Background: While acknowledging the generally poor prognostic features of brain metastases from renal cell carcinoma (BM RCC), it is important to be aware of the fact that neurosurgery still plays a vital role in managing this disease, even though we have entered an era of targeted therapies. Notwithstanding their initial high effectiveness, these agents often fail, as tumors develop resistance or relapse. Methods: The authors of this study aimed to evaluate patients presenting with BM RCC and their outcomes after being treated in the Neurosurgical Department of Clinical Emergency Hospital “Bagdasar-Arseni”, and the Neurosurgical Department of the National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania. The study is based on a thorough appraisal of the patient’s demographic and clinicopathological data and is focused on the strategic role of neurosurgery in BM RCC. Results: A total of 24 patients were identified with BM RCC, of whom 91.6% had clear-cell RCC (ccRCC) and 37.5% had a prior nephrectomy. Only 29.1% of patients harbored extracranial metastases, while 83.3% had a single BM RCC. A total of 29.1% of patients were given systemic therapy. Neurosurgical resection of the BM was performed in 23 out of 24 patients. Survival rates were prolonged in patients who underwent nephrectomy, in patients who received systemic therapy, and in patients with a single BM RCC. Furthermore, higher levels of hemoglobin were associated in our study with a higher number of BMs. Conclusion: Neurosurgery is still a cornerstone in the treatment of symptomatic BM RCC. Among the numerous advantages of neurosurgical intervention, the most important is represented by the quick reversal of neurological manifestations, which in most cases can be life-saving. With over 15 histological subtypes identified by the World Health Organization, renal cell carcinoma (RCC) comprises 3.8% of all new cancer diagnoses. A surge in the number of new cases has been reported, with more than 70,000 new cases of RCC in 2020 and more than 14,000 deaths in the last decade in the United States [Regarding mRCC, it has been reported to occur in approximately 25–30% of patients with RCC, while BM from RCC have a described incidence of almost 13% . The incIt is important to specify that the increasing reported number of RCC cases is also due to advancements in imaging techniques. Concerning this subject, the state of the art is represented by the use of radiomics, which is a field that combines artificial intelligence, computer science, and radiology, in order to amplify the accuracy of medical imaging . In spitThe prognostic role of RCC is decisive in determining therapeutic management. For metastatic RCC (mRCC), prognostic information is given by anatomical, histological, clinical, and molecular factors. The most important anatomical prognostic factor (PF) is represented by the tumor-node-metastasis (TNM) stage classification, but when it comes to clinical PFs, Karnofsky performance status (KPS) has persistently been the paramount determinant of survival. Regarding the histological PFs, RCC subtype, microvascular and collecting system invasion, Fuhrman nuclear grade, tumor necrosis, and sarcomatoid features are the most relevant. As for molecular PFs, worth mentioning are the expression of the Ubiquitin Carboxy-Terminal Hydrolase (BAP1) and Polybromo 1 (PBRM1) genes, chromosomal losses of regions 9p, 9q, and 14q, and CpG methylation-based assays ,20,21.The complexity of brain metastases from renal cell carcinoma (BM RCC) needs an understanding of this extremely heterogeneous pathology on a molecular level in an effort to address the poor prognosis. In order to succeed, treatments require adaptation to molecular susceptibilities among primary cancers and their metastases . Renal cThe CT scan may be extremely helpful in the evaluation of RCC, with greater than 95% accuracy. A contrast-enhanced CT scan reveals an enhanced renal mass, which is a solid clue for the diagnosis of the disease. While searching for diagnostic certainty, the histopathological examination after a tissue biopsy may be essential in the diagnosis and management of RCC . SubsequRCC is well known for the low rates of response to chemotherapy and radiotherapy, which gave rise to much research regarding the development and evolution of targeted therapies, including vascular endothelial growth factor (VEGF) and transforming growth factor alpha (TGF-α) pathways, mTOR inhibitors, immune checkpoint inhibitors (ICI), and more recently, combined targeted therapies. Anti-angiogenic strategies became alluring given the fact that RCC is a decidedly vascular cancer. Despite their high initial effectiveness, these agents often fail as tumors become resistant or relapse, and therefore some patients experience disease progression. Afterward, in advanced RCC, patients will frequently develop BM, and more than 80% are symptomatic at the moment of diagnosis ,37,38,39Hence, despite the increased availability of targeted agents along with multimodal therapies, neurosurgery is still the main pawn when approaching BM RCC in symptomatic patients, especially with solitary BM. Among the numerous advantages of surgical intervention, the most important is represented by the quick reversal of neurological manifestations ,41. DuriAlthough RCC is appraised to be radioresistant, some studies confirm the opposite, stating that in a multimodal approach, stereotactic radiosurgery (SRS) might be a major factor in the management of the disease . With thAn important part of the multimodal therapeutic approach, which can improve overall survival rates, includes cytoreductive nephrectomy (CN) . CN is dThe colonization of metastases in the brain is a result of tumor cells spreading throughout the blood, as well as seeding from an already existing metastasis in the body . MicroenIt is worth mentioning that several therapies can mimic intracranial disease progression, while new or incremented neuroimaging abnormalities in the course of immunotherapy or SRS may constitute pseudoprogression .At present, the primary approach to BM RCC comprises neurosurgery and/or radiotherapy (RT) ,66,67.The selection of the patients is of great importance, as the decision of neurosurgical intervention must consider the advantages and disadvantages when compared to other therapeutic options. At the present time, neurosurgical resection can be considered a safe option, as it is correlated with minimal morbidity and mortality ,69. NoneIn patients with single BM, if asymptomatic and smaller than 3 cm, or if not fit for neurosurgery, SRS alone or fractioned stereotactic RT (FSRT) might be the option . IndividIn patients with multiple BMs, aggressive treatment for intracranial disease in oligometastatic cases has better outcomes when compared to whole-brain RT (WBRT) ,79. It hGiven the fact that neurosurgery has a main role in BM RCC, our current study focuses on this exact matter in order to conclude to what extent patients with this pathology may benefit from it.The authors of this study aimed to evaluate patients presenting with BM from RCC and their outcomes after being treated in the Neurosurgical Department of Clinical Emergency Hospital “Bagdasar-Arseni”, Bucharest, Romania, and the Neurosurgical Department of the National Institute of Neurology and Neurovascular Diseases, Bucharest, Romania. We included adult patients with renal cell carcinoma as their only malignancy, and we excluded patients with more than one malignancy and patients who underwent prior neurosurgical interventions in other neurosurgical departments. In order to make the selection, registry databases from our departments, as well as the patient’s physical file, were queried for all patients with histologically confirmed BM from RCC from 2012 to 2022 and evaluated retrospectively. The selected data to review were represented by the clinical notes, demographics, histology, comorbidities, BM topography, neurosurgical treatment, systemic therapy, extracranial metastases, prior nephrectomy, and outcomes. Regarding the matter of cytoreductive nephrectomy, when admitted to our departments, 37.5% of patients with BM RCC had already undergone surgery for the primary RCC lesion. Of the total of 37.5% (9 patients), 66.6% were from urban settings.The current study is based on a thorough appraisal of the patient’s demographic and clinicopathological data and is focused on the strategic role of neurosurgery in the multimodal therapy of BM from RCC.p-values less than 0.05 were considered statistically significant. The one-sample t-test, one-way/two-way ANOVA, and the Chi-square (and Fisher’s exact) were used to assess differences in variables and correlate normally distributed data. Kaplan–Meier method was the choice for performing survival analysis. Overall survival was interpreted as the period between the histopathological diagnosis and the date of death.This retrospective study was carried out by reviewing the medical records from our institutional databases of 24 patients treated in our departments between January 2012 and December 2022 for BM RCC. We appraised demographic information, clinicopathological characteristics, as well as therapeutic options. Correlations between the obtained data were performed in order to draw conclusions. Statistical analyses of experimental data, figures, and tables were performed using GraphPad Prism 8.3.0 software. p = 0.042), showing that patients with smaller lesions were more likely to be symptomatic  were admitted with BM RCC , of whomptomatic . These rp = 0.058  patients underwent nephrectomy. From the total number (n = 9), 66.6% were from urban settings in comparison with half of that percentage (33.3%) that were from rural areas. In the group without nephrectomy (n = 15), 11 (73.3%) were from rural areas and 4 (26.6%) from urban settings;  = 0.058 .p = 0.375.In our study population, lesion sizes between 13 and 30 mm had a homogeneous distribution in both rural and urban settings (25% versus 25%), while the number of patients with lesion sizes between 30 and 63 mm doubled in rural areas: 33.3% in rural areas versus 16.6% in urban settings . HoweverOut of 24 patients with BM RCC, in 23 cases a neurosurgical resection was performed, and in 1 case SRS alone was indicated. The main purposes of neurosurgical intervention were gross-total resection (which occurred in 18 patients) and relief of mass effects in order to improve neurological symptoms. Due to the infiltration and adherence of BMs, as well as their localization in eloquent brain areas, only partial resection was possible in five patients . In caseRegarding the post-surgical complications, a postoperative intracerebral hematoma has been noted in one patient, and it was operated on without further consequences. The initial KPS in patients with BM RCC was <80 in 11 (45.8%) cases . After nSeven (29.1%) of our patients had intracranial metastases: six cases of lung metastases and one case of intestinal metastasis. The remaining 17 individuals did not have extracranial metastases.Three (12.5%) patients in our study population were treated with SRS for BM RCC. One patient with a small BM (13 mm) was treated with SRS alone, while two patients were treated with SRS and neurosurgical resection.The final diagnosis based on histopathology of the neurosurgical specimen was ccRCC in 91.6% of the patients  and pRCCp = 0.004 . The median survival rate in patients with nephrectomy was 12 months , while in patients without nephrectomy, it was 7 months ;  = 0.004 .p = 0.033 , while in patients without systemic therapy it was 12 months ,  = 0.033 .p = 0.0005  patients had multiple BM RCC, and 20 (83.3%) had a single BM. Compared to patients with more than one BM, those with a single BM were observed to have better survival rates: Median survival in patients with one BM was 9.5 months  vs. 4.5 months  in patients with more than one BM; = 0.0005 .In order to provide the best therapeutic options and to predict survival rates, patients with RCC were classified according to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk subgroup, which currently represents the gold standard ,64 Tabl.p < 0.0001.In our study, the majority of the population was in the intermediate IMDC risk subgroup (66.6%). We calculated the survival rates in each of the three subgroups . The