Comparison of health-related quality of life measures in asthma-COPD overlap.

OBJECTIVE: The Asthma Quality of Life Questionnaire (AQLQ) and COPD assessment test (CAT) are used to assess the health status of asthma and chronic obstructive pulmonary disease (COPD), respectively. However, whether these questionnaires are appropriate in patients with asthma-COPD overlap (ACO) has not been reported. This study aimed to evaluate the performance of the AQLQ and CAT in subjects with ACO. METHODS: Subjects were enrolled from two previously described observational studies in Beijing, China. ACO was defined by a consensus definition from a roundtable discussion. All subjects completed the AQLQ, CAT, St George's Respiratory Questionnaire (SGRQ), pulmonary function tests, and the Asthma Control Questionnaire (ACQ)-5. Cross-sectional construct validity was evaluated by correlating the AQLQ and CAT with SGRQ score and other measures of asthma and COPD severity. RESULTS: 147 subjects with ACO were recruited. There were floor effects on non-respiratory components of the CAT, and ceiling effects on emotion domains of the AQLQ. Both questionnaires were significantly correlated with ACQ-5 score but were not correlated with FEV1% predicted or FVC% predicted. The AQLQ and CAT were strongly correlated with SGRQ score (r = -0.657 and r = 0.623, respectively). Multivariable linear regression analysis showed that the AQLQ (standardized ß-coefficient = -0.449, p < .001) had a stronger association with SGRQ score compared with CAT (standardized ß-coefficient = 0.211, p = .023). DISCUSSION: The AQLQ and CAT were both valid for assessing the health-related quality of life in subjects with ACO, but the AQLQ performed better than CAT.

Efficacy of metoprolol combined with torasemide in elderly patients with degenerative valvular heart disease and heart failure and its influence on NT-proBNP levels.

Objective: To investigate the efficacy of metoprolol combined with torasemide in elderly patients with degenerative valvular heart disease (DVHD) and heart failure and its influence on N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations. Methods: The records of 129 DVHD patients ≥60 years old with heart failure diagnosed and treated in our hospital from January 2020 to February 2022 were retrospectively selected. According to the treatment records, 62 patients received metoprolol treatment (Control-group), and 67 patients received metoprolol combined with torasemide treatment (Observation-group). The changes in cardiac function, NT-proBNP and inflammatory factor concentrations and clinical efficacy were analyzed and compared between the two groups before and after treatment. Results: After treatment, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and the mitral ratio of peak early to late diastolic filling velocity (E/A) were lower, with a greater decrease in the Observation-group compared to the Control-group (P<0.05). After treatment, NT-proBNP and interleukin-1beta (IL-1ß), tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6) concentrations were lower in both groups, with a greater decrease in the Observation-group compared to the Control-group (P<0.05). The total clinical efficacy of the Observation-group was significantly higher than the Control-group (P<0.05). There was no significant difference in the total incidence of adverse drug reactions between the two groups (P>0.05). Conclusion: Metoprolol combined with torasemide has a significant therapeutic effect on DVHD patients with heart failure. This drug combination improved cardiac function, reduced NT-proBNP concentrations and has good safety.

Asymmetry of inferior turbinate in patients with nasal septum deviation and its significance for nasal ventilation surgery.

PURPOSE: To investigate the asymmetry of the inferior turbinate (IT) in patients with nasal septum deviation (NSD). METHODS: The paranasal sinus computed tomography (CT) of 100 patients with NSD were retrospectively investigated from February 2018 to December 2019. The thickness of IT, IT mucosa and IT bone, the distance between the IT and the midline were measured on both the concave and convex sides, and which correlation with NSD was analyzed. RESULTS: The widths of the IT, IT bone and IT medial mucosa on the concave side were larger than those on the convex side (all P < 0.05). The distance from the IT and IT bone to the midline on the concave side was smaller than those on the convex side (P < 0.05, respectively). The degree of NSD had a negative correlation with the widths of the IT and IT bone on the convex side, and the distance between the IT and the midline on the concave side; and a positive correlation with the distance from IT and IT bone to the midline on the convex side, and IT mucosa thickness on the concave side (all P < 0.05). CONCLUSION: The asymmetric IT width is mainly caused by both hypertrophies of the IT mucosa on the concave side and atrophy of the IT bone on the convex side. Therefore, during the surgery of nasal ventilation reconstruction, the IT on the convex side are suggested to be protected from intervention. In contrast, it is necessary to lateralize the IT bone and reduce the IT submucosal tissue on the concave side. However, routine excision of the IT bone is not recommended.

A Dopant Replacement-Driven Molten Salt Method toward the Synthesis of Sub-5-nm-Sized Ultrathin Nanowires.

