Ultra-Proximal Jejunostomy Application after McKeown-Type Esophagectomy: A Retrospective Case-Series Study.

Background: Jejunostomy is the main form of enteral nutritional support after McKeown-type esophagectomy. However, this requires the jejunum to be secured to the abdominal wall, which can lead to catheter-related complications. Here, we present a new type of jejunostomy, ultra-proximal jejunostomy, which does not require fixation of the jejunum to the abdominal wall. Methods: Patients who underwent McKeown-type esophagectomy between January 2021 and March 2022 were included in this study. Postoperative outcomes of patients who underwent ultra-proximal jejunostomy are also presented. Results: Forty-three patients were able to receive enteral nutritional support via an ultra-proximal jejunostomy after McKeown-type esophagectomy, and no cases of enteral fistulas were observed. The pain in the left lower abdomen largely disappeared after the removal of the jejunostomy tube in all patients, and there was no difficulty in removing the tube. To date, none of these patients have experienced bowel obstruction or jejunal torsion. Conclusion: An ultra-proximal jejunostomy is a safe and feasible method and a better option for enteral nutrition support after McKeown-type esophagectomy.

Characterization of an Emergent Chicken H3N8 Influenza Virus in Southern China: a Potential Threat to Public Health.

Although influenza A viruses of several subtypes have occasionally infected humans, to date only those of the H1, H2, and H3 subtypes have led to pandemics and become established in humans. The detection of two human infections by avian H3N8 viruses in April and May of 2022 raised pandemic concerns. Recent studies have shown the H3N8 viruses were introduced into humans from poultry, although their genesis, prevalence, and transmissibility in mammals have not been fully elucidated. Findings generated from our systematic influenza surveillance showed that this H3N8 influenza virus was first detected in chickens in July 2021 and then disseminated and became established in chickens over wider regions of China. Phylogenetic analyses revealed that the H3 HA and N8 NA were derived from avian viruses prevalent in domestic ducks in the Guangxi-Guangdong region, while all internal genes were from enzootic poultry H9N2 viruses. The novel H3N8 viruses form independent lineages in the glycoprotein gene trees, but their internal genes are mixed with those of H9N2 viruses, indicating continuous gene exchange among these viruses. Experimental infection of ferrets with three chicken H3N8 viruses showed transmission through direct contact and inefficient transmission by airborne exposure. Examination of contemporary human sera detected only very limited antibody cross-reaction to these viruses. The continuing evolution of these viruses in poultry could pose an ongoing pandemic threat. IMPORTANCE A novel H3N8 virus with demonstrated zoonotic potential has emerged and disseminated in chickens in China. It was generated by reassortment between avian H3 and N8 virus(es) and long-term enzootic H9N2 viruses present in southern China. This H3N8 virus has maintained independent H3 and N8 gene lineages but continues to exchange internal genes with other H9N2 viruses to form novel variants. Our experimental studies showed that these H3N8 viruses were transmissible in ferrets, and serological data suggest that the human population lacks effective immunological protection against it. With its wide geographical distribution and continuing evolution in chickens, other spillovers to humans can be expected and might lead to more efficient transmission in humans.

Proximate deconfined quantum critical point in SrCu2(BO3)2.

The deconfined quantum critical point (DQCP) represents a paradigm shift in quantum matter studies, presenting a "beyond Landau" scenario for order-order transitions. Its experimental realization, however, has remained elusive. Using high-pressure 11B nuclear magnetic resonance measurements on the quantum magnet SrCu2(BO3)2, we here demonstrate a magnetic field-induced plaquette singlet to antiferromagnetic transition above 1.8 gigapascals at a notably low temperature, Tc ≃ 0.07 kelvin. First-order signatures of the transition weaken with increasing pressure, and we observe quantum critical scaling at the highest pressure, 2.4 gigapascals. Supported by model calculations, we suggest that these observations can be explained by a proximate DQCP inducing critical quantum fluctuations and emergent O(3) symmetry of the order parameters. Our findings offer a concrete experimental platform for investigation of the DQCP.

Single-dose rAAV5-based vaccine provides long-term protective immunity against SARS-CoV-2 and its variants.

