Medical expenses of patients with severe mental disorders in Beijing, China

OBJECTIVES

Mental health has become a significant public health problem that impacts both economic and social development, with severe mental disorders (SMDs) being the top priority. Over recent years, Beijing, China, has introduced several policies to reduce the economic burden on patients with mental health disorders. The aim of this study was to investigate the current status and composition of patients' medical expenses following the introduction of multiple medical policies, explore the factors that may impact the utilisation of medical services and provide a reference and basis for subsequent policy improvements.

STUDY DESIGN

Multistage sampling was used to select a representative study population. A retrospective survey was used to collect patient information and data on medical expenses in 2019.

METHODS

Descriptive statistics were applied to analyse the current status of patients' medical expenses, and a two-part model was used to examine the factors influencing healthcare utilisation and to model predicted expenses.

RESULTS

Among 4940 participants, the average outpatient expenses of patients with SMD who incurred medical expenses were 8373.61 Yuan, and the average hospitalisation expenses were 81,594.05 Yuan. The out-of-pocket expenses were 29.22% of outpatient expenses and 8.13% of inpatient expenses. Factors such as age, household status, economic status, marital status, participation in the Community Free-Medication Service (CFMS) and the type of disease diagnosed influenced the differences in medical expenses and utilisation of services.

CONCLUSIONS

The medical expenses of patients with SMD in Beijing are high, but a number of introduced policies have effectively reduced these costs for patients. Future studies should focus on the impact of factors such as age, economic status, participation in the CFMS and the type of disease diagnosed on medical expenses.

Correlation of Efficient Dispersion and Catalytic Performance of Nanocombustion Catalysts in Energetic Materials: A Case Study of the Nanocopper Oxide Catalyst with Superfine Ammonium Perchlorate

Obviously, the dispersion of nanocatalytic materials has significant influence on their catalytic performance. In this study, an evaluation method for the dispersion of nanomaterials was established according to the different solid UV absorptions of different substances by taking the dispersion of nanocopper oxide (nano-CuO) in superfine ammonium perchlorate (AP) as an example. The nano-CuO/superfine AP composites with different nano-CuO dispersions can be obtained by changing the process parameters, such as varying the grinding method, the grinding strength, and the grinding time. Three replicate experiments were carried out for different composites to derive the average values of absorbance at 212 nm, and the dispersion of nano-CuO in superfine AP was calculated using the difference equation, as the solid UV curves at 210-214 nm were almost identical for each sample, especially at 212 nm. The properties of different samples were tested by X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (IR), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), differential scanning calorimetry (DSC), and thermogravimetry-mass spectrometry (TG-MS). The results show that the particle size and structure of superfine AP in the composites prepared by different methods were not changed. The XRD and IR techniques in this study were unable to characterize the dispersion of nano-CuO in the composites due to its low content. The dispersion of nano-CuO in the nano-CuO/superfine AP composites was significantly enhanced with the increase of grinding strength and grinding time, and the dispersion of nano-CuO was positively correlated with its catalytic performance, which means that the thermal decomposition performance of different composites improved with the increasing dispersion of nano-CuO. Highly dispersed nano-CuO exhibited a significant catalytic effect on superfine AP in TG-MS. The above conclusions demonstrate the accuracy of the difference equation for evaluating the dispersion of nanomaterials based on solid UV curves, which is expected to be used extensively in evaluating the dispersion of nanocatalytic materials in energetic materials.

The positive correlation between the dispersion and catalytic performance of Fe2O3 nanoparticles in nano-Fe2O3-ultrafine AP energetic composites supported by solid UV-vis spectroscopy

Recently, the widespread use of nanocatalytic materials has contributed to an enormous improvement in the performance of energetic materials, especially, highly dispersed nanomaterials. However, the lack of quantitative methods for analyzing the dispersion of nanomaterials limits their further widespread use. Although various techniques such as scanning electron microscopy (SEM), transmission electron microscopy (TEM), etc. are used to analyze the relative dispersion of nanomaterials, it is not possible to quantitatively analyze their dispersion. Therefore, there has been an effort to develop new methods for the quantitative analysis of nanocatalytic materials. Fortunately, we were able to analyze the dispersion of nanocatalytic materials using the difference in their UV absorbance. More importantly, we established the corresponding difference equation to quantify the dispersion of nanocatalytic materials, which is capable of quantifying the dispersion of nano-Fe2O3 in nano-Fe2O3-ultrafine AP composites. The accuracy of the difference equation was verified using a variety of techniques and the desired results were obtained. Based on the above conclusions, the quantitative analysis method for the dispersion of nanomaterials that we established is expected to be widely used and promote the development of energetic materials.

Correction to "Study on Effective Well Depth of Single U-Shaped Vertical Buried Pipe Based on Temperature Difference Analysis"

[This corrects the article DOI: 10.1021/acsomega.3c01207.].

Experimental Study on the Effect of Pitch Sloshing on the Heat Transfer and Pressure Drop of an LNG Spiral-Wound Heat Exchanger

With the development and utilization of offshore liquefied natural gas, it is increasingly important to study the influence of the heat transfer performance of a spiral-wound heat exchanger under sloshing conditions. This study focused on the effects of different sloshing amplitudes and sloshing periods on the heat transfer and pressure drop performance of a heat exchanger. Through experimental research, the results showed that the fluctuation of the UA (U is the heat transfer coefficient; A is the heat exchange area) value first increased and then decreased with an increase in the sloshing amplitude. The UA value increased by 12.92% and decreased by 42.03% compared to the static value at 3 and 9°, respectively. The fluctuation in the UA value first decreased and then increased with an increase in the sloshing period. The UA value decreased by 36.66% and increased by 10.82% slowly compared to the static value when the sloshing period was 6 and 20 s, respectively. Based on this, a mathematical model of heat transfer under the condition of pitch sloshing was established.

Study on the Effective Well Depth of Single U-Shaped Vertical Buried Pipes Based on Temperature Difference Analysis

A heat transfer model of a single U-shaped vertical buried pipe similar to an actual scenario is established, and the accuracy of the model is verified by experiments. The model is used to analyze the heat transfer performance of vertical buried pipe heat exchangers with well depths of 200, 160, 120, and 80 m. This includes the heat transfer per unit well depth, temperature change of the well wall and fluid along the pipe length, heat transfer coefficient, and section heat transfer validity. With the increase in well depth, the heat exchange per unit well depth decreases, and the proportion of heat exchange in the inlet section to the total heat exchange increases. When the well depths are 200, 160, 120, and 80 m, the last 10 m pipe sections have 30, 40.3, 53.7, and 66.4% of the heat exchange efficiencies of the initial 10 m pipe section, respectively. To obtain a reasonably effective well depth of a single U-shaped vertical buried pipe, it is necessary to comprehensively consider the heat exchange per unit well depth, the temperature difference between the well wall and the fluid, and the energy efficiency of the buried pipe section. Moreover, it should be analyzed in combination with economic factors.

