Opportunities to Improve the Quality of Environmental Reports and the Effectiveness of Environmental Impact Assessment: A Case of Electric Power Transmission Systems in Brazil

A good quality Environmental Impact Statement (EIS) is key for the effectiveness of Environmental Impact Assessment (EIA) processes and consequently to the acceptability of projects subject to EIA. The international literature has contributed to the understanding of the essential aspects to be verified regarding the quality of EIS, offering a wide spectrum of good practice examples related to the content of the studies. Even so, there is a need for empirical studies that allow the identification of specific aspects related to the context of application of the EIS, which could lead to the identification of opportunities to improve both the quality of the reports and also the effectiveness of EIA. Therefore, the present paper is focused on the quality review of a number of EIS submitted to the Brazilian Federal Environmental Agency (Ibama) to instruct the assessment of electric power transmission systems. Based on the application of the EIS quality review package as proposed by Lee and Colley (1992), the outcomes reveal opportunities for improving the scope of EIA, analysis of alternatives, prediction of magnitude and the assessment of impact significance. Finally, the development and/or adaptation of a similar tool for the systematic review of the quality of EIA reports is recommended.

Utilizing engineered extracellular vesicles as delivery vectors in the management of ischemic stroke:a special outlook on mitochondrial delivery

Ischemic stroke is a secondary cause of mortality worldwide,imposing considerable medical and economic burdens on society.Extracellular vesicles,serving as natural nanocarriers for drug delivery,exhibit excellent biocompatibility in vivo and have significant advantages in the management of ischemic stroke.However,the uncertain distribution and rapid clearance of extracellular vesicles impede their delivery efficiency.By utilizing membrane decoration or by encapsulating therapeutic cargo within extracellular vesicles,their delivery efficacy may be greatly improved.Furthermore,previous studies have indicated that microvesicles,a subset of large-sized extracellular vesicles,can transport mitochondria to neighboring cells,thereby aiding in the restoration of mitochondrial function post-ischemic stroke.Small extracellular vesicles have also demonstrated the capability to transfer mitochondrial components,such as proteins or deoxyribonucleic acid,or their sub-components,for extracellular vesicle-based ischemic stroke therapy.In this review,we undertake a comparative analysis of the isolation techniques employed for extracellular vesicles and present an overview of the current dominant extracellular vesicle modification methodologies.Given the complex facets of treating ischemic stroke,we also delineate various extracellular vesicle modification approaches which are suited to different facets of the treatment process.Moreover,given the burgeoning interest in mitochondrial delivery,we delved into the feasibility and existing research findings on the transportation of mitochondrial fractions or intact mitochondria through small extracellular vesicles and microvesicles to offer a fresh perspective on ischemic stroke therapy.

Molecule‑Level Multiscale Design of Nonflammable Gel Polymer Electrolyte to Build Stable SEI/CEI for Lithium Metal Battery

The risk of flammability is an unavoidable issue for gel polymer electrolytes(GPEs).Usually,flameretardant solvents are necessary to be used,but most of them would react with anode/cathode easily and cause serious interfacial instability,which is a big challenge for design and application of nonflammable GPEs.Here,a nonflammable GPE(SGPE)is developed by in situ polymerizing trifluoroethyl methacrylate(TFMA)monomers with flame-retardant triethyl phosphate(TEP)solvents and LiTFSI–LiDFOB dual lithium salts.TEP is strongly anchored to PTFMA matrix via polarity interaction between-P=O and-CH_(2)CF_(3).It reduces free TEP molecules,which obviously mitigates interfacial reactions,and enhances flame-retardant performance of TEP surprisingly.Anchored TEP molecules are also inhibited in solvation of Li^(+),leading to anion-dominated solvation sheath,which creates inorganic-rich solid electrolyte interface/cathode electrolyte interface layers.Such coordination structure changes Li^(+)transport from sluggish vehicular to fast structural transport,raising ionic conductivity to 1.03 mS cm^(-1) and transfer number to 0.41 at 30℃.The Li|SGPE|Li cell presents highly reversible Li stripping/plating performance for over 1000 h at 0.1 mA cm^(−2),and 4.2 V LiCoO_(2)|SGPE|Li battery delivers high average specific capacity>120 mAh g^(−1) over 200 cycles.This study paves a new way to make nonflammable GPE that is compatible with Li metal anode.

