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Tropical oceans are among the first places to exhibit climate change signals, affecting the habitat distribution and abundance of marine fish. These changes to stocks, and subsequent impacts on fisheries production, may have considerable implications for coastal communities dependent on fisheries for food security and livelihoods. Understanding the impacts of climate change on tropical marine fisheries is therefore an important step towards developing sustainable, climate-ready fisheries management measures. We apply an established method of spatial meta-analysis to assess species distribution modelling datasets for key species targeted by the Philippines capture fisheries. We analysed datasets under two global emissions scenarios (RCP4.5 and RCP8.5) and varying degrees of fishing pressure to quantify potential climate vulnerability of the target community. We found widespread responses to climate change in pelagic species in particular, with abundances projected to decline across much of the case study area, highlighting the challenges of maintaining food security in the face of a rapidly changing climate. We argue that sustainable fisheries management in the Philippines in the face of climate change can only be achieved through management strategies that allow for the mitigation of, and adaptation to, pressures already locked into the climate system for the near term. Our analysis may support this, providing fisheries managers with the means to identify potential climate change hotspots, bright spots and refugia, thereby supporting the development of climate-ready management plans.
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Ecosistema , Explotaciones Pesqueras , Animales , Océanos y Mares , Cambio Climático , Caza , PecesRESUMEN
High-quality care for older people is best delivered by multidisciplinary teams involving a range of professions. Similarly, if research evidence is to effectively inform practice, it needs to be designed and executed by teams that are both multidisciplinary and multiprofessional. Here, we summarise the discussions from a 1-day workshop convened by the National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre in Spring 2021, which focussed on multidisciplinary academic teams. Barriers to success include small numbers of clinical academic researchers across all professions focussing on older people, and lack of career pathways, role models and support for non-medical clinical researchers. The workshop identified strengths in the tradition of multidisciplinary working in the care of older people, research questions that lend themselves naturally to multidisciplinary working, increasing interest from funders in multidisciplinary research, and untapped opportunities for greater commercial engagement. Initiatives to improve engagement of students and trainees, mentorship, career pathways, networking across research centres and possibly developing a national School of Older People's Care Research are all ways that we can ensure the growth of multidisciplinary research to best serve older people's health and social care in the future.
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Investigación Biomédica , Geriatría , Humanos , Anciano , Calidad de la Atención de Salud , Grupo de Atención al PacienteRESUMEN
OBJECTIVES: To assess basement membrane remodelling in systemic lupus erythematosus (SLE) by studying serum levels of type IV collagen (C4M) and laminin (LG1M) fragments and their association with disease profile. METHODS: One hundred and six SLE patients without and 20 with previous cardiovascular events were included. One hundred and twenty male and female blood donors served as controls. Disease activity score (SLEDAI-2K) and cumulated damage index (SLICC-DI) were calculated. Coronary artery calcification (CAC) was studied by CT scan. Carotid intima-media thickness (IMT) was measured by ultrasound. C4M and LG1M were quantified by ELISAs. RESULTS: Serum levels of LG1M and C4M were significantly increased in the entire SLE cohort, median (IQR) 15.8 (26.16) ng/ml vs. 5.5 (5.8) ng/ml (±9.4), p<0.0001 and 31.3 (20.0) vs. 21.6 (9.2) ng/ml, p<0.0001. C4M and LG1M were mutually interrelated in patients and controls, r=0.44 (p<0.0001) and r=0.42 (p<0.0001). LG1M was significantly higher in patients with previous cardiovascular events (CVE), 27.2 (30.8) vs. 14.1 (21.4) p<0.03, while C4M did not differ between these subsets. LG1M, but not C4M, was borderline higher in anti-phospholipid antibody-positive patients vs. negatives (p=0.08). There was a weak correlation between LG1M and SLICC-DI, r=0.22 (p=0.01), but no associations between these markers and criterial lupus manifestations or asymptomatic atherosclerosis. CONCLUSIONS: These findings indicate that remodelling of collagen type IV and laminin is increased in SLE unrelated to disease activity, presumably reflecting clinically silent disease progression. The selective association of increased LG1M and cardiovascular events may represent a distinctive aspect of SLE-related vessel wall repair.
