Exacerbations of chronic obstructive pulmonary disease (COPD) may lead to a rapid decline in health and subsequent death, an unfortunate tyranny of having COPD—an irreversible health condition of 16 million individuals in the USA totaling 60 million in the world. While COPD is the third largest leading cause of death, causing 3.23 million deaths worldwide in 2019 (according to the WHO), most patients with COPD do not receive adequate treatment at the end stages of life. Although death is inevitable, the trajectory towards end-of-life is less predictable in severe COPD. Thus, clinician-patient discussion for end-of-life and palliative care could bring a meaningful life-prospective to patients with advanced COPD. Here, we summarized the current understanding and treatment of COPD. This review also highlights the importance of patient-centered discussion and summarizes current status of managing patients with advanced COPD.
We have investigated the electronic and magnetic ground state of La1− xSr xMnO3 thin films, especially around doping x = 0.50 in comparison to the well studied system of x = 0.33 and the low doped system of x = 0.04. The films discussed here were grown by molecular-beam epitaxy, epitaxially strained to (001) oriented strontium titanate substrates. Apart from resistivity and magnetization measurements probing the electronic and magnetic ground state, we also study the temperature dependence of the coercive field of these samples. Our measurements reveal that the coercive field increases as the doping is changed from x = 0.33. The coercive field at 5 K for the x = 0.50 sample is H c = 0.0450 T compared to H c = 0.0080 T for the x = 0.33 sample. The temperature dependent coercive field measurements on the x = 0.50 sample show a dramatic cusp around 100 K that is coincident with more subtle features observed in both magnetization and resistivity data at this temperature.
We have investigated the collective electronic and magnetic orderings of a series of La1−xSrxMnO3 thin films grown epitaxially strained to (001) oriented strontium titanate substrates as a function of doping, x, for 0 ≤ x ≤ 0.4. We find that the ground states of these crystalline thin films are, in general, consistent with that observed in bulk crystals and thin film samples synthesized under a multitude of techniques. Our systematic study, however, reveal subtle features in the temperature dependent electronic transport and magnetization measurements, which presumably arise due to Jahn-Teller type distortions in the lattice for particular doping levels. For the parent compound LaMnO3 (x = 0), we report evidence of a strain-induced ferromagnetic ordering in contrast to the antiferromagnetic ground state found in bulk crystals.
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