[Preventive effect of atropine premedication on vagal reflex in patients undergoing suspension laryngoscopy during anesthesia induction]

Objective: To evaluate the preventive effect of atropine premedication during anesthesia induction on vagal reflex in patients undergoing suspension laryngoscopy. Methods: A total of 342 patients (202 males and 140 females) scheduled for suspension laryngoscopy under general anesthesia in Beijing Tongren Hospital from October 2021 to March 2022 were prospectively enrolled, with a mean age of (48.1±11.9) years. The patients were randomly divided into two groups using the random number table method: the treatment group (n=171) and the control group (n=171). Patients in the treatment group were administrated with 0.5 mg atropine intravenously guttae (ivgtt) while patients in the control group were given equivalent volume of normal saline. For all patients, if heart rate (HR)<50 beats/min happened during the insertion of the suspension laryngoscope, the operation should be stopped and the laryngoscope should be removed. Patients without HR recovery after the removal of the laryngoscope should be given 0.5 mg atropine, and the operation should be continued after the HR recovered. The primary outcome was the incidence of HR fluctuation over 20% (ΔHR>20%) before and immediately after suspension laryngoscope fixation, and the secondary outcomes included HR, mean arterial pressure (MAP) of the two groups recorded before and after anesthesia induction, before and immediately after suspension laryngoscope fixation, and the incidences of sinus bradycardia, laryngoscope removal and atropine treatment during operation. Results: The incidences of ΔHR>20% and bradycardia immediately after the suspension laryngoscope fixation were 14.6% (25/171) and 12.9% (22/171) in the treatment group, which were significantly lower than those in the control group [28.1% (48/171) and 29.8% (51/171)] (both P<0.05). The HR immediately after the suspension laryngoscope fixation in the treatment group [(66.4±13.5) beats/min] and in the control group [(60.8±15.7) beats/min] was significantly lower than those before the suspension laryngoscope fixation [(74.7±11.1) beats/min and (67.6±12.8) beats/min, respectively] (both P<0.05). There were no significant differences in MAP between the two groups at each time point (all P>0.05). The incidence of laryngoscope removal once plus 0.5 mg atropine administration, laryngoscope removal twice plus 0.5 mg atropine administration and laryngoscope removal twice plus 1.0 mg atropine administration was 9.9% (17/171), 1.8% (3/171) and 0 (0) in the treatment group, respectively, which was significantly lower than those in the control group [24.0% (41/171), 5.8% (10/171) and 2.3% (4/171), respectively] (all P<0.05). Conclusion: Atropine premedication during anesthesia induction can effectively reduce the occurrence of vagal reflex in patients undergoing suspension laryngoscopy.

Mn substitution in the topological metal Zr2Te2P

Results are reported for Mn intercalated Zr₂Te₂P, where x-ray diffraction , energy dispersive spectroscopy, and transmission electron microscopy measurements reveal that the van der Waals bonded Te-Te layers are partially filled by Zr and Mn ions. This leads to the chemical formulas Zr_0.07Zr₂Te₂P and Mn_0.06Zr_0.03Zr₂Te₂P for the parent and substituted compounds, respectively. The impact of the Mn ions is seen in the anisotropic magnetic susceptibility, where Curie-Weiss fits to the data indicate that the Mn ions are in the divalent state. Heat capacity and electrical transport measurements reveal metallic behavior, but the electronic coefficient of the heat capacity (γ_Mn≈ 36.6 mJ (mol·K²)^-1) is enhanced by comparison to that of the parent compound. Magnetic ordering is seen atTM≈4 K, where heat capacity measurements additionally show that the phase transition is broad, likely due to the disordered Mn distribution. This transition also strongly reduces the electronic scattering seen in the normalized electrical resistance. These results show that Mn substitution simultaneously introduces magnetic interactions and tunes the electronic state, which improves prospects for inducing novel behavior in Zr₂Te₂P and the broader family of ternary tetradymites.

Experimental Study on the Slugging Characteristics of Gas-Liquid Slug Flow in Horizontal Pipes

This study investigates the slugging characteristics of the gas-liquid slug flow interface in horizontal pipes. Using air and water as the experimental media, an experimental system was established using double-parallel conductance probes in a pipe with an inner diameter of 5 cm. By capturing the transient development process of the gas-liquid interface, the slugging characteristics of the gas-liquid two-phase flow interface in different flow regions were revealed. The results show that the value of gas-phase superficial velocity has an important influence on the shape and development of the interface wave during the slugging process. When the gravity wave generated during the slugging process can propagate upstream, the slugging phenomenon is periodic, and when the gravity wave cannot propagate upstream, the slugging phenomenon is random. The experiment verified the correctness of the interface instability theory and the liquid slug stability theory, and clarified the definitions of h _o and h _s. In addition, the paper analyzed the influence of gas-liquid velocity on slugging distance, h _o and h _s, and liquid slug frequency.

[A qualitative systematic review and enlightenment of teaching models and evaluation in the general education of epidemiology in China and abroad]

Objective: This study aims to systematically sort out the effectiveness evaluation of the general education teaching models in epidemiology at home and abroad and provide a reference for the development and reform of epidemiology education. Methods: A systematic search of English databases such as PubMed, Embase, and Web of Science and Chinese databases such as CNKI, Sinomed, Wanfang, etc., were used to screen out the literature on different general teaching models of education in epidemiology. Each literature's teaching effect will be summarized and evaluated to conduct a systematic qualitative review in the narrative integration method, Results: A total of 45 articles (28 in Chinese and 17 in English) were included in this study, involving 14 teaching models, including mixed teaching models, PBL (problem-based learning), project designing models, and CBL (case-based learning) and other teaching models. Except for some teaching models such as project design, network platform, and flipped classroom model, the teaching effect of other innovative models is better than that of the traditional model. The distribution of teaching models was different in Chinese and foreign literature. Foreign teaching models were diverse, mainly concentrated in mixed teaching models and software/network platform learning. Domestic teaching models were relatively fixed. The mixed teaching model and PBL model were the most widely used in China, and there were fewer comparative studies between different teaching models than in foreign countries. Conclusion: General education in epidemiology is still in the early exploration stage. Compared with the traditional lecture model, the effect of various innovative teaching models has been improved. According to teaching objectives and student characteristics, we encourage extensive use of different teaching strategies, combining theoretical knowledge with practical applications and integrating epidemiological knowledge with inter-professional knowledge. Thus, students who can apply what they learn are becoming interdisciplinary talents our society needs.

[Effects of topical anesthesia with 1% tetracaine on hemodynamic responses in microlaryngosurgery]

