A cryptic site in class 5 epitope of SARS-CoV-2 RBD maintains highly conservation across natural isolates.

The emergence of SARS-CoV-2 variants raises concerns about the efficacy of existing COVID-19 vaccines and therapeutics. Previously, we identified a conserved cryptic class 5 epitope of SARS-CoV-2 receptor binding domain (RBD) by two cross-neutralizing antibodies 7D6 and 6D6. Intriguingly, this site remains resistant to substantial mutations occurred in ever-changing SARS-CoV-2 subvariants. As compared to class 3 antibody S309, 6D6 maintains broad and consistent neutralizing activities against SARS-CoV-2 variants. Furthermore, 6D6 effectively protected hamster from the virulent Beta strain. Sequence alignment of approximately 6 million documented SARS-CoV-2 isolates revealed that 6D6 epitope maintains an exceptionally high conservation rate (99.92%). Structural analysis demonstrated that all 33 mutations accumulated in XBB.1.5 since the original strain do not perturb the binding 6D6 to RBD, in line with the sequence analysis throughout the antigenicity evolution of SARS-CoV-2. These findings suggest the potential of this epitope serving as a critical determinant for vaccines and therapeutic design.

Modified femtosecond laser-assisted arcuate keratotomy for managing low corneal astigmatism using trifocal intraocular lens implantation in Chinese cataract patients.

To evaluate the visual outcome and astigmatic correction following trifocal intraocular lens (IOL) implantation using the modified femtosecond laser-assisted arcuate keratotomy (FSAK) in Chinese cataract patients with low astigmatism. This retrospective study included consecutive cataract patients with regular corneal astigmatism ranging from 0.75 to 1.5 D who underwent FSAK combined with the trifocal IOL implantation between November 2020 and September 2022. Monocular uncorrected distance visual acuity, uncorrected intermediate visual acuity, uncorrected near visual acuity, and refractive data were collected at the 3-month follow-up. The pre- and post-operative high-order aberrations (HOAs) were recorded. The variation in astigmatism was analyzed using Alpins vector analysis. A total of 27 eyes from 23 patients were analyzed. The monocular uncorrected distance visual acuity (UDVA) (5 m) at the 3-month follow-up was 0.04 ± 0.09 logarithm of the minimum angle of resolution (logMAR), which was significantly improved compared with the preoperative value of 0.95 ± 0.51 logMAR (P <.001). The corneal astigmatism was significantly reduced from 1.24 ± 0.42 D to 0.49 ± 0.34 D (P <.001). The target-induced astigmatism (TIA) was 1.25 ± 0.43 D, the surgically induced astigmatism (SIA) was 1.16 ± 0.52 D, and the difference vector (DV) was 0.5 ± 0.34 D. The magnitude of error (ME) (difference between SIA and TIA) was -0.1 ± 0.41 D, and the correction index (CI) (ratio of SIA to TIA) was 0.93 ± 0.36. The angle of error was 3.92° ± 16.90°. Total HOA was reduced from 0.89 ± 1.11 to 0.41 ± 0.55 (P = 0.184), and the corneal HOA was lowered from 0.17 ± 0.18 to 0.10 ± 0.10 (P = 0.129). Implantation of trifocal IOL following the modified FSAK in Chinese cataract patients exhibited excellent visual efficacy and effectively reduced corneal astigmatism.

Research on the enhancement material and culture method of soil aggregates composed of feldspathic sandstone and sand.

