Hemolymph protease-17b activates proHP6 to stimulate melanization and Toll signaling in Manduca sexta.

Manduca sexta hemolymph protease-6 (HP6) plays a central role in coordinating antimicrobial responses, such as prophenoloxidase (PPO) activation and Toll signaling. Our previous studies indicated that HP5 and GP6 activate proHP6 in larval hemolymph and extraembryonic tissues, respectively. Here, we report the characterization of HP17b as another HP6 activating enzyme and its regulation by multiple serpins in hemolymph. The precursor of HP17b expressed in baculovirus infected Sf9 cells became spontaneously cleaved at two sites, and these products were purified together in one preparation named HP17b', a mixture of proHP17b, a 35 kDa intermediate, and HP17b. HP17b' converted proHP6 to HP6. As reported before, HP6 converted precursors of PPO activating protease-1 (PAP1) and HP8 to their active forms. HP8 activates proSpӓtzle-1 to turn on Toll signaling. We found HP17b' directly activated proSPHI and II to form a cofactor for PPO activation by PAP1. Supplementation of larval hemolymph with HP17b', HP17b, or proHP17b significantly increased PPO activation. Adding Micrococcus luteus to the reactions did not enhance PPO activation in the reactions containing HP17b', HP17b, or proHP17b. Using HP17b antibodies, we isolated from induced plasma HP17b fragments and associated proteins (e.g., serpin-4). Serpin-1A, 1J, 1J', 4, 5, or 6 reduced the activation of proHP6 by HP17b' through formation of covalent complexes with active HP17b. We detected an activity for proHP17b cleavage in hemolymph from bar-stage pharate pupae but failed to purify the protease due to its high instability. Other known HPs did not activate proHP17b in vitro. Together, these results suggest that HP17b is a clip-domain protease activated by an unknown endopeptidase in response to a danger signal and regulated by multiple serpins.

Swimtrans Net: a multimodal robotic system for swimming action recognition driven via Swin-Transformer.

Introduction: Currently, using machine learning methods for precise analysis and improvement of swimming techniques holds significant research value and application prospects. The existing machine learning methods have improved the accuracy of action recognition to some extent. However, they still face several challenges such as insufficient data feature extraction, limited model generalization ability, and poor real-time performance. Methods: To address these issues, this paper proposes an innovative approach called Swimtrans Net: A multimodal robotic system for swimming action recognition driven via Swin-Transformer. By leveraging the powerful visual data feature extraction capabilities of Swin-Transformer, Swimtrans Net effectively extracts swimming image information. Additionally, to meet the requirements of multimodal tasks, we integrate the CLIP model into the system. Swin-Transformer serves as the image encoder for CLIP, and through fine-tuning the CLIP model, it becomes capable of understanding and interpreting swimming action data, learning relevant features and patterns associated with swimming. Finally, we introduce transfer learning for pre-training to reduce training time and lower computational resources, thereby providing real-time feedback to swimmers. Results and discussion: Experimental results show that Swimtrans Net has achieved a 2.94% improvement over the current state-of-the-art methods in swimming motion analysis and prediction, making significant progress. This study introduces an innovative machine learning method that can help coaches and swimmers better understand and improve swimming techniques, ultimately improving swimming performance.

Transcarotid flow reversal for proximal control during cerebral aneurysm clip reconstruction: illustrative case.

BACKGROUND: Paraclinoid aneurysms can pose an operative challenge during clip reconstruction, given the complex surrounding anatomy and the aneurysmal tendency to maintain turgor despite standard approaches to proximal control. This report demonstrates the use of intraoperative retrograde arteriovenous shunting with the transcarotid artery revascularization (TCAR) system to assist in the safe clip reconstruction of an irregular paraclinoid aneurysm. OBSERVATIONS: A 33-year-old woman presented with perimesencephalic subarachnoid hemorrhage and was found to have an incidental 9-mm ophthalmic aneurysm. Coil embolization was not successful. During microsurgical clip reconstruction, the left common carotid artery was exposed to allow for proximal control as well as transcarotid arterial sheath placement. Flow reversal was instituted throughout the aneurysm dissection and clipping, with a visible softening of the aneurysm. Intraoperative angiography confirming successful clip reconstruction was performed utilizing the TCAR sheath. The case was complicated by the development of cerebrospinal fluid rhinorrhea postoperatively, requiring surgical repair. The patient has since made a complete recovery. LESSONS: Transcarotid flow reversal utilizing the TCAR system has potential for use in the surgical treatment of paraclinoid aneurysms, as it may aid in softening the aneurysm for safer dissection and clip reconstruction, protect against aneurysm-associated emboli, and provide an avenue for intraoperative angiography. https://thejns.org/doi/10.3171/CASE24330.