Objective: To observe the effects of topical anesthesia with 1% tetracaine on hemodynamic responses in general anesthesia patients undergoing microlaryngosurgery. Methods: From October 2021 to December 2021, 92 patients (46 males and 46 females) in Beijing Tongren Hospital, with a median age [M (Q₁, Q₃)] of 51 (42, 57) years who scheduled for microlaryngosurgery under general anesthesia, were divided into two groups (n=46 in each group) using the random number table method. Group T received topical anesthesia with 1% tetracaine at the root of the tongue and epiglottis and glottis on the basis of general intravenous anesthesia induction, with 0.5 ml at each position, while the control group (group C) received equal volume of normal saline. Heart rate (HR) and mean arterial pressure (MAP) were recorded at the time of patients entering the operating room (baseline), after induction, after intubation, immediately after suspending laryngoscopy, 1 min after suspending laryngoscopy, 3 min after suspending laryngoscopy, 5 min after suspending laryngoscopy and immediately after extubation. The recovery profiles, including time to recover breathing, time to open eyes, time to extubation and adverse reactions were evaluated during recovery period. Results: The MAP of patients in group T at baseline, after induction, after intubation, immediately after suspending laryngoscopy, 1 min after suspending laryngoscopy, 3 min after suspending laryngoscopy, 5 min after suspending laryngoscopy and immediately after extubation were (99.4±12.9), (78.5±8.8), (79.2±10.2), (100.6±17.0), (101.9±14.7), (100.8±13.9), (97.4±12.1), (107.3±16.8) mmHg (1 mmH=0.133 kPa), respectively, while in group C were (99.5±11.6), (80.9±12.8), (90.5±16.0), (109.5±20.4), (108.0±18.9), (103.7±15.5), (100.1±13.3), (114.2±17.3) mmHg, respectively. The two critical time points of MAP after intubation and immediately suspending laryngoscopy in group C were significantly higher than group T (P<0.05).The HR of patients in group T at baseline, after induction, after intubation, immediately after suspending laryngoscopy, 1 min after suspending laryngoscopy, 3 min after suspending laryngoscopy, 5 min after suspending laryngoscopy and immediately after extubation was (71.3±10.6), (66.0±10.1), (69.5±11.4), (61.3±14.2), (69.8±9.8), (71.0±10.6), (70.6±11.0), (78.8±11.6) bmp, respectively, while in group C were (73.1±10.9), (67.8±9.9), (79.5±12.9), (57.1±18.1), (69.2±12.8), (71.4±11.7), (70.7±11.5), (85.3±13.0) bmp, respectively. The two critical time points of HR after intubation and after extubation in group C were significantly higher than that of group T (P<0.05). The time to recover breathing in the two groups was (11.8±3.5) min and (11.3±4.6) min, respectively. The time to open eyes was (12.0±3.3) min and (11.5±5.0) min, respectively. The time to extubation was (13.2±3.7) min and (12.6±4.9) min, respectively. There were no statistically significant difference in time to recovery between the two groups (P>0.05). Likewise, there were no toxic reactions to local anesthetics, respiratory depression, hypoxemia, laryngospasm and cough occurred in either group. Conclusion: Topical anesthesia with 1% tetracaine can effectively reduce the hemodynamic changes without influencing patient's recovery, and does not increase the incidence of adverse reactions.

AB1346 ULTRASOUND ASSESSMENT OF SUB-CLINICAL HAND JOINT INFLAMMATION: A COMPARATIVE STUDY BETWEEN EARLY RHEUMATOID AND PSORIATIC ARTHRITIS

Background

Ultrasound (US) detected subclinical inflammation can be present in early psoriatic arthritis (PsA) and rheumatoid arthritis (RA), and also in patients fulfilling clinical remission criteria[1-2]. Numerous evidences support that the persistence of subclinical synovitis detected by US is associated with a high risk of disease progression [2-3].

Objectives

To evaluate sub-clinical inflammation of PsA and RA at the level of small joints of the hand and wrist by B-mode and Power Doppler US.

Methods

30 patients of early PsA and 35 patients of early RA (no clinical evidence of hand joint involvement, PsA disease duration <2 years, and RA disease duration <1 year) were recruited. US [grey scale (GS) and power Doppler (PD)] was performed to assess synovitis, tenosynovitis, joint effusion, and bone erosion of bilateral wrists, metacarpophalangeal joints, proximal and distal interphalangeal joints, as well as the flexor tendons and extensor compartments.

Results

A total of 35 patients were included in the RA group, including 10 males and 25 females. A total of 30 patients were included in the PsA group, including 12 males and 18 females. There were no significant differences in gender composition, age, and duration of disease between the two groups (P>0.05) (Table 1). 19 (63.33%) PsA patients and 16 (45.71%) RA patients had sub-clinical hand joint synovitis. At the joint level, wrist joints were most commonly involved (23.08%), followed by MCP3 (15.38%) and DIP3 (13.46%) in PsA group. In RA group, wrist joints were most commonly involved (55.17%), followed by MCP3 (12.41%), and MCP2 (11.03%). Eight (26.67%) PsA patients and 16 (45.71%) RA patients were detected tenosynovitis. Tenosynovitis was most frequently presented at the extensor tendons in RA and at the flexor tendons in PsA patients (p<0.05). The two most commonly affected were the 4th and 1st extensor compartments in RA patients, and the flexor pollicis longus and flexor digitorum profundus in PsA patients. 81 (6.80%) joint recesses in the RA and 75 (7.35%) joint recesses in PsA were detected effusion. Joint effusion was most frequently detected at radiocarpal and midcarpal joints in RA (30.86%, 25.92%, respectively). Effusion in PsA was most commonly presented at the 3rd PIP joints (26.67%), followed by radiocarpal joints (24.00%). Bone erosions were uncommon, totally 2 (6.67%) PsA patients and 3 (8.57%) RA patients were detected bone erosions.

Table 1.

Demographic characteristics of RA and PsA patients

RA (n=35)PsA (n=30)PFemale, n(%)25 (71.43%)18 (60.00%)0.33Age, years, mean±SD53.20±14.5054.23±13.650.77Disease duration, years, mean±SD0.72±0.370.91±0.530.07

Conclusion

There are significant differences in the US findings of sub-clinical inflammation at the hand and wrist joints, such as the joint effusion and tenosynovitis, which may assist the identification between early RA and PsA. Simultaneously, it should be pointed out that there are some similarities in the joint involvement of sub-clinical synovitis between RA and PsA, physicians should take this into account in clinical work.

Figure 1.

Gray scale ultrasound sagittal view shows synovitis at the wrist joint in an RA patient (A) and at MCP3 in a PsA patient.

References

[1]Freeston JE, Coates LC, Nam JL, et al. Is there subclinical synovitis in early psoriatic arthritis? A clinical comparison with gray-scale and power Doppler ultrasound. Arthritis Care & Research, 2014,66:432-439.

[2]Kawashiri SY, Suzuki T, Nakashima Y, et al. Ultrasonographic examination of rheumatoid arthritis patients who are free of physical synovitis: power Doppler subclinical synovitis is associated with bone erosion. Rheumatology (Oxford), 2014,53:562-569.

[3]Vreju FA, Filippucci E, Gutierrez M, et al. Subclinical ultrasound synovitis in a particular joint is associated with ultrasound evidence of bone erosions in that same joint in rheumatoid patients in clinical remission. Clin Exp Rheumatol, 2016,34:673-678.

Acknowledgements

This work was supported by National Natural Science Foundation of China (No. 82071930).

Disclosure of Interests

None declared

POS1163 PHARMACOKINETICS OF PEGLOTICASE AND METHOTREXATE POLYGLUTAMATE(S) IN PATIENTS WITH UNCONTROLLED GOUT RECEIVING PEGLOTICASE AND CO-TREATMENT WITH METHOTREXATE

Background

In a prior open-label, single-arm trial in adults with uncontrolled gout (MIRROR open-label [OL] trial), methotrexate (MTX) co-treatment with pegloticase suggested improved efficacy of pegloticase by reducing its immunogenicity.1,2 The current randomized, controlled trial (MIRROR RCT) confirmed that pegloticase-MTX co-therapy markedly increased pegloticase response rate (response defined as serum uric acid <6 mg/dL during ≥80% of Month 6) compared to pegloticase-placebo (PBO) co-therapy (71.0% vs. 38.5%) with a decreased infusion reaction rate and no new safety signals reported.

