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1.
J Chem Phys ; 160(16)2024 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-38656441

RESUMO

In recent years, all-inorganic perovskite materials have become an ideal choice for new thin film solar cells due to their excellent photophysical properties and have become a research hotspot. Studying the ultrafast dynamics of photo-generated carriers is of great significance for further improving the performance of such devices. In this work, we focus on the transient dynamic process of CsPbBr3/TiO2 composite systems with different Mn2+ doping contents using femtosecond transient absorption spectroscopy technology. We used singular value decomposition and global fitting to analyze the transient absorption spectra and obtained three components, which are classified as hot carrier cooling, charge transfer, and charge recombination processes, respectively. We found that the doping concentration of Mn2+ has an impact on all three processes. We think that the following two factors are responsible: one is the density of defect states and the other is the bandgap width of perovskite. As the concentration of doped Mn2+ increases, the charge transfer time constant shows a trend of initially increasing, followed by a subsequent decrease, reaching a turning point. This indicates that an appropriate amount of Mn2+ doping can effectively improve the photoelectric performance of solar cell systems. We proposed a possible charge transfer mechanism model and further elucidated the microscopic mechanism of the effect of Mn2+ doping on the interface charge transfer process of the CsPbBr3/TiO2 solar cell system.

2.
Entropy (Basel) ; 25(12)2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-38136541

RESUMO

Complex data pose unique challenges for data processing [...].

3.
Heliyon ; 9(7): e17730, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37539280

RESUMO

As we all know, YOLOv4 can achieve excellent detection performance in object detection and has been effectively applied in many fields. However, the inconsistency of scale features affects the prediction accuracy of the path aggregation network (PANet) in YOLOv4 for small objects, resulting in low detection accuracy. This paper presents YOLOv4, which uses an adaptive recursive path aggregation network (AR-PANet) to improve the detection accuracy of small objects. First, the output characteristics of the PANet are fed back into the backbone network by using a recursive structure to enrich the characteristic information of the object. Second, an adaptive approach is developed to eliminate conflicting information in multi-scale feature space, thereby enhancing scale invariance and promoting feature extraction accuracy for small objects. Finally, the CBAM is used to map the multi-scale features obtained from the AR-PANet to independent channels and spatial dimensions to achieve feature refinement, thus improving the detection accuracy of small objects. Experimental results show that our proposed method can effectively improve the accuracy of small object detection in multiple datasets, addressing this challenging problem with impressive results. Thus, our proposed approach has great potential and valuable applications in the fields of remote sensing and intelligent transportation.

4.
Entropy (Basel) ; 25(7)2023 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-37509968

RESUMO

This paper reviews the potential use of fuzzy c-means clustering (FCM) and explores modifications to the distance function and centroid initialization methods to enhance image segmentation. The application of interest in the paper is the segmentation of breast tumours in mammograms. Breast cancer is the second leading cause of cancer deaths in Canadian women. Early detection reduces treatment costs and offers a favourable prognosis for patients. Classical methods, like mammograms, rely on radiologists to detect cancerous tumours, which introduces the potential for human error in cancer detection. Classical methods are labour-intensive, and, hence, expensive in terms of healthcare resources. Recent research supplements classical methods with automated mammogram analysis. The basic FCM method relies upon the Euclidean distance, which is not optimal for measuring non-spherical structures. To address these limitations, we review the implementation of a Mahalanobis-distance-based FCM (FCM-M). The three objectives of the paper are: (1) review FCM, FCM-M, and three centroid initialization algorithms in the literature, (2) illustrate the effectiveness of these algorithms in image segmentation, and (3) develop a Python package with the optimized algorithms to upload onto GitHub. Image analysis of the algorithms shows that using one of the three centroid initialization algorithms enhances the performance of FCM. FCM-M produced higher clustering accuracy and outlined the tumour structure better than basic FCM.

