New severity criteria for tricuspid regurgitation in a broad population of "real life" patients: Prevalence and prognostic impact.

Introduction Our objective was to determine, in "real life" patients, the prevalence of massive and torrential regurgitation among patients diagnosed with severe tricuspid regurgitation (TR), as well as its impact on long-term prognosis. Methods In a single-center retrospective study, all patients with an echocardiographic diagnosis of severe TR attended at a tertiary care hospital of an European country from January 2008 to December 2017 were recruited. Images were analysed off-line to measure the maximum vena contracta (VC) and TR was classified into three groups: severe (VC ≥ 7 mm), massive (VC 14-20 mm), and torrential (VC ≥ 21 mm). The impact of this classification on the combined event of heart failure (HF) admission and all-cause death in follow-up was investigated. Results A total of 614 patients (70 ± 13 years, 72 % women) were included. 81.4 % had severe TR, 15.8 % massive TR, and 2.8 % torrential TR. The 5-year HF-free survival  was 42 %, 43 %, and 12 % (p = 0.001), for the different subgroups of severe TR, respectively. After adjusting for baseline characteristics, TR severity was an independent predictor of survival free of the combined end-point: HR 0.91 [95 % CI 0.70-1.18] p = 0.46, for massive TR; and HR 2.5 [95 % CI 1.49-4.21] p = 0.001, for torrential TR considering severe TR as reference. Conclusions The prevalence of massive and torrential TR is not negligible among patients with severe TR in real life. The prognosis is significantly worse for patients with torrential TR measured by the maximum VC.

Risk scores for predicting incident heart failure admission in patients with chronic coronary syndromes: Validation in a prospective, monocentric, long-term, cohort study.

BACKGROUND: Heart failure (HF) admission in chronic coronary syndrome (CCS) patients has a prognostic impact. Stratification schemes have been described for predicting this endpoint, but none of them has been externally validated. OBJECTIVES: Our aim was to develop point scores for predicting incident HF admission with data from previous studies, to perform an external validation in an independent prospective cohort and to compare their discriminative ability for this event. METHODS: Independent predictive variables of HF admission in CCS patients without baseline HF were selected from four previous prospective studies (CARE, PEACE, CORONOR and CLARIFY), generating scores based on the relative magnitude of the coefficients of Cox of each variable. Finally, the scores were validated and compared in a monocentric prospective cohort. RESULTS: The validation cohort included 1212 patients followed for up to 17 years, with 171 patients suffering at least one HF admission in the follow-up. Discriminative ability for predicting HF admission was statistically significant for all, and paired comparisons among them were all nonsignificant except for CORONOR score was superior to CLARIFY score (C-statistic 0.73, 95%CI 0.69-0.76 vs. 0.69, 95% CI 0.65-0.73; p = 0.03). CONCLUSION: All tested scores showed significant discriminative ability for predicting incident HF admission in this independent validation study. Their discriminative ability was similar, with significant differences only between the two scores with higher and lower performance.

Long-Term Prognostic Impact of Sex in Patients with Chronic Coronary Syndrome: A 17-Year Prospective Cohort Study.

Background: Women and men with chronic coronary syndrome (CCS) have different clinical features and management, and studies on mid-term prognosis have reported conflicting results. Our objective was to investigate the impact of the female sex in the prognosis of the disease in the very long term. Methods and Results: We investigated differential features and very long-term prognosis in 1268 consecutive outpatients with CCS (337 [27%] women and 931 [73%] men). Women were older than men, more likely to have hypertension, diabetes, angina, and atrial fibrillation, and less likely to be exsmoker/active smoker and to have been treated with coronary revascularization (p < 0.05 for all). The prescription of statins, antiplatelets, and betablockers was similar in both groups. After up to 17 years of follow-up (median = 11 years, interquartile range = 4-15 years), cumulative incidences of acute myocardial infarction (10.2% vs. 11.8%) or stroke (11% vs. 10%) at median follow-up were similar, but the risks of major cardiovascular events (acute myocardial infarction, stroke, or cardiovascular death, 41.2% vs. 33.6%), hospital admission for heart failure (20.9% vs. 11.9%), or cardiovascular death (32.3% vs. 22.1%) were significantly higher for women (p < 0.0005), with a nonsignificant trend to higher overall mortality (45.2% vs. 39.1%, p = 0.07). However, after multivariate adjustment, all these differences disappeared. Conclusion: Although women and men with CCS presented a different clinical profile, and crude rates of major cardiovascular events, heart failure and cardiovascular death were higher in women, female sex was not an independent prognostic factor in this study with up to 17 years of follow-up.

