bluuebunny/crossref_metadata_2025 huggingface dataset:
The analysis of solar energy investment, digital economy, and carbon emissions in China
Authors: Wang Xue , Zhang Xiaolei , Song Jianqi
Published: August 2023

Solar energy supports sustainable economic growth by meeting the world’s growing demand for energy while addressing climate change and reducing emissions. The literature focuses on the impact of solar energy on carbon emissions, but ignores the role of solar energy investment and the digital economy. This study investigates the influence of solar energy investment and digital economy on carbon emissions in China with the STIRPAT model. It uses the SYS-GMM method to empirically test the proposed hypotheses using provincial data for China from 2011 to 2019. The empirical results show that solar energy investment notably reduces carbon emissions. The moderating effect analysis shows that China’s digital economy has a reverse moderating effect in the process of solar energy investment, affecting carbon emissions. The results of this research can be a useful contribution to the goal of carbon emission reduction in China, and relevant policy recommendations are proposed for the findings of this research. To reduce carbon emissions and help China reduce carbon emissions targets as soon as possible, more attention should be paid to solar energy investment. The rational use of the digital economy in investing in solar energy should be on the agenda.
Factors that influence the activity of biomass-degrading enzymes in the presence of ionic liquids—a review
Authors: Wolski Paul , Blankenship Brian W. , Umar Athiyya , Cabrera Mica , Simmons Blake A. , Sale Kenneth L. , Achinivu Ezinne C.
Published: August 2023

Ionic liquids (ILs) are seen as a more sustainable alternative to volatile organic solvents that are accelerating innovations in many industries such as energy storage, separations, and bioprocessing. The ability to effectively deconstruct lignocellulosic biomass is a significant hurdle in the biorefining/bioprocessing industry and presents limitations towards the commercial production of bioproducts (such as biofuels, biomaterials, etc.). Certain ILs have been shown to promote effective lignin removal, cellulose recovery, and sugar yields from various biomass feedstocks such as corn stover, wheat straw, sugarcane bagasse, sorghum, switchgrass, miscanthus, poplar, pine, eucalyptus, and certain mixtures of municipal solid waste. However, these improvements are often counteracted by the limited biocompatibility of ILs, which results in an IL-induced reduction in enzyme activity and stability—an important downstream step in the conversion of biomass to biofuels/bioproducts. As a result, significant efforts have been made to discover and engineer compatible enzyme-IL systems and to improve our understanding on the effect that these ILs have on these systems. This review seeks to examine the impact of ionic liquids on enzymes involved in lignocellulosic biomass deconstruction, with a specific focus on their relevance in the context of pretreatment. Beyond presenting an overview of the ionic liquid pretreatment landscape, we outline the main factors that influence enzyme activity and stability in the presence of ILs This data is consolidated and analyzed to apply this body of knowledge towards new innovations that could lead to improvements in the processing of biomass to biofuels and bioproducts.
Credit rating- and credit score-based carbon emission quota trading model of city dwellers
Authors: Tang Donglai , Li Qiang , Zhang Jie , Chen Yongdong , Liu Youbo , Song Weiping
Published: August 2023

Introduction: The reduction of electricity-related carbon emissions by city dwellers (CDs) is important for China to achieve low-carbon development and sustainable energy transformation. Due to the lack of incentives for reduction, electricity-related carbon emissions from CDs are increasing year by year. To this end, this paper proposes an electricity-related carbon emission quota trading model that integrates a credit rating and credit score system, particularly for motivating CDs to actively participate in carbon emission reduction.

Methods: With the history of electricity bill payment data, the density-based spatial clustering of applications with noise (DBSCAN) algorithm is used to cluster CDs, forming different clusters of CDs with different sensitivity levels to carbon emission quota prices. Thereafter, based on the total carbon emission quota and tiered electricity prices from the power company, incentive rules according to the classification result and credit scores of CDs are formulated. Under certain conditions, a leader–follower Stackelberg game between CDs and the power company is built to determine the base price of the carbon emission quota, and thereby, referring to the credit scores of CDs, floating carbon emission quota prices are offered to them in the final settlement.

Results: The simulation results for an actual community in a city in China show that the proposed method can considerably reduce the carbon emissions.

Discussion: The proposed credit rating and credit score system outperforms the asymmetric Nash negotiation method in terms of promoting carbon emission reduction.
Study on the spatial variability of thermal landscape in Xi’an based on OSM road network and POI data
Authors: Wu Jiang , Han Shenshan , Shi Leijie , Hui Qun
Published: August 2023

