Chronic obstructive pulmonary disease (COPD) is associated with atherosclerosis. Previous studies including limited sample sizes have shown the prevalence of peripheral arterial occlusive disease ...(PAOD) among COPD patients. We sought to investigate the incidence of PAOD among COPD patients in Taiwan using a national database.
COPD patients were collected from the National Health Insurance Research Database of Taiwan from 1996 to 2010. The COPD cohort was propensity score matched according to age, sex, and comorbidities of atrial fibrillation, hypertension, diabetes, hyperlipidemia, cerebrovascular accidents, and chronic liver disease to patients without COPD (the control cohort). We evaluated the incidence of PAOD in COPD patients and the risk of PAOD associated with atrial fibrillation, hypertension, diabetes, hyperlipidemia, cerebrovascular accidents, and chronic liver disease.
The study included 51,869 COPD patients and 51,869 control patients without COPD. The incidence of PAOD was 1.23-fold higher (95% confidence interval CI =1.17-1.29) in the COPD group than in the non-COPD group. Moreover, COPD and atrial fibrillation alone (adjusted hazard ratio (aHR) 2.99;
=0.001), hypertension alone (aHR, 2.05;
<0.001), diabetes alone (aHR, 2.62;
<0.001) and cerebrovascular accidents alone (aHR 2.05;
<0.001), increased the risk of developing PAOD. The significant aHRs increased (from 3.7 to 4.9) when the number of comorbidities increased (from ≥1 to ≥3 comorbidities).
COPD patients have a higher incidence and an independently higher risk of PAOD than patients without COPD. The risk of PAOD is markedly elevated in COPD patients with more comorbidities.
Risk of empyema in patients with COPD Lu, Hsueh-Yi; Liao, Kuang-Ming
International journal of chronic obstructive pulmonary disease,
01/2018, Letnik:
13
Journal Article
Recenzirano
Odprti dostop
Pneumonia is one of the most common infectious diseases in patients with COPD. The risk of empyema in COPD is controversial, and its incidence has not been reported. The aim of our study was to ...determine the risk of empyema in COPD patients and to assess its risk factors.
We used the National Health Insurance Research Database in Taiwan to conduct an observational cohort study. This study analyzed patients who were diagnosed with COPD between January 1, 2003 and December 31, 2009. The earliest date of COPD diagnosis was designated the index date. Patients who were younger than 40 years or had empyema before the index date were excluded.
We analyzed 72,085 COPD patients in our study. The incidence of empyema was higher in the COPD group than in the non-COPD group (15.80 vs 4.34 per 10,000 person-years). The adjusted hazard ratio for empyema was 3.25 (95% CI =2.73-3.87) in patients with COPD compared with patients without COPD. COPD patients with only comorbidity of stroke, cancer, and chronic renal disease had adjusted hazard ratios of 1.88, 4.84, and 3.90, respectively.
The likelihood of developing empyema is higher in patients with COPD than in those without COPD. Some comorbidities, such as stroke, cancer, and chronic renal disease, are associated with an elevated risk for empyema in COPD patients.
Abstract SHM is vital in quantitatively identifying engineered critical structural damage due to its potential economic and security interests. Convolutional Neural Network (CNN) is a popular method ...used for SHM on damage localization and classification. However, traditional CNN methods have limitations in predicting performance uncertainty and only provide point evaluations without indicating their accuracy. To address this issue, this paper introduces a PCNN framework, which combines a traditional CNN with a probabilistic layer to generate overall confidence intervals (CIs) for prediction results, as well as conditional probability distributions (CPDs) and likelihood for each prediction result. The PCNN method provides a manner to quantify the prediction uncertainty of neural networks and determine the confidence of each prediction. The paper also recommends using Leaky ReLU as the activation function, which retains negative value information. The effectiveness of the PCNN method is illustrated through case studies of carbon fiber-reinforced polymer beams with different layups. The results show that PCNN is effective in giving damage location prediction for CIs, CPDs and likelihood.