favp < 0.001 .The median survival in patients with normal levels of hemoglobin was 9 months, which was the same as in low hemoglobin cases, while individuals with elevated levels of hemoglobin had a lower median survival rate . When comparing this treatment with the geographic region of origin of our patients, we found that 73.3% of the patients without nephrectomy were from rural areas in comparison to only 26.6% from urban settings (p = 0.058). This statement is specifically significant because in Romania, there is limited availability of healthcare resources in most of the rural areas. Similarly, regarding the multimodal approach of BM RCC, in our study group, a total of 7 (29.1%) patients received systemic therapy in comparison to 17 (70.8%) who did not. Our study demonstrates that the median survival rate in patients treated with systemic therapy was longer than in those without systemic therapy: 13 months versus 12 months.Although not every patient with RCC will benefit from nephrectomy, some individuals will experience OS benefits, especially in the context of immune therapy ,71,72. Ip = 0.0005. It is worth mentioning that only four patients from the study group had multiple metastases, while the rest of the population had a single BM RCC. Four patients (16.6%) experienced local recurrence, of whom one had a single BM RCC, while the other three patients had two or more than two BM RCC.Likewise, when focusing on the number of BM RCC at the diagnosis, compared to patients with more than one BM, those with a single BM were observed to have better survival rates. Median survival in patients with one BM was 9.5 months , in comparison to 4.5 months  in patients with more than one BM; p = 0.042). Nine symptomatic patients (37.5%) had lesions of sizes between 13 and 27 mm, eight symptomatic patients (33.3%) had lesions of sizes between 30 and 40 mm, three symptomatic patients (12.5%) had lesions between 43 and 52 mm, and two symptomatic patients (8.3%) had lesions between 52 and 63 mm. One asymptomatic patient (4.1%) fell into the category of the 13–27 mm lesion size group, and one asymptomatic patient fell into the category of the 30–40 mm lesion size group. A possible explanation of this result could be the fact that the localization of the tumors, regardless of their small size, was in areas of the brain with important neurological and/or neuroendocrinological functions . Even if it was not statistically significant, it is worth mentioning that in our study group, the number of patients with lesion sizes between 30 and 63 mm has doubled in rural areas . When comparing the distribution of lesion size by symptom status, we found that patients with smaller lesions were more likely to be symptomatic  cases and higher in 13 (54.1%). After the neurosurgical intervention, the score improved in 15 (62.5%) cases, which represents more than half of the patients. The mainstay of treatment for symptomatic patients with BM RCC is still the classical neurosurgical approach, which first and foremost offers a quick reversal of neurological manifestations. However, neurosurgery alone is insufficient, but along with other therapies, it offers long-lasting local control and may extend the OS rate ,84. Even though RCC is considered radioresistant, it has been proven that SRS may improve the initial poor prognosis in a multimodal approach ,85,86,87p < 0.0001). In order to predict survival rates and provide the best therapeutic options for patients with RCC, the IMDC risk-scoring system has been designed ,89. In oA recent study by Honglin Jiang et al. discovered that in some categories of cancer, elevated iron concentrations are correlated with a lower survival rate . The autIt has been known for a long time that some cases of RCC have a hereditary constituent, and the most common examples encompass von Hippel–Lindau syndrome and the familial pRCC syndrome ,95. HoweMany of the patients in our study had comorbidities that may place them at a higher risk for chronic kidney disease or even end-stage renal disease. More precisely, as many as 45.8% of patients had a history of congestive heart failure or heart disease, and 29.1% had a history of diabetes. In one of their articles, Tyler Clemmensen et al. suggested that partial nephrectomy is especially important in this category of patients as a nephron-sparing approach [Overall, consistent with prior studies, the authors of this article established that neurosurgical patients with BM RCC may benefit from multimodal therapeutic approaches. Notwithstanding that neurosurgery is the gold standard for symptomatic patients with BM RCC, it alone does not suffice and, in addition to other therapies, may increase survival rates. One of the main limitations of the current study is represented by the small sample size, which may have resulted in insufficient statistical power to permit the detection of significance for some variables . Furthermore, the study was also limited by the small group of patients who were treated with radiation therapy (SRS). Among the limitations, we also consider the exclusion criteria regarding patients with BM RCC initially treated in other neurosurgical departments. In the current study, we solely included patients neurosurgically treated in our departments from the beginning for a better follow-up and evolution assessment. However, we are looking forward to including in future studies patients with possible recurrences initially treated in other neurosurgical departments.To our knowledge, this is the first study focused on BM RCC patients in Romania that involves a multicentric approach, and for a better understanding of the topic, we encourage other studies regarding the matter. Although the expectancy of life’s duration is rather short in patients with BM RCC, neurosurgical approaches combined with other therapeutical options can offer long-lasting local control and can increase survival rates. Moreover, histopathological examination of tumoral tissue can be obtained in order to establish the best targeted therapeutic agents. Among the numerous advantages of neurosurgical intervention, the most important is represented by the quick reversal of neurological manifestations, which in most cases can be life-saving. Despite the increased availability of targeted agents along with multimodal therapies, neurosurgery is still a cornerstone in the treatment of BM RCC in symptomatic patients.


Epicoccum latusicollum is a fungus that causes a severe foliar disease on flue-cured tobacco in southwest China, resulting in significant losses in tobacco yield and quality. To better understand the organism, researchers investigated its optimal growth conditions and metabolic versatility using a combination of traditional methods and the Biolog Phenotype MicroArray technique. The study found that E. latusicollum exhibited impressive metabolic versatility, being able to metabolize a majority of carbon, nitrogen, sulfur, and phosphorus sources tested, as well as adapt to different environmental conditions, including broad pH ranges and various osmolytes. The optimal medium for mycelial growth was alkyl ester agar medium, while oatmeal agar medium was optimal for sporulation, and the optimum temperature for mycelial growth was 25°C. The lethal temperature was 40°C. The study also identified arbutin and amygdalin as optimal carbon sources and Ala-Asp and Ala-Glu as optimal nitrogen sources for E. latusicollum. Furthermore, the genome of E. latusicollum strain T41 was sequenced using Illumina HiSeq and Pacific Biosciences technologies, with 10,821 genes predicted using Nonredundant, Gene Ontology, Clusters of Orthologous Groups, Kyoto Encyclopedia of Genes and Genomes, and SWISS-PROT databases. Analysis of the metabolic functions of phyllosphere microorganisms on diseased tobacco leaves affected by E. latusicollum using the Biolog Eco microplate revealed an inability to efficiently metabolize a total of 29 carbon sources, with only tween 40 showing some metabolizing ability. The study provides new insights into the structure and function of phyllosphere microbiota and highlights important challenges for future research, as well as a theoretical basis for the integrated control and breeding for disease resistance of tobacco Epicoccus leaf spot. This information can be useful in developing new strategies for disease control and management, as well as enhancing crop productivity and quality. The study mentioned by E. latusicollum.Molecular biology advancements allowed for the reclassification of certain species within the family Didymellaceae, transferring them to the newly established genus picoccum . Subsequa sativa , Zea mayZea mays , and Ela pungens , as well tobacco . Currentone time . A betteone time .To date,Epicoccus leaf spot, to clarify multiple microbial metabolic activities and investigate microbial community diversity. This analysis aimed to provide a basis for controlling the occurrence of tobacco Epicoccus leaf spot by optimizing the carbon supply structure of tobacco and improving the microbiota  assessed through Biolog EcoPlates™. CLPP can detect multiple microbial metabolic activities, making it a powerful tool for investigating microbial communities . By compcrobiota .E. latusicollum, (ii) to sequence the genome of E. latusicollum, and (iii) in order to elucidate the metabolic functions of phyllosphere microorganisms in tobacco affected by Epicoccus leaf spot and community level of physiological profiles. This study provides insights into the pathogenesis, biological characteristics, and genomics of E. latusicollum, a fungal pathogen that causes foliar diseases in tobacco-producing areas, outcome of this study may gain a better understanding of the genetic mechanisms and phenotypic characteristics of the pathogen, and may also provide some effective management suggestions to reduce the impact of the disease below economic thresholds.Therefore, the objectives of this study were: (i) to investigate the basic biological characteristics and metabolic phenotype of 22.1E. latusicollum strain T41, randomly selected from multiple isolates, was analyzed in the laboratory of Guizhou Academy of Tobacco Science , alkyl ester agar (AEA), and oatmeal agar (OA), over a temperature range of 10°C to 40°C. To ensure the reliability of the findings, three replicate plates were used for each temperature, and adverse temperature tests were carried out to assess the strain’s ability to withstand unfavorable conditions. In cases where non-growing mycelia were observed, re-culturing was performed under optimal temperature conditions to verify the strain’s viability. The effect of light on E. latusicollum T41 growth was also investigated by culturing the strain on PDA at 25°C under continuous darkness, continuous illumination and alternation of light and darklight. The growth of the fungus was assessed by measuring the colony diameters after five days of incubation. To minimize any experimental bias, each treatment was conducted in triplicate, and the entire experiment was repeated three times to ensure consistency and reproducibility of the results.The present study aimed to investigate the impact of temperature on the growth of 2.2E. latusicollum was assessed using the Phenotype MicroArray (PM) system  to determine its phenotype , and then rotated on the surface of the colony to absorb the spores. The swabs were then immersed in 12 mL of FF-IF inoculation solution, and the resulting suspension was filtered through a double layer of sterile cheesecloth with a Grade #40 and 24 × 20 threads per inch to eliminate mycelial fragments . The resOne hundred microliters (μl) of a dilution of 62% transmittance (T) suspension of cells were added to each well of the PM plates. FF-IF was used for PM plates 1 and 2, FF-IF plus 100 mM D-glucose, 5 mM potassium phosphate (pH 6.0), and 2 mM sodium sulfate was used for PM plates 3 and 6–8. FF-IF plus 100 mM D-glucose was used for PM plate 4. FF-IF plus yeast nitrogen base and 100 mM D-glucose was used for PM plates 9 and 10 . These sPhenotypic data were recorded by capturing digital images of microarrays and storing turbidity values. Kinetic and Parametric software  was used to analyze the data. The phenotype was estimated according to the area of each well under the staining formation kinetics curve , and