Saturation flow rate analysis for special width approach lanes: An empirical study in Karlsruhe, Germany.

The special width approach lane (SWAL) is a newly proposed unconventional design, whereby a wide approach lane is divided into two narrower lanes. The design entails the use of a single lane by two passenger cars or one heavy vehicle. Such design has been applicated at signalized intersections of Karlsruhe, Germany. This paper focuses on the saturation flow rate analysis since most existing studies on such design rely on the default highway capacity manual (HCM) values. Saturation flow rate data was collected at four SWAL design based signalized intersections with procedural steps of the HCM 2010 using the video camera. The two-sample t-test was performed to explore the potential influencing factors, and then the non-linear regression analysis was conducted to estimate the saturation flow rate of SWAL. The proposed model can effectively depict the saturation flow rate with lane marking, presence of cyclists, and rainfall being the influencing factors. The overall accuracy of the proposed model is about 95%. The results indicate that the three influencing factors are independent of each other. The existence of cyclists and rainfall lead to a decrease in the saturation flow rate, while the lane markings can improve the saturation flow rate. Moreover, the SWAL works well in Karlsruhe, Germany. The model predicts a base saturation flow rate value of 1652 pcu/h/ln, which is plausible with comparison of the base saturation flow rate recommended in the German Highway Capacity Manual.

Evaluation of red blood cell distribution width-platelet ratio as a predictor of adverse pregnancy outcomes and disease severity in systemic lupus erythematosus.

OBJECTIVE: The red blood cell distribution width to platelet ratio (RPR) is known to reflect systemic inflammation. This study aimed to explore the predictive value of RPR for disease activity and adverse pregnancy outcomes (APOs) in pregnant women with systemic lupus erythematosus (SLE). METHODS: We retrospectively evaluated case data of all pregnant women with SLE managed at the First Affiliated Hospital of Zhengzhou University from January 2014 to March 2017. Correlations between RPR and SLE clinical disease activity, organ involvement, and maternal complications were analysed. Changes in the RPR and erythrocyte sedimentation rate (ESR) were observed before and after treatment. A receiver operating characteristic (ROC) curve was used to predict disease activity and APOs based on RPR. RESULTS: A total of 118 patients were enrolled, including 77 in the disease-active group and 41 in the disease-inactive group. The live birth rate was significantly higher in the disease-inactive group than in the disease-active group (P < 0.001). Compared to the disease-inactive group, the number of patients with elevated RPR, anti-dsDNA antibody level, and ESR was significantly higher in the disease-active group, whereas their platelet-lymphocyte ratios and complement 3 and 4 levels were significantly lower. The disease-active group was more likely to experience APOs (P < 0.001), mainly due to premature birth, low birth weight, and pregnancy loss. The ROC curve indicated that RPR had an effect on disease activity and APOs. CONCLUSION: RPR can be used as a predictor of disease severity and APOs in pregnant women with SLE. Key Points • RPR positively correlated with SLEDAI; patients with elevated RPR have higher disease activity, more organ, and more maternal complications. • Monitoring RPR could better predict disease activity in pregnant patients with SLE and reduce the incidence of maternal complications and APOs.

The association between cytochrome P450 polymorphisms and anti-tuberculosis drug-induced liver injury: a systematic review and meta-analysis.

