Calcineurin-Inhibitor Minimization in Liver Transplant Patients with Calcineurin-Inhibitor-Related Renal Dysfunction: A Meta-Analysis

BACKGROUND: Introduction of calcineurin-inhibitor (CNI) has made transplantation a miracle in the past century. However, the side effects of long-term use of CNI turn out to be one of the major challenges in the current century. Among these, renal dysfunction attracts more and more attention. Herein, we undertook a meta-analysis to evaluate the efficacy and safety of calcineurin-inhibitor (CNI) minimization protocols in liver transplant recipients with CNI-related renal dysfunction. METHODS: We included randomized trials with no year and language restriction. All data were analyzed using random effect model by Review Manager 5.0. The primary endpoints were glomerular filtration rate (GFR), serum creatinine level (sCr) and creatinine clearance rate (CrCl), and the secondary endpoints were acute rejection episodes, incidence of infection and patient survival at the end of follow-up. RESULTS: GFR was significantly improved in CNI minimization group than in routine CNI regimen group (Z = 5.45, P<0.00001; I(2) = 0%). Likely, sCr level was significantly lower in the CNI minimization group (Z = 2.84, P = 0.005; I(2) = 39%). However, CrCl was not significantly higher in the CNI minimization group (Z = 1.59, P = 0.11; I(2) = 0%). Both acute rejection episodes and patient survival were comparable between two groups (rejection: Z = 0.01, P = 0.99; I(2) = 0%; survival: Z = 0.28, P = 0.78; I(2) = 0%, respectively). However, current CNI minimization protocols may be related to a higher incidence of infections (Z = 3.06, P = 0.002; I(2) = 0%). CONCLUSION: CNI minimization can preserve or even improve renal function in liver transplant patients with renal impairment, while sharing similar short term acute rejection rate and patient survival with routine CNI regimen

Non-marking collection of amino acids from fingerprints using hydrogels

The amino acid profile obtained from a fingerprint may provide valuable information on its donor. Unfortunately, the collection of chemicals from the fingerprint is often destructive to the fingerprint ridge detail. Herein we detail the use of cross-linkable solutions of dextran-methacrylate to form hydrogels capable of collecting amino acids from surfaces followed by extraction and quantification with UPLC-MS. This method allows for the amino acid profile analysis of fingerprints while allowing for their increased visualization at a later stage using the standard method of cyanoacrylate fuming followed by basic-yellow dyeing

Understanding global sea levels: past, present and future

The coastal zone has changed profoundly during the 20th century and, as a result, society is becoming increasingly vulnerable to the impact of sea-level rise and variability. This demands improved understanding to facilitate appropriate planning to minimise potential losses. With this in mind, the World Climate Research Programme organised a workshop (held in June 2006) to document current understanding and to identify research and observations required to reduce current uncertainties associated with sea-level rise and variability. While sea levels have varied by over 120 m during glacial/interglacial cycles, there has been little net rise over the past several millennia until the 19th century and early 20th century, when geological and tide-gauge data indicate an increase in the rate of sea-level rise. Recent satellite-altimeter data and tide-gauge data have indicated that sea levels are now rising at over 3 mm year−1. The major contributions to 20th and 21st century sea-level rise are thought to be a result of ocean thermal expansion and the melting of glaciers and ice caps. Ice sheets are thought to have been a minor contributor to 20th century sea-level rise, but are potentially the largest contributor in the longer term. Sea levels are currently rising at the upper limit of the projections of the Third Assessment Report of the Intergovernmental Panel on Climate Change (TAR IPCC), and there is increasing concern of potentially large ice-sheet contributions during the 21st century and beyond, particularly if greenhouse gas emissions continue unabated. A suite of ongoing satellite and in situ observational activities need to be sustained and new activities supported. To the extent that we are able to sustain these observations, research programmes utilising the resulting data should be able to significantly improve our understanding and narrow projections of future sea-level rise and variabilit