Size-Dependent Electrochemical Performance Mediated by Stress-Induced Cracking in Zn2SnO4 Electrodes.

Correlating the microscopic structural characteristics with the macroscopic electrochemical performance in electrode materials is critical for developing excellent-performance lithium-ion batteries, which however remains largely unexplored. Here, we show that the Zn2SnO4 (ZTO) nanowires (NWs) with smaller diameters (d < 5 nm) exhibit slower capacity fade rate and better cycling stability, as compared with the NWs with larger diameters ranging from tens to hundreds of nanometers. By applying in situ transmission electron microscopy (TEM), we discover a strong correlation of cracking behavior with the NW diameter. Upon the first lithiation, there exists a critical diameter of ∼80 nm, below which the NWs neither crack nor fracture, and above which the cracks could easily nucleate and propagate along the specific planes, resulting in the deteriorated cycling stability in larger sized electrodes. Further theoretical calculations based on the finite element model and the climbing image nudged elastic band method faithfully predict the size-dependent cracking behaviors, which may result from the synergistic effect of axial stress evolution as well as preferential Li-ion migration directions during the first lithiation. This work provides a real-time tracking of the tempo-spatial structural evolution of a single ZTO NW, which facilitates a fundamental understanding of how the sample size affects the electrochemical behavior and thus offers a reference for future battery design and application strategy.

Unexpected Two-Dimensional Polarons Induced by Oxygen Vacancies in Layered Structure MoO3-x.

Unveiling the effects of oxygen vacancies on the structural stability of layered α-MoO3 is critical for optimizing its physical and chemical properties. Herein, we present experimental evidence regarding the phase stability of α-MoO3 with ∼2% oxygen vacancy concentrations. Interestingly, we report a previously ignored oxygen-deficient orthorhombic MoO3-x phase in space group Cmcm. Further density functional theory calculations reveal a detailed phase transition mechanism from α-MoO3 to MoO3-x. More importantly, we demonstrate that two-dimensional (2D) large polarons must exist to stabilize the MoO3-x crystal structure. 2D large polarons are suspected to exist in numerous quasi-2D systems but have never been found in layered α-MoO3 or other molybdenum oxides. Our work contributes to a basic understanding of the polaronic behavior in MoO3-x and may broaden the application realm of molybdenum oxides.

Interlayer Engineering of VS2 Nanosheets via In Situ Aniline Intercalative Polymerization toward Long-Cycling Magnesium-Ion Batteries.

Rechargeable magnesium batteries (RMBs) show great potential in large-scale energy storage systems, due to Mg2+ with high polarity leading to strong interactions within the cathode lattice, and the limited discovery of functional cathode materials with rapid kinetics of Mg2+ diffusion and desirable cyclability retards their development. Herein, we innovatively report the confined synthesis of VS2/polyaniline (VS2/PANI) hybrid nanosheets. The VS2/PANI hybrids with expanded interlayer spacing are successfully prepared through the exfoliation of VS2 and in situ polymerization between VS2 nanosheets and aniline. The intercalated PANI increases the interlayer spacing of VS2 from 0.57 to 0.95 nm and improves its electronic conductivity, leading to rapid Mg-ion diffusivity of 10-10-10-12 cm2 s-1. Besides, the PANI sandwiched between layers of VS2 is conducive to maintaining the structural integrity of electrode materials. Benefiting from the above advantages, the VS2/PANI-1 hybrids present remarkable performance for Mg2+ storage, showing high reversible discharge capacity (245 mA h g-1 at 100 mA g-1) and impressive long lifespan (91 mA h g-1 after 2000 cycles at 500 mA g-1). This work provides new perspectives for designing high-performance cathode materials based on layered materials for RMBs.

Electronic structure engineering on NiSe2 micro-octahedra via nitrogen doping enabling long cycle life magnesium ion batteries.

