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IntroductionGeneralized immunization against COVID19 has become the cornerstone in prevention of severe acute respiratory syndrome associated with this pandemic. Maintenance dialysis patients (MDP) are at higher risk of both exposure and mortality from the disease. Efficacy and security of BNT162b2 vaccine is well documented for the general population, but not in MDP, particularly in peritoneal dialysis (PD) patients. This study aims to compare humoral response between hemodialysis (HD) and PD patients.Materials and MethodsObservational prospective study including MDP on HD or PD program from a Portuguese middle-sized Nephrology Center, who received BNT162b2 vaccine. Specific anti-Spike IgG was measured as arbitrary units per milliliter (AU/mL) on two separate occasions: 3 weeks after the first dose and 3 weeks after the second. The two modality groups were compared both for absolute value and number of non-responders (NR) after both inoculations. Demographic data was also compared.ResultsOf 73 patients enrolled, 67 were eligible for the final study: 42 HD and 25 PD patients. PD group developed significantly higher antibody titers in both inoculations: first dose with Med 5.44 vs 0.99 (pConclusionThis study demonstrated a better humoral response to immunization with BNT162b2 in PD patients, when compared to HD patients, after each of the two recommended inoculations. Both groups showed substantial humoral response after just one dose of the vaccine. Older age and higher comorbidity burden may explain the relative immunogenicity deficit, probably in a superior degree comparing with age matched healthy population.What is already known about this subjectMaintenance hemodialysis patients have lower humoral response to BNT162b2 mRNA COVID19 vaccine when compared to the general population;Maintenance dialysis patients are at high risk of exposure to COVID19 in addition to a more severe course of the disease;What this study addsMaintenance peritoneal dialysis patients have better humoral response with BNT162b2 when compared to those on hemodialysis;There is a substantial humoral response after a single dose of the vaccine for both hemodialysis (50%) and peritoneal dialysis (88%) patients.What impact this may have on clinical practice or policyProtocols for follow-up measures, including extra inoculations, might have to be considered for hemodialysis patients;Peritoneal dialysis patients should be promptly immunized in all centers, rejecting constraints regarding lower effectiveness or yield.

Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy (TMA) affecting the kidneys. Compared with typical HUS due to an infection from shiga toxin-producing Escherichia coli, atypical HUS involves a genetic or acquired dysregulation of the complement alternative pathway. In the presence of a mutation in a complement gene, a second trigger is often necessary for the development of the disease. We report a case of a 54-year-old female, with a past medical history of pulmonary tuberculosis, who was admitted to the emergency service with general malaise and reduction in urine output, 5 days after vaccination with ChAdOx1 nCoV-19. Laboratory results revealed microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Given the clinical picture of TMA, plasma exchange (PEX) was immediately started, along with hemodialysis. Complementary laboratory workup for TMA excluded thrombotic thrombocytopenic purpura and secondary causes. Complement study revealed normal levels of factors H, B, and I, normal activity of the alternate pathway, and absence of anti-factor H antibodies. Genetic study of complement did not show pathogenic variants in the 12 genes analyzed, but revealed a deletion in gene CFHR3/CFHR1 in homozygosity. Our patient completed 10 sessions of PEX, followed by eculizumab, with both clinical and laboratorial improvement. Actually, given the short time lapse between vaccination with ChAdOx1 nCoV-19 and the clinical manifestations, we believe that vaccine was the trigger for the presentation of aHUS in this particular case.

SUMMARY Churg–Strauss syndrome, Eosinophilic granulomatosis with polyangiitis (EGPA), is a systemic vasculitis that affects small– to medium-sized vessels. It is rare and part of the Anti-neutrophil cytoplasm antibody-associated vasculitis (ANCA) group. We present a 37-year-old man, with a previous history of asthma, that was sent to the ED due to 2 weeks of productive cough, occasional dyspnea on exertion, fever (one week), asthenia, and anorexia. Upon physical examination, he was subfebrile and tachycardic. He had leukocytosis (17.00 x10^9/L) and eosinophilia of 20.0 % (3.4 X10^9/L), creatinine level of 1.5 mg/dL, subtle elevation on liver function tests and CRP of 10.82mg/dL. On Chest X-Ray, there was infiltrate on the right pulmonary base. Due to a strong suspicion of EGPA, he was started on 80mg of prednisolone from admission. ANCA MPO was positive, with the remaining auto-immune study negative. He underwent Thorax CT (under corticotherapy) without relevant changes, as well as bronchoalveolar lavage, without macroscopic signs of alveolar hemorrhage. Because of active urinary sediment, nephrotic proteinuria (6.5g/24h), and acute renal failure he underwent a renal biopsy, which revealed pauci-immune crescentic glomerulonephritis, with predominantly acute findings (in the context of ANCA-MPO Vasculitis – EGPA). After the biopsy, he received three 1g methylprednisolone pulses and was started on Cyclophosphamide. He remained asymptomatic and renal function was restored. This case highlights the importance of integrating all findings in one clinical scenario to prevent a more complex disease diagnosis, with a specific treatment, from being missed.

BACKGROUND AND AIMS Living donor kidney transplantation (LDKT) provides the best outcomes of all renal replacement modalities, including survival and quality of life. Studies on the association between pre-donation estimated glomerular filtration rate (eGFR) and graft outcomes have yielded inconsistent results. Two eGFR thresholds are generally used to accept or deny a donor (respectively, ≥90 and METHOD This is a unicentric retrospective observational study that included the LDKT pairs submitted to transplant between 2008 and 2017. We gathered clinical data, including donor's comorbidities, immunological features of the transplant, the occurrence of acute rejection episodes in the first year, and graft eGFR during the follow-up period. For statistical purposes, we split the donors in three groups: group 1, with eGFR ≥90 mL/min/1.73 m2; group 2, eGFR RESULTS We studied 210 donor-recipient pairs. The average age at the time of transplant was 48.0 ± 10.6 years for donors and 41.3 ± 13.3 years for recipients. Pre-donation eGFR was 100.1 ± 14.2 mL/min/1.73 m2 and most donors (78%) were in group 1 (eGFR 105.9 ± 9.4 mL/min/1.73 m2). We found two independent predictors of death censored graft failure: the occurrence of rejection episode(s) during the first year (HR: 4.99, CI: 1.44–17.26, P = 0.011) and having a donor from group 3 (HR: 5.14, CI: 1.49–17.75, P 0% (HR: 3.802, CI: 1.387–10.489, P = 0.010) and donor from group 3 (HR: 3.514, CI: 1.087–11.355, P = 0.036). At 1-year after transplant, the recipients from group 1 had a significantly higher eGFR than patients from group 2, but did not differ from group 3 (respectively, 60.8 versus 54.4 [P CONCLUSION This study suggests that in LDKT, when donors’ eGFR is borderline (

