Fine scale physical-biological interactions during a shift from relaxation to upwelling with a focus on Dinophysis acuminata and its potential ciliate prey

Wind reversals and quick transitions from relaxation to upwelling in coastal areas cause major changes in water column structure, phytoplankton distribution and dominance, and rates of physiological processes. The cruise "ASIMUTH-Rías" (17–21 June 2013) was carried out in the Galician Rías and adjacent shelf, at the time of a DSP outbreak, to study small-scale physical processes associated with late spring blooms of "D. acuminata" and accompanying microzooplanktonic ciliates with the overall objective of improving predictive models of their occurrence. The cruise coincided with the initiation of an upwelling pulse following relaxation and deepening of a previously formed thin layer of diatoms. A 36-h cell cycle study carried on 18–20 June showed the vertical excursions of the thin layer, mainly delimited by the 13.5–14 °C isotherms and turbulence levels (ε) of 10−8–10−6 m2 s −3, as well as marked changes in phytoplankton composition (increased density and dominance of diatoms). There was no evidence of daily vertical migration of D. acuminata, which remained in the top layer during the cycle study, but the opposite was observed in the ciliate populations. Dinophysis and its potential prey (Mesodinium species) cell maxima overlapped after midday, when the ciliate moved to the surface, suggesting an “ambush” strategy of Dinophysis to catch prey. A remarkable decline (from 0.65 to 0.33 d−1) in division rates (µ) of D. acuminata was associated with increased turbulence (ε 2°C in about 8 h). In contrast, high division rates (µmin ∼ 0.69 d−1) persisted at a mid-shelf station where environmental conditions below the mixed layer were more stable. The onset of upwelling pulses appears to have a double negative effect on the net growth of Dinophysis populations: a direct physical effect due to advective dispersion and an indirect effect, decreased division rates. The latter would be caused by the rapid cooling of the mixed layer, and the increased turbulence at the surface resulting in shear stress to the cells. The short-term impact of upwelling pulses (and the winds promoting it) on the physiology of "Dinophysis" and its ciliate prey, and the role of mid-shelf populations of "Dinophysis" as a relatively undisturbed reservoir for the inoculation of subsequent blooms are discussed.European Commission | Ref. EC FP7-SPACE-2010-1, n. 261860Ministerio de Economía | Ref. CTM2016-75451-C2-2-RInterreg Atlantic Area | Ref. EAPA_182/2016Comisión Nacional de Ciencia y Tecnología Research (CONICYT), Chile | Ref. PAI79160065Comisión Nacional de Ciencia y Tecnología Research (CONICYT), Chile | Ref. REDES17010

Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals

This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (GSES) were the study’s main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.This research was funded by Fundación ASISA and Sociedad Española de Urgencias y Emergencias (SEMES)

Risk factors for infections caused by carbapenem-resistant Enterobacterales: an international matched case-control-control study (EURECA)

Cases were patients with complicated urinary tract infection (cUTI), complicated intraabdominal (cIAI), pneumonia or bacteraemia from other sources (BSI-OS) due to CRE; control groups were patients with infection caused by carbapenem-susceptible Enterobacterales (CSE), and by non-infected patients, respectively. Matching criteria included type of infection for CSE group, ward and duration of hospital admission. Conditional logistic regression was used to identify risk factors. Findings Overall, 235 CRE case patients, 235 CSE controls and 705 non-infected controls were included. The CRE infections were cUTI (133, 56.7%), pneumonia (44, 18.7%), cIAI and BSI-OS (29, 12.3% each). Carbapenemase genes were found in 228 isolates: OXA-48/like, 112 (47.6%), KPC, 84 (35.7%), and metallo-beta-lactamases, 44 (18.7%); 13 produced two. The risk factors for CRE infection in both type of controls were (adjusted OR for CSE controls; 95% CI; p value) previous colonisation/infection by CRE (6.94; 2.74-15.53; <0.001), urinary catheter (1.78; 1.03-3.07; 0.038) and exposure to broad spectrum antibiotics, as categorical (2.20; 1.25-3.88; 0.006) and time-dependent (1.04 per day; 1.00-1.07; 0.014); chronic renal failure (2.81; 1.40-5.64; 0.004) and admission from home (0.44; 0.23-0.85; 0.014) were significant only for CSE controls. Subgroup analyses provided similar results. Interpretation The main risk factors for CRE infections in hospitals with high incidence included previous coloni-zation, urinary catheter and exposure to broad spectrum antibiotics

