Generic substitution of amlodipine is not associated with increased risk of mortality or adverse cardiovascular events: An observational cohort study.

This study aims to assess clinical outcomes following switching from originator to generic amlodipine. This population-based, matched, cohort study included users of originator amlodipine using claims data during 2018-2020 from a health system in Tianjin, China, in which usage of generic amlodipine was promoted by a drug procurement policy, the national volume-based procurement. Non-switchers refer to those remained on originator after the policy, while pure-switchers were those who switched to and continued using generic amlodipine, and back-switchers were those switched to generic amlodipine but then back to the originator. Propensity score matching generates comparable non-switchers and pure-switchers pairs, and non-switchers and back-switchers pairs. The primary outcome was major adverse cardiovascular events (MACEs), defined as all-cause mortality, stroke, and myocardial infarction during follow-up (April 1, 2019 to December 30, 2020). Secondary outcomes included heart failure, atrial fibrillation, and adherence to amlodipine. The hazard ratio (HR) for each clinical outcome was assessed through Cox proportional hazard regression. In total, 5943 non-switchers, 2949 pure-switchers, and 3061 back-switchers were included (mean age: 62.9 years; 55.5% men). For the matched pairs, pure-switchers (N = 2180) presented no additional risks of clinical outcomes compared to non-switchers (N = 4360) (e.g., MACEs: 2.86 vs. 2.95 events per 100 person-years; HR = 0.97 [95%CI: 0.70-1.33]). Back-switchers (N = 1998) also presented no additional risk compared to non-switchers (N = 3996) for most outcomes except for stroke (HR = 1.55 [95%CI: 1.03-2.34]). Pure-switchers and back-switchers all had better amlodipine adherence than non-switchers. Generic substitution of amlodipine is not associated with increased risk of cardiovascular events or all-cause mortality, but improves medicine adherence.

The Emulsifying Properties, In Vitro Digestion Characteristics and Storage Stability of High-Pressure-Homogenization-Modified Dual-Protein-Based Emulsions.

The droplet size, zeta potential, interface protein adsorption rate, physical stability and microrheological properties of high-pressure-homogenization (HPH)-modified, dual-protein-based whey-soy (whey protein isolate-soy protein isolate) emulsions containing different oil phase concentrations (5%, 10% and 15%; w/w) were compared in this paper. The in vitro digestion characteristics and storage stability of the dual-protein emulsions before and after HPH treatment were also explored. The results show that with an increase in the oil phase concentration, the droplet size and interface protein adsorption rate of the untreated dual-protein emulsions increased, while the absolute value of the zeta potential decreased. When the oil phase concentration was 10% (w/w), HPH treatment could significantly reduce the droplet size of the dual-protein emulsion, increase the interface protein adsorption rate, and improve the elasticity of the emulsion. Compared with other oil phase concentrations, the physical stability of the dual-protein emulsion containing a 10% (w/w) oil phase concentration was the best, so the in vitro digestion characteristics and storage stability of the emulsions were studied. Compared with the control group, the droplet size of the HPH-modified dual-protein emulsion was significantly reduced after gastrointestinal digestion, and the in vitro digestibility and release of free amino groups both significantly increased. The storage stability results show that the HPH-modified dual-protein emulsion showed good stability under different storage methods, and the storage stability of the steam-sterilized dual-protein emulsion stored at room temperature was the best. These results provide a theoretical basis for the development of new nutritional and healthy dual-protein liquid products.

The Effect of High Pressure Homogenization on the Structure of Dual-Protein and Its Emulsion Functional Properties.

It has been proven that high-pressure homogenization (HPH) could improve the functional properties of proteins by modifying their structure. This study researched the effect of HPH on the structural and functional properties of whey-soy dual-protein (Soy Protein Isolation-Whey Protein Isolation, SPI-WPI). Different protein solution samples were treated with HPH at 30, 60, 90, 120 and 150 MPa, and the structure changed under different pressures was analyzed by measuring particle size, zeta potential, Fourier infrared spectrum (FTIR), fluorescence spectrum and scanning electron microscope (SEM). The results showed that HPH significantly reduced the particle size of SPI-WPI, changed the secondary and tertiary structures and improved the hydrophobic interaction between molecules. In addition, HPH significantly improved the solubility and emulsification of all proteins, and the improvement effect on SPI-WPI was significantly better than SPI and WPI. It was found that SPI-WPI treated with 60 MPa had the best physicochemical properties. Secondly, we researched the effect of HPH by 60 MPa on the emulsion properties of SPI-WPI. In this study, the SPI-WPI had the lowest surface tension compared to a single protein after HPH treatment. The emulsion droplet size was obviously decreased, and the elastic properties and physical stability of SPI-WPI emulsion were significantly enhanced. In conclusion, this study will provide a theoretical basis for the application of HPH in modifying the structure of dual-protein to improve its development and utilization in liquid specialty food.