The Mu Us Sandy Land is a region characterized by wind-blown sand and soil erosion in northern China. To enhance the soil quality of this area, various organic materials were incorporated into the mixed soil at a volume ratio of 1:2 for feldspathic sandstone to sand. Culture was conducted in the field and under constant temperature conditions in laboratory culture chambers. Four treatments were established in the experiment, each calculated based on weight ratio and controlled (with no organic material added, CK); single application of straw (5% straw, P1); single application of biochar (5% biochar, P2); combined application of biochar and straw (5% biochar + 5% straw, P3). After 90 days of culture, soil samples were collected for analysis of various indicators such as soil aggregate particle size distribution, water stability of soil aggregates, mean weight diameter, mean geometric diameter, and fractal dimension using dry sieving and wet sieving methods. The objective is to establish a scientific basis and provide technical support for addressing the challenges associated with compound soil and implementing rational fertilization measures. The research results indicate that: (1) The quantity of aggregates > 0.25 mm under different treatments follows the order CK < P1 < P2 < P3, and the differences between treatments are significant (P < 0.05); (2) Soil water stability, mean weight diameter (MWD), mean geometric diameter (GMD), and fractal dimension of soil aggregates in compound soil with different organic material additions are superior to the control, and the effect of biochar on improving soil aggregates is better than that of corn straw. The combined application of both significantly improves the effect compared to single applications. In both culture modes, under wet sieving, the P3 treatment shows the highest MWD and GMD of soil aggregates, with an increase ranging from 3.45% to 85% and 4.55% to 38.46%, respectively, compared to other treatments. (3) The trend of fractal dimension among treatments is consistent: P3 < P2 < P1 < CK, and the differences between treatments are significant (P < 0.05). Moreover, there is a good negative correlation linear equation relationship between the fractal dimension (y) and WR > 0.25 (x) of compound soil, with a correlation coefficient of up to 0.9851. In conclusion, the incorporation of organic materials can effectively enhance the proportion of macroaggregates in compound soil consisting of Feldspathic sandstone and sand, thereby improving soil stability and erosion resistance. The optimal outcome is achieved through the combined application of biochar and straw. Indoor culture proves to be more effective than field culture, while wet sieving accurately reflects the structural characteristics of compound soil under both dry and wet sieving treatments.

Qualitative study on the perception of good death in patients with end-stage cancer in oncology nurses.

OBJECTIVE: To explore the perception of good death of patients with end-stage cancer by nurses in the oncology department. METHOD: In the study we used a phenomenological approach and semi-structured interviews. A total of 11 nurses from the oncology department of a Grade A hospital in Taizhou were interviewed on the cognition of good death from July 1 to September 30, 2022. Colaizzi's analysis method was used to analyse the interview data. This study followed the consolidated criteria for reporting qualitative research (COREQ). RESULT: Four themes were identified: a strong sense of responsibility and mission; To sustain hope and faith; The important role of family members; Improve patients' quality of life. CONCLUSION: The nurses in the department of oncology have a low level of knowledge about the "good death", and the correct understanding and view of the "good death" is the premise of the realization of " good death". The ability of nursing staff to improve the "good death", attention, and meet the needs and wishes of individuals and families, is the guarantee of the realization of "good death".

A long-term growth stable Halomonas sp. deleted with multiple transposases guided by its metabolic network model Halo-ecGEM.

Microbial instability is a common problem during bio-production based on microbial hosts. Halomonas bluephagenesis has been developed as a chassis for next generation industrial biotechnology (NGIB) under open and unsterile conditions. However, the hidden genomic information and peculiar metabolism have significantly hampered its deep exploitation for cell-factory engineering. Based on the freshly completed genome sequence of H. bluephagenesis TD01, which reveals 1889 biological process-associated genes grouped into 84 GO-slim terms. An enzyme constrained genome-scale metabolic model Halo-ecGEM was constructed, which showed strong ability to simulate fed-batch fermentations. A visible salt-stress responsive landscape was achieved by combining GO-slim term enrichment and CVT-based omics profiling, demonstrating that cells deploy most of the protein resources by force to support the essential activity of translation and protein metabolism when exposed to salt stress. Under the guidance of Halo-ecGEM, eight transposases were deleted, leading to a significantly enhanced stability for its growth and bioproduction of various polyhydroxyalkanoates (PHA) including 3-hydroxybutyrate (3HB) homopolymer PHB, 3HB and 3-hydroxyvalerate (3HV) copolymer PHBV, as well as 3HB and 4-hydroxyvalerate (4HB) copolymer P34HB. This study sheds new light on the metabolic characteristics and stress-response landscape of H. bluephagenesis, achieving for the first time to construct a long-term growth stable chassis for industrial applications. For the first time, it was demonstrated that genome encoded transposons are the reason for microbial instability during growth in flasks and fermentors.

