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Resume But de l’etude Le lien entre l’ileus postoperatoire, la duree de sejour et l’autonomie rapportee par le patient (ARP) n’est pas connu alors que cette ARP pourrait aider le chirurgien a adapter le jour de sortie du patient. Le but de cette etude etait d’evaluer l’evolution de l’ARP dans la periode postoperatoire, ainsi que les differents facteurs influencant cette evolution. Patients et methodes Cette etude retrospective sur une base de donnees prospective incluait les patients operes d’une chirurgie colorectale dans un seul centre sur une periode de 14 mois. L’ARP etait defini en utilisant la premiere partie du Groningen Activity Restriction Scale appele « activity of the daily life » (de 9 le meilleur) a 45 (le moins bon). Resultats Parmi les 101 patients operes, 80 % retrouvaient leur ARP preoperatoire (± 5 points) pendant 2 jours precedant la sortie. L’ARP etait significativement diminuee par la chirurgie (p 2 l’aggravait (p = 0,03). Les programmes de rehabilitation amelioree tendaient a ameliorer la recuperation de l’ARP (p = 0,09). Conclusion L’ARP pourrait etre utilisee pour optimiser le jour de sortie d’un patient apres chirurgie colorectale.

The environmental control of reproductive processes is central to both fundamental and applied aspects of animal ecology. The present study experimentally assessed how environmental factors modulate gametogenesis and spawning and impact embryo development and survival in the holothuroid Cucumaria frondosa, a cold-water echinoderm with lecithotrophic development. Adults were exposed to three seawater temperatures, four photoperiod regimes, and two food concentrations during 120 days overlapping the natural gametogenic and spawning periods. Among all the treatments tested, exposure to ambient conditions of water temperature (−1 to 3 °C), photoperiod (8 to 13 h of light) and food concentration (3 × 103 ± 896 rotifers g−1 of sea cucumbers d−1) yielded the greatest reproductive output and embryo survival. At pre-spawning, males and females had the highest gonad index (~33%) and where filled with mature gametes. At spawning, females in ambient conditions released the highest number of oocytes (1.2 × 103 oocytes female−1) and yielded the highest embryo survival rates (21% at 20 days post fertilization). Individuals exposed to warmer water temperatures (6 and 12 °C) experienced delayed gametogenesis and did not spawn. Individuals under 24-h light, 24-h dark, and advanced (4 months) photoperiods showed delayed gametogenesis and low numbers of oocytes released; moreover, embryos died within 10 days post fertilization. Individuals fed with high food concentration (6 × 103 ± 982 rotifers g−1 of sea cucumbers d−1) showed similar results to ambient conditions, suggesting that increased food supply neither decreased nor enhanced reproductive output over the experimental period. This study sheds new light on the environmental drivers of reproductive success in C. frondosa, which is of value for developing conservation strategies and mariculture protocols in cold-water holothuroids with lecithotrophic development.

The present study investigated methods to trigger spawning and artificially induce oocyte maturation in the commercial cold-water suspension-feeding sea cucumber Cucumaria frondosa. Spawning occurred after exposure to live phytoplankton, commercial phytoplankton paste, and conspecific sperm. Live phytoplankton at 1 × 105 cells ml−1 induced the highest proportion of females to spawn (mean of 56%); promoted the greatest oocyte release (mean of 19,200 oocytes female−1), best quality of eggs and highest survival of embryos (65%; 20 d post fertilization). More concentrated live phytoplankton (1 × 106 cells ml−1) triggered 43% of the females to release ~16,100 oocytes female−1 and survival rates 20 d post fertilization were lower (50%). Both phytoplankton paste treatments (1 × 105 and 1 × 106 cells ml−1) yielded intermediate results in terms of percent spawning females (26%), abundance of oocytes released (11,000 and 7300 oocytes female−1, respectively), quality of eggs, and survival of embryos (44 and 50%, respectively). Sperm from conspecific (2 and 10 × 106 spermatozoa ml−1) induced the lowest proportion of females to spawn (16%) with release of 3000 and 1700 oocytes female−1, respectively; furthermore, all embryos died within 10 d post fertilization. Results for males were slightly different: spawning was more frequent (63%) in the sperm treatment at 2 × 106 spermatozoa ml−1 followed by live phytoplankton at 1 × 106 and 1 × 105 cells ml−1 (43%), and phytoplankton paste at 1 × 105 cells ml−1 (46%); the lowest spawning success was observed for phytoplankton paste at 1 × 106 cells ml−1 and conspecific sperm at 10 × 106 spermatozoa ml−1 (26%). Thermal shock, desiccation, potassium chloride (injection or bath), and serotonin (injection) did not induce spawning in C. frondosa. When oocytes isolated from mature ovaries were exposed to three different concentrations of 1-Methyladenine (1-MA), Dithiothreitol (DTT), 2,3-Dimercapto-1-propanol (BAL), and L-cysteine (L-cyst), DTT at 10−1 M induced the highest proportion of oocytes (48%) to shed follicle cells (i.e. ovulate); whereas other treatments induced only 2–6% of ovulation, similar to the control (seawater). All oocytes that shed follicle cells remained unfertilizable. Overall, live phytoplankton emerged as the most suitable spawning trigger for C. frondosa, a Dendrochirotida that produces maternally-provisioned oocytes. In the context of expanding sea cucumber aquaculture, this finding provides a tool to maximize the availability of gametes in this cold-water species, with possible applicability to similar commercial dendrochitotids.

Sea anemones are often presented as a major component of benthic communities and described as ecologically important in benthic food webs. However, studies on the trophic ecology of deep-sea species are rare. Here, the feeding habits and dietary sources of three species of bathyal sea anemones (Actinostola callosa, Actinauge cristata, Urticina sp.) from the Northwest Atlantic were studied in a multi-faceted approach including stable isotopes, gastrovascular contents, lipid and fatty acids analysis and observations in a mesocosm. Stable isotope analysis showed that A. callosa sits at a slightly lower trophic level than A. cristata and Urticina sp. and that the two latter species rely on different carbon sources at roughly the same trophic level. The gastrovascular cavity contents and mesocosm study revealed that all three species ingest a variety of food items, from inorganic materials to a diversity of metazoans, including whole large prey. Total lipid content varied across species and was highest in Urticina sp. Phospholipids constituted the main lipid class in all three species, with consistently high levels of wax ester storage lipids. All sea anemones were also characterized by high proportions of mono and polyunsaturated fatty acids (MUFA and PUFA) as well as ω3 and ω9 FAs, and strikingly low proportions of 20:4ω6 (ARA). High values of 20:5ω3 (EPA), 20:1ω9 and 22:1ω11(13) evoke a diet centered on zooplankton, with notable particularities. For instance, Urticina sp. had the highest PUFA to saturated FAs ratio, indicative of carnivory. Overall, results suggest that the three sea anemone species occupy different niches in the spectrum of opportunistic polyphagous predation/feeding, with Urticina sp. relying chiefly on more energetic and larger prey and A. cristata targeting smaller zooplankton, foraminifera and particulate food, highlighting that large actinians play diverse roles in benthic food webs.