As the primary contributor to the urban heat island effect, the construction land can be used to understand the spatial variation characteristics of the thermal landscape within the city at the microscopic scale. Taking the main urban area of Xi’an as the study area, this paper divides the minimum urban land unit by using OpenStreetMap (OSM) road network data and employs the kernel density analysis method based on Point of interest (POI) data to construct seven types of urban functional blocks. Furthermore, this paper also establishes a thermal landscape footprint characterization model to investigate the impact range of thermal landscape footprint for various types of functional blocks and quantitatively evaluate the spatial variation characteristics of urban thermal landscape, which is of great significance to the enhancement of urban ecological environment. The study indicates that: (1) The spatial distribution of urban functional blocks presents highly coupled characteristics with POI kernel density. (2) The surface thermal landscapes of seven types of urban functional blocks are predominantly medium-temperature and sub-high-temperature pixels, with the mean values of thermal fields ranked as logistics and storage blocks > industrial development blocks > transportation hub blocks > comprehensive service blocks > residential and living blocks > commercial and business blocks > strategic reserved blocks. (3) Apart from the strategic reserved blocks, the remaining urban functional blocks can produce thermal diffusion phenomena to the surrounding areas, and their thermal landscape footprints are obviously differentiated, with their influence ranges ranked as industrial development blocks > logistics and storage blocks > comprehensive service blocks > residential and living blocks > commercial and business blocks > transportation hub blocks. The findings of the study can provide scientific guidance for both the enhancement of urban ecological environment as well as the rational planning and layout of the city.
The impact of gene polymorphism and hepatic insufficiency on voriconazole dose adjustment in invasive fungal infection individuals
Authors: Li Guolin , Li Qinhui , Zhang Changji , Yu Qin , Li Qi , Zhou Xiaoshi , Yang Rou , Yang Xuerong , Liu Hailin , Yang Yong
Published: August 2023

Voriconazole (VRZ) is a broad-spectrum antifungal medication widely used to treat invasive fungal infections (IFI). The administration dosage and blood concentration of VRZ are influenced by various factors, posing challenges for standardization and individualization of dose adjustments. On the one hand, VRZ is primarily metabolized by the liver, predominantly mediated by the cytochrome P450 (CYP) 2C19 enzyme. The genetic polymorphism of CYP2C19 significantly impacts the blood concentration of VRZ, particularly the trough concentration (Ctrough), thereby influencing the drug’s efficacy and potentially causing adverse drug reactions (ADRs). Recent research has demonstrated that pharmacogenomics-based VRZ dose adjustments offer more accurate and individualized treatment strategies for individuals with hepatic insufficiency, with the possibility to enhance therapeutic outcomes and reduce ADRs. On the other hand, the security, pharmacokinetics, and dosing of VRZ in individuals with hepatic insufficiency remain unclear, making it challenging to attain optimal Ctrough in individuals with both hepatic insufficiency and IFI, resulting in suboptimal drug efficacy and severe ADRs. Therefore, when using VRZ to treat IFI, drug dosage adjustment based on individuals’ genotypes and hepatic function is necessary. This review summarizes the research progress on the impact of genetic polymorphisms and hepatic insufficiency on VRZ dosage in IFI individuals, compares current international guidelines, elucidates the current application status of VRZ in individuals with hepatic insufficiency, and discusses the influence of CYP2C19, CYP3A4, CYP2C9, and ABCB1 genetic polymorphisms on VRZ dose adjustments and Ctrough at the pharmacogenomic level. Additionally, a comprehensive summary and analysis of existing studies’ recommendations on VRZ dose adjustments based on CYP2C19 genetic polymorphisms and hepatic insufficiency are provided, offering a more comprehensive reference for dose selection and adjustments of VRZ in this patient population.
The impact of immunocompromise on outcomes of COVID-19 in children and young people—a systematic review and meta-analysis
Authors: Greenan-Barrett James , Aston Samuel , Deakin Claire T. , Ciurtin Coziana
Published: August 2023

Background

Despite children and young people (CYP) having a low risk for severe coronavirus disease 2019 (COVID-19) outcomes, there is still a degree of uncertainty related to their risk in the context of immunodeficiency or immunosuppression, primarily due to significant reporting bias in most studies, as CYP characteristically experience milder or asymptomatic COVID-19 infection and the severe outcomes tend to be overestimated.

Methods

A comprehensive systematic review to identify globally relevant studies in immunosuppressed CYP and CYP in general population (defined as younger than 25 years of age) up to 31 October 2021 (to exclude vaccinated populations) was performed. Studies were included if they reported the two primary outcomes of our study, admission to intensive therapy unit (ITU) and mortality, while data on other outcomes, such as hospitalization and need for mechanical ventilation were also collected. A meta-analysis estimated the pooled proportion for each severe COVID-19 outcome, using the inverse variance method. Random effects models were used to account for interstudy heterogeneity.

Findings

The systematic review identified 30 eligible studies for each of the two populations investigated: immunosuppressed CYP (n = 793) and CYP in general population (n = 102,022). Our meta-analysis found higher estimated prevalence for hospitalization (46% vs. 16%), ITU admission (12% vs. 2%), mechanical ventilation (8% vs. 1%), and increased mortality due to severe COVID-19 infection (6.5% vs. 0.2%) in immunocompromised CYP compared with CYP in general population. This shows an overall trend for more severe outcomes of COVID-19 infection in immunocompromised CYP, similar to adult studies.

Interpretation

This is the only up-to-date meta-analysis in immunocompromised CYP with high global relevance, which excluded reports from hospitalized cohorts alone and included 35% studies from low- and middle-income countries. Future research is required to characterize individual subgroups of immunocompromised patients, as well as impact of vaccination on severe COVID-19 outcomes.

