Two novel variants of the CAPN3 gene in Chinese patients with Limb-Girdle Muscular Dystrophy Recessive 1.

Introduction Recessive mutations in the CAPN3 gene can lead to Limb-girdle muscular dystrophy Recessive 1 (LGMD R1). Targeted next-generation sequencing facilitates the discovery of new mutations linked with disease, owing to its ability to selectively enrich specific genomic regions. Methods We performed targeted next-generation sequencing of all exons of the CAPN3 gene in four patients with sporadic LGMD and further analyzed the effects of the novel identified variant using various software tools. Results We found 5 variants in CAPN3 gene in four patients, c.82_83insC (insertion mutation) and c.1115+2T>C (splicing mutation) are reported for the first time in CAPN3 (NM_000070.2). The bioinformatics analysis indicated that these two novel variants affected CAPN3 transcription as well as translation. Discussion Our findings reveal previously unreported splicing mutation and insertion mutation in CAPN3 gene, further expanding the pathogenic gene profile of LGMD.

Two new aromatic tenvermectins from mutant Streptomyces avermitilis HU02-06.

Two new aromatic tenvermectins (TVMs), 13-oleandrosyl-oleandrosyloxy ST906 (1) and aromatic TVM B (2), were isolated from the fermentation broth of Streptomyces avermitilis HU02-06. Their structures were established by extensive spectroscopic analysis, including 1D and 2D NMR and HRESIMS data. Bioassay test showed that these two new tenvermectins exhibited weak nematocidal activity against Bursaphelenchus xylophilus and moderate cytotoxic activity against tumor cell lines HepG2 and HCT116.

Fabrication of Poly(Lactic Acid)@TiO2 Electrospun Membrane Decorated with Metal-Organic Frameworks for Efficient Air Filtration and Bacteriostasis.

The development of high-performance filtration materials is essential for the effective removal of airborne particles, and metal-organic frameworks (MOFs) anchored to organic polymer matrices are considered to be one of the most promising porous adsorbents for air pollutants. Nowadays, most air filters are generally based on synthetic fiber polymers derived from petroleum residues and have limited functionality, so the use of MOFs in combination with nanofiber air filters has received a lot of attention. Here, a conjugated electrostatic spinning method is demonstrated for the one-step preparation of poly(lactic acid) (PLA) nanofibrous membranes with a bimodal diameter distribution and the anchoring of Zeolitic Imidazolate Framework-8 (ZIF-8) by the introduction of TiO2 and in situ generation to construct favorable multiscale fibers and rough structures. The prepared PLA/TZ maintained a good PM2.5 capture efficiency of 99.97%, a filtration efficiency of 96.43% for PM0.3, and a pressure drop of 96.0 Pa, with the highest quality factor being 0.08449 Pa-1. Additionally, ZIF-8 was uniformly generated on the surface of PLA and TiO2 nanofibers, obtaining a roughened structure and a larger specific surface area. An enhanced filtration retention effect and electrostatic interactions, as well as active free radicals, can be generated for the deep inactivation of bacteria. Compared with the unmodified membrane, PLA/TZ prepared antibacterial characteristics induced by photocatalysis and Zn2+ release, with excellent bactericidal effects against S. aureus and E. coli. Overall, this work may provide a promising approach for the development of efficient biomass-based filtration materials with antimicrobial properties.

Bicomponent core/sheath melt-blown fibers for air filtration with ultra-low resistance.