As deep-sea benthic ecosystems of continental margins provide numerous functions and services to humans, a better understanding of these key habitats and their communities is needed to help predict climate-driven shifts and support conservation efforts. Here stable isotope (δ13C and δ15N), elemental (%C, %N, and molar C:N), and fatty acid (FA) composition of 50 different deep-sea species, belonging to 7 major taxa, were analyzed in order to characterize their diet and trophic position, and to study the fate of energy and essential nutrients in the food web. In addition, relationships between depth and biochemical signatures (δ13C, δ15N, %C, %N, C:Nmol, and FAs) were also investigated. In this regard, %C, oleic acid (18:1ω9), and arachidonic acid (ARA, 20:4ω6) increased with depth. While the increase of %C was likely due to the preferential assimilation of the more nutritious N along the gradient, that of 18:1ω9 was presumed to reflect the need for longer-term energy reserves in deeper organisms, and that of ARA to indicate a higher reliance on the benthic trophic pathway at greater depth. Analyses also revealed that the focal deep-sea invertebrates occupied three trophic levels, whereas the weak correlation between δ13C and δ15N indicated that two or more trophic pathways were represented. Several feeding modes were also recognized within the assemblage. The lowest trophic positions were occupied by sponges most likely feeding on bacteria. Intermediate positions were mainly occupied by suspension feeders (e.g. sea anemones, corals), detritivores (e.g. the sea urchin Phormosoma placenta), and predators on small infaunal animals (e.g. the sea star Leptychaster arcticus). Conversely, predator/scavengers (e.g. various sea stars, gastropods, polychaete worms) occupied the highest trophic positions, together with sponges that were determined to be either carnivorous (e.g. Iophon piceum), or to feed on 15N- and 13C-enriched organic matter. Energetic compounds (i.e. 20:1ω11(13), 20:1ω9, and 22:1ω7) and essential nutrients (i.e. ARA) increased in proportion across the trophic levels of this food web, emphasizing the importance of certain dietary FAs for optimal organism health, and the key role of benthic communities in carbon cycling.

While sea cucumbers have been fished in Belizean waters for ∼ 20 years for trade through Guatemala and the local Asian market in Belize, harvesting for export to international markets only started with the establishment of the sea cucumber fishery regulations in 2009. The fishery included two main species, Holothuria mexicana and Isostichopus badionotus but only the former was legally managed by the Belize Fisheries Department through a closed season and catch reporting. By 2016, H. mexicana was considered overfished and in 2017, the entire fishery was closed. Here we provide a comprehensive analysis of this fishery in Belize from 2009–2016 with the goal to make recommendations for policy development. This study combined key informant interviews with secondary data collection and observation of sea cucumber fishing, landing and processing. Fishers hand-picked sea cucumbers using mask and snorkel and sold their catch to exporters or middlemen. Sea cucumber harvesting increased fishers’ income to 154 times the minimum wage in 2010 and 5 times the minimum wage in 2016, concurrent with a drastic decline of stocks. Some fishers rated sea cucumber harvesting as their primary fishing activity but knew very little about their biology or ecology. They were concerned about the decrease in catch that forced them to fish in deeper waters and about the illegal fishing by Guatemalan and Honduran fishers in Belizean waters. Sea cucumbers sold locally since 2009 were neither reflected in the market economy nor used to adjust the Total Allowable Catch by the Belize Fisheries Department. Maintaining the long-term sustainability of this fishery will rely on greater investments in enforcing fisheries regulations, in scientific research to determine the viability of sea cucumber fishing, and in the education of fishers. A closer collaboration with fishers is necessary to adequately inform future management decisions on the socioeconomic consequence of overfishing.

The present study examined morphological and behavioural development in post-settled juveniles of the commercial sea cucumber Cucumaria frondosa, in an effort to assist captive breeding and conservation initiatives. Juveniles developed all 10 tentacles within 16 months; they had 9 podia and measured 4.6 mm in length after 21 months. Scaling between body length and number of podia was isometric, whereas dorsal tentacle metrics showed negative allometric scaling, indicating that growth was accompanied by a decreasing tentacle to body size ratio. Dorsally-oriented tentacles developed and ramified faster, showing 6 ramifications after 21 months, when ventrally-oriented tentacles only displayed one. This asynchrony underlines the distinctive roles of dorsal vs. ventral tentacles during the early months. The former were strictly used to capture plankton from the water column; whereas the latter were used for anchorage and feeding on deposited material. Ossicles of the body wall increased in length and thickness, and became slightly curved and rounded in older juveniles. Light intensity and water flow tolerance increased with age; from 25 lx and 5 cm s−1 in 1-month-old individuals, to >50 lx and 10 cm s−1 in 6, 12, and 21-month-old individuals, consistent with migration from sheltered to more exposed locations. Moreover, 1 and 6-month-old juveniles preferred rock substrates and black or red background colours; whereas 12 and 21-monthd-old individuals favoured substrates of coralline algae and a red background, also indicative of increasing affinity with sunlit environments and a shift from benthic to planktonic feeding. Juveniles of all age classes were feeding (i.e. had deployed tentacles) 24 h a day and commonly sought vertical surfaces. Together, the findings shed light on the early juvenile ecology of this cold-water suspension-feeding sea cucumber. Considering the expansion of sea cucumber fisheries and growing interest in the aquaculture of C. frondosa, this work also provides a framework for improved stock management and culture protocols.

Among arthropods, pycnogonids are generally considered of minor ecological significance in marine ecosystems. However, the fact that they can host a wide diversity and high abundance of epibiotic organisms suggests that their role in benthic communities may be underestimated. The present study characterized the diversity, dynamics and role of the epibiotic community associated with deep-sea pycnogonids (Nymphon hirtipes). Despite their small size, they hosted a mean of 62 macro-organisms belonging to at least 26 species from 11 different phyla. Foraminifera was the dominant phylum while other phyla, such as Bryozoa, Cnidaria (Hydrozoa), Porifera and Brachiopoda were common. The macro-epibiont burden varied from 1 to 235 organisms per pycnogonid; it was consistent across depths and locations but fluctuated as a function of sex and of the reproductive state in males. Specifically, most colonized individuals were females, which are larger and thus offer more surface for epibionts. Among males, burdens peaked in those carrying larvae. Maximum epibiont burden and coverage was correlated with the cessation of grooming at the beginning of the breeding period. Micro-epibionts consisted of bacterial mats covering most body parts. Several epibionts were estimated to have negative effects on their host (e.g. increasing drag, preventing mating, decreasing limb mobility and impeding feeding). However, because this species dies after reproducing, epibiosis may be considered as a positive trade-off since it may provide food to the mobile juveniles living on the male for several months. Furthermore, epibionts could be used as camouflage during this period. N. hirtipes has been identified as a common component of the benthofauna in the deep sea of the North Atlantic and Arctic Oceans, and the present study indicates that it displays the greatest diversity and burden of associates ever reported among pycnogonids.

