Efficacy of Vestibular Rehabilitation in Vestibular Neuritis: A Systematic Review and Meta-analysis.

OBJECTIVE: This study aimed to evaluate the efficacy of vestibular rehabilitation in vestibular neuritis. DESIGN: A randomized controlled trial was collected from MEDLINE, Embase, Cochrane Library, PEDro, LILACS, and Google Scholar before May 2023. RESULTS: This study included 12 randomized controlled trials involving 536 patients with vestibular neuritis. Vestibular rehabilitation was comparable with steroids in dizziness handicap inventory score at the first, sixth, and 12th months (pooled mean differences: -4.00, -0.21, and -0.31, respectively); caloric lateralization at the third, sixth, and 12th months (pooled mean difference: 1.10, 4.76, and -0.31, respectively); and abnormal numbers of vestibular-evoked myogenic potentials at the first, sixth, and 12th months. Patients receiving a combination of rehabilitation and steroid exhibited significant improvement in dizziness handicap inventory score at the first, third, and 12th months (mean difference: -14.86, pooled mean difference: -4.63, mean difference: -9.50, respectively); caloric lateralization at the first and third months (pooled mean difference: -10.28, pooled mean difference: -8.12, respectively); and numbers of vestibular-evoked myogenic potentials at the first and third months (risk ratios: 0.66 and 0.60, respectively) than did those receiving steroids alone. CONCLUSIONS: Vestibular rehabilitation is recommended for patients with vestibular neuritis. A combination of vestibular rehabilitation and steroids is more effective than steroids alone in the treatment of patients with vestibular neuritis.

Nitrogen Adsorption and Characteristics of Iron, Cobalt, and Nickel Oxides Impregnated on SBA-15 Mesoporous Silica.

Hexagonal SBA-15 mesoporous material was used as a catalytic template for impregnation, with the transition metals Fe, Co, and Ni as catalysts for chemical transformation. Nitrogen adsorption/desorption isotherms, scanning electron microscopy, and transmission electron microscopy were conducted to better understand the physicochemical properties of the metal oxide-impregnated SBA-15. The specific surface area of the original SBA-15 was approximately 680 m2/g, and the abundances of the catalysts impregnated ranged from 2 to 8%, corresponding to specific surface areas of 560-470 m2/g for Fe-SBA-15, 440-340 m2/g for Ni-SBA-15, and 410-340 m2/g for Co-SBA-15. The increase in impregnated metal loadings filled the pores and collapsed the silica walls during the metal oxides impregnation on SBA-15 and calcination procedures, resulting in a decrease in the specific surface area and pore volume of the templates. The results showed that the order of nitrogen adsorbed was SBA-15 > Fe-SBA-15 > Ni-SBA-15 > Co-SBA-15 when the metal loading was 5%. In addition, the metal oxides on SBA-15 increased the wall thickness compared with raw SBA-15. Based on the XRD spectrum analysis, Fe2O3, Co3O4, and NiO were the stable crystals on the Fe-SBA-15, Co-SBA-15, and Ni-SBA-15, respectively. The sequence of the average grain size of metal oxides on SBA-15 was Co-SBA-15 > Fe-SBA-15 > Ni-SBA-15, according to XRD spectra and Scherrer's equation. Isopropanol could be decomposed by metal oxide-impregnated SBA-15 to form carbon filament materials. Therefore, these materials have the potential to be employed for pollutant removal, catalytic reactions for organic solvent and bio-oil/biomass reforming, and recycling waste into high-value materials.

Vestibular paroxysmia: Long-term clinical outcome after treatment.

