Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Evaluation and optimization of ICOS atmosphere station data as part of the labeling process

The Integrated Carbon Observation System (ICOS) is a pan-European research infrastructure which provides harmonized and high-precision scientific data on the carbon cycle and the greenhouse gas budget. All stations have to undergo a rigorous assessment before being labeled, i.e., receiving approval to join the network. In this paper, we present the labeling process for the ICOS atmosphere network through the 23 stations that were labeled between November 2017 and November 2019. We describe the label-ing steps, as well as the quality controls, used to verify that the ICOS data (CO2, CH4, CO and meteorological measurements) attain the expected quality level defined within ICOS. To ensure the quality of the greenhouse gas data, three to four calibration gases and two target gases are measured: one target two to three times a day, the other gases twice a month. The data are verified on a weekly basis, and tests on the station sampling lines are performed twice a year. From these high-quality data, we conclude that regular calibrations of the CO2, CH4 and CO analyzers used here (twice a month) are important in particular for carbon monoxide (CO) due to the analyzer's variability and that reducing the number of calibration injections (from four to three) in a calibration sequence is possible, saving gas and extending the calibration gas lifespan. We also show that currently, the on-site water vapor correction test does not deliver quantitative results possibly due to environmental factors. Thus the use of a drying system is strongly recommended. Finally, the mandatory regular intake line tests are shown to be useful in detecting artifacts and leaks, as shown here via three different examples at the stations.Peer reviewe

Balkan Vegetation Database (BVD) – updated information and current status

The Balkan Vegetation Database (BVD; GIVD ID: EU-00-019) is a regional database, which was established in 2014. It comprises phytosociological relevés covering various vegetation types from nine countries of the Balkan Peninsula (Albania – 153 relevés, Bosnia and Herzegovina – 1715, Bulgaria – 12,282, Greece – 465, Croatia – 69, Kosovo – 493, Montenegro – 440, North Macedonia – 13 and Serbia – 2677). Currently, it contains 18,306 relevés (compared to 9.580 in 2016), and most of them (82.8%) are geo-referenced. The database includes both digitized relevés from the literature (65.6%) and unpublished data (34.5%). Plot size is available for 84.7% of all relevés. During the last four years some “header data information” was improved e.g. elevation (now available for 83.4% of all relevés), aspect (67.7%), slope (66%), total cover of vegetation (54.3%), cover of tree, shrub, herb, bryophyte and lichen layers (27.1%, 20.1%, 40.2%, 11.5% and 2.1%), respectively. Data access is either semi-restricted (65.6%) or restricted (34.4%). Most relevés (84.6%) are classified to syntaxa of different levels. The database has been used for numerous studies with various objectives from floristic, vegetation and habitat-related topics, to macroecological studies at the local, regional, national, continental and global levels. During the last four years, BVD data were requested from 111 different projects via the EVA and sPlot databases

Multi-laboratory compilation of atmospheric methane data for the year 2021; obspack_ch4_1_NRT_v4.0_2022-03-03

This product is constructed using the Observation Package (ObsPack) framework [Masarie et al., 2014; www.earth-syst-sci-data.net/6/375/2014/]. The framework is designed to bring together atmospheric greenhouse gas (GHG) observations from a variety of sampling platforms, prepare them with specific applications in mind, and package and distribute them in a self-consistent and well-documented product. ObsPack products are intended to support GHG budget studies and represent a new generation of cooperative value-added GHG data products

Multi-laboratory compilation of atmospheric methane data for the years 2020-2021; obspack_ch4_1_NRT_v3.0_2021-05-18

This product is constructed using the Observation Package (ObsPack) framework [Masarie et al., 2014; www.earth-syst-sci-data.net/6/375/2014/]. The framework is designed to bring together atmospheric greenhouse gas (GHG) observations from a variety of sampling platforms, prepare them with specific applications in mind, and package and distribute them in a self-consistent and well-documented product. ObsPack products are intended to support GHG budget studies and represent a new generation of cooperative value-added GHG data products

Multi-laboratory compilation of atmospheric carbon dioxide data for the years 2020-2021; obspack_co2_1_NRT_v6.1_2021-02-02

A full list of all contributors for this product can be found at www.esrl.noaa.gov/gmd/ccgg/obspack/providerlist/obspack_co2_1_NRT_v6.1_2021-02-02.html This product is constructed using the Observation Package (ObsPack) framework [Masarie et al., 2014; www.earth-syst-sci-data.net/6/375/2014/]. The framework is designed to bring together atmospheric greenhouse gas (GHG) observations from a variety of sampling platforms, prepare them with specific applications in mind, and package and distribute them in a self-consistent and well-documented product. ObsPack products are intended to support GHG budget studies and represent a new generation of cooperative value-added GHG data products

Multi-laboratory compilation of atmospheric carbon dioxide data for the year 2021; obspack_co2_1_NRT_v7.1_2022-03-04

This product is constructed using the Observation Package (ObsPack) framework [Masarie et al., 2014; www.earth-syst-sci-data.net/6/375/2014/]. The framework is designed to bring together atmospheric greenhouse gas (GHG) observations from a variety of sampling platforms, prepare them with specific applications in mind, and package and distribute them in a self-consistent and well-documented product. ObsPack products are intended to support GHG budget studies and represent a new generation of cooperative value-added GHG data products

Multi-laboratory compilation of atmospheric carbon dioxide data for the years 2020-2021; obspack_co2_1_NRT_v6.1.1_2021-05-17

This product is constructed using the Observation Package (ObsPack) framework [Masarie et al., 2014; www.earth-syst-sci-data.net/6/375/2014/]. The framework is designed to bring together atmospheric greenhouse gas (GHG) observations from a variety of sampling platforms, prepare them with specific applications in mind, and package and distribute them in a self-consistent and well-documented product. ObsPack products are intended to support GHG budget studies and represent a new generation of cooperative value-added GHG data products

Multi-laboratory compilation of atmospheric carbon monoxide data for the period 1989-2020; obspack_co_1_GLOBALVIEWplus_v2.0_2021-12-08

A full list of all creators for this product can be found at www.esrl.noaa.gov/gmd/ccgg/obspack/providerlist/obspack_co_1_GLOBALVIEWplus_v2.0_2021-12-08.html. This product is constructed using the Observation Package (ObsPack) framework [Masarie et al., 2014; www.earth-syst-sci-data.net/6/375/2014/]. The framework is designed to bring together atmospheric greenhouse gas (GHG) observations from a variety of sampling platforms, prepare them with specific applications in mind, and package and distribute them in a self-consistent and well-documented product. ObsPack products are intended to support GHG budget studies and represent a new generation of cooperative value-added GHG data products. This product includes 249 atmospheric carbon dioxide datasets derived from observations made by 25 laboratories from 10 countries. Data for the period 1989-2020 (where available) are included

Multi-laboratory compilation of atmospheric carbon dioxide data for the year 2021; obspack_co2_1_NRT_v7.0_2021-08-20

This product is constructed using the Observation Package (ObsPack) framework [Masarie et al., 2014; www.earth-syst-sci-data.net/6/375/2014/]. The framework is designed to bring together atmospheric greenhouse gas (GHG) observations from a variety of sampling platforms, prepare them with specific applications in mind, and package and distribute them in a self-consistent and well-documented product. ObsPack products are intended to support GHG budget studies and represent a new generation of cooperative value-added GHG data products