Subtypes of Patients Experiencing Exacerbations of COPD and Associations with Outcomes

Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous condition characterized by occasional exacerbations. Identifying clinical subtypes among patients experiencing COPD exacerbations (ECOPD) could help better understand the pathophysiologic mechanisms involved in exacerbations, establish different strategies of treatment, and improve the process of care and patient prognosis. The objective of this study was to identify subtypes of ECOPD patients attending emergency departments using clinical variables and to validate the results using several outcomes. We evaluated data collected as part of the IRYSS-COPD prospective cohort study conducted in 16 hospitals in Spain. Variables collected from ECOPD patients attending one of the emergency departments included arterial blood gases, presence of comorbidities, previous COPD treatment, baseline severity of COPD, and previous hospitalizations for ECOPD. Patient subtypes were identified by combining results from multiple correspondence analysis and cluster analysis. Results were validated using key outcomes of ECOPD evolution. Four ECOPD subtypes were identified based on the severity of the current exacerbation and general health status (largely a function of comorbidities): subtype A (n = 934), neither high comorbidity nor severe exacerbation; subtype B (n = 682), moderate comorbidities; subtype C (n = 562), severe comorbidities related to mortality; and subtype D (n = 309), very severe process of exacerbation, significantly related to mortality and admission to an intensive care unit. Subtype D experienced the highest rate of mortality, admission to an intensive care unit and need for noninvasive mechanical ventilation, followed by subtype C. Subtypes A and B were primarily related to other serious complications. Hospitalization rate was more than 50% for all the subtypes, although significantly higher for subtypes C and D than for subtypes A and B. These results could help identify characteristics to categorize ECOPD patients for more appropriate care, and help test interventions and treatments in subgroups with poor evolution and outcomes.

Análisis tipológico de la serie industrial achelense de Puyo (Lannemezan, Hautes-Pyrénées, France). Ensayo de clasificación de piezas “hacheroides”

[ES] El conjunto industrial achelense de Puyo (Lannemezan, Hautes-Pyrénées), descubierto por G. Laplace en 1954 en posición estratigráfica rissiense, está compuesto por 360 ejemplares líticos tallados en cuarcita local. Este efectivo industrial se reparte entre: 218 piezas retocadas (en las que se han definido 226 tipos primarios), 136 lascas y 6 núcleos. Tecnológicamente, la mayor parte de las industrias parecen estar en relación con un debitado sobre yunque; técnica de talla que ha procurado unas lascas con unos atributos muy específicos, en las que, en varios casos, son más que evidentes sus analogías morfológicas con los "hachereaux". En este sentido, la elevada presencia de "hachereaux" bien formateados y de otras piezas hacheroides más elementales, menos elaboradas, así como de varias formas particulares de utillaje macrolítico (ojivas, puntas), nos ha llevado a plantear una propuesta de definición y clasificación analítica particular para estos temas. La contribución global de estas piezas macrolíticas es superior a la de los útiles convencionales o más habituales. Por último, en lo que concierne a la valoración tipológica, este original complejo achelense está definido esencialmente, además de por los más numerosos tipos hacheroides, por una casi similar presencia de denticulados y una importante contribución de puntas carenoides. Más complementariamente, deben estimarse las aportaciones de ojivas y raederas, y son francamente minoritarios los restantes grupos tipológicos considerados (de cantos tallados, truncaduras, puntas planas, abruptos, raspadores, "becs", fragmentos de piezas bifaciales indeterminadas y "écaillés").

Evolutionary associations between sand seatrout (Cynoscion arenarius) and silver seatrout (C. nothus) inferred from morphological characters, mitochondrial DNA, and microsatellite markers

The evolutionary associations between closely related fish species, both contemporary and historical, are frequently assessed by using molecular markers, such as microsatellites. Here, the presence and variability of microsatellite loci in two closely related species of marine fishes, sand seatrout (Cynoscion arenarius) and silver seatrout (C. nothus), are explored by using heterologous primers from red drum (Sciaenops ocellatus). Data from these loci are used in conjunction with morphological characters and mitochondrial DNA haplotypes to explore the extent of genetic exchange between species offshore of Galveston Bay, TX. Despite seasonal overlap in distribution, low genetic divergence at microsatellite loci, and similar life history parameters of C. arenarius and C. nothus, all three data sets indicated that hybridization between these species does not occur or occurs only rarely and that historical admixture in Galveston Bay after divergence between these species was unlikely. These results shed light upon the evolutionary history of these fishes and highlight the genetic properties of each species that are influenced by their life history and ecology.