Multivalent ion batteries have attracted great attention because of their abundant reserves, low cost and high safety. Among them, magnesium ion batteries (MIBs) have been regarded as a promising alternative for large-scale energy storage device owing to its high volumetric capacities and unfavorable dendrite formation. However, the strong interaction between Mg2+ and electrolyte as well as cathode material results in very slow insertion and diffusion kinetics. Therefore, it is highly necessary to develop high-performance cathode materials compatible with electrolyte for MIBs. Herein, the electronic structure of NiSe2 micro-octahedra was modulated by nitrogen doping (N-NiSe2) through hydrothermal method followed by a pyrolysis process and this N-NiSe2 micro-octahedra was used as cathode materials for MIBs. It is worth noting that N-NiSe2 micro-octahedra shows more redox active sites and faster Mg2+ diffusion kinetics compared with NiSe2 micro-octahedra without nitrogen doping. Moreover, the density functional theory (DFT) calculations indicated that the doping of nitrogen could improve the conductivity of active materials on the one hand, facilitating Mg2+ ion diffusion kinetics, and on the other hand, nitrogen dopant sites could provide more Mg2+ adsorption sites. As a result, the N-NiSe2 micro-octahedra cathode exhibits a high reversible discharge capacity of 169 mAh g-1 at the current density of 50 mA g-1, and a good cycling stability over 500 cycles with a maintained discharge capacity of 158.5 mAh g-1. This work provides a new idea to improve the electrochemical performance of cathode materials for MIBs by the introduction of heteroatom dopant.

A machine learning-based prediction model for in-hospital mortality among critically ill patients with hip fracture: An internal and external validated study.

INTRODUCTION: Few studies have investigated the in-hospital mortality among critically ill patients with hip fracture. This study aimed to develop and validate a model to estimate the risk of in-hospital mortality among critically ill patients with hip fracture. METHODS: For this study, data from the Medical Information Mart for Intensive Care III (MIMIC-III) Database and electronic Intensive Care Unit (eICU) Collaborative Research Database were evaluated. Enrolled patients (n=391) in the MIMIC-III database were divided into a training (2/3, n=260) and a validation (1/3, n=131) group at random. Using machine learning algorithms such as random forest, gradient boosting machine, decision tree, and eXGBoosting machine approach, the training group was utilized to train and optimize models. The validation group was used to internally validate models and the optimal model could be obtained in terms of discrimination (area under the receiver operating characteristic curve, AUROC) and calibration (calibration curve). External validation was done in the eICU Collaborative Research Database (n=165). To encourage practical use of the model, a web-based calculator was developed according to the eXGBoosting machine approach. RESULTS: The in-hospital death rate was 13.81% (54/391) in the MIMIC-III database and 10.91% (18/165) in the eICU Collaborative Research Database. Age, gender, anemia, mechanical ventilation, cardiac arrest, and chronic airway obstruction were the six model parameters which were identified using the Least Absolute Shrinkage and Selection Operator (LASSO) method combined with 10-fold cross-validation. The model established using the eXGBoosting machine approach showed the highest area under curve (AUC) value (0.797, 95% CI: 0.696-0.898) and the best calibrating ability, with a calibration slope of 0.999 and intercept of -0.019. External validation also revealed favorable discrimination (AUC: 0.715, 95% CI: 0.566-0.864; accuracy: 0.788) and calibration (calibration slope: 0.805) in the eICU Collaborative Research Database. The web-based calculator could be available at https://doctorwangsj-webcalculator-main-yw69yd.streamlitapp.com/. CONCLUSION: The model has the potential to be a pragmatic risk prediction tool that is able to identify hip fracture patients who are at a high risk of in-hospital mortality in ICU settings, guide patient risk counseling, and simplify prognosis bench-marking by controlling for baseline risk.

Biological signatures and prediction of an immunosuppressive status-persistent critical illness-among orthopedic trauma patients using machine learning techniques.