With the escalating air pollution and frequent outbreaks of airborne diseases, there is a growing demand for personal protective filtration media. Melt-blown nonwovens have proven to be highly effective in capturing tiny particles, but their tightly packed fiber assemblages are more resistant to airflow and less comfortable to breathe. Here, we present a one-step melt-blown spinning process for the production of bicomponent core/sheath (BCS) crimped fibers and their application in high-efficiency, low-resistance air filtration. Fiber curl is caused by unbalanced internal stresses resulting from differences in the structure components, resulting in uneven shrinkage inside and outside the fibers. The resulting CM@S-2 filtration media features a uniform fiber curl and a porous fiber mesh structure, which reduces air filtration resistance. Under the same filtration conditions, the filtration efficiency of CM@S-2 (96.58% vs. 95.58%), filtration resistance (56.1 Pa vs. 108.0 Pa), quality factor (0.061 Pa-1vs. 0.029 Pa-1), and dust holding capacity (10.60 g m-2vs. 9.10 g m-2) were comparable to those of the single-component polypropylene filters. The filtration efficiency of the CM@S-2 remained above 94.0% after 30 days of indoor storage. Computational Fluid Dynamics (CFD) simulation demonstrated that crimped fibers effectively reduce pressure surges on the filter media caused by fiber accumulation. In comparative tests with commercial masks, the CM@S-2 cartridge masks demonstrated superior air permeability compared to commercial masks under similar filtration conditions. In conclusion, the bicomponent core/sheath melt-blown fibers significantly reduce air resistance and show excellent potential for application in protective masks.

The Influence of the Second Phase on the Microstructure Evolution of the Welding Heat-Affected Zone of Q690 Steel with High Heat Input.

Q690 steel is widely used as building steel due to its excellent performance. In this paper, the microstructure evolution of the heat-affected zone of Q690 steel under simulated high heat input welding conditions was investigated. The results show that under the heat input of 150-300 kJ/cm, the microstructures of the heat-affected zone are lath bainite and granular bainite. The content of lath bainite gradually decreased with the increase in heat input, while the content of granular bainite steadily increased. The proportion of large-angle grain boundaries decreased from 51.1% to 40.3%. Overall, the average size of original austenite increased, and the precipitates changed from Ti (C, N) to Cr carbides. During the cooling process, the nucleation position of bainitic ferrite was from high to low according to the nucleation temperature, and in order of inclusions at grain boundaries, triple junctions, intragranular inclusions, bainitic ferrite/austenite phase boundaries, twin boundaries, grain boundaries, and intragranular inclusions at the bainitic ferrite/austenite phase interface. The growth rate of bainitic ferrite nucleated at the phase interface, grain boundary, and other plane defects was faster, while it was slow at the inclusions. Moreover, it was noted that the Mg-Al-Ti-O composite inclusions promote the nucleation of lath bainitic ferrite, while the Al-Ca-O inclusions do not facilitate the nucleation of bainitic ferrite.

Semi-automatic proximal humeral trabecular bone density assessment tool: technique application and clinical validation.

PURPOSE: This study aimed to apply a newly developed semi-automatic phantom-less QCT (PL-QCT) to measure proximal humerus trabecular bone density based on chest CT and verify its accuracy and precision. METHODS: Subcutaneous fat of the shoulder joint and trapezius muscle were used as calibration references for PL-QCT BMD measurement. A self-developed algorithm based on a convolution map was utilized in PL-QCT for semi-automatic BMD measurements. CT values of ROIs used in PL-QCT measurements were directly used for phantom-based quantitative computed tomography (PB-QCT) BMD assessment. The study included 376 proximal humerus for comparison between PB-QCT and PL-QCT. Two sports medicine doctors measured the proximal humerus with PB-QCT and PL-QCT without knowing each other's results. Among them, 100 proximal humerus were included in the inter-operative and intra-operative BMD measurements for evaluating the repeatability and reproducibility of PL-QCT and PB-QCT. RESULTS: A total of 188 patients with 376 shoulders were involved in this study. The consistency analysis indicated that the average bias between proximal humerus BMDs measured by PB-QCT and PL-QCT was 1.0 mg/cc (agreement range - 9.4 to 11.4; P > 0.05, no significant difference). Regression analysis between PB-QCT and PL-QCT indicated a good correlation (R-square is 0.9723). Short-term repeatability and reproducibility of proximal humerus BMDs measured by PB-QCT (CV: 5.10% and 3.41%) were slightly better than those of PL-QCT (CV: 6.17% and 5.64%). CONCLUSIONS: We evaluated the bone quality of the proximal humeral using chest CT through the semi-automatic PL-QCT system for the first time. Comparison between it and PB-QCT indicated that it could be a reliable shoulder BMD assessment tool with acceptable accuracy and precision. This study developed and verify a semi-automatic PL-QCT for assessment of proximal humeral bone density based on CT to assist in the assessment of proximal humeral osteoporosis and development of individualized treatment plans for shoulders.

