Mapping knowledge structure and emerging trends of extracorporeal membrane oxygenation for acute respiratory distress syndrome: a bibliometric and visualized study.

Introduction: With the discovery of extracorporeal membrane oxygenation (ECMO), it is considered as a valuable tool for supporting the treatment of severe acute respiratory distress syndrome (ARDS). It has gained increasing attention, particularly during the COVID-19 epidemic. However, to date, no relevant bibliometric research on the association between ECMO and ARDS (ECMO-ARDS) has been reported. Our study aimed to summarize the knowledge structure and research focus of ECMO-ARDS through a bibliometric analysis. Method: Publications related to ECMO-ARDS from 2000 to 2022 were obtained from the Web of Science Core Collection (WoSCC). Research data underwent bibliometric and visual analysis by using CiteSpace, VOSviewer, and one online analysis platform. By analyzing the countries, institutions, journals, authors, the geographic distribution of research contributions as well as the leading institutions and researchers in this field were identified. Additionally, prominent journals and highly cited publications were highlighted, indicating their influence and significance in the field. Moreover, the co-citation references and co-occurring keywords provided valuable information on the major research topics, trends, and potential emerging frontiers. Results: A total of 1,565 publications from 60 countries/regions were retrieved. The annual publication number over time revealed exponential growth trends (R2 = 0.9511). The United States was dominant in ECMO-ARDS research, whereas the Univ Toronto was most productive institution. Prof Combes A published the most publications in this area. ASAIO Journal and Intensive Care Medicine were the most active and co-cited journals, respectively. Reference co-citation analysis showed that current research focus has shifted to COVID-related ARDS, multi-center studies, as well as prone positioning. Apart from the keywords "ECMO" and "ARDS", other keywords appearing at high frequency in the research field were "COVID-19", "mechanical ventilation", "extracorporeal life support", "respiratory failure", "veno-venous ECMO", "SARS-CoV-2", "outcome". Among them, keywords like "mortality", "veno-venous ECMO", "epidemiology", "obesity", "coagulopathy", "lung ultrasound", "inhalation injury", "noninvasive ventilation", "diagnosis", "heparin", "cytokine storm" has received growing interest in current research and also has the potential to continue to become research hotspots in the near future. Conclusion: This bibliometric analysis offers a comprehensive understanding of the current state of ECMO-ARDS research and can serve as a valuable resource for researchers, policymakers, and stakeholders in exploring future research directions and fostering collaborations in this critical field.

Ultra-high b-value DWI in rectal cancer: image quality assessment and regional lymph node prediction based on radiomics.

OBJECTIVES: This study aims to evaluate image quality and regional lymph node metastasis (LNM) in patients with rectal cancer (RC) on multi-b-value diffusion-weighted imaging (DWI). METHODS: This retrospective study included 199 patients with RC who had undergone multi-b-value DWI. Subjective (five-point Likert scale) and objective assessments of quality images were performed on DWIb1000, DWIb2000, and DWIb3000. Patients were randomly divided into a training (n = 140) or validation cohort (n = 59). Radiomics features were extracted within the whole volume tumor on ADC maps (b = 0, 1000 s/mm2), DWIb1000, DWIb2000, and DWIb3000, respectively. Five prediction models based on selected features were developed using logistic regression analysis. The performance of radiomics models was evaluated with a receiver operating characteristic curve, calibration, and decision curve analysis (DCA). RESULTS: The mean signal intensity of the tumor (SItumor), signal-to-noise ratio (SNR), and artifact and anatomic differentiability score gradually were decreased as the b-value increased. However, the contrast-to-noise (CNR) on DWIb2000 was superior to those of DWIb1000 and DWIb3000 (4.58 ± 0.86, 3.82 ± 0.77, 4.18 ± 0.84, p < 0.001, respectively). The overall image quality score of DWIb2000 was higher than that of DWIb3000 (p < 0.001) and showed no significant difference between DWIb1000 and DWIb2000 (p = 0.059). The area under curve (AUC) value of the radiomics model based on DWIb2000 (0.728) was higher than conventional ADC maps (0.690), DWIb1000 (0.699), and DWIb3000 (0.707), but inferior to multi-b-value DWI (0.739) in predicting LNM. CONCLUSION: DWIb2000 provides better lesion conspicuity and LNM prediction than DWIb1000 and DWIb3000 in RC. CLINICAL RELEVANCE STATEMENT: DWIb2000 offers satisfactory visualization of lesions. Radiomics features based on DWIb2000 can be applied for preoperatively predicting regional lymph node metastasis in rectal cancer, thereby benefiting the stratified treatment strategy. KEY POINTS: Lymph node staging is required to determine the best treatment plan for rectal cancer. DWIb2000 provides superior contrast-to-noise ratio and lesion conspicuity and its derived radiomics best predict lymph node metastasis. DWIb2000 may be recommended as the optimal b-value in rectal MRI protocol.