Electrocardiographic features and need for pacemaker in cardiac amyloidosis: Analysis of 58 cases. / Alteraciones electrocardiográficas y necesidad de marcapasos en amiloidosis cardiaca: análisis de 58 casos.

AIM: Amyloidosis is a disease in which amyloid fibrils can be deposited in different cardiac structures, and several electrocardiographic abnormalities can be produced by this phenomenon. The objective of this study was to describe the most common basal electrocardiographic alterations in patients diagnosed with cardiac amyloidosis (CA) and to determine if these abnormalities have an impact on the need of pacemaker. METHODS: This retrospective study included patients who had an established diagnosis of CA [light-chain cardiac amyloidosis (LA-CA) or transthyretin cardiac amyloidosis (TTR-CA)] between January 2013 and March 2021. The baseline heart rate, the percentage of patients with a pseudo-infarct pattern, low-voltage pattern or cardiac conductions disturbances, and the impact of these factors on the need of pacemaker were analysed. RESULTS: Fifty-eight patients with CA (20 with LA-CA and 38 with TTR-CA) were included, and the majority were male (69.0%). Twenty-one patients had atrial fibrillation (AF) at diagnosis. Thirty-five patients had a pseudo-infarct pattern, 35% had a low-voltage pattern, and 22% had criteria for ventricular hypertrophy. Two hirds had a conduction disorder: 18 patients with first degree atrioventricular block, 12 right bundle branch block, 3 left bundle branch block and 25 with a branch hemiblock. There were no differences between LA-CA and TTR-CA. Patients with TTR-CA had a greater need for pacemakers in the folow-up (39±40 meses). Bundle branch block was a predictor of the need for a permanent pacemaker (HR: 23.43; CI 95%: 4.09.134.09; P=.01). CONCLUSIONS: Electrocardiographic abnormalities in patients diagnosed wich CA are heterogeneus. Most frecuent is the presence of conduction disorders, the pseudoinfarction pattern, followed by the low voltage pattern. Patients with any bundle branch block at the baseline electrocardiogram need more frecuent to require a pacemaker during follow-up, especially in TTR-CA.

How to thrive in unstable environments: Gene expression profile of a riparian earthworm under abiotic stress.

Nowadays, extreme weather events caused by climate change are becoming more frequent. This leads to the occurrence of extreme habitats to which species must adapt. This challenge becomes crucial for species living in unstable environments, such as the riparian earthworm Eiseniella tetraedra. Its cosmopolitan distribution exposes it to various environmental changes, such as freezing in subarctic regions or droughts in Mediterranean areas. Transcriptional changes under cold and desiccation conditions could therefore shed light on the adaptive mechanisms of this species. An experiment was performed for each condition. In the cold experiment, the temperature was lowered to -14 °C ± 2 °C (compared to 8 °C for control samples), and in the desiccation treatment, humidity was lowered from 60% to 15%. Comparisons of gene expression levels between earthworms under freezing conditions and control earthworms revealed a total of 84 differentially expressed genes and comparisons between the desiccation experiment and the control yielded 163 differentially expressed genes. However, no common responses were found between the two treatments. The results suggest that E. tetraedra can acclimate to low temperatures due to the upregulation of genes involved in glucose accumulation. However, downregulation of the respiratory chain suggests that this earthworm does not tolerate freezing conditions. Under desiccation conditions, genes involved in cell protection from apoptosis and DNA repair were upregulated. In contrast, lipid metabolism was downregulated, presumably to conserve resources by reducing the rate at which they are consumed.