BACKGROUND AND AIMS Kidney transplantation (KT) improves survival and quality of life of patients with end-stage renal disease. However, there is still an unbalance between supply and demand for kidneys. To increase the number of available grafts and reduce the waiting list for transplantation, recruitment of older living donors has expanded. This approach remains controversial for several reasons, including the impact of kidney function decline on long-term graft and recipient survival. We aimed to evaluate the impact of living donor (LD) age on recipient graft survival and on graft function decline over time. METHOD This is a Unicenter retrospective observational study that included kidney transplants of LD between 2008 and 2017. Several clinical data were analyzed, including donors’ comorbidities, immunological features of the transplant, induction immunosuppression, number of acute rejections (AR) at the first year, and the graft glomerular filtration rate (eGFR) during the follow-up period. The eGFR was calculated using the CKD-EPI equation. The LDs were classified as young ( The Kaplan–Meier curves and Cox proportional hazards multivariable regression were used for survival analysis and linear mixed regression was used to evaluate the annual slope of recipient eGFR, comparing both groups. RESULTS We observed 210 LD kidney transplants: 86% (n = 181) from young (D The censored recipient graft survival was similar for D Linear mixed regression showed that recipient eGFR from D ≥60 was lower than D CONCLUSION Although the greater eGFR graft decline in the first 12 months and beyond, we demonstrated that kidneys from older living donors did not significantly compromise the censored recipient graft survival. We did not evaluate the age match between donor and recipient, as has been done in other studies, but even so, these results support the importance of increasingly encouraging KT from older living donors. It can improve the quality of life, compared to the time on dialysis and, especially for old candidates, can be the only chance to get transplanted.

BACKGROUND AND AIMS Living donor kidney transplantation (LDKT) is the best treatment for end-stage kidney disease and is associated with better recipient outcomes than deceased donor transplantation. Living kidney donors (LKD), however, seem to be at increased risk of chronic kidney disease (CKD), which mandates a careful selection to reduce the chances of selecting a donor at risk of developing CKD. A predictive model to estimate the 1-year post-donation estimated glomerular filtration rate (eGFR) and risk of CKD was developed from a Toulouse-Rangueil cohort in 2017 [1] and has been shown to have significant correlation to the observed 1-year post-donation eGFR [2]. We aimed to externally validate this predictive tool in a cohort of patients who underwent LDKT at our center. METHOD Retrospective analysis of the 210 LKD at Centro Hospitalar Universitário do Porto from 2008 to 2017. Observed eGFR using CKD-EPI formula at 1-year post-donation was compared with the predicted eGFR using the formula developed in Toulouse-Rangueil. This predictive model is based in pre-donation eGFR and age: Postoperative eGFR (CKD-EPI, mL/min/1.73m2) = 31.71 ± (0.521 × preoperative eGFR)—(0.314 × age). Pearson correlation coefficient was used to estimate correlation between predicted and observed eGFR. Agreement was evaluated by the Bland-Altman plot. Discriminative ability to predict CKD (defined as eGFR RESULTS From 2008 to 2017, 210 LDKT were performed. Six donors were excluded from the study for lacking evaluation of eGFR at 1-year. Mean donor age was 48.1 ± 10.5. Mean pre-donation eGFR was 100.2 ± 14.1 mL/min/1.73 m2. Mean 1-year post-donation observed and predicted eGFR were respectively 70.8 ± 14.5 mL/min/1.73 m2 and 68.8 ± 9.6 mL/min/1.73 m2. Significant correlation (Pearson r = 0.66; P CONCLUSION In this external validation of the formula developed in Toulouse-Rangueil, we found it to have a good correlation, agreement and accuracy for the prediction of the donors 1-year post-donation eGFR. Moreover, a good discriminative ability was also observed with significant sensitivity and specificity, allowing for a pertinent prediction of CKD. This model may be used to assist in the evaluation of potential donors.

BACKGROUND AND AIMS Serum intact parathyroid hormone (iPTH) is associated with the prognosis of haemodialysis (HD) patients; however, its optimal range for reducing mortality remains unknown. The aim of this study was to assess the association between different serum iPTH levels and mortality in incident HD patients. METHOD We conducted a retrospective single-centre study of incident HD patients between January 2013 and 2020. According to the iPTH level measured at baseline, patients were categorized into four groups: 600 pg/mL. Clinical, analytical and demographic data were compared among groups. All-cause mortality over a mean follow-up of 3.2 years was assessed using standard survival methods. Statistical analysis was performed using SPSS (Version 23 for Mac OSX). RESULTS The mean age of 149 patients was 74.14 ± 14.17 years, 95 (63.8%) were male, 75 (50.3%) were diabetic, 85 (57%) had congestive heart failure (CHF) and 110 (73.9%) had hypertension. A total of 46 patients (30.9%) were treated with vitamin D analogues, 2 (1.3%) with calcimimetics and 25 (16.8%) with oral phosphate binders. A total of 57 (38.3%) patients had iPTH 600 pg/mL. There were no age, gender, comorbidity or HD modality differences among groups. Patients with iPTH 600 pg/mL [HR: 0.36, 95% CI 0.19–0.70; P = .02] in both unadjusted and adjusted models for age, albumin, diabetes, CHF and hypertension. No significant difference was found between iPTH 600 pg/mL, patients in this group had a decreased mortality risk when compared with those with iPTH CONCLUSION In our study, the baseline iPTH level was associated with all-cause mortality in incident HD patients. Our results suggest that the optimal serum iPTH level conferring the lowest mortality risk is > 300 pg/mL in this group of patients.

Lanthanum (La) is one of the most abundant emergent rare earth elements. Its release into the environment is enhanced by its use in various industrial applications. In the aquatic environment, emerging contaminants are one of the stressors with the ability to compromise the fitness of its inhabitants. Warming and acidification can also affect their resilience and are another consequence of the growing human footprint on the planet. However, from information gathered in the literature, a study on the effects of ocean warming, acidification, and their interaction with La was never carried out. To diminish this gap of knowledge, we explored the effects, combined and as single stressors, of ocean warming, acidification, and La (15 μg L

Studies dealing with Rare Earth Elements (REE) ecotoxicological behavior are scattered and with potential conflicting results. Climate change impacts on aquatic biota and is known to modify contaminants toxicokinetic. Nevertheless, the current knowledge on the potential interactions between climate change and REE is virtually non-existent. Therefore, we focus our research on La and Gd as representatives of Light and Heavy REE that also are of great environmental concern. Experiments on different mediums (fresh-, brackish- and seawater) were designed to run at present-day and near-future conditions (T°=+4 °C, pH=△-0.4). Sampling was taken at different time scales from minutes to hours for one day. The main challenge was to evaluate the availability of La and Gd under environmental conditions closely related to climate changes scenarios. Furthermore, this study will contribute to the baseline knowledge by which future research towards understanding REE patterns and toxicity will build upon. Lanthanum and Gd behave differently with salinity. Temperature also affects the availability of dissolved La in freshwater. On the other hand, pH reduction causes the decrease of Gd in freshwater. In this medium, concentrations reduce sharply, presumably due to sorption processes or precipitates. In the brackish water experiment only the dissolved La levels in the Warming (T°=+4 °C) and WarmingAcidification (T°=+4 °C, pH=△0.4) diminished significantly through time. Dissolved La and Gd levels in seawater were relatively constant with time. The speciation of both elements is also of great relevance for ecotoxicological experiments. The trivalent free ions (La

GCA is not always a linear diagnosis. Rarely reported as a paraneoplastic condition when associated with solid tumors, the available cases are associated with poor response to corticosteroids.

