Blended self-management interventions to reduce disease burden in patients with chronic obstructive pulmonary disease and asthma: systematic review and meta-analysis

Background: Chronic obstructive pulmonary disease (COPD) and asthma have a high prevalence and disease burden. Blended self-management interventions, which combine eHealth with face-to-face interventions, can help reduce the disease burden.Objective: This systematic review and meta-analysis aims to examine the effectiveness of blended self-management interventions on health-related effectiveness and process outcomes for people with COPD or asthma. Methods: PubMed, Web of Science, COCHRANE Library, Emcare, and Embase were searched in December 2018 and updated in November 2020. Study quality was assessed using the Cochrane risk of bias (ROB) 2 tool and the Grading of Recommendations, Assessment, Development, and Evaluation.Results: A total of 15 COPD and 7 asthma randomized controlled trials were included in this study. The meta-analysis of COPD studies found that the blended intervention showed a small improvement in exercise capacity (standardized mean difference [SMD] 0.48; 95% CI 0.10-0.85) and a significant improvement in the quality of life (QoL; SMD 0.81; 95% CI 0.11-1.51). Blended intervention also reduced the admission rate (relative ratio [RR] 0.61; 95% CI 0.38-0.97). In the COPD systematic review, regarding the exacerbation frequency, both studies found that the intervention reduced exacerbation frequency (RR 0.38; 95% CI 0.26-0.56). A large effect was found on BMI (d=0.81; 95% CI 0.25-1.34); however, the effect was inconclusive because only 1 study was included. Regarding medication adherence, 2 of 3 studies found a moderate effect (d=0.73; 95% CI 0.50-0.96), and 1 study reported a mixed effect. Regarding self-management ability, 1 study reported a large effect (d=1.15; 95% CI 0.66-1.62), and no effect was reported in that study. No effect was found on other process outcomes. The meta-analysis of asthma studies found that blended intervention had a small improvement in lung function (SMD 0.40; 95% CI 0.18-0.62) and QoL (SMD 0.36; 95% CI 0.21-0.50) and a moderate improvement in asthma control (SMD 0.67; 95% CI 0.40-0.93). A large effect was found on BMI (d=1.42; 95% CI 0.28-2.42) and exercise capacity (d=1.50; 95% CI 0.35-2.50); however, 1 study was included per outcome. There was no effect on other outcomes. Furthermore, the majority of the 22 studies showed some concerns about the ROB, and the quality of evidence varied.Conclusions: In patients with COPD, the blended self-management interventions had mixed effects on health-related outcomes, with the strongest evidence found for exercise capacity, QoL, and admission rate. Furthermore, the review suggested that the interventions resulted in small effects on lung function and QoL and a moderate effect on asthma control in patients with asthma. There is some evidence for the effectiveness of blended self-management interventions for patients with COPD and asthma; however, more research is needed.Prevention, Population and Disease management (PrePoD)Public Health and primary car

Structure of Schlafen13 reveals a new class of tRNA/rRNA- targeting RNase engaged in translational control

Cleavage of transfer (t)RNA and ribosomal (r)RNA are critical and conserved steps of translational control for cells to overcome varied environmental stresses. However, enzymes that are responsible for this event have not been fully identified in high eukaryotes. Here, we report a mammalian tRNA/rRNA-targeting endoribonuclease: SLFN13, a member of the Schlafen family. Structural study reveals a unique pseudo-dimeric U-pillow-shaped architecture of the SLFN13 N'-domain that may clamp base-paired RNAs. SLFN13 is able to digest tRNAs and rRNAs in vitro, and the endonucleolytic cleavage dissevers 11 nucleotides from the 3'-terminus of tRNA at the acceptor stem. The cytoplasmically localised SLFN13 inhibits protein synthesis in 293T cells. Moreover, SLFN13 restricts HIV replication in a nucleolytic activity-dependent manner. According to these observations, we term SLFN13 RNase S13. Our study provides insights into the modulation of translational machinery in high eukaryotes, and sheds light on the functional mechanisms of the Schlafen family

Partial Wave Analysis of J/ψ→γ(K+K−π+π−)J/\psi \to \gamma (K^+K^-\pi^+\pi^-)

BES data on $J/\psi \to \gamma (K^+K^-\pi^+\pi^-)$ are presented. The $K^*\bar K^*$ contribution peaks strongly near threshold. It is fitted with a broad $0^{-+}$ resonance with mass $M = 1800 \pm 100$ MeV, width $\Gamma = 500 \pm 200$ MeV. A broad $2^{++}$ resonance peaking at 2020 MeV is also required with width $\sim 500$ MeV. There is further evidence for a $2^{-+}$ component peaking at 2.55 GeV. The non-$K^*\bar K^*$ contribution is close to phase space; it peaks at 2.6 GeV and is very different from $K^{*}\bar{K^{*}}$.Comment: 15 pages, 6 figures, 1 table, Submitted to PL

Measurements of the Mass and Full-Width of the ηc\eta_c Meson

In a sample of 58 million $J/\psi$ events collected with the BES II detector, the process J/$\psi\to\gamma\eta_c$ is observed in five different decay channels: $\gamma K^+K^-\pi^+\pi^-$, $\gamma\pi^+\pi^-\pi^+\pi^-$, $\gamma K^\pm K^0_S \pi^\mp$ (with $K^0_S\to\pi^+\pi^-$), $\gamma \phi\phi$ (with $\phi\to K^+K^-$) and $\gamma p\bar{p}$. From a combined fit of all five channels, we determine the mass and full-width of $\eta_c$ to be $m_{\eta_c}=2977.5\pm1.0 ({stat.})\pm1.2 ({syst.})$ MeV/$c^2$ and $\Gamma_{\eta_c} = 17.0\pm3.7 ({stat.})\pm7.4 ({syst.})$ MeV/$c^2$.Comment: 9 pages, 2 figures and 4 table. Submitted to Phys. Lett.

