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Gestion de l'Eau, Acteurs, Usages

facilityMontpellier, Occitanie, France

Research output, citation impact, and the most-cited recent papers from Gestion de l'Eau, Acteurs, Usages (France). Aggregated across the NobleBlocks index of 300M+ scholarly works.

Total works
6.9K
Citations
101.1K
h-index
124
i10-index
2.1K
Also known as
Gestion de l'Eau, Acteurs, Usages

Top-cited papers from Gestion de l'Eau, Acteurs, Usages

Effect of Hydrocortisone on 21-Day Mortality or Respiratory Support Among Critically Ill Patients With COVID-19
Pierre‐François Dequin, Nicholas Heming, Ferhat Meziani, Gaëtan Plantefève +4 more
2020· JAMA517doi:10.1001/jama.2020.16761

Importance: Coronavirus disease 2019 (COVID-19) is associated with severe lung damage. Corticosteroids are a possible therapeutic option. Objective: To determine the effect of hydrocortisone on treatment failure on day 21 in critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and acute respiratory failure. Design, Setting, and Participants: Multicenter randomized double-blind sequential trial conducted in France, with interim analyses planned every 50 patients. Patients admitted to the intensive care unit (ICU) for COVID-19-related acute respiratory failure were enrolled from March 7 to June 1, 2020, with last follow-up on June 29, 2020. The study intended to enroll 290 patients but was stopped early following the recommendation of the data and safety monitoring board. Interventions: Patients were randomized to receive low-dose hydrocortisone (n = 76) or placebo (n = 73). Main Outcomes and Measures: The primary outcome, treatment failure on day 21, was defined as death or persistent dependency on mechanical ventilation or high-flow oxygen therapy. Prespecified secondary outcomes included the need for tracheal intubation (among patients not intubated at baseline); cumulative incidences (until day 21) of prone position sessions, extracorporeal membrane oxygenation, and inhaled nitric oxide; Pao2:Fio2 ratio measured daily from day 1 to day 7, then on days 14 and 21; and the proportion of patients with secondary infections during their ICU stay. Results: The study was stopped after 149 patients (mean age, 62.2 years; 30.2% women; 81.2% mechanically ventilated) were enrolled. One hundred forty-eight patients (99.3%) completed the study, and there were 69 treatment failure events, including 11 deaths in the hydrocortisone group and 20 deaths in the placebo group. The primary outcome, treatment failure on day 21, occurred in 32 of 76 patients (42.1%) in the hydrocortisone group compared with 37 of 73 (50.7%) in the placebo group (difference of proportions, -8.6% [95.48% CI, -24.9% to 7.7%]; P = .29). Of the 4 prespecified secondary outcomes, none showed a significant difference. No serious adverse events were related to the study treatment. Conclusions and Relevance: In this study of critically ill patients with COVID-19 and acute respiratory failure, low-dose hydrocortisone, compared with placebo, did not significantly reduce treatment failure (defined as death or persistent respiratory support) at day 21. However, the study was stopped early and likely was underpowered to find a statistically and clinically important difference in the primary outcome. Trial Registration: ClinicalTrials.gov Identifier: NCT02517489.

Fundamentals for Future Mobile-Health (mHealth): A Systematic Review of Mobile Phone and Web-Based Text Messaging in Mental Health
Sofian Berrouiguet, Enrique Baca‐García, Sara A. Brandt, Michel Walter +1 more
2016· Journal of Medical Internet Research371doi:10.2196/jmir.5066

