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The surface distributions of aliphatic hydrocarbons and polycyclic aromatic hydrocarbons (PAHs) were investigated from coastal sediments of Brunei Bay, southern South China Sea. The concentrations of total n-alkane (TNA) and 16 USEPA priority PAHs ranged from 0.67 to 9.88 μg/g and 4.72 to 102 ng/g, respectively. Principal component analysis (PCA) clustered the hydrocarbons in surface sediments according to their relationship and geographical locations, anticipated to the inputs and activities in proximity. Biomarker diagnostic ratios revealed that biogenic n-alkane inputs in the coastal sediments are exported from the fluviomarine and mangrove swamp environment, while the PAHs inputs are derived from mixed petrogenic and petroleum combustion residues. Overall, the level of PAHs in the study area is between low to moderate, based on the comparison with other areas worldwide.

BACKGROUND Immunosuppression is an important factor in the incidence of infections in transplant recipient. Few studies are available on the management of immunosuppression (IS) treatment in the liver transplant (LT) recipients complicated with infection. The aim of this study is to describe our experience in the management of IS treatment during bacterial bloodstream infection (BSI) in LT recipients and assess the effect of temporary IS withdrawal on 30 d mortality of recipients presenting with severe infection. AIM To assess the effect of temporary IS withdrawal on 30 d mortality of LT recipients presenting with severe infection. METHODS A retrospective study was conducted with patients diagnosed with BSI after LT in the Department of Liver Surgery, Renji Hospital from January 1, 2016 through December 31, 2017. All recipients diagnosed with BSI after LT were included. Univariate and multivariate Cox regression analysis of risk factors for 30 d mortality was conducted in the LT recipients with Gram-negative bacterial (GNB) infection. RESULTS Seventy-four episodes of BSI were identified in 70 LT recipients, including 45 episodes of Gram-positive bacterial (GPB) infections in 42 patients and 29 episodes of GNB infections in 28 patients. Overall, IS reduction (at least 50% dose reduction or cessation of one or more immunosuppressive agent) was made in 28 (41.2%) cases, specifically, in 5 (11.9%) cases with GPB infections and 23 (82.1%) cases with GNB infections. The 180 d all-cause mortality rate was 18.5% (13/70). The mortality rate in GNB group (39.3%, 11/28) was significantly higher than that in GPB group (4.8%, 2/42) (P = 0.001). All the deaths in GNB group were attributed to worsening infection secondary to IS withdrawal, but the deaths in GPB group were all due to graft-versus-host disease. GNB group was associated with significantly higher incidence of intra-abdominal infection, IS reduction, and complete IS withdrawal than GPB group (P < 0.05). Cox regression showed that rejection (adjusted hazard ratio 7.021, P = 0.001) and complete IS withdrawal (adjusted hazard ratio 12.65, P = 0.019) were independent risk factors for 30 d mortality in patients with GNB infections after LT. CONCLUSION IS reduction is more frequently associated with GNB infection than GPB infection in LT recipients. Complete IS withdrawal should be cautious due to increased risk of mortality in LT recipients complicated with BSI. IS

To develop and validate a nomogram for predicting postoperative pulmonary infection (PPI) in patients undergoing lung surgery.Single-center retrospective cohort analysis.A university-affiliated cancer hospital PARTICIPANTS: A total of 1,501 adult patients who underwent lung surgery from January 2018 to December 2020.Observation for PPI within 7 days after lung surgery.A complete set of demographics, preoperative variables, and postoperative follow-up data was recorded. The primary outcome was PPI; a total of 125 (8.3%) out of 1,501 patients developed PPI. The variables with p0.1 in univariate logistic regression were included in the multivariate regression, and multivariate logistic regression analysis showed that surgical procedure, surgical duration, the inspired fraction of oxygen in one-lung ventilation, and postoperative pain were independent risk factors for PPI. A nomogram based on these factors was constructed in the development cohort (area under the curve: 0.794, 95% CI 0.744-0.845) and validated in the validation cohort (area under the curve: 0.849, 95% CI 0.786-0.912). The calibration slope was 1 in the development and validation cohorts. Decision curve analysis indicated that when the threshold probability was within a range of 0.02-to-0.58 and 0.02-to-0.42 for the development and validation cohorts, respectively, the nomogram model could provide a clinical net benefit.The authors developed and validated a nomogram for predicting PPI in patients undergoing lung surgery. The prediction model can predict the development of PPI and identify high-risk groups.