Systematic Review Registration

PROSPERO identifier, CRD42021278598.
Favorable response to PD-1 inhibitor plus chemotherapy as first-line treatment for metastatic follicular dendritic cell sarcoma of the spleen: a case report
Authors: Li Jielang , Ren Min , Bi Feng , Chen Ye , Li Zhiping
Published: August 2023

Follicular dendritic cell sarcoma (FDCS) is an uncommon low-grade malignant sarcoma. For localized FDCS, surgery is the most commonly recommended therapy option. However, there is no standard treatment protocol for metastatic FDCS. Here, we present a 68-year-old female with primary spleen FDCS who had multiple peritoneal metastases. She was treated with sintilimab (PD-1 inhibitor) plus chemotherapy (epirubicin plus ifosfamide) as first-line treatment achieving partial response (PR) and a relatively long progression-free survival (PFS) of 17 months. This case suggests that PD-1 inhibitor plus chemotherapy as first-line therapy seem to be a promising treatment option for metastatic FDCS.
Identification and verification of diagnostic biomarkers in recurrent pregnancy loss via machine learning algorithm and WGCNA
Authors: Wei Changqiang , Wei Yiyun , Cheng Jinlian , Tan Xuemei , Zhou Zhuolin , Lin Shanshan , Pang Lihong
Published: August 2023

Background

Recurrent pregnancy loss defined as the occurrence of two or more pregnancy losses before 20-24 weeks of gestation, is a prevalent and significant pathological condition that impacts human reproductive health. However, the underlying mechanism of RPL remains unclear. This study aimed to investigate the biomarkers and molecular mechanisms associated with RPL and explore novel treatment strategies for clinical applications.

Methods

The GEO database was utilized to retrieve the RPL gene expression profile GSE165004. This profile underwent differential expression analysis, WGCNA, functional enrichment, and subsequent analysis of RPL gene expression using LASSO regression, SVM-RFE, and RandomForest algorithms for hub gene screening. ANN model were constructed to assess the performance of hub genes in the dataset. The expression of hub genes in both the RPL and control group samples was validated using RT-qPCR. The immune cell infiltration level of RPL was assessed using CIBERSORT. Additionally, pan-cancer analysis was conducted using Sangerbox, and small-molecule drug screening was performed using CMap.

Results

A total of 352 DEGs were identified, including 198 up-regulated genes and 154 down-regulated genes. Enrichment analysis indicated that the DEGs were primarily associated with Fc gamma R-mediated phagocytosis, the Fc epsilon RI signaling pathway, and various metabolism-related pathways. The turquoise module, which showed the highest relevance to clinical symptoms based on WGCNA results, contained 104 DEGs. Three hub genes, WBP11, ACTR2, and NCSTN, were identified using machine learning algorithms. ROC curves demonstrated a strong diagnostic value when the three hub genes were combined. RT-qPCR confirmed the low expression of WBP11 and ACTR2 in RPL, whereas NCSTN exhibited high expression. The immune cell infiltration analysis results indicated an imbalance of macrophages in RPL. Meanwhile, these three hub genes exhibited aberrant expression in multiple malignancies and were associated with a poor prognosis. Furthermore, we identified several small-molecule drugs.

Conclusion

This study identifies and validates hub genes in RPL, which may lead to significant advancements in understanding the molecular mechanisms and treatment strategies for this condition.
Facts and prospects of peptide in targeted therapy and immune regulation against triple-negative breast cancer
Authors: Huang Yongxiu , Zeng Anqi , Song Linjiang
Published: August 2023

Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer. Due to the lack of specific therapeutic targets, treatment options are limited, and the recurrence and metastasis rate is high, the overall survival of patients is poor. However, with the discovery of some new targets and the corresponding immune regulation after targeting these targets, TNBC has a new hope in treatment. The peptide has a simple structure, strong binding affinity, and high stability, and has great potential in targeted therapy and immune regulation against TNBC. This review will discuss how single peptides and peptide combinations target triple-negative breast cancer to exert immunomodulatory effects. Among them, single peptides target specific receptors on TNBC cells, act as decoys to target key ligands in the regulatory pathway, and target TME-related cells. The combinations of peptides work in the form of cancer vaccines, engineered exosomes, microRNAs and other immune-related molecular pathways, immune checkpoint inhibitors, chimeric antigen receptor T cells, and drug-peptide conjugates. This article is mainly dedicated to exploring new treatment methods for TNBC to improve the curative effect and prolong the survival time of patients.
The functions and clinical application potential of exosomes derived from mesenchymal stem cells on wound repair: a review of recent research advances
Authors: Qin Xinchi , He Jia , Wang Xiaoxiang , Wang Jingru , Yang Ronghua , Chen Xiaodong
Published: August 2023

Wound repair is a complex problem for both clinical practitioners and scientific investigators. Conventional approaches to wound repair have been associated with several limitations, including prolonged treatment duration, high treatment expenses, and significant economic and psychological strain on patients. Consequently, there is a pressing demand for more efficacious and secure treatment modalities to enhance the existing treatment landscapes. In the field of wound repair, cell-free therapy, particularly the use of mesenchymal stem cell-derived exosomes (MSC-Exos), has made notable advancements in recent years. Exosomes, which are small lipid bilayer vesicles discharged by MSCs, harbor bioactive constituents such as proteins, lipids, microRNA (miRNA), and messenger RNA (mRNA). These constituents facilitate material transfer and information exchange between the cells, thereby regulating their biological functions. This article presents a comprehensive survey of the function and mechanisms of MSC-Exos in the context of wound healing, emphasizing their beneficial impact on each phase of the process, including the regulation of the immune response, inhibition of inflammation, promotion of angiogenesis, advancement of cell proliferation and migration, and reduction of scar formation.
Assessment the impact of operator experience on cyclic fatigue resistance in reciprocating and rotary NiTi files: a comparative study between dental students and pediatric dentistry specialists
Authors: Özyürek Hande , Elbay Mesut , Özyürek Taha
Published: August 2023

