HPM-14: A New Germanosilicate Zeolite with Interconnected Extra-Large Pores Plus Odd-Membered and Small Pores

HPM-14 is a new extra-large pore zeolite synthesized using imidazolium-based organic structure-directing agents (SDAs), fluoride anions, and germanium and silicon as tetrahedral components of the framework. Owing to the presence of stacking disorder, the structure elucidation of HPM-14 was challenging, and different techniques were necessary to clarify the details of the structure and to understand the nature of the disorder. The structure has been solved by three-dimensional electron-diffraction technique (3D ED) and consists of an intergrowth of two polymorphs possessing a three-dimensional channel system, including an extra-large pore opened through windows made up of sixteen tetrahedral atoms (16-membered ring, 16MR) as well as two additional sets of odd-membered (9MR) and small (8MR) pores. The intergrowth has been studied by scanning transmission electron microscopy (C-s-STEM) and powder X-ray diffraction simulations (DIFFaX), which show a large predominance of the monoclinic polymorph A

Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2015 and GOLD 2019 staging: a pooled analysis of individual patient data

In 2019, The Global Initiative for Chronic Obstructive Lung Disease (GOLD) modified the grading system for patients with COPD, creating 16 subgroups (1A-4D). As part of the COPD Cohorts Collaborative International Assessment (3CIA) initiative, we aim to compare the mortality prediction of the 2015 and 2019 COPD GOLD staging systems. We studied 17 139 COPD patients from the 3CIA study, selecting those with complete data. Patients were classified by the 2015 and 2019 GOLD ABCD systems, and we compared the predictive ability for 5-year mortality of both classifications. In total, 17139 patients with COPD were enrolled in 22 cohorts from 11 countries between 2003 and 2017; 8823 of them had complete data and were analysed. Mean +/- SD age was 63.9 +/- 9.8 years and 62.9% were male. GOLD 2019 classified the patients in milder degrees of COPD. For both classifications, group D had higher mortality. 5-year mortality did not differ between groups B and C in GOLD 2015; in GOLD 2019, mortality was greater for group B than C. Patients classified as group A and B had better sensitivity and positive predictive value with the GOLD 2019 classification than GOLD 2015. GOLD 2015 had better sensitivity for group C and D than GOLD 2019. The area under the curve values for 5-year mortality were only 0.67 (95% CI 0.66-0.68) for GOLD 2015 and 0.65 (95% CI 0.63-0.66) for GOLD 2019. The new GOLD 2019 classification does not predict mortality better than the previous GOLD 2015 system

Sex differences between women and men with COPD: A new analysis of the 3CIA study

Background: There is partial evidence that COPD is expressed differently in women than in men, namely on symptoms, pulmonary function, exacerbations, comorbidities or prognosis. There is a need to improve the characterization of COPD in females. Methods: We obtained and pooled data of 17 139 patients from 22 COPD cohorts and analysed the clinical differences by sex, establishing the relationship between these characteristics in women and the prognosis and severity of the disease. Comparisons were established with standard statistics and survival analysis, including crude and multivariate Cox-regression analysis. Results: Overall, 5355 (31.2%) women were compared with men with COPD. Women were younger, had lower pack-years, greater FEV1%, lower BMI and a greater number of exacerbations (all p < 0.05). On symptoms, women reported more dyspnea, equal cough but less expectoration (p < 0.001). There were no differences in the BODE index score in women (2.4) versus men (2.4) (p = 0.5), but the distribution of all BODE components was highly variable by sex within different thresholds of BODE. On prognosis, 5-year survival was higher in COPD females (86.9%) than in males (76.3%), p < 0.001, in all patients and within each of the specific comorbidities that we assessed. The crude and adjusted RR and 95% C.I. for death in males was 1.82 (1.69–1.96) and 1.73 (1.50–2.00), respectively. Conclusions: COPD in women has some characteristic traits expressed differently than compared to men, mainly with more dyspnea and COPD exacerbations and less phlegm, among others, although long-term survival appears better in female COPD patients

Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2015 and GOLD 2019 staging: a pooled analysis of individual patient data

In 2019, The Global Initiative for Chronic Obstructive Lung Disease (GOLD) modified the grading system for patients with COPD, creating 16 subgroups (1A–4D). As part of the COPD Cohorts Collaborative International Assessment (3CIA) initiative, we aim to compare the mortality prediction of the 2015 and 2019 COPD GOLD staging systems. We studied 17 139 COPD patients from the 3CIA study, selecting those with complete data. Patients were classified by the 2015 and 2019 GOLD ABCD systems, and we compared the predictive ability for 5-year mortality of both classifications. In total, 17 139 patients with COPD were enrolled in 22 cohorts from 11 countries between 2003 and 2017; 8823 of them had complete data and were analysed. Mean±sd age was 63.9±9.8 years and 62.9% were male. GOLD 2019 classified the patients in milder degrees of COPD. For both classifications, group D had higher mortality. 5-year mortality did not differ between groups B and C in GOLD 2015; in GOLD 2019, mortality was greater for group B than C. Patients classified as group A and B had better sensitivity and positive predictive value with the GOLD 2019 classification than GOLD 2015. GOLD 2015 had better sensitivity for group C and D than GOLD 2019. The area under the curve values for 5-year mortality were only 0.67 (95% CI 0.66–0.68) for GOLD 2015 and 0.65 (95% CI 0.63–0.66) for GOLD 2019