The COVID-19 pandemic, caused by the SARS-CoV-2 virus and its variants, has posed unprecedented challenges worldwide. Existing vaccines have limited effectiveness against SARS-CoV-2 variants. Therefore, novel vaccines to match mutated viral lineages by providing long-term protective immunity are urgently needed. We designed a recombinant adeno-associated virus 5 (rAAV5)-based vaccine (rAAV-COVID-19) by using the SARS-CoV-2 spike protein receptor binding domain (RBD-plus) sequence with both single-stranded (ssAAV5) and self-complementary (scAAV5) delivery vectors and found that it provides excellent protection from SARS-CoV-2 infection. A single-dose vaccination in mice induced a robust immune response; induced neutralizing antibody (NA) titers were maintained at a peak level of over 1:1024 more than a year post-injection and were accompanied by functional T-cell responses. Importantly, both ssAAV- and scAAV-based RBD-plus vaccines produced high levels of serum NAs against the circulating SARS-CoV-2 variants, including Alpha, Beta, Gamma and Delta. A SARS-CoV-2 virus challenge showed that the ssAAV5-RBD-plus vaccine protected both young and old mice from SARS-CoV-2 infection in the upper and lower respiratory tracts. Whole genome sequencing demonstrated that AAV vector DNA sequences were not found in the genomes of vaccinated mice one year after vaccination, demonstrating vaccine safety. These results suggest that the rAAV5-based vaccine is safe and effective against SARS-CoV-2 and several variants as it provides long-term protective immunity. This novel vaccine has a significant potential for development into a human prophylactic vaccination to help end the global pandemic.

Progress of the COVID-19: Persistence, Effectiveness, and Immune Escape of the Neutralizing Antibody in Convalescent Serum.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a new coronavirus causing Coronavirus Disease 2019 (COVID-19), is a major topic of global human health concern. The Delta and Omicron variants have caused alarming responses worldwide due to their high transmission rates and a number of mutations. During a one-year follow-up (from June 2020 to June 2021), we included 114 patients with SARS-CoV-2 infection to study the long-term dynamics and the correlative factors of neutralizing antibodies (NAbs) in convalescent patients. The blood samples were collected at two detection time points (at 6 and 12 months after discharge). We evaluated the NAbs response of discharged patients by performing a micro-neutralization assay using a SARS-CoV-2 wild type. In addition, a total of 62 serum samples from discharged COVID-19 patients with Alpha, Beta, Delta, and Omicron variants of infection were enrolled to perform cross-neutralization tests using the original SARS-CoV-2 strain and VOCs variants (including Alpha, Beta, Gamma, Delta, and Omicron variants) and to assess the ability of NAbs against the SARS-CoV-2 variants. NAbs seroconversion occurred in 91.46% of patients (n = 82) in the first timepoint and in 89.29% of patients (n = 84) in the second detection point, and three kinds of NAbs kinetics curves were perceived. The NAbs levels in young patients had higher values than those in elder patients. The kinetics of disease duration was accompanied by an opposite trend in NAbs levels. Despite a declining NAbs response, NAbs activity was still detectable in a substantial proportion of recovered patients one year after discharge. Compared to the wild strain, the Omicron strain could lead to a 23.44-, 3.42-, 8.03-, and 2.57-fold reduction in neutralization capacity in "SAlpha", "SBeta", "SDelta", and "SOmicron", respectively, and the NAbs levels against the Omicron strain were significantly lower than those of the Beta and Delta variants. Remarkably, the NAbs activity of convalescent serum with Omicron strain infection was most obviously detectable against six SARS-CoV-2 strains in our study. The role of the vaccination history in NAbs levels further confirmed the previous study that reported vaccine-induced NAbs as the convincing protection mechanism against SARS-CoV-2. In conclusion, our findings highlighted the dynamics of the long-term immune responses after the disappearance of symptoms and revealed that NAbs levels varied among all types of convalescent patients with COVID-19 and that NAbs remained detectable for one year, which is reassuring in terms of protection against reinfection. Moreover, a moderate correlation between the duration of disease and Nabs titers was observed, whereas age was negatively correlated with Nabs titers. On the other hand, compared with other VOCs, the Omicron variant was able to escape the defenses of the immune system more significantly, and the convalescent serum infected with the Omicron variant played a critical part in protection against different SARS-CoV-2 variants. Recovery serum from individuals vaccinated with inactivated vaccine preceding infection with the Omicron strain had a high efficacy against the original strain and the VOCs variants, whereas the convalescent serum of persons vaccinated by inactivated vaccine prior to infection with the Delta variant was only potent against the wild-type strain.