Objectives

To evaluate systemic exposures of pegloticase and its immunogenicity in uncontrolled gout patients receiving pegloticase with and without MTX as part of the MIRROR RCT; and to determine exposure of methotrexate polyglutamate(s) (MTX-PGs) in uncontrolled gout patients through Month 6 of treatment.

Methods

In MIRROR RCT, MTX (15 mg/wk) or matching PBO was given orally 4 weeks prior to the first pegloticase dose and continued weekly, in combination with pegloticase 8 mg given intravenously every 2 weeks, over a 52-week treatment period. Pre-infusion blood samples were collected to measure MTX polyglutamates (MTX-PGs, including MTX-PG1-5) in red blood cells and pre- and post-infusion serum samples were obtained to measure trough (Cmin) and peak (Cmax) concentrations of pegloticase, respectively, at multiple visits. MTX-PG and pegloticase concentrations were summarized by visit and by treatment group. Pre-infusion serum samples for anti-polyethylene glycol (PEG) antibody (Ab) measurement were also collected at multiple pre-defined time points. Anti-PEG Ab incidence and titer were summarized by visit and by treatment group.

Results

Overall, higher Cmax and Cmin of pegloticase were observed in the pegloticase + MTX group than in the pegloticase + PBO group (Figure 1). At Week 14, median (first quartile [Q1], third quartile [Q3]) Cmin was 1.32 (0.73, 1.74) µg/mL and 0.63 (0.30, 1.28) µg/mL for the pegloticase + MTX and pegloticase + PBO groups, respectively. Median (Q1, Q3) Cmax was 3.01 (1.94, 3.94) µg/mL and 2.66 (1.45, 3.20) µg/mL for the pegloticase + MTX and pegloticase + PBO groups, respectively. Improved pegloticase response was associated with higher pegloticase concentrations. At Week 14, Cmin was below the quantitation limit (0.6 µg/mL) for 8 of 10 non-responders and 1.26 (0.72, 1.71) µg/mL for responders. MTX co-administration reduced the incidence of new anti-PEG antibody formation. The proportion of subjects with an increase from baseline in anti-PEG Ab titers or who were negative at baseline and developed an anti-PEG Ab response at ≥1 post-dose time point during pegloticase treatment was 29.5% and 51.0%, for the pegloticase + MTX and pegloticase + PBO groups, respectively. The pegloticase + MTX group had overall lower titer levels than those in the pegloticase + PBO group. Positive anti-PEG Ab status was associated with a lower pegloticase Cmin. Concentrations of MTX-PGs were maintained during the treatment course in the pegloticase + MTX group, suggesting compliance with MTX administration. There was no apparent difference in concentrations of MTX-PGs (including MTX-PG3, the predominant form of MTX-PGs4) between responders and non-responders. MTX-PG concentrations were in the same range as those reported for low-dose oral MTX use in patients with rheumatoid arthritis,3 suggesting no impact of pegloticase on MTX PK.

Conclusion

Pegloticase 8 mg IV every 2 weeks with MTX co-treatment (oral 15 mg weekly) reduced anti-PEG Ab incidence and resulted in higher pegloticase exposures compared to pegloticase administered with PBO, consistent with the increased clinical efficacy observed with pegloticase + MTX co-administration.

References

[1]Botson J, et al. J Rheumatol 2021;48:767-74

[2]Song Y, et al. Arthritis Rheum 2020;72(suppl 10)

[3]Dervieux T, et al. Ann Rheum Dis 2013;72:908-10

[4]Choi R. J Pharm Biomed Anal 2021;201:114124

Disclosure of Interests

Yan Xin Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Yang Song Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Michael E. Weinblatt Consultant of: Horizon Therapeutics, Jason Chamberlain Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Jennifer Zarzoso Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Katie Obermeyer Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Stephen Sainati Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Colleen Canavan Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Srini Ramanathan Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics

[Research Progress on Touch DNA on Cartridge Cases in Forensic Field]

Abstract

Cartridge cases are crucial physical evidence in gun-related crimes. The successful identification of the touch DNA on cartridge cases can help to screen the suspects and reconstruct the gun-related crime scene. With the improvement of DNA extraction methods and the sensitivity of amplification kit, forensic examiners are expected to obtain more valuable information by testing the touch DNA on cartridge cases. In practical cases, the touch DNA detection on cartridge cases often encounters with low DNA content degradation, mixing and the gunshot residual interference, which brings more challenges to DNA examination and identification. This article reviews forensic research of touch DNA on the cartridge cases from the aspects of factors affecting touch DNA on cartridge cases, advances in the extraction and amplification methods, and the practical applications in order to provide reference for forensic identification of touch DNA on the cartridge cases in real cases.

Development of organogel-based emulsions to enhance the loading and bioaccessibility of 5-demethylnobiletin

5-Demethylnobiletin (5-DMN), identified in the aged citrus peels, has received increasing attentions due to its outstanding bioactivity among citrus polymethoxyflavones (PMFs). However, the poor water solubility and high crystallinity limit its oral bioavailability. Besides, the solubility of 5-DMN in the oil is very limited, which restricts its loading capacity in emulsions for bioavailability enhancement. In this study, an organogel formulation was developed to improve the solubility of 5-DMN in medium-chain triacylglycerols by 3.5 times higher without crystal formation during 5-day storage at room temperature. Increasing the gelator (i.e., sugar ester) concentration led to the increase of viscosity and a gel-like structure of the organogel. The ternary phase diagram of organogel-based emulsions was explored, and 40% organogel was selected as the oil phase for emulsion preparation. Increasing the concentration of Tween 80 from 0% to 6% decreased the droplet size and viscoelasticity of the emulsions. Two in vitro models, the pH-stat lipolysis model and TNO gastro-intestinal model (TIM-1), were applied to investigate the bioaccessibility of 5-DMN in different delivery systems. Compared with the conventional emulsion and oil suspension, the pH-stat lipolysis demonstrated that the organogel-based emulsion was the most efficient tool to enhance 5-DMN bioacccessibility. Moreover, TIM-1 digestive study indicated that 5-DMN bioaccessibility delivered by organogel-based emulsions was about 3.26-fold higher than that of oil suspension. Our results suggested that the organogel-based emulsion was an effective delivery route to enhance the loading and bioaccessibility of lipophilic compounds of high crystallinity.

Prediction and New Insight for the Drag Reduction of Turbulent Flow with Polymers and Its Degradation Mechanism

A physicochemical understanding of the mechanism of turbulent flow drag reduction with polymer and its degradation is of great interest from both science and industry perspectives. Although the correlation based on the Fourier series has been proposed to predict the drag reduction and its degradation, its physical meaning was not clear until now. This letter aims to clarify this issue. We develop a comprehensive model to predict the drag reduction and degradation of polymers in turbulent flow from a chemical thermodynamics and kinetics viewpoint. We demonstrate that the Fourier series employed to predict the drag reduction and its degradation is due to the viscoelastic property of drag-reducing polymer solution, and the phase angle in the model, in physical nature, represents the hysteresis of the polymer in turbulent flow. Besides, our new insight of drag reduction with flexible polymers can also explain why a maximum drag reduction in rotational flow appears before degradation happens.

WITHDRAWN: Urban citizen health risk assessment for epidemic pneumonia and research on innovation on economic development

Ahead of Print article withdrawn by publisher.

