Global research trends on melasma: a bibliometric and visualized study from 2014 to 2023.

Melasma, a prevalent pigmentary disorder, is characterized by its complex etiology, propensity for recurrence, and resistance to treatment. However, there is currently no research on melasma through bibliometrics and visualisation. This study analyses the hotspots and trends in the field based on 2,709 publications from the Web of Science Core Collection (WOSCC). We carried out bibliometric analyses using Citespace software for different countries/regions, institutions, authors, and keywords. References were also analysed using VoSviewer. The results indicate that overall, there has been an increase in publications related to melasma since 2014. According to the analysis of the collaborative network diagram, the United States, Egyptian Knowledge Bank, and Benjakul Soottawat are the most contributing countries, institutions, and authors, respectively. Reference and keyword analyses have identified the pathogenesis and treatment of melasma as a prevalent topic in recent years. And how to find new treatment options and more effective therapeutic drugs is a future research trend. This is the first bibliometric and visual analysis of melasma-related literature to explore research hotspots and trends.

Green, recyclable and high latent heat form-stable phase change composites supported by cellulose nanofibers for thermal energy management.

Efficiently addressing the challenge of leakage is crucial in the advancement of solid-liquid phase change thermal storage composite materials; however, numerous existing preparation methods often entail complexity and high energy consumption. Herein, a straightforward blending approach was adopted to fabricate stable phase change nanocomposites capitalizing on the interaction between TEMPO-oxidized cellulose nanofibers (TOCNF) and polyethylene glycol (PEG) molecules. By adjusting the ratio of TOCNF to PEG and the molecular weights of PEG, TOCNF/PEG phase change composites (TPCC) with customizable phase transition temperature (40.3-59.1 °C) and high phase transition latent heat (126.3-172.1 J/g) were obtained. The TPCC of high-loaded PEG (80-95 wt%) ensured a leakage rate of less than 1.7 wt% after 100 heating-cooling cycles. Moreover, TPCC exhibits excellent optical properties with a transmittance of over 90 % at room temperature and up to 96 % after heating. The thermal response analysis of TPCC demonstrates exceptional thermal-induced flexibility and good thermal stability, as well as recyclability and reshaping ability. This study may inspire others to design bio-based phase change composites with potential applications in thermal energy storage and management of smart-energy buildings, photothermal response devices, and waste heat-generating electronics.

Microbiome: Role in Inflammatory Skin Diseases.

As the body's largest organ, the skin harbors a highly diverse microbiota, playing a crucial role in resisting foreign pathogens, nurturing the immune system, and metabolizing natural products. The dysregulation of human skin microbiota is implicated in immune dysregulation and inflammatory responses. This review delineates the microbial alterations and immune dysregulation features in common Inflammatory Skin Diseases (ISDs) such as psoriasis, rosacea, atopic dermatitis(AD), seborrheic dermatitis(SD), diaper dermatitis(DD), and Malassezia folliculitis(MF).The skin microbiota, a complex and evolving community, undergoes changes in composition and function that can compromise the skin microbial barrier. These alterations induce water loss and abnormal lipid metabolism, contributing to the onset of ISDs. Additionally, microorganisms release toxins, like Staphylococcus aureus secreted α toxins and proteases, which may dissolve the stratum corneum, impairing skin barrier function and allowing entry into the bloodstream. Microbes entering the bloodstream activate molecular signals, leading to immune disorders and subsequent skin inflammatory responses. For instance, Malassezia stimulates dendritic cells(DCs) to release IL-12 and IL-23, differentiating into a Th17 cell population and producing proinflammatory mediators such as IL-17, IL-22, TNF-α, and IFN-α.This review offers new insights into the role of the human skin microbiota in ISDs, paving the way for future skin microbiome-specific targeted therapies.

Protective effect of paeoniflorin in diabetic nephropathy: A preclinical systematic review revealing the mechanism of action.