Dipolarization fronts (DFs) are frequently detected in the Earth's magnetotail from XGSM = −30 RE to XGSM = −7 RE. How these DFs are formed is still poorly understood. Three possible mechanisms have ...been suggested in previous simulations: (1) jet braking, (2) transient reconnection, and (3) spontaneous formation. Among these three mechanisms, the first has been verified by using spacecraft observation, while the second and third have not. In this study, we show Cluster observation of DFs inside reconnection diffusion region. This observation provides in situ evidence of the second mechanism: Transient reconnection can produce DFs. We suggest that the DFs detected in the near‐Earth region (XGSM > −10 RE) are primarily attributed to jet braking, while the DFs detected in the mid‐ or far‐tail region (XGSM < −15 RE) are primarily attributed to transient reconnection or spontaneous formation. In the jet‐braking mechanism, the high‐speed flow “pushes” the preexisting plasmas to produce the DF so that there is causality between high‐speed flow and DF. In the transient‐reconnection mechanism, there is no causality between high‐speed flow and DF, because the frozen‐in condition is violated.
Key Points
DFs are observed inside reconnection diffusion region
Three formation mechanisms of DF are compared
Causality between flow and DF is discussed
During reconnection, a flux pileup region (FPR) is formed behind a dipolarization front in an outflow jet. Inside the FPR, the magnetic field magnitude and Bz component increase and the whistler‐mode ...waves are observed frequently. As the FPR convects toward the Earth during substorms, it is obstructed by the dipolar geomagnetic field to form a near‐Earth FPR. Unlike the structureless emissions inside the tail FPR, we find that the whistler‐mode waves inside the near‐Earth FPR can exhibit a discrete structure similar to chorus. Both upper band and lower band chorus are observed, with the upper band having a larger propagation angle (and smaller wave amplitude) than the lower band. Most chorus elements we observed are “rising‐tone” type, but some are “falling‐tone” type. We notice that the rising‐tone chorus can evolve into falling‐tone chorus within <3 s. One of the factors that may explain why the waves are unstructured inside the tail FPR but become discrete inside the near‐Earth FPR is the spatial inhomogeneity of magnetic field: we find that such inhomogeneity is small inside the near‐Earth FPR but large inside the tail FPR.
Key Points
Near‐Earth FPR: structured chorus; midtail FPR: unstructured whistlersSpatial inhomogeneity of magnetic field can explain such phenomenonRising‐tone chorus can evolve into falling‐tone chorus within <3 s
A magnetic reconnection event detected by Cluster is analyzed using three methods: Single‐spacecraft Inference based on Flow‐reversal Sequence (SIFS), Multispacecraft Inference based on Timing a ...Structure (MITS), and the First‐Order Taylor Expansion (FOTE). Using the SIFS method, we find that the reconnection structure is an X line; while using the MITS and FOTE methods, we find it is a magnetic island (O line). We compare the efficiency and accuracy of these three methods and find that the most efficient and accurate approach to identify a reconnection event is FOTE. In both the guide and nonguide field reconnection regimes, the FOTE method is equally applicable. This study for the first time demonstrates the capability of FOTE in identifying magnetic reconnection events; it would be useful to the forthcoming Magnetospheric Multiscale (MMS) mission.
Key Points
FOTE is the most efficient and accurate method to identify reconnection
FOTE can be used in both the guide and nonguide field reconnection
FOTE is useful to the MMS mission
Due to its prevalence, recurrence, and the emergence of drug-resistance,
vaginitis significantly impacts the well-being of women. Although cinnamon essential oil (CEO) possesses antifungal activity, ...its hydrophobic properties limit its clinical application.
To overcome this challenge, a nanoemulsification technology was employed to prepare cinnamon essential oil-nanoemulsion (CEO@NE), and its therapeutic efficacy and action mechanism for
vaginitis was investigated in vivo and in vitro.
CEO@NE, composed of 4% CEO, 78% distilled water, and 18% Tween 80, was prepared by ultrasonic nanoemulsification. The physical properties, anti-
activity, cytotoxicity, immunomodulatory potential and storage stability of CEO@NE were explored. Subsequently, the effect of intravaginal CEO@NE treatment on
vaginitis was investigated in mice. To comprehend the possible mechanism of CEO@NE, an analysis was conducted to ascertain the production of intracellular reactive oxygen species (ROS) in
.