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Aterosclerosis , Lupus Eritematoso Sistémico , Humanos , Masculino , Femenino , Colágeno Tipo IV , Membrana Basal , Laminina , Grosor Intima-Media Carotídeo , Aterosclerosis/diagnóstico por imagen , Lupus Eritematoso Sistémico/complicaciones , Factores de RiesgoRESUMEN
Climate change will expose the food-producing sector to a range of challenges. Inland aquaculture farms are particularly vulnerable, due to the difficulty in changing their location, and therefore require specific tools to predict the influence of direct and indirect effects on production, environment and economic feasibility. The objective of our study was to apply a simple set of models to produce a set of growth, risk and suitability maps for stakeholders within the common carp sector in Poland, to assist decision-making under two different scenarios of climate change: a moderate situation (RCP 4.5) and an extreme situation (RCP 8.5). We used present (2000-2019) and future projections (2080-2099) for water surface temperature based on land surface temperature data from regionally downscaled climate models to draw maps to: (i) show optimal temperature conditions for carp growth, (ii) assess risk of disease outbreak caused by three important common carp pathogens: Cyprinid herpesvirus 3 (CyHV-3), carp oedema virus (CEV) and spring viremia of carp (SVCV) and (iii) predict potential suitability changes of carp farming in Poland. The study identified areas with the most and least favourable temperature conditions for carp growth, as well as those areas with the highest/lowest number of days with suitable temperatures for virus infection. These suitability maps showed the combined effect of direct and indirect effects of climate change projections under RCP 8.5 and RCP 4.5 scenarios. The approach applied herein will be of use worldwide for analysing the risks of temperature increase to land-based aquaculture, and the results presented are important for carp farmers in Poland and elsewhere, industry in general, and government stakeholders, to understand the direct and indirect effects of climate change on the triple bottom line of people, planet, and profit.
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Carpas , Enfermedades de los Peces , Animales , Acuicultura , Enfermedades de los Peces/epidemiología , Humanos , Temperatura , AguaRESUMEN
INTRODUCTION: Physical activity is acknowledged as an important factor for enhancing health, and the WHO recommends performing physical activity weekly. The aim of this study was to describe self-reported physical activity in a population of patients with systemic lupus erythematosus. METHODS: The patients were enrolled at outpatient consultations where patient and disease characteristics such as age, gender, disease damage (SLICC/ACR-DI), disease activity (SLEDAI-2K) and medication were registered. Self-reported physical activity was evaluated using the International Physical Activity Questionnaire (IPAQ), and a continuous variable on energy requirement in the form of the metabolic equivalent (MET) was calculated. Depression was evaluated with the Major Depression Inventory (MDI) questionnaire. RESULTS: A total of 210 patients reported a mean total MET score of 5,319 ± 3,650 (mean ± standard deviation) MET-min./week, and they spent an average of 194 ± 118 min./day being physically active. 70.5% of the patients reported a high level of physical activity and 89.5% met the WHO recommendations. The MDI questionnaire found that 10.5% were depressed. Severely depressed patients had lower MET scores, but this group only included six patients. Physical activity was inversely associated with time spent sitting according to the IPAQ (p = 0.001), disease duration (p = 0.02) and the SLICC/ACR DI score (p = 0.01), but not with the MDI (p = 0.26). CONCLUSION: A large share of the patients reported a high level of physical activity and met the WHO recommendations. FUNDING: Odense University Hospital Fund for Pre-graduate Scholarships (A 3478). TRIAL REGISTRATION: not relevant.
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Lupus Eritematoso Sistémico , Dinamarca , Ejercicio Físico , Humanos , Autoinforme , Índice de Severidad de la EnfermedadRESUMEN
Marine spatial planning that addresses ocean climate-driven change ('climate-smart MSP') is a global aspiration to support economic growth, food security and ecosystem sustainability. Ocean climate change ('CC') modelling may become a key decision-support tool for MSP, but traditional modelling analysis and communication challenges prevent their broad uptake. We employed MSP-specific ocean climate modelling analyses to inform a real-life MSP process; addressing how nature conservation and fisheries could be adapted to CC. We found that the currently planned distribution of these activities may become unsustainable during the policy's implementation due to CC, leading to a shortfall in its sustainability and blue growth targets. Significant, climate-driven ecosystem-level shifts in ocean components underpinning designated sites and fishing activity were estimated, reflecting different magnitudes of shifts in benthic versus pelagic, and inshore versus offshore habitats. Supporting adaptation, we then identified: CC refugia (areas where the ecosystem remains within the boundaries of its present state); CC hotspots (where climate drives the ecosystem towards a new state, inconsistent with each sectors' present use distribution); and for the first time, identified bright spots (areas where oceanographic processes drive range expansion opportunities that may support sustainable growth in the medium term). We thus create the means to: identify where sector-relevant ecosystem change is attributable to CC; incorporate resilient delivery of conservation and sustainable ecosystem management aims into MSP; and to harness opportunities for blue growth where they exist. Capturing CC bright spots alongside refugia within protected areas may present important opportunities to meet sustainability targets while helping support the fishing sector in a changing climate. By capitalizing on the natural distribution of climate resilience within ocean ecosystems, such climate-adaptive spatial management strategies could be seen as nature-based solutions to limit the impact of CC on ocean ecosystems and dependent blue economy sectors, paving the way for climate-smart MSP.