Relationship between overweight and obesity and cardiac dimensions and function in a paediatric population.

Obesity in adults is associated with left ventricular hypertrophy, dilatation, and myocardial fibrosis, as well as heart failure and coronary heart disease. These associations have been studied to a lesser extent in the paediatric population. This study aims to investigate the relationship between obesity and cardiac structure and function in the paediatric population. In a southern Spanish village, we selected all inhabitants aged 6-17 years stratifying by age, gender, and educational centres. We performed a complete transthoracic echocardiogram evaluating all the cardiac morphological and functional parameters commonly measured in an echocardiographic study. There were 212 children and adolescents included. Of them, 48.1% were males. The mean age was 10.9 ± 3.0 years. A total of 106 (50%) were normal weight, 57 (26.9%) overweight, and 49 (23.1%) obese. Sex and age were similar in all three groups. Overweight and obesity were associated with larger left ventricular end-diastolic and end-systolic volumes (p < 0.0005), greater left ventricular mass (p < 0.0005), and smaller ejection fraction (p < 0.0005). They were also associated with larger atrial, aortic, and right ventricular size. Lateral and mean E/e' ratios were higher (p = 0.007 and p = 0.01 respectively). Body mass index was independently associated with all cavity size variables as well as left ventricular ejection fraction. CONCLUSION: Childhood obesity is independently associated with larger heart chambers, greater left ventricle mass, and smaller left ventricle ejection fraction. WHAT IS KNOWN: • Childhood obesity is related to the development of cardiovascular risk factors and is considered an epidemic of the twenty-first century; its prevalence is rising. WHAT IS NEW: • Childhood overweight and obesity lead to changes in cardiac structure and function which, although not considered clinically pathological, are significant and a result of obesity, and which behave as unfavourable incipient alterations at an early age.

Impact on daily clinical practice of the latest evidence on percutaneous closure of patent foramen ovale after cryptogenic stroke: a single-center experience.

INTRODUCTION AND OBJECTIVES: At the end of 2017, three clinical trials demonstrated that, in selected patients, percutaneous closure of patent foramen ovale (PFO) after cryptogenic stroke (CS) reduces the risk of recurrence. Our aim was to determine the impact of these findings on routine clinical practice in a tertiary hospital. METHODS: Patients with CS and percutaneous closure of PFO during 2001-2020 were included. The clinical characteristics of the patient and the anatomical characteristics of the foramen were analyzed. Based on both, the closure indications were classified into three groups according to the latest European recommendations and were analyzed in two periods, before and after the publication date of the clinical trials. RESULTS: A total of 293 patients were included. The mean age was 49 ± 11 years, and 15% were older than 60 years. The median RoPE score was 6 [p25-75, 5-7] and 75% had complex anatomy (CA). After the publication of the studies, the frequency of CA and the mean age of the patients were significantly higher (89% vs. 69% p < 0.0005 and 51 ± 11 vs. 48 ± 11 years, p = 0.02, respectively), and the RoPE score, significantly lower (5 [5-7] versus 6 [5-7], p = 0.02). Inadequate closure indications were significantly reduced (8% vs. 18%, p = 0.02). CONCLUSION: After the publication of clinical trials that have shown benefit of PFO closure after CS, the number of inappropriate indications for closure has decreased significantly in our institution, with a higher percentage of CA, despite a clinical profile suggestive of lower causal probability of PFO.

Detección viral y respuesta serológica en pacientes críticos intubados con SARS-CoV-2. Implicaciones para retirada de aislamiento / Viral detection and serological response in critically ill patients with sars-cov-2. implications for isolation withdrawa

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Effectiveness and cost-effectiveness of a virtual community of practice to improve the empowerment of patients with ischaemic heart disease: study protocol of a randomised controlled trial.

