Search

Specific treatments targeting Ebola virus are crucial in managing Ebola virus disease. To support the development of clinical practice guidelines on medications for Ebola virus disease, we aimed to evaluate the efficacy and safety of therapies for patients with Ebola virus disease.In this systematic review and network meta-analysis, we searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Scopus, Global Health, African Index Medicus, World Health Organization Global Index Medicus, the Cumulative Index to Nursing and Allied Health Literature, ClinicalTrials.gov, Epistemonikos, bioRxiv, medRxiv, and SSRN without language restrictions for randomised controlled trials (RCTs) published between database inception and Jan 1, 2022, comparing at least one therapeutic agent for Ebola virus disease against standard care or another therapeutic agent for Ebola virus disease. Two reviewers assessed study eligibility and extracted summary data independently using a standardised form. Our outcomes of interest were mortality, adverse maternal outcomes, risk of onward transmission, duration of admission to a health-care facility, functional status after Ebola virus disease, serious adverse events from medication, adverse perinatal outcomes, time to symptom resolution, and time to viral clearance. We did frequentist network meta-analyses to estimate the effect of all interventions and applied the Grading of Recommendations Assessment, Development and Evaluation approach to rate the certainty of the evidence. We registered the protocol with PROSPERO, CRD42022296539.We identified 7840 records through database searches, of which two RCTs with a total of 753 patients proved eligible. Only data on mortality, the duration of admission, serious adverse events, and time to viral clearance were available for meta-analysis. Compared with standard care, REGN-EB3 (relative risk [RR] 0·40, 95% CI 0·18 to 0·89; moderate certainty) and mAb114 (0·42, 0·19 to 0·93; moderate certainty) probably reduce mortality. Whether ZMapp (0·60, 0·28 to 1·26; very low certainty) and remdesivir (0·64, 0·29 to 1·39; very low certainty) reduce mortality compared with standard care is uncertain. With high certainty, REGN-EB3 reduces mortality compared with ZMapp (0·67, 0·52 to 0·88) and remdesivir (0·63, 0·49 to 0·82). With high certainty, mAb114 also reduces mortality compared with ZMapp (0·71, 0·55 to 0·91) and remdesivir (0·66, 0·52 to 0·84). Compared with standard care, REGN-EB3, mAb114, ZMapp, and remdesivir might have little or no effect on the time to viral clearance (mean difference ranged from -0·25 days to -1·14 days; low certainty). ZMapp might reduce the duration of admission compared with standard care (mean difference -2·02 days, 95% CI -4·05 to 0·01; low certainty). Findings for all comparisons suggested that there might be little or no difference in the prevalence of serious adverse events, but certainty was low or very low in all comparisons but one.REGN-EB3 and mAb114 separately reduce mortality compared with ZMapp, remdesivir, or standard care in patients with Ebola virus disease. These findings suggest that health-care workers should prioritise the use of REGN-EB3 and mAb114 for patients with Ebola virus disease during future outbreaks.WHO.

Hypothesis The boundary layer holds the key to solve the puzzle of the unusual stability of the nanobubbles in solution. The quantitative determination on its mechanical and structural properties has not been achieved due to its diffusive and dynamic nature, lack of distinctive interfaces, and difficult differentiation from bulk background. Therefore, it is necessary to investigate this boundary using more sensitive interface analysis technologies to effectively differentiate the water molecules at the interface from those in the bulk. Experiments An in-situ and non-deconstructive method, solvent relaxation nuclear magnetic resonance, was used to investigate the boundary layer on bulk nanobubbles, where the relaxation rate of the water in the layer and its thickness were measured by solvent relaxation NMR and the ratio between the water molecules at the bubble interfaces and those in the bulk and the corresponding boundary layer thickness were determined. Findings The spin-spin relaxation time for the water in the layer (∼101ms) is found to be two orders of magnitude lower than that of the free water (∼103ms). As the first attempt, the determined boundary layer thickness is around 35-45 nanometers and 17.0 %-8.7 % of the effective gaseous size of the nanobubbles, which increases with the decrease of the bubble diameter. As a result, a quantitative measurement model for bubble boundary layer has been established in order to better understand the interfacial properties and stabilization mechanism for bulk nanobubbles.

