External validation of multidimensional prognostic indices (ADO, BODEx and DOSE) in a primary care international cohort (PROEPOC/COPD cohort)

Background: Due to the heterogeneous and systemic nature of the chronic obstructive pulmonary disease (COPD), the new guidelines are oriented toward individualized attention. Multidimensional scales could facilitate its proper clinical and prognostic assessment, but not all of them were validated in an international primary care cohort, different from the original ones used for model development. Therefore, our main aim is to assess the prognostic capacity of the ADO, BODEx and DOSE indices in primary care for predicting mortality in COPD patients and to validate the models obtained in subgroups of patients, classified by revised Global Initiative for Chronic Obstructive Lung Disease (2011) and updated Spanish Guideline (2014). Besides, we want to confirm that the prognostic capacity of all indices increases if the number of exacerbations is substituted by the interval between them and to assess the impact on health of the patient''s lifestyle, social network and adherence to treatment. Methods: Design: External validation of scales, open and prospective cohort study in primary care. Setting: 36 health centres in 6 European high, medium and low income countries. Subjects: 477 patients diagnosed with COPD, captured in clinical visit by their General Practitioner/Nurse. Predictors: Detailed patient history, exacerbations, lung function test and questionnaires at baseline. Outcomes: Exacerbations, all-cause mortality and specific mortality, within 5 years of recruitment. Analysis: Multivariate logistic regression and Cox regression will be used. Possible non-linear effect of the indices will be studied by using Structured Additive Regression models with penalised splines. Subsequently, we will assess different aspects of the regression models: discrimination, calibration and diagnostic precision. Clinical variables modulated in primary care and the interval between exacerbations will be considered and incorporated into the analysis. Discussion: The Research Agenda for General Practice/Family Medicine highlights that the evidence on predictive values of prognostic indices in primary care is scarce. A prospective cohort like that of PROEPOC/COPD provides good opportunities for research into COPD and make communication easier between family practitioners, nursing staff, pneumologists and other professionals, supporting a multi-disciplinary approach to the treatment of these patients. Trial registration:ISRCTN52402811. Date: 15/01/2015. Prospectively registered

Solution processed low-voltage organic transistors based on self-assembled monolayer gate dielectrics

Reduction in the operating voltage of organic field-effect transistors (OFETs) is sought for their successful implementation into future portable and low-power electronic applications. Here we demonstrate OFETs with operation below 2 V enabled by the use of self-assembled monolayer (SAM) gate dielectrics with high geometrical capacitances. A high surface energy monolayer is chosen to allow processing of small molecule semiconductors from solution. Impedance spectroscopy measurements of metal-insulator-semiconductor devices suggest the geometrical capacitance of the alumina-SAM dielectric can reach ∼1 μF/cm2 when accumulating charge at the semiconductor-insulator interface. Atomic force microscopy images reveal that the glass substrates and the SAM-functionalized aluminum gate electrode display significant roughness. Despite this, mobilities of 0.02 cm2/Vs are demonstrated. These results represent an important step towards low-power solution processable electronics. © 2009 SPIE

Solution processed self-assembled monolayer gate dielectrics for low-voltage organic transistors

Low-voltage organic transistors are sought for implementation in high volume low-power portable electronics of the future. Here we assess the suitability of three phosphonic acid based self-assembling molecules for use as ultra-thin gate dielectrics in low-voltage solution processable organic field-effect transistors. In particular, monolayers of phosphonohexadecanoic acid in metal-monolayer-metal type sandwich devices are shown to exhibit low leakage currents and high geometrical capacitance comparable to previously demonstrated self-assembled monolayer (SAM) type dielectrics [1, 2] but with a higher surface energy. The improved surface energy characteristics enable processing of a wider range of organic semiconductors from solution. Transistors based on a number of solution-processed organic semiconductors with operating voltages below 2 V are also demonstrated. © 2009 Materials Research Society