INTRODUCTION: Virtual Communities of Practice (VCoP) or knowledge-sharing virtual communities offer ubiquitous access to information and exchange possibilities for people in similar situations, which might be especially valuable for the self-management of patients with chronic diseases. In view of the scarce evidence on the clinical and economic impact of these interventions on chronic conditions, we aim to evaluate the effectiveness and cost-effectiveness of a VCoP in the improvement of the activation and other patient empowerment measures in patients with ischaemic heart disease (IHD). METHODS AND ANALYSIS: A pragmatic randomised controlled trial will be performed in Catalonia, Madrid and Canary Islands, Spain. Two hundred and fifty patients with a recent diagnosis of IHD attending the participating centres will be selected and randomised to the intervention or control group. The intervention group will be offered participation for 12 months in a VCoP based on a gamified web 2.0 platform where there is interaction with other patients and a multidisciplinary professional team. Intervention and control groups will receive usual care. The primary outcome will be measured with the Patient Activation Measure questionnaire at baseline, 6, 12 and 18 months. Secondary outcomes will include: clinical variables; knowledge (Questionnaire of Cardiovascular Risk Factors), attitudes (Self-efficacy Managing Chronic Disease Scale), adherence to the Mediterranean diet (Mediterranean Diet Questionnaire), level of physical activity (International Physical Activity Questionnaire), depression (Patient Health Questionnaire), anxiety (Hospital Anxiety Scale-A), medication adherence (Adherence to Refill Medication Scale), quality of life (EQ-5D-5L) and health resources use. Data will be collected from self-reported questionnaires and electronic medical records. ETHICS AND DISSEMINATION: The trial was approved by Clinical Research Ethics Committee of Gregorio Marañón University Hospital in Madrid, Nuestra Señora de Candelaria University Hospital in Santa Cruz de Tenerife and IDIAP Jordi Gol in Barcelona. The results will be disseminated through workshops, policy briefs, peer-reviewed publications, local/international conferences. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT03959631). Pre-results.

Mechanistic simulations predict that thermal and hydrological effects of climate change on Mediterranean trout cannot be offset by adaptive behaviour, evolution, and increased food production.

Streamflow is a main driver of fish population dynamics and is projected to decrease in much of the northern hemisphere, especially in the Mediterranean region, due to climate change. However, predictions of future climate effects on cold-water freshwater fish populations have typically focused only on the ecological consequences of increasing temperatures, overlooking the concurrent and interacting effects of climate-driven changes in streamflow regimes. Here, we present simulations that contrasted the consequences of changes in thermal regime alone versus the combined effects of changes in thermal regime and streamflow for resident trout populations in distinct river types with different sensitivities to climatic change (low-altitude main river vs. high-altitude headwaters). We additionally assessed the buffering effect of increased food production that may be linked to warming. We used an eco-genetic individual-based model that integrates the behavioural and physiological effects of extrinsic environmental drivers -temperature and flow- with intrinsic dynamics -density-dependence, phenotypic plasticity and evolutionary responses - across the entire trout life cycle, with Mediterranean brown trout Salmo trutta as the model species. Our simulations indicated that: (1) Hydrological change is a critical dimension of climate change for the persistence of trout populations, in that neither river type supported viable populations under strong rates of flow change, even under scenarios of increased food production. (2) Climate-change-related environmental change most affects the largest, oldest trout via increased metabolic costs and decreased energy inputs. In both river types, populations persisted under extreme warming alone but became dominated by younger, smaller fish. (3) Density-dependent, plastic and evolutionary changes in phenology and life-history traits provide trout populations with important resilience to warming, but strong concurrent shifts in streamflow could exceed the buffering conferred by such intrinsic dynamics.

Eco-evolutionary responses to recreational fishing under different harvest regulations.