Whole-exome sequencing screening for candidate genes and variants associated with primary sporadic keratoconus in Chinese patients.

The pathogenesis of keratoconus (KC) is complex, and genetic factors play an important role. The purpose of this study was to screen and analyse candidate genes and variants in Chinese patients with primary sporadic KC. Whole-exome sequencing (WES) was performed to identify candidate genes and variants in 105 unrelated Chinese patients with primary sporadic KC. Through a series of screening processes, 54 candidate variants in 26 KC candidate genes were identified in 53 KC patients (53/105, 50.5%). These 54 candidate variants included 10 previously identified variants in 9 KC candidate genes and 44 novel variants in 20 KC candidate genes. The previously identified variants occurred in 25.7% (27/105) of patients. Of these, 4 variants (COL6A5, c.5014T > G; CAST, c.1814G > A; ZNF469, c.946G > A; and MPDZ, c.3836A > G) were identified for the first time in Chinese KC patients. The novel variants occurred in 33.3% (35/105) of patients. Of the 26 screened KC candidate genes, 11 KC candidate genes (CAT, COL12A1, FLG, HKDC1, HSPG2, PLOD1, ITGA2, TFAP2B, USH2A, WNT10A, and COL6A5) were found to be potentially pathogenic in Chinese KC patients for the first time. Gene Ontology (GO) biological process (BP) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed on the 26 KC candidate genes using the Database for Annotation, Visualization, and Integrated Discovery (DAVID). The results showed that the KC candidate genes were significantly enriched in biological processes such as collagen fibril organization and extracellular matrix (ECM) organization and in ECM-receptor interaction and protein digestion and absorption pathways. The results further expand the spectrum of KC candidate variants and provide a basis for further KC gene studies.

Comprehensive Overview of Broadly Neutralizing Antibodies against SARS-CoV-2 Variants.

Currently, SARS-CoV-2 has evolved into various variants, including the numerous highly mutated Omicron sub-lineages, significantly increasing immune evasion ability. The development raises concerns about the possibly diminished effectiveness of available vaccines and antibody-based therapeutics. Here, we describe those representative categories of broadly neutralizing antibodies (bnAbs) that retain prominent effectiveness against emerging variants including Omicron sub-lineages. The molecular characteristics, epitope conservation, and resistance mechanisms of these antibodies are further detailed, aiming to offer suggestion or direction for the development of therapeutic antibodies, and facilitate the design of vaccines with broad-spectrum potential.

Predicting the impact of femtosecond-assisted arcuate keratotomy combined with tri-planar clear corneal incisions on astigmatism in implantable collamer lens surgery: one-year follow-up.

PURPOSE: To investigate the factors associated with and impact on the femtosecond-assisted (FS-assisted) limbal relaxing incision (LRI) combined with the steep-meridian tri-planar clear corneal incision (TCCI) to reduce astigmatism in patients undergoing Implantable Collamer Lens (ICL) surgery. METHODS: Retrospective case series. The study reviewed patients with ICL surgery combined with FS-assisted LRIs paired with steep-meridian TCCIs. Correlation analysis examined the relationship between independent variables, including preoperative characteristics (intraocular pressure, corneal thickness, axial length, et al.), TCCI, and LRI surgical parameters. The predictors of surgically induced astigmatism (SIA) were determined using individual-level analysis and accounting for inter-eye correlation with the generalized estimating equation (GEE). RESULTS: The study enrolled 69 patients, with 114 eyes (55 right and 59 left). The mean spherical equivalent (SEQ) was - 10.29 ± 2.99D and - 9.99 ± 2.72D for the right and left eye, respectively, while the mean preoperative corneal astigmatism was - 1.54 ± 0.47D and - 1.54 ± 0.46D for the right and left eyes, respectively. After 12 months of follow-up, univariate analysis revealed significant correlations between SIA and intraocular pressure (IOP), astigmatism type, TCCI position (degree), peripheral corneal thickness (PCT), LRI arc incision diameter, post depth (%), and angle, respectively (P = 0.046, 0.016, 0.039, 0.040, 0.009, 0.000, 0.000). Multivariate analysis using GEE demonstrated that axial length (AL), astigmatism type, LRI arc diameter, and angle were independent predictors of SIA (P = 0.000, 0.005, 0.029, 0.000). CONCLUSIONS: The type of astigmatism and axial length were independent factors that affected SIA when modifying the LRI arc diameter and angle through FS-assisted steep-meridian TCCI paired with LRI in ICL surgery.

