Pharmacologic inhibition of IL11/STAT3 signaling increases MHC-I expression and T cell infiltration.

BACKGROUND: Recent studies have discovered an emerging role of IL11 in various colitis-associated cancers, suggesting that IL11 mainly promotes tumor cell survival and proliferation in regulating tumorigenesis. Herein we aimed to reveal a novel function of IL-11 through STAT3 signaling in regulating tumor immune evasion. METHODS: AOM/DSS model in Il11-/- and Apcmin/+/Il11-/- mice were used to detect tumor growth and CD8+ T infiltration. STAT1/3 phosphorylation and MHC-I, CXCL9, H2-K1 and H2-D1 expression were detected in MC38 cells and intestine organoids treated with/without recombinant IL11 to explore effect of IL11/STAT3 signaling, with IL11 mutein used to competitively inhibit IL11 and rescue inhibited STAT1 activation. Correlation between IL11 and CD8+ T infiltration was analyzed using TIMER2.0 website. IL11 expression and survival prognosis was analyzed in clinical data of patient cohort from Nanfang Hospital. RESULTS: IL11 is highly expressed in CRC and indicates unfavorable prognosis. IL11 knockout increased CD8+ T cell infiltration and reduced intestinal and colon formation. Tumors were significantly suppressed while MHC-I and CXCL9 expression for CD8+ T infiltration were remarkably increased in the tumor tissues of Apcmin/+/Il11-/- mice or Il11-/- mice induced by AOM/DSS. IL11/STAT3 signaling downregulated MHC-I and CXCL9 by inhibiting IFNγ-induced STAT1 phosphorylation. IL11 mutein competitively inhibit IL11 to upregulate CXCL9 and MHC-I in tumor and attenuated tumor growth. CONCLUSIONS: This study ascribes for a new immunomodulatory role for IL11 during tumor development that is amenable to anti-cytokine based therapy of colon cancer.

Abnormal maxillary sinus diagnosing on CBCT images via object detection and 'straight-forward' classification deep learning strategy.

BACKGROUND: Pathological maxillary sinus would affect implant treatment and even result in failure of maxillary sinus lift and implant surgery. However, the maxillary sinus abnormalities are challenging to be diagnosed through CBCT images, especially for young dentists or dentists in grassroots medical institutions without systematical education of general medicine. OBJECTIVES: To develop a deep-learning-based screening model incorporating object detection and 'straight-forward' classification strategy to screen out maxillary sinus abnormalities on CBCT images. METHODS: The large area of background noise outside maxillary sinus would affect the generalisation and prediction accuracy of the model, and the diversity and imbalanced distribution of imaging manifestations may bring challenges to intellectualization. Thus we adopted an object detection to limit model's observation zone and 'straight-forward' classification strategy with various tuning methods to adapt to dental clinical need and extract typical features of diverse manifestations so that turn the task into a 'normal-or-not' classification. RESULTS: We successfully constructed a deep-learning model consist of well-trained detector and diagnostor module. This model achieved ideal AUROC and AUPRC of 0.953 and 0.887, reaching more than 90% accuracy at optimal cut-off. McNemar and Kappa test verified no statistical difference and high consistency between the prediction and ground truth. Dentist-model comparison test showed the model's statistically higher diagnostic performance than dental students. Visualisation method confirmed the model's effectiveness in region recognition and feature extraction. CONCLUSION: The deep-learning model incorporating object detection and straightforward classification strategy could achieve satisfying predictive performance for screening maxillary sinus abnormalities on CBCT images.

Blockade of IL-6 inhibits tumor immune evasion and improves anti-PD-1 immunotherapy.

Long-standing inflammatory bowel disease predisposes to the development of colorectal cancer (CRC). Interleukin (IL) -6, a pivotal link between chronic inflammation and tumor progression, has recently been recognized as a potential therapeutic target. The effect of IL-6 on proliferation and metastasis of CRC by activating the STAT3 pathway has been widely demonstrated in recent years, but few on mediating tumor immune evasion. In this study, we found that IL-6 was remarkably overexpressed in CRC and its elevation was associated with a poor prognosis. We studied CRC tumorigenesis in vivo by inoculating MC38 tumors and induced-CRC model via AOM/DSS (azoxymethane/dextransulfate sodium) in IL-6 deficient (IL-6-/-) and wild-type (WT) mice and found that IL-6-/- mice were less susceptible to develop tumors, compared to WT mice. We detected CD8+ T cells via immunofluorescence and found they exhibit high expression in tumor of IL-6-/- mice. High level of IL-6 was found in colitis model, with down-regulation of MHC-I molecules. In in vitro experiments, we found that IL-6 may act as a negative regulator in IFNγ-STAT1-MHC-I signaling. In addition, vivo trials also confirmed that MHC-I mRNA level was negatively related to the existence of IL-6. Furthermore, the blockade of IL-6 also activated CD8+T-cell accumulation and led to the high PD-L1 expression in CRC, which can sensitize animals to anti-PD-1 therapy. Our study provides a research basis for the significant role of IL-6 in tumor evasion and highlights a novel target to improve the efficacy of immunotherapy.