This work reported the n-alkanes contents in a 10 m peat core collected at Timbarap, Sarawak. Different biomarker proxies were used to understand the predominance of sources present in the tropical peatland of Borneo. The total concentrations of n-alkanes in selected depths of Timbarap peat core ranged between 0.01 and 12.60 μg/g with an average of 1.58 μg/g. The presence of strong odd-to-even predominance from higher molecular weight n-alkanes homologues with high values of carbon preference index (CPI) provide clear evidences of the terrestrial plant wax assemblages. Increment of low-molecular-weight n-alkanes provide an indicator of biogenic-aquatic organic materials. The ratios of isoprenoids (pristane and phytane) have shown that the peat core was under anaerobic and reducingdepositional conditions, which could result the predominance source that alternated between aquatic-biogenic and terrestrial-derived materials.

To understand the influence of the automated shuttles on active modes as pedestrians and bicyclists, data was collected at the pilot site Linköping within the context of the European project SHOW, where AS provide regular transport service on the campus and run along a corridor restricted to bike and pedestrian traffic with pre-defined stops. Three types of data were collected, i.e. video data, shuttle data and traffic counts with use of Telraam, while the first one was the main data source for analyzing VRU behaviors and the others were used for checking the validity of video data. The investigation mainly focused on VRU’s space usage, speed, acceleration and lateral position and distance with and without AS presence. Bikes maneuvers, compatible with overtaking, were also examined. The analysis results can help for simulation model improvement.

With the expeditious development in technology autonomous vehicles (AVs) are going to become a part of our daily life. Their possible influences on current transportation systems and the needs of the future traffic systems with the introduction of AVs have been investigated extensively with use of traffic simulation tools. Apart from simulative studies more and more real-life demonstrations of AVs are carried out and real AV data becomes available. The latter one facilitates to further properly model AVs’ driving behaviour in traffic simulation. Related AVs’ impact evaluations can then be more representative and support policy and decision making. In this paper, real autonomous shuttle bus data is analysed to understand driving situation, to derive vehicle-related parameters for enhancing microscopic traffic simulation model, and to find out possible issues in real traffic environment.

Background Clinical evidence has proved that enhanced recovery after surgery (ERAS) can improve short-term clinical outcomes after various types of surgeries, but the long-term benefits have not yet been examined, especially with respect to cancer surgeries. Therefore, a systematic review of the current evidence was conducted. Methods The Pubmed, Cochrane Library, Embase, and Web of Science databases were searched using the following key words as search terms: “ERAS” or “enhanced recovery” or “fast track”, “oncologic outcome”, “recurrence”, “metastasis”, “long-term outcomes”, “survival”, and “cancer surgery”. The articles were screened using the inclusion and exclusion criteria, and the data from the included studies were extracted and analyzed. Results A total of twenty-six articles were included in this review. Eighteen articles compared ERAS and conventional care, of which, 12 studies reported long-term overall survival (OS), and only 4 found the improvement by ERAS. Four studies reported disease-free survival (DFS), and only 1 found the improvement by ERAS. Five studies reported the outcomes of return to intended oncologic treatment after surgery (RIOT), and 4 found improvements in the ERAS group. Seven studies compared high adherence to ERAS with low adherence, of which, 6 reported the long-term OS, and 3 showed improvements by high adherence. One study reported high adherence could reduce the interval from surgery to RIOT. Four studies reported the effect of altering one single item within the ERAS protocol, but the results of 2 studies were controversial regarding the long-term OS between laparoscopic and open surgery, and 1 study showed improvements in OS with restrictive fluid therapy. Conclusions The use of ERAS in cancer surgeries can improve the on-time initiation and completion of adjuvant chemotherapy after surgery, and the high adherence to ERAS can lead to better outcomes than low adherence. Based on the current evidence, it is difficult to determine whether the ERAS protocol is associated with long-term overall survival or cancer-specific survival.