Harvesting alters demography and life histories of exploited populations, and there is mounting evidence that rapid phenotypic changes at the individual level can occur when harvest is intensive. Therefore, recreational fishing is expected to induce both ecological and rapid evolutionary changes in fish populations and consequently requires rigorous management. However, little is known about the coupled demographic and evolutionary consequences of alternative harvest regulations in managed freshwater fisheries. We used a structurally realistic individual-based model and implemented an eco-genetic approach that accounts for microevolution, phenotypic plasticity, adaptive behavior, density-dependent processes, and cryptic mortality sources (illegal harvest and hooking mortality after catch and release). We explored the consequences of a range of harvest regulations, involving different combinations of exploitation intensity and minimum and maximum-length limits, on the eco-evolutionary trajectories of a freshwater fish stock. Our 100-year simulations of size-selective harvest through recreational fishing produced negative demographic and structural changes in the simulated population, but also plastic and evolutionary responses that compensated for such changes and prevented population collapse even under intense fishing pressure and liberal harvest regulations. Fishing-induced demographic and evolutionary changes were driven by the harvest regime, and the strength of responses increased with increasing exploitation intensity and decreasing restriction in length limits. Cryptic mortality strongly amplified the impacts of harvest and might be exerting a selective pressure that opposes that of size-selective harvest. "Slot" limits on harvestable length had overall positive effects but lower than expected ability to buffer harvest impacts. Harvest regulations strongly shape the eco-evolutionary dynamics of exploited fish stocks and thus should be considered in setting management policies. Our findings suggest that plastic and evolutionary responses buffer the demographic impacts of fishing, but intense fishing pressure and liberal harvest regulations may lead to an unstructured, juvenescent population that would put the sustainability of the stock at risk. Our study also indicates that high rates of cryptic mortality may make harvest regulations based on harvest slot limits ineffective.

Admission inferior vena cava measurements are associated with mortality after hospitalization for acute decompensated heart failure.

BACKGROUND: Prognostication of patients hospitalized with acute decompensated heart failure (ADHF) is important to patients, providers, and healthcare systems. Few bedside tools exist to prognosticate patients hospitalized with ADHF. OBJECTIVE: The objective of this study was to assess the relationship between inferior vena cava (IVC) diameter and postdischarge mortality in patients hospitalized with ADHF. DESIGN: Prospective observational study. SETTING: A 247-bed urban teaching hospital in Spain PATIENTS: Ninety-seven patients hospitalized with ADHF. INTERVENTION: None. MEASUREMENTS: The IVC diameter and collapsibility were measured by a hospitalist at the time of admission and discharge. Primary outcome was 90-day all-cause mortality. Secondary outcomes were readmission rates at 90 and 180 days, and 180-day all-cause mortality. Patients were followed for 180 days. RESULTS: Data from 80 patients were analyzed. From admission to discharge, a significant improvement in IVC maximum (IVCmax ) diameter (2.12 vs 1.87 cm; P < 0.001) and IVC collapsibility (25.7% vs 33.1%; P < 0.001) was seen in the total study cohort. During the 90-day follow-up period, 11 patients (13.7%) died. An admission IVCmax diameter ≥1.9 cm was associated with a higher mortality rate at 90 days (25.4% vs 3.4%; P = 0.009) and 180 days (29.3% vs 3.4%; P = .003). In a multivariate Cox proportional hazards regression analysis, admission IVCmax diameter was an independent predictor of 90-day mortality (hazard ratio [HR]: 5.88; 95% confidence interval [CI]: 1.21-28.10; P = 0.025) and 90-day readmission (HR: 3.20; 95% CI: 1.24-8.21; P = 0.016). CONCLUSION: In patients hospitalized with acute decompensated heart failure, a dilated IVC by bedside ultrasound at the time of admission is associated with a higher 90-day mortality after hospitalization. Journal of Hospital Medicine 2016;11:778-784. © 2016 Society of Hospital Medicine.

Current Occurrence of the Atlantic Sturgeon Acipenser oxyrinchus in Northern Spain: A New Prospect for Sturgeon Conservation in Western Europe.