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Cambio Climático , Ecosistema , Adaptación Fisiológica , Conservación de los Recursos Naturales , Explotaciones Pesqueras , OceanografíaRESUMEN
The COVID-19 pandemic has caused (and continues to cause) severe disruption in global and local economies and has forced countries, societies, and individuals to adapt quickly to the unprecedented and unpredictable situations. Despite the obvious negative consequences of the pandemic, many have called for efforts to identify transformative opportunities for sustainable development throughout this disorderly time. In the present paper, we explore such potential opportunities in the context of an interdisciplinary, international research project, which is focusing on sustainable marine management in biosphere reserves and marine parks in Southeast Asia. During a virtual workshop conducted as part of the GCRF (Government's Global Challenges Research Fund) Blue Communities Project, future scenarios were developed depicting the potential effects of the COVID-19 pandemic on five case study sites. All of these sites are in areas of internationally recognized outstanding ecological value (Taka Bonerate Kepulauan-Selayar Biosphere Reserve, Indonesia; Tun Mustapha Park, Sabah, Malaysia; Palawan Biosphere Reserve, Philippines; North Devon Biosphere Reserve, United Kingdom; Cu Lao Cham-Hoi An Biosphere Reserve, Vietnam). At the macro-level, economies, governance structures, and societal norms are undergoing big changes. At the micro-level, the livelihoods, lifestyles, and backyards of local residents have to adapt. Collaboratively, we explored how COVID-19 posed challenges in our five case study sites, but we also focused on the potential COVID-19-related windows of opportunity for future sustainable development. Opportunities could be identified in all three pillars of sustainable development: the environment, the society, and the economy. Although remarkable similarities can be found across all five sites, we conclude that there cannot be a "one-size-fits-all" solution to turn the tide toward achieving sustainable development. Just as before the pandemic, sustainable development starts with engaging with and understanding local environments, challenges, and situations; building on local knowledge; and developing tailor-made solutions for the communities in situ.
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Forecasting of climate change impacts on marine aquaculture production has become a major research task, which requires taking into account the biases and uncertainties arising from ocean climate models in coastal areas, as well as considering culture management strategies. Focusing on the suspended mussel culture in the NW Iberian coastal upwelling system, we simulated current and future mussel growth by means of a multistructural net production Dynamic Energy Budget (DEB) model. We considered two scenarios and three ocean climate models to account for climate uncertainty, and applied a bias correction to the climate models in coastal areas. Our results show that the predicted impact of climate change on mussel growth is low compared with the role of the seeding time. However, the response of mussels varied across climate models, ranging from a minor growth decline to a moderate growth increase. Therefore, this work confirms that an accurate forecasting of climate change impacts on shellfish aquaculture should take into account the variability linked to both management strategies and climate uncertainty.
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Bivalvos , Mytilus , Animales , Acuicultura , Cambio Climático , Alimentos MarinosRESUMEN
This is the first attempt to apply an expert-based ecological vulnerability assessment of the effects of climate change on the main marine resources of Portugal. The vulnerability, exposure, sensitivity, adaptive capacity, and expected directional effects of 74 species of fish and invertebrates of commercial interest is estimated based on criteria related to their life-history and level of conservation or exploitation. This analysis is performed separately for three regions of Portugal and two scenarios of climate change (RCP 4.5 and RCP 8.5). To do that, the fourth assessment report IPCC framework for vulnerability assessments was coupled to the outputs of a physical-biogeochemical model allowing to weight the exposure of the species by the expected variability of the environmental variables in the future. The highest vulnerabilities were found for some migratory and elasmobranch species, although overall vulnerability scores were low probably due to the high adaptive capacity of species from temperate ecosystems. Among regions, the highest average vulnerability was estimated for the species in the Central region while higher vulnerabilities were identified under climate change scenario RCP 8.5 in the three regions, due to higher expected climatic variability. This work establishes the basis for the assessment of the vulnerability of the human activities relying on marine resources in the context of climate change.
