Sociodemographic factors associated with the success or failure of anti-tuberculosis treatment in the Chiapas Highlands, Mexico, 2019-2022.

OBJECTIVE: To estimate the incidence rate of tuberculosis (TB) in the Highlands (Tsotsil-Tseltal) region of Chiapas and to analyze sociodemographic factors that might influence the success of anti-TB treatment from the period of January 2019 to June 2022. METHODS: Retrospective study in which the TB databases of the National Epidemiological Surveillance System (SINAVE) were analyzed. TB incidence rates were calculated based on the number of registered TB cases and estimated annual populations. The success-failure of anti-TB treatment was analyzed according to sociodemographic indicators, degree of concentration of indigenous population of the municipality of residence and admission to SINAVE. RESULTS: Two hundred thirty-three cases were analyzed. The variables associated to a lower success rate of treatment against TB were: living in a municipality with high-very high concentration of indigenous population, being indigenous, having a primary school education or lower, and agricultural occupation. The number of TB diagnosed from 2020-2022 and the incidence rates from 2020-2021 decreased significantly compared to 2019. CONCLUSIONS: It is necessary to strengthen the follow-up of TB cases in the region, mainly in areas with high-very high indigenous concentration, in people with low levels of education and engaged in agricultural work.

Research Priorities for Precision Medicine in NAFLD.

NAFLD is a multisystem condition and the leading cause of chronic liver disease globally. There are no approved NAFLD-specific dugs. To advance in the prevention and treatment of NAFLD, there is a clear need to better understand the pathophysiology and genetic and environmental risk factors, identify subphenotypes, and develop personalized and precision medicine. In this review, we discuss the main NAFLD research priorities, with a particular focus on socioeconomic factors, interindividual variations, limitations of current NAFLD clinical trials, multidisciplinary models of care, and novel approaches in the management of patients with NAFLD.

The role of inputs of marine wrack and carrion in sandy-beach ecosystems: a global review.

Sandy beaches are iconic interfaces that functionally link the ocean with the land via the flow of organic matter from the sea. These cross-ecosystem fluxes often comprise uprooted seagrass and dislodged macroalgae that can form substantial accumulations of detritus, termed 'wrack', on sandy beaches. In addition, the tissue of the carcasses of marine animals that regularly wash up on beaches form a rich food source ('carrion') for a diversity of scavenging animals. Here, we provide a global review of how wrack and carrion provide spatial subsidies that shape the structure and functioning of sandy-beach ecosystems (sandy beaches and adjacent surf zones), which typically have little in situ primary production. We also examine the spatial scaling of the influence of these processes across the broader land- and seascape, and identify key gaps in our knowledge to guide future research directions and priorities. Large quantities of detrital kelp and seagrass can flow into sandy-beach ecosystems, where microbial decomposers and animals process it. The rates of wrack supply and its retention are influenced by the oceanographic processes that transport it, the geomorphology and landscape context of the recipient beaches, and the condition, life history and morphological characteristics of the macrophyte taxa that are the ultimate source of wrack. When retained in beach ecosystems, wrack often creates hotspots of microbial metabolism, secondary productivity, biodiversity, and nutrient remineralization. Nutrients are produced during wrack breakdown, and these can return to coastal waters in surface flows (swash) and aquifers discharging into the subtidal surf. Beach-cast kelp often plays a key trophic role, being an abundant and preferred food source for mobile, semi-aquatic invertebrates that channel imported algal matter to predatory invertebrates, fish, and birds. The role of beach-cast marine carrion is likely to be underestimated, as it can be consumed rapidly by highly mobile scavengers (e.g. foxes, coyotes, raptors, vultures). These consumers become important vectors in transferring marine productivity inland, thereby linking marine and terrestrial ecosystems. Whilst deposits of organic matter on sandy-beach ecosystems underpin a range of ecosystem functions and services, they can be at variance with aesthetic perceptions resulting in widespread activities, such as 'beach cleaning and grooming'. This practice diminishes the energetic base of food webs, intertidal fauna, and biodiversity. Global declines in seagrass beds and kelp forests (linked to global warming) are predicted to cause substantial reductions in the amounts of marine organic matter reaching many beach ecosystems, likely causing flow-on effects for food webs and biodiversity. Similarly, future sea-level rise and increased storm frequency are likely to alter profoundly the physical attributes of beaches, which in turn can change the rates at which beaches retain and process the influxes of wrack and animal carcasses. Conservation of the multi-faceted ecosystem services that sandy beaches provide will increasingly need to encompass a greater societal appreciation and the safeguarding of ecological functions reliant on beach-cast organic matter on innumerable ocean shores worldwide.

