We compared the spatiotemporal variability of temperatures and precipitation with that of the magnitude and timing of maximum daily spring flows in the geographically adjacent L’Assomption River ...(agricultural) and Matawin River (forested) watersheds during the period from 1932 to 2013. With regard to spatial variability, fall, winter, and spring temperatures as well as total precipitation are higher in the agricultural watershed than in the forested one. The magnitude of maximum daily spring flows is also higher in the first watershed as compared with the second, owing to substantial runoff, given that the amount of snow that gives rise to these flows is not significantly different in the two watersheds. These flows occur early in the season in the agricultural watershed because of the relatively high temperatures. With regard to temporal variability, minimum temperatures increased over time in both watersheds. Maximum temperatures in the fall only increased in the agricultural watershed. The amount of spring rain increased over time in both watersheds, whereas total precipitation increased significantly in the agricultural watershed only. However, the amount of snow decreased in the forested watershed. The magnitude of maximum daily spring flows increased over time in the forested watershed.
In the central part of the St. Lawrence Lowlands (Mauricie, Québec), Late Quaternary deglacial events led to the formation of a series of complex granular aquifers, such as those in the (1) ...Saint-Narcisse morainic complex, (2) paleodelta formed by the Saint-Maurice River, and (3) sandy littoral terraces left during marine regression. The aquifers are an important supply of potable water for most municipalities in the region, including the City of Trois-Rivières, which is a mid-size city where groundwater accounts for 46% of the water supply. The main objectives of this study were to build a three-dimensional (3D) model of the Quaternary deposits to define the main hydrogeological contexts of the Mauricie region and to characterize the regional aquifers. The compilation of existing hydrogeological data led to the selection of 5386 well logs that contained stratigraphic information of variable quality, ranging from only surficial sediment thickness to descriptions of fully cored boreholes. To supplement the existing data, fieldwork was undertaken in areas where few data were available, including 63 km of high-resolution seismic reflection surveys and 34 new boreholes. The final 3D model consists of six layers, from the bedrock surface to the upper littoral and deltaic sands. The total thickness of the deposits ranges from zero, on bedrock outcrops, to 150 m beneath central Trois-Rivières. Taking into account the thickness of the saturated layer and the porosity of the sand and gravel, the upper unconfined aquifer contains an estimated 364 million m
3
of water. The 3D model helped refine the understanding of regional aquifers and was used to identify unexploited aquifers, notably around the Saint-Narcisse morainic complex and along the St. Cuthbert Fault. The model clarified the regional stratigraphic architecture, especially topography of the bedrock surface, the lateral extent of Late Quaternary sands and development of Holocene post-glacial sediment sequences.
This study was undertaken to test the hypothesis that a reduction in midthigh muscle cross-sectional area obtained by CT scan (MTCSA(CT)) is a better predictor of mortality in chronic obstructive ...pulmonary disease (COPD) than low body mass index (BMI). We also wished to evaluate whether anthropometric measurements could be used to estimate MTCSA(CT). One hundred forty-two patients with COPD (age = 65 +/- 9 years, mean +/- SD, 26 F, BMI = 26 +/- 6 kg/m(2), FEV(1) = 42 +/- 16% predicted) were recruited from September 1995 to April 2000 with a mean follow-up of 41 +/- 18 months. The primary end-point was all-cause mortality during the study period. A Cox proportional hazards regression model was used to predict mortality using the following independent variables: age, sex, daily use of corticosteroid, FEV(1), DL(CO), BMI, thigh circumference, MTCSA(CT), peak exercise workrate, Pa(O2), and Pa(CO2). Only MTCSA(CT) and FEV(1) were found to be significant predictors of mortality (p = 0.0008 and p = 0.01, respectively). A second analysis was also performed with FEV(1) and MTCSA(CT) dichotomized. Patients were divided into four subgroups based on FEV(1) (< or >or= 50% predicted) and MTCSA(CT) (< or >or= 70 cm(2)). Compared with patients with an FEV(1) >or= 50% predicted and a MTCSA(CT) >or= 70 cm(2), those with an FEV(1) < 50% predicted and a MTCSA(CT) >or= 70 cm(2) had a mortality odds ratio of 3.37 (95% confidence interval, 0.41-28.00), whereas patients with an FEV(1) < 50% predicted and a MTCSA(CT) < 70 cm(2) had a mortality odds ratio of 13.16 (95% confidence interval, 1.74-99.20). MTCSA(CT) could not be estimated with sufficient accuracy from anthropometric measurements. In summary, we found in this cohort of patients with COPD that (1) MTCSA(CT) was a better predictor of mortality than BMI, and (2) MTCSA had a strong impact on mortality in patients with an FEV(1) < 50% predicted. These findings suggest that the assessment of body composition may be useful in the clinical evaluation of these patients.