This paper investigates tensile performances of strain-hardening cement-based composites (SHCC) with different curing ages varying from 3d to 28d. Cracking properties of SHCC specimens like the evolution of the number of cracks and the crack opening under direct tension was monitored simultaneously by using the digital images correlation (DIC) technique. Results show that the ultimate tensile strain in specimens cured for 7d is higher than that in specimens cured for 3d and 28d. The strain-hardening process involves three stages such as the initial, the intermediate, and the final stage, which are determined in terms of their cracking properties. Cracking properties of specimens cured for 3d and 7d display different rules from those of specimens cured for 28d at the intermediate strain-hardening stage, leading to different shape of stress-strain curve. Curing age influences fiber bridging stress-crack opening relation ( σ ( δ ) ) and interfacial mechanical behavior between PVA fiber and the matrix. σ ( δ ) gained by the DIC technique is similar to that observed in the tensile testing on notched specimens. The energy-based index of specimens cured for 7d has greater margin than that of specimens cured for 3d and 28d. The interfacial bond between fiber and matrix in specimens cured for 28d is larger than that in specimens cured for 3d and 7d.

The spatial and temporal distribution of polycyclic aromatic hydrocarbons (PAHs) in three sediment cores from Brunei Bay, Southern South China Sea was investigated. The total concentrations of 16 priority PAHs (∑PAH

With the consideration of the uneven traffic volume distribution at intersections on urban arterials, this paper aims to minimize the overall passenger delay (buses and private vehicles) at intersections and identify the applicable conditions of the proposed method with field data. The overlapping phase-based signal control logic and the bus priority control algorithm under two-way signal coordination on arterial roads are proposed. The vehicular capacities and occupancies for buses and passenger cars are considered in the evaluation of the method performance. A field test was carried out at two major intersections on an arterial road in Hefei, China. With the test data, the proposed method is examined and the possible influencing factors are analyzed for identifying the corresponding applicable conditions. The analysis result shows that the application of the overlapping phase helps to provide a relatively flexible signal control for the varying traffic demands at intersections. Compared to the conventional phase, it isof more practical significance to consider overlapping phase and apply bussignal priority control under two-way signal coordination according to the condition of uneven traffic volumedistribution at intersections on urban arterials. The proposed method can effectively decrease the total passenger delay at the intersections on urban arterials under certain applicable conditions. The possible factors influencing the method applicability are identified as well. It is verified that bus signal priority control under the two-way signal coordination, based on overlapping phases, is more conducive to improving traffic efficiency on urban arterials. Regarding the influencing factors and the applicability of the proposed method, the results show that not all situations are conducive to decreasing passenger delay at intersections. The proposed method should be applied under certain applicable conditions and principles in order to efficiently and effectively improve the traffic efficiency on arterial roads.

In light of the increasing trend towards vehicle connectivity and automation, there will be areas and situations on the roads where high automation can be granted, and others where it is not allowed or not possible. These are termed ‘Transition Areas’. Without proper traffic management, such areas may lead to vehicles issuing take-over requests (TORs), which in turn can trigger transitions of control (ToCs), or even minimum-risk manoeuvres (MRMs). In this respect, the TransAID Horizon 2020 project develops and demonstrates traffic management procedures and protocols to enable smooth coexistence of automated, connected, andconventional vehicles, with the goal of avoiding ToCs and MRMs, or at least postponing/accommodating them. Our simulations confirmed that proper traffic management, taking the traffic mix into account, can prevent drops in traffic efficiency, which in turn leads to a more performant, safer, and cleaner traffic system, when taking the capabilities of connected and autonomous vehicles into account.