A lineage-resolved cartography of microRNA promoter activity in C. elegans empowers multidimensional developmental analysis.

Elucidating the expression of microRNAs in developing single cells is critical for functional discovery. Here, we construct scCAMERA (single-cell cartography of microRNA expression based on reporter assay), utilizing promoter-driven fluorescent reporters in conjunction with imaging and lineage tracing. The cartography delineates the transcriptional activity of 54 conserved microRNAs in lineage-resolved single cells throughout C. elegans embryogenesis. The combinatorial expression of microRNAs partitions cells into fine clusters reflecting their function and anatomy. Notably, the expression of individual microRNAs exhibits high cell specificity and divergence among family members. Guided by cellular expression patterns, we identify developmental functions of specific microRNAs, including miR-1 in pharynx development and physiology, miR-232 in excretory canal morphogenesis by repressing NHR-25/NR5A, and a functional synergy between miR-232 and miR-234 in canal development, demonstrating the broad utility of scCAMERA. Furthermore, integrative analysis reveals that tissue-specific fate determinants activate microRNAs to repress protein production from leaky transcripts associated with alternative, especially neuronal, fates, thereby enhancing the fidelity of developmental fate differentiation. Collectively, our study offers rich opportunities for multidimensional expression-informed analysis of microRNA biology in metazoans.

The construction and evaluation of secretory expression engineering bacteria for the trans-Cry3Aa-T-HasA fusion protein against the Monochamus alternatus vector.

Pine wood nematode disease is currently the most deadly forest disease in China, and the Monochamus alternatus is its primary vector. Controlling the M. alternatus is crucial for managing pine wood nematode disease. This study, based on the selected HasA (pGHKW4) secretory expression vector, used electroporation to combine the genetically modified high-toxicity toxin Cry3Aa-T with the entomopathogenic bacterium Yersinia entomophaga isolated from the gut of the M. alternatus. The SDS-PAGE and Western blotting techniques were employed to confirm the toxin protein's secretion capability. The engineered bacteria's genetic stability and effectiveness in controlling M. alternatus were assessed for their insecticidal activity. The results of the SDS-PAGE and Western blotting analyses indicate that the HasA system effectively expresses toxin protein secretion, demonstrates certain genetic stability, and exhibits high insecticidal activity against M. alternatus. This study constructed a highly toxic entomopathogenic engineered bacterial strain against M. alternatus larvae, which holds significant implications for controlling M. alternatus, laying the foundation for subsequent research and application of this strain.

Identification of Lydicamycins as Main Antioomycete Compounds from the Biocontrol Agent Streptomyces sp. NEAU-S7GS2.

Oomycetes are well-known phytopathogens that seriously threaten many important crops worldwide. In this study, the endophytic actinobacterium Streptomyces sp. NEAU-S7GS2 demonstrated significant antagonistic activity against Phytophthora and Pythium and showed a potent biocontrol effect on suppression of soybean phytophthora root rot and pepper phytophthora blight. Two compounds were subsequently isolated as the main active components by bioassay-guided fractionation and identified as lydicamycins A and B. These two compounds showed high antioomycete activity against Phytophthora and Pythium with EC50 values of 0.73-2.67 µg/mL, which are equal to or lower than those of commercialized drug metalaxyl. In vivo bioassay using detached leaves demonstrated that lydicamycin A had a better control efficiency against soybean phytophthora root rot than metalaxyl. Taken together, these results suggest that the biocontrol agent Streptomyces sp. NEAU-S7GS2 and lydicamycins have the potential to be developed as promising pesticides to control diseases caused by oomycetes.

