A systematic review and network meta-analysis of the effectiveness of sclerotherapy for venous malformation.

OBJECTIVE: Sclerotherapy for venous malformation has been widely used; however, no guidelines are available to assess the effectiveness of different sclerotherapy agents. We conducted a systematic review and network meta-analysis to investigate the effectiveness of sclerotherapy agents for venous malformations. METHODS: Three electronic databases were searched from their inception (1950) to April 29, 2021. Studies comparing the effectiveness of different sclerotherapy agents were included. The risk of bias within and across studies was assessed. Pairwise meta-analyses were conducted, followed by a network meta-analysis. We also assessed inconsistency and publishing bias using various approaches. RESULTS: Seven studies with 547 patients in six arms were included in the present study. We defined the response and complete response as two separate outcomes. Significant differences were observed in four comparisons with respect to the response (ethanol vs bleomycin, ethanol vs polidocanol, ethanol vs sodium tetradecyl sulfate, polidocanol vs sodium tetradecyl sulfate). No statistically significant differences were found in the other comparisons. The evidence network revealed that for the response outcome, ethanol ranked first, followed by pingyangmycin, polidocanol, sodium morrhuate, bleomycin, and, finally, sodium tetradecyl sulfate. For the complete response outcome, pingyangmycin had the best results, followed by sodium morrhuate, polidocanol, ethanol, bleomycin, and, finally, sodium tetradecyl sulfate. Major complications, such as facial nerve palsy, serious local swelling, and necrosis, had occurred mostly in the ethanol group and rarely in the other groups. Because of the limited data, no further analysis of major complications was conducted. Our confidence in the comparisons and rankings was low. We found no verified inconsistency or publishing bias in the present study using the existing approaches. CONCLUSIONS: Ethanol showed a significantly better response statistically compared with the other agents. However, ethanol had also resulted in the highest incidence of complications. Pingyangmycin showed the second-best response, best complete response, and a low rate of complications, respectively. Overall, pingyangmycin achieved excellent performance and balance in terms of the different outcomes. However, they could not be adequately recommended from the available data. More superior trials, especially randomized controlled trials, are needed in the future.

Does the Spatial Pattern of Plants and Green Space Affect Air Pollutant Concentrations? Evidence from 37 Garden Cities in China.

Relevant studies have demonstrated that urban green spaces composed of various types of plants are able to alleviate the morbidity and mortality of respiratory diseases, by reducing air pollution levels. In order to explore the relationship between the spatial pattern of urban green spaces and air pollutant concentrations, this study takes 37 garden cities with subtropical monsoon climate in China as the research object and selects the urban air quality monitoring data and land use type data in 2019 to analyze the relationship between the spatial pattern and the air pollutant concentration through the landscape metrics model and spatial regression model. Moreover, the threshold effect of the impact of green space on air pollutant concentrations is estimated, as well. The results showed that the spatial pattern of urban green space was significantly correlated with the concentrations of PM2.5 (PM with aerodynamic diameters of 2.5 mmor less), NO2 (Nitrogen Dioxide), and SO2 (Sulfur dioxide) pollutants in the air, while the concentrations of PM10 (PM with aerodynamic diameters of 10 mmor less) pollutants were not significantly affected by the green space pattern. Among them, the patch shape index (LSI), patch density (PD) and patch proportion in landscape area (PLAND) of forest land can affect the concentration of PM2.5, NO2, and SO2, respectively. The PLAND, PD, and LSI of grassland and farmland can also have an additional impact on the concentration of SO2 pollutants. The study also found that there was a significant threshold effect within the impact mechanism of urban green space landscape pattern indicators (LSI, PD, PLAND) on the concentrations of PM2.5, NO2, and SO2 air pollutants. The results of this study not only clarified the impact mechanism of the spatial pattern of urban green space on air pollutant concentrations but also provided quantitative reference and scientific basis for the optimization and updating of urban green space to promote public health.

B, N Co-Doping Sequence: An Efficient Electronic Modulation of the Pd/MXene Interface with Enhanced Electrocatalytic Properties for Ethanol Electrooxidation.

Improving the electrocatalytic properties by regulating the surface electronic structure of supported metals has always been a hot issue in electrocatalysis. Herein, two novel catalysts Pd/B-N-Ti3C2 and Pd/N-B-Ti3C2 are used as the models to explore the effect of the B and N co-doping sequence on the surface electronic structure of metals, together with the electrocatalytic properties of ethanol oxidation reaction. The two catalysts exhibit obviously stratified morphology, and the Pd nanoparticles having the same amount are both uniformly distributed on the surface. However, the electron binding energy of Ti and Pd elements of Pd/B-N-Ti3C2 is smaller than that of Pd/N-B-Ti3C2. By exploring the electrocatalytic properties for EOR, it can be seen that all the electrochemical surface area, maximum peak current density, and antitoxicity of the Pd/B-N-Ti3C2 catalyst are much better than its counterpart. Such different properties of the catalysts can be attributed to the various doping species of B and N introduced by the doping sequence, which significantly affect the surface electronic structure and size distribution of supported metal Pd. Density functional theory calculations demonstrate that different B-doped species can offer sites for the H atom from CH3CH2OH of dehydrogenation in Pd/B-N-Ti3C2, thereby facilitating the progress of the EOR to a favorable pathway. This work provides a new insight into synthesizing the high-performance anode materials for ethanol fuel cells by regulating the supported metal catalyst with multielement doping.