Funding Information: This work was supported by Fundação para a Ciência e Tecnologia (FCT) , through the project Climatoxeel ( PTDC/AAG-GLO/3795/2014 ), by the Junior Researcher contract ( CEECIND/03517/2017 ), both awarded to Tiago F. Grilo, and the strategic project UIDB/04292/2020 granted to MARE and through project LA/P/0069/2020 granted to the Associate Laboratory ARNET . The work was also supported by the European Union's operation program Mar 2020 through the research project CEIC ( MAR-01.04.02-FEAMP-0012 ) awarded to Joana Raimundo. The Applied Molecular Biosciences Unit UCIBIO was financed by national funds from FCT ( UIDP/04378/2020 ). This work was also supported by the European Union through the grant ERC-2016-COG-725034 -ecotox awarded to Inês João Ferreira. Cátia Figueiredo acknowledges the FCT-PhD grant SFRH/BD/130023/2017 and the Early Career Research Grant awarded by National Geographic Society. Publisher Copyright: © 2022 The Author(s) Humans have exhaustively combusted fossil fuels, and released pollutants into the environment, at continuously faster rates resulting in global average temperature increase and seawater pH decrease. Climate change is forecasted to exacerbate the effects of pollutants such as the emergent rare earth elements. Therefore, the objective of this study was to assess the combined effects of rising temperature (Δ = + 4 °C) and decreasing pH (Δ = − 0.4 pH units) on the bioaccumulation and elimination of gadolinium (Gd) in the bioindicator bivalve species Spisula solida (Surf clam). We exposed surf clams to 10 µg L−1 of GdCl3 for seven days, under warming, acidification, and their combination, followed by a depuration phase lasting for another 7 days and investigated the Gd bioaccumulation and oxidative stress-related responses after 1, 3 and 7 days of exposure and the elimination phase. Gadolinium accumulated after just one day with values reaching the highest after 7 days. Gadolinium was not eliminated after 7 days, and elimination is further hampered under climate change scenarios. Warming and acidification, and their interaction did not significantly impact Gd concentration. However, there was a significant interaction on clam's biochemical response. The augmented total antioxidant capacity and lipid peroxidation values show that the significant impacts of Gd on the oxidative stress response are enhanced under warming while the increased superoxide dismutase and catalase values demonstrate the combined impact of Gd, warming & acidification. Ultimately, lipid damage was greater in clams exposed to warming & Gd, which emphasizes the enhanced toxic effects of Gd in a changing ocean. publishersversion published

Funder: Royal Society Wolfson Merit Award, Smart textiles consist of discrete devices fabricated from-or incorporated onto-fibres. Despite the tremendous progress in smart textiles for lighting/display applications, a large scale approach for a smart display system with integrated multifunctional devices in traditional textile platforms has yet to be demonstrated. Here we report the realisation of a fully operational 46-inch smart textile lighting/display system consisting of RGB fibrous LEDs coupled with multifunctional fibre devices that are capable of wireless power transmission, touch sensing, photodetection, environmental/biosignal monitoring, and energy storage. The smart textile display system exhibits full freedom of form factors, including flexibility, bendability, and rollability as a vivid RGB lighting/grey-level-controlled full colour display apparatus with embedded fibre devices that are configured to provide external stimuli detection. Our systematic design and integration strategies are transformational and provide the foundation for realising highly functional smart lighting/display textiles over large area for revolutionary applications on smart homes and internet of things (IoT)., EU H2020, 1D-NEON, Grant agreement ID:685758 EPSRC, EP/P027628/1

IntroductionMaintenance Hemodialysis (HD) patients are at higher risk of both infection and mortality associated with the new coronavirus 2. Immunization through large-scale vaccination is the cornerstone of infection prevention in this population. This study aims to identify risk factors for low response to the BNT-162b2 (Pfizer BioNTech) vaccine in a HD cohort.Materials and MethodsObservational prospective study of a HD group followed in a Portuguese Public Founded Hemodialysis Center who received BNT-162b2 vaccination. Specific anti-Spike IgG was evaluated as arbitrary units per milliliter (AU/mL) on two separate occasions: 3 weeks after the first dose and 3 weeks after the second. IgG titers, Non-Responders (NR), and Weak-Responders (WR) after each dose were evaluated against risk factors that included demographic, clinical and analytical variables.ResultsHumoral response evaluated by IgG anti-Spike levels showed a strong correlation with Charlson comorbidity index (CCI) and intact parathormone (iPTH) after each inoculation (1st dose: ρ=−0.64/0.54; 2nd dose: ρ=−0.66/0.63, respectively; pnd dose with OR (95% CI): 1.81 (1.06-3.08); 0.05 (0.01-0.65); 13.55 (1.06-174.18), respectively (p=0.01).ConclusionOlder age, higher CCI, lower iPTH and albumin, CVC as vascular access and recent hemodialysis initiation (less than 2 years) associate with lower response to vaccination in our study. A higher comorbidity burden is suggested as a more significant surrogate marker for low immunogenicity rather than age alone. Identifying HD patients as a population at high-risk for low response to vaccination is essential for proper policy-making, facilitating the implementation of adequate and individualized contingency protocols.What is already known about this subjectMaintenance hemodialysis patients have lower humoral response to BNT-162b2 COVID-19 vaccine when compared to the general population.Maintenance dialysis patients are at high risk of exposure to coronavirus 2 in addition to a more severe disease course.What this study addsWe suggest Charlson commorbidity index, older age, intact parathormone, central venous catheter as vascular access and lower dialysis vintage as possible surrogate markers of immunogenicity in HD patients.There is a low humoral response after a single dose of the vaccine (50%) that can be increased after the second (86%).What impact this may have on practice or policyStrict Protocols for follow-up measures in HD patients, including closer humoral titers assessment, risk stratification, adequate isolation, and surveillance of symptoms might be necessary in order to improve this population survival/life expectancy.Screening HD patients, seroconversion rates may be improved by giving extra inoculations for patients at risk for low response.

