The GenTree Platform: growth traits and tree-level environmental data in 12 European forest tree species.

BACKGROUND: Progress in the field of evolutionary forest ecology has been hampered by the huge challenge of phenotyping trees across their ranges in their natural environments, and the limitation in high-resolution environmental information. FINDINGS: The GenTree Platform contains phenotypic and environmental data from 4,959 trees from 12 ecologically and economically important European forest tree species: Abies alba Mill. (silver fir), Betula pendula Roth. (silver birch), Fagus sylvatica L. (European beech), Picea abies (L.) H. Karst (Norway spruce), Pinus cembra L. (Swiss stone pine), Pinus halepensis Mill. (Aleppo pine), Pinus nigra Arnold (European black pine), Pinus pinaster Aiton (maritime pine), Pinus sylvestris L. (Scots pine), Populus nigra L. (European black poplar), Taxus baccata L. (English yew), and Quercus petraea (Matt.) Liebl. (sessile oak). Phenotypic (height, diameter at breast height, crown size, bark thickness, biomass, straightness, forking, branch angle, fructification), regeneration, environmental in situ measurements (soil depth, vegetation cover, competition indices), and environmental modeling data extracted by using bilinear interpolation accounting for surrounding conditions of each tree (precipitation, temperature, insolation, drought indices) were obtained from trees in 194 sites covering the species' geographic ranges and reflecting local environmental gradients. CONCLUSION: The GenTree Platform is a new resource for investigating ecological and evolutionary processes in forest trees. The coherent phenotyping and environmental characterization across 12 species in their European ranges allow for a wide range of analyses from forest ecologists, conservationists, and macro-ecologists. Also, the data here presented can be linked to the GenTree Dendroecological collection, the GenTree Leaf Trait collection, and the GenTree Genomic collection presented elsewhere, which together build the largest evolutionary forest ecology data collection available.

Colonization of the nasal airways by Staphylococcus aureus on admission to a major heart surgery operating room: A real-world experience / Colonización nasal por Staphylococcus aureus en el ingreso quirúrgico para una cirugía cardíaca mayor: una experiencia en la práctica clínica real

INTRODUCTION: Nasal swab culture is used to identify Staphylococcus aureus colonization, as this is a major risk factor for surgical site infection (SSI) in patients who are going to undergo major heart surgery (MHS). We determined nasal carriage of S. aureus in patients undergoing MHS by comparing the yield of a conventional culture with that of a rapid molecular test (Xpert(R) SA Nasal Complete, Cepheid). METHODS: From July 2015 to April 2017, all patients who were to undergo MHS were invited to participate in the study. We obtained two nasal cultures from each patient just before entering the operating room, independently of a previous test for the determination of nasal colonization by this microorganism performed before surgery. One swab was used for conventional culture in the microbiology laboratory, and the other was used for the rapid molecular test. We defined nasal colonization as the presence of a positive culture for S. aureus using either of the two techniques. All patients were followed up until hospital discharge or death. RESULTS: Overall, 57 out of 200 patients (28.5%) were colonized by S. aureus at the time of surgery. Thirty-three patients had both conventional culture- and PCR-positive results. Twenty-four patients had a negative culture and a positive PCR test. Only twenty-one percent (12/57) of colonized patients had undergone an attempt to decolonise before the surgical intervention. CONCLUSION: A significant proportion of patients undergoing MHS are colonized by S. aureus in the nostrils on entering the operating room. New strategies to prevent SSI by this microorganism are needed. Rapid molecular tests immediately before MHS, followed by immediate decolonisation, must be evaluated

INTRODUCCIÓN: Los cultivos nasales se usan para identificar colonización por Staphylococcus aureus, ya que la colonización es un factor de riesgo para la infección de la herida quirúrgica en pacientes que van a ser sometidos a cirugía cardiaca mayor (CCM). En este trabajo, identificamos portadores de S. aureus en el momento quirúrgico en pacientes que van a ser sometidos a CCM, comparando el resultado del cultivo convencional con un test molecular rápido (Xpert(R) SA Nasal Complete, Cepheid). MÉTODOS: Desde julio del 2015 hasta abril del 2017, a todos los pacientes que iban a ser intervenidos con CCM se les invitó a participar en el estudio. Se obtuvieron 2 cultivos nasales de cada paciente, justo antes de entrar en el quirófano, independientemente de si había un test previo de colonización nasal realizada. Una torunda fue usada en el laboratorio de microbiología para cultivo convencional y la otra para el test molecular rápido. Se definió colonización nasal como la positividad para S.aureus por cualquiera de las 2 técnicas. Todos los pacientes fueron seguidos hasta el alta hospitalaria o éxitus. RESULTADOS: Un total de 57 de 200 pacientes (28,5%), estaban colonizados por S. aureus en el momento de la cirugía. En total, 33 pacientes tuvieron ambas muestras positivas (convencional y PCR); 24 pacientes tuvieron cultivo negativo y PCR positiva. Solo el 21% (12/57) de los pacientes colonizados habían tenido un intento de descolonización antes de la cirugía. CONCLUSIÓN: Un porcentaje alto de pacientes están colonizados por S. aureus en el momento de ser sometidos a CCM. Son necesarias nuevas estrategias para prevenir la infección de la herida quirúrgica por este microorganismo. Un test molecular rápido inmediatamente antes de la CCM y descolonización posterior inmediata debe ser evaluado