Background: Persistent critical illness (PerCI) is an immunosuppressive status. The underlying pathophysiology driving PerCI remains incompletely understood. The objectives of the study were to identify the biological signature of PerCI development, and to construct a reliable prediction model for patients who had suffered orthopedic trauma using machine learning techniques. Methods: This study enrolled 1257 patients from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Lymphocytes were tracked from ICU admission to more than 20 days following admission to examine the dynamic changes over time. Over 40 possible variables were gathered for investigation. Patients were split 80:20 at random into a training cohort (n=1035) and an internal validation cohort (n=222). Four machine learning algorithms, including random forest, gradient boosting machine, decision tree, and support vector machine, and a logistic regression technique were utilized to train and optimize models using data from the training cohort. Patients in the internal validation cohort were used to validate models, and the optimal one was chosen. Patients from two large teaching hospitals were used for external validation (n=113). The key metrics that used to assess the prediction performance of models mainly included discrimination, calibration, and clinical usefulness. To encourage clinical application based on the optimal machine learning-based model, a web-based calculator was developed. Results: 16.0% (201/1257) of all patients had PerCI in the MIMIC-III database. The means of lymphocytes (%) were consistently below the normal reference range across the time among PerCI patients (around 10.0%), whereas in patients without PerCI, the number of lymphocytes continued to increase and began to be in normal range on day 10 following ICU admission. Subgroup analysis demonstrated that patients with PerCI were in a more serious health condition at admission since those patients had worse nutritional status, more electrolyte imbalance and infection-related comorbidities, and more severe illness scores. Eight variables, including albumin, serum calcium, red cell volume distributing width (RDW), blood pH, heart rate, respiratory failure, pneumonia, and the Sepsis-related Organ Failure Assessment (SOFA) score, were significantly associated with PerCI, according to the least absolute shrinkage and selection operator (LASSO) logistic regression model combined with the 10-fold cross-validation. These variables were all included in the modelling. In comparison to other algorithms, the random forest had the optimal prediction ability with the highest area under receiver operating characteristic (AUROC) (0.823, 95% CI: 0.757-0.889), highest Youden index (1.571), and lowest Brier score (0.107). The AUROC in the external validation cohort was also up to 0.800 (95% CI: 0.688-0.912). Based on the risk stratification system, patients in the high-risk group had a 10.0-time greater chance of developing PerCI than those in the low-risk group. A web-based calculator was available at https://starxueshu-perci-prediction-main-9k8eof.streamlitapp.com/. Conclusions: Patients with PerCI typically remain in an immunosuppressive status, but those without PerCI gradually regain normal immunity. The dynamic changes of lymphocytes can be a reliable biomarker for PerCI. This work developed a reliable model that may be helpful in improving early diagnosis and targeted intervention of PerCI. Beneficial interventions, such as improving nutritional status and immunity, maintaining electrolyte and acid-base balance, curbing infection, and promoting respiratory recovery, are early warranted to prevent the onset of PerCI, especially among patients in the high-risk group and those with a continuously low level of lymphocytes.

New insight into the current study of high tibial osteotomy: A bibliometric analysis.

BACKGROUND: To analyze global trends in focus and funding of research related to high tibial osteotomy (HTO) and to identify the 100 most cited articles in this field. METHODS: A Web of Science search was used to identify HTO publications in English-language scientific journals from January 1967 till February 3th, 2021. Results were filtered to the 100 most cited articles by reading the abstract or full-text paper. Information of these articles was recorded for further analysis. The 10 top-cited articles during the last 5 years and the 10 top-cited articles about HTO ranked by average citations per year were selected to predict research trends. RESULTS: In all, 48 out of the 100 top-cited articles were published between 2000 and 2010. The United States of America was the primary contributor (n = 29) followed by Germany (n = 17) and Japan (n = 11). The total number of citations per article ranged from 65 to 563, median 108, mean 135 (standard deviation = 84). The American Journal of Bone and Joint Surgery accounted for 23 out of the 100 top-cited articles. Koshino T was the most cited author (603 citations). The most frequently highlighted study theme was prognostic research. Patient-based clinical research was the dominant study design (85%). The majority of articles (48 out of 100) were level IV evidence with a mean of 141 (standard deviation = 97) citations. Top-cited articles in the last 5 years focused on open wedge osteotomy. CONCLUSION: Technical optimization of open wedge osteotomy has emerged as the main area of research in HTO. More specifically, recent publications focus on the surgical technology, cartilage repair and new fixation devices. Besides, papers with a high level of evidence are needed for the development of HTO.