13 pages, 8 figures, 1 tables, aupplementary data https://doi.org/10.1016/j.jembe.2021.151607, The feeding behaviour of deep-sea animals is largely understudied despite being of relevance to assess changes in ecosystems functioning in the face of anthropogenic impacts and climate regime shifts. Here, time-lapse videography in dark, cold-water, flow-through laboratory settings was used to study the behaviours of a gastropod (Buccinum scalariforme) and three sea stars (Ceramaster granularis, Hippasteria phrygiana, Henricia lisa) from the bathyal Northwest Atlantic, to build knowledge on their foraging strategies (i.e. food search, assessment and handling). In all species tested, the presence/absence of a palatable food source modulated the speed and directionality of movements. Approach paths were erratic in the absence of palatable food and targeted in its presence: B. scalariforme, C. granularis and H. phrygiana, moved in straight line to the food, while H. lisa moved either in straight line or counterclockwise loop. The four species traveled at mean speeds of 2.9, 0.2, 0.7, and 0.6 cm min−1, respectively. At the finer scale, unprecedented pulses in displacement speed were detected, varying in amplitude and frequency depending on the food item. The results also support more generalist diets and broader scavenging habits in deep-sea sea gastropods and sea stars than assumed from previous studies and knowledge of shallower-water counterparts. Depth-related food limitation may drive greater flexibility in foraging strategies and acceptable food items, This work was supported in part by the Natural Sciences and Engineering Research Council of Canada (NSERC) via grants awarded to A.M., J.A. is a member of the Tecnoterra Associated Research Unit (ICM-CSIC/UPC) and supported by the Spanish Government through the ‘Severo Ochoa Centre of Excellence’ accreditation (CEX2019-000928-S)

Aims Over the last decades, Health-related Quality of Life (HRQoL) end-points have become an important outcome of the randomised controlled trials (RCTs). HRQoL methodology in RCTs has improved following international consensus recommendations. However, no international recommendations exist concerning the statistical analysis of such data. The aim of our study was to identify and characterise the quality of the statistical methods commonly used for analysing HRQoL data in cancer RCTs. Methods Building on our recently published systematic review, we analysed a total of 33 published RCTs studying the HRQoL methods reported in RCTs since 1991. We focussed on the ability of the methods to deal with the three major problems commonly encountered when analysing HRQoL data: their multidimensional and longitudinal structure and the commonly high rate of missing data. Results All studies reported HRQoL being assessed repeatedly over time for a period ranging from 2 to 36 months. Missing data were common, with compliance rates ranging from 45% to 90%. From the 33 studies considered, 12 different statistical methods were identified. Twenty-nine studies analysed each of the questionnaire sub-dimensions without type I error adjustment. Thirteen studies repeated the HRQoL analysis at each assessment time again without type I error adjustment. Only 8 studies used methods suitable for repeated measurements. Conclusion Our findings show a lack of consistency in statistical methods for analysing HRQoL data. Problems related to multiple comparisons were rarely considered leading to a high risk of false positive results. It is therefore critical that international recommendations for improving such statistical practices are developed.

In shallow benthic communities, sponges are widely recognized for their ability to contribute to food webs by cycling nutrients and mediating carbon fluxes through filter feeding. In comparison, little is known about filter feeding in deep-sea species and how it may be modulated by environmental conditions. Here, a rare opportunity to maintain live healthy deep-sea sponges for an extended period led to a preliminary experimental study of their feeding metrics. This work focused on demosponges collected from the continental slope of eastern Canada at ~ 1000 m depth. Filtration rates (as clearance of phytoplankton cells) at holding temperature (6 °C) were positively correlated with food particle concentration, ranging on average from 18.8 to 160.6 cells ml −1 h −1 at nominal concentrations of 10,000–40,000 cells ml −1 . Cell clearance was not significantly affected by decreasing seawater temperature, from 6 °C to 3 °C or 0 °C, although two of the sponges showed decreased filtration rates. Low pH (~ 7.5) and the presence of a predatory sea star markedly depressed or inhibited feeding activity in all sponges tested. While performed under laboratory conditions on a limited number of specimens, this work highlights the possible sensitivity of deep-sea demosponges to various types and levels of biotic and abiotic factors, inferring a consequent vulnerability to natural and anthropogenic disturbances.

As increasing anthropogenic CO2 emissions are absorbed by the oceans, a decrease in seawater pH is expected to occur, causing what is now termed ocean acidification (OA). Deep-sea species have been greatly understudied with respect to OA, even though their response may differ from those evidenced so far in shallow-water taxa. The polychaete worm Ophryotrocha sp. collected at bathyal depth was held and reproduced for several years, offering a rare opportunity to study environmental effects in a member of a deep-sea community. This hermaphroditic species exhibits well defined seasonality in feeding and reproduction and its development and growth have been characterized. The purpose of the present study was to explore the effects of OA on gametogenesis following exposure to a 0.4 unit pH decrease under realistic conditions over 26 weeks. Opportunistic assessments of spawning and development were also conducted. A flow-through design allowing for natural fluctuations in pH, temperature and salinity was used. Individuals exposed to low pH/high ρCO2 produced larger and more abundant oocytes but fewer spermatozoa, compared to individuals in ambient conditions. However, lower effective fecundity (number of eggs laid) was ultimately recorded under low pH conditions, together with slower development of the embryos and larvae. Microstructure of the body wall, and appearance and elemental composition of chaeta were not affected. Despite its ability to live and reproduce normally for years in the laboratory, a realistic decrease of pH in the environment of Ophryotrocha sp. led to reproductive disruption, highlighting its potential vulnerability to OA.