SUMMARY INTRODUCTION: Nephrogenic diabetes insipidus (DI) is a polyuric and polydipsic syndrome and can have multiple causing factors. CASE DESCRIPTION: A 69-year-old woman with bipolar disorder medicated with lithium 400mg for 12 years on a daily basis. The patient was admitted, after psychiatric decompensation, with hypernatremia unresponsive to hypotonic iv fluids. The diagnosis of DI was made with high plasmatic osmolality measurement, low urine osmolality, and high levels of antidiuretic hormone. Full clinical recovery was possible with lithium suspension, hydration, and chlorthalidone. DISCUSSION: Although frequently used in the past, Lithium (Li) is nowadays rarely used in clinical practice for prolonged treatments because of its potentially devastating side effects. Clinicians must be aware of those side effects in order to prevent organ damage, mainly in patients with severe bipolar disease and precarious response to alternative treatments. RESUMO INTRODUÇÃO: O diabetes insípido nefrogênico faz parte das síndromes poliúricas polidipsicas e pode ter múltiplos fatores causais. CASO CLÍNICO: Mulher de 69 anos, com doença bipolar medicada com lítio 400 mg por dia durante 12 anos. A doente foi internada, após descompensação da doença bipolar, por hipernatremia não responsiva a fluidoterapia hipotônica endovenosa. O diagnóstico de DI foi realizado com base na elevação da osmolaridade plasmática, baixa osmolaridade urinária e níveis elevados de hormona antidiurética. Verificou-se recuperação clínica completa com suspensão do lítio, hidratação e clorotalidona. DISCUSSÃO: Apesar do seu uso frequente no passado, o lítio (Li) é hoje em dia raramente utilizado na prática clínica por períodos prolongados pelos seus efeitos potencialmente devastadores. Os médicos devem ter em conta os potenciais efeitos secundários de forma a prevenir lesão de órgão em doentes com doença bipolar de difícil controle com outra terapêutica.

This document outlines key principles behind the project’s communication, growth hacking, ecosystem building activities and liaisons with relevant networks/ initiatives and accordingly presents a set of communication materials.

Background and Aims In 2010 a new histopatological classification for ANCA-associated GN (ANCA GN) was developed – the Berden classification. It is composed of four categories – focal, crescentic, sclerotic and mixed - based on the predominance (≥50%) of normal glomeruli, cellular crescents, and globally sclerotic glomeruli, respectively. The mixed category, related to an intermediate renal outcome, has no glomerular feature predominating. Our aim was to evaluate other histopathological characteristics that could be significant in the mixed group and their impact on survival and renal outcome. Method This is a multi-center retrospective observational study which included patients with ANCA GN who were submitted to kidney biopsy at the time of clinical diagnosis, between 2013 and 2018. Several histopathological data were analysed, including percentage of cellular, fibrocellular and fibrous crescents; presence of fibrinoid necrosis, interstitial hemorrhage, tubular atrophy ant interstitial fibrosis. Clinical data such as need of dialysis at presentation and death, during a 2 year follow up period, were also examined. The patients were classified accordingly to the histopathological Berden classification. For statistical analysis purposes they were divided in two groups: mixed and non-mixed. Categorical variables are presented as frequencies and percentages, continuous variables as means and standard deviations, or medians and interquartile ranges (IQR) for variables with skewed distributions. Statistical analysis was performed using SPSS version 25 for Windows. Results We observed 51 ANCA GN kidney biopsies: 68.5% (n=35) from mixed, 11.8% (n=6) from crescentic and sclerotic and 7.8% (n=4) from focal category. In average, the biopsies contained 10.4±4.8 glomeruli. The percentage of fibrous crescents was significantly higher in mixed than non-mixed group (16.1±18.6% vs 7.2±17.9%; p=0.037). Although not statistically significant, the percentage of fibrocellular crescents was higher (10.3±20.9 vs 6.2±12.5; p=0.512) and the percentage of cellular crescents was lower (15.4±18.2 vs 34.3±37.7; p=0.072) in mixed group. The presence of fibrinoid necrosis (54.3% vs 87.5%; p=0.021) and fibrinoid necrosis with cellular crescents (34.3% vs 68.8%; p=0.022) were both lower in mixed category. There was no difference in the need of dialysis at presentation between both groups, but the percentage of fibrous crescents was a predictor of dialysis induction at admission in all cases [p=0.009; adjusted odds ratio (OR) 1.053 (CI: 1.013–1.096)]. Deaths were significantly higher in mixed group (34.3% vs 6.3%; p=0.033). Conclusion There are other morphological aspects that seem to be relevant in the characterization of different histological classes of ANCA GN. Having more chronic lesions, like the percentage of fibrous crescents, and a less frequency of acute lesions, such as fibrinoid necrosis, proved to be relevant in the mixed group and may be associated to the higher mortality in this class. Besides, the percentage of fibrous crescents was itself a predictor of the need of dialysis, which highlights the importance of assess other characteristics, in addition to those included in the current ANCA GN classification. However, further studies and larger samples are needed to evaluate better the importance of other morphological features in this classification and their influence on survival and renal outcome of these patients.

Background and Aims Assessment of volume status is an important prognostic factor in hemodialysis (HD) patients. Several methods have been suggested to estimate it: bioimpedance analysis, brain natriuretic peptide levels (BNP) and lung and inferior vena cava (IVC) ultrasonography (US), which are emerging as a valuable technique in this field. Our aim was to evaluate effectiveness of lung US in assessment of volume status in chronic HD patients and compare it with the gold standard bioimpedance technique. Method Cross-sectional study of 58 prevalent HD patients. Several analytical data were analyzed, including BNP, albumin and sodium levels. Lung and IVC US were performed to assess the presence and distribution of B-lines and the diameter and respiratory collapsibility of IVC, respectively. Fresenius® body composition monitor (BCM) was the bioimpedance technique used. It defines hyperhydration as relative fluid overload (RFO) >15%. Both US and BCM were performed at the same day, immediately before the middle week HD session. Categorical variables are presented as frequencies and percentages, continuous variables as means and standard deviations, or medians and interquartile ranges (IQR) for variables with skewed distributions. Statistical analysis was performed using SPSS® version 25 for Windows. Results The average age was 75.3±1.6 years and 56.9% were male. The average time in HD was 36.6±4.1 months. Half of the patients (n=29) presented B-lines in lung US. The diameter of IVC was significantly higher in this group of patients, both inhaling (1.3±0.4 vs 0.9±0.4; p=0.001) and exhaling (2.0±0.4 vs 1.6±0.5; p Although not statistically significant, the RFO was higher in patients with presence of B-lines compared to those who did not present it (10.2±10.6% vs 5.4±6.9%; p=0.061). Considering the mean RFO value in patients with B-lines, we observed that its presence was significantly higher in patients with RFO > 10% compared to those with RFO < 10% (58.6% vs 31%; p=0.035). Besides, patients with RFO > 10% also presented higher BNP (9878±34646 pg/mL vs 3945±8634 pg/mL; p=0.009) and lower albumin levels (3.4±0.5 vs 3.7±0.4; p= 0.039) than other group. Conclusion Lung US seems to be a valuable tool to diagnose overhydration earlier than BCM, which currently defines hyperhydration as RFO >15%. In this study we verified that patients with lower levels of RFO (>10%) already presented signals of fluid overload, such as presence of B-lines at lung US, higher BNP and lower albumin levels. These findings support the benefit of lung US in guiding fluid removal and may change the practice in our HD unit to probe the ideal dry weight for chronic dialysis patients.