A Nanocrystal Catalyst Incorporating a Surface Bound Transition Metal to Induce Photocatalytic Sequential Electron Transfer Events.

Heterogeneous photocatalysis is less common but can provide unique avenues for inducing novel chemical transformations and can also be utilized for energy transductions, i.e., the energy in the photons can be captured in chemical bonds. Here, we developed a novel heterogeneous photocatalytic system that employs a lead-halide perovskite nanocrystal (NC) to capture photons and direct photogenerated holes to a surface bound transition metal Cu-site, resulting in a N-N heterocyclization reaction. The reaction starts from surface coordinated diamine substrates and requires two subsequent photo-oxidation events per reaction cycle. We establish a photocatalytic pathway that incorporates sequential inner sphere electron transfer events, photons absorbed by the NC generate holes that are sequentially funneled to the Cu-surface site to perform the reaction. The photocatalyst is readily prepared via a controlled cation-exchange reaction and provides new opportunities in photodriven heterogeneous catalysis.

Analysis of the sagittal root angle and its correlation with hard and soft tissue indices in anterior teeth for immediate implant evaluation: a retrospective study.

BACKGROUND: To assess the root angle characteristics of maxillary incisors, and to analyze the relationship between the root angle and other implant-related anatomical indices to use the sagittal root angle as an index for immediate implant evaluation and design. METHODS: A random sample consisting of 400 cone-beam computed tomography (CBCT) images and 65 maxillary plaster models were selected for the present study. CBCT and stereolithography (STL) scan images were imported as DICOM files into coDiagnostiX software for matching the hard and soft tissue. The angle between the long axis of the anterior tooth and the corresponding alveolar bone and implant-related hard and soft tissue indices were measured in the sagittal section. Descriptive statistics, frequency analysis, multi-level comparisons, and correlation analyses were performed. RESULTS: The average sagittal root angles were 15° at the central incisor and 19° at the lateral incisor. The root angle in males was significantly larger than that in females, and increased with age. The largest angle, 22.35°, was found in the lateral incisors of the oldest (> 50 years old) male group. The root angle was found to correlate with coronal buccal bone thickness, coronal palatal bone thickness, apical buccal bone thickness, palatal bone thickness, and the below apex bone thickness. CONCLUSIONS: The sagittal root angle could reflect the distribution of other implant-related anatomical indices, which may provide additional reference for the evaluation of immediate implant placement.

Photoredox Organic Synthesis Employing Heterogeneous Photocatalysts with Emphasis on Halide Perovskite.

Lately, heterogeneous semiconductor materials have been explored as an emerging type of efficient photocatalyst for photoredox organic synthesis. Among these semiconductors, lead halide perovskite materials demonstrate unique properties towards excellent charge separation and charge transfer, extremely long charge carrier migration, high efficiency in visible light absorption, and long excited states lifetimes, etc., as proved in ground-breaking solar cell applications, garnering necessary merits for an efficient catalytic system for photoredox organic reactions. Here, the latest progress in heterogeneous semiconductor materials towards this endeavor is examined, with particular emphasis on lead halide perovskite nanocrystals (NCs) in photocatalytic organic synthesis.

Lead-Halide Perovskites for Photocatalytic α-Alkylation of Aldehydes.

Cost-effective and efficient photocatalysis are highly desirable in chemical synthesis. Here we demonstrate that readily prepared suspensions of APbBr3 (A = Cs or methylammonium (MA)) type perovskite colloids (ca. 2-100 nm) can selectively photocatalyze carbon-carbon bond formation reactions, i.e., α-alkylations. Specifically, we demonstrate α-alkylation of aldehydes with a turnover number (TON) of over 52,000 under visible light illumination. Hybrid organic/inorganic perovskites are revolutionizing photovoltaic research and are now impacting other research fields, but their exploration in organic synthesis is rare. Our low-cost, easy-to-process, highly efficient and bandedge-tunable perovskite photocatalyst is expected to bring new insights in chemical synthesis.