Acipenser oxyrinchus is considered extirpated in Europe, but numerous breeding populations still exist on the Atlantic coast of North America. An adult female A. oxyrinchus, 2500 mm total length and 120 kg wet weight, was accidentally fished on 24 November 2010 near the coast of Gijón, Asturias, Spain. The fish was identified by its morphological pattern as well as by mitochondrial and nuclear DNA analyses. Because the sturgeon was found far away from any known breeding area, it was considered a stray or vagrant specimen. It certainly has a natural origin, but its eventual birthplace could not be determined. Because its current occurrence was unknown in southwestern Europe until now, the species is not cataloged or protected in this area. Therefore, the residual European stocks of A. oxyrinchus ought to be listed as Critically Endangered (CR) according to the IUCN categories. Likewise, it is imperative for southwestern European countries with an historic or recent occurrence of A. oxyrinchus to protect the species through domestic and international legislation. The present sympatric occurrence of A. sturio and A. oxyrinchus raises new challenges about key questions, such as the species selection for restoration program in European countries. Accurate monitoring is mandatory to obtain appropriate information for an assessment of the current occurrence of A. oxyrinchus in southwestern Europe.

Consentimiento informado por representación en unidades de cuidados intensivos. ¿Necesitan los familiares instrucciones previas? / Informed consent for representation in intensive care units. Do the relatives need previous instructions?

Introducción. La toma de decisiones en las unidades de cuidados intensivos (UCI) suele revertir gran complejidad, debido a la situación frecuente de invalidez del paciente condicionada por la sedación o el estado clínico crítico. El objetivo del presente estudio fue explorar la calidad del proceso de consentimiento informado (CI) por representación e investigar la opinión de los representantes sobre la utilidad de disponer del documento de instrucciones previas (DIP) al ingreso. Material y método. Estudio observacional y retrospectivo durante 24 meses en la UCI del Hospital San Juan de Dios del Aljarafe (Sevilla, España), mediante entrevista telefónica, a los representantes de los pacientes de la UCI que firmaron un documento de CI. Se analizaron los datos demográficos, el cuestionario sobre conocimientos del CI, la posibilidad de realizar DIP y la utilidad del DIP en los pacientes ingresados en la UCI. Resultados. Se realizaron 90 entrevistas. El 96% de los representantes encuestados sabían qué era un CI, y en el 65% de los casos conocían la posibilidad actual de poder realizar DIP. Refirieron no preferir que el CI lo hubiese firmado otra persona (81,1%) y negaron preferir que la existencia previa de DIP les hubiera evitado actuar como representante (75,5%). Reconocieron que hubiese sido positivo que su familiar hubiese firmado previamente un DIP (47,7%). Conclusiones. El CI por representación es una práctica aceptada, con calidad percibida adecuada. La ausencia de DIP no se percibe como un factor limitante en la asunción por los familiares de la responsabilidad sobre las decisiones en el paciente crítico (AU)

Introduction. Decision making in intensive care units (ICUs) usually returns very complex due to frequent invalidity of conditional patient sedation or critical medical condition. The goal of this study is to explore the quality of the informed consent (IC) for representation and to know their opinion about the availability of the advance directives document at admission. Material and method. Retrospective observational study during 24 months in the ICU of the Hospital San Juan de Dios del Aljarafe (Seville, Spain), by telephone interview, to the representative of ICU patients who signed one surrogated informed consent. We evaluated demographic data and developed a questionnaire about informed consent, their knowledge of advance directives and the usefulness in ICU patients. Results. Ninety interviews were conducted. 96,6% knew the meaning of informed consent. 65,5% of the representatives knew the advance directives document. 81,1% said not to prefer that informed consent was signed by another relative and 75,5% said not to prefer that an advance directive had avoided them to be the representative of the patient. 47,7% said it would be positive to have advance directives signed by the patient. Conclusions. The informed consent for representation is an accepted practice, with adequate perception of quality of information. Absence of advance directives is not perceived as a limiting factor when the relatives assume the decisions in the critically ill patient (AU)

Evaluation of PCBs and DDTs in endemic Iberian barbel Barbus bocagei (Steindachner, 1864) populations.