Tiempo en rango terapéutico e incidencia de complicaciones por warfarina en una cohorte retrospectiva de 20 años / Time in therapeutic range and incidence of warfarin complications in a 20-year retrospective cohort

Objetivo: Caracterizar el tiempo en rango terapéutico (TTR) y estimar la tasa de incidencia de complicaciones (PTIRc) en adultos con protocolo de warfarina. Diseño: Cohorte retrospectiva basada en registros médicos de pacientes mayores de 18años entre 1996 a 2016 y seguidos al menos tres meses. Emplazamiento: Unidad de Hematología de un centro especializado cardiovascular venezolano. Participantes: Registros médicos electrónicos. Mediciones principales: TTR y PTIRc. Las variables fueron: sexo, analfabetismo funcional, ocupación, international normalized ratio (INR) y tiempo de seguimiento, que fueron analizados con TTR and PTIRc mediante modelos de logística binomial y regresión de Poisson, respectivamente. Resultados: Un total de 2.770 pacientes fueron seguidos durante 1.201.380 días; el 42,3% tuvieron un TTR <65% y el 3,5% tuvieron indicación de INR 2,5-3,5. El 61,8% presentaron complicaciones. La PTIRc fue de 6,84/100 personas-mes (IC95%: 6,56-7,15). TTR <65% mostró OR ajustadas significativas con analfabetismo funcional e INR 2,5-3,5, mientras que para la mayor PTIRc se encontró un RR significativo en los dos factores mencionados, menor tiempo de seguimiento, TTR <65% y en mujeres. Conclusiones: A pesar de nuevos tratamientos anticoagulantes, la warfarina es útil. A medida que aumentó el tiempo de seguimiento el control fue mejor y la velocidad de aparición de complicaciones disminuyó; sin embargo, las condiciones que mostraron menor TTR y mayor velocidad de aparición de complicaciones requieren una profunda revisión del seguimiento, de manera especial en pacientes con analfabetismo funcional.(AU)

Objective: To characterize the time in therapeutic range (TTR) and estimate the incidence rate of complications (PTIRc) in adults with warfarin protocol. Design: Retrospective cohort based on medical records of patients older than 18years, between 1996 and 2016 and followed for at least three months. Site: Hematology unit of a Venezuelan specialized cardiovascular center. Participants: Electronic health record. Main measurements: TTR and PTIRc. The variables were sex, functional illiteracy, occupation, International Normalized Ratio (INR) and follow-up time, which were analyzed with TTR and PTIRc using binomial logistic and Poisson regression models, respectively. Results: 2,770 patients were followed up for a total of 1,201,380 days, 42.3% had a TTR<65% and 3.5% had INR 2.5-3.5. 61.8% had complications. PTIRc was 6.84/100 person-months (95%CI: 6.56-7.15). TTR<65% showed significant adjusted OR with functional illiteracy and INR 2.5-3.5, while for higher PTIRc a significant RR was found in the two factors mentioned, shorter follow-up time, TTR<65% and in women. Conclusions: Despite new anticoagulant treatments, warfarin is useful. As follow-up time increased, control was better and the rate of occurrence of complications decreased; however, the conditions that showed lower TTR and higher rate of occurrence of complications require a thorough review of follow-up especially in patients with functional illiteracy.(AU)

[Time in therapeutic range and incidence of warfarin complications in a 20-year retrospective cohort]. / Tiempo en rango terapéutico e incidencia de complicaciones por warfarina en una cohorte retrospectiva de 20 años.