Multiscale habitat associations of deepwater demersal fishes off central California

Fish-habitat associations were examined at three spatial scales in Monterey Bay, California, to determine how benthic habitats and landscape configuration have structured deepwater demersal fish assemblages. Fish counts and habitat variables were quantified by using observer and video data collected from a submersible. Fish responded to benthic habitats at scales ranging from cm’s to km’s. At broad-scales (km’s), habitat strata classified from acoustic maps were a strong predictor of fish assemblage composition. At intermediate-scales (m’s−100 m’s), fish species were associated with specific substratum patch types. At fine-scales (<1 m), microhabitat associations revealed differing degrees of microhabitat specificity, and for some species revealed niche separation within patches. The use of habitat characteristics in ecosystembased management, particularly as a surrogate for species distributions, will depend on resolving fish-habitat associations and habitat complexity over multiple scales.

Self-reported sitting time and physical activity: interactive associations with mental well-being and productivity in office employees

Background: Little is known about how sitting time, alone or in combination with markers of physical activity (PA), influences mental well-being and work productivity. Given the need to develop workplace PA interventions that target employees' health related efficiency outcomes; this study examined the associations between self-reported sitting time, PA, mental well-being and work productivity in office employees. Methods: Descriptive cross-sectional study. Spanish university office employees (n = 557) completed a survey measuring socio-demographics, total and domain specific (work and travel) self-reported sitting time, PA (International Physical Activity Questionnaire short version), mental well-being (Warwick-Edinburg Mental Well-Being Scale) and work productivity (Work Limitations Questionnaire). Multivariate linear regression analyses determined associations between the main variables adjusted for gender, age, body mass index and occupation. PA levels (low, moderate and high) were introduced into the model to examine interactive associations. Results: Higher volumes of PA were related to higher mental well-being, work productivity and spending less time sitting at work, throughout the working day and travelling during the week, including the weekends (p < 0.05). Greater levels of sitting during weekends was associated with lower mental well-being (p < 0.05). Similarly, more sitting while travelling at weekends was linked to lower work productivity (p < 0.05). In highly active employees, higher sitting times on work days and occupational sitting were associated with decreased mental well-being (p < 0.05). Higher sitting times while travelling on weekend days was also linked to lower work productivity in the highly active (p < 0.05). No significant associations were observed in low active employees. Conclusions: Employees' PA levels exerts different influences on the associations between sitting time, mental well-being and work productivity. The specific associations and the broad sweep of evidence in the current study suggest that workplace PA strategies to improve the mental well-being and productivity of all employees should focus on reducing sitting time alongside efforts to increase PA.

Dietary animal and plant protein intakes and their associations with obesity and cardio-metabolic indicators in European adolescents: the HELENA cross-sectional study

Background: Previous studies suggest that dietary protein might play a beneficial role in combating obesity and its related chronic diseases. Total, animal and plant protein intakes and their associations with anthropometry and serum biomarkers in European adolescents using one standardised methodology across European countries are not well documented. Objectives: To evaluate total, animal and plant protein intakes in European adolescents stratified by gender and age, and to investigate their associations with cardio-metabolic indicators (anthropometry and biomarkers). Methods: The current analysis included 1804 randomly selected adolescents participating in the HELENA study (conducted in 2006-2007) aged 12.5-17.5 y (47% males) who completed two non-consecutive computerised 24-h dietary recalls. Associations between animal and plant protein intakes, and anthropometry and serum biomarkers were examined with General linear Model multivariate analysis. Results: Average total protein intake exceeded the recommendations of World Health Organization and European Food Safety Authority. Mean total protein intake was 96 g/d (59% derived from animal protein). Total, animal and plant protein intakes (g/d) were significantly lower in females than in males and total and plant protein intakes were lower in younger participants (12.5-14.9 y). Protein intake was significantly lower in underweight subjects and higher in obese ones; the direction of the relationship was reversed after adjustments for body weight (g/(kg.d)). The inverse association of plant protein intakes was stronger with BMI z-score and body fat percentage (BF%) compared to animal protein intakes. Additionally, BMI and BF% were positively associated with energy percentage of animal protein. Conclusions: This sample of European adolescents appeared to have adequate total protein intake. Our findings suggest that plant protein intakes may play a role in preventing obesity among European adolescents. Further longitudinal studies are needed to investigate the potential beneficial effects observed in this study in the prevention of obesity and related chronic diseases.