Second magnetization peak, anomalous field penetration, and Josephson vortices in KCa[Formula: see text]Fe[Formula: see text]As[Formula: see text]F[Formula: see text] bilayer pnictide superconductor.

We performed magnetization measurements in a single crystal of the anisotropic bilayer pnictide superconductor KCa[Formula: see text]Fe[Formula: see text]As[Formula: see text]F[Formula: see text], with [Formula: see text] [Formula: see text] 34 K, for [Formula: see text] [Formula: see text] [Formula: see text]-axis and [Formula: see text] [Formula: see text] [Formula: see text]-planes. A second magnetization peak (SMP) was observed in the isothermal M(H) curves measured below 16 K for [Formula: see text] [Formula: see text] [Formula: see text]-planes. A peak in the temperature variation of the critical current density, [Formula: see text](T), at 16 K, strongly suggests the emergence of Josephson vortices at lower temperatures, which leads to the SMP in the sample. In addition, it is noticed that the appearance of Josephson vortices below 16 K renders easy magnetic flux penetration. A detailed vortex dynamics study suggests that the SMP can be explained in terms of elastic pinning to plastic pinning crossover. Furthermore, contrary to the common understanding, the temperature variation of the first peak field, [Formula: see text], below and above 16 K, behaves non-monotonically. A highly disordered vortex phase, governed by plastic pinning, has been observed between 17 and 23 K, within a field region around an extremely large first peak field. Pinning force scaling suggests that the point defects are the dominant source of pinning for H [Formula: see text] [Formula: see text]-planes, whereas, for H [Formula: see text] [Formula: see text]-axis, point defects in addition to surface defects are at play. Such disorder contributes to the pinning due to the variation in charge carrier mean free path, [Formula: see text] -pinning. Moreover, the large [Formula: see text] observed in our study is consistent with the literature, which advocates this material for high magnetic field applications.

Bamboo-like Vortex Chains Confined in Canals with Suppressed Superconductivity and Standing Waves of Quasiparticles.

The vortex core can be regarded as a nanoscale confined system for quasiparticles in a type-II superconductor. It is very interesting to investigate the interplay between the vortex core and other microscopic quantum confined systems. We observe band-like canals with the width of about 15 nm on the surface of KCa2(Fe1-xNix)4As4F2 (x = 0.05) by scanning tunneling microscopy. Some canals suppress superconductivity and confine parallel standing waves due to the quasiparticle interference. Upon magnetic fields being applied, some elongated vortices are formed within canals showing bamboo-like one-dimensional vortex chains. Interestingly, the confined vortex cores are elongated roughly along the perpendicular direction of canals, and the local density of states at positive and negative energies shows an in-phase oscillation at zero field; but, it becomes out-of-phase crossing the vortex cores. Our work reveals a new type of vortex patterns in confined canals and its interplay with the quasiparticle interference.

Lung image segmentation based on DRD U-Net and combined WGAN with Deep Neural Network.

PURPOSE: COVID-19 is a hot issue right now, and it's causing a huge number of infections in people, posing a grave threat to human life. Deep learning-based image diagnostic technology can effectively enhance the deficiencies of the current main detection method. This paper proposes a multi-classification model diagnosis based on segmentation and classification multi-task. METHOD: In the segmentation task, the end-to-end DRD U-Net model is used to segment the lung lesions to improve the ability of feature reuse and target segmentation. In the classification task, the model combined with WGAN and Deep Neural Network classifier is used to effectively solve the problem of multi-classification of COVID-19 images with small samples, to achieve the goal of effectively distinguishing COVID-19 patients, other pneumonia patients, and normal subjects. RESULTS: Experiments are carried out on common X-ray image and CT image data sets. The results display that in the segmentation task, the model is optimal in the key indicators of DSC and HD, and the error is increased by 0.33% and reduced by 3.57 mm compared with the original network U-Net. In the classification task, compared with SMOTE oversampling method, accuracy increased from 65.32% to 73.84%, F-measure increased from 67.65% to 74.65%, G-mean increased from 66.52% to 74.37%. At the same time, compared with other classical multi-task models, the results also have some advantages. CONCLUSION: This study provides new possibilities for COVID-19 image diagnosis methods, improves the accuracy of diagnosis, and hopes to provide substantial help for COVID-19 diagnosis.