Thrombotic microangiopathy (TMA) is a serious complication that may occur in patients with systemic lupus erythematosus (SLE), adversely affecting the prognosis and increasing mortality. The pathogenesis of TMA in these patients may be multifactorial and overlap between different entities may exist. We present a case of a 24-year-old man, previously diagnosed with SLE, class IV lupus nephritis, and antiphospholipid antibody syndrome, who was admitted with acute kidney injury, severe pancytopenia, and other features consistent with lupus flare. A clinical TMA diagnosis was made and the patient was treated with plasmapheresis, rituximab and immunoglobulin endovenous (EV) infusions. Hemodialysis was initiated during hospitalization and, despite the hematological recovery, the patient remained dialysis dependent. The complementary study revealed high levels of anti-factor H (fH) autoantibodies with no pathogenic mutations on complement genes (namely CFHR1 and CFHR3). Initially, the most likely cause of TMA seemed to be secondary to SLE, but the presence of anti-fH antibodies in our patient may suggest a concomitant complement-mediated TMA.

The available data on trace elements (TE) of deep-sea organisms is scarce and nonexistent for rare earth elements (REE). Hence, this study characterizes REE and TE in five porifera genera (Jaspis, Geodia, Hamacantha, Leiodermatium, Poliopogon) collected in deep-sea areas (between 481 and 2656 m) of the North Atlantic. Aluminium was the most common TE while lead was the less abundant. These sponges showed an increased accumulation of TE compared with other probably influenced by volcanic activity. Poliopogon amadou sampled at the deepest location presented the highest concentration of all REE. All studied species exhibited a Light REE enrichment in comparison to Heavy REE and showed a negative Ce anomaly with a less conspicuous Eu depletion. Besides the establishment of a baseline for future comparisons, this study provides the first record of REE in a sessile deep-sea marine invertebrate group.

info:eu-repo/semantics/publishedVersion

Giant cell arteritis (GCA) is rarely associated with cancer. The association paraneoplastic vasculitis and tumors appears to be more frequent with hematologic cancers. The authors report the case of 83-years-old Caucasian man, diagnosed with prostatic adenocarcinoma who developed a paraneoplastic GCA responsive to corticosteroids associated with disease progression.

Trace elements are potentially critical contaminants of aquatic environments and fish, occupying upper trophic levels, are especially vulnerable to bioaccumulation. Due to public health concerns, however, data on the elemental composition of non-commercially important marine species are particularly lacking. Ocean sunfish (Mola spp.) attain a low commercial value worldwide and information on their elemental composition is limited. In this context, we examined the concentration of 11 trace elements (V, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Cd and Pb) in eight tissues [brain, gills, gelatin (subcutaneous white gelatinous layer), gonads, spleen, liver, white muscle and red muscle] of 20 juvenile specimens (37.5–85.5 cm TL). Gender-related differences were solely found in the gonads and chiefly for essential elements possibly as a result of their importance in embryo development. Overall, Zn and As were the elements observed in greatest concentrations in body tissues. The considerably high presence of As should be related to the dietary preferences of juvenile ocean sunfish. Considerable inter-individual variability in the concentration of each element in any given tissue was observed, especially in the liver, likely originating from the inclusion of both benthic and pelagic prey in the diet of analysed fish. Greatest elemental loads were found in the liver and gills whereas lowest loads were observed in white muscle, brain and gelatin. Moreover, a clear distinction in elemental load and elemental composition was observed between white and red muscles, likely deriving from existing divergent metabolism-related physiological adaptations linked to their different roles in locomotion.

Background Ischaemic stroke can be classified according to its aetiology. In cryptogenic stroke, Lambl's excrescences should be considered since they can only be detected through transesophageal echocardiography (TEE), which is not routinely performed. Case description The authors report the case of a 63-year-old Caucasian man with two ischaemic cerebral events associated with the presence of Lambl's excrescences in the aortic valve detected with TEE. Switching antiaggregant therapy to anticoagulant therapy allowed the patient to remain asymptomatic throughout a 3-year follow-up. Conclusion The lack of protocols for the management of cryptogenic stroke results in a delay in the identification of less frequent causes of stroke, leading to recurrent vascular events, morbidity and loss of functionality. The authors describe a patient who experienced multiple cerebral ischaemic events until the correct diagnosis was made. Learning points Lambl's excrescences are a considered a rare cause of embolic stroke, probably because they are underdiagnosed.The pathophysiology is not fully understood, making therapeutic decisions difficult.Early recognition and management of this structural valve disease can prevent life-threatening complications.

This systematic review aimed to evaluate the accuracy of customized titanium plates in orthognathic surgery compared to standard outcome in virtual surgical planning. PRISMA and JBI guidelines were followed. Research protocol was registered in PROSPERO. Six databases and two gray literature repositories were used as sources of research articles. Descriptive clinical studies, that performed orthognathic surgery using custom titanium plates, were included. Risk of bias was assessed by "The Joanna-Briggs Institute Critical Appraisal tools for use in Systematic Reviews Checklist for Case Series". Of the 11,916 studies initially identified, seven met the eligibility criteria and were included. The studies were published between 2015 and 2019. Most of the studies (57%) had a low risk of bias, while one had a high risk of bias. Total sample included 74 patients with 63 bimaxillary surgeries and 11 unimaxillary surgeries. All studies showed acceptable accuracy within previously established clinical parameters. Although the eligible articles assessed the accuracy of the orthognathic surgery with respect to virtual planning, the wide variability of evaluation methodologies made it impossible to calculate a combined accuracy measure. It was not possible to perform a meta-analysis, so a pragmatic recommendation on the use of these plates is not possible.