Background: Postoperative cognitive dysfunction (POCD) is a very common event in elderly noncardiac surgical patients. The effects of inhalational anaesthetics and propofol on the incidence of POCD and postoperative cognitive status at different time points after surgery are currently unclear. Methods: We searched the Embase, Medline, Cochrane Library, and Web of Science databases for randomized controlled trials (RCTs), in which inhalation anaesthesia and propofol anaesthesia were compared. The incidence of POCD or postoperative cognitive status was assessed in elderly patients undergoing noncardiac surgery. Results: Fifteen RCTs with 1854 patients were included in this meta-analysis. The incidence of POCD on postoperative Days 2–6 after propofol anaesthesia was markedly lower than that after inhalation anaesthesia (risk ratio (RR): 0.37, 95% confidence interval (CI): 0.15–0.88, P = .025), and Mini-Mental State Examination (MMSE) scores after propofol anaesthesia were substantially higher than those after inhalation anaesthesia (standard mean difference (SMD): 0.59, 95% CI: 0.07–1.11, P = .026). The levels of interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) were much lower after propofol anaesthesia than after inhalation anaesthesia (SMD: -2.027, 95% CI: -3.748– -0.307, P = .021; SMD: -0.68, 95% CI: -0.93– -0.43, P

In light of the increasing trend towards vehicle connectivity and automation, there will be areas and situations on the roads where high automation can be granted, and others where it is not allowed or not possible. These are termed Transition Areas. Without proper traffic management (TM), such areas may lead to vehicles issuing take-over requests (TORs), which in turn can trigger transitions of control (ToCs), or even minimum-risk manoeuvres (MRMs) where a vehicle can come to a full stop in a safe spot. In this respect, the TransAID Horizon 2020 project develops and demonstrates TM procedures and protocols to enable smooth coexistence of automated, connected, and conventional vehicles, with the goal of avoiding ToCs and MRMs, or at least postponing/accommodating them. This paper investigates how TM can successfully assist connected and automated vehicles (CAVs) when they are approaching no automated driving zones (No-AD zone). Our simulation results indicate that a combined approach for distributing TORs and assigning safe spots significantly improves traffic efficiency and safety for such mixed autonomy situations in urban areas.

This deliverable explains how simulations of both the baseline (WP3) and the traffic management schemes (WP4) can be ported from the SUMO simulation environment (with the help of the TraCI interface and Python scripts) to the iCS environment (using the C++ language).We first gave an explanation on how to set up the creation of a traffic management application in the context of the iCS. Details were given on how to prepare the development of an application, based on the source code in the repository. We also explained the interactions between the iCS, SUMO, ns-3, and the various applications, using subscriptions and the exchange of messages.To this end, the TransAID version of the iTETRIS platform defined in WP6 includes a basic application known as baseAppthat manages the exchange of information between the applications and the iCS modules. The application developed for the different services of the TransAID project will inherit form this baseAppand extend the functionality with the traffic management procedures defined in WP4. In order to develop these applications,a new branch (transaid-apps) is added to the git repository. Note that all TransAID applications developed share the same baseApp. Hence, commits to the baseApp should be strictly separated from thecommits to the TransAID applications in development. Changes to the baseApp as well as other iTETRIS modules like iCS or ns-3 should be integrated into the transaid-dev branch. When porting the traffic management code from the WP4 to the WP6 environments, we need to make sure that the same logic is preserved. In order to guarantee this, all applications implemented in the use cases should create test suites, similarly as described in Deliverable D6.1. We use the same testing framework, called TextTest. Tests are created in the transaid-apps branch of the repository, separated for each use case individually. All tests are stored in the transaid/TransAIDScenarios/tests/scenariosfolder. All relevant data pertaining to a specific use case (i.e. SUMO networks, configuration files, ...) are copied to the relevant scenario in the tests folder. Just as before, the testing concept employed by TextTest is to compare expected output of an entire program run with actual output (output files or stdout and stderr). However, here we need to be a bit more careful and considerate of the complexity involved with comparing the various iCS traffic management applications to their previously created SUMO counterparts.We explain this via a method of aggregate quantities, rather than explicitly comparing time-space diagrams.A more detailed comparison of simulation outputs would be to use detector measurements and/or explicit vehicle trajectories, create time-space diagrams from these (of average speeds or flows), and then compare these with each other and define whether or not the deviation is significant. However, even though this type of analysis would certainly allow us to detect deviations in the time-space plane (e.g.,congested areas that may appear/disappear as artefacts, ...), it would be out of scope. In addition, such analyses have not been done widespread before, as they are also difficult to interpret, and still require some aggregation in order to test these 'automatically'.