Introduction: Devices reducing clinical practice time, and which get minimally affected by user experience are invaluable in pediatric dentistry. Additionally, knowing the fracture resistance of different nickel-titanium (NiTi) files for root canal preparation of primary teeth is important for treatment success. Thus, the present study aimed to compare the instrumentation time (IT) and fracture resistance of reciprocating T-endo MUST (TEM) and continuously rotating AF Baby File (ABF) NiTi files according to the use of pediatric dentistry specialists.

Methods: According to their clinical experience level, 3 experimental groups (EG)s were formed namely: no experience, 2-years (less-experienced), and 10-years experienced pediatric dentistry specialists' groups. The fourth group was the control group (CG). In each EGs, 10 TEM (25/.06) and 10 ABF 20/.04, and 10 ABF 25/.04 NiTi file systems were used in 20 artificial resin teeth. Instrumentation time was recorded for each tooth. In the CG, the same number of files were not used for instrumentation. The files in all groups were subjected to a dynamic cyclic fatigue test, and the data were analyzed using the Kruskal–Wallis test at 5% significance level.

Results: In all groups, TEM files showed a significant higher fatigue resistance as compared to ABF files. However, fatigue resistances were significantly lower in (EG)s both in TEM and ABF compared to (CG)s. The instrumentation time was found to be significantly lower in TEM compared to the ABF. Also, for both file systems, the experience level did not affect the fatigue resistance, and instrumentation time.

Discussion: The experience level of the pediatric dentist did not affect the cyclic fatigue resistance of the reciprocating and rotating NiTi files, but the instrumentation time was lower for the reciprocating NiTi files.
Corrosion law of cement paste under hydrogen sulfide conditions in natural gas wells
Authors: She Chaoyi , Zheng Youzhi , Chen Lili , Fan Yu , Yang Jian , Cai Jingxuan
Published: August 2023

Downhole anticorrosion in sour gas (H2S or CO2) wells is one of the technical problems in petroleum engineering, and the corrosion law of cement paste, which is the “first barrier of the wellbore,” needs to be focused on. Aiming at the problems existing in the current research on the corrosion of underground cement paste, a curing method for interfacial corrosion is proposed. X-ray diffraction and scanning electron microscopy are used to investigate the corrosion mechanism of cement paste cured under hydrogen sulfide (H2S) conditions in natural gas wells. Experimental results showed that the corrosion depth of cement paste is proportional to the partial pressure of H2S and the corrosion time, and the compressive strength of cement paste after corrosion is inversely proportional to the H2S partial pressure value and the corrosion time. Due to the gradual enrichment, accumulation, and migration of products after the cement paste is corroded by H2S, the cement paste forms a relatively stable dense layer or corrosion transition zone. The porosity and permeability of cement paste after corrosion increased with corrosion time, showing the characteristics of first increasing and then decreasing and finally making it more difficult for the corrosive medium to enter the interior of the cement paste. It is an important method stable corrosion transition zone forms as soon as possible, which is important to maintain the long-term sealing and chemical integrity of the cement sheaths in natural gas wells containing H2S.
Genomic characterization of dengue virus serotype 2 during dengue outbreak and endemics in Hangzhou, Zhejiang (2017–2019)
Authors: Sun Hua , Yao Wenwu , Siddique Abubakar , He Fan , Yue Min
Published: August 2023

Introduction

Dengue fever (DF) is a mosquito-borne viral disease caused by the dengue virus (DENV). In recent years, Hangzhou has undergone a DF epidemic, particularly in 2017, with an outbreak of 1,128 patients. The study aimed to investigate the genetic diversity and molecular evolution among the DF clinical isolates during and after the outbreak to aid in mapping its spread.

Methods

To understand the genetic diversity, 74 DENV-2 strains were isolated from DF epidemic cases between 2017 and 2019. Combining whole genome sequencing (WGS) technology, additional phylogenetic, haplotype, amino acid (AA) substitution, and recombination analyses were performed.

Results

The results revealed that strains from 2017 were closely related to those from Singapore, Malaysia, and Thailand, indicating an imported international transmission. Local strains from 2018 were clustered with those recovered from 2019 and were closely associated with Guangzhou isolates, suggesting a within-country transmission after the significant outbreak in 2017. Compared to DENV-2 virus P14337 (Thailand/0168/1979), a total of 20 AA substitutions were detected. Notably, V431I, T2881I, and K3291T mutations only occurred in indigenous cases from 2017, and A1402T, V1457I, Q2777E, R3189K, and Q3310R mutations were exclusively found in imported cases from 2018 to 2019. The recombination analysis indicated that a total of 14 recombination events were observed.

