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Glioblastoma (GBM) is among the most fatal and recurring malignant solid tumors. It arises from the GBM stem cell population. Conventional neurosurgical resection, temozolomide (TMZ)-dependent chemotherapy and radiotherapy have rendered the prognosis of patients unsatisfactory. Radiotherapy and chemotherapy can frequently induce non-specific damage to healthy brain and other tissues, which can be extremely hazardous. There is therefore a pressing need for a more effective treatment strategy for GBM to complement or replace existing treatment options. Cell-based and cell-free immunotherapies are currently being investigated to develop new treatment modalities against cancer. These treatments have the potential to be both selective and successful in minimizing off-target collateral harm in the normal brain. In this review, several aspects of cell-based and cell-free immunotherapies related to GBM will be discussed.

Tao Chang,1,&ast; Xigang Yan,2,&ast; Chao Zhao,3,&ast; Yufu Zhang,4 Bao Wang,4 Li Gao4 1Department of Emergency, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China; 2Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China; 3Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China; 4Department of Neurosurgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Li GaoDepartment of Neurosurgery, The Second Affiliated Hospital of Air Force Medical University, No. 1, Xinsi Road, Xi’an, 710038, Shaanxi Province, People’s Republic of ChinaTel +86 29-84777765Email gaoli553@163.comObjective: The purpose of this study was to explore the effect of coagulopathy in patients with traumatic brain injury (TBI) during the early postoperative period.Methods: The baseline characteristics, intraoperative management, and follow-up data of 462 patients with TBI between January 2015 and June 2019 were collected and retrospectively analyzed by multivariate logistic regression. Coagulopathy was defined as activated partial thromboplastin time > 40 s, international normalized ratio > 1.4, or platelet counts < 100× 109/L.Results: Multivariate logistic regression analysis revealed that the Glasgow Coma Scale (GCS) on admission, Injury Severity Score (ISS) on admission, pupil mydriasis, duration of surgery, intraoperative blood loss, and intraoperative crystalloid resuscitation were independent risk factors for patients who developed coagulopathy after surgery. There were statistical differences in mortality (p = 0.049), the Glasgow Outcome Scale-Extended (GCS-E; p = 0.024), and the modified Rankin Scale (p = 0.043) between the patients with and without coagulopathy 1 week after surgery. Coagulopathy within 72 h after surgery revealed the higher mortality at 1 week (66.7%), 3 months (71.4%), and 6 months (76.2%). Coagulopathy within 72 h after surgery in patients with a TBI predicted worse disease progression and unfavorable neurologic outcomes.Conclusion: Taking practical and reasonable measures to manage these risk factors may protect patients with TBI from postoperative coagulopathy.Keywords: traumatic brain injury, postoperative coagulopathy, surgery, risk factor, mortality

To improve fermentation efficiency during L-tyrosine production, we established a novel method to produce L-tyrosine by repeated batch fermentation through cell recycling. According to the characteristics of the fermented broth, the cells were recovered using two dish centrifuges in series. First, L-tyrosine crystals were removed from the previous batch of fermented broth by selective centrifugation. The cells were then concentrated in another centrifuge and recycled for use in the next cycle of batch fermentation. L-tyrosine removal and cell recovery rates were 86% and 67%, respectively, in a centrifuge bioreactor. Through repeated batch fermentation, L-tyrosine productivity was increased by up to 44.1% compared with that for fed-batch fermentation, and the coupling of fermentation and separation was achieved, which is useful in reducing production costs. This study provides a rationale for the fermentation of low-solubility products by repeated batch or cell-recycle fermentation.

Introduction The purpose of this study was to investigate the relationship between pulsatility index (PI) or optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in patients with traumatic brain injury (TBI), and the ability of ONSD and ICP to predict intracranial hypertension. Methods A total of 68 patients with TBI were included in this retrospective study. After receiving surgery treatment, they underwent transcranial Doppler ultrasound (TCD). The statistical correlation between PI or ONSD and ICP 1 week after surgery was analyzed. Furthermore, the areas under the curve (AUCs) of ONSD or PI or a combination of them were calculated to predict intracranial hypertension. Results There was a correlation between ONSD and ICP. This correlation still remained at ONSD ≥ 5 mm. Furthermore, there was a strong correlation between PI and ICP. There was a moderate correlation between ICP and PI on days 3, 4, and 5 after surgery (r = 0.508, p, The graphical interface shows scatter plots and linear regression between ICP and ONSD in patients with traumatic brain injury during the first week after surgery. Pearson's correlation indicated highly significant positive strong correlations between them (r = 0.679).

Estimates of riverine N

Estimates of riverine N2O emission contain great uncertainty because of the lack of quantitative knowledge concerning riverine N2O sources and fates. Using a 3.5-year record of monthly N2O measurements from the Yongan River network of eastern China, we developed a mass-balance model to address the riverine N2O source and sink processes. We achieved reasonable model efficacies (R2 = 0.44-0.84, Nash-Sutcliffe coefficients = 0.40-0.80) across three tributaries and the entire river system. Estimated riverine N2O loads originated from groundwater (38-88%), surface runoff (3-26%), and in-stream production (4-48%). Estimated in-stream losses via atmospheric release + complete denitrification accounted for 76, 95, 25, and 89% of riverine N2O fate for the agricultural, residential, forest, and entire river system, respectively. Considering limited complete denitrification, the model estimated an upper-bound riverine N2O emission rate of 2.65 ton N2O-N km-2 year-1 for the entire river system. Riverine N2O emission estimates were of comparable magnitude to those estimated with a power-law scaling model. Riverine N2O emissions using the IPCC default emission factor (0.26%) overestimated emissions by 3-15 times, whereas the dissolved N2O concentration-based emission factor overestimated or underestimated emissions. This study highlights the importance of combining comprehensive information on N2O sources and fates to achieve accurate riverine N2O emission estimates.