Optimization of QuEChERS cleanup for quantification of γ-oryzanol in vegetable oils by UHPLC-MS/MS.

This study was based on QuEChERS cleanup coupled with UHPLC-MS/MS for the determination of γ-oryzanol compounds in vegetable oils. Several parameters of QuEChERS and UHPLC-MS/MS were studied for purification and detection of γ-oryzanol compounds in oil samples. Under the optimized conditions, the whole pretreatment procedure could be accomplished within 10 min without tedious procedure, larger volume of organic solvent and complicated apparatus. The limit of detections and the limit of quantifications for γ-oryzanol compounds were ranging from 0.1-0.3 µg kg-1 and 0.4-1.0 µg kg-1, respectively. Satisfactory recoveries of all analyts were ranging from 72.2 % to 101.3 %, and the intra-day and inter-day precision were less than 10.6 %. The validation indicated that rice band oil and corn oil were rich in 24-mCAF, CAF, ß-SIF, CMF and STF. The QuEChERS-UHPLC-MS/MS simultaneously quantified five γ-oryzanol compounds in lipid matrices and assessed the nutritional and functional substances of vegetable oils.

Pancreatic islet transplantation: current advances and challenges.

Diabetes is a prevalent chronic disease that traditionally requires severe reliance on medication for treatment. Oral medication and exogenous insulin can only temporarily maintain blood glucose levels and do not cure the disease. Most patients need life-long injections of exogenous insulin. In recent years, advances in islet transplantation have significantly advanced the treatment of diabetes, allowing patients to discontinue exogenous insulin and avoid complications.Long-term follow-up results from recent reports on islet transplantation suggest that they provide significant therapeutic benefit although patients still require immunotherapy, suggesting the importance of future transplantation strategies. Although organ shortage remains the primary obstacle for the development of islet transplantation, new sources of islet cells, such as stem cells and porcine islet cells, have been proposed, and are gradually being incorporated into clinical research. Further research on new transplantation sites, such as the subcutaneous space and mesenteric fat, may eventually replace the traditional portal vein intra-islet cell infusion. Additionally, the immunological rejection reaction in islet transplantation will be resolved through the combined application of immunosuppressant agents, islet encapsulation technology, and the most promising mesenchymal stem cells/regulatory T cell and islet cell combined transplantation cell therapy. This review summarizes the progress achieved in islet transplantation, and discusses the research progress and potential solutions to the challenges faced.

Nicotinamide metabolism face-off between macrophages and fibroblasts manipulates the microenvironment in gastric cancer.

Immune checkpoint blockade has led to breakthroughs in the treatment of advanced gastric cancer. However, the prominent heterogeneity in gastric cancer, notably the heterogeneity of the tumor microenvironment, highlights the idea that the antitumor response is a reflection of multifactorial interactions. Through transcriptomic analysis and dynamic plasma sample analysis, we identified a metabolic "face-off" mechanism within the tumor microenvironment, as shown by the dual prognostic significance of nicotinamide metabolism. Specifically, macrophages and fibroblasts expressing the rate-limiting enzymes nicotinamide phosphoribosyltransferase and nicotinamide N-methyltransferase, respectively, regulate the nicotinamide/1-methylnicotinamide ratio and CD8+ T cell function. Mechanistically, nicotinamide N-methyltransferase is transcriptionally activated by the NOTCH pathway transcription factor RBP-J and is further inhibited by macrophage-derived extracellular vesicles containing nicotinamide phosphoribosyltransferase via the SIRT1/NICD axis. Manipulating nicotinamide metabolism through autologous injection of extracellular vesicles restored CD8+ T cell cytotoxicity and the anti-PD-1 response in gastric cancer.