Conclusion

This study may improve our understanding of DENV transmission in Hangzhou and provide further insight into DENV-2 transmission and the local vaccine choice.
Exploring rigid-backbone protein docking in biologics discovery: a test using the DARPin scaffold
Authors: Gaudreault Francis , Baardsnes Jason , Martynova Yuliya , Dachon Aurore , Hogues Hervé , Corbeil Christopher R. , Purisima Enrico O. , Arbour Mélanie , Sulea Traian
Published: August 2023

Accurate protein-protein docking remains challenging, especially for artificial biologics not coevolved naturally against their protein targets, like antibodies and other engineered scaffolds. We previously developed ProPOSE, an exhaustive docker with full atomistic details, which delivers cutting-edge performance by allowing side-chain rearrangements upon docking. However, extensive protein backbone flexibility limits its practical applicability as indicated by unbound docking tests. To explore the usefulness of ProPOSE on systems with limited backbone flexibility, here we tested the engineered scaffold DARPin, which is characterized by its relatively rigid protein backbone. A prospective screening campaign was undertaken, in which sequence-diversified DARPins were docked and ranked against a directed epitope on the target protein BCL-W. In this proof-of-concept study, only a relatively small set of 2,213 diverse DARPin interfaces were selected for docking from the huge theoretical library from mutating 18 amino-acid positions. A computational selection protocol was then applied for enrichment of binders based on normalized computed binding scores and frequency of binding modes against the predefined epitope. The top-ranked 18 designed DARPin interfaces were selected for experimental validation. Three designs exhibited binding affinities to BCL-W in the nanomolar range comparable to control interfaces adopted from known DARPin binders. This result is encouraging for future screening and engineering campaigns of DARPins and possibly other similarly rigid scaffolds against targeted protein epitopes. Method limitations are discussed and directions for future refinements are proposed.
Idiopathic sudden sensorineural hearing loss: effectiveness of salvage treatment with intratympanic dexamethasone or hyperbaric oxygen therapy in addition to systemic steroids
Authors: Mariani Cinzia , Carta Filippo , Catani Giulia , Lobina Sara , Marrosu Valeria , Corrias Simone , Tatti Melania , Puxeddu Roberto
Published: August 2023

Background

The development of standardized treatments for idiopathic sudden sensorineural hearing loss (ISSNHL) is hampered by uncertainty over the etiology of this disorder. Systemic steroids are historically the primary therapy, with variable hearing outcomes. Over the last two decades, intratympanic steroids (ITS) and hyperbaric oxygen therapy (HBOT) have been proposed as salvage treatments in case of failure of systemic steroids. The present study aims to evaluate the effectiveness of these salvage treatments in addition to systemic steroids.

Methods

We performed a retrospective study on 75 consecutive patients with a diagnosis of ISSNHL who were admitted to the Department of Otorhinolaryngology of our hospital between December 2018 and December 2022. All patients received primary treatment with systemic steroids. In case of slight or no hearing recovery within the 5th day from the beginning of the therapy (T1), a salvage treatment with ITS or HBOT was proposed. Patients were divided into three groups according to the therapy received: systemic steroids (group A), systemic steroids + HBOT (group B), and systemic steroids + ITS (group C). Pure-tone average at 500, 1000, 2000, and 3000 Hz and the mean gain were evaluated at T1 and 3 months after the beginning of the salvage treatment (T2). The hearing recovery was assessed according to the Siegel's criteria.

Results

Sixty-two patients (31 men and 31 women, mean age 56 years) with failure of the primary treatment were definitively enrolled in the study: 34 (54.8%) in group A, 16 (25.8%) in group B, and 12 (19.4%) in group C. The ratio of patients responding to therapy was higher in group A (29.4%) than in groups B (18.75%) and C (16.7%). We did not find any statistically significant difference between groups in terms of mean hearing gain at T2 (17.4 ± 15.4 dB in group A vs. 18.6 ± 21.1 dB in group B and 15.7 ± 14.2 dB in group C, p = 0.9).

Conclusion

In our experience, ITS or HBOT associated with systemic steroids, as salvage treatment, did not show significant improvement in hearing outcomes. The evolution of ISSNHL, regardless of the treatment, remains unpredictable.
Olfactory dysfunction after autoimmune encephalitis depending on the antibody type and limbic MRI pathologies
Authors: Hänsel Martin , Schmitz-Peiffer Henning , Hähner Antje , Reichmann Heinz , Schneider Hauke
Published: August 2023

Objective

Patients’ olfactory function after autoimmune encephalitis (AE) involving limbic structures may be impaired. This study aimed to characterize olfactory function in patients after autoimmune encephalitides.

Methods

A case–control study was performed including 11 AE patients with antibodies against NMDAR (n = 4), GAD (n = 3), VGKC (n = 3) and antibody-negative AE (n = 1) and a control group of 12 patients with pneumococcal meningo-encephalitis (PC). In subgroup analyses, AE patients with and without NMDAR-antibodies were compared. Olfactory function was assessed using the Sniffin Sticks test and the resulting TDI-score (threshold, discrimination, identification). Involvement of limbic structures was evaluated on imaging data (MRI). Statistical analyses were performed to test for correlations of TDI-score and MRI results.