In light of the controversies regarding the surgical treatment of adult Chiari malformation type I (CM-I) with syringomyelia, a retrospective study was conducted to evaluate the safety and efficacy of tonsillectomy followed by modified reconstruction of the cisterna magna with or without craniectomy. Between 2008 and 2017, 78 adult CM-I patients (36 males and 42 females, mean age 40.6 years old) with syringomyelia were treated with posterior fossa decompression (PFD) with tonsillectomy and modified reconstruction of the cisterna magna. Patients were divided into two study groups: group A (n = 40) underwent cranioplasty with replacement of the bone flap; group B (n = 38) underwent suboccipital craniectomy. Neurological outcomes were evaluated by traditional physician assessment (improved, unchanged, and worsened) and the Chicago Chiari Outcome Scale (CCOS). Syringomyelia outcomes were assessed radiologically. The procedure was successfully performed in all patients, and restoration of normal cerebrospinal fluid (CSF) flow was confirmed by intraoperative ultrasonography. The median postoperative follow-up was 20.3 months (range 18–60 months). Clinical improvement was evident in 66 (84.6%) patients, with no significant differences between the two groups (85.0% vs. 84.2%, P = 0.897). According to the CCOS, 36 patients (90.0%) in group A were labeled as “good” outcome, compared with that of 34 (86.8%) in group B (P = 0.734). Improvement of syringomyelia was also comparable between the groups, which was observed in 35 (87.5%) vs. 33 (86.8%) patients (P = 0.887). The postoperative overall (7.5% vs. 23.7%, P = 0.048) and CSF-related (2.5% vs. 18.4%, P = 0.027) complication rates were significantly lower in group A than group B. Tonsillectomy with modified reconstruction of the cisterna magna without craniectomy seems to be a safe and effective surgical option to treat adult CM-I patients with syringomyelia, though future well-powered prospective randomized studies are warranted to validate these findings.

OBJECTIVEAlthough enhanced recovery after surgery (ERAS) programs have gained acceptance in various surgical specialties, no established neurosurgical ERAS protocol for patients undergoing elective craniotomy has been reported in the literature. Here, the authors describe the design, implementation, safety, and efficacy of a novel neurosurgical ERAS protocol for elective craniotomy in a tertiary care medical center located in China.METHODSA multidisciplinary neurosurgical ERAS protocol for elective craniotomy was developed based on the best available evidence. A total of 140 patients undergoing elective craniotomy between October 2016 and May 2017 were enrolled in a randomized clinical trial comparing this novel protocol to conventional neurosurgical perioperative management. The primary endpoint of this study was the postoperative hospital length of stay (LOS). Postoperative morbidity, perioperative complications, postoperative pain scores, postoperative nausea and vomiting, duration of urinary catheterization, time to first solid meal, and patient satisfaction were secondary endpoints.RESULTSThe median postoperative hospital LOS (4 days) was significantly shorter with the incorporation of the ERAS protocol than that with conventional perioperative management (7 days, p < 0.0001). No 30-day readmission or reoperation occurred in either group. More patients in the ERAS group reported mild pain (visual analog scale score 1–3) on postoperative day 1 than those in the control group (79% vs. 33%, OR 7.49, 95% CI 3.51–15.99, p < 0.0001). Similarly, more patients in the ERAS group had a shortened duration of pain (1–2 days; 53% vs. 17%, OR 0.64, 95% CI 0.29–1.37, p = 0.0001). The urinary catheter was removed within 6 hours after surgery in 74% patients in the ERAS group (OR 400.1, 95% CI 23.56–6796, p < 0.0001). The time to first oral liquid intake was a median of 8 hours in the ERAS group compared to 11 hours in the control group (p < 0.0001), and solid food intake occurred at a median of 24 hours in the ERAS group compared to 72 hours in the control group (p < 0.0001).CONCLUSIONSThis multidisciplinary, evidence-based, neurosurgical ERAS protocol for elective craniotomy appears to have significant benefits over conventional perioperative management. Implementation of ERAS is associated with a significant reduction in the postoperative hospital stay and an acceleration in recovery, without increasing complication rates related to elective craniotomy. Further evaluation of this protocol in large multicenter studies is warranted.Clinical trial registration no.: ChiCTR-INR-16009662 (chictr.org.cn)

The purpose of this study was to compare the clinical efficacy and safety of temozolomide (TMZ) combined with three-dimensional conformal radiotherapy (3D-CRT) and radiotherapy alone after surgery in patients with high-risk low-grade gliomas (LGGs).Patients (N=110) with LGGs were enrolled. Patients receiving TMZ chemotherapy combined with radiotherapy were considered as combination group (n=55), while those treated with radiotherapy alone were regarded as control group (n=55). The patients were followed up, and the overall survival (OS) and progression-free survival (PFS) were recorded. Finally, factors possibly affecting prognosis were analyzed.The follow-up results exhibited median OS [(67.4±8.8) months vs. (63.9±8.6) months] and median PFS [(51.1±7.6) months vs. (46.8±6.9) months] as well as three-year OS rate and three-year PFS rate in combination group and control group. Log-rank test indicated that the difference in OS was not statistically significant between the two groups of patients, and PFS in combination group was significantly superior to that in control group. The results of univariate and multivariate analysis displayed that age40 years old and complete tumor resection were independent factors affecting the three-year OS of patients with high-risk LGGs. Besides, age40 years old, complete tumor resection and TMZ chemotherapy combined with radiotherapy after surgery were independent factors affecting the three-year PFS of patients with high-risk LGGs.TMZ chemotherapy combined with radiotherapy after surgery in patients with high-risk LGGs can prominently improve clinical efficacy, prolong PFS, and facilitate tolerance to adverse reactions, but not prolong the OS of patients. The OS is notably prolonged in patients aged40 years old and receiving complete tumor resection.

Through the technical analysis of many cracks and leaks occurred in the pressure vessel attached to the gas injection compressor during its long service period at high pressure, the chemical analysis, metallographic analysis, hardness measurement, finite element analysis and vibration monitoring of the three-stage outlet spherical tank were carried out. Finally, it is determined that the causes of the defects are the high hardness and stress values of the weld seam and heat affected zone of the nozzle, and the mechanical fatigue caused by the alternating load caused by the vibration of the unit.

