No abstract

In a wide variety of habitats, including some heavily urbanised areas, the adaptability of populations of common bottlenose dolphin (Tursiops truncatus) may depend on the social structure dynamics. Nonetheless, the way in which these adaptations take place is still poorly understood. In the present study we applied photo-identification techniques to investigate the social structure of the common bottlenose dolphin population inhabiting the Gulf of Alghero (Sardinia, Italy), analysing data recorded from 2008 to 2019. The social structure analysis showed a division of the entire population into five different communities and the presence of non-random associations, while there was no evidence of segregation between sexes. Furthermore, results highlighted an important change in social structure through time, likely due to a reduction in fish farm activity since 2015. The division of the population into different communities, the presence of segregation based on the foraging strategy (inside or outside the fish farm area) and the social network measures were evaluated by analysing independently the two datasets: the intense and low farm activity periods: 2008–2014 and 2015–2020, respectively. Segregation among individuals belonging to the same foraging strategy class was found only in the earlier period, and the composition of the four communities was consistent with this result. Our study improves the knowledge about bottlenose dolphin adaptation, as a lower complexity in social structure was linked to a reduction in anthropogenic food availability.

Background and purpose Early pharmacological deep vein thrombosis (DVT) prophylaxis is recommended by guidelines, but rarely started within 48 h. We aimed to analyze the effect of early (within 48 h) versus late (>48 h) DVT prophylaxis on hematoma expansion (HE) and outcome in patients with spontaneous intracerebral hemorrhage (ICH). Methods We analyzed 134 consecutive patients admitted to a tertiary neurointensive care unit with diagnosed spontaneous ICH, without previous anticoagulation, severe coagulopathy, hematoma evacuation, early withdrawal of therapy or ineligibility for DVT prophylaxis according to our institutional protocol. Significant late HE was defined as ≥6 mL increase of hematoma volume between neuroimaging within 48 h and day 3–6. Multivariate analysis was performed to identify risk factors for late HE, poor 3‐month outcome (modified Rankin Scale score ≥ 4) and mortality. Results Patients had a median Glasgow Coma Scale score of 14 [interquartile range (IQR), 10–15], ICH volume of 11 (IQR, 5–24) mL and were 71 (IQR, 61–76) years old. A total of 56% (n = 76) received early DVT prophylaxis, 37% (n = 50) received late DVT prophylaxis and 8 (6%) had unknown bleeding onset. Patients with early DVT prophylaxis had smaller ICH volume [9.5 (IQR, 4–18.5) vs. 17.5 (IQR, 8–29) mL, P = 0.038] and were more often comatose (26% vs. 10%, P = 0.025). Significant late HE [n = 5/134 (3.7%)] was associated with larger initial ICH volume (P = 0.02) and lower thrombocyte count (P = 0.03) but not with early DVT prophylaxis (P = 0.36). Early DVT prophylaxis was not associated with worse outcome. Conclusion Significant late HE is uncommon and DVT prophylaxis within 48 h of symptom onset may be safe in selected patients with ICH.

Background and Purpose— Global cerebral edema occurs in up to 57% of patients with subarachnoid hemorrhage (SAH) and is associated with prolonged hospital stay and poor outcome. Recently, admission brain edema was successfully graded using a simplified computed tomography-based semiquantitative score (subarachnoid hemorrhage early brain edema score [SEBES]). Longitudinal evaluation of the SEBES grade may discriminate patients with rapid and delayed edema resolution after SAH. Here, we aimed to describe the resolution of brain edema and to study the relationship between this radiographic biomarker and hospital course and outcome after SAH. Methods— For the current observational cohort study, computed tomography scans of 283 consecutive nontraumatic SAH patients admitted to the neurological intensive care unit of a tertiary hospital were graded based on the absence of visible sulci at 2 predefined brain tissue levels in each hemisphere (SEBES ranging from 0 to 4). A score of ≥3 was defined as high-grade SEBES. Multivariable regression models using generalized linear models were used to identify associated factors with delayed edema resolution based on the median time to resolution (SEBES ≤2) in SAH survivors. Results— Patients were 57 years old (interquartile range, 48–68) and presented with a median admission Hunt and Hess grade of 3 (interquartile range, 1–5). High-grade SEBES was common (106/283, 37%) and resolved within a median of 8 days (interquartile range, 4–15) in survivors (N=80). Factors associated with delayed edema resolution were early (<72 hours) hypernatremia (>150 mmol/L; adjusted odds ratio [adjOR], 4.88; 95% CI, 1.68–14.18), leukocytosis (>15 G/L; adjOR, 3.14; 95% CI, 1.24–8.77), hyperchloremia (>121 mmol/L; adjOR, 5.24; 95% CI, 1.64–16.76), and female sex (adjOR, 3.71; 95% CI, 1.01–13.64) after adjusting for admission Hunt and Hess grade and age. Delayed brain edema resolution was an independent predictor of worse functional 3-month outcome (adjOR, 2.52; 95% CI, 1.07–5.92). Conclusions— Our data suggest that repeated quantification of the SEBES can identify SAH patients with delayed edema resolution. Based on its’ prognostic value as radiographic biomarker, the SEBES may be integrated in future trials aiming to improve edema resolution after SAH.