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A new approach to recruitment overfishing diagnosis is presented. We hypothesize that condition of recruits should increase when recruitment failures are caused by fishing activity. This would be a consequence of the increase in trophic resource availability, because the population is smaller than that which the ecosystem could support. Temporal series of hake recruit condition were calculated from MEDITS survey data collected in Mediterranean geographical sub-areas (GSAs) 1, 6, 17 and 19 from 1994 to 2015. Multiple linear regressions were used to analyse the relationship between mean annual condition and abundance of recruits and climatic indices in each GSA. Significant correlations were only detected in GSA 6, where 69% of condition variability was explained by the negative correlation with recruit abundance, and with two climatic indices, the Western Mediterranean Oscillation and the standardized air temperature anomaly at surface from the Gulf of Lions. Despite the differences in recruit abundance among GSAs, their mean annual condition oscillated around the same basal value during most of the time series, pointing to density-dependent mortality rates as an important mechanism stabilizing hake recruitment to levels close to the carrying capacity when populations do not suffer recruitment overfishing. This pattern changed when the decreasing recruit abundance trend drove GSA 6 condition values persistently above those of the rest of the GSAs. According to our hypothesis, hake in GSA 6 is in recruitment overfishing., Este trabajo presenta una nueva aproximación al diagnóstico de la sobrepesca de reclutamiento. Nuestra hipótesis consiste en que la condición de los reclutas debe aumentar cuando suceden fallos en el reclutamiento debidos a la actividad pesquera. Esto sería una consecuencia del incremento en la disponibilidad de recursos tróficos debido a que la población es más reducida que la que el ecosistema podría soportar. Se calcularon series temporales de condición de reclutas de merluza a partir de datos recogidos en las campañas MEDITS en las sub-áreas geográficas (GSAs) 1, 6, 17 y 19 entre los años 1994 y 2015. Se utilizó la regresión lineal múltiple para analizar la relación entre la condición media anual y la abundancia de reclutas e índices climáticos en cada GSA. Solo se detectaron correlaciones significativas en la GSA 6, dónde el 69% de la variabilidad en la condición se explica por la correlación negativa con la abundancia de reclutas, y con dos índices climáticos, la Oscilación del Mediterráneo Occidental y la anomalía estandarizada de la temperatura del aire en superficie en el Golfo de León. A pesar de las diferencias en la abundancia de reclutas entre GSAs, su condición anual media osciló alrededor de un mismo valor basal durante la mayor parte de la serie temporal, sugiriendo que las tasas de mortalidad denso-dependiente son un mecanismo importante para la estabilización del reclutamiento de merluza en niveles próximos a la capacidad de carga cuando las poblaciones no sufren sobrepesca de reclutamiento. Este patrón cambió cuando la tendencia decreciente de la abundancia de reclutas elevó los valores de condición en la GSA 6 por encima de los del resto de GSAs de forma persistente. De acuerdo con nuestra hipótesis, la merluza de la GSA 6 se encuentra en sobrepesca de reclutamiento.

Marine litter is one of the main sources of anthropogenic pollution in the marine ecosystem, with plastic representing a global threat. This paper aims to assess the spatial distribution of plastic macro-litter on the seafloor, identifying accumulation hotspots at a northern Mediterranean scale. Density indices (items km–2) from the MEDITS trawl surveys (years 2013-2015) were modelled by generalized additive models using a Delta-type approach and several covariates: latitude, longitude, depth, seafloor slope, surface oceanographic currents and distances from main ports. To set thresholds for the identification of accumulation areas, the percentiles (85th, 90th and 95th) of the plastic spatial density distribution were computed on the raster data. In the northern Mediterranean marine macro-litter was widespread (90.13% of the 1279 surveyed stations), with plastic by far the most recurrent category. The prediction map of the plastic density highlighted accumulation areas (85th, 90th and 95th percentiles of the distribution, respectively, corresponding to 147, 196 and 316 items km–2) in the Gulf of Lions, eastern Corsica, the eastern Adriatic Sea, the Argo-Saronic region and waters around southern Cyprus. Maximum densities were predicted in correspondence to the shallower depths and in proximity to populated areas (distance from the ports). Surface currents and local water circulation with cyclonic and anticyclonic eddies were identified as drivers likely facilitating the sinking to the bottoms of floating debris., La basura marina es una de las principales fuentes de contaminación antropogénica en el ecosistema marino representando el plástico una amenaza global. El objetivo de este trabajo es evaluar la distribución espacial de las macro-basuras plásticas en el fondo marino, identificando los hotspots de acumulación en el Mediterráneo norte. Los índices de densidad (ítems km–2), procedentes de las campañas de arrastre MEDITS (años: 2013-2015), fueron modelados mediante Modelos Aditivos Generalizados, utilizando un enfoque de tipo delta y varias covariables: latitud, longitud, profundidad, pendiente del fondo marino, corrientes marinas y distancias desde los principales puertos. Para establecer los umbrales para la identificación de áreas de acumulación, se calcularon los percentiles (85-90-95) de la distribución espacial de densidad de plásticos en los datos ráster. En el Mediterráneo norte, la macro-basura marina estaba muy extendida (90.13% de las 1279 estaciones muestreadas), siendo el plástico, con diferencia, la categoría más recurrente. El mapa de predicción de la densidad de plásticos resaltó las áreas de acumulación (percentiles 85, 90 y 95 de la distribución, respectivamente, correspondientes a: 147, 196 y 316 ítems km–2), localizadas en el Golfo de León, Córcega oriental, Mar Adriático oriental, región Argo-Saronic y aguas que rodean el sur de Chipre. Se predijeron las densidades máximas a menor profundidad y cercanas a zonas pobladas (distancia desde los puertos). Las corrientes superficiales y la circulación local del agua, con giros ciclónicos y anticiclónicos, se identificaron como factores que favorecen el hundimiento de las basuras flotantes.

