condition indices such as the gonadosomatic and the hepatosomatic indices. Changes in diet and trophic level across the years in adult females were clearly linked to the different energetic requirements facing reproduction. Temporal changes throughout the year were mainly related to changes in food availability. This study confirms the opportunistic behaviour of this benthophagous species and its role as a mesopredator, opening new perspectives for further investigations on the effects of the overexploitation of this important fishery resource on the marine trophic web.

Skin Fractional Scar Treatment with a New Carbon Dioxide Scanner: Histological and Clinical Evaluation.

Background: The mechanism of action of fractional carbon dioxide (CO2) laser in the management of skin scarring is stimulation of collagen and fibroblasts in the dermis, resulting in remodeling and shrinking of the skin. Objective: The purpose of this research is to assess the safety and performance of a new CO2 laser scanner for treatment of acne scars. Methods: The study was carried out on 20 patients of both sexes, with a mean age of 25.7 ± 6.7 years. To assess the performance and safety of this new CO2 scanner, a preclinical histological evaluation was done. A clinical evaluation of acne scars was performed using Goodman and Baron's quantitative global acne scarring grading system (GBQGASGS) and a crusting scale where crusting scores ranged from 1 = none to 4 = severe. Digital photographs were taken to obtain esthetic results. Results: GBQGASGS showed a significant improvement in patients' scars and the treatment was well tolerated, with no lasting side effects. Conclusions: The new scanner seems to be an effective and safe device for skin scarring treatment, speeding up the healing time of scars.

COVID-19 lockdowns reveal the resilience of Adriatic Sea fisheries to forced fishing effort reduction.

The COVID-19 pandemic provides a major opportunity to study fishing effort dynamics and to assess the response of the industry to standard and remedial actions. Knowing a fishing fleet's capacity to compensate for effort reduction (i.e., its resilience) allows differentiating governmental regulations by fleet, i.e., imposing stronger restrictions on the more resilient and weaker restrictions on the less resilient. In the present research, the response of the main fishing fleets of the Adriatic Sea to fishing hour reduction from 2015 to 2020 was measured. Fleet activity per gear type was inferred from monthly Automatic Identification System data. Pattern recognition techniques were applied to study the fishing effort trends and barycentres by gear. The beneficial effects of the lockdowns on Adriatic endangered, threatened and protected (ETP) species were also estimated. Finally, fleet effort series were examined through a stock assessment model to demonstrate that every Adriatic fishing fleet generally behaves like a stock subject to significant stress, which was particularly highlighted by the pandemic. Our findings lend support to the notion that the Adriatic fleets can be compared to predators with medium-high resilience and a generally strong impact on ETP species.

Effective removal of solar lentigines by combination of pre- And post-fluorescent light energy treatment with picosecond laser treatment.

We present a novel treatment for removal of SL that is efficient and enables removal or lesions not immediately visible. Kleresca® FLE technology combined with picosecond laser treatment removes SL lesions and improves skin quality and appearance.

Incorporation in Lipid Microparticles of Acid Red 87, a Colorant Used in Tattoo Inks: Effect on Photodegradation Under Simulated Sunlight and Laser Radiation.

Tattoo colorants decompose under solar radiation and when exposed to laser light for their removal, leading to the accumulation in the dermis of toxic products. Aim of this study was to develop lipid microparticles (LMs) loaded with the colorant, Acid Red 87 (C.I. 45380) used in tattoo inks, and to investigate the effect of this system on the photostability of the colorant under simulated sunlight or laser irradiation. LMs loaded with C.I. 45380 were prepared by melt emulsification using tristearin and phosphatidylcholine as excipients. They were characterized by optical microscopy, laser diffraction, X-ray diffraction and release studies. Free C.I. 45380 and the colorant-loaded LMs were irradiated with a solar simulator or a Q-switched laser. Irradiation with a solar simulator demonstrated that photodecomposition of C.I. 45380 was markedly reduced by incorporation of the dye in the LMs, from 20.5 ± 4.6% to 1.3 ± 1.8%. Conversely, the laser-induced degradation of the colorant (30.1 ± 6.6%) was not significantly influenced by encapsulation in the LMs (the encapsulated C.I. 45380 loss was 27.4 ± 5.5%). Incorporation of C.I. 45380 in lipid microparticles enhances the photostability under sunlight of tattoo inks containing this colorant, without affecting its laser-induced degradation and hence laser removal efficiency.