Various process intensification methods were proposed to improve the yield, quality, and safety of fermented products. Here, we report the enhancement of L-leucine production by Corynebacterium glutamicum CP using ultrasound-assisted fed-batch fermentation. Response surface methodology was employed to optimize the sonication conditions. At an ultrasonic power density of 94 W/L, frequency of 25 kHz, interval of 31 min, and duration of 37 s, C. glutamicum CP produced 52.89 g/L of L-leucine in 44 h, representing a 21.6% increase compared with the control. The production performance of L-leucine was also improved under ultrasonic treatment. Moreover, the effects of ultrasound treatment on the fermentation performance of L-leucine were studied in terms of cell morphology, cell membrane permeability, and enzyme activity. The results indicate that ultrasonication is an efficient method for the intensification of L-leucine production by C. glutamicum CP., Graphical abstract

The multifunction antibacterial hemostatic materials can reduce blood loss, infection and wound complications, which probably decrease morbidity and health care costs. However, the contradictory relationship between antibacterial ability and biocompatibility, and the unnecessary blood loss restricts the practical application of hydrophilic cationic antibacterial hemostatic materials. Herein, a multifunctional temperature-triggered antibacterial hemostatic fluorocopolymer aggregate coating was developed. After self-assembly and quaternization process, the quaternized poly(N,N-dimethylaminoethylmethacrylate)-b-poly(1H,1H,2H,2H-heptadecafluorodecyl acrylate) block copolymers (PDMA-b-PFOEMA) aggregate coating consisting of fluoropolymer and quaternary ammonium salt were built. The synergistic effect on fluorinated block with low surface energy and quaternary ammonium salt block with bactericide activity severs the way of initial bacterial attachment and proliferation, while the migration of fluorinated block greatly promotes the biocompatibility and anti-adhesion performance in response to the switch from room temperature to physiological temperature. Furthermore, the fluorocopolymer aggregate coating with hydrophobic properties possessed the property of rapid coagulation, low blood loss, minor secondary bleeding and least bacteria infiltration. The multifunctional temperature-triggered fluorocopolymer aggregate coating with antifouling, antibacterial and hemostatic properties may have a great potential in the biomedical application.

Background There are few studies on the development and effect of coagulopathy in patients with a traumatic brain injury (TBI) during the early post-operative period. We determined the risk factors and neurologic outcomes of in patients with a TBI and coagulopathy diagnosed by routine laboratory tests within 72 hours post-operatively. Methods The baseline characteristics, intra-operative management, and follow-up results of 462 patients with TBIs were obtained and retrospectively analyzed by multivariate logistic regression from January 2015 to June 2019. Coagulopathy was defined as an activated partial thromboplastin time > 40 seconds, international normalized ratio >1.4, or a platelet count < 100×109 /L.Results Multivariate logistic regression analysis revealed that the Glasgow Coma Scale (GCS) at the time of admission, Injury Severity Score (ISS) at the time of admission, pupil mydriasis, duration of surgery, intra-operative blood loss, and intra-operative crystalloid resuscitation were independent risk factors for patients who developed a coagulopathy post-operatively. There were statistical differences in mortality (p = 0.049), the Glasgow Outcome Scale-Extended (GCS-E; p = 0.024), and the modified Rankin Scale (p = 0.043) between patients with and without coagulopathy 1 week after surgery. Coagulopathy within 72 h after surgery revealed a trend for higher mortality at 1 week (66.7%), 3 months (71.4%), and 6 months (76.2%). Furthermore, coagulopathy and contusion expansion in the early post-operative period were independent risk factors for TBI mortality after surgery. Intra-operative crystalloid resuscitation had a substantial diagnostic accuracy in predicting coagulopathy within 72 h post-operatively (area under the curve [AUC] = 0.972).Conclusion Coagulopathy within 72 h post-operatively in patients with a TBI predicted worse disease progression and unfavorable neurologic outcomes. Hence, we should take practical and reasonable measures to manage these risk factors, which may protect patients with a TBI from post-operative coagulopathy.

Various process intensification methods were proposed to improve the yield, quality, and safety of fermented products. Here, we report the enhancement of L-leucine production by Corynebacterium glutamicum CP using ultrasound-assisted fed-batch fermentation. Response surface methodology was employed to optimize the sonication conditions. At an ultrasonic power density of 94 W/L, frequency of 25 kHz, interval of 31 min, and duration of 37 s, C. glutamicum CP produced 52.89 g/L of L-leucine in 44 h, representing a 21.6% increase compared with the control. The production performance of L-leucine was also improved under ultrasonic treatment. Moreover, the effects of ultrasound treatment on the fermentation performance of L-leucine were studied in terms of cell morphology, cell membrane permeability, and enzyme activity. The results indicate that ultrasonication is an efficient method for the intensification of L-leucine production by C. glutamicum CP.

Background: Various process intensifications are proposed to improve process efficiency, quality, and safety of fermented products. With the market significantly growing, the production process of L-leucine needs significant improvements to increased productivity and yield. Ultrasound, a process intensification, is an emerging and fast-growing technology due to its wide range of applications in food science and fermentation industry. Results: By optimizing the time points and parameters of ultrasound, the biomass of Corynebacterium glutamicum CP was significantly improved. The response surface methodology was adopted to create prediction profiler model and optimize sonication conditions. C. glutamicum CP fermentation at conditions of ultrasonic power of 94 W/L, frequency of 25 kHz, interval of 31 min, and duration of 37 s produced 52.89 g/L of L-leucine in 44 h, increased by 21.6% compared with the control. The production performance of L-leucine was also improved under ultrasonic treatment. Moreover, the cell morphology of C. glutamicum CP were more irregular, elongated, and swollen cells under the ultrasonic condition. The cell permeability of C. glutamicum CP and the activity of key enzymes with ultrasonic treatment were significantly higher than the control. Conclusions: We successfully obtain the optimum ultrasonic conditions to produce L-leucine in fed-batch culture. The results indicate that ultrasonication is an efficient intensification process for enhancing fermentation to produce L-leucine from C. glutamicum CP.

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12883-020-02027-1.