Circulating Tumor Cell Phenotype Indicates Poor Survival and Recurrence After Surgery for Hepatocellular Carcinoma.

BACKGROUND: Circulating tumors cells (CTCs) may be a promising prognostic marker for patients with malignant tumors. However, there are few reports regarding its value for hepatocellular carcinoma (HCC) patients. AIMS: To investigate CTCs with epithelial and mesenchymal phenotypes as a potential prognostic biomarker for HCC patients. METHODS: Peripheral blood samples were obtained from 165 HCC patients before radical surgery. CTCs were isolated via the CanPatrol CTC enrichment technique and classified using epithelial-mesenchymal transition (EMT) markers. The relationship of CTC phenotype with clinicopathological factors and HCC recurrence in patients was analyzed. RESULTS: CTC-positive status (count ≥ 2/5 mL) was found in 70.9% of the 165 HCC patients. Increased CTC number was more common in patients with higher AFP levels, multiple tumors, advanced TNM and BCLC staging, and presence of embolus or microembolus (P < 0.05). CTCs heterogeneity was noted using EMT markers. Mesenchymal CTCs were significantly correlated with high AFP levels, multiple tumors, advanced TNM and BCLC stage, presence of embolus or microembolus, and earlier recurrence (P < 0.05). The presence of mesenchymal CTCs predicted the shortest relapse-free survival, followed by mixed phenotypic CTCs, and then epithelial CTCs (P < 0.001). CONCLUSION: CTC phenotype may serve as a prognostic indicator for HCC patients. CTCs assessment should include phenotypic identification tailored to characterize cells based on epithelial and mesenchymal markers.

CsPbBr3 Perovskite Nanocrystals for Photocatalytic [3+2] Cycloaddition.

Visible-light-induced halide-exchange between halide perovskite and organohalide solvents has been studied in which photoinduced electron transfer from CsPbBr3 nanocrystals (NCs) to dihalomethane solvent molecules produces halide anions via reductive dissociation, followed by a spontaneous anion-exchange. Photogenerated holes in this process are less focused. Here, for CsPbBr3 in dibromomethane (DBM), we discover that Br radical (Br⋅) is a key intermediate resulting from the hole oxidation. We successfully trapped Br⋅ with reported methods and found that Br⋅ is continuously generated in DBM under visible light irradiation, hence imperative for catalytic reaction design. Continuous Br⋅ formation within this halide-exchange process is active for photocatalytic [3+2] cycloaddition for vinylcyclopentane synthesis, a privileged scaffold in medicinal chemistry, with good yield and rationalized diastereoselectivity. The NC photocatalyst is highly recyclable due to Br-based self-healing, leading to a particularly economic and neat heterogeneous reaction where the solvent DBM also acts as a co-catalyst in perovskite photocatalysis. Halide perovskites, notable for efficient solar energy conversion, are demonstrated as exceptional photocatalysts for Br radical-mediated [3+2] cycloaddition. We envisage such perovskite-induced Br radical strategy may serve as a powerful chemical tool for developing valuable halogen radical-involved reactions.

Clinical evaluation of a novel digital microfluidic based point-of-care test platform for detection of SARS-Cov-2 and influenza A/B.

Respiratory pathogens, such as SARS-CoV-2 and influenza A/B, can cause severe illnesses in susceptible individuals. This research evaluated a novel digital microfluidic point-of-care testing platform designed to detect 23 pathogens, comparing its performance to conventional laboratory-based nucleic acid tests. The platform integrates nucleic acid extraction and amplification processes for rapid detection with only 2 min of hands-on time. Performance assays demonstrated that the platform has high sensitivity (87 %-100 %) and specificity (99 %-100 %) for the detection of the evaluated 3 viruses. Additionally, the platform can be adapted for the detection of other respiratory pathogens, aiding in the early diagnosis of respiratory diseases, identifying the source of an outbreak or epidemic, and curbing the spread of the disease.

Dicyclohexylcarbodiimide and disodium succinate induce the change of energy metabolism in relation to longan pulp breakdown.