Objective To explore the efficacy of the quantitative parameter histogram analysis of intravoxel incoherent motion (IVIM) for different molecular prognostic factors of breast cancer. Materials and methods A total of 72 patients with breast cancer who were confirmed by surgical pathology and underwent preoperative magnetic resonance imaging (MRI) were analyzed retrospectively. A region of interest (ROI) was drawn in each slice of the IVIM images. Whole-tumor histogram parameters were obtained with Firevoxel's software by accumulating all ROIs. Next, Kolmogorov-Smirnov test, Student's t-test, Mann-Whitney U test, receiver operating characteristic curve analysis and spearman rank correlation analysis were used to assess the relationship between histogram parameters and molecular prognostic factors of breast cancer. Results Among estrogen receptor (ER)-negative ROCs, the apparent diffusion coefficient (ADC) 10th percentile had the highest ROC of 0.792, with a cut-off value of 0.788 × 10−3 mm2/s, and sensitivity and specificity of 0.714 and 0.867, respectively. The negative correlation between lymph node metastasis status and ADC standard deviation was significant (ρ = −0.44, the correlation coefficients was represented by ρ). Positive correlations were observed between hormonal expression of ER and progesterone receptor (PR) with heterogeneity metrics of ADC or perfusion fraction (f), such as ADC inhomogeneity (ρ = 0.37, ρ = 0.29) and f skewness (ρ = 0.32, ρ = 0.28). Negative correlations were observed with numerical metrics, such as the ADC median (ρ = −0.31, ρ = −0.34) and f 45th percentile (ρ = −0.35, ρ = −0.28). The positive correlations between human epidermal receptor factor-2 (HER2) and pseudo-diffusivity (Dp) numerical metrics, Ki-67 expression, and heterogeneity metrics of Dp were high. Conclusions The ADC 10th percentile had the largest area under the curve in the ER-negative ROC analysis, and the ADC standard deviation was the most valuable in the correlation analysis of lymph node metastasis. Whole-lesion quantitative histogram parameters of IVIM could, therefore, provide a scientific basis for radiomics to further guide clinical practice in the prognosis of breast cancer.

Background Anxiety disorders are the most common mental disorders, for which some countries and organizations have developed guidelines. It is necessary to understand the quality of these guidelines. Methods The relevant guidelines were searched systematically by five reviewers using Appraisal of Guidelines for Research and Evaluation (AGREE) II and AGREE Recommendation Excellence (AGREE-REX) instruments. The scores in each domain were descriptively analyzed, and guidelines from different countries were compared. Results Seventeen guidelines were included. The scores in the domains “rigor of development” and “applicability” were the lowest and ranged from 16% to 77% and 25% to 71%, respectively. The scores in the domains “implementability” and “values and preferences” were similar and ranged from 30% to 67% and 25% to 77%. In terms of the comparison among countries, the Canadian guidelines achieved the highest scores in many domains but only scored 43% in the domain of “values and preferences”. The Indian guidelines scored less than 50% in many domains but achieved a high score of 83% in the domain “scope and purpose”. Limitations Language restrictions may cause selection bias. Besides, insufficient reports may lead to deviation of assessment results. Conclusions There was no obvious advantage in guidelines from different countries. There was still a lot of room for improvement in some domains, especially “applicability”, “implementability”, “rigor of development” and “values and preferences”.

Ethylene in principle can be obtained via oxidative coupling of methane (OCM), but it is urgently calling for a low-temperature active and selective catalyst. To accomplish this goal, the CexZr1-xO2 solid solutions with varied Ce/Zr molar ratio were modified with Mn2O3-Na2WO4 to fabricate OCM catalysts. The effects of Ce/Zr ratio and Mn2O3-Na2WO4 doping were investigated on the catalyst reactivity for the OCM, showing that the reaction light-off temperature, activity and selectivity are subject to the Ce/Zr molar ratio and Mn2O3-Na2WO4 doping. The promising catalyst with Ce/Zr molar ratio of 0.15/0.85 achieves 25% CH4 conversion with 67% selectivity to C2-C3 at 660 °C and is stable for at least 100 h. The catalysts were systematically studied by CH4-TPSR, O2-TPO/-TPD, CH4-pulse, in-situ FT-IR, EPR and XPS, showing that the Mn2O3-Na2WO4 doped Ce0.15Zr0.85O2 can generate more O2– species thereby leading to a markedly improved activity and selectivity at much lowered reaction temperature.

Objectives The objective of the study was to assess inconsistencies between individual protocols and associated full-text publications in the development of core outcome sets (COSs). Study Design and Setting Protocols and subsequent full-text publications were retrieved by searching the following electronic databases: PubMed, Embase, Web of Science, and the Core Outcome Measures in Effectiveness Trials database from inception to October 1, 2019. We summarized changes in the general and methodological characteristics by comparing the protocols with the full-text publications and reported change as information frequency and proportion. Results A total of 24 protocols and 32 corresponding full-text publications that encompassed 14 study topics were identified from databases. In the identified initial list of outcomes, five COSs (20.8%) changed the included study type, none of which explained the reasons for these changes. In addition, eight COSs showed inconsistencies between the protocols and full-text publications in the searched databases, of which, only two studies explained the reasons for these changes. Compared with the protocols, three COSs changed the number of Delphi rounds, eight COSs changed the participants (stakeholder groups), and three COSs changed the consensus definition of the Delphi survey. Only two COSs explained the reason for changing the number of Delphi rounds, and none of the studies explained why the participants changed. For the face-to-face consensus meeting, we found that nine COSs changed the participants and none explained the reasons for these changes. Conclusion Our study found many inconsistencies between protocols and the full-text publications concerning COS development. These inconsistencies related to the included study types, databases searched, Delphi surveys, and face-to-face consensus meetings. As it is necessary to publish protocols before developing COSs, transparency regarding any changes to the methods is needed.

