A nomogram for prediction of early mortality in patients undergoing cardiac surgery for infective endocarditis: a retrospective single-center study.

OBJECTIVE: Despite advancements in surgical techniques, operations for infective endocarditis (IE) remain associated with relatively high mortality. The aim of this study was to develop a nomogram model to predict the early postoperative mortality in patients undergoing cardiac surgery for infective endocarditis based on the preoperative clinical features. METHODS: We retrospectively analyzed the clinical data of 357 patients with IE who underwent surgeries at our center between January 2007 and June 2023. Independent risk factors for early postoperative mortality were identified using univariate and multivariate logistic regression models. Based on these factors, a predictive model was developed and presented in a nomogram. The performance of the nomogram was evaluated through the receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis (DCA). Internal validation was performed utilizing the bootstrapping method. RESULTS: The nomogram included nine predictors: age, stroke, pulmonary embolism, albumin level, cardiac function class IV, antibotic use <4weeks, vegetation size ≥1.5 cm, perivalvular abscess and preoperative dialysis. The area under the ROC curve (AUC) of the model was 0.88 (95%CI:0.80-0.96). The calibration plot indicated strong prediction consistency of the nomogram with satisfactory Hosmer-Lemeshow test results (χ2 = 13.490, p = 0.142). Decision curve analysis indicated that the nomogram model provided greater clinical net benefits compared to "operate-all" or "operate-none" strategies. CONCLUSIONS: The innovative nomogram model offers cardiovascular surgeons a tool to predict the risk of early postoperative mortality in patients undergoing IE operations. This model can serve as a valuable reference for preoperative decision-making and can enhance the clinical outcomes of IE patients.

Perspective on Fe0-PS synergetic effect and reaction mechanism in the thallium(I) contaminated water treatment.

Due to extreme toxicity of the element of thallium (Tl), increasing aqueous Tl pollution incidents have aroused growing concerns. As the prevalent and stable form, i.e., monovalent Tl, the highly efficient removal methodologies of Tl(I) from (waste)water remains limited and challenging. In this study, an advanced oxidation method, the feasibility of using zero valent iron (Fe0) coupled with persulfate (PS) to treat Tl(I)-containing synthetic wastewater was investigated. Its influence parameters, including reaction time, initial Tl concentration, dosages of PS and Fe0, initial and coagulation pH, temperature, coexisting ions and organic matter (NO3-, SO42-, Cl- and HA) were examined. The results revealed that the system can be applied to a wide range of pH and temperature and the reaction equilibrium can be reached in about 30 min. Favorable Tl(I) removal rate (>98%) was observed in the synthetic wastewater with medium and relatively high Tl(I) concentration (≤0.250 mM). The analyses of characterization results including electron spin resonance spectrometer and X-ray photoelectron spectroscopy indicated that ·OH played a vital role in the removal of Tl(I), which was oxidized and removed by co-precipitation. Fe0 can be served as a stable source of Fe2+ to efficiently catalyze PS. The remaining Fe0 can be easily separated because of its magnetism, assuring the promising reusability of the reactant. The study aims to provide references for treatment of real Tl polluted wastewater.

ASIC1a regulates miR-350/SPRY2 by N6 -methyladenosine to promote liver fibrosis.

As a reversible scar repair reaction, liver fibrosis can be blocked or even reversed by proper intervention during its formation. Our work suggests that acid-sensitive ion channel 1a (ASIC1a) participates in liver fibrosis and presents a novel mechanism involving m6 A modification and miR-350/SPRY2. We demonstrated that the expression of ASIC1a was significantly increased in liver tissue of patients with liver fibrosis and animal models of liver fibrosis, as well as PDGF-BB-induced activated HSC-T6. After downregulating the expression of ASIC1a, the degree of liver fibrosis is reduced and HSC activation was inhibited, the level of m6 A modification and miR-350 expression were also reduced. The results of dual luciferase reporter assay showed that miR-350 can bind to the target gene SPRY2 and inhibit its expression. We also found that METTL3 can regulate the extent of m6 A modification of pri-miR-350 by binding to DGCR8. In addition, silencing or blocking the expression of ASIC1a can reduce the expression of PI3K/AKT and ERK signaling pathway-related proteins in activated HSCs. Taken together, we demonstrated that ASIC1a regulates the processing of miR-350 through METTL3-dependent m6 A modification, and mature miR-350 targets SPRY2 and further promotes liver fibrosis through the PI3K/KT and ERK pathways.