the2.32.3.1E. latusicollum T41 strain was extracted using the SDS method, involving the disruption of fungal cells using SDS detergent to release the genomic DNA. Purification steps were performed to obtain high-quality genomic DNA for further analysis, as described by The genomic DNA of 2.3.1The genome annotation process is a fundamental step in analyzing the genetic information of a given organism. In this study, the genome annotation process was divided into three main components, namely repeat annotation, structural annotation, and functional annotation, as outlined by The functional annotation of genes was carried out using a diverse set of databases to predict their functions. These included GO (Gene Ontology) , KEGG K, KOG Cl, TCDB T, P450 C, and Swi2.4Epicoccus leaf spot were evaluated using Biolog Eco Plates™ following the method outlined by The metabolic capabilities of microbial communities in tobacco affected by 2.5590 values were then used to quantify the functional diversity of microbial communities by calculating the number of wells in which the substrate was utilized by the community (with OD590 > 0.15), representing the richness of the community (S). This method was conducted according to the protocol established by To analyze the community-level physiological profiles (CLPP), the raw absorbance value for each well was first blanked against the control well, and negative absorbance values were set to zero, following the method proposed by i is OD in each carbon source well and A0 is OD of the control. The growth curve of AWCD over incubation time for 168 h were performed. Then the area under the curve (AUC) of the AWCD over time was determined because according to H), the Simpson index (D) and the Pielou index (J) were calculated using the equation , a multiple comparison was performed by the LSD test (P< 0.05) to compare the diversity index of different treatments. The mean values were compared and P-value at ≦0.05 was considered to be statistically significant. Sequences obtained from each primer pair were assembled and aligned using MEGA v. 6.0  to gener33.13.1.1E. latusicollum strain T41, which was isolated from tobacco. The morphological features of the colonies grown on PDA medium for five days displayed a regular rounded shape with red mycelium, a white outer edge, and felted, dense, and red pigmentation on the back  on PM 3. Additionally, the fungus was capable of utilizing 98.60% of the tested nitrogen pathways, with complete utilization of all nitrogen substrates on PM 6 and PM 7, and 91 out of 95 substrates on PM 8. In terms of sulfur sources utilization, T41 was able to grow on 30 out of 35 tested substrates (85.71%) on PM 4, wells F02-H12. Similarly, the fungus demonstrated moderate utilization of phosphorus, growing on 30 out of 59 tested substrates (50.85%) on PM 4, wells A02-E12. Overall, these findings highlight the remarkable metabolic versatility of E. latusicollum and provide valuable insights into its ability to thrive in a wide range of environmental conditions.A comprehensive phenotypic characterization of 3.2.1E. latusicollum strain T41 was found to be capable of utilizing a wide range of carbon and nitrogen sources, as shown by its ability to metabolize over 117 different carbon sources and 94 different nitrogen sources in PM plates 1–3 , whereas no significant growth was observed under the stress of pH 9.5, except when combined with anthranilic acid   with accession PRJNA645278; BioSample SAMN15501750.After meeting quality control criteria, a total of 865,706 clean reads were obtained for the 3.3.1The genome assembly of the organism was annotated, resulting in the identification of 10,821 genes. The total length of these genes was 16,688,112 bp, and the average length was 1,542 bp, accounting for almost half (49.69%) of the genome. Transposable elements (TEs) were also identified in the genome assembly, representing 1.23% of the total genome with a total length of 412,616 bp. A total of 1679 TE families were analyzed with RepeatMasker, of which 99% (1663) belonged to the known TEs. These included 1287 retrotransposons (Class I) and 376 DNA transposons (Class II), which could be further divided into different groups and subgroups, such as LINE, LTR, SINE, etc. Retrotransposons, in particular, were found to be abundant in fungi, and they might play a role in genome expansion due to their redundancy and tolerance for mutations Table 4.Furthermore, non-coding RNAs (ncRNA) were identified in the genome assembly, with a total of 234 ncRNAs representing only 0.2% of the genome size Table 4.3.3.2The majority of genes (92.74%) were annotated using the databases described in the methods section. This paper focuses on genes involved in metabolic processes. Approximately 86.27% (9335) of all predicted genes were annotated by the KEGG pathway, and among these genes, those involved in metabolism accounted for a major proportion of 27.93% (2607) of the total predicted genes , Simpson (D), and Pielou (J) indices were computed. The results showed that the microbial diversity and evenness of the Epicoccus leaf spot were comparable to those of the healthy samples, although the values were slightly higher in the healthy samples. This suggests that although the microbial community structure of the Epicoccus leaf spot was not significantly different from that of the healthy samples, there could be subtle changes in the community composition and function due to the presence of the pathogenic fungus. These findings highlight the importance of assessing the ecological and functional impacts of plant-pathogen interactions on the phyllosphere microbial communities, which could have implications for plant health and disease management strategies.To further evaluate the microbial community structure of the infected and healthy tobacco leaves, the Shannon-Wiener . Furthermore, it was found that endophytic strains of the same species may contain more ‘loss of pathogenicity phenotypic genes’ than a pathogen. In the case of E. latusicollum, the endophytic HGUP191049 strain had more of these genes than the pathogenic T41 strain, which may contribute to differences in their pathogenicity within the species ’ genes, which are essential pathogenic factors according to the Pathogen Host Interactions (PHI) Database, revealed differences in the number of such genes between different nutrient modes of the same  species . SuppleD-cellobiose, D-mannitol, N-acetyl-D-glucosamine, glucose-1-phosphate, and D-galactonic acid γ-lactone were the most utilized carbohydrates in the healthy samples. The finding of Epicoccus leaf spot than those in Tobacco brown spot  by the researchers. The results of the BIOLOG assay demonstrated that the microbial communities had a robust ability to utilize carbohydrates, followed by polymers, carboxylic acids, amino acids, and amines, with minimal utilization of phenolic compounds. Specifically, own spot . To furtE. latusicollum and its metabolic versatility, optimal growth conditions, and genomic information can play a vital role in developing integrated strategies for disease control and breeding for disease resistance of tobacco Epicoccus leaf spot. Understanding the optimal carbon, nitrogen, phosphorus, and sulfur sources for the growth of E. latusicollum allows for targeted manipulation of these factors to limit the fungus’s growth and spread. By restricting the availability of specific carbon sources like arbutin and amygdalin, and nitrogen sources such as Ala-Asp and Ala-Glu, through modified agricultural practices or nutrient management strategies, the growth and proliferation of E. latusicollum can be effectively impeded. Additionally, adjusting the composition or application of phosphorus and sulfur fertilizers based on the fungus’s optimal requirements can create nutrient imbalances that hinder its growth and reduce infection potential. Manipulating the availability of optimal carbon, nitrogen, phosphorus, and sulfur sources creates an unfavorable environment for E. latusicollum, supplementing other preventive measures like crop rotation, sanitation practices, and the use of resistant cultivars. This targeted approach to nutrient management is crucial for integrated disease control strategies. The genomic information obtained from sequencing E. latusicollum strain T41 provides valuable insights into the genetic basis of pathogenicity and potential mechanisms of resistance. By identifying genes associated with virulence, pathogenicity, or resistance, researchers can further investigate these factors for potential utilization in breeding programs or genetic manipulation. This knowledge contributes to the development of resistant tobacco cultivars, enhancing long-term disease management and reducing crop losses. Furthermore, the study’s findings on the metabolic functions of phyllosphere microorganisms in diseased tobacco leaves offer insights into interactions between E. latusicollum and other microorganisms. Understanding the metabolic capabilities of these microorganisms can aid in the identification of potential biocontrol agents or the development of probiotic treatments. Exploiting microorganisms that efficiently metabolize carbon sources that E. latusicollum struggles to utilize can limit its resources and inhibit its growth. By integrating the research findings into practical strategies such as cultural practices, genetic manipulation, and biocontrol approaches, new and effective disease control and management strategies can be developed. These strategies have the potential to reduce the incidence and severity of tobacco Epicoccus leaf spot, minimize yield losses, and enhance overall crop productivity and quality.The data obtained in this research on 5Epicoccus leaf spot, a notorious foliar disease instigated by Epicoccum latusicollum, has been reported to cause significant losses in tobacco quality and yield in the southwest region of China. In this study, we aimed to investigate the physiological and genomic characteristics of the aforementioned pathogen. Specifically, we identified the optimal culture conditions for E. latusicollum isolate T41, including the alkyl ester agar medium for mycelial growth and oatmeal agar medium for sporulation, with the optimal temperature for mycelial growth being 25°C and the lethal temperature being 40°C. Moreover, we analyzed the metabolic phenotypes of E. latusicollum using Biolog Phenotype MicroArray and observed the utilization of the majority of the tested carbon sources, with arbutin and amygdalin being the preferred carbon sources. Ala-Asp and Ala-Glu were identified as the most suitable nitrogen sources among the tested nitrogen sources. Remarkably, E. latusicollum exhibited remarkable adaptability, metabolizing 61.46% of carbon sources, 99.48% of nitrogen sources, 85.71% of sulfur sources, and 50.85% of phosphorus sources, as well as displaying an active metabolism in a wide range of environments, including those with varying pH values and different osmolytes. Additionally, the genome of T41 was sequenced using Illumina HiSeq and Pacific Biosciences technologies and assembled into 33.59 Mbp with a N50 value of 1.58 Mbp, in which a total of 10,821 genes were predicted and analyzed using various databases. We further examined the metabolic functions of phyllosphere microorganisms in diseased tobacco leaves caused by E. latusicollum using Biolog Eco microplate and identified a significant incapacity to efficiently metabolize 29 carbon sources, except for tween 40. This study provides novel insights into the structural and functional characteristics of phyllosphere microbiota and underscores crucial challenges for future research, as well as a theoretical foundation for the integrated control and breeding for disease resistance of tobacco Epicoccus leaf spot.Tobacco https://www.ncbi.nlm.nih.gov/) repository, accession number PRJNA645278.The data presented in the study are deposited in the NCBI (ZL and H-CW conceived and designed the experiment. ZL, XC, and Z-NG conducted the experiment and collected the samples. Z-NG uploaded the genomic data. W-HL and L-TC performed the analysis of the samples. ZL and J-RH analyzed the data. ZL wrote the first draft of the manuscript, which was later revised by H-CW, J-RH and C-HS. All authors contributed to the article and approved the submitted version.