Streamflow components (e.g., young water vs old water) and hydrological transit times play an important role in water resource and water quality management. We collected a four-year record of stable isotopes of oxygen and hydrogen (δ18O and δ2H) in precipitation, groundwater and stream water for six catchments in the Yongan watershed of eastern China. The stable isotope records were used to identify spatio-temporal variations in the young water fraction (Fyw, defined as the proportion of the transit-time distribution younger than a threshold age) and mean transit time (MTT) based on sine-wave fitting and convolution integral methods, respectively. The Fyw ranged from 14 to 35% in the Yongan watershed. Cumulative transit time showed contrasting distributions, suggesting considerable heterogeneity and a complex interplay between catchment characteristics. Estimated MTTs ranged from 3.2 to 6.3 years and may be explained by catchment characteristics (e.g., elevation and topographic gradient). Observed spatial trends in MTTs likely result from contrasting contributions of different-aged subsurface water flows across the six catchments. The use of Fyw constraints in estimating MTTs reduced uncertainty in some catchments, suggesting the potential benefits of combining multiple approaches (e.g., Fyw) to optimize the results of traditional calibration methods. The relatively low Fyw and long MTTs highlight the importance of groundwater contributions to streamflow generation and imply a considerable lag time in river water quantity and quality responses to catchment-scale water resource management. Coupling multiple metrics (e.g., Fyw and MTT) and isotope models enhances our understanding of watershed-scale hydrologic processes and hydrograph separation.

Endoscopic endonasal transsphenoidal resection has been accepted as a routine therapy for pituitary adenoma, but the postoperative hospital stay is typically several days long. With the advantages of reduced cost and improved patient satisfaction, the application of ambulatory surgery (AS) has developed rapidly. However, AS was still rarely adopted in neurosurgery. Here we designed an AS treatment protocol for pituitary adenoma with the endoscopic endonasal approach (EEA), and reported our initial experiences regarding the safety and efficacy of the AS protocol. 63 patients who presented with pituitary adenoma were screened at the Department of Neurosurgery, Tangdu Hospital from July to September, 2017. A total of 20 pituitary adenoma patients who met the inclusion criteria underwent EEA surgery using this evidence-based AS protocol, which emphasized adequate assessment for eligibility, full preparation to minimize invasiveness, enhanced recovery, and active perioperative patient education. Of the 20 patients enrolled, 18 were discharged on the afternoon of the operation day with a median total length of stay (LOS) of 31 hours (range, 29–32) hours. The median LOS after surgery was 6.5 (range, 5–8) hours. Two patients were transferred from the AS protocol to conventional care due to intraoperative cerebrospinal fluid leakage (one case) and an unsatisfying post-anesthetic discharge score (one case). Complications included transient and reversible mild postoperative nausea and vomiting [visual analog scale (VAS) score

Quantitative information on long-term net anthropogenic phosphorus inputs (NAPI) and its relationship with riverine phosphorus (P) export are critical for developing sustainable and efficient watershed P management strategies. This is the first study to address long-term (1980-2015) NAPI and riverine P flux dynamics for the Yangtze River basin (YRB), the largest watershed in China. Over the 36-year study period, estimated NAPI to the YRB progressively increased by ∼1.4 times, with NAPIA (chemical fertilizer input+atmospheric deposition+seed input) and NAPIB (net food/feed imports+non-food input) contributing 65% and 35%, respectively. Higher population, livestock density and agricultural land area were the main drivers of increasing NAPI. Riverine total phosphorus (TP), particulate phosphorus (PP) and suspended sediment (SS) export at Datong hydrological station (downstream station) decreased by 52%, 75% and 75% during 1980-2015, respectively. In contrast, dissolved phosphorus (DP) showed an increase in both concentration (∼7-fold) and its contribution to TP flux (∼16-fold). Different trends in riverine P forms were mainly due to increasing dam/reservoir construction and changes in vegetation/land use and NAPI components. Multiple regression models incorporating NAPIA, NAPIB, dam/reservoir storage capacity and water discharge explained 84% and 92% of the temporal variability in riverine DP and PP fluxes, respectively. Riverine TP flux estimated as the sum of DP and PP fluxes showed high agreement with measured values (R2=0.87, NSE=0.84), indicating strong efficacy for the developed models. The model forecasted an increase of 50% and 7% and a decrease of 15% and 22% in riverine DP flux from 2015 to 2045 under developing, dam building, NAPIA and NAPIB reduction scenarios, respectively. This study highlights the importance of including enhanced P transformation from particulate to bioavailable forms due to river regulation and changes in land-use, input sources and legacy P pools in development of P pollution control strategies.

In this paper, a novel approach was established on the basis of a molecularly imprinted technique with the aid of double-stranded deoxyribonucleic acid (dsDNA) embedded in a molecularly imprinted polymer (MIP) membrane as a new functional unit with chiral recognition for highly specific chiral recognition. The chiral molecules were immobilized and anchored in the cavities of the MIP membrane on the basis of the three-dimensional structure of a molecule determined by the functional groups, spatial characterization of the cavities of MIPs, and the spatial orientation with dsDNA embedded in MIPs. D-carnitine was selected as an example of a chiral molecular template, which intercalated into dsDNA immobilized on the gold electrode surface to form dsDNA-D-carnitine complex, and then the complex was embedded in the MIP during electropolymerization. After elution, the stereo-selective cavities were obtained. Our findings have shown that AAAA-TTTT base sequence had high affinity for D-carnitine intercalation. Combined with the electrochemical detection method, MIP sensor was prepared. The selectivity of the MIP sensor to ultratrace D-carnitine was significantly improved; the sensor had remarkable stereo-selectivity and highly chiral specific recognition to D-carnitine, and L-carnitine with a concentration of 10,000 times D-carnitine did not interfere with the detection of D-carnitine in the assay of raceme. The sensor also exhibited high sensitivity to ultratrace D-carnitine determination with a linear response to the concentration of D-carnitine in the range of 3.0 × 10−16 mol/L to 4.0 × 10−13 mol/L, with a detection limit of 2.24 × 10−16 mol/L. The mechanism of chiral recognition was studied, and result showed that apart from the recognition effect of imprinted cavities, dsDNA provided chiral selectivity to the spatial orientation of chiral molecules via the intercalation of chiral molecules with dsDNA and electrostatic interaction with groups of DNA base.

