Fish bycatch of the laulao catfish Brachyplatystoma vaillantii (Valenciennes, 1840) trawl fishery in the Amazon Estuary

This study aimed to analyse the composition and seasonal variation in the fish bycatch of the Brachyplatystoma vaillantii trawl fishery in the Amazon Estuary in 2009 by monitoring the trips of 48 vessels. The bycatch represented 29% of the catches, totalling 22,228 specimens and 52 taxa, distributed in 22 families (the principal families were Ariidae, Pimelodidae, and Sciaenidae). Brachyplatystoma rousseauxii, Plagioscion squamosissimus, and Sciades herzbergii together contributed 69% of the bycatch and were considered consistent bycatch species. Although a higher proportion of bycatch was captured during the rainy season, the seasonal difference was not significant. A multidimensional scaling (MDS) ordination analysis and an analysis of similarity (ANOSIM) indicated that the species composition of the bycatch was similar across the seasons. However, larger numbers of B. rousseauxii and P. squamosissimus were captured during the rainy season, whereas S. herzbergii predominated during the dry season. The marine migrants and estuarine species guilds showed the greatest richness, whereas freshwater migrants were the most numerous. Among the feeding guilds, the zoobenthivores were the most diverse, whereas the piscivores were the most abundant. The results indicate that fishing pressure primarily affects small- (20-30 cm) and medium-sized (30-50 cm) individuals, although the catch of P. squamosissimus was composed primarily of adults. However, the catches of both B. rousseauxii and B. vaillantii were composed primarily of juveniles.Este estudo objetivou analisar a composição e variação sazonal da ictiofauna acompanhante da pesca de arrasto de Brachyplatystoma vaillantii no estuário amazônico, em 2009, através do monitoramento de viagens de 48 embarcações. A ictiofauna acompanhante representou 29% das capturas, totalizando 22.228 indivíduos e 52 táxons pertencentes a 22 famílias, sendo estas as principais: Ariidae, Pimelodidae e Sciaenidae. Brachyplatystoma rousseauxii, Plagioscion squamosissimus e Sciades herzbergii representaram juntas 69% da captura e foram consideradas constantes. Embora o maior percentual de captura tenha ocorrido no período chuvoso, as diferenças sazonais não foram significativas. Análises de ordenação (MDS) e de similaridade (ANOSIM) mostraram que a composição da captura entre os períodos é semelhante; entretanto, maiores capturas de B. rousseauxii e P. squamosissimus foram observadas no período chuvoso, enquanto S. herzbergii foi dominante no período seco. As guildas migrantes marinhas e espécies estuarinas apresentaram maior riqueza, enquanto as migrantes dulcícolas predominaram em percentual de indivíduos. Considerando as guildas alimentares, as zoobentívoras apresentaram a maior riqueza, enquanto as piscívoras predominaram em abundância relativa. Os resultados indicam que a pressão pesqueira atua sensivelmente sobre os indivíduos de pequeno (20-30 cm) e médio (30-50 cm) porte, embora a captura de P. squamosissimus seja composta predominantemente por adultos. A captura de B. rousseauxii e B. vaillantii, entretanto, foi composta predominantemente por juvenis

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Fish bycatch of the laulao catfish Brachyplatystoma vaillantii (Valenciennes, 1840) trawl fishery in the Amazon Estuary

This study aimed to analyse the composition and seasonal variation in the fish bycatch of the Brachyplatystoma vaillantii trawl fishery in the Amazon Estuary in 2009 by monitoring the trips of 48 vessels. The bycatch represented 29% of the catches, totalling 22,228 specimens and 52 taxa, distributed in 22 families (the principal families were Ariidae, Pimelodidae, and Sciaenidae). Brachyplatystoma rousseauxii, Plagioscion squamosissimus, and Sciades herzbergii together contributed 69% of the bycatch and were considered consistent bycatch species. Although a higher proportion of bycatch was captured during the rainy season, the seasonal difference was not significant. A multidimensional scaling (MDS) ordination analysis and an analysis of similarity (ANOSIM) indicated that the species composition of the bycatch was similar across the seasons. However, larger numbers of B. rousseauxii and P. squamosissimus were captured during the rainy season, whereas S. herzbergii predominated during the dry season. The marine migrants and estuarine species guilds showed the greatest richness, whereas freshwater migrants were the most numerous. Among the feeding guilds, the zoobenthivores were the most diverse, whereas the piscivores were the most abundant. The results indicate that fishing pressure primarily affects small- (20-30 cm) and medium-sized (30-50 cm) individuals, although the catch of P. squamosissimus was composed primarily of adults. However, the catches of both B. rousseauxii and B. vaillantii were composed primarily of juveniles