Impaction Bone Grafting with Low Dose Irradiated Freeze-Dried Allograft Bone for Acetabular Reconstruction.

OBJECTIVE: Reconstruction of acetabular defects has been extremely challenging in both primary and revision total hip arthroplasty (THA). Impaction bone grafting (IBG) can restore the acetabulum bone mass and anatomically reconstruct the acetabulum. Our study aimed to report the short and medium-term clinical and radiographic outcomes of IBG for acetabular reconstruction in the cemented THA in the Chinese population. METHODS: This was a single-center retrospective review enrolling 57 patients between May 2013 and July 2019. The patients with acetabular defects were treated with IBG, using low dose irradiated freeze-dried allograft bone with or without autograft bone, in the cemented THA performed by one senior surgeon. Harris hip score (HHS), standard pelvis anterior-posterior radiograph and lateral hip radiograph were obtained before operation and at 1 week, 3 months, 12 months, and yearly. Graft osteointegration was evaluated by Oswestry's criteria, and complication was documented at the last follow-up. Independent sample ANOVA test and Pearson chi-square tests are used for statistical analysis. RESULTS: There were 61 hips in 57 patients. The average follow-up time was 35.59 months (5-77 months). According to AAOS classification, a total of 18 hips were identified as segmental bone deficiency (type I), with 21 and 22 hips for cavitary bone deficiency (type II) and the combined bone deficiency (type III), respectively. The average HHS was improved from 44.49 (range: 32-58) preoperatively to 86.98 (range: 78-93) postoperatively. Graft osteointegration was satisfactory (Oswestry score ≥2) in all patients. No dislocation occurred in the 57 patients (61 hips) during follow-up. Although one cup migrated, no revision, re-revision, radiographic loosening, graft bone lysis, or postoperative complications were detected at the final follow-up. CONCLUSIONS: IBG with low-dose irradiated freeze-dried allograft bone in acetabular bone defect reconstruction is a reliable technique for restoring acetabular bone defects in THA.

Arthroscopic Management of Giant Meniscal Cysts Among Young Patients: An Average Three-Year MRI Follow-Up.

OBJECTIVE: To describe an arthroscopic technique for giant meniscal cyst excision with preservation of the functional meniscus, report the short- and medium-term outcomes, and assess magnetic resonance imaging (MRI) for follow-up imaging evaluations. METHODS: A total of 54 consecutive patients with symptomatic meniscal cysts were admitted to the Second Xiangya Hospital of Central South University between 2014 and 2019. Nine patients with giant meniscus cysts (six females and three males) were included in this study. The age range of the patients was 6-34 years. All patients underwent a complete physical examination, X-ray, Doppler ultrasound, and MRI of the knee preoperatively. After an arthroscopic diagnosis of a meniscal rupture with a giant meniscal cyst, partial meniscectomy, ablation of the cyst, and suturing of the retainable meniscus were performed. Lysholm and International Knee Documentation Committee (IKDC) scores were used preoperatively and at the most recent follow-up. Clinical outcomes were classified into four categories: excellent, good, fair, and poor. During the last visit, all patients underwent MRI to assess the recurrence of the cyst and meniscal suture healing. RESULTS: Preoperative MRI and arthroscopic examination revealed giant meniscal cysts combined with meniscal tears and congenital discoid meniscus, and all giant meniscal cysts occurred in the lateral meniscus. The main types of meniscal tears were horizontal and complex tears. The cysts were unicystic in one case and multicystic in eight cases. The mean size of the cysts on the MRI was 5.86 cm × 2.24 cm × 2.48 cm. The mean follow-up periods were 37.5 (19-60) months. Clinical outcomes were excellent in six patients and good in three patients. The postoperative scores were significantly improved compared to the preoperative scores (Lysholm: 90.78 ± 4.60 vs. 54.56 ± 7.25; IKDC: 96.2 ± 3.46 vs. 61.69 ± 3.36; p <0.01). No recurrence of the cyst was indicated on the MRI, and there was good healing of the torn meniscus. CONCLUSIONS: Arthroscopic cystectomy combined with the meniscus suture technique was effective to eradicate residual cyst cavities, and traffic orifices be highly recommended.

