A Chiral Bipyrimidine-Bridged Dy2 SMM: A Comparative Experimental and Theoretical Study of the Correlation Between the Distortion of the DyO6N2 Coordination Sphere and the Anisotropy Barrier

Chiral bipyrimidine-bridged dinuclear LnIII complexes of general formula [(μ-bipym){((+)-tfacam)3Ln}2] and [(μ-bipym){((-)-tfacam)3Ln}2], have been prepared from the assembly of Ln(AcO)3·nH2O (LnIII = Dy, Gd), (+)/(−)-3-(trifluoroacetyl)camphor enantiopure ligands ((+)/(-)-Htfacam) and bipyrimidine (bipym). The structure and chirality of these complexes have been supported by single-crystal X-Ray diffraction and circular dichroism. The study of the magnetic properties of the GdIII complexes revealed a very weak antiferromagnetic interaction between the GdIII ions through the bipyrimidine bridging ligand. Ab initio CASSCF calculations indicated that the ground Kramers doublet (KD) of both DyIII centers is almost purely axial with the anisotropy axis located close to the two tfacam−ligands at opposite sides of each DyIIIatom, which create an axial crystal field. In keeping with this, ac dynamic measurements indicated slow relaxation of the magnetization at zero field with Ueff = 55.1 K, a pre-exponential factor of τo = 2.17·10−6 s and τQTM = 8 μs. When an optimal dc field of 0.1 T is applied, QTM is quenched and Ueff increases to 75.9 K with τo = 6.16 × 10−7 s. The DyN2O8 coordination spheres and SMM properties of [(μ-bipym){((+)-tfacam)3Ln}2] and their achiral [(Dy(b-diketonate)3)2(μ-bpym)]analogous have been compared and a magneto-structural correlation has been established, which has been supported by theoretical calculations.ID-O, JH, and EC are grateful to Ministerio de Economía y Competitividad (MINECO) for Project CTQ2014-56312-P, the Junta de Andalucía (FQM-195 and the Project of excellence P11-FQM-7756) and the University of Granada. A part of this work has been made at HFLSM, IMR, Tohoku University. IDO also acknowledges support by COLABS. GR would like to thank SERB (EMR/2014/000247) for financial support. SDthanks UGC for Senior Research Fellowship. AC thanks the Marie Curie COFUND Action from the European Commission for co-financing his postdoctoral fellowship

Large scale synthesis of nanostructured zirconia-based compounds from freeze-dried precursors

Nanocrystalline zirconia powders have been obtained at the multigram scale by thermal decomposition of precursors resulting from the freeze-drying of aqueous acetic solutions. This technique has equally made possible to synthesize a variety of nanostructured yttria or scandia doped zirconia compositions. SEM images, as well as the analysis of the XRD patterns, show the nanoparticulated character of those solids obtained at low temperature, with typical particle size in the 1015 nm range when prepared at 673 K. The presence of the monoclinic, the tetragonal or both phases depends on the temperature of the thermal treatment, the doping concentration and the nature of the dopant. In addition, Rietveld refinement of the XRD profiles of selected samples allows detecting the coexistence of the tetragonal and the cubic phases for high doping concentration and high thermal treatment temperatures. Raman experiments suggest the presence of both phases also at relatively low treatment temperatures

Quantification of inaccurate diagnosis of COPD in primary care medicine: an analysis of the COACH clinical audit

[Background] Inaccurate diagnosis in COPD is a current problem with relevant consequences in terms of inefficient health care, which has not been thoroughly studied in primary care medicine. The aim of the present study was to evaluate the degree of inaccurate diagnosis in Primary Care in Spain and study the determinants associated with it.[Methods] The Community Assessment of COPD Health Care (COACH) study is a national, observational, randomized, non-interventional, national clinical audit aimed at evaluating clinical practice for patients with COPD in primary care medicine in Spain. For the present analysis, a correct diagnosis was evaluated based on previous exposure and airway obstruction with and without the presence of symptoms. The association of patient-level and center-level variables with inaccurate diagnosis was studied using multivariate multilevel binomial logistic regression models.[Results] During the study 4,307 cases from 63 centers were audited. The rate of inaccurate diagnosis was 82.4% (inter-regional range from 76.8% to 90.2%). Patient-related interventions associated with inaccurate diagnosis were related to active smoking, lung function evaluation, and specific therapeutic interventions. Center-level variables related to the availability of certain complementary tests and different aspects of the resources available were also associated with an inaccurate diagnosis.[Conclusions] The prevalence data for the inaccurate diagnosis of COPD in primary care medicine in Spain establishes a point of reference in the clinical management of COPD. The descriptors of the variables associated with this inaccurate diagnosis can be used to identify cases and centers in which inaccurate diagnosis is occurring considerably, thus allowing for improvement.Peer reviewe