Chromobox Homologue 7 Acts as a Tumor Suppressor in Both Lung Adenocarcinoma and Lung Squamous Cell Carcinoma via Inhibiting ERK/MAPK Signaling Pathway.

Chromobox homologue 7 (CBX7) is a member of the polycomb group family that plays a pivotal role in regulating cellular processes in human cancers. This study aims to explore the function and underlying molecular mechanisms of CBX7 in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC). The expression of CBX7 in LUAD and LUSC tissues was analyzed by UALCAN and GEPIA based on the TCGA database. Cell viability and apoptosis were measured by CCK-8 and flow cytometry assays, respectively. Cell migration and invasion were detected by transwell assay. The functions of downregulated genes in LUAD were enriched via GO and KEGG pathway analyses. The mRNA expression of CBX7, ERK1/2, and p38 was determined by qRT-PCR, and the protein levels of CBX7, ERK1/2, p-ERK1/2, p38, and p-p38 were measured by Western blotting. Tumor xenograft model was established to validate the antitumor effect of CBX7. The expression of CBX7 and Ki-67 in tumor tissues was detected by immunohistochemistry. CBX7 was downregulated in the tissues and cells of both LUAD and LUSC. Low CBX7 expression was associated with a poor overall survival rate in LUAD patients. CBX7 overexpression inhibited the viability, migration, and invasion and promoted the apoptosis of LUAD and LUSC cells. In addition, the downregulated genes in LUAD were enriched in MAPK cascade (GO) and MAPK signaling pathway (KEGG). ERK/MAPK pathway was then determined as a downstream target of CBX7, which was inhibited by CBX7 overexpression in LUAD and LUSC cells. The overexpression of CBX7 inhibited the malignant progression of LUAD and LUSC cells probably via suppressing the ERK/MAPK signaling pathway in vitro and in vivo.

Friedel Oscillations of Vortex Bound States under Extreme Quantum Limit in KCa_{2}Fe_{4}As_{4}F_{2}.

We report the observation of discrete bound states with the energy levels deviating from the widely believed ratio of 1∶3∶5 in the vortices of an iron-based superconductor KCa_{2}Fe_{4}As_{4}F_{2} through scanning tunneling microscopy (STM). Meanwhile Friedel oscillations of vortex bound states are also observed for the first time in related vortices. By doing self-consistent calculations of Bogoliubov-de Gennes equations, we find that at extreme quantum limit, the superconducting order parameter exhibits a Friedel-like oscillation, which modifies the energy levels of the vortex bound states and explains why it deviates from the ratio of 1∶3∶5. The observed Friedel oscillations of the bound states can also be roughly interpreted by the theoretical calculations, however some features at high energies could not be explained. We attribute this discrepancy to the high energy bound states with the influence of nearby impurities. Our combined STM measurement and the self-consistent calculations illustrate a generalized feature of vortex bound states in type-II superconductors.

Extreme Suppression of Antiferromagnetic Order and Critical Scaling in a Two-Dimensional Random Quantum Magnet.

Sr_{2}CuTeO_{6} is a square-lattice Néel antiferromagnet with superexchange between first-neighbor S=1/2 Cu spins mediated by plaquette centered Te ions. Substituting Te by W, the affected impurity plaquettes have predominantly second-neighbor interactions, thus causing local magnetic frustration. Here we report a study of Sr_{2}CuTe_{1-x}W_{x}O_{6} using neutron diffraction and µSR techniques, showing that the Néel order vanishes already at x=0.025±0.005. We explain this extreme order suppression using a two-dimensional Heisenberg spin model, demonstrating that a W-type impurity induces a deformation of the order parameter that decays with distance as 1/r^{2} at temperature T=0. The associated logarithmic singularity leads to loss of order for any x>0. Order for small x>0 and T>0 is induced by weak interplane couplings. In the nonmagnetic phase of Sr_{2}CuTe_{1-x}W_{x}O_{6}, the µSR relaxation rate exhibits quantum critical scaling with a large dynamic exponent, z≈3, consistent with a random-singlet state.

