The Different Fate of the Pyrenean Desman (Galemys pyrenaicus) and the Eurasian Otter (Lutra lutra) under Climate and Land Use Changes.

Climate and land use change can affect biodiversity in different ways, e.g., determining habitat loss, altering reproduction periods or disrupting biotic interactions. Here, we investigate the effects of climate and land use change on the spatial distribution of two semi-aquatic mammals, the Pyrenean desman (Galemys pyrenaicus) and the Eurasian otter (Lutra lutra). We first modeled the current potential distribution of the desman and the otter in the Iberian Peninsula, considering topographic, climatic and land use variables. Second, we predicted their potential distribution in 2050 under climate and land use change scenarios. We calculated the percentage of range gain/loss and shift predicted for the two species under such scenarios and quantified the present and future spatial overlap between the two species distribution. Irrespective of the scenario, desman models show loss of suitable habitat, whereas the otter will undergo an opposite trend. Aside from a preponderant habitat loss, the desman is predicted to increase its spatial overlap with otter range under the optimistic scenarios, potentially meaning it will face an exacerbated predation by otters. The potential increase of both habitat loss and otters' predation might represent a major threat for the desman, which may affect the long-term persistence of this endemic species in the Iberian Peninsula.

Better sturdy or slender? Eurasian otter skull plasticity in response to feeding ecology.

Otters are semi-aquatic mammals specialized in feeding on aquatic prey. The Eurasian otter Lutra lutra is the most widely distributed otter species. Despite a low degree of genetic variation across its European range, the population from Great Britain exhibits distinct genetic structuring. We examined 43 skulls of adult Eurasian otters belonging to 18 sampling localities and three genetic clusters (Shetlands, Wales and Scotland). For each sample location, information regarding climate was described using bioclimatic variables from WorldClim, and information on otter diet was extracted from the literature. By using photogrammetry, 3D models were obtained for each skull. To explore any evidence of adaptive divergence within these areas we used a three dimensional geometric morphometric approach to test differences in skull size and shape between areas with genetically distinct populations, as well as the influence of diet, isolation by distance and climate. Males were significantly larger in skull size than females across all the three genetic clusters. Skull shape, but not size, appeared to differ significantly among genetic clusters, with otters from Shetland exhibiting wider zygomatic arches and longer snouts compared to otters from Wales, whereas otters from Scotland displayed intermediate traits. A significant relationship could also be found between skull shape variation, diet as well as climate. Specifically, otters feeding on freshwater fish had more slender and short-snouted skulls compared to otters feeding mostly on marine fish. Individuals living along the coast are characterised by a mixed feeding regime based on marine fish and crustaceans and their skull showed an intermediate shape. Coastal and island otters also had larger orbits and eyes more oriented toward the ground, a larger nasal cavity, and a larger distance between postorbital processes and zygomatic arch. These functional traits could also represent an adaptation to favour the duration and depth of diving, while the slender skull of freshwater feeding otters could improve the hydrodynamics.

Is scat marking a reliable tool for otter census and surveys at the landscape scale?

Biological significance of scat marking by otters has been a controversial subject among scientists. Using multiyear (2014-2017) data of otter spraint counts in South Korea, this study aimed to test whether the observed pattern of spraint presence/absence is driven by detection error and if/how scat counts can be a proxy for otter abundance at the landscape scale. To test the first hypothesis, spraint presence/absence was analyzed through occupancy models, which relied on environmental variables related to otter detectability and presence. Spraint count models were used to test the second hypothesis against resource-related covariates in combination with landscape, anthropogenic, and climate variables through machine learning algorithms (MLAs). The detection probability has specifically decreased in areas characterized by high rainfall and human population densities, whereas the probability has increased near food-rich sites, characterized by high marking frequencies. The temporal trends of spraint count predictions were in line with changes in the diversity of fish communities in 2014-2017 instead of fish biomass, suggesting that the availability of feeding resources is higher where fish communities are more diverse. Because diverse fish communities can attract otters, fish diversity conservation is critical for preserving this mammal's populations. This fine scale four-year monitoring has contributed to the disentanglement of the role of spraint presence/absence and spraint counts in detectability and population trends. This will assist in identifying key resource areas and planning strategies to promote otter conservation and dispersal dynamics.