Background The selective occurrence of hepatotoxicity observed with use of pazopanib may be attributed to its high level of plasma protein binding and low hepatic extraction ratio. The primary objective was to investigate changes in free drug concentration amongst patients with varying albumin concentrations. Methods A HPLC-MS/MS method using C18 column (4.6 × 150 mm, 5 μm) with ESI source in positive mode had been developed and validated for the quantitative determination of free pazaopanib concentration in human plasma. Prior to sample preparation, patient samples were subjected to 6-hour equilibrium dialysis with molecular weight cut-off set at 8000 Da. Results The calibration curves were linear over the range of 5–1000 ng/mL, with a lower limit of quantification of 5 ng/mL. The intra-day and inter-day precisions and accuracies were all within ± 15 %, at 3 different quality controls. Higher median fraction unbound of pazopanib were observed in patients (n = 17) with lower than normal albumin concentrations. Conclusion With the developed assay, monitoring of plasma free concentrations may be evaluated as an indicator of pazopanib exposure in patients., Pazopanib; Plasma free drug concentration; Fraction unbound; Liquid chromatography-tandem mass spectrometry; Equilibrium dialysis; Pharmacology; Clinical toxicology; Oncology; Evidence-based medicine; Clinical research.

BACKGROUND: A bibliometric analysis was performed to reveal the current status of investigations in infectious diseases in patients with liver transplantation (LT) and to prioritize future research needs. METHODS: The present study comprehensively retrieved publications relevant to infectious diseases in LT recipients published between 2010 and 2020. The search was conducted on the Web of Science (WoS) database. A bibliometric analysis was conducted through machine learning and visualization tools, including VOSviewer, Bibliographic Item Co-Occurrence Matrix Builder, and Graphical Clustering Toolkit. Research hotspots and trends in the field were assessed, while the contributions and collaborations of countries, institutions, and authors were documented. RESULTS: A total of 691 publications were analyzed. Research output sharply increased in 2015, with a fast drop afterward. “Liver transplantation” was the most frequent keyword, with strong links to “hepatitis C virus” and “infection”. Study areas included risk factors of infectious diseases in LT recipients, pathogens causing post-transplantation infections, antibacterial therapy and prophylaxis for peritransplant infection complications, living donor LT, and pediatric LT. The efficacy and safety of direct-acting antivirals (DAAs) for hepatitis C virus (HCV) infection among liver transplant recipients has attracted recent research interest. Didier Samuel was the most productive author, while Xavier Forns was the top-cited author. Shanghai Jiao Tong University was the most productive contributor, and Gilead Sciences was the most cited organization. Moreover, the USA was the greatest contributor. Gastroenterology was the most cited journal, while Liver Transplantation was the most prolific journal. CONCLUSIONS: This bibliometric analysis will better understand the research status of infectious complications in LT recipients and forecast future research trends. Priority should be given to identifying risk factors for peritransplantation infections and effective treatments against infectious complications in the coming years.