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The aim of the study was to identify the prevalence of newly diagnosed malignancies in patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), with the aid of 18F-FDG PET/CT scan compared to conventional imaging techniques: Chest X-ray (CXR) and abdominal ultrasound (US). Secondarily, to examine the relative diagnostic accuracy of these two imaging modalities for the detection of cancer. Eighty consecutive patients with newly diagnosed PMR, GCA, or concomitant PMR and GCA, were included and followed up for 40 weeks. All patients underwent an 18F-FDG PET/CT scan, CXR, and abdominal US at diagnosis. Imaging findings were dichotomously categorized into malignant or benign. Among 80 patients, three patients were diagnosed with seronegative rheumatoid arthritis and were excluded from the analysis. Of the remaining 77, 64 (83.1%) patients were diagnosed with pure PMR, 3 (3.9%) with pure GCA, and 10 (13.0%) with concomitant PMR and GCA. Five types of cancer that were more prevalent than the one-year prevalence of 1.2% among the background population were found in four (5.2%; 95%CI: 1.4-12.8%) patients. CXR/abdominal US could detect the solid cancer in one patient, whereas 18F-FDG PET/CT could identify all four solid cancers. Furthermore, four (5.2%; 95%CI: 1.4-12.8%) cases of monoclonal gammopathy of undetermined significance (MGUS) were found. An increase in C reactive protein (CRP) implicated an increased risk for cancer of 2.4% (OR: 1.024, 95%CI: 1.001-1.047; p = 0.041). 18F-FDG PET/CT can reveal occult cancers at an early stage with a high negative predictive value, and it is specifically beneficial in PMR/GCA patients with nonspecific symptoms.
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The study covers two important deltaic systems of the north-east coast of India, viz. the Bengal and Mahanadi delta that support about 1.25 million people. The changes in potential marine fish production and socio-economic conditions were modelled for these two deltas under long-term changes in environmental conditions (sea surface temperature and primary production) to the end of the 21st century. Our results show that an increased temperature (by 4 °C) has a negative impact on fisheries productivity, which was projected to decrease by 5%. At the species level, Bombay duck, Indian mackerel and threadfin bream showed an increasing trend in the biomass of potential catches under the sustainable fishing scenario. However, under the business as usual and overfishing scenarios, our results suggest reduced catch for both states. On the other hand, mackerel tuna, Indian oil sardine, and hilsa fisheries showed a projected reduction in potential catch also for the sustainable fishing scenario. The socio-economic models projected an increase of up to 0.67% (involving 0.8 billion USD) in consumption by 2050 even under the best management scenario. The GDP per capita was projected to face a loss of 1.7 billion USD by 2050. The loss of low-cost fisheries would negatively impact the poorer coastal population since they strongly depend upon these fisheries as a source of protein. Nevertheless, adaptation strategies tend to have a negative correlation with poverty and food insecurity which needs to be addressed separately to make the sector-specific efforts effective. This work can be considered as the baseline model for future researchers and the policymakers to explore potential sustainable management options for the studied regions.
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Deltas are home to a large and growing proportion of the world's population, often living in conditions of extreme poverty. Deltaic ecosystems are ecologically significant as they support high biodiversity and a variety of fisheries, however these coastal environments are extremely vulnerable to climate change. The Ganges-Brahmaputra-Meghna (Bangladesh/India), the Mahanadi (India), and the Volta (Ghana) are among the most important and populous delta regions in the world and they are all considered at risk of food insecurity and climate change. The fisheries sector is vital for populations that live in the three deltas, as a source of animal protein (in Bangladesh and Ghana around 50-60% of animal protein is supplied by fish while in India this is about 12%) through subsistence fishing, as a source of employment and for the wider economy. The aquaculture sector shows a rapid growth in Bangladesh and India while in Ghana this is just starting to expand. The main exported species differ across countries with Ghana and India dominated by marine fish species, whereas Bangladesh exports shrimps and prawns. Fisheries play a more important part in the economy of Bangladesh and Ghana than for India, both men and women work in fisheries, with a higher proportion of women in the Volta then in the Asian deltas. Economic and integrated modelling using future scenarios suggest that changes in temperature and primary production could reduce fish productivity and fisheries income especially in the Volta and Bangladesh deltas, however these losses could be mitigated by reducing overfishing and improving management. The analysis provided in this paper highlights the importance of applying plans for fisheries management at regional level. Minimizing the impacts of climate change while increasing marine ecosystems resilience must be a priority for scientists and governments before these have dramatic impacts on millions of people's lives.
