Deficits in emotion recognition as markers of frontal behavioral dysfunction in Amyotrophic Lateral Sclerosis

Objective: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with prominent motor symptoms. Patients with ALS may also manifest frontal behavior symptoms and cognitive decline, including impairment in facial emotion recognition. The authors aimed to investigate whether deficits in emotion recognition were associated with frontal behavior symptoms in ALS. Methods: Participants were patients with probable or definite sporadic ALS (N521; male:female ratio, 11:10; median age, 62 years; median disease duration, 3 years) and agematched and education-matched healthy control subjects (N525; male:female ratio, 14:11; median age, 61 years). The Facial Emotion Recognition Test (FERT) was administered to all participants. Patients with ALS were assessed using the Cambridge Behavior Inventory-Revised and were classified into two groups according to the presence of frontal behavioral symptoms: ALS with no behavioral symptom (ALSns; N59) and ALS with at least one behavioral symptom (ALSbs; N512). Results: Apathy and mood symptoms were the most frequent neuropsychiatric symptoms in the patient group. Patients with ALS performed worse than control subjects in the recognition of sadness (p,0.004). There were no differences between control subjects and patients in the ALSns group in all FERT scores, but the ALSbs group had lower performance than control subjects in sadness (p,0.003). Conclusions: Emotion recognition deficit may be a marker of frontal behavior in ALS

Alternative Complement Activity in the Egg Cytosol of Amphioxus Branchiostoma belcheri: Evidence for the Defense Role of Maternal Complement Components

Background: The eggs in most invertebrates are fertilized externally, and therefore their resulting embryos are exposed to an environment full of microbes, many of which are pathogens capable of killing other organisms. How the developing embryos of invertebrates defend themselves against pathogenic attacks is an intriguing question to biologists, and remains largely unknown. Methodology/Principal Findings: Here we clearly demonstrated that the egg cytosol prepared from the newly fertilized eggs of amphioxus Branchiostoma belcheri, an invertebrate chordate, was able to inhibit the growth of both the Gramnegative bacterium Vibrio anguillarum and the Gram-positive bacterium Staphylococcus aureus. All findings point to that it is the complement system operating via the alternative pathway that is attributable to the bacteriostatic activity. Conclusions/Significance: This appears to be the first report providing the evidence for the functional role of the maternal complement components in the eggs of invertebrate species, paving the way for the study of maternal immunity in other invertebrate organisms whose eggs are fertilized in vitro. It also supports the notion that the early developing embryo

Highly Anomalous Energetics of Protein Cold Denaturation Linked to Folding-Unfolding Kinetics

Despite several careful experimental analyses, it is not yet clear whether protein cold-denaturation is just a “mirror image” of heat denaturation or whether it shows unique structural and energetic features. Here we report that, for a well-characterized small protein, heat denaturation and cold denaturation show dramatically different experimental energetic patterns. Specifically, while heat denaturation is endothermic, the cold transition (studied in the folding direction) occurs with negligible heat effect, in a manner seemingly akin to a gradual, second-order-like transition. We show that this highly anomalous energetics is actually an apparent effect associated to a large folding/unfolding free energy barrier and that it ultimately reflects kinetic stability, a naturally-selected trait in many protein systems. Kinetics thus emerges as an important factor linked to differential features of cold denaturation. We speculate that kinetic stabilization against cold denaturation may play a role in cold adaptation of psychrophilic organisms. Furthermore, we suggest that folding-unfolding kinetics should be taken into account when analyzing in vitro cold-denaturation experiments, in particular those carried out in the absence of destabilizing conditions