Multiemission of Ce3+ from a Single Crystallographic Site Induced by Disordering of Ions.

White-light emission with a single activator is an attractive function of phosphors. In this work, we investigated the photoluminescence properties of Ca5.7Y1.3Si7O16.7N3.3, which is a compound denoted as Ca4+xY3-xSi7O15+xN5-x discovered by our group, with Ce-activation using optical measurements and density functional theory (DFT) calculation. Samples showed a tunable emission from purple to white under ultraviolet (UV) light. In this compound, Ca and Y as well as anions are distributed disorderly, and Ca/Y ions occupy two crystallographically distinct sites; those sites are possible sites for Ce substitution. DFT calculation and structural refinement revealed that the tunable emission was generated by Ce at the crystallographically equivalent site but with distinct local structures caused by the disordering of cations and anions. As far as we know, this is the first report about a white-light-emitting phosphor with only Ce activation.

Pan-Immune-Inflammatory Value Predicts the 3 Months Outcome in Acute Ischemic Stroke Patients after Intravenous Thrombolysis.

BACKGROUND AND PURPOSE: Immune and inflammatory response plays a central role in the clinical outcomes of stroke. This study is aimed to explore the clinical significance of the new inflammation index named pan-immune-inflammation value (PIV) in patients with acute ischemic stroke (AIS) after intravenous thrombolysis therapy (IVT). METHODS: Data were collected from 717 patients who received IVT at the First Affiliated Hospital of Soochow University. Baseline data were collected before intravenous thrombolysis. Multivariate logistic regression analysis was used to assess the association between PIV and 3 months clinical outcome after intravenous thrombolysis. We also used receiver operating characteristic (ROC) curves analysis to assess the discriminative ability of PIV, platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in predicting 3 months poor outcome. RESULTS: Of 717 patients, 182 (25.4%) patients had poor outcomes at 3 months. Patients with 3 months of poor outcome had significantly higher PIV levels compared to those with favorable outcomes [316.32 (187.42-585.67) vs. 223.80 (131.76-394.97), p < 0.001)]. After adjusting for potential confounders, the risk of 3 months of poor outcome was significantly higher among patients whose PIV fell in the third quartile (244.21-434.49) and the fourth quartile (> 434.49) than those in the first quartile (< 139.93) (OR = 1.905, 95% CI: 1.040-3.489; OR = 2.229, 95%CI: 1.229-4.044). The area under the ROC curve of PIV to predict 3 months of poor outcome was 0.607 (95%CI: 0.560-0.654; p < 0.001). The optimal cut-off values of PIV were 283.84 (59% sensitivity and 62% specificity). CONCLUSION: The higher levels of PIV were independently associated with 3 months of poor outcomes in AIS patients receiving IVT. PIV like other inflammatory factors (PLR, NLR, and SII), can also predict adverse outcomes after IVT in AIS patients.

Herbicidal Activity of Secondary Metabolites Isolated from Streptomyces sp. NEAU-HV44 on Selected Weeds and Crops.

Streptomyces is an effective source of new natural bioherbicides. In this study, a novel isolated strain NEAU-HV44 showed strong inhibitory activity against Amaranthus retroflexus L. and was concluded to the genus Streptomyces. Strain NEAU-HV44 fermentation conditions were optimized to maximize the herbicidal activity. The supernatant of strain NEAU-HV44 could significantly control the growth of weeds (A. retroflexus L., Setaria viridis, Portulaca oleracea L., and Chenopodium album) and crops (maize, soybean, wheat, Chinese cabbage, cucumber, tomato, and romaine lettuce) with dose-dependent in preemergence. Notably, weeds were more sensitive to a low-concentration supernatant extract than crops in preemergence. In postemergence, the 2 mg mL-1 supernatant extract could significantly reduce the height and >50% biomass (fresh weight) of tested weeds. The supernatant extract could cause cell membrane destabilization and the cell death of weeds. In addition, the growth of tomato was also inhibited at a high concentration, but no obvious symptoms were observed on soybean and romaine lettuce after spraying the supernatant extract. Then two novel julichrome monomers, julichromes Q12 (1) and Q13 (2), and two known julichromes, julichrome Q3.3 (3) and julichrome Q3.5 (4), were isolated from the supernatant extract of strain NEAU-HV44 by bioactivity-guided approach. This is the first report of the herbicidal activity of julichromes. These four herbicidal compounds could inhibit the shoot and root growth of weeds at 0.2 mg mL-1, and compound 4 could completely inhibit the growth of P. oleracea L. Thus, julichromes (Q12, Q13, Q3.3, Q3.5 1-4) may be new bioherbicidal candidates.

