An intramolecular oxa-Michael reaction on α,β-unsaturated α-amino-δ-hydroxycarboxylic acid esters. Synthesis of functionalized 1,3-dioxanes

A highly diastereoselective intramolecular oxa-Michael reaction on α,β-unsaturated α-amino-δ-hydroxycarboxylic acid esters is presented; 1,3-dioxanes functionalized in positions 2,4 and 6 were obtained in good yields and with excellent selectivities; an experimental and computational study was carried out to understand the reaction course in terms of yields and selectivities. This reaction proceeds under mild reaction conditions using highly electrophilic aldehydes and ketones

Communicating climate change and biodiversity loss with local populations: exploring communicative utopias in eight transdisciplinary case studies

Climate change and biodiversity loss trigger policies targeting and impacting local communities worldwide. However, research and policy implementation often fail to sufficiently consider community responses and to involve them. We present the results of a collective self-assessment exercise for eight case studies of communications with regard to climate change or biodiversity loss between project teams and local communities. We develop eight indicators of good stakeholder communication, reflecting the scope of Verran’s (2002) concept of postcolonial moments as a communicative utopia. We demonstrate that applying our indicators can enhance communication and enable community responses. However, we discover a divergence between timing, complexity and (introspective) effort. Three cases qualify for postcolonial moments, but scrutinising power relations and genuine knowledge co-production remain rare. While we verify the potency of various instruments for deconstructing science, their sophistication cannot substitute trust building and epistemic/transdisciplinary awareness. Lastly, we consider that reforming inadequate funding policies helps improving the work in and with local communities

Phytoplankton evolution during the creation of a biofloc system for shrimp culture

[EN] Microalgae play a key role in the dynamics of biofloc technology aquaculture systems. Some phytoplankton groups, such as diatoms, are desired for their high nutritional value and contribution to water quality. Other groups, such as cyanobacteria, are undesired because of their low nutritional value and capacity of producing toxins. So, monitoring the phytoplankton community structure and succession is key for managing biofloc systems. However, research on phytoplankton in these systems is scarce and mostly done by microscopy. The primary objective of this research was to estimate phytoplankton community structure in shrimp biofloc system water samples, using high-performance liquid chromatography methods and CHEMTAX software. The major groups present in our system were diatoms, euglenophytes, cyanobacteria and chlorophytes, while dinoflagellates were only remarkable at the initial period. We observed a clear dominance of diatoms all along the 5 months that comprised a complete biofloc system culture. The characteristic succession of autotrophic processes by heterotrophs of the biofloc systems, was observed by the reduction of net primary production. Light intensity played a key role in determining the phytoplankton composition and abundance. Algal pigment analyses using high-performance liquid chromatography and subsequent CHEMTAX analysis in water samples was useful for estimating the phytoplankton community structure in the biofloc systems. However, we found some limitations when the