Efficacy of different photoprotection strategies in preventing actinic keratosis new lesions after photodynamic therapy. The ATHENA study: a two-center, randomized, prospective, assessor-blinded pragmatic trial.

Background: Treatment of actinic keratosis (AK) and field cancerization with photodynamic therapy (PDT) is an effective therapeutic approach with a significant reduction in the number of AK lesions (-75% or more) associated with a significant cosmetic improvement of the photodamaged skin. Recently, also, the daylight PDT (DL-PDT) has proven to be as effective as the conventional PDT (C-PDT), but with a better tolerability. After C-PDT and DL-PDT it is advised to use photoprotection strategies to improve the clinical evolution and prevent the appearance of new AK lesions that usually appear 3-6 months after the last phototherapy session. However, there are no robust clinical data regarding the type of photoprotection to be used (SPF level, duration of treatment, etc.) after successful PDT.Study aim: The present study (ATHENA trial) evaluated the efficacy and tolerability of a topical product based on 0.8% piroxicam and 50+ solar filters (ACTX), applied twice a day as sequential therapy after C-PDT or DL-PDT on the evolution of AK lesions number compared to the use of very high photoprotection products commonly used in this clinical setting (SPF50+ or SPF100+ associated with photolyase) (Standard Sunscreens: SS group). Subjects and methods: This was a multicenter, randomized, two-arm, prospective controlled, assessor-masked outcome evaluation, parallel group (1:1), pragmatic study of 6 months duration in patients with multiple AK lesions suitable for photodynamic therapy. The objectives of the study were the evaluation of the evolution of the number of AK lesions during the period of treatment/application of the study products, and the Investigator global clinical assessment score (IGA score; 4: marked improvement, 3: good, 2: moderate; 1 no improvement; 0: worsening) 2, 3, and 6 months after the last PDT session. A total of 68 subjects (50 men, 18 women; mean age 70 years), 34 assigned to treatment with ACTX and 34 to treatment with SS (17 treated with a SPF50+ and 17 with a photolyase-containing SPF100+ products), were enrolled in the study.Results: The number of AK lesions present before C-PDT/DL-PDT was 11.8 ± 5.8 in the ACTX group and 12.4 ± 6.9 in the SS group. In both groups, there was a progressive reduction of AK lesions observed at baseline (-86% and -87% after 2 months and -88% and -83% at month 3 in ACTX and in the SS group, respectively). At month 6, AK mean lesion number was 1.8 ± 1.6 in the ACTX and 3.2 ± 2.3 in the SS group; this difference was statistically significant (p = 0.03). The IGA score at the end of the study was 3.2 in the ACTX and 2.7 in the SS group (p = 0.05). The percentage of subjects with an IGA score of 4/3 (very good or good) was 81% in the ACTX and 55% in the SS group (p = 0.06).Conclusion: In subjects with AK treated with C-PDT or DL-PDT, a "medicalized" photoprotection treatment is associated with a favorable clinical outcome with progressive reduction of lesions. In contrast to a very high photoprotection (SPF50+ or SPF100+/photolyase), the use of piroxicam 0.8%/SPF 50+ is associated with a significantly greater improvement in clinical evolution of AK lesions.

Artificial spawning substrates and participatory research to foster cuttlefish stock recovery: A pilot study in the Adriatic Sea.