PCB and DDT levels were evaluated in populations of endemic Iberian barbel (Barbus bocagei) in the Jarama River in Spain via a pollution gradient from well-preserved areas upstream to contaminated downstream areas. Age structure, abundance, recruitment and levels of morphological abnormalities and ectoparasites were assessed. Upstream to downstream PCB concentrations ranged from 3.4 to 101.4 ng/g (ww) and from 0.9 to 19.6 ng/g ww for DDTs. The PCB pattern was dominated by the PCB 153, 138 and 180 congeners, and the less chlorinated ones had a relatively high contribution upstream. Barbels exposed to low PCB and DDT levels had a well-balanced population with a predominant cohort of young fish, indicating good recruitment. The most contaminated sites displayed a disrupted age distribution, where the proportion of young fish was clearly under-represented. Recruitment and total density of barbel populations decreased downstream where the highest PCB and DDT levels were found. In addition, a higher incidence of abnormalities and ectoparasites was observed at these sites. High concentrations of PCBs and DDTs most likely contribute to the reduction of Iberian barbel reproductive performance in the most contaminated sites, as shown by the disrupted age-distribution found in our study.

Thermal carrying capacity for a thermally-sensitive species at the warmest edge of its range.

Anthropogenic environmental change is causing unprecedented rates of population extirpation and altering the setting of range limits for many species. Significant population declines may occur however before any reduction in range is observed. Determining and modelling the factors driving population size and trends is consequently critical to predict trajectories of change and future extinction risk. We tracked during 12 years 51 populations of a cold-water fish species (brown trout Salmo trutta) living along a temperature gradient at the warmest thermal edge of its range. We developed a carrying capacity model in which maximum population size is limited by physical habitat conditions and regulated through territoriality. We first tested whether population numbers were driven by carrying capacity dynamics and then targeted on establishing (1) the temperature thresholds beyond which population numbers switch from being physical habitat- to temperature-limited; and (2) the rate at which carrying capacity declines with temperature within limiting thermal ranges. Carrying capacity along with emergent density-dependent responses explained up to 76% of spatio-temporal density variability of juveniles and adults but only 50% of young-of-the-year's. By contrast, young-of-the-year trout were highly sensitive to thermal conditions, their performance declining with temperature at a higher rate than older life stages, and disruptions being triggered at lower temperature thresholds. Results suggest that limiting temperature effects were progressively stronger with increasing anthropogenic disturbance. There was however a critical threshold, matching the incipient thermal limit for survival, beyond which realized density was always below potential numbers irrespective of disturbance intensity. We additionally found a lower threshold, matching the thermal limit for feeding, beyond which even unaltered populations declined. We predict that most of our study populations may become extinct by 2100, depicting the gloomy fate of thermally-sensitive species occurring at thermal range margins under limited potential for adaptation and dispersal.

Appearances can be deceptive: different diversification patterns within a group of Mediterranean earthworms (Oligochaeta, Hormogastridae).

Many recent studies on invertebrates have shown how morphology not always captures the true diversity of taxa, with cryptic speciation often being discussed in this context. Here, we show how diversification patterns can be very different in two clades of closely related earthworms in the genus Hormogaster stressing the risk of using nonspecific substitution rate values across taxa. On the one hand, the Hormogaster elisae species complex, endemic to the central Iberian Peninsula, shows morphological stasis. On the other hand, a clade of Hormogaster from the NE Iberian Peninsula shows an enormous morphological variability, with 15 described morphospecies. The H. elisae complex, however, evolves faster genetically, and this could be explained by the harsher environmental conditions to which it is confined-as detected in this study, that is, sandier and slightly poorer soils with lower pH values than those of the other species in the family. These extreme conditions could be at the same time limiting morphological evolution and thus be responsible for the observed morphological stasis in this clade. Contrarily, Hormogaster species from the NE Iberian Peninsula, although still inhabiting harsher milieu than other earthworm groups, have had the opportunity to evolve into a greater morphological disparity. An attempt to delimit species within this group following the recently proposed general mixed Yule-coalescent method showed a higher number of entities than expected under the morphospecies concept, most probably due to the low vagility of these animals, which considerably limits gene flow between distant conspecific populations, but also because of the decoupling between morphological and genetic evolution in the H. elisae complex.