The high-temperature molten-salt method is an important inorganic synthetic route to a wide variety of morphological phenotypes. However, its utility is limited by the fact that it is typically incapable of producing ultrathin (<5 nm diameter) nanowires, which have a crucial role in novel nanotechnology applications. Herein, a rapid molten salt-based synthesis of sub-5-nm-sized nanowires of hexagonal tungsten oxide (h-WO3 ) that is critically dependent on a substantial proportion of molybdenum (Mo) dopant is described. This dopant-driven morphological transition in tungsten oxide (WO3 ) may be attributable to the collapse of layered structure, followed by nanocluster aggregation, coalescence, and recrystallization to form ultrathin nanowires. Interestingly, due to the structural properties of h-WO3 , the thus-formed ultrathin nanowires are demonstrated to be excellent photocatalysts for the production of ammonia (NH3 ) from nitrogen (N2 ) and water. The ultrathin nanowires exhibit a high photocatalytic NH3 -production activity with a rate of 370 µmol g-1 h-1 and an apparent quantum efficiency of 0.84% at 420 nm, which is more than twice that obtained from the best-performing Mo-doped W18 O49 nanowire catalysts. It is envisaged that the dopant replacement-driven synthetic protocol will allow for rapid access to a series of ultrathin nanostructures with intriguing properties and increase potential applications.

"Bulky-Yet-Flexible" α-Diimine Palladium-Catalyzed Reductive Heck Cross-Coupling: Highly Anti-Markovnikov-Selective Hydroarylation of Alkene in Air.

To pursue a highly regioselective and efficient reductive Heck reaction, a series of moisture- and air-stable α-diimine palladium precatalysts were rationally designed, readily synthesized, and fully characterized. The relationship between the structures of the palladium complexes and the catalytic properties was investigated. It was revealed that the"bulky-yet-flexible"palladium complexes allowed highly anti-Markovnikov-selective hydroarylation of alkenes with (hetero)aryl bromides under aerobic conditions. Further synthetic application of the present protocol could provide rapid and straightforward access to functional and biologically active molecules.

Worldwide prevalence, risk factors and burden of chronic cough in the general population: a narrative review.

Background and Objective: Chronic cough is one of the commonest complaints requiring medical attention that significantly impacts on the patient's quality of life. In this review, we focus on chronic cough prevalence, risk factors, and health burden among the general adult population based on recent reports, which will be helpful for a better understanding of the global burden of chronic cough. Methods: A narrative search of Medline was performed for articles and their lists of references published using the keywords "chronic cough", "chronic bronchitis", "epidemiology", "prevalence", "risk factor", "burden", "quality of life", "adult" and "general population". Key Contents and Findings: Although there is a growing literature on the prevalence of chronic cough in the general population from different countries, the prevalence of chronic cough in different populations cannot be directly compared because of the use of varying definitions of chronic cough. Generally, the prevalence of chronic cough is higher in Europe and North America than in Asia. Regarding the risk factors for chronic cough, several have been identified, including age, smoking, asthma, allergic rhinitis, and rhinosinusitis, whereas for other imputed factors, such as occupational exposure, air pollution, and obesity, these remain inconclusive. Although chronic cough is usually not life-threatening, the physical and psychological impact of chronic cough is obvious, leading to substantial healthcare resource utilization, especially for the elderly or those with comorbidities. Conclusions: Chronic cough is a common symptom in the general population that can be associated with a deterioration of quality of life and with increased burden. The identification of risk factors and associated co-morbidities will help towards an improved management of this condition. There is an urgent need to apply the standard definition of chronic cough in future research, so that comparisons of the prevalence and other findings across populations can be made.

[Advances in etiology and mechanism of structural nasal obstruction].

Structural nasal obstruction（SNO） is a series of diseases caused by congenital or acquired structural anatomical abnormalities of nasal airway and its surrounding tissues, which leads to increased nasal ventilation resistance. The effect of medication drugs for SNO is poor and surgical intervention is often needed. However, the abnormal structure of nasal airway is very complex, including the periphery of nasal airway, internal nasal airway, the front and rear of nasal airway and complex factors. These abnormal structures may interfere with the nasal airflow mechanics by changing the nasal ventilation volume and disrupting the symmetry of the bilateral nasal cavity, and finally lead to subjective feeling of nasal obstruction. In addition, the structure of nasal airway has plasticity. After the abnormal structure appears, the corresponding compensation of nasal airway can occur to ensure normal nasal ventilation and bilateral nasal cavity symmetry. Therefore, the SNO is the result of the failure of nasal airway remodeling after the appearance of abnormal structures. The etiology of SNO is complex, involving original structural abnormalities, nasal symmetry changing and nasal airway structure remodeling. Therefore, accurate identification of the main factors leading to SNO is the vitalpremise of making personalized nasal ventilation surgery.

Impact of gender and age on 6-Minute Walking Test performance of patients with coronary heart disease compared to healthy elders.