OBJECTIVE: To characterize the time in therapeutic range (TTR) and estimate the incidence rate of complications (PTIRc) in adults with warfarin protocol. DESIGN: Retrospective cohort based on medical records of patients older than 18years, between 1996 and 2016 and followed for at least three months. SITE: Hematology unit of a Venezuelan specialized cardiovascular center. PARTICIPANTS: Electronic health record. MAIN MEASUREMENTS: TTR and PTIRc. The variables were sex, functional illiteracy, occupation, International Normalized Ratio (INR) and follow-up time, which were analyzed with TTR and PTIRc using binomial logistic and Poisson regression models, respectively. RESULTS: 2,770 patients were followed up for a total of 1,201,380 days, 42.3% had a TTR<65% and 3.5% had INR 2.5-3.5. 61.8% had complications. PTIRc was 6.84/100 person-months (95%CI: 6.56-7.15). TTR<65% showed significant adjusted OR with functional illiteracy and INR 2.5-3.5, while for higher PTIRc a significant RR was found in the two factors mentioned, shorter follow-up time, TTR<65% and in women. CONCLUSIONS: Despite new anticoagulant treatments, warfarin is useful. As follow-up time increased, control was better and the rate of occurrence of complications decreased; however, the conditions that showed lower TTR and higher rate of occurrence of complications require a thorough review of follow-up especially in patients with functional illiteracy.

Quantification of blue carbon stocks associated with Posidonia oceanica seagrass meadows in Corsica (NW Mediterranean).

In the last decades, the increasing necessity to reduce atmospheric carbon dioxide (CO2) concentrations has intensified interest in quantifying the capacity of coastal ecosystems to sequester carbon, referred to commonly as 'Blue Carbon' (BC). Among coastal habitats, seagrass meadows are considered as natural carbon sinks due to their capacity to store large amounts of carbon in their sediments over long periods of time. However, the spatial heterogeneity of carbon stocks in seagrass sediments needs to be better understood to improve the accuracy of BC assessments, particularly where there is high environmental variability. In the Mediterranean, Posidonia oceanica (L.) Delile constitutes extensive meadows considered as long-term carbon sinks due to the development of an exceptional structure known as 'matte', reaching several meters in height, which can be preserved over millennia. In order to specify the role of P. oceanica meadows in climate change mitigation, an estimate of carbon stocks has been conducted along the eastern coast of Corsica (NW Mediterranean). The approach is mainly based on the biogeochemical analysis of 39 sediment cores. Organic carbon (Corg; 327 ± 150 t ha-1, mean ± SE) and inorganic carbon stocks (Cinorg; 245 ± 45 t ha-1) show a high variability related to water depth, matrix (sandy vs rocky substrate) or the depositional environment (coastal vs estuary). The isotopic signature (δ13C) revealed a substantial contribution of allochthonous inputs of organic matter (macroalgae and sestonic sources) mainly in estuarine environment and shallow areas. The carbon stocks in the first 250 cm of matte (average thickness) were estimated at 5.6-14.0 million t Corg (study site) and 14.6-36.9 million t Corg (Corsica), corresponding to 11.6-29.2 and 30.4-76.8 years of CO2 emissions from the population of Corsica.

Sizing the carbon sink associated with Posidonia oceanica seagrass meadows using very high-resolution seismic reflection imaging.

Among blue carbon ecosystems, seagrass meadows have been highlighted for their contribution to the ocean carbon cycle and climate change mitigation derived from their capacity to store large amounts of carbon over long periods of time in their sediments. Most of the available estimates of carbon stocks beneath seagrass meadows are based on the analysis of short sediment cores in very limited numbers. In this study, high-resolution seismic reflection techniques were applied to obtain an accurate estimate of the potential size of the organic deposit underlying the meadows of the Mediterranean seagrass Posidonia oceanica (known as 'matte'). Seismic profiles were collected over 1380 km of the eastern continental shelf of Corsica (France, Mediterranean Sea) to perform a large-scale inventory of the carbon stock stored in sediments. The seismic data were ground-truthed by sampling sediment cores and using calibrated seismo-acoustic surveys. The data interpolation map highlighted a strong spatial heterogeneity of the matte thickness. The height of the matte at the site was estimated at 251.9 cm, being maximum in shallow waters (10-20 m depth), near river mouths and lagoon outlets, where the thickness reached up to 867 cm. Radiocarbon dates revealed the presence of seagrass meadows since the mid-Holocene (7000-9000 cal yr BP). Through the top meter of soil, the matte age was estimated at 1656 ± 528 cal yr BP. The accretion rate showed a high variability resulting from the interplay of multiple factors. Based on the surface area occupied by the meadows, the average matte thickness underneath them and the carbon content, the matte volume and total Corg stock were estimated at 403.5 ± 49.4 million m3 and 15.6 ± 2.2 million t Corg, respectively. These results confirm the need for the application of large-scale methods to estimate the size of the carbon sink associated with seagrass meadows worldwide.