Specimens of the neogastropod Buccinum scalariforme (60–70 mm shell height) collected between 700 and 1450 m depth along the continental slope of eastern Canada were kept for 4 years in mesocosm settings. Their mating, spawning and development were assessed, thereby generating the first complete life cycle account of a deep-sea gastropod. Egg laying occurred in March and September, with a total of 9 egg masses laid in 2013 and 2015, coinciding with periods of maximum deposition of particulate organic matter (phytodetritus). Oviposition lasted 2–3 days and the female protected the egg mass for ~3 more days until it had hardened. Typically, egg masses contained 50–75 egg capsules, each measuring 5–8 mm in diameter. A capsule contained between 100 and 150 spherical eggs (300–500 µm) of which ≤50 developed into embryos. Potential fecundity calculated from the entire egg mass at spawning was between 1500 and 2250 propagules; it drastically decreased over ~4–5 months of development to an effective fecundity of 30–50 juveniles emerging from the mass (0–2 juveniles per capsule). Development went through early embryonic stages in ~15 days and reached the trocophore in 15–21 days, followed by intracapsular veliger larva (480 µm) and intracapsular pediveliger (~1000 µm) after ~90 days. Completion of development relied on oophagy and adelphophagy. The juveniles hatched at a shell height of 1–2 mm and consumed the capsule membrane. Over 2.5 years, they reached a maximum size of ~8–10 mm shell height at an average of 9.8 µm day −1 . Estimations indicate that B. scalariforme could require between 20 and 50 years to reach maximum adult size. Large gastropods like B. scalariforme are among the most abundant motile benthic invertebrates of the bathyal zone of eastern Canada. Knowledge of their reproductive biology constitutes a first step in assessing their vulnerability and resilience to ever growing anthropogenic pressures, including fisheries, and oil/gas exploration and exploitation.

Sea cucumber is one of the top five luxury seafoods in Asia and its commercialization primarily revolves around the processed body wall. Hence, live transport and storage of sea cucumbers prior to processing must preserve the condition of the body wall and underlying muscles. Unlike most commercial shellfish on which industry standards are chiefly based, sea cucumbers lack a protective exoskeleton and have the ability to autolyze. Here, we tested the efficacy of different live storage methods on Cucumaria frondosa , a commercial species that is widely distributed in the North Atlantic and the Arctic. Current technologies and low-cost variants were experimentally tested under conditions prescribed for the transport of seafood in Canada. Markers of post-storage health, body wall condition and muscle integrity were compared among treatments. The most common method currently in use (icing and salting) yielded the highest rates of mortality and skin necrosis, whereas iced seawater emerged as the best storage condition. These findings should help stakeholders adapt their methodologies to optimize the exploitation of temperate and cold-water sea cucumber resources.

While the suspension-feeding sea cucumber Cucumaria frondosa is commercially exploited in the North Atlantic and is considered to have potential for integrated aquaculture, the impact of environmental conditions on its behaviour and population structure remains incompletely understood. The present study showed that adults are not photosensitive; they do not exhibit any preference for either illuminated or shaded areas. Within each photoperiod treatment, analyses of the daily activity cycle revealed that the proportion of individuals with feeding tentacles deployed did not change over time; however, the proportion of moving individuals increased in the dark phase under the 12 h light/12 dark regime, but remained constant under continuous light or darkness. Hence, from an aquaculture perspective, long days (i.e. summer photoperiod) might decrease the time spent moving in favour of feeding, potentially shifting the energy budget toward faster growth. Variations in phytoplankton concentration modulated the deployment of tentacles but did not trigger any displacement toward the food source, indicating that feeding responds directly to the presence of food. Moreover, C. frondosa exhibited a clear preference for substrates composed of bare rocks and rocks with coralline algae and displayed a weak preference for darker substrate backgrounds. Together, these findings highlight how some key environmental factors can govern the feeding, locomotor activities, and eventual distribution of cold-water suspension-feeding sea cucumbers.

While reproduction in deep-sea corals remains incompletely understood, there is a particularly crucial shortage of information related to corals living in deep waters of the Arctic Ocean. In the present study, colonies of the deep-sea pennatulacean coral Umbellula encrinus were collected in Baffin Bay (High Canadian Arctic) at bathyal depths between 2006 and 2010. From examination of gamete sizes, maturity levels and densities at several time points, U. encrinus was determined to be a gonochoric species with an equal sex ratio and a broadcast-spawning strategy. Fully mature oocytes measured between 800-950 μm in diameter, consistent with lecithotrophic larval development. Potential fecundity was ∼4200 mature oocytes colony−1 and ∼5300 mature spermatocysts colony−1. Gametogenesis was synchronous between sexes; a single main cohort of oocytes and spermatocysts was seen to increase in size throughout the year. Gametogenetically mature colonies were detected in late June during the earliest possible spring samplings. Spent colonies were detected in July and August. Early stages of gametogenesis appeared in early September shortly after the spawning months and more advanced growth stages occurred in late September and early November, after which time sampling was prevented by ice cover. The spawning season in U. encrinus appears to occur once a year, closely following the disappearance of the ice cover in early spring, when chlorophyll-a in Baffin Bay increases. The initiation of gametogenesis coincides with a period of sustained phytoplankton production and continues until the entire bay freezes over in fall. Since mature gametes were found in both male and female colonies just after the spring melt, gamete maturation likely continues under the ice. Both depth and latitude were shown to impact gamete development and fecundity in U. encrinus, with more advanced and fertile colonies occurring in deeper water and at higher latitudes.

Cardiac rehabilitation (CR) combines therapeutic education with physical training and is recognized to reduce mortality rates by approximately 22% following myocardial infarction (MI) [(1)][1]. Despite its broad acceptance, some studies have reported that CR may be harmful, in terms of left

Introduction The objective of the study to is to determine the characteristics associated with endotracheal intubation in septic shock patients. Methods This is a post hoc analysis of the database of the SEPSISPAM study, including patients with septic shock. Results Among the 776 patients, 633 (82%) were intubated within 12 hours of study inclusion (early intubation), 113 (15%) were never intubated, and 30 (4%) had delayed intubation. Intensive care units (ICUs) were classified according to frequency of early intubation: early intubation less than 80% of patients (lowest frequency: 7 ICUs, 254 patients), 80% to 90% (middle frequency: 5 ICUs, 170 patients), and greater than 90% (highest frequency: 6 ICUs, 297 patients). Type of ICU, pulmonary infection, lactate greater than 2 mmol/L, lower Pao 2 /fraction of inspired oxygen ratio, lower Glasgow score, and absence of immunosuppression were independently associated with early intubation. Patients never intubated had a lower initial severity and a low mortality rate. In comparison to patients intubated early, patients with delayed intubation had had fewer days alive without organ support by day 28. Intensive care units with the highest frequency of early intubation had a higher mortality rate in comparison to ICUs with middle frequency of early intubation. A nonsignificant increased mortality was observed in ICU with lowest frequency of early intubation. Conclusions Practices regarding the place of endotracheal intubation in septic shock may impact outcome.

