The effects of pharmaceutical interventions on potentially inappropriate medications in older patients: a systematic review and meta-analysis

IntroductionPotentially inappropriate medications (PIMs) is a particular concern in older patients and is associated with negative health outcomes. As various interventions have been developed to manage it, we performed a systematic review and meta-analysis to evaluate the effect of pharmaceutical interventions on outcomes of PIMs in older patients.MethodsMeta-analysis of eligible randomized controlled trials (RCTs) was conducted to report the outcomes of pharmaceutical interventions in older patients searching from the databases of Cochrane Library, PubMed, Embase, Web of Science, Clinicaltrials.gov, SinoMed and Chinese Clinical Trial Registry (ChiCTR). The PRISMA guidelines were followed and the protocol was registered in PROSPERO (CRD42019134754). Cochrane bias risk assessment tool and the modified Jadad scale were used to assess the risk bias. RevMan software was used for data processing, analysis and graphical plotting.ResultsSixty-five thousand, nine hundred seventy-one patients in 14 RCTs were included. Of the primary outcomes, pharmaceutical interventions could significantly reduce the incidence of PIMs in older patients (OR = 0.51, 95% CI: 0.42, 0.62; p < 0.001), and the number of PIMs per person (MD = -0.41, 95%CI: −0.51, −0.31; p < 0.001), accompanying by a low heterogeneity. Subgroup analysis showed that the application of computer-based clinical decision support for pharmacological interventions could remarkably decrease the incidence of PIMs and two assessment tools were more effective. Of the secondary outcomes, the meta-analysis showed that pharmacological interventions could reduce the number of drugs used per person (MD = -0.94, 95%CI: −1.51, −0.36; p = 0.001) and 30-day readmission rate (OR = 0.58, 95%CI: 0.36, 0.92; p = 0.02), accompanying by a low heterogeneity. However, the pharmaceutical interventions demonstrated no significant improvement on all-cause mortality and the number of falls.ConclusionOur findings supported the efficacy of pharmaceutical interventions to optimize the use and management of drugs in older patients.Systematic review registrationhttps://clinicaltrials.gov/, CRD42019134754

Insight-HXMT observations of Swift J0243.6+6124 during its 2017-2018 outburst

The recently discovered neutron star transient Swift J0243.6+6124 has been monitored by {\it the Hard X-ray Modulation Telescope} ({\it Insight-\rm HXMT). Based on the obtained data, we investigate the broadband spectrum of the source throughout the outburst. We estimate the broadband flux of the source and search for possible cyclotron line in the broadband spectrum. No evidence of line-like features is, however, found up to $\rm 150~keV$. In the absence of any cyclotron line in its energy spectrum, we estimate the magnetic field of the source based on the observed spin evolution of the neutron star by applying two accretion torque models. In both cases, we get consistent results with $B\rm \sim 10^{13}~G$, $D\rm \sim 6~kpc$ and peak luminosity of $\rm >10^{39}~erg~s^{-1}$ which makes the source the first Galactic ultraluminous X-ray source hosting a neutron star.Comment: publishe

Overview to the Hard X-ray Modulation Telescope (Insight-HXMT) Satellite

As China's first X-ray astronomical satellite, the Hard X-ray Modulation Telescope (HXMT), which was dubbed as Insight-HXMT after the launch on June 15, 2017, is a wide-band (1-250 keV) slat-collimator-based X-ray astronomy satellite with the capability of all-sky monitoring in 0.2-3 MeV. It was designed to perform pointing, scanning and gamma-ray burst (GRB) observations and, based on the Direct Demodulation Method (DDM), the image of the scanned sky region can be reconstructed. Here we give an overview of the mission and its progresses, including payload, core sciences, ground calibration/facility, ground segment, data archive, software, in-orbit performance, calibration, background model, observations and some preliminary results.Comment: 29 pages, 40 figures, 6 tables, to appear in Sci. China-Phys. Mech. Astron. arXiv admin note: text overlap with arXiv:1910.0443

Subjective or objective: How the style of text in computational advertising influences consumer behaviors?

In the era of computational advertising, advertising effectiveness can be measured by different metrics at different stages of the sales funnel. In the upper funnel, the click-through rate (CTR, the rate of click per impression) represents the attractiveness of the advertising; the conversion rate (CVR, the rate of conversion per click) in the lower funnel indicates the persuasiveness of the advertising. Achieving higher CTR and CVR may need distinct advertising strategies: improving CTR requires raising more consumers’ interest in the ad, which is more beneficial to publishers; boosting CVR needs the ad to inspire more consumers’ desire in the product (service), which is more profitable to advertisers. In order to study the performance of advertising texts in terms of the two dimensions and reconcile the two different goals, this paper draws on Speech act theory (SAT) in linguistics to classify advertising texts into three types (i.e., assertive, expressive, and directive), and analyzes how advertising texts can impact consumer behaviors. We further categorize the above three styles of advertising texts into subjective type (i.e., expressive and directive) and objective type (i.e., assertive). Based on a field study, we find that subjective advertising with more personalization leads to a higher CTR, while objective advertising with higher consistency with the brand information results in a higher CVR. The results suggest that firms with different marketing goals should utilize different styles of advertising texts to elicit desirable consumer behaviors during different stages of the sales funnel