Large-scale external validation and comparison of prognostic models: an application to chronic obstructive pulmonary disease

Background: External validations and comparisons of prognostic models or scores are a prerequisite for their use in routine clinical care but are lacking in most medical fields including chronic obstructive pulmonary disease (COPD). Our aim was to externally validate and concurrently compare prognostic scores for 3-year all-cause mortality in mostly multimorbid patients with COPD. Methods: We relied on 24 cohort studies of the COPD Cohorts Collaborative International Assessment consortium, corresponding to primary, secondary, and tertiary care in Europe, the Americas, and Japan. These studies include globally 15,762 patients with COPD (1871 deaths and 42,203 person years of follow-up). We used network meta-analysis adapted to multiple score comparison (MSC), following a frequentist two-stage approach; thus, we were able to compare all scores in a single analytical framework accounting for correlations among scores within cohorts. We assessed transitivity, heterogeneity, and inconsistency and provided a performance ranking of the prognostic scores. Results: Depending on data availability, between two and nine prognostic scores could be calculated for each cohort. The BODE score (body mass index, airflow obstruction, dyspnea, and exercise capacity) had a median area under the curve (AUC) of 0.679 [1st quartile-3rd quartile = 0.655-0.733] across cohorts. The ADO score (age, dyspnea, and airflow obstruction) showed the best performance for predicting mortality (difference AUC(ADO) - AUC(BODE) = 0.015 [95% confidence interval (CI) = - 0.002 to 0.032]; p = 0.08) followed by the updated BODE (AUCBODE updated - AUCBODE = 0.008 [95% CI = -0.005 to +0.022]; p = 0.23). The assumption of transitivity was not violated. Heterogeneity across direct comparisons was small, and we did not identify any local or global inconsistency. Conclusions: Our analyses showed best discriminatory performance for the ADO and updated BODE scores in patients with COPD. A limitation to be addressed in future studies is the extension of MSC network meta-analysis to measures of calibration. MSC network meta-analysis can be applied to prognostic scores in any medical field to identify the best scores, possibly paving the way for stratified medicine, public health, and research

Time Evolution of an Aluminogermanate Zeolite Synthesis: Segregation of Two Closely Similar Phases with the Same Structure Type

A synthesis of zeolite-like aluminogermanates using N,N,N-trimethyl-terc-butylammonium (TMTBA) and fluoride evolved from an initially crystallized zeolite with the AST Zeolite Framework Type and very little Al in it into an Al-free GeO2 phase with the same structure but a slightly smaller unit cell. In spite of both zeolites having the same framework type, same symmetry, a much similar unit cell size and almost the same framework composition, phase segregation occurred at intermediate crystallization times as the initial AST phase was gradually replaced by the new one. For reaction mixtures with a high Al content complete replacement of the large cell by the smaller cell phase was accomplished. The solids have been characterized by powder X-ray diffraction (XRD), Rietveld refinement from synchrotron diffraction data, multinuclear Nuclear Magnetic Resonance (NMR) of both intact and disolved solids and infrarred spectroscopy. The study reveals TMTBA can degrade under the crystallization conditions to initially yield triethylamine (tMA) while transmethylation between TMTBA and tMA produces tetramethylammonium (TMA), as probed by liquid NMR. The TMA cation can also structure-direct to AST zeolites but with a smaller unit cell volume and no Al in the framework. Phase segregation occurs despite the lack of structural mismatch because both crystallization events are decoupled, occurring at different moments and from largely different solutions. When both TMTBA and TMA cations are intentionally added at the start, no phase segregation but crystallization of a solid solution occurs instead.The authors acknowledge funding from the Spanish Ministery of Science and Competitiveness (Projects MAT2012-31759 and MAT2012-38429-C04) and Generalitat Valenciana (PROMETEOII/2014/047). We also thank A. Valera for technical expertise (FESEM) and Ms. Caramelitorl for help with the chemical analysis. Thanks are also due to the BM25 Spline staff at ESRF in Grenoble (France), particularly to G. Castro, and also to C. Belver for help in collecting the synchrotron XRD data and for helpful discussions.Villaescusa Alonso, LA.; Camblor, M. (2016). Time Evolution of an Aluminogermanate Zeolite Synthesis: Segregation of Two Closely Similar Phases with the Same Structure Type. Chemistry of Materials. 9(28):3090-3098. https://doi.org/10.1021/acs.chemmater.6b00507S3090309892