PI3-kinase/Akt pathway-regulated membrane transportation of acid-sensing ion channel 1a/Calcium ion influx/endoplasmic reticulum stress activation on PDGF-induced HSC Activation.

Acid-sensing ion channel 1a (ASIC1a) allows Na+ and Ca2+ flow into cells. It is expressed during inflammation, in tumour and ischaemic tissue, in the central nervous system and non-neuronal injury environments. Endoplasmic reticulum stress (ERS) is caused by the accumulation of misfolded proteins that interferes with intracellular calcium homoeostasis. Our recent reports showed ASIC1a and ERS are involved in liver fibrosis progression, particularly in hepatic stellate cell (HSC) activation. In this study, we investigated the roles of ASIC1a and ERS in activated HSC. We found that ASIC1a and ERS-related proteins were up-regulated in carbon tetrachloride (CCl4 )-induced fibrotic mouse liver tissues, and in patient liver tissues with hepatocellular carcinoma with severe liver fibrosis. The results show silencing ASIC1a reduced the expression of ERS-related biomarkers GRP78, Caspase12 and IREI-XBP1. And, ERS inhibition by 4-PBA down-regulated the high expression of ASIC1a induced by PDGF, suggesting an interactive relationship. In PDGF-induced HSCs, ASIC1a was activated and migrated to the cell membrane, leading to extracellular calcium influx and ERS, which was mediated by PI3K/AKT pathway. Our work shows PDGF-activated ASIC1a via the PI3K/AKT pathway, induced ERS and promoted liver fibrosis progression.

Comparative analysis of robotically-assisted versus conventional sternotomy approach in left atrial myxoma resection: A single-center retrospective observational study.

BACKGROUND: Minimally invasive surgery has emerged as a favorable alternative to conventional surgery for various cardiac conditions. This study aimed to compare the perioperative outcomes and follow-up results of the robotic approach versus the sternotomy approach for left atrial myxoma (LAM) resection. METHOD: We retrospectively analyzed the perioperative outcomes and follow-up results of 94 patients who underwent left atrial myxoma resection using either the sternotomy approach (n = 64) or the robotic approach (n = 30) at our center between January 2017 and April 2023. Multiple linear regressions were employed to examine the actual impact of the surgical approach on perioperative outcomes while controlling for potential confounding factors. RESULTS: There were no in-hospital deaths or follow-up deaths in the robotic group. Univariate analyses revealed that robotic LAM resection had a longer cardiopulmonary bypass (CPB) time (99.93 ± 22.30 vs. 76.28 ± 24.92, P < 0.001), longer aortic clamping time (57.80 ± 20.27 vs. 47.89 ± 18.10, P = 0.019), reduced postoperative drainage (P < 0.001), shorter mechanical ventilation time (P = 0.005), shorter postoperative bed-stay time (P < 0.001), shorter postoperative hospitalization time (P = 0.040), and higher hospital costs (P = 0.001) compared to the sternotomy group. After adjusting for baseline characteristics in a multiple regression model, a longer CPB time (B = 28.328; CI, 18.609-38.047; P < 0.001), longer aortic clamping time (B = 11.856; CI, 4.069-19.644; P = 0.003), reduced postoperative drainage (B = -200.224; CI, -254.962- -145.486; P < 0.001), shorter mechanical ventilation time (B = -3.429; CI, -6.562- -0.295; P = 0.032), shorter postoperative bed-stay time (B = -2.230; CI, -3.267- -1.193; P < 0.001), shorter postoperative hospitalization time (B = -1.998; CI, -3.747- -0.250; P = 0.026), and higher hospital costs (B = 2096.866, P = 0.002) were found in the robotic group. Furthermore, the robotic group exhibited a faster return to exercise compared to the sternotomy group (Log-Rank χ2 = 34.527, P < 0.001). CONCLUSION: Both the robotic and sternotomy approaches are viable and safe options for LAM resection. However, despite the higher costs, longer CPB time, and longer aortic clamping time associated with robotic LAM resection, this technique was correlated with reduced postoperative drainage and faster postoperative recovery compared to the sternotomy technique.

