Resilience of seagrass populations to thermal stress does not reflect regional differences in ocean climate.

The prevalence of local adaptation and phenotypic plasticity among populations is critical to accurately predicting when and where climate change impacts will occur. Currently, comparisons of thermal performance between populations are untested for most marine species or overlooked by models predicting the thermal sensitivity of species to extirpation. Here we compared the ecological response and recovery of seagrass populations (Posidonia oceanica) to thermal stress throughout a year-long translocation experiment across a 2800-km gradient in ocean climate. Transplants in central and warm-edge locations experienced temperatures > 29°C, representing thermal anomalies > 5°C above long-term maxima for cool-edge populations, 1.5°C for central and < 1°C for warm-edge populations. Cool-edge, central and warm-edge populations differed in thermal performance when grown under common conditions, but patterns contrasted with expectations based on thermal geography. Cool-edge populations did not differ from warm-edge populations under common conditions and performed significantly better than central populations in growth and survival. Our findings reveal that thermal performance does not necessarily reflect the thermal geography of a species. We demonstrate that warm-edge populations can be less sensitive to thermal stress than cooler, central populations suggesting that Mediterranean seagrasses have greater resilience to warming than current paradigms suggest.

A Spanish Intentional Mass-Casualty Incidents Medical Response Model: Delphi Consensus.

The increase in global violence in recent years has changed the paradigm of emergency health care, requiring early medical response to victims in hostile settings where the usual work cannot be done safely. In Spain, this specific role is provided by the Tactical Environment Medical Support Teams (in Spanish, EMAETs). The Victoria I Consensus document defines and recognizes this role, whose main lines of work are the emergency medical response to the tactical team and to the victims in areas under indirect threat, provided that the tactical operators can guarantee their safety. To reinforce the suitability of this approach, we submitted the possible outcomes of this response model to a panel of national experts to assess this proposal in the different areas of Spain. The chosen research design is a conventional Delphi method, based on the content of the Victoria I Consensus response model. The panel of 52 expert reviewers from 11 different regions were surveyed anonymously; a high degree of accord was recognized when the congruence of the responses exceeded 75%. Consensus agreement was reached in all sections of the survey after two iterations. Specific contributions and recommendations were made to achieve unanimous consensus despite the population and resource differences in the country. Our results suggest that the EMAET approach is useful in areas with short response times. However, in more sparsely populated areas, this may not be feasible, and a more pragmatic response model may be suitable.

Recent trend reversal for declining European seagrass meadows.

Seagrass meadows, key ecosystems supporting fisheries, carbon sequestration and coastal protection, are globally threatened. In Europe, loss and recovery of seagrasses are reported, but the changes in extent and density at the continental scale remain unclear. Here we collate assessments of changes from 1869 to 2016 and show that 1/3 of European seagrass area was lost due to disease, deteriorated water quality, and coastal development, with losses peaking in the 1970s and 1980s. Since then, loss rates slowed down for most of the species and fast-growing species recovered in some locations, making the net rate of change in seagrass area experience a reversal in the 2000s, while density metrics improved or remained stable in most sites. Our results demonstrate that decline is not the generalised state among seagrasses nowadays in Europe, in contrast with global assessments, and that deceleration and reversal of declining trends is possible, expectingly bringing back the services they provide.

Victory I Consensus Document: Proposal for the Implementation of the Hartford Doctrine in the Spanish Context.

Several international recommendations advise adapting military healthcare response models to intentional mass casualty incidents (IMCIs) in civil environments. The IMCI experience and associated published research from the United States, where these situations are frequent and properly analyzed more often, are, unfortunately, not directly applicable to the Spanish model of emergency medical services (EMS), where each autonomous region has its own competencies and protocols. However, there is a series of common elements that served as a reference for the development of an effective, evidence- based, IMCI consensus response plan called Victoria I. In this plan, we have tried to define each intervening role during an IMCI, from the occasional first responder to the final hospital staff at the reference trauma centers. We believe that each professional role in this response chain, on and off the scene, must have a clear mission and function to improve victim survival.

A GIS-based tool for an integrated assessment of spatial planning trade-offs with aquaculture.