Results

The overall olfactory function of the AE-group and the PC-group was comparable (mean TDI 32.0 [CI 27.3–36.7], 32.3 [CI 28.5–36.0)]. The proportions of hyposmic patients were similar compared to the general population. However, AE patients of the non-NMDAR group had significantly lower TDI-scores (28.9 ± 6,8) than NMDAR patients (37.4 ± 3.5) (p = 0.046) and a significantly lower discrimination capability than the NMDAR patients (9.9 ± 2.0 vs. 14.5 ± 0.6) (p = 0.002). The non-NMDAR patients had significantly more limbic MRI pathologies (6/7) compared to the NMDAR patients (0/4) (p = 0.015). Furthermore, a correlation between limbic MRI pathologies and worse capability of smelling discrimination was found (p = 0.016, r = −0.704, n = 11).

Conclusion

Our results indicate that patients with NMDAR autoimmune encephalitis have normal long term olfactory function. However, patients with non-NMDAR autoimmune encephalitis appear to have a persistently impaired olfactory function, probably mediated by encephalitic damage to limbic structures.
Feasibility and effectiveness of a remote individual rehabilitation program for people with Parkinson's disease living in the Brazilian Amazon: a randomized clinical trial
Authors: Pastana Ramos Luciana Fernandes , Vilacorta-Pereira Tamires de Cássia Santos , Duarte Juliana dos Santos , Yamada Elizabeth Sumi , Santos-Lobato Bruno Lopes
Published: August 2023

Parkinson's disease (PD) is a chronic and progressive neurodegenerative disorder, and the current treatment involves pharmacological intervention and physiotherapy. Telerehabilitation, which involves remote support and guidance for patients undergoing rehabilitation, can potentially improve access to physiotherapy services for people with Parkinson's disease, especially those who face geographic barriers to healthcare. The primary aim of this study was to assess the feasibility and efficacy of a telerehabilitation program for people with Parkinson's disease living in an underrepresented community of the Brazilian Amazon. We conducted a parallel-group, single-center, single-blind, phase 2 randomized controlled clinical trial involving 19 participants diagnosed with Parkinson's disease from Belém, Brazil. Participants were assigned to a 4-week individual telerehabilitation program or a booklet-based exercise program (control group). Assessments were conducted before the intervention, immediately after the intervention, and 4 weeks after the end of the intervention. We showed that our telerehabilitation program had high adherence among patients, with minimal adverse effects. Both telerehabilitation and booklet orientation reduced the time to complete the Timed Up and Go test. In conclusion, our telerehabilitation program was feasible and effective for people with Parkinson's disease in an Amazonian setting. This trial was registered at the Registro Brasileiro de Ensaios Clínicos (ReBEC) under the identifier: RBR-6sz837s.
Miller Fisher syndrome: an updated narrative review
Authors: Noioso Ciro Maria , Bevilacqua Liliana , Acerra Gabriella Maria , Della Valle Paola , Serio Marina , Vinciguerra Claudia , Piscosquito Giuseppe , Toriello Antonella , Barone Paolo , Iovino Aniello
Published: August 2023

Introduction

Miller Fisher syndrome (MFS) is considered a rare variant of Guillain-Barré syndrome (GBS), a group of acute-onset immune-mediated neuropathies characterized by the classic triad of ataxia, areflexia, and ophthalmoparesis. The present review aimed to provide a detailed and updated profile of all aspects of the syndrome through a collection of published articles on the subject, ranging from the initial description to recent developments related to COVID-19.

Methods

We searched PubMed, Scopus, EMBASE, and Web of Science databases and gray literature, including references from the identified studies, review studies, and conference abstracts on this topic. We used all MeSH terms pertaining to “Miller Fisher syndrome,” “Miller Fisher,” “Fisher syndrome,” and “anti-GQ1b antibody.”

Results

An extensive bibliography was researched and summarized in the review from an initial profile of MFS since its description to the recent accounts of diagnosis in COVID-19 patients. MFS is an immune-mediated disease with onset most frequently following infection. Anti-ganglioside GQ1b antibodies, detected in ~85% of patients, play a role in the pathogenesis of the syndrome. There are usually no abnormalities in MFS through routine neuroimaging. In rare cases, neuroimaging shows nerve root enhancement and signs of the involvement of the central nervous system. The most consistent electrophysiological findings in MFS are reduced sensory nerve action potentials and absent H reflexes. Although MFS is generally self-limited and has excellent prognosis, rare recurrent forms have been documented.

Conclusion

This article gives an updated narrative review of MFS with special emphasis on clinical characteristics, neurophysiology, treatment, and prognosis of MFS patients.
Comparison of the effects of different percentages of soy protein in the diet on patients with type 2 diabetic nephropathy: systematic reviews and network meta-analysis
Authors: Sun Jun , Wei Yu , Miao Runyu , Zhang Xiangyuan , Zhang Boxun , Zhang Lili , Zhao Linhua
Published: August 2023

Background

Dietary soy protein (SP) is a potential intervention for protecting the kidneys and improving glucose and lipid metabolism. However, whether this effect is related to the percentage of SP intake remains unclear.

Objective

This study aims to review and analyze the results of randomized clinical trials (RCTs) in patients with type 2 diabetic nephropathy (T2DN) who received diets with different percentages of SP.

Methods

The databases: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database (CBM), WanFang, Weipu (VIP), and ClinicalTrials.gov were searched until February 2023, for RCTs on T2DN and SP.

