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The relationships between the interannual variations of the Levantine intermediate water (LIW) core properties and the corresponding biochemical variations in the euphotic zone were systematically studied in the Southeastern Mediterranean during 2013–2021 and since 2002 based on a previous study. Salinity and temperature interannual fluctuations in the LIW continue to follow the Adriatic–Ionian Bimodal Oscillating System (BiOS) mechanism, with salinity and temperature peaks in the years 2008–2010, 2014–2015, and 2018–2019 coinciding with periods of anticyclonic circulation of the North Ionian Gyre (NIG). During these anticyclonic periods, the transport of Atlantic Water into the Levant is reduced together with the transport of LIW out of the basin. These interannual fluctuations are superimposed on a long-term warming trend clearly evident from previous studies, showing a maximal temperature in 2018–2019, higher than the previously mentioned temperature peaks by ~0.7°C and ~0.4°C. The enhanced warming in 2018–2019 has caused a decrease in density (sigma) values of the LIW core, which gave way to the shallowest record of this water mass (~110-m depth), bringing it well within the lower photic zone. We suggest that a higher level of nutrients became available, supporting the observed long-term rise of the intergraded chlorophyll a (Chl.a) (0.89 mg m−2 year−1), with a maximum recorded during 2018–2019. The long-term record of the mixed layer depths shows no significant change; thus, the uplift of nutrients during winter mixing cannot support the trend and variations of the integrated Chl.a. Additional biological parameters of specific pico-phytoplankton populations and integrated bacterial production and abundance were measured in 2013–2021, but the measurements were too sparse to follow a clear interannual dynamics. Yet significantly higher average levels for integrated primary production and bacterial abundances were observed during the anticyclonic period (as for Chl.a). The combined impacts of the BiOS mechanism and global warming, and hence the increase in LIW residence time and buoyancy, may impact the primary producers’ biomass at the photic zone. This latter feedback may slightly counter the enhanced oligotrophication due to enhanced stratification.

Mapping and quantifying degree of forest modification is critical to conserve and manage forests. Here the authors propose a new quantitative metric for landscape integrity and apply it to a global forest map, showing that less than half of the world’s forest cover has high integrity, most of which is outside nationally designed protected areas.

Over the past several decades, jellyfish blooms have intensified spatially and temporally, affecting functions and services of ecosystems worldwide. At the demise of a bloom, an enormous amount of jellyfish biomass sinks to the seabed and decomposes. This process entails reciprocal microbial and biogeochemical changes, typically enriching the water column and seabed with large amounts of organic and inorganic nutrients. Jellyfish decomposition was hypothesized to be particularly important in nutrient-impoverished ecosystems, such as the Eastern Mediterranean Sea – one of the most oligotrophic marine regions in the world. Since the 1970s, this region has been experiencing the proliferation of a notorious invasive scyphozoan jellyfish, Rhopilema nomadica. In this study, we estimated the short-term decomposition effects of R. nomadica on nutrient dynamics at the sediment–water interface. Our results show that the degradation of R. nomadica has led to increased oxygen demand and acidification of overlying water as well as high rates of dissolved organic nitrogen and phosphate production. These conditions favored heterotrophic microbial activity and bacterial biomass accumulation, and triggered a shift towards heterotrophic biodegrading bacterial communities, whereas autotrophic picophytoplankton abundance was moderately affected or reduced. This shift may further decrease primary production in the water column of the Eastern Mediterranean Sea. Deoxygenation, acidification, nutrient enrichment, and microbial community shifts at the sediment–water interface may have a detrimental impact on macrobenthic communities. Based on these findings, we suggest that jelly-falls and their decay may facilitate an additional decline in ecosystem functions and services.

Respiratory derangements, including irregular, tachypnic breathing and central or obstructive apnea can be consequences of seizure activity in epilepsy patients and animal models. Periods of seizure-associated central apnea, defined as periods >1 s with rapid onset and offset of no airflow during plethysmography, suggest that seizures spread to brainstem respiratory regions to disrupt breathing.We sought to characterize seizure-associated central apneic episodes as an indicator of seizure impact on the respiratory rhythm in rats anesthetized with urethane and given parenteral kainic acid to induce recurring seizures. We measured central apneic period onsets and offsets to determine if onset-offset relations were a consequence of 1) a reset of the respiratory rhythm, 2) a transient pausing of the respiratory rhythm, resuming from the pause point at the end of the apneic period, 3) a transient suppression of respiratory behavior with apnea offset predicted by a continuation of the breathing pattern preceding apnea, or 4) a random re-entry into the respiratory cycle.Animals were monitored with continuous ECG, EEG, and plethysmography. One hundred ninety central apnea episodes (1.04 to 36.18 s, mean: 3.2 ± 3.7 s) were recorded during seizure activity from 7 rats with multiple apneic episodes. The majority of apneic period onsets occurred during expiration (125/161 apneic episodes, 78%). In either expiration or inspiration, apneic onsets tended to occur late in the cycle, i.e. between the time of the peak and end of expiration (82/125, 66%) or inspiration (34/36, 94%). Apneic period offsets were more uniformly distributed between early and late expiration (27%, 34%) and inspiration (16%, 23%). Differences between the respiratory phase at the onset of apnea and the corresponding offset phase varied widely, even within individual animals.Each central apneic episode was associated with a high frequency event in EEG or ECG records at onset. High frequency events that were not associated with flatline plethysmographs revealed a constant plethysmograph pattern within each animal, suggesting a clear reset of the respiratory rhythm. The respiratory rhythm became highly variable after about 1 s, however, accounting for the unpredictability of the offset phase. The dissociation of respiratory rhythm reset from the cessation of airflow also suggested that central apneic periods involved activation of brainstem regions serving the diving reflex to eliminate the expression of respiratory movements. This conclusion was supported by the decreased heart rate as a function of apnea duration.We conclude that seizure-associated central apnea episodes are associated with 1) a reset of the respiratory rhythm, and 2) activation of brainstem regions serving the diving reflex to suppress respiratory behavior. The significance of these conclusions is that these details of seizure impact on brainstem circuitry represent metrics for assessing seizure spread and potentially subclassifying seizure patterns.