Assessment of scores in diabetic patients demonstrated the significant influence of age demographics on cognitive impairment . Furthermore, a higher proportion of diabetic patients displayed cognitive impairment despite a higher score in a single subdomain, making it evident that diabetes is diverse and multifactorial in origin, where oxidative stress and inflammatory responses play a predominant role. This study suggested that the local T2DM population residing in Mysuru (India) has a high prevalence of cognitive impairment, evident from poor performance in almost all cognitive domains assessed by MoCA. Future studies could examine the generalizability of cognitive function findings in diabetic patients across diverse geographic regions and ethnic groups, as well as investigate interventions such as lifestyle modifications and medication to prevent or delay cognitive decline in those with diabetes.The goal of this research is to study the prevalence of cognitive impairment in diabetes mellitus (DM) patients and establish the necessity of detecting and treating it early in these patients. A cross-sectional study was conducted at a tertiary care hospital in Mysuru for 4 months examined diabetic patients (test) and nondiabetic subjects (control) for cognitive decline using the Montreal Cognitive Assessment (MoCA) tool. Cognitive functions such as visuospatial/executive function, naming, attention, language, abstraction, delayed recall, and orientation were assessed in both groups. The diabetic group showed a significantly lower total MoCA score than the non-diabetic group (18.99 ± 0.48 and 26.21 ± 0.46, respectively;  A serious issue in terms of world health is diabetes mellitus (DM). The steep surge in DM cases worldwide and the future projections are alarming. In 2019, 463 million people (9.3%) worldwide suffered from DM, which is projected to rise to 578 million (10.2%) by 2030 and 700 million people (10.9%) by 2045 [DM is a metabolic disorder, and its various complications result in compromised quality of life ,4. The rNeurons, being metabolically active, depend on brain glucose metabolism for function and survival . Hence, th family or one of every 12 individuals above 20 years was diabetic and that the overall prevalence rate of DM was higher than the national prevalence rate in different age groups and family sizes [The current management strategies for T2DM do not primarily target cognitive dysfunction. The increasing prevalence of diabetes and the aging population suggest that diabetes-related cognitive decline would substantially affect the globe and the nation, which defines the need to explore the less addressed cognitive decline in diabetes. Further, a recent study conducted in the rural district of South Karnataka established that one individual in every 5ly sizes . Hence, After receiving human ethical approval, a cross-sectional study was carried out for 4 months at a tertiary care hospital in Mysuru, India. The participants were grouped into two groups: test and control. This study included body mass index (BMI), smoking, and education score as factors that might influence cognitive function in diabetic individuals. BMI was classified based on WHO criteria, smoking status was classified as current, ex-smoker, or non-smoker, and the education score was based on the number of years of formal education completed, classified as grades. These classifications are supported by guidelines from organizations such as WHO and CDC and previous research on cognitive reserve and educational attainment ,18. The The MoCA scale’s assessment of cognitive decline used performance scores from 0–6, 0–5, 0–3, 0–3, 0–7, and 0–6, respectively, in the domains of name, attention, language, abstraction and delayed recall, and orientation. The lowest score of zero signifies poor performance in that domain .The T2DM patients (inpatients and outpatients) from the General Medicine Department were screened for eligibility as per the inclusion criteria and included in the test group.T2DM patients of any gender aged between 30 years and 60 years;T2DM patients with minimal literacy (able to read and write) in Kannada or English.Inclusion criteria for the test group:Patients with a history or present condition of type 1 diabetes, secondary diabetes, or gestational diabetes;Patients with psychiatric illness or on medication having psychoactive activity;Patients suffering from severe diseases such as, but not confined to, cancer (diagnosed less than five years ago) or severe autoimmune diseases;Patients with neurological diseases;Patients whose caregivers did not give consent.Exclusion criteria for the test group:Subjects in the control group followed the same inclusion and exclusion criteria except that these were individuals without T2DM.The subjects were interviewed after obtaining informed consent. Demographic and anthropometric data were collected from their medical records and interviews and recorded in a specially designed data collection form. The subjects with MoCA scores below 26 were considered cognitively impaired, and those above 26 were considered normal.The sample size was calculated using N = 4PQ/d2, and 100 volunteers were chosen for the control group and 100 patients were chosen for the test group. In each group, there were more male patients than females.p-value was calculated using MedCalc statistical software (Version 20.218), which helped determine the level of statistical significance associated with the results obtained.This study was conducted in two arms, each consisting of 100 subjects. Data collected from the participants were observed to follow a normal distribution and was subsequently analyzed using SPSS Version 23. Descriptive statistical measures such as the mean with standard deviation were utilized, while inferential statistical tests such as the chi-square test, Student’s t-test, and multivariate correlational analysis were performed to derive relevant insights from the data. The p < 0.001) was observed for demographic measures such as age group, gender, marital status, mean height, BMI, educational level, area, and smoking status.The mean age of participants was 51 ± 8 and 50 ± 8 years for the diabetic and nondiabetic groups, respectively. Both groups recruited a higher proportion of male subjects. A larger proportion of individuals were married. Moreover, most of the recruited population showed a normal BMI (49% of patients in the diabetic group and 74% in the nondiabetic group). A larger percentage of subjects had education levels higher than grade 6. In the diabetic group, a larger population belonged to the urban community than in the nondiabetic group, where a larger population belonged to the rural community. Most of the participants in the test and control groups were nonsmokers. A significant difference . However, when analyzed individually, the test group showed statistically lower cognitive function in terms of visuospatial/executive function, naming, attention, abstraction, and delayed recall but similar functions in language and orientation to the control group.As evident from The mean MoCA score for the diabetic group concerning the patient demographics was evaluated further, as depicted in The diabetic patients showed no significant difference in their mean MoCA scores based on their demographic factors except their age. The patients displayed a higher MoCA score and better cognition at a younger age, which decreased in elder patients. Moreover, the patients with a lesser duration of diabetes mellitus and the patients taking their medications regularly scored a little higher than those with a longer duration of diabetes mellitus or who were not regular in taking their medication. However, the difference in scores was statistically insignificant.A relationship between the MoCA score and PPBS among the test group was determined to correlate the impact of hyperglycemia on cognitive dysfunction. The data are presented in In this study, PPBS levels were recorded for participants in the test group. Analysis of the data revealed that 40% of the participants had PPBS levels above 250 mg/dL, 16% maintained PPBS levels between 75 and 150 mg/dL, and the remaining participants had PPBS levels in the range of 151–200 mg/dL (25%), and 201–250 mg/dL (19%).The results further indicated that diabetic patients who exhibited mild cognitive impairment (MCI) had an average PPBS level of 249.85 (107.973) mg/dL, whereas those with normal cognitive function (8%) demonstrated an average PPBS level of 229.75 (85.081) mg/dL, although this difference was not statistically significant.The results of this study’s last stage compared the MoCA scores of the two groups in order to examine various cognitive subdomains, such as visuospatial/executive function, naming, attention, language, abstraction, delayed recall, and orientation. The data obtained are presented in p < 0.0001). Similar results were obtained for attention, i.e., 71.42% of patients showed cognitive impairment despite a high score of 6, compared to 43.47% of non-diabetic individuals with a high score of 6. For the language subdomain, only 50% of the diabetic patients with a maximum score of 3 showed normal cognition, compared to 93.75% of non-diabetic individuals with a maximum score of 3. For the abstraction subdomain, 12.76% of the diabetic group and 86.46% of non-diabetic individuals showed normal cognition for a score of 2 which was significant (p < 0.0001). For delayed recall of the diabetic patients with a maximum score of 5, only 25% showed normal cognition against 75% of individuals in the nondiabetic group. Finally, for the orientation subdomain of the diabetic patients scoring a maximum score of 6, only 9.19% showed normal cognition compared to 74.41% of individuals in the nondiabetic group, which was significant (p < 0.0001).The results show that in the diabetic group, a large proportion of the patients (71.42%) with a high visuospatial/executive function score were cognitively impaired. In contrast, in the nondiabetic group, all the individuals with high visuospatial/executive function scores (4 and 5) showed normal cognition. Similarly, for the naming subdomain, 88.52% of diabetic patients showed cognitive impairment despite a maximum score of 3, while in the non-diabetic group, only 30.76% of individuals with a score of 3 showed cognitive impairment, which was significant (p < 0.01) moderate-to-strong correlation (r = 0.4 − 0.7) between the total and the sub-domain scores in the diabetes group, indicating that the diabetic subjects with cognitive impairment (MOCA score < 25) also had poor subdomain scores. In contrast, the control group did not depict any relation between a subdomain and total cognitive scores. The scatter plot and bubble plot in A multivariate correlation analysis was performed to determine the association between the total score (<25), indicating cognitive impairment, and the