Pycnogonids (sea spiders) are commonly collected at bathyal and abyssal depths all around the world; however, little is known about species from deep-water habitats. The present study explores the life history of Nymphon hirtipes collected in northeastern Newfoundland between 700 and 1450 m depth and monitored in mesocosms for over 2 years. The pycnogonids were found in association with octocorals, hydrozoans and sea anemones. Adult females developed mature oocytes between June and August. Paired mating followed by oviposition occurred between early July and mid-October. Up to three egg masses were brooded by each male. It took a maximum of 4 months for the propagules to hatch from the egg mass. Offspring developed from walking leg-bearing larvae to early juveniles over the next ~5 months before leaving the male’s protection. Mating and oviposition coincided with the highest water temperatures of the annual cycle and dispersal of juveniles occurred in spring, when phytodetritus deposition was high and as ocean temperature rose markedly. All the females died after oviposition and the males ~9 months later, after juvenile dispersal. The sex ratio of mature individuals (~55–60 mm leg span) was 2 males for 3 females. Fecundity was estimated to be 184–288 eggs per adult female. Adults of N. hirtipes were seen feeding on hydrozoan polyps, small sea anemones (Stephanauge nexilis) and nudibranchs. Larvae and early juveniles did not feed while brooded by the male. Upon dispersal, their feeding apparatus became functional and they began feeding on hydrozoan polyps. After 13 months of growth post hatching, the juveniles reached ~21 mm leg span. Curve fitting estimated that ~7 years are required to reach the adult size of 55 mm leg span.

Shallow-water annelids of the genus Ophryotrocha have become a popular biological system for exploring ecological, behavioral, developmental, and toxicological questions. Here we report on the successful maintenance in holding tanks, complete life cycle, and reproductive phenology of a first deep-water representative that could be used as a model species. This Ophryotrocha , which has yet to be formally described, is large (12–16 mm long) and exhibits simultaneous hermaphroditism. Specimens collected off northeast Newfoundland (eastern Canada) between 500 and 1500 m depth were monitored under flow-through laboratory conditions for over three years. They consistently exhibited seasonal feeding from April to February, followed by a reproductive season between February and May. Gametogenesis was initiated in early January and completed in early to mid-February, followed by courtship, which mainly involved pairs of individuals attached head to tail for hours to days. Transparent gelatinous masses containing 80–110 eggs were laid from mid-February to late-March. Propagules developed in the mass to the 1-chaetiger stage and, at an ambient temperature of ~1–4 °C, offspring emerged 30–45 days post-laying. Only ~40–45% of the eggs laid developed to the 1-chaetiger stage, with evidence of adelphophagy. After emerging from the gelatinous mass, 1-chaetiger stages remained aggregated and were guarded by adults for a few days before dispersing. All parents died following the dispersal of their offspring. The new generation reached sexual maturity in 8–9 months and was ready to reproduce the following January–February. A few cases of segmenting adult worms were also observed. Three complete generations developed successively to sexual maturity over the course of this study.

There is increasing evidence that spatial factors modulate reproductive processes over large (>150 km) and medium (10–100 km) scales in marine taxa, but few studies have explicitly determined the degree of inter-individual synchrony in gamete development at smaller scales within benthic populations. Using a ubiquitous broadcast-spawning species, the brittlestar Ophiopholis aculeata, we assessed variations in gametogenic activity over the annual reproductive cycle at various scales. Quantitative indices of oogenic maturity were compared in females collected: (1) in two substrata at a given site (distant ∼200–300 m), (2) among clusters of individuals living in relatively close proximity (∼10–50 m), and (3) within each cluster of individuals collected under/inside a given substratum (∼2–20 cm). Gametogenic maturity was also examined in females collected from distant sites (∼50–150 km). At the main study site, oogenic cohesion was greater within and among clusters of a given substratum than between substrata, and differences in reproductive output and spawning periods occurred between individuals from the two substrata studied. At the finest scale (within clusters of individuals) oogenic synchrony was maximal just before spawning. Comparing samples from distant geographic locations (>50 km) showed significant asynchrony outside the pre-spawning period. The present study shows that relatively high levels of asynchrony in gamete maturation may exist among conspecifics of a seemingly homogeneous population, except at the closest scale (within clusters) at the culmination of the reproductive cycle (near spawning). This emphasizes the likely interplay of inter-individual exchanges and small-scale distribution on the fine coordination of reproductive events.

Henoch-Schonlein purpura (HSP) is a common autoimmune vasculitis in childhood. The detailed pathogenesis of HSP is still unclear, whereas several types of predisposing factors have been proved to be the initial step. The objectives of present study were to analyze the distribution of predisposing factors, association of the predisposing factors with clinical manifestations and HSP relapse/recurrence. 1200 children with HSP were recruited between January 2015 and December 2017. We reviewed their laboratory tests and medical histories associated with HSP onset. The annual incidence of HSP was 8.13–9.17 per 100 000 in Anhui province. HSP occurred more commonly in spring and winter than in summer with an obvious west-to-east gradient. Cutaneous purpura was the most prevalent manifestation (100%), followed by arthritis/arthralgias (43.67%), abdominal pain (40.17%) and renal involvement (18.17%). On admission, series of potential infections were identified in 611 patients (50.92%). The histories of allergy, injury, surgery, vaccination and tick bite were declared by 231 patients (19.25%), 15 patients (1.25%), 12 patients (1.00%), 4 patients (0.33%) and 3 patients (0.25%), respectively. However, predisposing factors could not be identified in 521 children with HSP (43.42%) yet. 123 cases (10.25%) relapsed or recurred more than one time; the mean number was 2.92, and the mean interval was 11.4 weeks. The infection is the most frequent predisposing factor regardless of clinical phenotypes and relapse/recurrence, whereas the clinical manifestations exhibit an obvious heterogenicity according to different predisposing factors.

Resume Le deni de grossesse est une entite floue, mal definie, ne faisant l’objet d’aucun consensus international. Pourtant, ce phenomene est souvent rencontre par les professionnels de sante, suscitant de nombreuses interrogations tant sur son origine que sur sa prise en charge. Le deni de grossesse constitue une situation potentiellement a risque pour la mere et son enfant. Nous presentons notre etude retrospective sur cinq ans a la maternite du CHU d’Angers a partir de 75 dossiers de femmes ayant decouvert tardivement leur grossesse. L’absence de consensus precis et la necessite d’etablir des criteres d’inclusion ont permis une reflexion concernant la definition du deni de grossesse. Nous avons recherche des parametres epidemiologiques, cliniques et de prise en charge dans une tentative explicative et preventive. L’analyse des donnees recueillies nous amene a proposer systematiquement un entretien psychologique ou psychiatrique a toute femme qui presente un deni de grossesse. On peut penser que le double abord parallele, somatique et psychique, pourrait ameliorer la prise en charge et prevenir les recidives.