Risk assessment and strontium isotopic tracing of potentially toxic metals in creek sediments around a uranium mine, China.

The contamination of creek sediments near industrially nuclear dominated site presents significant environmental challenges, particularly in identifying and quantifying potentially toxic metal (loid)s (PTMs). This study aims to measure the extent of contamination and apportion related sources for nine PTMs in alpine creek sediments near a typical uranium tailing dam from China, including strontium (Sr), rubidium (Rb), manganese (Mn), lithium (Li), nickel (Ni), copper (Cu), vanadium (V), cadmium (Cd), zinc (Zn), using multivariate statistical approach and Sr isotopic compositions. The results show varying degrees of contamination in the sediments for some PTMs, i.e., Sr (16.1-39.6 mg/kg), Rb (171-675 mg/kg), Mn (224-2520 mg/kg), Li (11.6-78.8 mg/kg), Cd (0.31-1.38 mg/kg), and Zn (37.1-176 mg/kg). Multivariate statistical analyses indicate that Sr, Rb, Li, and Mn originated from the uranium tailing dam, while Cd and Zn were associated with abandoned agricultural activities, and Ni, Cu, and V were primarily linked to natural bedrock weathering. The Sr isotope fingerprint technique further suggests that 48.22-73.84% of Sr and associated PTMs in the sediments potentially derived from the uranium tailing dam. The combined use of multivariate statistical analysis and Sr isotopic fingerprint technique in alpine creek sediments enables more reliable insights into PTMs-induced pollution scenarios. The findings also offer unique perspectives for understanding and managing aqueous environments impacted by nuclear activities.

Ligand effect of PdRu on Pt-enriched surface for glucose complete electro-oxidation to carbon dioxide and abiotic direct glucose fuel cells.

The development of advanced electrocatalysts for the abiotic direct glucose fuel cells (ADGFCs) is critical in the implantable devices in living organisms. The ligand effect in the Pt shell-alloy core nanocatalysts is known to influence the electrocatalytic reaction in interfacial structure. Herein, we reported the synthesis of ternary Pt@PdRu nanoalloy aerogels with ligand effect of PdRu on Pt-enriched surface through electrochemical cycling. Pt@PdRu aerogels with optimized Pt surface electronic structure exhibited high mass activity and specific activity of Pt@PdRu about 450 mA·mgPt-1 and 1.09 mA·cm-2, which were 1.4 and 1.6 times than that of commercial Pt/C. Meanwhile, Pt@PdRu aerogels have higher electrochemical stability comparable to commercial Pt/C. In-situ FTIR spectra results proved that the glucose oxidation reaction on Pt@PdRu aerogels followed the CO-free direct pathway reaction mechanism and part of the products are CO2 by completed oxidation. Furthermore, the ADGFC with Pt@PdRu ultrathin anode catalyst layer showed a much higher power density of 6.2 mW·cm-2 than commercial Pt/C (3.8 mW·cm-2). To simulate the blood fuel cell, the Pt@PdRu integrated membrane electrode assembly was exposed to glucose solution and a steady-state open circuit of approximately 0.6 V was achieved by optimizing the glucose concentration in cell system.

A Wireless Acoustic Emission Sensor System with ACMD-IGWO-XGBoost Algorithm for Living Tree Moisture Content Diagnosis.