Measurement of Branching Ratios for ηc\eta_c Hadronic Decays

In a sample of 58 million $J/\psi$ events collected with the BES II detector, the process J/$\psi\to\gamma\eta_c$ is observed in five decay channels: $\eta_c \to K^+K^-\pi^+\pi^-$, $\pi^+\pi^-\pi^+\pi^-$, $K^\pm K^0_S \pi^\mp$ (with $K^0_S\to\pi^+\pi^-$), $\phi\phi$ (with $\phi\to K^+K^-$) and $p\bar{p}$. From these signals, we determine $Br(J/\psi\to\gamma\eta_c)\times Br(\eta_c\to K^+K^-\pi^+\pi^-)$ $=(1.5\pm0.2\pm0.2)\times10^{-4}$, $Br(J/\psi\to\gamma\eta_c)\times Br(\eta_c\to \pi^+\pi^-\pi^+\pi^-)$ $=(1.3\pm0.2\pm0.4)\times10^{-4}$, $Br(J/\psi\to\gamma\eta_c)\times Br(\eta_c\to K^\pm K_{S}^{0}\pi^\mp)$ $=(2.2\pm0.3\pm0.5)\times10^{-4}$, $Br(J/\psi\to\gamma\eta_c)\times Br(\eta_c\to \phi\phi)$ $=(3.3\pm0.6\pm0.6)\times10^{-5}$ and $Br(J/\psi\to\gamma\eta_c)\times Br(\eta_c\to p\bar{p})$ $=(1.9\pm0.3\pm0.3)\times10^{-5}$.Comment: 8 pages, 1 figures and 4 table. Submitted to Phys. Lett.

Measurements of J/psi --> p \bar{p}

The process J/\psi --> p \bar{p} is studied using 57.7 X 10^6 J/\psi events collected with the BESII detector at the Beijing Electron Positron Collider. The branching ratio is determined to be Br(J/\psi --> p \bar{p})=(2.26 +- 0.01 +- 0.14) X 10^{-3}, and the angular distribution is well described by \frac{dN}{d cos\theta_p}=1+\alpha\cos^2\theta_p with \alpha = 0.676 +- 0.036 +- 0.042, where \theta_p is the angle between the proton and beam directions. The value of \alpha obtained is in good agreement with the predictions of first-order QCD.Comment: 6 pages, 2 figures, RevTex4, Submitted to Phys.Lett.

Search for K_S K_S in J/psi and psi(2S) decays

The CP violating processes J/psi-->K_S K_S and psi(2S)-->K_S K_S are searched for using samples of 58 million J/psi and 14 million psi(2S) events collected with the Beijing Spectrometer at the Beijing Electron Positron Collider. No signal is observed, and upper limits on the decay branching ratios are determined to be BR(J/psi-->K_S K_S) K_S K_S) < 4.6x10^{-6} at the 95% confidence level.Comment: 6 pages, 4 figures, submitted to Phys. Lett.

ELM mitigation by supersonic molecular beam injection: KSTAR and HL-2A experiments and theory

We report recent experimental results from HL-2A and KSTAR on ELM mitigation by supersonic molecular beam injection (SMBI). Cold particle deposition within the pedestal by SMBI is verified in both machines. The signatures of ELM mitigation by SMBI are an ELM frequency increase and ELM amplitude decrease. These persist for an SMBI influence time τI. Here, τI is the time for the SMBI influenced pedestal profile to refill. An increase in fELMSMBI/fELM0 and a decrease in the energy loss per ELM ΔWELM were achieved in both machines. Physical insight was gleaned from studies of density and vΦ (toroidal rotation velocity) evolution, particle flux and turbulence spectra, divertor heat load. The characteristic gradients of the pedestal density soften and a change in vΦ was observed during a τI time. The spectra of the edge particle flux Γ ∼ 〈ṽrñe〉 and density fluctuation with and without SMBI were measured in HL-2A and in KSTAR, respectively. A clear phenomenon observed is the decrease in divertor heat load during the τI time in HL-2A. Similar results are the profiles of saturation current density Jsat with and without SMBI in KSTAR. We note that τI/τp (particle confinement time) is close to ∼1, although there is a large difference in individual τI between the two machines. This suggests that τI is strongly related to particle-transport events. Experiments and analysis of a simple phenomenological model support the important conclusion that ELM mitigation by SMBI results from an increase in higher frequency fluctuations and transport events in the pedestal. © 2014 IAEA, Vienna