BACKGROUND: Mobile phone text messages (short message service, SMS) are used pervasively as a form of communication. Almost 100% of the population uses text messaging worldwide and this technology is being suggested as a promising tool in psychiatry. Text messages can be sent either from a classic mobile phone or a web-based application. Reviews are needed to better understand how text messaging can be used in mental health care and other fields of medicine. OBJECTIVE: The objective of the study was to review the literature regarding the use of mobile phone text messaging in mental health care. METHODS: We conducted a thorough literature review of studies involving text messaging in health care management. Searches included PubMed, PsycINFO, Cochrane, Scopus, Embase and Web of Science databases on May 25, 2015. Studies reporting the use of text messaging as a tool in managing patients with mental health disorders were included. Given the heterogeneity of studies, this review was summarized using a descriptive approach. RESULTS: From 677 initial citations, 36 studies were included in the review. Text messaging was used in a wide range of mental health situations, notably substance abuse (31%), schizophrenia (22%), and affective disorders (17%). We identified four ways in which text messages were used: reminders (14%), information (17%), supportive messages (42%), and self-monitoring procedures (42%). Applications were sometimes combined. CONCLUSIONS: We report growing interest in text messaging since 2006. Text messages have been proposed as a health care tool in a wide spectrum of psychiatric disorders including substance abuse, schizophrenia, affective disorders, and suicide prevention. Most papers described pilot studies, while some randomized clinical trials (RCTs) were also reported. Overall, a positive attitude toward text messages was reported. RCTs reported improved treatment adherence and symptom surveillance. Other positive points included an increase in appointment attendance and in satisfaction with management and health care services. Insight into message content, preventative strategies, and innovative approaches derived from the mental health field may be applicable in other medical specialties.

The Routledge Handbook of Research Methods for Social-Ecological Systems
Reinette Biggs, Rika Preiser, Alta de Vos, Maja Schlüter +2 more
2021335doi:10.4324/9781003021339

The Routledge Handbook of Research Methods for Social-Ecological Systems provides a synthetic guide to the range of methods that can be employed in social-ecological systems (SES) research.\nThe book is primarily targeted at graduate students, lecturers and researchers working on SES, and has been written in a style that is accessible to readers entering the field from a variety of different disciplinary backgrounds. Each chapter discusses the types of SES questions to which the particular methods are suited and the potential resources and skills required for their implementation, and provides practical examples of the application of the methods. In addition, the book contains a conceptual and practical introduction to SES research, a discussion of key gaps and frontiers in SES research methods, and a glossary of key terms in SES research. Contributions from 97 different authors, situated at SES research hubs in 16 countries around the world, including South Africa, Sweden, Germany and Australia, bring a wealth of expertise and experience to this book.\nThe first book to provide a guide and introduction specifically focused on methods for studying SES, this book will be of great interest to students and scholars of sustainability science, environmental management, global environmental change studies and environmental governance. The book will also be of interest to upper-level undergraduates and professionals working at the science–policy interface in the environmental arena.

Soil nutrient maps of Sub-Saharan Africa: assessment of soil nutrient content at 250 m spatial resolution using machine learning
Tomislav Hengl, J.G.B. Leenaars, Keith Shepherd, Markus Walsh +4 more
2017· Nutrient Cycling in Agroecosystems314doi:10.1007/s10705-017-9870-x

Spatial predictions of soil macro and micro-nutrient content across Sub-Saharan Africa at 250 m spatial resolution and for 0-30 cm depth interval are presented. Predictions were produced for 15 target nutrients: organic carbon (C) and total (organic) nitrogen (N), total phosphorus (P), and extractable-phosphorus (P), potassium (K), calcium (Ca), magnesium (Mg), sulfur (S), sodium (Na), iron (Fe), manganese (Mn), zinc (Zn), copper (Cu), aluminum (Al) and boron (B). Model training was performed using soil samples from ca. 59,000 locations (a compilation of soil samples from the AfSIS, EthioSIS, One Acre Fund, VitalSigns and legacy soil data) and an extensive stack of remote sensing covariates in addition to landform, lithologic and land cover maps. An ensemble model was then created for each nutrient from two machine learning algorithms- random forest and gradient boosting, as implemented in R packages ranger and xgboost-and then used to generate predictions in a fully-optimized computing system. Cross-validation revealed that apart from S, P and B, significant models can be produced for most targeted nutrients (R-square between 40-85%). Further comparison with OFRA field trial database shows that soil nutrients are indeed critical for agricultural development, with Mn, Zn, Al, B and Na, appearing as the most important nutrients for predicting crop yield. A limiting factor for mapping nutrients using the existing point data in Africa appears to be (1) the high spatial clustering of sampling locations, and (2) missing more detailed parent material/geological maps. Logical steps towards improving prediction accuracies include: further collection of input (training) point samples, further harmonization of measurement methods, addition of more detailed covariates specific to Africa, and implementation of a full spatiotemporal statistical modeling framework.

