Bidirectional causal associations between type 2 diabetes and COVID-19.

Observational studies have reported high comorbidity between type 2 diabetes (T2D) and severe COVID-19. However, the causality between T2D and COVID-19 has yet to be validated. We performed genetic correlation and Mendelian randomization (MR) analyses to assess genetic relationships and potential causal associations between T2D and three COVID-19 outcomes (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] infection, COVID-19 hospitalization, and critical COVID-19). Molecular pathways connecting SARS-CoV-2 and COVID-19 were reconstructed to extract insights into the potential mechanisms underlying the connection. We identified a high genetic overlap between T2D and each COVID-19 outcome (genetic correlations 0.21-0.28). The MR analyses indicated that genetic liability to T2D confers a causal effect on hospitalized COVID-19 (odds ratio 1.08, 95% confidence interval [CI] 1.04-1.12) and critical COVID-19 (1.09, 1.03-1.16), while genetic liability to SARS-CoV-2 infection exerts a causal effect on T2D (1.25, 1.00-1.56). There was suggestive evidence that T2D was associated with an increased risk for SARS-CoV-2 infection (1.02, 1.00-1.03), while critical COVID-19 (1.06, 1.00-1.13) and hospitalized COVID-19 (1.09, 0.99-1.19) were associated with an increased risk for T2D. Pathway analysis identified a panel of immunity-related genes that may mediate the links between T2D and COVID-19 at the molecular level. Our study provides robust support for the bidirectional causal associations between T2D and COVID-19. T2D may contribute to amplifying the severity of COVID-19, while the liability to COVID-19 may increase the risk for T2D.

Experimental Determination and Computational Prediction of Dehydroabietic Acid Solubility in (-)-α-Pinene + (-)-ß-Caryophyllene + P-Cymene System.

The solubility of dehydroabietic acid in (-)-α-pinene, p-cymene, (-)-ß-caryophyllene, (-)-α-pinene + p-cymene, (-)-ß-caryophyllene + p-cymene and (-)-α-pinene + (-)-ß-caryophyllene were determined using the laser monitoring method at atmospheric pressure. The solubility of dehydroabietic acid was positively correlated with temperature from 295.15 to 339.46 K. (-)-α-pinene, p-cymene, and (-)-ß-caryophyllene were found to be suitable for the solubilization of dehydroabietic acid. In addition, the non-random two liquid (NRTL), universal quasi-chemical (UNIQUAC), modified Apelblat, modified Wilson, modified Wilson-van't Hoff, and λh models were applied to correlate the determined solubility data. The modified Apelblat model gave the minor deviation for dehydroabietic acid in monosolvents, while the λh equation showed the best result in the binary solvents. A comparative analysis of compatibility between solutes and solvents was carried out using Hansen solubility parameters. The thermodynamic functions of ΔsolH0, ΔsolS0, ΔsolG0 were calculated according to the van't Hoff equation, indicating that the dissolution was an entropy-driven heat absorption process. The Conductor-like Screening Model for Real Solvents (COSMO-RS) combined with an experimental value was applied to predict the reasonable solubility data of dehydroabietic acid in the selected solvents systems. The interaction energy of the dehydroabietic acid with the solvent was analyzed by COSMO-RS.

A new cyst-forming nematode, Cactodera tianzhuensis n. sp. (Nematoda:Heteroderinae) from Polygonum viviparum in China with a key to the Genus Cactodera.

A new cyst-forming nematode, Cactodera tianzhuensis n. sp. was isolated from the rhizosphere soil of Polygonum viviparum L. in Tianzhu county, China. Morphologically, the new species is characterized by lemon-shaped or rounded cysts that have protruding necks and vulval cones. The vulval cone of the new species appeared to be circumfenestrate without bullae and underbridge, vulval denticle present and anus distinct. Second-stage juveniles are vermiform, stylet well-developed with the rounded stylet knobs to slightly concave anteriorly. Lateral field with four incisures. Tail gradually tapering to a finely rounded terminus with a length of ca 54 (47-59) µm, outline of hyaline portion is V-shaped or U-shaped. Egg shells without visible markings or punctations. The phylogenetic analyses based on ITS-rDNA, D2-D3 of 28S-rDNA clearly revealed that the new species formed a separate clade from other Cactodera species, which further support the unique status of C. tianzhuensis n. sp. Therefore, it is described herein as a new species of the genus Cactodera.

Perceived Value of Electronic Medical Records in Community Health Services: A National Cross-Sectional Survey of Primary Care Workers in Mainland China.

