Improving sea level simulation in Mediterranean regional climate models

For now, the question about future sea level change in the Mediterranean remains a challenge. Previous climate modelling attempts to estimate future sea level change in the Mediterranean did not meet a consensus. The low resolution of CMIP-type models prevents an accurate representation of important small scales processes acting over the Mediterranean region. For this reason among others, the use of high resolution regional ocean modelling has been recommended in literature to address the question of ongoing and future Mediterranean sea level change in response to climate change or greenhouse gases emissions. Also, it has been shown that east Atlantic sea level variability is the dominant driver of the Mediterranean variability at interannual and interdecadal scales. However, up to now, long-term regional simulations of the Mediterranean Sea do not integrate the full sea level information from the Atlantic, which is a substantial shortcoming when analysing Mediterranean sea level response. In the present study we analyse different approaches followed by state-of-the-art regional climate models to simulate Mediterranean sea level variability. Additionally we present a new simulation which incorporates improved information of Atlantic sea level forcing at the lateral boundary. We evaluate the skills of the different simulations in the frame of long-term hindcast simulations spanning from 1980 to 2012 analysing sea level variability from seasonal to multidecadal scales. Results from the new simulation show a substantial improvement in the modelled Mediterranean sea level signal. This confirms that Mediterranean mean sea level is strongly influenced by the Atlantic conditions, and thus suggests that the quality of the information in the lateral boundary conditions (LBCs) is crucial for the good modelling of Mediterranean sea level. We also found that the regional differences inside the basin, that are induced by circulation changes, are model-dependent and thus not affected by the LBCs. Finally, we argue that a correct configuration of LBCs in the Atlantic should be used for future Mediterranean simulations, which cover hindcast period, but also for scenarios

How to follow the guidelines, when the appropriate fluid is missing?

Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. Recently paediatric societies have produced evidence-based practice guidelines that recommend the use of balanced isotonic fluid when prescribing IV-MFT in both acute and critical paediatric care. Unfortunately, the applicability of these guidelines could be called into question when a ready-to-use glucose-containing balanced isotonic fluid is not available. The main objective of this study was to describe the availability of glucose-containing balanced isotonic fluids in European and Middle Eastern paediatric acute and critical care settings. This work is an ancillary study of the survey dedicated to IV-MFT practices in the paediatric acute and critical care settings in Europe and Middle East, a cross-sectional electronic 27-item survey, emailed in April–May 2021 to paediatric critical care physicians across 34 European and Middle East countries. The survey was developed by an expert multi-professional panel within the European Society of Peadiatric and Neonatal Intensive Care (ESPNIC). Balanced isotonic fluid with glucose 5% was available for only 32/153 (21%) responders. Balanced isotonic fluid with glucose 5% was consistently available in the UK (90%) but not available in France, Greece, The Netherlands and Turkey.    Conclusion: Ready-to-use isotonic balanced IV solutions containing glucose in sufficient amount exist but are inconsistently available throughout Europe. National and European Medication Safety Incentives should guarantee the availability of the most appropriate and safest IV-MFT solution for all children. What is Known:• Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care.• Balanced isotonic fluid is recommended when prescribing IV-MFT in both acute and critical paediatric care. What is New:• Balanced isotonic fluid with glucose 5% is available for less than 25% of the prescribers in Europe and the Middle East. Availability of balanced isotonic fluid with glucose 5% varies from one country to another but can also be inconsistent within the same country.• Clinicians who have access to a ready-to-use balanced isotonic fluid with glucose 5% are more likely to consider its use than clinicians who do not have access to such an IV solution

The SURFEXv7.2 land and ocean surface platform for coupled or offline simulation of Earth surface variables and fluxes

CC Attribution 3.0 License.Final revised paper also available at http://www.geosci-model-dev.net/6/929/2013/gmd-6-929-2013.pdfInternational audienceSURFEX is a new externalized land and ocean surface platform that describes the surface fluxes and the evolution of four types of surface: nature, town, inland water and ocean. It can be run either coupled or in offline mode. It is mostly based on pre-existing, well validated scientific models. It can be used in offline mode (from point scale to global runs) or fully coupled with an atmospheric model. SURFEX is able to simulate fluxes of carbon dioxide, chemical species, continental aerosols, sea salt and snow particles. It also includes a data assimilation module. The main principles of the organization of the surface are described first. Then, a survey is made of the scientific module (including the coupling strategy). Finally the main applications of the code are summarized. The current applications are extremely diverse, ranging from surface monitoring and hydrology to numerical weather prediction and global climate simulations. The validation work undertaken shows that replacing the pre-existing surface models by SURFEX in these applications is usually associated with improved skill, as the numerous scientific developments contained in this community code are used to good advantage

ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children- a systematic review and meta-analysis

