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.

OPEN DOORS AND OPEN MINDS: WHAT FACULTY AUTHORS CAN DO TO ENSURE OPEN ACCESS TO THEIR WORK THROUGH THEIR INSTITUTION

The Internet has brought unparalleled opportunities for expanding availability of research by bringing down economic and physical barriers to sharing. The digitally networked environment promises to democratize access, carry knowledge beyond traditional research niches, accelerate discovery, encourage new and interdisciplinary approaches to ever more complex research challenges, and enable new computational research strategies. However, despite these opportunities for increasing access to knowledge, the prices of scholarly journals have risen sharply over the past two decades, often forcing libraries to cancel subscriptions. Today even the wealthiest institutions cannot afford to sustain all of the journals needed by their faculties and students. To take advantage of the opportunities created by the Internet and to further their mission of creating, preserving, and disseminating knowledge, many academic institutions are taking steps to capture the benefits of more open research sharing. Colleges and universities have built digital repositories to preserve and distribute faculty scholarly articles and other research outputs. Many individual authors have taken steps to retain the rights they need, under copyright law, to allow their work to be made freely available on the Internet and in their institutionâ s repository. And, faculties at some institutions have adopted resolutions endorsing more open access to scholarly articles. Most recently, on February 12, 2008, the Faculty of Arts and Sciences (FAS) at Harvard University took a landmark step. The faculty voted to adopt a policy requiring that faculty authors send an electronic copy of their scholarly articles to the universityâ s digital repository and that faculty authors automatically grant copyright permission to the university to archive and to distribute these articles unless a faculty member has waived the policy for a particular article. Essentially, the faculty voted to make open access to the results of their published journal articles the default policy for the Faculty of Arts and Sciences of Harvard University. As of March 2008, a proposal is also under consideration in the University of California system by which faculty authors would commit routinely to grant copyright permission to the university to make copies of the facultyâ s scholarly work openly accessible over the Internet. Inspired by the example set by the Harvard faculty, this White Paper is addressed to the faculty and administrators of academic institutions who support equitable access to scholarly research and knowledge, and who believe that the institution can play an important role as steward of the scholarly literature produced by its faculty. This paper discusses both the motivation and the process for establishing a binding institutional policy that automatically grants a copyright license from each faculty member to permit deposit of his or her peer-reviewed scholarly articles in institutional repositories, from which the works become available for others to read and cite.

ENIGMA and the individual: Predicting factors that affect the brain in 35 countries worldwide.

In this review, we discuss recent work by the ENIGMA Consortium (http://enigma.ini.usc.edu) - a global alliance of over 500 scientists spread across 200 institutions in 35 countries collectively analyzing brain imaging, clinical, and genetic data. Initially formed to detect genetic influences on brain measures, ENIGMA has grown to over 30 working groups studying 12 major brain diseases by pooling and comparing brain data. In some of the largest neuroimaging studies to date - of schizophrenia and major depression - ENIGMA has found replicable disease effects on the brain that are consistent worldwide, as well as factors that modulate disease effects. In partnership with other consortia including ADNI, CHARGE, IMAGEN and others(1), ENIGMA's genomic screens - now numbering over 30,000 MRI scans - have revealed at least 8 genetic loci that affect brain volumes. Downstream of gene findings, ENIGMA has revealed how these individual variants - and genetic variants in general - may affect both the brain and risk for a range of diseases. The ENIGMA consortium is discovering factors that consistently affect brain structure and function that will serve as future predictors linking individual brain scans and genomic data. It is generating vast pools of normative data on brain measures - from tens of thousands of people - that may help detect deviations from normal development or aging in specific groups of subjects. We discuss challenges and opportunities in applying these predictors to individual subjects and new cohorts, as well as lessons we have learned in ENIGMA's efforts so far.

Development of open models and tools for seismic risk assessment: application to Portugal

The exponential growth of the world population has led to an increase of settlements often located in areas prone to natural disasters, including earthquakes. Consequently, despite the important advances in the field of natural catastrophes modelling and risk mitigation actions, the overall human losses have continued to increase and unprecedented economic losses have been registered. In the research work presented herein, various areas of earthquake engineering and seismology are thoroughly investigated, and a case study application for mainland Portugal is performed. Seismic risk assessment is a critical link in the reduction of casualties and damages due to earthquakes. Recognition of this relation has led to a rapid rise in demand for accurate, reliable and flexible numerical tools and software. In the present work, an open-source platform for seismic hazard and risk assessment is developed. This software is capable of computing the distribution of losses or damage for an earthquake scenario (deterministic event-based) or earthquake losses due to all the possible seismic events that might occur within a region for a given interval of time (probabilistic event-based). This effort has been developed following an open and transparent philosophy and therefore, it is available to any individual or institution. The estimation of the seismic risk depends mainly on three components: seismic hazard, exposure and vulnerability. The latter component assumes special importance, as by intervening with appropriate retrofitting solutions, it may be possible to decrease directly the seismic risk. The employment of analytical methodologies is fundamental in the assessment of structural vulnerability, particularly in regions where post-earthquake building damage might not be available. Several common methodologies are investigated, and conclusions are yielded regarding the method that can provide an optimal balance between accuracy and computational effort. In addition, a simplified approach based on the displacement-based earthquake loss assessment (DBELA) is proposed, which allows for the rapid estimation of fragility curves, considering a wide spectrum of uncertainties. A novel vulnerability model for the reinforced concrete building stock in Portugal is proposed in this work, using statistical information collected from hundreds of real buildings. An analytical approach based on nonlinear time history analysis is adopted and the impact of a set of key parameters investigated, including the damage state criteria and the chosen intensity measure type. A comprehensive review of previous studies that contributed to the understanding of the seismic hazard and risk for Portugal is presented. An existing seismic source model was employed with recently proposed attenuation models to calculate probabilistic seismic hazard throughout the territory. The latter results are combined with information from the 2011 Building Census and the aforementioned vulnerability model to estimate economic loss maps for a return period of 475 years. These losses are disaggregated across the different building typologies and conclusions are yielded regarding the type of construction more vulnerable to seismic activity.