5.
Health Sci Rep ; 6(6): e1350, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37342293

RESUMO

Background and Aims: Since the beginning of the coronavirus disease 2019 (COVID-19), a large number of government policies have been implemented worldwide in response to the global spread of COVID-19. This paper aims at developing a data-driven analysis to answer the three research questions: (a) Compared to the pandemic development, are the global government COVID-19 policies sufficiently active? (b) What are the differences and characteristics in the policy activity levels at the country level? (c) What types of COVID-19 policy patterns are forming? Methods: Using the Oxford COVID-19 Government Response Tracker data set, we present a global analysis of the COVID-19 policy activity levels and evolution patterns from January 1, 2020 to June 30, 2022, based on the differential expression-sliding window analysis (DE-SWAN) algorithm and the clustering ensemble algorithm. Results: Within the period under study, the results indicate that (a) the global government policy responses to COVID-19 are very active, and the policy activity levels are significantly higher than those of global pandemic developments; (b) a high activity of policy is positively correlated to pandemic prevention at the country level; and (c) a high human development index (HDI) score is negatively correlated to the country policy activity level. Furthermore, we propose to categorize the global policy evolution patterns into three categories: (i) Mainstream (152 countries); (ii) China; and (iii) Others (34 countries). Conclusion: This work is one of the few studies that quantitatively explores the evolutionary characteristics of global government policies on COVID-19, and our results provide some new perspectives on global policy activity levels and evolution patterns.

6.
Math Biosci Eng ; 20(4): 7088-7112, 2023 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-37161142

RESUMO

This paper investigates a novel multi-objective optimization framework for the multi-stage missile target allocation (M-MTA) problem, which also widely exists in other real-world complex systems. Specifically, a constrained model of M-MTA is built with the trade-off between minimizing the survivability of targets and minimizing the cost consumption of missiles. Moreover, a multi-objective optimization algorithm (NSGA-MTA) is proposed for M-MTA, where the hybrid encoding mechanism establishes the expression of the model and algorithm. Furthermore, rule-based initialization is developed to enhance the quality and searchability of feasible solutions. An efficient non-dominated sorting method is introduced into the framework as an effective search strategy. Besides, the genetic operators with the greedy mechanism and random repair strategy are involved in handling the constraints with maintaining diversity. The results of numerical experiments demonstrate that NSGA-MTA performs better in diversity and convergence than the excellent current algorithms in metrics and Pareto front obtained in 15 scenarios. Taguchi method is also adopted to verify the contribution of proposed strategies, and the results show that these strategies are practical and promotive to performance improvement.

7.
PLoS One ; 18(5): e0283336, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37172032

RESUMO

The Fenwei Plain is listed as one of the most serious air pollution regions in China, along with Beijing-Tianjin-Hebei and Yangtze River Delta regions. This paper proposed a functional data analysis method to study the environmental pollution problem in the Fenwei Plain of China. Functional spatial autoregressive combined (FSAC) model with spatial autocorrelation of both the response variable and error term is developed. The model takes the SO2 concentration of Fenwei Plain as the dependent variable and the dew point temperature as the independent variable and realizes the maximum likelihood estimation using functional principal component analysis to obtain the asymptotic properties of parameter estimation and the confidence interval of the slope function. According to the findings of the empirical analysis of the Fenwei Plain, the SO2 concentration has significant seasonal characteristics and has decreased year over year for three years in a row. Winter is the season with the highest concentration on the Fenwei Plain, followed by spring and autumn, while summer is the season with the lowest concentration. Winter also has a high spatial autocorrelation. The FSAC model is more effective at fitting the concentration and dew point temperature of the Fenwei Plain in China because its mean square error (MSE) is significantly lower than that of the other models. As a result, this paper can more thoroughly study the pollution problem on the Fenwei Plain and offer guidance for prevention and control.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Material Particulado/análise , Monitoramento Ambiental/métodos , Poluição do Ar/análise , China , Pequim
8.
Polymers (Basel) ; 15(5)2023 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-36904411

RESUMO

This paper studies the ballistic impact performance of 3D woven composites (3DWCs) with hexagonal binding patterns. Para-aramid/polyurethane (PU) 3DWCs with three kinds of fiber volume fraction (Vf) were prepared by compression resin transfer molding (CRTM). The effect of Vf on the ballistic impact behavior of the 3DWCs was analyzed by characterizing the ballistic limit velocity (V50), the specific energy absorption (SEA), the energy absorption per thickness (Eh), the damage morphology and the damage area. 1.1 g fragment-simulating projectiles (FSPs) were used in the V50 tests. Based on the results, when the Vf increases from 63.4% to 76.2%, the V50, the SEA and the Eh increase by 3.5%, 18.5% and 28.8%, respectively. There are significant differences in damage morphology and damage area between partial penetration (PP) cases and complete penetration (CP) cases. In the PP cases, the back-face resin damage areas of the sample III composites were significantly increased to 213.4% of the sample I counterparts. The findings provide valuable information for the design of ballistic protection 3DWCs.

