Background: Janus kinase (JAK) inhibitors have emerged as a progressively utilized therapeutic approach for the management of rheumatoid arthritis (RA). However, the complete determination of their cardiovascular safety remains inconclusive. Hence, the primary objective of this network meta-analysis is to meticulously assess and juxtapose the cardiovascular risks linked to distinct JAK inhibitors employed in RA patients.Methods: A systematic review and network meta-analysis were meticulously conducted, encompassing a collection of randomized controlled trials (RCTs) that focused on investigating the incidence of major adverse cardiovascular events (MACE) and all-cause mortality associated with Janus kinase (JAK) inhibitors administered to patients with rheumatoid arthritis (RA). Extensive exploration was performed across multiple electronic databases, incorporating studies published until March 2023. To be included in this analysis, the RCTs were required to involve adult participants diagnosed with RA who received treatment with JAK inhibitors. To ensure accuracy, two authors independently undertook the selection of eligible RCTs and meticulously extracted aggregate data. In order to examine the outcomes of MACE and all-cause mortality, a frequentist graph theoretical approach within network meta-analyses was employed, utilizing random-effects models. Third study has been registered on PROSPERO under the reference CRD42022384611.Findings: A specific selection encompassing a total of 14 meticulously chosen randomized controlled trials was undertaken, wherein 13,524 patients were assigned randomly to distinct treatment interventions. The analysis revealed no notable disparity in the occurrence of major adverse cardiovascular events (MACE) between the interventions and the placebo group. However, in comparison to adalimumab, the employment of JAK inhibitors exhibited an association with higher rates of all-cause mortality [odds ratio (OR): 1.7, 95% confidence interval (CI): 1.02–2.81]. This observed increase in risk primarily stemmed from the usage of tofacitinib (OR: 1.9, 95% CI: 1.12–3.23). None of the other JAK inhibitors exhibited a statistically significant variance in all-cause mortality when compared to adalimumab.Interpretation: Our study suggests that JAK inhibitors may not increase the risk of MACE in RA patients but may be associated with a higher risk of all-cause mortality compared to adalimumab, primarily due to tofacitinib use. Rheumatologists should carefully consider the cardiovascular risks when prescribing JAK inhibitors, particularly tofacitinib, for RA patients.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=384611, CRD42022384611.

Hemoglobin concentration is an indicator for assessing blood product quality. To measure hemoglobin concentration in blood products without damaging blood bags, we proposed a method based on visible-near infrared transmission spectroscopy. Complex optical properties of blood bag walls result in measurement irregularities. Analyses showed that the slope of the light intensity-pathlength curve was more robust to the influence of the blood bag wall. In this study, the transmission spectra of red blood cell suspensions at multiple optical pathlengths were obtained, and the slopes of logarithmic light intensity-pathlength curves were calculated through curve fitting. A nondestructive measurement of hemoglobin content was achieved by using a regression model correlating slope spectra and hemoglobin concentration. Sixty samples with hemoglobin concentrations ranging from 72 to 161 g/L were prepared. Among them, 40 samples were used as a calibration set, and the remaining 20 samples were used as a prediction set. The determination coefficient of the prediction set was 0.97, with a mean square error of 2.78 g/L. This result demonstrates that a non-destructive measurement of hemoglobin levels in blood bags can be achieved by multiple-pathlength transmission spectroscopy.

Our aim was to investigate the association of glycated haemoglobin A1c (HbA1c) variability score (HVS) with estimated glomerular filtration rate (eGFR) slope in Chinese adults living with type 2 diabetes. This cohort study included adults with type 2 diabetes attending outpatient clinics between 2011 and 2019 from a large electronic medical record-based database of diabetes in China (WECODe). We estimated the individual-level visit-to-visit HbA1c variability using HVS, a proportion of changes in HbA1c of ≥0.5% (5.5 mmol/mol). We estimated the odds of people experiencing a rapid eGFR annual decline using a logistic regression and differences across HVS categories in the mean eGFR slope using a mixed-effect model. The analysis involved 2397 individuals and a median follow-up of 4.7 years. Compared with people with HVS ≤ 20%, those with HVS of 60% to 80% had 11% higher odds of experiencing rapid eGFR annual decline, with an extra eGFR decline of 0.93 mL/min/1.73 m² per year on average; those with HVS > 80% showed 26% higher odds of experiencing a rapid eGFR annual decline, with an extra decline of 1.83 mL/min/1.73 m² per year on average. Chinese adults with type 2 diabetes and HVS > 60% could experience a more rapid eGFR decline.

Digital lock-in amplifier using square wave reference is much easier to be implemented compared to digital lock-in amplifier using sinusoidal wave reference. However, because of the odd harmonics containing in the square wave reference, the interferences at the odd harmonics of the reference cannot be removed with conventional algorithm. A new square wave digital lock-in algorithm is presented in this paper. It cannot only be capable of removing the interferences of the odd harmonics in the signal, but also can detect the amplitudes and the phases of the interferences. The real and imaginary parts of the frequency component of interest and those of the odd harmonic interferences are calculated simultaneously. The results of simulation experiments show the feasibility of the proposed algorithm. The algorithm is computationally efficient and thus suitable for weak signal detection implemented in the general microprocessor.

A digital lock-in detection technique is commonly used to measure the amplitude and phase of a selected frequency signal. A technique that uses a square wave as the reference signal has an advantage over the one using a sinusoidal wave due to its easier implementation and higher computational efficiency. However, demodulating multiple-frequency composite signals using square wave reference may result in interference between channels. To avoid interference between channels and reduce the computational complexity, we modify the calculations and determine the optimal parameter settings of the low-pass filter and carrier frequency, as detailed in this paper. The results of our analysis show that when the length of the average filter and carrier frequencies are properly set, the interference between the channels is removed. This optimization produces the digital lock-in detection suitable for measuring multi-channel sensor signals.