Compared to control longan, DCC-treated longan had higher pulp breakdown index, lower ATP, ADP and EC levels, and lower H+, Ca2+ and Mg2+-ATPase activities. On day 6, DCC-treated longan presented 18% higher pulp breakdown index, with 44%, 9% and 31% lower levels of ATP, ADP and EC, respectively. Additionally, DCC-treated longan showed 29%, 53%, 37% lower activity of H+-ATPase, 34%, 54%, 4% lower activity of Ca2+-ATPase, and 13%, 21%, 6% lower activity of Mg2+-ATPase in the membranes of plasma, vacuole, and mitochondria, respectively. Whereas, DS-treated longan manifested the opposite trends of DCC treatment. These results suggest that the accelerated pulp breakdown in DCC-treated longan was linked to energy deficiency and reduced energy production. However, DS treatment restrained pulp breakdown occurrence in fresh longan by maintaining a higher energy level through the elevated energy production and ATPase activity.

DNP and ATP modulate the pulp softening and breakdown in fresh longan by acting on the antioxidant system and the metabolisms of membrane lipids and cell wall polysaccharides.

Compared to the control longan, DNP treatment elevated pulp breakdown index, reduced the values of pulp firmness, CSP, ISP, cellulose, and hemicellulose by enhancing the activities of PE, PG, Cx, XET, and ß-Gal. Additionally, DNP treatment increased the levels of PLD, lipase, LOX, PA, and SFA, and decreased the values of PC, PI, USFA, U/S, and IUFA, displaying higher cell membrane permeability and more severe cell membrane damage in longan pulp. Furthermore, DNP treatment weakened the levels of SOD, CAT, APX, AsA, GSH, TP, and TF, thereby exacerbating ROS outbreak and MDA production. These results indicate that DNP treatment destroyed the antioxidant system to cause ROS eruption. This disruption further disturbed the metabolisms of membrane lipids and cell wall polysaccharides, leading to the breakdown of cell membrane and cell wall, and eventually aggravated longan pulp softening and breakdown. However, ATP treatment exhibited the opposite effects of DNP treatment.

Comparison between two cultivars of longan fruit cv. 'Dongbi' and 'Fuyan' in the metabolisms of lipid and energy and its relation to pulp breakdown.

This work studied the difference in pulp breakdown between two cultivars of longan cv. 'Dongbi' and 'Fuyan' from the aspect of metabolisms of lipid and energy. The results reflected that, compared to 'Fuyan' longan, 'Dongbi' longan had higher levels of energy charge, U/S and IUFA, and higher amounts of USFA, PC, PI, ATP and ADP. Moreover, 'Dongbi' longan exhibited lower levels of SFA, PA, AMP and cell membrane permeability. Also, lower PLD, LOX and lipase activities, but higher ATPase activity, lower pulp breakdown index, and better pulp appearance were exhibited in 'Dongbi' longan. These data revealed that the mitigated pulp breakdown in 'Dongbi' longan was due to the comprehensive coordination of metabolisms in lipid and energy through maintaining a higher level of energy, a higher unsaturation degree of fatty acids, delaying the degradation of phospholipids, and better retaining the membrane structural integrity of microsome and entire cell.

Hydrogen peroxide induced changes in the levels of disease-resistant substances and activities of disease-resistant enzymes in relation to the storability of longan fruit.

The influences of hydrogen peroxide (H2O2) on the storability and metabolism of disease-resistant substances in fresh longan were investigated. Compared to the control samples, H2O2-treated longan exhibited a higher index of fruit disease, pericarp browning, and pulp breakdown, a higher rate of fruit weight loss, but lower chromaticity values (L*, a* and b*) in pericarp appearance, and a lower commercially acceptable fruit rate. Additionally, H2O2-treated longan showed a lower lignin content, lower activities of enzymes including phenylalnine ammonia lyase (PAL), cinnamate 4-hydroxylase (C4H), 4-coumaryl coenzyme A ligase (4-CL), cinnamate dehydrogenase (CAD), peroxidase (POD), chitinase (CHI), and ß-1,3-glucanase (GLU). These data collectively suggest that H2O2 negatively impacted the storability of fresh longan. This can be attributed to H2O2's role in reducing the levels of disease-resistant substances and suppressing the activities of disease-resistant enzymes, implying that H2O2 reduced the postharvest storability of longan by compromising its disease resistance.

High Genetic Diversity of HIV-1 and Active Transmission Clusters among Male-to-Male Sexual Contacts (MMSCs) in Zhuhai, China.