Objective: To study the long-term treatment outcome of vestibular paroxysmia (VP). Study design: Retrospective study. Setting: Tertiary referral hospital. Methods: We analyzed records of 29 consecutive patients who were diagnosed with VP and who were treated with VP-specific anticonvulsants for at least 3 months. Patients were followed for a minimum of 6 months. We recorded and assessed starting and target dosage of medications, time to achieve adequate therapeutic response, adverse effects, and the rates of short-term and long-term remission without medication. Results: All 29 patients were started on oxcarbazepine as first-line treatment, and 93.1% and 100% of patients reported good-to-excellent therapeutic response within 2 and 4 weeks, respectively. Three patients switched to other anticonvulsants at 3 months. At long-term follow-up (8-56 months), most (84.6%) oxcarbazepine-treated patients maintained good therapeutic response at doses between 300 and 600 mg/day. Eleven (37.9%) patients experienced complete remission without medication for more than 1 month, of which six (20.7%) had long-term remission off medication for more than 12 months. Nineteen (65.5%) patients had neurovascular compression (NVC) of vestibulocochlear nerve on MRI, but its presence or absence did not predict treatment response or remission. Conclusion: Low-dose oxcarbazepine monotherapy for VP is effective over the long term and is generally well-tolerated. About 20% of patients with VP in our study had long-term remission off medication.

Poststroke Cognitive Impairment: A Longitudinal Follow-Up and Pre/Poststroke Mini-Mental State Examination Comparison.

BACKGROUND: Poststroke cognitive impairment (PSCI) is a prevalent cause of disability in people with stroke. PSCI results from either lesion-dependent loss of cognitive function or augmentation of Alzheimer's pathology due to vascular insufficiency. The lack of prestroke cognitive assessments limits the clear understanding of the impact of PSCI on cognition. OBJECTIVE: The present study aims to make a direct comparison of longitudinal cognitive assessment results to clarify the impact of ischemic stroke on PSCI and assess the cognitive decline in PSCI compared to people with Alzheimer's disease (AD). METHODS: All study participants had their Mini-Mental State Examination (MMSE) at the chronic poststroke stage (≥6 months after stroke), which was compared with prestroke or acute poststroke (<6 months after stroke) MMSE to investigate the two aspects of PSCI. A group of patients with AD was used to reference the speed of neurodegenerative cognitive deterioration. Repeated measures analysis of variance was used to compare the longitudinal change of MMSE. RESULTS: MMSE score between acute and chronic poststroke revealed a 1.8 ± 6.49 decline per year (n=76), which was not significantly different from the AD patients who underwent cholinesterase inhibitors treatment (-1.11 ± 2.61, p=0.35, n=232). MMSE score between prestroke and chronic poststroke (n=33) revealed a significant decline (-6.52 ± 6.86, p < 0.001). In addition, their cognitive deterioration was significantly associated with sex, age, and stroke over the white matter or basal ganglia. CONCLUSION: Ischemic stroke substantially affects cognition with an average six-point drop in MMSE. The rate of cognitive decline in PSCI was similar to AD, and those with white matter or basal ganglia infarct were at greater risk of PSCI.

Stabilized High-Membered and Phase-Pure 2D All Inorganic Ruddlesden-Popper Halide Perovskites Nanocrystals as Photocatalysts for the CO2 Reduction Reaction.

In contrast to the 2D organic-inorganic hybrid Ruddlesden-Popper halide perovskites (RPP), a new class of 2D all inorganic RPP (IRPP) has been recently proposed by substituting the organic spacers with an optimal inorganic alternative of cesium cations (Cs+ ). Nevertheless, the synthesis of high-membered 2D IRPPs (n > 1) has been a very challenging task because the Cs+ need to act as both spacers and A-site cations simultaneously. This work presents the successful synthesis of stable phase-pure high-membered 2D IRPPs of Csn+1 Pbn Br3n+1 nanosheets (NSs) with n = 3 and 4 by employing the strategy of using additional strong binding bidentate ligands. The structures of the 2D IRPPs (n = 3 and 4) NSs are confirmed by powder X-ray diffraction and high-resolution aberration-corrected scanning transmission electron microscope measurements. These 2D IRPPs NSs exhibit a strong quantum confinement effect with tunable absorption and emission in the visible light range by varying their n values, attributed to their inherent 2D quantum-well structure. The superior structural and optical stability of the phase-pure high-membered 2D IRPPs make them a promising candidate as photocatalysts in CO2 reduction reactions with outstanding photocatalytic performance and long-term stability.

