Education on inhaler technique is critical for effective asthma treatment. However, traditionally used face-to-face education is time-consuming, costly, and often laborious. The current study ...evaluated the efficacy of a newly developed video-based inhaler technique education method.
A total of 184 subjects with well-controlled or partly-controlled asthma were enrolled from 12 hospitals in South Korea from 30 November 2015 to 01 June 2016. Subjects were randomly divided into two groups in a 1:1 ratio; a control group that received face-to-face education, and a study group that received video education. All subjects received fluticasone propionate plus salmeterol xinafoate (Fluterol® 250/50 inhalation capsules) for 12 weeks. The primary outcome measure was forced expiratory volume in the 1st second (FEV1) at 12 weeks. The secondary outcome measures were change in FEV1 at 4 weeks, change in asthma control test (ACT) score, and changes in various inhaler technique parameters. These measures were assessed with a non-inferiority margin of 10% between the control group and the study group.
FEV1 was significantly improved at 12 weeks in the control group and the study group. After adjustment, FEV1 improvement was not significantly inferior in the study group compared to the control group. The secondary outcome measures, including change in FEV1 at 4 weeks, ACT score, and various parameters pertaining to inhaler technique and satisfaction at 4 and 12 weeks did not differ significantly in the two groups. In subgroup analysis of elderly subjects and subjects with well-controlled asthma, FEV1 was significantly improved at 12 weeks in the study group but not the control group.
The newly developed video education technique investigated functioned as a suitable substitute for face-to-face education on inhaler technique (dry powder inhalation capsule) in patients with stable asthma, particularly in elderly patients and patients with well-controlled asthma.
We report on synthetic strategies to fabricate DNA-coated micrometer-sized colloids that, upon thermal annealing, self-assemble into various crystal structures. Colloids of a wide range of chemical ...compositions, including poly(styrene), poly(methyl methacrylate), titania, silica, and a silica-methacrylate hybrid material, are fabricated with smooth particle surfaces and a dense layer of surface functional anchors. Single-stranded oligonucleotides with a short sticky end are covalently grafted onto particle surfaces employing a strain-promoted alkyne–azide cycloaddition reaction resulting in DNA coatings with areal densities an order of magnitude higher than previously reported. Our approach allows the DNA-coated colloids not only to aggregate upon cooling but also to anneal and rearrange while still bound together, leading to the formation of colloidal crystal compounds when particles of different sizes or different materials are combined.
There are insufficient data in managing patients at high risk of deterioration. We aimed to investigate that national early warning score (NEWS) could predict severe outcomes in patients identified ...by a rapid response system (RRS), focusing on the patient's age. We conducted a retrospective cohort study from June 2019 to December 2020. Outcomes were unplanned intensive care unit (ICU) admission, ICU mortality, and in-hospital mortality. We analyzed the predictive ability of NEWS using receiver operating characteristics (ROC) curve and the effect of NEWS parameters using multivariable logistic regression. A total of 2,814 RRS activations were obtained. The predictive ability of NEWS for unplanned ICU admission and in-hospital mortality was fair but was poor for ICU mortality. The predictive ability of NEWS showed no differences between patients aged 80 years or older and under 80 years. However, body temperature affected in-hospital mortality for patients aged 80 years or older, and the inverse effect on unplanned ICU admission was observed. The NEWS showed fair predictive ability for unplanned ICU admission and in-hospital mortality among patients identified by the RRS. The different presentations of patients 80 years or older should be considered in implementing the RRS.
Cancer is a multifactorial disease which involves complex genetic mutation and dysregulation. Combinatorial RNAi technology and concurrent multiple gene silencing are expected to provide advanced ...strategies for effective cancer therapy, but a safe and effective carrier system is a prerequisite to successful siRNA delivery in vivo. We previously developed an effective tumor-targeting siRNA delivery system for in vivo application. In response to the success of this development, herein we present a dual-gene targeted siRNA and its delivery system, to achieve synergistic effects in cancer therapy. Two different sequences of siRNA were chemically modified to be randomly copolymerized in a single backbone of siRNA polymer (Dual-poly-siRNA), and the resulting Dual-poly-siRNA was incorporated into tumor-homing glycol chitosan nanoparticles. Based on the stability in serum and delivery in a tumor-targeted manner, intravenously administered Dual-poly-siRNA carrying glycol chitosan nanoparticles (Dual-NP) demonstrated successful dual-gene silencing in tumors. Notably, co-delivery of VEGF and Bcl-2 targeting siRNA led to more effective cancer therapy for convenient application.
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•To detect carbaryl pesticides, simple colorimetric detection method is developed based on azo-coupling reaction.•Carbaryl pesticide can be detected selectively within 1 min with ...other carbamates.•Limit-of-detection for carbaryl is lower than permissible exposure level (∼15 ppm).•The carbaryl concentration are estimated in real fruit samples with natural interferences.
For rapid detection of carbaryl pesticides, we developed a simple colorimetric detection method based on azo-coupling reaction. Pretreating carbaryl pesticides with an organic base yielded 1-naphthol, which readily reacted with a diazonium salt with a dramatic color change. Since the resulting azo dye can further change color with the organic base used in the pretreatment, phosphoric acid was added to suppress the confounding colorimetric response. We report that this new colorimetric method can selectively detect carbaryl pesticides from other carbamate pesticides within a minute. Moreover, carbaryl can be detected below 10 parts per million (ppm), which is below its permissible exposure limit (∼15 ppm). Finally, we successfully estimated the concentrations of carbaryl pesticides on fruit samples in the presence of natural interferences.
