The vertebrate fauna of the Upper Permian of Niger. IV. Nigerpeton ricqlesi (Temnospondyli: Cochleosauridae), and the Edopoid Colonization of Gondwana

We describe the edopoid temnospondyl Nigerpeton ricqlesi from the Upper Permian Moradi Formation of northern Niger on the basis of two partial skulls and tentatively associated postcranial material. This crocodile-like taxon displays several edopoid characters states such as a long prenarial region with enlarged premaxillae, elongated vomers, large, posteriorly tapering choanae, and a jugal that broadens anteriorly. Nigerpeton possesses a unique carnivorous dentition. It is autapomorphic in its possession of an extremely elongate snout bearing a maxillary bulge that accommodates three hypertrophied caniniform teeth, inner premaxillary tusks, and anterior paired fenestrae, which pierce the skull roof. In addition, both the maxilla and dentary tooth rows show the sporadic appearance of ‘doubled’ tooth positions. The lateral-line system is present at the adult stage, which suggests an aquatic habitat for this taxon. A phylogenetic analysis of Edopoidea and its relatives places Nigerpeton as the sister taxon to the Permo-Carboniferous genus Chenoprosopus from the U.S.A. As with other members of the Moradi tetrapod fauna, the discovery of Nigerpeton strengthens support for the hypothesis that West Africa hosted an endemic fauna at the close of the Paleozoic Era. Biogeographically, we propose that Late Carboniferous and Permian edopoids were geographically widespread and that they twice crossed the Central Pangean mountain chain (between Laurussia and Gondwana) during their evolution. This distribution was later fragmented with the onset of Late Permian climatic warming

Supplemental Material for 'Pennaraptoran theropod dinosaurs : past progress and new frontiers. (Bulletin of the American Museum of Natural History, no. 440)'

Supplemental Material for 'Pennaraptoran theropod dinosaurs : past progress and new frontiers. (Bulletin of the American Museum of Natural History, no. 440)

Immunocompromised patients with acute respiratory distress syndrome : Secondary analysis of the LUNG SAFE database

The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013