Insurance Reimbursement for Special Foods and Phenylalanine Levels in Patients With PKU in China.

Importance: Recent changes in China's social medical insurance reimbursement policy have impacted the financial burden of patients with phenylketonuria (PKU) for special foods. However, whether this policy change is associated with their blood phenylalanine (PHE) concentration is unclear. Objective: To investigate the association between the reimbursement policy and blood PHE concentration in patients with PKU. Design, Setting, and Participants: This cohort study measured the blood PHE concentrations of 167 patients with PKU across 4 newborn screening centers in China from January 2018 to December 2021. The reimbursement policy for special foods for patients with PKU at 2 centers was canceled in 2019 and restored from 2020 onwards. In contrast, the other 2 centers consistently implemented the policy. Data were analyzed from September 10 to December 6, 2023. Exposures: The implementation and cancelation of the reimbursement policy for special foods of patients with PKU. Main Outcomes and Measures: The blood PHE concentration was regularly measured from 2018 to 2021. A 1-sided Z test was used to compare the mean of the blood PHE concentration between different years. Results: Among 167 patients with PKU (mean [SD] age, 84.4 [48.3] months; 87 males [52.1%]), a total of 4285 measurements of their blood PHE concentration were collected from 2018 to 2021. For patients at the center that canceled the reimbursement policy in 2019, the mean (SD) of the blood PHE concentrations in 2019 was 5.95 (5.73) mg/dL, significantly higher than 4.84 (4.11) mg/dL in 2018 (P < .001), 5.06 (5.21) mg/dL in 2020 (P = .006), and 4.77 (4.04) mg/dL in 2021 (P < .001). Similarly, for patients at the other center that canceled the policy in 2019, the mean (SD) of the blood PHE concentrations in 2019 was 5.95 (3.43) mg/dL, significantly higher than 5.34 (3.45) mg/dL in 2018 (P = .03), 5.13 (3.15) mg/dL in 2020 (P = .003), and 5.39 (3.46) mg/dL in 2021 (P = .03). On the contrary, no significant difference was observed between any of the years for patients at the 2 centers that consistently implemented the policy. Conclusions and Relevance: In this cohort study of patients with PKU from multiple centers, the implementation of the reimbursement policy for special foods was associated with controlling the blood PHE concentration. Special foods expenditure for patients with PKU should be included in the scope of long-term social medical insurance reimbursement.

Prenatal Diagnosis and Molecular Cytogenetic Analyses of a de novo Deletion on Chromosome 4p16.3p15.33.

Wolf-Hirschhorn syndrome (WHS) (OMIM 194190) is a contiguous gene syndrome with an estimated prevalence of around 1 in 50,000 births. The syndrome is caused by the deletion of a critical region (Wolf-Hirschhorn Syndrome Critical region-WHSCR) on chromosome 4p16.3. Its core features are typical facial gestalt, growth retardation, intellectual disability, developmental delay, and seizures. Prenatal diagnosis of WHS helps clinicians and parents make informed decisions about pregnancy management. In this research, a 31-year-old woman (gravida 1, para 0) underwent amniocentesis at 18 weeks gestation because of the short nasal bone of the fetus on prenatal ultrasound. Chromosomal microarray analysis (CMA) on uncultured amniocytes revealed a de novo 11.36-Mb deletion on chromosome 4p16.3p15.33, spanning from position 40 000 to 11 400 000 (hg19). After genetic counselling and being informed of the unfavorable prognosis, the parents decided to terminate the pregnancy. We provide a detailed description of a de novo 11.36-Mb deletion on chromosome 4p16.3p15.33 (Wolf-Hirschhorn syndrome). CMA has more advantages than karyotype analysis in detecting chromosomal microdeletions/microduplications. A combination of karyotype analysis, CMA, prenatal ultrasound, and genetic counseling is helpful for the prenatal diagnosis of chromosomal deletions/duplications.

Multilayer Self-Assemblies for Fabricating Graphene-Supported Single-Atomic Metal via Microwave-Assisted Emulsion Micelle.

