Impact of bronchoscopic thermal vapor ablation on lung volume reduction in patients with emphysema: a meta-analysis.

BACKGROUND: Bronchoscopic lung volume reduction (LVR) could significantly improve pulmonary function and quality of life in patients with emphysema. We aimed to assess the efficacy and safety of bronchoscopic thermal vapor ablation (BTVA) on LVR in patients with emphysema at different stage. METHODS: A systematic search of database including PubMed, Embase and Cochrane library was conducted to determine all the studies about bronchoscopic thermal vapor ablation published through Dec 1, 2022. Related searching terms were "lung volume reduction", "bronchoscopic thermal vapor ablation", "bronchial thermal vapor ablation" "BTVA" and "emphysema", "efficacy" and"safety". We used standardized mean difference (SMD) to analyze the summary estimates for BTVA therapy. RESULTS: We retrieved 30 records through database search, and 4 trials were selected for meta-analysis, including 112 patients with emphysema. Meta-analysis of the pooled effect showed that levels of forced expiratory volume in 1 s (FEV1), residual volume (RV), total lung capacity (TLC), 6-min walk distance (6MWD) and St George's Respiratory Questionnaire (SGRQ) were significantly improved in patients with emphysema following BTVA treatment between 6 months vs. baseline. Additionally, no significant changes in FEV1, RV, TLC and SGRQ occurred from 3 to 6 months of follow-up except for 6MWD. The magnitude of benefit was higher at 3 months compared to 6 months. The most common complications at 6 months were treatment-related chronic obstructive pulmonary disease (COPD) exacerbations (RR: 12.49; 95% CI: 3.06 to 50.99; p < 0.001) and pneumonia (RR: 9.49; 95% CI: 2.27 to 39.69; p < 0.001). CONCLUSIONS: Our meta-analysis provided clinically relevant information about the impact and safety of BTVA on predominantly upper lobe emphysema. Particularly, short-term significant improvement of lung function and quality of life occurred especially within the initial 3 months. Further large-scale, well-designed long-term interventional investigations are needed to clarify this issue.

BC-DUnet-based segmentation of fine cracks in bridges under a complex background.

Crack is the external expression form of potential safety risks in bridge construction. Currently, automatic detection and segmentation of bridge cracks remains the top priority of civil engineers. With the development of image segmentation techniques based on convolutional neural networks, new opportunities emerge in bridge crack detection. Traditional bridge crack detection methods are vulnerable to complex background and small cracks, which is difficult to achieve effective segmentation. This study presents a bridge crack segmentation method based on a densely connected U-Net network (BC-DUnet) with a background elimination module and cross-attention mechanism. First, a dense connected feature extraction model (DCFEM) integrating the advantages of DenseNet is proposed, which can effectively enhance the main feature information of small cracks. Second, the background elimination module (BEM) is proposed, which can filter the excess information by assigning different weights to retain the main feature information of the crack. Finally, a cross-attention mechanism (CAM) is proposed to enhance the capture of long-term dependent information and further improve the pixel-level representation of the model. Finally, 98.18% of the Pixel Accuracy was obtained by comparing experiments with traditional networks such as FCN and Unet, and the IOU value was increased by 14.12% and 4.04% over FCN and Unet, respectively. In our non-traditional networks such as HU-ResNet and F U N-4s, SAM-DUnet has better and higher accuracy and generalization is not prone to overfitting. The BC-DUnet network proposed here can eliminate the influence of complex background on the segmentation accuracy of bridge cracks, improve the detection efficiency of bridge cracks, reduce the detection cost, and have practical application value.

Extraordinary phase coherence length in epitaxial halide perovskites.

Inorganic halide perovskites have emerged as a promising platform in a wide range of applications from solar energy harvesting to computing and light emission. The recent advent of epitaxial thin film growth of halide perovskites has made it possible to investigate low-dimensional quantum electronic devices based on this class of materials. This study leverages advances in vapor-phase epitaxy of halide perovskites to perform low-temperature magnetotransport measurements on single-domain cesium tin iodide (CsSnI3) epitaxial thin films. The low-field magnetoresistance carries signatures of coherent quantum interference effects and spin-orbit coupling. These weak anti-localization measurements reveal a micron-scale low-temperature phase coherence length for charge carriers in this system. The results indicate that epitaxial halide perovskite heterostructures are a promising platform for investigating long coherent quantum electronic effects and potential applications in spintronics and spin-orbitronics.