Habitat variability and the individual variability of juvenile Atlantic salmon (Salmo salar)

La variabilité spatiale et temporelle de l’écoulement en rivière contribue à créer une mosaïque d’habitat dynamique qui soutient la diversité écologique. Une des questions fondamentales en écohydraulique est de déterminer quelles sont les échelles spatiales et temporelles de variation de l’habitat les plus importantes pour les organismes à divers stades de vie. L’objectif général de la thèse consiste à examiner les liens entre la variabilité de l’habitat et le comportement du saumon Atlantique juvénile. Plus spécifiquement, trois thèmes sont abordés : la turbulence en tant que variable d’habitat du poisson, les échelles spatiales et temporelles de sélection de l’habitat et la variabilité individuelle du comportement du poisson. À l’aide de données empiriques détaillées et d’analyses statistiques variées, nos objectifs étaient de 1) quantifier les liens causaux entre les variables d’habitat du poisson « usuelles » et les propriétés turbulentes à échelles multiples; 2) tester l’utilisation d’un chenal portatif pour analyser l’effet des propriétés turbulentes sur les probabilités de capture de proie et du comportement alimentaire des saumons juvéniles; 3) analyser les échelles spatiales et temporelles de sélection de l’habitat dans un tronçon l’été et l’automne; 4) examiner la variation individuelle saisonnière et journalière des patrons d’activité, d’utilisation de l’habitat et de leur interaction; 5) investiguer la variation individuelle du comportement spatial en relation aux fluctuations environnementales. La thèse procure une caractérisation détaillée de la turbulence dans les mouilles et les seuils et montre que la capacité des variables d’habitat du poisson usuelles à expliquer les propriétés turbulentes est relativement basse, surtout dans les petites échelles, mais varie de façon importante entre les unités morphologiques. D’un point de vue pratique, ce niveau de complexité suggère que la turbulence devrait être considérée comme une variable écologique distincte. Dans une deuxième expérience, en utilisant un chenal portatif in situ, nous n’avons pas confirmé de façon concluante, ni écarté l’effet de la turbulence sur la probabilité de capture des proies, mais avons observé une sélection préférentielle de localisations où la turbulence était relativement faible. La sélection d’habitats de faible turbulence a aussi été observée en conditions naturelles dans une étude basée sur des observations pour laquelle 66 poissons ont été marqués à l’aide de transpondeurs passifs et suivis pendant trois mois dans un tronçon de rivière à l’aide d’un réseau d’antennes enfouies dans le lit. La sélection de l’habitat était dépendante de l’échelle d’observation. Les poissons étaient associés aux profondeurs modérées à micro-échelle, mais aussi à des profondeurs plus élevées à l’échelle des patchs. De plus, l’étendue d’habitats utilisés a augmenté de façon asymptotique avec l’échelle temporelle. L’échelle d’une heure a été considérée comme optimale pour décrire l’habitat utilisé dans une journée et l’échelle de trois jours pour décrire l’habitat utilisé dans un mois. Le suivi individuel a révélé une forte variabilité inter-individuelle des patrons d’activité, certains individus étant principalement nocturnes alors que d’autres ont fréquemment changé de patrons d’activité. Les changements de patrons d’activité étaient liés aux variables environnementales, mais aussi à l’utilisation de l’habitat des individus, ce qui pourrait signifier que l’utilisation d’habitats suboptimaux engendre la nécessité d’augmenter l’activité diurne, quand l’apport alimentaire et le risque de prédation sont plus élevés. La variabilité inter-individuelle élevée a aussi été observée dans le comportement spatial. La plupart des poissons ont présenté une faible mobilité la plupart des jours, mais ont occasionnellement effectué des mouvements de forte amplitude. En fait, la variabilité inter-individuelle a compté pour seulement 12-17% de la variabilité totale de la mobilité des poissons. Ces résultats questionnent la prémisse que la population soit composée de fractions d’individus sédentaires et mobiles. La variation individuelle journalière suggère que la mobilité est une réponse à des changements des conditions plutôt qu’à un trait de comportement individuel.