BACKGROUND: Paeoniflorin (PF), the main active glucoside of Paeonia Lactiflora, has many pharmacological activities, such as inhibition of vasodilation, hypoglycemia, and immunomodulation. Although the current evidence has suggested the therapeutic effects of PF on diabetic nephropathy (DN), its potential mechanism of action is still unclear. PURPOSE: A systematic review and meta-analysis of the existing literature on paeoniflorin treatment in DN animal models was performed to evaluate the efficacy and mechanism of PF in DN animal models. METHODS: The risk of bias in each study was judged using the CAMARADES 10-item quality checklist with the number of criteria met varying from 4 / 10 to 7 / 10, with an average of 5.44. From inception to July 2022, We searched eight databases. We used the Cochrane Collaboration's 10-item checklist and RevMan 5.3 software to assess the risk of bias and analyze the data. Three-dimensional dose/time-effect analyses were conducted to examine the dosage/time-response relations between PF and DN. RESULTS: Nine animal studies were systematically reviewed to evaluate the effectiveness of PF in improving animal models of DN. Meta-analysis data and intergroup comparisons indicated that PF slowed the index of mesangial expansion and tubulointerstitial injury, 24-h urinary protein excretion rate, expression of anti-inflammatory mediators (mRNA of MCP-1, TNF-α, iNOS, and IL-1 ß), and expression of immune downstream factors (P-IRAK1, TIRF, P-IRF3, MyD88, and NF-κBp-p65). Furthermore, modeling methods, animal species, treatment duration, thickness of tissue sections during the experiment, and experimental procedures were subjected to subgroup analyses. CONCLUSION: The present study demonstrated that the reno-protective effects of PF were associated with its inhibition on macrophage infiltration, reduction of inflammatory mediators, and immunomodulatory effects. In conclusion, PF can effectively slow down the progression of DN and hold promise as a protective drug for the treatment of DN. Due to the low bioavailability of PF, further studies on renal histology in animals are urgently needed. We therefore recommend an active exploration of the dose and therapeutic time frame of PF in the clinic and in animals. Moreover, it is suggested to actively explore methods to improve the bioavailability of PF to expand the application of PF in the clinic.

The Facile and Efficient Fabrication of Rice Husk/poly (lactic acid) Foam Composites by Coordinated the Interface Combination and Bubble Hole Structure.

The possibility of agricultural-forestry waste (rice husks) and biodegradable plastics (poly(lactic acid)) being used to produce ecologically friendly foam composite was discussed in this work. The effects of different material parameters (the dosage of PLA-g-MAH, type and content of chemical foaming agent) on the microstructure and physical properties of composite were investigated. PLA-g-MAH promoted the chemical grafting between cellulose and PLA, and made the structure denser, thus improving the interface compatibility of the two phases and resulting in good thermal stability, high tensile strength (6.99 MPa) and bending strength (28.85 MPa) of composites. Furthermore, the properties of rice husk/PLA foam composite prepared by two kinds of foaming agents (endothermic and exothermic) were characterized. The addition of fiber limited the growth of pores, which provided better dimensional stability and narrower pore size distribution, made the interface of the composite bond tightly. And the bubble can prevent crack propagation and improve the mechanical properties of the composite. The bending strength and tensile strength of composite were 37.36 MPa and 25.32 MPa, which increased by 28.35 % and 23.27 %, respectively. Therefore, the composite prepared by using agricultural-forestry wastes and poly(lactic acid) possess acceptable mechanical properties, thermal stability and water resistance, expanding the scope of application.

Superhydrophobic polyurethane sponge based on sepiolite for efficient oil/water separation.

Massive oil leakage accidents and illegal discharge of oily wastewater have not just destroyed the sustainability of the ecological environment but caused permanent damage to marine ecosystems, which makes it urgent to handle it. In this paper, by means of sol-gel, micro-nan silica that grew from the surface of fibrous sepiolite was organically modified with 1 H, 1 H, 2 H, 2 H-perfluorodecyltriethoxysilane (PFDS). The superhydrophobic sepiolite/silica firmly attached to the surface of polyurethane sponge under the action of oily epoxy resin with strong adhesion. The sponge exhibited superhydrophobicity and excellent selective oil adsorption capacity (19.98-40 times of their own weight). More importantly, besides the effective separation of immiscible oil-water mixtures (the separation rate reached 98.72%), it could also efficiently separate oil with water and oil with salt solution emulsions. In addition, the sponges kept hydrophobic even after floating in extremely corrosive liquids for 20 h, showing a strong resistance to strong acidic as well as alkaline liquids. After 100 times of mechanical compression, the three-dimensional structure of sponge held still and the water contact angle was greater than 144°, demonstrating an excellent mechanical stability, which provided a reference for its practical application in oil-water separation.

MUC13 promotes lung cancer development and progression by activating ERK signaling.