PURPOSE Intravenous maintenance fluid therapy (IV-MFT) prescribing in acute and critically ill children is very variable among pediatric health care professionals. In order to provide up to date IV-MFT guidelines, the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) undertook a systematic review to answer the following five main questions about IV-MFT: (i) the indications for use (ii) the role of isotonic fluid (iii) the role of balanced solutions (iv) IV fluid composition (calcium, magnesium, potassium, glucose and micronutrients) and v) and the optimal amount of fluid. METHODS A multidisciplinary expert group within ESPNIC conducted this systematic review using the Scottish Intercollegiate Guidelines Network (SIGN) grading method. Five databases were searched for studies that answered these questions, in acute and critically children (from 37 weeks gestational age to 18 years), published until November 2020. The quality of evidence and risk of bias were assessed, and meta-analyses were undertaken when appropriate. A series of recommendations was derived and voted on by the expert group to achieve consensus through two voting rounds. RESULTS 56 papers met the inclusion criteria, and 16 recommendations were produced. Outcome reporting was inconsistent among studies. Recommendations generated were based on a heterogeneous level of evidence, but consensus within the expert group was high. "Strong consensus" was reached for 11/16 (69%) and "consensus" for 5/16 (31%) of the recommendations. CONCLUSIONS Key recommendations are to use isotonic balanced solutions providing glucose to restrict IV-MFT infusion volumes in most hospitalized children and to regularly monitor plasma electrolyte levels, serum glucose and fluid balance

Inactivation du gène codant l'étape finale de la synthèse du lipide A de Pseudomonas aeruginosa et ses effets sur la croissance, le système de sécré tion de type III et la sécrétion de TNT-a [alpha] par les cellules sanguines

LYON1-BU Santé (693882101) / SudocSudocFranceF

Mécanismes moléculaires et détection de la résistance à deux antituberculeux apparentés (l'isoniazide et l'éthionamide)

Lors de l évaluation des performances de tests diagnostiques de la résistance à la rifampicine et à l isoniazide chez ycobacterium tuberculosis, nous avons identifié une dizaine de nouvelles mutations dans KatG dans des souches cliniques résistantes à l isoniazide pour lesquelles des études enzymatique et structurale ont été entreprises. Nous avons aussi réalisé une étude moléculaire de la résistance à l éthionamide, un analogue de l isoniazide, dans des souches cliniques de M. tuberculosis. Notre but était d augmenter notre capacité à prédire la résistance à ces deux antituberculeux.In the course of the evaluation of the performance of diagnostic tests for resistance to rifampicin and isoniazid in Mycobacterium tuberculosis, we identified ten new mutations in KatG in clinical strains resistant to isoniazid for which enzymatic and structural studies have been undertaken. We also conducted a molecular study of resistance to ethionamide, an analogue of isoniazid, in clinical strains of M. tuberculosis. Our goal was to increase our ability to predict resistance to both antituberculous drugs.CHATENAY M.-PARIS 11-BU Pharma. (920192101) / SudocSudocFranceF

New Insights into the Geographic Distribution of Mycobacterium leprae SNP Genotypes Determined for Isolates from Leprosy Cases Diagnosed in Metropolitan France and French Territories

International audienceBackgroundBetween 20 and 30 bacteriologically confirmed cases of leprosy are diagnosed each year at the French National Reference Center for mycobacteria. Patients are mainly immigrants from various endemic countries or living in French overseas territories. We aimed at expanding data regarding the geographical distribution of the SNP genotypes of the M. leprae isolates from these patients.Methodology/Principal findingsSkin biopsies were obtained from 71 leprosy patients diagnosed between January 2009 and December 2013. Data regarding age, sex and place of birth and residence were also collected. Diagnosis of leprosy was confirmed by microscopic detection of acid-fast bacilli and/or amplification by PCR of the M. leprae-specific RLEP region. Single nucleotide polymorphisms (SNP), present in the M. leprae genome at positions 14 676, 1 642 875 and 2 935 685, were determined with an efficiency of 94% (67/71). Almost all patients were from countries other than France where leprosy is still prevalent (n = 31) or from French overseas territories (n = 36) where leprosy is not totally eradicated, while only a minority (n = 4) was born in metropolitan France but have lived in other countries. SNP type 1 was predominant (n = 33), followed by type 3 (n = 17), type 4 (n = 11) and type 2 (n = 6). SNP types were concordant with those previously reported as prevalent in the patients’ countries of birth. SNP types found in patients born in countries other than France (Comoros, Haiti, Benin, Congo, Sri Lanka) and French overseas territories (French Polynesia, Mayotte and La Réunion) not covered by previous work correlated well with geographical location and history of human settlements.Conclusions/SignificanceThe phylogenic analysis of M. leprae strains isolated in France strongly suggests that French leprosy cases are caused by SNP types that are (a) concordant with the geographic origin or residence of the patients (non-French countries, French overseas territories, metropolitan France) or (b) more likely random in regions where diverse migration flows occurred

The in vitro mechanisms of isoniazid and ethionamide resistance poorly reflect those in vivo in Mycobacterium tuberculosis

International audienceTo be active against Mycobacterium tuberculosis, isoniazid (INH) and ethionamide (ETH) need to be activated by the catalase/peroxidase KatG for INH and by the mono-oxygenase EthA (regulated by EthR) for ETH [1]. ETH and INH both target the enzyme InhA involved in the cell wall biosynthesis [2]. Clinical isolates resistant (R) to INH and ETH display a wide range of mutations altering KatG (mutation S315T in 70% of INH-R isolates), EthA (in 50% of ETH-R isolates) and, InhA and the inhA promoter (in 25% of INH-R and 65% of ETH-R isolates) [1] and [3]