Late effects of the treatment of childhood cancer

Excellent progress has been made in the last few decades in the cure rates of pediatric malignancies,with more than 80%of children with cancer who have access to contemporary treatment being cured.However,the therapies responsible for this survival can also produce adverse physical and psychological long-term outcomes,referred to as late effects,which appear months to years after the completion of cancer treatment.Research has shown that 60%to 90%of childhood cancer survivors(CCSs)develop one or more chronic health conditions,and 20%to 80%of survivors experience severe or life-threatening complications during adulthood.Therefore,understanding the late side effects of such treatments is important to improve the health and quality of life of the growing population of CCSs.

Simulation of the Ecosystem Productivity Responses to Aerosol Diffuse Radiation Fertilization Effects over the Pan-Arctic during 2001–19

The pan-Arctic is confronted with air pollution transported from lower latitudes.Observations have shown that aerosols help increase plant photosynthesis through the diffuse radiation fertilization effects(DRFEs).While such DRFEs have been explored at low to middle latitudes,the aerosol impacts on pan-Arctic ecosystems and the contributions by anthropogenic and natural emission sources remain less quantified.Here,we perform regional simulations at 0.2o×0.2ousing a well-validated vegetation model(Yale Interactive terrestrial Biosphere,YIBs)in combination with multi-source of observations to quantify the impacts of aerosol DRFEs on the net primary productivity(NPP)in the pan-Arctic during 2001-19.Results show that aerosol DRFEs increase pan-Arctic NPP by 2.19 Pg C(12.8%)yr^(-1)under clear-sky conditions,in which natural and anthropogenic sources contribute to 8.9% and 3.9%,respectively.Under all-sky conditions,such DRFEs are largely dampened by cloud to only 0.26 Pg C(1.24%)yr^(-1),with contributions of 0.65% by natural and 0.59% by anthropogenic species.Natural aerosols cause a positive NPP trend of 0.022% yr^(-1)following the increased fire activities in the pan-Arctic.In contrast,anthropogenic aerosols induce a negative trend of-0.01% yr^(-1)due to reduced emissions from the middle latitudes.Such trends in aerosol DRFEs show a turning point in the year of 2007 with more positive NPP trends by natural aerosols but negative NPP trends by anthropogenic aerosols thereafter.Though affected by modeling uncertainties,this study suggests a likely increasing impact of aerosols on terrestrial ecosystems in the pan-Arctic under global warming.

Prevention and Control Strategies of Nosocomial Infection and Effectiveness Evaluation in a Tertiary Teaching Hospital during the Epidemic of COVID-19

Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.

Seismic effectiveness evaluation and optimized design of tie up method for securing museum collections

To quantify the seismic effectiveness of the most commonly used fishing line tie up method for securing museum collections and optimize fixed strategies for exhibitions,shaking table tests of the seismic systems used for typical museum collection replicas have been carried out.The influence of body shape and fixed measure parameters on the seismic responses of replicas and the interaction behavior between replicas and fixed measures have been explored.Based on the results,seismic effectiveness evaluation indexes of the tie up method are proposed.Reasonable suggestions for fixed strategies are given,which provide a basis for the exhibition of delicate museum collections considering the principle of minimizing seismic responses and intervention.The analysis results show that a larger ratio of height of mass center to bottom diameter led to more intense rocking responses.Increasing the initial pretension of fishing lines was conducive to reducing the seismic responses and stress variation of the lines.Through comprehensive consideration of the interaction forces and effective securement,it is recommended to apply 20%of breaking stress as the initial pretension.For specific museum collections that cannot be effectively protected by the independent tie up method,an optimized strategy of a combination of fishing lines and fasteners is recommended.

Effectiveness and economic outcomes in patients undergoing laparoscopic radical prostatectomy with a new surgical shear with an integrated energy system:A retrospective study based on a tertiary hospital database in China