A novel neurosurgical enhanced recovery after surgery (ERAS) program shortens postoperative hospital stay and accelerates functional recovery in elective craniotomy patients. There is a need to evaluate the impact of ERAS program on patients’ health-related quality of life (HRQOL). In a single-center randomized controlled trial, patients were randomized 1:1 to receive perioperative ERAS or conventional care. As a secondary outcome, HRQOL was measured with the EORTC QLQ-C30/BN20 prior to randomization (baseline), at discharge, and at 3- and 6-month follow-up. A total of 65 patients (ERAS: n = 36, conventional care: n = 29) with pathologically confirmed glioma (WHO grade 2–4) were included in the analysis. Progression-free survival at 6 months and HRQOL at baseline were similar between the two groups. Changes of scores did not vary significantly over time, but differed significantly between intervention groups. A clinically relevant better QoL (at 3-month follow-up), physical functioning (at 6-month follow-up) and role functioning (at discharge) was observed in patients in the ERAS group. Symptom scores of constipation (at discharge), motor dysfunction (at discharge, 3- and 6-month follow-up), drowsiness (at 3- and 6-month follow-up), weakness of legs (at 3-month follow-up), and nausea/vomiting (at discharge and 6-month follow-up) were significantly lower in the ERAS group. The neurosurgical ERAS program seems to improve functioning and symptoms scores in glioma patients within 6-month follow-up compared with conventional care. The intervention has a significant main effect HRQOL changes without significant interaction with time. Future well-powered multicenter studies are warranted to confirm this result and address long-term benefits. This study has been registered in the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/showproj.aspx?proj=16480 ) with registration number ChiCTR-INR-16009662.

BACKGROUND: Infratentorial craniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS) protocols have been shown in multiple surgical disciplines to improve outcomes, including reduced PONV. However, very few studies have described the application of ERAS to infratentorial craniotomy. The aim of this study was to examine whether our ERAS protocol for infratentorial craniotomy could improve PONV. METHODS: We implemented an evidence-based, multimodal ERAS protocol for patients undergoing infratentorial craniotomy. A total of 105 patients who underwent infratentorial craniotomy were randomized into either the ERAS group (n = 50) or the control group (n = 55). Primary outcomes were the incidence of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery. Secondary outcomes included postoperative anxiety level, sleep quality, and complications. RESULTS: Over the entire 72 h post-craniotomy observation period, the cumulative incidence of vomiting was significantly lower in the ERAS group than in the control group. Meanwhile, the incidence of vomiting was significantly lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the proportion of patients with mild nausea (VAS 0-4) was higher in the ERAS group as compared to the control group on PODs 2 or 3. Additionally, the postoperative anxiety level and quality of sleep were significantly better in the ERAS group. CONCLUSION: Successful implementation of our ERAS protocol in infratentorial craniotomy patients could attenuate postoperative anxiety, improve sleep quality, and reduce the incidence of PONV, without increasing the rate of postoperative complications. TRIAL REGISTRATION: ChiCTR-INR-16009662, 27 Oct 2016, Clinical study on the development and efficacy evaluation of Enhanced Recovery After Surgery (ERAS) in Neurosurgery. KEYWORDS: enhanced recovery after surgery (ERAS), postoperative nausea and vomiting (PONV), infratentorial craniotomy, anxiety, sleep quality.

Objective: To prospectively evaluate the efficacy of a neurosurgical enhanced recovery after surgery (ERAS) protocol on the management of postoperative pain after elective craniotomies. Methods: This randomized controlled trial was conducted in the neurosurgical center of Tangdu Hospital (Fourth Military Medical University, Xi'an, China). A total of 129 patients undergoing craniotomies between October 2016 and July 2017 were enrolled in a randomized clinical trial comparing an ERAS protocol to a conventional postoperative care regimen. The primary outcome was the postoperative pain score assessed by a verbal numerical rating scale (NRS). Results: Patients in the ERAS group had a significant reduction in their postoperative pain scores on POD 1 compared to patients in the control group (p < 0.05). More patients (n = 44, 68.8%) in the ERAS group experienced mild pain (NRS: 1 to 3) on POD1 compared with patients (n = 23, 35.4%) in the control group (p < 0.05). A further reduction in pain scores was also observed on POD 2 and maintained on POD 3 in the ERAS group compared with that in the control group. In addition, the median postoperative length of hospital stay was significantly decreased with the incorporation of the ERAS protocol compared to controls (ERAS: 4 days, control: 7 days, P

Objectives : Infratentorial craniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS) protocols have been shown in multiple surgical disciplines to improve outcomes, including reduced PONV. However, very few studies have described the application of ERAS to infratentorial craniotomy. The aim of this study was to examine whether our ERAS protocol for infratentorial craniotomy could improve PONV. Methods : We implemented an evidence-based, multimodal ERAS protocol for patients undergoing infratentorial craniotomy. A total of 105 patients who underwent infratentorial craniotomy were randomized into either the ERAS group (n = 50) or the control group (n = 55). Primary outcomes were the incidence of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery. Secondary outcomes included postoperative anxiety level, sleep quality, and complications. Results: Over the entire 72 h post-craniotomy observation period, the cumulative incidence of vomiting was significantly lower in the ERAS group than in the control group. Meanwhile, the incidence of vomiting was significantly lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the proportion of patients with mild nausea (VAS 0-4) was higher in the ERAS group as compared to the control group on PODs 2 or 3. Additionally, the postoperative anxiety level and quality of sleep were significantly better in the ERAS group. Conclusion: Successful implementation of our ERAS protocol in infratentorial craniotomy patients could attenuate postoperative anxiety, improve sleep quality, and reduce the incidence of PONV, without increasing the rate of postoperative complications.

Additional file 1:.

Objectives: Infratentorial craniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS) protocols have been shown in multiple surgical disciplines to improve outcomes, including reduced PONV. However, very few studies have described the application of ERAS to infratentorial craniotomy. The aim of this study was to examine whether our ERAS protocol for infratentorial craniotomy could improve PONV.Methods: We implemented an evidence-based, multimodal ERAS protocol for patients undergoing infratentorial craniotomy. A total of 105 patients who underwent infratentorial craniotomy were randomized into either the ERAS group (n = 50) or the control group (n = 55). Primary outcomes were the incidence of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery. Secondary outcomes included postoperative anxiety level, sleep quality, and complications.Results: Over the entire 72 h post-craniotomy observation period, the cumulative incidence of vomiting was significantly lower in the ERAS group than in the control group. Meanwhile, the incidence of vomiting was significantly lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the proportion of patients with mild nausea (VAS 0-4) was higher in the ERAS group as compared to the control group on PODs 2 or 3. Additionally, the postoperative anxiety level and quality of sleep were significantly better in the ERAS group.Conclusion: Successful implementation of our ERAS protocol in infratentorial craniotomy patients could attenuate postoperative anxiety, improve sleep quality, and reduce the incidence of PONV, without increasing the rate of postoperative complications.