Accuracy of 14 intraocular lens power calculation formulas in extremely long eyes.

PURPOSE: To compare the accuracy of 14 formulas in calculating intraocular lens (IOL) power in extremely long eyes with axial length (AL) over 30.0 mm. METHODS: In this retrospective study, 211 eyes (211 patients) with ALs > 30.0 mm were successfully treated with cataract surgery without complications. Ocular biometric parameters were obtained from IOLMaster 700. Fourteen formulas were evaluated using the optimized A constants: Barrett Universal II (BUII), Kane, Emmetropia Verifying Optical (EVO) 2.0, PEARL-DGS, T2, SRK/T, Holladay 1, Holladay 2, Haigis and Wang-Koch AL adjusted formulas (SRK/Tmodified-W/K, Holladay 1modified-W/K, Holladay 1NP-modified-W/K, Holladay 2modified-W/K, Holladay 2NP-modified-W/K). The mean prediction error (PE) and standard deviation (SD), mean absolute errors (MAE), median absolute errors (MedAE), and the percentage of prediction errors (PEs) within ± 0.25 D, ± 0.50 D, ± 1.00 D were analyzed. RESULTS: The Kane formula had the smallest MAE (0.43 D) and MedAE (0.34 D). The highest percentage of PE within ± 0.25 D was for EVO 2.0 (37.91%) and the Holladay 1NP-modified-W/K formulas (37.91%). The Kane formula had the highest percentage of PEs in the range of ± 0.50, ± 0.75, ± 1.00, and ± 2.00 D. There was no significant difference in PEs within ± 0.25, ± 0.50 ± 0.75 and ± 1.00 D between BUII, Kane, EVO 2.0 and Wang-Koch AL adjusted formulas (P > .05) by using Cochran's Q test. The Holladay 2modified-W/K formula has the lowest percentage of hyperopic outcomes (29.38%). CONCLUSIONS: The BUII, Kane, EVO 2.0 and Wang-Koch AL adjusted formulas have comparable accuracy for IOL power calculation in eyes with ALs > 30.0 mm.

Investigation on the effects of an elliptical wall on the dynamic behaviors of a bubble restricted by two parallel plates.

The present paper investigates the dynamic behaviors of a bubble restricted by two parallel plates near an elliptical wall. The typical experimental phenomena of the bubble are recorded employing the high-speed photography and a theoretical Kelvin impulse model is established. The impacts of the spatial position and the curvature of the wall on the bubble collapse behaviors are quantitatively investigated through the theoretical model and verified against the experimental results. The Kelvin impulse intensity and the direction during the bubble collapse process are compared and discussed for different elliptical-shaped walls. The main conclusions include: (1) During the bubble collapse process, the phenomenon of the bubble uneven splitting is discovered. (2) At different spatial positions and wall curvatures, the bubble collapse jet angle, movement distance, and velocity are in good agreement with the theoretical Kelvin impulse predictions. (3) As the short-to-long axis ratio increases, the differences in the distributions of the Kelvin impulse intensity and the direction near the elliptical wall gradually become larger, and the range of the influence of the impulse intensity expands.

The influence of biological rhythms on the initial onset of status epilepticus in critically ill inpatients and the study of its predictive Model.

This study aims to explore the relationship between the circadian rhythms of critically ill patients and the incidence of Status Epilepticus (SE), and to develop a predictive model based on circadian rhythm indicators and clinical factors. We conducted a diurnal rhythm analysis of vital sign data from 4413 patients, discovering significant differences in the circadian rhythms of body temperature, blood oxygen saturation, and heart rate between the SE and non-SE groups, which were correlated with the incidence of SE. We also employed various machine learning algorithms to identify the ten most significant variables and developed a predictive model with strong performance and clinical applicability. Our research provides a new perspective and methodology for the study of biological rhythms in critically ill patients, offering new evidence and tools for the prevention and treatment of SE. Our findings are consistent or similar to some in the literature, while differing from or supplementing others. We observed significant differences in the vital signs of epileptic patients at different times of the day across various diagnostic time groups, reflecting the regulatory effects of circadian rhythms. We suggest heightened monitoring and intervention of vital signs in critically ill patients, especially during late night to early morning hours, to reduce the risk of SE and provide more personalized treatment plans.