IntroductionResearch undertaken since the beginning of the COVID-19 pandemic has provided us information about the impact of the pandemic on the gambling habits of the general population. However, ...very little is known about certain subgroups at increased risk of developing gambling disorder, such as the LGBTQIA2S+ population. The purpose of this study is to describe the impact of the COVID-19 pandemic on gambling behaviours among LGBTQIA2S+ individuals. In addition, we want to understand the experiences of the LGBTQIA2S+ population with gambling disorder and identify interventions that LGBTQIA2S+ people have found to be effective in addressing problem gambling during the COVID-19 pandemic.Methods and analysisThis study has a sequential explanatory mixed-method design in two phases over 2 years. The first phase is a correlational study. We will conduct a cross-sectional survey using a stratified random sampling among Canadian residents who are 18 years of age or older, self-identify as sexually and gender-diverse (ie, LGBTQIA2S+) and have gambled at least once in the previous 12 months. This survey will be administered online via a web panel (n=1500). The second phase is a qualitative study. Semistructured interviews will be conducted with LGBTQIA2S+ people with problematic gambling (n=30).Ethics and disseminationThis research project has been ethically and scientifically approved by the Research Ethics Committee and by the CIUSSS de l’Estrie—CHUS scientific evaluation committee on 3 March 2022 (reference number: 2022-4633—LGBTQ-JHA). Electronic and/or written informed consent, depending on the data collection format (online survey and online or in-person interviews), will be obtained from each participant. A copy of the consent form and contact information will be delivered to each participant.
Overweight⁄obesity is associated with longer survival in chronically ill patients, a phenomenon referred to as the 'obesity paradox'.
To investigate whether the obesity paradox in patients with ...chronic obstructive pulmonary disease (COPD) is due to fat accumulation or confounding factors.
A total of 190 patients with stable COPD who underwent a mean (± SD) follow-up period of 72±34 months were enrolled. Anthropometry, pulmonary function tests, midthigh muscle cross-sectional area obtained using computed tomography (MTCSACT), arterial blood gas and exercise testing data were measured at baseline. Patients were categorized into two subgroups according to body mass index (BMI) <25 kg⁄m2 or ≥25 kg⁄m2 (normal and overweight⁄obese, respectively).
Seventy-two patients (38%) died during the follow-up period. Survival tended to be better in the overweight⁄obese patients but this difference did not reach statistical significance. Overweight⁄obese patients had better lung function and a larger MTCSACT than those with normal BMI (P<0.001). Overweight⁄obese patients also had a significantly higher peak work rate than patients with normal BMI (P<0.001). PaO2 and PaCO2 were not significantly different in the two groups. When adjusted for PaCO2, peak work rate and MTCSACT, the tendency for improved survival in overweight⁄obese patients disappeared. In fact, when these variables were considered in the survival analysis, patients with lower BMI tended to have better survival.
These results suggest that important confounders, such as hypercapnia, exercise capacity and muscle mass, should be considered when interpreting the association between increased BMI and survival in patients with COPD.
Abnormal heart rate recovery (HRR) after exercise, a marker of cardiac autonomic dysfunction, is associated with poor prognosis in various populations. As chronic obstructive pulmonary disease (COPD) ...is associated with cardiac autonomic dysfunction, we tested the hypothesis that patients with COPD have a lower HRR than healthy people, and evaluated whether a delay in HRR is associated with an increased risk of mortality in COPD. The records of 147 COPD patients were reviewed (65.1±9.1 years, mean±
sd, 42 women/105 men, forced expiratory volume in 1
s (FEV
1): 42±15% predicted) and compared to 25 healthy subjects (61.6±4.5 years, 5 women/20 men, FEV
1: 100±14% predicted) during recovery after an exercise test. Heart rate was measured at peak exercise and at 1-min recovery, the difference between the two being defined as HRR (11±9 beats in COPD patients vs. 20±9 beats in healthy subjects,
P
<
0.0001
). During a mean follow-up of 43.1±22.0 months, 32 patients died. Abnormal HRR (⩽14 beats) was a strong predictor of mortality in COPD patients (adjusted hazard ratio: 5.12, 95% CI 1.54–17.00). In conclusion, COPD patients have a lower HRR than healthy subjects, and have a worse prognosis when presenting abnormal HRR.
Little is known about the comparative impact of chronic obstructive pulmonary disease (COPD) between women and men and about women's response to pulmonary rehabilitation.
To compare lung function, ...disability, mortality and response to pulmonary rehabilitation between women and men with COPD.
In the present retrospective study, 68 women (mean age 62.5+/-8.9 years) and 168 men (mean age 66.3+/-8.4 years) were evaluated by means of pulmonary function testing and an incremental symptom-limited cycle exercise test. Forty women and 84 men also participated in a 12-week pulmonary rehabilitation program. A 6 min walking test and the chronic respiratory questionnaire were used to assess the effects of pulmonary rehabilitation. Survival status was also evaluated.
Compared with men, women had a smaller tobacco exposure (31+/-24 versus 48+/-27 pack-years, P<0.05), displayed better forced expiratory volume in 1 s (44+/-13 versus 39+/-14 % predicted, P<0.05), a higher functional residual capacity (161+/-37 versus 149+/-36 % predicted, P<0.05) and total lung capacity (125+/-20 versus 115+/-19 % predicted, P<0.001). Peak oxygen consumption was not different between women and men when expressed in predicted values but lower in women when expressed in absolute values. Pulmonary rehabilitation resulted in significant improvements in 6 min walking test and quality of life in both sexes, but women had a greater improvement in chronic respiratory questionnaire dyspnea. Survival status was similar between sexes, but predictors of mortality were different between sexes.
Women may be more susceptible to COPD than men. The clinical expression of COPD may differ between sexes with greater degree of hyperinflation in women, who also benefit from pulmonary rehabilitation.
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