Mucin 13 (MUC13) is a glycoprotein that is expressed on the cell surface and participates in the tumorigenesis of multiple malignancies, including pancreatic cancer, colorectal cancer and renal cancer. However, to the best of our knowledge, the expression levels and function of MUC13 in lung cancer progression have not yet been demonstrated. Therefore, the present study examined the expression pattern and regulatory role of MUC13 in lung cancer tumorigenesis. The results demonstrated that MUC13 was highly expressed in lung cancer tissues and cell lines compared with that in normal tissues and cell lines. Functionally, knockdown of MUC13 inhibited cell proliferation and enhanced the apoptosis of A549 and NCI-H1650 lung cancer cells. Furthermore, silencing of MUC13 suppressed the migration and invasion of lung cancer cells. Additionally, a xenograft tumor model demonstrated that knockdown of MUC13 delayed the development of the lung cancer xenograft and suppressed the expression of proliferation marker Ki-67 in tumor tissues. Mechanistically, MUC13 activated the ERK signaling pathway by enhancing the phosphorylation of ERK, JNK and p38 in lung cancer tissues compared with that in normal tissues. Knockdown of MUC13 inhibited the phosphorylation of ERK/JNK/p38 in A549 and NCI-H1650 cells. Overall, these findings suggested that MUC13 could act as an oncogenic glycoprotein to accelerate the progression of lung cancer via abnormal activation of the ERK/JNK/p38 signaling pathway and might serve as a therapeutic target for lung cancer treatment.

Effect of dissolved oxygen on N2O release in the sewer system during controlling hydrogen sulfide by nitrate dosing.

Nitrate dosing is commonly used for controlling hydrogen sulfide in sewer systems. However, it may potentially facilitate N2O emission due to the denitrification process promoted by nitrate addition. In this study, lab-scale sewer reactors were operated to investigate the impact of nitrate addition on N2O production in sewer systems. Results showed that the N2O flux even increased by six times with the addition of nitrate when dissolved oxygen (DO) in the wastewater exceeded 0.4 mg/L. Principal component analysis showed that the N2O concentration was notably affected by DO and oxidation-reduction potential (ORP) in the wastewater. Furthermore, it was founded that N2O flux had a strong linear relationship with the DO concentration in the batch test. The microbial analysis found that the nosZ possessing organisms decreased significantly in the micro-aerobic condition and the copy numbers of nosZ gene declined consequently. It indicated that the inhibition of N2O reduced to N2 was responsible for significant accumulation and emission of N2O in the micro-aerobic condition. Given the gravity sewers are not completely anaerobic, the DO concentration is ranged from 0.1 to 2.4 mg/L in gravity sewers with the partially filled flow. Therefore, more attention should be paid to the N2O production when nitrate dosing for hydrogen sulfide controlling in gravity sewers.

Hypoxia induces chemoresistance of esophageal cancer cells to cisplatin through regulating the lncRNA-EMS/miR-758-3p/WTAP axis.

Hypoxia contributes significantly to the development of chemoresistance of many malignancies including esophageal cancer (EC). Accumulating studies have indicated that long non-coding RNAs play important roles in chemotherapy resistance. Here, we identified a novel lncRNA-EMS/miR-758-3p/WTAP axis that was involved in hypoxia-mediated chemoresistance to cisplatin in human EC. Hypoxia induced the expressions of lncRNA EMS and WTAP, and reduced the expression of miR-758-3p in EC cell line ECA-109. In addition, the expressions of EMS and WTAP were required for the hypoxia-induced drug resistance to cisplatin in EC cells, while overexpression of miR-758-3p reversed such chemoresistance. The targeting relationships between EMS and miR-758-3p, as well as miR-758-3p and WTAP, were verified by luciferase-based reporter assays and multiple quantitative assays after gene overexpression/knockdown. Moreover, we found significant correlations between tumor expressions of these molecules. Notably, higher levels of EMS/WTAP, or lower levels of miR-758-3p in tumors predicted worse survivals of EC patients. Furthermore, in a xenograft mouse model, targeted knockdown of EMS and WTAP in ECA-109 cells markedly attenuated the resistance of tumors to cisplatin treatments. Our study uncovers a critical lncRNA-EMS/miR-758-3p/WTAP axis in regulating hypoxia-mediated drug resistance to cisplatin in EC.

Enhanced adsorption of tetracycline by an iron and manganese oxides loaded biochar: Kinetics, mechanism and column adsorption.