Phytoplankton evolution during the creation of a biofloc system for shrimp culture

[EN] Microalgae play a key role in the dynamics of biofloc technology aquaculture systems. Some phytoplankton groups, such as diatoms, are desired for their high nutritional value and contribution to water quality. Other groups, such as cyanobacteria, are undesired because of their low nutritional value and capacity of producing toxins. So, monitoring the phytoplankton community structure and succession is key for managing biofloc systems. However, research on phytoplankton in these systems is scarce and mostly done by microscopy. The primary objective of this research was to estimate phytoplankton community structure in shrimp biofloc system water samples, using high-performance liquid chromatography methods and CHEMTAX software. The major groups present in our system were diatoms, euglenophytes, cyanobacteria and chlorophytes, while dinoflagellates were only remarkable at the initial period. We observed a clear dominance of diatoms all along the 5 months that comprised a complete biofloc system culture. The characteristic succession of autotrophic processes by heterotrophs of the biofloc systems, was observed by the reduction of net primary production. Light intensity played a key role in determining the phytoplankton composition and abundance. Algal pigment analyses using high-performance liquid chromatography and subsequent CHEMTAX analysis in water samples was useful for estimating the phytoplankton community structure in the biofloc systems. However, we found some limitations when the biofloc system was in heterotrophic mode. Under these conditions, some dinoflagellates and cyanobacteria behaved as heterotrophs and lost or decreased their biomarkers pigments. So, further research is needed to increase knowledge on the accuracy of high-performance liquid chromatography /CHEMTAX under these conditions.Financial support for this research was provided by Conselleria d’Educació, Investigació, Cultura i Esport of the Generalitat Valenciana, through the program VALi+D, fle number ACIF/2014/244. We would like to express our deepest thanks to Professor Luis Henrique da Silva Poersch of FURG (Universidade Federal do Rio Grande) and Ivan Vidal (Langostinos el Real) for his support. Finally, the authors wish to thank Le Gouessant and Michaël Metz for providing the commercial feed.Llario-Sempere, F.; Rodilla, M.; Escrivá-Perales, J.; Falco, S.; Sebastiá-Frasquet, M. (2018). Phytoplankton evolution during the creation of a biofloc system for shrimp culture. International Journal of Environmental Science and Technology. 1-12. https://doi.org/10.1007/s13762-018-1655-5S112Ahmed A, Kurian S, Gauns M, Chndrasekhararao AV, Mulla A, Naik B, Naik H, Naqvi SWA (2016) Spatial variability in phytoplankton community structure along the eastern Arabian Sea during the onset of south-west monsoon. Cont Shelf Res 119:30–39. https://doi.org/10.1016/j.csr.2016.03.005Avnimelech Y (1999) Carbon/nitrogen ratio as a control element in aquaculture systems. Aquaculture 176:227–235. https://doi.org/10.1016/S0044-8486(99)00085-XAvnimelech Y (2007) Feeding with microbial flocs by tilapia in minimal discharge bio-flocs technology ponds. Aquaculture 264:140–147. https://doi.org/10.1016/j.aquaculture.2006.11.025Avnimelech Y (2009) Biofloc technology. A practical guide book. The World Aquaculture Society, Baton RougeAzim ME, Little DC (2008) The biofloc technology (BFT) in indoor tanks: water quality, biofloc composition, and growth and welfare of Nile tilapia (Oreochromis niloticus). Aquaculture 283:29–35. https://doi.org/10.1016/j.aquaculture.2008.06.036Ballester ELC, Abreu PC, Cavalli RO, Emerenciano M, de Abreu L, Wasielesky WJ (2010) Effect of practical diets with different protein levels on the performance of Farfantepenaeus paulensis juveniles nursed in a zero exchange suspended microbial flocs intensive system. Aquac Nutr 