This two-year study evaluates the effects of new management strategies directed at helping the recovery of Adriatic cuttlefish populations. The ability of three specially developed artificial spawning devices-seagrass collectors (SC; deployed on artificial reefs), longline collectors (LC; deployed at mussel farms), and trap collectors (TC; delivered to 19 professional and 54 recreational trap fishermen together with a dedicated logbook)-to attract egg deposition was tested. All devices were provided with a polyethylene floating rope 8 mm in diameter that served as a collector for egg deposition. Total rope length was 1,440 m in SC (2,880 segments of 0.5 m), 250 m in LC (500 segments of 0.5 m), and 250 m in TC (10 m per trap). Although the sites where SC and LC were deployed were sheltered from the action of destructive fishing gears, heavy winter storms destroyed the SC after a year. Most recreational fishermen and none of the professional fishermen provided detailed information on percent egg coverage on their collectors. The collectors attached to the three devices proved highly suitable for cuttlefish spawning, collecting more than 500,000 eggs on 2,440 m of rope. The analysis of egg diameter distribution suggested three laying events during the spawning season. The logbook data showed that egg number peaked in June. The present approach, combining habitat reconstruction and participatory research, has the potential to contribute to the recovery of cuttlefish stocks in the framework of a broader management plan.

Treatment of solar lentigines using a combination of picosecond laser and biophotonic treatment.

Treating solar lentigines using picosecond-switched lasers that selectively remove the excess pigment was combined with Kleresca® biophotonic treatment. This therapy uses fluorescent light energy to stimulate healing by increasing collagen production and reducing inflammation. Combining these therapies successfully removed solar lentigines and achieved normalized and rejuvenated treated skin.

Evidence of subtle genetic structure in the sympatric species Mullus barbatus and Mullus surmuletus (Linnaeus, 1758) in the Mediterranean Sea.

Using thirteen microsatellite loci for Mullus barbatus and Mullus surmuletus collected in the Mediterranean Sea, the biogeographic boundaries, genetic distribution among and within basins and the impact of prolonged exploitation in both species were investigated as a basis for understanding their population dynamics and for improving Mullus spp. stock management. Different level of diversity indices among these co-occurring species were obtained, with M. barbatus showing higher allele richness and higher mean observed and expected heterozygosity than M. surmuletus. Reduced contemporary effective population size (Ne) and M-ratio values found in both species likely reflects recent demographic changes, due to a combination of high fishing pressures, habitat fragmentation and naturally occurring fluctuations in population size. Different patterns of genetic connectivity among populations sampled within the Mediterranean were observed for both species. Higher genetic structure was found for M. barbatus as opposed to a more homogenous pattern observed in M. surmuletus samples. Adriatic populations, previously considered panmictic and isolated from other Mediterranean regions, showed geographical partitioning within the basin but also population connectivity with the northern Ionian and Tyrrhenian Seas. Our results highlight the need for temporal sampling in understanding the complex pattern of population connectivity in the Mediterranean, particularly for management purposes.

Efficacy of a film-forming medical device containing sunscreen (50+) and piroxicam 0.8% in actinic keratosis and field cancerization: a multicenter, assessor-blinded, 3 month trial.