Phenopyrrolizins A and B, Two Novel Pyrrolizine Alkaloids from Marine-Derived Actinomycetes Micromonospora sp. HU138.

Two previously undescribed pyrrolizine alkaloids, named phenopyrrolizins A and B (1 and 2), were obtained from the fermentation broth of marine-derived Micromonospora sp. HU138. Their structures were established by extensive spectroscopic analysis, including 1D and 2D NMR spectra as well as HRESIMS data. The structure of 1 was confirmed by single-crystal diffraction analysis and its racemization mechanism was proposed. The antifungal activity assay showed that 2 could inhibit the mycelial growth of Botrytis cinerea with the inhibitory rates of 18.9% and 35.9% at 20 µg/disc and 40 µg/disc, respectively.

Omnidirectional Printing of PEDOT:PSS for High-Conductivity Spanning Structures.

Poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS), a prominent conducting polymer, holds significance in both industry and academia. However, prevailing fabrication techniques struggle to build spanning features of PEDOT:PSS with both high electrical conductivity and fine resolution due to layerwise assembly in the xy plane. Here, we report an "omnidirectional printing and secondary doping" strategy to construct spanning, filamentary and out-of-plane 3D PEDOT:PSS with high conductivity. The pristine PEDOT:PSS suspension is homogeneously concentrated to form a printable ink with high solids (∼15 wt %) consisting of entangled PEDOT:PSS nanofibrils. Such ink shows a high storage modulus G' (43531 Pa) and a high yield stress τy (4325 Pa), thereby enabling omnidirectional printing. Secondary doping with sulfuric acid or other polar solvents is used to induce a synergetic process of PSS loss, conformational change, phase separation, and crystallinity enhancement in the printed structures, resulting in a remarkable enhancement of conductivity in dehydrated (65,378 S/m) and swollen (7190 S/m) states. As a proof-of-concept, 2D grids with a feature size of 15 µm and 3D overhanging arches are fabricated for high-performance transparent glass heaters and 3D interconnection, respectively. This work promises great potential for the development of advanced flexible electronics, wearable devices, and bioelectronics.

Machine learning-based models for the prediction of breast cancer recurrence risk.

Breast cancer is the most common malignancy diagnosed in women worldwide. The prevalence and incidence of breast cancer is increasing every year; therefore, early diagnosis along with suitable relapse detection is an important strategy for prognosis improvement. This study aimed to compare different machine algorithms to select the best model for predicting breast cancer recurrence. The prediction model was developed by using eleven different machine learning (ML) algorithms, including logistic regression (LR), random forest (RF), support vector classification (SVC), extreme gradient boosting (XGBoost), gradient boosting decision tree (GBDT), decision tree, multilayer perceptron (MLP), linear discriminant analysis (LDA), adaptive boosting (AdaBoost), Gaussian naive Bayes (GaussianNB), and light gradient boosting machine (LightGBM), to predict breast cancer recurrence. The area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and F1 score were used to evaluate the performance of the prognostic model. Based on performance, the optimal ML was selected, and feature importance was ranked by Shapley Additive Explanation (SHAP) values. Compared to the other 10 algorithms, the results showed that the AdaBoost algorithm had the best prediction performance for successfully predicting breast cancer recurrence and was adopted in the establishment of the prediction model. Moreover, CA125, CEA, Fbg, and tumor diameter were found to be the most important features in our dataset to predict breast cancer recurrence. More importantly, our study is the first to use the SHAP method to improve the interpretability of clinicians to predict the recurrence model of breast cancer based on the AdaBoost algorithm. The AdaBoost algorithm offers a clinical decision support model and successfully identifies the recurrence of breast cancer.