9.
Entropy (Basel) ; 25(2)2023 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-36832605

RESUMO

In this paper, we focus on the homogeneity test that evaluates whether two multivariate samples come from the same distribution. This problem arises naturally in various applications, and there are many methods available in the literature. Based on data depth, several tests have been proposed for this problem but they may not be very powerful. In light of the recent development of data depth as an important measure in quality assurance, we propose two new test statistics for the multivariate two-sample homogeneity test. The proposed test statistics have the same χ2(1) asymptotic null distribution. The generalization of the proposed tests into the multivariate multisample situation is discussed as well. Simulations studies demonstrate the superior performance of the proposed tests. The test procedure is illustrated through two real data examples.

10.
J Infect Public Health ; 16(3): 361-367, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36689854

RESUMO

BACKGROUND: With the increase in drug resistance rates of pathogens isolated from complicated intra-abdominal infections (cIAIs), ceftazidime/avibactam (CAZ-AVI) is increasingly used clinically. However, given the high drug cost and the fact that not yet covered by the health insurance payment, this study evaluated the cost-effectiveness of CAZ-AVI plus metronidazole versus meropenem as a first-line empiric treatment for cIAIs from the perspective of the Chinese healthcare system. METHODS: A decision analytic model with a one-year time horizon was constructed to assess the cost-effectiveness based on the entire disease course. Model inputs were mainly obtained from clinical studies, published literature, and publicly available databases. Primary outcomes were cost, quality-adjusted life years (QALYs), life years (Lys), and incremental cost-effectiveness ratio (ICER). One-way sensitivity analysis and probabilistic sensitivity analysis were also performed. RESULTS: In the base cases, compared to meropenem, CAZ-AVI plus metronidazole had a shorter mean hospital length of stay (-0.77 days per patient) and longer life expectancy (+0.05 LYs and +0.06 QALYs). CAZ-AVI plus metronidazole had an ICER of $25517/QALY, which is well below the threshold of $31509 per QALY in China. The one-way sensitivity analysis showed that the change of the treatment duration of CAZ-AVI plus metronidazole was the parameter that most influenced the results of the ICER. In probabilistic sensitivity analysis, CAZ-AVI plus metronidazole was the optimal strategy in 75% of simulations at $31510/QALY threshold. CONCLUSIONS: CAZ-AVI plus metronidazole could be considered as a cost-effective option for the empiric treatment of patients with cIAIs in China, and this benefit will be more evident when the price of CAZ-AVI decreases by 23.8%.


Assuntos
Ceftazidima , Infecções Intra-Abdominais , Humanos , Ceftazidima/uso terapêutico , Meropeném/uso terapêutico , Metronidazol/uso terapêutico , Metronidazol/efeitos adversos , Antibacterianos , Análise Custo-Benefício , Infecções Intra-Abdominais/tratamento farmacológico , Infecções Intra-Abdominais/induzido quimicamente , Testes de Sensibilidade Microbiana
11.
Environ Technol ; 44(17): 2512-2524, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35084290

RESUMO

The performance of the ozone microbubble(MB) process for the degradation of Methyl Orange (MO) in a bubble column reactor with added packing was investigated. The highest decolorization efficiency of 96.04% was achieved by the ozone MB process with packing, which was 10.17% and 62.02% higher than that of the ozone MB process without packing and the ozone millimeter bubble(MLB) process, respectively while keeping other operating parameters the same. In addition, the saturation gas holdup, ozone mass transfer coefficient, and decolorization rate constant of the ozone MB process with packing were 15.32%, 0.260 min-1, and 0.027 min-1, respectively, which were much better than those of the ozone MB process without packing and the ozone MLB process. The study also suggested that within a certain porosity range, the types of packings did not affect the performance of the ozone MB process in the degradation of MO. Moreover, the optimum operating conditions were initial concentration of MO of 30 mg/L, initial pH of 3, circulating liquid flow of 75 L/h, and ozone dosage of 0.56 mg/L. The decolorization efficiency was 99.28% within 120 min.


