The usage and costs of national drug price-negotiated anticancer medicines in a first-tier city in Northeast China: a study based on health insurance data.

BACKGROUND: The National Drug Price Negotiation (NDPN) policy has entered a normalisation stage, aiming to alleviate, to some extent, the disease-related and economic burdens experienced by cancer patients. This study analysed the use and subsequent burden of anticancer medicines among cancer patients in a first-tier city in northeast China. METHODS: We assessed the usage of 64 negotiated anticancer medicines using the data on the actual drug deployment situation, the frequency of medical insurance claims and actual medication costs. The affordability of these medicines was measured using the catastrophic health expenditure (CHE) incidence and intensity of occurrence. Finally, we used the defined daily doses (DDDs) and defined daily doses cost (DDDc) as indicators to evaluate the actual use of these medicines in the region. RESULTS: During the study period, 63 of the 64 medicines were readily available. From the perspective of drug usage, the frequency of medical insurance claims for negotiated anticancer medicines and medication costs showed an increasing trend from 2018 to 2021. Cancer patients typically sought medical treatment at tertiary hospitals and purchased medicines at community pharmacies. The overall quantity and cost of medications for patients covered by the Urban Employee Basic Medical Insurance (UEBMI) were five times higher than those covered by the Urban and Rural Resident Medical Insurance (URRMI). The frequency of medical insurance claims and medication costs were highest for lung and breast cancer patients. Furthermore, from 2018 to 2021, CHE incidence showed a decreasing trend (2.85-1.60%) under urban patients' payment capability level, but an increasing trend (11.94%-18.42) under rural patients' payment capability level. The average occurrence intensities for urban (0.55-1.26 times) and rural (1.27-1.74 times) patients showed an increasing trend. From the perspective of drug utilisation, the overall DDD of negotiated anticancer medicines showed an increasing trend, while the DDDc exhibited a decreasing trend. CONCLUSION: This study demonstrates that access to drugs for urban cancer patients has improved. However, patients' medical behaviours are affected by some factors such as hospital level and type of medical insurance. In the future, the Chinese Department of Health Insurance Management should further improve its work in promoting the fairness of medical resource distribution and strengthen its supervision of the nation's health insurance funds.

A facile chemiluminescence sensing for ultrasensitive detection of heparin using charge effect of positively-charged AuNPs.

Heparin is a glycosaminoglycan with the highest negative charge density of any known biological molecule. Herein, this highly negative charge structure of heparin and the charge effect from positively-charged AuNPs for luminol chemiluminescence (CL) reaction were combined to build a facile and sensitive CL strategy for detection of heparin. The highly negative charge structure of heparin molecules (four negatively-charged side groups per repeat unit) and the effective signal amplification of charge effect from positively-charged AuNPs make this analysis to display high sensitivity for heparin detection, and the detection limit is as low as 0.06 ng/mL. It is about two orders of magnitude lower than the previously reported colorimetric assay and far lower than the current analysis methods. The established CL strategy is to use the electrostatic interaction between heparin and signal probe (positively-charged AuNPs). Since polyanionic heparin has the highest negative charge in biological system, this CL sensing shows high selectivity for the detection of heparin, and hyaluronic acid (HA), an analogue of heparin, cannot cause interference. This CL sensing succeeded in detecting heparin in human serum samples. Besides, polycationic protamine, heparin antidote, can respond to the system's CL signals through its strong interactions with heparin, thus indirectly detecting protamine. For protamine in serum samples, the detection result was basically consistent with Coomassie brilliant blue assay.

Improved image quality of low-dose CT combining with iterative model reconstruction algorithm for response assessment in patients after treatment of malignant tumor.