Preparation of fluffy bimodal conjugated electrospun poly(lactic acid) air filters with low pressure drop.

Electrospun nanofiber membranes have been extensively studied as air filters. However, their limited filtration efficiency for submicron inhalable particulate matter (PM), high resistance to filtration, and limited capacity to hold dust have hindered their widespread use. The majority of materials come from petroleum, and the use of organic solvents during the spinning process has a significant negative impact on the environment. In this work, a sustainable method has been proposed for producing filters using poly(lactic acid) (PLA) with a bimodal diameter distribution through conjugated electrospinning. This technique allows for the continuous production of interconnected micro/nano hybrid porous membranes, resulting in reduced resistance and improved dust holding capacity. The filtration efficiency, pressure drop, long-term filtration performance, and actual performance of the conjugated bimodal membrane (CBM) were extensively investigated. The results indicate that the filter has a high capacity for retaining particles, with filtration efficiencies of 99.94% for PM 0.3 and 99.96% for PM 2.5. It also demonstrates a high quality factor (0.078 Pa-1 for PM 0.3 and 0.084 Pa-1 for PM 2.5), long-term stability (a decrease of 2.35% for PM 0.3 and 0.05% for PM 2.5 over a period of 60 days) and outstanding dust holding capacity (9.17 g m-2). The conjugated bimodal membrane (CBM) shows a 22.64% decrease in resistance compared to the non-conjugated bimodal membrane (BM). In general, the approach outlined in this work provides valuable insights into the development of high-performance biodegradable air filters. These filters have improved filtration efficiency and reduced resistance.

Cortical Endplate Bone Density Measured by Novel Phantomless Quantitative Computed Tomography May Predict Cage Subsidence more Conveniently and Accurately.

OBJECTIVE: Previous studies have shown that bone mineral density (BMD) is a predictor of cage subsidence. Phantom-less quantitative computed tomography (PL-QCT) can measure volumetric bone mineral density (vBMD) of lumbar trabecular and cortical bone. The study of endplate vBMD (EP-vBMD) is important in predicting cage settlement after extreme lateral interbody fusion (XLIF). This study aimed to determine the risk factors for postoperative cage subsidence after XLIF, particularly focusing on the relationship between vBMD measured by automatic PL-QCT and cage subsidence. METHODS: Patients who underwent XLIF surgery from January 2018 to October 2020 with a minimum of 6 months of follow-up were retrospectively included. Cage subsidence was defined as >2 mm cage sinking on the adjacent endplate in follow-up imaging evaluation. Outcome measures were localized vBMDs included EP-vBMDs with different region of interest (ROI) heights measured by PL-QCT based on a customized muscle-fat algorithm. Shapiro-Wilk test, one-way ANOVA, Mann-Whitney test, Fisher exact test, univariable and multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were executed in this study. RESULTS: One hundred and thirteen levels of 78 patients were included in the analysis. The mean age was 65 ± 7.9 years for 11 males and 67 females. Cage subsidence occurred on 45 (39.8%) surgical levels. There was no significant difference in demographics, fused levels, or preoperative radiographic parameters. 1.25-mm EP-vBMD (0.991 [0.985,0.997], p = 0.004) and P-TB-vBMD (cage-positioned trabecular volumetric bone mineral density) (0.988 [0.977-0.999], p = 0.026) were cage-subsidence relevant according to univariate analysis. Low 1.25-mm EP-vBMD (0.992 [0.985, 0.999], p = 0.029) was an independent risk factor according to multifactorial analysis. CONCLUSION: Preoperative low EP-vBMD was an independent risk factor for postoperative cage subsidence after XLIF. EP-vBMD measured by most cortex-occupied ROI may be the optimal vBMD parameter for cage subsidence prediction.