Impact of transition to a subterranean lifestyle on morphological disparity and integration in talpid moles (Mammalia, Talpidae).

BACKGROUND: Understanding the mechanisms promoting or constraining morphological diversification within clades is a central topic in evolutionary biology. Ecological transitions are of particular interest because of their influence upon the selective forces and factors involved in phenotypic evolution. Here we focused on the humerus and mandibles of talpid moles to test whether the transition to the subterranean lifestyle impacted morphological disparity and phenotypic traits covariation between these two structures. RESULTS: Our results indicate non-subterranean species occupy a significantly larger portion of the talpid moles morphospace. However, there is no difference between subterranean and non-subterranean moles in terms of the strength and direction of phenotypic integration. CONCLUSIONS: Our study shows that the transition to a subterranean lifestyle significantly reduced morphological variability in talpid moles. However, this reduced disparity was not accompanied by changes in the pattern of traits covariation between the humerus and the mandible, suggesting the presence of strong phylogenetic conservatism within this pattern.

Where will it cross next? Optimal management of road collision risk for otters in Italy.

Collisions with vehicles represent the main conflict between infrastructures and wildlife, causing damages to both humans and animals. As to the latter, road mortality is a growing phenomenon and the largest single cause of death for many vertebrates. When focusing on endangered species, the Eurasian otter (Lutra lutra) is among the most vulnerable to road-kills, which represent the predominant cause of deaths recorded in Europe. We propose a large scale spatially-explicit assessment of road-kill risk for the Eurasian otter in Italy as a tool to identify road stretches at high collision risk, thus optimizing the location of mitigation measures. The modelling approach was produced for South Central Italy, hosting the only remnant viable population of otters in Italy. We used a maximum entropy approach including 56 road collision events recorded between 2004 and 2016 through a citizen science initiative, along with seven environmental predictors measured on 1 km grid cells. Four predictors were selected to describe roads characteristics, i.e. density of highways, and of state, regional and local roads. The remaining three variables referred to the quality of otter habitat in the surrounding of the collision sites, i.e. elevation, density of freshwater bodies, and a measure of landscape heterogeneity calculated on land-cover categories. The model achieved a good predictive accuracy (AUC > 0.8; Boyce index > 0.8). The collision probability was mostly affected by elevation, density of state roads, and density of freshwater bodies. Specifically, collision risk was higher in areas at low elevation and medium density of state roads located near rivers and wetlands. In addition, model predictions evidenced that implementing mitigation measures along 10% of road network in the study area could have potentially hampered ca. 50% of otter casualties recorded during the study period.

Pseudomonas aeruginosa severe skin infection in a toddler with X-linked agammaglobulinemia due to a novel BTK mutation.

Agammaglobulinemia is a congenital deficit of humoral immunity characterized by a decreased level or complete absence of immunoglobulins and profound reduction of B-lymphocytes associated with an increased risk of life-threatening bacterial infection. We report a case of invasive Pseudomonas aeruginosa severe skin and soft tissue infection treated with vacuum-assisted closure and antibiotics in a toddler with a previously unreported mutation of the Bruton tyrosin kinase gene.

Prolonged antibiotic administration for surgical site infection in pediatric laryngotracheal surgery.

OBJECTIVES/HYPOTHESIS: Incidence of surgical site infection (SSI) after laryngotracheal (LT) surgery is relatively high, especially in children. STUDY DESIGN: Retrospective and prospective cohort study. METHODS: Clinical records of children who underwent open LT surgery at the Istituto Giannina Gaslini Children's Hospital from January 2008 to August 2017 were reviewed for development of SSI. Standard antibiotic prophylaxis was administered until February 2015. In March 2015, an antibiotic treatment tailored on pathogens isolated from surveillance cultures and prolonged until extubation was introduced. Incidence and risk factors for SSI before and after the new protocol implementation were analyzed by means of univariate and multivariable analyses. RESULTS: A total of 57 procedures were analyzed. SSI incidence was 36% in patients receiving standard prophylaxis and 4% in those treated with the new strategy (P = .004), with an absolute benefit increase of 32% (95% confidence interval: 11%-52%), in absence of any difference in clinical conditions between the two groups. CONCLUSIONS: The new management protocol had a highly favorable impact on the development of an SSI. LEVEL OF EVIDENCE: 2b Laryngoscope, 129:2634-2639, 2019.