Hepatitis C Micro-Elimination beyond Prison Walls: Navigator-Assisted Test-and-Treat Strategy for Subjects Serving Non-Custodial Sentences.

BACKGROUND AND AIMS: The Spanish prison population includes two groups: people in prison and those who are serving non-custodial sentences. The latter has not yet been studied. This study aims to describe this population and the results of a test-and-treat strategy for hepatitis C including a holistic health assessment. METHOD: This prospective study included all subjects serving non-custodial sentences at the Center for Social Integration. It was assisted by the medical team, a navigator, and a systematic screening of HCV (Hepatitis C Virus) performed by point-of-care tests. All cases with active infection are evaluated using telemedicine by a specialist to prescribe antiviral treatment. The navigator facilitates continuity for medical and social assistance. RESULTS: The screening rate reached 92.8% (548/590). HCV seroprevalence and viraemia prevalence were 8% (44) and 2.9% (16), respectively. Regarding comorbidities: problems related to drug dependence were detected in 264 (48.2%), suspected serious mental disorder in 44 (8.3%), and previous stay in prison in 122 cases (22.2%). The navigator monitored 59 (15.2%) patients regarding HCV treatment or comorbidities. All patients (10/10) completing 12 weeks follow-up achieved sustained virological response. CONCLUSIONS: The population serving non-custodial sentences is a challenging group with a high prevalence of HCV infection. Micro-elimination programs using point of care diagnostic tests, telemedicine, and a navigator are necessary in this underserved vulnerable population.

Sexually transmitted infections and factors associated with risky sexual practices among female sex workers: A cross sectional study in a large Andean city.

BACKGROUND: There are limited published data on factors related to risky sexual practices (RSP) affecting sexually transmitted infections (STIs) among female sex workers (FSWs) in Ecuador. METHODS: Cross-sectional study of FSWs presenting for a consultation in a primary health care centre during 2017. A questionnaire was administered to collect information on RSP and potential risk factors including age, membership of an FSW association, self-report of previous STI diagnosis, previous treatment for suspected STI and temporary migration for sex work. Associations between RSP and potential risk factors were estimated by logistic regression. The proportion of STI was estimated from vaginal swabs by real-time PCR for four sexually transmitted pathogens (Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, and Mycoplasma genitalium). RESULTS: Of 249 FSWs recruited, 22.5% had reported RSPs at least once during sex work. Among FSWs reporting unprotected vaginal sex in the previous three months, 25.5% had at least one other RSP type. 17.6% (95%CI 13.3-22.8) had at least one active STI. Prevalence of co-infections was 2.4% (95%CI 1.1-5.2). In multivariable analysis, RSP was associated with age (adjusted OR 1.06; 95%CI 1.02-1.10), membership of an FSWs association (aOR 3.51; 95%CI 1.60-7.72) and self-reported previous STI (aOR 3.43; 95%CI 1.28-9.17). CONCLUSIONS: Among a population of female sex workers with high proportion of STIs, increasing age and belonging to an FSWs association was associated with a higher likelihood of engaging in RSP with clients. Engaging with FSWs organisations may reduce the burden of STI among sex workers.

A temporal record of microplastic pollution in Mediterranean seagrass soils.

Plastic pollution is emerging as a potential threat to the marine environment. In the current study, we selected seagrass meadows, known to efficiently trap organic and inorganic particles, to investigate the concentrations and dynamics of microplastics in their soil. We assessed microplastic contamination and accumulation in 210Pb dated soil cores collected in Posidonia oceanica meadows at three locations along the Spanish Mediterranean coast, with two sites located in the Almería region (Agua Amarga and Roquetas) and one at Cabrera Island (Santa Maria). Almería is known for its intense agricultural industry with 30 000 ha of plastic-covered greenhouses, while the Cabrera Island is situated far from urban areas. Microplastics were extracted using enzymatic digestion and density separation. The particles were characterized by visual identification and with Fourier-transformed infrared (FTIR) spectroscopy, and related to soil age-depth chronologies. Our findings showed that the microplastic contamination and accumulation was negligible until the mid-1970s, after which plastic particles increased dramatically, with the highest concentrations of microplastic particles (MPP) found in the recent (since 2012) surface soil of Agua Amarga (3819 MPP kg-1), followed by the top-most layers of the soil of the meadows in Roquetas (2173 kg-1) and Santa Maria (68-362 kg-1). The highest accumulation rate was seen in the Roquetas site (8832 MPP m-2 yr-1). The increase in microplastics in the seagrass soil was associated to land-use change following the intensification of the agricultural industry in the area, with a clear relationship between the development of the greenhouse industry in Almería and the concentration of microplastics in the historical soil record. This study shows a direct linkage between intense anthropogenic activity, an extensive use of plastics and high plastic contamination in coastal marine ecosystems such as seagrass meadows. We highlight the need of proper waste management to protect the coastal environment from continuous pollution.