Trunk water has an important influence on the metabolism and ecological balance of living trees, which affects the vegetation growth and moisture cycle of the whole forest ecosystem. The accurate and real-time measurement of moisture content (MC) is of vital guiding meaning to living tree cultivation and forest management. In this paper, a water content diagnosis system based on a wireless acoustic emission sensor network (WASN) was designed and implemented with the aim of the nondestructive detection of water content in living wood trunks. Firstly, the acoustic emission (AE) signal of the trunk epidermis was sampled at high speed; then, its characteristic parameters were calculated and transmitted wirelessly to the gateway. Furthermore, the optimal characteristic wavelet sequence was decomposed by the adaptive chirp mode decomposition (ACMD), and the improved grey wolf optimizer (IGWO) optimization XGBoost established the MC prediction model, which was improved by the multi-strategy joint optimization. Finally, field monitoring was carried out on Robinia Pseudoacacia, Photinia serrulata, Pinus massoniana and Toona sinensis. The average diagnostic accuracy reached 96.75%, which shows that the diagnosis system has excellent applicability in different working conditions.

Internet-of-Things-Based Multiple-Sensor Monitoring System for Soil Information Diagnosis Using a Smartphone.

The rise of Internet of Things (IoT) technology has moved the digital world in a new direction and is considered the third wave of the information industry. To meet the current growing demand for food, the agricultural industry should adopt updated technologies and smart agriculture based on the IoT which will strongly enable farmers to reduce waste and increase productivity. This research presents a novel system for the application of IoT technology in agricultural soil measurements, which consists of multiple sensors (temperature and moisture), a micro-processor, a microcomputer, a cloud platform, and a mobile phone application. The wireless sensors can collect and transmit soil information in real time with a high speed, while the mobile phone app uses the cloud platform as a monitoring center. A low power consumption is specified in the hardware and software, and a modular power supply and time-saving algorithm are adopted to improve the energy effectiveness of the nodes. Meanwhile, a novel soil information prediction strategy was explored based on the deep Q network (DQN) reinforcement learning algorithm. Following the weighted combination of a bidirectional long short-term memory, online sequential extreme learning machine, and parallel extreme machine learning, the DQN Bi-OS-P prediction model was obtained. The proposed data acquisition system achieved a long-term stable and reliable collection of time-series soil data with equal intervals and provided an accurate dataset for the precise diagnosis of soil information. The RMSE, MAE, and MAPE of the DQN Bi-OS-P were all reduced, and the R2 was improved by 0.1% when compared to other methods. This research successfully implemented the smart soil system and experimentally showed that the time error between the value displayed on the mobile phone app and its exact acquisition moment was no more than 3 s, proving that mobile applications can be effectively used for the real-time monitoring of soil quality and conditions in wireless multi-sensing based on the Internet of Things.

Ginseng as a Key Immune Response Modulator in Chinese Medicine: From Antipandemic History to COVID-19 Management.

The cytokine storm plays an indispensable role in the severe and critical illness and death of the COVID-19 vulnerable population. Thus, suppressing the cytokine storm is of great significance. Ginseng is a traditional Chinese herb originally used for improving physiological conditions and ameliorating disease. Common throughout the history of ancient Chinese medicine is utilizing ginseng as a major ingredient to successfully fight various pandemics, and the most famous decoction is Renshen Baidu powder. In recent years, ginseng has been observed to provide preventive and therapeutic benefits in the treatment of various conditions by suppressing hyper-inflammation, inhibiting virus intrusion, and balancing the host's immunity. This paper summarizes the ancient Chinese medicine books' recordings of, the clinical practice of, and the laboratory exploration of ginseng for the treatment of pandemics and COVID-19. Ginseng and its active ingredients were found to downregulate inflammatory cytokines, upregulate anti-inflammatory cytokines, stimulate the secretion of the antiviral cytokine IFN-[Formula: see text], prevent viral entry and replication, and improve viral clearance. Furthermore, ginseng modulates both natural and acquired immunity during viral infection. Collectively, we propose that ginseng can act as a key immune response modulator against the cytokine storm of COVID-19. This paper may provide a new approach to discover specific medications using ginseng to combat COVID-19.