Analysis of Gillies Temporal Approach vs Towel Clip Method for Reduction of Zygoma Fractures.

PURPOSE: The purpose of this study was to analyse Gillies Temporal approach Vs Towel Clip method for reduction of zygoma fractures. METHOD: A randomised comparative study was conducted on 30 patients having zygoma fractures confirmed with pre-operative NCCT face with 3 D reconstruction. Patients were divided into 2 groups, Group-1- Gillies temporal approach and Group-2- Towel clip method. Clinical observations were recorded in a predesigned proforma for all the patients and analysed statistically. RESULTS: Gillies Temporal Approach significantly p < 0.001 took longer time for reduction than Towel Clip Method. Post-operative pain was experienced more in Group 1 than Group 2. Intraocular pressure was compared at different time intervals and significant difference was noted. Also, Occulocardiac reflex was observed in Group 1. Mean trismus index was 16.87 ± 5.12 mm in Group 1 and 13.33 ± 4.11 mm in Group 2 preoperatively which significantly increased to 51.93 mm in Group 1 and 51.73 mm in Group 2 one month post-op. Reduction was maintained post-operatively with good quality of outcome in both the groups. CONCLUSION: Non-comminuted zygomatic complex fractures can be effectively treated using Towel Clip Method as this method is cost-effective, minimally invasive, safe, causing minimum or no damage to soft tissue and easy to perform based on surgeon's skill and requires less operating time, proving it equally efficient method with excellent aesthetic outcomes.

Endoscopic Management of Iatrogenic Perforations.

The evolution of sophisticated technology has brought about the rise of endoscopic strategies for managing iatrogenic esophageal perforation. This approach is reserved for stable patients with limited contamination. The most commonly performed procedures are reviewed, focusing on procedural steps and outcomes. Esophageal stenting remains the most widely implemented strategy with promising success rates. Clipping, endoluminal vacuum therapy, and suturing are also viable options. Patient selection and further study are paramount to establishing this less invasive strategy as a more standard approach.

Clinical management controversy caused by a rare case of silver clip detachment and displacement after tubal silver clip sterilization.

Introduction and importance: The treatment of rare long-term complications such as ectopic silver clips after tubal silver clip sterilization, still follows the principle of removing metal foreign body (MFB) in the abdominal cavity: first choice removal, which seems to be a habitual treatment method by clinical gynecologists. However, this measure has recently been greatly questioned. Case presentation: A 54-year-old postmenopausal woman who had undergone tubal sterilization with a silver clip 32 years ago, presented to the emergency department (ED) with severe left upper abdominal colic, paroxysmal, accompanied by vomiting and radiating pain. Her vital signs were stable, and an emergency routine urine test showed microscopic hematuria. Preliminary consideration was given to ureteral stones, and abdominal pain was relieved after treatment. Abdominal computed tomography confirmed the previous consideration, but unexpectedly found that the left tubal sterilization metal clip disappeared and was ectopic in the perihepatic space. Clinical discussion: This traditional conception of removing MFB in the abdominal cavity is often accepted by many surgeons. Based on the management measures of this case and the systematic review of the literature, we found that the detached ectopic silver clip did not cause serious long-term complications, possibly due to its good tissue receptivity and other characteristics. Conclusion: Although an ectopic silver clip is an MFB in the abdominal cavity, it has been increasingly shown that removing the silver clip is not necessary because of the good receptivity of silver to human tissue and the uncertainty of long-term side effects on the human body.

Outcomes and predictors of intraprocedural rupture in patients with cerebral aneurysm.