To evaluate the safety and efficacy of an enhanced recovery after surgery (ERAS) program for intraspinal tumors in a single-institutional prospective randomized controlled trial.A multimodal and multidisciplinary ERAS protocol for intraspinal tumor surgery was developed. A total of 94 enrolled patients were randomized into 2 groups: 48 were managed following the ERAS protocol (ERAS group), and 46 received conventional perioperative care (control group). The primary end point was postoperative length of stay (LOS). The secondary outcomes included postoperative pain score and pain medication use, urinary catheterization, ambulation, mortality, reoperation/readmission rates, complication rates, patient satisfaction, and overall cost.A significant reduction in LOS was achieved in patients undergoing ERAS protocol compared with the controls (5 vs. 8 days; P0.0001). Moreover, patients in the ERAS group had better postoperative pain scores (1.0 ± 1.3 vs. 1.9 ± 1.3; P = 0.007), decreased use of patient-controlled analgesia (4.2% vs. 19.6%; P = 0.020) and oral opioid (37.5% vs. 58.7%; P = 0.040), early urinary catheter removal (58.3% vs. 6.5%; P0.0001), greater ambulation (68.8% vs. 17.4%; P0.0001), and higher satisfaction scores (91.8 ± 4.4 vs. 88.2 ± 6.8; P = 0.022) than did the control group. There were no deaths or 30-day readmission/reoperation in both groups, nor did the postoperative complication rates differ between groups.The ERAS protocol for intraspinal tumor surgery seems to be feasible, effective, and safe in shortening postoperative LOS, improving postoperative pain control with reduced opioid use, and accelerating functional recovery without increasing rates of complications or reoperation/readmission. Adoption of spine ERAS programs could be encouraged in practice, although validation with larger-scale multicenter trials is warranted.

Legacy phosphorus (P) accumulated in watersheds from excessive historical P inputs is recognized as an important component of water pollution control and sustainable P management in watersheds worldwide. However, little is known about how watershed P buffering capacity responds to legacy P pressures over time and how long it takes for riverine P concentrations to recover to a target level, especially in developing countries. This study examined long-term (1960–2010) accumulated legacy P stock, P buffering capacity and riverine TP flux dynamics to predict riverine P-reduction recovery times in the Yongan watershed of eastern China. Due to a growing legacy P stock coupled with changes in land use and climate, estimated short- and long-term buffering metrics (i.e., watershed ability to retain current year and historically accumulated surplus P, respectively) decreased by 65% and 36%, respectively, resulting in a 15-fold increase of riverine P flux between 1980 and 2010. An empirical model incorporating accumulated legacy P stock and annual precipitation was developed (R² = 0.99) and used to estimate a critical legacy P stock of 22.2 ton P km⁻² (95% CI 19.4–25.3 ton P km⁻²) that would prevent exceedance of a target riverine TP concentration of 0.05mg P L⁻¹. Using an exponential decay model, the recovery time for depleting the estimated legacy P stock in 2010 (29.3 ton P km⁻²) to the critical level (22.2 ton P km⁻²) via riverine flux was 456years (95% CI 353–560years), 159years (95% CI 57–262years) and 318years (95% CI 238–400years) under scenarios of a 4% reduction in annual P inputs, total cessation of P inputs, and 4% reduction of annual P inputs with a 10% increase in average annual precipitation, respectively. Given the lower P buffering capacity and lengthening recovery time, strategies to reduce P inputs and utilize soil legacy P for crop production are necessary to effectively control riverine P pollution and conserve global rock P resources. A long-term perspective that incorporates both contemporary and historical information is required for developing sustainable P management strategies to optimize both agronomic and environmental benefits at the watershed scale.

Accurate source identification is critical for optimizing water pollution control strategies. Although the dual stable isotope (15N-NO3-/18O-NO3-) approach has been widely applied for differentiating riverine nitrogen (N) sources, the relatively short-term (75% of river discharge and were likely the major hydrological pathways for N delivery to the river. Riverine NO3- sources varied with dominant land use (p 30%) were the dominant riverine NO3- sources, implying considerable potential for N pollution legacy effects. Results were consistent with observed nitrous oxide dynamics and N sources identified in previous modeling studies. As the first attempt to apply multiple isotope tracers for exploring and quantifying N transformation and transport pathways, this study provides an integrated approach for verifying and understanding the N pollution legacy effects observed in many watersheds worldwide. This study highlights that river N pollution control in many watersheds requires particular attention to groundwater restoration and soil N management in addition to N input control strategies.

The environmental threshold for upland soil phosphorus (P) content (ETSP, i.e., inflection point of soil P content leading to enhanced P loss) provides an important metric for guiding agricultural nonpoint source P pollution control. This study achieved the first meta-analysis to determine ETSP values for upland soils in China. The estimated national-level ETSP based on 472 field experimental observations of Olsen-P content and P loss rate was 30.1 ± 4.0 mg P kg−1, which was lower than the average ETSP value (52.1 ± 5.0 mg P kg−1) but higher than the average agronomic threshold values (16.0 ± 6.4 mg P kg−1) previously reported. Lower upland ETSP values occurred in acidic soils and soils having higher organic matter content (SOM), precipitation and slope (ETSP: 30.5 for pH 56.4 for SOM 3%; 33 for precipitation 1200 mm yr−1; and 39.8 for slopes