A temperature-modulated dilatometer by using a piezobender-based device.

We report a new design of a temperature-modulated dilatometer, which obtains the linear thermal expansion coefficient by measuring the oscillating changes of the sample's length and temperature by using a piezobender and a thermocouple, respectively. Using an iron-based superconductor KFe2As2 as an example, we show that this device is able to measure thin samples with high resolutions at low temperatures and high magnetic fields. Despite its incapability of giving absolute values, the new dilatometer provides a high-resolution method to study many important physical properties in condensed matter physics, such as thermal and quantum phase transitions and vortex dynamics in the superconducting state. The prototype design of this device can be further improved in many aspects to meet particular requirements.

Neutron Spin Resonance in a Quasi-Two-Dimensional Iron-Based Superconductor.

The neutron spin resonance is generally regarded as a key to understanding the magnetically mediated Cooper pairing in unconventional superconductors. Here, we report an inelastic neutron scattering study on the low-energy spin excitations in a quasi-two-dimensional iron-based superconductor KCa_{2}Fe_{4}As_{4}F_{2}. We have discovered a two-dimensional spin resonant mode with downward dispersions, a behavior closely resembling the low branch of the hourglass-type spin resonance in cuprates. While the resonant intensity is predominant by two broad incommensurate peaks near Q=(0.5,0.5) with a sharp energy peak at E_{R}=16 meV, the overall energy dispersion of the mode exceeds the measured maximum total gap Δ_{tot}=|Δ_{k}|+|Δ_{k+Q}|. These results deeply challenge the conventional understanding of the resonance modes as magnetic excitons regardless of underlining pairing symmetry schemes, and it also points out that when the iron-based superconductivity becomes very quasi-two-dimensional, the electronic behaviors are similar to those in cuprates.

Quantum Phases of SrCu_{2}(BO_{3})_{2} from High-Pressure Thermodynamics.

We report heat capacity measurements of SrCu_{2}(BO_{3})_{2} under high pressure along with simulations of relevant quantum spin models and map out the (P,T) phase diagram of the material. We find a first-order quantum phase transition between the low-pressure quantum dimer paramagnet and a phase with signatures of a plaquette-singlet state below T=2 K. At higher pressures, we observe a transition into a previously unknown antiferromagnetic state below 4 K. Our findings can be explained within the two-dimensional Shastry-Sutherland quantum spin model supplemented by weak interlayer couplings. The possibility to tune SrCu_{2}(BO_{3})_{2} between the plaquette-singlet and antiferromagnetic states opens opportunities for experimental tests of quantum field theories and lattice models involving fractionalized excitations, emergent symmetries, and gauge fluctuations.

Safety and immunogenicity of an 8 year interval heterologous prime-boost influenza A/H7N7-H7N9 vaccination.

BACKGROUND: Influenza A/H7N9 viruses are undergoing antigenic drift since their emergence in 2013, and vaccination strategies are needed for pandemic preparedness. Two doses of adjuvanted monovalent inactivated influenza A/H7N9 vaccine (IIV1 A/H7N9) are needed for optimal serological responses. However, administering 2 doses in a pandemic setting might be challenging. We evaluated the immunogenicity of "boosting" with IIV1 A/H7N9 in subjects "primed" 8 years previously with IIV1 A/H7N7. METHODS: We administered 1 booster dose containing 45 mcg of IIV1 A/H7N9 hemagglutinin to 17 recipients of 2 prior doses of IIV1 A/H7N7, and to 10 influenza A/H7-naïve subjects. We tested their post-boosting sera for antibodies (Ab) against homologous influenza A/H7N9 using a hemagglutination inhibition assay; and compared their Ab titers to those in stored sera from recipients of AS03-adjuvanted IIV1 A/H7N9 against 9 strains of influenza A/H7N9 viruses. RESULTS: The percentage of subjects with Ab titers ≥40 on Days 9 and 29 post boosting, respectively, was 65% and 41% in primed subjects and 10% and 0% in unprimed subjects. The Ab titers in recipients of AS03-adjuvanted IIV1 A/H7N9 were higher than those in the prime-boost group against a panel of influenza A/H7N9 viruses, except for 2 highly pathogenic strains. CONCLUSIONS: Priming with IIV1 A/H7 results in serological responses following a delayed boost with 1 dose of unadjuvanted IIV1 A/H7N9, despite lack of antibody response after the prime. Optimizing prime-boost approaches would benefit pandemic preparedness. ClinicalTrials.gov identifier: NCT02586792.