Results

A total of six studies comprising 116 participants were included. The interventions were classified as 0% SP, 35% SP, and 100% SP. To improve serum creatinine (Scr), blood urea nitrogen (BUN), 24-h urine total protein (24hUTP), and glomerular filtration rate (GFR), a 35% SP diet was the most effective, compared to a 0% SP diet, which showed a mean difference of −154.00 (95% confidence interval: −266.69, −41.31) for 24hUTP. Although it had significant benefits for 24hUTP, great heterogeneity was observed. To improve the glycolipid metabolism-related markers such as cholesterol (CHO), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), and weight, the 35% SP diet demonstrated superior efficacy compared to the 0% SP diet. Specifically, the mean difference for CHO was −0.55 (95% confidence interval: −1.08, −0.03), and for LDL-C, it was −17.71 (95% confidence interval: −39.67, −4.24). The other indicators were not statistically significant. Most studies had concerns regarding the risk of bias.

Conclusion

The findings of this study demonstrate that both 35% and 100% SP diets are more effective than a diet with no SP in improving renal function and glucolipid metabolism in patients with T2DN. As a result, a diet incorporating 35% SP may be the optimal choice for individuals with T2DN.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=352638, identifier CRD42022352638.
Medication guide for dose adjustment and management of cardiotoxicity and lipid metabolic adverse events of oral antineoplastic therapy
Authors: Ramos-Ruperez Elena , Escudero-Vilaplana Vicente , Ruiz-Briones Paula , Collado-Borrell Roberto , Villanueva-Bueno Cristina , Revuelta-Herrero José Luis , González-Haba Eva , Garcia-Gonzalez Xandra , Ibañez-Garcia Sara , Perez-Ramirez Sara , Zatarain-Nicolás Eduardo , Herranz Ana , Sanjurjo María
Published: August 2023

Objective

The management of cardiotoxicity concerning the use of oral antineoplastic agents (OAAs) is a challenge for healthcare professionals. Our objective was to create a comprehensive medication management guide with dose adjustment recommendations on OAAs concerning cardiotoxic and lipid metabolic adverse events (AEs) to assist healthcare professionals when prescribing OAAs.

Materials and methods

A review of the available information on all dose adjustments necessary to safely prescribe and dispense OAAs concerning cardiotoxicity was conducted. In January 2023, we identified all OAAs authorized by the European Medicines Agency (EMA). For each drug, the latest summary of product characteristics (SPC) approved by the EMA and the tertiary data source Lexicomp® were reviewed. Cardiotoxic AEs were recorded, namely, QT interval prolongation, decrease in left ventricular ejection fraction (LVEF), imbalances in blood pressure (hypertension and hypotension), alterations in heart rate (tachycardia and bradycardia), and thrombosis. Any available dose adjustment recommendations in case of an occurrence of these adverse events were collected.

Results

In all, 93 different OAAs had been approved by the EMA and were reviewed. Among them, 51.6% have recognized cardiotoxic AEs and 10.8% can cause alterations in lipid metabolism. A total of 27 (29.0%) OAAs had specific recommendations regarding QT prolongation; 88.9% were listed in the SPC and 59.3% in Lexicomp®. Eight OAAs (9.68%) have reported a decrease in LVEF, and four of these drugs, namely, encorafenib, lorlatinib, ripretinib, and sunitinib, have specific management recommendations. Almost half (49.5%) of currently approved OAAs can potentially alter blood pressure; 34 (36.6%) of them have been reported to cause hypertension and 12 (12.9%) are related to hypotension. Tachycardia and/or bradycardia are associated with 22.6% and 8.6% of the evaluated drugs, respectively. Regarding thrombosis, 30 (32.3%) of the drugs analyzed included the appearance of a thrombus as a possible AE.

Conclusions

More than half of the OAAs can produce cardiotoxic effects, with the most frequent being blood pressure alteration and QT interval prolongation with a non-depreciable incidence of LV dysfunction or thrombosis. Before starting the treatment, it is necessary to stratify baseline cardiovascular risk, plan a surveillance schedule, and consider referral to cardio-oncology units.
Potential diagnostic value of quantitative superb microvascular imaging in premalignant and malignant cervical lesions
Authors: Zhu Yi , Tang Yixin , Jiang Zhuolin , Zhang Jie , Jia Shijun , Li Yanjie , Luo Xinyi , Kato Tomoyasu , Zhang Guonan
Published: August 2023

Objective

The purpose of this study was to assess the diagnostic efficacy of the vascular index (VI) on superb microvascular imaging (SMI) in distinguishing normal uterine cervical epithelium, high-grade cervical intraepithelial neoplasia (CIN), and cervical cancer.

Methods

The retrospective study included women with pathology-confirmed CIN or cervical cancer, who underwent transvaginal ultrasound and SMI between April 2021 and October 2022. The SIM manifestations of normal cervix and cervical lesions were reviewed. SIM were measured and converted into vascular index (VI) which compared between cervical lesions and control groups. We have retrospectively compared ultrasound features of cervical lesions and characteristics of patients. Measurement reliability was evaluated by intra class correlation coefficient (ICC).

