Search

AimsAdverse drug reactions (ADRs) contribute to poorer patient outcomes and additional burden to the healthcare system. However, data on the true burden, relevant types and drugs causing ADRs are lacking. The aim of this study was to determine the prevalence of ADR-related hospitalization in the general adult population in Singapore and to investigate their characteristics.MethodsWe prospectively recruited 1000 adult patients with unplanned admission to a large tertiary-care hospital. Two independent reviewers evaluated all suspected ADRs for causality, type, severity and avoidability. The prevalence of ADR-related hospitalization was calculated based on 'definite' and 'probable' ADRs. Logistic regression was used to evaluate predictors for having an ADR at admission.ResultsThe prevalence of all ADRs at admission was 12.4% (95% CI: 10.5-14.6%) and ADRs causing admission was 8.1% (95% CI: 6.5-10.0%). The most common ADRs were gastrointestinal-related. The most common drug category causing ADRs were cardiovascular drugs. Patients with ADRs had a longer length of stay than those who did not (median 4 vs. 3 days, P = 1.70 × 10-3 ). About 30% of ADRs at admission were caused by at least one drug with a clinical annotation in the Pharmacogenomics KnowledgeBase (PharmGKB), suggesting that some of these ADRs may have been predicted by pharmacogenetic testing.ConclusionsWe have quantified the burden and characteristics of clinically impactful ADRs in the Singaporean general adult population. Our results will provide vital information for efforts in reducing ADRs through targeted vigilance, patient education and pharmacogenomics in Singapore.

This paper investigates the formation and segmentation of the tongue of ionization into two consecutive polar cap patches using multi‐instrument observations from 27 February 2014. We provide insights into how the interplanetary magnetic field (IMF) variations influence the formation and segmentation of these patches. Our findings reveal that the entry of dayside dense plasma into the polar cap is predominantly driven by the modified convection near the cusp region, which is controlled by the transition of IMF By or the sudden drop of IMF Bz. Furthermore, we observe a rapid north‐westward plasma flow within the patch segmentation region, accompanied by equatorward‐expanded and enhanced convection near the cusp region. This fast‐moving flow, approximately 1.5 km/s, is characterized by low density and high electron temperature and shows a signature of a Subauroral Polarization Stream. This suggests that the fast‐westward flow, in conjunction with the expansion and contraction of ionospheric convection, plays a crucial role in the segmentation of polar cap patches from the dayside plasma reservoir. This study provides a comprehensive observation of the evolution of polar cap patches, thereby advancing our understanding of the dynamic mechanisms governing patch formation and segmentation. Plain Language Summary: Polar cap patches are highly dense structures in the polar cap region, typically forming in the cusp region and moving toward the nightside due to ionospheric convections. To better understand the factors that govern the formation and segmentation of these patches, a combination of satellite and ground‐based observations is used to investigate two consecutive polar cap patches on 27 February 2014. We found that the configuration of IMF By and Bz significantly influences cusp region convection, causing dayside sunlit dense plasma to enter the polar cap when cusp convection expands equatorward and the flow shifts northward, a process that leads to patch formation. Additionally, we observe strong north‐westward flows of low‐density, high‐electron‐temperature plasma in the subauroral region during periods of geomagnetic disturbance, displaying characteristics of Subauroral Polarization Streams (SAPS). This flow is observed in the patch segmentation region along with the equatorward‐expanding, enhanced cusp convection. These observations indicate that SAPS, along with the expansion and contraction of ionospheric convection, play a key role in the segmentation of polar cap patches from their equatorward plasma reservoir. This study significantly advances our understanding of the dynamic mechanisms governing the formation and segmentation of polar cap patches. Key Points: The transient change of IMF By and Bz leads to the formation of the tongue of ionization and segmentation of polar cap patchesA tongue of ionization is segmented into two polar cap patches by low electron density, high electron temperature, fast westward flowsThe expansion/contraction of the ionospheric convection also plays a crucial role in the segmentation of dayside dense plasma [ABSTRACT FROM AUTHOR]

Sixty genetic loci associated with abdominal obesity, measured by waist circumference (WC) and waist-hip ratio (WHR), have been previously identified, primarily from studies conducted in European-ancestry populations. We conducted a meta-analysis of associations of abdominal obesity with approximately 2.5 million single nucleotide polymorphisms (SNPs) among 53,052 (for WC) and 48,312 (for WHR) individuals of Asian descent, and replicated 33 selected SNPs among 3,762 to 17,110 additional individuals. We identified four novel loci near the EFEMP1, ADAMTSL3 , CNPY2, and GNAS genes that were associated with WC after adjustment for body mass index (BMI); two loci near the NID2 and HLA-DRB5 genes associated with WHR after adjustment for BMI, and three loci near the CEP120, TSC22D2, and SLC22A2 genes associated with WC without adjustment for BMI. Functional enrichment analyses revealed enrichment of corticotropin-releasing hormone signaling, GNRH signaling, and/or CDK5 signaling pathways for those newly-identified loci. Our study provides additional insight on genetic contribution to abdominal obesity.