Traditional Chinese Exercise for Neurodegenerative Diseases: A Bibliometric and Visualized Analysis With Future Directions.

Background: Traditional Chinese Exercise (TCE) has expanded out of China into the world and is frequently used in the prevention and treatment of many diseases. Although many studies have explored the ability of TCE as an intervention for neurodegenerative diseases, there are limited articles summarizing the research. The aim of this study was to investigate current research trends around TCE for neurodegenerative diseases and predict future directions for such research. Materials and Methods: Data was collected from the Web of Science Core Collection (WoSCC). All articles and reviews on TCE in relation to neurodegenerative diseases were retrieved. The data analysis was performed using the CiteSpace (5.8R3) software, and the results were displayed in network maps. Results: The search identified 220 publications between 1999 and 2021. The United States was the most productive country (n = 89), followed by China (n = 68). The United States had the greatest centrality, indicating its tremendous global influence and close collaborations with other countries. Fuzhong Li from the Oregon Research Institute, United States, was not only the most prolific author (n = 5), but also the most co-cited author (n = 120). The Shanghai University of Sport contributed to the most publications (n = 12). PLOS ONE was the most published journal, while Movement Disorders was the most cited journal. Tai Chi, Parkinson's disease, quality of life, balance, and older adult were the most high-frequency keywords, while Alzheimer's disease had the highest centrality. Conclusion: The number of publications on TCE related to neurodegenerative diseases has shown major growth in the past decade. However, there is a need for research institutions to strengthen cooperation between countries and institutions. Tai Chi, Parkinson's disease (PD), Alzheimer's disease, older adults and falls reduction have been the recent research focus. It is anticipated that in the future, PD will continue to be a central focus with the effects of Baduanjin, Wuqinxi, and Yijinjing requiring further research.

Identification of Distinct Immune Cell Subsets Associated With Asymptomatic Infection, Disease Severity, and Viral Persistence in COVID-19 Patients.

The cell-mediated protective and pathogenic immune responses to SARS-CoV-2 infection remain largely elusive. Here we identified 76 distinct cell subsets in the PBMC samples that were associated with various clinical presentations of COVID-19 using scRNA-seq technology coupled with a deep and comprehensive analysis of unique cell surface markers and differentially expressed genes. We revealed that (TRAV1-2+CD8+)MAIT cells and (NCAM1hiCD160+)NK cells significantly enriched in the asymptomatic subjects whereas (LAG3+CD160+CD8+)NKT cells increased in the symptomatic patients. We also observed that (CD68-CSF1R-IL1BhiCD14+)classical monocytes were positively correlated with the disease severity. Moreover, (CD33-HLA-DMA-CD14+)classical monocytes and (CLEC10A-S100A9lo)pDC were associated with the viral persistence. The GO and KEGG analyses identified enriched pathways related to immune responses, inflammation, and apoptosis. These findings may enhance our understanding of the immunopathogenesis of COVID-19 and help develop novel strategies against SARS-CoV-2 infection.

A bibliometric analysis of Wnt signaling pathway: from the top-100 cited articles to emerging trends.