Orfeo ToolBox: open source processing of remote sensing images
Manuel Grizonnet, Julien Michel, Victor Poughon, Jordi Inglada +2 more
2017· Open Geospatial Data Software and Standards295doi:10.1186/s40965-017-0031-6

Orfeo ToolBox is an open-source project for state-of-the-art remote sensing, including a fast image viewer, applications callable from command-line, Python or QGIS, and a powerful C++ API. This article is an introduction to the Orfeo ToolBox’s flagship features from the point of view of the two communities it brings together: remote sensing and software engineering.

Export of a Toxoplasma gondii Rhoptry Neck Protein Complex at the Host Cell Membrane to Form the Moving Junction during Invasion
Sébastien Besteiro, Adeline Michelin, Joël Poncet, Jean‐François Dubremetz +1 more
2009· PLoS Pathogens290doi:10.1371/journal.ppat.1000309

One of the most conserved features of the invasion process in Apicomplexa parasites is the formation of a moving junction (MJ) between the apex of the parasite and the host cell membrane that moves along the parasite and serves as support to propel it inside the host cell. The MJ was, up to a recent period, completely unknown at the molecular level. Recently, proteins originated from two distinct post-Golgi specialised secretory organelles, the micronemes (for AMA1) and the neck of the rhoptries (for RON2/RON4/RON5 proteins), have been shown to form a complex. AMA1 and RON4 in particular, have been localised to the MJ during invasion. Using biochemical approaches, we have identified RON8 as an additional member of the complex. We also demonstrated that all RON proteins are present at the MJ during invasion. Using metabolic labelling and immunoprecipitation, we showed that RON2 and AMA1 were able to interact in the absence of the other members. We also discovered that all MJ proteins are subjected to proteolytic maturation during trafficking to their respective organelles and that they could associate as non-mature forms in vitro. Finally, whereas AMA1 has previously been shown to be inserted into the parasite membrane upon secretion, we demonstrated, using differential permeabilization and loading of RON-specific antibodies into the host cell, that the RON complex is targeted to the host cell membrane, where RON4/5/8 remain associated with the cytoplasmic face. Globally, these results point toward a model of MJ organization where the parasite would be secreting and inserting interacting components on either side of the MJ, both at the host and at its own plasma membranes.

Four years of mass balance on Chhota Shigri Glacier, Himachal Pradesh, India, a new benchmark glacier in the western Himalaya
Patrick Wagnon, Anurag Linda, Yves Arnaud, Rajesh Kumar +4 more
2007· Journal of Glaciology274doi:10.3189/002214307784409306

Little is known about the Himalayan glaciers, although they are of particular interest in terms of future water supply, regional climate change and sea-level rise. In 2002, a long-term monitoring programme was started on Chhota Shigri Glacier (32.2° N, 77.5° E; 15.7 km 2 , 6263–4050 ma.s.l., 9 km long) located in Lahaul and Spiti Valley, Himachal Pradesh, India. This glacier lies in the monsoon–arid transition zone (western Himalaya) which is alternately influenced by Asian monsoon in summer and the mid-latitude westerlies in winter. Here we present the results of a 4 year study of mass balance and surface velocity. Overall specific mass balances are mostly negative during the study period and vary from a minimum value of –1.4 m w.e. in 2002/03 and 2005/06 (equilibrium-line altitude (ELA) ∼5180 m a.s.l.) to a maximum value of +0.1 m w.e. in 2004/05 (ELA 4855 m a.s.l.). Chhota Shigri Glacier seems similar to mid-latitude glaciers, with an ablation season limited to the summer months and a mean vertical gradient of mass balance in the ablation zone (debris-free part) of 0.7mw.e.(100 m) –1 , similar to those reported in the Alps. Mass balance is strongly dependent on debris cover, exposure and the shading effect of surrounding steep slopes.