Assuntos
Ozônio , Poluentes Químicos da Água , Microbolhas , Compostos Azo , Concentração de Íons de Hidrogênio , Poluentes Químicos da Água/análise
12.
Front Public Health ; 11: 1292162, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38179563

RESUMO

Background: Invasive mold diseases (IMD) is associated with high mortality and a substantial economic burden. For high-risk patients, fever drive or diagnostic drive therapy is usually initiated prior to the differential diagnosis of the pathogen. This study evaluated the cost-effectiveness of isavuconazole, posaconazole, vs. voriconazole in the treatment of IMD from the perspective of the Chinese healthcare system, informing healthcare decision-making and resource allocation. Methods: A decision analytic model was constructed using TreeAge Pro 2011 software to evaluate the cost-effectiveness of the entire disease course. We assumed that the prevalence of mucormycosis in the patients entering the model was 7.8%. Efficacy, cost, adverse events, and other data included in the model were mainly derived from clinical studies, published literature, and publicly available databases. The primary outcomes of the model output were total cost, quality-adjusted life years (QALYs), life years (Lys), and incremental cost-effectiveness ratio (ICER). The willing-to-pay (WTP) threshold was defined as one to three times China's GDP per capita in 2022. One-way sensitivity analysis and probability sensitivity analysis were used to determine the robustness of the model. At the same time, the cost-effectiveness of three triazole antifungal agents under a broader range of mucormycosis prevalence, when voriconazole was covered by medical insurance reimbursement, and after the price reduction of posaconazole was discussed. Results: Compared with voriconazole, isavuconazole provided an additional 0.38 Lys (9.29 vs. 8.91 LYs) and 0.31 QALYs (7.62 vs. 7.31 QALYs); ICER was $15,702.46/QALY, well-below the WTP threshold ($38,223/QALY). However, posaconazole did not provide a significant economic advantage over voriconazole (9.40 vs. 9.36 Lys; 7.71 vs. 7.68 QALYs; ICER $64,466.57/QALY). One-way sensitivity analysis found that ICER was highly sensitive to the mortality of patients with invasive aspergillus infection. In the probabilistic sensitivity analysis, when the WTP threshold was $38,223/QALY, the probability of isavuconazole being cost-effective was 72.9%. The scenario analysis results indicated that posaconazole would become cost-effective when the price was reduced by 15% or the prevalence of mucormycosis was 14%. Conclusions: Isavuconazole represents a cost-effective initial option for treating IMD in high-risk hematological patients prior to the differential diagnosis of pathogens. It will also be economical when a 15% reduction in posaconazole cost is achieved.


Assuntos
Mucormicose , Humanos , Voriconazol/uso terapêutico , Mucormicose/diagnóstico , Mucormicose/tratamento farmacológico , Mucormicose/epidemiologia , Farmacoeconomia , Diagnóstico Diferencial , Triazóis/uso terapêutico
13.
Polymers (Basel) ; 14(24)2022 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-36559931

RESUMO

A composite thin shell with a high fiber volume fraction prepared by resin transfer molding (RTM) may have void defects, which create deformations in the final curing and lead to the final product being unable to meet the actual assembly requirements. Taking a helmet shell as an example, a multi-directional compression RTM (M-CRTM) method with an adjustable injection gap is proposed according to the shape of the thin shell. This method can increase the injection gap to reduce the fiber volume fraction during the injection process, making it easier for the resin to penetrate the reinforcement and for air bubbles to exit the mold. X-ray CT detection shows that the porosity of the helmet shell prepared by the newly developed technology is 36.6% lower than that of the RTM-molded sample. The void's distribution is more uniform, and its size is decreased, as is the number of voids, especially large voids. The results show that the maximum curing deformation of the M-CRTM-molded helmet shell is reduced by 13.7% compared to the RTM molded sample. This paper then further studies the deformation types of the shell and analyzes the causes of such results, which plays an important role in promoting the application of composite thin shells.

14.
Entropy (Basel) ; 24(11)2022 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-36421507

RESUMO

A change point is a location or time at which observations or data obey two different models: before and after. In real problems, we may know some prior information about the location of the change point, say at the right or left tail of the sequence. How does one incorporate the prior information into the current cumulative sum (CUSUM) statistics? We propose a new class of weighted CUSUM statistics with three different types of quadratic weights accounting for different prior positions of the change points. One interpretation of the weights is the mean duration in a random walk. Under the normal model with known variance, the exact distributions of these statistics are explicitly expressed in terms of eigenvalues. Theoretical results about the explicit difference of the distributions are valuable. The expansions of asymptotic distributions are compared with the expansion of the limit distributions of the Cramér-von Mises statistic and the Anderson and Darling statistic. We provide some extensions from independent normal responses to more interesting models, such as graphical models, the mixture of normals, Poisson, and weakly dependent models. Simulations suggest that the proposed test statistics have better power than the graph-based statistics. We illustrate their application to a detection problem with video data.