Appendicectomy pathway: Insights from electronic medical records of a local health district in Australia.

BACKGROUND: This study aims to identify the common pathways of appendicectomy, the most common emergency surgery in Australia's public hospitals and any variations within a regional public health district in New South Wales, Australia. METHODS: We analyzed the electronic medical records of 3,943 patients who underwent appendicectomy between January 2014 and July 2020 at 2 hospitals in the Illawarra Shoalhaven Local Health District, New South Wales, Australia, using the PM2 approach for surgical pathway identification and subsequent statistical analyses. RESULTS: Among 3,943 patients, 3,606 (91.5%) followed an 11-step main pathway: (1) emergency department admission, (2) surgery booking, (3) anesthesia start, (4) operating room entry, (5) surgery start, (6) surgery end, (7) anesthesia end, (8) operating room discharge, (9) postanesthesia care unit admission, (10) postanesthesia care unit discharge, and (11) hospital discharge. The median length of stay was 48.13 hours (interquartile range 32.74). The main pathway differed from either variation 1 (n = 246, 6.2%) or variation 2 (n = 30, 0.8%) only in the timing and location of anesthesia administration or conclusion. Variation 3 (n = 26, 0.7%) included patients who underwent appendicectomy twice, whereas variation 4 (n = 25, 0.6%) included patients booked for surgery before emergency department admission through community doctor referrals. Thirteen exceptional cases experienced combinations of the aforementioned pathways. The length of stay and phase durations varied between the main pathway and these variations. CONCLUSION: The appendicectomy pathway was largely standardized across the studied hospitals, with the location of anesthesia administration or conclusion affecting specific stages but not the overall length of stay. Only a complex 2-surgery pathway increased length of stay.

A deep learning-based method for the detection and segmentation of breast masses in ultrasound images.

Objective.Automated detection and segmentation of breast masses in ultrasound images are critical for breast cancer diagnosis, but remain challenging due to limited image quality and complex breast tissues. This study aims to develop a deep learning-based method that enables accurate breast mass detection and segmentation in ultrasound images.Approach.A novel convolutional neural network-based framework that combines the You Only Look Once (YOLO) v5 network and the Global-Local (GOLO) strategy was developed. First, YOLOv5 was applied to locate the mass regions of interest (ROIs). Second, a Global Local-Connected Multi-Scale Selection (GOLO-CMSS) network was developed to segment the masses. The GOLO-CMSS operated on both the entire images globally and mass ROIs locally, and then integrated the two branches for a final segmentation output. Particularly, in global branch, CMSS applied Multi-Scale Selection (MSS) modules to automatically adjust the receptive fields, and Multi-Input (MLI) modules to enable fusion of shallow and deep features at different resolutions. The USTC dataset containing 28 477 breast ultrasound images was collected for training and test. The proposed method was also tested on three public datasets, UDIAT, BUSI and TUH. The segmentation performance of GOLO-CMSS was compared with other networks and three experienced radiologists.Main results.YOLOv5 outperformed other detection models with average precisions of 99.41%, 95.15%, 93.69% and 96.42% on the USTC, UDIAT, BUSI and TUH datasets, respectively. The proposed GOLO-CMSS showed superior segmentation performance over other state-of-the-art networks, with Dice similarity coefficients (DSCs) of 93.19%, 88.56%, 87.58% and 90.37% on the USTC, UDIAT, BUSI and TUH datasets, respectively. The mean DSC between GOLO-CMSS and each radiologist was significantly better than that between radiologists (p< 0.001).Significance.Our proposed method can accurately detect and segment breast masses with a decent performance comparable to radiologists, highlighting its great potential for clinical implementation in breast ultrasound examination.

