Final version of the software running operationally for the demonstration

This report includes the description and the manuals (both at User and Administrator level) for the OSPAC service and its application

The MEDESS-GIB database: Tracking the Atlantic water inflow

On 9 September 2014, an intensive drifter deployment was carried out in the Strait of Gibraltar. In the frame of the MEDESS-4MS Project (EU MED Program), the MEDESS-GIB experiment consisted of the deployment of 35 satellite tracked drifters, mostly of CODE-type, equipped with temperature sensor sampling at a rate of 30min. Drifters were distributed along and on both sides of the Strait of Gibraltar. The MEDESS-GIB deployment plan was designed as to ensure quasi-synoptic spatial coverage. To this end, four boats covering an area of about 680NM2 in 6h were coordinated. As far as these authors know, this experiment is the most important exercise in the area in terms of number of drifters released. Collected satellite-tracked data along drifter trajectories have been quality controlled and processed to build the presented MEDESS-GIB database. This paper reports the MEDESS-GIB data set that comprises drifter trajectories, derived surface currents and in situ SST measurements collected along the buoys tracks. This series of data is available through the PANGAEA (Data Publisher for Earth and Environmental Science) repository, with the following doi:10.1594/PANGAEA.853701. Likewise, the MEDESS-GIB data will be incorporated as part of the Copernicus Marine historical products. The MEDESS-GIB data set provides a complete Lagrangian view of the surface inflow of Atlantic waters through the Strait of Gibraltar and thus, very useful data for further studies on the surface circulation patterns in the Alboran Sea, and their links with one of the most energetic Mediterranean Sea flows: the Algerian Current

Model-observations synergy in the coastal ocean

Integration of observations of the coastal ocean continuum, from regional oceans to shelf seas and estuaries/deltas with models, can substantially increase the value of observations and enable a wealth of applications. In particular, models can play a critical role at connecting sparse observations, synthesizing them, and assisting the design of observational networks; in turn, whenever available, observations can guide coastal model development. Coastal observations should sample the two-way interactions between nearshore, estuarine and shelf processes and open ocean processes, while accounting for the different pace of circulation drivers, such as the fast atmospheric, hydrological and tidal processes and the slower general ocean circulation and climate scales. Because of these challenges, high-resolution models can serve as connectors and integrators of coastal continuum observations. Data assimilation approaches can provide quantitative, validated estimates of Essential Ocean Variables in the coastal continuum, adding scientific and socioeconomic value to observations through applications (e.g., sea-level rise monitoring, coastal management under a sustainable ecosystem approach, aquaculture, dredging, transport and fate of pollutants, maritime safety, hazards under natural variability or climate change). We strongly recommend an internationally coordinated approach in support of the proper integration of global and coastal continuum scales, as well as for critical tasks such as community-agreed bathymetry and coastline products

EuroGOOS roadmap for operational coastal downstream services

The EuroGOOS Coastal working group examines the entire coastal value chain from coastal observations to services for coastal users. The main objective of the working group is to review the status quo, identify gaps and future steps needed to secure and improve the sustainability of the European coastal service provision. Within this framework, our white paper defines a EuroGOOS roadmap for sustained “community coastal downstream service” provision, provided by a broad EuroGOOS community with focus on the national and local scale services. After defining the coastal services in this context, we describe the main components of coastal service provision and explore community benefits and requirements through sectoral examples (aquaculture, coastal tourism, renewable energy, port, cross-sectoral) together with the main challenges and barriers to user uptake. Technology integration challenges are outlined with respect to multiparameter observations, multi-platform observations, the land-coast-ocean continuum, and multidisciplinary data integration. Finally, the technological, financial, and institutional sustainability of coastal observing and coastal service provision are discussed. The paper gives special attention to the delineation of upstream and downstream services, public-private partnerships and the important role of Copernicus in better covering the coastal zone. Therefore, our white paper is a policy and practice review providing a comprehensive overview, in-depth discussion and actionable recommendations (according to key short-term or medium-term priorities) on the envisaged elements of a roadmap for sustained coastal service provision. EuroGOOS, as an entity that unites European national operational oceanography centres, research institutes and scientists across various domains within the broader field of operational oceanography, offers to be the engine and intermediary for the knowledge transfer and communication of experiences, best practices and information, not only amongst its members, but also amongst the different (research) infrastructures, institutes and agencies that have interests in coastal oceanography in Europe

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Spontaneous Breathing in Early Acute Respiratory Distress Syndrome: Insights From the Large Observational Study to UNderstand the Global Impact of Severe Acute Respiratory FailurE Study