15.
Materials (Basel) ; 15(19)2022 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-36234324

RESUMO

All-inorganic perovskite materials (CsPbX3) have attracted increasing attention due to their excellent photoelectric properties and stable physical and chemical properties. The dynamics of charge carriers affect the photoelectric conversion efficiencies of perovskite materials. Regulating carrier dynamics by changing pressure is interesting with respect to revealing the key microphysical processes involved. Here, ultrafast spectroscopy combined with high-pressure diamond anvil cell technology was used to study the generation and transfer of photoinduced carriers of a Mn-doped inorganic perovskite CsPbBr3 material under pressure. Three components were obtained and assigned to thermal carrier relaxation, optical phonon-acoustic phonon scattering and Auger recombination. The time constants of the three components changed under the applied pressures. Our experimental results show that pressure can affect the crystal structure of Mn-doped CsPbBr3 to regulate carrier dynamics. The use of metal doping not only reduces the content of toxic substances but also improves the photoelectric properties of perovskite materials. We hope that our study can provide dynamic experimental support for the exploration of new photoelectric materials.

16.
J Exp Child Psychol ; 224: 105513, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35914332

RESUMO

A growing body of research suggests that mathematical anxiety (MA) seriously affects an individual's math achievement. However, few studies have focused on the cognitive mechanisms of MA in elementary school children. Based on attention control theory (ACT), this research aimed to explore the cognitive mechanism of MA in elementary school children using two studies. In Study 1, the dual-task paradigm of number memory and computation span was used to investigate the difference in processing efficiency between the high-mathematical anxiety (HMA) group and the low-mathematical anxiety (LMA) group. In total, 59 students with HMA and 54 students with LMA participated in Study 1. The results showed that students with HMA had lower processing efficiency in dealing with high-load math tasks. To further investigate the underlying mechanism of low processing efficiency for students with HMA, Study 2 explored the attention bias toward math-related stimuli of students with HMA using the Posner paradigm. In total, 48 students with HMA and 49 students with LMA participated in Study 2. The results showed that math trials put children with HMA in a state of heightened vigilance in general, which might be related to the low processing efficiency in dealing with high-load math tasks. These findings support the ACT and further reveal the mechanism of MA in elementary school children from a cognitive perspective.


Assuntos
Logro , Ansiedade , Ansiedade/psicologia , Criança , Cognição , Humanos , Matemática , Instituições Acadêmicas
17.
Entropy (Basel) ; 24(7)2022 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-35885138

RESUMO

Medical data are often missing during epidemiological surveys and clinical trials. In this paper, we propose the MCMCINLA estimation method to account for missing data. We introduce a new latent class into the spatial lag model (SLM) and use a conditional autoregressive specification (CAR) spatial model-based approach to impute missing values, making the model fit into the integrated nested Laplace approximation (INLA) framework. Combining the advantages of both the Markov chain Monte Carlo (MCMC) and INLA frameworks, the MCMCINLA algorithm is used to implement imputation of the missing data and fit the model to derive estimates of the parameters from the posterior margins. Finally, the economic data and the hemorrhagic fever with renal syndrome (HFRS) disease data of mainland China from 2016-2018 are used as examples to explore the development of public health in China in the post-epidemic era. The results show that compared with expectation maximization (EM) and full information maximum likelihood estimation (FIML), the predicted values of the missing data obtained using our method are closer to the true values, and the spatial distribution of HFRS in China can be inferred from the imputation results with a southern-heavy and northern-light distribution. It can provide some references for the development of public health in China in the post-epidemic era.

18.
Appl Psychophysiol Biofeedback ; 47(3): 223-229, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35691974

RESUMO

Attention plays an important role in children's development and learning, and neurofeedback training (NFT) has been proposed as a promising method to improve attention, mainly in population with attention problems such as attention deficit hyperactivity disorder. However, whether this approach has a positive effect on attention in normal developing children has been rarely investigated. This pilot study conducted ten sessions of alpha/theta ratio (ATR) NFT on eight primary students in school environment, with two to three sessions per week. The results showed inter-individual difference in NFT learning efficacy that was assessed by the slope of ATR over training sessions. In addition, the attention performance was significantly improved after NFT. Importantly, the improvement of attention performance was positively correlated with the NFT learning efficacy. It thus highlighted the need for optimizing ATR NFT protocol for the benefits on attention at the individual level. Future work can employ a double-blind placebo-controlled design with larger sample size to validate the benefits of ATR NFT for attention in normal developing children.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Neurorretroalimentação , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Método Duplo-Cego , Eletroencefalografia/métodos , Humanos , Neurorretroalimentação/métodos , Projetos Piloto
19.
J Clin Pharm Ther ; 47(10): 1563-1569, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35670240