A comparison of total thoracoscopic versus robotic approach for cardiac myxoma resection: a single-center retrospective study.

Advances in instrumentation and technique have facilitated minimally invasive surgeries for cardiac myxoma treatment. This study aims to compare the clinical outcomes between the thoracoscopic and robotic approaches for myxoma resection. Intraoperative data and postoperative data of 46 patients who underwent either thoracoscopic (n = 15) or robotic (n = 31) cardiac myxoma resection in our center between July 2013 and September 2022 were retrospectively compared. There was no in-hospital death in either group. Meanwhile, the operative time and cardiopulmonary bypass time were significantly shorter in the robotic group than in thoracoscopic group (P = 0.015 and P = 0.035, respectively). Furthermore, shorter ICU stays (P = 0.006), shorter postoperative mechanical ventilation time (P = 0.035) and less thoracic drainage (P = 0.040) were observed in the robotic group. However, the operating room costs and total hospital costs were both significantly lower in thoracoscopic group (P = 0.004 and P = 0.007, respectively). There was no significant difference between two groups regarding the incidence of postoperative complications (P > 0.05). Lastly, a faster return to exercise was noted in robotic group than in thoracoscopic group (Log-Rank χ2 = 4.094, P = 0.043). Both approaches can be safe and feasible for myxoma resection. However, regardless of higher expenses, the robotic myxoma resection approach provides shorter operation time, less postoperative thoracic drainage, and faster recovery than total thoracoscopic technique.

The impact of wearing powered air purifying respirators or N95 masks on the olfactory function in healthcare workers: A randomized controlled trial.

BACKGROUND: With the Coronavirus disease 2019 epidemic, wearing a mask has become routine to prevent and control the virus's spread, especially for healthcare workers. However, the impact of long-term mask wear on the human body has not been adequately investigated. This study aimed to investigate whether Powered Air Purifying Respirators and N95 masks impact the olfaction in healthcare workers. METHODS: We recruited fifty-six healthcare workers and randomly divided them into 2 groups, wearing a powered air purifying respirator (PAPR) (experiment group, N = 28) and an N95 mask (control group, N = 28). Olfactory discrimination and threshold tests were performed before and after wearing the masks. SPSS 26.0 (SPSS Inc., Chicago, Illinois) software was used for the statistical analyses. RESULTS: There was a statistical difference in the olfactory threshold test after wearing the mask in both PAPR Group (Z = -2.595, P = .009) and N95 Group (Z = -2.120, P = .034), with no significant difference between the 2 (χ2 = 0.29, P = .589). There was no statistical difference in the discrimination test scores in both 2 groups after wearing the masks. CONCLUSION: Wearing a mask affects the healthcare workers' olfaction, especially odor sensitivity. Healthcare workers have a higher olfactory threshold after long-term mask wear, whether wearing PAPRs or N95 masks.

Clinical Characteristics and Surgical Outcomes of Right Heart Myxoma and Its Comparison with Left Heart Myxoma: A Single-Center Retrospective Study.

