Esophageal Cancer: Surgical Treatment of Esophageal Cancer – early outcomes and complications
Postoperative complications following esophagectomy are frequent and clinically heterogeneous. Serum C-reactive protein (CRP) is a widely available inflammatory marker, yet its longitudinal trajectory after esophagectomy and its relationship with complication severity have not been systematically characterized. This study aimed to identify distinct postoperative CRP trajectory patterns and evaluate their association with Clavien-Dindo graded complication outcomes.
Among 809 consecutive esophagectomy patients at a single center, 131 patients (16.2%) had complete serial CRP measurements on postoperative days (POD) 1, 3, 5, and 7. K-means clustering was applied to identify distinct CRP trajectory groups. Associations between trajectory groups and complications (Clavien-Dindo grading), anastomotic leak, and ICU length of stay were evaluated using chi-square tests, Kruskal-Wallis tests, and multivariable logistic regression. Receiver operating characteristic (ROC) analysis assessed the predictive utility of individual CRP timepoints and derived indicators.
Three distinct CRP trajectories were identified: Low-Stable (n=86, 65.6%), Moderate-Declining (n=20, 15.3%), and High-Persistent (n=25, 19.1%). Complication rates increased significantly across trajectories: severe complications (CD≥III) occurred in 15.1%, 25.0%, and 56.0% of patients in each group, respectively (p<0.001). The High-Persistent group showed a 5.71-fold increased odds of severe complications on multivariable analysis (OR 5.71, 95%CI 1.99–16.40, p=0.001). CRP on day 7 demonstrated the highest individual discriminative value (AUC=0.671), while the CRP D3/D1 ratio (AUC=0.632) offered the earliest actionable prediction at POD 3.
Postoperative CRP trajectory patterns are significantly associated with complication severity after esophagectomy. The High-Persistent trajectory identifies a high-risk subgroup, and the D3/D1 ratio enables early risk stratification by POD 3. Prospective studies with larger cohorts are warranted to validate these findings.
This study constructed a pH-responsive P-TN/SF@Fe-Cur composite coating that demonstrated significant anti-infective, anti-inflammatory, antioxidant, pro-angiogenic, and pro-osteogenic effects in rat subcutaneous infection and femoral defect models.
The results show that alternative transcript diversity extensively enters translation-supported proteoform space and establish a systematic link between transcript variation and protein functional diversification.
Felicia T. Jiang, Dengwang Chen, Ziwei Wang et al.· bioRxiv· 1 citation
Protein therapeutic design and property prediction are frequently hampered by data scarcity. Here we propose a model, DyAb, that addresses these issues by leveraging a pair-wise representation to predict differences in binding affinity, rather than absolute values. DyAb is built on top of a pre-trained protein language model and achieves a Spearman rank correlation of up to 0.85 on binding affinity prediction across monoclonal antibodies targeting three different antigens (EGFR, IL-6, and an internal target), given as few as 100 training data. We employ DyAb in two design contexts: as a ranking model to score combinations of known mutations, and combined with a genetic algorithm to generate new sequences. Our method consistently generates antibody variants with high binding rates, including designs that improve on the binding affinity of the lead molecule by more than ten-fold. DyAb represents a powerful tool for optimizing antibody binding affinity in low data regimes common in early-stage drug development.
Joshua Yao-Yu Lin, Jennifer L. Hofmann, Andrew Leaver‐Fay et al.· mAbs· 1 citation
Due to its importance and wide adoption, wheat cultivation is promptly required to shift towards sustainable practices, reducing the dependency on chemical components. Among bio-based solutions aimed at securing the sustainability of wheat cultivation, biostimulants offer a versatile platform of eco-friendly tools assuring sustainability and profitability. Microalgae present a concrete example of a biostimulant source due to their richness in metabolites and high value products. Therefore, this study evaluated the biostimulant potential of eleven eco-extracts prepared from soil-isolated microalgae strains. Eco-extracts applied via soil drench at low dose (0.1 g/L) were investigated for their biostimulant effects on wheat growth, physiology, yield, and quality under controlled conditions. Results demonstrated significant ameliorations in treated plants as compared to the control, with no phytoinhibitory effects. Remarkable enhancements were notable in growth parameters such as shoot and root lengths (+40-70%), physiological traits such as total chlorophyll and stomatal conductance (+7-52%), yield components in the example of grain number per spike and thousand grain weight (+17-103%), and grain quality namely protein and polyphenol content (+2-fold to 4-fold). Similarly, phosphorus accumulation and uptake were significantly improved, while soil physicochemical status was ameliorated, indicating enhanced fertility. Multivariate analysis and composite index ranking marked Chlorella sp. GA18, Chlorella sp. GA65, Scenedesmus sp. GA69, and Chlorococcum sp. GA63 as eco-extracts with consistent performances across all plant traits. These findings highlighted the promising potential of integrating microalgae-based eco-friendly extracts in sustainable wheat cultivation.
Amer Chabili, Z. Hakkoum, F. Minaoui et al.· Plant Science· 1 citation
ProteinReasoner is developed, a multimodal generative protein foundation model that sequentially connects amino acid sequence, evolutionary constraints and three-dimensional structure within a shared autoregressive architecture and suggests a general route towards reasoning across interdependent representations in other scientific domains.
Chaozhong Liu, Linlin Chao, Shaomin Ji et al.· bioRxiv· 1 citation
HydroGym is introduced, a solver-independent reinforcement learning platform providing more than 60 validated, openly available flow control environments spanning from canonical laminar flows to complex turbulent flows, with systematic progression in the Reynolds number up to Re = 4 × 105, and Mach number variations in two and three dimensions.
Christian Lagemann, Sajeda Mokbel, Miro Gondrum et al.· Nature· 1 citation