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IMPORTANCE It is necessary to determine whether psoriasis responds to methotrexate in the same manner in patients with and without psoriatic arthritis. OBJECTIVE To evaluate the effectiveness and safety of methotrexate in treating patients with psoriasis with and without psoriatic arthritis. DESIGN, SETTING, AND PARTICIPANTS In this prospective, single-arm, interventional study, a total of 235 patients with psoriasis, 107 without psoriatic arthritis and 128 with psoriatic arthritis who were receiving methotrexate therapy from April 1, 2015, to December 31, 2017, were recruited from the outpatient department of a hospital at a large Chinese university. There were no significant demographic or clinical differences between the subgroups with the exception of diabetes. INTERVENTIONS A 12-week course of low-dosage oral methotrexate (7.5-15 mg weekly). MAIN OUTCOMES AND MEASURES Changes in disease severity, adverse events, blood cell counts, and liver and renal function. RESULTS A total of 235 patients with psoriasis (166 male [66.0%]; mean [SD] age, 49.6 [15.1] years) received methotrexate treatment for 12 weeks. The 90% reduction from baseline Psoriasis Area Severity Index response was significantly lower in patients with psoriatic arthritis than in patients without psoriatic arthritis at week 8 (4 0f 128 [3.1%] vs 12 of 107 [11.2%]; P = .02) and week 12 (19 of 128 [14.8%] vs 27 of 107 [25.2%]; P = .049). Furthermore, the incidence of adverse events, including dizziness (12 of 128 [9.4%] vs 1 of 107 [0.9%]; P = .007), gastrointestinal symptoms (32 of 128 [25.0%] vs 13 of 107 [12.1%]; P = .01), and hepatoxicity (34 of 128 [26.6%] vs 16 of 107 [15.0%]; P = .04), was significantly higher in patients with psoriatic arthritis than in patients without psoriatic arthritis. Methotrexateinduced elevation of alanine aminotransferase levels was associated with body mass index (mean [SD] body mass index, 26 [4] in patients with [P = .04] vs 26 [4] in those without [P = .005] psoriatic arthritis) and smoking (17 of 34 [50.0%] in patients with [P = .02] vs 9 of 16 [56.3%] in those without [P = .04] psoriatic arthritis). CONCLUSIONS AND RELEVANCE In this study, methotrexate was well tolerated and effective in treating psoriasis. It was more effective, with fewer adverse effects, in patients with psoriasis who did not have psoriatic arthritis than in patients who presented with both psoriasis and psoriatic arthritis. Therefore, methotrexate can be recommended as first-line treatment for psoriasis without arthritis.

Catalytic conversion of a biomass derivative (levulinic acid, LA) to a high value-added product (γ-valerolactone, GVL) has attracted much attention, in which the control of catalytic selectivity plays an important role. Herein, a stepwise method was developed to prepare Co-MoO x catalysts via topological transformation (calcination reduction) from layered double hydroxide (Mo/CoAl-LDH) precursors. X-ray diffraction, high-resolution transmission electron microscopy, and hydrogen temperature-programmed reduction demonstrate the formation of MoO x -decorated Co structures of Co-MoO x samples. Remarkably, the sample that is reduced at 500 °C is featured with the most abundant interfacial Coδ+ (denoted as Co-MoO x -500), which exhibits an excellent catalytic performance toward the hydrodeoxygenation (HDO) reaction of several biomass-derived platform molecules (furfural, FAL; succinic acid, SA; 5-hydroxymethyl-furfural, HMF; and levulinic acid, LA). Especially, this optimal catalyst displays a high yield (99%) toward the HDO reaction of LA to GVL, which stands at the highest level among non-noble metal catalysts. The combination of in situ FT-IR characterization and theoretical calculation further confirms that interfacial Coδ+ sites in Co-MoO x -500 act as adsorption active sites for the polarization of a CO bond in an LA molecule, which simultaneously promotes CO hydrogenation and CO cleavage. Moreover, the MoO x overlayer suppresses the formation of byproducts by covering the Co0 sites. This work offers a cost-effective and efficient catalyst, which can be potentially applied in catalytic conversion of biomass-derived platform molecules.

Wireless sensor technology plays an important role in the military, medical, and commercial fields nowadays. Wireless Body Area Network (WBAN) is a special application of the wireless sensor network in human health monitoring, through which patients can know their physical condition in real time and respond to emergencies on time. Data reliability, guaranteed by the trust of nodes in WBAN, is a prerequisite for the effective treatment of patients. Therefore, authenticating the sensor nodes and the sink nodes in WBAN is necessary. This paper proposes a lightweight Physical Unclonable Function (PUF)-based and cloud-assisted authentication mechanism for multi-hop body area networks, which compared with the star single-hop network, can enhance the adaptability to human motion and the integrity of data transmission. Such authentication mechanism can significantly reduce the storage overhead and resource loss in the data transmission process.

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