BACKGROUND: Wnt signaling pathway plays a vital role in the regulation of development. An increasing number of articles about Wnt pathway components have been published. By analyzing these studies' characteristics and qualities, we aim to reveal the current research focus and emerging trends in Wnt signaling. METHODS: The databases of Web of Science Core Collection, BIOSIS Citation Index, MEDLINE, etc. were utilized to identify articles on May 23rd, 2020. Wnt signaling pathway-related articles were identified, the 100 most cited articles and articles in the last decade were selected and calculated for citations without self-citation. The subsequent analysis included citation density (citations/article age), time-related flux, authorship, institution, journal, geographic distribution, and theme. RESULTS: These articles were published mainly from 2000 to 2009 (62%). Citations per article ranged from 599 to 3,780 with a median number of 880 times. Most studies (66%) came from the United States. Nusse Roel and Clevers Hans (15 and 13 papers) have contributed significantly to the field. The most highlighted study themes were cancer (15%), embryo development (14%), and cytoplasm signal transduction (11%). From 2011 to 2020, interest in emerging subtopics, including osteogenesis, immune, apoptosis, autophagy, microRNA, and cancer stem cell, are rising. CONCLUSIONS: Cancer, embryo development, stem cell, and signal transduction process still play a major role in the field. With multiple emerging subtopics and investigation on an integrated view of the Wnt signal network, the association of Wnt with diseases was further revealed.

Femoroacetabular Impingement and Labral Tear: From the Most Highly Cited Articles to Research Interests.

OBJECTIVE: To highlight the characteristics of the most highly cited articles and propose the research interests over the past decades in the field of femoroacetabular impingement (FAI) and labral tear. METHODS: The ISI Web of Science database (Clarivate Analytics, New York, the United States) was utilized for the identification of articles on 15 December 2020. FAI and labral tear-related articles (1138 articles) were retrieved, of which the 100 most-cited articles (top 100) were identified. Subsequent analysis included citation density (citations/article age), authorship, institution, journal, geographic distribution, level of evidence, and theme. RESULTS: The number of citations per article ranged from 66 to 1189 with a mean of 163.31. The majority of articles were published in the United States (all articles/top 100 = 655/57) and Switzerland (85/22). University of Bern (n = 10) was the most prolific institution. The journal with the most of articles was Arthroscopy: The Journal of Arthroscopic and Related Surgery. The most prolific coauthor (all articles) or first authors (top 100) was Domb (n = 109) and Philippon (n = 6), respectively. The evidence with the most articles is level IV (n = 41). The top three most popular topics of research article were outcomes of surgery (n = 23), imaging diagnosis (n = 18), and comparison of surgery (n = 8). The top four most prevalent themes of review were labral tears (n = 3), FAI (n = 3), comparison of surgery imaging diagnosis, and outcomes of surgery (both n = 2). Six keywords with the newest average publication year, including FAI syndrome (average publication year = 2019.50), patient-reported outcomes (2019.43), femoroplasty (2018.60), clinical outcomes (2018.17), borderline dysplasia (2018.00), and capsule (2018.00). Five keywords with the highest average citations, including outcome (average citations = 88.50), alpha angle (58.00), complications (55.86), revision hip arthroscopy (49.00), and systematic review (46.14). CONCLUSIONS: Outcomes research is the most popular research interest and patient-reported outcome instruments might be further and widely used in the emerging articles in the near future. The field of FAI and labral tear has shown an obvious trend of development and is steadily evolving. It could be predicted that there will be an increasing number of publications in the following years, with the United States and Switzerland maintaining leadership in this field.

Room-temperature oxygen vacancy migration induced reversible phase transformation during the anelastic deformation in CuO.