Background and Aims One of the aims of the regular, intermittent HD therapy prescribed for patients with end-stage chronic kidney disease, is correction of metabolic acidosis by addition of HCO3- to dialysate fluid. The KDOQI guidelines therapeutic goal is to maintain pre-dialysis HCO3-≥22mmol/L. The aim of the study was to evaluate an individualized HCO3-hemodialysis prescription as a preventing factor of metabolic changes in a HD facility and define a new standard HCO3-prescription. Method 36-month prospective study of patients on online high-flux hemodiafiltration. Every 3 months (13 time points) HCO3-, Calcium (Ca2+), Phosphorus (P+), intact Parathyroid hormone (iPTH) and protein C reactive (PCR) blood levels were analyzed. HCO3-prescription was changed using the following rules: The data collected comprised demographic information, renal disease etiology, comorbidities, HD treatment information and lab results. Categorical variables are presented as frequencies and percentages, continuous variables as means and standard deviations, or medians and interquartile ranges (IQR) for variables with skewed distributions. A p-value Results From the 50 patients that were evaluated at Time point 0, only 24 patients completed the follow-up period. Sixteen (66.7%) were males, 54.2% (n=13) diabetic and 58.3% (n=14) hypertensives and the median age was 76 years (IQR 13). At baseline (time point 0), median pH was 7.4 (IQR 0.09) and serum HCO3-26.5 mmol/L (IQR 2.32). At time point 12, pH was 7.35 (IQR 0.12) and serum HCO3-23.25mmol/L (IQR 1.93). A repeated measures ANOVA determined that prescribed HCO3- differed with statistical significance during time (F(2.787,83.308)=39.055, p=0.001), and the post Hoc tests confirmed those assumptions between time point 1 and all the others time points, as an example the mean difference between initial prescribed HCO3-and time point 12 was 5.39mmol/L (p=0.001). Wilcoxon Sign-Rank Tests determined that throughout the analyzed period the serum HCO3- approached the reference serum HCO3- (23mmol/L) that we have defined as ideal (at time point 0, median=26.5mmol/L, Z=4.144, p=0-001; at time point 12, median 23.25mmol/L, Z=1.243, p=0.214). On the other hand, a one sample T-Test determined that the HCO3- prescription differed more in each time point from the 32mmol/L defined as standard (at time point 12, t=-2.798, p=0.01) and approached a new suggested value of 26mmol/L. However, at time point 8, 62.5% (n=15) patients had a HCO3-prescription of 28mmol/L, (t(23)=0.001,p=1) and at that time we had hypothesized that that a prescription of 28 mmol/L should be the new standard. Gender, Diabetes Mellitus, Hypertension, and renal disease etiology did not influence the HCO3- prescription neither serum HCO3-. Conclusion HCO3-prescription and serum HCO3- were not influenced by comorbidities like DM and Hypertension. Our findings suggest that the standard HCO3- prescription of 32mmol/L should be rethought, as an individualized HCO3- prescription could be beneficial for the patient. At this time, we suggest that a prescription of 26 mmol/L should be the new standard. However, the limitations of our findings include the small sample size, so further studies with larger samples should be attempted.

Background and Aims In the last years there has been an increase in elderly patients with multiple comorbidities inducing hemodialysis (HD). Since dialysis treatment itself may be associated with a further deterioration in functional status, nephrologists are increasingly careful in selecting these patients for HD. Concerned with this reality we tried to understood if early mortality predictors (in the first 6 months) in incident HD patients have changed in almost 10 years, in the same hospital HD unit. Method This is a retrospective observational study of incident HD patients between 01 January 2017 and 30 June 2019. We evaluated similar clinical, analytical and demographic data to those used to predict mortality in the same HD unit from 1 January 2010 to 30 September 2014. Logistic regression analysis was used to evaluate 6 month mortality predictors. Statistical analysis was performed using SPSS version 25 for Windows. Results The average age of 163 incident HD patients were 70.63±3.9 years (similar to the previous population: n= 235; 70.7 ± 14.9 years) and 57.1% were male. During this study we observed 26 (16%) deaths, 12 of which (46.15%) occurred in the first 6 months of hemodialysis. Pneumonia and cachexia were the major causes of mortality, unlike the previous population, in which majority of deaths were attributed to cardiovascular events. Between January 2010 to 30 September 2014 the strongest predictors of early mortality were dementia [adjusted odds ratio (OR) 15.94 (CI: 4.09–62.10)], central venous catheter use [(OR) 12.29; (CI: 3.54-42.65)], cancer [(OR) 4.64 (CI: 1.48-14.54)] and heart failure [(OR) 3.57 (CI: 1.08-11.75)]. Differently, in this study, the institutionalization and the presence of metastases were the predictors that showed a higher risk of death [p=0.005; adjusted odds ratio [(OR) 10.4 (CI: 2.017–49.9) and p=0.01; (OR): 14.9 (CI: 1.89-42), respectively]. Longer hospitalizations at the time of HD induction [(p=0.044; (OR):1.103; CI: 1.003-1.213)] and albumin values Conclusion Nowadays, nephrologists are less liberal in initiating dialysis to elderly patients with dementia and cardiovascular comorbidities. However, the population is getting older and our recent mortality predictors may reflect the aging of chronic kidney disease patients, who have multiple comorbidities as cachexia, requiring institutionalization and longer hospitalizations. It is increasingly important to evaluate patients prior to dialysis initiation, so our goal is to create an adjusted mortality score in our HD unit to help make the decision about inducing or not HD in our patients.

Background and Aims There are evidences suggesting that 50-90% of hemodialysis (HD) patients are vitamin D deficient [25(OH) D level Method Prospective study with an 18 months follow-up period. HD patients were supplemented with 12000 IU cholecalciferol 3 times a week if vitamin D level under 30ng/mL and 4000 IU if above. Every 6 months (3 time points) vitamin D, bone alkaline phosphatase (AF), calcium (Ca2+), phosphorus (P+) and intact parathyroid hormone (iPTH) blood levels were measured. Demographic, analytical and clinical data, including diabetic status, were analyzed. Categorical variables are presented as frequencies and percentages, continuous variables as means and standard deviations, or medians and interquartile ranges (IQR) for variables with skewed distributions. Statistical analysis was performed using SPSS version 21 for Windows. Results Sixty patients completed the follow-up period. The average was 74.70±1.43 years, 65% (n=39) were male and 41.7% (n=25) were diabetic. The average HD time at point 3 (18 months) was 3.15±3.62 years. A repeated measures ANOVA with a Greenhouse-Geisser correction showed that cholecalciferol supplementation significantly changed vitamin D blood levels along time (F(2.492;144.54)=26.832; p Conclusion Oral cholecalciferol supplementation increases significantly vitamin D blood levels and can be a good option in the management of secondary hyperparathyroidism and hypocalcemia. However, one of the limitations of our study was not to evaluate the use of medication such as P+ chelating agents and the small sample size. Therefore, large randomized clinical trials with clinically meaningful endpoints (fracture, hospitalization, parathyroidectomy, death) are still required to assess the usefulness of different vitamin D compounds for CKD and dialysis patients.

Increased Rare earth elements (REE) usage culminates in discharges into the environment. Mussels have been chosen as models in biomonitoring, hence, REE concentrations in Mytilus galloprovincialis from six locations on the Portuguese coast were accessed to determine natural concentrations and possible linkage to local ecosystem characteristics and temporal variations, by determining them in distinct seasons (autumn and spring). Samples from Porto Brandão (located on the south bank of the Tagus estuary) exhibited the highest REE concentrations, while mussels from Aljezur (the southernmost point on the Portuguese coast) exhibited the lowest, in both seasons. Overall, ∑REE concentration was greater in the spring. LREE enrichment relative to HREE occurs and a negative Ce and Eu anomaly was observed. This study constitutes the first assessment of REE composition on this model species in the Portuguese coast, in two distinct seasons and contributes to a better understanding of REE uptake for future biomonitoring studies.