Co-engineering Participatory Water Management Processes: Theory and Insights from Australian and Bulgarian Interventions
Katherine A. Daniell, Ian White, Nils Ferrand, Irina Ribarova +4 more
2010· Ecology and Society246doi:10.5751/es-03567-150411

Daniell, K. A., I. White, N. Ferrand, I. S. Ribarova, P. Coad, J.-E. Rougier, M. Hare, N. A. Jones, A. Popova, D. Rollin, P. Perez, and S. Burn. 2010. Co-engineering participatory water management processes: theory and insights from Australian and Bulgarian interventions. Ecology and Society 15(4): 11. https://doi.org/10.5751/ES-03567-150411

Comparison of genetic diversity of the invasive weed <i>Rubus alceifolius</i> Poir. (Rosaceae) in its native range and in areas of introduction, using amplified fragment length polymorphism (AFLP) markers
Laurent Amsellem, Jean‐Louis Noyer, Thomas Le Bourgeois, Martine Hossaert‐McKey
2000· Molecular Ecology238doi:10.1046/j.1365-294x.2000.00876.x

Theory predicts that colonization of new areas will be associated with population bottlenecks that reduce within-population genetic diversity and increase genetic differentiation among populations. This should be especially true for weedy plant species, which are often characterized by self-compatible breeding systems and vegetative propagation. To test this prediction, and to evaluate alternative scenarios for the history of introduction, the genetic diversity of Rubus alceifolius was studied with amplified fragment length polymorphism (AFLP) markers in its native range in southeast Asia and in several areas where this plant has been introduced and is now a serious weed (Indian Ocean islands, Australia). In its native range, R. alceifolius showed great genetic variability within populations and among geographically close populations (populations sampled ranging from northern Vietnam to Java). In Madagascar, genetic variability was somewhat lower than in its native range, but still considerable. Each population sampled in the other Indian Ocean islands (Mayotte, La Réunion, Mauritius) was characterized by a single different genotype of R. alceifolius for the markers studied, and closely related to individuals from Madagascar. Queensland populations also included only a single genotype, identical to that found in Mauritius. These results suggest that R. alceifolius was first introduced into Madagascar, perhaps on multiple occasions, and that Madagascan individuals were the immediate source of plants that colonized other areas of introduction. Successive nested founder events appear to have resulted in cumulative reduction in genetic diversity. Possible explanations for the monoclonality of R. alceifolius in many areas of introduction are discussed.

Classification of Canal Control Algorithms
Pierre‐Olivier Malaterre, D. C. Rogers, Jan Schuurmans
1998· Journal of Irrigation and Drainage Engineering235doi:10.1061/(asce)0733-9437(1998)124:1(3)

Different control algorithms for the regulation of irrigation canals have been developed and applied throughout the world. Each of them can be characterized according to several criteria, among which are: the considered variables (controlled, measured, and control action variables), the logic of control (type and direction), and the design technique. This paper defines these terms and classifies the algorithms detailed in the literature. To summarize and compare algorithms, a structured table of the main published canal control algorithms is presented.