Respiratory Syncytial Virus Vaccination Recommendations for Adults Aged 60 Years and Older: The NeumoExperts Prevention Group Position Paper

Respiratory syncytial virus (RSV) is a major cause of respiratory tract infections in adults, particularly older adults and those with underlying medical conditions. Vaccination has emerged as a potential key strategy to prevent RSV-related morbidity and mortality. This Neumoexperts Prevention (NEP) Group scientific paper aims to provide an evidence-based positioning and RSV vaccination recommendations for adult patients. We review the current literature on RSV burden and vaccine development and availability, emphasising the importance of vaccination in the adult population. According to our interpretation of the data, RSV vaccines should be part of the adult immunisation programme, and an age-based strategy should be preferred over targeting high-risk groups. The effectiveness and efficiency of this practice will depend on the duration of protection and the need for annual or more spaced doses. Our recommendations should help healthcare professionals formulate guidelines and implement effective vaccination programmes for adult patients at risk of RSV infection now that specific vaccines are available.This work was supported by consorcio Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CB21/06/00103; FM-T), DIAVIR (Instituto de Salud Carlos III (ISCIII)/DTS19/00049/Cofinanciado FEDER; Proyecto de Desarrollo Tecnológico en Salud), Resvi-Omics (Instituto de Salud Carlos III (ISCIII)/PI19/01039/Cofinanciado FEDER), BI-BACVIR (PRIS-3; Agencia de Conocimiento en Salud (ACIS)—Servicio Gallego de Salud (SERGAS)—Xunta de Galicia; Spain), Programa Traslacional COVID-19 (ACIS—Servicio Gallego de Salud (SERGAS)—XUNTA de Galicia; Spain) and Axencia Galega de Innovacion (GAIN; IN607B 2020/08—XUNTA de Galicia; Spain); and ReSVinext (Instituto de Salud Carlos III (ISCIII)/PI16/01569/Cofinanciado FEDER), Enterogen (Instituto de Salud Carlos III (ISCIII)/PI19/01090/Cofinanciado FEDER), OMI-COVI-VAC (PI22/00406/Cofinanced European Regional Development Fund, Grupos de Referencia Competitiva (IIN607A2021/05) and Axencia Galega de Innovación (GAIN; IN845D 2020/23—Xunta de Galicia; Spain).S

The new official adult vaccination schedule does not contemplate the prevention of pneumococcal pneumonia

Sr. Editor: El pasado mes de septiembre de 2018, el grupo de trabajo de vacunación en población adulta y grupos de riesgo (GT-GR) del Ministerio de Sanidad, Consumo y Bienestar Social publicó un documento que contiene las recomendaciones de vacunación en la población adulta sana y en inmigrantes [1]. El grupo de Neumoexpertos en Prevención (NEP) (www. neumoexpertos.org), quiere en primer lugar, felicitar la decisión del Ministerio de Sanidad por elaborar dicho documento y recomendar un calendario de vacunación para la población adulta, reforzando la importancia de las vacunas en el sistema sanitario, como medida preventiva y de salud pública para la población de todas las edades

The new official adult vaccination schedule does not contemplate the prevention of pneumococcal pneumonia

Sr. Editor: El pasado mes de septiembre de 2018, el grupo de trabajo de vacunación en población adulta y grupos de riesgo (GT-GR) del Ministerio de Sanidad, Consumo y Bienestar Social publicó un documento que contiene las recomendaciones de vacunación en la población adulta sana y en inmigrantes [1]. El grupo de Neumoexpertos en Prevención (NEP) (www. neumoexpertos.org), quiere en primer lugar, felicitar la decisión del Ministerio de Sanidad por elaborar dicho documento y recomendar un calendario de vacunación para la población adulta, reforzando la importancia de las vacunas en el sistema sanitario, como medida preventiva y de salud pública para la población de todas las edades

Recursos asistenciales en atención primaria para manejo del asma: proyecto Asmabarómetro