INTRODUCTION: Sunscreen protection in subjects with actinic keratosis (AK) is highly recommended to prevent clinical evolution of this in situ skin cancer condition. Use of topical anti-cyclooxygenase drugs such as diclofenac and piroxicam reduces the number of lesions and improves the cancerization field. A film-forming medical device in a cream formulation containing organic and inorganic sun-filters (50+ SPF) and piroxicam 0.8% (ACTX) has shown in a pilot, single-center, open trial to reduce AK lesions improving the cancerization field. AIM: We evaluated in a multicenter, assessor-blinded, 3 month trial the efficacy of ACTX in AK. METHODS: A total of 70 subjects with at least three AK lesions on the scalp or face were enrolled after written informed consent. Primary outcomes of the study were the clinical evolution of number of AK lesions on a target zone area and the evolution of dermoscopy features of the target lesion, assessing erythema, scaling, pigmentation, and follicular plug, using a 5 point score (from 0 to 4; maximum score: 16). Lesion count and dermoscopy score were evaluated in a blind fashion assessing digital color high definition coded images. A secondary outcome was the Investigator Global Score (IGS) of clinical evolution of the target area using a 7 point scale from -2 (significantly worse) to +4 (completely cured). IGS was evaluated in an open fashion. Subjects were instructed to apply the cream twice daily on the target area, using one finger-tip unit for the treatment of a 35 cm2 area. RESULTS: All but one subject (40 men and 30 women, mean age 73 years) concluded the study period. At baseline the mean (±SD) number of AK lesions in the target area were 7.0 (5.9) with a median value of 5 and the dermoscopy score of the target lesion was 7.0 (2.3) with a median value of 7.0. ACTX treatment reduced AK lesions to 3.2 (2.9), (p = .0001; Wilcoxon Test), representing a 55% relative reduction. Dermoscopy score was reduced to 3.3 (2.6) (p = .0001) (a reduction of 53%). The IGS after ACTX treatment was +1.9 (1.1), with a median of 2.0. A total of 86% of subjects showed a clinical improvement of IGS (≥1) with a very significant/complete clearance (score +3 or +4) in 42% subjects. No change or a worsening of AK lesions was observed in 14% of the subjects. The product was well tolerated. No serious adverse events were reported during the duration of the trial. CONCLUSION: In this multicenter, assessor-blinded trial, the use of a film-forming medical device with sun protection and anti-inflammatory actions was effective in reducing AK lesions and improving the dermoscopy aspect of the target lesion in 86% of treated subjects. A head-to-head trial evaluating the efficacy of this medical device in comparison with diclofenac is warranted to establish whether this therapeutic approach could offer additional advantages in term of AK lesion reduction compared to an established topical treatment. (Trial ID: ISRCTN72020277).

Seabed litter composition, distribution and sources in the Northern and Central Adriatic Sea (Mediterranean).

Detecting the origin of marine benthic litter is fundamental for developing policies aimed at achieving the Good Environmental Status in European Seas by 2020, as requested by the Marine Strategy Framework Directive (MSFD). The abundance and composition of benthic litter in the Northern and Central Adriatic Sea were investigated at 67 stations with bottom trawl nets. Average density of benthic litter was 913±80items/km2, ranking the Adriatic as one of the most polluted basins worldwide. Plastic was dominant in terms of numbers (80%) and weight (62%), and mainly consisted in bags, sheets and mussel nets. Higher quantities of litter were found in coastal areas, especially in front river mouths, coastal cities and mussel farms. In deep waters, litter hotspots were associated with most congested shipping lanes, indicating an additional litter input to the basin. Benthic litter composition resulted to be largely driven by the vicinity to local sources, i.e. mussel farming installations and most congested shipping routes. These findings provide useful insights to set measures to manage marine litter in the Adriatic region, and possibly to minimize this anthropogenic pollution.

Occurrence of the Leech, Pontobdella muricata Linnaeus, on Elasmobranch Species in the Northern and Central Adriatic Sea.

This study provides a parasitological analysis of the elasmobranch species caught in the northern and central Adriatic Sea. Sixty-two marine leeches were recorded on 747 individuals of Raja clavata Linnaeus, 1758 (thornback ray), Myliobatis aquila Linnaeus, 1758 (common eagle ray), and Torpedo marmorata Risso, 1810 (marbled torpedo ray) caught in 56 hauls over a 5 yr period. All leeches were identified as Pontobdella muricata, which is a typical ectoparasite of benthic elasmobranchs. The prevalence of infection ranged from 7.11% on R. clavata to 12.00% on M. aquila. The intensity of infection, the preferential sites of attachment to the host, and the periodicity of infection were evaluated.

The seascape of demersal fish nursery areas in the North Mediterranean Sea, a first step towards the implementation of spatial planning for trawl fisheries.