Association of continuous positive airway pressure with F2-isoprostanes in adults with obstructive sleep apnea: a meta-analysis.

PURPOSE: Obstructive sleep apnea (OSA) is associated with increased F2-isoprostanes, a reliable standard biomarker of oxidative stress. Treatment with continuous positive airway pressure (CPAP) is effective for all degrees of OSA. However, it remains unknown whether treatment with CPAP will decrease F2-isoprostanes. A meta-analysis was conducted to determine the effect of CPAP treatment on F2-isoprostanes among patients with OSA. METHODS: The PubMed, Embase, Web of Science, and Cochrane library were searched before September, 2018. Eight articles assessing indices of F2-isoprostanes from various body fluids were identified. Pooled standardized mean difference (SMD) and weighted mean difference (WMD) were appropriately calculated through fixed or random effects models after assessing between-study heterogeneity. RESULTS: A total of 4 studies with 108 patients were pooled for exhaled breath condensate (EBC) F2-isoprostanes; 3 studies with 93 patients were pooled for serum or plasma F2-isoprostanes; and 3 studies with 102 patients were pooled for urinary F2-isoprostanes. A significant decrease of EBC F2-isoprostanes was observed after CPAP treatment (WMD = 2.652, 95% CI = 0.168 to 5.136, z = 2.09, p = 0.036), as well as serum or plasma F2-isoprostanes and urinary F2-isoprostanes (SMD = 1.072, 95% CI = 0.276 to 1.868, z = 2.64, p = 0.008 and WMD = 85.907, 95% CI = 50.443 to 121.372, z = 4.75, p = 0.000, respectively). CONCLUSIONS: This meta-analysis suggested that CPAP therapy was associated with a significant decrease in F2-isoprostanes in patients with OSA.

Impact of continuous positive airway pressure on vascular endothelial growth factor in patients with obstructive sleep apnea: a meta-analysis.

PURPOSE: Cumulative evidence supports the clear relationship of obstructive sleep apnea (OSA) with cardiovascular disease (CVD). And, adherence to continuous positive airway pressure (CPAP) treatment alleviates the risk of CVD in subjects with OSA. Vascular endothelial growth factor (VEGF), a potent angiogenic cytokine regulated by hypoxia-inducible factor, stimulates the progression of CVD. Thus, whether treatment with CPAP can actually decrease VEGF in patients with OSA remains inconclusive. The purpose of the present study was to quantitatively evaluate the impact of CPAP therapy on VEGF levels in OSA patients. METHODS: We systematically searched Web of Science, Cochrane Library, PubMed, and Embase databases that examined the impact of CPAP on VEGF levels in OSA patients prior to May 1, 2017. Related searching terms were "sleep apnea, obstructive," "sleep disordered breathing," "continuous positive airway pressure," "positive airway pressure," and "vascular endothelial growth factor." We used standardized mean difference (SMD) to analyze the summary estimates for CPAP therapy. RESULTS: Six studies involving 392 patients were eligible for the meta-analysis. Meta-analysis of the pooled effect showed that levels of VEGF were significantly decreased in patients with OSA before and after CPAP treatment (SMD = - 0.440, 95% confidence interval (CI) = - 0.684 to - 0.196, z = 3.53, p = 0.000). Further, results demonstrated that differences in age, body mass index, apnea-hypopnea index, CPAP therapy duration, sample size, and racial differences also affected CPAP efficacy. CONCLUSIONS: Improved endothelial function measured by VEGF may be associated with CPAP therapy in OSA patients. The use of VEGF levels may be clinically important in evaluating CVD for OSA patients. Further large-scale, well-designed long-term interventional investigations are needed to clarify this issue.

Effect of continuous positive airway pressure on liver enzymes in obstructive sleep apnea: A meta-analysis.

