Changes in plasma levels of B-type natriuretic peptide with acute exacerbations of chronic obstructive pulmonary disease.

Background: Elevated plasma B-type natriuretic peptide (BNP) levels and their association with heart failure have been reported in subjects with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Purpose: To examine and compare plasma BNP levels and diastolic and systolic dysfunction in subjects with AECOPD and s table chronic obstructive pulmonary disease (COPD). Methods: In all,87 unselected consecutive hospitalizations due to AECOPD in 61 subjects and a total of 190 consecutive subjects with stable COPD were recruited. Plasma BNP levels were compared cross-sectionally and longitudinally. Transthoracic echocardiographic examinations were also performed in the hospitalized subjects. Results: In the hospitalized subjects, the median plasma BNP level (interquartile range) was 55.4 (26.9–129.3) pg/mL and was higher than that of patients with stable COPD: 18.3 (10.0–45.3)for Global Initiative for Chronic Obstructive Lung Disease grade I; 25.8 (11.0–53.7) for grade II; 22.1 (9.1–52.6) for grade III; and 17.2 (9.6–22.9) pg/mL for grade IV, all P,0.001. In 15 subjects studied prospectively, the median plasma BNP level was 19.4 (9.8–32.2) pg/mL before AECOPD, 72.7 (27.7–146.3) pg/mL during AECOPD, and 14.6 (12.9–39.0) pg/mL after AECOPD (P,0.0033 and P,0.0013, respectively). Median plasma BNP levels during AECOPD were significantly higher in ten unsuccessfully discharged subjects 260.5 (59.4–555.0) than in 48 successfully discharged subjects 48.5(24.2–104.0) pg/mL (P=0.0066). Only 5.6% of AECOPD subjects were associated with systolic dysfunction defined as a left ventricular ejection fraction (LVEF),50%; a further 7.4% were considered to have impaired relaxation defined as an E/A wave velocity ratio,0.8 and a deceleration time of E.240 ms. BNP levels were weakly correlated with the E/peak early diastolic velocity of the mitral annulus (Ea) ratio (Spearman’s rank correlation coefficient =0.353,P =0.018), but they were not correlated with the LVEF (Spearman’s rank correlation coefficient =−0.221,P = 0.108). Conclusion: A modest elevation of plasma BNP is observed during AECOPD. It appears that AECOPD may have an impact on plasma BNP levels that is not attributable to heart failure

Aptitude of Groundwaters for Irrigation in Katiola Area

The increasing pressures of agricultural development surfaces on water resources availability of Katiola area obliged farmers to the use groundwater for food crops irrigation. However, groundwater used for irrigation makes an impact on soil quality. The aim of this study is to estimate the capability of Katiola area ground waters to irrigate food crops by using an approach based on Sodium Absorption Ratio (SAR) and Permeability Index (PI). The results show that most of the groundwater samples (67%) in the study area are suitable for irrigation, except few points located in south-east

Caractérisation hydrochimique des aquifères fissurés de la région de San- Pedro (Sud-Ouest de la Côte d’Ivoire)

La région de San-Pedro est située dans le Sud-Ouest de la Côte d’Ivoire. Son substratum est constitué de roches cristallines et métamorphiques fracturées. L’objectif de la présente étude est de mieux connaître lespropriétés hydrochimiques et les mécanismes d’acquisition de la minéralisation des eaux souterraines de la région de San-Pedro. La base de données comporte les données des analyses physico-chimiques des eaux souterraines des aquifères fissurés et des fiches techniques des forages. L’approche hydrochimique et l’Analyse en Composantes Principales Normées ont été utilisées pour le traitement de ces données. Les résultats de cette étude montrent que les eaux souterraines de San-Pedro sont caractérisées par une faible minéralisation. Elles se subdivisent en deux principaux hydrofaciès : les eaux bicarbonatées et les eaux chlorurées. D’après le système calco-carbonique, on distingue trois familles d’eau dans la zone d’étude en fonction des indices de saturation vis-à-vis des carbonates : les eaux à circulation très lente, les eaux à circulation lente et les eaux à circulation rapide. L’ACPN a permis de mettre en évidence trois phénomènes principaux gouvernant la minéralisation des eaux souterraines : le temps de séjour de l’eau dans la roche aquifère, les apports superficiels et l’hydrolyse acide. Les eaux souterraines de la région de San-Pedro sont potables pour la consommation des populations humaines d’une manière générale. Ces résultats concourent à une meilleure connaissance des propriétés hydrochimiques des ressources en eaux souterraines du socle cristallin de Côte d’Ivoire