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

La renovación de la palabra en el bicentenario de la Argentina : los colores de la mirada lingüística

El libro reúne trabajos en los que se exponen resultados de investigaciones presentadas por investigadores de Argentina, Chile, Brasil, España, Italia y Alemania en el XII Congreso de la Sociedad Argentina de Lingüística (SAL), Bicentenario: la renovación de la palabra, realizado en Mendoza, Argentina, entre el 6 y el 9 de abril de 2010. Las temáticas abordadas en los 167 capítulos muestran las grandes líneas de investigación que se desarrollan fundamentalmente en nuestro país, pero también en los otros países mencionados arriba, y señalan además las áreas que recién se inician, con poca tradición en nuestro país y que deberían fomentarse. Los trabajos aquí publicados se enmarcan dentro de las siguientes disciplinas y/o campos de investigación: Fonología, Sintaxis, Semántica y Pragmática, Lingüística Cognitiva, Análisis del Discurso, Psicolingüística, Adquisición de la Lengua, Sociolingüística y Dialectología, Didáctica de la lengua, Lingüística Aplicada, Lingüística Computacional, Historia de la Lengua y la Lingüística, Lenguas Aborígenes, Filosofía del Lenguaje, Lexicología y Terminología

Biología, autoecología y toxinología de las principales especies del género "Dinophysis" asociadas a episodios de intoxicación diarreogénica por bivalvos (DSP).

Los dinoflagelados del género Dinophysis producen potentes toxinas lipofílicas que se transmiten a través de los bivalvos filtradores a niveles superiores de la red trófica, y los convierten en no aptos para el consumo humano. Se puede afirmar que las apariciones crónica de poblaciones de Dinophysis spp constituyen el principal factor de riesgo en las explotaciones marisqueras en el Atlántico nororiental. El principal propósito de esta tesis era resolver las incertidumbres en la clasificación de especies del género Dinophysis causantes de la presencia de toxinas diarreicas (DSP) en Galicia y mejorar los conocimientos sobre la biología y variabilidad de contenido de toxinas de estas especies. Para ello, se propuso un estudio de las especies más abundantes del género sobre la base de observaciones en muestreos intensivos de campo y manipulación e incubación de muestras naturales en el laboratorio. Los objetivos parciales del proyecto eran: A) Describir las variaciones morfológicas intra-específicas de especies del género Dinophysis e investigar sus causas; B) Estimar tasas de crecimiento in situ y las condiciones asociadas al incremento poblacional de distintas especies de Dinophysis, y C) Determinar el perfil y contenido de toxinas, y la contribución de las distintas especies de Dinophysis a los episodios de presencia de toxinas diarreogénicas. En el capítulo 1, de introducción, y el Anexo I, se detallan los objetivos de la tesis, se hace una revisión histórica de los pasos seguidos hasta la identificación del síndrome diarreico por consumo de bivalvos y de Dinophysis fortii como la microalga dinoflagelada planctónica agente de estos episodios. Asimismo, se resumen las estrategias de muestreo aplicadas para resolver las cuestiones planteadas sobre las especies de Dinophysis no disponibles en cultivo (hasta la fecha) y que suelen constituir un componente minoritario de la comunidad de fitoplancton global. En la primera parte (capítulos 2 y 3) se describen morfológicamente las principales especies de Dinophysis y su variabilidad intra-específica, se revisa la aparición de "formas pequeñas" e intermedias en su ciclo de vida y se propone un ciclo vital polimórfíco de tres bucles, común a todas las especies del género, que explica la gran variabilidad morfológica intra-específica observada en este género. En la segunda parte (capítulos 4-5-6) se presentan resultados sobre ciclos anuales de crecimiento de las dos especies más abundantes, Dinophysis acuminata y D. acuta, en relación con las condiciones físicas en las rías de Vigo y Pontevedra (Rías Baixas) y sobre la puesta a punto de un método de estimación de tasas de división in situ de varias especies de Dinophysis, basado en el modelo del índice mitótico, utilizando diferencias morfológicas en las células en división y recién divididas como marcadores de eventos terminales necesarios para la aplicación de este modelo. Finalmente en la tercera parte (capítulos 7-8) se muestran resultados sobre la distribución de niveles de toxina diarreica (ácido okadaico, AO) en las cuerdas de mejillón de batea en relación con las poblaciones de Dinophysis y sobre el contenido de toxinas diarreicas (AO y dinofisistoxinas) en células aisladas por micro-manipulación y analizadas mediante cromatografía líquida de alta eficacia