Abordajes teóricos en la comprensión de la influencia de los recursos económicos en la actividad física

Estudio cualitativo que analiza los abordajes teóricos utilizados por diferentes autores en la comprensión de la influencia de los recursos económicos en la actividad física desde los modelos de determinantes y determinación social.

Learning from errors : effects of teachers training on students??? attitudes towards and their individual use of errors

Resumen basado en el de la publicaci??n

Leisure time behaviors: Prevalence, correlates and associations with overweight in Brazilian adults. A cross-sectional analysis

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Entropy of bosonic open string and boundary conditions

The entropy of the states associated to the solutions of the equations of motion of the bosonic open string with combinations of Neumann and Dirichlet boundary conditions is given. Also, the entropy of the string in the states \A(i)] = alpha(-1)(i)\0] and \phi(a)]= alpha(-1)(a)\0] that describe the massless fields on the world-volume of the Dp-brane is computed. (C) 2002 Elsevier B.V. B.V. All rights reserved.

Open Data and Earth Observations The Case of Opening Up Access to and Use of Earth Observation Data Through the Global Earth Observation System of Systems

Earth observations (EO) represent a growing and valuable resource for many scientific, research and practical applications carried out by users around the world. Access to EO data for some applications or activities, like climate change research or emergency response activities, becomes indispensable for their success. However, often EO data or products made of them are (or are claimed to be) subject to intellectual property law protection and are licensed under specific conditions regarding access and use. Restrictive conditions on data use can be prohibitive for further work with the data. Global Earth Observation System of Systems (GEOSS) is an initiative led by the Group on Earth Observations (GEO) with the aim to provide coordinated, comprehensive, and sustained EO and information for making informed decisions in various areas beneficial to societies, their functioning and development. It seeks to share data with users world-wide with the fewest possible restrictions on their use by implementing GEOSS Data Sharing Principles adopted by GEO. The Principles proclaim full and open exchange of data shared within GEOSS, while recognising relevant international instruments and national policies and legislation through which restrictions on the use of data may be imposed.The paper focuses on the issue of the legal interoperability of data that are shared with varying restrictions on use with the aim to explore the options of making data interoperable. The main question it addresses is whether the public domain or its equivalents represent the best mechanism to ensure legal interoperability of data. To this end, the paper analyses legal protection regimes and their norms applicable to EO data. Based on the findings, it highlights the existing public law statutory, regulatory, and policy approaches, as well as private law instruments, such as waivers, licenses and contracts, that may be used to place the datasets in the public domain, or otherwise make them publicly available for use and re-use without restrictions. It uses GEOSS and the particular characteristics of it as a system to identify the ways to reconcile the vast possibilities it provides through sharing of data from various sources and jurisdictions on the one hand, and the restrictions on the use of the shared resources on the other. On a more general level the paper seeks to draw attention to the obstacles and potential regulatory solutions for sharing factual or research data for the purposes that go beyond research and education.

Hα emission fluxes and lithium abundances of low-mass stars in the young open cluster IC 4665

As part of a long term effort to understand pre-main sequence Li burning, we have obtained high resolution spectroscopic observations of 14 late type stars (G0-M1) in the young open cluster IC 4665. Most of the stars have Hα filled-in and Li I absorption, as expected for their young age. From the equivalent widths of Hα emission excess (obtained using the spectral subtraction technique) and the the Li i λ6708 feature, we have derived Hα emission fluxes and photospheric Li abundances. The mean Li abundance of IC 4665 solar-type stars is log N(Li) = 3.1; the same as in other young clusters (α Per, Pleiades) and T Tauri stars. Our results support the conclusions from previous works that PMS Li depletion is very small for masses ∼ 1 M_⨀ . Among the IC 4665 late-G and early K-type stars, there is a spread in Li abundances of about one order of magnitude. The Li-poor IC 4665 members have low Hα excess and vsini≤10. Hence, the Li-activity-rotation connection which has been clearly established in the Pleiades also seems to hold in IC 4665. One M-type IC 4665 star that we have observed does not show Li, implying a very efficient Li depletion as observed in α Per stars of the same spectral type. The level of chromospheric activity and Li depletion among the low-mass stars of IC 4665 is similar to that in the Pleiades. In fact, we note that the Li abundance distributions in several young clusters (α Per, Pleiades, IC 2391, IC 4665) and in post T Tauri stars are strikingly similar. This result suggests that Hα emission and Li abundance not well correlated with age for low-mass stars between 20 and 100 Myr old. We argue that a finer age indicator, the ''LL-clock'', would be the luminosity at which the transition between efficient Li depletion and preservation takes place for fully convective objects. The LL-clock could allow in the near future to derive the relative ages of young open clusters, and clarify the study of PMS evolution of cool stars.

The flags of the world : their history, blazonry and associations /

Leaves of plates bound throughout the text.