Author Correction: The GenTree Dendroecological Collection, tree-ring and wood density data from seven tree species across Europe.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The GenTree Dendroecological Collection, tree-ring and wood density data from seven tree species across Europe.

The dataset presented here was collected by the GenTree project (EU-Horizon 2020), which aims to improve the use of forest genetic resources across Europe by better understanding how trees adapt to their local environment. This dataset of individual tree-core characteristics including ring-width series and whole-core wood density was collected for seven ecologically and economically important European tree species: silver birch (Betula pendula), European beech (Fagus sylvatica), Norway spruce (Picea abies), European black poplar (Populus nigra), maritime pine (Pinus pinaster), Scots pine (Pinus sylvestris), and sessile oak (Quercus petraea). Tree-ring width measurements were obtained from 3600 trees in 142 populations and whole-core wood density was measured for 3098 trees in 125 populations. This dataset covers most of the geographical and climatic range occupied by the selected species. The potential use of it will be highly valuable for assessing ecological and evolutionary responses to environmental conditions as well as for model development and parameterization, to predict adaptability under climate change scenarios.

Colonization of the nasal airways by Staphylococcus aureus on admission to a major heart surgery operating room: A real-world experience.

INTRODUCTION: Nasal swab culture is used to identify Staphylococcus aureus colonization, as this is a major risk factor for surgical site infection (SSI) in patients who are going to undergo major heart surgery (MHS). We determined nasal carriage of S. aureus in patients undergoing MHS by comparing the yield of a conventional culture with that of a rapid molecular test (Xpert® SA Nasal Complete, Cepheid). METHODS: From July 2015 to April 2017, all patients who were to undergo MHS were invited to participate in the study. We obtained two nasal cultures from each patient just before entering the operating room, independently of a previous test for the determination of nasal colonization by this microorganism performed before surgery. One swab was used for conventional culture in the microbiology laboratory, and the other was used for the rapid molecular test. We defined nasal colonization as the presence of a positive culture for S. aureus using either of the two techniques. All patients were followed up until hospital discharge or death. RESULTS: Overall, 57 out of 200 patients (28.5%) were colonized by S. aureus at the time of surgery. Thirty-three patients had both conventional culture- and PCR-positive results. Twenty-four patients had a negative culture and a positive PCR test. Only twenty-one percent (12/57) of colonized patients had undergone an attempt to decolonise before the surgical intervention. CONCLUSION: A significant proportion of patients undergoing MHS are colonized by S. aureus in the nostrils on entering the operating room. New strategies to prevent SSI by this microorganism are needed. Rapid molecular tests immediately before MHS, followed by immediate decolonisation, must be evaluated. Trial Registration Clinical Trials.gov NCT02640001.

Impact of selective digestive decontamination without systemic antibiotics in a major heart surgery intensive care unit.

PURPOSE: The incidence density of ventilator-associated pneumonia (VAP) is higher in patients undergoing major heart surgery than in other populations, despite the introduction of bundles of preventive measures, because many risk factors are not amenable to intervention. Selective digestive decontamination (SDD) has been shown to be efficacious for decreasing the frequency of VAP, although it has not been incorporated into the routine of most intensive care units. The objective of our study was to evaluate the efficacy of SDD without parenteral antibiotics for preventing VAP in a major heart surgery intensive care unit. METHODS: We compared the incidence of VAP before the introduction of SDD (17 months) and during the 17 months after the introduction of SDD and examined its ecologic influence. RESULTS: The rates of VAP in the overall population before and during the intervention were 16.26/1000 days and 6.80 episodes/1000 days of mechanical ventilation, respectively (P = .01). The rates of VAP in the 173 patients remaining under mechanical ventilation > 48 hours after surgery were, respectively, 25.85/1000 days of mechanical ventilation versus 12.06 episodes/1000 days of mechanical ventilation (P = .04). We found a significant reduction in the number of patients with multidrug-resistant microorganisms (P = .01) in the second period of the study. CONCLUSIONS: Our study shows that SDD without parenteral antibiotics can reduce the incidence of VAP in high-risk patients after major heart surgery, with no significant ecologic influence.