A Fe/Mn oxides loaded biochar (FeMn-BC) was prepared to enhance the adsorption of tetracycline (TC). γ-Fe2O3 and MnO2 were assigned to the Fe and Mn oxides, respectively. The enhanced adsorption of TC was dominated by the loaded γ-Fe2O3 and MnO2. According to Akaike-Information-Criteria evaluation, Elovich kinetic and Langmuir isotherm models could best describe the adsorption with a maximum capacity of 14.24 mg/g. During adsorption process, the γ-Fe2O3 and MnO2 hydrolyzed into hydroxides (FeOOH and MnOOH) which acted as bases to complex with TC2- ion under alkaline condition (pH = 11). After the adsorption, the concentrations of leached Fe and Mn could meet the requirements PRC standards GB13456-2012 and GB8978-1996, respectively. The FeMn-BC had ~24% on TC removal (initial concentration of 20 mg/L) after four-cycles regeneration. The FeMn-BC was also available for TC adsorptions in column tests and actual wastewater.

Status of Gene Methylation and Polymorphism in Different Courses of Ulcerative Colitis and Their Comparison with Sporadic Colorectal Cancer.

BACKGROUND: The objective of this study is to explore the common genetic and epigenetic mechanism of ulcerative colitis (UC) and sporadic colorectal cancer (SCRC) by observing genes methylation level and single nucleotide polymorphisms (SNPs) of different disease courses in UC and SCRC. METHODS: Two hundred subjects were enrolled, including 40 in the healthy control (HC) group, 50 in the short disease course UC group (SUC), 52 in the long disease course UC group (LUC), and 58 in the SCRC group. Methylation-specific polymerase chain reaction was used to detect the methylation of MINT1 and cyclooxygenase 2 (COX-2) gene. Single nucleotide polymorphisms of interleukin (IL)-23R rs10889677 and IL-1ß rs1143627 were detected by Sanger sequencing. RESULTS: Compared with HCs (32.5%), methylation level of MINT1 was significantly increased in SCRC (67.2%; P = 0.001) and was a risk factor for CRC (odds ratio, [OR] 4.26). The methylation ratios of COX-2 were 95.0%, 58.0%, 23.1%, and 24.1% in HC, SUC, LUC, and SCRC, respectively, which were negatively correlated with the disease course of UC (r = -0.290). Hypermethylation of COX-2 was a protective factor for SUC (OR, 0.11), LUC (OR, 0.02), and SCRC (OR, 0.03; P < 0.05). Compared with HCs, rs10889677 allele A was a risk factor for SUC and LUC, and rs1143627 allele T was a protective factor for SUC and LUC. Genotype TT was a protective factor for SUC. CONCLUSION: The hypomethylation of COX-2 gene was a common risk factor and epigenetic modification for UC and SCRC, which might be one of the mechanisms through which UC patients were susceptible to CRC. The hypermethylation of MINT1 was a risk factor for SCRC but not for UC; alleles of IL-23Rrs10889677 and IL-1ßrs1143627 were related to UC but not to SCRC.

Association between CYP2A13 polymorphisms and lung cancer: A protocol for systematic review and meta-analysis.

BACKGROUND: Recently, lung cancer has become the most common cause of cancer-related death, several studies indicate that the cytochrome P450 2A13 (CYP2A13) polymorphisms may be correlated with lung cancer susceptibility, but the results have been inconsistent and inconclusive. Therefore, the aim of this meta-analysis is to provide a precise conclusion on the potential association between CYP2A13 polymorphisms and the risk of lung cancer based on case-control studies. METHODS: The PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI) databases will be searched for case-control studies published up to September 2020. Odds ratio (OR) and 95% confidence interval (95% CI) were used to determine the effects of the CYP2A13 polymorphism on lung cancer risk, respectively. RESULTS: The results of this meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION: This meta-analysis will summarize the association between CYP2A13 polymorphisms and the risk of lung cancer. INPLASY REGISTRATION NUMBER: INPLASY202090102.

Exosomal long non-coding RNA UCA1 functions as growth inhibitor in esophageal cancer.

PURPOSE: Esophageal cancer is a highly lethal and broad-spreading malignant tumor worldwide. Exosome-carrying lncRNAs play an essential role in the pathogenesis of various cancers. RESULTS: The results revealed that the expression of UCA1 was decreased in esophageal cancer tissues and plasma exosomes. UCA1 was enriched in exosomes, and exosomal UCA1 was a promising biomarker for the diagnosis of esophageal cancer with 86.7% sensitivity and 70.2% specificity. Overexpression of UCA1 played anticancer roles in esophageal cancer cells through inhibiting cell proliferation, invasion and migration, and colony formation. Also, exosomal UCA1 was taken up by esophageal cancer cells and inhibited the progression of esophageal cancer in vitro and tumor growth in vivo. Furthermore, exosomal UCA1 could directly target miRNA-613 in esophageal cancer cells. CONCLUSIONS: The results suggested that exosomal UCA1 inhibits tumorigenesis and progression of esophageal cancer in vitro and in vivo, and might be a promising biomarker for esophageal cancer. PATIENT AND METHODS: In this study, we determined the expression of UCA1 in esophageal cancer tissues, plasma exosomes of patients with esophageal cancer. We determined the potential of exosomal UCA1 as a biomarker and its effect on the pathogenesis and progression of esophageal cancer in vitro and in vivo.

