Epidemiology of potential drug- drug interactions in hospitalized patients with type 2 diabetes mellitus in China: a retrospective study

BackgroundCombination therapy was associated with an increased risk of drug- drug interactions (DDIs) in patients with type 2 diabetes mellitus (T2DM). The present study aimed to investigate the epidemiology of potential DDIs (pDDIs), including potential chemical drug-drug interactions (pCDIs) and potential herb-drug interactions (pHDIs), and classify the influencing factors of pDDIs in these patients.MethodsA retrospective study of the epidemiology of pDDIs among T2DM hospitalized patients older than 18 years and treated with at least two drugs during hospitalization was conducted over a 12-month period in 2019. PDDIs were identified with C (monitor therapy), D (consider therapy modification), and X (avoid combination) risk ratings. Binary logistic regression was used to analyze the risk factors of pDDIs.ResultsA total of 6796 pDDIs were identified from 737 T2DM hospitalized patients during hospitalization, with 0.87% classified as X risk rating, 13.39% as D risk rating. Additionally, 1753 pDDIs were identified after discharge, with 0.11% as X and 25.73% as D risk rating. The drug-drug association networks showed that the majority of pCDIs were associated with cardiovascular system drugs. Chlorphenamine-potassium chloride and danshen-warfarin were the most prevalent interacting pairs of pCDIs and pHDIs with X rating during hospitalization. Multivariate analysis indicated that the likelihood of developing over 4 pDDIs was significantly higher among T2DM patients who had received over 8 medications. The presence of pDDIs after discharge was strongly associated with the complications of T2DM and the number of discharge medications.ConclusionsT2DM patients were frequently exposed to pDDIs, including pCDIs and pHDIs, both during hospitalization and after discharge. Multi-drug combination was the primary risk factor for pDDIs. Strategies such as enhancing the monitoring and warning for pDDIs, increasing clinical pharmacological experience, as well as developing universally applicable clinical guidelines for pDDIs may be beneficial in reducing the incidence of potentially harmful drug-combinations

Mechanism of Subordinate Peak Skewing of FBG Sensor during Cracks Propagation Monitoring on Aluminum Alloy Structure

This study investigates the variety of the spectra features of fiber Bragg grating (FBG) around the crack tip during fatigue crack propagation. The study results reveal that the turning of the subordinate peak is significantly associated with crack lengths and corresponds to strain gradient along the FBG. Meanwhile, the strain distribution sensed by the FBG changes with the sensing section of the grating. FBG sensors could observe the monotonic plastic zone ahead of the fatigue crack tip. The cubic strain is distributed along the grating, with monotonic plastic zone propagation at the initial and terminal part of the grating, at approximately a 30% ratio of the entire grating. However, the monotonic plastic zone is sensed by the FBG, at ±15% bias of the grating center, with the quadratic strain gradient pattern along the grating. In particular, when the initial and terminal parts of the grating experience highly inhomogeneous strain distribution, the spectrum distortion occurs

Inflammatory Cytokine-Induced Intercellular Adhesion Molecule-1 and Vascular Cell Adhesion Molecule-1 in Mesenchymal Stem Cells Are Critical for Immunosuppression

Cell-cell adhesion mediated by ICAM-1 and VCAM-1 is critical for T cell activation and leukocyte recruitment to the inflammation site and, therefore, plays an important role in evoking effective immune responses. However, we found that ICAM-1 and VCAM-1 were critical for mesenchymal stem cell (MSC)-mediated immunosuppression. When MSCs were cocultured with T cells in the presence of T cell Ag receptor activation, they significantly upregulated the adhesive capability of T cells due to the increased expression of ICAM-1 and VCAM-1. By comparing the immunosuppressive effect of MSCs toward various subtypes of T cells and the expression of these adhesion molecules, we found that the greater expression of ICAM-1 and VCAM-1 by MSCs, the greater the immunosuppressive capacity that they exhibited. Furthermore, ICAM-1 and VCAM-1 were found to be inducible by the concomitant presence of IFN-γ and inflammatory cytokines (TNF-α or IL-1). Finally, MSC-mediated immunosuppression was significantly reversed in vitro and in vivo when the adhesion molecules were genetically deleted or functionally blocked, which corroborated the importance of cell-cell contact in immunosuppression by MSCs. Taken together, these findings reveal a novel function of adhesion molecules in immunoregulation by MSCs and provide new insights for the clinical studies of antiadhesion therapies in various immune disorders. Copyright © 2010 by The American Association of Immunologists, Inc

Investigation on Characteristic Variation of the FBG Spectrum with Crack Propagation in Aluminum Plate Structures

In order to monitor the crack tip propagation of aluminum alloy, this study investigates the variation of the spectrum characteristics of a fiber Bragg grating (FBG), combined with an analysis of the spectrum simulation. The results identify the location of the subordinate peak as significantly associated with the strain distribution along the grating, corresponding to the different plastic zones ahead of the crack tip with various crack lengths. FBG sensors could observe monotonic and cyclic plastic zones ahead of the crack tip, with the quadratic strain distribution along the grating at the crack tip-FBG distance of 1.2 and 0.7 mm, respectively. FBG sensors could examine the process zones ahead of the crack tip with the cubic strain distribution along the grating at the crack tip-FBG distance of 0.5 mm. The spectrum oscillation occurs as the crack approaches the FBG where the highly heterogeneous strain is distributed. Another idea is to use a finite element method (FEM), together with a T-matrix method, to analyze the reflection intensity spectra of FBG sensors for various crack sizes. The described crack propagation detection system may apply in structural health monitoring

A Fiber Bragg Grating Interrogation System with Self-Adaption Threshold Peak Detection Algorithm