Lipophilic Toxins in Chile: History, Producers and Impacts

A variety of microalgal species produce lipophilic toxins (LT) that are accumulated by filter-feeding bivalves. Their negative impacts on human health and shellfish exploitation are determined by toxic potential of the local strains and toxin biotransformations by exploited bivalve species. Chile has become, in a decade, the world's major exporter of mussels (Mytilus chilensis) and scallops (Argopecten purpuratus) and has implemented toxin testing according to importing countries' demands. Species of the Dinophysis acuminata complex and Protoceratium reticulatum are the most widespread and abundant LT producers in Chile. Dominant D. acuminata strains, notwithstanding, unlike most strains in Europe rich in okadaic acid (OA), produce only pectenotoxins, with no impact on human health. Dinophysis acuta, suspected to be the main cause of diarrhetic shellfish poisoning outbreaks, is found in the two southernmost regions of Chile, and has apparently shifted poleward. Mouse bioassay (MBA) is the official method to control shellfish safety for the national market. Positive results from mouse tests to mixtures of toxins and other compounds only toxic by intraperitoneal injection, including already deregulated toxins (PTXs), force unnecessary harvesting bans, and hinder progress in the identification of emerging toxins. Here, 50 years of LST events in Chile, and current knowledge of their sources, accumulation and effects, are reviewed. Improvements of monitoring practices are suggested, and strategies to face new challenges and answer the main questions are proposed.This works was funded by the Chilean National Agency of Research and Development ANID-projects FONDECYT 11170682; FONDEF/ANID 2017, IT17F10002, developed within the framework of a cooperation agreement between the Consellería do Mar, Xunta de Galicia, Spain and the Universidad Católica del Norte, Chile; and project REDES170101 from the International Cooperation Programme of the ANID for cooperation between Chile and IEO (CSIC), Spain. Beatriz Reguera was funded by the EC-INTERREG Atlantic Area project PRIMROSE (EAPA_182/2016) and Patricio A. Díaz by the Centro de Biotecnología y Bioingeniería (CeBiB) (PIA project FB0001, ANID, Chile).Peer reviewe

Interannual variability in mesoscale distribution of Dinophysis acuminata and D. acuta in Northwestern Patagonian fjords

Dinophysis acuminata and D. acuta, which produce diarrheogenic toxins and pectenotoxins in southern Chile, display site-specific differences in interannual variability (2006 - 2018) in Reloncaví, Pitipalena and Puyuhuapi fjords (41 - 46 °S), Chilean Patagonia. Linear Models show decreasing trends in rainfall and river discharge. Latitudinal decreasing gradients in SST temperature and vertical salinity gradients were observed. A brackish water layer (FW salinity 103 cells L‒1) densities every season. Dinophysis acuminata, associated with toxin profiles in shellfish that include only pectenotoxins, bloomed everywhere with a poleward increasing gradient. Absence of the FW layer provides a possible index of risk for D. acuta blooms. An apparent poleward shift of D. acuta populations, responsible for DSP outbreaks in Reloncaví in the 1970s, and the recent EU deregulation of pectenotoxins will have a positive impact on the mussel industry in Los Lagos Region. Changes to ongoing monitoring protocols to improve risk assessment capabilities are suggested.This work was funded by ANID-FONDECYT 11170682 from the National Agency of Research and Development (ANID), Chile. Ángela M. Baldrich was funded by a Ph.D. fellowship from the Universidad de Los Lagos. Carlos Molinet was partially funded by INCAR (FONDAP, grant N°15110027). Beatriz Reguera was funded by the EU-Interreg Atlantic Area project PRIMROSE (EAPA_182/2016).Peer reviewe