Clases de tamaño, grupos quimiotaxonómicos y propiedades bio-ópticas del fitoplancton a lo largo de un transecto desde el mar Mediterráneo al SO del océano Atlántico

The relationships between the structure of the phytoplankton community and the bio-optical properties of surface waters were studied during the TransPEGASO cruise along a transect across the Atlantic Ocean that covered seven biogeographical provinces, from the Alborán Sea (SW Mediterranean) to the Patagonian Shelf. We characterized the composition of the phytoplankton community by means of high-performance liquid chromatography and CHEMTAX pigment analyses applied to whole water and two filtration size classes ( 0.5 mg m-3) with a single Mediterranean (MEDI) sample and those from the southwestern Atlantic Shelf (SWAS). According to CHEMTAX, the most important taxa in the tropical and subtropical Atlantic were Prochlorococcus, haptophytes and Synechoccoccus, while the MEDI and SWAS were dominated by diatoms and haptophytes. Both the VU and HI algorithms, which are based on pigment composition or Chl a concentration, predicted for SWAS a high proportion of nano- and microphytoplankton, while the SFF indicated dominance of the 0.5 mg m-3) con una sola muestra mediterránea (MEDI) y las de la plataforma patagónica, en el sudoeste del Atlántico (SWAS). Según CHEMTAX, los taxones más importantes en el Atlántico tropical y subtropical fueron Prochlorococcus, haptofitos y Synechoccoccus, mientras que las provincias MEDI y SWAS estuvieron dominadas por diatomeas y haptofitos. Tanto los algoritmos VU como los HI, que se basan en la composición de pigmentos o en la concentración de Chl a, predijeron para SWAS una alta proporción de nano y microfitoplancton, mientras que la SFF indicó un dominio de la clase de tamaño < 3 μm. Por otra parte, los resultados de CHEMTAX indicaron que, en promedio, la contribución de las diatomeas era importante en esta provincia. Sin embargo, en varias estaciones de SWAS para las que CHEMTAX estimaba una elevada contribución de diatomeas, las observaciones microscópicas encontraron solamente escasas concentraciones de células de diatomeas de tamaño nano- o microplanctónico. Esta discrepancia parece deberse a la presencia, confirmada por microscopía electrónica de barrido, de pequeñas células (< 3 μm) de la diatomea Minidiscus sp. y de Parmales (un grupo que comparte la composición pigmentaria con las diatomeas). Estos hallazgos advierten contra una asignación rutinaria de los pigmentos de las diatomeas a la clase de tamaño de microplancton. La absorción total (sin contar la propia del agua) en la columna de agua estuvo dominada por CDOM. En promedio, la contribución de la absorción de fitoplancton para las diferentes provincias osciló de 19.3% en MEDI a 45.7% en SWAS y 47% en la provincia del Atlántico Tropical Occidental (WTRA). La absorción del fitoplancton por unidad de Chl a [aph*(443), m2 mg-1] fue menor en MEDI y SWAS que en las provincias oligotróficas. aph*(443) se correlacionó negativamente con el primer componente derivado de un análisis de los componentes principales basado en la concentración de los pigmentos más importantes y no se correlacionó con indicadores de la estructura de tamaños de la comunidad fitoplanctónica tales como la proporción de Chl a en la clase < 3 μm o un índice de tamaño (SI) derivado de la distribución de clases de tamaño obtenida mediante el algoritmo VU. Estas observaciones indican que la variabilidad observada en aph*(443) se relacionaba principalmente con diferencias en la composición pigmentaria y posiblemente también con procesos de fotoaclimatación del fitoplancton, y que cualquier efecto de empaquetamiento debido al tamaño de las células quedaba probablemente enmascarado por otros factores. Este último resultado puede estar relacionado con una influencia relativamente pequeña del tamaño dentro del estrecho rango de concentraciones de Chl a considerado en nuestro estudio (todas eran ≤2.4 mg m-3)

Bioavailability of once-daily tacrolimus formulations used in clinical practice in the management of De Novo kidney transplant recipients: the better study.

Multicenter, prospective, observational study to compare the relative bioavailability of once-daily tacrolimus formulations in de novo kidney transplant recipients. De novo kidney transplant recipients who started a tacrolimus-based regimen were included 14 days post-transplant and followed up for 6 months. Data from 218 participants were evaluated: 129 in the LCPT group (Envarsus) and 89 in the PR-Tac (Advagraf) group. Patients in the LCPT group exhibited higher relative bioavailability (Cmin /total daily dose [TDD]) vs. PR-Tac (61% increase; P

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

International audienceBackground: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society