biofloc system was in heterotrophic mode. Under these conditions, some dinoflagellates and cyanobacteria behaved as heterotrophs and lost or decreased their biomarkers pigments. So, further research is needed to increase knowledge on the accuracy of high-performance liquid chromatography /CHEMTAX under these conditions.Financial support for this research was provided by Conselleria d’Educació, Investigació, Cultura i Esport of the Generalitat Valenciana, through the program VALi+D, fle number ACIF/2014/244. We would like to express our deepest thanks to Professor Luis Henrique da Silva Poersch of FURG (Universidade Federal do Rio Grande) and Ivan Vidal (Langostinos el Real) for his support. Finally, the authors wish to thank Le Gouessant and Michaël Metz for providing the commercial feed.Llario-Sempere, F.; Rodilla, M.; Escrivá-Perales, J.; Falco, S.; Sebastiá-Frasquet, M. (2018). Phytoplankton evolution during the creation of a biofloc system for shrimp culture. International Journal of Environmental Science and Technology. 1-12. https://doi.org/10.1007/s13762-018-1655-5S112Ahmed A, Kurian S, Gauns M, Chndrasekhararao AV, Mulla A, Naik B, Naik H, Naqvi SWA (2016) Spatial variability in phytoplankton community structure along the eastern Arabian Sea during the onset of south-west monsoon. Cont Shelf Res 119:30–39. https://doi.org/10.1016/j.csr.2016.03.005Avnimelech Y (1999) Carbon/nitrogen ratio as a control element in aquaculture systems. Aquaculture 176:227–235. https://doi.org/10.1016/S0044-8486(99)00085-XAvnimelech Y (2007) Feeding with microbial flocs by tilapia in minimal discharge bio-flocs technology ponds. Aquaculture 264:140–147. https://doi.org/10.1016/j.aquaculture.2006.11.025Avnimelech Y (2009) Biofloc technology. A practical guide book. The World Aquaculture Society, Baton RougeAzim ME, Little DC (2008) The biofloc technology (BFT) in indoor tanks: water quality, biofloc composition, and growth and welfare of Nile tilapia (Oreochromis niloticus). Aquaculture 283:29–35. https://doi.org/10.1016/j.aquaculture.2008.06.036Ballester ELC, Abreu PC, Cavalli RO, Emerenciano M, de Abreu L, Wasielesky WJ (2010) Effect of practical diets with different protein levels on the performance of Farfantepenaeus paulensis juveniles nursed in a zero exchange suspended microbial flocs intensive system. Aquac Nutr 16:163–172. https://doi.org/10.1111/j.1365-2095.2009.00648.xBaloi M, Arantes R, Schveitzer R, Magnotti C, Vinatea L (2013) Performance of Pacific white shrimp Litopenaeus vannamei raised in biofloc systems with varying levels of light exposure. Aquac Eng 52:39–44. https://doi.org/10.1016/j.aquaeng.2012.07.003Baumgarten MGZ, Wallner-Kersanach M, Niencheski LFH (2010) Manual de análises em oceanografia química. Furg, Rio GrandeBecerra-Dórame MJ, Martínez-Córdova LR, Martínez-Porchas M, Lopez-Elías JA (2011) Evaluation of autotrophic and heterotrophic microcosm- based systems on the production response of Litopenaeus vannamei intensively nursed without Artemia and with zero water exchange. Isr J Aquac Bamidgeh 63:7Brito LO, dos Santos IGS, de Abreu JL, de Araújo MT, Severi W, Gàlvez AO (2016) Effect of the addition of diatoms (Navicula spp.) and rotifers (Brachionus plicatilis) on water quality and growth of the Litopenaeus vannamei postlarvae reared in a biofloc system. Aquac Res 47:3990–3997. https://doi.org/10.1111/are.12849Campa-Córdova AI, Núñez-Vázquez EJ, Luna-González A, Romero-Geraldo MJ, Ascencio F (2009) Superoxide dismutase activity in juvenile Litopenaeus vannamei and Nodipecten subnodosus exposed to