A distribution law for relative humidity in the upper troposphere and lower stratosphere derived from three years of MOZAIC measurements
Klaus Gierens, U. Schumann, M. Helten, H. G. J. Smit +1 more
1999· Annales Geophysicae232doi:10.1007/s00585-999-1218-7

Abstract. Data from three years of MOZAIC measurements made it possible to determine a distribution law for the relative humidity in the upper troposphere and lower stratosphere. Data amounting to 13.5% of the total were obtained in regions with ice supersaturation. Troposphere and stratosphere are distinguished by an ozone concentration of 130 ppbv as threshold. The probability of measuring a certain amount of ice supersaturation in the troposphere decreases exponentially with the degree of ice supersaturation. The probability of measuring a certain relative humidity in the stratosphere (both with respect to water and ice) decreases exponentially with the relative humidity. A stochastic model that naturally leads to the exponential distribution is provided. Mean supersaturation in the troposphere is about 15%, whereas ice nucleation requires 30% supersaturation on the average. This explains the frequency of regions in which aircraft induce persistent contrails but which are otherwise free of clouds. Ice supersaturated regions are 3-4 K colder and contain more than 50% more vapour than other regions in the upper troposphere. The stratospheric air masses sampled are dry, as expected, having mean relative humidity over water of 12% and over ice of 23%, respectively. However, 2% of the stratospheric data indicate ice supersaturation. As the MOZAIC measurements have been obtained on commercial flights mainly between Europe and North America, the data do not provide a complete global picture, but the exponential character of the distribution laws found is probably valid globally. Since water vapour is the most important greenhouse gas and since it might enhance the anthropogenic greenhouse effects via positive feedback mechanisms, it is important to represent its distribution correctly in climate models. The discovery of the distribution law of the relative humidity makes possible simple tests to show whether the hydrological cycle in climate models is represented in an adequate way or not.Key words. Atmospheric composition and structure (troposphere · composition and chemistry)

On explicit formulas of edge effect correction for Ripley's<i>K</i>‐function
François Goreaud, Raphaël Pélissier
1999· Journal of Vegetation Science220doi:10.2307/3237072

Abstract. The analysis of spatial pattern in plant ecology usually implies the solution of some edge effect problems. We present in this paper some explicit formulas of edge effect correction that should enable plant ecologists to analyse a wider range of real field data. We consider the local correcting factor of edge effect for Ripley's K ‐function, that can also be used for other statistics of spatial analysis based on the counting of neighbours within a given distance. For both circular and rectangular study areas, we provide a review of explicit formulas and an extension of these formulas for long and narrow plots. In the case of irregular‐shaped study plots, we propose a generalization of the method that computes edge effect correction by excluding triangular surfaces from a simple (rectangular or circular) initial shape. An example in forest ecology, where the soil characteristics determine a study plot of complex shape, illustrates how this edge effect correction can be effective in avoiding misinterpretations.

A Framework for Clarifying &amp;#8220;Participation&amp;#8221; in Participatory Research to Prevent its Rejection for the Wrong Reasons
Olivier Barreteau, Pieter W. G. Bots, Katherine A. Daniell
2010· Ecology and Society212doi:10.5751/es-03186-150201

Barreteau, O., P. W. G. Bots, and K. A. Daniell. 2010. A framework for clarifying “participation” in participatory research to prevent its rejection for the wrong reasons. Ecology and Society 15(2): 1. https://doi.org/10.5751/ES-03186-150201

Impact of limited streamflow data on the efficiency and the parameters of rainfall—runoff models
Charles Perrin, Ludovic Oudin, Vazken Andréassian, Claudia Rojas‐Serna +2 more
2007· Hydrological Sciences Journal212doi:10.1623/hysj.52.1.131

Abstract Streamflow data are essential for the calibration of continuous rainfall—runoff (RR) models. The quantity and quality of streamflow data can significantly influence parameter calibration and thus model robustness. Most existing sensitivity analysis studies on the role of streamflow data have used continuous periods to calibrate model parameters, with a minimum of one year, though ideally much longer periods are generally advised. However, in practical model applications, streamflow data series available for model calibration may be rather short or non-continuous. This study aims at assessing the sensitivity of continuous RR models to the quantity of information used during model calibration when it is randomly sampled in the observed hydrograph, i.e. using non-continuous calibration periods. This sampling provides less auto-correlated streamflow information for model calibration than continuous records. Two daily RR models with four and six free parameters were tested on a sample of 12 basins in the USA to obtain more general conclusions. The results showed that, in general, 350 calibration days sampled out of a longer data set including dry and wet conditions are sufficient to obtain robust estimates of model parameters. The more parsimonious model requires fewer calibration data to obtain stable and robust parameter values. Stable parameter values prove more difficult to reach in the driest catchments.