Clinical Spectrum of Positional Vertigo in an Outpatient Setting.

OBJECTIVES: To explore the clinical spectrum of positional vertigo (PV) and to study the causes of PV with atypical positional nystagmus (PN) and PV without PN. DESIGN: We retrospectively analyzed the registry (2425 cases) in a university hospital. Patients who actively reported PV as their main dizziness pattern were included. Candidates were divided into three groups according to their PN: (1) benign paroxysmal PV (BPPV); (2) PV with atypical PN; and (3) PV without PN. The diagnoses and reported symptoms in each group were analyzed. RESULTS: PV was the most commonly (n = 518, 28.3%) reported pattern in the registry. The two most common diagnoses of PV were BPPV (n = 146, 29.2%) and vestibular migraine (VM; n = 137, 27.4%). Fifty-seven (11.4%) patients had PV with atypical PN, the majority of which was caused by VM. Moreover, 297 (59.4%) patients had PV without PN. The two main diagnoses in this group were VM and functional dizziness, although the cause remained uncertain in 23.9% of the cases of PV without PN. The odds ratio of VM was 3.95 in patients with PV who reported headaches. CONCLUSIONS: PV is the most common self-reported dizziness pattern and is predominantly caused by BPPV and VM. VM is the most common cause of PV with atypical PN and PV without PN. Clinicians often erroneously assume the presence of PN in those with PV. Managing PV without PN can be challenging because of the uncertainty surrounding this phenomenon. Structured patient-oriented questionnaires assist clinicians in making timely diagnoses and adjusting treatment goals accordingly.

Deep cerebral microbleeds are associated with poor cholinesterase inhibitor treatment response in people with Alzheimer disease.

OBJECTIVES: Cholinesterase inhibitors (ChEIs) are the most effective treatment for Alzheimer disease (AD), but the response to treatment varies. Vascular lesions are associated with the pathogenesis of AD, and cerebral microbleeds (CMBs) are an indicator of hemorrhagic vascular pathology, which can be detected through susceptibility-weighted magnetic resonance imaging (SWMRI). This study investigated the association between CMBs and ChEI treatment response in patients with AD. PATIENTS AND METHODS: We reviewed the medical records of 112 Taiwanese people with mild to moderate AD and at least 2 years of ChEI treatment between 2009 and 2016. Their baseline CMBs were quantified using the Microbleed Anatomical Rating Scale on SWMRI. Cognitive function of the patients was assessed using the Mini-Mental State Examination (MMSE) and Cognitive Abilities Screening Instrument (CASI). Student t test and multivariable logistic regression were used to analyze the association between cognitive decline and CMBs. RESULTS: The mean age of the study population was 76.0 ±â€¯8.0 years. In total, 79 out of 112 patients were women. The presence of deep, but not lobar CMBs at baseline was associated with a significant cognitive decline according to the MMSE and CASI, particularly in long-term memory, attention, orientation, mental manipulation, and verbal fluency. Among deep CMBs, those in the basal ganglia and thalamus were significantly associated with cognitive decline. CONCLUSIONS: Deep CMBs, particularly those in the basal ganglia and thalamus, but not lobar CMBs, are associated with poor response to ChEI treatment in people with AD. This can serve as a biomarker for predicting ChEI treatment response.

Complete Genome Sequence of Spiroplasma alleghenense PLHS-1T (ATCC 51752), a Bacterium Isolated from Scorpion Fly (Panorpa helena).

Spiroplasma alleghenense PLHS-1T (ATCC 51752) was isolated from the gut of a scorpion fly (Panorpa helena) collected in West Virginia. The complete genome sequence of this bacterium, which consists of a single 1,336,077-bp circular chromosome, is reported in this work.

