Background Little information is available about the geo-economic variations in demographics, management, and outcomes of patients with acute respiratory distress syndrome (ARDS). We aimed to characterise the effect of these geo-economic variations in patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE). Methods LUNG SAFE was done during 4 consecutive weeks in winter, 2014, in a convenience sample of 459 intensivecare units in 50 countries across six continents. Inclusion criteria were admission to a participating intensive-care unit (including transfers) within the enrolment window and receipt of invasive or non-invasive ventilation. One of the trial's secondary aims was to characterise variations in the demographics, management, and outcome of patients with ARDS. We used the 2016 World Bank countries classification to define three major geo-economic groupings, namely European high-income countries (Europe-High), high-income countries in the rest of the world (rWORLD-High), and middle-income countries (Middle). We compared patient outcomes across these three groupings. LUNG SAFE is registered with ClinicalTrials.gov, number NCT02010073. Findings Of the 2813 patients enrolled in LUNG SAFE who fulfilled ARDS criteria on day 1 or 2, 1521 (54%) were recruited from Europe-High, 746 (27%) from rWORLD-High, and 546 (19%) from Middle countries. We noted significant geographical variations in demographics, risk factors for ARDS, and comorbid diseases. The proportion of patients with severe ARDS or with ratios of the partial pressure of arterial oxygen (PaO 2) to the fractional concentration of oxygen in inspired air (F I O 2) less than 150 was significantly lower in rWORLD-High countries than in the two other regions. Use of prone positioning and neuromuscular blockade was significantly more common in Europe-High countries than in the other two regions. Adjusted duration of invasive mechanical ventilation and length of stay in the intensive-care unit were significantly shorter in patients in rWORLD-High countries than in Europe-High or Middle countries. High gross national income per person was associated with increased survival in ARDS; hospital survival was significantly lower in Middle countries than in Europe-High or rWORLD-High countries. Interpretation Important geo-economic differences exist in the severity, clinician recognition, and management of ARDS, and in patients' outcomes. Income per person and outcomes in ARDS are independently associated.

The quality of seed-conservation collections, and hence their value for species reintroduction or restoration, is critically dependent on factors operating in the period between the point of collection and arrival at environmentally controlled processing and storage facilities. The timing of the acquisition of desiccation tolerance and seed longevity in air-dry storage, in relation to mass maturity and the time of natural seed dispersal, varies across species. In some wild plant species, seed quality continues to improve up to, and possibly beyond, the point of dispersal. Holding immature berries of Solanum dulcamara L. and capsules of Digitalis purpurea L. under natural conditions enabled comparison of seed quality between seeds stored under natural conditions and those dried rapidly under seedbank dry-room conditions. While seeds from fully ripe (post-mature) capsules of D. purpurea were insensitive to different post-harvest drying treatments, seed quality declined when mature berries of S. dulcamara were held under natural conditions. These results emphasise that the selection of post-harvest treatment will not only depend on the maturity of collected seeds but also may vary across species depending on the fruit type. Except for subtropical and tropical coastal locations, ambient daytime conditions during the main seed-collecting season (November–February) across Australia can be expected to result in tolerable rates of seed deterioration for the duration of seed-collecting missions. However, because seed moisture levels can be considerably higher than when equilibrated with ambient relative humidity, post-harvest handling decisions should ideally be informed by measurements of seed moisture at the time of collection, and subsequently seed moisture should be monitored during transit.

We investigated variation in concentration of the secondary metabolite, camptothecin (CPT), in relation to leaf, branch and tree age, season, and leaf drying method in Camptotheca acuminata Decaisne saplings. Younger leaves contained higher CPT concentrations than older leaves. Within a branch, there was a linear decline in CPT concentration from leaves at the apex of the branch down to Leaf 7. Comparing leaves of similar age, those from younger trees had higher CPT concentrations than those from older trees. Over the course of the growing season, there was a steady decline of 11% per month in leaf CPT concentration. Branches showed a similar seasonal decline in CPT concentration to leaves; however, the rate of decline was threefold greater in leaves than in branches. Freeze-dried tissues had a 27% higher CPT concentration than oven- or air-dried tissues, suggesting that oven- and air-drying caused degradation of CPT. The decline in CPT concentration with tissue aging may reflect a genetically determined mechanism whereby, in young trees, chemicals serve as a first line of defense against attacks by herbivores and pathogenic microorganisms until other mechanisms are developed and deployed. We hypothesize that chemical defense mechanisms are programmed for early ontogenic stages, whereas they are induced by biotic and abiotic factors during later ontogenic stages.

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