Aptitude of Groundwaters for Irrigation in Katiola Area

The increasing pressures of agricultural development surfaces on water resources availability of Katiola area obliged farmers to the use groundwater for food crops irrigation. However, groundwater used for irrigation makes an impact on soil quality. The aim of this study is to estimate the capability of Katiola area ground waters to irrigate food crops by using an approach based on Sodium Absorption Ratio (SAR) and Permeability Index (PI). The results show that most of the groundwater samples (67%) in the study area are suitable for irrigation, except few points located in south-east

Development of a Communication Tool between Patients and Physicians for Recognizing COPD Exacerbations in Japan.

In Japan, exacerbations are underreported compared with other countries, possibly due in part to a failure to recognize them. This study aimed to create a simple chronic obstructive pulmonary disease (COPD) Exacerbation Recognition Tool (CERT-J) specifically for Japanese patients. Patients ≥40 years with confirmed COPD or asthma-COPD overlap were included. Focus groups were held to identify words and phrases used by patients to describe symptoms associated with an exacerbation, resulting in candidate items being identified. Following cognitive debriefing, the items were refined based on item frequency, level of endorsement and effect of demographic factors. Exploratory factor analysis (EFA) was then performed to inform an expert panel's choice of items to form the new tool. A total of 41 patients were included in the focus groups and nine patients performed the cognitive debrief. Following this, the expert panel identified 26 items for testing in a further 100 patients (mean age 72 years, forced expiratory volume in 1 s 54.8% predicted and 1.8 exacerbations in the preceding 12 months). Eleven items were associated with breathlessness or activity limitation and seven of these were the most frequently endorsed. EFA identified four factors, with one (breathlessness) being dominant. The expert panel recommended that the CERT-J should include six items: breathlessness and activity limitation (3 items), cough (1 item) and phlegm (2 items). The final CERT-J should benefit patients with COPD by providing them with an increased understanding and recognition of exacerbations.Clinical Trial Registration: GSK K.K (jRCT1080224526)

Airflow limitation or static hyperinflation: which is more closely related to dyspnea with activities of daily living in patients with COPD?

<p>Abstract</p> <p>Background</p> <p>Dyspnea while performing the activities of daily living has been suggested to be a better measurement than peak dyspnea during exercise. Furthermore, the inspiratory capacity (IC) has been shown to be more closely related to exercise tolerance and dyspnea than the FEV₁, because dynamic hyperinflation is the main cause of shortness of breath in patients with COPD. However, breathlessness during exercise is measured in most studies to evaluate this relationship.</p> <p>Purpose</p> <p>To evaluate the correlation between breathlessness during daily activities and airflow limitation or static hyperinflation in COPD.</p> <p>Methods</p> <p>We examined 167 consecutive outpatients with stable COPD. The Baseline Dyspnea Index (BDI) was used to evaluate dyspnea with activities of daily living. The relationship between the BDI score and the clinical measurements of pulmonary function was then investigated.</p> <p>Results</p> <p>The Spearman rank correlation coefficients (Rs) between the BDI score and the FEV₁(L), FEV₁(%pred) and FEV₁/FVC were 0.60, 0.56 and 0.56, respectively. On the other hand, the BDI score also correlated with the IC, IC/predicted total lung capacity (TLC) and IC/TLC (Rs = 0.45, 0.46 and 0.47, respectively). Although all of the relationships studied were strongly correlated, the correlation coefficients were better between dyspnea and airflow limitation than between dyspnea and static hyperinflation. In stepwise multiple regression analyses, the BDI score was most significantly explained by the FEV₁(R²= 26.2%) and the diffusion capacity for carbon monoxide (R²= 14.4%) (Cumulative R²= 40.6%). Static hyperinflation was not a significant factor for clinical dyspnea on the stepwise multiple regression analysis.</p> <p>Conclusion</p> <p>Both static hyperinflation and airflow limitation contributed greatly to dyspnea in COPD patients.</p