BACKGROUND: To evaluate the image quality and radiation dose of low-dose (LD) computed tomography (LD-CT) combining with iterative model reconstruction (IMR) algorithm for response assessment in patients after treatment of malignant tumor compared with routine-dose CT (RD-CT). METHODS: Forty-seven patients [mean age 57.8±10.9 years, 30 males, body mass index (BMI) 22.09±2.35 kg/m2] after treatment of malignant tumor underwent contrast-enhanced chest and abdomen CT twice for response assessment with an interval of 6 months according to clinical routine. The first CT scans were performed with RD protocol at 120 kVp and images were reconstructed with filtered back projection (FBP) algorithm; while the second scans were performed with LD protocol at 100 kVp and images were reconstructed with FBP and IMR algorithm respectively. All scans were performed using an automatic tube current modulation technique with 150 mAs as reference. Objective image quality including CT attenuation, image noise, and contrast to noise ratio (CNR), and subjective image quality including artifacts, noise, visualization of small structures and confidence of targeted lesions, as well as lesion detection were assessed and compared. RESULTS: Effective radiation dose of LD-CT scans was reduced 54.8% compared to RD-CT scans (26.89±3.35 vs. 12.14±2.09 mSv). Higher CT attenuation was found in both LD-IMR and LD-FBP images compared to RD-FBP images. Better subjective image quality and CNR as well as lower objective noise were found in LD-IMR images (all, P<0.05). Two small lesions with the diameter less than 1 cm were missed in LD-FBP images, which were able to be observed in LD-IMR images. CONCLUSIONS: IMR is able to help more than half of reduction of radiation dose without compromising the quality of diagnostic information in patients after treatment of malignant tumors to chest and abdomen CT for response assessment.

Simple and rapid chemiluminescence aptasensor for Hg2+ in contaminated samples: A new signal amplification mechanism.

Detection of ultralow concentration of heavy metal ion Hg2+ is important for human health protection and environment monitoring because of the gradual accumulation in environmental and biological fields. Herein, we report a convenient chemiluminescence (CL) biosensing platform for ultrasensitive Hg2+ detection by signal amplification mechanism from positively charged gold nanoparticles ((+)AuNPs). It is based on (+)AuNPs charge effect and aptamer conformation change induced by target to stimulate the generation of CL in the presence of H2O2 and luminol without high salt medium. Notably particularly, the typical problem of the high salt medium from (-) AuNPs system, like influencing aptamers' bind with target and hindering CL reaction can be effectively addressed through the direct introduction of (+)AuNPs. Therefore, the proposed biosensing exhibits a high sensitivity toward target Hg2+ with a detection limit of 16 pM, which is far below the limit (10nM) defined by the U.S. Environmental Protection Agency in drinkable water, and is about 10-fold lower than the previously reported aptamer-based assays for Hg2+. This sensing platform provides a simple, rapid, and cost-effective approach for label-free sensitive detection of Hg2+. Moreover, it is universal for the detection of other targets. Undoubtedly, such a direct utilizing of (+)AuNPs' charge effect will provide a new signal amplification way for label-free aptamer-based CL analysis.

A simple and rapid chemiluminescence aptasensor for acetamiprid in contaminated samples: Sensitivity, selectivity and mechanism.

Ultralow concentration and selective detection of pesticide residue is important to evaluate the environmental and biological pollution and the threat to human health which single component pesticide can bring. Herein, we report an amplified chemiluminescence (CL) sensing platform for ultrasensitive and selective acetamiprid (widely used pesticide) detection. It is based on aptamer's high binding affinity to target and the relevance between AuNPs' morphology and its catalytic effect to stimulate the generation of CL in the presence of H2O2 and luminol. Moreover, AuNPs morphological slight change induced by aptamers' conformation during targets binding could lead to the significant change of catalytic properties. Therefore, the proposed sensing platform for pesticide residue exhibited a high sensitivity toward acetamiprid with a detection limit of 62pM, which was about 100-fold lower than that of other aptamer-based sensor for acetamiprid detection. Because of the intrinsic specificity of aptamer's recognization, this sensing platform has high selectivity. So, this sensing platform provides a label-free and cost-effective approach for sensitive and selective detection of single component pesticide residue. More importantly, this CL method was successfully used to determine acetamiprid in real contaminated samples.

Rapid and sensitive detection of potassium ion based on K(+)-induced G-quadruplex and guanine chemiluminescence.

A simple and rapid method for detection of potassium ion (K(+)) based on a guanine chemiluminescence (CL) system is presented. In this system, one guanine-rich DNA molecule is used as the recognition element. K(+) can cause the guanine-rich DNA to form a G-quadruplex conformation, resulting in remarkable quenching of the guanine CL intensity of guanine-rich DNA. The CL intensity of this CL system decreased with increasing K(+) concentration, revealing a linear relationship in K(+) concentration range from 3 × 10(-5) to 1 × 10(-3) M. A complete detection process can be accomplished in about 5 min. Other common cations (such as Na(+), NH4 (+), Mg(2+), Ca(2+), Zn(2+), and Pb(2+)) did not notably interfere with K(+) detection. The mechanism of this strategy is also discussed. The sensing strategy is low cost and simple without the requirement of complex labeling of probe DNA. The scheme is applicable to the detection of other guanine-rich aptamer-binding chemicals or biomolecules.