subdomain scores. The MoCA is a widely accepted tool for assessing MCI and is primarily utilized to detect potential cognitive decline in patients . In thisNormal cognitive abilities are defined by a MoCA score of 26 or higher. In this study, the non-diabetic (control) group exhibited a mean MoCA score of >26 (26.21 ± 0.46), while the diabetic group demonstrated a low MoCA score of 18.99 ± 0.48, indicating a significant association between diabetes and cognitive impairment. These findings are consistent with previous studies reporting a higher incidence of mild MCI in patients with T2DM. Specifically, sociodemographic factors were associated with cognitive impairment in 50% of the diabetic study population, and another study demonstrated statistically significant MCI in T2DM patients with higher levels of HbA1C, FBS, and PPBS levels ,24.The control group demonstrated significantly superior performance compared to the test group across various subdomains of the MoCA tool, including visuospatial/executive function, naming, attention, abstraction, and delayed recall. However, both groups had average scores in the language and orientation domains, indicating that DM may not cause problems with language skills such as comprehension, fluency, or grammar or with orientation skills such as the capacity to judge time and place .p-value < 0.001). These results agreed with a recent study illustrating the age-related prevalence of MCI in T2DM patients in the Indian population, which demonstrated a consistently lower performance on the MoCA scale with increasing age groups of the diabetic population [Furthermore, an assessment of the influence of demographics on cognitive impairment revealed that age was the only factor that statistically influenced cognitive impairment  of diabetic participants had a diabetes duration of at least 5 years, while only a small percentage (13%) had diabetes for 10 or more years. Furthermore, over 93% of participants were taking regular medication for diabetes, with oral anti-diabetic medication being the most common treatment; however, medication use did not significantly affect MoCA scores. Notably, the participant with the highest MoCA score of 23(0) was both single and married, while the lowest score of 17.43 (5.224) was recorded in seven participants who did not adhere to their medication regimen consistently.Analysis of PPBS data in the test group revealed that 40% of the participants had their PPBS above 250 mg/dL while 19% were in the range of 201–205 mg/dL, 25% had PPBS in the range of 151–200, and 16% were within the range of 75–150 mg/dL. The diabetic patients assessed with MCI (92%) had a PPBS of 249.85 (107.973), and those who had normal cognition (8%) were found to have 229.75 (85.081) mg/dL, but the data were not significant.This study revealed that a significant number of individuals with diabetes showed mild MCI despite scoring well in specific cognitive domains. Conversely, individuals without diabetes who scored highly in the same cognitive domains demonstrated normal cognitive function. The findings suggest that the prevalence of MCI among diabetic individuals may be because of the complex and diverse nature of diabetes, which has multiple contributing factors, including oxidative stress and inflammatory responses. These factors might play a crucial role in the development of cognitive impairment in diabetic individuals, as supported by previous research ,29,30.According to the observational cross-sectional study, there is a substantial prevalence of cognitive impairment among the local T2DM community in Mysuru, India, as evidenced by their subpar performance on practically every cognitive domain tested by MoCA. This study had the limitation that it was a single-center study with a limited population size. Moreover, due to the unavailability of HbA1C data for the subjects, this study could not infer the association between cognitive decline and HbA1C, an essential marker of diabetes. Additionally, the lack of characterization of diabetic complications cannot be substituted by disease onset. However, the higher occurrence of MCI in the diabetic group suggested that detecting MCI in T2DM should be incorporated into routine clinical practice and supported with early treatment through lifestyle and pharmacological interventions. Further studies are required to explore the therapeutic use of anti-glycemic agents and antioxidants to combat the hyperglycemia, oxidative stress, and inflammatory conditions existing in the diabetic brain and alleviate the cognitive decline across diverse geographic regions and ethnic groups, as well as investigate interventions such as lifestyle modifications and medication to prevent or delay cognitive decline in T2DM patients.


Evidence shows that early treatment targeted directly to mitochondria could extend the lifespan of model mice and decrease the relevant neuropathological markers. Therefore, research on the mitochondrial dysfunction of AD can be of potential significance for clinical treatment. To date, few bibliometric analysis articles related to mitochondrial dysfunction of AD have been published. Bibliometric analysis refers to quantitatively analyzing certain aspects of articles like publishers, authors, and countries by using statistical and mathematical methods. Combined with statistical software, a large number of papers can be converted to visualization figures and tables, which provide vital information such as keyword hotspots and the names of contributing authors. Through the bibliometric analysis method, our study aimed to provide study trends and keyword hotpots for researchers to conduct further relevant research in this field.Alzheimer’s disease (AD) is a neurodegenerative disease characterized by progressive progress and memory loss, which eventually develops into dementia. It can cause personality disorders and decreased quality of life of patients. Currently, AD patients account for 60–70% of global dementia patients and the incidence rate of AD is increasing annually. AD not only causes pain to patients but also brings a heavy burden to the entire family. Studies have found that there is a connection between mitochondrial dysfunction and other biochemical changes in AD like classical neuropathological hallmarks ] ND [TS = (mitochondrion)], ranging from January 1, 2000 to June 30, 2022. VOSviewer v1.6.18, Arcgis 10.8, and HistCite pro 2.1 were used to conduct data visualization analysis. VOSviewer v1.6.18 made relevant network visualization maps of the cooperative relationship between relevant countries, institutions, and authors (co-authorship), the frequency of different keywords appearing together (co-occurrence), and the frequency of different articles cited together (co-cited). Arcgis 10.8 created the world map of publications distribution in this field and Histcite pro 2.1 was used to count the local citation score (LCS) of references. In addition, Journal Citation Reports were used to consult the latest journal import factor and JCI quartile.As of June 30, 2022, from the Web of Science core collection, we selected 2,474 original articles in English, excluding the document types of the news items, meeting abstracts, and some articles that had little relevance to our theme. The United States acted as the leader and enjoyed a high reputation in this field. The University of California System was the institution that made the greatest contribution (3.64% with 90 papers). Most articles were published in the Journal of Alzheimer’s Disease . The most frequently co-cited journal in Q1 was the Journal of Biological Chemistry . Russel H. Swerdlow (55 publications) was the most productive author and PH Reddy was the most co-cited author with 1,264 citations (TLS: 62971). The hotpots of mitochondrial dysfunction in AD were as follows: “oxidative stress,” “amyloid-beta-protein,” “tau,” “apoptosis,” “inflammation,” “autophagy,” “precursor protein,” “endoplasmic-reticulum,” “dynamics” and “mitochondrial unfolded protein response.”This bibliometric analysis research will help readers rapidly identify current hotpots and milestone studies related to directions of interest in AD research. Its core symptom is cognitive impairment, which gradually worsens over time, making it the leading cause of dementia in humans. According to the World Alzheimer Report, approximately 50 million people worldwide are suffering from dementia, of which 35 million are Alzheimer’s patients. According to data from different countries and regions, about 4.6% ~ 8.7% of adults over 60 years old are suffering from this disease and the incidence rate increases with age. The prevalence rate can be as high as 69.4% among people aged over 90. Because of its feature of progressive progress and gradually aggravated memory loss, AD patients will eventually completely lose their ability to take care of themselves. Their families need to spend enough time and money to take care of them. AD is a heavy burden and brings great pain to both patients and their families. Currently, clinical treatment drugs for AD do not effectively delay disease progression and it is, therefore, necessary to explore new drugs for this purpose.β plaque and tau protein but had no expected therapeutic effect. Mitochondrial dysfunction not only leads to the abnormal energy metabolism of neurons but also interrelates with Aβ plaque, tau protein, aberrant reactive oxygen species(ROS) homeostasis, calcium overload, abnormal apoptosis, mitochondrial morphology, dynamics, DNA changes, and autophagy, etc. ROS is a natural by-product of normal oxygen metabolism. When ROS increases sharply, it can damage the cellular structure and cause oxidative stress (aberrant ROS homeostasis). , neurofibrillary tangles (tau protein), vital mitochondrial dysfunction, oxidative stress, and inflammation pathways in brain neurons . Neurocystasis). . As the artments . Mitochoitophagy . Mitochoitophagy . In addiitophagy . The intitophagy .Although many studies on mitochondria have been carried out, to date, no analyses have been conducted a systematic statistical review analysis. Many articles have been published related to mitochondrial dysfunction in AD, meaning it can be difficult for readers to quickly identify interesting articles. Bibliometric analysis refers to the use of mathematical and statistical methods to analyze all knowledge carriers quantitatively. The main measurement objects are literature volume, number of authors, institutions, countries, and keywords. VOSviewer v1.6.18, Arcgis 10.8, and HistCite pro 2.1 are used to analyze knowledge carriers and made visualization maps or tables. VOSviewer is a knowledge graph software based on thousands of articles that can construct relationships  between literature knowledge units  and achieve visual analysis through network maps. In the visualization network map, all nodes are divided into several clusters. Different clusters show