Metabolic Engineering of Escherichia coli for Efficient Production of Pseudouridine.

Pseudouridine-incorporated mRNA vaccines can enhance protein expression and reduce immunogenicity, leading to a high demand for pseudouridine to be used in mRNA drug production. To achieve the low-cost production of pseudouridine, Escherichia coli was systematically modified to utilize inexpensive raw materials to efficiently produce pseudouridine. First, in the pyrimidine biosynthesis pathway, genes related to the precursor competing pathway and the negative regulator were deleted, which increased pseudouridine production. Second, two critical genes, pseudouridine-5'-phosphate glycosidase (psuG) and phosphatase genes from different bacteria, were screened and employed in various genetic constructs, and the pseudouridine yield of the optical strain increased to 599 mg/L. The accumulation of pseudouridine was further increased by the deletion of pseudouridine catabolism-related genes. Ultimately, the pseudouridine titer in a 5 L bioreactor reached 7.9 g/L, and the yield of pseudouridine on glucose was 0.15 g/g. Overall, a cell factory producing pseudouridine was successfully constructed and showed potential for industrial production.

Safety and Effectiveness of Baricitinib in Chinese Patients with Moderate-to-Severe Rheumatoid Arthritis: 24-Week Results from a Post-Marketing Safety Study.

INTRODUCTION: Baricitinib, a JAK1/JAK2 inhibitor, is approved for treatment of moderate-to-severe rheumatoid arthritis (RA) in China. This single-arm, prospective, multi-center, post-marketing safety study (PMSS) evaluated the safety and effectiveness of baricitinib in Chinese patients. METHODS: This study included adult patients with moderate-to-severe active RA who received baricitinib over periods of approximately 12 and 24 weeks. The primary endpoint was safety, defined as week 12 adverse event (AE)/serious AE incidence. Secondary endpoints were week 24 safety and effectiveness (disease activity score with 28 joints/C-reactive protein [DAS28-CRP] and simplified/Clinical Disease Activity Index [SDAI/CDAI]). RESULTS: Safety analyses included 667 patients (female, 82.3%; mean age, 53.3 years; mean RA duration, 86.9 months); 106/667 (15.9%) were 65-74 years old and 19/667 (2.8%) were ≥ 75 years old; 87.0% received baricitinib 2 mg QD. Total exposure was 262.1 patient-years (PY). At week 12, AEs had occurred in 214 (32.1%; exposure-adjusted incidence rate [EAIR], 172.5 per 100 PY) patients (serious AEs: 22 [3.3%; EAIR, 15.0]). At week 24, AEs had occurred in 250 (37.5%; EAIR, 125.9) patients (serious AEs: 28 [4.2%; EAIR, 10.9]). Two patients (0.3%) died (of pneumonia and unknown cause); EAIR for death, 0.77. Serious infection occurred in 1.2% of patients (EAIR, 3.1). Hepatotoxicity occurred in 3.4% of patients (EAIR, 9.0). No patients met potential Hy's law laboratory criteria (alanine/aspartate aminotransferases ≥ 3 × upper limit of normal (ULN) and total bilirubin ≥ 2 × ULN). Malignancy occurred in one patient. No patients experienced venous thromboembolism (VTE) or major adverse cardiovascular events (MACE). At week 24, 52.4%, 27.5%, and 27.6% of patients achieved remission per DAS28-CRP, SDAI, and CDAI, respectively. CONCLUSIONS: This PMSS investigated the safety and effectiveness of baricitinib in clinical practice in China. No VTE/MACE or new safety signals were reported and there was promising effectiveness, supporting the use of baricitinib in Chinese patients with moderate-to-severe active RA. TRIAL REGISTRATION: EU PAS Register: EUPAS34213.