Efficient recovery of highly pure CaF2 from fluorine-containing wastewater using an icy lime solution.

Developing a feasible and low-cost strategy for the recovery of calcium fluoride efficiently from fluoride-containing wastewater is very essential for the recycle of fluoride resources. Herein, a modified lime precipitation method was employed to recover CaF2 from fluorinated wastewater using a special icy lime solution. Intriguingly, the highest F- removal was greater than 95% under the optimal condition, leaving a fluoride concentration from 200 to 8.64 mg/L, while the lime dosage was much lower than that of industry. Importantly, spherical-shaped CaF2 particles with a 93.47% purity and size smaller than 600 nm were recovered, which has a high potential for the production of hydrofluoric acid. Besides, the precipitation was significantly affected by Ca/F molar ratio, stirring time, temperature, and solution pH. Furthermore, the thermodynamics and kinetics were investigated in detail to reveal the crystallization process. As a result, the defluorination reaction followed the pseudo-second order reaction kinetics model. Also, CO2 in the air adversely influenced the CaF2 purity. Based on this facile method, a high lime utilization efficiency was applied to defluorination, which contributed to protecting the environment and saving costs. This study, therefore, provides a feasible approach for the green recovery of fluorine resources and has significance for related research.

Microcapsule Modification Strategy Empowering Separator Multifunctionality to Enhance Safety of Lithium-Metal Batteries.

The uncontrollable growth of lithium dendrites and the flammability of electrolytes are the direct impediments to the commercial application of high-energy-density lithium metal batteries (LMBs). Herein, this study presents a novel approach that combines microencapsulation and electrospinning technologies to develop a multifunctional composite separator (P@AS) for improving the electrochemical performance and safety performance of LMBs. The P@AS separator forms a dense charcoal layer through the condensed-phase flame retardant mechanism causing the internal separator to suffocate from lack of oxygen. Furthermore, it incorporates a triple strategy promoting the uniform flow of lithium ions, facilitating the formation of a highly ion-conducting solid electrolyte interface (SEI), and encouraging flattened lithium deposition with active SiO2 seed points, considerably suppressing lithium dendrites growth. The high Coulombic efficiency of 95.27% is achieved in Li-Cu cells with additive-free carbonate electrolyte. Additionally, stable cycling performance is also maintained with a capacity retention rate of 93.56% after 300 cycles in LFP//Li cells. Importantly, utilizing P@AS separator delays the ignition of pouch batteries under continuous external heating by 138 s, causing a remarkable reduction in peak heat release rate and total heat release by 23.85% and 27.61%, respectively, substantially improving the fire safety of LMBs.

Metabolic profile of follicular fluid in patients with ovarian endometriosis undergoing IVF: a pilot study.

RESEARCH QUESTION: What are the metabolic characteristics of follicular fluid in patients with ovarian endometriosis undergoing IVF? DESIGN: This was an exploratory cohort study on endometriosis. In total, 19 infertile patients with ovarian endometriosis diagnosed by laparoscopy, and 23 controls matched in terms of age and body mass index (women with infertility due to male or tubal factors) were enrolled in this study. All patients underwent IVF treatment with a gonadotrophin-releasing hormone antagonist protocol, and follicular fluid was collected at oocyte retrieval. The metabolomics of follicular fluid samples was analysed using an ultra-high-performance liquid chromatography Orbitrap Exploris mass spectrometer (UHPLC-OE-MS). The best combination of biomarkers was selected by performing stepwise logistic regression analysis with backward elimination. RESULTS: Fifteen metabolites were identified as biomarkers associated with endometriosis. A final model containing 8-hydroxy-2-deoxyguanosine, biotin, n-acetyl-L-methionine and n-methylnicotinamide was constructed. Receiver operating characteristic analysis confirmed the value of these parameters in diagnosing endometriosis, with sensitivity of 94.7% and specificity of 95.7%. Enrichment analysis via the Kyoto Encyclopedia of Genes and Genome showed that 15 metabolites were enriched in eight metabolic pathways. CONCLUSION: Metabolomics based on UHPLC-OE-MS effectively characterized the metabolomics analysis of follicular fluid in patients with ovarian endometriosis. These findings may provide a new basis for better understanding of how diseases progress, and for the discovery of new biomarkers.