ObjectiveThis study aimed to demonstrate a new surgical shear with an integrated energy system(Harmonic ACE^(®)+7)value by determining its effectiveness and economic outcomes compared with conventional ultrasonic shears(CUSs)in a real-world setting.MethodsThis was a retrospective study of adults with prostate cancer undergoing laparoscopic radical prostatectomy with the ACE^(®)+7 shear or CUSs between August 2019 and April 2021 at Shanghai Ruijin Hospital(the headquarters and Luwan Center in China).Demographic and diagnosis information,intraoperative and postoperative clinical outcomes,and total and categorical costs were collected.Propensity score matching was performed to form the study population for each clinical group.Data were compared between the two groups using t-test and Chi-squared test.ResultsThe ACE^(®)+7 was associated with a lower mean number of hemostatic clips used per surgery compared with CUSs(12.8 vs.19.8,p<0.001),a moderate but not significant difference in mean postoperative drainage duration(6.6[standard deviation,SD 2.2]days vs.7.9[SD 4.1]days,p=0.082),a reduction on mean total drainage volume(275.5[SD 374.3] mL vs.492.9[SD 1495.0]mL,p=0.321),and a lower mean rate of postoperative hemostatic drug usage(16.0%vs.52.0%,p<0.001).There was no significant difference in total costs between the ACE^(®)+7 and CUS groups.ConclusionThis study provides real-world data demonstrating that the ACE^(®)+7 shear with an integrated energy system improves clinical outcomes compared with CUSs and can offer cost savings for hospitals and health systems.Using the ACE^(®)+7 during laparoscopic radical prostatectomy allows physicians to help their patients achieve better outcomes and not spend additional money.

Ultrasonic enhancement of persulfate oxidation system governs emerging pollutants decontamination

Emerging contaminants (ECs) are widely present in aquatic environments, posing potential risks to both ecosystems and human health. Theultrasound-assisted persulfate oxidation process has attracted considerable attention in the degradation of ECs due to its ability to generate bothsulfate radicals and cavitation effects, enhancing degradation effects. In this paper, the principle of ultrasonic synergistic Fenton-like oxidationsystem for degrading organic pollutants was reviewed, divided into homogeneous system, non-homogeneous system, and single-atom system toexplore the synergistic effect of ultrasound-enhanced persulfate technology in three aspects, and the effects of environmental factors such asultrasonic frequency and power, system pH, temperature, and initial oxidant concentration on the system's decontamination performance werediscussed. Finally, future research on ultrasonically activated persulfate technology is summarized and prospected.

Systematic analysis and modeling of the FLASH sparing effect as a function of dose and dose rate

Ultrahigh-dose-rate radiotherapy(FLASH-RT)is a revolutionary radiotherapy technology that can spare normal tissues without compromising tumor control.Although qualitative experimental results have been reported,quantitative and systematic analysis of data is necessary.Particularly,the FLASH effect response model to the dose or dose rate is still unclear.This study investigated the relationships between the FLASH effect and experimental parameters,such as dose,dose rate,and other factors by analyzing published in vivo experimental data from animal models.The data were modeled based on logistic regression analysis using the sigmoid function.The model was evaluated using prediction accuracy,receiver operating characteristic(ROC)curve,and area under the ROC curve.Results showed that the FLASH effect was closely related to the dose,mean dose rate,tissue type,and corresponding biological endpoints.The dose rate corresponding to a 50% probability of triggering cognitive protection in the brain was 45 Gy s^(-1).The dose rate corresponding to a 50% probability of triggering intestinal crypt survival and regeneration was 140 Gy s^(-1).For the skin toxicity effect,the dose corresponding to a 50% probability of triggering the FLASH effect was 24 Gy.This study helps to characterize the conditions underlying the FLASH effect and provides important information for optimizing experiments.

Dynamic thermo-mechanical responses of road-soft ground system under vehicle load and daily temperature variation

A complete road-soft ground model is established in this paper to study the dynamic responses caused by vehicle loads and/or daily temperature variation.A dynamic thermo-elastic model is applied to capturing the behavior of the rigid pavement,the base course,and the subgrade,while the soft ground is characterized using a dynamic thermo-poroelastic model.Solutions to the road-soft ground system are derived in the Laplace-Hankel transform domain.The time domain solutions are obtained using an integration approach.The temperature,thermal stress,pore water pressure,and displacement responses caused by the vehicle load and the daily temperature variation are presented.Results show that obvious temperature change mainly exists within 0.3 m of the road when subjected to the daily temperature variation,whereas the stress responses can still be found in deeper places because of the thermal swelling/shrinkage deformation within the upper road structures.Moreover,it is important to consider the coupling effects of the vehicle load and the daily temperature variation when calculating the dynamic responses inside the road-soft ground system.