Hyaluronic acid injection in the auricular base for the aesthetic correction of lying ears: A retrospective study

Background: Ears play an important role in facial profiles. Lying ears are not perceived favorably in Asian cultures; therefore, surgical procedures are implemented to adjust this defect. However, surgery has complications and requires recovery time. We introduced a hyaluronic acid (HA) injection technique to aesthetically improve ear prominence. Methods: This retrospective study examined 25 Chinese patients aged 20–47 years with congenital lying ears who received HA injections in the auricular base at Shanghai Ninth People’s Hospital and Hangzhou Yijie Medical Cosmetology Clinic between November 2019 and December 2022. The average injection volume was 6.32 ​± ​1.22 mL in the auricular base unilaterally, and the follow-up time ranged from 6 to 24 months. Morphological measurement data were recorded. Two-dimensional (2D) and three-dimensional (3D) images were obtained to evaluate the effects. Results: All patients showed improvements in ear prominence. The cranioauricular angle (CAA) increased from 22.24° ​± ​4.53° to 65.90° ​± ​5.38° immediately post-injection and was maintained at 49.18° ​± ​4.74° 6 months later. The ear projection (EP) increased from 14.75 ​± ​2.72 mm to 26.26 ​± ​2.94 mm immediately post-injection and was 22.51 ​± ​2.68 mm after 6 months. No serious complications were noted. Conclusion: HA injection in the auricular base effectively corrected the lying ears and aesthetically optimized the facial profile. It also had a face-lift effect that made the face look younger and more compact. The injection procedure was minimally invasive and required no recovery period. The effect was maintained for a long time and was satisfactory

Green accounting for forest and green policies in China -- A pilot national assessment

Green accounting is a debated issue. This pilot study for the first time estimates the values of China's forest resources and calculates its forest green GDP. It relies primarily on existing data on previously published information by the government in China. Our estimates indicate that the total stock value of forestlands and standing timber in 1999 was 4564.43 billion Yuan (RMB) in China, in 2003 was 5273.05 billion Yuan, and the sum of flow values of forest resources from 1999 to 2003 was 11,072.36 billion Yuan annually. In the value of forest ecological services, the value of water conservation was largest, and the value of air pollution and dust purifying was least. The nation's eaGDP (environmentally adjusted GDP) for forest in 1999 was 9281.55 billion Yuan, Larger than GDP of 8967.71 billion Yuan, the eaNDP (environmentally adjusted NDP) for forest was 9280.73 billion Yuan, was about 1.05 times that of the NDP. In 2003 both of the eaGDP and eaNDP for forest calculated by the production method at the marketing price exceeded the conventional GDP and NDP, but the annual average growth rate of eaNDP for forest was 10.68%, less than the annual average growth rate of NDP 11.27% during the accounting period, which mostly caused by the increased depreciation value of the planted forest, and the loss of forest resource assets and degradation of forest environment assets since the greater economic development in recent years in China. We propose that forest compensation should be enhanced, and the legal protection of forests should be strengthened, as well as the economic activities which cause deterioration in forest service functions should be avoided or at least minimized.Green accounting Forests Evaluation Green GDP Policy-making

Clinical effects of injectable collagen in lower-lid pretarsal fullness rejuvenation

Background: Lower-lid pretarsal fullness rejuvenation is a popular surgery for Asian women. However, the current procedures have clinical complications and are not stable in the long-term. Here, we analyzed the effect of injectable collagen on lower-lid pretarsal fullness rejuvenation. Methods: To investigate the clinical effect of injectable collagen in lower-lid pretarsal fullness rejuvenation, we observed 32 Chinese Han female patients aged 18–55 years with non-distinctive lower-lid pretarsal fullness and no history of lower eyelid surgery or trauma. The injectable collagen products were used for local filling correction. After surgery, the patients were followed up for 12 months. A correction effect was evaluated through an analysis of volume changes using a visual analog scale. Adverse reactions were also recorded. Results: All patients achieved good aesthetic outcomes and strong stereoscopic impressions of lower-lid pretarsal fullness. Complications, such as edema and bruising, were not observed after the injection. Immediately after the operation, the average visual analog score was 2.65 ​± ​0.56. Six months after the operation, the average visual analog score was 2.96 ​± ​0.41. The patients reported high satisfaction levels. Immediately after the operation, the average lower-lid pretarsal fullness volume increase was 0.19 ​± ​0.04 ​mL on the left side and 0.21 ​± ​0.03 ​mL on the right side. After a 12-month follow-up, the average residual volume was 0.17 ​± ​0.06 ​mL on the left side and 0.19 ​± ​0.04 ​mL on the right side, suggesting that the injected collagen impact was stable. Conclusion: Injectable collagen promotes a vivid, natural appearance and is highly effective in rejuvenating lower-lid pretarsal fullness with low absorption rates in later stages. Therefore, injectable collagen should be considered in correcting congenital, non-distinctive, lower-lid pretarsal fullness in clinical practice