Causal role of immune cell phenotypes in idiopathic sudden sensorineural hearing loss: a bi-directional Mendelian randomization study.

Background: A growing body of evidence suggests that immunological processes have a significant role in developing idiopathic sudden sensorineural hearing loss (SSHL). However, few studies have examined the association between immune cell phenotype and SSHL using Mendelian Randomization (MR). Methods: The online genome-wide association studies (GWAS) database was used to compile data from GWAS covering 731 immunophenotypes and SSHL. Inverse variance weighted (IVW) analysis was primarily used for MR study, and single nucleotide polymorphisms (SNPs) associated with immunophenotypes served as dependent variables. A sensitivity study and the false discovery rate (FDR) correction were used to examine the MR hypothesis. In addition, the possibility of reverse causality between immunophenotype and SSHL was validated by reverse MR. Reverse MR was analyzed in a manner consistent with forward MR. Results: After FDR correction and sensitivity analysis, we screened 7 immunophenotypes, including IgD+ CD38dim %lymphocyte (95% CI: 1.0019, 1.0742, p = 3.87 × 10-2, FDR = 1.15 × 10-2); Unsw mem AC (95% CI: 1.004, 1.2522, p = 4.23 × 10-2, FDR = 2.25 × 10-2); CD86+ myeloid DC AC (95% CI: 1.0083, 1.1147, p = 2.24 × 10-2, FDR = 4.27 × 10-2); CD33dim HLA DR- AC (95% CI: 1.0046, 1.0583, p = 2.12 × 10-2, FDR = 4.69 × 10-2); SSC-A on CD8br (95% CI: 1.0028, 1.1461, p = 4.12 × 10-2, FDR = 4.71 × 10-2); CD45RA- CD4+ %T cell (95% CI: 1.0036, 1.0503, p = 2.32 × 10-2, FDR = 4.82 × 10-2); DP (CD4+CD8+) AC (95% CI: 1.011, 1.2091, p = 2.78 × 10-2, FDR = 4.97 × 10-2). There was a strong causal relationship with SSHL onset, and the reliability of the results was verified. Furthermore, the immunological cell profile and SSHL did not appear to be closely associated, as shown by reverse MR analysis. Conclusion: Our study provides more support for the current hypothesis that immunophenotypes and the pathophysiology of SSHL are closely associated. Further validation is needed to assess the role of these immunophenotypes in SSHL.

Mapping knowledge landscapes and emerging trends of Marburg virus: A text-mining study.

Background: Marburg virus (MARV), a close relative of Ebola virus, could induce hemorrhagic fevers in humans with high mortality rate. In recent years, increasing attention has been paid to this highly lethal virus due to sporadic outbreaks observed in various African nations. This bibliometric analysis endeavors to elucidate the trends, dynamics, and focal points of knowledge that have delineated the landscape of research concerning MARV. Methods: Relevant literature on MARV from 1968 to 2023 was extracted from the Web of Science Core Collection database. Following this, the data underwent bibliometric analysis and visualization procedures utilizing online analysis platform, CiteSpace 6.2R6, and VOSviewer 1.6.20. Three different types of bibliometric indicators including quantitative indicator, qualitative indicators, and structural indicators were used to gauge a researcher's productivity, assess the quality of their work, and analyze publication relationships, respectively. Results: MARV is mainly prevalent in Africa. And approximately 643 confirmed cases have been described in the literature to date, and mortality observed was 81.2 % in overall patients. A total of 1014 papers comprising 869 articles and 145 reviews were included. The annual publications showed an increasing growth pattern from 1968 to 2023 (R2 = 0.8838). The United States stands at the forefront of this discipline, having dedicated substantial financial and human resources to scientific inquiry. However, co-authorship analysis showed the international research collaboration needs to be further strengthened. Based on reference and keywords analysis, contemporary MARV research encompasses pivotal areas: primarily, prioritizing the creation of prophylactic vaccines to impede viral spread, and secondarily, exploring targeted antiviral strategies, including small-molecule antivirals or MARV-specific monoclonal antibodies. Additionally, a comprehensive grasp of viral transmission, transcription, and replication mechanisms remains a central focus in ongoing investigations. And future MARV studies are expected to focus on evaluating clinical trial safety and efficacy, developing inhibitors to contain viral spread, exploring vaccine immunogenicity, virus-host association studies, and elucidating the role of neutralizing antibodies in MARV treatment. Conclusion: The present study offered comprehensive insights into the contemporary status and trajectories of MARV over the past decades. This enables researchers to discern novel collaborative prospects, institutional partnerships, emerging topics, and research forefronts within this domain.