Multi-blade rubbing characteristics of the shaft-disk-blade-casing system with large rotation

Blade rubbing faults cause detrimental impact on the operation of aeroengines. Most of the existing studies on blade rubbing in the shaft-disk-blade-casing(SDBC) system have overlooked the elastic deformation of the blade, while some only consider the whirl of the rotor, neglecting its spin. To address these limitations, this paper proposes a dynamic model with large rotation for the SDBC system. The model incorporates the spin and whirl of the rotor, enabling the realistic reproduction of multiblade rubbing faults. To verify the accuracy of the SDBC model with large rotation and demonstrate its capability to effectively consider the rotational effects such as the centrifugal stiffening and gyroscopic effects, the natural characteristics and dynamic responses of the proposed model are compared with those obtained from reported research and experimental results. Furthermore, the effects of the rotating speed, contact stiffness,and blade number on the dynamic characteristics of the SDBC system with multi-blade rubbing are investigated. The results indicate that the phase angle between the rotor deflection and the unbalance excitation force increases with the increasing rotating speed,which significantly influences the rubbing penetration of each blade. The natural frequency of the SDBC system with rubbing constrain can be observed in the acceleration response of the casing and the torsional response of the shaft, and the frequency is related to the contact stiffness. Moreover, the vibration amplitude increases significantly with the product of the blade number under rubbing, and the rotating frequency approaches the natural frequency of the SDBC system. The proposed model can provide valuable insight for the fault diagnosis of rubbing in bladed rotating machinery.

Flexible ureteroscopic treatment of kidney stones: How do the new laser systems change our concepts?

Objective: Flexible ureteroscopy (fURS) has become a widely accepted and effective technique for treating kidney stones. With the development of new laser systems, the fURS approach has evolved significantly. This literature review aims to examine the current state of knowledge on fURS treatment of kidney stones, with a particular focus on the impact of the latest laser technologies on clinical outcomes and patient safety.Methods: We conducted a search of the PubMed/PMC, Web of Science Core Collection, Scopus, Embase (Ovid), and Cochrane Databases for all randomized controlled trial articles on laser lithotripsy in September 2023 without time restriction.Results: We found a total of 22 relevant pieces of literature. Holmium laser has been used for intracavitary laser lithotripsy for nearly 30 years and has become the golden standard for the treatment of urinary stones. However, the existing holmium laser cannot completely powder the stone, and the retropulsion of the stone after the laser emission and the thermal damage to the tissue have caused many problems for clinicians. The introduction of thulium fiber laser and Moses technology brings highly efficient dusting lithotripsy effect through laser innovation, limiting pulse energy and broadening pulse frequency.Conclusion: While the holmium:yttrium-aluminum-garnet laser remains the primary choice for endoscopic laser lithotripsy, recent technological advancements hint at a potential new gold standard. Parameter range, retropulsion effect, laser fiber adaptability, and overall system performance demand comprehensive attention. The ablation efficacy of high-pulse-frequency devices relies on precise targeting, which may pose practical challenges.

Evaluation of the effectiveness of preventive nursing measures for pressure injuries in patients in the neurology intensive care unit

BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complications to patients,but also increases medical burden,prolongs hospitalization time,and affects the recovery process.AIM To evaluate and optimize the effectiveness of pressure injury prevention nursing measures in neurology ICU patients.METHODS A retrospective study was conducted,and 60 patients who were admitted to the ICU of the Department of Neurology were selected and divided into an observation group and a control group according to the order of admission,with 30 people in each group.The observation group implemented pressure injury prevention and nursing measures,while the control group adopted routine care.RESULTS Comparison between observation and control groups following pressure injury prevention nursing intervention revealed significantly lower incidence rates in the observation group compared to the control group at 48 h(8.3%vs 26.7%),7 d(16.7%vs 43.3%),and 14 d(20.0%vs 50.0%).This suggests a substantial reduction in pressure injury incidence in the observation group,with the gap widening over time.Additionally,patients in the observation group exhibited quicker recovery,with a shorter average time to get out of bed(48 h vs 72 h)and a shorter average length of stay(12 d vs 15 d)compared to the control group.Furthermore,post-intervention,patients in the observation group reported significantly improved quality of life scores,including higher scores in body satisfaction,feeling and function,and comfort(both psychological and physiological),indicating enhanced overall well-being and comfort following the implementation of pressure injury prevention nursing measures.CONCLUSION Implementing pressure injury preventive care measures for neurology ICU patients will have better results.