Myctophids are key members of mesopelagic communities with a world biomass estimated at 600 million tons. They play a central role in oceanic food webs and are known to perform diel vertical migrations, crossing the thermocline and reaching the oxygen minimum zone, however, very scarce information exists on trace element content in these organisms. Therefore, the trace elemental composition (Cr, Mn, Co, Ni, Cu, Zn, As, Se, Cd and Pb) of Triphoturus mexicanus and Benthosema panamense specimens was determined. Zinc (Zn) was the most common trace element for both species, T. mexicanus presented 39.8 &micro, g.g&minus, 1 dw and B. panamense 30.6 &micro, 1 dw. Contrasting, for T. mexicanus the less abundant trace element was Ni (0.332 &micro, 1 dw) and for B. panamense was Pb (0.236 &micro, 1 dw). T. mexicanus exhibited significantly higher concentrations of Cr, Cu, Zn and Pb in comparison to B. panamense, and these differences seemed to be related to inherent physiological and/or ecological traits rather than environmental element availability. These diel vertical migrators are crucial in the energy transfer between the deep-sea and epipelagic zones (and vice-versa), and the estimation of the Biomagnification Factor (based on Cu, Zn, Cd and Pb) levels revealed that both T. mexicanus and B. panamense play a major role in trace element transfer to higher trophic levels in the pelagic food web of the Gulf of California.

The European eel (Anguilla anguilla) has attracted scientific inquiry for centuries due to its singular biological traits. Within the European Union, glass eel fisheries have declined sharply since 1980, from up to 2000 t (t) to 62.2 t in 2018, placing wild populations under higher risk of extinction. Among the major causes of glass eels collapse, climate change has become a growing worldwide issue, specifically ocean warming and acidification, but, to our knowledge, data on physiological and biochemical responses of glass eels to these stressors is limited. Within this context, we selected some representative biomarkers [e.g. glutathione peroxidase (GPx), catalase (CAT), total antioxidant capacity (TAC), heat shock proteins (HSP70), ubiquitin (Ub) and DNA damage] to study physiological responses of the European glass eel under distinct laboratory-climate change scenarios, such as increased water temperature (+ 4 °C) and pH reduction (− 0.4 units), for 12 weeks. Overall, the antioxidant enzymatic machinery was impaired, both in the muscle and viscera, manifested by significant changes in CAT, GPx and TAC. Heat shock response varied differently between tissues, increasing with temperature in the muscle, but not in the viscera, and decreasing in both tissues under acidification. The inability of HSP to maintain functional protein conformation was responsible for boosting the production of Ub, particularly under warming and acidification, as sole stressors. The overproduction of reactive oxygen species (ROS), either elicited by warming - due to increased metabolic demand - or acidification - through H+ interaction with O2−, generating H2O2 - overwhelmed defense mechanisms, causing oxidative stress and consequently leading to protein and DNA damage. Our results emphasize the vulnerability of eels' early life stages to climate change, with potential cascading consequences to adult stocks.

Marine pleustonic species such as the hydrozoans Velella velella and Physalia physalis , are known to drift in the world's oceans driven by winds, currents and tides. Here we present the first chemotaxonomic characterization, based on the fatty acid (FA) profile, of these two charismatic oceanic species that thrive in the interface layer between air and the water column in adult stages. Moreover, we compared their FA profiles with those from other representative cnidarian orders (Rhizostomeae, Anthomedusae, Siphonophorae, Alcyonacea, Scleractinia, Helioporacea and Pennatulacea). Velella velella and P. physalis mainly differed in the presence of symbiotic dinoflagellates markers (18:3 n -6, 18:4 n -3 and 20:5 n -3 polyunsaturated FAs), present in higher percentage in the former, and bacterial markers (odd-numbered, branched and 18:1 n -7 FAs), which were more representative in the latter. When comparing these species' FA profiles with the ones of other cnidarians orders, the presence/absence of endosymbionts and of specific FAs (tetracosapentaenoic and tetracosahexaenoic acids) as well as the latitudinal habitats were the main drivers for the distinction between groups.

Dissertação de mestrado intregrado em Psicologia, As instituições de acolhimento residencial têm sido consideradas pela investigação um meio de privação, por haver evidências de que não fornecem à criança as condições necessárias para satisfazer as necessidades básicas de proteção, afeto e exploração do ambiente, podendo conduzir a um impacto muito negativo no seu desenvolvimento. As variáveis que influenciam a qualidade dos comportamentos interativos das crianças no contexto institucional têm merecido uma menor atenção na literatura existente. De forma a contribuir para um conhecimento mais aprofundado deste tema, este estudo examinou as contribuições do comportamento interativo do prestador de cuidados, das experiências pré-institucionais adversas da criança e do seu estatuto desenvolvimental na qualidade dos comportamentos interativos da criança. Assim, um grupo de crianças, entre os 0 e os 21 meses, em acolhimento residencial foi avaliado no momento de admissão na instituição e reavaliado 9 meses depois com os respetivos cuidadores. O desenvolvimento mental da criança foi avaliado nos dois momentos do estudo, foram avaliados os comportamentos da criança e do cuidador numa tarefa estruturada e ainda foram identificadas as experiências pré-institucionais adversas. Relativamente às crianças, os resultados evidenciaram associações significativas positivas entre o humor positivo e desenvolvimento da linguagem e motor; entre o foco atencional face a objetos e o desenvolvimento da linguagem e motor; e ainda associações significativas negativas entre o nível de atividade e o desenvolvimento cognitivo. Estes resultados permitiram um melhor conhecimento da relação entre os comportamentos interativos das crianças, evidenciando o papel dos mesmos no seu desenvolvimento mental., Residential care institutions for children and young people have been considered by research as a place where basic needs as protection, affection and exploration of the environment are not totally satisfy. This fact may lead to a very negative impact on normal development of these children. It is also known that the variables that influence the quality of children's interactive behaviors in institutional context have deserved less attention in the current literature. In order to contribute to a deeper understanding of this topic, this study examined the contributions of the caregiver's interactive behavior, the child's adverse pre-institutional experiences and their developmental status in the quality of the child's interactive behaviors. Thus, a group of children, between 0 and 21 months, in residential care was evaluated at the time of admission to the institution and re-evaluated 9 months later with their caregivers. Child's developmental status was evaluated at two moments, child's and the caregiver's behavior were evaluated in a structured task, and adverse pre-institutional experiences of each child were also identified. Concerning children, the results showed significant positive associations between positive mood and language and motor development; between attentional focus on objects and language and motor development; and significant negative associations were found between activity level and cognitive development of the children. These results helped to better understand the relationship between the interactive behaviors of the children, demonstrating their role in their development status.

