Genotoxicity assessment of titanium dioxide nanoparticles using a standard battery of in vivo assays.

As one representative of nanometal oxides, titanium dioxide nanoparticles (TiO2-NPs) have been widely used, particularly in the food industry. The genotoxicity of TiO2-NPs has attracted great attention over the years. This study was undertaken to investigate the chromosome and DNA damage effects of TiO2-NPs (0, 50, 150, and 500 mg/kg BW) using rodent models. After a comprehensive characterization, we conducted a standard battery of in vivo genotoxicity tests, including the chromosomal aberration test (CA), micronucleus (MN) test, and the comet test. The results of all these tests were negative. There were no structural or numerical chromosomal abnormalities in mice bone marrow cells, no increase in the frequency of micronucleated polychromatic erythrocytes in mice bone marrow cells, and no elevation in % tail DNA in rat hepatocytes. This indicated that TiO2-NPs did not cause chromosomal damage or have a direct impact on DNA. These findings suggested that TiO2-NPs did not exhibit genotoxicity and provided valuable data for risk assessment purposes.

An Energy-Economic-Environment Tri-Objective Evaluation Method for Gas Membrane Separation Processes of H2/CO2.

For pre-combustion carbon capture, the high syngas pressure provides a sufficient mass transfer driving force to make the gas membrane separation process an attractive option. Comparisons of combined different membrane materials (H2-selective and CO2-selective membranes) and membrane process layouts are very limited. Especially, the multi-objective optimization of such processes requires further investigation. Therefore, this paper proposes 16 two-stage combined membranes system for pre-combustion CO2 capture, including 4 two-stage H2-selective membrane systems, 4 two-stage CO2-selective membrane systems, and 8 two-stage hybrid membrane systems. A tri-objective optimization method of energy, economy, and environment is proposed for comprehensive evaluation of the proposed systems. Results show that with the targets of 90% CO2 purity and recovery, six gas membrane separation systems could be satisfied. After further multi-objective optimization and comparison, the C1H2-4 system (the hybrid system with H2-selective membranes and CO2-selective membranes) has the best performance. Feed composition and separation requirements also have an important influence on the multi-objective optimization results. The effects of selectivity and permeance of H2-selective and CO2-selective membranes on the performance of the C1H2-4 system are also significant.

Comparation of magnetic resonance hysterosalpingography and hysterosalpingosonography for the assessment of fallopian tubal occlusion of female infertility: A protocol for systematic review and meta-analysis.

OBJECTIVE: To evaluate the diagnostic performance of magnetic resonance hysterosalpingography (MR-HSG) for fallopian tubal occlusion in the context of female infertility when compared to the diagnostic performance of hysterosalpingosonography in evaluation of fallopian tubal occlusion of female infertility. METHODS: We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the October 31, 2021, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis. RESULTS: This systematic review will investigate whether MR-HSG has more diagnostic value than hysterosalpingosonography in evaluation of fallopian tubal occlusion of female infertility. CONCLUSION: Our meta-analysis indicated MR-HSG may serve as an alternative for further evaluation of fallopian tubal occlusion of female infertility. SYSTEMATIC REVIEW REGISTRATION: INPLASY2021110050.

The relationship between demands for lung cancer screening and the constructs of health belief model: a cross-sectional survey in Hefei, China.

The aim of investigation is to explore the relationship between demands for lung cancer screening (LCS) and the constructs derived from the health belief model (HBM) in Hefei. The study collected data about socio-demographics, health beliefs in and demands for LCS during early June to later July 2015. By constructing a LCS demands HBM constructs, it calculated indices of demands for LCS (DSI) and HBM constructs, which include perceived risk (PR) and seriousness (PS) of the cancers; and perceived effectiveness (PE), benefits (PB) and difficulties (PD) of the screening. It also performed descriptive and multivariate regression analysis of the demands and the HBM constructs. The amount of 823 respondents participated and completed the survey. 6.4% of them had ever undertaken LCS, whereas 60.1% of them expressed willingness to accept the service of LCS if it is free. In multiple regression analysis which used weights in calculating the HBM construct indices, education displayed significant positive associations with DSI (p = .044), and most of HBM constructs indices (PSI, PRI, PBI, and PDI) were statistically significant with DSI (p < .05). HBM-based constructs regarding LCS have important effects on demands for the service, and may provide effective paths to cancer screening promotion.

Insight into selective removal of copper from high-concentration nickel solutions with XPS and DFT: New technique to prepare 5N-nickel with chelating resin.