OBJECTIVE: To evaluate the degree to which electronic medical records (EMRs) were used in primary care and the value of EMRs as perceived by primary care workers in China. METHODS: A cross-sectional survey was conducted on 2719 physicians (n = 2213) and nurses (n = 506) selected from 462 community health centres across all regions of mainland China except for Tibet. Regional differences in the responses regarding the functionality of existing EMR systems and the perceived value of EMRs were examined using Chi-square tests and ordinal regression analyses. RESULTS: Less than 59% of the community health centres had adopted EMRs. More than 89% of the respondents believed that it was necessary to adopt EMRs in primary care. Of the existing EMR systems, 50% had access to telehealth support for laboratory, imaging or patient consultation services. Only 38.4% captured data that met all task needs and 35.4% supported referral arrangements. "Management of chronic conditions" was voted (66%) as the top preferred feature of EMRs. Higher levels of recognition of the value of EMRs were found in the relatively more developed eastern region compared with their counterparts in other regions. CONCLUSIONS: Rapid EMR adoption in primary care is evident in mainland China. The low level of functionality in data acquisition and referral arrangements runs counter to the requirements for "management of chronic conditions", the most preferred feature of EMRs in primary care. Regional disparities in the realised value of EMRs in primary care deserve policy attention.

Effect of an intelligent family physician-optimised coordination model program on hypertension management in a Beijing community.

The prevalence of hypertension in China is increasing. To control chronic diseases, the Beijing Municipal Government implemented an intelligent family physician-optimised collaborative model (IFOCM). The present retrospective study assessed the effectiveness of the IFOCM in the management of hypertensive patients at the Fangzhuang Community Health Service Centre, Beijing. Using deidentified data from hypertensive patients, blood pressure (BP), BP control rate, 10-year risks of ASCVD, lifestyle changes and blood lipid levels were compared before and after implementation of the IFOCM. In all, 7332 patients with hypertension were included in the study. Systolic BP decreased from 144.59 to 142.96mmHg after program implementation (P<0.001), and the overall BP control rate increased from 41.43% to 46.49% (P<0.001). The proportion of patients predicted to be at a high 10-year risk of developing atherosclerotic cardiovascular disease decreased from 77.27% to 64.61% (P<0.001). After program implementation, body mass index decreased (from 24.87 to 24.36kg/m2; P<0.001), exercise frequency and intensity increased and salt intake, cigarette smoking, total cholesterol and low-density lipoprotein cholesterol all decreased significantly (P<0.001). The IFOCM program is effective in managing hypertension and providing timely patient care.

Intelligent Internet-based information system optimises diabetes mellitus management in communities.

OBJECTIVE: To evaluate the effect of an intelligent Internet-based information system upon optimising the management of patients diagnosed with type 2 diabetes mellitus (T2DM). METHODS: In 2015, a T2DM information system was introduced to optimise the management of T2DM patients for 1 year in Fangzhuang community of Beijing, China. A total of 602 T2DM patients who were registered in the health service centre of Fangzhuang community were enrolled based on an isometric sampling technique. The data from 587 patients were used in the final analysis. The intervention effect was subsequently assessed by statistically comparing multiple parameters, such as the prevalence of glycaemic control, standard health management and annual outpatient consultation visits per person, before and after the implementation of the T2DM information system. RESULTS: In 2015, a total of 1668 T2DM patients were newly registered in Fangzhuang community. The glycaemic control rate was calculated as 37.65% in 2014 and significantly elevated up to 62.35% in 2015 ( p < 0.001). After application of the Internet-based information system, the rate of standard health management was increased from 48.04% to 85.01% ( p < 0.001). Among all registered T2DM patients, the annual outpatient consultation visits per person in Fangzhuang community was 24.88% in 2014, considerably decreased to 22.84% in 2015 ( p < 0.001) and declined from 14.59% to 13.66% in general hospitals ( p < 0.05). CONCLUSION: Application of the T2DM information system optimised the management of T2DM patients in Fangzhuang community and decreased the outpatient numbers in both community and general hospitals, which played a positive role in assisting T2DM patients and their healthcare providers to better manage this chronic illness.

Effects of home telemonitoring on the control of high blood pressure: a randomised control trial in the Fangzhuang Community Health Center, Beijing.

This study aimed to evaluate the effect of home telemonitoring on the control of high blood pressure in the Fangzhuang Community Health Center in Fengtai District, Beijing. A total of 110 hypertensive patients with uncontrolled high blood pressure were equally allocated to an intervention group and a control group randomly. The participants in the intervention group received home telemonitoring for blood pressure delivered by a team comprising a GP, a hypertension specialist, a general nurse and an information manager. The participants in the control group received the usual care. The levels of systolic and diabolic blood pressure of the participants were assessed on days 0 (baseline), 30, 90 and 180. On average, the intervention group had a greater reduction in blood pressure compared with the control by 6.6-8.0mmHg in systolic blood pressure and 0-3.0mmHg in diastolic blood pressure. Similarly, higher proportions of patients with normal blood pressure were achieved in the intervention group (63.6-71.2%) compared with the control (38.5-41.8%). The reduction in systolic blood pressure for the participants in the intervention group was positively correlated with the utilisation of the app (P<0.05). Home telemonitoring is effective in the control of high blood pressure.