Infectivity and Transmissibility of Avian H9N2 Influenza Viruses in Pigs.

UNLABELLED: The H9N2 influenza viruses that are enzootic in terrestrial poultry in China pose a persistent pandemic threat to humans. To investigate whether the continuous circulation and adaptation of these viruses in terrestrial poultry increased their infectivity to pigs, we conducted a serological survey in pig herds with H9N2 viruses selected from the aquatic avian gene pool (Y439 lineage) and the enzootic terrestrial poultry viruses (G1 and Y280 lineages). We also compared the infectivity and transmissibility of these viruses in pigs. It was found that more than 15% of the pigs sampled from 2010 to 2012 in southern China were seropositive to either G1 or Y280 lineage viruses, but none of the sera were positive to the H9 viruses from the Y439 lineage. Viruses of the G1 and Y280 lineages were able to infect experimental pigs, with detectable nasal shedding of the viruses and seroconversion, whereas viruses of the Y439 lineage did not cause a productive infection in pigs. Thus, adaptation and prevalence in terrestrial poultry could lead to interspecies transmission of H9N2 viruses from birds to pigs. Although H9N2 viruses do not appear to be continuously transmissible among pigs, repeated introductions of H9 viruses to pigs naturally increase the risk of generating mammalian-adapted or reassorted variants that are potentially infectious to humans. This study highlights the importance of monitoring the activity of H9N2 viruses in terrestrial poultry and pigs. IMPORTANCE: H9N2 subtype of influenza viruses has repeatedly been introduced into mammalian hosts, including humans and pigs, so awareness of their activity and evolution is important for influenza pandemic preparedness. However, since H9N2 viruses usually cause mild or even asymptomatic infections in mammalian hosts, they may be overlooked in influenza surveillance. Here, we found that the H9N2 viruses established in terrestrial poultry had higher infectivity in pigs than those from aquatic birds, which suggests that adaptation of the H9N2 viruses in terrestrial poultry might have increased the infectivity of the virus to mammals. Therefore, monitoring the prevalence and evolution of H9 viruses prevalent in terrestrial birds and conducting risk assessment of their threat to mammals are critical for evaluating the pandemic potential of this virus.

[Immune Protection against H9N2 Provided by H1N1 Pre-infection in Pigs].

To explore the impact of the history of infection by the influenza A virus subtype H1N1 on secondary infection by the influenza A virus subtype H9N2, pigs non-infected and pre-infected with H1N1 were inoculated with H9N2 in parallel to compare nasal shedding and seroconversion patterns. Unlike pigs without a background of H1N1 infection, nasal shedding was not detected in pigs pre-infected with H1N1. Both groups generated antibodies against H9N2. However, levels of H1N1 antibodies in pigs pre-infected with H1N1 increased quickly and dramatically after challenge with H9N2. Cross-reaction was not observed between H1N1 antibodies and H9N2 viruses. These findings suggest that circulation of the H1N1 virus might be a barrier to the introduction and transmission of the avian H9N2 virus, thereby delaying its adaptation in pigs.

Dual E627K and D701N mutations in the PB2 protein of A(H7N9) influenza virus increased its virulence in mammalian models.

The ongoing avian H7N9 influenza outbreaks in China have caused significant human fatal cases and the virus is becoming established in poultry. Mutations with potential to increase mammalian adaptation have occurred in the polymerase basic protein 2 (PB2) and other viral genes. Here we found that dual 627K and 701N mutations could readily occur during transmission of the virus among ferrets via direct physical contact, and these mutations conferred higher polymerase activity and improved viral replication in mammalian cells, and enhanced virulence in mice. Special attention needs to be paid to patients with such mutations, as these may serve as an indicator of higher virus replication and increased pathogenicity.