Microplastics and Nanoplastics in Atheromas and Cardiovascular Events.

BACKGROUND: Microplastics and nanoplastics (MNPs) are emerging as a potential risk factor for cardiovascular disease in preclinical studies. Direct evidence that this risk extends to humans is lacking. METHODS: We conducted a prospective, multicenter, observational study involving patients who were undergoing carotid endarterectomy for asymptomatic carotid artery disease. The excised carotid plaque specimens were analyzed for the presence of MNPs with the use of pyrolysis-gas chromatography-mass spectrometry, stable isotope analysis, and electron microscopy. Inflammatory biomarkers were assessed with enzyme-linked immunosorbent assay and immunohistochemical assay. The primary end point was a composite of myocardial infarction, stroke, or death from any cause among patients who had evidence of MNPs in plaque as compared with patients with plaque that showed no evidence of MNPs. RESULTS: A total of 304 patients were enrolled in the study, and 257 completed a mean (±SD) follow-up of 33.7±6.9 months. Polyethylene was detected in carotid artery plaque of 150 patients (58.4%), with a mean level of 21.7±24.5 µg per milligram of plaque; 31 patients (12.1%) also had measurable amounts of polyvinyl chloride, with a mean level of 5.2±2.4 µg per milligram of plaque. Electron microscopy revealed visible, jagged-edged foreign particles among plaque macrophages and scattered in the external debris. Radiographic examination showed that some of these particles included chlorine. Patients in whom MNPs were detected within the atheroma were at higher risk for a primary end-point event than those in whom these substances were not detected (hazard ratio, 4.53; 95% confidence interval, 2.00 to 10.27; P<0.001). CONCLUSIONS: In this study, patients with carotid artery plaque in which MNPs were detected had a higher risk of a composite of myocardial infarction, stroke, or death from any cause at 34 months of follow-up than those in whom MNPs were not detected. (Funded by Programmi di Ricerca Scientifica di Rilevante Interesse Nazionale and others; ClinicalTrials.gov number, NCT05900947.).

The challenge of managing the commercial harvesting of the sea urchin Paracentrotus lividus: advanced approaches are required.

Sea urchins act as a keystone herbivore in marine coastal ecosystems, regulating macrophyte density, which offers refuge for multiple species. In the Mediterranean Sea, both the sea urchin Paracentrotus lividus and fish preying on it are highly valuable target species for artisanal fisheries. As a consequence of the interactions between fish, sea urchins and macrophyte, fishing leads to trophic disorders with detrimental consequences for biodiversity and fisheries. In Sardinia (Western Mediterranean Sea), regulations for sea urchin harvesting have been in place since the mid 90s. However, given the important ecological role of P. lividus, the single-species fishery management may fail to take into account important ecosystem interactions. Hence, a deeper understanding of population dynamics, their dependance on environmental constraints and multispecies interactions may help to achieve long-term sustainable use of this resource. This work aims to highlight how sea urchin population structure varies spatially in relation to local environmental constraints and species interactions, with implications for their management. The study area (Sinis Peninsula, West Sardinia, Italy) that includes a Marine Reserve was divided into five sectors. These display combinations of the environmental constraints influencing sea urchin population dynamics, namely type of habitat (calcareous rock, granite, basalt, patchy and continuous meadows of Posidonia oceanica), average bottom current speed and predatory fish abundance. Size-frequency distribution of sea urchins under commercial size (<5 cm diameter size) assessed during the period from 2004 to 2007, before the population collapse in 2010, were compared for sectors and types of habitat. Specific correlations between recruits (0-1 cm diameter size) and bottom current speeds and between middle-sized sea urchins (2-5 cm diameter size) and predatory fish abundance were assessed. Parameters representing habitat spatial configuration (patch density, perimeter-to-area ratio, mean patch size, largest patch index, interspersion/juxtaposition index) were calculated and their influence on sea urchin density assessed. The density of sea urchins under commercial size was significantly higher in calcareous rock and was positively and significantly influenced by the density and average size of the rocky habitat patches. Recruits were significantly abundant in rocky habitats, while they were almost absent in P. oceanica meadows. The density of middle-sized sea urchins was more abundant in calcareous rock than in basalt, granite or P. oceanica. High densities of recruits resulted significantly correlated to low values of average bottom current speed, while a negative trend between the abundance of middle-sized sea urchins and predatory fish was found. Our results point out the need to account for the environmental constraints influencing local sea urchin density in fisheries management.

