Browsing by Issue Date, starting with "2024-11-25"
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- Community versus academic hospital community-acquired pneumonia patients: a nested cohort studyPublication . Tsang, Jennifer L. Y.; Rego, Kian; Binnie, Alexandra; Binnie, Alexandra; Lee, Terry; Mccarthy, Anne; Cowan, Juthaporn; Archambault, Patrick; Lellouche, Francois; Turgeon, Alexis F.; Yoon, Jennifer; Lamontagne, Francois; Mcgeer, Allison; Douglas, Josh; Daley, Peter; Fowler, Robert; Maslove, David M.; Winston, Brent W.; Lee, Todd C.; Tran, Karen C.; Cheng, Matthew P.; Vinh, Donald C.; Boyd, John H.; Walley, Keith R.; Singer, Joel; Marshall, John C.; Haljan, Gregory; Jain, Fagun; Russell, James A.Background: Most Canadians receive their care in community hospitals, yet most clinical research is conducted in academic hospitals. This study aims to compare patients with community acquired pneumonia (CAP) treated in academic and community hospitals with respect to their demographics, clinical characteristics, treatments and outcomes. Methods This nested observational cohort substudy of the Community Acquired Pneumonia: Toward InnoVAtive Treatment (CAPTIVATE) trial included 1,329 hospitalized adults with CAP recruited between March 1st, 2018 and September 31st, 2023 from 15 Canadian hospitals. Unadjusted and adjusted analyses for age, sex and co-morbidities using logistic, Cox and censored quantile regressions were conducted. Results Patients in community hospitals were older (mean [SD] 75.0 [15.7] years vs. 68.3 [16.2] years; p < 0.001), were more likely to be female (49.7% vs. 41.0%, p = 0.002), and had more comorbidities (75.9% vs. 64.8%, p < 0.001). More patients in community hospitals received corticosteroids (49.2% vs. 37.4%, p < 0.001). Community hospital patients had a higher likelihood of developing acute respiratory distress syndrome (OR 3.13, 95% CI: 1.87, 5.24, p = < 0.001), and acute cardiac injury (OR 2.53, 95% CI: 1.33, 4.83, p = 0.005). In unadjusted and adjusted analyses, 28-day mortality difference did not meet statistical significance (OR 1.43, 95% CI: 0.98, 20.7, p = 0.062 and OR 1.23, 95% CI: 0.81, 1.87, p = 0.332, respective). Conclusion Patients with CAP in Canadian community and academic hospitals differed with respect to their age, clinical characteristics, treatments and outcomes, emphasizing the importance of including more community hospitals in clinical research studies to ensure the generalizability of results.
- Beyond the twilight zone: taxonomic and functional diversity of epifauna associated with black coral forests across an oceanic archipelagoPublication . Díaz Vergara, Sonia; Tuya Cortés, Fernando; Silva, JoãoBlack coral forests are important components of mesophotic and deep-water marine ecosystems. However, their low accessibility has resulted in a considerable lack of studies on their associated epifauna, particularly regarding their functional traits, which are essential for understanding how community structure influences ecosystem processes. This study focused on epifaunal assemblages associated with Antipathella wollastoni black coral forests across an east-to-west longitudinal gradient in a subtropical oceanic archipelago (the Canary Islands, eastern Atlantic). Dominated by amphipods, these assemblages peaked in abundance in the easternmost island, where denser and bigger coral formations provided more habitable space. In contrast, species richness was highest in the westernmost island, where the greater habitat heterogeneity promoted enhanced ecological diversity. We found an east-west gradient in functional traits, with greater body size variation among amphipod species (i.e., interspecific) and individuals within a population (i.e., intraspecific) on the westernmost and central relative to the easternmost island. Feeding traits also varied along this gradient, with amphipods adopting animal diets in the easternmost island, while shifting to vegetal diets in the central and westernmost islands, where food sources were more diverse. These dietary shifts were reflected in morphological adaptations, with changes in the anatomy of gnathopods (i.e., size and angle of feeding structures), as a result of varying animal prey consumption. These findings emphasize the plasticity of amphipods and underscore the complex interplay between functional traits and habitat features, highlighting the need for further research to better understand the largely undescribed mesophotic epifauna associated with black coral forests.
- Eficácia de uma experiência comportamental na redução de sintomatologia de ansiedade social: estudo experimental de caso únicoPublication . Correia, Filipa Santos; Jimenez-Ros, AntóniaAlguns estudos realizados sobre experiências comportamentais utilizadas na Terapia Cognitivo-Comportamental no tratamento da Perturbação de Ansiedade Social, apesar dos resultados eficazes, referem que há necessidade de mais estudos acerca do efeito terapêutico da técnica no momento em que ocorre a mudança da modificação de crenças específicas de ansiedade social e redução de comportamentos de segurança. Por este motivo, o presente estudo é sobre o efeito de uma experiência comportamental concebida para modificar a crença incondicional de “vão todos olhar para mim”, com recurso a uma metodologia de estudo experimental de caso único. Método: Foram recrutados 4 participantes de uma amostra de 80 pessoas que se encontravam acima do percentil 80 nas EAESDIS e EPAAS, e que apresentassem a crença “vão todos olhar para mim”. Foi utilizado um desing experimental de caso único com linha de base múltipla (ABFU). A fase baseline teve uma duração de 5 sessões, foi seguida de 1 sessão de intervenção, e de 5 sessões pós-manipulação. Uma sessão de fase follow-up realizou-se 1 mês após a última sessão de pós-manipulação. Resultados: Os resultados mostraram que os níveis dos comportamentos de segurança, ansiedade e grau de crença diminuíram após a sessão de intervenção. Houve diferenças significativas entre os 4 participantes, tendo todos os casos evidenciado o efeito imediato de forma diferente. A intervenção teve um efeito elevado na redução da ansiedade (AB-NAP=0.82; TAU-U=0.57) e da crença “vão todos olhar para mim” (AB-NAP=0.88; TAU-U=0.69). Conclusões: De acordo com o nosso estudo, as experiências comportamentais demonstraram, por si sós, eficácia na redução imediata, a curto e a médio prazo dos comportamentos de segurança, crença e níveis de ansiedade na Perturbação de Ansiedade Social, pelo que podem constituir-se como intervenções de primeira linha no tratamento desta perturbação.