BACKGROUND: Cardiac myxomas are commonly located in the left atrium but rarely affect the right side of the heart. We retrospectively analyzed 28 patients receiving surgical treatment for right heart myxomas at our center and aimed to summarize the clinical features and surgical outcomes of right heart myxomas. METHODS: Between May 2001 and June 2022, 244 patients with sporadic cardiac myxomas underwent complete surgical resection. Twenty-eight patients (28/244, 11.48%) were right heart myxomas. Among the 28 right heart myxoma cases, 25 underwent median sternotomy and 3 underwent robotic or total thoracoscopic procedures. The clinical features, operative information, and follow-up data of right heart myxoma were comprehensively reviewed, and clinical characteristics between right heart myxoma and left heart myxoma were also compared. RESULTS: A significant difference was noted in sex between right heart myxoma and left heart myxoma (P <.05). Right heart myxoma had a higher asymptomatic rate (17.86% vs. 3.70%, P =.007) and a lower embolization rate (3.57% vs. 30.09%, P =.003) than left heart myxoma. The most common attachment site of right heart myxoma is the atrial septum. The mean operative duration and cardiopulmonary bypass time of right heart myxoma resection were 207.71 ± 53.40 minutes and 63.86 ± 29.73 minutes, respectively, with an in-hospital mortality rate of 3.57%. During the follow-up, 2 patients died of noncardiac causes. The overall 1-, 2-, and 5-year actuarial survival rates after right heart myxoma resection were 95.8%, 90.8%, and 84.7%, respectively. CONCLUSIONS: As a rare cardiac tumor, the clinical characteristics of right heart myxoma are different from typical left heart myxoma in some aspects, such as sex, asymptomatic rate, and embolization rate. Prompt surgical resection of right heart myxoma gives excellent early and midterm results.

Hidden risks from potentially toxic metal(loid)s in paddy soils-rice and source apportionment using lead isotopes: A case study from China.

Pyrite is a typical sulfide mineral which contains various potentially toxic metal(loid)s (PTMs). The pyrite smelting and subsequent industrial utilization activities usually release numerous amounts of PTMs into nearby ecosystem, which may be enriched in the nearby farmland soils and crops, leading to hidden but irreversible harm to human health via the food chain. Herein, the distribution pattern, source apportionment, and potential health risks of Pb, Zn, Cu, Cd and multiple seldom monitored PTMs (Ag, Bi, Sb, Sr, Th, U, W, and V) in the paddy soils and different organs of the rice plants from ten various sites in a typical industrial zone were investigated, where pyrite ores were used for the production of sulfuric acid and subsequent cement over several decades. The results showed that the contents of Cd, Pb and Zn in studied paddy soils generally exceeded the maximum permissible level (MPL) in China, and the contents of Sb and V were approaching the MPL. Moreover, the rice is easier to bioaccumulate Cd, Cu, and Zn than the other studied elements. The hazard quotient (HQ) calculations indicate that the rice containing such multiple elements may cause a high potential non-carcinogenic and carcinogenic health risk for residents, particularly for the senior group. The Pb isotope tracing method combined with PCA (principal component analysis) further uncovered that the pyrite industrial utilization contributed 18.58-55.41 % to the highly enriched PTMs in paddy soils. All these findings indicate that the paddy soil system has been contaminated by the pyrite industrial activities and certain distances or areas should be rigidly forbidden from rice cultivation in the proximity of the pyrite smelting and related industrial sites.

Thallium adsorption on three iron (hydr)oxides and Tl isotopic fractionation induced by adsorption on ferrihydrite.

Thallium (Tl) is an extraordinarily toxic metal, which is usually present with Tl(I) and highly mobile in aquatic environment. Limited knowledge is available on the adsorption and isotopic variations of Tl(I) to Fe-(hydr)oxides. Herein, the adsorption behavior and mechanism of Tl(I) on representative Fe-(hydr)oxides, i.e. goethite, hematite, and ferrihydrite, were comparatively investigated kineticly and isothermally, additional to crystal structure modelling and Tl isotope composition (205Tl/203Tl). The results showed that ferrihydrite exhibited overall higher Tl(I) adsorption capacity (1.11-10.86 mg/kg) than goethite (0.21-1.83 mg/kg) and hematite (0.14-2.35 mg/kg), and adsorption by the three prevalent Fe-minerals presented strong pH and ionic strength dependence. The magnitude of Tl isotopic fractionation during Tl(I) adsorption to ferrihydrite (αsolid-solution ≈ 1.00022-1.00037) was smaller than previously observed fractionation between Mn oxides and aqueous Tl(I) (αsolid-solution ≈ 1.0002-1.0015). The notable difference is likely that whether oxidation of Tl(I) occurred during Tl adsorption to the mineral surfaces. This study found a small but detectable Tl isotopic fractionation during Tl(I) adsorption to ferrihydrite and heavier Tl isotope was slightly preferentially adsorbed on surface of ferrihydrite, which was attributed to the formation of inner-sphere complex between Tl and ≡Fe-OH. The findings offer a new understanding of the migration and fate of 205Tl/203Tl during Tl(I) adsorption to Fe (hydr)oxides.