Enhanced Carrier Diffusion Enables Efficient Back-Contact Perovskite Photovoltaics.

Back-contact architectures offer a promising route to improve the record efficiencies of perovskite solar cells (PSCs) by eliminating parasitic light absorption. However, the performance of back-contact PSCs is limited by inadequate carrier diffusion in perovskite. Here, we report that perovskite films with a preferred out-of-plane orientation show improved carrier dynamic properties. With the addition of guanidine thiocyanate, the films exhibit carrier lifetimes and mobilities increased by 3-5 times, leading to diffusion lengths exceeding 7 µm. The enhanced carrier diffusion results from substantial suppression of nonradiative recombination and improves charge collection. Devices using such films achieve reproducible efficiencies reaching 11.2 %, among the best performances for back-contact PSCs. Our findings demonstrate the impact of carrier dynamics on back-contact PSCs and provide the basis for a new route to high-performance back-contact perovskite optoelectronic devices at low cost.

Impact of China's National Volume-Based Procurement on Drug Procurement Price, Volume, and Expenditure: An Interrupted Time Series Analysis in Tianjin.

BACKGROUND: National Volume-Based Procurement (NVBP) program has been carried out in China to lower drug prices and reduce patients' medication burden. This study aims to evaluate its impact on drug purchasing in Tianjin city, one of the first 11 cities piloting NVBP in China. METHODS: Using monthly drug procurement data from Tianjin Medical Purchasing Center between 2018 and 2020, this study identified bid-winning drugs and their alternative drugs in the pilot NVBP, and evaluated the policy impacts on their procurement price (cost of defined daily dose, DDDc), volume (the number of defined daily dose, DDDs), and expenditure, during the first (initiated at April 1, 2019) and second (initiated at April 25, 2020) procurement cycles of pilot NVBP, applying interrupted time series (ITS) analysis. Included drugs were classified into 12 pharmacological subgroups for further analysis. RESULTS: Decrease in DDDc of NVBP-covered drugs (bid-winning and non-winning drugs) were observed in the first (level change: -CNY 3.878/DDD, P<.001; trend change: -CNY 0.068/DDD, P=.001; relative change: -61.55%) and second (level change: -CNY 0.356/DDD, P=.049) procurement cycles of pilot NVBP, while no significant change was observed for the DDDc of alternative drugs, except for the increase in antidiarrheic and anti-inflammatory/antirheumatic subgroups as more expensive drugs were purchased from new suppliers in the second procurement cycle. The DDDs of bid-winning drugs significantly increased, while decreased for the non-winning original and generic drugs. Procurement expenditure was saved for NVBP-covered drugs (level change: -CNY 7.29×107, P<.001; trend change: -CNY 5.62×106, P<.001; relative change: -62.60%). However, during the second procurement cycle, procurement volume and expenditure of alternative drugs increased significantly in 7 out of 12 subgroups. CONCLUSION: The pilot NVBP policy in China reduced procurement price, promoted generic substitution, and saved procurement expenditure. However, the increase in procurement price, volume and expenditure of alternative drugs may reveal the significance of regulating healthcare institutions' drug purchasing behavior.

[Access channels on nutrition and health knowledge of Chinese adults in 2021].

OBJECTIVE: To analyze the access channels on nutritional health knowledge of Chinese residents aged 18-64 years in 2021. METHODS: A multi-stage cluster random sampling was used to select 302 survey sites across the country, there were 102 398 people surveyed, with 98 424 valid questionnaires, 49.4% male and 42.0% urban, with an average age of(38.5±12.2) years old. A standardized questionnaire certified by experts and evaluated for reliability and validity was used to conduct the face-to-face survey. Descriptive statistics were used to report the access channels on nutrition and health knowledge of respondents, and the proportion of access channels of respondents with different characteristics was compared by chi-square test. RESULTS: The access channels on nutrition and health knowledge of Chinese residents aged 18-64 in 2021 were, in descending order, WeChat/Microblog/Tik Tok/Kuaishou and other software(77.0%), TV/radio(55.7%), family/relatives/friends(41.8%), books/newspapers/journals/magazines(32.5%), website search(30.7%), promotional lectures(29.3%) and other(1.9%). A high proportion of people who access nutrition and health knowledge through software, website searches and books/newspapers were mostly from the lower age groups, higher education groups, urban and eastern regions. People with a high proportion of access through TV/radio, family/relatives/friends and promotional lectures were mostly from the higher age groups, lower education groups, rural and western areas(P<0.001). Women are more likely than men to obtain nutrition and health information from all channels except website search. The higher the level of education, the higher the level of concern for nutrition and health knowledge(P<0.001). CONCLUSION: In 2021, the top access channel for Chinese residents aged 18-64 to obtain nutrition and health knowledge is WeChat/Microblog/Tik Tok/Kuaishou and other software. There are differences in access channels for different groups of people.