16:163–172. https://doi.org/10.1111/j.1365-2095.2009.00648.xBaloi M, Arantes R, Schveitzer R, Magnotti C, Vinatea L (2013) Performance of Pacific white shrimp Litopenaeus vannamei raised in biofloc systems with varying levels of light exposure. Aquac Eng 52:39–44. https://doi.org/10.1016/j.aquaeng.2012.07.003Baumgarten MGZ, Wallner-Kersanach M, Niencheski LFH (2010) Manual de análises em oceanografia química. Furg, Rio GrandeBecerra-Dórame MJ, Martínez-Córdova LR, Martínez-Porchas M, Lopez-Elías JA (2011) Evaluation of autotrophic and heterotrophic microcosm- based systems on the production response of Litopenaeus vannamei intensively nursed without Artemia and with zero water exchange. Isr J Aquac Bamidgeh 63:7Brito LO, dos Santos IGS, de Abreu JL, de Araújo MT, Severi W, Gàlvez AO (2016) Effect of the addition of diatoms (Navicula spp.) and rotifers (Brachionus plicatilis) on water quality and growth of the Litopenaeus vannamei postlarvae reared in a biofloc system. Aquac Res 47:3990–3997. https://doi.org/10.1111/are.12849Campa-Córdova AI, Núñez-Vázquez EJ, Luna-González A, Romero-Geraldo MJ, Ascencio F (2009) Superoxide dismutase activity in juvenile Litopenaeus vannamei and Nodipecten subnodosus exposed to the toxic dinoflagellate Prorocentrum lima. Comp Biochem Physiol C Toxicol Pharmacol 149:317–322. https://doi.org/10.1016/j.cbpc.2008.08.006Casé M, Leça EE, Leitão SN, SantAnna EE, Schwamborn R, de Moraes Junior AT (2008) Plankton community as an indicator of water quality in tropical shrimp culture ponds. Mar Pollut Bull 56:1343–1352. https://doi.org/10.1016/j.marpolbul.2008.02.008Chen YC (2001) Immobilized microalga Scenedesmus quadricauda (Chlorophyta, Chlorococcales) for long-term storage and for application for water quality control in fish culture. Aquaculture 195:71–80. https://doi.org/10.1016/S0044-8486(00)00540-8Correia ES, Wilkenfeld JS, Morris TC, Wei L, Prangnell DI, Samocha TM (2014) Intensive nursery production of the Pacific white shrimp Litopenaeus vannamei using two commercial feeds with high and low protein content in a biofloc-dominated system. Aquac Eng 59:48–54. https://doi.org/10.1016/j.aquaeng.2014.02.002Duarte CM, Marrasé C, Vaqué D, Estrada M (1990) Counting error and the quantitative analysis of phytoplankton communities. J Plankton Res 12:295–304. https://doi.org/10.1093/plankt/12.2.295Ebeling J, Timmons M, Bisogni J (2006) Engineering analysis of the stoichiometry of photoautotrophic, autotrophic, and heterotrophic removal of ammonia–nitrogen in aquaculture systems. Aquaculture 257:346–358. https://doi.org/10.1016/j.aquaculture.2006.03.019El-Dahhar AA, Salama M, Elebiary EH (2015) Effect of energy to protein ratio in biofloc technology on water quality, survival and growth of mullet (Mugil cephalus). J Arab Aquac Soc 10:15–32. https://doi.org/10.12816/0026633Emerenciano MGC, Martínez-Córdova LR, Martínez-Porchas M, Miranda-Baeza A (2017) Biofloc technology (BFT): a tool for water quality management. In: Tutu H (ed) water quality. InTech, Rijeka. https://doi.org/10.5772/66416Figueroa F, Niell F, Figueiras F, Villarino M (1998) Diel migration of phytoplankton and spectral light field in the Ria de Vigo (NW Spain). Mar Biol 130:491–499Gaona CAP, Poersch LH, Krummenauer D, Foes GK, Wasielesky WJ (2011) The effect of solids removal on water quality, growth and survival of Litopenaeus vannamei in a biofloc technology culture system. Int J Recirc Aquac. https://doi.org/10.21061/ijra.v12i1.1354Garrido JL, Airs RL, Rodríguez F, Van Heukelem L, Zapata M (2011) New HPLC separation techniques. In: Roy S, Llewellyn CA, Egeland ES, Johnsen G (eds) Phytoplankton pigments: characterization, chemotaxonomy, and applications in oceanography. University Press, Cambridge, pp 165–194Ge H, Li J, Chang Z, Chen P, Shen M, Zhao F (2016) Effect of microalgae with semicontinuous harvesting on water quality and zootechnical performance of white shrimp reared in the zero water exchange system. Aquac Eng 72–73:70–76. https://doi.org/10.1016/j.aquaeng.2016.04.006Godoy LC, Odebrecht C, Ballester E, Martins TG, Wasielesky WJ (2012) Effect of diatom supplementation during the nursery