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Cambio Climático , Ecosistema , Explotaciones Pesqueras/estadística & datos numéricos , Peces , Abastecimiento de Alimentos , Animales , Bangladesh , Conservación de los Recursos Naturales , Ghana , IndiaRESUMEN
To better anticipate potential impacts of climate change, diverse information about the future is required, including climate, society and economy, and adaptation and mitigation. To address this need, a global RCP (Representative Concentration Pathways), SSP (Shared Socio-economic Pathways), and SPA (Shared climate Policy Assumptions) (RCP-SSP-SPA) scenario framework has been developed by the Intergovernmental Panel on Climate Change Fifth Assessment Report (IPCC-AR5). Application of this full global framework at sub-national scales introduces two key challenges: added complexity in capturing the multiple dimensions of change, and issues of scale. Perhaps for this reason, there are few such applications of this new framework. Here, we present an integrated multi-scale hybrid scenario approach that combines both expert-based and participatory methods. The framework has been developed and applied within the DECCMA1 project with the purpose of exploring migration and adaptation in three deltas across West Africa and South Asia: (i) the Volta delta (Ghana), (ii) the Mahanadi delta (India), and (iii) the Ganges-Brahmaputra-Meghna (GBM) delta (Bangladesh/India). Using a climate scenario that encompasses a wide range of impacts (RCP8.5) combined with three SSP-based socio-economic scenarios (SSP2, SSP3, SSP5), we generate highly divergent and challenging scenario contexts across multiple scales against which robustness of the human and natural systems within the deltas are tested. In addition, we consider four distinct adaptation policy trajectories: Minimum intervention, Economic capacity expansion, System efficiency enhancement, and System restructuring, which describe alternative future bundles of adaptation actions/measures under different socio-economic trajectories. The paper highlights the importance of multi-scale (combined top-down and bottom-up) and participatory (joint expert-stakeholder) scenario methods for addressing uncertainty in adaptation decision-making. The framework facilitates improved integrated assessments of the potential impacts and plausible adaptation policy choices (including migration) under uncertain future changing conditions. The concept, methods, and processes presented are transferable to other sub-national socio-ecological settings with multi-scale challenges.
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The Paris Conference of Parties (COP21) agreement renewed momentum for action against climate change, creating the space for solutions for conservation of the ocean addressing two of its largest threats: climate change and ocean acidification (CCOA). Recent arguments that ocean policies disregard a mature conservation research field and that protected areas cannot address climate change may be oversimplistic at this time when dynamic solutions for the management of changing oceans are needed. We propose a novel approach, based on spatial meta-analysis of climate impact models, to improve the positioning of marine protected areas to limit CCOA impacts. We do this by estimating the vulnerability of ocean ecosystems to CCOA in a spatially explicit manner and then co-mapping human activities such as the placement of renewable energy developments and the distribution of marine protected areas. We test this approach in the NE Atlantic considering also how CCOA impacts the base of the food web which supports protected species, an aspect often neglected in conservation studies. We found that, in this case, current regional conservation plans protect areas with low ecosystem-level vulnerability to CCOA, but disregard how species may redistribute to new, suitable and productive habitats. Under current plans, these areas remain open to commercial extraction and other uses. Here, and worldwide, ocean conservation strategies under CCOA must recognize the long-term importance of these habitat refuges, and studies such as this one are needed to identify them. Protecting these areas creates adaptive, climate-ready and ecosystem-level policy options for conservation, suitable for changing oceans.