The identification of nursery grounds and other essential fish habitats of exploited stocks is a key requirement for the development of spatial conservation planning aimed at reducing the adverse impact of fishing on the exploited populations and ecosystems. The reduction in juvenile mortality is particularly relevant in the Mediterranean and is considered as one of the main prerequisites for the future sustainability of trawl fisheries. The distribution of nursery areas of 11 important commercial species of demersal fish and shellfish was analysed in the European Union Mediterranean waters using time series of bottom trawl survey data with the aim of identifying the most persistent recruitment areas. A high interspecific spatial overlap between nursery areas was mainly found along the shelf break of many different sectors of the Northern Mediterranean indicating a high potential for the implementation of conservation measures. Overlap of the nursery grounds with existing spatial fisheries management measures and trawl fisheries restricted areas was also investigated. Spatial analyses revealed considerable variation depending on species and associated habitat/depth preferences with increased protection seen in coastal nurseries and minimal protection seen for deeper nurseries (e.g. Parapenaeus longirostris 6%). This is partly attributed to existing environmental policy instruments (e.g. Habitats Directive and Mediterranean Regulation EC 1967/2006) aiming at minimising impacts on coastal priority habitats such as seagrass, coralligenous and maerl beds. The new knowledge on the distribution and persistence of demersal nurseries provided in this study can support the application of spatial conservation measures, such as the designation of no-take Marine Protected Areas in EU Mediterranean waters and their inclusion in a conservation network. The establishment of no-take zones will be consistent with the objectives of the Common Fisheries Policy applying the ecosystem approach to fisheries management and with the requirements of the Marine Strategy Framework Directive to maintain or achieve seafloor integrity and good environmental status.

A tale of two seas: contrasting patterns of population structure in the small-spotted catshark across Europe.

Elasmobranchs represent important components of marine ecosystems, but they can be vulnerable to overexploitation. This has driven investigations into the population genetic structure of large-bodied pelagic sharks, but relatively little is known of population structure in smaller demersal taxa, which are perhaps more representative of the biodiversity of the group. This study explores spatial population genetic structure of the small-spotted catshark (Scyliorhinus canicula), across European seas. The results show significant genetic differences among most of the Mediterranean sample collections, but no significant structure among Atlantic shelf areas. The data suggest the Mediterranean populations are likely to have persisted in a stable and structured environment during Pleistocene sea-level changes. Conversely, the Northeast Atlantic populations would have experienced major changes in habitat availability during glacial cycles, driving patterns of population reduction and expansion. The data also provide evidence of male-biased dispersal and female philopatry over large spatial scales, implying complex sex-determined differences in the behaviour of elasmobranchs. On the basis of this evidence, we suggest that patterns of connectivity are determined by trends of past habitat stability that provides opportunity for local adaptation in species exhibiting philopatric behaviour, implying that resilience of populations to fisheries and other stressors may differ across the range of species.

Effects of two offshore gas platforms on soft-bottom benthic communities (northwestern Adriatic Sea, Italy).

The macrozoobenthos living around two offshore gas platforms, Barbara NW (pB) and Calipso (pC) located in the northwestern Adriatic Sea were investigated for three years after their construction to detect eventual effects due to the platforms. The sampling stations were spaced at increasing distance from the platforms up to 1000 m. Both multivariate and univariate analysis showed an initial defaunation (short-term effect) at pB and within a 120 m radius at pC. A general recovery in terms of abundance, species richness and diversity was observed for the benthic communities after one year. During the third monitoring year a mussel mound developed at both the platforms (longer-term effect) extending up to 30 m from pC, whereas similar soft-bottom communities were found at all the other distances. The geographical position plays an important role in the "timing" of the above effects. Moreover, despite the different environmental features, a 3-year monitoring plan can be effective to evaluate the potential impact on benthic communities of offshore gas platforms in the north-central Adriatic Sea.