The increasing demand for protein from aquaculture will trigger a global expansion of the sector in coastal and offshore waters. While contributing to food security, potential conflicts with other traditional activities such as fisheries or tourism are inevitable, thus calling for decision-support tools to assess aquaculture planning scenarios in a multi-use context. Here we introduce the AquaSpace tool, one of the first Geographic Information System (GIS)-based planning tools empowering an integrated assessment and mapping of 30 indicators reflecting economic, environmental, inter-sectorial and socio-cultural risks and opportunities for proposed aquaculture systems in a marine environment. A bottom-up process consulting more than 350 stakeholders from 10 countries across southern and northern Europe enabled the direct consideration of stakeholder needs when developing the GIS AddIn. The AquaSpace tool is an open source product and builds in the prospective use of open source datasets at a European scale, hence aiming to improve reproducibility and collaboration in aquaculture science and research. Tool outputs comprise detailed reports and graphics allowing key stakeholders such as planners or licensing authorities to evaluate and communicate alternative planning scenarios and to take more informed decisions. With the help of the German North Sea case study we demonstrate here the tool application at multiple spatial scales with different aquaculture systems and under a range of space-related development constraints. The computation of these aquaculture planning scenarios and the assessment of their trade-offs showed that it is entirely possible to identify aquaculture sites, that correspondent to multifarious potential challenges, for instance by a low conflict potential, a low risk of disease spread, a comparable high economic profit and a low impact on touristic attractions. We believe that a transparent visualisation of risks and opportunities of aquaculture planning scenarios helps an effective Marine Spatial Planning (MSP) process, supports the licensing process and simplifies investments.

Thermal tolerance of Mediterranean marine macrophytes: Vulnerability to global warming.

The Mediterranean Sea is warming at three times the rate of the global ocean raising concerns about the vulnerability of marine organisms to climate change. Macrophytes play a key role in coastal ecosystems, therefore predicting how warming will affect these key species is critical to understand the effects of climate change on Mediterranean coastal ecosystems. We measured the physiological performance of six dominant native Mediterranean macrophytes under ten temperature treatments ranging from 12 to 34°C to examine their thermal niche, and vulnerability to projected warming in the western Mediterranean up until 2100. Among the macrophytes tested, Cymodocea nodosa was the species with the highest thermal optima and it was beyond current summer temperature. Therefore, C. nodosa may benefit from projected warming over the coming century. The optimal temperature for growth of the other species (Posidonia oceanica, Cystoseira compressa, Padina pavonica, Caulerpa prolifera, and Halimeda tuna) was lower. Similarly, the species presented different upper lethal limits, spanning at least across 5.1°C between 28.9°C (P. oceanica) and >34°C (C. nodosa). Our results demonstrate the variable physiological responses of species within the same local community to temperature changes and highlight important potential differences in climate change vulnerability, among species within coastal marine ecosystems.

Using seagrasses to identify local and large-scale trends of metals in the Mediterranean Sea.

To manage trace metal pollution it is critical to determine how much temporal trends can be attributed to local or large-scale sources. We tracked changes in metal content in the seagrass Posidonia oceanica, along the NW Mediterranean from 2003 to 2010. While Cu, Cd and Ni showed a large inter-site variation, likely due to local factors, Fe, Mn and Pb showed little local variation and synchronous interannual variability across sites, most likely due to large-scale sources. Zn showed equal importance of local and large-scale sources of variation. Temporal trends of Ni, Zn, Cd, Cu remained almost stable. In contrast, Fe, Mn and Pb slightly increased in the last decade. These trends suggest that metals like Cu, Cd, Ni can be effectively managed at local scale. Whereas, elements like Fe, Mn and Pb have an important large-scale component that needs to be managed across the frontiers of national jurisdictions.

Estudio comparativo preliminar entre la Puntuación Motora Simplificada modificada y la Escala de Coma de Glasgow en pacientes adultos atendidos por traumatismo craneoencefálico en el ámbito extrahospitalario / Spanish versions of the Simplified Motor Score and the Glasgow Coma Scale in out-of-hospital treatment of head injury in adults: a preliminary study of each scale’s ability to predict adverse events