Monitoring genetic diversity and recent HIV infections (RHIs) is critical for understanding HIV epidemiology. Here, we report HIV-1 genetic diversity and RHIs in blood samples from 190 HIV-positive MMSCs in Zhuhai, China. MMSCs with newly reported HIV were enrolled from January 2020 to June 2022. A nested PCR was performed to amplify the HIV polymerase gene fragments at HXB2 positions 2604-3606. We constructed genetic transmission network at both 0.5% and 1.5% distance thresholds using the Tamura-Nei93 model. RHIs were identified using a recent infection testing algorithm (RITA) combining limiting antigen avidity enzyme immunoassay (LAg-EIA) assay with clinical data. The results revealed that 19.5% (37/190) were RHIs and 48.4% (92/190) were CRF07_BC. Two clusters were identified at a 0.5% distance threshold. Among them, one was infected with CRF07_BC for the long term, and the other was infected with CRF55_01B recently. We identified a total of 15 clusters at a 1.5% distance threshold. Among them, nine were infected with CRF07_BC subtype, and RHIs were found in 38.8% (19/49) distributed in eight genetic clusters. We identified a large active transmission cluster (n = 10) infected with a genetic variant, CRF79_0107. The multivariable logistic regression model showed that clusters were more likely to be RHIs (adjusted OR: 3.64, 95% CI: 1.51~9.01). The RHI algorithm can help to identify recent or ongoing transmission clusters where the prevention tools are mostly needed. Prompt public health measures are needed to contain the further spread of active transmission clusters.

Regulating Blood Clot Fibrin Films to Manipulate Biomaterial-Mediated Foreign Body Responses.

The clinical efficacy of implanted biomaterials is often compromised by host immune recognition and subsequent foreign body responses (FBRs). During the implantation, biomaterials inevitably come into direct contact with the blood, absorbing blood protein and forming blood clot. Many studies have been carried out to regulate protein adsorption, thus manipulating FBR. However, the role of clot surface fibrin films formed by clotting shrinkage in host reactions and FBR is often ignored. Because of the principle of fibrin film formation being relevant to fibrinogen or clotting factor absorption, it is feasible to manipulate the fibrin film formation via tuning the absorption of fibrinogen and clotting factor. As biological hydroxyapatite reserved bone architecture and microporous structure, the smaller particle size may expose more microporous structures and adsorb more fibrinogen or clotting factor. Therefore, we set up 3 sizes (small, <0.2 mm; medium, 1 to 2 mm; large, 3 to 4 mm) of biological hydroxyapatite (porcine bone-derived hydroxyapatite) with different microporous structures to investigate the absorption of blood protein, the formation of clot surface fibrin films, and the subsequent FBR. We found that small group adsorbed more clotting factors because of more microporous structures and formed the thinnest and sparsest fibrin films. These thinnest and sparsest fibrin films increased inflammation and profibrosis of macrophages through a potential signaling pathway of cell adhesion-cytoskeleton-autophagy, leading to the stronger FBR. Large group adsorbed lesser clotting factors, forming the thickest and densest fibrin films, easing inflammation and profibrosis of macrophages, and finally mitigating FBR. Thus, this study deepens the understanding of the role of fibrin films in host recognition and FBR and demonstrates the feasibility of a strategy to regulate FBR by modulating fibrin films via tuning the absorption of blood proteins.

The difference of the cell wall metabolism between 'Fuyan' and 'Dongbi' longans and its relationship with the pulp breakdown.

The aims of present works were to explore the difference in pulp breakdown of 'Fuyan' and 'Dongbi' longans and its relationship with cell wall metabolism. Comparison with 'Fuyan' longan fruit, postharvest 'Dongbi' longan fruit showed lower pulp breakdown index, lower activities of PE, PG, cellulase, ß-Gal, XET, and lower expression levels of their corresponding genes. In addition, higher levels of cell wall polysaccharides including ISP, CSP, cellulose and hemicellulose were exhibited in 'Dongbi' longan pulp. These findings implied that, the reduced activities of enzymes and the down-regulated expressions of genes-involved in cell wall disassembly were shown in 'Dongbi' longan pulp, which might reduce the dissolution of polysaccharides and maintain a higher structural integrity in 'Dongbi' longan pulp cell wall, and consequently the mitigated pulp breakdown was displayed in 'Dongbi' longan during storage.

Clinical value of circ-PNPT1 on adverse pregnancy outcomes of patients with gestational diabetes mellitus.