the toxic dinoflagellate Prorocentrum lima. Comp Biochem Physiol C Toxicol Pharmacol 149:317–322. https://doi.org/10.1016/j.cbpc.2008.08.006Casé M, Leça EE, Leitão SN, SantAnna EE, Schwamborn R, de Moraes Junior AT (2008) Plankton community as an indicator of water quality in tropical shrimp culture ponds. Mar Pollut Bull 56:1343–1352. https://doi.org/10.1016/j.marpolbul.2008.02.008Chen YC (2001) Immobilized microalga Scenedesmus quadricauda (Chlorophyta, Chlorococcales) for long-term storage and for application for water quality control in fish culture. Aquaculture 195:71–80. https://doi.org/10.1016/S0044-8486(00)00540-8Correia ES, Wilkenfeld JS, Morris TC, Wei L, Prangnell DI, Samocha TM (2014) Intensive nursery production of the Pacific white shrimp Litopenaeus vannamei using two commercial feeds with high and low protein content in a biofloc-dominated system. Aquac Eng 59:48–54. https://doi.org/10.1016/j.aquaeng.2014.02.002Duarte CM, Marrasé C, Vaqué D, Estrada M (1990) Counting error and the quantitative analysis of phytoplankton communities. J Plankton Res 12:295–304. https://doi.org/10.1093/plankt/12.2.295Ebeling J, Timmons M, Bisogni J (2006) Engineering analysis of the stoichiometry of photoautotrophic, autotrophic, and heterotrophic removal of ammonia–nitrogen in aquaculture systems. Aquaculture 257:346–358. https://doi.org/10.1016/j.aquaculture.2006.03.019El-Dahhar AA, Salama M, Elebiary EH (2015) Effect of energy to protein ratio in biofloc technology on water quality, survival and growth of mullet (Mugil cephalus). J Arab Aquac Soc 10:15–32. https://doi.org/10.12816/0026633Emerenciano MGC, Martínez-Córdova LR, Martínez-Porchas M, Miranda-Baeza A (2017) Biofloc technology (BFT): a tool for water quality management. In: Tutu H (ed) water quality. InTech, Rijeka. https://doi.org/10.5772/66416Figueroa F, Niell F, Figueiras F, Villarino M (1998) Diel migration of phytoplankton and spectral light field in the Ria de Vigo (NW Spain). Mar Biol 130:491–499Gaona CAP, Poersch LH, Krummenauer D, Foes GK, Wasielesky WJ (2011) The effect of solids removal on water quality, growth and survival of Litopenaeus vannamei in a biofloc technology culture system. Int J Recirc Aquac. https://doi.org/10.21061/ijra.v12i1.1354Garrido JL, Airs RL, Rodríguez F, Van Heukelem L, Zapata M (2011) New HPLC separation techniques. In: Roy S, Llewellyn CA, Egeland ES, Johnsen G (eds) Phytoplankton pigments: characterization, chemotaxonomy, and applications in oceanography. University Press, Cambridge, pp 165–194Ge H, Li J, Chang Z, Chen P, Shen M, Zhao F (2016) Effect of microalgae with semicontinuous harvesting on water quality and zootechnical performance of white shrimp reared in the zero water exchange system. Aquac Eng 72–73:70–76. https://doi.org/10.1016/j.aquaeng.2016.04.006Godoy LC, Odebrecht C, Ballester E, Martins TG, Wasielesky WJ (2012) Effect of diatom supplementation during the nursery rearing of Litopenaeus vannamei (Boone, 1931) in a heterotrophic culture system. Aquac Int 20:559–569. https://doi.org/10.1007/s10499-011-9485-1Grasshoff K (1976) Methods of seawater analysis. Verlag Chemie: Weinstei, New YorkGreen BW, Schrader KK, Perschbacher PW (2014) Effect of stocking biomass on solids, phytoplankton communities, common off-flavors, and production parameters in a channel catfish biofloc technology production system. Aquac Res 45:1442–1458. https://doi.org/10.1111/are.12096Gris B, Sforza E, Morosinotto T, Bertucco A, La Rocca N (2017) Influence of light and temperature on growth and high-value molecules productivity