Controllable acetylation of cellulose nanocrystal by uniform design and response surface methodology.

Acetylation of Cellulose nanocrystal (CNC) can reduce its surface polarity and therefore extends its application in biomedical and chemical fields. A method combining uniform design (UD) and response surface methodology (RSM) was developed to produce the acetylated CNC with arbitrary degree of substitution (DS) and crystallinity index (CrI). The effects of three factors (i.e., temperature, reaction time and the volume of acetic anhydride) on DS and CrI were investigated in their respective ranges (i.e., 60-90 oC, 1.0-5.0 h and 1.0-5.0 mL). Both mathematical models for DS and CrI were developed by multiple stepwise regression (MSR) based on UD data and their significances were evaluated by analysis of variance. The controllable acetylation of CNC was realized by using either UD alone or the combination of UD and RSM. Eight verification experiments show that the relative errors between the predicted and the measured results are less than 16.77 % and 6.08 % for DS and CrI, respectively, confirming the reliability and validity of the method. This developed methodology is ingenious and expected to be expanded to any other fields that controllable preparations are required.

Recent Advances in Iridium-based Electrocatalysts for Acidic Electrolyte Oxidation.

Ongoing research to develop advanced electrocatalysts for the oxygen evolution reaction (OER) is needed to address demand for efficient energy conversion and carbon-free energy sources. In the OER process, acidic electrolytes have higher proton concentration and faster response than alkaline ones, but their harsh strongly acidic environment requires catalysts with greater corrosion and oxidation resistance. At present, iridium oxide (IrO2) with its strong stability and excellent catalytic performance is the catalyst of choice for the anode side of commercial PEM electrolysis cells. However, the scarcity and high cost of iridium (Ir) and the unsatisfactory activity of IrO2 hinder industrial scale application and the sustainable development of acidic OER catalytic technology. This highlights the importance of further research on acidic Ir-based OER catalysts. In this review, recent advances in Ir-based acidic OER electrocatalysts are summarized, including fundamental understanding of the acidic OER mechanism, recent insights into the stability of acidic OER catalysts, highly efficient Ir-based electrocatalysts, and common strategies for optimizing Ir-based catalysts. The future challenges and prospects of developing highly effective Ir-based catalysts are also discussed.

N6-Methyladenosine reader HNRNPC-mediated downregulation of circITCH prevents miR-224-3p sequestering and contributes to tumorigenesis in nasopharyngeal carcinoma.