A Fiber Bragg Grating (FBG) interrogation system with a self-adaption threshold peak detection algorithm is proposed and experimentally demonstrated in this study. This system is composed of a field programmable gate array (FPGA) and advanced RISC machine (ARM) platform, tunable Fabry–Perot (F–P) filter and optical switch. To improve system resolution, the F–P filter was employed. As this filter is non-linear, this causes the shifting of central wavelengths with the deviation compensated by the parts of the circuit. Time-division multiplexing (TDM) of FBG sensors is achieved by an optical switch, with the system able to realize the combination of 256 FBG sensors. The wavelength scanning speed of 800 Hz can be achieved by a FPGA+ARM platform. In addition, a peak detection algorithm based on a self-adaption threshold is designed and the peak recognition rate is 100%. Experiments with different temperatures were conducted to demonstrate the effectiveness of the system. Four FBG sensors were examined in the thermal chamber without stress. When the temperature changed from 0 °C to 100 °C, the degree of linearity between central wavelengths and temperature was about 0.999 with the temperature sensitivity being 10 pm/°C. The static interrogation precision was able to reach 0.5 pm. Through the comparison of different peak detection algorithms and interrogation approaches, the system was verified to have an optimum comprehensive performance in terms of precision, capacity and speed

Time-Variant Reliability Analysis for Rubber O-Ring Seal Considering Both Material Degradation and Random Load

Due to the increase in working hours, the reliability of rubber O-ring seals used in hydraulic systems of transfer machines will change. While traditional methods can only analyze one of the material properties or seal properties, the failure of the O-ring is caused by these two factors together. In this paper, two factors are mainly analyzed: the degradation of material properties and load randomization by processing technology. Firstly, the two factors are defined in terms of material failure and seal failure, before the experimental methods of rubber materials are studied. Following this, the time-variant material properties through experiments and load distribution by monitoring the processing can be obtained. Thirdly, compressive stress and contact stress have been calculated, which was combined with the reliability model to acquire the time-variant reliability for the O-ring. Finally, the life prediction and effect of oil pressure were discussed, then compared with the actual situation. The results show a lifetime of 12 months for the O-ring calculated in this paper, and compared with the replacement records from the maintenance workshop, the result is credible

The value of dual-energy spectral CT in differentiating solitary pulmonary tuberculosis and solitary lung adenocarcinoma

BackgroundTo explore the value of dual-energy spectral CT in distinguishing solitary pulmonary tuberculosis (SP-TB) from solitary lung adenocarcinoma (S-LUAD).MethodsA total of 246 patients confirmed SP-TB (n = 86) or S-LUAD (n = 160) were retrospectively included. Spectral CT parameters include CT40keV value, CT70keV value, iodine concentration (IC), water concentration (WC), effective atomic number (Zeff), and spectral curve slope (λ70keV). Data were measured during the arterial phase (AP) and venous phase (VP). Chi-square test was used to compare categorical variables, Wilcoxon rank-sum test was used to compare continuous variables, and a two-sample t-test was used to compare spectral CT parameters. ROC curves were used to calculate diagnostic efficiency.ResultsThere were significant differences in spectral CT quantitative parameters (including CT40keV value [all P< 0.001] , CT70keV value [all P< 0.001], λ70keV [P< 0.001, and P = 0.027], Zeff [P =0.015, and P = 0.001], and IC [P =0.002, and P = 0.028]) between the two groups during the AP and VP. However, WC (P = 0.930, and P = 0.823) was not statistically different between the two groups. The ROC curve analysis showed that the AUC in the AP and VP was 90.9% (95% CI, 0.873-0.945) and 83.4% (95% CI, 0.780-0.887), respectively. The highest diagnostic performance (AUC, 97.6%; 95% CI, 0.961-0.991) was achieved when all spectral CT parameters were combined with clinical variables.ConclusionDual-energy spectral CT has a significant value in distinguishing SP-TB from S-LUAD

Development of a Nomogram Based on 3D CT Radiomics Signature to Predict the Mutation Status of EGFR Molecular Subtypes in Lung Adenocarcinoma: A Multicenter Study

BackgroundThis study aimed to noninvasively predict the mutation status of epidermal growth factor receptor (EGFR) molecular subtype in lung adenocarcinoma based on CT radiomics features.MethodsIn total, 728 patients with lung adenocarcinoma were included, and divided into three groups according to EGFR mutation subtypes. 1727 radiomics features were extracted from the three-dimensional images of each patient. Wilcoxon test, least absolute shrinkage and selection operator regression, and multiple logistic regression were used for feature selection. ROC curve was used to evaluate the predictive performance of the model. Nomogram was constructed by combining radiomics features and clinical risk factors. Calibration curve was used to evaluate the goodness of fit of the model. Decision curve analysis was used to evaluate the clinical applicability of the model.ResultsThere were three, two, and one clinical factor and fourteen, thirteen, and four radiomics features, respectively, which were significantly related to each EGFR molecular subtype. Compared with the clinical and radiomics models, the combined model had the highest predictive performance in predicting EGFR molecular subtypes [Del-19 mutation vs. wild-type, AUC=0.838 (95% CI, 0.799-0.877); L858R mutation vs. wild-type, AUC=0.855 (95% CI, 0.817-0.894); and Del-19 mutation vs. L858R mutation, AUC=0.906 (95% CI, 0.869-0.943), respectively], and it has a stable performance in the validation set [AUC was 0.813 (95% CI, 0.740-0.886), 0.852 (95% CI, 0.790-0.913), and 0.875 (95% CI, 0.781-0.929), respectively].ConclusionOur combined model showed good performance in predicting EGFR molecular subtypes in patients with lung adenocarcinoma. This model can be applied to patients with lung adenocarcinoma