Adding complexity to the complex: new insights into the phylogeny, diversification and origin of parthenogenesis in the Aporrectodea caliginosa species complex (Oligochaeta, Lumbricidae).

The importance of the Aporrectodea caliginosa species complex lies in the great abundance and wide distribution of the species which exist within it. For more than a century, chaos has surrounded this complex; morphological criteria has failed to solve the taxonomic status of these species. This present body of work aims to study the phylogeny of this complex by increasing the number of samples used in previous molecular works and by including morphologically-similar species that were never studied using molecular tools (A. giardi, Nicodrilus monticola, N. carochensis and N. tetramammalis). Two basal clades were obtained: one formed by A. caliginosa and A. tuberculata and the other by the rest of the species. This second clade was divided into two more: one with Eurosiberian and another with Mediterranean forms. A. caliginosa and A. longa were divided into two paraphyletic groups. Both A. giardi and A. nocturna showed characteristics consistent with monophyletic groups. Each of the two recovered lineages of A. trapezoides were phylogenetically related to different sexual species. While lineage I of A. trapezoides was monophyletic, lineage II resulted to be paraphyletic, as well as the three Nicodrilus 'species'. The diversification of the complex occurred during the Late Miocene-Early Pliocene (6.92-11.09 Mya). The parthenogenetic forms within the Mediterranean clade would have diversified before the ones in the Eurosiberian clade (3.13-4.64 Mya and 1.05-3.48 Mya, respectively), thus implying the existence not only of at least two different moments in which parthenogenesis arose within this complex of species, but also of two different and independent evolutionary lines. Neither the 4× rule nor the GMYC method for species delimitation were successful for distinguishing taxonomically-distinct species.

Respuesta: Abordaje quirúrgico en el fracaso de la terapia de resincronización cardiaca por vía intravascular / Reply: Surgical approach to endovascular cardiac resynchronisation after failure

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Understanding the biogeography of a group of earthworms in the Mediterranean basin--the phylogenetic puzzle of Hormogastridae (Clitellata: Oligochaeta).

Traditional earthworm taxonomy is hindered due to their anatomical simplicity and the plasticity of the characteristics often used for diagnosing species. Making phylogenetic inferences based on these characters is more than difficult. In this study we use molecular tools to unravel the phylogeny of the clitellate family Hormogastridae. The family includes species of large to mid-sized earthworms distributed almost exclusively in the western Mediterranean region where they play an important ecological role. We analyzed individuals from 46 locations spanning the Iberian Peninsula to Corsica and Sardinia, representing the four described genera in the family and 20 species. Molecular markers include mitochondrial regions of the cytochrome c oxidase subunit I gene (COI), 16S rRNA and tRNAs for Leu, Ala, and Ser, two nuclear ribosomal genes (nearly complete 18S rRNA and a fragment of 28S rRNA) and two nuclear protein-encoding genes (histones H3 and H4). Analyses of the data using different approaches corroborates monophyly of Hormogastridae, but the genus Hormogaster is paraphyletic and Hormogaster pretiosa appears polyphyletic, stressing the need for taxonomic revisionary work in the family. The genus Vignysa could represent an early offshoot in the family, although the relationships with other genera are uncertain. The genus Hemigastrodrilus is related to the Hormogaster elisae complex and both are found in the Atlantic drainage of the Iberian Peninsula and France. From a biogeographic perspective Corsica and Sardinia include members of two separate hormogastrid lineages. The species located in Corsica and Northern Sardinia are related to Vignysa, whereas Hormogaster pretiosa pretiosa, from Southern Sardinia, is closely related to the Hormogaster species from the NE Iberian Peninsula. A molecular dating of the tree using the separation of the Sardinian microplate as a calibration point (at 33 MY) and assuming a model of vicariance indicates that the diversification of Hormogastridae may be ancient, ranging from 97 to 67 Ma.