Comparative observation of the effectiveness and safety of remimazolam besylate versus dexmedetomidine in gastrointestinal surgery in obese patients

BACKGROUND Surgery for obese patients carries a higher risk of anesthesia complications compared with surgery for nonobese patients.Thus,a safe and effective anesthesia strategy is necessary to improve the medical experience of such patients and ensure their safety.AIM To compared the effectiveness and safety of remimazolam besylate versus dexmedetomidine(DEX)in gastrointestinal surgery in obese patients.METHODS The study cohort included 60 obese patients undergoing gastrointestinal surgery between July 2021 and April 2023,comprising 30 patients who received DEX intervention(control group)and 30 patients who received remimazolam besylate intervention(research group).Heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),blood oxygen saturation(SpO_(2)),safety(nausea and vomiting,bradycardia,hypotension,and apnea),anesthesia and examination indices[induction time,anesthesia recovery time,and postanesthesia care unit(PACU)discharge time],sedation effect(Ramsay Sedation Scale),and postoperative pain visual analog scale were comparatively analyzed before anesthesia(T0),during anesthesia(T1),and after anesthesia(T2).RESULTS At T1,the research group showed significantly smaller changes in HR,RR,MAP,and SpO_(2) than the control group,with a significantly lower adverse reaction rate and shorter induction,anesthesia recovery,and PACU discharge times.Additionally,the intra-and postoperative Ramsay Sedation Scale scores were statistically higher in the research group than in the control group.CONCLUSION Remimazolam besylate was significantly more effective than DEX in gastrointestinal surgery in obese patients and had a higher safety profile and value in clinical promotion.

Recent advances in fabrication and functions of neuromorphic system based on organic field effect transistor

The development of various artificial electronics and machines would explosively increase the amount of information and data,which need to be processed via in-situ remediation.Bioinspired synapse devices can store and process signals in a parallel way,thus improving fault tolerance and decreasing the power consumption of artificial systems.The organic field effect transistor(OFET)is a promising component for bioinspired neuromorphic systems because it is suitable for large-scale integrated circuits and flexible devices.In this review,the organic semiconductor materials,structures and fabrication,and different artificial sensory perception systems functions based on neuromorphic OFET devices are summarized.Subsequently,a summary and challenges of neuromorphic OFET devices are provided.This review presents a detailed introduction to the recent progress of neuromorphic OFET devices from semiconductor materials to perception systems,which would serve as a reference for the development of neuromorphic systems in future bioinspired electronics.

Spatio-temporal evolution and topographic gradient effect of land use and ecosystem service value in the Lhasa River Basin

The Lhasa River Basin forms an essential human settlement area in the southern part of the Qinghai-Tibet Plateau.This study employed ecosystem service value(ESV)evaluation model,terrain gradient grading,and Geodetector to analyze land use and ESV in the Lhasa River Basin from 1985 to 2020.The findings reveal that:(1)From 1985 to 2020,grassland was the dominant land use.There was a trend of grassland reduction and the expansion of other land types.(2)ESV has increased over the research period(with a total increase of 0.84%),with higher values in the southeast and lower values in the northwest.Grassland contributed the most to ESV,and climate regulation and hydrological regulation were the ecosystem services that contribute the most to ESV.(3)Natural factors like NDVI and altitude,as well as economic factors like population density and distance from roads,influenced the spatial differentiation of ESV,the explanatory power of NDVI reached up to 0.47.The interaction between factors had a greater impact than individual factors.These research results can provide theoretical support for national spatial planning and ecological environment protection in the Lhasa River Basin and other similar areas.

Elevational patterns of warming effects on plant community and topsoil properties: focus on subalpine meadows ecosystem