Ultrafast Formation of Charge Transfer Trions at Molecular-Functionalized 2D MoS2 Interfaces.

In this work, we investigate trion dynamics occurring at the heterojunction between organometallic molecules and a monolayer transition metal dichalcogenide (TMD) with transient electronic sum frequency generation (tr-ESFG) spectroscopy. By pumping at 2.4 eV with laser pulses, we have observed an ultrafast hole transfer, succeeded by the emergence of charge-transfer trions. This observation is facilitated by the cancellation of ground state bleach and stimulated emission signals due to their opposite phases, making tr-ESFG especially sensitive to the trion formation dynamics. The presence of charge-transfer trion at molecular functionalized TMD monolayers suggests the potential for engineering the local electronic structures and dynamics of specific locations on TMDs and offers a potential for transferring unique electronic attributes of TMD to the molecular layers.

Spotlight: Visualization of Moiré Quantum Phenomena in Transition Metal Dichalcogenide with Scanning Tunneling Microscopy.

Transition metal dichalcogenide (TMD) moiré superlattices have emerged as a significant area of study in condensed matter physics. Thanks to their superior optical properties, tunable electronic band structure, strong Coulomb interactions, and quenched electron kinetic energy, they offer exciting avenues to explore correlated quantum phenomena, topological properties, and light-matter interactions. In recent years, scanning tunneling microscopy (STM) has made significant impacts on the study of these fields by enabling intrinsic surface visualization and spectroscopic measurements with unprecedented atomic scale detail. Here, we spotlight the key findings and innovative developments in imaging and characterization of TMD heterostructures via STM, from its initial implementation on the in situ grown sample to the latest photocurrent tunneling microscopy. The evolution in sample design, progressing from a conductive to an insulating substrate, has not only expanded our control over TMD moiré superlattices but also promoted an understanding of their structures and strongly correlated properties, such as the structural reconstruction and formation of generalized two-dimensional Wigner crystal states. In addition to highlighting recent advancements, we outline upcoming challenges, suggest the direction of future research, and advocate for the versatile use of STM to further comprehend and manipulate the quantum dynamics in TMD moiré superlattices.

Genome-wide association study and development of molecular markers for yield and quality traits in peanut (Arachis hypogaea L.).

BACKGROUND: This study aims to decipher the genetic basis governing yield components and quality attributes of peanuts, a critical aspect for advancing molecular breeding techniques. Integrating genotype re-sequencing and phenotypic evaluations of seven yield components and two grain quality traits across four distinct environments allowed for the execution of a genome-wide association study (GWAS). RESULTS: The nine phenotypic traits were all continuous and followed a normal distribution. The broad heritability ranged from 88.09 to 98.08%, and the genotype-environment interaction effects were all significant. There was a highly significant negative correlation between protein content (PC) and oil content (OC). The 10× genome re-sequencing of 199 peanut accessions yielded a total of 631,988 high-quality single nucleotide polymorphisms (SNPs), with 374 significant SNP loci identified in association with the nine traits of interest. Notably, 66 of these pertinent SNPs were detected in multiple environments, and 48 of them were linked to multiple traits of interest. Five loci situated on chromosome 16 (Chr16) exhibited pleiotropic effects on yield traits, accounting for 17.64-32.61% of the observed phenotypic variation. Two loci on Chr08 were found to be strongly associated with protein and oil contents, accounting for 12.86% and 14.06% of their respective phenotypic variations, respectively. Linkage disequilibrium (LD) block analysis of these seven loci unraveled five nonsynonymous variants, leading to the identification of one yield-related candidate gene and two quality-related candidate genes. The correlation between phenotypic variation and SNP loci in these candidate genes was validated by Kompetitive allele-specific PCR (KASP) marker analysis. CONCLUSIONS: Overall, molecular markers were developed for genetic loci associated with yield and quality traits through a GWAS investigation of 199 peanut accessions across four distinct environments. These molecular tools can aid in the development of desirable peanut germplasm with an equilibrium of yield and quality through marker-assisted breeding.