BACKGROUND: Intraprocedural rupture (IPR) is a devastating complication of cerebral aneurysm treatment. While several studies have investigated its risk factors and clinical impact, further research with larger populations is warranted. METHODS: We retrospectively reviewed data from 4,039 patients with 4,233 cerebral aneurysms treated at our institution between January 2009 and December 2018. Multivariate logistic regression with stepwise elimination was performed to identify the independent risk factors of IPR. Unfavorable clinical outcome was defined as a Modified Rankin Scale (mRS) ≥ 3 points at 3 months post-treatment. RESULTS: IPR occurred in 61 (1.44%) of the 4,233 aneurysms. Multivariate analysis showed that previously ruptured aneurysms (odds ratio [OR] 3.182; 95% confidence interval [CI] 1.851-5.470; p < 0.001), surgical clipping (OR 3.598; 95% CI 1.894-6.836; p < 0.001), and higher aspect ratio (OR 1.310; 95% CI 1.032-1.663; p = 0.024) were independent risk factors for IPR. Patients with IPR had significantly higher rates of unfavorable clinical outcomes (mRS ≥ 3) compared to those without (18.0% vs. 3.3%, p < 0.001). However, within the ruptured aneurysm subgroup, the rate of unfavorable outcomes did not differ significantly between IPR and non-IPR groups (22.7% vs. 19.2%, p = 0.594). CONCLUSION: Ruptured aneurysms, surgical clipping, and higher aspect ratio were independently associated with IPR. IPR significantly increased the risk of unfavorable clinical outcomes regardless of treatment approach, except in the subgroup of ruptured aneurysms.

Efficacy of a novel traction method: outside-lesion clip-thread method for gastric endoscopic submucosal dissection of lesions of the greater curvature of the upper/middle stomach (with video).

BACKGROUND: Gastric endoscopic submucosal dissection (ESD) for lesions located on the greater curvature of the upper and middle (U/M) third of the stomach remains challenging, even for experienced endoscopists. Accordingly, we have developed a novel traction technique, termed the outside-lesion clip-thread method (O-CTM). In this method, a clip thread is attached to the healthy mucosa outside the circumferential incision line, and traction is applied to bring the scope and lesion into proximity for ESD. Here, we assessed the efficacy of ESD using the O-CTM compared to ESD without the O-CTM. METHODS: We retrospectively reviewed data from 63 consecutive patients who underwent gastric ESD for 63 lesions located on the greater curvature of the U/M third of the stomach between September 2015 and April 2024. The primary outcome was the operation time, and secondary outcomes were resection speed, en bloc resection, R0 resection and complications in the O-CTM and without O-CTM ESD groups. RESULTS: Of the 63 included lesions, 37 were resected without the O-CTM between September 2015 and June 2022 (without O-CTM group), and 26 lesions were resected using the O-CTM between July 2022 and April 2024 (O-CTM group). The O-CTM group had significantly shorter operation times (40 min vs. 77 min, p = 0.01) than the without O-CTM group. The resection speed was also significantly faster (20.1 mm2/min vs. 11.3 mm2/min, p = 0.02). No significant differences in en bloc resection rate, R0 resection rate, and complications were observed. CONCLUSIONS: Gastric ESD using O-CTM is beneficial when compared with the ESD without O-CTM in reducing operation time and improving resection speeds for treating lesions located on the greater curvature of the U/M region.

Exportin-5 binding precedes 5'- and 3'-end processing of tRNA precursors in Drosophila.

Exportin5 (Exp5) is the major miRNA nuclear export factor and recognizes structural features of pre-miRNA hairpins, while it also exports other minihelix-containing RNAs. In Drosophila, Exp5 is suggested to play a major role in tRNA export because the gene encoding the canonical tRNA export factor Exportin-t is missing in its genome. To understand molecular functions of fly Exp5, we studied the Exp5/RNA interactome in the cell line S2R + using the crosslinking and immunoprecipitation (CLIP) technology. The CLIP experiment captured known substrates such as tRNAs and miRNAs and detected candidates of novel Exp5 substrates including various mRNAs and long non-coding RNAs (lncRNAs). Some mRNAs and lncRNAs enriched PAR-CLIP tags compared to their expression levels, suggesting selective binding of Exp5 to them. Intronless mRNAs tended to enrich PAR-CLIP tags; therefore, we proposed that Exp5 might play a role in the export of specific classes of mRNAs/lncRNAs. This result suggested that Drosophila Exp5 might have a wider variety of substrates than initially thought. Surprisingly, Exp5 CLIP reads often contained sequences corresponding to the flanking 5'-leaders and 3'-trailers of tRNAs, which were thought to be removed prior to nuclear export. In fact, we found pre-tRNAs before end-processing were present in the cytoplasm, supporting the idea that tRNA end-processing is a cytoplasmic event. In summary, our results provide a genome-wide list of Exp5 substrate candidates and suggest that flies may lack a mechanism to distinguish pre-tRNAs with or without the flanking sequences.

