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.

Representações sociais e construção da identidade de cabo-verdianos no Rio de Janeiro: estudantes, imigrantes e descendentes

A presente pesquisa que ora se apresenta trata das representações sociais da comunidade cabo-verdiana residente no Rio de Janeiro sobre diversos objetos que estão implicados no processo de construção de suas identidades, no entrecruzamento das culturas e identidades cabo-verdianas e brasileiras. Nesse sentido, realizou-se um estudo comparativo entre três grupos de cabo-verdianos residentes no Rio de Janeiro. As entrevistas realizadas com 20 estudantes, 20 imigrantes e 10 brasileiros filhos de cabo-verdianos residentes no Brasil permitiram identificar conteúdos mais específicos, diversificados e detalhados das representações formadas por eles acerca do Brasil e do povo brasileiro, bem como das suas próprias relações com os países de origem e de acolhimento, bem como com os seus respectivos povos, o que, em última análise, consubstancia as identidades sociais próprias que terão reconstruído durante a sua permanência aquém do ou melhor, de parte do Oceano Atlântico. A teoria das Representações Sociais, desenvolvida por Serge Moscovici (1961) se constituiu em uma valiosa sustentação teórica para o presente estudo. Por meio da pesquisa comparativa das representações sociais dos distintos grupos de cabo-verdianos no Rio de Janeiro acerca de variados aspectos dos seus contextos sócio-culturais de origem e de acolhimento, foi possível compreender o complexo processo de construção, reconstrução e atualização das suas respectivas identidades. É isso que se acredita ter aqui demonstrado no que se refere às trajetórias dos estudantes e imigrantes cabo-verdianos, bem como às histórias de vida dos filhos destes, no Brasil e, em especial, no Rio de Janeiro. É nessa perspectiva que os cabo-verdianos no Rio de Janeiro tomados tanto como sujeitos quanto como objetos de representação, na presente pesquisa têm construído um conhecimento ao mesmo tempo, prático e reflexivo da sua inserção nos contextos brasileiro e carioca, através do contato face a face com a sociedade receptora e, no caso de dois desses grupos (estudantes e imigrantes), a partir das representações que já haviam elaborado no país de origem, sob a influência dos meios de comunicação de massa. Assim, com base na hibridização cultural e identitária dos cabo-verdianos, procurou-se compreender de forma mais ampla e circunstanciada o processo de (re) construção das identidades dos estudantes, imigrantes e dos descendentes destes no Rio de Janeiro. Tais mudanças mostraram-se mais visíveis nos convívios sociais em que os grupos cabo-verdianos participam em diferentes espaços sociais desta cidade, nas próprias residências, nas sedes de associações, as quais participam, não só cabo-verdianos, mas, também, alguns brasileiros e outros africanos. Nestes convívios, notam-se diferenças de relacionamento entre eles, estruturam-se em pequenos grupos, ocorrendo uma intensificação das aproximações identitárias e representacionais. As mudanças que foram observadas superficialmente entre os estudantes são, por conseguinte, mais intensas entre os cabo-verdianos imigrantes, em virtude do maior tempo e freqüência cotidiana da comunicação e da troca de experiências com mais variados estratos da população brasileira, o que se aproxima a uma autêntica fusão cultural. Não obstante, constatou-se que, nesse processo, a comunidade imigrante perdeu alguns elementos importantes da cultura cabo-verdiana, o principal dos quais foi a língua crioula. A perda do crioulo representa uma descontinuidade na reprodução da identidade cabo-verdiana pelos imigrantes no Brasil. Nesse sentido, os brasileiros filhos de pais cabo-verdianos não tiveram acesso a esse poderoso instrumento de comunicação e de preservação da cultura cabo-verdiana. Esses cabo-verdianos imigrantes consideram-se bem sucedidos e avaliam positivamente a sua trajetória de vida enquanto imigrantes no Brasil. De igual modo, os estudantes se consideram realizados, devido à oportunidade de estudar no Brasil, o que representa a concretização de um desejo coletivo, uma vez que a instrução escolar é amplamente valorizada no país de origem.

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.

Eurobalise-Train communication modelling to assess interferences in railway control signalling systems

The evolution of the railway sector depends, to a great extent, on the deployment of advanced railway signalling systems. These signalling systems are based on communication architectures that must cope with complex electromagnetical environments. This paper is outlined in the context of developing the necessary tools to allow the quick deployment of these signalling systems by contributing to an easier analysis of their behaviour under the effect of electromagnetical interferences. Specifically, this paper presents the modelling of the Eurobalise-train communication flow in a general purpose simulation tool. It is critical to guarantee this communication link since any lack of communication may lead to a stop of the train and availability problems. In order to model precisely this communication link we used real measurements done in a laboratory equipped with elements defined in the suitable subsets. Through the simulation study carried out, we obtained performance indicators of the physical layer such as the received power, SNR and BER. The modelling presented in this paper is a required step to be able to provide quality of service indicators related to perturbed scenarios.

On preservation of data

This paper presents, for three aquatic research projects, the type of data that were collected, and the reasons why these data eventually became lost or inaccessible. A strategy for countering such data loss is proposed.

Length correction for larval and early-juvenile Atlantic menhaden (Brevoortia tyrannus) after preservation in alcohol

Body length measurement is an important part of growth, condition, and mortality analyses of larval and juvenile fish. If the measurements are not accurate (i.e., do not reflect real fish length), results of subsequent analyses may be affected considerably (McGurk, 1985; Fey, 1999; Porter et al., 2001). The primary cause of error in fish length measurement is shrinkage related to collection and preservation (Theilacker, 1980; Hay, 1981; Butler, 1992; Fey, 1999). The magnitude of shrinkage depends on many factors, namely the duration and speed of the collection tow, abundance of other planktonic organisms in the sample (Theilacker, 1980; Hay, 1981; Jennings, 1991), the type and strength of the preservative (Hay, 1982), and the species of fish (Jennings, 1991; Fey, 1999). Further, fish size affects shrinkage (Fowler and Smith, 1983; Fey, 1999, 2001), indicating that live length should be modeled as a function of preserved length (Pepin et al., 1998; Fey, 1999).

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.