rearing of Litopenaeus vannamei (Boone, 1931) in a heterotrophic culture system. Aquac Int 20:559–569. https://doi.org/10.1007/s10499-011-9485-1Grasshoff K (1976) Methods of seawater analysis. Verlag Chemie: Weinstei, New YorkGreen BW, Schrader KK, Perschbacher PW (2014) Effect of stocking biomass on solids, phytoplankton communities, common off-flavors, and production parameters in a channel catfish biofloc technology production system. Aquac Res 45:1442–1458. https://doi.org/10.1111/are.12096Gris B, Sforza E, Morosinotto T, Bertucco A, La Rocca N (2017) Influence of light and temperature on growth and high-value molecules productivity from Cyanobacterium aponinum. J Appl Phycol 29:1781–1790. https://doi.org/10.1007/s10811-017-1133-3Higgins HW, Wright SW, Schlüter L (2011) Quantitative interpretation of chemotaxonomic pigment data. In: Roy S, Llewellyn CA, Egeland ES, Johnsen G (eds) Phytoplankton pigments: characterization, chemotaxonomy, and applications in oceanography. Cambridge University Press, Cambridge, pp 257–313Hooker S, Firestone E, Claustre H, Ras J (2001) The first SeaWiFS HPLC analysis round-robin experiment (SeaHARRE-1). https://ntrs.nasa.gov/search.jsp?R=20010072242 . Accessed 19 July 2017Horabun T (1997) Relationships between water quality and phytoplankton in the Bangpakong river. http://agris.fao.org/agris-search/search.do?recordID=TH2000001898 . Accessed 19 July 2017Ismael AA (2003) Succession of heterotrophic and mixotrophic dinoflagellates as well as autotrophic microplankton in the harbour of Alexandria, Egypt. J Plankton Res 25:193–202. https://doi.org/10.1093/plankt/25.2.193Jeffrey SW, Sielicki M, Haxo FT (1975) Chloroplast pigment patterns in dinoflagellates. J Phycol 11:374–384. https://doi.org/10.1111/j.1529-8817.1975.tb02799.xJeong HJ, Yoo YD, Kim JS, Seong KA, Kang NS, Kim TH (2010) Growth, feeding and ecological roles of the mixotrophic and heterotrophic dinoflagellates in marine planktonic food webs. Ocean Sci J 45:65–91. https://doi.org/10.1007/s12601-010-0007-2Jory DE, Cabrera TR, Dugger DM, Fegan D, Lee PG, Lawrence L, Jackson C, Mcintosh R, Castañeda J, International B, Park H, Hwy N, Pierce F (2001) A global review of shrimp feed management: status and perspectives. Aquaculture 318:104–152Ju ZY, Forster I, Conquest L, Dominy W, Kuo WC, Horgen FD (2008) Determination of microbial community structures of shrimp floc cultures by biomarkers and analysis of floc amino acid profiles. Aquac Res 39:118–133. https://doi.org/10.1111/j.1365-2109.2007.01856.xKingston MB (1999) Effect of light on vertical migration and photosynthesis of Euglena proxima (euglenophyta). J Phycol 35:245–253. https://doi.org/10.1046/j.1529-8817.1999.3520245.xLatasa M, Scharek R, Vidal M, Vila-Reixach G (2010) Preferences of phytoplankton groups for waters of different trophic status in the northwestern Mediterranean Sea. Mar Ecol Prog Ser 40:27–42. https://doi.org/10.3354/meps08559Li Y, Swift E, Buskey EJ (1996) Photoinhibition of mechanically stimulable bioluminescence in the heterotrophic dinoflagellate Protoperidinium depressum (pyrrophyta). J Phycol 32:974–982. https://doi.org/10.1111/j.0022-3646.1996.00974.xLi A, Stoecker D, Adolf J (1999) Feeding, pigmentation, photosynthesis and growth of the mixotrophic dinoflagellate Gyrodinium galatheanum. Aquat Microb Ecol 19:163–176. https://doi.org/10.3354/ame019163Lin YC, Chen JC (2001) Acute toxicity of ammonia on Litopenaeus vannamei (Boone) juveniles at different salinity levels. J Exp Mar Biol Ecol 259:109–119. https://doi.org/10.1016/S0022-0981(01)00227-1Lin YC, Chen JC (2003) Acute toxicity of nitrite on Litopenaeus vannamei (Boone) juveniles at different salinity levels. Aquaculture 224:93–201. https://doi.org/10.1016/S0044-8486(03)00220-5Lohscheider JN, Strittmatter M, Küpper H, Adamska I, Heaney S, Cunningham C (2011) Vertical distribution of epibenthic freshwater cyanobacterial Synechococcus spp. Strains depends on their ability for photoprotection. PLoS ONE. https://doi.org/10.1371/journal.pone.0020134Lukwambe B, Qiuqian L, Wu J, Zhang D, Wang K, Zheng Z (2015) The effects of commercial microbial