OBJECTIVE: Several circular RNAs are associated with important pathophysiological characteristics of gestational diabetes mellitus (GDM). This study intended to measure the expression of circ-PNPT1 in sera of GDM patients and to expound on its values on pregnancy outcomes.

Methods: About 104 GDM patients and 71 healthy controls were recruited. The expression pattern of serum circ-PNPT1 was measured by reverse transcription-quantitative polymerase chain reaction. The diagnostic efficacy of circ-PNPT1 and fasting blood glucose (FBG) on GDM was evaluated by receiver operating characteristic (ROC) analysis. Parameters of glycolipid metabolism were determined using automatic biochemical analyzers. The correlation between circ-PNPT1 and glycolipid metabolism parameters was analyzed using Pearson analysis. GDM patients were divided into a high expression group and a low expression group based on the median value of circ-PNPT1 expression. Curves of adverse neonatal outcomes were drawn by Log Rank analysis.

Results: GDM patients exhibited higher circ-PNPT1 expression than healthy controls. The area under the ROC curve of circ-PNPT1 diagnosing GDM was 0.9184 and the cut-off value was 1.435 (90.38% sensitivity, 85.92% specificity). Serum circ-PNPT1 expression was positively correlated with FBG, total cholesterol, and triglyceride in GDM patients. Neonates born to GDM patients with high circ-PNPT1 expression were prone to adverse outcomes.

Conclusion: Circ-PNPT1 was highly-expressed in the sera of GDM patients. Circ-PNPT1 affected glycolipid metabolism and its expression had certain reference values on adverse pregnancy outcomes.

Triplet Energy Transfer from Lead Halide Perovskite for Highly Selective Photocatalytic 2 + 2 Cycloaddition.

Triplet excitons are generally confined within a semiconductor. Hence, solar energy utilization via direct triplet energy transfer (TET) from semiconductors is challenging. TET from lead halide perovskite semiconductors to nearby organic molecules has been illustrated with ultrafast spectroscopy. Direct utilization of solar energy, i.e., visible light, via TET for photocatalysis is an important route but has not yet been demonstrated with lead halide perovskite semiconductors. Here, we show that a photocatalytic reaction, focusing on a 2 + 2 cycloaddition reaction, can been successfully demonstrated via TET from lead halide perovskite nanocrystals (PNCs). The triplet excitons are shown to induce a highly diastereomeric syn-selective 2 + 2 cycloaddition starting from olefins. Such photocatalytic reactions probe the TET process previously only observed spectroscopically. Moreover, our observation demonstrates that bulk-like PNCs (size, >10 nm; PL = 530 nm), in addition to quantum-confined smaller PNCs, are also effective for TET. Our findings may render a new energy conversion pathway to employ PNCs via direct TET for photocatalytic organic synthesis.

Construction of an end-to-end regression neural network for the determination of a quantitative index sagittal root inclination.

BACKGROUND: Immediate implant placement in the esthetic area requires comprehensive assessments with nearly 30 quantitative indexes. Most artificial intelligence (AI)-driven measurements of quantitative indexes depend on segmentation or landmark detection, which require extra labeling of images and contain possible intraclass errors. METHODS: For the initial attempt, the method was tested on sagittal root inclination measurement. This study had developed an accurate and efficient end-to-end model incorporating a convolutional neural network (CNN) based on unlabeled cone-beam computed tomography (CBCT) images for immediate implant placement diagnosis and treatment. The model took pretrained ResNeXt101 as the backbone and was constructed based on 2,920 CBCT images with corresponding angles of the tooth axis and bone axis. The performance of our CNN model was evaluated on a separate test set. RESULTS: Our model exhibited high prediction accuracy in sagittal root inclination measurements, as evidenced by the low mean average error of 2.16°, the high correlation coefficient of 0.915 to manual measurement, and the narrow 95% confidence interval shown by Bland-Altman plots. The intraclass correlation coefficient further confirmed the measurement accuracy of our model was comparable with that of junior clinicians. The model took merely 0.001 seconds for each CBCT image, making it highly efficient. To better understand the model's quality, we visualized our end-to-end CNN model through Guided Backpropagation, Grad-CAM, and Guided Grad-CAM, and confirmed its effectiveness in region recognition. CONCLUSIONS: We succeeded in taking the first step in constructing the end-to-end immediate implant placement AI tool through sagittal root inclination measurements without intermediate steps and extra labeling on images.