Inspired by molecular self-assemblies in nature, this article reports a versatile strategy for confined encapsulation of single-atomic metal into high-quality rGO nanosheets by the microwave-assisted emulsion micelle method. Multilayer self-assembly of organometallics-surfactants micelles into the interlayer of nanosheets can not only promote microwave exfoliation and reduction of GO but also precisely control loading and distribution of single-metal atoms. With this synthetic strategy, the simultaneous trinity of exfoliation, reduction, and composition are achieved for 1 min. Experimental results and density functional theory calculations demonstrate that graphene-supported FeN4 O2 sites exhibit optimal binding energy toward superior selective adsorption (adsorption amount of 1975.6 mg g-1 with separation efficiency of 97.6%) and electrocatalytic oxidation (TOFs as high as 1.31 min-1 ). This work provides a simple and efficient avenue for the large-scale preparation of single-atomic metal composites in environmental and energy fields.

Emission of volatile organic compounds (VOCs) from application of commercial pesticides in China.

Applying pesticides can result in emissions of volatile organic compounds (VOCs), but little is known about VOC emission characteristics and the quantities in particular regions. We investigated the use of pesticides in China based on a large-scale survey of 330 counties in 31 provinces and evaluated the national pesticide VOC emission potentials based on thermogravimetric analysis of 1930 commercial pesticides. The results showed that herbicides were the most extensively used pesticide category in China, accounting for 43.47%; emulsifiable concentrate (EC), suspension concentrate, and wettable powder were the dominant pesticide formulations, with proportions of 26.75%, 17.68%, and 17.31%, respectively. The VOC emission potential coefficient (EP) of the liquid formulations was higher than the solid formulations, and the maximum mean EP was 45.59% for EC and the minimum was 0.76% for WP. Among 437 high-VOC pesticide products used in China, EC accounted for 83.52%, and 16.93% of those contained abamectin. The total VOC emissions derived from commercial pesticides in China were 280 kt (kilotons) in 2018, and 65.35% of the contribution was derived from EC. Shandong, Hunan, and Henan were the three provinces with the highest pesticide VOC emissions (>21 kt/y). The emission rate of VOCs from pesticides was 24.80 t/d in China, which was higher than in San Joaquin Valley, California. These findings suggest that some comprehensive measures (e.g., perfecting pesticide management policy, strict supervision for pesticide production and use, and strengthening pesticide reduction publicity) should be taken to reduce VOC emissions from pesticide applications.

Prenatal diagnosis of a novel 7q31.31q31.33 microduplication with a favorable outcome.

BACKGROUND: Copy number variants (CNVs) are an important source of normal and pathogenic genome variations. Especially CNVs identified in prenatal cases need careful considerations and correct interpretation if those are harmless or harmful variants from the norm. CASE PRESENTATION: Herein, we reported a paternally inherited duplication of 7.6 Mb in 7q31.3 with, surprisingly, a favorable outcome. GTG-banding and CMA on the DNA derived from uncultured amniocytes revealed a karyotype: 46,XX.arr[GRCh37] 7q31.31q31.33(118,601,001_126,177,044) × 3. Ultrasound examination showed no dysmorphisms or intrauterine growth restriction in the fetus and the father was clinically normal as well. CONCLUSION: Prenatal detection of a 7.6 Mb in 7q31.31 to 7q31.33 duplication in a female fetus turned out to be a yet unreported unbalanced chromosome abnormality. This is another example that parental testing and GTG-banding are necessary additional tests to be done in prenatal cases, before a reliable conclusion on the meaning of an aberration can be drawn.

Bioinspired Assembly of Double Honeycomb-Like Hierarchical Capsule Confined Encapsulation with Functional Micro/Nanocrystals.

Inspired by "micro/nanoreactor" effect of cellular organelle on specific biochemical reactions, a double honeycomb-like hierarchical capsule confined encapsulation with functional micro/nanocrystals is designed. The bioinspired hierarchical capsules derived from polymeric composite microspheres are successfully fabricated through a combination of selective chemical etching and pyrolysis. In situ introduction of functional guests (including organometallic molecules, tetraethoxysilane, or metal-organic frameworks (MOFs)) into internal cellular structure of microspheres is first put forward by phase inversion method. The development of selective etching creates honeycomb-like structure on the outside surface of capsule and allows sulfur to homogeneously distribute into matrix. With the novel approach, the hierarchical channels (micro-meso-macropore) of composite capsule enhance transportation of reactants and dispersion of active sites, and thus exhibit superior photocatalytic oxidation and electromagnetic absorbing. The promising strategy will be applied more generally to encapsulate different species into hierarchical capsule with tailored properties and functionalities.