[Geographical distribution differences of nutrition and health knowledge among Chinese adults in 2021].

OBJECTIVE: To explore the geographical distribution of nutrition and health knowledge among 18-64 years old adults in China. METHODS: A total of 102 398 residents aged 18-64 from 302 survey sites were selected by multi-stage cluster random sampling method, a total of 98 567 respondents were included in the study. Both mean and rate were calculated by complex sampling weighting. RESULTS: The nutrition and health knowledge score in eastern region(65.5±12.0) was higher than that in central(62.4±11.9) and western(61.4±12.9), and the score in northern region(63.9±11.8) was higher than that in southern(63.1±12.8). In the seven geographical regions, the highest score was in north(65.8±11.4), and the lowest score was in northwest(61.6±12.2). The awareness rate of nutrition and health in eastern region(22.4%) was higher than that in central(14.7%) and western(14.9%), the highest awareness rate among the seven geographic regions was in east(23.2%), followed by north(22.5%) and the lowest was in northwest(13.2%). There were also differences in nutritional health knowledge levels of residents in different regions in the five dimensions(P<0.001). Northwest China had the lowest awareness of food characteristics and nutrition and disease dimensions, South China had the lowest awareness of dietary recommendations and food choices dimensions, and Southwest China had the lowest awareness of food safety dimensions. CONCLUSION: The level of nutrition and health knowledge of Chinese adults have large geographical differences.

Adherence to statins and its impact on clinical outcomes: a retrospective population-based study in China.

BACKGROUND: While the benefit of adherence to statins on clinical outcomes has been proved, this benefit may be heterogeneous among patients who initiated statins for primary or secondary prevention purpose. This study aimed to investigate the impact of statin adherence on clinical outcomes among patients who initiated statins for primary and secondary prevention in China. METHODS: Adult patients in Tianjin Urban Employee Basic Medical Insurance database who initiated ≥2 prescriptions of statins from 2012 through 2013 were included and grouped into primary and secondary prevention subgroups according to their cardiovascular diseases (CVD) history during the prior 12-month baseline period. Proportion of days covered (PDC) was used to measure statin adherence in the initial 12-month follow-up. Clinical outcomes were measured by the incidence of major adverse cardiovascular events (MACE) during the 13th-24th months follow-up, and were compared between the patients with PDC ≥ 0.5 and patients with PDC < 0.5 using Cox regression models in primary and secondary prevention subgroups. Sensitivity analyses were conducted in propensity score matched groups. RESULTS: 99,655 patients were finally included. The mean (SD) PDC was 0.19 (0.15) in primary prevention subgroup (N = 34,372), with 5.4% patients had PDC ≥ 0.5. The patients with PDC ≥ 0.5 had a 37% reduced risk of MACE compared with patients with PDC < 0.5 (Unadjusted incidence rate of MACE: 1.1% vs. 1.4%; all-adjusted HR = 0.63; 95% CI, 0.41-0.98). While, no significant difference was observed in the secondary prevention subgroup (N = 65,283) between patients with PDC ≥ 0.5 and patients with PDC < 0.5 (Unadjusted incidence rate of MACE: 4.6% vs. 2.8%; all-adjusted HR = 1.08, 95% CI, 0.92-1.28). These findings were confirmed by the sensitivity analyses in propensity score matched groups. CONCLUSIONS: Statin adherence was very poor in China, and statin adherence is associated with decreased risk of MACE in patients for primary prevention, while further exploration is needed for secondary prevention.

Single-Crystalline Nanosheets of Hybrid Perovskite Fabricated by a Vapor-Solution Sequential Deposition Route.

Organic-inorganic hybrid perovskite single crystals have attracted much attention due to their superior optoelectronic properties. Herein, we report a facile vapor-solution sequential route to prepare single-crystalline nanosheets of hybrid lead triiodide perovskite. It is found that this two-step deposition is able to fabricate sizeable high-quality single-crystalline nanosheets with no need of delicate control of crystallization conditions such as concentration or temperature for normal single crystal growth. The resulting perovskite nanosheets show good reproducibility and single crystallinity with bright and uniform photoluminescence. Our study provides a promising strategy for scalable fabrication of perovskite single crystals with great potential in optoelectronic applications.

Thermodynamically Stable Orthorhombic γ-CsPbI3 Thin Films for High-Performance Photovoltaics.