different colors. The size of the nodes represents the frequency of occurrence of the specific knowledge unit and links between nodes represent the relevance between units. To view the publications of each country/region in the world more clearly, Arcgis 10.8 was used to create a world map of publications distribution. HistCite Pro 2.1 was used to analyze the LCS of references in this field so that we can quickly identify the influential articles on mitochondrial dysfunction of AD. By combining bibliometric analysis with statistical software, we can select a high number of publications from different countries/regions, institutions, journals, authors, the most highly-cited references, authors, journals, and popular keywords from thousands of papers published in recent decades.Our study conducted a bibliometric analysis of published papers in the direction of mitochondrial dysfunction during the last 20 years and aimed to discover the current research hotspots and study trends to provide a roadmap for further research .2.The Web of Science core collection database was queried with the following search string: [TS = (Alzheimer’s disease)] ND [TS = (mitochondrion)]. The date ranged from January 1, 2000, to June 30, 2022. We excluded some special article types including meeting abstracts, news items, and so on. Articles, reviews, proceeding papers, and book chapters were collected. We also screened low-relevance papers in this field. Eventually, only the above four types of original articles written in English and published within the search range date were included.We used the “export” function to save documents locally. The storage format of the document was as a “txt” file, which is suitable for VOSviewer v1.6.18 and HistCite pro 2.1 software. These data were imported into VOSviewer v 1.6.18 to create network visualization maps, aiming to analyze co-authorship, co-occurrence, and co-cited countries/regions, institutions, authors, journals, and hotspot keywords. In the visualization map, the size of the nodes represents the occurrence frequency of relevant elements, the thickness of the chain represents the degree of connection, and the color of the nodes indicates that they belong to different modules. Meanwhile, these data were imported into HistCite Pro 2.1 to analyze the LCS of articles. We made an Excel spreadsheet of the top 30 countries/regions publications and imported the table into Arcgis 10.8 to make a world map of publications distribution with a color gradient. The top 10 countries were marked on the world map. Journal Citation Reports (2021) was used to consult the latest journal import factor and JCI quartile.3.3.1.From January 1, 2000, to June 30, 2022, 2,474 papers were provided by the Web of Science core collection online database (2022.9), including 1719 original research articles (69.48%), 745 reviews (30.11%), 78 proceeding papers (3.15%), and 22 book chapters (0.89%). Other document types like meeting abstracts and news items were excluded . A totaln = 117). More recently, 238 papers were published in 2020, 273 papers were published in 2021 and 128 papers were published in the first half of 2022. Compared with 20 years ago, the annual output in 2021 (n = 273) is nearly 15 times that of 2000 (n = 19).The annual publication output in this field with an overall growth trend is shown in 3.2.n = 992, 40.10%), followed by China , Italy , the Germany , India , Spain , England , South Korea , Portugal , and Japan . In these countries/regions, the United States had 78,280 citations, 141 h-index, and its citations per publication (CPP) was 78.91. These all ranked first among 10 countries/regions. The network visualization map analysis of co-authorship of countries/regions , Universidade DE Comibra , University of Texas System , Cornell University , University of Kansas . The University of California System had the highest H (%)-index (50) and Case Western Reserve University was the institution with the most citations per publication (135.30). Seven of the top 10 institutions were from the United States and others were from Portugal, Britain, and France. The network visualization map of co-authorship of institutions  published the most research in this field and had the highest H-index (61) followed by Molecular Neurobiology , Neurobiology of Aging , the International Journal of Molecular Sciences , and the Journal of Neurochemistry . Among these journals, Cells  ranked tenth and had the highest IF (7.666) and its CCP was 15.49. Biochimica ET Biophysica ACTA-Molecular Basis of Disease  had the highest CCP of 138.12 and had the second highest IF (6.633). The analysis diagram of co-cited journals showed in The top 10 productive journals related to mitochondrial dysfunction of Alzheimer’s disease are shown in 3.3.3.4.The top 10 LCS of articles is shown in 3.5.The network visualization map of co-occurrence keywords shown in 4.β plaques and tau protein, we concentrated on articles related to mitochondrion changes in neuron cells, which is one of the research directions of AD. Through the bibliometric analysis method, we aimed to illustrate keyword hotspots and research trends in this field that are convenient for researchers in conducting further studies. We used the Web of Science core collection database to search relevant articles from January 1, 2000, to June 30, 2022. Some special types of articles such as meeting abstracts, editorial materials, and new items were excluded. Through screening articles with low relevance, a total of 2,474 original papers in English were collected. As a neurodegenerative disease, AD is characterized by progressive progress and memory loss that eventually contribute to dementia, which causes patients to lose their ability to take care of themselves, with most of them dying of infection eventually. During this period, a large amount of time and money is spent, creating a heavy burden on the patient’s family. Due to these facts, finding approaches to delaying disease progression and increasing the quality of a patient’s life is key to AD research. AD is considered a multifactorial disease, including Aβ plaque, tau protein, inflammation pathways, mitochondrial dysfunction, and oxidative stress. Additionally, several risk factors such as aging, genetic factors, head injuries, vascular diseases, infections, and environmental factors play a role in the disease . Becausen < 200) compared with the United States. Despite all this, these countries/regions still play an important role and promote the development of this field.From the distribution of countries/regions, the United States is the main driving force, with a high academic reputation in the field of AD. In just over 20 years, the United States published 992 articles, approximately 40% of the total, with 78,280 citations, 141 H-index, and 78.91 CCP, all ranking first among all countries/regions. Furthermore, 43 countries/regions had a close cooperative relationship with the United States, such as China, Japan, Portugal, and France. China ranked second (403 articles) with quick progress in these years. Other countries/regions like Italy, Germany, India, Spain, England, South Korea, Portugal, and Japan all had a lower publication amount   . Relevane brain) .β plaque and tau protein), which interact with mitochondrial dysfunctions including abnormal mitochondria dynamics, altered mitochondrial morphology, altered mitochondrial gene expression, increased free radical production, lipid peroxidation, reduced COX activity, and reduced ATP production. Studies have shown that Aβ/tau protein can impair mitochondrial quality control systems including autophagy and mitophagy, and eventually lead to the accumulation of abnormal mitochondria . T2DM leads to body metabolic disorders that activate oxidative stress, abnormal protein processing, and proinflammatory cytokines, causing chronic inflammation and impaired neuronal insulin signaling in the brain . The incAs another recent research hotspot, mitochondrial unfolded protein response (UPRmt) belonging to the mitochondrial quality control system is a mitochondria stress response. UPRmt is the transcriptional activation program of mitochondrial chaperone proteins and proteases are initiated to maintain proteostasis in mitochondria. Mitochondrial chaperone proteins help misfolded proteins to restore to normal conformation and newly synthesized proteins to fold correctly. Proteases help to degrade useless proteins. Aβ and tau deposition contribute to the accumulation of damaged or unfolded protein, which will increase the expression levels of mitochondrial chaperone proteins and proteases . MeanwhiIn general, researchers have concentrated on undertaking basic medicine studies of AD. However, most of the time, clinical treatment with relevant theories has not achieved good results due to the onset complexity of AD. There is still a long way for researchers to go on exploring the neuropathology of AD.Previous bibliometric studies of AD have analyzed the relationship between the intestine and AD, epilepsy and AD, and brain energy metabolism disorder in AD . Our stu4.1.Our study also has some limitations as we could not retrieve all articles meeting the requirements of this field. Due to not all types of papers were selected, our findings might not be fair to authors who published papers in excluded types. We may ignore their contributions in this field. Our study also only included articles in the first half of 2022, meaning these data do not represent the whole research trend for that year. Finally, our analysis was subjective and it can’t represent all people’s views.5.The highest number of publications were from the United States followed by China, Italy, Germany, and India. The primary partners of the United States were China, Italy, Germany, India, and Portugal.The University of California System in the United States and Russell. H. Swerdlow were the most cited institution and author, respectively. The Journal of Alzheimer’s Disease was the highest-cited journal.The research hotspot in this field included the following five aspects: abnormal mitochondrial dynamics, the direct relationship between abnormal mitochondria and oxidative damage, the cytochrome C oxidase deficiency, modulation of the endoplasmic reticulum-mitochondria interface, and high levels of mitochondrial DNA deletions in substantia nigra neurons.The research trend from 2012 to 2021 was: “calcium homeostasis,” “precursor protein,” “amyloid beta,” “autophagy,” “dynamics,” “abnormal interaction,” and “unfolded protein response (UPR).”This bibliometric analysis study aimed to help researchers and non-researchers quickly find research hotspots and landmark studies related to mitochondrial dysfunction in AD. There are shortcomings from insufficient data or analysis and more progressive studies are needed in the future.The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.YGe conceptualized