CEO@NE, with the droplet size less than 100 nm and robust storage stability for up to 8 weeks, exhibited comparable anti-
activity with CEO. CEO@NE at the concentration lower than 400 μg/mL had no cytotoxic and immunomodulatory effects on murine splenocytes. Intravaginal treatment of CEO@NE (400 μg/mL, 20 μL/day/mouse for 5 consecutive days) curbed
colonization, ameliorated histopathological changes, and suppressed inflammatory cytokine production in mice intravaginally challenged with
. Notably, this treatment preserved the density of vaginal lactic acid bacteria (LAB) crucial for vaginal health. Co-culturing
with CEO@NE revealed concentration-dependent augmentation of intracellular ROS generation and ensuing cell death. In addition, co-culturing LPS-stimulated murine splenocytes with CEO@NE yielded a decrease in the generation of cytokines.
This discovery provides insight into the conceivable antifungal and anti-inflammatory mechanisms of CEO@NE to tackle
vaginitis. CEO@NE offers a promising avenue to address the limitations of current treatments, providing novel strategy for treating
vaginitis.
Alternate adsorption of oppositely charged myoglobin (Mb) and gold nanoparticles with different sizes were used to assemble {Au/Mb} n layer-by-layer films on solid surfaces by electrostatic ...interaction between them. The direct electrochemistry of Mb was realized in {Au/Mb} n films at pyrolytic graphite (PG) electrodes, showing a pair of well-defined, nearly reversible cyclic voltammetry (CV) peaks for the Mb heme FeIII/FeII redox couple. Quartz crystal microbalance (QCM), electrochemical impedance spectroscopy (EIS), and CV were used to monitor or confirm the growth of the films. Compared with other Mb layer-by-layer films with nonconductive nanoparticles or polyions, {Au/Mb} n films showed much improved properties, such as smaller electron-transfer resistance (R ct) measured by EIS with Fe(CN)3-/4- redox probe, higher maximum surface concentration of electroactive Mb (Γ*max), and better electrocatalytic activity toward reduction of O2 and H2O2, mainly because of the good conductivity of Au nanoparticles. Because of the high biocompatibility of Au nanoparticles, adsorbed Mb in the films retained its near native structure and biocatalytic activity. The size effect of Au nanoparticles on the electrochemical and electrocatalytic activity of Mb in {Au/Mb} n films was investigated, demonstrating that the {Au/Mb} n films assembled with smaller-sized Au nanoparticles have smaller R ct, higher Γ*max, and better biocatalytic reactivity than those with larger size.
Pulmonary rehabilitation (PR) effectively improves symptoms and exercise ability in patients with stable chronic obstructive pulmonary disease (COPD). However, the effectiveness and timing of early ...PR on hospitalized patients with acute exacerbation of COPD (AECOPD) is still debated.
This study conducted a meta-analysis to compare the outcome benefits between early PR and usual care for patient hospitalized due to AECOPD. A systematic search was performed for retrieving randomized control trials (RCTs) from the PubMed, Embase, and Cochrane library until November 2021. RCTs reporting early PR for AECOPD with hospitalization, either during admission or within four weeks of discharge, were enrolled for systematic review and meta-analysis.
Twenty RCTs (1274 participants) were included. Early PR showed significantly improved readmission rate (ten trials, risk ratio 0.68, 95% confidence interval (CI) 0.50-0.92), 6-minute walking distance (6MWD, twelve trials, MD 59.73, 95% CI 36.34-83.12), St George's Respiratory Questionnaire score (eight trials, MD -10.65, 95% CI -14.78 to -6.52), Borg score (eight trials, MD -0.79, 95% CI -1.26 to -0.32), and modified Medical Research Council dyspnea scale (eight trials, MD -0.38, 95% CI -0.5 to -0.25). However, the trend of mortality (six trials, risk ratio 0.72, 95% CI 0.39-1.34) benefit was not significant. The subgroup analysis showed non-significant trends of better effect in early PR during admission than those after discharge for outcomes of 6MWD, quality of life, and dyspnea. However, non-significant trends of less benefits on mortality and readmission rate were found in early PR during the admission.
Overall, early PR is beneficial for AECOPD with hospitalization, and there was no significant outcome difference between PR initiated during admission or within 4 weeks of discharge.
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