Pre-emptive broad-spectrum treatment for ventilator-associated pneumonia in high-risk patients.

PURPOSE: Patients requiring mechanical ventilation (MV) for >48 h after major heart surgery (MHS) are at a high risk of acquiring ventilator-associated pneumonia (VAP) and tracheobronchitis (VAT). Most non-pharmacological interventions to prevent VAP in such patients are usually already implemented. The objective of this study was to evaluate the efficacy in preventing lower respiratory infections of antibiotics active against multidrug-resistant pathogens in this very high-risk population. METHODS: We performed a prospective randomized open-label study of MHS patients requiring MV for >48 h. Patients were randomly allocated to one of two groups: the intervention group, which received a 3-day course of linezolid and meropenem, and the control group, which received the standard of care. The main outcome was the development of VAP or VAT. RESULTS: Overall, of the 78 patients included in the study, 40 were in the intervention group and 38 in the control group. Both groups were comparable. Data for the intervention and control groups respectively were as follows: VAP + VAT/1,000 days was 31.79 vs 64.78 (p = 0.03), median length of MV before the first episode of VAP or VAT 9 vs 4.5 days (p = 0.02). No significant differences were observed in median length of stay in the intensive care unit, median length of hospital stay, antibiotic use, Clostridium difficile infection, and overall mortality rate. We detected linezolid-resistant coagulase-negative and coagulase-positive staphylococci in the MHS intensive care unit after the study period. CONCLUSIONS: A pre-emptive approach with broad-spectrum antibiotics may be effective in reducing the incidence and delaying the onset of VAP + VAT after MHS. The ecological consequences have to be carefully evaluated in future trials.

Haemodynamic monitoring and liver function evaluation by pulsion cold system Z-201 (PCS) during orthotopic liver transplantation.

Pulsion cold system (PCS, COLD) is a haemodynamic monitoring system that allows measurement of cardiac output (CO), partial blood volumes, lung water, and liver function. The aim of the study was to evaluate this monitoring system during human orthotopic liver transplantation (OLT) for the following: (a) to determine agreement between CO measurements via pulmonary artery thermodilution (CO TDpa), and aortic transpulmonary thermodilution (CO TDa); (b) to compare the preload dates obtained with the COLD with central venous pressure (CVP) and pulmonary capillary wedge (PCWP); and (c) to assess the use of the plasma disappearance rate (PDR) of indocyanine green (ICG) as a measure of graft function. Fifteen consecutive patients undergoing OLT were studied. Each patient received a pulmonary artery catheter and a 5F aortic catheter with an integrated thermistor. The thermistor of the aortic catheter were connected to one computer system (COLD-Z201, Pulsion Medical Systems, Munich, Germany). Haemodynamic data were registered an all the phases of OLT. PDR was measured during surgery in 12 patients. Correlations between PDR and the other markers of graft function (transaminases, protrombine time, and bile production) were sought. The correlation coefficient between CO TDa (COLD) and CO TDpa was r = 0.766 (p < 0.001), and an additional analysis according to Bland-Altman was also performed. There was a better correlation between the cardiac index (determined by two monitoring systems) and the volume measurements than the correlation observed with pressure preload parameters. The best correlations were found between the cardiac index in the femoral artery and intrathoracic blood volume index (ITBVI) and pulmonary blood volume index (PBVI) (r = 0.79 and r = 0.72, respectively; p < 0.01). PDR measured in the group patients with bad early graft function were lower (13.6 +/- 2.7) than those in the group with a good graft function (21.6 +/- 9) (p < 0.05). The degree of discrepancy between femoral and pulmonary thermodilution cardiac output measures is very wide during OLT so as to make the techniques using the COLD machine clinically useless. On the other hand, the volumes measured by COLD, specially ITBVI and PBVI, are more useful to asses the pre-load than pressure measurements. In OLT, the PDR measured within the first few hours after liver reperfusion may become a useful tool for early diagnosis of primary graft dysfunction (PDF).