agents (probiotics) on phytoplankton community structure in intensive white shrimp (Litopenaeus vannamei) aquaculture ponds. Aquac Int 23:1443–1455. https://doi.org/10.1007/s10499-015-9895-6Mackey MD, Mackey DJ, Higgins HW, Wright SW (1996) CHEMTAX—a program for estimating class abundances from chemical markers: application to HPLC measurements of phytoplankton. Mar Ecol Prog Ser 144:265–283Maicá PF, de Borba MR, Wasielesky WJ (2012) Effect of low salinity on microbial floc composition and performance of Litopenaeus vannamei (Boone) juveniles reared in a zero-water-exchange super-intensive system. Aquac Res 43:361–370. https://doi.org/10.1111/j.1365-2109.2011.02838.xManan H, Moh JHZ, Kasan NA, Suratman S, Ikhwanuddin M (2016) Identification of biofloc microscopic composition as the natural bioremediation in zero water exchange of Pacific white shrimp, Penaeus vannamei, culture in closed hatchery system. Appl Water Sci. https://doi.org/10.1007/s13201-016-0421-4Marinho YF, Brito LO, Campos S, Severi W, Andrade HA, Galvez AO (2016) Effect of the addition of Chaetoceros calcitrans, Navicula sp. and Phaeodactylum tricornutum (diatoms) on phytoplankton composition and growth of Litopenaeus vannamei (Boone) postlarvae reared in a biofloc system. Aquac Res 48:4155–4164. https://doi.org/10.1111/are.13235Martins TG, Odebrecht C, Jensen LV, D’Oca MG, Wasielesky WJ (2016) The contribution of diatoms to bioflocs lipid content and the performance of juvenile Litopenaeus vannamei (Boone, 1931) in a BFT culture system. Aquac Res 47:1315–1326. https://doi.org/10.1111/are.12592Murphy J, Riley JP (1962) A modified single solution method for the determination of phosphate in natural waters. Anal Chim Acta 27:31–36. https://doi.org/10.1016/S0003-2670(00)88444-5Natrah FMI, Bossier P, Sorgeloos P, Yusoff FM, Defoirdt T (2014) Significance of microalgal-bacterial interactions for aquaculture. Rev Aquac 6:48–61. https://doi.org/10.1111/raq.12024Niemi G, Wardrop D, Brooks R, Anderson S, Brady V, Paerl H, Rakocinski C, Brouwer M, Levinson B, McDonald M (2004) Rationale for a new generation of indicators for coastal waters. Environ Health Perspect 112:979–986. https://doi.org/10.1289/ehp.6903Paerl H, Tucker C (1995) Ecology of blue-green algae in aquaculture ponds. J World Aquac 26:109–131. https://doi.org/10.1111/j.1749-7345.1995.tb00235.xPérez-Linares J, Ochoa JL, GagoMartínez A (2008) Effect of PSP toxins in white leg shrimp Litopenaeus vannamei Boone, 1931. J Food Sci 73:T69–T73. https://doi.org/10.1111/j.1750-3841.2008.00710.xPérez-Morales A, Band-Schmidt CJ, Martínez-Díaz SF (2017) Mortality on zoea stage of the Pacific white shrimp Litopenaeus vannamei caused by Cochlodinium polykrikoides (Dinophyceae) and Chattonella spp. (Raphidophyceae). Mar Biol 164:57. https://doi.org/10.1007/s00227-017-3083-3Ray AJ, Dillon KS, Lotz JM (2011) Water quality dynamics and shrimp (Litopenaeus vannamei) production in intensive, mesohaline culture systems with two levels of biofloc management. Aquac Eng 45:127–136. https://doi.org/10.1016/j.aquaeng.2011.09.001Schlüter L, Lauridsen T, Krogh G (2006) Identification and quantification of phytoplankton groups in lakes using new pigment ratios–a comparison between pigment analysis by HPLC and microscopy. Freshwater 51:1474–1485. https://doi.org/10.1111/j.1365-2427.2006.01582.x/fullSchlüter L, Behl S, Striebel M, Stibor H (2016) Comparing microscopic counts and pigment analyses in 46 phytoplankton communities from lakes of different trophic state. Freshw Biol 61:1627–1639. https://doi.org/10.1111/fwb.12803Schrader KK, Green BW, Perschbacher PW (2011) Development of phytoplankton communities and common off-flavors in a biofloc technology system used for the culture of channel catfish (Ictalurus punctatus). Aquac Eng 45:118–126. https://doi.org/10.1016/j.aquaeng.2011.08.004Sebastiá M, Rodilla M (2013) Nutrient and phytoplankton analysis of a Mediterranean Coastal area. Environ Manage 51:225–240. https://doi.org/10.1007/s00267-012-9986-3Sebastiá M, Rodilla M, Sanchis J, Altur V (2012) Influence of nutrient inputs from a wetland dominated by agriculture on the