from Cyanobacterium aponinum. J Appl Phycol 29:1781–1790. https://doi.org/10.1007/s10811-017-1133-3Higgins HW, Wright SW, Schlüter L (2011) Quantitative interpretation of chemotaxonomic pigment data. In: Roy S, Llewellyn CA, Egeland ES, Johnsen G (eds) Phytoplankton pigments: characterization, chemotaxonomy, and applications in oceanography. Cambridge University Press, Cambridge, pp 257–313Hooker S, Firestone E, Claustre H, Ras J (2001) The first SeaWiFS HPLC analysis round-robin experiment (SeaHARRE-1). https://ntrs.nasa.gov/search.jsp?R=20010072242 . Accessed 19 July 2017Horabun T (1997) Relationships between water quality and phytoplankton in the Bangpakong river. http://agris.fao.org/agris-search/search.do?recordID=TH2000001898 . Accessed 19 July 2017Ismael AA (2003) Succession of heterotrophic and mixotrophic dinoflagellates as well as autotrophic microplankton in the harbour of Alexandria, Egypt. J Plankton Res 25:193–202. https://doi.org/10.1093/plankt/25.2.193Jeffrey SW, Sielicki M, Haxo FT (1975) Chloroplast pigment patterns in dinoflagellates. J Phycol 11:374–384. https://doi.org/10.1111/j.1529-8817.1975.tb02799.xJeong HJ, Yoo YD, Kim JS, Seong KA, Kang NS, Kim TH (2010) Growth, feeding and ecological roles of the mixotrophic and heterotrophic dinoflagellates in marine planktonic food webs. Ocean Sci J 45:65–91. https://doi.org/10.1007/s12601-010-0007-2Jory DE, Cabrera TR, Dugger DM, Fegan D, Lee PG, Lawrence L, Jackson C, Mcintosh R, Castañeda J, International B, Park H, Hwy N, Pierce F (2001) A global review of shrimp feed management: status and perspectives. Aquaculture 318:104–152Ju ZY, Forster I, Conquest L, Dominy W, Kuo WC, Horgen FD (2008) Determination of microbial community structures of shrimp floc cultures by biomarkers and analysis of floc amino acid profiles. Aquac Res 39:118–133. https://doi.org/10.1111/j.1365-2109.2007.01856.xKingston MB (1999) Effect of light on vertical migration and photosynthesis of Euglena proxima (euglenophyta). J Phycol 35:245–253. https://doi.org/10.1046/j.1529-8817.1999.3520245.xLatasa M, Scharek R, Vidal M, Vila-Reixach G (2010) Preferences of phytoplankton groups for waters of different trophic status in the northwestern Mediterranean Sea. Mar Ecol Prog Ser 40:27–42. https://doi.org/10.3354/meps08559Li Y, Swift E, Buskey EJ (1996) Photoinhibition of mechanically stimulable bioluminescence in the heterotrophic dinoflagellate Protoperidinium depressum (pyrrophyta). J Phycol 32:974–982. https://doi.org/10.1111/j.0022-3646.1996.00974.xLi A, Stoecker D, Adolf J (1999) Feeding, pigmentation, photosynthesis and growth of the mixotrophic dinoflagellate Gyrodinium galatheanum. Aquat Microb Ecol 19:163–176. https://doi.org/10.3354/ame019163Lin YC, Chen JC (2001) Acute toxicity of ammonia on Litopenaeus vannamei (Boone) juveniles at different salinity levels. J Exp Mar Biol Ecol 259:109–119. https://doi.org/10.1016/S0022-0981(01)00227-1Lin YC, Chen JC (2003) Acute toxicity of nitrite on Litopenaeus vannamei (Boone) juveniles at different salinity levels. Aquaculture 224:93–201. https://doi.org/10.1016/S0044-8486(03)00220-5Lohscheider JN, Strittmatter M, Küpper H, Adamska I, Heaney S, Cunningham C (2011) Vertical distribution of epibenthic freshwater cyanobacterial Synechococcus spp. Strains depends on their ability for photoprotection. PLoS ONE. https://doi.org/10.1371/journal.pone.0020134Lukwambe B, Qiuqian L, Wu J, Zhang D, Wang K, Zheng Z (2015) The effects of commercial microbial agents (probiotics) on phytoplankton community structure in intensive white shrimp (Litopenaeus vannamei) aquaculture ponds. Aquac Int 23:1443–1455. https://doi.org/10.1007/s10499-015-9895-6Mackey MD, Mackey DJ, Higgins HW, Wright SW (1996) CHEMTAX—a program for estimating class abundances from chemical markers: application to HPLC measurements of phytoplankton. Mar Ecol Prog Ser 144:265–283Maicá PF, de Borba MR, Wasielesky WJ (2012) Effect of low salinity on microbial floc composition and performance of Litopenaeus vannamei (Boone) juveniles reared in a zero-water-exchange super-intensive system. Aquac Res 43:361–370. https://doi.org/10.1111/j.1365-2109.2011.02838.xManan H, Moh JHZ, Kasan NA, Suratman S, Ikhwanuddin M (2016) Identification of biofloc microscopic composition as the natural bioremediation in zero water exchange of Pacific white shrimp, Penaeus vannamei, culture in closed hatchery system. Appl Water Sci. https://doi.org/10.1007/s13201-016-0421-4Marinho YF, Brito LO, Campos S, Severi W, Andrade HA, Galvez AO (2016) Effect of the addition of Chaetoceros calcitrans, Navicula sp. and Phaeodactylum tricornutum (diatoms) on phytoplankton composition and growth of Litopenaeus vannamei (Boone) postlarvae reared in a biofloc system. Aquac Res 48:4155–4164. https://doi.org/10.1111/are.13235Martins TG, Odebrecht C, Jensen LV, D’Oca MG, Wasielesky WJ (2016) The contribution of diatoms to bioflocs lipid content and the performance of juvenile Litopenaeus vannamei (Boone, 1931) in a BFT culture system. Aquac Res 47:1315–1326. https://doi.org/10.1111/are.12592Murphy J, Riley JP (1962) A modified single solution method for the determination of phosphate in natural waters. Anal Chim Acta 27:31–36. https://doi.org/10.1016/S0003-2670(00)88444-5Natrah FMI, Bossier P, Sorgeloos P, Yusoff FM, Defoirdt T (2014) Significance of microalgal-bacterial interactions for aquaculture. Rev Aquac 6:48–61. https://doi.org/10.1111/raq.12024Niemi G, Wardrop D, Brooks R, Anderson S, Brady V, Paerl H, Rakocinski C, Brouwer M, Levinson B, McDonald M (2004) Rationale for a new generation of indicators for coastal waters. Environ Health Perspect 112:979–986. https://doi.org/10.1289/ehp.6903Paerl H, Tucker C (1995) Ecology of blue-green algae in aquaculture ponds. J World Aquac 26:109–131. https://doi.org/10.1111/j.1749-7345.1995.tb00235.xPérez-Linares J, Ochoa JL, GagoMartínez A (2008) Effect of PSP toxins in white leg shrimp Litopenaeus vannamei Boone, 1931. J Food Sci 73:T69–T73. https://doi.org/10.1111/j.1750-3841.2008.00710.xPérez-Morales A, Band-Schmidt CJ, Martínez-Díaz SF (2017) Mortality on zoea stage of the Pacific white shrimp Litopenaeus vannamei caused by Cochlodinium polykrikoides (Dinophyceae) and Chattonella spp. (Raphidophyceae). Mar Biol 164:57. https://doi.org/10.1007/s00227-017-3083-3Ray AJ, Dillon KS, Lotz JM (2011) Water quality dynamics and shrimp (Litopenaeus vannamei) production in intensive, mesohaline culture systems with two levels of biofloc management. Aquac Eng 45:127–136. https://doi.org/10.1016/j.aquaeng.2011.09.001Schlüter L, Lauridsen T, Krogh G (2006) Identification and quantification of phytoplankton groups in lakes using new pigment ratios–a comparison between pigment analysis by HPLC and microscopy. Freshwater 51:1474–1485. https://doi.org/10.1111/j.1365-2427.2006.01582.x/fullSchlüter L, Behl S, Striebel M, Stibor H (2016) Comparing microscopic counts and pigment analyses in 46 phytoplankton communities from lakes of different trophic state. Freshw Biol 61:1627–1639. https://doi.org/10.1111/fwb.12803Schrader KK, Green BW, Perschbacher PW (2011) Development of phytoplankton communities