OpenMICE: an open spatial and temporal data set of small mammals in south-central Italy based on owl pellet data.

The use of database technologies as a tool for implementing data for quantitative ecological studies and biodiversity conservation planning has recently attracted the attention of the biological community. Despite the fact that the number of biodiversity data sets is quickly rising, online databases of small mammals are still scarce, especially for Mediterranean ecosystems. We implemented the first standardized and accessible georeferenced European database of small mammal occurrences, abundances, and functional traits. Data derived from owl pellets was obtained from different sources, including original field surveys, publications, gray literature, existing databases, and museum collections. The OpenMICE database covers the years 1972 to 2017 and includes nearly 50,000 individuals from 23 species (13 Rodentia and 10 Eulipotyphla) at 190 sites in south-central Italy. Our specific goals in compiling this data set were as follows: (1) to make data that is usually accessible to a restricted audience widely available; (2) to identify the gaps in knowledge about small mammal communities and guide future sampling and conservation efforts; and (3) to gain a first insight into small mammal diversity and abundance in the study area. The potential applications of our spatial relational database are many, from individual-based to community-based models as potential indicators of environmental changes at different geographical scales. Given the long-term support for data storage, the OpenMICE database could be further expanded to include other geographical contexts and implemented with new information and traits. We would appreciate that researchers cite this paper if using all or part of the data set. We also request that researchers and teachers inform us of how they are using the data. We intend to keep it up to date as novel studies become available (see Data Availability).

Epidemiology of Infectious Complications During Extracorporeal Membrane Oxygenation in Children: A Single-Center Experience in 46 Runs.

BACKGROUND: Infections represent a severe complication of extracorporeal membrane oxygenation (ECMO). Aim of the present study was to describe the epidemiology of infections acquired during ECMO in a tertiary care children's hospital. METHODS: Retrospective analysis of clinical records of patients undergoing ECMO between January 2009 and December 2016. For each patient, data were collected on clinical characteristics, modality of ECMO support, site and etiology of documented infections, survival within 1 week after ECMO weaning and/or at pediatric intensive care unit discharge. These data were employed to evaluate overall infection prevalence, infection rate expressed as episodes/1000 days of support and cumulative risk estimates of infections occurring during ECMO. RESULTS: During the study period, a total of 46 ECMO procedures were performed. The overall prevalence of documented infections was 33%, with an infection rate of 27.22 and a cumulative risk of 55%. Bloodstream infection represented the most frequently documented (53%), followed by pneumonia (40%). Coagulase-negative staphylococci and Pseudomonas aeruginosa prevailed as isolated pathogens. Overall survival was 59%, and 46% among those developing infections during ECMO. CONCLUSIONS: ECMO is a procedure at high risk for infections. Our data, limited to 1 center, represent a recent benchmark for further investigations.

Granulated sugar for adjuvant treatment of surgical wound infection due to multi-drug-resistant pathogens in a child with sarcoma: a case report and literature review.

The use of sugar for treating wounds which are difficult to heal and positive to resistant pathogens has already been documented. The authors describe the successful treatment by direct instillation of granular sugar in the antibiotic-resistant infected surgical site wound of a child with sarcoma. Sugar instillation in the extended spectrum beta-lactamase (ESBL)-producing Enterobacter cloacae positive wound, in addition to systemic treatment with meropenem and levofloxacin, allowed culture negativization in six days and complete wound healing in 30 days. These results make the use of sugar an attractive option for wounds which are difficult to treat, even in an immunocompromised child.

Management of Lyme Disease in European Children: a Review for Practical Purpose.

PURPOSE OF REVIEW: Lyme disease is a tick-borne zoonosis transmitted through a bite of a tick carrying a spirochete belonging to Borrelia species. In the last 20 years, the reported incidence of Lyme disease is increased by three times in Europe. Clinically, the illness develops through a primary stage with a typical skin rash (erythema marginatum), then a secondary stage with possible neurologic or cardiac involvement. The last stage (chronic Lyme disease) is mainly represented by arthritis or late neurological complications but nowadays is rarely seen due to precocious antibiotic use. RECENT FINDINGS: The diagnosis of Lyme disease is essentially based on history in agreement with tick exposure (living/recent traveling in endemic area or tick bite) and clinical findings compatible with the disease. At present, no laboratory diagnostic tool available can neither establish nor exclude the diagnosis of Lyme disease. The management of Lyme disease should comprise a prophylactic administration of antibiotic in selected population (patients exposed to a tick bite in endemic regions) in which the typical signs of Lyme disease are not yet appeared; conversely, patients with current signs of Lyme disease should undergo a standard therapeutic course. First-line therapy should be oral tetracycline or oral penicillin/cephalosporin (in pediatric populations, beta-lactamic drugs are preferred). In severe courses, intravenous route should be preferred. The aim of this review is to provide an updated guide to the management of pediatric Lyme patients, from prophylaxis to first- and second-line therapy in European setting.