Juvenile Red Rockfish, Sebastes sp., Associations with Sponges in the Gulf of Alaska

In 2001, a research submersible was used to survey seafloor habitat and associated benthos in the northeastern Gulf of Alaska. One inspected site had a uniform sand-silt substrate, punctuated by widely spaced (10–20 m apart) boulders. Two-thirds of the boulders had sponge, Aphrocallistes sp., colonies. Eighty-two juvenile (5–10 cm) red rockfish (Sebastes sp.) were also observed during the dive, and all of these fish were closely associated with the sponges. No juvenile red rockfish were seen in proximity to boulders without sponges, nor were any observed on the sand-silt substrate between boulders.

Beluga, Delphinapterus leucas, Habitat Associations in Cook Inlet, Alaska

A review of available information describing habitat associations for belugas, Delphinapterus leucas, in Cook Inlet was undertaken to complement population assessment surveys from 1993-2000. Available data for physical, biological, and anthropogenic factors in Cook Inlet are summarized followed by a provisional description of seasonal habitat associations. To summarize habitat preferences, the beluga summer distribution pattern was used to partition Cook Inlet into three regions. In general, belugas congregate in shallow, relatively warm, low-salinity water near major river outflows in upper Cook Inlet during summer (defined as their primary habitat), where prey availability is comparatively high and predator occurrence relatively low. In winter, belugas are seen in the central inlet, but sightings are fewer in number, and whales more dispersed compared to summer. Belugas are associated with a range of ice conditions in winter, from ice-free to 60% ice-covered water. Natural catastrophic events, such as fires, earthquakes, and volcanic eruptions, have had no reported effect on beluga habitat, although such events likely affect water quality and, potentially, prey availability. Similarly, although sewage effluent and discharges from industrial and military activities along Cook Inlet negatively affect water quality, analyses of organochlorines and heavy metal burdens indicate that Cook Inlet belugas are not assimilating contaminant loads greater than any other Alaska beluga stocks. Offshore oil and gas activities and vessel traffic are high in the central inlet compared with other Alaska waters, although belugas in Cook Inlet seem habituated to these anthropogenic factors. Anthropogenic factors that have the highest potential negative impacts on belugas include subsistence hunts (not discussed in this report), noise from transportation and offshore oil and gas extraction (ship transits and aircraft overflights), and water quality degradation (from urban runoff and sewage treatment facilities). Although significant impacts from anthropogenic factors other than hunting are not yet apparent, assessment of potential impacts from human activities, especially those that may effect prey availability, are needed.

Associations among chlorophyll concentration and climatic variables for Suisun Bay and the Sacramento-San Joaquin Delta [abstract]

EXTRACT (SEE PDF FOR FULL ABSTRACT): The recent changes in phytoplankton production and community composition within the Suisun Bay and Sacramento-San Joaquin Delta may be related to climate. Chlorophyll a concentration, decreased by 42% (spring-summer) and 29% (fall) between 1972 through 1976 and 1977 through 1981. The decrease in biomass was characterized by a shift in phytoplankton community dominance from Skeletonema spp., Cyclotella spp. and Coscinodiscus spp. to Melosira granulata. The possible influence of climate on phytoplankton abundance was suggested by multivariate statistical analyses that demonstrated an association between changes in phytoplankton community composition and abundance between 1975 and 1982 and the climate related variables wind velocity, precipitation, river flow and water temperature.