When modeling life-history evolution of marine benthic invertebrates, it has been common to assume constant mortality rate of offspring during the pre-settlement phase and greater propagule vulnerability in the pelagic than in the benthic habitat. However, recent findings have challenged these assumptions, emphasizing the need for further empirical tests. Here we present the results of a multifactorial experimental investigation of predation rates on propagules of various taxa by benthic invertebrates. Planktotrophic and lecithotrophic propagules of echinoderms, cnidarians and annelids (i.e. sea cucumbers, sea stars, sea urchins, corals, sea anemones, jellyfishes, and polychaetes) were tested at various stages of development to examine the effects of ontogeny, size and behavior on predation rates by common filter feeders (mussels, tunicates) and suspension feeders (sea anemones). Overall, propagule survival was positively correlated with their size, although on closer inspection this was essentially due to the size difference between developmental modes (larger lecithotrophic propagules being less vulnerable). A slight inverse relationship between survival and age was detected in both lecithotrophic and planktotrophic propagules; however ingestion rates were not systematically higher on more advanced life stages within prey species due to predator-specific responses to ontogenetic changes. Filter feeders were generally more effective predators than suspension feeders. Tunicates expressed greater selectivity based on size and age of propagules than on their behavior, while the inverse occurred in the two other predators. A combination of factors, i.e. size, buoyancy and chemical defenses, presumably underlie overall higher survival rates in lecithotrophic than in planktotrophic propagules, supporting the hypothesis that the former but not the latter may have evolved due to increased epibenthic predation.

While conditions in shallow-water and deep-sea environments differ markedly, it remains unclear how eurybathic species adapt their life histories to cope with these changes. The present study compared indicators of maternal reproductive investment of three common echinoderms collected shallower than 20 m and deeper than 850 m: Cucumaria frondosa (Holothuroidea), Solaster endeca and Henricia sanguinolenta (Asteroidea). Depth-specific and species-specific differences were found in gonad indices (GI), potential fecundity, oocyte size frequency, as well as lipid classes and fatty acids measured in gonad tissue and oocytes. The asteroids, S. endeca and H. sanguinolenta , exemplified the interspecific trade-off between size and number of oocytes: the former had fewer larger oocytes than the latter, with higher total lipid proportions in them. However, intraspecifically, larger oocytes found in deep specimens of S. endeca did not translate into lower fecundity but rather into a seemingly higher GI, indicating greater investment per oocyte without reducing fecundity. Oocytes were absent in specimens of C. frondosa sampled in deep water, suggesting delayed or impaired maturation at the limit of their depth tolerance. Analysis of S. endeca sterol proportions in gonads and oocytes across depths showed higher sterol input into oocytes in females from the deep. Gonads of S. endeca and H. sanguinolenta contained similar essential fatty acids, but showed significant differences in major fatty acids and some of the less dominant ones, indicating diet specificities. Analyses within S. endeca showed evidence of similar feeding mode (carnivory) at both depths, but suggested shifts in the diet or synthesis of fatty acids, presumably reflecting differences in available food sources and/or adaptations to their respective environments.

Asteroids (sea stars) can be important predators in benthic communities and are often present in ecologically important and vulnerable deep-sea coral and sponge habitats. However, explicit studies on the trophic ecology of deep-sea asteroids are rare. We investigated the diets of seven species of deep-sea asteroid from the bathyal zone of Newfoundland and Labrador, eastern Canada. A multifaceted approach including live animal observations, stomach content analysis, and stable isotope analysis revealed the asteroids to be either top predators of megafauna or secondary consumers (mud ingesters, infaunal predators, and suspension feeders). The stable isotope signatures of Ceramaster granularis, Hippasteria phrygiana, and Mediaster bairdi are characteristic of high-level predators, having δ15N values 4.4‰ (more than one trophic level) above Ctenodiscus crispatus, Leptychaster arcticus, Novodinia americana, and Zoroaster fulgens. We present strong evidence that corals and sponges are common food items for two of the predatory species, C. granularis and H. phrygiana. During laboratory feeding trials, live H. phrygiana fed on several species of soft coral and C. granularis fed on sponges. Stomach content analysis of wild-caught individuals revealed sclerites from sea pens (e.g. Pennatula sp.) in the stomachs of both asteroid species; H. phrygiana also contained sclerites from at least two other species of octocoral and siliceous sponge spicules were present in the stomachs of C. granularis. The stomach contents of the secondary consumers contained a range of invertebrate material. Leptychaster arcticus and Ctenodiscus crispatus feed infaunally on bulk sediment and molluscs, Zoroaster fulgens is a generalist infaunal predator, and the brisingid Novodinia americana is a specialist suspension feeder on benthopelagic crustaceans. This study provides a foundation for understanding the ecological roles of bathyal asteroids, and suggests that some species may have the potential to be important modulators of deep-sea benthic communities.

This study examined the influence of temporal and spatial factors on the determination of reproductive cycles in selected deep-water echinoderms. The prevalence of inter-individual synchrony in the gametogenesis of three ubiquitous species, Phormosoma placenta (Echinoidea), Hippasteria phrygiana (Asteroidea) and Mesothuria lactea (Holothuroidea) collected off the coast of Newfoundland and Labrador (eastern Canada), was determined. Analyses revealed diverse degrees of gametogenic asynchrony at the scales examined (within trawls, between trawls over similar or different periods, as well as among depths and locations over the same period). Taken as a whole, samples did not show any annual or seasonal patterns, whereas some sets of samples, taken over a particular time period in the same area and at the same depth, revealed well synchronized maturing and/or spawning periods in P. placenta and H. phrygiana. This study presents evidence that determination of reproductive cycles in many deep-sea species may be affected by low sampling resolution inherent to most deep-sea studies. More accurate assessments of reproductive patterns and periodicities may require much tighter collection designs as several species are likely to rely on long-term or transient pairing and aggregation to synchronize their breeding activities.

While epibiotic associations between macrobenthic invertebrates are common, the role they play in the feeding ecology of intervening species is often incompletely understood. The diets of epibiotic sea anemones Allantactis parasitica and their gastropod hosts were analyzed using digestive tract contents, lipid biomarkers and observations of live specimens in an attempt to detect dietary feedback from the facultative association. Comparisons were made using symbiotic individuals and asymbiotic counterparts collected at depths of 191–627 m from three neighbouring areas in the northwest Atlantic. Gastropods carrying one or two epibionts had higher stomach indices than those harbouring three epibionts or no epibiont. The diet of symbiotic gastropods was also more diversified based on stomach contents and lipid analysis. Among other things, symbiotic gastropods contained four times more lipids and a greater proportion of Σn−3 fatty acids. Gastrovascular cavity content indices of asymbiotic sea anemones were generally lower than those of symbiotic counterparts. Their cavities were more often empty, and their diet less diversified with fewer benthic items, suggesting that foraging of gastropods through the sediments makes more food available to sea anemones living as epibionts. Lipid analysis showed some disparities between symbiotic and asymbiotic sea anemones at the regional scale, including in percent phospholipids and in the proportion of certain fatty acids. Together these findings indicate that mutual protection against predators leads to prolonged and more efficient foraging for gastropods and increased time spent deployed (feeding) in food-rich areas for sea anemones, thus enabling both partners to fully exploit food resources that may be limited at bathyal depths.