An efficient and profitable separation process was proposed to prepare 5N (the purity of the metal solution reaches 99.999%) high-purity nickel from 3N nickel-solutions using Purolite S984. The adsorption performance of this superior resin, especially its selectivity for metal ions, was explored quantitatively. The maximum adsorption capacity for copper was 2.286mmol/g calculated by the Langmuir model, which was twice as large as that for nickel. In the binary systems, the adsorption capacity for nickel was decreased by 45%, indicating direct competition for the active sites. The infinite separation factor for copper versus nickel exceeded 300, revealing the feasibility of preparing 5N-level high-purity nickel solutions, which was further verified using the 800BV (bed volume) effluent in the column dynamic process. According to the cost-benefit analysis, purification contributed to a profit of approximately 60,000USD per cycle, and the investment return period was less than 1/3years. Density functional theory analysis confirmed that four nitrogen atoms would be involved in the coordination complex and thus a structure involving two five-membered rings could be achieved. The X-ray photoelectron spectra confirmed the involvement of nitrogen atoms, implying a coordination ratio of approximately 1:1.

Assessment of synergistic thyroid disrupting effects of a mixture of EDCs in ovariectomized rats using factorial analysis and dose addition.

Endocrine disrupting chemicals (EDCs) have been implicated in a broad spectrum of health problems related to reproduction, thyroid function, neurodevelopment, and metabolism. In many cases, EDCs in the environment are at extremely low concentrations which rarely induce health problems alone, however, a mixture of these EDCs may interact and induce potential additive and synergistic effects. Many mixture studies on EDCs were conducted in terms of high doses with the direct effect addition method, which didn't comply with the dose-response relationship of toxicants in the "S" or "U" shaped curves. In the present study, the thyroid disrupting effects of a mixture of three EDCs, propylthiouracil (PTU), polychlorinated biphenyls (PCBs), and ammonium perchlorate (AP), were measured in an ovariectomized rat model. Sixty female SD rats were ovariectomized bilaterally and randomly assigned to ovariectomization (OVX) control, PTU + PCBs, PTU + AP, PCBs + AP and PTU + PCBs + AP groups treated with doses at lowest observed adverse effect levels (LOAELs) or benchmark dose lower limits (BMDLs) obtained from our previous dose-response relationship studies. OVX control animals were treated with vehicle control while all other animals were treated with different combinations of EDCs by gavage for 8 days. The body weight change, serum total thyroxine (tT4), triiodothyroxine (tT3), the thyroid/body weight ratio, and thyroid histopathological endpoints were measured and analyzed using factorial analysis and dose addition. All EDC treated groups showed a marked change compared to vehicle control in serum tT4, the thyroid/body weight ratio, and the thyroid epithelium/colloid ratio. Both factorial analysis and dose addition analysis showed a synergistic effect on thyroid function by PTU, PCBs and AP together, but the modes of interaction varied when either two were mixed at LOAELs. To conclude, a mixture of PTU, PCBs, and AP mainly acted synergistically on thyroid function and induced a significant health effect.

How public reporting of prescription quality indicators influence prescribing practices? A survey of general practitioners.

RATIONALE, AIMS AND OBJECTIVES: Public reporting of performance data is one of the most popular topics in health care field. The aim of this study was to investigate the transparency mechanism, that is, how public reporting influenced general practitioners' (GPs) prescribing practices. METHOD: GPs who had the license to prescribe medicine of all 10 primary care institutions were surveyed. Data were collected by an instrument, which exhibited satisfactory reliability and validity (Cronbach's alpha > 0.7; average variance extracted > 0.5; composite reliability > 0.7). Data analysis was conducted by structural equation model. RESULTS: The results showed that GPs' perceived value (GP's overall assessment of the worth of the public reporting) and attitude (the psychological reaction to public reporting) had a significantly direct effect on behavioural intention (r = 0.28; r = 0.36), and were affected by information accessibility (r = 0.63; r = 0.32). Attitude had a significant effect on perceived value(r = 0.45). Perceived risk (the perceptions of the possible loss due to public reporting, e.g. decreasing their income) did not have a significant relationship with information accessibility, attitude and behavioural intention(r = -0.09; r = 0.01; r = -0.07). CONCLUSION: The information accessibility, perceived value and attitude have strong effects on prescribing practices of GPs, whereas perceived risk did not play a role in influencing the prescribing practices. Policymakers need to improve the accessibility of prescription quality indicators and pay attention to the perceived values and attitudes of GPs. Policymakers also need to strengthen the risk education of GPs and attach incentives to transparent regulation.

Application of propensity scores to explore the effect of public reporting of medicine use information on rational drug use in China: a quasi-experimental design.