Stable thallium (Tl) isotopic signature as a reliable source tracer in river sediments impacted by mining activities.

Thallium (Tl) is an extremely toxic metal, whose geochemical behavior remains poorly understood. This study aims to clarify the migration pathway and source apportionment of Tl in sediments from a watershed downstream of an open and large-scale pyrite mine area in south China, using high-precised Tl isotopic compositions. Results showed that Tl isotopic fractionations were mainly influenced by the anthropogenic Tl sources in all the sediments as a whole from the studied watershed, while in situ mineral adsorption and biological activity were limited. Moreover, plot of ε205Tl vs. 1/Tl further illustrated that three possible end-members, viz. background sediments, pyrite tailings, and sewage treatment wastes were ascribed to predominant sources of Tl enrichment in the sediments. A ternary mixing model unveiled that waste from pyrite mining activities (i.e., both pyrite tailings and sewage treatment wastes) affected the downstream sediments up to 10 km. All these findings suggest that Tl isotopic signature is a reliable tool to trace Tl sources in the sediments impacted by mining activities. It is highly critical for further target-oriented and precise remediation of Tl contamination.

Frontier and hotspot evolution in Brugada syndrome: A bibliometric analysis from 2002 to 2022.

BACKGROUND: Brugada syndrome (BrS) is a genetic disorder characterized by a typical electrocardiogram pattern and predisposition to arrhythmias and sudden cardiac death. Despite our considerably evolved understanding of BrS, no bibliometrics have been performed in this research field. We aimed to analyze and visualize the characteristics of the scientific outputs, topical evolutions, and research trends of BrS over the past 2 decades using bibliometric analysis. METHODS: The literature associated with BrS was retrieved from the Science Citation Index Expanded of the Web of Science Core Collection database. Acquired data were then visually analyzed using CiteSpace and VOSviewer. RESULTS: 3042 qualifying records were included in the final analysis. The publication outputs increased over time. The United States was the leading country in the BrS research. The University of Amsterdam (Netherlands) was the most prolific and influential institution. Pedro Brugada, Arthur Wilde, and Charles Antzelevitch exerted notable publication impact and made the most significant contributions in the field of BrS. Heart Rhythm had the highest outputs and Circulation was the most influential journal. Bundle branch block, ST-segment elevation, mechanism, management, right precordial lead, and guideline were the keywords with the strongest citation burst. CONCLUSION: Research on BrS is prosperous. Keywords and co-citation analysis revealed that the mechanism, diagnosis, risk stratification, and management of BrS were the research hotspots. Besides, the underlying pathophysiology, novel therapies, and personalized risk assessment might be the emerging trends of future research.

High-efficiency removal of arsenic(III) from wastewater using combined copper ferrite@biochar and persulfate.

Arsenic (As) is a potentially toxic element with variable valence states. Due to high toxicity and bioaccumulation, As can pose a severe threat to the quality of the ecology as well as human health. In this work, As(III) in water was effectively removed by biochar-supported copper ferrite magnetic composite with persulfate. The copper ferrite@biochar composite exhibited higher catalytic activity than copper ferrite and biochar. The removal of As(III) could reach 99.8% within 1 h under the conditions of initial As(III) concentration at 10 mg/L, initial pH at 2-6, and equilibrium pH at 10. The maximum adsorption capacity of As(III) by copper ferrite@biochar-persulfate was 88.9 mg/g, achieving superior performance than mostly reported the metal oxide adsorbents. By means of a variety of characterization techniques, it was found that ∙OH acted as the main free radical for removing As(III) in the copper ferrite@biochar-persulfate system and the major mechanisms were oxidation and complexation. As a natural fibre biomass waste-derived adsorbent, ferrite@biochar presented a high catalytic efficiency and easy magnetic separation for As(III) removal. This study highlights the great potential of copper ferrite@biochar-persulfate application in As(III) wastewater treatment.