Processes driving seagrass soils composition along the western Mediterranean: The case of the southeast Iberian Peninsula.

Seagrasses are distributed all along the coast of the Mediterranean Sea being Posidonia oceanica and Cymodocea nodosa the most common species. They promote sedimentation, leading to the formation of well-structured soils. Over the last decade, a growing attention has been paid to their role as CO2 sinks in the form of organic carbon (Corg) and to their use as environmental archives. However, most of the knowledge about pedogenetic processes in these soils refer to the rhizosphere. This study aims to understand seagrass soils biogeochemistry in the rhizosphere and below, which in turn can help to understand their long term formation processes. Fifteen cores were strategically sampled along a 350 km stretch of the Southeast Iberian coast, and analyzed for elemental composition (XRF core-scanning), magnetic susceptibility, Corg content and gran size distribution. The cores were dated by 210Pb and 14C-AMS techniques to estimate soil accretion. Principal component analysis was used to explore the main geochemical processes linked to soil formation. The results showed that terrestrial runoff plays a key role in meadow soil composition. Furthermore, Corg accumulation did not follow any general depth trend in our soil records, suggesting that temporal variation in Corg inputs is an important factor in determining carbon depth distribution within the soil. We obtained evidence that the establishment of well-developed, stable C. nodosa meadows in the Mediterranean Sea may be promoted by adverse environmental conditions to P. oceanica settlement. Metal's behavior within the meadow deposit and their interaction with organic matter and carbonates is unclear. The results presented in this paper highlight the importance of the influence of land-based inputs in the characteristics of seagrass meadow deposits, highly determining their Corg content, as well as the need for further studies on metal behavior, to understand their full potential as environmental records.

Long-term dynamics of production in western Mediterranean seagrass meadows: Trade-offs and legacies of past disturbances.

Seagrasses are marine angiosperms that can form highly productive, and valuable underwater meadows, which are currently in regression. A reliable assessment of their status and future evolution requires studies encompassing long-term temporal scales. With the aim of understanding seagrass ecosystem dynamics over the last centuries and millennia, twelve sediment cores were studied from seagrass meadows located along the Andalusian coast and at the Cabrera Island (western Mediterranean). This study is pioneer in using Fourier Transform Infrared (FTIR) spectroscopy as a tool to study environmental change in seagrass sediments. FTIR is a form of vibrational spectroscopy that provides information about the sediment chemical composition. Principal Component Analysis (PCA) was used to summarise spatio-temporal data of the FTIR vibratory peaks in combination with climate and geochemical proxy data. Several PCA signals were identified: (1) one likely related to the relative changes of the main primary producers and the sedimentary environment (carbonate or siliciclastic sediments, with aromatic or aliphatic organic matter); (2) the marine community production (polysaccharides, total organic matter content and biogenic silica); and (3) the seagrass production (aromatics, carbohydrates, phenols, proteins and lipids). A decrease of seagrass production along the mainland coast was evident since AD ~1850, which may be due to combined negative impacts of seawater warming, local anthropogenic impacts, and extreme setting conditions. The legacy of these combined stressors might have influenced the current poor state of seagrass meadows in the Alboran Sea. Our results also revealed a significant long-term trade-off between the level of seagrass production and its temporal stability (calculated as the inverse of the coefficient of variation). This study provides a reliable baseline data, helping to assess the magnitude of seagrass regression and its drivers. This paleoecological information can help design more targeted management plans and identify meadows where local management could be more efficient.

Telemedicine efficiently improves access to hepatitis C management to achieve HCV elimination in the penitentiary setting.