Molecular-Scale Visualization of Steric Effects of Ligand Binding to Reconstructed Au(111) Surfaces.

Direct imaging of single molecules at nanostructured interfaces is a grand challenge with potential to enable new, precise material architectures and technologies. Of particular interest are the structural morphology and spectroscopic signatures of the adsorbed molecule, where modern probes are only now being developed with the necessary spatial and energetic resolution to provide detailed information at the molecule-surface interface. Here, we directly characterize the adsorption of individual m-terphenyl isocyanide ligands on a reconstructed Au(111) surface through scanning tunneling microscopy and inelastic electron tunneling spectroscopy. The site-dependent steric pressure of the various surface features alters the vibrational fingerprints of the m-terphenyl isocyanides, which are characterized with single-molecule precision through joint experimental and theoretical approaches. This study provides molecular-level insights into the steric-pressure-enabled surface binding selectivity as well as its effect on the chemical properties of individual surface-binding ligands.

Deep learning assists detection of esophageal cancer and precursor lesions in a prospective, randomized controlled study.

Endoscopy is the primary modality for detecting asymptomatic esophageal squamous cell carcinoma (ESCC) and precancerous lesions. Improving detection rate remains challenging. We developed a system based on deep convolutional neural networks (CNNs) for detecting esophageal cancer and precancerous lesions [high-risk esophageal lesions (HrELs)] and validated its efficacy in improving HrEL detection rate in clinical practice (trial registration ChiCTR2100044126 at www.chictr.org.cn). Between April 2021 and March 2022, 3117 patients ≥50 years old were consecutively recruited from Taizhou Hospital, Zhejiang Province, and randomly assigned 1:1 to an experimental group (CNN-assisted endoscopy) or a control group (unassisted endoscopy) based on block randomization. The primary endpoint was the HrEL detection rate. In the intention-to-treat population, the HrEL detection rate [28 of 1556 (1.8%)] was significantly higher in the experimental group than in the control group [14 of 1561 (0.9%), P = 0.029], and the experimental group detection rate was twice that of the control group. Similar findings were observed between the experimental and control groups [28 of 1524 (1.9%) versus 13 of 1534 (0.9%), respectively; P = 0.021]. The system's sensitivity, specificity, and accuracy for detecting HrELs were 89.7, 98.5, and 98.2%, respectively. No adverse events occurred. The proposed system thus improved HrEL detection rate during endoscopy and was safe. Deep learning assistance may enhance early diagnosis and treatment of esophageal cancer and may become a useful tool for esophageal cancer screening.

Relationship between the microenvironment and survival in kidney transplantation: a bibliometric analysis from 2013 to 2023.

Background: Kidney transplantation is considered the most effective treatment for end-stage renal failure. Recent studies have shown that the significance of the immune microenvironment after kidney transplantation in determining prognosis of patients. Therefore, this study aimed to conduct a bibliometric analysis to provide an overview of the knowledge structure and research trends regarding the immune microenvironment and survival in kidney transplantation. Methods: Our search included relevant publications from 2013 to 2023 retrieved from the Web of Science core repository and finally included 865 articles. To perform the bibliometric analysis, we utilized tools such as VOSviewer, CiteSpace, and the R package "bibliometrix". The analysis focused on various aspects, including country, author, year, topic, reference, and keyword clustering. Results: Based on the inclusion criteria, a total of 865 articles were found, with a trend of steady increase. China and the United States were the countries with the most publications. Nanjing Medical University was the most productive institution. High-frequency keywords were clustered into 6 areas, including kidney transplantation, transforming growth factor ß, macrophage, antibody-mediated rejection, necrosis factor alpha, and dysfunction. Antibody mediated rejection (2019-2023) was the main area of research in recent years. Conclusion: This groundbreaking bibliometric study comprehensively summarizes the research trends and advances related to the immune microenvironment and survival after kidney transplantation. It identifies recent frontiers of research and highlights promising directions for future studies, potentially offering fresh perspectives to scholars in the field.