Loss of Reduction after Cephalomedullary Nail Fixation of Intertrochanteric Femoral Fracture: A Brief Report.

OBJECTIVE: At present, cephalomedullary nail is the most frequently used implant in the management of intertrochanteric fractures around the world. The implant design and fixation techniques of the cephalomedullary nail have been continuously improved to ensure uncomplicated bone union during the past decade. However, a degree of reduction loss during bone healing is still not rare in clinical work. Many attributed this complication to misoperation during the surgery and hold that a series of techniques and tips could help to avoid the loss of reduction. However, until now there has been no research to explore whether the reduction loss after the operation can be fully prevented in the best cases. The purposes of the study are as follows: (i) to evaluate the efficiency of the current established CMN techniques; (ii) to quantify the loss of reduction under an appropriately implanted CMN to anatomically realigned intertrochanteric fractures; and (iii) to explore the possible underlying causes for the inevitable loss of reduction. METHODS: In the retrospective study, 163 consecutive cases with the intertrochanteric fractures fixed with standard cephalomedullary nail technique were reviewed. The anatomical reduction and optimal positioning of the nail were confirmed by postoperative imaging. The fracture types ranged from 31-A1.1-2.3 according to the OTA/AO fracture classification. One hundred and fifteen cases with stable fracture types (31A1.1-2.1) were allocated to Group A, and 48 cases with unstable 31A2.2-2.3 fracture types were allocated to Group B. The radiological measurements included femoral neck shortening, loss of the neck-shaft angle, cutout, and cut-through of the blade. The outcomes between postoperative and 1 year after the operation were evaluated and compared. RESULTS: The patients consisted of 66 males and 97 females with an average age of 69.4 (range: 46-78, SD: 14.6) years. At the 1-year follow-up, no fixation failure or nonunion was observed in each group. The mean femoral neck shortening and loss of the neck-shaft angle were 4.47 mm (range: 0.43-17.68, SD: 3.71) and 5.4° (range: 0.51-19.10, SD: 3.58) separately. The mean cutout and cut-through were 1.84 mm (range: 0.24-11.30, SD: 2.33) and 1.25 mm (range: 0.51-10.29, SD: 1.74). The average femoral neck shortening and loss of the neck-shaft angle were higher in Group B than Group A. Among the 23 cases with the femoral neck shortening more than 10 mm, 19 cases (16.5%) were from Group A and four cases (8.3%) were from Group B. There were nine (7.8%) cases with the loss of the neck-shaft angle more than 10° in Group A and six (12.5%) cases in Group B. CONCLUSIONS: Current established CMN techniques are efficient in treating intertrochanteric femoral fracture. However, even with currently consensual techniques of cephalomedullary nail, the process of fracture healing still risks the loss of reduction, although the migration of the blade could be minimized. This situation may associate with the intrinsic design of the CMN and further improvement is still needed.

Experimental study on volatile sulfur compound inhibition using a single-chamber membrane-free microbial electrolysis cell.

Odor emissions from sewer systems and wastewater treatment plants have attracted much attention due to the potential negative effects on human health. A single-chamber membrane-free microbial electrolysis cell was proposed for the removal of sulfides in a sewer system. The feasibility of the use of volatile sulfur compounds and their removal efficiency in liquid and headspace gas phases were investigated using synthetic wastewater with real sewer sediment and Ru/Ir-coated titanium electrodes. The results indicate that hydrogen sulfide and volatile organic sulfur compounds were effectively inhibited in the liquid phase upon electrochemical treatment at current densities of 1.55, 2.06, and 2.58 mA/cm2, and their removal rates reached up to 86.2-100%, except for dimethyl trisulfide, the amount of which increased greatly at 1.55 mA/cm2. In addition, the amount of volatile sulfur compounds in the headspace decreased greatly; however, the total theoretical odor concentration was still high, and methanethiol and ethanethiol greatly contributed to the total strength of the odor concentration due to their low odor threshold concentrations. The major pathway for sulfide removal in the single-chamber membrane-free microbial electrolysis cell is biotic oxidation, the removal rate of which was 0.4-0.5 mg/min, 4-5 times that of indirect electrochemical oxidation.