Nuclear PKM2 binds pre-mRNA at folded G-quadruplexes and reveals their gene regulatory role.

Nuclear localization of the metabolic enzyme PKM2 is widely observed in various cancer types. We identify nuclear PKM2 as a non-canonical RNA-binding protein (RBP) that specifically interacts with folded RNA G-quadruplex (rG4) structures in precursor mRNAs (pre-mRNAs). PKM2 occupancy at rG4s prevents the binding of repressive RBPs, such as HNRNPF, and promotes the expression of rG4-containing pre-mRNAs (the "rG4ome"). We observe an upregulation of the rG4ome during epithelial-to-mesenchymal transition and a negative correlation of rG4 abundance with patient survival in different cancer types. By preventing the nuclear accumulation of PKM2, we could repress the rG4ome in triple-negative breast cancer cells and reduce migration and invasion of cancer cells in vitro and in xenograft mouse models. Our data suggest that the balance of folded and unfolded rG4s controlled by RBPs impacts gene expression during tumor progression.

RL-CWtrans Net: multimodal swimming coaching driven via robot vision.

In swimming, the posture and technique of athletes are crucial for improving performance. However, traditional swimming coaches often struggle to capture and analyze athletes' movements in real-time, which limits the effectiveness of coaching. Therefore, this paper proposes RL-CWtrans Net: a robot vision-driven multimodal swimming training system that provides precise and real-time guidance and feedback to swimmers. The system utilizes the Swin-Transformer as a computer vision model to effectively extract the motion and posture features of swimmers. Additionally, with the help of the CLIP model, the system can understand natural language instructions and descriptions related to swimming. By integrating visual and textual features, the system achieves a more comprehensive and accurate information representation. Finally, by employing reinforcement learning to train an intelligent agent, the system can provide personalized guidance and feedback based on multimodal inputs. Experimental results demonstrate significant advancements in accuracy and practicality for this multimodal robot swimming coaching system. The system is capable of capturing real-time movements and providing immediate feedback, thereby enhancing the effectiveness of swimming instruction. This technology holds promise.

Achieving a cure for anastomotic leakage following laparoscopic low anterior resection for rectal cancer using an endoscopic closure device, a MANTIS clip.

Anastomotic leakage (AL) following low anterior resection (LAR) for rectal cancer is a major complication. While most reports focus on the closure of AL using over-the-scope clip (OTSC), few reports are available on the use of through-the-scope clip (TTSC). This is because TTSC is not typically designed for full-thickness closure, unlike OTSC. However, a MANTIS clip, categorized as TTSC, is indicated for full-thickness closure. A 73-year-old man diagnosed with AL 7 days postoperatively following laparoscopic LAR underwent laparoscopic drainage and ileostomy the next day. Although the drainage led to the shrinkage of the fistula, it persisted even after 2 months. Consequently, the fistula orifice was closed using a MANTIS clip under colonoscopy and radiography. Two days later, the patient was discharged. The drain was withdrawn cautiously to prevent residual fistula and removed completely on day 29. This report highlights our experience in using a MANTIS clip for AL following LAR.

Comparative Evaluation of USG-Guided Single Tissue Marker Versus Multiple Tissue Marker Placements in Breast Malignancy Patients Undergoing Neoadjuvant Chemotherapy for Tumor Localization.