Wound healing is a complex process involved in repairing tissue damage and preventing infection. However, there is a lack of appropriate treatment solutions that can simultaneously promote tissue repair and protect againstbacteria, especially antibiotic-resistant bacteria. In this study, we have developed an injectable hydrogel encapsulating acidic fibroblast growth factor (aFGF) and bacteriophage, termed as ABgel, for combating antibiotic-resistant bacteria and enhancing wound regeneration. ABgel is composed of oxidized sodium alginate (OSA), gelatin and hyaluronic acid (HA), and can rapidly form hydrogel with an elastic modulus of 13 kPa, which mimics the skin tissues. In addition, ABgel can effectively load and stabilize bacteriophage and aFGF, allowing for preventing bacterial infections and improving regeneration of damaged dermal tissues. In vitro studies demonstrate that ABgel exhibits enormous antibacterial activity against antibiotic-resistant E. coli and enhanced angiogenetic activity. Importantly, ABgel can promote skin regeneration and prevent bacterial infections in mice, thereby promoting wound healing process. Therefore, ABgel represents a decent bioactive engineered hydrogel dressing with a broad application potential.

Previous studies have emphasized the association between baseline body mass index (BMI) and mortality in patients during a stay in the intensive care unit (ICU). However, to our knowledge, few studies have focused on BMI change during an ICU stay. The aim of this study was to explore the prognostic value of BMI change during ICU hospitalization.This was a multicenter, retrospective cohort study with data extracted from the eICU Collaborative Research Database. Logistic regression models were used to explore the relationship between BMI change and mortality in ICU patients. BMI change was calculated as follows: {[discharge ICU weight (kg) - admission ICU weight (kg)] / height (m)Compared with those with weight loss (n = 17 134), patients with weight gain during ICU hospitalization (n = 17 436) were associated with higher hospital mortality (odds ratio [OR], 1.251; 95% confidence interval [CI], 1.155-1.356; P0.001) and ICU mortality (OR, 1.360; 95% CI, 1.227-1.506; P0.001) after multivariable adjustment. The associations remained robust in patients with different baseline BMI levels and were especially remarkable among those with higher APACHE IV score and the longer ICU stay.The present study exposed the potential hazard of increasing BMI for hospital and ICU mortalities during ICU hospitalization and indicating that patients in the ICU may benefit from a more balanced nutritional strategy.

Effective treatment of liver fibrosis remains a challenging medical problem. Taraxasterol (TAR) has anti-inflammatory, anti-tumor and hepatoprotective effects. Studies have shown that TAR has good biological activity against liver injury induced by various factors. However, the anti-fibrotic effect of TAR and its mechanism are never clarified. The purpose of this study was to investigate the effects of TAR in liver fibrosis and to reveal its possible mechanism by RNA sequencing. Our results suggested that TAR attenuated CCl

Although the existing studies have suggested a significant association between high temperatures and urolithiasis, no nationwide studies have quantified the burden attributable to environmental heat stress and explored how the urolithiasis burden would vary in a warming climate.We collected data on urolithiasis attacks from 137 hospitals in 59 main cities from 20 provincial regions of China from 2000 to 2020. An individual-level case-crossover analysis was conducted to estimate the effect of daily wet-bulb globe temperature (WBGT), a heat stress index combining temperature and humidity, on urolithiasis attacks. Stratified analyses were performed by region, age, and sex. We further quantified the future WBGT-related burden of urolithiasis from the Coupled Model Intercomparison Project Phase 6 under three Shared Socioeconomic Pathway (SSP) scenarios.In total, 118,180 urolithiasis patients were evaluated. The exposure-response curve for the association between WBGT and urolithiasis attacks was J-shaped, with a significantly increased risk for WBGT higher than 14.8 °C. The middle-aged and elderly group (≥45 years old) had a higher risk of WBGT-related urolithiasis attacks than in the younger group, while no significant sex difference was observed. The attributable fraction (AF) due to high WBGT would increase from 10.1% in the 2010s to 16.1% in the 2090s under the SSP585 scenario. Warm regions were projected to experience disproportionately higher AFs and larger increments in the future.This nationwide investigation provides novel evidence on the acute effect of high WBGT on urolithiasis attacks and demonstrates the increasing disease burden in a warming climate.