BACKGROUND: Transparency has become a hottest topic and a growing movement in the health care system worldwide. This study used a quasi-experimental design method to explore whether public reporting of medicine use information can improve rational drug use. METHODS: 20 township hospitals and 274 doctors of City Y in Hubei Province, China were divided into the intervention and control groups on the basis of their characteristics. In the intervention group, the values and rankings of the average expenditure per prescription, percentage of prescriptions requiring antibiotics and percentage of prescriptions requiring injections of each hospital and doctor were publicly released to patients and doctors in an appropriate format monthly. Data were gathered both four months before and after the intervention. Propensity score matching (PSM) was used to minimize the observed covariate (gender, age, experience, education level, title, and monthly income) differences in the doctors' characteristics. 108 pairs of doctors were obtained after PSM. Chi-square test and t-test were employed to explore the effect of public reporting of medicine use information on rational drug use. The study was approved by the Committee of Tongji Medical College, Hua Zhong University of Science and Technology (IORG No: IORG0003571). RESULTS: In baseline, the average expenditure per prescription of the 274 doctors was 42.82 RMB yuan (USD 6.97), the percentage of prescriptions requiring antibiotics was 63.00%, and the percentage of prescriptions requiring injections was 70.79%, all higher than the average of Hubei Province and the standard recommended by WHO. Before the intervention all the three indicators were all comparable (p > 0.05), whereas after the intervention, a significant difference (p < 0.05) was found for the percentage of prescriptions requiring injections between the intervention (64.66%) and control groups (70.52%). CONCLUSIONS: Irrational drug use remains a policy issue in township hospitals in the study area. We demonstrated that publicly reporting medicine use information could decrease the percentage of prescriptions requiring injections in township hospitals in China, but this effect was not observed on prescription costs and antibiotics use. Analyses of the mechanism and long-term effect of public reporting of medicine use information are recommended for further studies.

Effect of publicly reporting performance data of medicine use on injection use: a quasi-experimental study.

BACKGROUND: Inappropriate use of prescribing pharmaceuticals, particularly injections, not only affects the quality of medical care, but also leads to an increase in medical expenses. Publicly reporting performance data of medical care is becoming a common health policy tool adopted to supervise medical quality. To our knowledge, few studies about public reporting applied to medicine use have been reported. This study intended to introduce public reporting in the field of medicine use, and evaluate the effect of publicly reporting performance data of medicine use on the use of injections. METHODS: The research sites were 20 primary healthcare institutions in Q City, Hubei. By matching, the institutions were divided into the intervention group and control group. A quasi-experimental design was applied in this study. In the intervention group, the performance data of medicine use were publicly reported. The injection prescribing rates of the two groups before and after intervention were measured and compared. Difference-in-difference method and logistic regression were employed to estimate the effect of public reporting on injection use. RESULTS: Public reporting led to a reduction of approximately 4% in the injection prescribing rate four months after intervention (OR = 0.96; 95%CI: 0.94, 0.97). The intervention effect was inconsistent in each month after intervention, and it was most positive in the second month after intervention (OR = 0.90; 95%CI: 0.89, 0.92). CONCLUSIONS: In general, publicly reporting performance data of medicine use may have positive effects on injection use to some extent. Further research is needed to investigate the mechanism by which public reporting influences injection use. Comprehensive measures are also necessary to promote the rational use of injections.

Application of propensity scores to estimate the association between government subsidy and injection use in primary health care institutions in China.

BACKGROUND: The problem posed by therapeutic injection is a clinical practice issue that influences health care quality and patient safety. Although sufficient government subsidy was one of the 12 key interventions to promote rational drug use initiated by WHO (World Health Organization), limited information is available about the association between government subsidy and injection use in primary health care institutions. In 2009, National Essential Medicines System (NEMS) was implemented in China. The subsidy policy plays an important role in maintaining primary health care institutions. This study explores the impact of government subsidies on the injection use in primary health care institutions in China. METHODS: 126 primary health institutions were included in this study. Institutions were divided into two groups (intervention and control groups) according to the median GS (General subsidy per personnel). Propensity score matching (PSM) was used to minimize the observed covariate differences in the characteristics of the primary institutions between the two groups. Kappa score was calculated to determine the consistency between the groups. Paired chi-square test and Relative Risk (RR) were calculated to compare the differences in injection use between the groups. RESULTS: Among all the investigated prescriptions, the overall percent of people who received an injection prescribed was 36.96% (n = 12600). PSM showed no significant covariate difference among the 34 groups obtained through this analysis. Kappa score (k = -0.082, p = 0.558) indicated an inconsistency between groups and paired chi-square test revealed a significant difference (p < 0.05) in injection use between the two groups. Relative Risk = 0.679 (95%CI [0.485, 0.950]) indicate that high General subsidy per personnel is a protective factor for primary health care institutions to prescribe injections properly. The intervention group obtained a higher possibility of using injection properly. CONCLUSIONS: The overall effect of government subsidy on the use of injection was positively significant. However, the mechanism by which government subsidy influence injection administration remains unclear, and thus requires further study.