and common off-flavors in a biofloc technology system used for the culture of channel catfish (Ictalurus punctatus). Aquac Eng 45:118–126. https://doi.org/10.1016/j.aquaeng.2011.08.004Sebastiá M, Rodilla M (2013) Nutrient and phytoplankton analysis of a Mediterranean Coastal area. Environ Manage 51:225–240. https://doi.org/10.1007/s00267-012-9986-3Sebastiá M, Rodilla M, Sanchis J, Altur V (2012) Influence of nutrient inputs from a wetland dominated by agriculture on the phytoplankton community in a shallow harbour at the Spanish Mediterranean coast. Agric Ecosyst Environ 152:10–20. https://doi.org/10.1016/j.agee.2012.02.006Seoane S, Garmendia M, Revilla M, Borja Á, Franco J, Orive E, Valencia V (2011) Phytoplankton pigments and epifluorescence microscopy as tools for ecological status assessment in coastal and estuarine waters, within the Water Framework. Mar Pollut 62:1484–1497. https://doi.org/10.1016/j.marpolbul.2011.04.010Sinden A, Sinang SC (2016) Cyanobacteria in aquaculture systems: linking the occurrence, abundance and toxicity with rising temperatures. Int J Environ Sci Technol 13:2855–2862. https://doi.org/10.1007/s13762-016-1112-2Sospedra J, Niencheski LFH, Falco S, Andrade CF, Attisano KK, Rodilla M (2017) Identifying the main sources of silicate in coastal waters of the Southern Gulf of Valencia (Western Mediterranean Sea). Oceanologia. https://doi.org/10.1016/j.oceano.2017.07.004Strickland J (1960) Measuring the production of marine phytoplankton. Bull Fish Res Bd Canada 122:172Ter Braak CJF (1994) Canonical community ordination. Part I: basic theory and linear methods. Écoscience 1:127–140. https://doi.org/10.1080/11956860.1994.11682237Ter Braak C, Smilauer P (2002) CANOCO reference manual and CanoDraw for Windows user’s guide: software for canonical community ordination (version 4.5). http://library.wur.nl/WebQuery/wurpubs/wever/341885 . Accessed 19 July 2017Utermohl M (1985) Zur Vervollkommnung der quantitative Phytoplankton-Methodik. Limnologie 9:1–38Van Wyk P, Scarpa J (1999) Water quality requirements and management. In: Institution Harbor Branch Oceanographic (ed) Farming marine shrimp in recirculating freshwater systems. Florida Department of Agriculture and Consumer Services, Florida, pp 128–138Vinatea L, Gálvez AO, Browdy CL, Stokes A, Venero J, Haveman J, Lewis BL, Lawson A, Shuler A, Leffler JW (2010) Photosynthesis, water respiration and growth performance of Litopenaeus vannamei in a super-intensive raceway culture with zero water exchange: interaction of water quality variables. Aquac Eng 42:17–24. https://doi.org/10.1016/j.aquaeng.2009.09.001Wright S, Jeffrey S, Mantoura R (1991) Improved HPLC method for the analysis of chlorophylls and carotenoids from marine phytoplankton. Mar Ecol Prog Ser 77:186–196Yu H, Jia S, Dai Y (2009) Growth characteristics of the cyanobacterium Nostoc flagelliforme in photoautotrophic, mixotrophic and heterotrophic cultivation. J Appl Phycol 21:127–133. https://doi.org/10.1007/s10811-008-9341-5Yusoff FM, Zubaidah MS, Matias HB, Kwan TS (2002) Phytoplankton succession in intensive marine shrimp culture ponds treated with a commercial bacterial product. Aquac Res 33:269–278. https://doi.org/10.1046/j.1355-557x.2002.00671.

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

© 2024 The Authors. Journal of Extracellular Vesicles, published by Wiley Periodicals, LLC on behalf of the International Society for Extracellular Vesicles. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly.Peer reviewe

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369