A Correction to this paper has been published: https://doi.org/10.1038/s41467-021-20999-7.

Abstract Objectives (1) To plot the trajectory of humoral and cellular immune responses to the primary (two‐dose) COVID‐19 mRNA series and the third/booster dose in B‐cell‐depleted multiple sclerosis (MS) patients up to 2 years post‐vaccination; (2) to identify predictors of immune responses to vaccination; and (3) to assess the impact of intercurrent COVID‐19 infections on SARS CoV‐2‐specific immunity. Methods Sixty ocrelizumab‐treated MS patients were enrolled from NYU (New York) and University of Colorado (Anschutz) MS Centers. Samples were collected pre‐vaccination, and then 4, 12, 24, and 48 weeks post‐primary series, and 4, 12, 24, and 48 weeks post‐booster. Binding anti‐Spike antibody responses were assessed with multiplex bead‐based immunoassay (MBI) and electrochemiluminescence (Elecsys®, Roche Diagnostics), and neutralizing antibody responses with live‐virus immunofluorescence‐based microneutralization assay. Spike‐specific cellular responses were assessed with IFNγ/IL‐2 ELISpot (Invitrogen) and, in a subset, by sequencing complementarity determining regions (CDR)‐3 within T‐cell receptors (Adaptive Biotechnologies). A linear mixed‐effect model was used to compare antibody and cytokine levels across time points. Multivariate analyses identified predictors of immune responses. Results The primary vaccination induced an 11‐ to 208‐fold increase in binding and neutralizing antibody levels and a 3‐ to 4‐fold increase in IFNγ/IL‐2 responses, followed by a modest decline in antibody but not cytokine responses. Booster dose induced a further 3‐ to 5‐fold increase in binding antibodies and 4‐ to 5‐fold increase in IFNγ/IL‐2, which were maintained for up to 1 year. Infections had a variable impact on immunity. Interpretation Humoral and cellular benefits of COVID‐19 vaccination in B‐cell‐depleted MS patients were sustained for up to 2 years when booster doses were administered.

Introduction Mounting evidence indicates that an individual's humoral adaptive immune response plays a critical role in the setting of SARS-CoV-2 infection, and that the efficiency of the response correlates with disease severity. The relationship between the adaptive immune dynamics in the lower airways with those in the systemic circulation, and how these relate to an individual's clinical response to SARS-CoV-2 infection, are less understood and are the focus of this study. Material and methods We investigated the adaptive immune response to SARS-CoV-2 in paired samples from the lower airways and blood from 27 critically ill patients during the first wave of the pandemic (median time from symptom onset to intubation 11 days). Measurements included clinical outcomes (mortality), bronchoalveolar lavage fluid (BALF) and blood specimen antibody levels, and BALF viral load. Results While there was heterogeneity in the levels of the SARS-CoV-2-specific antibodies, we unexpectedly found that some BALF specimens displayed higher levels than the paired concurrent plasma samples, despite the known dilutional effects common in BALF samples. We found that survivors had higher levels of anti-spike, anti-spike-N-terminal domain and anti-spike-receptor-binding domain IgG antibodies in their BALF (p

IntroductionAlzheimer’s Disease (AD) constitutes a major societal problem with devastating neuropsychiatric involvement in over 90% of those diagnosed. The large spectrum of AD neuropsychiatric symptoms leads to polypharmacological prescribing that, in turn, poses a major risk for increased side effects. Non-pharmacological interventions such as music therapy (MT) are therefore recommended as first-line treatments. The amalgamation of an aging population, long lifespan, and shortage of qualified music therapists limits access to MT services for AD.ObjectiveThe purpose of this paper is to provide a rationale for a protocolized music teletherapy (MTT) intervention to increase accessibility for MT as a psychosocial intervention for neuropsychiatric symptoms in people with AD by conducting a narrative review of the existing MT and AD literature.MethodsWe conducted a narrative review of MT and MTT publications indexed in PubMed and Google Scholar wherein authors used the Neuropsychiatric Inventory. We examined the impact of MT on neuropsychiatric symptoms of AD and identified MTT as a way to increase access to clinical services.ResultsMT can have positive impacts on neuropsychiatric symptoms in AD. However, we identified an ensuing need for protocolized MT interventions, access to services, and increased awareness. MTT is an option that can address these needs.DiscussionAlthough MT can have positive effects on neuropsychiatric symptoms and can be beneficial and safe for individuals with AD, the current approach to MT practice is enormously heterogeneous with studies demonstrating variable therapist qualifications, uses of music, therapy approaches, and clinical populations. Congruently, the existing literature indicates that MT has not been standardized with protocolized interventions, making it difficult for clinicians and researchers to objectively assess the evidence, and thus, prescribe MT interventions. The lack of MT standardization, coupled with a low number of music therapists relative to people with AD, result in a lack of awareness that hinders access to MT as a psychosocial treatment for neuropsychiatric symptoms in people with AD. We therefore propose that protocolized MTT interventions are needed to increase access to better address neuropsychiatric symptoms associated with AD.