Relative Hidden Markov Models for Video-Based Evaluation of Motion Skills in Surgical Training.

A proper temporal model is essential to analysis tasks involving sequential data. In computer-assisted surgical training, which is the focus of this study, obtaining accurate temporal models is a key step towards automated skill-rating. Conventional learning approaches can have only limited success in this domain due to insufficient amount of data with accurate labels. We propose a novel formulation termed Relative Hidden Markov Model and develop algorithms for obtaining a solution under this formulation. The method requires only relative ranking between input pairs, which are readily available from training sessions in the target application, hence alleviating the requirement on data labeling. The proposed algorithm learns a model from the training data so that the attribute under consideration is linked to the likelihood of the input, hence supporting comparing new sequences. For evaluation, synthetic data are first used to assess the performance of the approach, and then we experiment with real videos from a widely-adopted surgical training platform. Experimental results suggest that the proposed approach provides a promising solution to video-based motion skill evaluation. To further illustrate the potential of generalizing the method to other applications of temporal analysis, we also report experiments on using our model on speech-based emotion recognition.

Visual chiral recognition of tryptophan enantiomers using unmodified gold nanoparticles as colorimetric probes.

A simple protocol to distinguish enantiomers is extremely intriguing and useful. In this study, we propose a low-cost, facile, sensitive method for visual chiral recognition of enantimers. It is based on the inherent chirality of gold nanoparticles (AuNPs), and the unmodified AuNPs are used as chiral selector for D- and L-Tryptophan (Trp). In the presence of D-Trp, an appreciable red-to-blue color change of AuNPs solution can be observed, whereas no color change is found in the presence of L-Trp. The method can be used to detect D-Trp in the range of 0.2-10 µM, and the limit of detection is 0.1 µM. The chiral assay described in this work is easily readout with the naked eye or using a UV-vis spectrometer. Furthermore, the AuNPs can selectively adsorb D-Trp, and simple centrifugation can allow the precipitation of D-Trp with AuNPs and leave a net excess of the other enantiomer in solution, thus resulting in enantioseparation. In this method, AuNPs do not need any labeling or modifying with chiral molecules. The method is more attractive because of its high sensitivity, low cost, ready availability and simple manipulation.

Exploiting motion correlations in 3-D articulated human motion tracking.

In 3-D articulated human motion tracking, the curse of dimensionality renders commonly-used particle-filter-based approaches inefficient. Also, noisy image measurements and imperfect feature extraction call for strong motion prior. We propose to learn the correlation between the right-side and the left-side human motion using partial least square (PLS) regression. The correlation effectively constrains the sampling of the proposal distribution to portions of the parameter space that correspond to plausible human motions. The learned correlation is then used as motion prior in designing a Rao-Blackwellized particle filter algorithm, RBPF-PLS, which estimates only one group of state variables using the Monte Carlo method, leaving the other group being exactly computed through an analytical filter that utilizes the learned motion correlation. We quantitatively assessed the accuracy of the proposed algorithm with challenging HumanEva-I/II data set. Experiments with comparison with both the annealed particle filter and the standard particle filter show that the proposed method achieves lower estimation error in processing challenging real-world data of 3-D human motion. In particular, the experiments demonstrate that the learned motion correlation model generalizes well to motions outside of the training set and is insensitive to the choice of the training subjects, suggesting the potential wide applicability of the method.

Application of waste eggshell as low-cost solid catalyst for biodiesel production.

Waste eggshell was investigated in triglyceride transesterification with a view to determine its viability as a solid catalyst for use in biodiesel synthesis. Effect of calcination temperature on structure and activity of eggshell catalysts was investigated. Reusability of eggshell catalysts was also examined. It was found that high active, reusable solid catalyst was obtained by just calcining eggshell. Utilization of eggshell as a catalyst for biodiesel production not only provides a cost-effective and environmental friendly way of recycling this solid eggshell waste, significantly reducing its environmental effects, but also reduces the price of biodiesel to make biodiesel competitive with petroleum diesel.