Modification of cyanobacterial bloom-derived biomass using potassium permanganate enhanced the removal of microcystins and adsorption capacity toward cadmium (II).

Cyanobacterial biomass shows high adsorption capacity toward heavy metal ions. However, the cyanotoxins in the cyanobacterial biomass inhibit its application in heavy metals removal. In order to safely and effectively remove Cd(II) from water using cyanobacterial bloom-derived biomass (CBDB), KMnO4 was used to modify CBDB. The results indicated that the microcystins in the CBDB were successfully removed by KMnO4. Potassium permanganate oxidation caused the transformation of hydroxyl to carboxyl on the CBDB, and formed manganese dioxide on the surface of CBDB. The oxidized CBDB showed higher adsorption capacity toward Cd(II) than that of unoxidized treatment. The optimal KMnO4 concentration for increasing the adsorption capacity of CBDB toward Cd(II) was 0.2g/L. The adsorption isotherm of Cd(II) by oxidized- or unoxidized-CBDB was well fitted by Langmuir model, indicating that the adsorption of Cd(II) by CBDB was monolayer adsorption. The desorption ratio of Cd(II) from oxidized CBDB was higher than that from unoxidized CBDB in the desorption process using NH4NO3 and EDTA as desorbent. The results presented in this study suggest that KMnO4 modified CBDB may be used as a safe and high efficient adsorbent in Cd(II) removal from water.

Modified granulation of red mud by weak gelling and its application to stabilization of Pb.

This study presents a novel modification of red mud (RM) with cementitious materials by rotary drum granulation under partial hydration. Admixtures and surfactants were applied to improve the microspore structure of red mud-based granules in order to stabilize Pb steadily. Through XRD and SEM-EDS analyses, it was demonstrated that calcite, the main alkali in RM, was partially concreted and coated. Compared to pH 12.47 for RM, the lowest pH of the granules was 10.66 implying that the release of OH(-) from hydrolysis and decomposition was decreased. Based on stabilization of Pb, influence on soil properties and forming qualities, composition of the optimum granule PSP was determined as 5% cement, 5% gypsum, 1% rice straw, and 0.1% emulsifier OP-10. Within a 90 d remediation, immobilization of ionic Pb in a 500 mg kg(-1) Pb-contaminated artificial soil was 9.85 mg kg(-1) at day 30 with 5% PSP2 as substitute. Furthermore, the reverse increase diminished as the final concentration was 11.13 mg kg(-1) while it was 14.25 mg kg(-1) by RM. The increase of residual Pb was 122.61%, which was better than the 83.92% of RM. Particularly, the highest pH in mine soil was 11.09 at day 1 with RM, but the decrease of ionic Pb was 46.26%. Meanwhile, a significant deviation from the control soil zeta-potential lasted longer and the recovery was more difficult, as compared to the granules. Therefore, a granulated modification of RM is shown to be very important when aiming at steady release of OH(-) to improve the later stabilization of Pb.

A novel class of P-O monophosphite ligands derived from D-mannitol: broad applications in highly enantioselective Rh-catalyzed hydrogenations.

We report on a new class of P-O monophosphite ligands (designated 3a-k) with a double six-membered-ring backbone onto which are attached additional groups and on applications of their Rh complexes in the hydrogenation of enamides, alpha-dehydroamino acid esters, dimethyl itaconate, and beta-(acylamino)acrylates. Our results demonstrate that the Rh complexes with ligands 3a-k exhibit high enantioselectivity and reactivity in asymmetric hydrogenation reactions. An ee value of up to 98.0% was obtained for the hydrogenation of alpha-dehydroamino acid esters, and the ee values were all over 99% for the other three types of substrate, with a turnover number of up to 5000.

Chiral monophosphites derived from carbohydrate: conformational effect in catalytic asymmetric hydrogenation.

[reaction: see text]. The carbohydrate-derived chiral monophosphites with additional groups have been synthesized and used for asymmetric hydrogenation of dimethyl itaconate and enamides. Up to 99.6% ee and 98.5% ee have been obtained, respectively.