From the mechanical perspectives, the influence of point defects is generally considered at high temperature, especially when the creep deformation dominates. Here, we show the stress-induced reversible oxygen vacancy migration in CuO nanowires at room temperature, causing the unanticipated anelastic deformation. The anelastic strain is associated with the nucleation of oxygen-deficient CuOx phase, which gradually transforms back to CuO after stress releasing, leading to the gradual recovery of the nanowire shape. Detailed analysis reveals an oxygen deficient metastable CuOx phase that has been overlooked in the literatures. Both theoretical and experimental investigations faithfully predict the oxygen vacancy diffusion pathways in CuO. Our finding facilitates a better understanding of the complicated mechanical behaviors in materials, which could also be relevant across multiple scientific disciplines, such as high-temperature superconductivity and solid-state chemistry in Cu-O compounds, etc.

The Top 100 Most Cited Articles on Anterior Cruciate Ligament Reconstruction: A Bibliometric Analysis.

BACKGROUND: The concept of anterior cruciate ligament (ACL) reconstruction (ACLR) has become widely accepted, gaining increased attention in recent years and resulting in many research achievements in this field. PURPOSE: The aim of this study was to determine which original articles on ACLR have been most influential in this field by identifying and analyzing the characteristics of the 100 most cited articles. STUDY DESIGN: Cross-sectional study. METHODS: Articles on ACLR were identified via the Thomson ISI Web of Science database on November 30, 2019. The 100 most cited articles were identified based on inclusion and exclusion criteria. The data extracted from each article for the subsequent analysis included title, date of publication, total citations, average citations per year (ACY), journal name, first author, institutions, themes, level of evidence, and keywords. RESULTS: The total number of citations was 29,629. The date of publication ranged from 1975 to 2015. A majority of the articles originated from the United States (58%) and were published in the 1990s (32%) and 2000s (48%). The mean ACY was 18.43 ± 9.51. Of the selected articles, nearly one-half were published in the American Journal of Sports Medicine (42%). The most prolific co-author and first author were Freddie H. Fu (n = 13) and K. Donald Shelbourne (n = 5), respectively. The most productive institution was the University of Pittsburgh (14%). Material comparison (19%) and technique comparison (16%) were the 2 most popular themes. More than one-quarter of articles were level 4 evidence (37%). Moreover, the keywords ACL, ACL reconstruction, ACL rupture, knee joint, knee injuries, and human showed the highest degree of centrality. CONCLUSION: By analyzing the characteristics of articles, this study demonstrated that ACLR is a growing and popular area of research, with the focus of research varying through timeline trends. Studies on anatomic reconstruction and biomechanics might be areas of future trends.

The Top 100 Most-Cited Articles on Arthroscopy: Most Popular Topic Is Rotator Cuff Rather Than Cartilage in the Last 5 Years.

PURPOSE: To highlight the characteristics of the 100 most-cited articles on arthroscopy and provide the variation trend of citation rate among the top 25 articles in the past 9 years. We further analyzed the topics of interest in the past or currently. METHODS: The Thomson ISI Web of Science database was used to identify arthroscopy-related articles that were published from 1950 to March 31, 2020. The 100 most-cited articles were selected for further analysis. In addition, author key words of the articles that published in the recent 5 years were further analyzed. RESULTS: Mean of citations was 433.59 ± 400.73. The publication year ranged from 1980 to 2013. Most articles were focused on cartilage lesions and treatments (26%). A large proportion of articles were published in the 2000s (61%). Arthroscopy-the Journal of Arthroscopic and Related Surgery (23%) was the most popular journal. One half of the articles originated from the United States. The most prolific institution and first author were the Steadman Philippon Research Institute (5%) and Marc J. Philippon (4%), respectively. Most of the articles were Level IV evidence (33%). The citation rate increased by 131% from the previous top 25 articles published in 2011. A growth trend can be seen in the citation density over time. "Shoulder" (occurrences = 535) was the most used joint key word and "rotator cuff" (342) was the most used key word of research objective in the last 5 years, whereas "cartilage" only occurred 262 times. CONCLUSIONS: Based on bibliometric analysis of the 100 most-cited articles on arthroscopy combined with network analysis of the whole articles that published in the recent 5 years, the topic of most interest in the recent 5 years was rotator cuff rather than cartilage. The number of citations among the 25 most-cited articles is growing rapidly and has at least doubled in size on average in the past 9 years. Citation density among the 100 most-cited articles on arthroscopy has seen a growth trend. CLINICAL RELEVANCE: This article clarifies the characteristics of the 100 most-cited papers and provides guidance on the topics of interest in the past or currently as a roadmap for future research on arthroscopy.