this study and designed this project. RS and HY undertook data curation. RS performed the major procedures and wrote the manuscript. YGe revised the manuscript and approved the final manuscript. YGu, YF, HR, and HW assisted in the analysis of the data.This study was funded by the Natural Science Foundation of Liaoning Province [2022-MS-317], the United Fund of the Second Hospital of Dalian Medical University and Dalian Institute of Chemical Physics, Chinese Academy of Sciences [UF-ZD-202012], and the “1 + X” program for Clinical Competency enhancement–Improvement of Clinical Technology Project, The Second Hospital of Dalian Medical University [2022LCJSGC04].The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Rapid technological, industrial and agricultural development has resulted in the release of large volumes of pollutants, including metal ions, into the environment. Heavy metals have become of great concern due to their toxicity, persistence, and adverse effects caused to the environment and population. In this regard, municipal and industrial effluents should be thoroughly treated before being discharged into natural water or used for irrigation. The physical, chemical, and biological techniques applied for wastewater treatment adsorption have a special place in enabling effective pollutant removal. Currently, plenty of adsorbents of different origins are applied for the treatment of metal-containing aqueous solution and wastewater. The present review is focused on mesoporous materials. In particular, the recent achievements in mesoporous materials’ synthesis and application in wastewater treatment are discussed. The mechanisms of metal adsorption onto mesoporous materials are highlighted and examples of their multiple uses for metal removal are presented. The information contained in the review can be used by researchers and environmental engineers involved in the development of new adsorbents and the improvement of wastewater treatment technologies.  Water contamination is one of the most significant issues the globe has faced in recent years. According to the United Nations, approximately 80% of all industrial and urban wastewater is discharged into the environment, particularly in developing countries , often wThe intensification of human activities and the active application of metals in agriculture, the plating and electroplating industry, the chemical industry, mechanical engineering, the textile industry, metal smelting, the petrochemical industry, etc. ,3, has cGreat efforts are required to reduce the negative impact of toxic elements on natural ecosystems. One of the important tools for addressing the problem is the careful treatment of wastewater before its discharge into the environment or further use. Currently, a wide variety of techniques, including biological treatment, coagulation, ultrafiltration, coagulation, flocculation, membrane separation procedures, chemical precipitation, ion exchange, enhanced oxidation, reverse osmosis, membrane filtration, ion exchange, electrochemical treatment, irradiation, extraction, and adsorption are applied to reduce concentrations of heavy metals in wastewater to maximum admissible levels ,9,10. HoAdsorption has demonstrated great potential among the technologies available for metal removal due to its economic feasibility, ease of handling, the accessibility of sorbents, affordability, large surface area, high adsorption capacity, and environmental sustainability, as well as its potential selectivity for the target metal and low sludge generation. Heavy metal ions can be captured and removed from wastewater using commercial and natural adsorbents, which are often characterized by high removal capacity ,15,16,17Functional mesoporous materials are now seen as intriguing compounds for a variety of applications, including drug delivery, biomedicine, catalysis, and the adsorption of pollutants of different origins. These materials are characterized by large pore volumes, exceptionally large specific surface area, homogeneous pore size distributions, and tunable pore sizes, which contribute to their technological advantages ,31. AddiThe aim of the present review is to discuss the main researchers’ achievements in the synthesis and application of mesoporous materials for metal removal from aqueous solutions attained in the last several years. Furthermore, a discussion of the factors affecting the adsorbents’ removal capacity usually described in review papers ,33, the The synthesis of mesoporous materials (pore diameters 2–50 nm) is a rapidly developing field of bioremediation studies. Today, mesoporous materials with different mesostructures and high surface areas can be obtained in different forms for a wide range of applications . Recent The synthesis of new mesoporous materials requires their detailed characteristics in order to determine the particle size, pore morphology, surface area, and structure, and a detailed study of the surface of the produced material, including the specification of functional groups. A set of techniques, including X-ray diffraction (XRD), transmission and scanning electron microscopy (TEM and SEM), energy dispersive X-ray analysis (EDXA), Fourier transform infrared spectroscopy (FTIR), nitrogen adsorption–desorption, and thermal gravimetric analysis (TGA) can be applied to solve this task . Among various mesoporous adsorbents available for the removal of heavy metals, silica-based materials are one of the most popular due to their large surface area and excellent chemical, thermal, and mechanical stabilities . An intr2/g. The XRD pattern confirmed the SBA-15 structure 3NBr(CTAB), while SBA-15 was produced using (EO)20(PO)70(EO)20. The XRD pattern of MCM-41 showed the hexagonal structure of the material, while in the case of SBa-15, the excellent textural uniformity of the material was demonstrated. The surface area of Al-MCM-41 was 842 m2/g, the pore volume was 0.75 cm3/g, and the pore diameter was 3.7 nm. The surface area of SBA-15 was 483 m2/g, the pore volume was 0.53 cm3/g, and the pore diameter was 5.5 nm. The TEM images confirmed the pore system symmetries for Al-MCM-41 and showed the porous structure of SBA-15. Zhai  applied orted by . The sur-authors  applied 2/g and a pore size of 6.9 nm. XRD measurements showed that the obtained MI was hematite (α-Fe2O3), and TEM images revealed that MI has an irregular shape with diameters in the 0.5–1 μm range 2+ complex was formed. As the Cu concentration in solution increases, the [Cu(RNH2)2]2+ turns into [Cu(RNH2)]2+, enhancing adsorption. The reaction of Cu with hydroxyl groups via Si–O–Cu–O–Si bridging species is considered another possible mechanism of metal ion removal. The adsorption of Cu onto SBA-1 occurred due to the formation of a covalent bond between the Cu atom and oxygen in the adsorbent medium, Si–O–Cu [2 groups as well as p-delocalized electrons of the triazine ring (C3N3) participated in Cu adsorption onto Zr–G–C3N4 sorbent [Copper ions’ adsorption onto DAPy@MSA NPs occurred mainly due to the coordination of Cu ions with the pyridyl and hydroxyl groups . Da’na a Si–O–Cu . The OH  sorbent . At the  sorbent . Ryu et  sorbent  showed t3O4@n-SiO2@mSiO2/EDTA) proceeded by ion exchange and surface complexation mechanisms [3+ groups is a possible mechanism for Cr(VI) sorption by amino-functionalized mesoporous silica [3O4 occurred mainly due to surface complexation between Sb(III) and amorphous ferric oxide. The presence of Fe3+ can contribute to additional Sb(III) removal by co-precipitation [The mechanism responsible for Hg adsorption onto ethylenediamine functionalized KIT–6 (DA-KIT–6) silica materials was physical adsorption, which consisted of the formation of a physical bond between the Hg ions and basic nitrogen atoms on the adsorbent surface . It was chanisms . Electros silica . Electros silica . The ions silica . The Zn s silica . The adspitation . Accordipitation .The mechanisms of metal ions’ removal by mesoporous materials are strongly dependent on the type of the applied adsorbent as well as experimental conditions. At the same time, metal ions’ interaction with functional groups can be specified as the most frequently reported mechanism of adsorption onto mesoporous materials.3, EDTA, NaOH, etc. In some cases, depending on the type of adsorbent, specific eluents can be applied. For example, in the case of CeO2-based mesoporous adsorbents, the ion exchange mechanism with peroxide treatment can be applied for sorbent regeneration due to the reaction of CeO2 with H2O2, resulting in the formation of stable cerium-oxo and peroxide bonds on the CeO2 surface. This technology allowed for the recycling of the adsorbent for six consecutive adsorption–desorption cycles in the Othman et al. [To justify the economic and environmental value of the adsorbent, it is important to demonstrate not only its high adsorption capacity but also the possibility of the adsorbent’s multiple uses. The repeated use of adsorbents allows for a reduction in the cost of the wastewater treatment process. In desorption experiments, an essential component is the eluent used for metal recovery, which should effectively elute the adsorbed heavy metals without altering the adsorption capacity of the adsorbent . The attn et al.  study.2SO4, losing only 5% of its adsorption capacity [The adsorption capacity of amine-functionalized SBA-15 used for Cu adsorption after ten cycles was 90% comparable to the raw material when EDTA was used for regeneration . Mesoporcapacity . Thus, m−3 at optimal experimental conditions [The cost of adsorbent synthesis and application is an important factor that determines material suitability for wastewater treatment in light of existing competing technologies . Kobylinnditions .Shewanella xiamenensis biofilm and zeolite was calculated to be 530 USD [For comparison, the price of one ton of mineral–organic hybrid adsorbent, consisting of bacteria  530 USD . The aut 530 USD . Mukherj 530 USD  showed tMesoporous materials are excellent candidates for the removal of heavy metals from wastewater. Their application in remediation processes is determined by the high variety of materials; the possibility of adsorbent modification, which allows for increasing their adsorption capacity; high removal efficiency; and resistance to aggressive media. Moreover, the mesoporous materials can be easily regenerated, and their adsorption capacity is maintained at a high level even after more than five cycles of adsorption–desorption. Several mechanisms, including physical adsorption, complexation, coordination, ion exchange, and precipitation participate in metal adsorption on the mesoporous materials. However, the main role belongs to metal ions’ interaction with functional groups. Consequently, further efforts of scientists and engineers should be directed toward the development of low-cost mesoporous materials for large-scale applications.