Recent genetic association studies have identified 55 genetic loci associated with obesity or body mass index (BMI). The vast majority, 51 loci, however, were identified in European-ancestry populations. We conducted a meta-analysis of associations between BMI and ∼2.5 million genotyped or imputed single nucleotide polymorphisms among 86 757 individuals of Asian ancestry, followed by in silico and de novo replication among 7488-47 352 additional Asian-ancestry individuals. We identified four novel BMI-associated loci near the KCNQ1 (rs2237892, P = 9.29 × 10(-13)), ALDH2/MYL2 (rs671, P = 3.40 × 10(-11); rs12229654, P = 4.56 × 10(-9)), ITIH4 (rs2535633, P = 1.77 × 10(-10)) and NT5C2 (rs11191580, P = 3.83 × 10(-8)) genes. The association of BMI with rs2237892, rs671 and rs12229654 was significantly stronger among men than among women. Of the 51 BMI-associated loci initially identified in European-ancestry populations, we confirmed eight loci at the genome-wide significance level (P < 5.0 × 10(-8)) and an additional 14 at P < 1.0 × 10(-3) with the same direction of effect as reported previously. Findings from this analysis expand our knowledge of the genetic basis of obesity.

Inorganic‐organic hybrid materials are a kind of multiduty materials with high crystallinity and definite structures, built from functional inorganic and organic components with highly tunable photochemical properties. Perylenediimides (PDIs) are a kind of strong visible light‐absorbing organic dyes with π‐electron‐deficient planes and photochemical properties depending on their micro‐environment, which provides a platform for designing tunable and efficient hybrid photocatalytic materials. Herein, four radical‐doped PDI‐based crystalline hybrid materials, Cl4‐PDI⋅SiW12O40 (1), Cl4‐PDI⋅SiMo12O40 (2), Cl4‐PDI⋅PW12O40 (3), and Cl4‐PDI⋅PMo12O40 (4), were attained by slow diffusion of polyoxometalates (POMs) into acidified Cl4‐PDI solutions. The obtained PDI‐based crystalline hybrid materials not only exhibited prominent photochromism, but also possessed reactive organic radicals under ambient conditions. Furthermore, all hybrid materials could be easily photoreduced to their radical anions (Cl4‐PDI⋅−), and then underwent a second photoexcitation to form energetic excited state radical anions (Cl4‐PDI⋅−*). However, experiments and theoretical calculations demonstrated that the formed energetic Cl4‐PDI⋅−* showed unusual POM‐dependent photocatalytic efficiencies toward the oxidative coupling of amines and the iodoperfluoroalkylation of alkenes; higher photocatalytic efficiencies were found for hybrid materials 1 (anion: SiW12O404−) and 2 (anion: SiMo12O404−) compared to 3 (anion: PW12O403−) and 4 (anion: PMo12O403−). The photocatalytic efficiencies of these hybrid materials are mainly controlled by the energy differences between the SOMO‐2 level of Cl4‐PDI⋅−* and the LUMO level of the POMs. The structure‐photocatalytic activity relationships established in present work provide new research directions to both the photocatalysis and hybrid material fields, and will promote the integration of these areas to explore new materials with interesting properties. [ABSTRACT FROM AUTHOR]

The role of turbine blade cooling and coolants are significant factors in modern gas turbine aerodynamic design. This paper presents an effective and rapid airfoil design method based on CFD computation of the S1 surface and the existing loss correlations. The method can assess the coolant mixing loss by identifying each cooling hole separately and obtain the overall mainflow aerodynamic loss for cooled airfoil. The CFD computation code of the S1 surface is powered by a two-dimensional Euler equation, which is inviscid. Typical Kacker–Okapuu empirical correlations are then used to assess the airfoil friction loss, trailing edge loss, and shock loss. A novel form of the Hartsel model for coolant mixing loss is developed and employed in the CFD codes. In the reformed model, the mixing loss coefficient is directly associated with the blowing ratio and the total pressure/temperature ratio of mainstream-to-coolant, making it more convenient than the original model in the airfoil design process. Based on a transonic turbine vane airfoil, the influences of the film outflow location and outflow Mach number on the coolant mixing loss are investigated using the above prediction method and the cascade blowing test. [ABSTRACT FROM AUTHOR]

Dayside magnetosphere interactions are essential for energy and momentum transport between the solar wind and the magnetosphere. In this study, we investigate a new phenomenon within this regime. Sudden enhancements of ion fluxes followed by repeating dropouts and recoveries were observed by Magnetospheric Multiscale on 5 November 2016, which is the very end of the recovery phase from a moderate geomagnetic storm. These repetitive flux variations display energy‐dispersive characteristics with periods relevant to ion bounce motion, suggesting they are corresponding echoes. Alongside the flux variations, bipolar electric field impulses originating from external sources were detected. We traced the source region of the initial injection and found it is located near the spacecraft's position. To elucidate the underlying physics, a test‐particle simulation is conducted. The results reveal that radial transport resulting from impulse‐induced acceleration can give rise to these echoes. Observations demonstrate dayside magnetosphere interactions are more common than we previously considered, which warrants further research. Plain Language Summary: In spacecraft observations, the quasi‐periodical motion of particles in the geomagnetic field can generate repeating signals known as "echoes". Examining the relationship between the periods of echoes and the particle's energy is necessary for determining their types. The present study reports a novel mechanism responsible for generating echoes that arise from the ion bounce motion along magnetic field lines. Observations from both ground‐based stations and spacecraft, as well as numerical simulations, suggest these echoes can result from the acceleration and radial diffusion of ions responding to external field variations. These findings extend the current understanding of interactions in the dayside outer magnetosphere. Key Points: Ion acceleration and corresponding bounce echoes were observed by MMS in the dayside outer magnetosphereObservations and simulations suggest these echoes are driven by the accompanied electric field impulsesImpulse‐induced ion radial transport with positive phase space density radial gradient leads to the observed pattern [ABSTRACT FROM AUTHOR]