Comparative Study on Temperature Response of Hydropower Development in the Dry-Hot Valley

Due to the specific hydrothermal conditions of dry-hot valleys, temperature changes caused by the development of large-scale hydropower projects may be more extreme than they are in other regions. In this study, we analyzed these temperature changes at four hydropower stations in both dry-hot and non-dry-hot valleys. Based on the calculated relative temperatures of the downstream river and the areas surrounding the reservoirs, we employed two indices to quantify the influence of the reservoirs on the temperatures of these two regions: the downstream river temperature change and the reservoir effect change intensity. Our results are as follows: (a) In the downstream rivers, the temperature regulation effect was more pronounced in the wet season; in the regions surrounding the reservoirs, the temperature regulation effect was more pronounced in the dry season. (b) The downstream river temperature in both the dry-hot and wet-hot valleys exhibited noticeable warming in both the wet and dry seasons, while the cold-dry valley was characterized by cooling in the dry season and warming in the wet season. With the exception of the Liyuan station (where the influence of the reservoir on the downstream temperatures only extended to a distance of 9 km from the dam) during the dry season, the existence of the hydropower stations affected the temperatures of the entire downstream region. (c) For the areas surrounding the reservoir, the presence of a hydropower station mainly caused the temperatures in the dry-hot valleys to rise and the temperatures in the non-dry-hot valleys to decrease.

POS1136 PHARMACOKINETICS OF PEGLOTICASE AND METHOTREXATE POLYGLUTAMATE(S) IN PATIENTS WITH UNCONTROLLED GOUT RECEIVING PEGLOTICASE AND CO-TREATMENT OF METHOTREXATE

Background:

In an open-label, single-arm trial in adult patients with uncontrolled gout (MIRROR open-label [OL] trial) evaluating pegloticase co-treatment with methotrexate (MTX); 78.6% patients were responders, defined as maintenance of serum uric acid <6 mg/dL for at least 80% of the time during month 6 [weeks 20, 22, and 24]. In comparison, 42% patients achieved a response during month 3 and 6 in historical Phase 3 monotherapy trials of pegloticase (C0405 and C0406)1. MTX co-treatment is shown to improve the pharmacokinetics (PK) of biologics by attenuating the formation of anti-drug antibodies2.

Objectives:

To determine the systemic exposures of pegloticase and methotrexate polyglutamate(s) (MTX-PGs) in uncontrolled gout patients receiving pegloticase and MTX; to evaluate the effect of MTX on the PK of pegloticase in comparison to historical pegloticase monotherapy trials (C0405 and C0406)3, 4; and to evaluate the immunogenicity of pegloticase in co-treatment with MTX.

Methods:

In the MIRROR OL trial, MTX (15 mg/week) was given orally 4 weeks prior to the first pegloticase dose and continued weekly, in combination with pegloticase 8 mg given intravenously every 2 weeks, for a treatment duration of up to 52 weeks. Pre-infusion samples were collected to measure MTX-PGs in red blood cells. Pre- and post-infusion blood samples were obtained to measure the peak (Cmax) and trough (Cmin) concentrations of pegloticase at multiple visits. Anti-drug antibody blood samples were collected at multiple visits. The impact of MTX on pegloticase PK was evaluated by comparing pegloticase exposures with MTX from this trial to historical monotherapy data (C0405 and C0406)3, 4. The observed pegloticase concentrations with MTX were also overlaid with the 90% prediction interval based on the population PK model5 from C0405 and C0406.

Results:

Pegloticase and MTX-PG levels were determined in 14 patients. The 11 responders were generally associated with higher pegloticase exposures than the non-responders, especially Cmin (Figure 1). Concomitant treatment of MTX resulted in fewer patients with Cmin below quantitation limit (BQL) (5/14 [36%] with MTX vs 63/82 [77%] without MTX), and higher overall Cmin (median: 1.03 µg/ml with MTX vs BQL without MTX); Cmax was slightly higher (median [Q1, Q3]: 2.11 [1.65, 2.59] µg/mL with MTX vs 1.51 [BQL, 2.48] µg/mL without MTX). Pegloticase co-treatment with MTX resulted in more concentrations above the predicted median value of pegloticase, compared to monotherapy. ADA data is consistent with pegloticase PK and efficacy. Significant increase in ADA titers were only observed in 2 subjects (both were non-responders) at time corresponding to the loss of pegloticase exposure and increases in sUA levels. Concentrations of MTX-PGs were maintained during the treatment course, suggesting compliance of MTX administration. There was no apparent difference in concentrations of MTX-PGs between responders and non-responders.

Conclusion:

Pegloticase 8 mg IV every 2 weeks co-treatment with MTX 15 mg weekly resulted in fewer patients with pegloticase Cmin below the quantification limit (BQL) and gave higher overall trough concentrations (Cmin) compared to pegloticase monotherapy in the phase 3 studies.

Pegloticase 8 mg IV every 2 weeks co-treatment with MTX 15 mg weekly was associated with an improved response rate for pegloticase in association with improved drug levels in these patients with uncontrolled gout compared to pegloticase monotherapy in the phase 3 studies.

References:

[1]Botson J., et al. J Rheumatol. 2020; doi: 10.3899/jrheum.200460

[2]Goss S. L., et al. Clin Ther;2018, 40 (2).

[3]Lipsky P. E., et al. Arthritis Res Ther;2014, 16 (2).

[4]Sundy J. S., et al. JAMA;2011, 306 (7).

[5]Yue C. S., et al. ASCPT, Atlanta, 2010.

Disclosure of Interests:

Yang Song Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Yan Xin Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Michael E. Weinblatt Shareholder of: Canfite, Inmedix, Lycera, Vorso, Scipher, Grant/research support from: Crescendo Bioscience, Bristol Myers Squibb, Sanofi, Eli Lilly, Amgen, Jason Chamberlain Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Katie Obermeyer Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Lin Zhao Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Colleen Canavan Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Paul M. Peloso Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc, Srini Ramanathan Shareholder of: Horizon Therapeutics plc, Employee of: Horizon Therapeutics plc.

POS1062 ULTRASOUND ASSESSMENT OF SUB-CLINICAL HAND JOINT SYNOVITIS: A COMPARATIVE STUDY BETWEEN PSORIATIC AND RHEUMATOID ARTHRITIS

Background:

Ultrasound (US) detected subclinical synovitis can be present in early psoriatic arthritis (PsA) and rheumatoid arthritis (RA), and also in patients fulfilling clinical remission criteria[1-2]. Numerous evidences support that the persistence of subclinical synovitis detected by US is associated with a high risk of disease progression [2-3].

Objectives:

To evaluate sub-clinical synovitis of PsA and RA at the level of small joints of the hand and wrist by B-mode and Power Doppler US.

Methods:

21 patients of early PsA and 25 patients of early RA (no clinical evidence of hand joint involvement, PsA disease duration <2 years, and RA disease duration <1 year) were recruited. DAS28 and DAPSA score used for assessment of articular disease activity for RA and PsA, respectively. US [grey scale (GS) and power Doppler (PD)] was performed to assess synovitis of bilateral wrists, metacarpophalangeal joints, proximal and distal interphalangeal joints, altogether 30 joints. A GS score ≥2 and/or a PD score ≥1 were used to identify US detected synovitis.