Background Breast cancer remains one of the most common malignancies affecting women globally, contributing significantly to the disease burden. The advent of neoadjuvant chemotherapy (NAC) has revolutionized the treatment for locally advanced breast cancer, allowing tumors to be downstaged and making breast-conserving surgery (BCS) feasible. Accurate localization of the tumor bed post-NAC is crucial for successful surgical removal of residual disease. While traditional single tissue marker placement has been effective, recent advances suggest multiple markers might provide superior localization by comprehensively delineating the entire tumor area. This study aims to compare the effectiveness of single versus multiple tissue marker placements in breast malignancy patients undergoing NAC. Materials and methods A prospective study was conducted in the Department of Radio-diagnosis at Saveetha Medical College over 18 months, including 10 patients diagnosed with breast carcinoma, selected through convenience sampling. Inclusion criteria involved patients diagnosed with breast cancer via mammography, sonography, and histological confirmation, referred for clip placement before NAC. Exclusion criteria were patients unwilling to participate. The procedure involved placing one to two surgical clips within the tumor using a 14/16-gauge coaxial guiding needle under USG guidance, with additional clips for larger or multiple tumors. Data collection included pre-procedural USG, post-procedural mammography (MG1), pre-operative mammography (MG2)/USG, and gross specimen histopathological examination/specimen mammography. Statistical analysis Demographic data, clipping distribution, receptor status, localization methods, surgical outcomes, operation diagnoses, and correlation analysis were statistically analyzed. Mean age, standard deviation, and p-values were calculated to determine the significance of differences between single and multiple clip groups. Results The study included 10 patients with a mean age of 52.5 years. Of these, five (50%) had a single clip, and two (20%) had four clips. The average time from clipping to the second mammogram (MG2) was 106.3 days, and from clipping to operation was 111.0 days, with longer follow-up times for multiple clip patients. Six (60%) of the patients were estrogen receptor (ER) positive, and six (60%) were human epidermal growth factor receptor 2 (HER2) negative. Localization methods were similar between single and multiple clip groups. However, multiple clip patients tended to undergo more extensive surgeries like modified radical mastectomy (MRM). Imaging responses showed no preoperative ultrasound lesions in single clip patients, while multiple clip patients had higher inconsistent diagnoses (10 (100%)) suggesting that multiple clips provide better tumor localization but are linked to increased complexity and longer follow-up times. Conclusion Patients with multiple clips experienced significantly longer follow-up times, reflecting more complex clinical scenarios. Despite no significant differences in receptor status distributions, multiple clip patients required more extensive surgeries, emphasizing the need for tailored surgical planning. The study underscores the importance of considering the number of clips in clinical decision-making. Future research should focus on larger, prospective studies to validate these findings and explore underlying mechanisms.

How to close mucosal incisions?

This article provides an overview of the techniques for closure of the mucosal entry point following advanced procedures in the third space. The outbreak of natural orifice transluminal endoscopic surgery (NOTES) has significantly impacted the treatment of various benign and malignant conditions. Reliable and secure closure of the mucosal entrance is essential for avoiding serious adverse events. Although small defects are typically closed using through-the-scope clips (TTSCs) or over-the-scope clips (OTSCs), challenges may occur with larger or transmural defects. Alternative methods, such as specialised stitches and full-thickness suturing systems, have been developed to address these challenges with promising results. Each method has its own pros and cons, and the choice of closure technique depends on various factors such as anatomical location, endoscopist expertise, costs, and clinical context. By understanding the technical specifications of each closure device, endoscopists can make decisions that enhance patient outcomes and minimise the risk of complications associated with the approximation of defect edges. Continued research is essential to optimise the evolution of newer closure devices and techniques for advancing NOTES.

Clip-on lens for scanning tunneling luminescence microscopy.

We demonstrate and verify the in-situ addition of a collecting lens for electroluminescence experiments to an existing scanning tunneling microscope. We fabricate a simple clip-on lens that we reversibly attach at the sample plate via regular sample transfer tools to collimate the light emitted from a plasmonic tunneling junction to the viewport ordinarily used for optical access. The proximity of the lens to the tunneling junction allows us achieve good collection efficiencies, demonstrating the quick turnaround of converting an existing setup with optical access into a practical scanning luminescence microscope. We verify the function of the clip-on lens by measuring the bias dependent plasmon of Au, Ag, and spatial luminescence maps.•Reversible clip-on lens.•In-situ transfer.•Luminescence.

Ultrasonic Scalpel vs. Polymeric Clip Laparoscopic Varicocelectomy in Adolescents with Symptomatic Varicocele.