INTRODUCTION: Linkage to care for hepatitis C includes a new tool: teleconsultation. Micro-elimination in prison is a recommendation and is feasible. An economic evaluation of telemedicine for hepatitis C virus (HCV) treatment in prisons has not yet been performed. This study aimed to provide a cost-minimization analysis comparing two strategies of HCV treatment in a prison: telemedicine clinical practice (TCP) and the usual clinical practice (UCP). METHODS: An observational cost-minimization study was carried out on a cohort of inmates who received anti-HCV treatment in El Dueso prison (May 2016-November 2017). A decision tree was constructed, incorporating different clinical profiles according to the severity of the disease, the results of diagnostic tests, and treatment outcomes as well as the costs of each profile. Satisfaction with telemedicine was evaluated through an 11-question questionnaire with a 5-point Likert scale. RESULTS: Seventy-five inmates were treated and underwent TCP with a follow-up of one year. The average cost per patient with the TCP strategy was €1,172 (€1,151 direct costs). Had UCP been carried out, the cost would have been €1,687 (€1,630 direct). Telemedicine consultation practice produced savings of €516 (30.6%) per patient, with total savings of €38,677. The transfer costs from prison to hospital represented the most important saving item, accounting for 99.3% of the TCP-related savings. The questionnaire revealed high levels of satisfaction with TCP, with a median score of 5 in each question. Sustained virological response rates were 94.7% after the first treatment and 100% after retreatment of the four relapses. CONCLUSION: Telemedicine consultation practice is a more efficient strategy than UCP, mainly due to the reduction of transfer costs while preserving effectiveness and user satisfaction.

Seismic interval velocity in the matte of Posidonia oceanica meadows: Towards a non-destructive approach for large-scale assessment of blue carbon stock.

High-resolution seismic reflection data have been used over the last decades to estimate the thickness of the long-term Blue Carbon sink associated to the below-ground sediment deposit (matte) of the Posidonia oceanica meadows. Time-to-depth conversion of these geophysical datasets was usually performed assuming a sound velocity in this structure, but appropriate seismic interval velocity measurements is necessary to achieve accurate calibration. This study describes the first methodology to estimate the seismic interval velocity in the matte. This approach performed on the eastern continental shelf of Corsica island (France, NW Mediterranean) is based on measurements of the vertical matte profile from high-resolution seismic reflection profiles (s TWTT) and from seafloor morpho-bathymetric DTM (multibeam echosounders - MBES and Light Detection and Ranging - LiDAR surveys) calibrated with ground-truthing data. A biogeosedimentological analysis of horizontal cores sampled in vertical matte escarpments has been undertaken to identify the potential relationship of sediment and environmental parameters with sound velocity. The cross-comparison and the data intercalibration show significant correlation of MBES (R2 = 0.872) and LiDAR datasets (R2 = 0.883) with direct underwater measurements. Seismic interval velocities (n = 367) have been found to range between 1631.9 and 1696.8 m s-1 (95% confidence interval) and are estimated on average at 1664.4 m s-1, which is similar to the literature for unconsolidated marine sediments. The prediction map provided by the ordinary kriging method emphasized, however, a high variability of sound velocity within the study area. The results showed that changes in sound velocity in the matte are positively and strongly correlated with sand and gravel content and environmental factors such as distance to coastal river mouths and coastline. However, it was found that a negative relationship linked sound velocity with total and coarse organic content of matte deposits.

Deciphering organic matter sources and ecological shifts in blue carbon ecosystems based on molecular fingerprinting.

Blue carbon ecosystems (BCE) play an essential role in the global carbon cycle by removing atmospheric carbon dioxide and storing it as organic carbon (OC) in biomass and sediments. However, organic matter (OM) deposition and degradation/preservation processes are poorly understood, especially on the long-term and at molecular scales. We analysed sediment samples from six cores collected in tidal marshes, mangroves and seagrasses (up to 150 cm long cores spanning up to 10,000 yrs of OC accumulation) from Spencer Gulf (South Australia), by pyrolysis (Py-GC-MS and THM-GC-MS), and we compared the results with elemental and stable isotope data, to decipher OM provenance and to assess degradation/preservation dynamics. The results showed that: (1) the major biopolymers preserved were polysaccharides, polyphenolic moieties (lignin and tannin) and polymethylenic moieties (e.g. cutin, suberin, chlorophyll) with smaller apportions of proteins and resins; (2) the OM originates predominantly from vascular plant materials (in particular lignocellulose) that have been well-preserved, even in some of the oldest sediments; (3) mangroves were found to be the most efficient OC sinks, partially explained by syringyl lignin preservation; (4) seagrasses were shown to store polysaccharide-enriched OM; (5) large proportions of polycyclic aromatic hydrocarbons (PAHs) in surficial tidal marsh and mangrove sediments probably reflect pyrogenic OM from industrial combustion, and; (6) "ecosystem shifts", i.e. mangrove encroachment in tidal marsh and transition from seagrass to mangrove, were detected. Deposition environment and source vegetation control OC sequestration and there is no specific recalcitrant form of OM that is selectively preserved. For the first time, we demonstrate how analytical pyrolysis in combination with stable isotope analysis can be used to reconstruct (palaeo-)ecological shifts between different BCE. This study improves our knowledge on OC accumulation dynamics and the response of BCE to environmental change, which can inform the implementation of strategies for climate change mitigation.