Nitrogen (N) runoff loss from croplands due to excessive anthropogenic N additions is a principal cause of non-point source water pollution worldwide. Quantitative knowledge of regional-scale N runoff loss from croplands is essential for developing sustainable agricultural N management and efficient water N pollution control strategies. This meta-analysis quantifies N runoff loss rates and identifies the primary factors regulating N runoff loss from uplands (n = 570) and paddy (n = 434) fields in the Yangtze River Basin (YRB). Results indicated that total N (TN) runoff loss rates from uplands and paddy fields consistently increased from upstream to downstream regions. Runoff depth, soil N content and fertilizer addition rate (chemical fertilizer + manure) were the major factors regulating variability of TN runoff loss from uplands, while runoff depth and fertilizer addition rate were the main controls for paddy fields. Multiple regression models incorporating these influencing factors effectively predicted TN runoff loss rates from uplands (calibration: R2 = 0.60, n = 242; validation: R2 = 0.55, n = 104) and paddy fields (calibration: R2 = 0.70, n = 189; validation: R2 = 0.85, n = 82). Models estimated total cropland TN runoff loss load in YRB of 0.54 (95% Cl: 0.23–1.33) Tg, with 0.30 (95% Cl: 0.15–0.56) Tg from uplands and 0.24 (95% Cl: 0.08–0.77) Tg from paddy fields in 2017. Guangxi, Jiangxi, Fujian, Hunan and Henan provinces within the YRB were identified as cropland TN runoff loss hotspots. Models predicted that TN runoff loss loads from croplands in YRB would decrease by 0.8–13.7% for five scenarios, with higher TN load reductions occurring from scenarios with decreased runoff amounts. Reducing upland TN runoff loss should focus primarily on soil N utilization and runoff management, while reducing N fertilizer addition and runoff provided the most sensitive strategies for paddy fields. Integrated management of water, soil and fertilizer is required to effectively reduce cropland N runoff loss.

Objective: To prospectively evaluate the efficacy of improvement on postoperative pain after elective craniotomies based on neurosurgical enhanced recovery after surgery (ERAS) protocol. Methods: This randomised controlled trial was conducted in neurosurgical center of Tangdu Hospital (Fourth Military Medical University, Xi’an, China). A total of 129 patients undergoing craniotomies between October 2016 and July 2017 were enrolled in a randomized clinical trial comparing ERAS protocol and conventional care. The primary outcome was the score of postoperative pain by means of a verbal numerical rating scale (NRS). Results: Patients following ERAS had a significant reduction in postoperative pain according to the NRS score on POD 1 compared to patients with control group (mean NRS 3.12 vs. 4.44, OR 0.0968, 95% CI 0.3299 to 2.317, p = 0.010). More patients (n = 44, 68.8%) in ERAS groups experienced mild pain (NRS: 1 to 3) on POD1, which compared with patients (n = 23, 35.4%) in control groups (p < 0.05). The difference reached a reduction from POD 2 to POD 3 in ERAS group postoperatively compared with that in control group (POD2: mean NRS 2.85 vs. 4.32, OR 0.2628, 95% CI 0.5619 to 2.379, p=0.002. POD3: mean NRS 2.32 vs. 4.03, OR 0.1468, 95% CI 0.9537 to 2.458, p < 0.001, respectively). In addition, the median postoperative length of hospital stay was significantly decreased with the incorporation of ERAS protocol compared to conventional standard care (ERAS: 4 days, control: 7 days, respectively, P

The aim of this study was to evaluate the effect of preoperative oral carbohydrate loading versus fasting on the outcomes of patients undergoing elective craniotomy.In a single-center randomized controlled study, 120 neurosurgical patients who were admitted for elective craniotomy were included and randomized into 2 groups: 58 patients received 400 mL of oral carbohydrate loading 2 h before surgery (intervention group), and 62 patients were fasting for 8 h prior to surgery as routine management (control group). The primary end point was glucose homeostasis. Secondary outcomes included handgrip strength, pulmonary function and postoperative complications.Better glucose homeostasis (5.6 ± 1.0 mmol/L vs. 6.3 ± 1.2 mmol/L, P = 0.001) was achieved in patients who received preoperative oral carbohydrate loading compared to fasting. Furthermore, patients in the intervention group had better handgrip strength (25.3 ± 7.1 kg vs. 19.9 ± 7.5 kg, P 0.0001) and pulmonary function (in terms of peak expiratory flow rate) (315.8 ± 91.5 L/min vs. 270.0 ± 102.7 L/min, P = 0.036) compared to the controls postoperatively. The rates of postoperative surgical and non-surgical complications did not differ between the groups. Both postoperative and total hospital length of stay (LOS) reduced significantly in the intervention group (-3d, P 0.0001 and P = 0.004).Oral carbohydrate loading given 2 h before surgery in patients undergoing elective craniotomy seems to improve glucose homeostasis, handgrip strength and pulmonary function as well as decrease LOS without increasing the risk of postoperative complications. Routine use of preoperative oral carbohydrate loading could be suggested in clinical settings, though further evaluation of its safety and efficacy is warranted.

Legacy nutrient accumulation from excess anthropogenic inputs has become a serious environmental issue in many watersheds worldwide. In this review, we provide a systematic overview of sources, legacy nutrient pools, watershed-scale water quality models, and agronomic and environmental implications of legacy nitrogen and phosphorus pools. Hydrological, biogeochemical, and anthropogenic factors exert interacting controls on legacy nutrient dynamics in soils, sediments, and vadose zone/groundwater. Most current watershed models do not effectively incorporate legacy nutrient dynamics, while models that consider legacy effect often have high uncertainty in their treatment of legacy nutrient dynamics. In many intensively managed watersheds, legacy nutrients are a dominant and long-term (> 10 years) source of nutrients to receiving waters, as well as a potentially important nutrient source for crop production. Many existing beneficial management measures have limitations for reducing legacy nutrient losses to surface waters due to appreciable differences in legacy nutrient forms, watershed storage locations, and temporal dynamics compared to those of contemporary nutrient inputs. Recognizing the importance of legacy nutrients is necessary for developing sustainable watershed nutrient management plans for future food, bioenergy, and water security. These plans require strategies to maximize use of legacy nutrient resources to minimize their loss to the atmosphere (e.g., N2O emissions) and surface waters. Finally, this synthesis identified future research needs for improving the understanding, utilization, and mitigation of watershed legacy nutrient pools.