Background: The aim of this study was to investigate treatment outcomes in adolescents who underwent laparoscopic surgery with an ultrasonic scalpel for symptomatic varicocele compared with adolescents who underwent surgery with a polymer clip. Methods: A total of 270 adolescents with a median age of 16 (interquartile range, IQR 13-17) years were included in the study. Taking into account the laparoscopic varicocelectomy technique used, the patients were divided into two groups. In the first group (n = 151), a polymer clip was used, while in the second group (n = 119), an ultrasonic scalpel was used to resect the spermatic vessels. The primary outcome measure was the effect of the laparoscopic technique used on treatment outcomes (postoperative complications and recurrence rates). Secondary outcomes were the duration of surgery and anesthesia and the length of hospital stay. Results: The duration of the surgical procedure (12 min (IQR 11, 15) versus 15 min (12, 19), p = 0.029) and anesthesia (21.5 min (16, 29.5) versus 28 min (23, 34), p = 0.003) was shorter in the group of adolescents in whom laparoscopic varicocelectomy was performed with an ultrasonic scalpel than in the group in which a polymer clip was used. No statistically significant difference was found between the groups studied in terms of length of hospital stay, recurrence rate (p >0.999), and complications (p = 0.703). There were no cases of testicular atrophy in either group. In the group of patients who underwent laparoscopic varicocelectomy with an ultrasonic scalpel, a slightly higher incidence of hydroceles was found (n = 4, 3.4%) than in the group in which a polymer clip was used (n = 2, 1.3%) (p = 0.410). At six-month follow-up, it was found that the majority of patients showed moderate or significant improvement in the spermogram after laparoscopic varicocelectomy (n = 85, 89.5%). In addition, the subjective discomfort or pain disappeared in the majority of patients (n = 71, 93.4%). The testicular volume increased significantly in 132 adolescents (89.8%). Conclusions: Laparoscopic varicocelectomy with a polymer clip or ultrasonic scalpel is safe and effective in adolescents with symptomatic varicocele. Treatment outcomes after laparoscopic varicocelectomy are the same regardless of whether a polymer clip or an ultrasonic scalpel is used to resect the spermatic vessels. The use of an ultrasonic scalpel for resection of the spermatic vessels shortens the overall duration of surgery and anesthesia.

Upper Gastrointestinal Bleeding Due to Metastatic Lung Adenocarcinoma in the Stomach and Duodenum.

There are very few reports of bloodborne metastasis of lung adenocarcinoma to the gastrointestinal tract, primarily due to poor prognosis and short survival rate of metastasized carcinoma. We present a case of a 79-year-old man with a medical history of lung adenocarcinoma, who presented with complaints of weakness and melena for 1 week. He had symptomatic anemia, for which he was transfused with blood. Esophagogastroduodenoscopy showed a 10 mm sessile polyp in the gastric body that was removed. One month later, the patient presented with a similar complaint, and another esophagogastroduodenoscopy revealed 2 ulcerated lesions in the second portion of the duodenum. These lesions were treated by hemostatic clip placement and heater probe coagulation. Biopsy of lesions demonstrated thyroid transcription factor 1 and Napsin-positive tumor cells, consistent with lung adenocarcinoma. Owing to the poor prognosis of lung adenocarcinoma metastasizing to the lymph nodes, stomach, and duodenum, the patient was transferred to hospice care.

Detecting images generated by diffusers.

In recent years, the field of artificial intelligence has witnessed a remarkable surge in the generation of synthetic images, driven by advancements in deep learning techniques. These synthetic images, often created through complex algorithms, closely mimic real photographs, blurring the lines between reality and artificiality. This proliferation of synthetic visuals presents a pressing challenge: how to accurately and reliably distinguish between genuine and generated images. This article, in particular, explores the task of detecting images generated by text-to-image diffusion models, highlighting the challenges and peculiarities of this field. To evaluate this, we consider images generated from captions in the MSCOCO and Wikimedia datasets using two state-of-the-art models: Stable Diffusion and GLIDE. Our experiments show that it is possible to detect the generated images using simple multi-layer perceptrons (MLPs), starting from features extracted by CLIP or RoBERTa, or using traditional convolutional neural networks (CNNs). These latter models achieve remarkable performances in particular when pretrained on large datasets. We also observe that models trained on images generated by Stable Diffusion can occasionally detect images generated by GLIDE, but only on the MSCOCO dataset. However, the reverse is not true. Lastly, we find that incorporating the associated textual information with the images in some cases can lead to a better generalization capability, especially if textual features are closely related to visual ones. We also discovered that the type of subject depicted in the image can significantly impact performance. This work provides insights into the feasibility of detecting generated images and has implications for security and privacy concerns in real-world applications. The code to reproduce our results is available at: https://github.com/davide-coccomini/Detecting-Images-Generated-by-Diffusers.