Objetivo: Describir la situación actual con respecto a la dotación de recursos básicos para el manejo del asma en los centros de atención primaria (AP). Disen ̃o: Estudio transversal, encuesta cuantitativa ad hoc. Emplazamiento y participantes: trescientos ochenta médicos de AP en Espan ̃a. Intervenciones y mediciones principales: Análisis de las percepciones de manejo y uso de recur- sos materiales, humanos y organizativos básicos de los que deberían estar dotados los centros de AP para garantizar una correcta asistencia clínica a los pacientes con asma. Resultados: Los encuestados afirman no disponer de profesional médico o de enfermería refe- rente en enfermedad respiratoria en su centro, en un 64% y un 62% respectivamente. El 92% dispone de espirómetro, el 70% de medidor de pico flujo y el 93% de dispositivos inhaladores placebo. Han recibido en el último an ̃o formación teórico-práctica específica promovida por el centro (46%) y por terceros (83%). Se dispone de material educativo para pacientes (78%). No existe protocolo asistencial específico (36%). El 43% no dispone de protocolo de derivación. Se utiliza entrevista clínica para el seguimiento del paciente (90%), pero no cuestionarios validados para medir la adherencia terapéutica (85%), ni checklist para verificar la técnica de inhalación (83%). Se observan diferencias en variables relevantes en el análisis por comunidades autónomas (CC. AA.). Conclusiones: El acceso a determinados recursos en la atención al paciente con asma es limitado en aspectos de coordinación entre niveles, variable según CC. AA. y mejorable en la mayoría de los recursos de salud en asma

Recursos asistenciales en atención primaria para manejo del asma: proyecto Asmabarómetro.

The objective of this study was to describe the current provision of basic resources for asthma management in Primary Health Care (PHC). Cross-sectional study, with an ad hoc quantitative survey. A total of 380 primary healthcare physicians in Spain. Analysis of perceptions of management and use of basic human, organisational and material resources to ensure appropriate care provision to asthma patients. Survey respondents stated that their centre did not have a consultant doctor (64%) or nurse (62%) in respiratory disease. Almost all (92%) of the centres have spirometers, of which 70% have peak flow meters, and 93% have placebo inhalers. In the last year, respondents have received specific theoretical/practical training from the centre (46%), and by third parties (83%). More than three-quarters (78%) of the centres has educational material available for patients. There is no specific healthcare protocol in 36% of the centres, and 43% had no referral protocol. A clinical interview is conducted to monitor the patient (90%), but there are no validated questionnaires to measure therapeutic adherence (85%), or a checklist to check inhalation technique (83%). Differences are observed in the relevant variables in the analysis of each Spanish Autonomous Community. Access to certain resources in the care of patients with asthma is limited in aspects of coordination between levels, varied according to Spanish Autonomous Community, and improved in most health resources in Asthma

Clinical Factors Associated With Overuse of Asthma Reliever Medication

MISTRAL Investigators Group.[Objective] Our aim was to evaluate the relationship between the clinical factors of asthma and the use of reliever medication.[Methods] We performed an observational cross-sectional study in Spain. The study population comprised patients aged ≥12 years diagnosed with persistent asthma according to the criteria of the Global Initiative for Asthma and receiving maintenance treatment for at least 12 months. Use of reliever medication was classified as low use of reliever medication (LURM) (≤2 times/wk) and high use of reliever medication (HURM) (≥3 times/wk). A variety of clinical variables and patient-reported outcomes (PROs) were recorded (eg, scores on the Asthma Control Questionnaire-5 [ACQ-5] and Test of Adherence to Inhalers [TAI]).[Results] A total of 406 patients were recruited. Mean (SD) age was 44.3 (17.9) years, and 64% were women. Reliever medication was used ≤2 times/wk in 76.1%. Bivariate analysis showed that HURM was related to smoking habit, unscheduled emergency department visits, hospital admissions, higher doses of inhaled corticosteroid, and night awakenings in the previous 4 weeks (P<.001). The multivariate analysis showed a higher risk of using reliever medication in smokers and former smokers, when the number of night awakenings increased, in cases of self-perception of partially controlled or uncontrolled asthma, or when asthma is uncontrolled according to the ACQ-5.[Conclusions] Our study identifies the potential of poor use of reliever medication in the last week as an alarm signal for disease-related parameters such as exacerbations, poor asthma control, and disease severity.This study received financial Support from AstraZeneca