Double-blind, placebo-controlled study with alginate suspension for laryngopharyngeal reflux disease.

OBJECTIVE: Treatment for laryngopharyngeal reflux disease (LPRD) is challenging because of delays in recognition and poor responsiveness to proton-pump inhibitor therapy. The aim of this study was to determine the efficacy and safety of liquid alginate suspension for treating LPRD. METHODS: A double-blind, placebo-controlled, prospective study comparing 8 weeks of treatment with Alginos Oral Suspension (TTY Biopharm Co. Ltd., Taipei, Taiwan) (sodium alginate 1,000 mg three times daily) with a placebo was conducted on patients who fulfilled the criteria of at least one symptom consistent with LPRD, a total reflux symptom index (RSI) score of > 10, and a total reflux finding score (RFS) of > 5. Those with erosive gastroesophageal reflux disease, as evidenced through screened transnasal upper gastrointestinal endoscopy, were excluded. Efficacy was assessed by RSI, RFS, and ambulatory multichannel intraluminal impedance and pH (MII-pH) monitoring. RESULTS: A total of 80 patients aged 22 to 72 years were enrolled. Compared with baseline, both Alginos (TTY Biopharm Co. Ltd.) and the placebo significantly reduced the total RSI (P < 0.001) and the total number of reflux episodes shown by MII-pH monitoring (P < 0.05) after 8 weeks of treatment. However, liquid alginate suspension was unable to show superiority over the placebo. The incidence of various adverse events from Alginos (TTY Biopharm Co. Ltd.) was relatively low (7.7%) and mild. CONCLUSION: This study showed that liquid alginate suspension was well tolerated by LPRD patients. It effectively improved symptoms and reflux numbers but was unable to show superiority over placebo. As observed in previous studies, a great placebo effect was present. The importance of lifestyle modification could not be overlooked. LEVEL OF EVIDENCE: 2. Laryngoscope, 128:2252-2260, 2018.

Human adipose-derived stem cells for the treatment of intracerebral hemorrhage in rats via femoral intravenous injection.

Human adipose-derived stem cells (huADSC) were generated from fat tissue of a 65-year-old male donor. Flow cytometry and reverse transcription polymerase chain reaction (RT-PCR) analyses indicated that the huADSC express neural cell proteins (MAP2, GFAP, nestin and ß-III tubulin), neurotrophic growth factors (BDNF and GDNF), and the chemotactic factor CXCR4 and its corresponding ligand CXCL12. In addition, huADSC expressed the characteristic mesenchymal stem cell (MSC) markers CD29, CD44, CD73, CD90, CD105 and HLA class I. The huADSC were employed, via a right femoral vein injection, to treat rats inflicted with experimental intracerebral hemorrhage (ICH). Behavioral measurement on the experimental animals, seven days after the huADSC therapy, showed a significant functional improvement in the rats with stem cell therapy in comparison with rats of the control group without the stem cell therapy. The injected huADSC were detectable in the brains of the huADSC treated rats as determined by histochemistry analysis, suggesting a role of the infused huADSC in facilitating functional recovery of the experimental animals with ICH induced stroke.

A subtle change in p38 MAPK activity is sufficient to suppress in vivo tumorigenesis.

Emerging evidence supports a role for p38 MAPK in negative regulation of tumorigenesis. Here we show that a subtle activation of p38 MAPK is sufficient to suppress tumorigenesis as measured by the ability to form tumors when MKK6-inducible cells were explanted into nude mice. On the other hand, this activation of p38 MAPK did not necessarily cause an immediate inhibition of cell growth in vitro as measured by standard MTS assay. This data uncovers a new methodology for anti-cancer drugs screening and suggests that a substantial number of potential anti-tumor compounds, such as activators of MKK6/p38 signaling, was missed out in previous high throughput screens based on conventional growth inhibition assays.