Dryland hydrology in Mediterranean regions—a review
Christophe Cudennec, Christian Leduc, Demetris Koutsoyiannis
2007· Hydrological Sciences Journal206doi:10.1623/hysj.52.6.1077

Dryland hydrology in Mediterranean regions - a review

Evidence that niche specialization explains species–energy relationships in lake fish communities
Norman W. H. Mason, Pascal Irz, Cédric Lanoiselée, David Mouillot +1 more
2007· Journal of Animal Ecology200doi:10.1111/j.1365-2656.2007.01350.x

1. Interspecific niche differences have long been identified as a major explanation for the occurrence of species-rich communities. However, much fieldwork studying variation in local species richness has focused upon physical habitat attributes or regional factors, such as the size of the regional species pool. 2. We applied indices of functional diversity and niche overlap to data on the species niche to examine the importance of interspecific niche differentiation for species richness in French lake fish communities. We combined this information with environmental data to test generalizations of the physiological tolerance and niche specialization hypotheses for species-energy relationships. 3. We found evidence for a largely non-saturating relationship (relative to random expectation) between species richness and functional evenness (evenness of spacing between species in niche space), while functional richness (volume of niche space occupied) peaked at moderate levels of species richness and niche overlap showed an initial decrease followed by saturation. This suggests that increased niche specialization may have allowed species to coexist in the most species-rich communities. 4. We tested for evidence that increased temperature, local habitat area, local habitat diversity and immigration affected species richness via increased niche specialization. Temperature explained by far the largest amount of variation in species richness, functional diversity and niche overlap. These results, combined with the largely non-saturating species richness-functional evenness relationship, suggest that increased temperature may have permitted increased species richness by allowing increased niche specialization. 5. These results emphasize the importance of niche differences for species coexistence in species-rich communities, and indicate that the conservation of functional diversity may be vital for the maintenance of species diversity in biological communities. Our approach may be applied readily to many types of community, and at any scale, thus providing a flexible means of testing niche-based hypotheses for species richness gradients.

Spatiotemporal changes in the genetic diversity of a bloom-forming <i>Microcystis aeruginosa</i> (cyanobacteria) population
Enora Briand, Nicolas Escoffier, Cécile Straub, Marion Sabart +2 more
2008· The ISME Journal196doi:10.1038/ismej.2008.121

The variations in microcystin concentrations during cyanobacterial blooms in freshwater ecosystems appear to depend on numerous factors, which have still not been fully identified. To contribute to clarify the situation, we have developed a spatial sampling approach to determine the dynamics and genetic diversity of a bloom-forming population of Microcystis aeruginosa in a large French reservoir, and the variations in the proportions of microcystin-producing genotypes. We demonstrated that marked changes occurred in the internal transcribed spacer (ITS) genotype composition of the M. aeruginosa population during the development of the bloom. These changes led progressively to the selection of one dominant ITS genotype throughout the entire reservoir when the cell number reached its maximum. At the same time, we identified a decrease in the proportion of the mcyB+ genotype, and a significant negative correlation between this proportion and that of the dominant ITS genotype during the bloom. Thus, it appeared that favorable conditions for Microcystis cell growth led to the selection, within the Microcystis population, of a non-microcystin-producing genotype, whereas potentially microcystin-producing genotypes were dominant in this population before and after the bloom, when environmental conditions were less favorable for growth.

Climate policy integration, coherence and governance
Per Mickwitz, F. Aix, Silke Beck, Carss, D. +4 more
2009· HAL (Le Centre pour la Communication Scientifique Directe)185

Created in 2001, PEER is a partnership of seven large European environmental research centres. PEER members cover the full spectrum of the environmental sciences and combine basic with applied research anticipating societal needs.