Climate warming profoundly affects plant biodiversity, community productivity, and soil properties in alpine and subalpine grassland ecosystems. However, these effects are poorly understood across elevational gradients in subalpine meadow ecosystems. To reveal the elevational patterns of warming effects on plant biodiversity, community structure, productivity, and soil properties, we conducted a warming experiment using open-top chambers from August 2019 to August 2022 at high(2764 m a. s. l.), medium(2631 m a. s. l.), and low(2544 m a. s. l.) elevational gradients on a subalpine meadow slope of Mount Wutai, Northern China. Our results showed that three years of warming significantly increased topsoil temperature but significantly decreased topsoil moisture at all elevations(P<0.05), and the percentage of increasing temperature and decreasing moisture both gradually raised with elevation lifting. Warming-induced decreasing proportions of soil organic carbon(SOC, by 19.24%), and total nitrogen(TN, by 24.56%) were the greatest at high elevational gradients. Experimental warming did not affect topsoil C: N, p H, NO_(3)^(-)-N, or NH_(4)^(+)-N at the three elevational gradients. Warming significantly increased species richness(P<0.01) and Shannon-Weiner index(P<0.05) at low elevational gradients but significantly decreased belowground biomass(P<0.05) at a depth of 0–10 cm at three elevational gradients. Warming caused significant increases in the aboveground biomass in the three elevational plots. Warming significantly increased the aboveground biomass of graminoids in medium(by 92.47%) and low(by 98.25%) elevational gradients, that of sedges in high(by 72.44%) and medium(by 57.16%) elevational plots, and that of forbs in high(by 75.88%), medium(by 34.38%), and low(by 74.95%) elevational plots. Species richness had significant linear correlations with SOC, TN, and C: N(P<0.05), but significant nonlinear responses to soil temperature and soil moisture in the warmed treatment(P<0.05). The warmed aboveground biomass had a significant nonlinear response to soil temperature and significant linear responses to soil moisture(P<0.05). This study provided evidence that altitude is a factor in sensitivity to climate warming, and these different parameters(e.g., plant species richness, Shannon-Weiner index, soil temperature, soil moisture, SOC, and TN) can be used to measure this sensitivity.

Design and Implementation of a High-Sensitivity Magnetic Sensing System Based on GMI Effect

A high-sensitivity magnetic sensing system based on giant magneto-impedance(GMI)effect is designed and fabricated.The system comprises a GMI sensor equipped with a gradient probe and an signal acquisition and processing module.A segmented superposition algorithm is used to increase target signal and reduce the random noise.The results show that under unshielded,room temperature conditions,the system achieves successful detection of weak magnetic fields down to 2 pT with a notable sensitivity of 1.84×10^(8)V/T(G=1000).By applying 17 overlays,the segmented superposition algorithm increases the power proportion of the target signal at 31 Hz from6.89%to 45.91%,surpassing the power proportion of the 2 Hz low-frequency interference signal.Simultaneously,it reduces the power proportion of the 20 Hz random noise.The segmented superposition process effectively cancels out certain random noise elements,leading to a reduction in their respective power proportions.This high-sensitivity magnetic sensing system features a simple structure,and is easy to operate,making it highly valuable for both practical applications and broader dissemination.

Safety of teplizumab in patients with high-risk for diabetes mellitus type 1:A systematic review

BACKGROUND The incidence of diabetes mellitus type 1(DM1)has been rising worldwide because of improvements in diagnostic techniques and improved access to care in countries with lower socioeconomic status.A new anti-CD4 antibody,Teplizumab,has been shown to delay the progression of DM1 and is the only medication approved for this indication.However,more information is needed about the safety profile of this drug.AIM To identify the odds ratios(OR)of systems-based adverse effects for Teplizumab when compared to Placebo.METHODS An extensive systematic review was conducted from the inception of the medication until December 31,2023.All clinical trials and studies that evaluated Teplizumab vs placebo were included in the initial review.The study protocol was designed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines guidelines and was registered in PROSPERO(ID:CRD42024496169).Crude OR were generated using RevMan Software version 5.4.RESULTS After screening and review,5 studies were selected to determine the risk of adverse effects of teplizumab compared to placebo.A total of 561 patients were included in the study population.Total adverse effects and system-based adverse effects were studied and reported.We determined that patients receiving Teplizumab had a higher risk of developing gastrointestinal(GI)(OR=1.60,95%CI:1.01-2.52,P=0.04),dermatological(OR=6.33,95%CI:4.05-9.88,P<0.00001)and hematological adverse effects(OR=19.03,95%CI:11.09-32.66,P<0.00001).These patients were also significantly likely to have active Epstein-Barr Virus infection(OR=3.16,95%CI:1.51-6.64,P<0.002).While our data showed that patients receiving Teplizumab did have a higher incidence of total adverse effects vs placebo,this finding did not reach statistical significance(OR=2.25,95%CI:0.80-6.29,P=0.12).CONCLUSION Our systematic review suggests that Teplizumab patients are at risk for significant adverse effects,primarily related to GI,dermatological,and hematological systems.The total adverse effect data is limited as study populations are small.More studies should be conducted on this medication to better inform the target population of potential adverse effects.