Degree of egg-taking by humans determines the fate of maleo (Macrocephalon maleo) nesting grounds across Sulawesi

The version of record of this article, first published in Biodiversity and Conservation, is available online at Publisher’s website: http://dx.doi.org/10.1007/s10531-022-02527-1The maleo (Macrocephalon maleo) of Sulawesi, Indonesia, is culturally iconic and Critically Endangered, but the causes of its decline have never been systematically analyzed nor its nesting grounds comprehensively surveyed. We visited 122 previously known and 58 previously unrecorded sites, collecting data and interviewing local people at each site. We used ordinal logistic regression to fit models with combinations of 18 different predation, habitat, and nesting ground variables to determine the strongest predictors of nesting ground success, as represented by maleo numbers. At least 56% of known nesting grounds are now inactive (abandoned), and 63% of remaining active sites host ≤ 2 pairs/day at peak season. Egg-taking by humans is the single biggest driver of maleo decline. Protecting eggs in situ predicts higher numbers than protecting eggs through hatchery methods. After egg-taking, quality (not length) of the travel corridor connecting nesting ground to primary forest best predicts nesting ground success. Being inside a federally protected area is not a primary driver of success, and does not ensure persistence: 28% of federally protected nesting grounds have become inactive. Local conservation efforts protected nesting grounds 2‒3 times better than federal protection. We update the methodology for assessing nesting ground status, and recommend five measures for maleo conservation, the foremost being to protect nesting grounds from egg-taking by humans at all remaining active sites

Relationship between peripheral airway function and patient-reported outcomes in COPD: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Health status, dyspnea and psychological status are important clinical outcomes in chronic obstructive pulmonary disease (COPD). However, forced expiratory volume in one second (FEV₁) measured by spirometry, the standard measurement of airflow limitation, has only a weak relationship with these outcomes in COPD. Recently, in addition to spirometry, impulse oscillometry (IOS) measuring lung resistance (R) and reactance (X) is increasingly being used to assess pulmonary functional impairment.</p> <p>Methods</p> <p>We aimed to identify relationships between IOS measurements and patient-reported outcomes in 65 outpatients with stable COPD. We performed pulmonary function testing, IOS, high-resolution computed tomography (CT), and assessment of health status using the St. George's Respiratory Questionnaire (SGRQ), dyspnea using the Medical Research Council (MRC) scale and psychological status using the Hospital Anxiety and Depression Scale (HADS). We then investigated the relationships between these parameters. For the IOS measurements, we used lung resistance at 5 and 20 Hz (R5 and R20, respectively) and reactance at 5 Hz (X5). Because R5 and R20 are regarded as reflecting total and proximal airway resistance, respectively, the fall in resistance from R5 to R20 (R5-R20) was used as a surrogate for the resistance of peripheral airways. X5 was also considered to represent peripheral airway abnormalities.</p> <p>Results</p> <p>R5-R20 and X5 were significantly correlated with the SGRQ and the MRC. These correlation coefficients were greater than when using other objective measurements of pulmonary function, R20 on the IOS and CT instead of R5-R20 and X5. Multiple regression analyses showed that R5-R20 or X5 most significantly accounted for the SGRQ and MRC scores.</p> <p>Conclusions</p> <p>IOS measurements, especially indices of peripheral airway function, are significantly correlated with health status and dyspnea in patients with COPD. Therefore, in addition to its simplicity and non-invasiveness, IOS may be a useful clinical tool not only for detecting pulmonary functional impairment, but also to some extent at least estimating the patient's quality of daily life and well-being.</p