Establishing species–habitat associations for 4 eteline snappers with the use of a baited stereo-video camera system

With the use of a baited stereo-video camera system, this study semiquantitatively defined the habitat associations of 4 species of Lutjanidae: Opakapaka (Pristipomoides filamentosus), Kalekale (P. sieboldii), Onaga (Etelis coruscans), and Ehu (E. carbunculus). Fish abundance and length data from 6 locations in the main Hawaiian Islands were evaluated for species-specific and size-specific differences between regions and habitat types. Multibeam bathymetry and backscatter were used to classify habitats into 4 types on the basis of substrate (hard or soft) and slope (high or low). Depth was a major influence on bottomfish distributions. Opakapaka occurred at depths shallower than the depths at which other species were observed, and this species showed an ontogenetic shift to deeper water with increasing size. Opakapaka and Ehu had an overall preference for hard substrate with low slope (hard-low), and Onaga was found over both hard-low and hard-high habitats. No significant habitat preferences were recorded for Kalekale. Opakapaka, Kalekale, and Onaga exhibited size-related shifts with habitat type. A move into hard-high environments with increasing size was evident for Opakapaka and Kalekale. Onaga was seen predominantly in hard-low habitats at smaller sizes and in either hard-low or hard-high at larger sizes. These ontogenetic habitat shifts could be driven by reproductive triggers because they roughly coincided with the length at sexual maturity of each species. However, further studies are required to determine causality. No ontogenetic shifts were seen for Ehu, but only a limited number of juveniles were observed. Regional variations in abundance and length were also found and could be related to fishing pressure or large-scale habitat features.

Juvenile salmonid distribution, growth, condition, origin, and environmental and species associations in the Northern California Current

Information is summarized on juvenile salmonid distribution, size, condition, growth, stock origin, and species and environmental associations from June and August 2000 GLOBEC cruises with particular emphasis on differences related to the regions north and south of Cape Blanco off Southern Oregon. Juvenile salmon were more abundant during the August cruise as compared to the June cruise and were mainly distributed northward from Cape Blanco. There were distinct differences in distribution patterns between salmon species: chinook salmon were found close inshore in cooler water all along the coast and coho salmon were rarely found south of Cape Blanco. Distance offshore and temperature were the dominant explanatory variables related to coho and chinook salmon distribution. The nekton assemblages differed significantly between cruises. The June cruise was dominated by juvenile rockfishes, rex sole, and sablefish, which were almost completely absent in August. The forage fish community during June comprised Pacific herring and whitebait smelt north of Cape Blanco and surf smelt south of Cape Blanco. The fish community in August was dominated by Pacific sardines and highly migratory pelagic species. Estimated growth rates of juvenile coho salmon were higher in the GLOBEC study area than in areas farther north. An unusually high percentage of coho salmon in the study area were precocious males. Significant differences in growth and condition of juvenile coho salmon indicated different oceanographic environments north and south of Cape Blanco. The condition index was higher in juvenile coho salmon to the north but no significant differences were found for yearling chinook salmon. Genetic mixed stock analysis indicated that during June, most of the Chinook salmon in our sample originated from rivers along the central coast of Oregon. In August, chinook salmon sampled south of Cape Blanco were largely from southern Oregon and northern California; whereas most chinook salmon north of Cape Blanco were from the Central Valley in California.

Shortspine thornyhead (Sebastolobus alascanus) abundance and habitat associations in the Gulf of Alaska

Shortspine thornyhead (Sebastolobus alascanus) abundance was estimated from 107 video transects at 27 stations recorded from a research submersible in 1991 off southeast Alaska at depths ranging from 165 to 355 m. Numbers of invertebrates in seven major taxa were estimated, as was substrate type. Thornyhead abundance ranged from 0 to 7.5/100 m2, with a mean of 1.22/100 m2, and was positively correlated with depth and amount of hard substrate. Invertebrate abundances were not significantly correlated with numbers of thornyheads. Shortspine thornyhead abundance estimates from this study were several times higher than estimates produced by bottom trawl surveys off southeast Alaska in 1990 and 1993, the two years of survey that encompassed the submersible transects; however, the trend of increasing abundance with depth was similar in the trawl surveys and in the submersible transects, suggesting that trawl surveys systematically underestimate abundance of shortspine thornyheads