miR-135b-5p promotes gastric carcinogenesis by targeting CLIP4-mediated JAK2/STAT3 signal pathway.

BACKGROUND: Gastric cancer (GC) is a common cancer worldwide; however, its molecular and pathogenic mechanisms remain unclear. MicroRNAs (miRNAs), which target key genes in GC, are associated with tumor promotion or suppression. Therefore, identifying new miRNA mechanisms could improve the novel diagnostic and therapeutic strategies for patients with GC. METHODS: To explore the biological functions of miR-135b-5p in GC, bioinformatic analysis and in vitro functional assays, including colony formation, wound healing, Transwell, and EdU assays, were used to assess the proliferative, invasive, and migratory capacities of GC cells. Target genes were predicted using RNA-seq and online databases. Dual-luciferase reporter assay, fluorescence in situ hybridization and western blotting were used to confirm the regulatory relationship between miR-135b-5p and CLIP4. The role of CLIP4 in tumor progression was assessed using clinical samples and both in vitro and in vivo assays. The tumor-suppressive mechanism of CLIP4 in GC was elucidated using rescue assays. RESULTS: Our study identified that miR-135b-5p as one of the top three over-expressed miRNAs in GC tissues, with RT-qPCR confirming its upregulation. Functional analysis showed that upregulated miR-135b-5p promoted malignant phenotypes in GC cells. Mechanistic research indicated that miR-135b-5p acts as a cancer promoter by targeting CLIP4. Moreover, our study suggested that CLIP4 exerts its tumor-suppressive function by inhibiting the JAK2/STAT3 signaling pathway. CONCLUSION: This study reveals a novel mechanism by which miR-135b-5p exerts its tumor-promoting functions by targeting CLIP4. The tumor-suppressive function of CLIP4 by inactivating the JAK2/STAT3 pathway is also elucidated. Regulatory mechanism of CLIP4 by miR-135b-5p provides a promising novel therapeutic strategy for GC patients.

Novel reopenable clip with anchor prongs facilitates mucosal defect closure after colorectal endoscopic submucosal dissection: Pilot feasibility study (with video).

Closure of mucosal defects following colorectal endoscopic submucosal dissection (C-ESD) is often performed to prevent post-C-ESD adverse events. However, large mucosal defect closure using conventional clips remains technically challenging. Here, we evaluated the feasibility of the novel endoclip with anchor prongs, called the MANTIS Clip (Boston Scientific, Tokyo, Japan), for mucosal defect closure after C-ESD. This high-volume retrospective study was conducted at a single center. From March until December 2023, consecutive patients who underwent post-C-ESD mucosal defect closure using MANTIS Clip to achieve complete closure were enrolled. Patient clinical characteristics and outcomes were evaluated. Closure of the mucosal defect using the MANTIS Clip was attempted following C-ESD in 32 lesions. The median sizes of the resection specimens and the tumors were 32 mm (range, 17-100 mm) and 23.5 mm (range, 5-96 mm), respectively. The lesions were distributed between the cecum, ascending, transverse, descending, sigmoid, and rectum. Complete closure was achieved in 96.9% of cases (31/32). All lesions up to 61 mm in defect size were completely closed. The median closure time was 7.9 (range, 3.3-18.0) min. The median numbers of MANTIS Clip and additional conventional clips were 3 (range, 1-4) and 5 (range, 1-11), respectively. No adverse events associated with closure, post-ESD bleeding, and delayed perforation occurred. MANTIS Clip closure for large post-C-ESD mucosal defects was found to be feasible and reliable with a high complete closure rate and a short procedure time.