The performance of 6-minute walking test (6MWT) of patients with coronary heart disease (CHD) was significantly related to patients' cardiopulmonary functions. The 6MWT may provide prognostic information for patients. However, the impact of gender and age on the 6MWT performance and related cardiopulmonary parameters of patients with CHD compared to the healthy group has not be fully investigated and discussed. In this study, a total of 118 subjects, including 70 CHD patients and 48 healthy elders, were enrolled. The subjects performed the 6MWT while fourteen cardiopulmonary parameters were measured during the task and the walking distance was recorded at the end. Factors of gender, age, and disease on the 6MWT performance were analyzed using multivariate analysis of variance and the parameters between the patients and healthy people in age- and gender-specific subgroups were compared by Pearson's correlation coefficient. Results showed that age (60-65 and ≥65 years) and gender significantly influenced the 6MWT performance of subjects. Featured parameters were observed in older subgroups (≥65 years) between the patients and healthy people while patients aged 60-65 had similar 6MWT performance with the healthy control group. It would be potential to distinguish patients with CHD from healthy elders based on the 6MWT where factors of age and gender should be considered.

Controlling n-Type Molecular Doping via Regiochemistry and Polarity of Pendant Groups on Low Band Gap Donor-Acceptor Copolymers.

We demonstrate the impact of the type and position of pendant groups on the n-doping of low-band gap donor-acceptor (D-A) copolymers. Polar glycol ether groups simultaneously increase the electron affinities of D-A copolymers and improve the host/dopant miscibility compared to nonpolar alkyl groups, improving the doping efficiency by a factor of over 40. The bulk mobility of the doped films increases with the fraction of polar groups, leading to a best conductivity of 0.08 S cm-1 and power factor (PF) of 0.24 µW m-1 K-2 in the doped copolymer with the polar pendant groups on both the D and A moieties. We used spatially resolved absorption spectroscopy to relate commensurate morphological changes to the dispersion of dopants and to the relative local doping efficiency, demonstrating a direct relationship between the morphology of the polymer phase, the solvation of the molecular dopant, and the electrical properties of doped films. Our work offers fundamental new insights into the influence of the physical properties of pendant chains on the molecular doping process, which should be generalizable to any molecularly doped polymer films.

Amphipathic Side Chain of a Conjugated Polymer Optimizes Dopant Location toward Efficient N-Type Organic Thermoelectrics.

There is no molecular strategy for selectively increasing the Seebeck coefficient without reducing the electrical conductivity for organic thermoelectrics. Here, it is reported that the use of amphipathic side chains in an n-type donor-acceptor copolymer can selectively increase the Seebeck coefficient and thus increase the power factor by a factor of ≈5. The amphipathic side chain contains an alkyl chain segment as a spacer between the polymer backbone and an ethylene glycol type chain segment. The use of this alkyl spacer does not only reduce the energetic disorder in the conjugated polymer film but can also properly control the dopant sites away from the backbone, which minimizes the adverse influence of counterions. As confirmed by kinetic Monte Carlo simulations with the host-dopant distance as the only variable, a reduced Coulombic interaction resulting from a larger host-dopant distance contributes to a higher Seebeck coefficient for a given electrical conductivity. Finally, an optimized power factor of 18 µW m-1 K-2 is achieved in the doped polymer film. This work provides a facile molecular strategy for selectively improving the Seebeck coefficient and opens up a new route for optimizing the dopant location toward realizing better n-type polymeric thermoelectrics.

Quality indicators for cardiac rehabilitation after myocardial infarction in China: a consensus panel and practice test.

OBJECTIVES: Cardiac rehabilitation (CR) improves outcomes after myocardial infarction (MI), but it is underused in China. The purpose of this study was to develop a set of quality indicators (QIs) to improve clinical practices and to confirm the measurability and performance of the developed QIs for CR in Chinese patients after MI. DESIGN AND SETTING: The QIs were developed by a Chinese expert consensus panel during in-person meetings. The five QIs most in need of improvement were selected using a national questionnaire. Finally, the completion rate and feasibility of the QIs were verified in a group of MI survivors at university hospitals in China. PARTICIPANTS: Seventeen professionals participated in the consensus panel, 89 personnel in the field of CR participated in the national questionnaire and 165 MI survivors participated in the practice test. RESULTS: A review of 17 eligible articles generated 26 potential QIs, among which 17 were selected by the consensus panel after careful evaluation. The 17 QIs were divided into two domains: (1) improving participation and adherence and (2) CR process standardisation. Nationwide telephone and WeChat surveys identified the five QIs most in need of improvement. A multicenter practice test (n=165) revealed that the mean performance value of the proposed QIs was 43.9% (9.9%-86.1%) according to patients with post-MI. CONCLUSIONS: The consensus panel identified a comprehensive set of QIs for CR in patients with post-MI. A nationwide questionnaire survey was used to identify the QIs that need immediate attention to improve the quality of CR. Although practice tests confirmed the measurability of the proposed QIs in clinical practice, the implementation of the QIs needs to be improved. TRIAL REGISTRATION NUMBER: This study is part of a study registered in ClinicalTrials.gov (NCT03528382).