Management of Traumatology Patients During the Coronavirus (COVID-19) Pandemic: Experience in a Hub Trauma Hospital in Northern Italy.

BACKGROUND: As a result of the uncontrolled spread of the COVID-19 virus infection, a health reorganization according to the "hub and spoke" model was necessary. The purpose of the article was to document the adopted corporate protocol and describe the management of the traumatized patient in a Hub center. METHODS: Our hospital has been identified as one of the three regional Hubs for polytrauma and major traumas, requiring suitable pathways to receive confirmed or suspected COVID-19-positive patients, from the emergency room entrance to the operating room, and finally to the inpatient ward or ICU. From February 23th to April 30th 2020 we analyzed the total number of trauma patients hospitalized and the number of femoral neck fractures surgically treated within 48 h; the data were then compared with the corresponding period of the previous year. RESULTS: There has been a reduction in the overall number of traumas as a result of government restraint measures. Total occupancy time in the operating theater has increased, but not drastically considering dressing procedures and anesthesia (carried out inside the operating room). The number of patients with femoral neck fractures surgically treated within 48 h (none of the COVID-19-positive patients) decreased from 83.33 to 58.70%, but only slightly lower than the Italian pre-COVID average of 64.70%. CONCLUSIONS: The correct management of the hospital and the meticulous organization of the traumatized patient have made it possible to contain the potential negative effects on the medical care quality during this unexpected and severe health emergency.

Self-organisation in striped seagrass meadows affects the distributional pattern of the sessile bivalve Pinna nobilis.

Striped seagrass meadows are formed by narrow ribbons which are elevated over the seabed and separated by channels. Limited information on the genesis and development of this morphological pattern, including the adaptive responses of associated biota, is preventing holistic insight into the functioning of such protected ecosystems. This paper assessed the structural dynamics of a Posidonia oceanica striped meadow and the distribution and 3D orientation of the associated bivalve Pinna nobilis. Our analysis of the interaction between bedforms, bottom currents, and the distribution of P. nobilis revealed that the striped seascape is the result of a self-organisation process driven by feedback interactions among seagrass growth, sediment deposition, and hydrodynamics. The results suggest that the ribbon wall is the most suitable sub-habitat for this species, because it supports the highest density of P. nobilis, compared to the meadow top and bottom. Here, specimens can take advantage of the resuspension induced by hydrodynamics and open their shells towards the current, thus enhancing food intake. Therefore, our results show that self-organisation in striped seagrass meadow affects the distributional pattern of P. nobilis, providing new insights into the autoecology of this species beyond the conservation implications for its habitat.

Imaging of articular cartilage: current concepts.

Magnetic resonance imaging (MRI) is the gold standard method for non-invasive assessment of joint cartilage, providing information on the structure, morphology and molecular composition of this tissue. There are certain minimum requirements for a MRI study of cartilage tissue: machines with a high magnetic field (> 1.5 Tesla); the use of surface coils; and the use of T2-weighted, proton density-weighted fast-spin echo (T2 FSE-DP) and 3D fat-suppressed T1-weighted gradient echo (3D-FS T1W GRE) sequences. For better contrast between the different joint structures, MR arthography is a method that can highlight minimal fibrillation or fractures of the articular surface and allow evaluation of the integrity of the native cartilage-repair tissue interface. To assess the biochemical composition of cartilage and cartilage repair tissue, various techniques have been proposed for studying proteoglycans [dGEMRIC, T1rho mapping, sodium (23Na) imaging MRI, etc.], collagen, and water distribution [T2 mapping, "magnetisation transfer contrast", diffusion-weighted imaging (DWI), and so on]. Several MRI classifications have been proposed for evaluating the processes of joint degeneration (WORMS, BLOKS, ICRS) and post-surgical maturation of repair tissue (MOCART, 3D MOCART). In the future, isotropic 3D sequences set to improve image quality and facilitate the diagnosis of disorders of articular structures adjacent to cartilage.