BACKGROUND: N6-Methyladenosine (m6A) RNA methylation modulators are implicated in nasopharyngeal carcinoma (NPC). Circular RNAs (circRNAs) stimulate/inhibit the development of NPC by sponging microRNAs (miRNAs). Herein, m6A modifications affecting the circRNA/miRNA axis in NPC were explored. METHODS: Twenty prognostic m6A RNA methylation regulators were identified from 504 head/neck squamous cell carcinoma and 44 normal samples from The Cancer Genome Atlas (TCGA). Differentially expressed miRNAs were screened from the TCGA and Gene Expression Omnibus (GEO) databases. RNA-binding protein (RBP)-circRNA and circRNA-miRNA interactive pairs were verified using RBPmap and RNAhybrid, respectively. The RBP/circRNA/miRNA network was constructed using Cytoscape. Furthermore, CircITCH (hsa_circ_00059948), HNRNPC, and miR-224-3p expressions were detected by western blotting and quantitative polymerase chain reaction. The role of circITCH in NPC was examined using apoptosis, scratch wound healing, transwell invasion, and cell counting kit-8 assays. Finally, CircITCH-miR-224-3p and circITCH-HNRNPC interactions were assessed by dual-luciferase reporter and RNA-immunoprecipitation (RIP) assays, respectively. RESULTS: Bioinformatics analysis revealed that high pathological grade, late-stage tumors, and low survival were associated with increased HNRNPC expression. MiR-224-3p was upregulated in NPC and sequestered by circITCH. Construction of the RBP/circRNA/miRNA network highlighted the HNRNPC/circITCH/miR-224-3p axis. In vitro experiments demonstrated decreased circITCH expression and increased HNRNPC and miR-224-3p expressions in NPC. In NPC cells overexpressing circITCH, HNRNPC and miR-224-3p expressions were significantly decreased. Dual-luciferase assays demonstrated a targeting relationship between circITCH and miR-224-3p, and RIP assays demonstrated interaction of HNRNPC targets with circITCH. CONCLUSION: CircITCH overexpression inhibited NPC progression by sequestering miR-224-3p, and HNRNPC reduced circITCH expression through direct interaction.

Alleviating OH Blockage on the Catalyst Surface by the Puncture Effect of Single-Atom Sites to Boost Alkaline Water Electrolysis.

Nonprecious transition metal catalysts have emerged as the preferred choice for industrial alkaline water electrolysis due to their cost-effectiveness. However, their overstrong binding energy to adsorbed OH often results in the blockage of active sites, particularly in the cathodic hydrogen evolution reaction. Herein, we found that single-atom sites exhibit a puncture effect to effectively alleviate OH blockades, thereby significantly enhancing the alkaline hydrogen evolution reaction (HER) performance. Typically, after anchoring single Ru atoms onto tungsten carbides, the overpotential at 10 mA·cm-2 is reduced by more than 130 mV (159 vs 21 mV). Also, the mass activity is increased 16-fold over commercial Pt/C (MA100 = 17.3 A·mgRu-1 vs 1.1 A·mgPt-1, Pt/C). More importantly, such electrocatalyst-based alkaline anion-exchange membrane water electrolyzers can exhibit an ultralow potential (1.79 Vcell) and high stability at an industrial current density of 1.0 A·cm-2. Density functional theory (DFT) calculations reveal that the isolated Ru sites could weaken the surrounding local OH binding energy, thus puncturing OH blockage and constructing bifunctional interfaces between Ru atoms and the support to accelerate water dissociation. Our findings exhibit generality to other transition metal catalysts (such as Mo) and contribute to the advancement of industrial-scale alkaline water electrolysis.

New insight into the plastic deformation mechanisms during the SiO2 phase transition process.

The removal of lattice impurities is the key to the purification of high-purity quartz (HPQ), especially for the intracell lattice impurities. Generally, the intracell lattice impurities can be migrated to the quartz surface via roasting, then removed by acid leaching. In order to reveal the phase transition of quartz during the roasting process, the evolution of structure, bond length, volume, lattice parameter and lattice stress in original, Ti4+, Al3+/Li+ and 4H+ substituted SiO2 phases were employed to investigate the mechanisms of plastic deformation based on density functional theory calculations. Results showed that the evolution of bond lengths and volumes were mainly dominated by phase transition, and the interstitial volume in high temperature SiO2 phases was higher than that in low temperature, indicating that the phase transition from α-quartz to ß-cristobalite was beneficial to the migration of interstitial impurities. In addition, the phase transition from α-quartz to ß-cristobalite needs to overcome the energy barriers while the phase transition from α-cristobalite to ß-cristobalite needs to overcome the lattice stress. This study therefore provides an excellent theoretical basis for the plastic deformation mechanism, for the first time, beneficial to understanding the removal mechanisms of lattice impurities.