BACKGROUND: Previous studies have suggested that obstructive sleep apnea (OSA) was associated with nonalcoholic fatty liver disease (NAFLD). However, the impact of OSA treatment using continuous positive airway pressure (CPAP) on liver enzymes remained controversial. This meta-analysis was conducted to determine whether CPAP therapy could reduce liver enzyme levels. METHODS: Two reviewers independently searched PubMed, Cochrane library, Embase and Web of Science before December 2015. Information on characteristics of subjects, study design and pre- and post-CPAP treatment of serum ALT and AST was extracted for analysis. A total of five studies with seven cohorts that included 192 patients were pooled into meta-analysis. RESULTS: CPAP was associated with a statistically significant decrease on both ALT and AST levels in OSA patients (WMD = 8.036, 95% CI = 2.788-13.285, z = 3.00, P = .003 and WMD = 4.612, 95% CI = 0.817-8.407, z = 2.38, P = .017, respectively). Subgroup analyses indicated that CPAP therapy was more effective in OSA patients with treatment duration > 3 mo (WMD = 12.374, 95% CI = 2.727-22.020, z = 2.51, P = .012 for ALT and WMD = 7.576, 95% CI = 1.781-13.370, z =2.56, P = .010 for AST). CONCLUSION: This meta-analysis suggested that CPAP was associated with a statistically significant decrease on liver enzymes in OSA patients. Further large-scale well-designed RCTs with long-term follow-up are required to clarify this issue.

Association between continuous positive airway pressure and serum aminotransferases in patients with obstructive sleep apnea.

INTRODUCTION: Obstructive sleep apnea (OSA) has been suggested to be a potential contributing factor for nonalcoholic fatty liver disease (NAFLD). Studies on the association between continuous positive airway pressure (CPAP) and NAFLD in OSA patients are limited and controversial. OBJECTIVES: The aim of this study was to assess the relationship between OSA and NAFLD and the effect of CPAP therapy on serum aminotransferase levels in OSA patients. METHODS: A total of 160 consecutive patients who underwent standard polysomnography were enrolled. Blood samples were obtained in the morning after sleep for biological profile measurements. Non-invasive ultrasound techniques were used to assess liver steatosis and fibrosis. Within the OSA group, serum aminotransferases were detected before and after CPAP treatment. RESULTS: Alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase, and liver steatosis score increased significantly with an increase in OSA severity. Stepwise multiple regression with liver steatosis score, ALT, AST as dependent variable, respectively, apnea-hypopnea index (ß = 0.447, p = 0.020; ß = 0.266, p = 0.001; ß = 0.351, p = 0.020, respectively) significantly predicted the liver steatosis score, ALT, AST after adjustment for confounders. After 3 months of CPAP treatment, there was a significant decrease in both ALT (54.20 ± 24.34 vs. 46.52 ± 24.95, p = 0.000) and AST (31.82 ± 8.91 vs. 29.00 ± 8.34, p = 0.039). CONCLUSIONS: OSA severity was independently associated with liver steatosis and elevation of serum aminotransferases. 3 months of CPAP therapy were associated with a statistically significant improvement on liver injury in OSA patients.

Preparation of single phase Zn2TiO4 spinel from a new ZnTi layered double hydroxide precursor.

A single-source ZnTi-layered double hydroxide precursor was used to prepare single phase Zn2TiO4. This approach involves two steps: the calcination of a ZnTi-layered double hydroxide precursor and selective leaching zinc oxide from the resultant calcined products. The materials were characterized by X-ray diffraction (XRD), scanning electron microscope (SEM) thermogravimetric and differential thermal analysis (TG-DTA), transmission electron microscope (TEM), surface area measurement and UVvis diffuse reflection spectroscopy. The results indicated that a single phase Zn2TiO4 could be successfully obtained from a ZnTi-layered double hydroxide precursor at a relatively low temperature in short calcination time. The TEM and SEM show that the diameter of Zn2TiO4 particles prepared at 900 degrees C is in the range of 20-100 nm and smaller than that prepared by the solid-state method. UV-Vis diffuse reflection spectroscopy demonstrates that the material has an energy bandgap around 3.7 eV.