We present Very Large Telescope (VLT) UVES echelle spectrophotometry of the Orion nebula in the 3100-10 400 Å range. We have measured the intensity of 555 emission lines, many of them corresponding to permitted lines of different heavy-element ions. This is the largest set of spectral emission lines ever obtained for a Galactic or extragalactic H II region. We have derived He + , C 2+ , O + , O 2+ and Ne 2+ abundances from pure recombination lines. This is the first time that O + and Ne 2+ abundances have been obtained from these kinds of lines in the nebula. We have also derived abundances from collisionally excited lines for a large number of ions of different elements. In all cases, ionic abundances obtained from recombination lines are larger than those derived from collisionally excited lines. We have obtained remarkably consistent independent estimations of the temperature fluctuation parameter, t 2 , from different methods, which are also similar to other estimates from the literature. This result strongly suggests that moderate temperature fluctuations (t 2 between 0.02 and 0.03) are present in the Orion nebula. We have compared the chemical composition of the nebula with those of the Sun and other representative objects. The heavy-element abundances in the Orion nebula are only slightly higher than the solar ones, a difference that can be explained by the chemical evolution of the solar neighbourhood.

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Objective:  To describe the development and validation of the Clinical Global Impression–Schizophrenia (CGI‐SCH) scale, designed to assess positive, negative, depressive and cognitive symptoms in schizophrenia. Method:  The CGI‐SCH scale was adapted from the CGI scale. Concurrent validity and sensitivity to change were assessed by comparison with the Positive and Negative Symptom Severity (PANSS) and Global Assessment of Functioning (GAF) scales. To evaluate inter‐rater reliability, all patients were assessed by two clinicians. Results:  Symptoms were assessed in 114 patients. Correlation coefficients between the CGI‐SCH and the GAF and PANSS scores were high (most above 0.75), and were highest for positive and negative symptoms. Reliability was substantial (intraclass correlation coefficient, ICC > 0.70) in all but one dimension (depressive dimension, ICC = 0.64). Conclusion:  The CGI‐SCH scale is a valid, reliable instrument to evaluate severity and treatment response in schizophrenia. Given its simplicity, brevity and clinical face validity, the scale is appropriate for use in observational studies and routine clinical practice.

Objectives To analyse the characteristics and predictors of death in hospitalized patients with coronavirus disease 2019 (COVID-19) in Spain. Methods A retrospective observational study was performed of the first consecutive patients hospitalized with COVID-19 confirmed by real-time PCR assay in 127 Spanish centres until 17 March 2020. The follow-up censoring date was 17 April 2020. We collected demographic, clinical, laboratory, treatment and complications data. The primary endpoint was all-cause mortality. Univariable and multivariable Cox regression analyses were performed to identify factors associated with death. Results Of the 4035 patients, male subjects accounted for 2433 (61.0%) of 3987, the median age was 70 years and 2539 (73.8%) of 3439 had one or more comorbidity. The most common symptoms were a history of fever, cough, malaise and dyspnoea. During hospitalization, 1255 (31.5%) of 3979 patients developed acute respiratory distress syndrome, 736 (18.5%) of 3988 were admitted to intensive care units and 619 (15.5%) of 3992 underwent mechanical ventilation. Virus- or host-targeted medications included lopinavir/ritonavir (2820/4005, 70.4%), hydroxychloroquine (2618/3995, 65.5%), interferon beta (1153/3950, 29.2%), corticosteroids (1109/3965, 28.0%) and tocilizumab (373/3951, 9.4%). Overall, 1131 (28%) of 4035 patients died. Mortality increased with age (85.6% occurring in older than 65 years). Seventeen factors were independently associated with an increased hazard of death, the strongest among them including advanced age, liver cirrhosis, low age-adjusted oxygen saturation, higher concentrations of C-reactive protein and lower estimated glomerular filtration rate. Conclusions Our findings provide comprehensive information about characteristics and complications of severe COVID-19, and may help clinicians identify patients at a higher risk of death.

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The study was supported by Novartis.

Seasonally dry tropical forests are distributed across Latin America and the Caribbean and are highly threatened, with less than 10% of their original extent remaining in many countries. Using 835 inventories covering 4660 species of woody plants, we show marked floristic turnover among inventories and regions, which may be higher than in other neotropical biomes, such as savanna. Such high floristic turnover indicates that numerous conservation areas across many countries will be needed to protect the full diversity of tropical dry forests. Our results provide a scientific framework within which national decision-makers can contextualize the floristic significance of their dry forest at a regional and continental scale. N eotropical seasonally dry forest (dry forest) is a biome with a wide and fragmented distribution, found from Mexico to Argentina and throughout the Caribbean (1, 2) ( Fig. 1). It is one of the most threatened tropical forests in the world (3), with less than 10% of its original extent remaining in many countries (4).Following other authors (5, 6), we define dry forest as having a closed canopy, distinguishing it from more open, grass-rich savanna. It occurs on fertile soils where the rainfall is less thañ 1800 mm per year, with a period of 3 to 6 months receiving less than 100 mm per month (5-7), during which the vegetation is mostly deciduous. Seasonally dry areas, especially in Peru and Mexico, were home to pre-Columbian civilizations, so human interaction with dry forest has a long history (8). The climates and fertile soils of dry forest regions have led to higher human population densities and an increasing demand for energy and land, enhancing degradation (9). More recently, destruction of dry forest has been accelerated by intensive cultivation of crops, such as sugar cane, rice and soy, or by conversion to pasture for cattle.Dry forest is in a critical state because so little of it is intact, and of the remnant areas, little is protected (3). For example, only 1.2% of the total Caatinga region of dry forest in Brazil is fully protected compared with 9.9% of the Brazilian Amazon (10). Conservation actions are urgently needed to protect dry forest's unique biodiversity-many plant species and even genera are restricted to it and reflect an evolutionary history confined to this biome (1).We evaluate the floristic relationships of the disjunct areas of neotropical dry forest and highlight those that contain the highest diversity and endemism of woody plant species. We also explore woody plant species turnover across geographic space among dry forests. Our results provide a framework to allow the conservation significance of each separate major region of dry forest to be assessed at a continental scale. Our analyses are based on a subset of a data set of 1602 inventories made in dry forest and related semi-deciduous forests from Mexico and the Caribbean to Argentina and Paraguay that covers 6958 woody species, which has been compiled by the Latin American and Caribbean Seasonally Dry Tropica...

The human intestine is home to a diverse range of bacterial and fungal species, forming an ecological community that contributes to normal physiology and disease susceptibility. Here, the fungal microbiota (mycobiome) in obese and non-obese subjects was characterized using Internal Transcribed Spacer (ITS)-based sequencing. The results demonstrate that obese patients could be discriminated by their specific fungal composition, which also distinguished metabolically “healthy” from “unhealthy” obesity. Clusters according to genus abundance co-segregated with body fatness, fasting triglycerides and HDL-cholesterol. A preliminary link to metabolites such as hexadecanedioic acid, caproic acid and N-acetyl-L-glutamic acid was also found. Mucor racemosus and M. fuscus were the species more represented in non-obese subjects compared to obese counterparts. Interestingly, the decreased relative abundance of the Mucor genus in obese subjects was reversible upon weight loss. Collectively, these findings suggest that manipulation of gut mycobiome communities might be a novel target in the treatment of obesity.