Efficacy of levetiracetam in STXBP1 encephalopathy with different phenotypic and genetic spectra.

OBJECTIVE: Syntaxin binding protein 1 (STXBP1) plays an important role in the release of synaptic vesicles. STXBP1-related encephalopathy is a brain dysfunction caused by STXBP1 variation. Levetiracetam (LEV) exerts antiepileptic effects by binding to synaptic vesicle protein 2A (SV2A). This study aimed to analyze the prognosis of LEV treatment of STXBP1 encephalopathy (STXBP1-E) and the correlation among genotype, phenotype, and LEV efficacy. METHODS: Patients with pathogenic STXBP1 variants were collected from multiple centers, and their clinical history, video electroencephalogram (vEEG) characteristics, imaging examination data, and anti-seizure medication (ASM) history were systematically analyzed. The ASMs related to the prognosis were explored. RESULTS: Forty patients with STXBP1-E were enrolled in this study. The detailed ASM usage of 37 patients was recorded without intervening in ASM selection. At the endpoint of six months treatment, the results of Fisher's exact test showed that in all ASMs, LEV affected the prognosis of patients with STXBP1-E. LEV was effective in improving the partial remission rate but did not achieve seizure freedom. However, LEV monotherapy could achieve seizure freedom in patients with other early-onset epileptic and encephalopathy. For refractory West syndrome (WS) or Ohtahara syndrome (OS), LEV combined with other ASMs could improve the seizure remission rate. CONCLUSION: LEV increased the seizure reduction rate and improved the vEEG characteristics in patients with STXBP1-E, but not seizure freedom. LEV combined with other ASMs could increase the seizure reduction rate, especially for refractory WS or OS. Thus, LEV could be considered after identifying the pathogenicity of STXBP1 variants.

Effectiveness comparisons of antiviral treatments for Bell palsy: a systematic review and network meta-analysis.

OBJECTIVES: Antiviral treatments for Bell palsy have been widely used, but there is no definite conclusion of which is the most effective antiviral drug. We conducted a systematic review of randomized controlled trials (RCTs) including network meta-analysis to investigate the comparative effectiveness of antiviral treatments for Bell palsy. DATA: RCTs comparing effectiveness between antiviral treatments and placebo were included. Risk of bias within and across studies was assessed with the Cochrane tool and the GRADE approach, respectively. Random-effects pairwise meta-analyses were conducted, followed by network meta-analysis. SOURCES: Three electronic databases were searched from inception to May 18, 2020. STUDY SELECTION: 11 trials and 3393 patients with four arms and eleven contrasts were included. RESULTS: Significant differences were observed between placebo and famciclovir with respect to overall recovery and no statistically significant differences were found from other comparisons. Treatment ranking based on the evidence network indicated that famciclovir shared the best results, followed by valacyclovir, acyclovir, and finally placebo. Adverse events of famciclovir were too rare and slight to be analyzed. Our confidence in pairwise comparisons was moderate to low, due to study limitations, inconsistency, and imprecision; our confidence in ranking was moderate, due to study limitations. Inconsistency is not deemed to exist by a loop-specific approach and node-splitting procedure. Results of exploring publication bias are satisfying. CONCLUSIONS: According to pairwise and network comparisons, famciclovir could be better than placebo and the effectiveness of other antiviral treatments are similar. For clinical efficacy, famciclovir obtains the best recovery rate of facial function for Bell palsy. Acyclovir has the lowest rate of synkinesis, though, it is not adequately recommended and more superior trails are needed in the future.

Improving Urban Water Environment in Eastern China by Blending Traditional with Modern Landscape Planning.

As a fundamental part of greenspace, urban water landscape contributes greatly to the ecological system and at the same time supplies a leisure area for residents. The paper did an analysis on the number of aquatic plant communities, the form of water spaces, and water quality condition by investigating 135 quadrats (90 at amphibious boundary and the land, 45 in the water) in 45 transects of 15 urban and suburban parks. We found that water spaces had monotonous forms with low biodiversity and poor water quality. In addition, urban water landscapes hardly provided ecological functions given excessive construction. Accordingly, a proposition to connect tradition with modernism in the improvement and innovation of urban water landscape planning was put forward, and further, the way to achieve it was explored. By taking Qinhu Wetland Park as a case, the principles and specific planning methods on macro- and microperspectives were discussed to guide the development of urban landscape in eastern China.