Results

A total of 235 consecutive females were enrolled, comprising 38 with high-grade CIN, 96 with cervical cancer, and 101 with a normal uterine cervix. The microvascular architecture exhibited significant variations between premalignant and malignant cervical lesions. Branch-like patterns were predominantly observed in high-grade CIN, while crab claw-like and fireball-like patterns were more commonly associated with cervical cancer. The median VI of cervical cancer (34.7 ± 10.3) was significantly higher than that of high-grade CIN (17.6 ± 4.2) (P < 0.001). Moreover, the VI values of cervical cancer differed significantly among different FIGO stages and pathological types (P < 0.001 and P = 0.003, respectively). The VI demonstrated superior diagnostic performance for cervical lesions compared to vascular patterns (AUC = 0.974 and 0.969, respectively). Using a cut-off value of 25.5, the VI yielded a sensitivity of 82.3% and a specificity of 99.3% for cervical lesion detection.

Conclusions

The SMI parameter (VI) exhibited a significantly higher value in cervical cancer compared to high-grade CIN, with a high level of agreement among observers. These findings suggest that quantitative SMI holds promise as an imaging technique for the detection and characterization of cervical lesions.
The effect of time interval between antenatal corticosteroid administration and delivery on outcomes in late preterm neonates born to mothers with diabetes: a retrospective cohort study
Authors: Li Xiaoyu , Zhang Jing , Hao Qingfei , Du Yanna , Cheng Xiuyong
Published: August 2023

Objectives

The study aims to investigate whether the time interval between administering antenatal corticosteroids (ACS) and delivery influences the neonatal outcomes in late preterm (LPT) neonates (34 + 0 to 36 + 6 weeks) born to mothers with diabetes.

Study design

This retrospective cohort study included women with any type of diabetes who gave birth between 34 + 0 weeks and 36 + 6 weeks of gestation. Based on the time interval between the first dose of corticosteroid and delivery, the cases were stratified into the following groups: <2, 2–7, and >7 days. Women unexposed to ACS served as the control group. The primary outcomes included the incidence of neonatal hypoglycemia and respiratory distress syndrome/transient tachypnea of the newborn. Multivariate logistic regression was used to assess the relationship between the time interval and neonatal outcomes and adjust for potential confounders.

Results

The study enrolled a total of 636 parturients. Among them, 247 (38.8%) delivered within 2 days after ACS administration, 169 (26.6%) within 2–7 days, and 126 (19.8%) at >7 days. Baseline characteristics such as type of diabetes, methods of glycemic control, preterm premature rupture of membrane, placenta previa, cesarean delivery, indication for delivery, percentage of large for gestational age, birth weight, and HbA1c in the second or third trimester were significantly different among the four groups. The multivariate analysis showed no statistically significant difference in the incidence of primary or secondary neonatal outcomes between the case and control groups.

Conclusions

ACS treatment was not associated with neonatal hypoglycemia and respiratory outcomes in LPT neonates born to diabetic mothers, regardless of the time interval to delivery.
Evaluation of late cardiac effects after multisystem inflammatory syndrome in children
Authors: De Wolf Rik , Zaqout Mahmoud , Tanaka Kaoru , Muiño-Mosquera Laura , van Berlaer Gerlant , Vandekerckhove Kristof , Dewals Wendy , De Wolf Daniël
Published: August 2023

Introduction

Multisystem inflammatory syndrome in children (MIS-C) is associated with important cardiovascular morbidity during the acute phase. Follow-up shows a swift recovery of cardiac abnormalities in most patients. However, a small portion of patients has persistent cardiac sequelae at mid-term. The goal of our study was to assess late cardiac outcomes of MIS-C.

Methods

A prospective observational multicenter study was performed in children admitted with MIS-C and cardiac involvement between April 2020 and March 2022. A follow-up by NT-proBNP measurement, echocardiography, 24-h Holter monitoring, and cardiac MRI (CMR) was performed at least 6 months after MIS-C diagnosis.

Results

We included 36 children with a median age of 10 (8.0–11.0) years, and among them, 21 (58%) were girls. At diagnosis, all patients had an elevated NT-proBNP, and 39% had a decreased left ventricular ejection fraction (LVEF) (<55%). ECG abnormalities were present in 13 (36%) patients, but none presented with arrhythmia. Almost two-thirds of patients (58%) had echocardiographic abnormalities such as coronary artery dilation (20%), pericardial effusion (17%), and mitral valve insufficiency (14%). A decreased echocardiographic systolic left ventricular (LV) function was detected in 14 (39%) patients. A follow-up visit was done at a mean time of 12.1 (±5.8) months (range 6–28 months). The ECG normalized in all except one, and no arrhythmias were detected on 24-h Holter monitoring. None had persistent coronary artery dilation or pericardial effusion. The NT-proBNP level and echocardiographic systolic LV function normalized in all patients, except for one, who had a severely reduced EF. The LV global longitudinal strain (GLS), as a marker of subclinical myocardial dysfunction, decreased (z < −2) in 35%. CMR identified one patient with severely reduced EF and extensive myocardial fibrosis requiring heart transplantation. None of the other patients had signs of myocardial scarring on CMR.

Conclusion

Late cardiac outcomes after MIS-C, if treated according to the current guidelines, are excellent. CMR does not show any myocardial scarring in children with normal systolic LV function. However, a subgroup had a decreased GLS at follow-up, possibly as a reflection of persistent subclinical myocardial dysfunction.