The hormathiid sea anemone Allantactis parasitica was found living as an epibiont on numerous species of gastropods at depths of 725–1100 m along the continental slope of eastern Canada. The proportion of bathyal gastropods hosting 1–6 sea anemones reached 72.5% in a single trawl. Although A. parasitica was occasionally found on other substrata (i.e. empty shells, pebbles), laboratory trials confirmed that they preferably associate with living gastropods. Settlement of planula larvae occurred significantly more often on the shells of live bathyal gastropods than on all other substrata present in the tanks. Juvenile sea anemones (∼ 1 mm diameter) readily moved from the mud or other inert substrata onto shells of burrowed bathyal gastropods. Conversely, larvae, juveniles and adults of A. parasitica never associated with any shallow-water gastropods when given the opportunity. Trials exposing predatory sea stars (Leptasterias polaris) from shallow and bathyal depths to bathyal gastropods (Buccinum undatum) with epibiotic A. parasitica, and to asymbiotic bathyal and shallow-water B. undatum, revealed adaptive behaviours in both prey and predator. Shallow-water gastropods (devoid of epibionts) reacted defensively to L. polaris, whereas bathyal gastropods relied mostly on their epibionts to protect them, thus falling prey to L. polaris when the epibionts were removed. L. polaris from bathyal depths typically ignored symbiotic gastropods, but they consistently preyed on asymbiotic ones, while L. polaris from shallow areas initially attempted to prey on all gastropods, but learned to avoid those harbouring sea anemones. Furthermore, living as epibionts afforded sea anemones a means to escape one of their own predators, the sea star Crossaster papposus. The mutualistic relationship between hormathiid sea anemones and bathyal gastropods from the NW Atlantic may have evolved in response to predation pressure.

Aim Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement for high-risk patients. The relative event rates following TAVI have not yet been well described and seem to differ between genders. We sought to determine gender imbalances in TAVI patients with regard to baseline presentation, management, and prognosis. Methods and results A total of 3,972 patients underwent TAVI and were prospectively included in the FRANCE 2 registry. Women (n=1967) presented with older age and lower rates of coronary artery disease, chronic obstructive pulmonary disease, renal failure, and arrhythmia, though higher prevalence of hypertension and congestive heart failure (43.7% vs. 39.7%; p=0.010). EuroSCORE was similar between genders. Women presented with smaller aortic annulus and were implanted with smaller bioprostheses. At 1 month, mortality rates were similar between genders. Multivariate analysis revealed the following independent predictors for 1-month all-cause mortality: female gender; New York Heart Association (NYHA) Class III or IV; transapical approach; moderate to severe postprocedural aortic regurgitation. We observed a specific interaction between gender and EuroSCORE, confirming EuroSCORE as less capable to discriminate women in order to establish 1-month mortality. Women presented with lower 1-year mortality rates than men (19.3% vs. 23.7%; p=0.021). Female gender was an independent predictor of 1-year survival (HR: 0.71, 95% CI: [0.57-0.88]). Conclusion Men and women exhibited several differing baseline characteristics, as well as procedural and clinical outcomes. Notably, Euroscore proved inconvenient for 1-month survival prediction in women. Women also presented with an 18.5% decrease in 1-year all-cause mortality compared to men.

Objectif Ce travail propose de creer un score d’aide a l’evaluation du risque de symptomes musculo-squelettiques chroniques des membres superieurs (SMS-MS), base sur des donnees d’exposition professionnelle. Ce score ne prenant pas en compte les facteurs individuels, permettra de classer les situations de travail devant beneficier d’une action de prevention. Methodes L’echantillon d’etude etait constitue de 1 749 salaries recrutes lors de la phase d’inclusion de la Cohorte des Salaries Ligeriens (COSALI). Les facteurs organisationnels, biomecaniques et psychosociaux et les variables associees aux SMS-MS chroniques (douleur quotidienne au cours de l’annee ecoulee pour au moins une localisation du membre superieur) ont ete recueillis par auto-questionnaire. Trois methodes statistiques ont ete utilisees : une regression logistique binaire, une analyse en clusters suivie d’une analyse par arbre de decision et une modelisation par classes latentes. La methode maximisant le critere statistique AUC (area under the curve) a ete retenue pour la creation du score. Resultats La prevalence des salaries declarant au moins un SMS-MS chronique etait de 12,9 %. La regression logistique a ete retenue pour la creation du score (AUC = 0,7). Les facteurs associes aux SMS-MS chroniques etaient l’intensite elevee des efforts physiques ressentie (echelle RPE de Borg), la repetitivite des gestes plus de 4 h/j, le travail avec un ou deux bras au-dessus des epaules plus de 2 h/j, la flexion du coude plus de 2 h/j, l’utilisation de la pince pouce-index plus de 4 h/j, la possibilite d’influencer le deroulement de son travail et l’aide des collegues. Le score a ensuite ete cree a partir des parametres estimes de la regression logistique, il s’etend de 0 a 13. Par exemple, 58,0 % de l’echantillon a un score superieur ou egal a deux. Pour ce seuil, la valeur predictive negative est de 92,8 %, ce qui signifie que pour l’ensemble des salaries on classe correctement 92,8 % des salaries qui ne declaraient pas de SMS-MS chroniques. En revanche, on ne classe correctement que 19,5 % des salaries qui declaraient au moins un SMS-MS chronique. Conclusions Selon le seuil choisi, le score aboutit a une forte valeur predictive negative. Il pourrait constituer un outil utile aux preventeurs en entreprise afin de cibler l’effectif pour lequel il n’est pas indispensable de mettre en place des actions de prevention. Neanmoins, ce score ne permet pas de predire avec confiance les salaries qui seront atteints de SMS. Pour avoir un score plus performant, il faudrait integrer des facteurs individuels tels que l’âge et le sexe, mais la caracterisation par situation de travail n’est alors plus envisageable.

