9 research outputs found

    Preliminary Analysis for Identification of Priority Species of Small Pelagic Shared Stocks in GSA01 And GSA03 (Alborán Sea)

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    Small pelagic resources and particularly sardine (Sardina pilchardus) and anchovy (Engraulis encrasicholus) represent an important fishery activity for the countries bordering the Alboran Sea. This paper aims at contributing to the identification of priority species of small pelagic shared stocks in GSA01 and GSA03 (northern and southern Alboran Sea GFCM regions) for carrying out joint stock assessments and promoting new management measures that would allow the sustainability of the resources and its exploitation. The WG on small pelagic shared stocks met twice during 2011 progressing in analysing the available data on the stocks and its exploitation and building a common data base. Moreover a comparative analysis on sardine landings data from 2003-2010 in GSA01 and GSA03 was carried out explaining that the exploitation pattern in sub-areas (GSAs 01 and 03) is different but the total length-frequency distribution of sardine exploited by each country appears to be similar. A tentative in applying a LCA analysis of the Moroccan and Spanish data on sardine using different biological parameters and with the VIT software was unsuccessful but orientated for future works of the W

    Key challenges for maritime governance in West Africa: Fishery-based lessons from Guinea and Mauritania

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    International audienceMaritime governance stakes are important in West Africa, if only due to the dominant role of fisheries, which coastal populations mainly depend on. In this context, with reference to the fishery sector mostly studied in two countries (Guinea and Mauritania), this paper aims to identify and synthesize the challenges to be met towards developing the governance of marine spaces. To this end, the analysis is based on field knowledge, which provides input into a grid set according to the various integration levels of the concept of ICZM. This paper thus reports the major methodological obstacles to be overcome, commensurate to the stakes insofar as marine policies can and must contribute to the economic and social development of this region

    Hydrocortisone plus fludrocortisone for community acquired pneumonia-related septic shock: a subgroup analysis of the APROCCHSS phase 3 randomised trial

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    International audienceBackground: Glucocorticoids probably improve outcomes in patients hospitalised for community acquired pneumonia (CAP). In this a priori planned exploratory subgroup analysis of the phase 3 randomised controlled Activated Protein C and Corticosteroids for Human Septic Shock (APROCCHSS) trial, we aimed to investigate responses to hydrocortisone plus fludrocortisone between CAP and non-CAP related septic shock.Methods: APROCCHSS was a randomised controlled trial that investigated the effects of hydrocortisone plus fludrocortisone, drotrecogin-alfa (activated), or both on mortality in septic shock in a two-by-two factorial design; after drotrecogin-alfa was withdrawn on October 2011, from the market, the trial continued on two parallel groups. It was conducted in 34 centres in France. In this subgroup study, patients with CAP were a preselected subgroup for an exploratory secondary analysis of the APROCCHSS trial of hydrocortisone plus fludrocortisone in septic shock. Adults with septic shock were randomised 1:1 to receive, in a double-blind manner, a 7-day treatment with daily administration of intravenous hydrocortisone 50 mg bolus every 6h and a tablet of 50 μg of fludrocortisone via the nasogastric tube, or their placebos. The primary outcome was 90-day all-cause mortality. Secondary outcomes included all-cause mortality at intensive care unit (ICU) and hospital discharge, 28-day and 180-day mortality, the number of days alive and free of vasopressors, mechanical ventilation, or organ failure, and ICU and hospital free-days to 90-days. Analysis was done in the intention-to-treat population. The trial was registered at ClinicalTrials.gov (NCT00625209).Findings: Of 1241 patients included in the APROCCHSS trial, CAP could not be ruled in or out in 31 patients, 562 had a diagnosis of CAP (279 in the placebo group and 283 in the corticosteroid group), and 648 patients did not have CAP (329 in the placebo group and 319 in the corticosteroid group). In patients with CAP, there were 109 (39%) deaths of 283 patients at day 90 with hydrocortisone plus fludrocortisone and 143 (51%) of 279 patients receiving placebo (odds ratio [OR] 0·60, 95% CI 0·43-0·83). In patients without CAP, there were 148 (46%) deaths of 319 patients at day 90 in the hydrocortisone and fludrocortisone group and 157 (48%) of 329 patients in the placebo group (OR 0·95, 95% CI 0·70-1·29). There was significant heterogeneity in corticosteroid effects on 90-day mortality across subgroups with CAP and without CAP (p=0·046 for both multiplicative and additive interaction tests; moderate credibility). Of 1241 patients included in the APROCCHSS trial, 648 (52%) had ARDS (328 in the placebo group and 320 in the corticosteroid group). There were 155 (48%) deaths of 320 patients at day 90 in the corticosteroid group and 186 (57%) of 328 patients in the placebo group. The OR for death at day 90 was 0·72 (95% CI 0·53-0·98) in patients with ARDS and 0·85 (0·61-1·20) in patients without ARDS (p=0·45 for multiplicative interaction and p=0·42 for additive interaction). The OR for observing at least one serious adverse event (corticosteroid group vs placebo) within 180 days post randomisation was 0·64 (95% CI 0·46-0·89) in the CAP subgroup and 1·02 (0·75-1·39) in the non-CAP subgroup (p=0·044 for multiplicative interaction and p=0·042 for additive interaction).Interpretation: In a pre-specified subgroup analysis of the APROCCHSS trial of patients with CAP and septic shock, hydrocortisone plus fludrocortisone reduced mortality as compared with placebo. Although a large proportion of patients with CAP also met criteria for ARDS, the subgroup analysis was underpowered to fully discriminate between ARDS and CAP modifying effects on mortality reduction with corticosteroids. There was no evidence of a significant treatment effect of corticosteroids in the non-CAP subgroup.Funding: Programme Hospitalier de Recherche Clinique of the French Ministry of Health, by Programme d'Investissements d'Avenir, France 2030, and IAHU-ANR-0004
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