Distribution and outcomes of a phenotype-based approach to guide COPD management: Results from the CHAIN cohort

Rationale: The Spanish guideline for COPD (GesEPOC) recommends COPD treatment according to four clinical phenotypes: non-exacerbator phenotype with either chronic bronchitis or emphysema (NE), asthma-COPD overlap syndrome (ACOS), frequent exacerbator phenotype with emphysema (FEE) or frequent exacerbator phenotype with chronic bronchitis (FECB). However, little is known on the distribution and outcomes of the four suggested phenotypes. Objective: We aimed to determine the distribution of these COPD phenotypes, and their relation with one-year clinical outcomes. Methods: We followed a cohort of well-characterized patients with COPD up to one-year. Baseline characteristics, health status (CAT), BODE index, rate of exacerbations and mortality up to one year of follow-up were compared between the four phenotypes. Results: Overall, 831 stable COPD patients were evaluated. They were distributed as NE, 550 (66.2%); ACOS, 125 (15.0%); FEE, 38 (4.6%); and FECB, 99 (11.9%); additionally 19 (2.3%) COPD patients with frequent exacerbations did not fulfill the criteria for neither FEE nor FECB. At baseline, there were significant differences in symptoms, FEV1 and BODE index (all p<0.05). The FECB phenotype had the highest CAT score (17.1±8.2, p<0.05 compared to the other phenotypes). Frequent exacerbator groups (FEE and FECB) were receiving more pharmacological treatment at baseline, and also experienced more exacerbations the year after (all p<0.05) with no differences in one-year mortality. Most of NE (93%) and half of exacerbators were stable after one year. Conclusions: There is an uneven distribution of COPD phenotypes in stable COPD patients, with significant differences in demographics, patient-centered outcomes and health care resources use

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3�6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55 of the global rise in mean BMI from 1985 to 2017�and more than 80 in some low- and middle-income regions�was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing�and in some countries reversal�of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. © 2019, The Author(s)

Analysis of reproduction and litter performance of the Zlotnicka Spotted breed and its different crossbreeds

Zlotnicka Spotted (ZS) is a native Polish pig breed. It is characterized by low reproduction and litter performance. This study aimed to determine the suitability of ZS pigs when crossed with Duroc and Polish Large White (PLW) according to reproduction and litter performance. Data concerning the number of piglets in the litter, litter weight, litter balance and piglet wastage were evaluated at birth, on the 7th and 21st days, and during weaning. ZS sows in purebred litters had 8.82 piglets at birth. However, the number of weaned piglets was of particular importance being only 7.33 heads in this study population. Wastage in purebred litters up to weaning was 17.34%. The highest number of piglets at birth (10.76 heads) and number of weaned piglets (8.98 heads) were estimated for D/ZS x ZS litters, although, at weaning, the heaviest piglets (9.61 kg) came from PLW x ZS litters. Results show that crossing ZS sows with Duroc, PLW boars, as well as crossing of D x ZS, improves reproduction and litter performance

A remark on the spectrum of the Dirac operator on pseudo-Riemannian spin manifolds

It is proved that the eigenvalues of the Dirac operator on even dimensional space- and time-oriented pseudo-Riemannian spin manifolds lie symmetric to the real and to the imaginary axes, and that the Dirac operator does not have residual spectrum if the associated Riemannian metric is complete. (orig.)Available from TIB Hannover: RR 1596(136) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Diferentes concentrações do inóculo de Cercospora sojina na intensidade da mancha foliar "olho-de-rã" em soja

A mancha foliar "olho-de-rã", cujo agente causal é o fungo Cercospora sojina, causa grandes perdas no cultivo da soja, principalmente na Argentina. Em experimento conduzido em laboratório e câmara climatizada, objetivou-se verificar o efeito de diferentes concentrações do inóculo de C. sojina na intensidade da mancha foliar "olho-de-rã" em folíolos de soja. As concentrações de conídios utilizadas foram de 10x10³, 20x10³, 30x10³, 40x10³, 50x10³ e 60x10³ conídios.mL-1, com e sem espalhante. Após a inoculação dos conídios por aspersão sobre os folíolos de soja, as plantas foram mantidas com molhamento foliar de 48 horas. Decorrido este período, as plantas permaneceram em câmara climatizada, em temperatura de 25 ºC por 15 dias. Avaliou-se a severidade, número e diâmetro de lesões. A concentração de 35.000 conídios.mL-1 com espalhante gerou intensidade de doença que possibilita a quantificação rápida e precisa da doença, podendo ser utilizada em futuros trabalhos de pesquisa

Efeito de restritores hídricos sobre a germinação, comprimento da radícula e níveis de detecção de Colletotrichum gossypii var. cephalosporioides em sementes de algodão

O fungo Colletotrichum gossypii var. cephalosporioides, agente causal da ramulose do algodoeiro, é transmitido pela semente que se constitui em uma das mais importantes fontes de inóculo inicial e de introdução da doença em áreas indenes. Para que se possa identificar sua presença em lotes de sementes, é importante que se empreguem métodos de detecção rápidos e seguros. O mais empregado é o do papel de filtro, que se baseia na avaliação de sinais do patógeno desenvolvidos sobre as sementes, seguida da sua identificação morfológica. O método apresenta a desvantagem do crescimento das plântulas no período de incubação das sementes que pode favorecer o desenvolvimento de outros fungos e prejudicar a caracterização do patógeno. Para minimizar este problema vem sendo empregada a técnica da restrição hídrica. O presente trabalho teve como objetivo avaliar o efeito de três solutos em dois potenciais osmóticos, comparados ao tratamento padrão de água destilada, ao congelamento e ao 2,4 D, sobre a germinação, comprimento da radícula e detecção do agente causal da ramulose, durante o teste de sanidade. Os solutos Manitol e NaCl foram mais eficientes em inibir a germinação e favorecer a incidência do patógeno no potencial osmótico de -0,8 MPa. O KCl mostrou-se eficiente em inibir a germinação nos dois potenciais osmóticos testados, -0,6 e -0,8 MPa, porém reduziu a incidência do patógeno no potencial de -0,8 MPa. Os solutos Manitol, nos potenciais osmóticos de -0,8 e -0,6 MPa e o NaCl no potencial osmótico de -0,8 foram eficientes em reduzir o comprimento da radícula, sem interferir negativamente nos níveis de detecção de C. gossypii var. cephalosporioides, podendo ser recomendados para uso em análises sanitárias de rotina