Results:

A total of 25 patients were included in the RA group, including 5 males and 20 females. A total of 21 patients were included in the PsA group, including 7 males and 14 females. There were no significant differences in gender composition, age, and duration of disease between the two groups (P>0.05) (Table 1). 14 (66.67%) PsA patients and 12 (48%) RA patients had sub-clinical hand joint synovitis. Among 630 hand joints scanned in PsA group, 49 (7.78%) joints showed evidence of sub-clinical synovitis. Wrist joint was most commonly involved (24.49%), followed by MCP3 (14.29%), MCP1 (12.24%) and DIP3 (10.20%). Among 750 hand joints scanned in RA group, 110 (14.67%) joints showed evidence of sub-clinical synovitis. Wrist joint was most commonly involved (60.00%), followed by MCP3 (8.24%), MCP1 (8.24%) and MCP2 (7.06%). No correlation noted between numbers of joints with subclinical synovitis with DAPSA and DAS28 score. There was no correlation between number of joints with sub-clinical synovitis and disease activity indices.

Conclusion:

Almost two-thirds patients with PsA and half patients with RA had US evidence of sub-clinical synovitis in wrist and hand joints, most commonly in wrist. There are some similarities in the joint involvement of sub-clinical synovitis between RA and PsA, physicians should take this into account in clinical work.

Table 1.

Demographic characteristics of RA and PsA patients

RA (n=25)PsA (n=21)PFemale, n(%)20 (80.00%)14 (66.67%)0.305Age, years, mean±SD56.32±12.1854.31±15.820.637Disease duration, years, mean±SD1.06±0.590.90±0.580.363

References:

[1]Freeston JE, Coates LC, Nam JL, Moverley AR, Hensor EM, Wakefield RJ, et al. Is there subclinical synovitis in early psoriatic arthritis? A clinical comparison with gray-scale and power Doppler ultrasound. Arthritis care & research 2014, 66:432-439.

[2]Kawashiri SY, Suzuki T, Nakashima Y, Horai Y, Okada A, Iwamoto N, et al. Ultrasonographic examination of rheumatoid arthritis patients who are free of physical synovitis: Power doppler subclinical synovitis is associated with bone erosion. Rheumatology (Oxford), 2014, 53:562-569.

[3]Vreju FA, Filippucci E, Gutierrez M, Di Geso L, Ciapetti A, Ciurea ME, et al. Subclinical ultrasound synovitis in a particular joint is associated with ultrasound evidence of bone erosions in that same joint in rheumatoid patients in clinical remission. Clinical and experimental rheumatology, 2016, 34:673-678.

Acknowledgements:

This work was supported by National Natural Science Foundation of China (No. 82071930 and 81571684).

Disclosure of Interests:

None declared.

Expression of lncRNA TUG1 in hypertensive patients and its relationship with change state of an illness

OBJECTIVE

To investigate the expression of LncRNA TUG1 in hypertensive patients and its relationship with the change state of illness.

PATIENTS AND METHODS

A prospective analysis was carried out. Eighty-two patients with hypertension admitted to our hospital from March 2016 to February 2019 were regarded as a research group, and 79 healthy people admitted to our hospital during the same period were regarded as a control group. The serum LncRNA TUG1, platelet activating factor (PAF), endothelin-1 (ET-1), serum tumor necrosis factor-α (TNF-α), high sensitive C-reactive protein (hsCRP), and the relationship between the expression of LncRNA TUG1 and the clinicopathological characteristics of patients with hypertension in the two groups were detected, and finally, the risk factors of hypertension were analyzed.

RESULTS

The expression levels of LncRNA TUG1, PAF, ET-1, TNF-α, and hsCRP in the serum of patients in research group were significantly higher than those in control group (p<0.05). LncRNA TUG1 has a positive correlation with the severity of an illness of hypertensive patients (r=0.881, p<0.001), and also has a positive correlation with the expression levels of PAF, ET-1, TNF-α, and hsCRP (r=0.735, p<0.001; r=0.756, p<0.001; r=0.712, p<0.05; r=0.723, p<0.05). The expression of LncRNA TUG1 in the serum of patients with hypertension was related to hypertension mode, severity of disease, hyperlipidemia, and obesity (p<0.05). Obesity (OR: 3.469, 95% CI: 2.175-4.095), drinking (OR: 3.677, 95% CI: 1.695-4.892), hyperlipidemia (OR: 3.374, 95% CI: 1.759-6.988), and the high expression of TUG1 (OR: 2.693, 95% CI: 1.679-7.472) are independent risk factors for the attack of hypertension.

CONCLUSIONS

LncRNA TUG1 is highly expressed in the serum of hypertensive patients and it is closely related to the progression of hypertension. Also, it may be one of the independent risk factors for hypertension and a new molecular target for hypertension treatment.

[The study of the protection function of the sphingosine kinase 1 in the nerve cell damage caused by acrylamide]

Objective: To study the protective effect and effect of SphK1 overexpression on the injury of nerve cells induced by acrylamide. Methods: ACR with 99% purity was prepared into 1.25 mmol/L and 2.5 mmol/L solutions. SH-SY5Y cells were divided into control group (NC group) , experimental group and SphK1 activator group. The experimental group was given ACR solution with final concentration of 1.25 mmol/L and 2.5 mmol/L respectively for 24 h. In the SphK1 activator group, on the basis of the exposure concentration of the experimental group, the SphK1 specific activator (12-) phorbol tetradecanoate (-13-) acetate (PMA) solution[prepared by dimethyl sulfoxide (DMSO) , the final concentration was 100 nmol/l], and other treatments were the same as the experimental group. Control group (NC group) added PMA solution into normal cells. Western blot was used to detect the expression of SphK1 protein; CCK-8 was used to detect the proliferation of SH-SY5Y cells; hoechst33342 method was used to observe the morphological changes of nerve cells; flow cytometry was used to analyze the apoptosis of cells. Results: Compared with NC group, the expression of SphK1 protein in the experimental group and the SphK1 activator group was significantly lower (P<0.05) . Compared with the experimental group, the expression of SphK1 protein in each concentration of SphK1 activator group was increased, and the difference was statistically significant (P<0.05) . In addition to 1.25 mmol/L SphK1 activator group, compared with NC group, the relative growth survival rate of experimental group and 2.5 mmol/L SphK1 activator group were lower, the difference was statistically significant (P<0.05) . Compared with the experimental group, the relative survival rate of cells in the SphK1 activator group was higher, and the difference was statistically significant (P<0.05) . With the increase of exposure concentration, the cells in the experimental group showed the morphological characteristics of early apoptosis at ACR 1.25 mmol/L and late apoptosis at ACR 2.5 mmol/L. Compared with NC group, the apoptosis rate of experimental group and SphK1 activator group at ACR 2.5 mmol/L was significantly different (P<0.05) ; compared with experimental group, the apoptosis rate of SphK1 activator group at ACR 2.5 mmol/L was lower, the difference was statistically significant (P<0.05) . Conclusion: The SphK1 excessive expression plays the protective function to the nerve cell damage caused by acrylamide.