Research on Environmental Influencing Factors of Overweight and Obesity in Children and Adolescents in China.

This study aimed to explore the impact of environmental factors such as latitude, altitude, family socioeconomic status (SES), and level of urbanization on overweight and obesity (ow/ob) in children and adolescents. The participants comprised 26,120 children and adolescents aged 10-18 from 16 provinces in China. Differences in the prevalence of ow/ob under different environmental conditions were evaluated by the chi-square test. The influence of various environmental factors on ow/ob was obtained by logistic regression analysis. We found that (1) the prevalence of ow/ob fell between from 19.2% to 11.9% at 10 years old and from 13.8% to 6% at 18 years old; (2) latitude, family SES, income, and urbanization level are positively correlated with the prevalence of ow/ob; and (3) altitude has a negative correlation with the prevalence of ow/ob. The prevalence of ow/ob decreased with age in children and adolescents aged 10-18, and the risk of ow/ob showed significant differences in latitude, altitude, family SES level, gross domestic product (GDP), and level of urbanization.

Classification of four distinct osteoarthritis subtypes with a knee joint tissue transcriptome atlas.

The limited molecular classifications and disease signatures of osteoarthritis (OA) impede the development of prediagnosis and targeted therapeutics for OA patients. To classify and understand the subtypes of OA, we collected three types of tissue including cartilage, subchondral bone, and synovium from multiple clinical centers and constructed an extensive transcriptome atlas of OA patients. By applying unsupervised clustering analysis to the cartilage transcriptome, OA patients were classified into four subtypes with distinct molecular signatures: a glycosaminoglycan metabolic disorder subtype (C1), a collagen metabolic disorder subtype (C2), an activated sensory neuron subtype (C3), and an inflammation subtype (C4). Through ligand-receptor crosstalk analysis of the three knee tissue types, we linked molecular functions with the clinical symptoms of different OA subtypes. For example, the Gene Ontology functional term of vasculature development was enriched in the subchondral bone-cartilage crosstalk of C2 and the cartilage-subchondral bone crosstalk of C4, which might lead to severe osteophytes in C2 patients and apparent joint space narrowing in C4 patients. Based on the marker genes of the four OA subtypes identified in this study, we modeled OA subtypes with two independent published RNA-seq datasets through random forest classification. The findings of this work contradicted traditional OA diagnosis by medical imaging and revealed distinct molecular subtypes in knee OA patients, which may allow for precise diagnosis and treatment of OA.

Fixed- versus mobile-bearing unicompartmental knee arthroplasty: a meta-analysis.

Unicompartmental knee arthroplasty (UKA) can be either a fixed bearing (FB) or a mobile bearing (MB) construct with controversy as to which design is superior. This question is addressed with a systematic review and meta-analysis. A literature search was performed using PubMed, Embase and the Cochrane Library. Studies were reviewed according to the inclusion and exclusion criteria developed in advance. We compared the differences in clinical and radiological outcomes between the FB and MB UKAs. Analyses were performed with the Review Manager and STATA software. A total of 17 studies involving 2612 knees were included. No significant differences were presented between the FB and MB prostheses in clinical and radiological outcomes. However, it was evident that there were differences in the modes and timing of the failures, bearing dislocation led to earlier failures in the MB prosthesis, while the FB prosthesis failed later due to polyethylene wear. There was no evidence of publication bias using the incidence of revisions. There is no significant difference between the FB and MB UKAs; however, there are differences in the modes and timing of failures.