Objetivo: Determinar la capacidad predictiva de resultados adversos durante la hospitalización de la escala Simplified Motor Score (SMS) adaptada al español (Puntuación Motora Simplificada modificada, PMSm), y compararla con la Escala del Coma de Glasgow (ECG) en los pacientes adultos atendidos por traumatismo craneoencefálico en el ámbito extrahospitalario. Metodología: Estudio observacional de cohortes retrospectivo que incluyó a todo paciente mayor de 14 años atendido por un traumatismo craneoencefálico de menos de 24 horas de evolución en una unidad de soporte vital avanzado con enfermería entre el 1 de mayo de 2013 y el 1 de mayo de 2014. Se realizó una traducción directa-inversa de la SMS por consenso formal obteniendo la PMSm. Se recogieron a partir de las historias clínicas de la atención extrahospitalaria los datos de la ECG desglosada y la PMSm. Se calculó el área bajo la curva (ABC) COR de la PMSm y la ECG para la predicción de lesión cerebral, necesidad de intervención neuroquirúrgica y/o de intubación y mortalidad durante la hospitalización. Resultados: Del total de 115, se incluyeron finalmente 64 pacientes con una edad media de 47 (DE 24) años. Doce pacientes (18,8%) presentaron algún resultado adverso (91,6% lesión cerebral, 58,3% necesidad de intubación, 8,3% necesidad de intervención quirúrgica y 41,6% fallecieron) durante la hospitalización. El ABC COR de la puntuación ECG fue 0,907 (IC 95%: 0,81-1,00; p < 0,001) y de la PMSm fue 0,796 (IC 95%: 0,64-0,95; p = 0,001). Conclusiones: La capacidad predictiva de resultados adversos durante la hospitalización de la PMSm es buena pero inferior a la ECG en los pacientes adultos atendidos por traumatismo craneoencefálico en el ámbito extrahospitalario (AU)

Objectives: To determine the ability of the modified (Spanish) version of the Simplified Motor Score (mSMS) to predict adverse events during hospitalization and to compare its predictive ability to that of the Glasgow Coma Scale (GCS) in adults with head injuries treated outside the hospital. Methods: Observational study of retrospective cohorts including all patients over the age of 14 years attended for head injuries occurring within 24 hours of treatment by an advanced life-support unit staffed by nurses between May 1, 2013, and May 1, 2014. The mSMS was a translation of the English original, created through a process of discussions of direct and back translations to arrive at consensus. Out-of-hospital patient records were searched to find GCS and mSMS scores. To predict the ability of each scale to predict brain injuries, neurosurgery, intubation, and/or inhospital death, we calculated the area under the receiving operator characteristic curves (AUCs). Results: Of the total of 115 head-injury patients attended, 64 met the inclusion criteria. The mean (SD) age was 47 (24) years. Twelve (18.8%) patients developed some form of adverse event during hospitalization; 91.6% had brain damage, 58.3% required intubation, 8.3% required surgery, and 41.6% died. The AUC for the GCS was 0.907 (95% CI, 0.81–1.00; P<.001); the AUC for the mSMS was 0.796 (95% CI, 0.64–0.95; P=.001). Conclusions: Although the ability of the mSMS to predict in-hospital adverse outcomes is good, it is inferior to the GCS in adults with head injuries attended outside the hospital (AU)

[Spanish versions of the Simplified Motor Score and the Glasgow Coma Scale in out-of-hospital treatment of head injury in adults: a preliminary study of each scale's ability to predict adverse events]. / Estudio comparativo preliminar entre la Puntuación Motora Simplificada modificada y la Escala de Coma de Glasgow en pacientes adultos atendidos por traumatismo craneoencefálico en el ámbito extrahospitalario.

OBJECTIVES: To determine the ability of the modified (Spanish) version of the Simplified Motor Score (mSMS) to predict adverse events during hospitalization and to compare its predictive ability to that of the Glasgow Coma Scale (GCS) in adults with head injuries treated outside the hospital. MATERIAL AND METHODS: Observational study of retrospective cohorts including all patients over the age of 14 years attended for head injuries occurring within 24 hours of treatment by an advanced life-support unit staffed by nurses between May 1, 2013, and May 1, 2014. The mSMS was a translation of the English original, created through a process of discussions of direct and back translations to arrive at consensus. Out-of-hospital patient records were searched to find GCS and mSMS scores. To predict the ability of each scale to predict brain injuries, neurosurgery, intubation, and/or inhospital death, we calculated the area under the receiving operator characteristic curves (AUCs). RESULTS: Of the total of 115 head-injury patients attended, 64 met the inclusion criteria. The mean (SD) age was 47 (24) years. Twelve (18.8%) patients developed some form of adverse event during hospitalization; 91.6% had brain damage, 58.3% required intubation, 8.3% required surgery, and 41.6% died. The AUC for the GCS was 0.907 (95% CI, 0.81-1.00; P<.001); the AUC for the mSMS was 0.796 (95% CI, 0.64-0.95; P=.001). CONCLUSION: Although the ability of the mSMS to predict in-hospital adverse outcomes is good, it is inferior to the GCS in adults with head injuries attended outside the hospital.