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Only a few studies about polymyxin B (PMB) against multidrug-resistant gram-negative bacteria (MDR GNB) infection were conducted in liver transplantation recipients (LTRs). The purpose of this study was to investigate the efficacy and safety of PMB in the treatment of MDR-GNB in liver transplant recipients and to determine the risk factors affecting clinical cure and 30-day all-cause mortality. METHODS: Data of LTRs receiving PMB from January 2016 to February 2020 were collected. Clinical cure and 30-day all-cause mortality were the main efficacy outcomes, while the incidence of nephrotoxicity, neurotoxicity, and hyperpigmentation of PMB was the main safety outcome. RESULTS AND DISCUSSION: Data of 42 LTRs were included. Clinical cure with PMB was observed in 27 recipients (64.3%), and the 30-day all-cause mortality rate was 31.0% (13/42). The incidence of acute kidney injury (AKI), neurotoxicity, and hyperpigmentation was 57.1% (16/28), 4.8% (2/42), and 16.7% (7/42), respectively. Logistic regression analysis showed that Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR, 1.203; 95% CI, 1.016-1.423, p = 0.032) was an independent risk factor for 30-day all-cause mortality, whereas renal replacement therapy (OR, 0.128; 95% CI, 0.019-0.860, p = 0.034) was an independent risk factor for clinical cure with PMB. WHAT IS NEW AND CONCLUSIONS: This is the first study to evaluate the application of PMB in LTRs. If there were no better therapeutic options left for LTRs other than PMB, it can be used against MDR GNB infection in LTRs. We should closely observe adverse events or reactions, and adjust the dose based on the balance of efficacy and safety.


Assuntos
Injúria Renal Aguda , Infecções por Bactérias Gram-Negativas , Hiperpigmentação , Transplante de Fígado , Injúria Renal Aguda/induzido quimicamente , Antibacterianos/efeitos adversos , Bactérias Gram-Negativas , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Hiperpigmentação/induzido quimicamente , Transplante de Fígado/efeitos adversos , Polimixina B/efeitos adversos
20.
BMC Infect Dis ; 22(1): 368, 2022 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-35410140

RESUMO

BACKGROUND: There have been no reports of tigecycline-associated drug-related liver injury (DILI) identified by histopathological assistance and causal assessment method. We reported the histopathological manifestations for the first time and described tigecycline-associated liver injury's pattern, severity, duration, and outcome. CASE PRESENTATION: A 68-year-old male with post-liver transplantation was given high-dose tigecycline intravenously (loading dose 200 mg, followed by 100 mg every 12 h) combined with polymyxin B (50,000 units by aerosol inhalation every 12 h) for hospital-acquired pneumonia caused by carbapenem-resistant Klebsiella pneumoniae. At the same time, tacrolimus was discontinued. Liver function was initially normal but started to decline on day 4 of tigecycline. Reducing the dose of tigecycline and resuming tacrolimus could not reverse the deterioration. Therefore, a liver puncture biopsy was performed for further diagnosis, with histopathological findings being cytotoxic injury. The updated RUCAM scale was used to evaluate the causal relationship between tigecycline and liver injury, with the result of 7 points indicating a "probable" causality grading. Methylprednisolone was initiated to treat DILI that was determined to be Grade 1 cholestatic injury. Total bilirubin and transaminase levels returned to normal on day 4 and 11 after tigecycline withdrawal, respectively. Monthly outpatient follow-up showed that the patient's liver function stayed normal. CONCLUSIONS: This case possessed a significant reference value for differential diagnosis and treatment prognosis of tigecycline-associated DILI. With early diagnosis and timely management, the tigecycline-associated DILI of this patient was successfully reversed.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Idoso , Causalidade , Doença Hepática Induzida por Substâncias e Drogas/diagnóstico , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Humanos , Klebsiella pneumoniae , Masculino , Tigeciclina/efeitos adversos
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