The effects of body size and season on the elemental composition of ocean sunfish Mola mola were assessed for the first time. A total of 57 by-caught juvenile specimens measuring between 31.8 and 120.3 cm were sampled in spring and autumn. Concentrations of trace elements (three essential - Co, Cu, Zn, and three non-essential - As, Cd, Pb) were determined in five body tissues [gills, gelatin (subcutaneous white gelatinous layer), liver, white muscle and red muscle]. Elemental composition of M. mola tissues was found to vary with both body size and season. When an effect of size was verified, the most common trend was a decrease in elemental levels with increasing fish size, most likely deriving from the fast growth rate of this fish (i.e. dilution effect) and the occurrence of an ontogenetic shift in dietary preferences. Differently, Zn levels increased with fish size in both gills and red muscle, potentially deriving from a greater physiological need in those tissues as fish grow. Seasonal differences in trace element levels were observed for approximately half of the studied cases (tissue/trace element) with greater elemental concentrations being mostly found in autumn. Such pattern was most obvious in liver tissue, presumably resulting from a greater dietary elemental uptake in the end of summer/autumn. A general absence of seasonal differences was observed in the gills, white muscle and red muscle. Interestingly, a trend of enhanced concentrations in spring was observed for gelatin, potentially deriving from past long-term differences in exposure to trace elements.

Atmospheric carbon dioxide (CO2) levels are increasing at the fastest rate ever recorded, causing higher CO2 dissolution in the ocean, leading to a process known as ocean acidification (OA). Unless anthropogenic CO2 emissions are reduced, they are expected to reach ~900 ppm by the century’s end, resulting in a 0.13–0.42 drop in the seawater pH levels. Since the transgenerational effects of high CO2 in marine organisms are still poorly understood at lower levels of biological organization (namely at the biochemical level), here we reared a key ecological relevant marine amphipod, Gammarus locusta, under control and high CO2 conditions for two generations. We measured several stress-related biochemical endpoints: i) oxidative damage [lipid peroxidation (LPO) and DNA damage]; ii) protein repair and removal mechanisms [heat shock proteins (HSPs) and ubiquitin (Ub)]; as well as iii) antioxidant responses [superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione s-transferase (GST)] and total antioxidant capacity (TAC). The present results support the premise that exposure to high CO2 is expected to decrease survival rates in this species and cause within- and transgenerational oxidative damage. More specifically, the predicted upsurge of reactive oxygen and nitrogen species seemed to overwhelm the stimulated amphipod antioxidant machinery, which proved insufficient in circumventing protein damage within the parents. Additionally, negative effects of OA are potentially being inherited by the offspring, since the oxidative stress imposed in the parent’s proteome appears to be restricting DNA repair mechanisms efficiency within the offspring’s. Thus, we argue that a transgenerational exposure of G. locusta could further increase vulnerability to OA and may endanger the fitness and sustainability of natural populations.

Rare earth elements (REEs) comprise elements from lanthanum to lutetium that together with yttrium and scandium are emergent contaminants of critical importance for numerous groundbreaking environmental technologies. Transfer to aquatic ecosystems is expected to increase, however, little information is known about their potential impacts in marine biota. Considering the endangered conservation status of the European eel (Anguilla anguilla) and the vulnerability of early fish life stages to contaminants, we exposed glass eels, through water, to an environmentally relevant concentration (120 ng.L−1) of lanthanum (La) for 7 days (plus 7 days of depuration). The aim was to study the accumulation and elimination of La in eel's body and subsequent quantification of acetylcholinesterase (AchE), lipid peroxidation and antioxidant enzymatic machinery. Accumulation peaked after 72 h-exposure to La, decreasing afterwards, even in continuous exposure. Accumulation was higher in the viscera, followed by the skinless body and ultimately in the head, possibly as a protective mechanism to cope with La neurotoxicity. A significant increase in AChE activity was observed in La-exposed glass eels, suggesting that La3+ may inhibit the binding of acetylcholine. A depression in lipid peroxidation was registered under La exposure, possibly indicating that La3+ may play physiological activities and functions as a free radical scavenger. Catalase activity was significantly inhibited in La-exposed glass eels after 72 h, indicating that the availability of La may induce physiological impairment. The quantification of Glutathione S-Transferase activity revealed no differences between control and La-exposed organisms. Further investigation is needed towards understanding the biological effects of REEs.

Ocean acidification (OA) poses a global threat to marine biodiversity. Notwithstanding, marine organisms may maintain their performance under future OA conditions, either through acclimation or evolutionary adaptation. Surprisingly, the transgenerational effects of high CO2 exposure in crustaceans are still poorly understood. For the first time, the present study investigated the transgenerational effect of OA, from hatching to maturity, of a key amphipod species (Gammarus locusta). Negative transgenerational effects were observed on survival of the acidified lineage, resulting in significant declines (10–15%) compared to the control groups in each generation. Mate-guarding duration was also significantly reduced under high CO2 and this effect was not alleviated by transgenerational acclimation, indicating that precopulatory behaviours can be disturbed under a future high CO2 scenario. Although OA may initially stimulate female investment, transgenerational exposure led to a general decline in egg number and fecundity. Overall, the present findings suggest a potential fitness reduction of natural populations of G. locusta in a future high CO2 ocean, emphasizing the need of management tools towards species’ sustainability.

Climate change and chemical contamination are global environmental threats of growing concern for the scientific community and regulatory authorities. Yet, the impacts and interactions of both stressors (particularly ocean warming and emerging chemical contaminants) on physiological responses of marine organisms remain unclear and still require further understanding. Within this context, the main goal of this study was to assess, for the first time, the effects of warming (+5°C) and accumulation of a polybrominated diphenyl ether congener (BDE-209, brominated flame retardant) through dietary exposure on energy budget of the juvenile white seabream (Diplodus sargus). Specifically, growth (G), routine metabolism (R), excretion (faecal, F and nitrogenous losses, U) and food consumption (C) were calculated to obtain the energy budget. The results demonstrated that the energy proportion spent for G dominated the mode of the energy allocation of juvenile white seabream (56.0-67.8%), especially under the combined effect of warming plus BDE-209 exposure. Under all treatments, the energy channelled for R varied around 26% and a much smaller percentage was channelled for excretion (F: 4.3-16.0% and U: 2.3-3.3%). An opposite trend to growth was observed to faeces, where the highest percentage (16.0±0.9%) was found under control temperature and BDE-209 exposure via diet. In general, the parameters were significantly affected by increased temperature and flame retardant exposure, where higher levels occurred for: i) wet weight, relative growth rate, protein and ash contents under warming conditions, ii) only for O:N ratio under BDE-209 exposure via diet, and iii) for feed efficiency, ammonia excretion rate, routine metabolic rate and assimilation efficiency under the combination of both stressors. On the other hand, decreased viscerosomatic index (VSI) was observed under warming and lower fat content was observed under the combined effect of both stressors. Overall, under future warming and chemical contamination conditions, fish energy budget was greatly affected, which may dictate negative cascading impacts at population and community levels. Further research combining other climate change stressors (e.g. acidification and hypoxia) and emerging chemical contaminants are needed to better understand and forecast such biological effects in a changing ocean. &nbsp