Listeria Meningitis in an Immunocompetent Child.

Listeria monocytogenes is a facultative anerobic, gram-positive bacillus that is isolated from the soil, vegetables, and wild or domestic animals. Listeria infection is usually found in the older adults, immunocompromised patients, pregnant women, and newborns, whereas it is rare in healthy infants and children. Listeria monocytogenes may cause meningitis, meningoencephalitis, brain abscess, pyogenic arthritis, osteomyelitis, and liver abscess in children. The course of meningoencephalitis by Listeria is often severe and even fatal. Complications such as acute hydrocephalus, brain abscess, and spine abscess can develop, and the mortality associated with listeriosis is significantly high. We present a case of a previously healthy 7-year-old boy who developed Listeria monocytogenes meningitis.

Candida infections in paediatrics: Results from a prospective single-centre study in a tertiary care children's hospital.

To describe the epidemiology of invasive Candida infection in a tertiary care paediatric hospital. Prospective single-centre survey on all Candida strains isolated from normally sterile fluids and urines in the period 2005-2015 . A total of 299 ICI were documented in 262 patients. Urinary tract infection represented the most frequent diagnosis (62%), followed by fungaemia (34%) and peritonitis (4%). Fungaemia was most frequent in children with cancer (59%) or in low birth weight neonates (61%), while urinary tract infections were more frequent in patients with urinary tract malformation. C.albicans was the most frequently isolated species (60%) compared with C. non-albicans, but differences were present according to the site of isolation and underlying conditions. Overall 90-day mortality was 7%, 13% in fungaemias, 8% in peritonitis and 2% in urinary tract infections. The rates of invasive Candida infection increased during the study period. Invasive Candida infection is diagnosed with increasing frequency in children. Site of isolation and aetiology are frequently related with the presence of underlying, favouring conditions. Mortality was not negligible, especially in the presence of more invasive infections and specific underlying conditions.

Intra- and Interspecific Interactions as Proximate Determinants of Sexual Dimorphism and Allometric Trajectories in the Bottlenose Dolphin Tursiops truncatus (Cetacea, Odontoceti, Delphinidae).

Feeding adaptation, social behaviour, and interspecific interactions related to sexual dimorphism and allometric growth are particularly challenging to be investigated in the high sexual monomorphic Delphinidae. We used geometric morphometrics to extensively explore sexual dimorphism and ontogenetic allometry of different projections of the skull and the mandible of the bottlenose dolphin Tursiops truncatus. Two-dimensional landmarks were recorded on the dorsal, ventral, lateral, and occipital views of the skull, and on the lateral view of the left and the right mandible of 104 specimens from the Mediterranean and the North Seas, differing environmental condition and degree of interspecific associations. Landmark configurations were transformed, standardized and superimposed through a Generalized Procrustes Analysis. Size and shape differences between adult males and females were respectively evaluated through ANOVA on centroid size, Procrustes ANOVA on Procrustes distances, and MANOVA on Procrustes coordinates. Ontogenetic allometry was investigated by multivariate regression of shape coordinates on centroid size in the largest homogenous sample from the North Sea. Results evidenced sexual dimorphic asymmetric traits only detected in the adults of the North Sea bottlenose dolphins living in monospecific associations, with females bearing a marked incision of the cavity hosting the left tympanic bulla. These differences were related to a more refined echolocalization system that likely enhances the exploitation of local resources by philopatric females. Distinct shape in immature versus mature stages and asymmetric changes in postnatal allometry of dorsal and occipital traits, suggest that differences between males and females are established early during growth. Allometric growth trajectories differed between males and females for the ventral view of the skull. Allometric trajectories differed among projections of skull and mandible, and were related to dietary shifts experienced by subadults and adults.