Assessment of Oral Bioavailability and Biotransformation of Emulsified Nobiletin Using In Vitro and In Vivo Models

Nobiletin has received much attention for its promising biological activities. Owing to its limited solubility, various encapsulation strategies have been developed to enhance nobiletin bioavailability. However, the understanding of the bioavailability and biotransformation of nobiletin in vivo and the correlation between in vitro and in vivo data remains limited. This study developed a high-loading nobiletin (1%) emulsion. The in vitro models, which combined pH-stat lipolysis with a Franz cell, showed very good correlation with in vivo data for the relative bioavailability. Rat studies showed that nobiletin had a high absolute bioavailability (≈20% for oil suspension). Besides, the emulsification improved the amount of bioavailable nobiletin and its major metabolite in the blood by about two times, as compared to an oil suspension. This work provides scientific insights into a rapid screening method for delivery systems and a better understanding of the biological fate of nobiletin in vivo.

Comparative Analyses of Bioavailability, Biotransformation, and Excretion of Nobiletin in Lean and Obese Rats

Nobiletin, one of the prevalent polymethoxyflavones in citrus peels, was reported to possess various health benefits. We conducted the excretion study and pharmacokinetics study of nobiletin via oral administration and intravenous injection and 15 day consecutive dosing study using the high fat diet-induced obese rats and their lean counterparts. By comparing the demethylated metabolite profiles in the urine and feces, gut microbiota demonstrated greater biotransformation activity on nobiletin than the host. The absolute oral bioavailability of nobiletin in lean (22.37% ± 4.52%) and obese (18.67% ± 4.80%) rats has a negligible statistically significant difference (P > 0.05). However, a higher extent of demethylated metabolites was found in the feces and plasma of obese rats than lean rats (P < 0.05). Moreover, the consecutive dosing of nobiletin might lead to a higher extent of demethylated metabolites in the plasma and in feces. These results suggested that gut microbiota played important roles in nobiletin metabolism.

Effects of early nutritional intervention on oral mucositis in patients with radiotherapy for head and neck cancer

BACKGROUND

To observe the effect of early nutritional intervention on radiation-induced oral mucositis and nutritional status in patients with head and neck cancer (HNC).

METHODS

A total of 54 HNC patients were divided into early (28 cases) and late (26 cases) nutritional intervention groups. The early group received enteral nutrition at the beginning of radiotherapy (RT), while the late group received enteral nutrition after restricted feeding. Operators reported and assessed the timing and extent of oral mucositis and nutritional status during treatment. The nutritional status assessment indicators included body weight; body mass index (BMI); Patient-Generated-Subjective Global Assessment (PG-SGA) score; levels of albumin, hemoglobin and pre-albumin and total lymphocyte count.

RESULTS

The incidence of high-grade oral mucositis was significantly lower in the early group than that in the late group (P < 0.05). Nutritional status assessments showed more significant weight and BMI losses in the late group than in the early group at weeks 4 and 7 after RT (P < 0.01). The albumin decreased in the late group at week 7 after RT was more significant than that in the early group (P < 0.05). Albumin, hemoglobin and pre-albumin levels and total lymphocyte count decreased significantly in both groups (P > 0.05). During therapy, more patients in the early group were well-nourished and fewer were malnourished according to PG-SGA scores (P < 0.05).

CONCLUSION

Early nutritional intervention can reduce the incidence of high-grade oral mucositis during RT in patients with HNC and improve the nutritional status during treatment, which has important clinical significance.

Development and validation of a nomogram to predict the risk of occult cervical lymph node metastases in cN0 squamous cell carcinoma of the tongue

We have explored the relations between clinicopathological features and cervical lymph node metastases (LNM) in patients with cN0 squamous cell carcinoma (SCC) of the tongue, and developed and validated a nomogram for predicting the risk of their development. Clinical data on 230 patients with cN0 SCC of the tongue who had had primary extended excision and lymph node dissection of the neck were collected retrospectively. They were divided into a development cohort and a validation cohort in a 4:1 ratio. Logistic regression analysis was used to assess the risk factors of cervical LNM in patients in the development cohort, and a nomogram was established to predict the risk of such nodes. In the validation cohort, the predictive performance and compliance of the model were evaluated using the consistency index (C-index) and calibration curve, and the clinical value was evaluated by decision curve analysis. Of the 230 patients, 60 had cervical LNM, of which 60 were invaded (26%). Analysis of the development cohort showed that the site of the primary lesion, depth of invasion, size of the tumour, and histopathological grade were included in the prediction model, which was validated in the validation cohort. Consistency was high (C-index=0.846), calibration good, and it was clinically valuable. The nomogram could be used to predict the probability of occult cervical LNM before operation in patients with stage cN0 SCC of the tongue. It could also be used as a reference tool for dissection of cervical nodes and a communication tool between the doctor and the patient.

Type 2 diabetes remission: economic evaluation of the DiRECT/Counterweight-Plus weight management programme within a primary care randomized controlled trial

AIM

The Counterweight-Plus weight management programme achieved 46% remission of Type 2 diabetes at 1 year in the DiRECT trial. We estimated the implementation costs of the Counterweight-Plus programme and its 1-year cost-effectiveness in terms of diabetes remission, compared with usual care, from the UK National Health Service (NHS) perspective.

METHODS

Within-trial total costs included programme set-up and running costs (practitioner appointment visits, low-energy formula diet sachets and training), oral anti-diabetes and anti-hypertensive medications, and healthcare contacts. Total costs were calculated for aggregated resource use for each participant and 95% confidence intervals (CI) were based on 1000 non-parametric bootstrap iterations.

RESULTS

One-year programme costs under trial conditions were estimated at £1137 per participant (95% CI £1071, £1205). The intervention led to a significant cost-saving of £120 (95% CI £78, £163) for the oral anti-diabetes drugs and £14 (95% CI £7.9, £22) for anti-hypertensive medications compared with the control. Deducting the cost-savings of all healthcare contacts from the intervention cost resulted an incremental cost of £982 (95% CI £732, £1258). Cost per 1 year of diabetes remission was £2359 (95% CI £1668, £3250).

CONCLUSIONS

Remission of Type 2 diabetes within 1-year can be achieved at a cost below the annual cost of diabetes (including complications). Providing a reasonable proportion of remissions can be maintained over time, with multiple medical gains expected, as well as immediate social benefits, there is a case for shifting resources within diabetes care budgets to offer support for people with Type 2 diabetes to attempt remission. (Clinical Trial Registry No.: ISRCTN03267836).

The relationship between plasma homocysteine levels and MTHFR gene variation, age, and sex in Northeast China

Background

Hyperhomocysteinemia (HHcy) is the risk factor for cardiovascular disease and stroke. However, the impacts on the genetic variation of methylene tetrahydrofolate reductase (MTHFR) on plasma homocysteine levels in the Northeast Chinese population have not been studied. Therefore, this study was carried out to determine the relationship between HHcy and MTHFR gene variation, and whether it was influenced by age and sex of the population in Northeast China.

Materials and Methods

A total of 466 subjects were randomly enrolled in this study. According to the homocysteine levels (Hcy ≥ 15 μmol/L) of the subjects, they were divided into hyperhomocysteine (HHcy = 206) and normal homocysteine (Hcy = 260). Polymerase chain reaction/high-resolution dissolution curve and homocysteine determination kit methods were used for genotype testing and homocysteine detection, respectively.

Results

High plasma homocysteine levels are associated with MTHFR 677T and 1298A [P < 0.00, odds ratio (confidence interval) = 1.842 (1.418-2.394) >1], which is related to increasing age (P_range = 0.0005-0.0161), with the homocysteine levels of males higher than females (P < 0.0001).