OBJETIVO: Determinar la capacidad predictiva de resultados adversos durante la hospitalización de la escala Simplified Motor Score (SMS) adaptada al español (Puntuación Motora Simplificada modificada, PMSm), y compararla con la Escala del Coma de Glasgow (ECG) en los pacientes adultos atendidos por traumatismo craneoencefálico en el ámbito extrahospitalario. METODO: Estudio observacional de cohortes retrospectivo que incluyó a todo paciente mayor de 14 años atendido por un traumatismo craneoencefálico de menos de 24 horas de evolución en una unidad de soporte vital avanzado con enfermería entre el 1 de mayo de 2013 y el 1 de mayo de 2014. Se realizó una traducción directa-inversa de la SMS por consenso formal obteniendo la PMSm. Se recogieron a partir de las historias clínicas de la atención extrahospitalaria los datos de la ECG desglosada y la PMSm. Se calculó el área bajo la curva (ABC) COR de la PMSm y la ECG para la predicción de lesión cerebral, necesidad de intervención neuroquirúrgica y/o de intubación y mortalidad durante la hospitalización. RESULTADOS: Del total de 115, se incluyeron finalmente 64 pacientes con una edad media de 47 (DE 24) años. Doce pacientes (18,8%) presentaron algún resultado adverso (91,6% lesión cerebral, 58,3% necesidad de intubación, 8,3% necesidad de intervención quirúrgica y 41,6% fallecieron) durante la hospitalización. El ABC COR de la puntuación ECG fue 0,907 (IC 95%: 0,81-1,00; p < 0,001) y de la PMSm fue 0,796 (IC 95%: 0,64-0,95; p = 0,001). CONCLUSIONES: La capacidad predictiva de resultados adversos durante la hospitalización de la PMSm es buena pero inferior a la ECG en los pacientes adultos atendidos por traumatismo craneoencefálico en el ámbito extrahospitalario.

Habitat and scale shape the demographic fate of the keystone sea urchin Paracentrotus lividus in Mediterranean macrophyte communities.

Demographic processes exert different degrees of control as individuals grow, and in species that span several habitats and spatial scales, this can influence our ability to predict their population at a particular life-history stage given the previous life stage. In particular, when keystone species are involved, this relative coupling between demographic stages can have significant implications for the functioning of ecosystems. We examined benthic and pelagic abundances of the sea urchin Paracentrotus lividus in order to: 1) understand the main life-history bottlenecks by observing the degree of coupling between demographic stages; and 2) explore the processes driving these linkages. P. lividus is the dominant invertebrate herbivore in the Mediterranean Sea, and has been repeatedly observed to overgraze shallow beds of the seagrass Posidonia oceanica and rocky macroalgal communities. We used a hierarchical sampling design at different spatial scales (100 s, 10 s and <1 km) and habitats (seagrass and rocky macroalgae) to describe the spatial patterns in the abundance of different demographic stages (larvae, settlers, recruits and adults). Our results indicate that large-scale factors (potentially currents, nutrients, temperature, etc.) determine larval availability and settlement in the pelagic stages of urchin life history. In rocky macroalgal habitats, benthic processes (like predation) acting at large or medium scales drive adult abundances. In contrast, adult numbers in seagrass meadows are most likely influenced by factors like local migration (from adjoining rocky habitats) functioning at much smaller scales. The complexity of spatial and habitat-dependent processes shaping urchin populations demands a multiplicity of approaches when addressing habitat conservation actions, yet such actions are currently mostly aimed at managing predation processes and fish numbers. We argue that a more holistic ecosystem management also needs to incorporate the landscape and habitat-quality level processes (eutrophication, fragmentation, etc.) that together regulate the populations of this keystone herbivore.

Ecological status of seagrass ecosystems: An uncertainty analysis of the meadow classification based on the Posidonia oceanica multivariate index (POMI).

Quantifying the uncertainty associated with monitoring protocols is essential to prevent the misclassification of ecological status and to improve sampling design. We assessed the Posidonia oceanica multivariate index (POMI) bio-monitoring program for its robustness in classifying the ecological status of coastal waters within the Water Framework Directive. We used a 7-year data set covering 30 sites along 500 km of the Catalonian coastline to examine which version of POMI (14 or 9 metrics) maximises precision in classifying the ecological status of meadows. Five factors (zones within a site, sites within a water body, depth, years and surveyors) that potentially generate classification uncertainty were examined in detail. Of these, depth was a major source of uncertainty, while all the remaining spatial and temporal factors displayed low variability. POMI 9 matched POMI 14 in all factors, and could effectively replace it in future monitoring programs.