The surface distribution of lipid biomarkers, elemental and isotopic compositions ( δ 13 C and δ 15 N, C/N) were investigated from coastal sediments of Brunei Bay, in order to understand the sources and biogeochemical processes of the organic matter. Fatty acid biomarkers from terrestrial higher plants (e.g., long-chain fatty acids > 20), phytoplankton (e.g., 20:5n-3 and 22:6n-3) and microbial activity (e.g., iso-, anteiso fatty acids, 10Me-16:0) were identified. The ratios of carbon and nitrogen isotopes ( δ 13 C, δ 15 N) and C/N had values ranging from –30.62 to –27.43‰, 1.70 to 3.57‰, and 4.07 to 15.62 respectively, suggesting the prevailed inputs of terrestrially-derived organic matter sources with typical characterization of mangrove estuaries. Principal component analysis separated lipids of autochthonous aquatic production as the major source, followed by allochthonous terrestrial derived input. The presence of bacterial derived lipids and short chain lipids with low and C/N ratios suggest the preferential utilization and decomposition of organic matter by microbial activity. An enrichment of the δ 15 N ratios could be due to marine cage culture activities and surface runoff from cultivated areas via fluvial transport.

The distribution of aliphatic hydrocarbons in three sediment cores from Brunei Bay was investigated in order to understand their sources and the biogeochemical processes of these hydrocarbons. The total concentrations of C15 to C37 n-alkanes ranged from 0.70 to 16.5 μg g−1. Traces of hopanes with C29–C31 carbon homologs were detected in the study area. The carbon preference index (CPI15–37) ranged from 1.23 to 3.42 coupled with the natural n-alkane ratio (NAR19–32) ratios (1.52 to 5.34), and the presence of unresolved complex mixtures and hopanes, suggested slight contamination by anthropogenic hydrocarbons, presumably derived from activities along the coasts. The presence of C27 trisnorhopene and diploptene, as well as their association with long-chain and short-chain n-alkanes, revealed a depositional environment of organic matter in the sediment cores.

In recent years, cold-formed steel has been widely utilized in emergency construction for high strength and installation efficiency. In this paper, the eccentric compressive behaviour and design method of non-symmetric cold-formed angular columns with complex edges were investigated. Eight specimens were tested under eccentric compression, and the ultimate loads and buckling modes were obtained. A detailed finite element model was developed and verified through a comparative analysis of the finite element analysis with the experimental test results. Then, parametric analysis on the eccentric compression capacity of cold-formed angular column with complex edges was performed, and the effects of the specimen length, specimen thickness and eccentric distance on the ultimate load capacity of the eccentric members of this section were evaluated. An equation for calculating the load-bearing capacity of non-symmetric cold-formed angular column with complex edges under eccentric compression was derived using the direct strength method. The theoretical design method was verified through a comparison of the theoretical results with the experimental and numerical results, and the proposed method was found to be accurate and conservative to some extent. This paper revealed the eccentric compression behaviour and provides a practical method for design of the cold-formed non-symmetric angular columns, and the proposed method will be useful in the design and construction of cold-formed steel structures.

Objectives: Anti-pentraxin 3 (PTX3) auto-antibodies were found to be associated with the absence of renal involvement in systemic lupus erythematosus (SLE). This study is to investigate the prevalence of anti-PTX3 auto-antibodies and their clinical significance based on a large Chinese lupus nephritis cohort. Methods: One hundred and ninety-six active lupus nephritis patients, 150 SLE patients without clinical renal involvement, and 100 healthy controls were enrolled. Serum anti-PTX3 auto-antibodies and PTX3 levels were screened by enzyme-linked immunosorbent assay (ELISA). The associations between anti-PTX3 auto-antibodies and clinicopathological parameters in lupus nephritis were further analyzed. Results: Anti-PTX3 auto-antibodies were less prevalent in active lupus nephritis patients compared with SLE without renal involvement (19.4% (38/196) versus 40.7% (61/150), p