China’s fish maw demand and its implications for fisheries in source countries

The demand for fish maw (i.e., dried swim bladder) has apparently intensified during the past decades in Hong Kong and mainland China; currently, maw has similar annual import volumes but far higher mean unit values than other important seafood delicacies like shark fins and sea cucumber. Escalated demand for seafood delicacies can significantly contribute to the depletion of marine resources; yet a comprehensive understanding of maw value and the fisheries that supply it is lacking. We review available information on eight important maw-supplying species in major and largely undocumented source countries to examine the susceptibility and exposure of fisheries to the maw trade, which primarily serves Chinese demand. Comparing ex-vessel price ratios of maw to flesh (USD/kg), the overall mean price of maw can be as much as 72 times higher (range between 12:1 and 8389:1). Catch, price and export trends demonstrate that demand for maw is likely intensifying in countries already supplying it, shifting or expanding to new species, and emerging in new regions. We find that most maw-supplying species are under high fishing pressure, poorly or not protected. Those that yield the highest maw prices exhibit spawning aggregations, making them exceptionally vulnerable to overexploitation. While management interventions are needed to sustain fishery resources and capture economic benefits, their effectiveness will be challenged by the high value of maw

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project

PURPOSE: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). METHODS: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. RESULTS: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. CONCLUSION: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection.status: publishe

Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units

evere intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. In this study, we report on resistance profiles of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis and Enterococcus faecium in distinct European geographic regions based on an observational cohort study on intra-abdominal infections in intensive care unit (ICU) patients. Resistance against aminopenicillins, fluoroquinolones, and third-generation cephalosporins in E. coli, K. pneumoniae and P. aeruginosa is problematic, as is carbapenem-resistance in the latter pathogen. For E. coli and K. pneumoniae, resistance is mainly an issue in Central Europe, Eastern and South-East Europe, and Southern Europe, while resistance in P. aeruginosa is additionally problematic in Western Europe. Vancomycin-resistance in E. faecalis is of lesser concern but requires vigilance in E. faecium in Central and Eastern and South-East Europe. In the subcohort of patients with secondary peritonitis presenting with either sepsis or septic shock, the appropriateness of empiric antimicrobial therapy was not associated with mortality. In contrast, failure of source control was strongly associated with mortality. The relevance of these new insights for future recommendations regarding empiric antimicrobial therapy in intra-abdominal infections is discussed.Severe intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by diseasespecific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. In this study, we report on resistance profiles of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis and Enterococcus faecium in distinct European geographic regions based on an observational cohort study on intra-abdominal infections in intensive care unit (ICU) patients. Resistance against aminopenicillins, fluoroquinolones, and third-generation cephalosporins in E. coli, K. pneumoniae and P. aeruginosa is problematic, as is carbapenem-resistance in the latter pathogen. For E. coli and K. pneumoniae, resistance is mainly an issue in Central Europe, Eastern and South-East Europe, and Southern Europe, while resistance in P. aeruginosa is additionally problematic in Western Europe. Vancomycin-resistance in E. faecalis is of lesser concern but requires vigilance in E. faecium in Central and Eastern and South-East Europe. In the subcohort of patients with secondary peritonitis presenting with either sepsis or septic shock, the appropriateness of empiric antimicrobial therapy was not associated with mortality. In contrast, failure of source control was strongly associated with mortality. The relevance of these new insights for future recommendations regarding empiric antimicrobial therapy in intra-abdominal infections is discussed