Objective
Rheumatoid arthritis (RA) is a morbid, mortal, and costly condition without a cure. Treatments for RA have expanded over the last 2 decades, and direct medical costs may differ by types of ...treatments. There has not been a systematic literature review since the introduction of new RA treatments, including biologic disease‐modifying antirheumatic drugs (bDMARDs).
Methods
We conducted a systematic literature review with meta‐analysis of direct medical costs associated with RA patients cared for in the US since the marketing of the first bDMARD. Standard search strategies and sources were used, and data were extracted independently by 2 reviewers. The methods and quality of included studies were assessed. Total direct medical costs as well as RA‐specific costs were calculated using random‐effects meta‐analysis. Subgroups of interest included Medicare patients and those using bDMARDs.
Results
We found 541 potentially relevant studies, and 12 articles met the selection criteria. The quality of studies varied: one‐third were poor, one‐third were fair, and one‐third were good. Total direct medical costs were estimated at $12,509 (95% confidence interval 95% CI 7,451–21,001) for all RA patients using any treatment regimen and $36,053 (95% CI 32,138–40,445) for bDMARD users. RA‐specific costs were $3,723 (95% CI 2,408–5,762) for all RA patients using any treatment regimen and $20,262 (95% CI 17,480–23,487) for bDMARD users.
Conclusion
The total and disease‐specific direct medical costs for patients with RA is substantial. Among bDMARD users, the cost of RA care is more than half of all direct medical costs.
This article provides a perspective review on the use of modified cotton fabrics for oil–water separation. The principles of surface hydrophobicity of cotton fabrics are first described, from which ...the basis for producing superhydrophobic surfaces is presented. Then the preparation methods to convert hydrophilic cotton fabrics to hydrophobic fabrics are reviewed and discussed. Based on literature results the way to design novel preparation methods, the need to summarize testing protocols, and the comprehensive technoeconomic and sustainability analyses, are proposed. A demonstrative cotton fabrics test is used to reveal the significant role of conjugated fluid flows and surface interactions under different application scenarios for determining the separation efficiency of the oil–water mix.
As smart technology proliferates, enterprises must engage not only in the transformation of intelligence but contend with pressure do so as soon as possible. Smart transformation is critical for ...manufacturing enterprises in the development of smart manufacturing. This study addressed the gap between maturity models and project management by designing an effective assessment framework for smart transformation. It adopts the Smart Industry Readiness Index, created by the Singapore Economic Development Board, as a maturity assessment model to analyze enterprises’ smart transformation and formulate project management strategies. Enterprises can use this model to examine the maturity level of their transformation and assess scope for improvement in their project strategies and implementation barriers. This study focuses on Taiwanese enterprises using data collected from 165 valid questionnaires and subjected to a cluster analysis. Enterprises were divided into three categories. The results reveal that, first, most enterprises’ smart transformation is at an immature or medium-maturity level, and is therefore amenable to further improvement. Second, inconsistent with research findings, many enterprises invest in transformation projects but fail to advance these projects to maturity. Third, most enterprises’ project management plans fail to meet actual transformation needs. Using the thematically oriented maturity model proposed in this study, Taiwanese enterprises can effectively evaluate the maturity of their transformation projects. In conclusion, the study highlights that Taiwanese enterprises must identify more effective external resources to strengthen their competitiveness.
Objective
To elucidate how postdiagnosis multimorbidity and lifestyle changes contribute to the excess mortality of rheumatoid arthritis (RA).
Methods
We performed a matched cohort study among women ...in the Nurses’ Health Study (1976–2018). We identified women with incident RA and matched each by age and year to 10 non‐RA comparators at the RA diagnosis index date. Specific causes of death were ascertained via death certificates and medical record review. Lifestyle and morbidity factors were reported biennially; 61 chronic conditions were combined into the Multimorbidity Weighted Index (MWI). After adjusting for baseline confounders, we used inverse probability weighting analysis to examine the mediating influence of postindex MWI scores and lifestyle factors on total, cardiovascular, and respiratory mortality, comparing women with RA to their matched comparators.