It is unclear whether various bronchodilator reversibility (BDR) criteria affect the prognosis of chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate the impact of ...positive BDR defined according to various BDR criteria on the risk of severe acute exacerbation (AE) in COPD patients.
Patients from four prospective COPD cohorts in South Korea who underwent follow-up for at least 1 year were enrolled in this study. The assessed BDR criteria included the Global Initiative for Chronic Obstructive Lung Disease (GOLD), American Thoracic Society (ATS), American College of Chest Physicians, (ACCP), major criteria of the Spanish definition of asthma-COPD overlap syndrome (ACOS), criteria compatible with ACOS in the Global Initiative for Asthma (GINA), and European Respiratory Society (ERS). The rate of patients with severe AE who required hospitalization within 1 year due to BDR results according to each set of criteria was analyzed using logistic regression models.
Among a total of 854 patients, the BDR-positive cases varied according to the criteria used. There was a 3.5% positive BDR rate according to GINA and a 29.9% rate according to the ATS criteria. Positive BDR according to the GOLD criteria was significantly associated with a decreased risk of severe AE (adjusted odds ratio (aOR) = 0.38; 95% Confidence interval (CI) = 0.15-0.93). This result remained statistically significant even in a sensitivity analysis that included only participants with a smoking history of at least 10 pack-years and in the analysis for the propensity score-matched participants.
Among different criteria for positive BDR, the use of the GOLD ones was significantly associated with a decreased risk of severe AE in COPD patients. Increase use of ICS/LABA may have affected this relationship.
Background:
A considerable proportion of patients have features of both asthma and chronic obstructive pulmonary disease (COPD) simultaneously, called asthma–COPD overlap (ACO).
Objectives:
The aim ...of this study was to identify heterogeneity of ACO from a cohort of patients with severe asthma and COPD using the same diagnostic criteria.
Design:
We used the International Severe Asthma Registry (ISAR) and the Korean COPD Subgroup Study (KOCOSS) to evaluate clinical characteristics of ACO from each cohort.
Methods:
We classified subjects into four groups: (1) pure severe asthma, (2) ACO from the severe asthma cohort, (3) ACO from the COPD cohort, and (4) pure COPD. ACO was defined by satisfying extreme bronchodilator response (BDR) >15% and 400 ml and/or blood eosinophil count ⩾300 /µL in patients aged 40 years or older and post-BD forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7.
Results:
The ACO group had 25 (23%) of 111 in the ISAR cohort and 403 (23%) of 1781 in the KOCOSS cohort. The ACO from the COPD cohort was older with more males and more smokers, but had similar degree of airflow limitation compared with the ACO from the severe asthma cohort. ICS-containing inhaler treatment was prescribed for all severe asthma subjects, but only for 43.9% of ACO subjects from the COPD cohort. Compared with patients having pure severe asthma, the risk for exacerbation was comparable in ACO either from severe asthma or COPD cohort adjusted odds ratio (aOR): 1.54, 95% CI: 0.22–10.95 or aOR: 2.15, 95% CI: 0.59–7.85.
Conclusion:
The prevalence of ACO was similar in severe asthma and COPD cohorts applying identical diagnostic criteria. ACO from the severe asthma cohort was similar to ACO from the COPD cohort in terms of lung function and exacerbation risk.
To create printing substrates for colorimetric sensor arrays, chemically resistant membranes are prepared by coating cellulose filter paper with perfluoroalkoxy (PFA) polymer nanoparticles. A ...water-based fluorothermoplastic polymer dispersion was diluted with an organic solvent that causes weak aggregation of polymer nanoparticles. The resulting solution improved adhesion between the polymer and the cellulose membrane, providing a more mechanically stable substrate. These PFA polymer-coated substrates demonstrated superior chemical resistance against strong alkalines and had relatively uniform nanoporous structures that substantially improved the printability of a colorimetric sensor array. Finally, colorimetric sensor arrays printed on these substrates were evaluated for the detection of four different toxic industrial chemicals (e.g., ammonia, hydrogen sulfide, nitrogen dioxide, and sulfur dioxide) at or below their permissible exposure limits.
ObjectiveCigarette smoke-induced oxidative stress plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Dietary antioxidants are thought to prevent ...smoke-induced oxidative damage. The aim of this study was to investigate associations between lung function and the consumption of antioxidant vitamins in Korean adults.MethodsIn total, 21 148 participants from the Korean National Health and Nutrition Examination Survey (2007–2014) were divided into four groups based on smoking history and gender. Multivariate regression models were used to evaluate associations between lung function and intake of dietary antioxidants.ResultsSubjects in the highest intake quintile (Q5) of vitamin A, carotene and vitamin C intake had mean forced expiratory volume in 1 s (FEV1) measurements that were 30 mL, 32 mL and 36 mL higher than those of individuals in the lowest intake quintile (Q1), respectively (p for trend; p=0.008, p=0.010 and p<0.001, respectively). The risks of COPD for male smokers in Q1 increased 7.60-fold (95% CI 5.92 to 9.76), 7.16-fold (95% CI 5.58 to 9.19) and 7.79-fold (95% CI 6.12 to 9.92), for vitamin A, carotene and vitamin C, respectively, compared with those of female non-smokers in Q5. Among patients with COPD, men who smoked >20 pack-years had mean FEV1 measurements that were 192 mL, 149 mL and 177 mL higher than those of patients in Q1 (p for trend; p=0.018, p=0.024 and p=0.043, for vitamin A, carotene and vitamin C, respectively).ConclusionsThese findings indicate that the influence of antioxidant vitamins on lung function depends on gender and smoking status in the Korean COPD population.
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