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Cambio Climático , Conservación de los Recursos Naturales , Ecosistema , Océanos y Mares , Cadena Alimentaria , Actividades Humanas , HumanosRESUMEN
OBJECTIVE: Atherosclerosis is highly prevalent among patients with systemic lupus erythematosus (SLE), but has been demonstrated predominantly in non-European SLE cohorts and few investigations have included more than 1 imaging modality. We aimed to investigate the prevalence of atherosclerosis in 3 frequently affected vascular territories, the coronary, carotid, and lower-extremity arteries, in a Danish, predominantly population-based SLE cohort. METHODS: Patients with SLE without prior cardiovascular disease (CVD; n = 103) were screened for coronary artery calcification, carotid intima-media thickening and plaque, and abnormal ankle-brachial index by means of cardiac computed tomography, ultrasound of the carotid arteries, and ankle systolic blood pressure. RESULTS: In patients with SLE, the prevalence of atherosclerosis in any vascular territory was 41%. The distribution of the atherosclerotic manifestations showed an overlap with 45% of the patients having involvement in more than 1 vascular territory. However, more than one-third of the patients with SLE with coronary, carotid, or lower-extremity atherosclerosis exclusively demonstrated this particular manifestation. Based on a multiple logistic regression model, age (p < 0.001), current smoking (p = 0.009), and the Systemic Lupus International Collaborating Clinics (SLICC; p = 0.008) were significant independent risk factors for atherosclerosis at any vascular territory. CONCLUSION: Atherosclerosis is highly prevalent among Danish patients with SLE without prior CVD. Screening for atherosclerosis in 1 vascular territory is insufficient in diagnosing atherosclerosis in patients with SLE. In Danish patients with SLE, the presence of atherosclerosis was not only assigned to traditional CV risk factors, but also associated with SLICC.
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Aterosclerosis/complicaciones , Enfermedades de las Arterias Carótidas/complicaciones , Lupus Eritematoso Sistémico/complicaciones , Adulto , Anciano , Aterosclerosis/epidemiología , Aterosclerosis/fisiopatología , Presión Sanguínea , Arterias Carótidas/diagnóstico por imagen , Enfermedades de las Arterias Carótidas/epidemiología , Enfermedades de las Arterias Carótidas/fisiopatología , Grosor Intima-Media Carotídeo , Dinamarca , Endotelio Vascular/diagnóstico por imagen , Femenino , Humanos , Lupus Eritematoso Sistémico/fisiopatología , Masculino , Persona de Mediana Edad , PrevalenciaRESUMEN
The Sundarbans mangrove ecosystem, located in India and Bangladesh, is recognized as a global priority for biodiversity conservation and is an important provider of ecosystem services such as numerous goods and protection against storm surges. With global mean sea-level rise projected as up to 0.98 m or greater by 2100 relative to the baseline period (1985-2005), the Sundarbans - mean elevation presently approximately 2 m above mean sea-level - is under threat from inundation and subsequent wetland loss; however the magnitude of loss remains unclear. We used remote and field measurements, geographic information systems and simulation modelling to investigate the potential effects of three sea-level rise scenarios on the Sundarbans within coastal Bangladesh. We illustrate how the Sea Level Affecting Marshes Model (SLAMM) is able to reproduce the observed area losses for the period 2000-2010. Using this calibrated model and assuming that mean sea-level is a better proxy than the SLAMM assumed mean lower low water for Mangrove area delineation, the estimated mangrove area net losses (relative to year 2000) are 81-178 km2, 111-376 km2 and 583-1393 km2 for relative sea-level rise scenarios to 2100 of 0.46 m, 0.75 m and 1.48 m, respectively and net subsidence of ±2.5 mm/year. These area losses are very small (<10 % of present day area) and significantly smaller than previous research has suggested. Our simulations also suggest that erosion rather than inundation may remain the dominant loss driver to 2100 under certain scenarios of sea-level rise and net subsidence. Only under the highest scenarios does inundation due to sea-level rise become the dominant loss process.
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OBJECTIVES: Knowledge of cardiac involvement in idiopathic inflammatory myopathies (IIM) is limited, especially in the early stage of disease. The objective of the present study was to perform a controlled evaluation of cardiac abnormalities in newly diagnosed, untreated patients with idiopathic inflammatory myopathies (IIM) by means of non-invasive techniques. METHODS: Fourteen patients with IIM (8 polymyositis, 4 dermatomyositis, 2 cancer-associated dermatomyositis) and 14 gender- and age- matched healthy control subjects were investigated. Participant assessments included a cardiac questionnaire, cardiac troponin-I (TnI), electrocardiogram (standard 12-lead and 48-h Holter monitoring), echocardiography with tissue Doppler measures, cardiac magnetic resonance (CMR) imaging with T2 mapping and semi-quantitative (99m)technetium pyrophosphate ((99m)Tc-PYP) scintigraphy. RESULTS: Dyspnoea was present in 8 (57%) of the patients compared to none of the controls (p<0.01). Median levels of TnI in patients and controls were 20 ng/L and 6 ng/L, respectively (p=0.06). QTc intervals were prolonged in the patient group (p=0.01). Two patients had systolic dysfunction, and one diastolic dysfunction. The myocardial (99m)Tc-PYP uptake and CMR results differed between patients and controls, albeit not with statistical significance. Overall, cardiac abnormalities were demonstrated in 9 (64%) of the patients versus 2 (14%) of the controls (p=0.02). CONCLUSIONS: Cardiac abnormalities assessed by TnI, ECG or imaging modalities were significantly more common in newly diagnosed, treatment naïve patients with IIM compared to healthy control subjects. These abnormalities, although subclinical, may indicate that myocardial involvement is common in patients and calls for larger controlled studies and further investigations of the prognostic implications of this finding.