This study investigated the daily activities of juvenile sea cucumbers Holothuria scabra Jaeger. All individuals exhibited daily burrowing and feeding rhythms in response to environmental factors. The cycle of the smallest juvenile, >10–40 mm, was linked to light; they began to burrow around sunrise and emerged close to sunset. Their burrowing activity was inhibited by continuous darkness. Juveniles >40–140 mm responded to changes in temperature; they burrowed earlier around 03:30 h, seeking shelter in the sediment as temperature declined, and emerged around mid-day. The maintenance of a constant warm temperature prevented them from burrowing. For all juveniles, time spent on the surface corresponded with feeding and periods of locomotion; while burrowed they remained stationary, did not feed and had a low intestinal transit. Organic matter content in the intestine was also found to vary with the daily cycle. Decreases in salinity from 35 to 30, 25 and 20‰ induced the burrowing of all juveniles within minutes, but they began to re-emerge after a few hours. Acclimation occurred most rapidly at salinity 30‰ and was slowest at salinity 20‰. Conversely, nearly 40% of the juveniles were unable to cope with a decrease to salinity 15‰. Juveniles of all sizes demonstrated a strong selectivity for sediment characteristics. In two substrate selection experiments, their preference for sand with a grain size around 0.4 mm and for organically rich material was firmly expressed within an hour. The general behavior of juvenile H. scabra reflects their ability to inhabit shallow sandy areas with high terrigenous inputs and variable environmental conditions.

Introduction Le change, realise de maniere pluri-quotidienne en reanimation, est souvent decrit comme douloureux par les patients. La mesure du reflexe de dilatation pupillaire (RDP) par pupillometrie permet de predire le niveau d’analgesie au bloc operatoire et lors des aspirations tracheales en reanimation [1] . L’objectif de cette etude est d’evaluer si la pupillometrie permet de predire la survenue de douleur lors d’un change. Materiel et methodes Etude prospective, interventionnelle, apres accord du CPP Ouest 2 et consentement (proches puis patients), les patients de reanimation, intubes-ventiles, sedates et non communiquants etaient inclus en l’absence de pathologie oculaire, de pace-maker, de curarisation, de TC ou de lesion medullaire. Avant chaque change, le RDP etait mesure a l’aide du pupillometre (AlgiScan, IDMed France) pendant des stimulations electriques d’intensite croissante (5, 10, 20, 40 et 60 mA). Le score PPI (de 0 a 10) etait egalement mesure. La douleur durant le change etait mesuree a l’aide de la Behavorial Pain Scale (BPS). Les valeurs de RDP pour chaque seuil de stimulation et le score PPI etaient compares pour les changes douloureux (BPS > 5) ou non (BP ≤ 5). La meilleure valeur diagnostique etait recherchee a l’aide de courbes ROC. Resultats Parmi les 170 changes realises chez 41 patients (âges de 65 ± 15 ans, 33 [80 %] hommes, IGS 56 ± 18, 82 % chirurgies urgentes, 5 % chirurgies reglees), 32 (18,8 %) etaient douloureux. Les niveaux de PA pendant le change etaient plus eleves en cas de douleur (p = 0,02). Mais aucun autre parametre n’etait associe avec la douleur durant le change (notamment pas les debits de la sedation et de morphiniques recus). Les aires sous la courbes du RDP obtenues aux differents niveaux de stimulation ne depassent pas 0,6 ( Fig. 1 ), sans difference entre les niveau de stimulation. Le score PPI ne fait pas mieux (4,1 [3,2–5] vs 4,9 [4–5,4], pour douloureux ou non, p = 0,10). Discussion La pupillometrie ne permet pas de predire une douleur au change des patients non communiquants de reanimation chirurgicale. L’heterogeneite des pathologies (peritonite, mediastinite, polytraumatisme, cause medicale…) pourrait expliquer ces resultats, une meme procedure (ex. le change) pouvant induire un degre de douleur tres variable selon les conditions du patient.

The sea star Leptasterias polaris , an important predator in the benthic community of the St. Lawrence Estuary (eastern Canada), was used in assessing the degradation potential and toxicological implications of tributyltin (TBT) ingested with food. TBT was chosen as a representative of the organotins, a group of wide-spread chemicals used as biocides and plastic stabilizers. Male and female individuals were fed daily with TBT-contaminated mussels for a 53-day period. Their digestive system showed a relatively constant TBT concentration (0.26 ± 0.10 μg / g wet mass) throughout the experiment. Sequential debutylation occurred within 2 weeks, first yielding dibutyltin (DBT) which seemed to accumulate more readily in the caeca (up to 1.10 μg/g), and then monobutyltin (MBT) which appeared only in few individuals at low concentrations (below 0.35 μg/g). Although the total amount of TBT ingested from food continuously increased throughout the experiment (mean of 657 μg for a starfish fed over 53 d), the total amount of tin traced in the analyzed starfish tissues remained below 80 μg, suggesting an excretion system and/or a storage of tin in an undetectable form. All species of the contaminant remained barely detectable in the gonads. Nevertheless, a histological study revealed smaller mature oocytes and thinner epithelium in the gonads of the contaminated individuals compared to control organisms. These results show that sea stars and possibly other echinoderms, avoid immediate accumulation of TBT by dealkylating the toxicant to less harmful metabolites. However, this natural defense process was only partly effective and subtle effects on reproductive organs were induced by disturbing reserve acquisition in growing gametes.

Introduction Forensic doctors are frequently asked by magistrates when dealing principally with knife wounds, about the depth of the blade which may have penetrated the victim's body. Without the use of imaging, it is often difficult to respond to this question, even in an approximate way. Knowledge of the various distances between organs and the skin wall would allow an assessment to be made of the minimum blade length required to obtain the injuries observed. The objective of this study is thus to determine average distances between the vital organs of the thorax and abdomen, and the skin wall, taking into account the person's body mass index (BMI). Materials and methods This is a prospective single-center study, carried out over a 2-month period at University Hospital in Angers. A sample of 200 people was studied. The inclusion criteria were as follows: all patients coming to the radiology department and the emergency department for an abdominal, thoracic or thoraco-abdominal scan with injection. The exclusion criteria included patients presenting a large lymphoma, a large abdominal or retroperitoneal tumor, a tumor in one of the organs targeted by our study and patients presenting ascites. The organs focused on were: the pericardium, pleura, aorta, liver, spleen, kidneys, abdominal aorta and femoral arteries. The shortest distance between the organ and the skin wall was noted. Median distances were calculated according to gender, abdominal diameter and BMI. Results We associated these values to propose an indicative chart which may be used by doctors in connection with their forensic activities. Discussion The problem of the depth of a wound is frequently exposed to the expert. Without a reliable tool, it is difficult to value and a personal interpretation is often done. Even if, in current days, tomodensitometry is frequently done in vivo or after death, measurement can be difficult because of the local conditions. We classified values according to the different factors of fat repartition (BMI, abdominal diameter, gender). These tables, collectively used, permit evaluation of the distance between wall and thoracic or abdominal vital organs. Conclusion We suggest an indicative chart designed for forensic doctors in their professional life to help determine the minimum penetration length for a knife, which may wound a vital organ.