OBJECTIVES: To describe the characteristics and outcomes of patients with acute respiratory distress syndrome with or without spontaneous breathing and to investigate whether the effects of spontaneous breathing on outcome depend on acute respiratory distress syndrome severity. DESIGN: Planned secondary analysis of a prospective, observational, multicentre cohort study. SETTING: International sample of 459 ICUs from 50 countries. PATIENTS: Patients with acute respiratory distress syndrome and at least 2 days of invasive mechanical ventilation and available data for the mode of mechanical ventilation and respiratory rate for the 2 first days. INTERVENTIONS: Analysis of patients with and without spontaneous breathing, defined by the mode of mechanical ventilation and by actual respiratory rate compared with set respiratory rate during the first 48 hours of mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: Spontaneous breathing was present in 67% of patients with mild acute respiratory distress syndrome, 58% of patients with moderate acute respiratory distress syndrome, and 46% of patients with severe acute respiratory distress syndrome. Patients with spontaneous breathing were older and had lower acute respiratory distress syndrome severity, Sequential Organ Failure Assessment scores, ICU and hospital mortality, and were less likely to be diagnosed with acute respiratory distress syndrome by clinicians. In adjusted analysis, spontaneous breathing during the first 2 days was not associated with an effect on ICU or hospital mortality (33% vs 37%; odds ratio, 1.18 [0.92-1.51]; p = 0.19 and 37% vs 41%; odds ratio, 1.18 [0.93-1.50]; p = 0.196, respectively ). Spontaneous breathing was associated with increased ventilator-free days (13 [0-22] vs 8 [0-20]; p = 0.014) and shorter duration of ICU stay (11 [6-20] vs 12 [7-22]; p = 0.04). CONCLUSIONS: Spontaneous breathing is common in patients with acute respiratory distress syndrome during the first 48 hours of mechanical ventilation. Spontaneous breathing is not associated with worse outcomes and may hasten liberation from the ventilator and from ICU. Although these results support the use of spontaneous breathing in patients with acute respiratory distress syndrome independent of acute respiratory distress syndrome severity, the use of controlled ventilation indicates a bias toward use in patients with higher disease severity. In addition, because the lack of reliable data on inspiratory effort in our study, prospective studies incorporating the magnitude of inspiratory effort and adjusting for all potential severity confounders are required

Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries

Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

EuroGOOS roadmap for operational coastal downstream services

The EuroGOOS Coastal working group examines the entire coastal value chain from coastal observations to services for coastal users. The main objective of the working group is to review the status quo, identify gaps and future steps needed to secure and improve the sustainability of the European coastal service provision. Within this framework, our white paper defines a EuroGOOS roadmap for sustained “community coastal downstream service” provision, provided by a broad EuroGOOS community with focus on the national and local scale services. After defining the coastal services in this context, we describe the main components of coastal service provision and explore community benefits and requirements through sectoral examples (aquaculture, coastal tourism, renewable energy, port, cross-sectoral) together with the main challenges and barriers to user uptake. Technology integration challenges are outlined with respect to multiparameter observations, multi-platform observations, the land-coast-ocean continuum, and multidisciplinary data integration. Finally, the technological, financial, and institutional sustainability of coastal observing and coastal service provision are discussed. The paper gives special attention to the delineation of upstream and downstream services, public-private partnerships and the important role of Copernicus in better covering the coastal zone. Therefore, our white paper is a policy and practice review providing a comprehensive overview, in-depth discussion and actionable recommendations (according to key short-term or medium-term priorities) on the envisaged elements of a roadmap for sustained coastal service provision. EuroGOOS, as an entity that unites European national operational oceanography centres, research institutes and scientists across various domains within the broader field of operational oceanography, offers to be the engine and intermediary for the knowledge transfer and communication of experiences, best practices and information, not only amongst its members, but also amongst the different (research) infrastructures, institutes and agencies that have interests in coastal oceanography in Europe.Mathematical PhysicsStatistic

Recent Progress in Performance Evaluations and Near Real-Time Assessment of Operational Ocean Products

Operational ocean forecast systems provide routine marine products to an ever-widening community of users and stakeholders. The majority of users need information about the quality and reliability of the products to exploit them fully. Hence, forecast centres have been developing improved methods for evaluating and communicating the quality of their products. Global Ocean Data Assimilation Experiment (GODAE) OceanView, along with the Copernicus European Marine Core Service and other national and international programmes, has facilitated the development of coordinated validation activities among these centres. New metrics, assessing a wider range of ocean parameters, have been defined and implemented in real-time. An overview of recent progress and emerging international standards is presented here