phytoplankton community in a shallow harbour at the Spanish Mediterranean coast. Agric Ecosyst Environ 152:10–20. https://doi.org/10.1016/j.agee.2012.02.006Seoane S, Garmendia M, Revilla M, Borja Á, Franco J, Orive E, Valencia V (2011) Phytoplankton pigments and epifluorescence microscopy as tools for ecological status assessment in coastal and estuarine waters, within the Water Framework. Mar Pollut 62:1484–1497. https://doi.org/10.1016/j.marpolbul.2011.04.010Sinden A, Sinang SC (2016) Cyanobacteria in aquaculture systems: linking the occurrence, abundance and toxicity with rising temperatures. Int J Environ Sci Technol 13:2855–2862. https://doi.org/10.1007/s13762-016-1112-2Sospedra J, Niencheski LFH, Falco S, Andrade CF, Attisano KK, Rodilla M (2017) Identifying the main sources of silicate in coastal waters of the Southern Gulf of Valencia (Western Mediterranean Sea). Oceanologia. https://doi.org/10.1016/j.oceano.2017.07.004Strickland J (1960) Measuring the production of marine phytoplankton. Bull Fish Res Bd Canada 122:172Ter Braak CJF (1994) Canonical community ordination. Part I: basic theory and linear methods. Écoscience 1:127–140. https://doi.org/10.1080/11956860.1994.11682237Ter Braak C, Smilauer P (2002) CANOCO reference manual and CanoDraw for Windows user’s guide: software for canonical community ordination (version 4.5). http://library.wur.nl/WebQuery/wurpubs/wever/341885 . Accessed 19 July 2017Utermohl M (1985) Zur Vervollkommnung der quantitative Phytoplankton-Methodik. Limnologie 9:1–38Van Wyk P, Scarpa J (1999) Water quality requirements and management. In: Institution Harbor Branch Oceanographic (ed) Farming marine shrimp in recirculating freshwater systems. Florida Department of Agriculture and Consumer Services, Florida, pp 128–138Vinatea L, Gálvez AO, Browdy CL, Stokes A, Venero J, Haveman J, Lewis BL, Lawson A, Shuler A, Leffler JW (2010) Photosynthesis, water respiration and growth performance of Litopenaeus vannamei in a super-intensive raceway culture with zero water exchange: interaction of water quality variables. Aquac Eng 42:17–24. https://doi.org/10.1016/j.aquaeng.2009.09.001Wright S, Jeffrey S, Mantoura R (1991) Improved HPLC method for the analysis of chlorophylls and carotenoids from marine phytoplankton. Mar Ecol Prog Ser 77:186–196Yu H, Jia S, Dai Y (2009) Growth characteristics of the cyanobacterium Nostoc flagelliforme in photoautotrophic, mixotrophic and heterotrophic cultivation. J Appl Phycol 21:127–133. https://doi.org/10.1007/s10811-008-9341-5Yusoff FM, Zubaidah MS, Matias HB, Kwan TS (2002) Phytoplankton succession in intensive marine shrimp culture ponds treated with a commercial bacterial product. Aquac Res 33:269–278. https://doi.org/10.1046/j.1355-557x.2002.00671.

More Evidence that Depressive Symptoms Predict Mortality in COPD Patients: Is Type D Personality an Alternative Explanation?

The present study attempted to replicate our previous finding that depressive symptoms are a risk factor for mortality in stable chronic obstructive pulmonary disease (COPD), but in a different population with a different measure of depressive symptoms. We further investigated whether type D personality is associated with mortality in patients with COPD and whether it explains any relationship observed between depressive symptoms and mortality. In 122 COPD patients, mean age 60.8 +/- 10.3 years, 52% female, and mean forced expiratory volume in 1 s (FEV(1)) 41.1 +/- 17.6%pred, we assessed body mass index, post bronchodilator FEV(1), exercise capacity, depressive symptoms with the Hospital Anxiety and Depression Scale, and type D with the Type D Scale. In the 7 years follow-up, 48 (39%) deaths occurred. The median survival time was 5.3 years. Depressive symptoms (hazard ratio = 1.07, 95% confidence intervals = 1.00-1.14) were an independent risk factor for mortality. Type D was not associated with mortality. We can rule out type D as an explanation for the relationship between depressive symptoms and mortality observed in this sample. However, ambiguity remains as to the interpretation of the value of depressive symptoms in predicting death