Factors regulating primary producers' assemblages in Posidonia oceanica (L.) Delile ecosystems over the past 1800 years.

Posidonia oceanica (L.) Delile meadows are highly productive coastal marine ecosystems that provide multiple ecosystem services. The seagrass is not always the major contributor to total primary production, however, little is known about long-term changes in the composition of primary producers within seagrass meadows. Understanding compositional shifts within the community of primary producers is crucial to evaluate how climate and anthropogenic change affect the functioning of seagrass ecosystems. Here we analysed marker pigment composition in seagrass cores from two bays of the Cabrera Island (Balearic Islands, Spain) to asses long-term changes in phototrophic community composition and production in seagrass meadows, and identify the environmental factors triggering those changes. The proxy dataset was explored using principal component analyses (PCA): one including the pigment dataset to look for associations between producers' groups, and another one combining the pigment dataset with plausible local and global regulatory factors to assess the environmental drivers of change. Analyses of characteristic pigments and morphological fossils (cysts) showed that the abundance of dinoflagellates increased over the last 150-300 years, coeval with a rise in solar irradiance and air temperature. When compared among embayments, pigments from cyanobacteria predominated in seagrass meadows located at Es Port, a sheltered bay receiving higher terrestrial runoff; whereas pigments from diatoms, seagrasses and rodophytes were more common at Santa Maria, an exposed bay with clearer waters. Water depth also played a role in controlling the phototrophic community composition, with greater abundance of diatoms in the shallowest waters (<5 m). Overall, our results suggested that historical and spatial variation in seagrass meadows' phototrophic community composition was influenced by the interaction between local factors (catchment-bay characteristics) and global climate processes (energy influx). Together these patterns forecast how marine primary producers and seagrass ecosystem structure may respond to future global warming.

Australian vegetated coastal ecosystems as global hotspots for climate change mitigation.

Policies aiming to preserve vegetated coastal ecosystems (VCE; tidal marshes, mangroves and seagrasses) to mitigate greenhouse gas emissions require national assessments of blue carbon resources. Here, we present organic carbon (C) storage in VCE across Australian climate regions and estimate potential annual CO2 emission benefits of VCE conservation and restoration. Australia contributes 5-11% of the C stored in VCE globally (70-185 Tg C in aboveground biomass, and 1,055-1,540 Tg C in the upper 1 m of soils). Potential CO2 emissions from current VCE losses are estimated at 2.1-3.1 Tg CO2-e yr-1, increasing annual CO2 emissions from land use change in Australia by 12-21%. This assessment, the most comprehensive for any nation to-date, demonstrates the potential of conservation and restoration of VCE to underpin national policy development for reducing greenhouse gas emissions.

Microenvironment Eradication of Hepatitis C: A Novel Treatment Paradigm.

OBJECTIVES: Prisons are major reservoirs of hepatitis C virus (HCV) in which a therapeutic approach has been particularly difficult so far. Our aim was to create a permanent program of HCV elimination in a prison based on a "test and treat" strategy. METHODS: This open-label clinical trial was conducted in the Spanish prison "El Dueso" between May 2016 and July 2017. Viremic patients were treated with a ledipasvir-sofosbuvir regimen (8-12 weeks) according to the 2015 Spanish Guidelines. A teleconsultation program was established to follow-up patients from the hospital. Non-responders were submitted for a phylogenetic analysis and offered retreatment. An evaluation of new cases of HCV infection was performed every 6 months and upon release in all inmates. RESULTS: 847 (99.5%) inmates accepted to participate. HCV antibodies were present in 110 (13.0%) and 86 (10.2%) had detectable viremia. Most of them were genotype 1 or 3 (82.6%) and had