Anthropogenic drivers and global warming are altering the occurrence of infectious marine diseases, some of which produce mass mortalities with considerable ecosystemic and economic costs. The Mediterranean Sea is considered a laboratory to examine global processes, and the fan mussel Pinna nobilis a sentinel species within it. Since September 2016, fan mussels suffer a die-off, very likely provoked by the protozoan Haplosporidium pinnae. Population dynamic surveys, rescue programmes, larvae collector installation and protection of infected adults from predators, have increased knowledge about the factors conditioning the spread of the die-off; previous model simulations indicate that water temperature and salinity seem to be related to the manifestation of the disease, which at the end are strongly influenced by climate change and anthropogenic actions. The absence of natural recruitment implies that fan mussel populations are not recovering, but the survival of populations living in paralic environments provides an opportunity to study the disease and its conditioning factors. The present situation is proposed as an example of what is to come in the global context of climate change and poses several questions: are we the witnesses of the potential extinction of a sentinel species? Can we avoid the potential extinction of this species by applying active measures, and which measures will be more effective? How many other more overlooked species might experience a massive and unnoticed die-off before it is too late to implement any preservation action? For the extinction of community structure species will provoke unpredicted ecological cascade effects with global implications.

Most southern European regions have experienced a rapid economical change during the last decades, moving from a historical economy based on agriculture to a society based on industry and technology. We test here whether causes of admission of birds admitted to a large southern European rehabilitation centre, during a 14‐year period (1994–2007), reflect these socio‐economical changes. Specifically, we estimated the trends in the number of birds admitted to the centre by shooting (S) over the number of birds admitted due to impacts caused by infrastructures (I), for the 10 most commonly admitted species with complete time series available. Species were grouped in three groups following ecological traits: raptors (diurnal and nocturnal) and aquatic birds. Trends were estimated by means of the slope of a linear regression of the log‐transformed S/I ratio over time, which provided the finite population growth rate (λ) and its 95% confidence intervals. We used the ratio to prevent possible biases caused by changes in wild population densities over the years. We conclude that the overall trend in the S/I ratio, as well as the trends for all three bird groups considered, were negative, and indicated a c. 10% annual reduction in the number of birds admitted by shooting in relation to those admitted by infrastructure‐related injuries. Causal relationships were analysed by means of Poisson regressions on absolute numbers. Importantly we show that despite the direct historical war against wildlife seems to be coming to an end in southern Europe, impact to wildlife continues in an indirect way, as collateral damages caused by our post‐industrial way of life. So the overall scenario is most likely not one of improved conservation status in southern Europe, but rather one of shifting ways of impacting wildlife in parallel with socio‐economic changes.

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Systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), and Sjögren’s syndrome (SS) are heterogeneous autoimmune diseases. Severe manifestations and refractory/intolerance to conventional immunosuppressants demand other options, namely biological drugs, and small molecules. We aimed to define evidence and practice-based guidance for the off-label use of biologics in SLE, APS, and SS. Recommendations were made by an independent expert panel, following a comprehensive literature review and two consensus rounds. The panel included 17 internal medicine experts with recognized practice in autoimmune disease management. The literature review was systematic from 2014 until 2019 and later updated by cross-reference checking and experts’ input until 2021. Preliminary recommendations were drafted by working groups for each disease. A revision meeting with all experts anticipated the consensus meeting held in June 2021. All experts voted (agree, disagree, neither agree nor disagree) during two rounds, and recommendations with at least 75% agreement were approved. A total of 32 final recommendations (20 for SLE treatment, 5 for APS, and 7 for SS) were approved by the experts. These recommendations consider organ involvement, manifestations, severity, and response to previous treatments. In these three autoimmune diseases, most recommendations refer to rituximab, which aligns with the higher number of studies and clinical experience with this biological agent. Belimumab sequential treatment after rituximab may also be used in severe cases of SLE and SS. Second-line therapy with baricitinib, bortezomib, eculizumab, secukinumab, or tocilizumab can be considered in SLE-specific manifestations. These evidence and practice-based recommendations may support treatment decision and, ultimately, improve the outcome of patients living with SLE, APS, or SS.

This paper examines the impact of Internet use on economic growth and the extent to which educational inequality modulates this impact for a panel data set of 94 countries between 1995 and 2010. We obtain a positive and significant impact of Internet use on economic growth and a negative influence of educational inequality on the Internet’s impact on growth. When we disaggregate by income levels, the results indicate that Internet use is positively associated with economic growth for middle- and high-income countries. Educational inequality influences the impact of Internet use on economic growth only for middle- and low-income countries, although with the opposite sign. For middle-income countries, the impact is negative, while the impact is positive for low-income economies. The research provides evidence for the first time about how inequalities in education may limit the positive economic outcomes and benefits derived from the use of information and communication technologies.