Prognostic factors in lung transplantation after extracorporeal membrane oxygenation bridging therapy: a systematic review and meta-analysis.

Background: Extracorporeal membrane oxygenation (ECMO) has recently emerged as a critical support system for lung function in patients awaiting lung transplantation. This meta-analysis investigates the prognostic factors of lung transplantation following ECMO bridging therapy. Methods: A comprehensive search was conducted in PubMed, Cochrane Library, Embase, CINAHL, Web of Science, Scopus, and ProQuest databases from inception to August 11, 2023. Included were cohort or case-control studies focusing on prognostic factors of lung transplantation with ECMO bridging therapy. Data extraction was performed independently, and study quality was assessed. A meta-analysis was carried out using RevMan 5.4 and Stata17.0 software to aggregate mortality rates and pertinent prognostic factors of ECMO as a bridge to lung transplantation. Results: The search identified eight trials encompassing 1,086 participants. The prognosis of patients undergoing lung transplantation with ECMO bridging was significantly associated with several factors: prolonged ECMO support [odds ratio 1.07, 95% confidence interval (CI): 1.02-1.12, I2=77%], deterioration in liver and kidney function (odds ratio 3.62, 95% CI: 2.37-5.54, I2=0%), and complications during ECMO (odds ratio 2.24, 95% CI: 1.45-3.44, I2=5%). Conclusions: Prolonged ECMO support, declining liver and kidney functions, and complications during ECMO are vital prognostic factors in lung transplantation following ECMO bridging therapy.

Clinical evaluation of droplet digital pcr for suspected ascites infection in patients with liver cirrhosis.

BACKGROUND: Droplet digital PCR (ddPCR) is increasingly used in diagnosing clinical pathogens, but its effectiveness in cirrhosis patients with suspected ascites infection remains uncertain. METHODS: The diagnostic performance of ddPCR was assessed in 305 ascites samples, utilizing culture and clinical composite standards. The quantitative value and potential clinical impact of ddPCR were further analyzed in patients with spontaneous bacterial peritonitis. RESULTS: With culture standards, ddPCR demonstrated a sensitivity of 86.5% and specificity of 83.2% for bacterial or fungal detection. After adjustment of clinical composite criteria, specificity increased to 96.4%. Better diagnostic performance for all types of targeted pathogens, particularly fungi, was observed with ddPCR compared to culture, and more polymicrobial infections were detected (30.4% versus 5.7%, p < 0.001). Pathogen loads detected by ddPCR correlated with white blood cell count in ascites and blood, as well as polymorphonuclear cell (PMN) count in ascites, reflecting infection status rapidly. A positive clinical impact of 55.8% (43/77) was observed for ddPCR, which was more significant among patients with PMN count ≤ 250/mm3 in terms of medication adjustment and new diagnosis. ddPCR results for fungal detection were confirmed by clinical symptoms and other microbiological tests, which could guide antifungal therapy and reduce the risk of short-term mortality. CONCLUSIONS: ddPCR, with appropriate panel design, has advantages in pathogen detection and clinical management of ascites infection, especially for patients with fungal and polymicrobial infections. Patients with atypical spontaneous bacterial peritonitis benefited more from ddPCR.

Biomass-Derived Carbon-Based Multicomponent Integration Catalysts for Electrochemical Water Splitting.

Electrocatalytic water splitting powered by sustainable electricity is a crucial approach for the development of new generation green hydrogen technology. Biomass materials are abundant and renewable, and the application of catalysis can increase the value of some biomass waste and turn waste into fortune. Converting economical and resource-rich biomass into carbon-based multicomponent integrated catalysts (MICs) has been considered as one of the most promising ways to obtain inexpensive, renewable and sustainable electrocatalysts in recent years. In this review, recent advances in biomass-derived carbon-based MICs towards electrocatalytic water splitting are summarized, and the existing issues and key aspects in the development of these electrocatalysts are also discussed and prospected. The application of biomass-derived carbon-based materials will bring some new opportunities in the fields of energy, environment, and catalysis, as well as promote the commercialization of new nanocatalysts in the near future.

Competitive Relationship Between Cleistocalyx operculatus and Syzygium jambos Under Well-Watered Conditions Transforms Into a Mutualistic Relationship Under Waterlogging Stress.

Competition and abiotic stress such as waterlogging (WL) represent main factors limiting plant growth and determining plant resistance and distribution patterns in wetland ecosystems. One of the basic steps for wetland restoration is to plant trees to ensure a quicker recovery and prevent erosion. Plant survival and adaptation are considered criteria of principal priority for the screening of plant species for wetland ecosystem restoration. WL influences plant species in wetlands via the deterioration of the plant root environment which leads to oxygen deficiency that affects plant growth, photosynthesis, respiration, and other metabolic processes. A suitable plant species was determined according to tolerance to WL during wetland vegetation recovery activities. Thus, two tree species (Cleistocalyx operculatus and Syzygium jambos) that showed a certain waterlogging tolerance were chosen to study their behaviors in different planting model and environmental conditions. Given that interspecific relationship should be considered during plant community construction, the eco-physiological adaptable mechanisms between these woody plants under well-watered condition and waterlogging stress were explored. Results showed that both species were waterlogging-tolerant species due to their ability to adapt to submergence conditions for 120 days. Moreover, C. operculatus possessed stronger tolerance to waterlogging stress because of a significant adventitious roots biomass accumulation. A competitive relationship was found between C. operculatus and S. jambos under well-watered condition, and C. operculatus showed better growth performance benefited from morphological responses (plant height, number of blade and leaf area) and endogenous hormone variations. In comparison, S. jambos suffered some negative effects when the well-watered mixed planting was used. However, the competitive relationship under well-watered condition was transformed into mutualistic relationship under waterlogging stress. The mixed planting under waterlogging condition significantly improved the tolerance of C. operculatus and S. jambos to waterlogging stress, compared with the monoculture., Especially, S. jambos showed improvements in root length, root surface area, and redox equilibration between lower levels of relative conductivity, malondialdehyde, and O 2 ⋅ - and had increased levels of non-enzymatic antioxidant components, such as reduced glutathione and soluble proteins. The interspecific relationship between C. operculatus and S. jambos was altered by waterlogging stress, and both showed improved tolerance to waterlogging stress. This study can provide a glimmer of light on suitable plant species selection and plant community construction during the revegetation activities in wetland zones. C. operculatus and S. jambos represent potential candidates in wetland restoration in a mixed planting model.