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Dermatomiositis/complicaciones , Cardiopatías/etiología , Polimiositis/complicaciones , Adulto , Anciano , Biomarcadores/sangre , Estudios de Casos y Controles , Dermatomiositis/diagnóstico , Diagnóstico por Imagen , Disnea/diagnóstico , Disnea/etiología , Disnea/fisiopatología , Electrocardiografía Ambulatoria , Femenino , Cardiopatías/sangre , Cardiopatías/diagnóstico , Cardiopatías/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Polimiositis/diagnóstico , Valor Predictivo de las Pruebas , Encuestas y Cuestionarios , Troponina I/sangre , Disfunción Ventricular/diagnóstico , Disfunción Ventricular/etiología , Disfunción Ventricular/fisiopatología , Función VentricularRESUMEN
Global increase in sea temperatures has been suggested to facilitate the incoming and spread of tropical invaders. The increasing success of these species may be related to their higher physiological performance compared with indigenous ones. Here, we determined the effect of temperature on the aerobic metabolic scope (MS) of two herbivorous fish species that occupy a similar ecological niche in the Mediterranean Sea: the native salema (Sarpa salpa) and the invasive marbled spinefoot (Siganus rivulatus). Our results demonstrate a large difference in the optimal temperature for aerobic scope between the salema (21.8°C) and the marbled spinefoot (29.1°C), highlighting the importance of temperature in determining the energy availability and, potentially, the distribution patterns of the two species. A modelling approach based on a present-day projection and a future scenario for oceanographic conditions was used to make predictions about the thermal habitat suitability (THS, an index based on the relationship between MS and temperature) of the two species, both at the basin level (the whole Mediterranean Sea) and at the regional level (the Sicilian Channel, a key area for the inflow of invasive species from the Eastern to the Western Mediterranean Sea). For the present-day projection, our basin-scale model shows higher THS of the marbled spinefoot than the salema in the Eastern compared with the Western Mediterranean Sea. However, by 2050, the THS of the marbled spinefoot is predicted to increase throughout the whole Mediterranean Sea, causing its westward expansion. Nevertheless, the regional-scale model suggests that the future thermal conditions of Western Sicily will remain relatively unsuitable for the invasive species and could act as a barrier for its spread westward. We suggest that metabolic scope can be used as a tool to evaluate the potential invasiveness of alien species and the resilience to global warming of native species.
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OBJECTIVE: To determine the occurrence of traditional cardiovascular (CV) risk factors and coronary artery calcification (CAC) in adults with polymyositis (PM) or dermatomyositis (DM) compared to healthy controls and to assess the association between CV risk factors, PM/DM, and CAC score. METHODS: Traditional CV risk factors were assessed in a cross-sectional, observational study of 76 patients with PM/DM and in 48 sex- and age-matched healthy controls. CAC was quantified by means of cardiac computed tomography scan and expressed in Agatston units. The associations between CV risk factors, PM/DM, and CAC were studied by multivariate analyses. RESULTS: Thirty-three percent of the patients were obese compared to 11% of the controls (P = 0.005). Hypertension and diabetes mellitus were more frequent in patients (71% versus 42%; P = 0.002, and 13% versus 0%; P = 0.007), and patients had higher levels of triglycerides (P = 0.0009). High CAC score occurred more frequently in patients (20% versus 4%; P = 0.04). In multivariate analysis of patient factors associated with CAC were age (P = 0.02) and smoking (P = 0.02). CONCLUSION: In this study, traditional CV risk factors and severe CAC were commonly found in patients with PM/DM. However, severe CAC was not associated with PM/DM per se, but rather with age and smoking in these patients.