Comparative Efficacy and Safety of Nivolumab and Nivolumab Plus Ipilimumab in Advanced Cancer: A Systematic Review and Meta-Analysis.

BACKGROUND: Combination therapy with immune checkpoint inhibitors (ICIs) has been applied in the clinic to achieve synergistic effects and to improve clinical efficacy. Compared with monotherapy, combination therapy has promising efficacy against various advanced cancers. To further verify the effectiveness of combination therapy, we conducted a meta-analysis of the efficacy and safety of nivolumab (NIVO) and NIVO plus ipilimumab (IPI) in advanced cancer. METHODS: Electronic databases (PubMed, EMbase, and The Cochrane Library) were systematically searched for applicable studies published in English between January 1990 and June 2019. Relevant outcomes included objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), median overall survival (mOS), and grade 3-4 adverse events (AEs). RESULTS: A total of 1,297 patients from six studies were included. Compared with NIVO alone, NIVO + IPI was more efficacious for advanced tumors. Pooled outcome values were: ORR, 1.73 (95% CI: 1.34-2.23); DCR, 1.80 (95% CI: 1.21-2.69); mPFS, 0.22 (95% CI: 0.03-0.41); mOS, 0.03 (95% CI: -0.20-0.26); and grade 3-4 AEs, 3.64 (95% CI: 2.86-4.62). CONCLUSION: NIVO + IPI is more effective than NIVO alone for the treatment of advanced cancer and can significantly improve ORR and DCR and prolong mPFS. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to validate the above conclusions.

Percutaneous transforaminal endoscopic discectomy for the treatment of lateral recess stenosis secondary occurred the discal fungus infection.

BACKGROUND: This is a case of lateral recess stenosis secondary occurred the discal fungus infection treated with percutaneous transforaminal endoscopic discectomy (PTED). There has been no relevant reports before. CASE PRESENTATION: A 49-year-old patient who had taken itraconazole for 13 months for lateral recess stenosis secondary occurred the discal fungus infection complained of gradually worsening radiating pain and numbness in the back and inguinal and inner thigh region of right side. In order to relieve the radiating neuralgia and reduce the damage to spinal stability, the minimally invasive PTED was performed.The patient's prognosis was assessed using Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS). During the follow-up, the patient's ODI and VAS scores were decreased significantly. The radiating pain in the inguinal and inner thigh region of right side were significantly alleviated and the discomfort caused by lower back instability was improved by plaster vest. DISCUSSION AND CONCLUSION: PTED not only avoids further damage to the stability of the lumbar spine, but also effectively relieves the symptoms of leg neuroradialgia caused by lateral recess stenosis secondary occurred the discal fungus infection.

The diagnostic accuracy of artificial intelligence in thoracic diseases: A protocol for systematic review and meta-analysis.

INTRODUCTION: Thoracic diseases include a variety of common human primary malignant tumors, among which lung cancer and esophageal cancer are among the top 10 in cancer incidence and mortality. Early diagnosis is an important part of cancer treatment, so artificial intelligence (AI) systems have been developed for the accurate and automated detection and diagnosis of thoracic tumors. However, the complicated AI structure and image processing made the diagnosis result of AI-based system unstable. The purpose of this study is to systematically review published evidence to explore the accuracy of AI systems in diagnosing thoracic cancers. METHODS AND ANALYSIS: We will conduct a systematic review and meta-analysis of the diagnostic accuracy of AI systems for the prediction of thoracic diseases. The primary objective is to assess the diagnostic accuracy of thoracic cancers, including assessing potential biases and calculating combined estimates of sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). The secondary objective is to evaluate the factors associated with different models, classifiers, and radiomics information. We will search databases such as PubMed/MEDLINE, Embase (via OVID), and the Cochrane Library. Two reviewers will independently screen titles and abstracts, perform full article reviews and extract study data. We will report study characteristics and assess methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. RevMan 5.3 and Meta-disc 1.4 software will be used for data synthesis. If pooling is appropriate, we will produce summary receiver operating characteristic (SROC) curves, summary operating points (pooled sensitivity and specificity), and 95% confidence intervals around the summary operating points. Methodological subgroup and sensitivity analyses will be performed to explore heterogeneity. PROSPERO REGISTRATION NUMBER: CRD42019135247.