What Is the Best Initial Empirical Treatment of Suspected Sepsis in a Newborn Readmitted Soon after Discharge Home in an Era of Increased Resistance to Antibiotics? A Report of Two Cases.

Background Colonization/infection by antibiotic-resistant bacteria is becoming a major threat to health care systems. Case report Two septic neonates were readmitted in our hospital few days after hospital discharge. In both of them, microbiological workup revealed an infection caused by multiresistant pathogens. Noteworthy, one baby had received intensive care management for 4 weeks, whereas the other had been vaginally delivered and sent home on his second day of life. Conclusion These cases suggest that in countries and/or hospital with high prevalence of colonization/infection by resistant pathogens in nurseries, neonatal intensive care units, and obstetric wards, the choice of initial therapy of suspected sepsis in a neonate readmitted from home soon after discharge should take into account the possibility of an infection due to a multiresistant pathogen.

A systematic conservation planning approach to fire risk management in Natura 2000 sites.

A primary challenge in conservation biology is to preserve the most representative biodiversity while simultaneously optimizing the efforts associated with conservation. In Europe, the implementation of the Natura 2000 network requires protocols to recognize and map threats to biodiversity and to identify specific mitigation actions. We propose a systematic conservation planning approach to optimize management actions against specific threats based on two fundamental parameters: biodiversity values and threat pressure. We used the conservation planning software Marxan to optimize a fire management plan in a Natura 2000 coastal network in southern Italy. We address three primary questions: i) Which areas are at high fire risk? ii) Which areas are the most valuable for threatened biodiversity? iii) Which areas should receive priority risk-mitigation actions for the optimal effect?, iv) which fire-prevention actions are feasible in the management areas?. The biodiversity values for the Natura 2000 spatial units were derived from the distribution maps of 18 habitats and 89 vertebrate species of concern in Europe (Habitat Directive 92/43/EEC). The threat pressure map, defined as fire probability, was obtained from digital layers of fire risk and of fire frequency. Marxan settings were defined as follows: a) planning units of 40 × 40 m, b) conservation features defined as all habitats and vertebrate species of European concern occurring in the study area, c) conservation targets defined according with fire sensitivity and extinction risk of conservation features, and d) costs determined as the complement of fire probabilities. We identified 23 management areas in which to concentrate efforts for the optimal reduction of fire-induced effects. Because traditional fire prevention is not feasible for most of policy habitats included in the management areas, alternative prevention practices were identified that allows the conservation of the vegetation structure. The proposed approach has potential applications for multiple landscapes, threats and spatial scales and could be extended to other valuable natural areas, including protected areas.

Ultra high performance liquid chromatography-tandem mass spectrometry vs. commercial immunoassay for determination of vancomycin plasma concentration in children. Possible implications for everyday clinical practice.

BACKGROUND: Vancomycin therapeutic drug monitoring (TDM) is necessary for effective and safetherapy. The aim of the this paper was to develop a specific and robust ultra high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method for vancomycin quantification starting from low plasma volumes to be applied for the routine TDM in children. METHODS: Samples from children receiving intravenous vancomycin were analysed using a TSQ Quantum Access MAX Triple Quadrupole system coupled with an Accela 1250 UHPLC system after a rapid protein precipitation. Gradient separation chromatography was carried out using a Hypersil GOLD aQ C18 column (50 × 2.1 mm, particle size 1.9 µm). Method performance was validated following international guidelines. RESULTS: UHPLC-MS/MS allowed a rapid and specific quantification of vancomycin over the range 0.1-128 µg/mL from 50 µL of plasma with high reproducibility and accuracy in the absence of matrix effect. The comparison with the commercial immunoassay performed on 138 samples demonstrated the presence of a proportional bias. The concentrations of vancomycin measured with immunoassay were found to be 4.5% (95% CI: 1.3-7.7) higher than those determined with UHPLC-MS/MS. Importantly, a clinical discordance was found in about 10% of samples analysed. CONCLUSIONS: This new UHPLC-MS/MS method is accurate and specific for the measurement of vancomycin starting from small (50 µL) plasma volumes. The use of UHPLC-MS/MS is recommended to prevent a misclassification of therapeutic or toxic vancomycin levels in paediatrics.