All-inorganic lead halide perovskites demonstrate improved thermal stability over the organic-inorganic halide perovskites, but the cubic α-CsPbI3 with the most appropriate bandgap for light harvesting is not structurally stable at room temperature and spontaneously transforms into the undesired orthorhombic δ-CsPbI3. Here, we present a new member of black-phase thin films of all-inorganic perovskites for high-efficiency photovoltaics, the orthorhombic γ-CsPbI3 thin films with intrinsic thermodynamic stability and ideal electronic structure. Exempt from introducing organic ligands or incorporating mixed cations/anions into the crystal lattice, we stabilize the γ-CsPbI3 thin films by a simple solution process in which a small amount of H2O manipulates the size-dependent phase formation through a proton transfer reaction. Theoretical calculations coupled with experiments show that γ-CsPbI3 with a lower surface free energy becomes thermodynamically preferred over δ-CsPbI3 at surface areas greater than 8600 m2/mol and exhibits comparable optoelectronic properties to α-CsPbI3. Consequently, γ-CsPbI3-based solar cells display a highly reproducible efficiency of 11.3%, among the highest records for CsPbI3 thin-film solar cells, with robust stability in ambient atmosphere for months and continuous operating conditions for hours. Our study provides a novel and fundamental perspective to overcome the Achilles' heel of the inorganic lead iodide perovskite and opens it up for high-performance optoelectronic devices.

Deep Spatial-Temporal Joint Feature Representation for Video Object Detection.

With the development of deep neural networks, many object detection frameworks have shown great success in the fields of smart surveillance, self-driving cars, and facial recognition. However, the data sources are usually videos, and the object detection frameworks are mostly established on still images and only use the spatial information, which means that the feature consistency cannot be ensured because the training procedure loses temporal information. To address these problems, we propose a single, fully-convolutional neural network-based object detection framework that involves temporal information by using Siamese networks. In the training procedure, first, the prediction network combines the multiscale feature map to handle objects of various sizes. Second, we introduce a correlation loss by using the Siamese network, which provides neighboring frame features. This correlation loss represents object co-occurrences across time to aid the consistent feature generation. Since the correlation loss should use the information of the track ID and detection label, our video object detection network has been evaluated on the large-scale ImageNet VID dataset where it achieves a 69.5% mean average precision (mAP).

[Pyrolysates of novel latent fragrant compound 3,6-dimethyl-2,5-pyrazinedicarboxylic acid menthol ester].

In order to develop a new tobacco flavor released at high-temperature, the novel latent fragrant compound 3,6-dimethyl-2,5-pyrazinedicarboxylic acid menthol ester (DPAME) was synthesized by esterification using 2,3,5,6-tetramethylpyrazine and menthol as raw materials. In air atmosphere, the pyrolysis behavior of DPAME was investigated using an on-line pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) method at three temperature levels of 300, 600 and 900 degrees C, separately. The pyrolysis products were directly introduced into GC-MS and were qualitatively and semi-quantitatively analyzed. The results showed that a variety of aroma compounds of aldehydes, 3-p-menthene and menthol were released and identified at 300 degrees C. While at 600 degrees C and 900 degrees C, flavor alkene class, the alkyl pyrazines, menthol and 3-p-menthene were generated. And the types and relative amounts of pyrazines were significantly increased, at these two temperatures. Combined the analytical results of DPAME pyrolysates and the results of sensory evaluation of the cigarette, the possible pyrolysis mechanism was preliminarily speculated. The Py-GC-MS technique for the study of the pyrolysis products of DPAME was convenient and rapid. The investigation provided a reliable theoretical foundation for the perfume reinforcement technology in tobacco products, contributing to the development of cigarette products with better aroma and taste. This method is an accurate and quick way to study the pyrolysis products of latent fragrant substance.

Ionothermal synthesis and crystal structures of novel aluminum phosphates with in situ generated templates.

Protic ionic liquids (PILs) are a subgroup of ionic liquids and easily formed by proton transfer from a Brønsted acid to a Brønsted base. Two new crystalline aluminophosphates, [C5H16N2][Al(PO4)(HPO4)] (AlPO-PIL1) and [C5H16N2][Al2(OH)2 (PO4)2] (AlPO-PIL2), are successfully prepared for the first time from a protic ionic liquid, 3-dimethylaminopropylamine acetate. Their structures were determined from single-crystal X-ray diffraction data. It was found that HF in the reaction mixture is crucial in determining the selectivity of the phase. In the absence of HF, AlPO-PIL1 with a one-dimensional chain structure was synthesized by templating the protonated 3-dimethylaminopropylamine cation of the PIL. Upon addition of HF to the initial reaction mixture, AlPO-PIL2 was obtained by templating the protonated N,N'-dimethyl-1,3-propanediamine, which was in situ generated from the protonated 3-dimethylaminopropylamine through migration of methyl groups during the crystallization. AlPO-PIL2 has a novel layered structure with a 3-connected 4·8·8 two-dimensional network which has never been found in the previously reported layered aluminophosphates.