TM Round SilkSurface  in Korean women. A total of 87 women (n = 87) were included in the current study. We compared preoperative anthropometric measurements between the right side and the left side of the breast. Moreover, we also compared the thickness of the skin, subcutaneous tissue and the pectoralis major measured on a breast ultrasound preoperatively and 3 months postoperatively. Furthermore, we analyzed the incidences of postoperative complications and the cumulative complication-free survival. Preoperatively, there was a significant difference in the distance from the nipple to the midline between the left and right side of the breast (p = 0.000). Both sides of the breast showed significant differences in the thickness of the pectoralis major preoperatively and 3 months postoperatively (p = 0.000). A total of 11 cases (12.6%) of postoperative complications occurred; these included five cases (5.7%) of early seroma, two cases (2.3%) of infection, two cases (2.3%) of rippling, one case (1.1%) of hematoma and one case (1.1%) of capsular contracture. Time-to-events were estimated at 386.68 ± 27.79 days (95% CI 334.11–439.27). Here, we describe our experience with imaging modalities in combination with the Motiva ErgonomixTM Round SilkSurface in Korean women.With the occurrence of breast implant crises in Korea, it has become increasingly important to detect complications earlier in patients receiving a device. We have therefore combined imaging modalities with an implant-based augmentation mammaplasty. In this study, we assessed the short-term treatment outcomes and safety of the Motiva Ergonomix A silicone gel-filled breast implant (SGBI) is a shell of silicone elastomer that is filled with silicone gel. It is placed either under the breast tissue or the chest muscle of a patient, thus being used for an implant-based augmentation mammaplasty . Its useThe prevalent use of an SGBI for aesthetic purposes reflects the growth of the cosmetic industry. This has been recently fueled by advertisement, social media and medical tourism . In partThe global market for breast implantation is expected to generate USD 2866.7 million by 2027, growing at compound annual growth rate of 6.55% between 2022 and 2027 . This isDespite the popularity of medical tourism and the expansion of the global market for breast implants, concerns have been raised regarding a lack of standardized regulatory action on cosmetic surgical procedures worldwide. This should be taken seriously because an implant-based augmentation mammaplasty is the most popular cosmetic surgery worldwide . Moreove®  breast implant scandal) [Historically, the breast implant industry has been heavily affected by a series of crisis events, thus termed as breast implant crises (BICs) . Global scandal) ,23,24,25scandal) .A wide variety of SGBIs are commercially available for surgery. It is mandatory, however, to select the optimal type of SGBI, which is essential for maximizing the aesthetic outcomes and minimizing the risk of postoperative complications . In thisOver the past 50 years, SGBIs have undergone many changes that are closely associated with their safety, quality and clinical performance . Among sThe surface texturing of an SGBI aims to lower the incidences of common complications of an implant-based augmentation mammaplasty, such as capsular contracture (CC) and the excessive movement of the device in the breast pocket ,33,34,35The use of a textured breast implant has been advocated based on the argument that it is useful in lowering the rates of malposition, decreasing the risk of CC and providing superior cosmetic outcomes compared with a smooth device ,39,40,41The emergence of a textured breast implant was followed by the development of a microtextured device that is characterized by a surface with a miniaturized roughness . Indeed,TM Round SilkSurface  is the latest generation of an SGBI with a microtextured surface. It is closely associated with the popularity of microtextured devices in the Korean market. Its 3-year safety has been recently assessed using high-resolution ultrasound (HRUS) [TM Round SilkSurface. Here, we describe plastic surgeons’ experience with imaging modalities in combination with the Motiva ErgonomixTM Round SilkSurface in Korean women. Its safety in a cohort of Korean women has been well documented [The Motiva Ergonomixd (HRUS) . Indeed,d (HRUS) ,25,51,52cumented ,24,25,53n = 87; mean age = 33.79 ± 7.68 years old and mean follow-up period = 183.14 ± 158.03 days) were included in the current study. Their demographic and clinical characteristics are summarized in A total of 87 women . This indicates that the patients with a significant difference in the distance from the nipple to the midline between the two sides of the breast should be corrected for symmetry. A preoperative assessment of breast anthropometrics is an essential factor for breast surgery [Differences in the anthropometric measurements between the left and right side of the breast are summarized in  surgery . This en surgery . A preop surgery . It also surgery .We obtained measurements of the thickness of the dermis, subcutaneous tissue and pectoralis major preoperatively and at 3 months postoperatively, as summarized in t = 5.633, p = 0.000 and left side: 4.07 ± 1.44 vs. 2.04 ± 0.46 mm, t = 4.882, p = 0.000) (Both sides of the breast showed no significant differences in the thickness of the dermis and subcutaneous tissue preoperatively and 3 months postoperatively (= 0.000) . This inAn illustrative case is shown in A total of 11 cases (12.6%) of postoperative complications occurred; these included five cases (5.7%) of early seroma, two cases (2.3%) of infection, two cases (2.3%) of rippling, one case (1.1%) of hematoma and one case (1.1%) of CC . The patThe time-to-events (TTEs) were estimated at 386.68 ± 27.79 days (95% CI 334.11–439.27) . The corWith the identification of a causal relationship between a textured breast implant and the onset of BIA-ALCL, there has been controversy surrounding the use of a textured device . This isTM Round SilkSurface was approved by the KMFDS on 17 June 2016. The shift from textured breast implants to microtextured devices is an interesting phenomenon in Korea [Controversial opinions exist regarding the discontinued use of textured breast implants. Efforts have been made to reduce the risk of BIA-ALCL, for which the use of a textured breast implant has shifted to that of a smooth device among plastic surgeons ,63. The in Korea . Accordiin Korea .Despite the advancement of breast implant technology and surgical techniques, there have been no changes in the occurrence of complications of implant-based augmentation mammaplasty. Among such complications, CC and the rupture of a breast implant remain serious events. It is therefore mandatory to perform continuous monitoring of the possible complications of an implant-based augmentation mammaplasty, which is essential for ensuring the safety of patients receiving a device .TM Round SilkSurface is an innovative type of a product whose characteristics are distinguishable from those of other manufacturers. That is, its visible barrier layer, nanoscale smooth surface and optional radiofrequency are advantageous in ensuring postoperative safety [The Motiva Ergonomixe safety . Moreovee safety . Indeed,e safety ,67.TM Round SilkSurface is useful in fulfilling two goals: a natural appearance and feel of the breast and a reduction in the risks of malrotation. Thus, it has efficiently combined its rheologic properties with the use of a specific elastomer shell, thus adjusting with gravity to the patient’s position, as previously described [The size, shape and projection of breast implants have been diversified to cater for the needs of patients who are in need of augmentation mammaplasties by preserving the natural appearance of the breast, which poses a challenge for plastic surgeons. Round breast implants were formerly used to improve the upper pole fullness, but anatomical ones have become available to maximally imitate the natural shape of the breast by providing more fullness in the lower pole . Despiteescribed .n = 15,570), Establishment Labs Holdings Inc. (n = 9732), Groupe Sebbin SAS (n = 7374), GC Aesthetics PLC (n = 1406), Allergan Inc. (n = 145) and Silimed Inc. (n = 2) in decreasing order [TM Round SilkSurface might be the device of choice for Korean women who have been faced with the BIA-ALCL crisis and the first Korean case of medical device fraud [TM Round SilkSurface is the highest, although it triggered a boom in microtextured devices [TM Round SilkSurface is the most popular brand of SGBI in Korea. A recent study also reported that breast cancer survivors receiving the Motiva ErgonomixTM Round SilkSurface achieved improvements in quality of life following a 4-week nurse-led exercise rehabilitation [Currently in Korea, diverse types of SGBI are commercially available, and their safety profile varies according to the manufacturer. It would therefore be mandatory to consider the safety profile of each device when selecting the optimal type of device for Korean women who are in need of an implant-based augmentation mammaplasty . Indeed,ng order . Indeed,ce fraud ,70. The  devices . As desc devices . Conside devices . This inlitation .TM Round SilkSurface in Korea. Previous studies have shown that patients receiving the Motiva ErgonomixTM Round SilkSurface presented with postoperative complications at rates of 6.58–12.82% [2, the volume of breast implant > 350 cc, the submammary pocket and a smoking habit served as risk factors of early seroma [2, however, we assume that the high incidence of early seroma might arise from foreign body reactions, as previously advocated [To date, evidence-based efforts have been made to define the safety of the Motiva Ergonomix8–12.82% ,53,71,73y seroma . Considedvocated .TM Round SilkSurface [Global researchers have also evaluated the safety of the Motiva ErgonomixkSurface ,82,83,84kSurface ,82,83,84kSurface ,86. HoweTM Round SilkSurface. This deserves further studies based on mathematical and mechanical models, as proposed by the existing literature [The results of the current study cannot be generalized. First, we failed to consider the prospective design. Prospective studies are more reliable in providing more scientifically reliable results compared with retrospective ones . Second,terature ,89.TM Round SilkSurface in Korean women. This deserves further large-scale, prospective studies.Here, we describe our experience with imaging modalities, including HRUS, in combination with an implant-based augmentation mammaplasty using the Motiva ErgonomixTM Round SilkSurface for aesthetic purposes at our hospitals between December 2020 and November 2022 [Following the occurrence of the first Korean case of medical device fraud, a total of 87 Korean women (174 breasts) received the Motiva Ergonomixber 2022 ,25. We iTM 3-D scanner (Establishment Labs Holdings Inc.) by measuring breast anthropometrics . Under general anesthesia or intravenous sedation, all surgical procedures were performed in accordance with a 14-point plan, as previously proposed ,97,98. Wa pocket . We reduced the risk of skin contamination using a wipe/prep skin, barrier or sleeve. We shortened the implant open time and replaced sizers. While changing surgical gloves prior to handling, we used new or cleaned instruments and drapes. However, we did not use a drainage tube because it may be a potential site of bacterial entry . We closThe patients underwent stringent postoperative monitoring at 1, 2, 3, and 4 weeks; 3, 6, 9, and 12 months; and thereafter using HRUS  ,22,23,24To assess the possible occurrence of postoperative swelling, we measured the thickness of the dermis, subcutaneous tissue and pectoralis major on HRUS. Then, we compared measurements preoperatively and 1 and 3 months postoperatively, as previously described ,70.TM Round SilkSurface, as previously described [We compared anthropometric measurements, such as breast base width, breast base height, distance from the sternal notch to the nipple, distance from the nipple to the midline, distance from the nipple to the inframammary fold (IMF), areolar diameter, breast volume, internipple distance and intermammary distance, between the left and right side of the breast. Moreover, we also monitored time-dependent changes in the thickness of the dermis, subcutaneous tissue and pectoralis major muscle preoperatively and 1 and 3 months postoperatively ,70. Furtescribed ,53,71,73t-test. To analyze the survival rates of the Motiva ErgonomixTM Round SilkSurface, we estimated the TTEs, defined as the length of time until a well-defined end point of interest occurs, expressed as the percentage of the Motiva ErgonomixTM Round SilkSurface remaining without undergoing revision or removal. Then, we plotted the Kaplan–Meier complication-free survival curve, for which the cumulative overall complication-free survival was estimated, and 95% confidence intervals (CIs) were provided [p < 0.05.Measurements are expressed as mean ± standard deviation or the number of the patients with percentage. The differences in measurements between the left and right side of the breast, or preoperatively and postoperatively 1 and 3 months were analyzed using the Student’s provided ,73,105.