Efficacy and mechanisms of δ-MnO2 modified biochar with enhanced porous structure for uranium(VI) separation from wastewater.

Even though uranium (U) is considered to be an essential strategic resource with vital significance to nuclear power development and climate change mitigation, U exposure to human and ecological environment has received growing concerns due to its both highly chemically toxic and radioactively hazardous property. In this study, a composite (M-BC) based on Ficus macrocarpa (banyan tree) aerial roots biochar (BC) modified by δ-MnO2 was designed to separate U(VI) from synthetic wastewater. The results showed that the separation capacity of M-BC was 61.53 mg/g under the solid - liquid ratio of 1 g/L, which was significantly higher than that of BC (12.39 mg/g). The separation behavior of U(VI) both by BC and M-BC fitted well with Freundlich isothermal models, indicating multilayer adsorption occurring on heterogeneous surfaces. The reaction process was consistent with the pseudo-second-order kinetic model and the main rate-limiting step was particle diffusion process. It is worthy to note that the removal of U(VI) by M-BC was maintained at 94.56% even after five cycles, indicating excellent reusability and promising application potential. Multiple characterization techniques (e.g. Scanning Electron Microscope-Energy Dispersive Spectrometer (SEM-EDS), Fourier Transform Infrared Spectroscopy (FTIR), X-ray Diffraction (XRD), Brunauer-Emmett-Teller (BET) and X-ray Photoelectron Spectroscopy (XPS)) uncovered that U(VI) complexation with oxygen-containing functional groups (e.g. O-CO and Mn-O) and cation exchange with protonated ≡MnOH were the dominant mechanisms for U(VI) removal. Application in real uranium wastewater treatment showed that 96% removal of U was achieved by M-BC and more than 92% of co-existing (potentially) toxic metals such as Tl, Co, Pb, Cu and Zn were simultaneously removed. The work verified a feasible candidate of banyan tree aerial roots biowaste based δ-MnO2-modified porous BC composites for efficient separation of U(VI) from uranium wastewater, which are beneficial to help address the dilemma between sustainability of nuclear power and subsequent hazard elimination.

Modulation of visceral pain by brain nuclei and brain circuits and the role of acupuncture: a narrative review.

Visceral pain is a complex and heterogeneous pain condition that is often associated with pain-related negative emotional states, including anxiety and depression, and can exert serious effects on a patient's physical and mental health. According to modeling stimulation protocols, the current animal models of visceral pain mainly include the mechanical dilatation model, the ischemic model, and the inflammatory model. Acupuncture can exert analgesic effects by integrating and interacting input signals from acupuncture points and the sites of pain in the central nervous system. The brain nuclei involved in regulating visceral pain mainly include the nucleus of the solitary tract, parabrachial nucleus (PBN), locus coeruleus (LC), rostral ventromedial medulla (RVM), anterior cingulate cortex (ACC), paraventricular nucleus (PVN), and the amygdala. The neural circuits involved are PBN-amygdala, LC-RVM, amygdala-insula, ACC-amygdala, claustrum-ACC, bed nucleus of the stria terminalis-PVN and the PVN-ventral lateral septum circuit. Signals generated by acupuncture can modulate the central structures and interconnected neural circuits of multiple brain regions, including the medulla oblongata, cerebral cortex, thalamus, and hypothalamus. This analgesic process also involves the participation of various neurotransmitters and/or receptors, such as 5-hydroxytryptamine, glutamate, and enkephalin. In addition, acupuncture can regulate visceral pain by influencing functional connections between different brain regions and regulating glucose metabolism. However, there are still some limitations in the research efforts focusing on the specific brain mechanisms associated with the effects of acupuncture on the alleviation of visceral pain. Further animal experiments and clinical studies are now needed to improve our understanding of this area.