BACKGROUND: Isoniazid (INH), rifampicin (RMP), pyrazinamide (PZA), and ethambutol (EMB) are the four most common drugs for the first-line treatment of tuberculosis (TB). Although chemotherapy drugs are widely used in the treatment of TB, and achieved good results, but the side effects, especially anti-tuberculosis drug-induced liver injury (ATDILI), cannot be overlooked. Many researchers have made efforts to uncover the association of cytochrome P450 (CYP) enzyme genetic polymorphisms with ATDILI. In this study, we systematically reviewed and meta-analyzed the relationship between CYP polymorphism and susceptibility to ATDILI. METHODS: We carried out literature searches of PubMed, Ovid, the Cochrane Library, Web of Science and Chinese National Knowledge Infrastructure (CNKI). Medical Subject Headings (MeSH) terms including "cytochrome P450 enzyme", "drug-induced liver injury", "polymorphism", "tuberculosis", and "hepatotoxicity" were used as keywords for our searches. RESULTS: The pooled odds ratio (OR) of all studies for CYP2E1 to the risk of ATDILI was 1.18 [95% confidence interval (CI): 0.82-1.71]. The articles in this meta-analysis were observed to be mildly heterogeneous. Further subgroup analysis revealed that the patients who receiving a four-drug protocol (INH + RIF + PZA + EMB) or three-drug protocol (INH + RIF + PZA) regimens showed a higher risk of ATDILI than those who receiving INH alone. However, subgroup analyses according to participants' ethnic origin, study type, and the definition of ATDILI produced no statistically significant results. Associations between other genes in the CYP family and ATDILI were indistinct and equivocal. DISCUSSION: Our meta-analysis has uncovered an association between CYP2E1 RsaI/PstI polymorphisms and ATDILI, especially among patients who receive a four-drug (INH + RIF + PZA + EMB) or three-drug (INH + RIF + PZA) anti-TB treatment regimen.

Clinical features of new-onset systemic lupus erythematosus during pregnancy in Central China: a retrospective study of 68 pregnancies.

The aim of this study is to explore the clinical features and pregnancy outcomes of Chinese patients with new-onset systemic lupus erythematosus (SLE) during pregnancy or puerperium. We retrospectively evaluated the data of all pregnant women with SLE managed at the First Affiliated Hospital of Zhengzhou University between April 2013 and March 2017. Clinical characteristics, laboratory features, medication use, and pregnancy outcomes were compared between pregnant women with new-onset SLE and pregnant women with pre-existing SLE. Risk factors for adverse pregnancy outcomes were determined using binary regression analyses. Overall, 223 pregnancies in 216 patients were included; 148 (69.6%) patients had a history of SLE, and 68 (30.4%) were diagnosed with SLE during pregnancy or puerperium. Most cases of new-onset SLE (72.1%) occurred during the first and second trimesters. Thrombocytopaenia (especially severe thrombocytopaenia) (76.5% vs 54.2%, P = 0.008; 39.7% vs 15.5%, P = 0.001) and anaemia (especially moderate anaemia) (73.5% vs 56.9%, P = 0.007; 52.9% vs 35.2%, P = 0.035) were more common in women with new-onset SLE than in women with pre-existing SLE and active disease during pregnancy. Additionally, patients with new-onset SLE experienced higher rates of moderate-to-severe disease activity than patients with pre-existing SLE (P < 0.01); disease activity occurred mostly during the first and second trimesters (75.4%). Compared with pre-existing SLE patients, disease activity in new-onset SLE patients occurred mostly in the first trimester (33.3% vs 15.3%, P = 0.043) and less in the third trimester (21.1% vs 47.2%, P < 0.001). Pregnancy loss was significantly higher in patients with new-onset SLE than in patients with pre-existing SLE (62.4% vs 27.1%, P < 0.001), with most cases occurring during the first and second trimesters (95.3%). However, there were no significant differences in neonatal outcomes between new-onset and pre-existing SLE patients with active disease. Within the new-onset SLE group, active disease was an independent risk factor for pregnancy loss (odds ratio [OR] = 16.185, confidence interval [CI] = 1.895-138.232, P = 0.011), whereas disease onset at late gestation was a protective factor against pregnancy loss (OR = 0.589, CI = 0.435-0.796, P = 0.013). Patients with new-onset SLE suffered greater haematological involvement (mainly thrombocytopaenia and anaemia) and higher rates of moderate-to-severe disease activity and pregnancy loss than patients with pre-existing SLE. Controlling disease activity and extending gestational age may improve pregnancy outcomes in women with new-onset SLE. Key Points • The clinical features of new-onset SLE during pregnancy and its impact on pregnancy outcomes have rarely been reported, especially in Chinese patients. • New-onset SLE during pregnancy in Chinese women occurred primarily during the first and second trimesters and was characterised by haematological disorders, including thrombocytopaenia and anaemia. • Women with new-onset SLE during pregnancy had significantly higher disease activity scores and pregnancy loss rates than women with pre-existing SLE, especially during the first and second trimesters; controlling disease activity and prolonging gestational age may improve pregnancy outcomes in this setting.