Results
We identified 1,007 patients with incident RA and matched them to 10,070 non‐RA comparators. After adjusting for preindex confounders, we found that hazard ratios (HRs) and 95% confidence intervals (95% CIs) were higher for total mortality (HR 1.46 95% CI 1.32, 1.62), as well as cardiovascular (HR 1.54 95% CI 1.22, 1.94) and respiratory (HR 2.75 95% CI 2.05, 3.71) mortality in patients with RA compared to non‐RA comparators. Adjusting for postindex lifestyle factors (physical activity, body mass index, diet, smoking) attenuated but did not substantially account for this excess RA mortality. After additional adjustment for postindex MWI scores, patients with RA had HRs of 1.18 (95% CI 1.05, 1.32) for total, 1.19 (95% CI 0.94, 1.51) for cardiovascular, and 1.93 (95% CI 1.42, 2.62) for respiratory mortality.
Conclusion
We found that MWI scores substantially accounted for the excess total and cardiovascular mortality among women with RA. This finding underscores the importance of monitoring for the total disease burden as a whole in monitoring patients with RA.
A series of new amino (NH)-type hydrogen-bonding (H-bonding) compounds comprising 2-(2′-aminophenyl)benzothiazole and its extensive derivatives were designed and synthesized. Unlike in the hydroxyl ...(OH)-type H-bonding systems, one of the amino hydrogens can be replaced with electron-donating/withdrawing groups. This, together with a versatile capability for modifying the parent moiety, makes feasible the comprehensive spectroscopy and dynamics studies of amino-type excited-state intramolecular proton transfer (ESIPT), which was previously inaccessible in the hydroxyl-type ESIPT systems. Empirical correlations were observed among the hydrogen-bonding strength (the N–H bond distances and proton acidity), ESIPT kinetics, and thermodynamics, demonstrating a trend that the stronger N–H···N hydrogen bond leads to a faster ESIPT, as experimentally observed, and a more exergonic reaction thermodynamics. Accordingly, ESIPT reaction can be harnessed for the first time from a highly endergonic type (i.e., prohibition) toward equilibrium with a measurable ESIPT rate and then to the highly exergonic, ultrafast ESIPT reaction within the same series of amino-type intramolecular H-bond system.
Objective
To assess whether more frequent fish consumption is associated with lower rheumatoid arthritis (RA) disease activity scores among participants in an RA cohort.
Methods
We conducted a ...cross‐sectional analysis using baseline data from participants in the Evaluation of Subclinical Cardiovascular Disease and Predictors of Events in Rheumatoid Arthritis cohort study. Frequency of fish consumption was assessed by a baseline food frequency questionnaire assessing usual diet in the past year. Multivariable, total energy–adjusted linear regression models provided effect estimates and 95% confidence intervals (95% CIs) for frequency of fish consumption (i.e., never to <1 time/month, 1 time/month to <1 time/week, 1 time/week, and ≥2 times/week) on baseline Disease Activity Score in 28 joints (DAS28) using the C‐reactive protein (CRP) level. We also estimated the difference in DAS28‐CRP associated with increasing fish consumption by 1 serving per week.
Results
Among 176 participants, the median DAS28‐CRP score was 3.5 (interquartile range 2.9–4.3). In an adjusted linear regression model, subjects consuming fish ≥2 times/week had a significantly lower DAS28‐CRP compared with subjects who ate fish never to <1 time/month (difference −0.49 95% CI −0.97, −0.02). For each additional serving of fish per week, DAS28‐CRP was significantly reduced by 0.18 (95% CI −0.35, −0.004).
Conclusion
Our findings suggest that higher intake of fish may be associated with lower disease activity in RA patients.