Platinum(IV) bis-carboxylates are highly versatile prodrug scaffolds with different axial ligands that can be functionalized while keeping the platinum(II) pharmacophore intact. Using a sequential acylation strategy, we developed a class of PtIV prodrugs of cisplatin with contrasting lipophilic and hydrophilic ligands. We investigated their stability, reduction rates, lipophilicity, aqueous solubility, and antiproliferative efficacies, and assessed for correlations among the parameters that could be useful in drug design. We showed that compounds with high lipophilicity result in better antiproliferative effects in vitro and in vivo, with one of the three compounds tested showing better efficacy than satraplatin against an animal model of colorectal cancer, owing to its higher solubility and lower reduction rates. Our asymmetric PtIV prodrugs may pave the way for a highly predictable, fine-tuned class of orally available PtIV prodrugs for the treatment of colorectal cancer.

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by overproduction of numerous autoantibodies. Many studies have sought to identify such biomarkers to distinguish patients with active lupus nephritis from SLE patients without renal involvement. Because antibodies to complement C1q appear to be prevalent in patients with active lupus nephritis, we analyzed the frequency of antigenic epitopes of C1q and their clinical significance in a large multicenter study of Chinese patients. The lupus cohort consisted of 210 patients with active lupus nephritis as a discovery cohort, 130 active patients as a validation cohort along with 130 SLE patients without clinical renal involvement, and 100 healthy controls. Serum antibodies to intact C1q, the collagen-like region, the globular head region, and the new linear A08 epitope to C1q were screened by specific ELISA. The frequency of antibodies to intact C1q, the C1q-collagen-like region, and the A08 antibodies in the discovery cohort were significantly higher than that in patients without renal involvement or healthy controls. Antibodies to the globular head region were not prevalent enough for further study. The results were confirmed in the validation cohort. The area under the curve for anti-A08 antibodies was significantly greater than those for both the intact and collagen-like region antibodies to discriminate between active lupus nephritis and active SLE without clinical renal involvement. The A08 antibodies were all negative at remission. The serum A08 antibody level correlated better with disease relapse than that of antibodies to either the intact or the collagen-like region, significantly predicting renal prognosis. Thus, serum levels of A08 C1q antibodies are closely associated with disease activity and prognosis in lupus nephritis.

Introduction Tigecycline (TGC) is effective for the infections caused by carbapenem-resistant gram-negative bacteria (CRGNB) in adults, but it is not investigated systematically in children because of concern about adverse effects. This study aimed to analyze the effectiveness of TGC in treating CRGNB infections in children after receiving liver transplant. Methods The subjects in this retrospective study were pediatric liver transplant recipients treated with TGC for at least 3 days to fight microbiologically verified CRGNB infection after initial antibiotic failure during the period from January 2014 to May 2018. Clinical and microbiological outcomes were reviewed to evaluate the efficacy and safety of TGC. Results Of the 1177 pediatric liver transplant recipients, 13 patients were eligible for inclusion in this analysis. All the patients received TGC at dose of 2 mg/kg every 12 hours for a duration of 10.1 ± 5.1 days on average to treat CRGNB infections, including complicated intra-abdominal infection, ventilator-associated pneumonia, and bloodstream infection. The isolates included Klebsiella pneumoniae (69.2%, 9/13) and Acinetobacter baumannii (30.8%, 4/13). Clinical efficacy was achieved in 84.6% (11/13) and pathogen eradicated in 69.2% (9/13) of the patients. The overall mortality rate was 15.4% (2/13). No TGC-related serious adverse event was reported. Conclusion Tigecycline can be considered in combination antimicrobial regimen for treating CRGNB-related infections in pediatric liver transplant recipients.