Conclusion

High plasma homocysteine levels were linked to the MTHFR gene mutation. In addition, plasma homocysteine levels increased significantly with age with male's homocysteine levels higher than that of females.

Synthesis of a well-dispersed CaFe2O4/g-C3N4/CNT composite towards the degradation of toxic water pollutants under visible light

Herein, we fabricated a ternary photocatalyst composed of CaFe₂O₄, multiwalled carbon nanotubes (CNTs) and graphitic carbon nitride (g-C₃N₄) via a simple hydrothermal route. CaFe₂O₄ acted as a photosensitizer medium and the CNT acted as a co-catalyst, which remarkably enhanced the photocatalytic performances of g-C₃N₄ towards the degradation of hexavalent chromium (Cr(vi)) and the antibiotic tetracycline (TC) under visible light irradiation. To investigate the morphological and topological features of the photocatalyst, field-emission scanning electron microscopy (FE-SEM) and transmission electron microscopy (TEM) analyses were performed. The surface properties and oxidation state of the CaFe₂O₄/g-C₃N₄/CNT composite were determined by X-ray photoelectron spectroscopy (XPS). The recombination rate of the charge carriers and the band gap values of the as-synthesized catalysts were analyzed by photoluminescence spectroscopy (PL) and diffused reflectance spectroscopy (UV/Vis DRS) studies, respectively. Besides the degradation reactions, the high hydrogen production rate of 1050 μmol h⁻¹ under visible light using the CaFe₂O₄/g-C₃N₄/CNT composite loaded with 5 wt% CNT was observed. The superior photocatalytic performances of the CaFe₂O₄/g-C₃N₄/CNT composite can be ascribed to the effective heterojunction formed between g-C₃N₄ and the CaFe₂O₄ matrix, in which the CNT act as a conducting bridge in the system, promoting the production of photoinduced charge carriers in the semiconductor system. Finally, the plausible photocatalytic mechanism towards the degradation of pollutants and hydrogen production was discussed carefully.

Herein, we fabricated a ternary photocatalyst composed of CaFe₂O₄, multiwalled carbon nanotubes (CNTs) and graphitic carbon nitride (g-C₃N₄) via a simple hydrothermal route.

Correction: Synthesis of a well-dispersed CaFe2O4/g-C3N4/CNT composite towards the degradation of toxic water pollutants under visible light

Correction for ‘Synthesis of a well-dispersed CaFe₂O₄/g-C₃N₄/CNT composite towards the degradation of toxic water pollutants under visible light’ by Fei Liu et al., RSC Adv., 2019, 9, 25750–25761.

[The analysis of pathogens distribution and drug resistance of bacteria in sputum samples of pneumoconiosis patients combined with lower respiratory tract infection.]

Objective: To guide the rational use of antibiotic drugs in clinical practice for doctors by the analysis of pathogens distribution, transition and drug resistance of bacteria in sputum samples of pneumoconiosis patients combined with lower respiratory tract infection. Methods: 2 199 qualified sputum samples from 214 pneumoconiosis patients collected from January 2008 to December 2012 were examined by bacterium or fungus education. BioMerieux API and Eastern Cowin application software were used to do bacterial identification, and K-B method recommended by the NCCLS was used to take drug sensitivity tests. Results: 508 pathogens were isolated from sputum specimens and the positive rate among them was 23.1%. The majority of pathogens were fungus and Gram-negative bacteria, with the detection rates 50.0%, 40.7% respectively. Bacterial identification results show that the majority of pathogens of sputum samples were candida albicans, pseudomonas aeruginosa and acinetobacter baumannii. Susceptibility results show that P. aeruginosa was 100% sensitive to ceftriaxone (non-meningitis) and acinetobacter baumannii was 100% sensitivite to ampicillin/sulbactam, cefoperazone/sul-bactam and imipenem. These two bacteria were resistant to many kinds of antibiotic drugs, and the sensitive rates to cephalothin and clindamycin were 0%. Conclusion: The infections of pneumoconiosis patients combined with lower respiratory tract infection were fungi, pseudomonas aeruginosa and acinetobacter baumannii, which have a significant drug resistance. Doctors should consider the results of laboratory detection of pathogens and sensitivity test to select the antibiotic drugs in order to reduce the generation of resistant strains.

Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study, a collaborative study carried out in 14 countries

AIMS

To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries.

METHODS

People with diabetes aged 18-65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected.

RESULTS

A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (P<0.0001), a lower level of education (P<0.05), doing less exercise (P<0.01), higher levels of diabetes distress (P<0.0001) and a previous diagnosis of major depressive disorder (P<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0-29.6%).

CONCLUSIONS

Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes.

The effect of aspirin on circulating tumor cells in metastatic colorectal and breast cancer patients: a phase II trial study

PURPOSE

Aspirin could reduce the risk of cancer metastasis. Circulating tumor cells (CTCs) are a key factor of cancer metastasis, but no evidence has revealed how aspirin affects CTCs and its epithelial-mesenchymal transition (EMT). Here, we conducted a clinical trial to investigate how aspirin affects CTCs in metastatic colorectal cancer (MCC) and breast cancer patients (MBC).

METHODS

The trial is retrospective registered at clinicaltrials.gov (NCT02602938). The eligible patients are given 100 mg aspirin q.d. for 8 weeks, and CTCs are evaluated at baseline, 4 and 8 weeks for absolute number, phenotype (epithelial type, E+, mesenchymal type, M+, and biophenotypic type, B+), and vimentin expression.

RESULTS

Data on 21 MCC and 19 MBC patients are analyzed, and it revealed that the CTC numbers decreased with aspirin treatment in MCC (p < 0.001) but not MBC (p = 0.0532); besides, ratio of E+ CTCs increased (p = 0.037) and M+ CTCs decreased at 2 months in MCC (p = 0.013), but neither the ratio of E+ or M+ CTCs changes significantly in MBC; vimentin expression of M+ CTCs is higher than E+ and B+ CTCs either in MBC or MCC patients at baseline (p < 0.01); and aspirin suppresses the vimentin expression in M+ (p = 0.002)and B+ (p = 0.006) CTCs of MCC and M+ CTCs of MBC (p = 0.004); besides it find vimentin expression in B+ (p = 0.004) or M+ (p < 0.001), CTCs are markedly decreased in patients with total CTC numbers declined.

CONCLUSION

Aspirin could decrease CTCs numbers and block EMT transition in MCC patients and part of MBC patients.

Measurements of the associated production of a Z boson and b jets in pp collisions at s = 8 TeV

Measurements of the associated production of a Z boson with at least one jet originating from a b quark in proton-proton collisions ats = 8 TeV are presented. Differential cross sections are measured with data collected by the CMS experiment corresponding to an integrated luminosity of 19.8fb - 1 . Z bosons are reconstructed through their decays to electrons and muons. Cross sections are measured as a function of observables characterizing the kinematics of the b jet and the Z boson. Ratios of differential cross sections for the associated production with at least one b jet to the associated production with any jet are also presented. The production of a Z boson with at least two b jets is investigated, and differential cross sections are measured for the dijet system. Results are compared to theoretical predictions, testing two different flavour schemes for the choice of initial-state partons.