Background: The rate of surgical site infections (SSI) is strongly influenced by operating room quality, which is determined by the structural features of the facility and its systems and by the management and behaviour of healthcare workers. The aim of the present study was to assess the microbial contamination in operating room during hip- and knee-replacement procedures, the behavior of operating room staff and the incidence of SSI through postdischarge surveillance. Methods: Microbial contamination was evaluated by active and passive samplings at rest and in operating conditions. Organizational and behavioral characteristics were collected by observational assessment. The incidence of SSI was evaluated in 255 patients and the follow-up examinations were carried out at 30 and 365 days after the procedure. Results: The mean value of the airborne and sedimenting microbial load was respectively 12.90 CFU/m3 and 0.02 CFU/cm2/h. With regard to outcome, the infection rate proved to be 0.89%, associated with knee-replacement procedures. The microorganism responsible for this superficial infection was Staphylococcus aureus. Conclusion: Clinical outcomes proved to be satisfactory explained by the microbial load (in both at-rest and operating conditions), the appropriate behavior of the staff, compliance with the guidelines on preoperative antibiotic prophylaxis, and efficient management of the ventilation system., Journal of Preventive Medicine and Hygiene, Vol 57, No 3 (2016): 2016573

Prognosis informs the physician's decision-making process, especially for frail older adults. So far, any non-disease-specific index has proven full evidence for routine use in clinical practice. Here, we aimed at assessing, prospectively, the calibration and discriminating accuracy of validated prognostic indices in a cohort of elderly hospitalized patients.This was a prospective observational study that enrolled elderly patients (n = 100). The patients' assessment included clinical variables, as well as the following five prognostic indices of mortality: (i) Levine index (2007); (ii) Walter index (2001); (iii) CARING (C, primary diagnosis of cancer; A, ≥ 2 admissions to the hospital for a chronic illness within the last year; R, resident in a nursing home; I, intensive care unit admission with multiorgan failure, NG, noncancer hospice guidelines [meeting ≥ 2 of the National Hospice and Palliative Care Organization's guidelines]) criteria of Fischer (2006-2011); (iv) Silver Code of Di Bari (2010); and (v) Burden of Illness Score for Elderly Persons of Inouye (2003).Patients' clinical characteristics: 70% women (age 86.20 ± 0.69 years), 30% men (age 85.40 ± 1.07 years), Comorbidity Illness rating scale (CIRS) 4.3 ± 0.61 and Barthel Index 28 ± 0.54. Walter and Burden of Illness Score for Elderly Persons scores showed similar prediction rates when compared with the expected validated values (ancova: F = 14.00, P 0.008). Burden of Illness Score for Elderly Persons was the most calibrated and accurate index (receiver operating characteristic curve 0.72; P 0.02).None of the assessed prognostic indices, in a "real world" scenario, afforded the optimal predictive accuracy (receiver operating characteristic curve 0.90); all these indices are still far from a robust answer to the prognosis in older age, reflecting a poor ability to encompass the spectrum of frailty. Effort should be made to tailor the prognostication in geriatrics, moving from a disease-centered model to a precision model, tailored to the frail phenotype. Geriatr Gerontol Int 2017; 17: 1015-1021.