BACKGROUND Intra-operative hypotension might induce poor postoperative outcomes in non-cardiac surgery, and the relationship between the level or duration of Intra-operative hypotension (IOH) and postoperative adverse events is still unclear. In this study, we performed a meta-analysis to determine how IOH could affect acute kidney injury (AKI), myocardial injury and mortality in non-cardiac surgery. METHODS We searched PubMed (Medline), Embase, Springer, The Cochrane Library, Ovid and Google Scholar, and retrieved the related clinical trials on intra-operative hypotension and prognosis in non-cardiac surgery. RESULTS Fifteen observational studies were included. The meta-analysis showed that in non-cardiac surgery, intra-operative hypotension (mean arterial pressure [MAP]) 10 minutes: OR = 1.35, 95% CI (1.1, 1.67), I2 = 52.6%, P = .004] and myocardial injury [1-5 minutes: OR = 1.16, 95% CI (1.01, 1.33), I2 = 30.6%, P = .04; 5-10 minutes: OR = 1.34, 95% CI (1.01, 1.77), I2 = 70.4%, P = .046; >10 minutes: OR = 1.43, 95% CI (1.18, 1.72), I2 = 39.4%, P

Underdevelopment of nose and chin in East Asians is quite common. Rhinoplasty and mentoplasty are effective procedures to solve the above-depicted defects and can achieve remarkable cosmetic effects. An autologous costal cartilage graft has become an ideal material for rhinoplasty, especially for revision surgery. However, many problems in the clinical application of costal cartilage remain unresolved. This study is to investigate application strategies of autologous costal cartilage grafts in rhino- and mentoplasty.The methods involved are as follows: application of an integrated cartilage scaffold; comprehensive application of diced cartilage; and chin augmentation of an autologous costal cartilage graft.In this study, satisfactory facial contour appearance was immediately achieved in 28 patients after surgery; 21 patients had satisfactory appearance of the nose and chin during the 6- to 18-month follow-up. Cartilage resorption was not observed. Two patients had nasal tip skin redness and were cured after treatment.This procedure can be used to effectively solve: curvature of the costal cartilage segment itself; warping of the carved costal cartilage; and effective use of the costal cartilage segment. The procedure has achieved satisfactory outcomes, and its application is worth extending to clinical practice.

Transitions of Control (ToC) play an important role in the simulative impact assessment of automated driving because they may represent major perturbations of smooth and safe traffic operation. The drivers' efforts to take back control from the automation are accompanied by a change of driving behavior and may lead to increased error rates, altered headways, safety critical situations, and, in the case of a failing takeover, even to minimum risk maneuvers. In this work we present modeling approaches for these processes, which have been introduced into SUMO recently in the framework of the TransAID project. Further, we discuss the results of an evaluation of some hierarchical traffic management (TM) procedures devised to ameliorate related disturbances in transition areas, i.e., zones of increased probability for the automation to request a ToC.

Tiopronin (TP), a glycine derivative with a free thiol, is extensively used for the treatment of cystinuria. Moreover, TP is usually prescribed as hepatoprotective medicine in China. In the present case, a 36-year-old female who presented with foamy urine and general edema was admitted to the hospital. She had been taking TP for six months to treat drug-induced liver injury due to anti-tuberculosis drugs including isoniazid, rifampicin and pyrazinamide. The urine tests at admission revealed nephritic-range proteinuria with a daily urinary protein level of 8,024 mg. Meanwhile, albumin and cholesterol levels were abnormal. The light microscopy was negative and electron microscopy showed foot process effacement. Thus, minimal change disease (MCD) was diagnosed, and TP was consequently discontinued. Finally, the patient accomplished complete remission within five weeks after the cessation of TP without undergoing glucocorticoid therapy. TP was speculated to play an antigenic role in this adverse effect. To date, there are only two similar cases documented in the literature. Herein, we first report a case of a Chinese patient who generated MCD after prolonged TP administration. Clinicians should be wary of the occurrence of MCD due to TP when administering long-term therapy of TP. A weekly urinalysis may be useful for early identification of TP-induced MCD.