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ObjectivesCardiac rehabilitation (CR) improves outcomes after myocardial infarction (MI), but it is underused in China. The purpose of this study was to develop a set of quality indicators (QIs) to improve clinical practices and to confirm the measurability and performance of the developed QIs for CR in Chinese patients after MI.Design and settingThe QIs were developed by a Chinese expert consensus panel during in-person meetings. The five QIs most in need of improvement were selected using a national questionnaire. Finally, the completion rate and feasibility of the QIs were verified in a group of MI survivors at university hospitals in China.ParticipantsSeventeen professionals participated in the consensus panel, 89 personnel in the field of CR participated in the national questionnaire and 165 MI survivors participated in the practice test.ResultsA review of 17 eligible articles generated 26 potential QIs, among which 17 were selected by the consensus panel after careful evaluation. The 17 QIs were divided into two domains: (1) improving participation and adherence and (2) CR process standardisation. Nationwide telephone and WeChat surveys identified the five QIs most in need of improvement. A multicenter practice test (n=165) revealed that the mean performance value of the proposed QIs was 43.9% (9.9%–86.1%) according to patients with post-MI.ConclusionsThe consensus panel identified a comprehensive set of QIs for CR in patients with post-MI. A nationwide questionnaire survey was used to identify the QIs that need immediate attention to improve the quality of CR. Although practice tests confirmed the measurability of the proposed QIs in clinical practice, the implementation of the QIs needs to be improved.Trial registration numberThis study is part of a study registered in ClinicalTrials.gov (NCT03528382).

IntroductionHomelessness is a global issue with a detrimental impact on health. Individuals who experience homelessness are often labelled as frequent healthcare users; yet it is a small group of individuals who disproportionately use the majority of services. This protocol outlines the approach to combine survey data from a prospective cohort study and randomised controlled trial with administrative healthcare data to characterise patterns and predictors of healthcare utilisation among a group of adults with a history of homelessness.Methods and analysisThis cohort study will apply survey data from the Health and Housing in Transition study and the At Home/Chez Soi study linked with administrative healthcare databases in Ontario, Canada. We will use count models to quantify the associations between baseline predisposing, enabling, and need factors and hospitalisations, emergency department visits and physician visits in the following year. Subsequently, we will identify individuals who are high-cost users of the health system (top 5%) and characterise their patterns of healthcare utilisation. Logistic regression will be applied to develop a set of models to predict who will be high-cost users over the next 5 years based on predisposing, enabling and need factors. Calibration and discrimination will be estimated with bootstrapped optimism (bootstrap performance—test performance) to ensure the model performance is not overestimated.Ethics and disseminationThis study is approved by the St Michael’s Hospital Research Ethics Board and the University of Toronto Research Ethics Board. Findings will be disseminated through publication in peer-reviewed journals, presentations at research conferences and brief reports made available to healthcare professionals and the general public.Trial Registration NumberThis is a secondary data analysis of a cohort study and randomized trial. The At Home/Chez Soi study has been registered with the International Standard Randomised Control Trial Number Register and assignedISRCTN42520374.

Cationic methylene blue (MB) was intercalated into layered semiconductor KLaNb 2 O 7 for the first time by the ion-exchange method. MB + forms an inclined monolayer between LaNb 2 O 7 − nanosheets and the nanocomposite exhibited a pair of characteristic redox peaks of MB + cation. The nanocomposite was proved to be capable of immobilizing glucose oxidase (GOD) and facilitate catalytic activities of GOD. The MB + –LaNb 2 O 7 /GOD/CTS/GCE biosensor we constructed showed high electrochemical catalytic activities towards oxidation of glucose with the existence of oxygen. The biosensor had a linear range on detection of glucose from 2.5×10 −5 M to 2.83×10 −3 M and a detection limit of 2.0×10 −5 M.

The crystal structure is reported for 2,7-dimethoxy-3-(1-naphthoyl)naphthalene (1), C23H17O3, one of b-aroylated naphthalene compounds. In crystal, two naphthalene ring moieties of respective molecules are non-coplanarly located to each other, and two molecules are nested inside one another through a pair of C–H···π hydrogen-bonding interactions (C–H···Cg = 2.73 Å) forming a dimeric molecular aggregate. Each dimeric molecular aggregate is linked with four adjacent dimers by regular-squarely directed four (sp3)C–H···OCH3 hydrogen bonds between the methoxy groups (C–H···O = 2.50 Å) forming two-dimensionally spread plane. The planes are stacked into piles of layers along ac diagonal. On the other hand, the b-aroylated naphthalene homologues, 3-benzoylated naphthalene derivative I and 3-(2-naphthoylated) one II, are proved to take unidimensional molecular accumulation. Though each dimeric molecular aggregate has four identical interactions between adjacent dimeric molecular aggregates in crystal of homologue I, the rectangular, i.e., non-regular-square aligned situation of four interactions makes the linkage of each aggregate with only two adjacent dimers resulting in ribbon structure. In crystal of homologue II, molecules are stacked without formation of dimeric aggregates in columnar structure. On the basis of the results of systematic comparison of molecular packing structure and effective noncovalent-bonding interactions among title compound 1 and the b-aroylated naphthalene homologues I and II, the presence of large difference in strength of intermolecular interactions, i.e., predominant or apparently sole functioning of either C–H···O hydrogen bond or C–H···π hydrogen-bonding interaction induces only unidimensional molecular accumulation, e.g., ribbon-like alignment composed of dimeric molecular aggregates or columnar assembling of molecules. 1H NMR spectra suggest that conformational interconversion behaviour of title compound 1 through rotation around two kinds of C–C bonds in solution is disturbed rather largely compared to two homologous compounds I and II. Spatial organization characteristics of single molecular and molecular packing structures of b-aroylated naphthalene homologues in crystal are comparatively analyzed along with those in solution for the sake of elucidation of relationship among spatial organization, noncovalent bonding intermolecular interaction in crystal, and steric factors in solution., European Chemical Bulletin, Vol 5, No 6 (2016): European Chemical Bulletin