A new series of molecules, T1–T4, possessing thermally activated delayed fluorescence (TADF) have been strategically designed and synthesized. Molecules T1–T4 contain the dimethyl acridine as the ...electron donor, which is linked to either symmetrical or unsymmetrical diphenyl pyrimidine as an acceptor. In comparison to the ubiquitous triazine acceptor, the selection of pyrimidine as an acceptor has advantages of facile functionalization and less stabilized unoccupied π orbitals, so that the energy gap toward the blue region can be accessed. Together with acridine donors, the resulting donor–acceptor functional materials reveal remarkable TADF properties. In the solid state, molecules T1–T4 all exhibit intriguing mechanochromism. The crystal structures, together with spectroscopy and dynamics acquired upon application of stressing, lead us to propose two types of structural arrangement that give distinct emission properties, one with and the other without TADF. Upon fabricating organic light‐emitting diodes, the T1–T4 films prepared from sublimation all exhibit dominant TADF behavior; this accounts for their high performance: an electroluminescent emission at λ=490 nm, with an external quantum efficiency of 14.2 %, can be attained when T2 is used as an emitter.
Functional pyrimidine acceptors: A new series of molecules, T1–T4, possessing thermally activated delayed fluorescence (TADF) have been strategically designed and synthesized. Together with acridine donors, the resulting donor– acceptor functional materials reveal remarkable TADF properties. In the solid state, molecules T1–T4 also exhibit intriguing mechanochromism (see figure).
Objective
To assess hepatitis B virus (HBV) reactivation rates in patients with resolved or chronic HBV infection, receiving disease‐modifying antirheumatic drugs (DMARDs) and with or without ...antiviral prophylaxis.
Methods
We conducted a systematic review and meta‐analysis. Electronic searches were conducted in PubMed, Medline, and Embase using Ovid through December 31, 2015. A search strategy was developed for each database using the following inclusion criteria: for participants, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and resolved or chronic HBV infection; for intervention, tumor necrosis factor (TNF) inhibitors or non‐TNF biologic or nonbiologic DMARDs; and for outcome, HBV reactivation. Four reviewers independently extracted study data and assessed study quality using the Newcastle‐Ottawa Scale. To determine the pooled HBV reactivation rate, the variances of the raw proportions were stabilized using a Freeman‐Tukey‐type arcsine square root transformation, using a random‐effects model.
Results
Twenty‐five studies met the inclusion criteria. The overall pooled rate of HBV reactivation was 1.6% (95% confidence interval 95% CI 0.8–2.6) in patients with resolved HBV. Similar rates were observed in resolved patients taking TNF inhibitors (1.4% 95% CI 0.5–2.6), non‐TNF biologics (6.1% 95% CI 0.0–16.6), and nonbiologic DMARDs (1.7% 95% CI 0.2–4.2). We also found that the reactivation rate was lower in patients with chronic HBV infection who received antiviral prophylaxis (9.0% 95% CI 4.1–15.5) than in those who did not (14.6% 95% CI 4.3–29.0).
Conclusion
We found that the HBV reactivation rate in inflammatory arthritis patients receiving DMARDs was low in resolved patients and moderate in patients with chronic HBV infection. Further, lower rates were observed in patients with chronic HBV infection who were using antiviral prophylaxis.
The lack of structural information impeded the access of efficient luminescence for the exciplex type thermally activated delayed fluorescence (TADF). We report here the pump-probe Step-Scan Fourier ...transform infrared spectra of exciplex composed of a carbazole-based electron donor (CN-Cz2) and 1,3,5-triazine-based electron acceptor (PO-T2T) codeposited as the solid film that gives intermolecular charge transfer (CT), TADF, and record-high exciplex type cyan organic light emitting diodes (external quantum efficiency: 16%). The transient infrared spectral assignment to the CT state is unambiguous due to its distinction from the local excited state of either the donor or the acceptor chromophore. Importantly, a broad absorption band centered at ~2060 cm
was observed and assigned to a polaron-pair absorption. Time-resolved kinetics lead us to conclude that CT excited states relax to a ground-state intermediate with a time constant of ~3 µs, followed by a structural relaxation to the original CN-Cz2:PO-T2T configuration within ~14 µs.
PDF