Can Commercial Digital Cameras Be Used as Multispectral Sensors? A Crop Monitoring Test
Valentine Lebourgeois, Agnès Bégué, Sabrina Labbé, Benjamin Mallavan +2 more
2008· Sensors184doi:10.3390/s8117300

The use of consumer digital cameras or webcams to characterize and monitor different features has become prevalent in various domains, especially in environmental applications. Despite some promising results, such digital camera systems generally suffer from signal aberrations due to the on-board image processing systems and thus offer limited quantitative data acquisition capability. The objective of this study was to test a series of radiometric corrections having the potential to reduce radiometric distortions linked to camera optics and environmental conditions, and to quantify the effects of these corrections on our ability to monitor crop variables. In 2007, we conducted a five-month experiment on sugarcane trial plots using original RGB and modified RGB (Red-Edge and NIR) cameras fitted onto a light aircraft. The camera settings were kept unchanged throughout the acquisition period and the images were recorded in JPEG and RAW formats. These images were corrected to eliminate the vignetting effect, and normalized between acquisition dates. Our results suggest that 1) the use of unprocessed image data did not improve the results of image analyses; 2) vignetting had a significant effect, especially for the modified camera, and 3) normalized vegetation indices calculated with vignetting-corrected images were sufficient to correct for scene illumination conditions. These results are discussed in the light of the experimental protocol and recommendations are made for the use of these versatile systems for quantitative remote sensing of terrestrial surfaces.

Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest
Bruno François, Alain Cariou, Raphaël Clère-Jehl, Pierre‐François Dequin +4 more
2019· New England Journal of Medicine182doi:10.1056/nejmoa1812379

BACKGROUND: Patients who are treated with targeted temperature management after out-of-hospital cardiac arrest with shockable rhythm are at increased risk for ventilator-associated pneumonia. The benefit of preventive short-term antibiotic therapy has not been shown. METHODS: We conducted a multicenter, double-blind, randomized, placebo-controlled trial involving adult patients (>18 years of age) in intensive care units (ICUs) who were being mechanically ventilated after out-of-hospital cardiac arrest related to initial shockable rhythm and treated with targeted temperature management at 32 to 34°C. Patients with ongoing antibiotic therapy, chronic colonization with multidrug-resistant bacteria, or moribund status were excluded. Either intravenous amoxicillin-clavulanate (at doses of 1 g and 200 mg, respectively) or placebo was administered three times a day for 2 days, starting less than 6 hours after the cardiac arrest. The primary outcome was early ventilator-associated pneumonia (during the first 7 days of hospitalization). An independent adjudication committee determined diagnoses of ventilator-associated pneumonia. RESULTS: A total of 198 patients underwent randomization, and 194 were included in the analysis. After adjudication, 60 cases of ventilator-associated pneumonia were confirmed, including 51 of early ventilator-associated pneumonia. The incidence of early ventilator-associated pneumonia was lower with antibiotic prophylaxis than with placebo (19 patients [19%] vs. 32 [34%]; hazard ratio, 0.53; 95% confidence interval, 0.31 to 0.92; P = 0.03). No significant differences between the antibiotic group and the control group were observed with respect to the incidence of late ventilator-associated pneumonia (4% and 5%, respectively), the number of ventilator-free days (21 days and 19 days), ICU length of stay (5 days and 8 days if patients were discharged and 7 days and 7 days if patients had died), and mortality at day 28 (41% and 37%). At day 7, no increase in resistant bacteria was identified. Serious adverse events did not differ significantly between the two groups. CONCLUSIONS: A 2-day course of antibiotic therapy with amoxicillin-clavulanate in patients receiving a 32-to-34°C targeted temperature management strategy after out-of-hospital cardiac arrest with initial shockable rhythm resulted in a lower incidence of early ventilator-associated pneumonia than placebo. No significant between-group differences were observed for other key clinical variables, such as ventilator-free days and mortality at day 28. (Funded by the French Ministry of Health; ANTHARTIC ClinicalTrials.gov number, NCT02186951.).