BACKGROUND Surgical managements were recommended for unstable distal clavicle fracture owing to the high incidence of nonunion. The present study compared the efficacy of anatomical locking plate with versus without additional suture anchor fixation for the treatment of unstable Neer type II distal clavicle fractures. MATERIAL AND METHODS Between January 2013 to January 2015, 28 consecutive patients with unstable Neer type II fractures were treated by using anatomical locking plate with or without additional suture anchor fixation. The patients were divided into anatomical locking plate group (group A) and anatomical locking plate combined with suture anchor group (group B) according to the surgical method. The operative-related parameters such as operation time, blood loss, length of hospitalization, union time, functional outcomes (Constant score, UCLA score and DASH score) and CC distance were compared. RESULTS The mean follow-up period of the 28 patients was 19.60 months (21.80 versus 18.39 months, respectively). No statistical differences in general and peri-operative parameters were found between 2 groups. The group B had significant higher Constant score than group A (P=0.004, 91.67 versus 83.10). While no statistical differences were reached in the UCLA score and DASH score between 2 groups (P=0.112 and 0.163, respectively). The group A had longer CC distance than group B (11.67 versus 8.94 mm), while no statistic difference was found (P=0.067). CONCLUSIONS For the treatment of acute unstable Neer type II distal clavicle fractures, both surgical methods could offer satisfactory outcome. However, anatomical locking plate combined with additional suture anchor fixation had a better functional and radiographic outcome than that without additional suture anchor fixation.

ObjectiveTo evaluate patient satisfaction and associated predictors at discharge, as well as patient experience at 30-day follow-up, in a neurosurgical enhanced recovery after surgery (ERAS) programme.DesignA single-centre, prospective, randomised controlled study.SettingA tertiary hospital in China.ParticipantsA total of 140 neurosurgical patients aged 18–65 years old who had a single intracranial lesion and were admitted for elective craniotomy between October 2016 and July 2017 were included.InterventionsPatients were randomised into two groups: 70 patients received care according to a novel neurosurgical ERAS protocol (ERAS group) and 70 patients received conventional perioperative care (control group).Outcome measuresPatient satisfaction at discharge was evaluated using a multimodal questionnaire. A secondary analysis of patient experience regarding participation in the ERAS programme was conducted using a semistructured qualitative interview via telephone at 30-day follow-up.ResultsThe mean patient satisfaction was significantly higher in the ERAS group than in the control group at discharge (92.2±4.3 vs 86.8±7.4, p=0.0001). The most important predictors of patient satisfaction included age (OR=6.934), postoperative nausea and vomiting (PONV) Visual Analogue Scale (VAS) score (OR=0.184), absorbable skin suture (OR=0.007) and postoperative length of stay (LOS) (OR=0.765). Analysis on patient experience revealed five themes: information transfer, professional support, shared responsibility and active participation, readiness for discharge, and follow-up, all of which are closely related and represent positive and negative aspects.ConclusionsMeasures that include decreasing PONV VAS score, incorporating absorbable skin suture and shortening LOS seem to increase patient satisfaction in a neurosurgical ERAS programme. Analysis of data on patient experience highlights several aspects to achieve patient-centred and high-quality care. Further studies are warranted to standardise the assessment of patient satisfaction and experience in planning, employing and appraising the ERAS programme.Trial registration numberChiCTR-INR-16009662.

Thermal/power issues have become increasingly important with more and more transistors being placed on a single chip. Many dynamic thermal/power management techniques have been proposed to address such issues but they all depend heavily on accurate knowledge of the chip's thermal state during runtime. In this paper, we describe a unified statistical framework for designing an on-chip thermal sensing infrastructure that can be used to track the chip's thermal state at runtime. Specifically, we address the following problems in this statistical framework: 1) sensor placement; 2) sensor data compression; 3) sensor data fusion; and 4) overall interplay. Our methods exploit the correlations between temperatures in different parts of the chip to drive sensor placement, data compression, and data fusion in both noiseless and noisy sensor cases. Our framework is also capable of choosing the appropriate degree of compression for each sensor while accounting for their local space constraints during deployment. The experimental results show that the root-mean-square error of the thermal estimates produced by our sensing infrastructure is on average 35% better than an equivalent system that uses a range-based placement scheme and a uniform compression scheme. It took our methods at most about 9 s to decide the overall solution for placement, compression, and data fusion at the design stage. This demonstrates the effectiveness and applicability of our unified statistical design methodology.

In this paper, we investigate dynamic thermal management (DTM) policies under soft thermal constraint that allow the thermal constraint to be violated occasionally for boosting system performance. First, we investigate soft-constraint DTM using lumped radio control (RC) thermal models. We develop analytical expressions for the optimal core frequency policies that maximize overall performance under soft thermal constraint for both single-core and homogeneous multicore processors. We then generalize the problem to heterogeneous multicore processor and use a more accurate distributed RC thermal model to account for the spatial thermal variation. The generalized problem also takes into account the impact of increased temperature on transistor delay and leakage power. The problem is solved by convex optimization. Experimental results indicate that for a two-core processor, a mere 10 °C increase in the core temperature for 100 s results in about 30% performance gain.

Nonylphenol (NP) is the final biodegradation product of nonylphenol polyethoxylates, which are widely used as surfactants in domestic and industrial products. NP was reported to exert estrogenic actions and shown to potentially adversely affect reproductive functions. However, NP influence on immune system function remains unclear. To address this issue, the effects of NP on spleen and thymus were examined in this study. Female Sprague-Dawley rats were treated with NP orally at doses of 0, 20, 80, or 200 mg/kg respectively. Data showed that NP increased the levels of natural killer (NK) cells and natural killer T (NKT) cells in peripheral blood and decreased the levels of interleukin-4 (IL-4) and interferon gamma (IFN-γ) in serum. These findings suggest that exposure to NP by oral route may induce adverse effects on the spleen and thymus and affect the immune function of female rats.

In this paper, we investigate the gate sizing problem and develop techniques for improving the runtime by effectively exploiting the graphics processing unit (GPU) resources. Theoretically, we investigate a randomized cutting plane-based convex optimization technique which is highly parallelizable and can effectively exploit the single instruction multiple data structure imposed by GPUs. In order to further improve the runtime, we also develop GPU-oriented implementation guidelines that exploit the specific structure that convex gate sizing formulations impose. We implemented our method on NVIDIA Tesla 10 GPU and obtain 21× to 400× speedup compared to the MOSEK optimization tool implemented on conventional CPU. The quality of solution of our method is very close to that achieved by MOSEK, since both are optimal.