Thirty-day readmissions after an AECOPD remain a major healthcare burden, and are characterized by a similar spectrum of readmission diagnoses. Predictors associated with readmission include both patient and clinical factors. Development of a COPD-specific risk stratification algorithm based on these factors may be necessary to better predict patients with AECOPD at high risk of early readmission.

We consider identifiability and estimation in a generalized linear model in which the response variable and some covariates have missing values and the missing data mechanism is nonignorable and unspecified. We adopt a pseudo likelihood approach that makes use of an instrumental variable to help identifying unknown parameters in the presence of nonignorable missing data. Explicit conditions for the identifiability of parameters are given. Some asymptotic properties of the parameter estimators based on maximizing the pseudo likelihood are established. Explicit asymptotic covariance matrix and its estimator are also derived in some cases. For the numerical maximization of the pseudo likelihood, we develop a two-step iteration algorithm that decomposes a non-concave maximization problem into two problems of maximizing concave functions. Some simulation results and an application to a data set from cotton factory workers are also presented.

Objective To compare and contrast the efficacy and safety of patiromer and sodium zirconium cyclosilicate (ZS-9) in the treatment of hyperkalemia. Design A systematic review and meta-analysis of phase II and III clinical trial data was completed. Patients or Participants Eight studies (2 phase II and 4 phase III trials with 2 subgroup analyses) were included in the qualitative analysis whereas six studies (2 phase II and 4 phase III trials) were included in the meta-analysis. Measurements and Results There was significant heterogeneity in the meta-analysis with an I2 value ranging from 80.6–99.6%. A random-effects meta-analysis was applied for all endpoints. Each clinical trial stratified results by hyperkalemia severity and dosing; therefore, these were considered separate treatment groups in the meta-analysis. For patiromer, there was a significant −0.70mEq/L (95% confidence interval [CI] −0.48 to −0.91mEq/L) change in potassium at 4 weeks. At day 3 of patiromer treatment, potassium change was −0.36mEq/L (range of standard deviation: 0.07 to 0.30). The primary endpoint for ZS-9-- change in potassium at 48 hours-- was −0.67mEq/L (95% CI −0.45 to −0.89mEq/L). By 1 hour after ZS-9 administration, change in potassium was −0.17mEq/L (95% CI −0.05 to −0.30). Analysis of pooled adverse effects from these trials indicates that patiromer was associated with more gastrointestinal upset (7.6% constipation, 4.5% diarrhea) and electrolyte depletion (7.1% hypomagnesemia), whereas ZS-9 was associated with adverse effects of urinary tract infections (1.1%) and edema (0.9%). Conclusion Patiromer and ZS-9 represent significant pharmacologic advancements in the treatment of hyperkalemia. Both agents exhibited statistically and clinically significant reductions in potassium for the primary endpoint of this meta-analysis. Given the adverse effect profile and the observed time dependent effects, ZS-9 may play more of a role in treating acute hyperkalemia.

An amphiphilic composite with magnetic Fe3O4 core and dodecylamine-modified polyoxometalate-paired poly(ionic liquid) shell was synthesized and characterized by (1)H NMR, thermogravimetric analysis (TGA), vibrating sample magnetometry (VSM), transmission electron microscopy (TEM), scanning electron microscopy (SEM), Fourier transform infrared (FT-IR) spectroscopy, UV-vis spectroscopy, X-ray diffraction (XRD), and digital microscopy. Catalytic tests for H2O2-based epoxidation of bioderived olefins, along with comparisons to various counterparts, demonstrate well that this newly designed catalyst exhibits high activity and selectivity, coupled with convenient magnetic recovery, and effective regeneration. The unique amphiphilic catalyst structure and the intramolecular charge transfer between amino groups and heteropolyanions are revealed to be responsible for the catalyst's excellent performances in epoxidation reactions.

Organic electrode materials free of rare transition metal elements are promising for sustainable, cost‐effective, and environmentally benign battery chemistries. However, severe shuttling effect caused by the dissolution of active materials in liquid electrolytes results in fast capacity decay, limiting their practical applications. Here, using a gel polymer electrolyte (GPE) that is in situ formed on Nafion‐coated separators, the shuttle reaction of organic electrodes is eliminated while maintaining the electrochemical performance. The synergy of physical confinement by GPE with tunable polymer structure and charge repulsion of the Nafion‐coated separator substantially prevents the soluble organic electrode materials with different molecular sizes from shuttling. A soluble small‐molecule organic electrode material of 1,3,5‐tri(9,10‐anthraquinonyl)benzene demonstrates exceptional electrochemical performance with an ultra‐long cycle life of 10 000 cycles, excellent rate capability of 203 mAh g−1 at 100 C, and a wide working temperature range from −70 to 100 °C based on the solid–liquid conversion chemistry, which outperforms all previously reported organic cathode materials. The shielding capability of GPE can be designed and tailored toward organic electrodes with different molecular sizes, thus providing a universal resolution to the shuttling effect that all soluble electrode materials suffer.